scispace - formally typeset
Search or ask a question
Journal ArticleDOI

Public opinion and medical cannabis policies: examining the role of underlying beliefs and national medical cannabis policies.

TL;DR: The belief that cannabis has medical benefits is particularly salient for support for medical cannabis legalization, and it is possible that the recent surge in evidence supporting the medical benefits of cannabis will increase the belief about medical benefits in the general population which may in turn increase public support forMedical cannabis legalization.
Abstract: Debate about medical cannabis legalization are typically informed by three beliefs: (1) cannabis has medical effects, (2) medical cannabis is addictive and (3) medical cannabis legalization leads to increased used of cannabis for recreational purposes (spillover effects). We examined how strongly these beliefs are associated with public support for medical cannabis legalization and whether this association differs across divergent medical cannabis policy regimes. Robust regression analysis was used to analyse data derived from two nationally representative samples of adults participating in comparable cross-sectional online surveys in one country where medical cannabis smoking is illegal (Norway, n = 2175, 51 % male) and in one country where medical cannabis smoking is legal (Israel, n = 648, 49 % male). The belief that cannabis has medical benefits was more strongly related to support for medical cannabis legalization than were beliefs about addiction and spillover effects. While the support for medical cannabis legalization was stronger in Israel than in Norway (78 vs. 51 %, p < 0.01), the belief variables had, in general, more impact on the policy stand in Norway. The belief that cannabis has medical benefits is particularly salient for support for medical cannabis legalization. It is possible that the recent surge in evidence supporting the medical benefits of cannabis will increase the belief about medical benefits of cannabis in the general population which may in turn increase public support for medical cannabis legalization. Results also suggest that once medical cannabis is legalized, factors beyond cannabis-specific beliefs will increasingly influence medical cannabis legalization support. These conclusions are, however, only suggestive as the current study is based on cross-sectional data. Hopefully, future research will be able to capitalize on changes in medical cannabis policies and conduct longitudinal studies that enable an examination of the causal relation between public opinion and medical cannabis policy changes.

Content maybe subject to copyright    Report

Citations
More filters
Journal ArticleDOI
01 May 2017
TL;DR: With increased use of medical cannabis as pharmacotherapy for pain comes a need for comprehensive risk-benefit discussions that take into account cannabis' significant possible side effects.
Abstract: Introduction: Cannabis has been used for medical purposes across the world for centuries As states and countries implement medical and recreational cannabis policies, increasing numbers of people are using cannabis pharmacotherapy for pain There is a theoretical rationale for cannabis' efficacy for pain management, although the subjective pain relief from cannabis may not match objective measurements of analgesia As more patients turn to cannabis for pain relief, there is a need for additional scientific evidence to evaluate this increase Materials and Methods: Research for this review was performed in the PubMed/National Library of Medicine database Discussion: Preclinical studies demonstrate a narrow therapeutic window for cannabis as pharmacotherapy for pain; the body of clinical evidence for this indication is not as extensive A recent meta-analysis of clinical trials of cannabis and cannabinoids for pain found modest evidence supporting the use of cannabinoid pharmacotherapy for pain Recent epidemiological studies have provided initial evidence for a possible reduction in opioid pharmacotherapy for pain as a result of increased implementation of medical cannabis regimens Conclusion: With increased use of medical cannabis as pharmacotherapy for pain comes a need for comprehensive risk-benefit discussions that take into account cannabis' significant possible side effects As cannabis use increases in the context of medical and recreational cannabis policies, additional research to support or refute the current evidence base is essential to attempt to answer the questions that so many healthcare professionals and patients are asking

166 citations


Cites background from "Public opinion and medical cannabis..."

  • ...Whether cannabis is the best treatment for pain or not, many patients around the world believe that cannabis has helped them with their pain.(7) As more and more states legalize cannabis for medicinal uses, a greater number...

    [...]

