Alcohol

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

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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Benjamin Caplan, MDAdolescent Female Cannabis-Users are Less Likely to Engage in Sexual Intercourse
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Cannabis Use Causes Increased Impulsivity

Cannabis and alcohol use, affect and impulsivity in psychiatric out-patients’ daily lives

In Summary

A recent study revealed the increased impulsivity seen throughout the day in psychiatric out-patients who consumed cannabis. Cannabis was also found to increase momentary hostility in psychiatric patients, namely those suffering from bipolar disorder. The study also compared the difference of activity between alcohol and cannabis, finding that although alcohol also caused an increase in impulsivity it was only momentary rather than prolonged. By observing the effects of alcohol and cannabis in patients researchers were able to determine that the two compounds are part of separate processes and operate on different time-scales. 

Very little research has been conducted that addresses drug interactions with cannabis. As the prevalence of cannabis use continues to rise as state governments continue to legalize medical and recreational cannabis it is imperative to understand how cannabis affects everyday medications. For those who need blood thinners, muscle relaxants, etc., drug interactions can be dangerous, even fatal, emphasizing the importance of understanding how cannabis interacts with other medications at the cellular level. Pharmacists and physicians need more knowledge to be able to thoroughly inform patients consuming marijuana of the potential risks. Future research should be conducted, as well as chemical modeling studies, to ensure the safety of cannabis users. 

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Benjamin Caplan, MDCannabis Use Causes Increased Impulsivity
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Addictive Disorders are Associated with Neuroticism, Low Agreeableness, and Low Conscientiousness

Big Five personality traits and alcohol, nicotine, cannabis, and gambling disorder comorbidity

In summary

In a recent study published by the American Psychological Association researchers determined that addictive disorders, like cannabis use disorder, are associated with neuroticism, low agreeableness, and low conscientiousness. Neuroticism, agreeableness, and conscientiousness are some of the Big Five personality traits, which was the taxonomy chosen by the researchers to examine possible personality underpinnings of addictive behavior and comorbidity. As all three of the traits were equally associated with substance use disorders they may explain the co-occurrence of addictive behaviors but these traits also may more broadly associate the propensity to develop any psychiatric disorder. Further research is needed to fully elucidate the relationship between neuroticism, agreeableness, and conscientiousness for substance use disorders as the research may lead to the development of better prevention programs. 

The idea of cannabis use disorder is interesting as the endocannabinoid system does not act upon the reward system, making the threat of addiction almost nil. Cannabis is often pedestilized by advocates for its safety profile, especially when compared to other pain medications like opioids, yet there are still some concerns for dependency. The endocannabinoid system is ever changing, especially as we learn more about it. Very little research has been done that assesses cannabis dependency although it is known that, like with most substances, frequent users gain a tolerance to cannabis.  Tolerance to cannabis can be reset with abstinence, supposedly for a 48 hour period, but again more research is needed. Tolerance, addiction, and dependence all need to be properly defined and standardized across the medical community, not just the advocates, because addiction and dependence can be frightening words that should not be thrown about.

The study is available for review or download here: https://drive.google.com/file/d/1xQqAEU3sr5niKtarRR_nUutUwDE6E4um/view?usp=sharing

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Benjamin Caplan, MDAddictive Disorders are Associated with Neuroticism, Low Agreeableness, and Low Conscientiousness
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Alcohol and Cannabis Used to Cope with Depression

Internalizing Symptoms and Cannabis and Alcohol Use- Between- and Within-Person Risk Pathways With Coping Motives

In Summary

The American Psychology Association recently shared research demonstrating how individuals use alcohol and cannabis to cope with depression. Between and within-person analysis demonstrated that those who abused alcohol to cope with their depression demonstrated increased alcohol coping habits 12 months later and worsened depression symptoms. Although those patients who utilized cannabis to treat their depression maintained that use at the 12-month check-up their depression they did not report worsening depressive symptoms or increased cannabis use. Further research is needed to determine the validity of cannabinoids as an efficient treatment method for depression and to development of coping-related interventions for those abusing substances. 

