Adolescents

The Possible Effects of Cannabis Use in Adolescent Females

May 16, 2020 Adolescents, Cannabis, Pediatrics, Women in Cannabis

What Every Pediatric Gynecologist Should Know About Marijuana Use in Adolescents

In summary

A recent article has called for pediatric gynecologists to ward against the use of cannabis in adolescent females. By pointing out the inconsistent conclusions from multiple papers discussing the effect of cannabis use on neural development and fertility the author hopes to reduce the number of adolescent females utilizing cannabis. It is also pointed out that very little is known about the association between cannabis and mental health problems such as various forms of psychosis, anxiety, and depression. Considering how little conclusive evidence has been agreed upon by overarching associations of medical professions it does seem appropriate to warn against the risks of recreational cannabis but not without also acknowledging the possible benefits of medical cannabis.

While there are many inconsistencies surrounding cannabis research some of the inconsistent conclusions can be heavily biased by funding parties. Biased articles are difficult to get around because they require fully delving into the material listed analyzed in the paper and looking into the studies that were included and left out of the meta-analysis to determine the validity of their findings. It is extremely frustrating to have articles presented to the public that are so heavily biased they cherry-pick data just to prove their side of a politically controversial therapy. Not all cannabis use is beneficial and is not well understood, but posting articles like this one give fodder to people attempting to prevent the rescheduling of cannabis so that specific chemicals can be harnessed for novel therapies to treat ailments we have no effective treatment for, such as Alzheimer’s, specific cancer types, and a slew of psychiatric disorders. Scientists have a responsibility to remain objective and this type of biased research is disappointing to come across.

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More Research on Adolescent Cannabis Use and Mental Disorders

May 14, 2020 Adolescents, Cannabis, Mental Health

The persistence of the association between adolescent cannabis use and common mental disorders into young adulthood

In summary

Further examination of chronic cannabis use in adolescents correlates with a higher prevalence of anxiety. Research discussing adolescent cannabis use and mental disorders has been inconsistent, mainly debating whether or not some mental disorders are caused by cannabis use. The featured article found no evidence of causation but did notice a positive correlation between chronic (described here as daily) adolescent cannabis use and the development of anxiety. The development of major depressive disorders was not positively correlated with cannabis use, even in regular users. Causation, especially for psychosis, should continue to be looked into in order to determine the full safety profile of cannabis-based medications.

Adolescent cannabis use does seem risky when considering that cannabis directly affects the brain while the brain is still developing and very few researchers have published well recognized and accepted data discussing the effect of cannabis on neural development. It seems interesting that chronic cannabis use is positively correlated to the development of anxiety when the most abundant non-psychoactive cannabinoid and multiple terpenes are praised for their anxiolytic effects. Research into the effect of each chemical component of cannabis should be researched to fully elucidate which cannabinoid or combinations of cannabinoids, terpenes, etc., cause alternations in neurodevelopment and other effects.

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Adolescent Use is not Increased by Cannabis Legalization

May 2, 2020 Adolescents, Adult, Cannabis

Does liberalization of cannabis policy influence levels of use in adolescents and young adults_ A systematic review and meta-analysis

In summary

A recent meta-analysis and systematic review has shown that the liberalization of cannabis use has not increased the amount of reported cannabis use in adolescents. There appeared to be a slight increase in adult cannabis use post-recreational cannabis legalization but not a significant amount to clearly report that trend. These reports may be skewed due to the social stigma that continues to surround cannabis use and therefore prevents participants from accurately reporting their history, but further research in an area where cannabis legalization is likely to occur but hasn’t yet would provide an interesting opportunity to confirm these findings.

Medical cannabis use has been legalized in 33 states at the time of this blog and legalized for recreational use in 11 states, highlighting the importance of looking into current demographics and legal activity. Some studies have suggested a decrease in adolescent cannabis use as illicit dealers are replaced by state-regulated dispensaries implying that legalization and regulation may actually provide a safer environment for cannabis use and allow better prevention practices for adolescents. Further research would be needed to confirm these hypotheses and previous findings but prove promising for future legalization.

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Adolescent Female Cannabis-Users are Less Likely to Engage in Sexual Intercourse

April 30, 2020 Adolescents, Alcohol, sex-specific treatment, Women in Cannabis

Daily co-occurrences of marijuana use, alcohol use, and sexual intercourse among at-risk, truant adolescent girls

In summary

A recent study conducted by Brown University found that adolescent female cannabis users were less likely than their peers to engage in sexual intercourse. It remains uncertain whether cannabis is reducing participants’ desire to engage in sexual intercourse or if there is a second common factor that wards them away from intercourse. Within the same population, it was found that the participants who consumed alcohol were far more likely to engage in sexual intercourse that day than controls or cannabis users. This knowledge may aid in the development of prevention programs, specifically for those consuming alcohol underage and then engaging in sexual intercourse, defined as a high-risk behavior in this study.