  • ...Unfortunately, many patients currently use cannabis to treat a host of medical problems and do so without contacting their healthcare provider.(7) Healthcare professionals need to be prepared to answer questions regarding...

    [...]

Journal ArticleDOI
TL;DR: Cannabinoid drugs may prevent the onset of pain by producing small increases in pain thresholds but may not reduce the intensity of experimental pain already being experienced; instead, cannabinoids may make experimental pain feel less unpleasant and more tolerable, suggesting an influence on affective processes.
Abstract: Importance Cannabinoid drugs are widely used as analgesics, but experimental pain studies have produced mixed findings. The analgesic properties of cannabinoids remain unclear. Objective To conduct a systematic review and meta-analysis of the association between cannabinoid drug administration and experimental pain outcomes in studies of healthy adults. Design, Setting, and Participants A systematic search of PubMed, EMBASE, MEDLINE, PsycINFO, and CINAHL was conducted from the inception of each database to September 30, 2017. Studies were eligible for inclusion if they met criteria, including healthy participants and an experimentally controlled administration of any cannabinoid preparation in a quantified dose. Studies that used participants with chronic pain were excluded. Data extracted included study characteristics, cannabinoid types and doses, sex composition, and outcomes. Study quality was assessed using a validity measure previously established in published reviews. Random-effects meta-analyses were used to pool data and generate summary estimates. Main Outcomes and Measures Experimental pain threshold, pain tolerance, pain intensity, pain unpleasantness, and mechanical hyperalgesia. Results Eighteen placebo-controlled studies (with 442 participants) were identified. Of the 442 participants, 233 (52.7%) were male and 209 (47.3%) were female. For sample ages, 13 (72%) of the 18 studies reported a mean sample age (26.65 years), 4 (22%) reported a range, and 1 (6%) reported a median value. The search yielded sufficient data to analyze 18 pain threshold comparisons, 22 pain intensity comparisons, 9 pain unpleasantness comparisons, 13 pain tolerance comparisons, and 9 mechanical hyperalgesia comparisons. Cannabinoid administration was associated with small increases in pain threshold (Hedgesg = 0.186; 95% CI, 0.054-0.318;P = .006), small to medium increases in pain tolerance (Hedgesg = 0.225; 95% CI, 0.015-0.436;P = .04), and a small to medium reduction in the unpleasantness of ongoing experimental pain (Hedgesg = 0.288; 95% CI, 0.104-0.472;P = .002). Cannabinoid administration was not reliably associated with a decrease in experimental pain intensity (Hedgesg = 0.017; 95% CI, −0.120 to 0.154;P = .81) or mechanical hyperalgesia (Hedgesg = 0.093; 95% CI, −0.059 to 0.244;P = .23). The mean quality rating across studies was good. Conclusions and Relevance Cannabinoid drugs may prevent the onset of pain by producing small increases in pain thresholds but may not reduce the intensity of experimental pain already being experienced; instead, cannabinoids may make experimental pain feel less unpleasant and more tolerable, suggesting an influence on affective processes. Cannabis-induced improvements in pain-related negative affect may underlie the widely held belief that cannabis relieves pain.

