The changing landscape of the use of medical marijuana after traumatic brain injury: a narrative review

Saulino, Patrick A; Greenwald, Brian D.; Gordon, Dustin J.

doi:10.1080/02699052.2021.1978548

Cited by 5 publications

(5 citation statements)

References 66 publications

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“…Reported side effects were consistent with common cannabis-related side effects including dizziness, fatigue, and anxiety [51]. It is important to note that these reported side effects do not suggest that cannabis exacerbates neurocognitive deficits following a TBI including loss of concentration and memory [9]. With regards to this latter point, although the neurocognitive function was not specifically assessed in the present study, a number of important recent studies have shown that initiation of medical cannabis either has no harmful effect or actually improves neurocognitive function in users [67][68][69], in domains such as executive function.…”

Section: Cannabis Use Patternsmentioning

confidence: 69%

“…Injuries can be either focal or diffuse and include primary brain damage from mechanical trauma, as well as secondary pathology from excitotoxicity, mitochondrial dysfunction, oxidative stress, lipid peroxidation, neuroinflammation, axon degeneration, and apoptotic cell death [8]. While most symptoms from mild TBIs resolve within 1-3 months, some individuals experience long-term effects including fatigue, insomnia, anxiety, and depression, collectively known as post-concussion syndrome (PCS) [9].…”

Section: Introductionmentioning

confidence: 99%

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Exploring medical cannabis use in individuals with a traumatic brain injury

Schjelderup

MacCallum

et al. 2023

Exploration of Medicine

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Aim: Traumatic brain injury (TBI) is a common neurological condition, which can present with a wide range of neuropsychological symptoms. Treating this broad spectrum of symptoms represents a significant medical challenge. In part because of this, there is growing interest in the use of medical cannabis to treat the sequelae of TBI, as medical cannabis has been used to treat multiple associated conditions, such as pain. However, medical cannabis represents a heterogeneous collection of therapies, and relatively little is known about their effectiveness in treating TBI symptoms. The aim of the present study was therefore to assess medical cannabis use in patients with TBI. Methods: In the present study, a retrospective chart review was conducted of patterns of cannabis use and TBI symptoms in individuals who used medical cannabis to treat TBI-related symptoms. All subjects were recruited from a medical cannabis clinic, where cannabis was authorized by physicians, using licensed cannabis products. A total of 53 subjects provided written consent to have their charts reviewed. Results: Neuropsychiatric conditions, including depression, pain, and anxiety were frequent in this group. The most common forms of medical cannabis consumption at intake included smoking, vaping, and oral ingestion. Patients used a combination of high tetrahydrocannabinol (THC)/low cannabidiol (CBD) and low THC/high CBD products, typically 1–3 times per day. Medical cannabis appeared to be relatively well-tolerated in subjects, with few serious side effects. At follow-up, subjects self-reported improvements in TBI symptoms, although these were not statistically significant when assessed using validated questionnaires. Conclusions: Overall findings indicate modest potential benefits of medical cannabis for TBI, but further research will be required to validate these results.

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Section: Cannabis Use Patternsmentioning

confidence: 69%

Section: Introductionmentioning

confidence: 99%

Exploring medical cannabis use in individuals with a traumatic brain injury

Schjelderup

MacCallum

et al. 2023

Exploration of Medicine

View full text Add to dashboard Cite

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“…cardiovascular rhythm abnormalities; Pasha et al, 2021). Short‐term cognitive deficits were also reported following MC treatment, including impaired executive function and short‐term memory (Saulino et al, 2021). Finally, concerns have been raised regarding possible psychological effects, including the risk of developing dependence and addiction (Maharajan et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

Negative experiences of patients using medicinal cannabis: A systematic review of qualitative studies

