hi all well today for the umpteenth time i went to the doctors for the copd clinic and was told again how cannabis makes holes in your lungs and destroys airways,well again i asked her where she had learned this and asked to point me to a source to back up the claim which she could not do,she then went on telling me that vaping cannabis is the same as smoking it!i went on to explain the difference between vaping and combusting and gave her a link to this and several other studies,real ones not made up by some nhs office bod! but it makes interesting reading,i was diagnosed as having moderate copd and emphysema some time ago due to visible scarring on my lungs caused by childhood tb not cannabis!peace
Increasing cannabis use and legalisation highlights the paucity of data we have on the safety of cannabis smoking for respiratory health. Unfortunately, concurrent use of tobacco among marijuana smokers makes it difficult to untangle individual effect of marijuana smoking. Chronic cannabis only smoking has been shown in large cohort studies to reduce forced expiratory volume in 1 s/forced vital capacity via increasing forced vital capacity in chronic use contrary to the picture seen in tobacco smoking. The cause of this is unclear and there are various proposed mechanisms including respiratory muscle training secondary to method of inhalation and acute anti-inflammatory effect and bronchodilation of cannabis on the airways. While cannabis smoke has been shown to increase symptoms of chronic bronchitis, it has not been definitively shown to be associated with shortness of breath or irreversible airway changes. The evidence surrounding the development of lung cancer is less clear; however, preliminary evidence does not suggest association. Bullous lung disease associated with marijuana use has long been observed in clinical practice but published evidence is limited to a total of 57 published cases and only one cross-sectional study looking at radiological changes among chronic users which did not report any increase in macroscopic emphysema. More studies are required to elucidate these missing points to further guide risk stratification, clinical diagnosis and management.
Cannabis smoking has increased and is likely to increase further with relaxation of legalisation and medicinal use of cannabinoids.
Chronic marijuana smoking often produces symptoms similar to those of chronic tobacco smoking such as cough, sputum production, shortness of breath and wheeze.
Cessation of marijuana smoking is associated with a reduction in respiratory symptoms and no increased risk of chronic bronchitis.
Spirometry changes seen in chronic marijuana smokers appear to differ from those in chronic tobacco smokers. In chronic marijuana smokers there is an increase in FVC as opposed to a definite decrease in FEV1.
Multiple case series have demonstrated peripheral bullae in marijuana smokers, but no observational studies have elucidated the risk.
There is currently no clear association between cannabis smoking and lung cancer, although the research is currently limited.
Educational aims
To update readers on legalisation of recreational and medicinal cannabis.
To summarise the evidence base surrounding the respiratory effects of inhaled marijuana use.
To provide clinicians with an understanding of the main differences between cannabis and tobacco to be able to apply this to patient education.
To highlight common respiratory problems among cannabis users and the need for recreational drug history taking.
Go to:
Short abstract
Chronic cannabis smoking develops a different respiratory picture compared to tobacco. The mechanism behind this is unclear; however, given the increasing prevalence and legalisation it is important to keep in mind the differences in clinical practice. http://ow.ly/kcv930l1sG1
Cannabis is the most widely used illicit substance, and the second most widely smoked, in the world. Cannabis refers to products of the cannabis plant including marijuana (the flowers and tops of the plant; bud) and the resin (hash). Other terms in common use include “weed”, “dope”, “grass”, “hemp”, “ganga”, “reefer”, “spliff”, “toke” and “blunt”.
Although alcohol, caffeine and tobacco indulgence are more widespread, illicit recreational drug use polarises opinion more. Cannabis is seen as harmless on the one hand and as a gateway to hard drug use on the other. Dependence is associated with cannabis use disorder which is increasing in prevalence. Cannabis as a public health issue has risen up the political agenda. With an aim to disrupt an illicit industry funding organised crime, Canada began regulating tetrahydrocannabinol (THC) content in July 2018 in an attempt to improve safety and protect the young. Not surprisingly, there are vocal critics and cries for much more research [1].
As healthcare professionals, we deal with tobacco all the time but we also need to know about the respiratory effects of marijuana to be able to advise our patients and colleagues. This brief review aims to summarise what is known and how concerned we should be, particularly with regards to the lungs.