This article also highlights the relationship between cannabis and social anxiety as well as alcohol and social anxiety. Cannabis products are frequently recommended for anxiety, specifically the most popular non-psychoactive component, cannabidiol (CBD). The featured article focussed on cannabis as a whole which includes ∆-9-tetrahydrocannabinol (THC), the most abundant psychoactive component of cannabis, which has been known to exacerbate feelings of anxiety. When studying the relationship between cannabis use and anxiety-related disorders it is important to study each cannabinoid separately for their effect because they operate so differently within the endocannabinoid system; then move on to examine whole cannabis effects as cannabinoids and other chemical compounds produced by cannabis plants are able to interact with each other and produce an entourage effect. 

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Benjamin Caplan, MDAlcohol and Cannabis Used to Cope with Depression
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The Effect of Cannabidiol on Alcohol

Effects of Cannabidiol on Alcohol-Related Outcomes- A Review of Preclinical and Human Research

In Summary

A review of preclinical research studies has revealed to possible beneficial effects of cannabidiol on alcohol-related outcomes. It was found that cannabidiol (CBD) is able to lessen alcohol consumption although the mechanism is not well understood. CBD may also protect consumers from the negative effects of alcohol use such as liver and brain damage. It is likely that CBD provides these protective effects through its modulation of inflammatory processes. It is recommended that further research is conducted in order to validate these findings and expand upon the knowledge of how CBD interacts with other common substances. 

As cannabis-based products become more widely accepted among the medical community and within society it is imperative that the interactions between cannabis and other drugs are known. Those who wish to use cannabis for certain ailments but are already on other medications may consume cannabis and experience negative side-effects due to the interaction of those drugs. Cannabinoids, terpenes, and flavonoids need to be modeled alongside other common medications so that physicians can safely recommend medications and so that pharmacists are able to accurately advise customers when they pick up prescriptions. Research is needed to ensure public safety in this time of evolving medications. 

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Benjamin Caplan, MDThe Effect of Cannabidiol on Alcohol
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Brief Interventions by Pediatricians can Reduce Adolescent Alcohol and Drug Abuse

Understanding Which Teenagers Benefit Most From a Brief Primary Care Substance Use Intervention

In Summary

A recent study has revealed that brief interventions given by primary care physicians can reduce alcohol and drug abuse among at-risk adolescents. This study aimed to address only alcohol and cannabis use disorders in teenagers who already reported the misuse of such substances. Participants were randomly assigned to receive an intervention from their physician or assigned as controls and then asked about their substance use habits 12 months later. Those who received an intervention reported a marked decrease in substance use through self-reporting and chemical screening. This research suggests that pediatricians and other general practitioners should speak candidly about the risks of substance use disorders with their patients. 

Pieces like the featured article highlight the importance of responsible cannabis use. Cannabis is becoming more socially acceptable as states continue to put forth policies that legalize medical and recreational use. Like alcohol and other drugs, cannabis should remain a semi-controlled substance whose availability is restricted by age or other factors so that at-risk youth are unable or less likely to abuse its benefits. State laws currently decide who has access to cannabis but as at-home cultivators become more prominent it will be necessary to ensure the security of those plants to prevent adolescents from misusing plants grown by family or friends. 

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Benjamin Caplan, MDBrief Interventions by Pediatricians can Reduce Adolescent Alcohol and Drug Abuse
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Beta-Caryophyllene Oxide Lessens the Sedative Effects of Alcohol

The sesquiterpene beta-caryophyllene oxide attenuates ethanol drinking and place conditioning in mice

In Summary

It has recently been revealed that the terpene beta-caryophyllene and its derivative, beta-caryophyllene oxide, are able to lessen the sedative effects of alcohol while not affecting its pharmacokinetics. Researchers determined that a high dose of ß-caryophyllene oxide was 10 times more effective at reducing the sedative effects than its precursor by conducting a loss of righting reflex (LORR) assay on mice who had been administered a consistent amount of ethanol. Interestingly the caryophyllene compounds were found to act on cannabinoid receptor 2 (CB2), not directly interact with the ethanol, and therefore not affect the pharmacokinetics of ethanol. This study provides a basis for further analysis of the mechanism for alcohol modulation by the endocannabinoid system. 