51 citations

Journal ArticleDOI
01 Dec 2016-Cancer
TL;DR: The main objective of this study was to determine the factors associated with UDT ordering and results in outpatients with advanced cancer.
Abstract: BACKGROUND Data are limited on the use and outcomes of urine drug tests (UDTs) among patients with advanced cancer. The main objective of this study was to determine the factors associated with UDT ordering and results in outpatients with advanced cancer. METHODS A retrospective chart review was conducted of 1058 patients who attended an outpatient supportive care clinic from March 2014 to November 2015. Sixty-one patients who were receiving chronic opioid therapy and underwent UDTs were identified. A control group of 120 patients who did not undergo UDTs was selected for comparison. RESULTS Sixty-one of 1058 patients (6%) underwent UDTs, and 33 of 61 patients (54%) had abnormal results. Multivariate analysis indicated that the odds ratio for UDT ordering was 3.9 in patients who had positive Cut Down, Annoyed, Guilty, and Eye Opener (CAGE) questionnaire results (P = .002), 4.41 in patients aged < 45 years (P < .001), 5.58 in patients who had moderate-to-severe pain (Edmonton Symptom Assessment Scale pain scores ≥4; P < .001), 0.27 in patients with advanced-stage cancer, (P = .008), and 0.25 in patients who had moderate-to-severe fatigue (P = .001). Among 52 abnormal UDT results in 33 patients, the most common opioid findings were prescribed opioids absent in urine (14 of 52 tests; 27%) and unprescribed opioids in urine (13 of 52 tests; 25%). CONCLUSIONS UDTs were used infrequently among outpatients with advanced cancer who were receiving chronic opioid therapy. Younger age, positive CAGE questionnaire results, early stage cancer or no evidence of disease status, higher pain intensity, and lower fatigue scores were significant predictors of UDT ordering. More than 50% of UDT results were abnormal. More research is necessary to better characterize aberrant opioid use in patients with advanced cancer. Cancer 2016;122:3732-9. © 2016 American Cancer Society.

45 citations

Journal ArticleDOI
TL;DR: Male GPs and those with higher levels of addiction training are more likely to support a more liberal drug policy approach to cannabis for personal use, and over 60% agreed that cannabis can have a role in palliative care, pain management and treatment of multiple sclerosis.
Abstract: Governmental debate in Ireland on the de facto decriminalisation of cannabis and legalisation for medical use is ongoing. A cannabis-based medicinal product (Sativex®) has recently been granted market authorisation in Ireland. This unique study aimed to investigate Irish general practitioner (GP) attitudes toward decriminalisation of cannabis and assess levels of support for use of cannabis for therapeutic purposes (CTP). General practitioners in the Irish College of General Practitioner (ICGP) database were invited to complete an online survey. Anonymous data yielded descriptive statistics (frequencies, percentages) to summarise participant demographic information and agreement with attitudinal statements. Chi-square tests and multi-nominal logistic regression were included. The response rate was 15% (n = 565) which is similar to other Irish national GP attitudinal surveys. Over half of Irish GPs did not support the decriminalisation of cannabis (56.8%). In terms of gender, a significantly higher proportion of males compared with females (40.6 vs. 15%; p < 0.0001) agreed or strongly agreed with this drug policy approach. A higher percentage of GPs with advanced addiction specialist training (level 2) agreed/strongly agreed that cannabis should be decriminalised (54.1 vs. 31.5%; p = 0.021). Over 80% of both genders supported the view that cannabis use has a significant effect on patients’ mental health and increases the risk of schizophrenia (77.3%). Over half of Irish GPs supported the legalisation of cannabis for medical use (58.6%). A higher percentage of those who were level 1-trained (trained in addiction treatment but not to an advanced level) agreed/strongly agreed cannabis should be legalised for medical use (p = 0.003). Over 60% agreed that cannabis can have a role in palliative care, pain management and treatment of multiple sclerosis (MS). In the regression response predicator analysis, females were 66.2% less likely to agree that cannabis should be decriminalised, 42.5% less likely to agree that cannabis should be legalised for medical use and 59.8 and 37.6% less likely to agree that cannabis has a role in palliative care and in the treatment of multiple sclerosis (respectively) than males. The majority of Irish GPs do not support the present Irish governmental drug policy of decriminalisation of cannabis but do support the legalisation of cannabis for therapeutic purposes. Male GPs and those with higher levels of addiction training are more likely to support a more liberal drug policy approach to cannabis for personal use. A clear majority of GPs expressed significant concerns regarding both the mental and physical health risks of cannabis use. Ongoing research into the health and other effects of drug policy changes on cannabis use is required.

43 citations

Journal ArticleDOI
TL;DR: It is suggested that a sizable proportion of cannabis users in Israel self-prescribe cannabis and that licensed medical cannabis users differ from unlicensed users, suggestive of a rigorous medicalized cannabis program that does not function as a backdoor for legal access to recreational use.

