Bakgrund: Liberaliseringen av cannabis sker för tillfället på olika områden i världen och är ett väldebatterat ämne. Syftet med denna uppsats är att undersöka vilka potentiella effekter liberaliseringen av cannabis kan ha för bruk av cannabis, bruk av tyngre droger samt kriminalitet.Metod: Studierna som användes i denna uppsats samlades in med hjälp av sökningar i databasen PubMed som anses vara en av de största databaserna för medicinsk– och substansrelaterad forskning. 18 studier inkluderades i litteraturstudiens resultat. 8 studerade hur liberaliseringen påverkade rekreationsbruk och 10 studerade hur legalisering av medicinsk cannabis påverkade bruk av cannabis, bruk av tyngre narkotika och kriminalitet.Resultat: 6 fann att prevalensen för bruk av cannabis ökade efter en liberalisering av cannabis, 8 fann ingen skillnad och 2 fann en minskning av prevalensen. 2 studier fann att bruk av tyngre droger ökade efter en liberalisering av cannabis, 2 fann ingen skillnad och 2 fann en minskning. 2 studier fann att kriminaliteten inte påverkades av liberaliseringen av cannabis och 2 fann att den minskades.Slutsatser: Studierna visar att prevalensen för cannabis troligtvis ökar något eller hålls oförändrat efter en liberalisering. Liberaliseringens påverkan på tyngre droger är oklart då ingen klar majoritet återfanns i resultatet. Studierna tyder även på att kriminalitet antingen / Background: Liberalization of cannabis is a highly debated subject and is happening around the world. The aim of this study is collecting all relevant studies investigating potential effects the liberalization have on prevalence of cannabis, hard drugs and criminality.Methods: The studies were collected by searching in the database PubMed which is the largest database for medical and substance journals. 18 studies were found to have appropriate quality to be presented as a result. 8 studies were conducted regarding liberalization of recreational use of cannabis and 10 were investigating the effects on prevalence from a medical cannabis legislation.Results: 6 studies found an increase of prevalence of cannabis after the liberalization of cannabis, 8 found no difference and 2 found a decrease of prevalence. 2 studies found an increase in prevalence for hard drugs after a liberalization of cannabis, 2 studies found no difference in use and 2 found a decrease of prevalence. Regarding criminality no studies showed an increase of criminality after liberalization of cannabis, 2 studies found no difference and 2 studies found a decrease of prevalence.Conclusions: The studies indicate that there will either be a small increase of prevalence regarding use of cannabis after liberalization or no difference. Unclear evidence regarding hard drugs since no majority in results were found. Criminality seems to either be stable or decrease after a liberalization of cannabis.

Cannabisbruk bland ungdomar är ett internationellt problem, eftersom substansen kan förändra den utvecklande processen I hjärnan hos brukaren. Därav blir målet med denna studie att kasta ljus på vilka faktorer som har en effekt på risken för individer i en utvecklande fas av livet att bruka cannabis sett genom ett svenskt perspektiv. Tobak och dess prevalens är också diskuterat inom denna studie, eftersom det inte är ovanligt att substansen blandas med cannabis eller används kort efter cannabis. Tobak har historiskt sett visats åstadkomma hälsoproblem som en konsekvens av bruk. I studier som relateras till cannabis framträder fyra centrala teorier för att försöka förklara sambandet mellan tobak och cannabis. Dessa teorier kallas Gateway Theory, Reverse Gateway Theory, Route of Administration Theory och till sist Common Liability Theory.  Dessa teorier diskuteras inom denna studie i förhållande till studiens resultat. Denna studie har hämtat sin data från forskningsprogrammet Longitudinal Research on Development in Adolescence (LoRDIA).  Kvantitativ data insamlat från 774 ungdomar i årskurs 9 på högstadiet och i årskurs 2 på gymnasiet har inom denna studie blivit analyserat. Data inom denna studie är analyserad och testad via användningen av bivariata och multivariata analyser. Detta har gjorts för att se vilka av de testade faktorerna har störst påverkanseffekt i relation till ett senare bruk av cannabis. Fynden från denna studie visar, i motsats till vad tidigare forskning visat, att en tidig debutering i alkoholanvändning är den variabel med störst risk att leda till ett senare cannabisbruk. Ungdomar som bor i trångbebodda lägenheter lider också större risk för ett senare cannabisbruk, medans familjens ekonomiska situation har mindre effekt på risken. Denna studie försöker att bredda perspektivet av hur ungdomar är påverkade av deras val och omgivning under deras tonår. Fynden från denna studie föreslår att arbete riktat mot