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What Is The Impact Of Marijuana Usage On Sexual Dysfunction Among Individual And How Do Factors Such As Frequency Of Use, Dosage, And Duration Of Marijuana Consumption Influence Sexual Function, Zachary A. Harris, Russell Levi, Saad Ahmed

Rowan-Virtua Research Day

Sexual health is an integral piece of human vitality, encompassing a multitude of psychological & physiological factors. There has been an unprecedented amount of interest surrounding cannabis and its impact on sexual function in the past decade. The interplay between the acceptance of cannabis and its widespread use presents the need for research into the correlation between cannabis and sexual health outcomes. The primary components of cannabis, cannabidiol (CBD) and tetrahydrocannabinol (THC) have attracted scrutiny for their potential effects on sexual function. Anecdotal accounts suggest heightened sexual desire and pleasure, however there are conflicting reports raising concerns regarding performance issues …

Educating Anesthesia Providers On The Physiological Effects And Anesthesia Implications Of Cannabis, Carmel Loud

Doctor of Nursing Practice Projects

In the U.S., currently 37 states have legalized cannabis for medicinal use prescribed by qualified medical professionals (National Conference of State Legislatures [NCSL], 2022). In 2012, the legalization of recreational cannabis began; as of 2022, 19 states have legalized the recreational use of marijuana (NCSL, 2022). This project aimed to optimize care for patients using cannabis by increasing anesthesia provider knowledge about cannabis. The project's aim was accomplished through a thorough review of the current medical literature and implementation of education to anesthesia providers about the physiological effects and anesthesia implications of cannabis. Thirteen CRNAs took a pre- and post-quiz …

Aspects Of Pharmaceutical Networks, Hannah Rita Joseph, Afia L. Rahaman, Kaya Wilson

ENGL 1102 Showcase

The theme of our anthology is different drugs and processes of drug usage in the result how the various aspects of the pharmaceutical companies. We analyze the quality of health that Americans receive from certain parts of the health care industry. We have focused on informing and analyzing the increase of insulin prices, and how that affects Americans everyday lives. The delivery methods of medical cannabis, how each method is effective, and how they are administered. As well as pharmaceutical scams and how it affects elderly people, who rely on medication.

Individual Differences In Cannabis Use Disorder With Implications For Endocannabinoid Modulation In Therapeutics Development, Erin Martin

MUSC Theses and Dissertations

Cannabis use disorder (CUD) is increasingly prevalent in the United States, but there is no effective pharmacological means to treat it. The endocannabinoid (eCB) system has emerged as a candidate therapeutic target demonstrating some evidence of efficacy in treating CUD. However, clinical trials evaluating eCB-modulating therapeutics have historically undervalued individual differences that could contribute to variation in treatment outcome (e.g. sex, comorbid psychiatric illness). To address this gap in the literature, the present set of studies (a) compared plasma eCB tone in groups underrepresented in treatment trials for CUD (females, individuals with comorbid major depressive disorder; MDD/CUD) with males or …

Detailing The Effects Of Cannabidiol On Exosome Release In Ewing’S Sarcoma, Bennett Hasley

Theses

Ewing’s sarcoma (ES) is a highly aggressive pediatric cancer found within bone that carries a low five-year survival rate within its patients. This is due, in part, to the cancer’s high malignancy properties as well as the development of resistance to the chemotherapies used to combat this cancer. This project aims to determine if cannabidiol (CBD) has an effect on either exosome release or the protein, signal transducer and activator of transcription 3 (STAT3) within ES cells. Exosomes are vesicles that can carry proteins and other signaling molecules which are released by the cell and allow for cell-to-cell communication. Within …

Alcohol And Cannabis Use Among Women With Infertility: Associations With Psychological Distress, Attempts To Conceive, And Engagement In Fertility Treatment, Genevieve E. M. Joseph-Mofford Ms, Leah M. Hecht Phd, Rory Iacobelli Bs, Amy M. Loree Phd, Lisa R. Miller-Matero Phd

Medical Student Research Symposium

Objective: An infertility diagnosis can lead to distress. Although substance use is common and can also lead to distress, little is known about use among those with an infertility diagnosis. This is important since substance use can have implications for fertility. The purpose of this study was to estimate the rate of alcohol and cannabis use among women with infertility and examine whether substance use had associations with psychiatric symptoms, attempts to conceive, and engagement in fertility treatments.

