Focus on Cannabis policy Flashcards
What is the principle ingredient of cannabis that was identified in 1964?
THC
Why is there controversy on the optimal policy approach for cannabis?
Health effects of cannabis are less known, compared to alcohol and tobacco
Why do we currently know less about cannabis than alcohol or tobacco?
> Illegal status of cannabis has tampered research on potential medical benefits
> Cannabis is less harmful than other illicit drugs such as cocaine and heroin
> Most people stop using cannabis on their own when entering adulthood
How have cohort trends in cannabis use evolved?
> 1940-44: 2% of cohorts used cannabis at age 21
> 1975-79:v 60% of cohorts used cannabis at age 21
- AND younger cohorts reporting cannabis use
What are the cannabis use disorders in the ICD and DSM?
- Cannabis misuse
- Cannabis dependence
Criteria similar to other diagnoses
What is the prevalence of cannabis use disorders in most countries?
Most prevalent illicit drug use disorder in most countries
What are the peak age periods for cannabis use disorders?
- Adolescence
- Young adulthood
Is there a cannabis withdrawal syndrome in the nosographies?
Withdrawal syndrome in cannabis use disorders recently added in DSM
What is the prevalence of withdrawal symptoms?
One of the most frequently reported symptoms of dependence: 30%
What is the association between cannabis and schizophrenia?
> Reasonable evidence cannabis use exacerbates schizophrenia
> Consistent evidence cannabis use can precipitate schizophrenia
- consistent risk ratio of 2 (2-fold increase)
- attributable risk to schizophrenia cases: 13%
What is the evidence of biological plausibility of the cannabis-schizophrenia association?
- Cannabinoid-dopamine interaction
- Provocation studies induce transient psychotic symptoms
What does Denise Kandel’s Stage theory on cannabis use (1992) propose?
Invariant sequence of drug use:
- cannabis precedes use of other drugs
BUT it does not mean causation
What is the current evidence on the causality between early cannabis use and subsequent use of other drugs?
Several studies have not been able to invalidate the possibility that early onset cannabis use may increase risk for subsequent use of other illicit drugs
Which pharmacological mechanisms could explain the potential association between early onset cannabis use and subsequent use of other illicit drugs?
> Cannabis and heroin have similar effects on dopamine neurotransmission
> Chronic treatment with THC induces cross-tolerance to amphetamine and opioids in rats
Which evidence invalidates the pharmacological explanation for association between early onset cannabis use and subsequent use of other illicit drugs?
Amount of THC inhaled by humans is significantly lower than dosage administered to rodents in experiments
- between 5000 and 25000-fold lower
What could explain the association between early onset cannabis use and subsequent use of other illicit drugs?
> Initial experiences with cannabis rated as pleasurable
> Early experiences with cannabis perceived as safe
> Access to cannabis may provide access to other drugs
Which argument led the Netherlands to decriminalise cannabis in the 1970s?
Access to cannabis may provide access to other illicit drugs
Is cannabis the only drug with which early onset use is associated to subsequent use of other illicit drugs?
Similar associations for alcohol and tobacco
- early use associated to subsequent use of cannabis and other illicit drugs
What is the state of evidence on the association between cannabis use and motor vehicle accidents?
> Only 9 studies could be included in recent meta-analysis
> Very little empirical evidence about effects of cannabis use on motor vehicle accidents
What does the recent analysis of Asbridge and colleagues (2012) show about the association between cannabis use and motor vehicle accidents?
Driving under influence of cannabis increase by 2-fold the risk of having a motor vehicle accident
- 2.5% of traffic deaths in France
What is the rank of cannabis use as actual cause of death in the United States in 1990 and 2000, compared to tobacco and alcohol?
- First is tobacco
- Illicit drug use is 9th
- > not even cannabis use specifically
What is the evidence on the adverse effects of cannabis use?
Insufficient evidence
Why is there insufficient evidence on the adverse effects of cannabis use?
- Low number of studies assessing whether all cause mortality rate is elevated among heavy cannabis users in general population
What is the prevalence of dependence in tobacco and alcohol use compared to cannabis use in the general population?
Dependence is more prevalent in alcohol and tobacco use compared to cannabis use