41 citations

References
More filters
Book
31 Jan 2012
TL;DR: In this article, the authors present an approach for the diagnosis of Alzheimer's disease based on the concept of cognitive disambiguation, which they call Cognitive Disparity and Cognitive Dissonance.
Abstract: J.S. Lerner, Accountability and Social Cognition. G.R. Goethals, Actor-Observer Differences in Attribution. C. Barrett, Addictive Behavior. G. Holmbeck, Adolescence. L. Parker, Adrenal Glands. R. Baenninger, Aggression. M.R. Levenson, Aging, Personality, and Adaptation. G.L. Thorpe, Agoraphobia. M. Wilbur, AIDS and Sexual Behavior. E.G. Clary, Altruism and Helping Behavior. G.G. Glenner, Alzheimer's Disease. J.F. Kihlstrom, Amnesia. D.D. Cummins, Analogical Reasoning. J.R. Averill, Anger. R.G. Meyer, Antisocial Personality Disorder. E.A. Meadows, Anxiety Disorders. D.W. McNeil, Anxiety and Fear. H.S. Kirschner, Aphasia. N.D. Geary, Appetite. R. Hanlon, Apraxia. A. Anastasi, Aptitude Testing. R.D. Bretz, Arbitration. T. Kitajima, Associative Learning. D.H. Saklofske, Attention-Deficit Hyperactivity Disorders. J.T. Cacioppo, Attitude Change. A.R. Pratkanis, Attitude Formation. J.A. Krosnick, Attitude Strength. M.E. Losch, Attitude-Discrepant Behavior-Cognitive Dissonance. G. Weary, Attribution. E. Schubert, Auditory Discrimination. B. Altemeyer, Authoritarianism. R. Romanczyk, Autism. C. Barclay, Autobiographical Remembering. M. Katz, Behavior Measurement in Psychobiological Research. R.G. Geen, Behavioral Effects of Observing Violence. C.T. Nagoshi, Behavioral Genetics. J.K. Luiselli, Behavioral Medicine. W.A. McKim, Behavioral Pharmacology. V. Gluhoski, Bereavement. F. Genesee, Bilingualism. J.P. Hatch, Biofeedback. R. Eisenman, Birth Order, Effect on Personality and Behavior. J.K. Thompson, Body Image. J. Kroll, Borderline Personality Disorder. B.E. Kolb, Brain. E.C. Azmitia, Brain Chemicals. M.C. Diamond, Brain Development and Plasticity. V.G. Iyer, Brain Electric Activity. D. Anthony, Brain Washing. J.P. Blount, Caffeine: Psychosocial Effects. M. McCloskey, Calculation. S. Osipow, Career Development. A.J. Friedhoff, Catecholamines and Behavior. E. Rosch, Categorization. F. Eustache, Central Auditory Disorders. R.T. Brown, Central Nervous System. V. Carlson, Child Abuse. F.S. Bellezza, Chunking. E. Gambrill, Clinical Assessment. J.B. Persons, Cognitive Behavior Therapy. M.W. Daehler, Cognitive Development. K. Langfield-Smith, Cognitive Maps, Thinking. R.S. Vealey, Competition. A. Parker, Conflict. D.D. Cahn, Conflict Communication. M.D. Alicke, Conformity. A.G. Miller, Conformity and Obedience. B.J. Baars, Consciousness. W.F. Stone, Conservatism/Liberalism. T.Page, Consumer Psychology/Behavior. S.T. Fiske, Control. E. Zamble, Coping. M.A. Runco, Creative and Imaginative Thinking. C.L. Britt, III, Criminal Behavior. J.R. Purvis, Crisis Management. Y.Y. Kim, Cross Cultural Adaptation. E.G. King, Crowd