droganvändning bör riktas mer mot ungdomar som debuterar tidigt med alkoholbruk, och mindre mot ungdomar som röker cigaretter. / Cannabis use among adolescents is a worldwide issue, since the substance may alter the developing process of the brain in the user. Hence, the goal of this study is to shed light on which factors influence the risk of using cannabis for individuals in emerging adulthood through a Swedish perspective. Tobacco and its prevalance is also discussed in this study, since its not uncommon that this substance are used together or subsequently used after cannabis or before. Tobacco has historically been proved to cause serious health problems (as a consequence of using). In studies relating to cannabis there are four major theories that are applied to explain the relationship between tobacco and cannabis. These theories are called Gateway Theory, Reverse Gateway Theory, Route of Administration Theory and lastly Common Liability Theory. These theories are discussed in this study in relation to the result (from this study.) This current study has acquired its data from the research program Longitudinal Research on Development in Adolescence (LoRDIA). The quantitative data collected from 774 adolescents in grade 9 in high school and in grade 2 in upper secondary school have been analyzed in this study. The data in this study is analyzed and tested through the use of bivariate and multivariate regression analyzes. This is done to see which of the tested factors that has the most impactful in relation to a later use of cannabis. Findings from this study shows, in opposition to what earlier research has concluded, that an early introduction to alcohol is the most impactful risk factor for later cannabis use. Adolescents who live in overcrowded apartments are also in a greater risk for later cannabis use, while the economic situation of the family has less effect on this risk. This current study attempts to add a wider perspective to how young people are affected by their choices and surroundings in their adolescence. The findings from this study suggests that work regarding drug use in adolescents should be directed more toward early debutants in alcohol use and less towards teenagers who smoke cigarettes.

The popularity of cannabis and reduction of cannabis prohibition in the United States has led to increased consumption in human users. However, relatively little is understood about the abuse potential of cannabis and its main psychoactive ingredient, THC. One reason for the lack of insight into the addictive effects of THC is that the animal models investigating voluntary intake of THC have been hampered by low rates of behavior and THC intake often does not surpass intake of vehicle. We hypothesized that, in addition to supporting operant behavior (smoking, vaping, or consuming edibles) THC might increase the reinforcing effects of non-drug rewards (e.g., playing video games, listening to music, eating snacks). To investigate this hypothesis, we evaluated whether THC injections could increase responding for saccharin (0.2% w/v, SACC) in male and female rats. During our investigation we noted that the pharmacology of THC was complex, with potent motor suppressant effects, and that changes in behavior depended on the pharmacokinetics of THC administration. To further explore the pharmacokinetics, we conducted 3 experiments that manipulated THC dose (Experiment 1), Injection-Test interval (Experiment 2) and Injection-Injection interval (washout duration, Experiment 3). We hypothesized that THC would increase responding for SACC, but that this effect would depend on having a longer time between sessions to reduce motor-suppressing effects of THC accumulation. Male and female rats were shaped to respond for SACC under a progressive ratio (PR) schedule of reinforcement. The PR schedule measures motivation by increasing the response requirement after each reinforcer is earned. In Experiment 1 there was a significant effect of THC dose, with moderate doses (0.3-0.75 mg/kg) increasing motivation for SACC and high doses (3 mg/kg) causing significant motor suppression. In Experiment 2 (Injection-Test interval) we found that the timing of THC injections was critical – enhancing effects were observed soon after THC injections were administered (30-60 min) but after 120 min THC no longer increased motivation for SACC. Finally, in Experiment 3 (Injection-Injection interval) we found that daily injections of THC (24 h washout) resulted in significant decreases in motivation from Session 1 to session 8. In contrast, 72 h washout intervals resulted in stable enhancement of motivation for SACC by THC. These studies indicate that the reinforcement enhancing effects of THC are robust but depend critically on the pharmacokinetics and bioavailability of THC.

