When Cannabis Use Goes Wrong: Mental Health Side Effects of Cannabis Use That Present to Emergency Services

Crocker, Candice; Carter, Alix; Emsley, Jason G.; Magee, Kirk; Atkinson, Paul; Tibbo, Philip G.

doi:10.3389/fpsyt.2021.640222

Cited by 32 publications

(25 citation statements)

References 87 publications

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“…Whilst for some its use is not associated with harms, for others, especially heavy users, cannabis is associated with adverse health effects. Psychological adverse effects of cannabis use, such as anxiety, are well documented 4–6 . In the gastrointestinal system, the most well‐described manifestation of prolonged, heavy cannabis use is cannabinoid hyperemesis syndrome (CHS).…”

Section: Introductionmentioning

confidence: 99%

Cannabinoid hyperemesis syndrome in North America: evaluation of health burden and treatment prevalence

Andrews

Rehak

Woo

et al. 2022

Aliment Pharmacol Ther

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Summary Background Cannabinoid hyperemesis syndrome (CHS) is a poorly understood vomiting disorder associated with chronic cannabis use. Aims To characterise patients experiencing CHS in North America and to obtain a population‐based estimate of CHS treatment prevalence in Canada before and during the Covid‐19 pandemic Methods Internet survey of 157 CHS sufferers in Canada and the United States. Administrative health databases for the province of Alberta (population 5 million) were accessed to measure emergency department (ED) visits for vomiting, with a concurrent diagnostic code for cannabis use. Three time periods of 1 year were assessed: prior to recreational cannabis legalisation (2017–2018), after recreational legalisation (2018–2019) and during the first year of the Covid‐19 pandemic (2020–2021). Results Problematic cannabis use (defined as a CUDIT‐R score ≥8) was universal among the survey cohort, and 59% and 68% screening for moderate or worse anxiety or depression, respectively. The overall treatment prevalence of CHS across all ages increased from 15 ED visits per 100,000 population (95% CI, 14–17) prior to legalisation, to 21 (95% CI, 20–23) after legalisation, to 32 (95% CI, 31–35) during the beginning of the Covid‐19 pandemic (p < 0.001). Treatment prevalence among chronic cannabis users was as high as 6 per 1000 in the 16–24 age group. Conclusion Survey data suggest patients with CHS almost universally suffer from a cannabis use disorder, which has significant treatment implications. Treatment prevalence in the ED has increased substantially over a very short time period, with the highest rates seen during the Covid‐19 pandemic.

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Section: Introductionmentioning

confidence: 99%

Cannabinoid hyperemesis syndrome in North America: evaluation of health burden and treatment prevalence

Andrews

Rehak

Woo

et al. 2022

Aliment Pharmacol Ther

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“…Cannabis industry advocates and individuals who use cannabis medicinally have emphasized cannabis use to achieve well-being and to cease use of other harmful substances (like opioids) (Barcott 2016;Dutcher 2018; Stukin 2019). On the other hand, prevention, treatment, and public health professionals have expressed concerns about widespread acceptance of a substance that can be addictive and that has been associated with a range of health risks, including increased dependence on and potential use of other substances (National Academy of Sciences 2017; Crocker et al 2021;Hall 2018).…”

Section: Introductionmentioning

confidence: 99%

Cannabis-only use in the USA: prevalence, demographics, use patterns, and health indicators