Materials and Methods: Patients from one healthcare system were eligible if they received a female infertility diagnosis within the past 2 years. …

A Rare Case Of Acute Pancreatitis Associated With Cannabinoids Consumption, Mays Abdulazeez, Michael Perez, Alejandro Hidalgo Parada, Rani Rabah, Greity Dominguez, Rowel Perez Vargas, Jose Cano, Jesus Garza-Tamez, Sunand Kallumadanda

Research Symposium

Introduction: Acute pancreatitis is an inflammatory condition of the pancreas characterized by abdominal pain and elevated levels of pancreatic enzymes in the blood. Acute pancreatitis is a leading gastrointestinal cause of hospitalization in the United States. Several conditions are associated with acute pancreatitis, of which gallstones and chronic alcohol use disorder account for approximately two-thirds of the cases. Others, including smoking, hypertriglyceridemia, infections, trauma, drugs, malignancy, scorpion stings, hypercalcemia, endoscopic retrograde cholangiopancreatography (ERCP), opioids, angiotensin-converting enzyme (ACE) inhibitors, macrolides, diuretics, statins, and cannabis have also been associated with acute pancreatitis. Cannabis is the most widely used recreational drug worldwide, with …

Trans-Ancestry Epigenome-Wide Association Meta-Analysis Of Dna Methylation With Lifetime Cannabis Use, Fang Fang, Laura J Bierut, Et Al.

2020-Current year OA Pubs

Cannabis is widely used worldwide, yet its links to health outcomes are not fully understood. DNA methylation can serve as a mediator to link environmental exposures to health outcomes. We conducted an epigenome-wide association study (EWAS) of peripheral blood-based DNA methylation and lifetime cannabis use (ever vs. never) in a meta-analysis including 9436 participants (7795 European and 1641 African ancestry) from seven cohorts. Accounting for effects of cigarette smoking, our trans-ancestry EWAS meta-analysis revealed four CpG sites significantly associated with lifetime cannabis use at a false discovery rate of 0.05

Neural Hyperactivity During Value-Based Decision-Making In People With Daily/Near Daily Cannabis Use, Miranda Ramirez

Theses and Dissertations--Psychology

Value-based decision-making involves the coordinated effort of multiple brain regions to guide future choices based on past experiences. These processes are disrupted in cannabis use disorder, where individuals continue to use cannabis despite negative consequences. Reinforcement learning (RL) paradigms can be used to capture changes in the value of available options and may inform how the brain is impacted by frequent cannabis use. This study combined fMRI with behavioral modeling of probabilistic choice task data to compare value-based choices between young adults reporting daily/near daily cannabis use (CAN) and controls (CTRL). Participants selected one of two options reinforced ($0.25) at …

Cannabinoids In Periodontology: Where Are We Now?, Yésica Carmona Rendón, Hernán Santiago Garzón, Bruno Bueno-Silva, Roger M Arce, Lina Janeth Suárez

Journal Articles

INTRODUCTION: Cannabinoids are a well-documented treatment modality for various immune and inflammatory diseases, including asthma, chronic obstructive pulmonary disease, Crohn's disease, arthritis, multiple sclerosis, and a range of neurodegenerative conditions. However, limited information is available regarding the therapeutic potential of cannabinoids in treating periodontal disease.

OBJECTIVE: The objective of this study is to analyze the current evidence on the antibacterial and immunomodulatory effects of cannabis and its role in the healing and regeneration processes within periodontal tissues.

RESULTS: This review discusses the potential role of cannabinoids in restoring periodontal tissue homeostasis.

CONCLUSIONS: The examination of the endocannabinoid system and the …

Adverse Childhood Experiences And Current Cannabis Use Among U.S. Young Adults, Afolakemi C. Olaniyan, Keith A. King, Laura A. Nabors, Ashley L. Merianos

Health Behavior Research

Cannabis use is a significant public health issue among U.S. young adults. The objective of this study was to assess the associations between adverse childhood experiences (ACEs) and current cannabis use among U.S. young adults. We conducted a secondary analysis of the 2021 Behavioral Risk Factor Surveillance System (BRFSS) data, which involved 498 U.S. young adults 18-24 years old who had data available for analysis on ACEs and current cannabis use. Unadjusted and adjusted logistic regression models were fitted to examine the associations between ACEs and current cannabis use. Adjusted models included participants’ sex, race/ethnicity, education level, and household income …

The Association Between Reasons For First Using Cannabis, Later Pattern Of Use, And Risk Of First-Episode Psychosis: The Eu-Gei Case-Control Study, Edoardo Spinazzola, Emma C Johnson, Et Al.