Psychology. S.J. Lepore, Crowding: Effects on Health and Behavior. J.N. Warfield, Cybernetics. K.J. Radford, Decision-Making Individuals. W.J. Lyddon, Deductive Reasoning. P. Cramer, Defense Mechanisms. J. Becker, Dementia. R.F. Bornstein, Dependent Personality. R.E. Ingram, Depression. S. Coren, Depth Perception. G.C.L. Davey, Disgust. E. Shilony, Dissociative Disorders. S. Stack, Divorce. J. Antrobus, Dreaming. D.N. Bub, Dysgraphia. C. Chase, Dyslexia. J.R. Pierce, Ears and Hearing. R. Sommer, Ecological Psychology. H. Singh, Economic Behavior, Traditional and Non-Traditional Approaches. P. Winne, Educational Psychology. D. Giannitrapani, EEG, Cognition, and Dementia. R.J. Edelmann, Embarrassment and Blushing. N. Eisenberg, Empathy. C. Spencer, Environmental Cognition. R. Gifford, Environmental Psychology. P.J. Snyder, Epilepsy. G. Gillund, Episodic Memory. C. McClintock, Equity. W.W. Tryon, Expectation. J.E. Alcock, Extrasensory Perception. B. Bridgeman, Eye Movements. E. Loftus, Eyewitness Testimony. R. Bruyer, Face Recognition. D. Keltner, Facial Expressions of Emotion. D. Miklowitz, Family Systems. T.D. Crespi, Forensic Psychology. H. Rachlin, Free Will. T.S. Hartshorne, Friendship. N.E. Jackson, Genius, Eminence, and Giftedness. P. Bull, Gestures. L. Hertz, Glial Cells. P.B. Paulus, Group Dynamics. D.L. Mosher, Guilt. J.B. Hellige, Handedness. G. Schoenewolf, Hate. D.G. Amaral, Hippocampal Formation. P.-M. Lledo, Homeostasis. C.R. Snyder, Hope and Optimism. C.M. Buchanan, Hormones and Behavior. G.J. Dupaul, Hyperactivity. S.J. Lynn, Hypnosis. Q.J. Pittman, Hypothalamus. D.K. Lapsley, Id/Ego/Superego. S. Lewandowsky, Implicit Memory. S.T. Fiske, Impression Formation. N.A. Fox, Individual Differences in Temperament. T.J. Schoeneman, Individualism. P.W. Corrigan, Information Processing and Clinical Psychology. D.B. Yaden, Jr., Inner Speech, Composing and the Reading/Writing Connection. R.J. Sternberg, Intelligence. S.T. Fiske, Intention. S. Duck, Interpersonal Attraction and Personal Relationships. J.H. Fleming, Interpersonal Communication. J.H. Harvey, Interpersonal Perception and Communication. D.H. Saklofske, Introversion/Extraversion. P.N. Stearns, Jealousy. I.F. Tucker, Jungian Personality Types. A.J. Hart, Jury Psychology. M.M. Chemers, Leadership. C. Peterson, Learned Helplessness. R. Joseph, Limbic System. J. Langer, Logic. E. Hatfield, Love and Intimacy. G.R. Birchler, Marital Dysfunction. N. Epstein, Marriage. H.J. Markman, Mate Selection. G.A. Radvansky, Memory. D. Tranel, Memory, Neural Substrates. S.M. Kosslyn, Mental Imagery. R.M. Hodapp, Mental Retardation. T.O. Nelson, Metacognition. H.L. Taylor, Military Psychology. F.C. Power, Moral Development. C.E. Izard, Motivation, Emotional Basis. S. Swinnen, Motor Control. J.E. Clark, Motor Development. D. Lester, Murder. R.E. Radocy, Musical Ability. S. Akhtar, Narcissistic Personality