Cannabis

After a nursing woman smokes marijuana once, her baby through her breast milk will consume traces of the drug's chief psychoactive element for at least six weeks and possibly longer, according to a soon-to-be-released study out of Colorado. 

For physicians who see cannabis-associated birth complications and long-term brain development concerns with children, the research is another step to try to square growing public nonchalance about marijuana with medical guidelines about use.

Researchers and clinicians have long warned women not to use marijuana while they are pregnant or nursing. They agree that infants' exposure to tetrahydrocannabinol, or THC, demonstrably changes their brain development. But their studies are limited. Legally, child protective services would have to step in if a child tests positive for the drug—a challenge for researchers who want to figure out how much THC infants absorb and what this means for them in the long term. 

Meanwhile, marijuana laws are loosening, and attitudes about cannabis have shifted. Physicians who witness the trends up close fear there will be another public health crisis that will hurt children. 

"We are in the opioid crisis due to expanding prescriptions for opioids with little thought to the consequences of widespread use, including use during pregnancy," said Dr. Lauren M. Jansson, director of pediatrics for the Johns Hopkins Center for Addiction and Pregnancy. "My fear is that we will see the same thing with marijuana. 

For complete Article

J Clin Psychiatry 2018;79(6):17m11977m 10.4088/JCP.17m11977 © Copyright 2018 Physicians Postgraduate Press, Inc.

Objective: Associations between adolescent cannabis use and poor neurocognitive functioning have been reported from cross-sectional studies that cannot determine causality. Prospective designs can assess whether extended cannabis abstinence has a beneficial effect on cognition.

Conclusions: This study suggests that cannabis abstinence is associated with improvements in verbal learning that appear to occur largely in the first week following last use. Future studies are needed to determine whether the improvement in cognition with abstinence is associated with improvement in academic and other functional outcomes.

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October 2018

Marijuana use causes more long-term damage to teen brains than alcohol use, according to a new study entitled “A Population-Based Analysis of the Relationship Between Substance Use and Adolescent Cognitive Development.”

The study – completed by researchers at the University of Montreal – followed 3,800 Montreal teens over the course of four years. As part of the study, teen participants were questioned about their marijuana and alcohol use, and took computer-based cognitive tests.

They found that marijuana had more of an effect on the teens’ skills, memory and behavior than alcohol… Even after students reported stopping marijuana, their cognition did not improve.

“Cannabis causes cognitive impairment and delayed cognitive development in adolescents," Patricia Conrad, the lead author and professor of psychiatry at the University of Montreal, told NBC News. “This study focuses on the neuropsychological effects of cannabis. We think it’s important because it is linked to how someone functions in life.”

The findings were published in the American Journal of Psychiatry. 

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  • Cannabis oil will become available on the NHS next Thursday, November 1 
  • A group of 166 pain consultants has written a letter slating the plans
  • They say it is being done for political reasons, not based on medical advice
  • And patients are already demanding cannabis, losing interest in other treatment 

For complete article

Abstract—Background: Cannabis is one of the most abused drugs worldwide, with more than 20 million users in the United States (US). As access to cannabis products increases with expanding US legislation and decriminalization of marijuana, emergency physicians must be adept in recognizing unintentional cannabis toxicity in young children, which can range from altered mental status to encephalopathy and coma. Case Report: We report the case of a 13- month-old female presenting with self-limiting altered mental status and lethargy, with a subsequent diagnosis of tetrahydrocannabinol exposure on confirmatory urine gas chromatography-mass spectrometry. 

Why Should an Emergency Physician Be Aware of This?: Considering caretakers rarely report possible cannabis exposure, history-taking must review caretakers’ medicinal and recreational drug exposures to prevent inadvertently missing the diagnosis. In the young child with altered mental status, prompt urine screening for cannabinoid detection can prevent further invasive and costly diagnostic investigations, such as brain imaging and lumbar puncture. © 2018 Elsevier Inc. All rights reserved.

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