Sex differences in the acute effects of smoked cannabis: evidence from a human laboratory study of young adults

Matheson, Justin; Sproule, Beth; Ciano, Patricia Di; Fares, Andrew; Foll, Bernard Le; Mann, Robert E.; Brands, Bruna

doi:10.1007/s00213-019-05369-y

Cited by 94 publications

(83 citation statements)

References 58 publications

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“…Some have demonstrated higher concentrations of THC and THC-COOH levels among females compared to males after administration of smoked [49,50] or vaporized cannabis [50], and greater subjective ratings of cannabis intoxication among females [49]. In contrast, a study with young adults aged 19-25 years who regularly used cannabis (1-4 days per week) found that females smoked less of the cannabis cigarette compared to males to reach their desired effect, but that blood THC and THC-COOH (a metabolite of THC) levels were lower among females compared to males even after adjusting for differences in the dose of THC inhaled [51]. The authors suggest that the similar subjective effects experienced by females at lower doses may reflect sex differences in the endocannabinoid system, as some animal studies have demonstrated greater cannabinoid type-1 (CB1) receptor availability and binding affinity with cannabinoids in females [51].…”

Section: Routes Of Administrationmentioning

confidence: 82%

“…In contrast, a study with young adults aged 19-25 years who regularly used cannabis (1-4 days per week) found that females smoked less of the cannabis cigarette compared to males to reach their desired effect, but that blood THC and THC-COOH (a metabolite of THC) levels were lower among females compared to males even after adjusting for differences in the dose of THC inhaled [51]. The authors suggest that the similar subjective effects experienced by females at lower doses may reflect sex differences in the endocannabinoid system, as some animal studies have demonstrated greater cannabinoid type-1 (CB1) receptor availability and binding affinity with cannabinoids in females [51]. Ovarian hormones may also influence the subjective effects of cannabis in females; studies with other substances have revealed differences in subjective effects depending on menstrual cycle phase, though similar research on cannabis is currently lacking [51].…”

Section: Routes Of Administrationmentioning

confidence: 86%

“…Sex differences in the subjective effects of cannabis may impact impairment. As noted above, the greater subjective effects that females tend to experience at lower doses and with a lower blood level of THC may suggest the potential for greater impairment with a lower dose of cannabis among females [51]. It is possible that females may require more time to achieve sobriety before driving, though further research is required to investigate sex differences in the metabolism of cannabinoids and the effects on intoxication and impaired driving.…”

Section: Driving Under the Influence Of Cannabismentioning

confidence: 99%

“…The authors suggest that the similar subjective effects experienced by females at lower doses may reflect sex differences in the endocannabinoid system, as some animal studies have demonstrated greater cannabinoid type-1 (CB1) receptor availability and binding affinity with cannabinoids in females [51]. Ovarian hormones may also influence the subjective effects of cannabis in females; studies with other substances have revealed differences in subjective effects depending on menstrual cycle phase, though similar research on cannabis is currently lacking [51].…”

Section: Routes Of Administrationmentioning

confidence: 99%

“…Further, Matheson et al (2019) suggest that there may be sex differences in cannabis smoking topography [51]. In their experiment, females and males smoked for the same duration yet females smoked less of the cannabis cigarette suggesting they took smaller puffs, inhaled less deeply or held the smoke in the lungs for a shorter duration [51]. This finding may be influenced by neuro-biological factors, such as greater cannabinoid sensitivity among females [21], causing females to titrate their dose via their smoking behaviors.…”

Section: Routes Of Administrationmentioning

confidence: 99%

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Sex and Gender Interactions on the Use and Impact of Recreational Cannabis

Greaves

Hemsing

2020

IJERPH

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Cannabis is the second most frequently used substance in the world and regulated or legalized for recreational use in Canada and fourteen US states and territories. As with all substances, a wide range of sex and gender related factors have an influence on how substances are consumed, their physical, mental and social impacts, and how men and women respond to treatment, health promotion, and policies. Given the widespread use of cannabis, and in the context of its increasing regulation, it is important to better understand the sex and gender related factors associated with recreational cannabis use in order to make more precise clinical, programming, and policy decisions. However, sex and gender related factors include a wide variety of processes, features and influences that are rarely fully considered in research. This article explores myriad features of both sex and gender as concepts, illustrates their impact on cannabis use, and focuses on the interactions of sex and gender that affect three main areas of public interest: the development of cannabis use dependence, the impact on various routes of administration (ROA), and the impact on impaired driving. We draw on two separate scoping reviews to examine available evidence in regard to these issues. These three examples are described and illustrate the need for more comprehensive and precise integration of sex and gender in substance use research, as well as serious consideration of the results of doing so, when addressing a major public health issue such as recreational cannabis use.