2020-Current year OA Pubs

BACKGROUND: While cannabis use is a well-established risk factor for psychosis, little is known about any association between reasons for first using cannabis (RFUC) and later patterns of use and risk of psychosis.

METHODS: We used data from 11 sites of the multicentre European Gene-Environment Interaction (EU-GEI) case-control study. 558 first-episode psychosis patients (FEPp) and 567 population controls who had used cannabis and reported their RFUC.We ran logistic regressions to examine whether RFUC were associated with first-episode psychosis (FEP) case-control status. Path analysis then examined the relationship between RFUC, subsequent patterns of cannabis use, and case-control status.

RESULTS: Controls (86.1%) …

A Case Of Cannabis Smoking Induced Leukocytosis, Ramiro A. Rodriguez Jr., Rukayat Akande, Nevin Varghese

Research Colloquium

Background: Leukocytosis relates to infections, malignancies, stress response, and multiple intoxicants. Like other intoxicants, cannabis smoking can result in a persistent leukocytosis. Here we report a case of cannabis-induced leukocytosis.

Case Presentation: A 20-year-old Hispanic female with a history of anxiety disorder presented with 3-days of nausea, vomiting, and colicky abdominal pain. She endorsed heavy marijuana smoking as self-medication and compulsive hot showers for symptom relief. She was admitted for oral intake intolerance, concerning for cannabis hyperemesis syndrome. Her history demonstrated multiple admission for cannabis hyperemesis syndrome during which she demonstrated a leukocytosis which improved with abstinence of marijuana. Her …

Epicutaneous Sensitization To The Phytocannabinoid Β-Caryophyllene Induces Pruritic Inflammation, Saadet Inan, Sara J Ward, Citlalli T Baltazar, Gabrielle A. Peruggia, Elham Javed, Ajay P. Nayak

Center for Translational Medicine Faculty Papers

In recent years, there has been increased accessibility to cannabis for recreational and medicinal use. Incidentally, there has been an increase in reports describing allergic reactions to cannabis including exacerbation of underlying asthma. Recently, multiple protein allergens were discovered in cannabis, yet these fail to explain allergic sensitization in many patients, particularly urticaria and angioedema. Cannabis has a rich chemical profile including cannabinoids and terpenes that possess immunomodulatory potential. We examined whether major cannabinoids of cannabis such as cannabidiol (CBD) and the bicyclic sesquiterpene beta-caryophyllene (β-CP) act as contact sensitizers. The repeated topical application of mice skin with β-CP at …

Proteomics-Based Approach For Detailing The Allergenic Profile Of Cannabis Chemotypes, Cali Loblundo, Jenna Severa, Gabrielle A Peruggia, Kristina Reid Black, Suman Chandra, Hemant Lata, Mahmoud Elsohly, Martin D Chapman, Deepak A. Deshpande, Ajay P. Nayak

Center for Translational Medicine Faculty Papers

Allergic sensitization to cannabis is an emerging public health concern and is difficult to clinically establish owing to lack of standardized diagnostic approaches. Attempts to develop diagnostic tools were largely hampered by the Schedule I restrictions on cannabis, which limited accessibility for research. Recently, however, hemp was removed from the classified list, and increased accessibility to hemp allows for the evaluation of its practical clinical value for allergy diagnosis. We hypothesized that the proteomic profile is preserved across different cannabis chemotypes and that hemp would be an ideal source of plant material for clinical testing. Using a proteomics-based approach, we …

Evaluation Of Field Sobriety Tests For Identifying Drivers Under The Influence Of Cannabis: A Randomized Clinical Trial, Thomas D Marcotte, Anya Umlauf, David J Grelotti, Emily G Sones, Kyle F Mastropietro, Raymond T Suhandynata, Marilyn A. Huestis, Igor Grant, Robert L Fitzgerald

Institute of Emerging Health Professions Faculty Papers

IMPORTANCE: With increasing medicinal and recreational cannabis legalization, there is a public health need for effective and unbiased evaluations for determining whether a driver is impaired due to Δ9-tetrahydrocannabinol (THC) exposure. Field sobriety tests (FSTs) are a key component of the gold standard law enforcement officer-based evaluations, yet controlled studies are inconclusive regarding their efficacy in detecting whether a person is under the influence of THC.