The purpose of this paper was to examine how people experience the practice of Cannabis in daily life. The study was based on interviews with five individuals who have experience with cannabis use. They do not represent a bigger population only themselves. We chose these particular individuals because all of them began using cannabis at a young age- everyone before they were twenty. But they have been using cannabis because of different reasons. The results of the interviews were analyzed with the thesis of Howard Becker and the new developed thesis of Hallstone about social control. The thesis explains the pattern of becoming a drug addict and what the steps are. The final results of this study contain answers about how much cannabis they have been using, how often, with whom and with what purpose. We compared these answers to the patterns to see if there was any truth to them and then we explained the function the drug has in their lives. For further explaining we used former researches about cannabis use in different areas of life. In the discussion we try to understand what these answers mean, what the thought behind cannabis use is and if these people really have the control over it.

Termen cannabis används för samtliga droger som framställs ur växten Cannabis sativa, inklusive marijuana. Cannabis är, i flertalet länder, ett narkotikaklassat preparat som är ett återkommande debatt tema. Debatterna angående cannabis styrs främst utav en legalisering gällande cannabisbruk, vilket lett till att flera länder runt om i världen inlett en legaliseringsprocess av detta bruk. Cannabis är den mest brukade drogen i västvärlden trots att den generellt anses har en skadlig påverkan på individer. Denna uppsats avser att genom en litteraturstudie undersöka om det finns något samband mellan cannabisbruk och brottslighet, ett annat syfte är att undersöka hur starkt ett eventuellt samband är. Till denna uppsats har den sociala inlärningsteorin använts som teoretisk förankring. Sammanfattningsvis visar resultaten i denna uppsats att bruk av cannabis har ett samband med brottslighet men att en exakt styrka på detta samband är svårt att utläsa. Frekventa cannabisbrukare har dock ett starkt samband med brottslighet, jämfört med individer som brukar cannabis mindre frekvent. Det behövs mer kunskap gällande sambandet mellan cannabisbruk och brottslighet, inte minst angående riktningen på detta samband / The term cannabis is used for all drugs produced from the plant Cannabis sativa, including marijuana. Cannabis is, in most countries, a narcotic preparation and is a recurring debate theme. The debates regarding cannabis are primarily out of a legalization regarding cannabis use, which led to that several countries around the world launched a legalization process of this use. Cannabis is the most widely used drug in the Western world, although it is generally considered to have an adverse impact on individuals. This paper intends to use a literature review to exam whether there is any association between cannabis use and crime. Another purpose is to exam the strength of a possible relationship. In this paper, the social learning theory has been used as a theoretical foundation. In summary, the results in this paper show that the use of cannabis is associated with crime, but the exact strength of this relationship is difficult to determine. However, frequent cannabis users do have a strong association with crime, compared with individuals who use cannabis less frequently. More knowledge is needed regarding the relationship between cannabis use and crime, particularly regarding the direction of this relationship.