Disorder. P.J. Carnevale, Negotiation. B.L. Finlay, Neocortex. N.C. Spitzer, Neurons. R. Rosenthal, Nonverbal Behavior. N.G. Hamilton, Object Relations Theory. M.A. Stanley, Obsessive-Compulsive Behavior. E.J. Mahon, Oedipus Complex. W.F. Angermeier, Operant Learning. K.H. Roberts, Organizational Behavior. Y. Lampl, Pain. J.A. Lucas, Panic. A. Fenigstein, Paranoia. B.I. Fagot, Parenting. W.R. Uttal, Pattern Recognition. K.H. Rubin, Peer Relationships and Influences in Childhood. D.W. Massaro, Perceptual Development. P.T. Costa, Personality Assessment. K.B. MacDonald, Personality Development. R.G. Meyer, Personality Disorders. M. Winkler, Persuasion. J.H. Riskind, Phobias. J.K. Torgesen, Phonological Processing and Reading. E.K. Scholnick, Planning. A. Pellegrini, Play. W.A. Fisher, Pornography, Effect on Behavior. R. Katz, Post-Traumatic Stress Disorder. D.A. Houston, Preference Judgments. W. Bergmann, Prejudice and Stereotypes. M.L. Moline, Premenstrual Syndrome. R.E. Mayer, Problem-Solving. H.S. Friedman, Psychological Predictors of Heart Disease. D.H. Saklofske, Psychology and Pseudoscience. R.W. Hood, Psychology and Religion. K.S. Dobson, Psychopathology. R.S. Guglielmi, Psychosomatic Illness. K.S. Dobson, Psychotherapy. C.A. Weaver, III, Reading. W.F. Overton, Reasoning. J.C. Smith, Relaxation. M. Thayer, Risk Compensating Behavior. M.F. Lenzenweger, Schizophrenia. R.C. Curtis, Self-Defeating Behaviors. A. Bandura, Self-Efficacy. R.F. Baumeister, Self-Esteem. J.H. Fleming, Self-Fulfilling Prophesies. C. Chiarello, Semantic Memory. C. Goddard, Semantics. J.H. Patton, Sensation-Seeking. S. Van Toller, Sense of Smell. B. MacWhinney, Sentence Processing. J.D. Sinnott, Sex Roles. J.D. Baldwin, Sexual Behavior. R.M. Doctor, Sexual Disorders. K. Kelley, Sexual Orientation. K. Emmorey, Sign Language. R. Armitage, Sleep, Biological Rhythms and Human Performance. E. Borgida, Social Cognition. R.M. Arkin, Social Comparison. S.J. Karau, Social Loafing. S.J. Lepore, Social Support. J. Beggan, Social Values. H.R. Holcomb, Sociobiology. R.A. Thompson, Socioemotional Development. S.C. Hirtle, Spatial Knowledge Representations. J.J. Rieser, Spatial Orientation. H.R. Schiffman, Spatial Perception. S.R. Heyman, Sport Psychology. R.M. Doctor, Stress. T.B. Herbert, Stress and Illness. H.C. Triandis, Subjective Culture. B. Segal, Substance Abuse. D. Lester, Suicide. W.-U. Meyer, Surprise. S.M. Stahl, Synaptic Transmitters and Neuromodulators. H. Lasnik, Syntax. D.W. Smothergill, Tactile Perception. R. Drozdenko, Taste/Gustation. A. Merari, Terrorism. D.J. Bateson, Test Behavior. N. Brody, Traits. J. Sulls, Type A-Type B Personalities. M. Smithson, Uncertainty. P. Grobstein, Variability in Brain Function and Behavior. S. Grossberg, Visual Motion Perception. W.L. Gulick, Visual Perception. M. Tarr, Visual Representation. G.W. Peterson, Vocational Choice. R.A. Gabriel, War. D. Burke, Word Retrieval. E.B. Goldsmith, Work Efficiency and Motivation.