OBJECTIVE: To examine the classification accuracy of FSTs with respect to cannabis exposure and driving impairment (as determined via a driving simulation).

DESIGN, SETTING, AND PARTICIPANTS: This double-blind, placebo-controlled parallel randomized clinical trial was …

A Phenomenological Inquiry Into Healthcare Professionals Who Are Experts In Cannabinoid Therapy And The Endocannabinoid System (Ecs), Courtney Collins

Electronic Theses and Dissertations

Cannabis is a prevalent alternative treatment for many symptoms and conditions given its medicinal qualities and few side effects. As legalization for both medical and recreational purposes continue to develop quickly across the United States of America, there is serious discrepancy between legalization and clinical research. Clinical data is difficult since the U.S. federal government still classifies cannabis as a Drug Enforcement Agency (DEA) Schedule I drug with no clearly established medical value. This lag in evidence-base data has affected cannabinoid therapy and endocannabinoid system education (ECS) for healthcare professionals. There are gaps in medical school and continuing medical education …

A Review Of Social Media Platform Policies That Address Cannabis Promotion, Marketing And Sales, Carla J Berg, Cassidy R Loparco, Yuxian Cui, Alexandria Pannell, Grace Kong, Lynniah Griffith, Katelyn F Romm, Y Tony Yang, Yan Wang, Patricia A Cavazos-Rehg

2020-Current year OA Pubs

BACKGROUND: Cannabis marketing exposure via social media may impact use in youth and young adults. Most states with recreational cannabis lack policies regarding social media-based marketing. Thus, we examined such policies among prominent platforms, particularly those popular among youth and young adults.

METHODS: In September-October 2022, 3 research team members extracted policies applying to the general community, advertising, and any specific content regarding drug-related content for 11 social media sites: Discord, Facebook, Instagram, Pinterest, Reddit, Snapchat, TikTok, Tumblr, Twitch, Twitter, and YouTube. Using inductive thematic analysis, they then dual-coded restrictions on cannabis-related content (e.g., paid advertising, unpaid promotion, sales). Descriptive …

An Ecological Momentary Assessment Study To Examine Covariates And Effects Of Concurrent And Simultaneous Use Of Electronic Cigarettes And Marijuana Among College Students, Anne Buu, James J Yang, Tzung-Shiang Ou, Joon Kyung Nam, Ganghui Suh, Hsien-Chang Lin

Journal Articles

INTRODUCTION: The prevalence of concurrent and simultaneous use of e-cigarette and marijuana among college students is high. Yet, the literature was mainly based on cross-sectional surveys with emphasis on the smoking route. This is the first ecological momentary assessment (EMA) study that examined the vaping route of nicotine-marijuana co-use and the associated short-term psychological effects.

METHODS: This study recruited 686 college student e-cigarette users to participate in an on-line survey and 7-day EMA. Frequent marijuana users (247) - using marijuana weekly or daily - were compared with infrequent/non-users (439) on academic performance, e-cigarette use patterns, and dependence and respiratory symptoms. …

Sociodemographically Stratified Exploration Of Pancreatic Cancer Incidence In Younger Us Patients: Implication Of Cannabis Exposure As A Risk Factor, Albert S. Reece, Gary K. Hulse

Research outputs 2022 to 2026

Introduction. The aetiology for the recent increase in pancreatic cancer incidence (PCI) in the US is unknown. This paper provides an epidemiological investigation of the exponential increase in PCI in young people aged 15–34 years, particularly amongst females, with a focus on the exponential rise amongst African American females, and its relationship to substance use. Methods. National pancreatic cancer data from recent reports. Tobacco, alcohol and daily cannabis use data taken from the annual nationally representative National Survey of Drug Use and Health, response rate = 74%. Results. Amongst the 15–34-year-aged cohort, PCI was found to be significantly more common …

Driving Under The Influence Of Cannabis: Impact Of Combining Toxicology Testing With Field Sobriety Tests, Robert L. Fitzgerald, Anya Umlauf, Jacqueline A. Hubbard, Melissa A. Hoffman, Philip M. Sobolesky, Shannon E. Ellis, David J. Grelotti, Raymond T. Suhandynata, Marilyn A. Huestis, Igor Grant, Thomas D. Marcotte

Institute of Emerging Health Professions Faculty Papers

BACKGROUND: Cannabis is increasingly used both medically and recreationally. With widespread use, there is growing concern about how to identify cannabis-impaired drivers.

