Progress in Neuro-Psychopharmacology and Biological Psychiatry
Review articleAdverse effects of cannabis on health: an update of the literature since 1996
Introduction
Since the publication of the Indian Hemp Drugs Commission Report of 1893–1894 Indian Hemp Drugs Commission, 1894, Kalant, 1972, there have been many excellent reviews of the literature on health effects of cannabis, both harmful and potentially beneficial. One of the most extensive recent reviews, carried out by a WHO ad hoc Working Group in 1994–1996 (Kalant et al., 1999), was based on a series of commissioned reviews of the literature published up to 1996. The present update is therefore based on a review of the literature from 1996 to the present day, as identified in Medline and in the monthly research notes of the Canadian Consortium for the Clinical Investigation of Cannabis.
During the past 8 years, there has been a considerable increase in the volume of research literature on cannabis and cannabinoids, but much of this increase has been in the area of potential therapeutic uses of cannabinoids, both natural and synthetic, and in the area of the physiological roles of the endocannabinoid system (the compounds formed naturally in the mammalian body that act upon the cannabinoid receptors in brain and other organs). Much of the research in experimental animals also deals with molecular mechanisms of action and with neurobiology of cannabis. Much of this material has been discussed in thorough reviews elsewhere, and is not covered here, since it is not directly relevant to the question of adverse effects arising from the non-medical use of cannabis.
The great bulk of the recent literature dealing with these adverse effects in humans has focused on three topics: cannabis and driving accidents, dependence on cannabis, and psychiatric effects of cannabis use. Significant but smaller amounts of the recent literature deal with pulmonary effects, cancer, toxicity, and cognitive function. These various topics are reviewed separately below.
Section snippets
Driving ability
A thorough review of the literature on the effects of cannabis on driving skills and driving safety was published by Smiley (1999), originally prepared as a background paper for the WHO report but later updated to 1999 for publication in the separate volume of background papers (Kalant et al., 1999). She concluded that experimental studies have shown clear but modest impairment of driving skills and actual driving performance in subjects smoking small or moderate doses of cannabis, but that the
Summary
This review of the literature since 1996, concerning adverse health effects of cannabis smoking, does not alter in a major way the conclusions reached in an earlier review of the literature up to 1996. The principal additions to, or modifications of, those earlier conclusions are as follows:
- •
The potential role of cannabis in driving accidents has been further supported by analytical data showing the presence of THC in the blood and saliva of injured or impaired drivers with a higher frequency
References (141)
- et al.
Illicit drugs and driving: prevalence, beliefs and accident involvement among a cohort of current out-of-treatment drug users
Drug Alcohol Depend
(2000) - et al.
Cannabis and schizophrenia. A longitudinal study of Swedish conscripts
Lancet
(1987) Heavy cannabis users seeking treatment: prevalence of psychiatric disorders
Eur. Psychiatry
(2002)- et al.
Precipitation and determination of the onset and course of schizophrenia by substance abuse—a retrospective and prospective study of 232 population-based first illness episodes
Schizophr. Res
(2002) - et al.
Alcohol, illicit drugs and medicinal drugs in fatally injured drivers in Spain between 1991 and 2000
Forensic Sci. Int
(2002) - et al.
Relationships between frequency and quantity of marijuana use and last year proxy dependence among adolescents and adults in the United States
Drug Alcohol Depend
(1997) - et al.
Drugged driving in the Nordic countries—a comparative study between five countries
Forensic Sci. Int
(1999) - et al.
Cannabis dependence, withdrawal, and reinforcing effects among adolescents with conduct symptoms and substance use disorders
Drug Alcohol Depend
(1998) - et al.
Cannabis use and traffic accidents in a birth cohort of young adults
Accident Anal. Prev
(2001) - et al.