Gliksberg

Kushnir

Sznitman

et al. 2023

Journal of Clinical Nursing

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Aims and ObjectivesIn this study, we systematically reviewed qualitative studies concerning patients' experience with medicinal cannabis (MC) use, to gain insight into the negative effects of MC.BackgroundOver the past decades, the use of MC for therapeutic purposes has increased. However, there is conflicting and insufficient data on possible negative physiological and psychological effects of MC treatment.DesignA systematic review was conducted and the PRISMA guidelines were adopted. Literature searches were conducted using PubMed, PsycINFO and EMBASE. Critical Appraisal Skills Programme (CASP) qualitative checklist used to assess risk of bias in the included studies.MethodsWe included studies focusing on conventional medical treatment using cannabis‐based products, approved by a physician for a particular health issue.ResultsOf the 1230 articles identified in the initial search, eight articles were included in the review. Following the compilation of themes in the eligible studies, six themes were identified: (1) MC approval; (2) administrative barriers; (3) social perception; (4) MC misuse/widespread effect; (5) adverse effects; and (6) dependence or addiction. These were grouped into two meta‐themes: (1) administrative and social aspects of MC use; and (2) experiences of the effects of medicinal cannabis.ConclusionsOur findings call for specific attention to unique consequences associated with MC use. Further research is needed in order to assess the degree to which negative experiences associated with MC use may affect various aspects of patients' medical condition.Relevance to clinical practiceDescribing the complex experience of MC treatment and its spectrum of consequences for patients may enable physicians, therapists and researchers to provide more attentive and accurate MC treatment to their patients.Patient or public contributionIn this review, patients' narratives were explored, yet the research methods did not directly involve patients or the public.

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“…In contrast to opiates, the evidence regarding cannabis/marijuana use in individuals with TBI is relatively sparse despite it being the most common drug used by people with TBI who endorse using drugs other than alcohol 9. The rapidly changing legal environment surrounding marijuana may be contributing to its use, given it is legalized or decriminalized to varying degrees across states, yet remains illegal at the federal level 9,16. Consequently, to date, no large-scale studies within the United States have been conducted to examine marijuana use post-TBI.…”

mentioning

confidence: 99%

“…9 The rapidly changing legal environment surrounding marijuana may be contributing to its use, given it is legalized or decriminalized to varying degrees across states, yet remains illegal at the federal level. 9,16 Consequently, to date, no large-scale studies within the United States have been conducted to examine marijuana use post-TBI. However, 1 study in Colorado found that approximately 45% of individuals with TBI (n = 64) reported using cannabis, with 31% reporting daily use.…”

mentioning

confidence: 99%

The Interaction of Opiate Misuse and Marijuana Use on Behavioral Health Outcomes Using the Traumatic Brain Injury Model Systems Pain Collaborative Dataset

Callender,

Lai,

Driver

et al. 2024

Journal of Head Trauma Rehabilitation

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Objective: To determine if the interaction of opiate misuse and marijuana use frequency is associated with behavioral health outcomes. Setting: Community. Participants: Three thousand seven hundred fifty participants enrolled in the Traumatic Brain Injury Model Systems who completed the Pain Survey and had complete opioid use and marijuana use information. Design: Cross-sectional, secondary analysis from a multisite observational cohort. Main Outcome Measure(s): Clinically significant behavioral health symptoms for posttraumatic stress disorder (PTSD), depression, anxiety, and sleep quality. Results: Three thousand five hundred thirty-five (94.3%) participants did not misuse opiates, 215 (5.7%) did misuse opiates (taking more opioid pain medication than prescribed and/or using nonprescription opioid pain medication); 2683 (70.5%) participants did not use marijuana, 353 (9.3%) occasionally used marijuana (less than once a week), and 714 (18.8%) regularly used marijuana (once a week or more frequently). There was a statistically significant relationship (P < .05) between the interaction of opiate misuse and marijuana use frequency and all behavioral health outcomes and several covariates (age, sex, cause of injury, severity of injury, and pain group category). Pairwise comparisons confirm that statistically significant associations on behavioral health outcomes are driven by endorsing opiate misuse and/or regular marijuana use, but occasional marijuana use was not associated. Conclusions: Higher odds of clinically significant PTSD, depression, anxiety, and poor sleep quality are present in people with traumatic brain injury (TBI) who misuse opiates and/or who use marijuana regularly. In the absence of opiate misuse, regular marijuana use had higher odds of worse behavioral health outcomes than occasional and no use. The interaction of opiate misuse and regular marijuana use yielded the highest odds. Individuals with TBI should be informed of the relationship of substance use and behavioral health outcomes and that current chronic pain may mediate the association.

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The changing landscape of the use of medical marijuana after traumatic brain injury: a narrative review

Cited by 5 publications

References 66 publications

Exploring medical cannabis use in individuals with a traumatic brain injury

Exploring medical cannabis use in individuals with a traumatic brain injury

Negative experiences of patients using medicinal cannabis: A systematic review of qualitative studies

The Interaction of Opiate Misuse and Marijuana Use on Behavioral Health Outcomes Using the Traumatic Brain Injury Model Systems Pain Collaborative Dataset

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