Cultural perspectives on marijuana consumption have undergone substantial reforms in recent years, and the decriminalization and legalization of cannabis are a matter of debate now. The conditions of determining factors are not the same among societies; therefore, each society should decide independently. Herein, the considerations that Iran should contemplate before legalizing cannabis were addressed. Global trends, social status, influence on the judiciary, costs, health effects, quality control, shifting substance use patterns, societal detachment, and changes in prevalence were the discussed determinant factors. Now that religious, cultural, and legal status has suppressed the increase in prevalence, legalization of recreational use that leads to a significant increase in consumption is not advisable. However, the legalization and production of medical cannabis should be on the agenda, as none of the items that hinder the legalization of recreational cannabis do not apply to medical cannabis. Research should continue to reduce uncertainties, especially by combining big data from sale systems of areas where recreational cannabis use has been legalized with big data sources like social media.

BACKGROUND: Data are needed on differences in community-dwelling populations with bipolar disorder (BP) regarding trust in research and access to care. We characterized community members by lifetime history of bipolar disorder. We hypothesized that those with BP would have less trust in research, visit a health provider less, and participate less in research than those without BP. We also hypothesized that those with BP would be more likely to have a history of marijuana (MJ) use.
METHODS: A cross-sectional design was used for this analysis. The study population consisted of 12,489 members (78.0%) from the HealthStreet community engagement program who were interviewed by a Community Health Worker about health history and demographics.
RESULTS: Among the sample, the rate of BP was 10.6% (n = 1326). Those reporting BP were more likely than those who did not (n = 11,163), to report muscle, bone, and mental health problems, to be younger, female, to have visited the doctor in the past 12 months, to be interested in participating in research, and be current MJ users. Trust did not differ between BP groups.
CONCLUSIONS: Our analysis found that persons with BP had higher access to care and more interest in research, thus our primary hypothesis was rejected. Our secondary hypothesis, that persons with BP were more likely to have a history of MJ use was upheld. These findings are important because they address a crucial gap in the literature surrounding BP and lay the groundwork for future community-level research.

UNASSIGNED: This study aimed to analyze tobacco and marijuana use by middle and high school students identifying as bisexual, gay, lesbian, or heterosexual using data from the National Youth Tobacco Survey (NYTS) spanning from 2020 to 2022. By comparing substance use patterns among different sexual orientation groups, the study sought to identify disparities and potential socioeconomic factors influencing these behaviors.
UNASSIGNED: Data from the 2020 to 2022 NYTS were analyzed, focusing on responses regarding ever use of cigarettes, e-cigarettes, and marijuana by students of varying sexual orientations. Descriptive statistics and chi-square tests were employed to analyze differences in substance use and socioeconomic indicators between sexual orientation groups.
UNASSIGNED: Of the 37 541 students included in the analysis, significant differences in substance use were observed among bisexual, gay, lesbian, and heterosexual students. Bisexual and gay/lesbian students exhibited higher rates of ever use of cigarettes, e-cigarettes, and marijuana compared to heterosexual students. In addition, socioeconomic differences, such as lower rates of family vehicle ownership and reduced access to vacations, were noted among bisexual and gay/lesbian students.
UNASSIGNED: The findings underscore significant differences in tobacco and marijuana use by adolescents based on sexual orientation, mirroring differences observed in LGBTQ adults. These results highlight the importance of targeted interventions, educational initiatives, and support systems tailored to the unique needs of LGBTQ youth. Addressing socioeconomic disparities and fostering inclusive environments are crucial steps in promoting the health and well-being of LGBTQ adolescents. Continued research and collaborative efforts are essential in mitigating health disparities and creating equitable environments for all adolescents.

