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Kannabis on ihan oikeasti haitallinen päihde

Kannabis on ihan oikeasti haitallista päihdettä
 
By Wayne Hall

Centre for Youth Substance Abuse Research, the University of Queensland, Herston, Australia
 
 
Cannabis Harms
 
Cannabis Harms - Virtual Issue
With more and more jurisdictions ‘legalising’ cannabis for medical and recreational use there is an increasing need to better understand the potential harms of cannabis use. This virtual issue provides an invaluable resource that sets out many recent findings and helps to set the agenda for future research. The papers in the virtual issue illustrate the massive growth in good quality epidemiological studies of the correlates and possible consequences of different patterns of cannabis use among young people in many developed countries.
 
My paper provides an overview of research on cannabis use over the past 20 years. It documents that prospective epidemiological studies in a number of countries have produced greater clarity on some health issues. For example, they have established that cannabis-impaired drivers are at increased risk of being in car crashes. They also show that there is a cannabis dependence syndrome (that includes withdrawal symptoms) that is prompting increasing numbers of cannabis users to present to addiction treatment services for assistance in quitting, in many countries second only to alcohol as a reason for treatment seeking.
 
Prospective epidemiological studies have also found that daily cannabis use in adolescence and young adulthood is consistently associated with a number of poorer psychosocial outcomes, namely, an increased risk of early school leaving (that may partially reflect the adverse effects of regular cannabis use on cognitive performance); an increased risk of using other illicit drugs; and an increased risk of reporting psychotic symptoms and receiving a diagnosis of schizophrenia. These associations have often shown dose response relationships in longitudinal studies and these associations have often persisted (with some attenuation) after adjustment for the effects of plausible confounders. A commentary by Fergusson and colleagues - major contributors to the literature on the adverse health and psychosocial consequences of adolescent cannabis use - puts these findings into a larger context.
 
The other research papers in the virtual issue provide more detailed information on several of these themes.
 
The first set of papers report epidemiological studies that report associations between regular cannabis use in adolescence and the risk of developing mental disorders in adult life. These include: a cross sectional study of associations between cannabis use and vulnerability to developing psychotic experiences over a number of waves of interviews with young people in the Netherlands (Griffith-Lendering et al, 2013); a neuroimaging study of patterns of neuropsychological activation in persons with bipolar disorder who did and did not regularly use cannabis (Bitter et al, 2014); a study of the association between adolescent cannabis use and the persistence of anxiety disorders into young adulthood in an Australian adolescent cohort (Degenhardt et al, 2013); a study comparing activity in the hypothalamic-pituitary-adrenocorticotrophic axis in young Swiss adults who did and did not use cannabis (Van Leuwin et al, 2011); a study comparing the risk of common mental health disorders in a sample of regular cannabis users in the Netherlands who did and did not meet criteria for cannabis dependence (Van Der Pol et al, 2013); and a review of the contribution that twin studies have made to our understanding of the extent to which the common associations between regular cannabis use and mental disorders may be explained by shared genetic risks for each disorder (Agrawal and Lynskey, 2014).
 
The second set of articles includes papers on the social and general health correlates of regular and dependent cannabis use. These include: a prospective study of self-reported health among regular cannabis users in Switzerland (Baggio et al, 2014); the effects of adolescent initiation of cannabis and tobacco use on educational outcomes in later adolescence in a British birth cohort (Stiby et al, 2015); the effects of regular cannabis use and the desistance from cannabis use on measures of cognitive performance in adulthood in an Australian cohort (Tait et al, 2011); the association between cannabis use and the degree of work commitment in a Norwegian cohort (Hyggen, 2012); and a study assessing the extent to which regular cannabis users in the Netherlands are able to titrate their cannabis doses depending upon the potency of the product that they consume (Van der Pol et al, 2014), an important question given the increased potency of cannabis products in many countries and debates about the extent to which regular users are able to titrate their dose.
 
Wayne Hall

Centre for Youth Substance Abuse Research, the University of Queensland, Herston, Australia
 
Papers
What has research over the past two decades revealed about the adverse health effects of recreational cannabis use?
Wayne Hall: Addiction 2015; 110: 19-35
Commentary on Hall (2015): The health effects of recreational cannabis use
David M. Fergusson and Joseph M. Boden: Addiction 2015; 110: 36-37
Cannabis use and vulnerability for psychosis in early adolescence—a TRAILS study
Griffith-Lendering MFH et al: Addiction 2013; 108: 733-740
Commentary on Griffith-Lendering et al. (2013): Cross-lagging cannabis and psychosis vulnerability
Glyn Lewis, Jon Heron and Stanley Zammit: Addiction 2013; 108: 741-742
Neurofunctional changes in adolescent cannabis users with and without bipolar disorder
Bitter SM et al: Addiction 2014; 109: 1901-1909
The persistence of the association between adolescent cannabis use and common mental disorders into young adulthood
Degenhardt L et al: Addiction 2013; 108: 124-133
Commentary on Degenhardt et al. (2013): Specific effect of adolescent cannabis use on anxiety – tentative explanations
Anja C Huizink: Addiction 2013; 108: 134-135
Hypothalamic–pituitary–adrenal axis reactivity to social stress and adolescent cannabis use: the TRAILS study
Prince van Leeuwen A et al: Addiction 2011; 106: 1484-1492
Mental health differences between frequent cannabis users with and without dependence and the general population
van der Pol P et al: Addiction 2013; 108: 1459-1469
Cannabis controversies: how genetics can inform the study of comorbidity
Arpana Agrawal and Michael T. Lynskey: Addiction 2013; 109: 360-370
Patterns of cannabis use and prospective associations with health issues among young males
Baggio S et al: Addiction 2014; 109: 937-945
Adolescent cannabis and tobacco use and educational outcomes at age 16: birth cohort study
Stiby AI et al: Addiction 2015; 110: 658-668
Cannabis use and cognitive function: 8-year trajectory in a young adult cohort
Robert J. Tait, Andrew Mackinnon and Helen Christensen: Addiction 2011; 106: 2195-2203
Does smoking cannabis affect work commitment?
Christer Hyggen: Addiction 2012; 107: 1309-1315
Cross-sectional and prospective relation of cannabis potency, dosing and smoking behaviour with cannabis dependence: an ecological study
van der Pol P et al: Addiction 2014; 109: 1101-1109
Commentary on van der Pol et al. (2014): Reconsidering the association between cannabis exposure and dependence
Elizabeth C. Temple: Addiction 2014; 109: 1110-1111
 
Lähde: Addiction-lehti