METHODS: A placebo-controlled randomized double-blinded protocol was conducted to study the effects of cannabis on driving performance. One hundred ninety-one participants were randomized to smoke ad libitum a cannabis cigarette containing placebo or delta-9-tetrahydrocannabinol (THC) (5.9% or 13.4%). Blood, oral fluid (OF), and breath samples were collected along with longitudinal driving performance on a simulator (standard deviation of lateral position [SDLP] and car following [coherence]) over a 5-hour period. Law enforcement officers performed field sobriety tests (FSTs) to …

Medical Marijuana In Mississippi: A Journalistic View Of Physician Opinions And Patient Education, Michael Pitts

Honors Theses

Medical Marijuana in Mississippi: A Journalistic View of Physician Opinions and Patient Education is an in-depth investigative journalism project examining aspects of the Mississippi Medical Cannabis Program. Specific areas of interest were Mississippi physician opinions on the use medical marijuana and their views on the application of the state’s program as well as an examination into how patients are receiving education on medical marijuana. This project involved interviews of healthcare providers, dispensary staff, and patients, in addition to background research that was used to formulate interview questions, determine areas of interest and add necessary context. This project occurred during the …

Medical Cannabis In Mississippi: Practitioner Education And Continuing Research, Andrea Cleveland

Honors Theses

Use of medical cannabis in Mississippi was legalized in February 2022 following many years of cannabis research at the University of Mississippi. Issues immediately became apparent, beginning with the lack of education about medical cannabis among providers. A 2017 study showed that the majority of physicians are not exposed to information about medical cannabis despite its legalization in 37 states. Another issue with Mississippi’s medical cannabis program is the cost of the product itself. The most effective way to decrease spending on medication is for patients to have access to medication that is guaranteed to work. Further research on cannabis …

Associations Between Cannabis Use, Polygenic Liability For Schizophrenia, And Cannabis-Related Experiences In A Sample Of Cannabis Users, Emma C Johnson, Sarah M C Colbert, Paul W Jeffries, Rebecca Tillman, Nicole R Karcher, Elliot C Nelson, Arpana Agrawal, Et Al.

2020-Current year OA Pubs

BACKGROUND AND HYPOTHESIS: Risk for cannabis use and schizophrenia is influenced in part by genetic factors, and there is evidence that genetic risk for schizophrenia is associated with subclinical psychotic-like experiences (PLEs). Few studies to date have examined whether genetic risk for schizophrenia is associated with cannabis-related PLEs.

STUDY DESIGN: We tested whether measures of cannabis involvement and polygenic risk scores (PRS) for schizophrenia were associated with self-reported cannabis-related experiences in a sample ascertained for alcohol use disorders (AUDs), the Collaborative Study on the Genetics of Alcoholism (COGA). We analyzed 4832 subjects (3128 of European ancestry and 1704 of African …

Characterization Of Childhood Trauma, Hippocampal Mediation And Cannabis Use In A Large Dataset Of Psychosis And Non-Psychosis Individuals, Elisabetta C. Del Re, Walid Yassin, Victor Zeng, Sarah Keedy, Ney Alliey-Rodriguez, Elena Ivleva, Scott Hill, Nicole Rychagov, Jennifer E. Mcdowell, Jeffrey R. Bishop

School of Medicine Publications and Presentations

Background

Cannabis use (CA) and childhood trauma (CT) independently increase the risk of earlier psychosis onset; but their interaction in relation to psychosis risk and association with endocannabinoid-receptor rich brain regions, i.e. the hippocampus (HP), remains unclear. The objective was to determine whether lower age of psychosis onset (AgePsyOnset) is associated with CA and CT through mediation by the HP volumes, and genetic risk, as measured by schizophrenia polygene scores (SZ-PGRS).