BACKGROUND: As access to cannabis has increased, there has been a rise in a condition called cannabinoid hyperemesis syndrome (CHS). This study estimates annual prevalence of suspected CHS at emergency department visits (ED) over an 11-year period in Northern California.
METHODS: This retrospective observational cohort study used electronic health records from Kaiser Permanente Northern California. Two CHS case definitions were used to construct two cohorts of adults (18+) with ≥1 CHS visits from 2009 to 2019. The primary definition used a narrow definition based on past studies (CHS group 1) and an exploratory definition allowed for a broader range of codes (CHS group 2); both definitions required a primary diagnosis of vomiting. Annual prevalence of CHS and annual rates of counts of CHS visits estimated using a log-link Poisson model are reported per group.
RESULTS: There were 57,227 patients with ≥1 CHS visits included in CHS group 1 and 65,645 patients included in CHS group 2. Over eleven years, CHS increased across groups with the fastest rise in CHS group 1 (prevalence ratio = 2.75, 95 % confidence interval [CI] 2.65-2.85, p<.0001 from 2009 to 2019 vs. prevalence ratio = 2.34, 95 % CI 2.27-2.43). CHS group 1 also exhibited the largest increase in ED visits (rate ratio = 2.35, 95 % CI 2.27-2.43, p<.0001).
CONCLUSIONS: In a large California population, suspected CHS increased over time across definitions. Annual prevalence increased by 134-175 %, depending on CHS definition. CHS group 2\'s definition may have been too broad and changes in ICD-10-CM coding may have impacted estimates.

Marijuana use among adolescents and young adults has increased, however, there is a paucity of research concerning marijuana use among adolescents in rural areas. Current literature holds the assumption that adolescents in rural areas tend to use less marijuana and marijuana associated products compared with youth from urban and suburban areas. However, geographical features may contribute to unique stressors experienced by rural youth, resulting in distinct differences in usage that have been previously unexplored. The purpose of the current study was to explore the relationship between rurality and geographic region by examining patterns of lifetime marijuana use in 12th graders across various geographical backgrounds. Using data from the Monitoring the Future Study database, participants were classified based on rurality (rural, medium suburban/urban, large suburban/urban) and geographic region (Northeast, Midwest, South, West) and data was analyzed to investigate the differences in lifetime marijuana and hash usage. Results demonstrated that rural adolescents in the Northeast and West reported lifetime marijuana and hash product use at the same level as their urban/suburban counterparts; however, there were differences across rurality among Midwest and Southern regions. These results suggest that lifetime marijuana use among rural adolescents is not uniform across geographic regions, indicating that geography should be heavily considered when formulating preventative and educational marijuana programs.

Behavioral economic approaches to measuring cannabis demand represent a well-validated, low-cost method of assessing risk for hazardous cannabis use. One widely used measure of cannabis demand is the Marijuana Purchase Task (MPT), which has shown good psychometric properties across multiple samples. However, preliminary data suggest that changes could improve task ecological validity and acceptability. Using a predominantly White convenience sample, this study aimed to develop a revised MPT that uses a modern dispensary scenario to better reflect national trends in cannabis use (e.g., multiple forms of cannabis consumption). Participant inattentiveness due to increased task length and difficulty estimating purchases for the next month may have impacted demand measures. Lessons learned are discussed to inform future efforts to assess cannabis demand in a manner that is more reflective of naturalistic use: including minimizing participant burden, setting higher price ceilings to increase task utility, and considering person-level factors that may influence demand.

Rates of cannabis initiation among teenagers and young adults are increasing. Further, the use of various forms of cannabis (smoked or vaped) with nicotine (dual use) is increasingly common among young people. The health effects of dual use are lesser known, particularly in the context of high-potency cannabis products and across different routes of administration, which is ominous in terms of predicting future health outcomes. There is a long history of cannabis use being associated with decreased activity and increased snacking, both of which could portend an increased risk of metabolic and cardiovascular disease, particularly when these habits begin during formative years. However, modern forms of cannabis may not have these same effects. Here, we assess whether cannabis use alone and dual use of cannabis with nicotine impact dietary and exercise habits in young people. An anonymous, social media-based survey was designed based on the UC San Diego Inhalant Questionnaire and published diet and exercise questionnaires. A total of 457 surveys were completed. Young sole cannabis users represented 29% of responders, 16% were dual users of cannabis and nicotine, and 55% were non-users of either drug. Although the sole use of cannabis was not associated with dietary or activity differences relative to non-users, dual users of cannabis and nicotine reported higher consumption of unhealthy sugars. This novel finding of dual use being associated with increased sugar intake in young people raises concerns for an increased risk of metabolic syndrome and cardiovascular disease in this population.