Tracheobronchial histopathology in habitual smokers of cocaine, marijuana, and/or tobacco
Chest
(1997)
Marijuana use and cessation of tobacco smoking in adults from a community sample
Drug Alcohol Depend
Growth from birth to early adolescence in offspring prenatally exposed to cigarettes and marijuana
Neurotoxicol. Teratol
Differential effects on cognitive functioning in 13- to 16-year-olds prenatally exposed to cigarettes and marihuana
Neurotoxicol. Teratol
SPME-GC analysis of THC in saliva samples collected with “EPITOPE” device
Forensic Sci. Int
Effects of prenatal marijuana exposure on child behavior problems at age 10
Neurotoxicol. Teratol
The relationship between cannabis use and DSM-IV cannabis abuse and dependence: results from the National Longitudinal Alcohol Epidemiologic Survey
J. Subst. Abuse
Substance abuse and the onset of schizophrenia
Biol. Psychiatry
Drugs of abuse and the elicitation of human aggressive behavior
Addict. Behav
The prevalence of analgesics containing dextropropoxyphene or codeine in individuals suspected of driving under the influence of drugs
Forensic Sci. Int
Prenatal substance exposure: effects on attention and impulsivity of 6-year-olds
Neurotoxicol. Teratol
Endocannabinoids in cognition and dependence
Prostaglandins, Leukot. Essent. Fat. Acids
Intoxicación por ingesta accidental de cannabis
An. Esp. Pediatr
Comparison of the prevalence of alcohol, cannabis and other drugs between 900 injured drivers and 900 control subjects: results of a French collaborative study
Forensic Sci. Int
Dose related risk of motor vehicle crashes after cannabis use
Drug Alcohol Depend
Prenatal alcohol and marijuana exposure: effects on neuropsychological outcomes at 10 years
Neurotoxicol. Teratol
Cannabis and schizophrenia: a longitudinal study of cases treated in Stockholm county
Acta Psychiatr. Scand
“You can't go without a fag, you need it for your hash”—a qualitative exploration of smoking, cannabis and young people
Addiction
DSM-IV-TR
Cannabis use in adolescence and risk for adult psychosis: longitudinal prospective study
Br. Med. J
Histopathologic and molecular alterations in bronchial epithelium in habitual smokers of marijuana, cocaine and/or tobacco
J. Natl. Cancer Inst
Cannabis psychosis and acute schizophrenia: a case-control study from India
Eur. Addict. Res
Role of cannabis in motor vehicle crashes
Epidemiol. Rev
Cannabis abuse and serious suicide attempts
Addiction
Cannabis and schizophrenia: impact on onset, course, psychopathology and outcomes
Eur. Arch. Psychiatry Clin. Neurosci
Respiratory effects of non-tobacco cigarettes
Br. Med. J
Dose-related neurocognitive effects of marijuana use
Neurology
Cannabis cookies: a cause of coma
J. Paediatr. Child Health
Uvulitis and partial upper airway obstruction following cannabis inhalation
Emerg. Med. (Fremantle)
Development and consequences of cannabis dependence
J. Clin. Pharmacol
The time course and significance of cannabis withdrawal
J. Abnormal Psychol
Cannabis and schizophrenia: results of a follow-up study
Eur. Arch. Psychiatr. Clin. Neurosci
Etude epidémiologique de l'abus et de la dépendance du cannabis chez 256 adolescents
Encéphale
Marijuana use and the risk of major depressive episode. Epidemiological evidence from the United States National Comorbidity Survey
Soc. Psychiatry Psychiatr. Epidemiol
Being “at fault” in traffic crashes: does alcohol, cannabis, cocaine, or polydrug abuse make a difference?
Inj. Prev
Cannabis dependence in young adults: an Australian population study
Addiction
Adolescent precursors of cannabis dependence: findings from the Victorian Adolescent Health Cohort Study
Br. J. Psychiatry
Drug driving among injecting drug users in Sydney, Australia: prevalence, risk factors and risk perceptions
Addiction
Alcohol, cannabis and tobacco use among Australians: a comparison of their associations with other drug use and use disorders, affective and anxiety disorders, and psychosis
Addiction
Exploring the association between cannabis use and depression
Addiction
Cannabis-induced Koro in Americans
Addiction
Cited by (245)
How machine learning is used to study addiction in digital healthcare: A systematic review
2023, International Journal of Information Management Data InsightsLatent inhibition, aberrant salience, and schizotypy traits in cannabis users
2022, Schizophrenia Research: CognitionCitation Excerpt :In general, cognitive deficits, including associative learning difficulties, have been linked to specific parameters of cannabis use, notably earlier onset of use (Ehrenreich et al., 1999; Pope et al., 2003), longer duration of use (Solowij et al., 2002; Messinis et al., 2006), and higher frequency of use (Becker et al., 2010). Effects of long-term use of cannabis are less consistent; some have reported no evidence for effects of cannabis use (e.g. Kalant, 2004), while others reported more subtle deficits across various domains of cognition (Block et al., 2002; Bolla et al., 2002; Eldreth et al., 2004; Grant et al., 2003; Solowij et al., 2002). The finding that self-reported cannabis use does not affect LI performance is consistent with our previous study demonstrating no relationship between history of cannabis use and Kamin blocking (KB), another associative learning task which measures the effects on current learning of prior exposure to other learning contingencies (Kamin, 1968).
A fast and simple approach for the quantification of five anti-hypersensitivity drugs in saliva and urine by portable ion mobility spectrometry based on magnetic graphene oxide dispersive solid phase extraction
2020, Journal of Pharmaceutical and Biomedical AnalysisAddictive behaviors: Clinical facts
2020, Bulletin de l'Academie Nationale de MedecineAge of first use, current marijuana use and driving after use among Canadian high school students
2019, Addictive Behaviors