Background: Cannabis has been legalized in Canada since October 2018 and shown to be effective for chemotherapy-induced nausea (CIN). Purpose: Guided by the Ottawa Model of Research use, the aim was to determine factors influencing oncology nurses discussing cannabis use with patients experiencing CIN. Part I: A literature review to identify oncology nurses’ practices, knowledge, and attitude toward providing guidance on cannabis use for patients with CIN. Twelve articles were included. Results showed that health care professionals were hesitant to provide guidance for patients on using cannabis for medical purposes. But no studies specifically focus on nurses and CIN. Part II: A descriptive, cross-sectional study was conducted using survey methods. Twenty-five Canadian oncology nurses responded to the survey. Half (n=11) correctly answered the knowledge question about the effectiveness of cannabis. Most (n=18) did not feel confident providing guidance on use of cannabis for CIN. The top three barriers identified are social stigma, lack of knowledge, and lack of support in the workplace. Conclusion: Few Canadian oncology nurses discuss cannabis use for CIN. Identified barriers need to be addressed for oncology nurses to be prepared to discuss use of cannabis for CIN.

Hippocampal neurogenesis is linked to the onset, progression and remission of major mood disorder such as anxiety and depression. Neurogenesis is the process by which new neurons are formed in the brain. Mitochondria mediate cellular adaption and provide energy to support growth of new neurons. Chronic stress and mood disorders have been associated with impairments in mitochondrial function and neuronal growth. Individuals experiencing stress and mood disorders reportedly use cannabis as a means to self-medicate. The impacts of cannabis on stress-related effects on hippocampal neurogenesis and mitochondria are vastly unexplored. To investigate these effects we generated an in vitro model of hippocampal neuron stress by treating HT22 cells with corticosterone, the major effector molecule of stress in rodents. We first characterized the impacts of corticosterone on markers of neurogenesis and mitochondrial function in HT22 hippocampal cells. We found that corticosterone decreased gene markers of neurogenesis, mitochondrial biogenesis, content, dynamics and decreased mitochondrial membrane potential. Corticosterone also decreased levels of antioxidant enzymes but did not alter levels of reactive oxygen species (ROS) or elicit lipid peroxidation. We then investigated with potential impacts of cannabis components, delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD), on corticosterone-induced stress. Individually, THC and CBD decreased markers of neurogenesis, dysregulated mitochondrial dynamics and decreased mitochondrial membrane potential. Interestingly, both THC and CBD increased a marker of mitochondrial biogenesis. Finally, we co-treated HT22 cells with corticosterone and THC or CBD to interrogate the impacts of THC and CBD on corticosterone-induced alterations. Our results indicated THC and CBD had no effect on corticosterone-related reductions in neurogenesis markers or mitochondrial membrane potential. However, THC demonstrated a rescuing effect on a marker of mitochondrial biogenesis and CBD normalized a marker of mitochondrial fission; both of which were decreased with individual corticosterone treatments. This thesis ultimately identifies some of the pathways THC and CBD may impact stress response in relation to neurogenesis and mitochondria. / Thesis / Master of Science (MSc) / Neurogenesis is a process that describes the production of new nerve cells in the brain. It mainly occurs during early life, but persists in a central brain structure responsible for learning and memory, known as the hippocampus, throughout our lives. This active brain structure relies on the function of certain organelles called mitochondria, which are the primary cellular energy producers and promote nerve cell production. Mood disorders, such as anxiety and depression, may result as a consequence of impaired hippocampal neurogenesis. Evidently, people suffering from anxiety and depression turn to cannabis use for management and treatment of their mood disorders. Considering cannabis has been shown to affect neurogenesis and mitochondrial function, our primary objective was to explore its effects on hippocampal neurogenesis by focusing on mitochondrial function, in the context of stress. We demonstrate that components found in cannabis, delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD), alter the stress-induced changes in mitochondrial functions related to neurogenesis, suggesting that cannabis may play a role in protecting nerve cells.