BACKGROUND: With the increasing legalization of medical and recreational cannabis, patients and providers have growing interest in the role of cannabinoids in treating inflammatory bowel disease. Prior meta-analysis has shown inconclusive evidence for efficacy of cannabinoids. We sought to produce an up-to-date meta-analysis that pools new data to evaluate the therapeutic effects of cannabinoids in both Crohn\'s disease (CD) and ulcerative colitis (UC).
METHODS: PubMed, Embase, CENTRAL and CINAHL were queried for randomized-controlled trials evaluating the impact cannabinoids in CD or UC. Random effects modeling was used to compute pooled estimates of risk difference. Heterogeneity was assessed using I2.
RESULTS: Eight studies, including 4 studies of CD, 3 studies of UC, and 1 study of both diseases met inclusion criteria. Among 5 studies of CD, a statistically significant decrease in clinical disease activity following intervention was observed (risk ratios [RR],  -0.91; 95% CI, CI:1.54 to CI:0.28, I2 = 71.9%). Clinical disease activity in UC was not significantly lower in the pooled analysis (RR, -2.13; 95% CI, -4.80 to 0.55; I2 = 90.3%). Improvement in quality of life (QoL) was observed in both CD and UC combined (RR, 1.79; 95% CI, 0.92-0.2.66; I2 = 82.8%), as well as individually. No differences were observed in the analysis on endoscopic disease activity and inflammatory markers.
CONCLUSIONS: This meta-analysis of clinical trials suggests that cannabinoids are associated with improved quality of life in both CD and UC, as well as improved disease activity but not inflammation.
This updated systematic review and meta-analysis suggests that cannabis for inflammatory bowel disease may improve quality of life and disease activity but not inflammation.

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UNASSIGNED: Secondhand tobacco smoke is associated with worsening asthma symptoms among children. However, the relationship between secondhand marijuana smoke and asthma symptoms among youth has not been examined. This study compares the prevalence of secondhand tobacco and marijuana smoke exposure, overall and by asthma status, among middle and high school students.
UNASSIGNED: The study assessed participants of the 2019-2020 California Student Tobacco Survey: a large, cross-sectional random sample of 8th, 10th, and 12th graders (N = 158,937). Descriptive analyses examined exposure to combustible tobacco and marijuana secondhand smoke by students\' asthma status and sociodemographic characteristics.
UNASSIGNED: More students with asthma were exposed to combustible tobacco secondhand smoke (13.4 %) and marijuana secondhand smoke (12.0 %) than students without asthma (10.9 % and 9.3 %, respectively). The prevalence of secondhand marijuana smoke exposure was higher among 12th grade students (12.2 %) while the prevalence of secondhand tobacco smoke exposure was higher among 8th grade students (13.4 %) and those who lived in rural locations (15.4 %).
UNASSIGNED: California students are exposed to marijuana secondhand smoke at similar proportions to combustible tobacco secondhand smoke and more students with asthma are exposed to marijuana secondhand smoke. These results expand the public health issue of secondhand smoke exposure among children with asthma by highlighting the need to examine marijuana secondhand smoke. Given the rapid shift in marijuana laws across the US, exposure to secondhand marijuana smoke is likely to increase. Therefore, vulnerable populations, such as children with asthma, should be prioritized for interventions that aim to alleviate secondhand marijuana exposure.