The need for research concerning drug interactions with cannabinoids, both endogenous, naturally occurring, or synthesized, is emphasized by this research. Opioid and cannabinoid interactions have been looked into but the results are inconsistent across the board, and very little is known about how cannabinoids interact with other common medications such as ibuprofen, birth control, blood thinners, and alcohol. This research is vital moving forward as state legislature continues to recognize the benefit of medical marijuana and chemists and pharmacists need to recognize how little is known about the mechanism behind the endocannabinoid systems far-reaching effects. 

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Benjamin Caplan, MDBeta-Caryophyllene Oxide Lessens the Sedative Effects of Alcohol
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Cannabis Abuse May Be Caused By Genetic Factors

CNR1 and FAAH variation and affective states induced by marijuana smoking 

In Summary

Researchers have recently described how genetic variation determines individual mood state after the consumption of cannabis. The variation of genes may prove useful when attempting to understand either motivation for illicit cannabis use or risk for associated abuse behaviors. Researchers determined participants affect by utilizing tension-anxiety and confusion-bewilderment assessment in order two examine CRN1 and FAAH, two encoding factors for receptors of the endocannabinoid system. Further research should be conducted to elucidate the exact genetic variations so that the risk of abuse can be screened for in individuals. 

The possibility of being able to screen for genetic variations within the endocannabinoid system that affect mood may prove useful when recommending cannabis to particularly anxious patients. ∆-9-tetrahydrocannabinol (THC) has been known to cause excess anxiety is some patients and exacerbate some mood symptoms. If physicians were able to screen for particularly whose anxiety would be exacerbated by certain cannabinoids then they may be able to help guide the patient towards other cannabinoids, like cannabidiol, or a different method of treatment entirely. 

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Benjamin Caplan, MDCannabis Abuse May Be Caused By Genetic Factors
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THC Users Show No Increased Crash Risk

Cannabis use as a risk factor for causing motor vehicle crashes- a prospective study 

In Summary:

A recent study has revealed that drivers who use ∆-9-tetrahydrocannabinol (THC) do not show an increased risk of crashing. Users of THC were also showed a statistically insignificant increased risk of crash responsibility than drivers who tested negative for THC use. Further research should be conducted to include all types of vehicles while excluding those involving drugs of abuse. The results seen in the featured study may have been skewed by the inclusion of drivers who used one or more drugs in combination with cannabis, including alcohol. Accident rates involving just cannabis use may prove to be even less than those found here. 

Driving while under the influence is still very risky, but perhaps the featured research warrants an examination of how to trace the amount of THC effect driving. Adults who are above the legal drinking age can drive as long as they are under a 0.08 blood-alcohol level so theoretically, there may be a level of THC consumption that may be allowed when driving, especially considering the lasting effects of certain consumption methods such as edibles and tinctures. Researchers could possibly create a mechanism, similar to that of a diabetes test, that would prick a driver’s finger and test for various cannabinoid content in their blood. This would obviously have challenges as there is a vast array of natural and synthetic cannabinoids but may be worth looking into as cannabis becomes more popular throughout North America. 

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Benjamin Caplan, MDTHC Users Show No Increased Crash Risk
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Cannabis Prevents Antipsychotic-Induced Weight Gain

Cannabis consumption and non-alcoholic fatty liver disease. A three years longitudinal study in first episode non-affective psychosis patients

A recent study has revealed that cannabis is able to prevent weight gain in psychiatric patients taking antipsychotics. Cannabis was found to have a protective effect against liver steatosis, which is an accumulation of fat in the liver that can lead to obesity and type 2 diabetes. These findings may prove useful when developing improved treatments for schizophrenia as one of the main reasons patients find treatment so difficult to comply with is the weight gain caused by liver steatosis. 

Highlighted in this study is the lack of knowledge surrounding the mechanisms of the endocannabinoid system. In the featured study, the researchers were left uncertain about whether or not the cannabis was acting directly on the liver to prevent steatosis or if cannabis modulates weight indirectly through a related system. If more research concerning cannabis were able to be conducted so that the exact mechanisms underlying the endocannabinoid system could be elucidated than novel therapies could be developed for a slew of ailments. Our lack of knowledge concerning cannabis prevents us from possible developing therapies for treatment-resistant disorders. 

The study is available for review or download here

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Benjamin Caplan, MDCannabis Prevents Antipsychotic-Induced Weight Gain
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