Methods

Cross-sectional, case-control, multicenter sample from 5 metropolitan US regions. Participants (n = 1185) included 397 controls not affected by psychosis (HC); 209 participants with bipolar disorder type-1; …

Effects Of Cannabichromene On Pain And Neuroinflammation In Hiv-1 Tat Transgenic Mice, Sydney Wheeler

Honors Theses

HIV-1 TransActivator of Transcription (Tat) is a vital regulatory protein involved in HIV replication and implicated in development of HIV-associated pain and neurocognitive deficits. Tat is thought to contribute to these pathologies through proinflammatory pathways. Developing mechanisms to curb Tat-mediated inflammation is a key step in improving the quality of life of those living with HIV. Both recreational and medicinal cannabis use is prevalent among many people living with HIV; given this prevalence and the perceived anti-inflammatory benefits of cannabis use, it is important to investigate how chemical constituents of cannabis may impact HIV. In the present study, the effects …

A Scoping Review Of Risk And Protective Factors For Negative Cannabis Use Consequences, Timothy J. Grigsby, Andrea Lopez, Larisa Albers, Christopher J. Rogers, Myriam Forster

Social & Behavioral Health Faculty Publications

Objective:

Numerous reviews have examined risk and protective factors for alcohol-related negative consequences, but no equivalent review of risk and protective factors exists for cannabis-related negative consequences (CRNCs)-a gap filled by the present study. This scoping review examined survey-based research of risk and protective factors for CRNCs such as neglecting responsibilities, blacking out, or needing more cannabis.

Methods:

Three databases (PubMed, PsycINFO, and Google Scholar) were searched for peer-reviewed manuscripts published between January 1, 1990, and December 31, 2021. A qualitative synthesis was performed using the matrix method and the results were organized using the socioecological model as a framework. …

Adolescent Use And Co-Use Of Tobacco And Cannabis In California: The Roles Of Local Policy And Density Of Tobacco, Vape, And Cannabis Retailers Around Schools, Georgiana Bostean, Anton M. Palma, Alison A. Padon, Erik Linstead, Joni Ricks-Oddie, Jason A. Douglas, Jennifer B. Unger

Sociology Faculty Articles and Research

Adolescent tobacco use (particularly vaping) and co-use of cannabis and tobacco have increased, leading some jurisdictions to implement policies intended to reduce youth access to these products; however, their impacts remain unclear. We examine associations between local policy, density of tobacco, vape, and cannabis retailers around schools, and adolescent use and co-use of tobacco/vape and cannabis.

We combined 2018 statewide California (US) data on: (a) jurisdiction-level policies related to tobacco and cannabis retail environments, (b) jurisdiction-level sociodemographic composition, (c) retailer locations (tobacco, vape, and cannabis shops), and (d) survey data on 534,176 middle and high school students (California Healthy Kids …

A Narrative Review Of The Lesser Known Medications For Treatment Of Restless Legs Syndrome And Pathogenetic Implications For Their Use, Paul Gerardo Yeh, Karen Spruyt, Lourdes M. Delrosso, Arthur S. Walters

Physician Assistant Studies Faculty Publications and Presentations

Background: There are several well-known treatments for Restless Legs Syndrome (RLS), including dopamine agonists (pramipexole, ropinirole, rotigotine), anticonvulsants (gabapentin and its analogs, pregabalin), oral or intravenous iron, opioids and benzodiazepines. However, in clinical practice, treatment is sometimes limited due to incomplete response or side effects and it is necessary to be aware of other treatment options for RLS, which is the purpose of this review.

Methods: We performed a narrative review detailing all of the lesser known pharmacological treatment literature on RLS. The review purposefully excludes well-established, well-known treatments for RLS which are widely accepted as treatments for …

Congenital Gastrointestinal Anomalies In Europe 2010–2019: A Geo-Spatiotemporal And Causal Inferential Study Of Epidemiological Patterns In Relationship To Cannabis- And Substance Exposure, Albert Stuart Reece, Gary Kenneth Hulse

Research outputs 2022 to 2026

Introduction: Congenital anomalies (CA’s) of most of the gastrointestinal tract have been linked causally with prenatal or community cannabis exposure. Therefore, we studied this relationship in Europe. Methods: CA data were from Eurocat. Drug-use data were sourced from the European Monitoring Centre for Drugs and Drug Addiction. Income data were taken from the World Bank. Results: When countries with increasing rates of daily cannabis use were compared with those which were not, the overall rate of gastrointestinal CA’s (GCA’s) was higher in the former group (p = 0.0032). The five anomalies which were related to the metrics of cannabis exposure …