1,979 citations

01 Jan 2012
TL;DR: This report presents findings from the 2009/2010 survey on the demographic and social influences on the health of young people (aged 11, 13 and 15 years) in 43 countries and regions in the WHO European Region and North America.
Abstract: Through this international report on the results of its most recent survey, the Health Behaviour in School-aged Children (HBSC) study supplies the up-to-date information needed by policy-makers at various levels of government, nongovernmental organizations, and professionals in sectors such as health, education, social services, justice and recreation The latest addition to a series of HBSC reports on young people’s health, this report presents findings from the 2009/2010 survey on the demographic and social influences on the health of young people (aged 11, 13 and 15 years) in 43 countries and regions in the WHO European Region and North America Responding to the survey, the young people described their social context (relations with family, peers and school), physical health and satisfaction with life, health behaviours (patterns of eating, tooth brushing and physical activity) and risk behaviours (use of tobacco, alcohol and cannabis, sexual behaviour, fighting and bullying) Statistical analyses were carried out to identify meaningful differences in the prevalence of health and social indicators by gender, age group and levels of family affluence The aim was to provide a rigorous, systematic statistical base for describing cross-national patterns, in terms of the magnitude and direction of differences between subgroups, thus contributing to a better understanding of the social determinants of health and well-being among young people, and providing the means to help protect and promote their health

1,272 citations

Journal ArticleDOI
TL;DR: With high rates of abuse of opiate analgesics among teenagers in the United States, a particularly urgent priority is the investigation of best practices for treating pain in adolescents as well as the development of prevention strategies to reduce diversion and abuse.

789 citations


"Public opinion and medical cannabis..." refers background in this paper

  • ...Indeed, other pharmaceuticals (and especially those used for chronic pain and cancer pain management) are highly addictive and have spillover effects [44, 45], so negative side effects do not per se imply that such drugs should not be used in medical practice....

    [...]

01 May 2012
TL;DR: This summary presents key results from the 2011 survey in the ESPAD countries as well as findings regarding the long-term trends.
Abstract: The main purpose of the European School Survey Project on Alcohol and Other Drugs (ESPAD) is to collect comparable data on substance use among 15- to 16-year-old European students in order to monitor trends within as well as between countries. So far, five data-collection waves have been conducted in the framework of the project. The first study was carried out in 26 countries in 1995, while data collection in 2011 was performed in 37 countries. However, results for 2011 are available only for 36 countries, since the Isle of Man collected data but unfortunately did not have the possibility to deliver any results. This summary presents key results from the 2011 survey in the ESPAD countries as well as findings regarding the long-term trends. An initial section gives a short overview of the methodology.

630 citations

Journal ArticleDOI
TL;DR: The epidemiological literature in the past 20 years shows that cannabis use increases the risk of accidents and can produce dependence, and that there are consistent associations between regular cannabis use and poor psychosocial outcomes and mental health in adulthood.
Abstract: Aims To examine changes in the evidence on the adverse health effects of cannabis since 1993 Methods A comparison of the evidence in 1993 with the evidence and interpretation of the same health outcomes in 2013 Results Research in the past 20 years has shown that driving while cannabis-impaired approximately doubles car crash risk and that around one in 10 regular cannabis users develop dependence Regular cannabis use in adolescence approximately doubles the risks of early school-leaving and of cognitive impairment and psychoses in adulthood Regular cannabis use in adolescence is also associated strongly with the use of other illicit drugs These associations persist after controlling for plausible confounding variables in longitudinal studies This suggests that cannabis use is a contributory cause of these outcomes but some researchers still argue that these relationships are explained by shared causes or risk factors Cannabis smoking probably increases cardiovascular disease risk in middle-aged adults but its effects on respiratory function and respiratory cancer remain unclear, because most cannabis smokers have smoked or still smoke tobacco Conclusions The epidemiological literature in the past 20 years shows that cannabis use increases the risk of accidents and can produce dependence, and that there are consistent associations between regular cannabis use and poor psychosocial outcomes and mental health in adulthood

484 citations


Additional excerpts

  • ...Official policies mandated by the 1961 UN Convention highlight the abuse potential of cannabis, and there is a vast research literature that identifies harmful effects of cannabis use [6]....

    [...]