Carlini-Cotrim

Schauer

2022

J Cannabis Res

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Background The prevalence of adults who consume cannabis while abstaining from other substances is not known in the USA. This study used nationally representative data to estimate the prevalence and explore the demographic characteristics, cannabis use behaviors, and self-reported health of US adults with past 30-day cannabis-only use, as compared with adults who used cannabis as well as other substances. Methods Data came from adults 18 years and older who responded to the 2017 or 2018 National Survey on Drug Use and Health and reported past 30-day cannabis use (n = 12,143). Cannabis-only use was defined as past 30-day cannabis use with no past 30-day use of other substances (alcohol, tobacco, other illicit substances, non-prescribed controlled medications). Weighted frequencies and 95% confidence intervals (CI) were computed for all sociodemographic and cannabis-related variables, overall, and across the two categories of cannabis consumers, stratified by age. Results The prevalence of past 30-day cannabis-only use among US adults was 0.9% (95% CI: 0.8, 1.0) and varied by age (2.0% of 18–25 years old; 0.7% of 26–49 year olds, and 0.6% of those ≥ 50 years). Among adults with any past 30-day cannabis use, 8.4% (95% CI: 7.6, 9.2; n = 980) reported cannabis-only use. Age was significantly associated with past 30-day cannabis-only use, with adults 18–25 years and 26–49 years having higher odds of cannabis-only use compared with older adults. Past year cannabis dependence was lowest among cannabis-only consumers aged ≥ 50 years (0.2%; 95% CI: 0.1, 0.5) and highest among young adult cannabis and other substance consumers (16.7%; 95% CI: 15.3, 18.2). Past year prevalence of any mental illness was generally similar across cannabis use groups and by age. Conclusions The prevalence of adult cannabis-only use in the US is low — most cannabis consumers report using other substances in the past 30 days as well. While cannabis-only use among older adults is rare, it does not appear to be accompanied by a high prevalence of dependence. These findings should guide future research and policymaking.

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“…Recent research has shown that individuals are consuming more alcohol [ 35 – 38 ] and more cannabis [ 35 , 39 , 40 ] than they did before the pandemic. Such patterns in substance use may result in acute and chronic harms, such as injury, substance use dependence, and death [ 41 – 44 ]. People may be using more alcohol and cannabis to cope with anxiety, depression and loneliness experienced during the pandemic [ 45 – 47 ].…”

Section: Introductionmentioning

confidence: 99%

Self-reported mental health during the COVID-19 pandemic and its association with alcohol and cannabis use: a latent class analysis

et al. 2022

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Background Mental health problems and substance use co-morbidities during and after the COVID-19 pandemic are a public health priority. Identifying individuals at high-risk of developing mental health problems and potential sequela can inform mitigating strategies. We aimed to identify distinct groups of individuals (i.e., latent classes) based on patterns of self-reported mental health symptoms and investigate their associations with alcohol and cannabis use. Methods We used data from six successive waves of a web-based cross-sectional survey of adults aged 18 years and older living in Canada (6,021 participants). We applied latent class analysis to three domains of self-reported mental health most likely linked to effects of the pandemic: anxiety, depression, and loneliness. Logistic regression was used to characterize latent class membership, estimate the association of class membership with alcohol and cannabis use, and perform sex-based analyses. Results We identified two distinct classes: (1) individuals with low scores on all three mental health indicators (no/low-symptoms) and (2) those reporting high scores across the three measures (high-symptoms). Between 73.9 and 77.1% of participants were in the no/low-symptoms class and 22.9–26.1% of participants were in the high-symptom class. We consistently found across all six waves that individuals at greater risk of being in the high-symptom class were more likely to report worrying about getting COVID-19 with adjusted odds ratios (aORs) between 1.72 (95%CI:1.17–2.51) and 3.51 (95%CI:2.20–5.60). Those aged 60 + were less likely to be in this group with aORs (95%CI) between 0.26 (0.15–0.44) and 0.48 (0.29–0.77) across waves. We also found some factors associated with class membership varied at different time points. Individuals in the high-symptom class were more likely to use cannabis at least once a week (aOR = 2.28, 95%CI:1.92–2.70), drink alcohol heavily (aOR = 1.71, 95%CI:1.49–1.96); and increase the use of cannabis (aOR = 3.50, 95%CI:2.80–4.37) and alcohol (aOR = 2.37, 95%CI:2.06–2.74) during the pandemic. Women in the high-symptom class had lower odds of drinking more alcohol during the pandemic than men. Conclusions We identified the determinants of experiencing high anxiety, depression, and loneliness symptoms and found a significant association with alcohol and cannabis consumption. This suggests that initiatives and supports are needed to address mental health and substance use multi-morbidities.

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When Cannabis Use Goes Wrong: Mental Health Side Effects of Cannabis Use That Present to Emergency Services

Cited by 32 publications

References 87 publications

Cannabinoid hyperemesis syndrome in North America: evaluation of health burden and treatment prevalence

Cannabinoid hyperemesis syndrome in North America: evaluation of health burden and treatment prevalence

Cannabis-only use in the USA: prevalence, demographics, use patterns, and health indicators

Self-reported mental health during the COVID-19 pandemic and its association with alcohol and cannabis use: a latent class analysis

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