The cannabis genus includes three species: Cannabis sativa, Cannabis indica and Cannabis ruderalis. Each species contains varying concentrations of the two major psychoactive compounds: delta-9-THC and cannabidiol [2]. The concentrations of psychoactive compounds in recreational marijuana also vary over time, with concentrations higher now than they were 50 years ago due to selective breeding. Positive psychoactive effects of cannabis include euphoria and relaxation [3]. However, negative psychological side-effects range from anxiety to psychosis [3]. Commonly available high potency cannabis, dubbed skunk (based on its distinct smell), is associated with a high risk of psychosis due to its high concentration of delta-9-THC [2, 3].
Go to:
Pharmacology
The high number of cannabinoids recognised (perhaps over 90) means that cannabis pharmacology is necessarily complex; and a full discussion is not warranted here.
Cannabis smoking has increased and is likely to increase further with relaxation of legalisation and medicinal use of cannabinoids.
Chronic marijuana smoking often produces symptoms similar to those of chronic tobacco smoking such as cough, sputum production, shortness of breath and wheeze.
Cessation of marijuana smoking is associated with a reduction in respiratory symptoms and no increased risk of chronic bronchitis.
Spirometry changes seen in chronic marijuana smokers appear to differ from those in chronic tobacco smokers. In chronic marijuana smokers there is an increase in FVC as opposed to a definite decrease in FEV1.
Multiple case series have demonstrated peripheral bullae in marijuana smokers, but no observational studies have elucidated the risk.
There is currently no clear association between cannabis smoking and lung cancer, although the research is currently limited.
Educational aims
To update readers on legalisation of recreational and medicinal cannabis.
To summarise the evidence base surrounding the respiratory effects of inhaled marijuana use.
To provide clinicians with an understanding of the main differences between cannabis and tobacco to be able to apply this to patient education.
To highlight common respiratory problems among cannabis users and the need for recreational drug history taking.
Go to:
Short abstract
Chronic cannabis smoking develops a different respiratory picture compared to tobacco. The mechanism behind this is unclear; however, given the increasing prevalence and legalisation it is important to keep in mind the differences in clinical practice. http://ow.ly/kcv930l1sG1
Cannabis is the most widely used illicit substance, and the second most widely smoked, in the world. Cannabis refers to products of the cannabis plant including marijuana (the flowers and tops of the plant; bud) and the resin (hash). Other terms in common use include “weed”, “dope”, “grass”, “hemp”, “ganga”, “reefer”, “spliff”, “toke” and “blunt”.
Although alcohol, caffeine and tobacco indulgence are more widespread, illicit recreational drug use polarises opinion more. Cannabis is seen as harmless on the one hand and as a gateway to hard drug use on the other. Dependence is associated with cannabis use disorder which is increasing in prevalence. Cannabis as a public health issue has risen up the political agenda. With an aim to disrupt an illicit industry funding organised crime, Canada began regulating tetrahydrocannabinol (THC) content in July 2018 in an attempt to improve safety and protect the young. Not surprisingly, there are vocal critics and cries for much more research [1].
As healthcare professionals, we deal with tobacco all the time but we also need to know about the respiratory effects of marijuana to be able to advise our patients and colleagues. This brief review aims to summarise what is known and how concerned we should be, particularly with regards to the lungs.
The cannabis genus includes three species: Cannabis sativa, Cannabis indica and Cannabis ruderalis. Each species contains varying concentrations of the two major psychoactive compounds: delta-9-THC and cannabidiol [2]. The concentrations of psychoactive compounds in recreational marijuana also vary over time, with concentrations higher now than they were 50 years ago due to selective breeding. Positive psychoactive effects of cannabis include euphoria and relaxation [3]. However, negative psychological side-effects range from anxiety to psychosis [3]. Commonly available high potency cannabis, dubbed skunk (based on its distinct smell), is associated with a high risk of psychosis due to its high concentration of delta-9-THC [2, 3].
Go to:
Pharmacology
The high number of cannabinoids recognised (perhaps over 90) means that cannabis pharmacology is necessarily complex; and a full discussion is not warranted here.
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