Adolescent cannabis use is a hot topic of conversation as state governments continue to legalize medical and recreational cannabis. At-home cultivators and those who maintain a large amount of cannabis at their homes need to ensure proper storage and restriction methods to ensure the safety of their children. Too little is known about the long-term effects of cannabis to allow adolescents to have unsupervised access to cannabis. There should also be more studies conducted addressing the effect of cannabis-based medications in adolescents so it can be deemed safe to give children for various disorders or if it affects neural development.

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Drug Resilience is Age-Dependent

April 22, 2020 Adolescents, Adult, Cannabis, Cannabis Dependence

Behavioral effects of chronic WIN 55,212-2 administration during adolescence and adulthood in mice

In summary

A recent study has revealed that adolescents appear resilient to some effects of cannabis yet early use leads to increased impulsivity later on in life. Researchers administered 3.0 of a cannabis receptor 1 (CB1) agonist, WIN55,212-2, per day for 21 days to one group of mice in adolescence and another in adulthood before testing their impulsivity, judgment, and learning abilities. Adolescent mice who had been given cannabis performed as well as controls at the learning activity while the adult group experienced a serious delay, suggesting an age-dependent difference in the cannabinoid system. Adolescent mice who had been given cannabis and then tested later as adults demonstrated increased impulsivity suggesting that exposure to cannabis during development does have a lasting effect on processes. Further research will need to validate these findings in non-human primates or be examined in naturalistic observation studies.

When considering the implications of a study like this one it is important to note the varying accuracy of cannabis research conducted in murine models. While rats and mice are convenient physiological models due to their availability and economic value they do not always provide the most accurate representation of specific biological systems in humans. The endocannabinoid system of rats has been shown in previous featured studies to act differently than the human or primate endocannabinoid system meaning that any scientific evidence for cannabis-based medicine found from murine studies cannot be conclusive without further validation.

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https://drive.google.com/open?id=12Yzwxy5Vd1MXmyBjeGCIcHOmHIiO6VIg

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Legalizing Medical and Recreational Cannabis May Decrease Adolescent Use

April 21, 2020 Adolescents, Behavior change, Law, Medical Cannabis, Recreational Cannabis

Association of marijuana laws with teen marijuana use- new estimates from the youth risk behavior surveys

In summary

Earlier this July a letter was published providing evidence that adolescent cannabis use may actually decrease post-legalization of medical and recreational cannabis. An analysis of Youth Risk Behavioral Surveys from the past two decades revealed that legalizing medical cannabis had little to no effect on cannabis use among adolescents in 8th and 10th grade but that legalization of recreational cannabis actually led to an overall decrease of adolescent cannabis use across the states. The authors hypothesize that the rate of adolescent use may decrease as illegal drug dealers are replaced by legal, regulated dispensaries. This evidence may prove compelling for the possible rescheduling of cannabis under the federal Controlled Substances Act.

Adolescent substance use, like that of alcohol, has been found to be detrimental to brain development. There have been varying results regarding the effects of adolescent cannabis use on brain development yet some caretakers are given special permission to administer cannabis-based products to children experiencing rare forms of epilepsy or other seizure disorders. Cannabis-based medications may be a more ethical and far less dangerous substance to administer to children so that they aren’t set up for a substance use disorder at a young age. Research focussed on adolescent cannabis use needs to be conducted for better regulations and to better advise the parents and pediatricians of adolescents who have accidentally consumed cannabis or need a cannabis-based medical intervention.

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The Motivative for Abusing Cannabis as an Adolescent

April 8, 2020 Adolescents, Cannabis, Substance Abuse

Motives for cannabis use in high-risk adolescent users

In Summary

A recent article has revealed some of the motives behind adolescent cannabis abuse. Researchers found that cannabis is misused as a coping mechanism in individual adolescents who internalized behavioral problems which then leads to the development of a number of cannabis dependence symptoms. Participants who reported cannabis use for enhancement, social, and conformity purposes did not report similar issues with dependency. The gathered data suggests that the motivation behind cannabis use should be considered when addressing an individual’s use and that targeted intervention tools should focus on the motivation of drug abuse to better educate at-risk youth.

This article emphasizes the need to educate adolescents on the medical benefits and proper use of cannabis before it can be abused. If at-risk youth are using cannabis to mitigate feelings of anxiety they may be worsening their symptoms as tetrahydrocannabinol (THC), the most abundant psychoactive component of cannabis, is known to exacerbate anxiety. If they knew about cannabidiol (CBD), which is a non-psychoactive cannabinoid, which is readily available in most states within the United States and has been beneficial for most people dealing with anxiety. Cannabinoids, terpenes, and flavonoids provide a myriad of medical benefits but a lack of education may allow teenagers to misuse those substances, including legal products, and worsen their symptoms, leading to continued misuse and may prevent them from seeking medical help for their ailments.

