Is the Urine Cannabinoid Level Measured via a Commercial Point-of-Care Semiquantitative Immunoassay a Cannabis Withdrawal Syndrome Severity Predictor?

Claus, Benedikt B.; Specka, Michael; McAnally, Heath B.; Scherbaum, Norbert; Schifano, Fabrizio; Bonnet, Udo

doi:10.3389/fpsyt.2020.598150

Cited by 9 publications

(13 citation statements)

References 43 publications

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“…Evidence for non-medical use of NSAIDs dates back to 1966 in the literature [ 8 ], and a recent German study included NSAIDs in its analysis of harms associated with drugs with addictive potential [ 31 ]. This review found that the majority of NSAID use in the general population was unsupervised and therefore created an opportunity for overdose, despite high levels of awareness around the abuse potential of analgesics in general found in one study [ 70 ].…”

Section: Resultsmentioning

confidence: 99%

A Scoping Review of Non-Medical and Extra-Medical Use of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

et al. 2021

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Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most commonly used medications worldwide and have analgesic, antipyretic and anti-inflammatory properties. Although NSAIDs are recognised as generally safe and effective, non-medical and extra-medical use of these products can occur. Unlike the use of illegal and many prescription drugs, which are subject to extensive research attention, inappropriate use of NSAIDs has been less well investigated. This scoping review collates and describes what is known regarding non-medical and extra-medical use of NSAIDs. In total, 72 studies were included in this scoping review. Three themes emerged from the review: (1) indicative profile of people who engage in non-medical or extra-medical use of NSAIDs; (2) antecedents for non-medical or extra-medical use; and (3) adverse health effects of non-medical and extra-medical use of NSAIDs. The review concluded that there is a need for enhanced patient education, including among sports people; pharmacovigilance in terms of clinician recognition of aberrance; and prescriber and pharmacist awareness of the potential for extra-medical and non-medical use and the related health harms.

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Section: Resultsmentioning

confidence: 99%

A Scoping Review of Non-Medical and Extra-Medical Use of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

et al. 2021

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“…'In the past month, on how many days have you used cannabis?' (Record n days/month from: never, 0 to30) This item is a brief assessment of frequency of cannabis use. It is similar to items with established validity and reliability in quantifying frequency of alcohol use, for example, item 1 of the Alcohol Use Disorder Identification Test[16]: 'How often do you have a drink containing alcohol?'…”

mentioning

confidence: 99%

The International Cannabis Toolkit (iCannToolkit): a multidisciplinary expert consensus on minimum standards for measuring cannabis use

et al. 2021

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Background The lack of an agreed international minimum approach to measuring cannabis use hinders the integration of multidisciplinary evidence on the psychosocial, neurocognitive, clinical and public health consequences of cannabis use. Methods A group of 25 international expert cannabis researchers convened to discuss a multidisciplinary framework for minimum standards to measure cannabis use globally in diverse settings. Results The expert‐based consensus agreed upon a three‐layered hierarchical framework. Each layer—universal measures, detailed self‐report and biological measures—reflected different research priorities and minimum standards, costs and ease of implementation. Additional work is needed to develop valid and precise assessments. Conclusions Consistent use of the proposed framework across research, public health, clinical practice and medical settings would facilitate harmonisation of international evidence on cannabis consumption, related harms and approaches to their mitigation.

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“…Individuals with cannabis use disorder (CUD) generally experience greater severity and duration of cannabis withdrawal symptoms than those without CUD. This is most probably related to the greater frequency and quantity of their cannabis use and their heavier exposure to THC [ 8 ]. CUD is characterized by persistent cannabis use despite negative effects on the social functioning and physical or mental health of the user or the health of other individuals.…”

Section: Dependence Withdrawal States and Clinical Managementmentioning

confidence: 99%

Section: Gold-standard Current Practicementioning

confidence: 99%

“…THC-COOH is generally associated with severity of the cannabis withdrawal syndrome, as measured by scores on the MWC [ 8 ]. Future research studies may determine if THC-COOH levels can more precisely guide the management and duration of cannabis withdrawal [ 8 ]. Figure 1 displays typical reductions in mean daily creatinine-normalized THC-COOH levels after abstinence in heavy, chronic cannabis users [ 35 ].…”

Section: Gold-standard Current Practicementioning

confidence: 99%

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Clinical management of cannabis withdrawal

Connor

Stjepanović

Budney³

et al. 2022

Addiction

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Background and Aims Cannabis withdrawal is a well‐characterized phenomenon that occurs in approximately half of regular and dependent cannabis users after abrupt cessation or significant reductions in cannabis products that contain Δ9‐tetrahydrocannabinol (THC). This review describes the diagnosis, prevalence, course and management of cannabis withdrawal and highlights opportunities for future clinical research. Methods Narrative review of literature. Results Symptom onset typically occurs 24–48 hours after cessation and most symptoms generally peak at days 2–6, with some symptoms lasting up to 3 weeks or more in heavy cannabis users. The most common features of cannabis withdrawal are anxiety, irritability, anger or aggression, disturbed sleep/dreaming, depressed mood and loss of appetite. Less common physical symptoms include chills, headaches, physical tension, sweating and stomach pain. Despite limited empirical evidence, supportive counselling and psychoeducation are the first‐line approaches in the management of cannabis withdrawal. There are no medications currently approved specifically for medically assisted withdrawal (MAW). Medications have been used to manage short‐term symptoms (e.g. anxiety, sleep, nausea). A number of promising pharmacological agents have been examined in controlled trials, but these have been underpowered and positive findings not reliably replicated. Some (e.g. cannabis agonists) are used ‘off‐label’ in clinical practice. Inpatient admission for MAW may be clinically indicated for patients who have significant comorbid mental health disorders and polysubstance use to avoid severe complications. Conclusions The clinical significance of cannabis withdrawal is that its symptoms may precipitate relapse to cannabis use. Complicated withdrawal may occur in people with concurrent mental health and polysubstance use.

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Is the Urine Cannabinoid Level Measured via a Commercial Point-of-Care Semiquantitative Immunoassay a Cannabis Withdrawal Syndrome Severity Predictor?

Cited by 9 publications

References 43 publications

A Scoping Review of Non-Medical and Extra-Medical Use of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

A Scoping Review of Non-Medical and Extra-Medical Use of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

The International Cannabis Toolkit (iCannToolkit): a multidisciplinary expert consensus on minimum standards for measuring cannabis use

Clinical management of cannabis withdrawal

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