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Section: Routes Of Administrationmentioning

confidence: 82%

Section: Routes Of Administrationmentioning

confidence: 86%

Section: Driving Under the Influence Of Cannabismentioning

confidence: 99%

Section: Routes Of Administrationmentioning

confidence: 99%

Section: Routes Of Administrationmentioning

confidence: 99%

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Sex and Gender Interactions on the Use and Impact of Recreational Cannabis

Greaves

Hemsing

2020

IJERPH

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Cannabis and Driving in Older Adults

Di Ciano,

Rajji,

Hong

et al. 2024

JAMA Netw Open

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ImportanceEpidemiological studies have found that cannabis increases the risk of a motor vehicle collision. Cannabis use is increasing in older adults, but laboratory studies of the association between cannabis and driving in people aged older than 65 years are lacking.ObjectiveTo investigate the association between cannabis, simulated driving, and concurrent blood tetrahydrocannabinol (THC) levels in older adults.Design, Setting, and ParticipantsUsing an ecologically valid counterbalanced design, in this cohort study, regular cannabis users operated a driving simulator before, 30 minutes after, and 180 minutes after smoking their preferred legal cannabis or after resting. This study was conducted in Toronto, Canada, between March and November 2022 with no follow-up period. Data were analyzed from December 2022 to February 2023.ExposuresMost participants chose THC-dominant cannabis with a mean (SD) content of 18.74% (6.12%) THC and 1.46% (3.37%) cannabidiol (CBD).Main outcomes and measuresThe primary end point was SD of lateral position (SDLP, or weaving). Secondary outcomes were mean speed (MS), maximum speed, SD of speed, and reaction time. Driving was assessed under both single-task and dual-task (distracted) conditions. Blood THC and metabolites of THC and CBD were also measured at the time of the drives.ResultsA total of 31 participants (21 male [68%]; 29 White [94%], 1 Latin American [3%], and 1 mixed race [3%]; mean [SD] age, 68.7 [3.5] years), completed all study procedures. SDLP was increased and MS was decreased at 30 but not 180 minutes after smoking cannabis compared with the control condition in both the single-task (SDLP effect size [ES], 0.30; b = 1.65; 95% CI, 0.37 to 2.93; MS ES, −0.58; b = −2.46; 95% CI, −3.56 to −1.36) and dual-task (SDLP ES, 0.27; b = 1.75; 95% CI, 0.21 to 3.28; MS ES, −0.47; b = −3.15; 95% CI, −5.05 to −1.24) conditions. Blood THC levels were significantly increased at 30 minutes but not 180 minutes. Blood THC was not correlated with SDLP or MS at 30 minutes, and SDLP was not correlated with MS. Subjective ratings remained elevated for 5 hours and participants reported that they were less willing to drive at 3 hours after smoking.Conclusions and relevanceIn this cohort study, the findings suggested that older drivers should exercise caution after smoking cannabis.

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Heavy Lifetime Cannabis Use and Mortality by Sex

Vallée

2024

JAMA Netw Open

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ImportanceThe association between mortality and cannabis use remains unclear.ObjectiveTo examine sex-stratified associations of cumulative lifetime cannabis use with all-cause, cardiovascular disease (CVD), and cancer mortality in the UK Biobank population.Design, Setting, and ParticipantsThis cohort study used data from volunteers in the UK Biobank population. Participant monitoring for mortality in the UK Biobank study commenced from the point of their inclusion between 2006 and 2010 and continued until December 19, 2020. Data regarding the causes of death were sourced from the National Health Service Information Centre. Data were analyzed from inception of study inclusion to December 2020.ExposureCannabis use status was assessed by questionnaire and categorized as heavy, moderate, low, and never.Main Outcomes and MeasuresThe main outcomes were all-cause, CVD, and cancer mortality. Sex-stratified associations of cumulative lifetime cannabis use with mortality were estimated using Cox proportional hazards regression with adjustment for demographic and clinical variables.ResultsAmong 121 895 participants (54.51% females with mean [SD] age of 55.15 [7.64] years; 45.49% males with mean [SD] age of 56.46 [7.79] years) during an overall median of 11.80 years (IQR, 10.53-13.22 years) of follow-up, 2375 total deaths occurred, including 1411 deaths from CVD and 440 from cancer. In males, after full adjustment, the hazard ratios (HRs) were 1.28 (95% CI, 0.90-1.81) for all-cause mortality, 0.98 (95% CI, 0.43-2.25) for CVD mortality, and 1.09 (95% CI, 0.71-1.67) for cancer mortality among heavy cannabis users compared with never users. In females, after full adjustment, the HRs were 1.49 (95% CI, 0.92-2.40) for all-cause mortality, 2.67 (95% CI, 1.19-4.32) for CVD mortality, and 1.61 (95% CI, 0.91-2.83) for cancer mortality among heavy cannabis users compared with never users. In female current tobacco users, after full adjustment, heavy cannabis use was associated with all-cause mortality (HR, 2.25; 95% CI, 1.12-4.53), CVD mortality (HR, 2.56; 95% CI, 1.43-15.36), and cancer mortality (HR, 3.52; 95% CI, 1.50-8.33) and among never tobacco users was associated with CVD mortality (HR, 2.98; 95% CI, 1.67-6.61). In male current tobacco users, heavy cannabis use was associated with cancer mortality (HR, 2.44; 95% CI, 1.14-5.23).Conclusions and RelevanceIn this study, a positive association between CVD mortality and heavy lifetime cannabis use was observed among females. Longitudinal studies are needed in general populations to investigate the potential effects of cannabis on mortality.

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Sex differences in the acute effects of smoked cannabis: evidence from a human laboratory study of young adults

Cited by 94 publications

References 58 publications

Sex and Gender Interactions on the Use and Impact of Recreational Cannabis

Sex and Gender Interactions on the Use and Impact of Recreational Cannabis

Cannabis and Driving in Older Adults

Heavy Lifetime Cannabis Use and Mortality by Sex

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