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Those Who Increase Marijuana Use Between their Teens and Adulthood are Risky Drivers

March 5, 2020 Adolescents, Driving

Marijuana trajectories and associations with driving risk behaviors in Canadian youth

In Summary

A recent study has found that drivers who increase their cannabis use as they transition from their teens into adulthood are more likely to participate in risky driving behavior. This data was gathered from interviews conducted utilizing the same population over a period of 6 years and split the groups into increased users, users who decreased use, those who abstained, and those who used cannabis occasionally. Only those who self-identified as increased users were likely to engage in dangerous driving situations, such as driving under the influence of drugs and alcohol simultaneously. This data will hopefully improve harm reduction strategies to prevent at-risk groups from engaging in dangerous behaviors, especially in combination with alcohol.

This study brings to light the issue of driving while under the influence of cannabis. Not all of the active cannabinoids in cannabis are psychoactive which means they are not necessarily dangerous to drive while taking. Cannabidiol (CBD) is well known and praised for its therapeutic effects without being psychoactive which is why it is so widely consumed. Users should still be mindful of any side effects, but not all cannabis products will inhibit driving capabilities.

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Volume of Lateral Orbitofrontal Cortex Predicts Drug Use

February 12, 2020 Adolescents, Orbitofrontal Cortex, Substance Abuse

Orbitofrontal cortex volume prospectively predicts cannabis and other substance use onset in adolescents

In Summary:

Researchers have recently unveiled that the volume of the lateral orbitofrontal cortex (OFC) is able to predict future substance use in adolescents. Individuals were followed for 13 years after undergoing magnetic functional resonance imaging and surveyed for cannabis and alcohol use. Interesting the authors chose to utilize those who had used cannabis, but in limited quantities, as a control group instead of including them in their cannabis users group. Similarly, the alcohol only group of participants also included those who used cannabis multiple times within the past year. Nevertheless, the authors conclude that the size of the lateral OFC is able to predict drug use in adolescents although not without admitting the need for replication and validity.

This paper is a perfect example of biased information within the medical community. Bias is inherent, there is no way around it, but it is the duty of researchers to publish their findings while remaining as objective as possible. The grouping and subsequent statistical analysis of this data mentioned in the featured article are rather odd considering their terminology and broad claims. This may be due to the views of the organization funding the research, or the bias of the research team, but the limitations of this study should have been a larger factor, such as the odd groupings and the fact that this research took place in a state where cannabis use is legal for recreational and medical use. Scientists have an obligation to pursue the truth and not extrapolate their findings to fit their personal agenda. A slew of articles out there suffer from cherry-picking statistics and the extrapolation of data; readers and media outlets who popularize findings should take care to nitpick the methodology and demographics of studies.

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An Analysis of Sudden Cardiac Death Exposes the Danger of Tobacco and Cocaine

December 21, 2019 Abuse, Addiction, Adolescents, Adult, Adverse Effects, Cannabis, Cannabis Education, Cannabis Science, Cardiovascular Effects, Future Medicine, Impairment, Products, THC

Sudden cardiac death associated to substances of abuse and psychotropic drugs consumed by young people- A population study based on forensic autopsies

In Summary:

A recent study out of Spain has revealed alarming trends among cases of sudden cardiac death associated with substances of abuse consumed by young people. Half of the 15-36-year-olds who suffered sudden cardiac death were found with illicit substances in their bodies, primarily cannabis, tobacco, and cocaine. Researchers found that although cannabis was the most common substance found in the deceased systems, cocaine and tobacco are known to have a stronger impact on the cardiovascular system and lead to ischemic heart disease, which is often the more acute causes of sudden death. It was also mentioned here that the duration of cannabis is far longer in the body than that of either tobacco or cocaine, and this duration may easily confuse people to associate it as a trigger for sudden death.

However, on the other hand, there are several tragic cases of young, otherwise heart-healthy individuals who have died with cannabis as the only substance discovered. Fortunately, these cases are extraordinarily rare, but unfortunately, no reproducible association has been established, so the mysterious concerns are not easily relieved or forgotten.

Dr. Caplan and the #MDTake:

While the return of medical cannabis to modern medical care seems to bring with it a return of appreciation for more naturalistic care, it is critical for us all to recognize that we still have much to learn. The tools and high standards of scientific evaluation have only recently been applied to cannabis, and there are reasonable arguments that the usual tools may not actually apply (for example, some are suggesting that the placebo effect, a cornerstone of randomized control trials may be a facet of effects related to the endocannabinoid system.)

For these, and a great many other unknowns, it is important for the discerning consumer to consult with trusted resources, including friends, family, scientists, and where possible, doctors, to ensure the appropriateness of use on an individual basis.

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