Accessible in vitro models recapitulating the human airway that are amenable to study whole cannabis smoke exposure are needed for immunological and toxicological studies that inform public health policy as well as medicinal and recreational cannabis use. In the present study, we developed and validated a novel three-dimensional (3D)-printed in vitro exposure system (IVES) that can be directly applied to study the effect of cannabis smoke exposure on primary human bronchial epithelial cells (HBECs). Using commercially available design software and a 3D printer, we designed a four-chamber Transwell insert holder for exposures to whole smoke. COMSOL Multiphysics software was used to model gas distribution, concentration gradients, velocity profile, and shear stress within IVES. Following simulations, primary HBECs cultured at the air–liquid interface on Transwell inserts were exposed to whole cannabis smoke using a modified version of the Foltin puff procedure. Following 24 h, outcome measurements included cell morphology, epithelial barrier function, lactate dehydrogenase (LDH) levels, cytokine expression and gene expression. HBECs exposed to cannabis smoke using IVES showed changes in cell morphology and disruption of barrier function without significant cytotoxicity. Cannabis smoke elevated interleukin-1 (IL-1) family cytokines and elevated CYP1A1 and CYP1B1 expression relative to control. These findings validate IVES to have an effect in HBECs at a molecular level following cannabis smoke exposure. In addition, HBECs stimulated with a viral mimetic, Poly I:C, challenge following cannabis smoke exposure showed a suppression of key antiviral cytokines. The growing legalization of cannabis on a global scale must be paired with research related to potential health impacts on lung exposures. IVES represents an accessible, open-source, exposure system that can be used to model varying types of cannabis smoke exposures with HBECs grown under air–liquid interface culture conditions. / Thesis / Master of Science (MSc) / Despite its recent legalization in Canada, cannabis smoke has been understudied and a lack of evidence exists to inform legislative policies, medicinal and recreational usage. Due to a lack of relevant ways to study cannabis smoke in a lab setting, it is difficult to accumulate literature around its impacts in the lungs. Here, we addressed this gap by engineering and validating a novel model to expose lung cultures to cannabis smoke. In addition, we investigated its impact on the immune response. Our findings suggest exposure to cannabis smoke alters the immune functions of these cells. We also found that in response to a viral mimetic stimulus, cell cultures pre-exposed to cannabis smoke exhibited impaired immune responses. Our novel model to expose cell cultures to cannabis smoke creates a foundation for future researchers to investigate environmental insults, such as cannabis smoke, in the context of respiratory health and infectious disease.

Background: Cannabis is increasingly used for management of chronic pain; however, the benefits and harms of this therapy remain uncertain. We conducted a systematic review to inform harms associated with inhaled cannabis for chronic pain. Methods: We searched MEDLINE, EMBASE, PsychInfo, and Web of Science for non-randomized studies reporting on harms associated with inhaled cannabis use, from inception to October 6, 2021. We used random-effects models for meta-analyses and assessed the certainty of evidence using the GRADE approach. Results: We identified 29 eligible studies enrolling 174,562 participants that reported 145 adverse events. Moderate certainty evidence suggests inhaled cannabis use is probably associated with dry mouth (prevalence: 56%; 95%CI 49 to 64), thirst (prevalence: 44%; 95% CI 33 to 55), fatigue (prevalence: 38%; 95%CI 31 to 45), nausea (prevalence: 17%; 95%CI 8 to 27), increased appetite (prevalence: 13%; 95%CI 9 to 18), dizziness (prevalence: 10%; 95%CI 6 to 14), diarrhea (prevalence: 9%; 95%CI 3 to 18), confusion (prevalence: 9%; 95%CI 5 to 13), mood changes (prevalence: 8%; 95%CI 4 to 15), hallucinations (prevalence: 7%; 95%CI 4 to 10), amnesia (prevalence: 6%; 95%CI 3 to 11), impaired coordination (prevalence: 5%; 95%CI 4 to 6), and disorientation (prevalence: 3%; 95%CI 1 to 7). Moderate certainty evidence shows that, compared to non-users, inhaling cannabis is probably associated with increased risk of shortness of breath (risk difference [RD]: 7%; 95%CI 4 to 10). Conclusions: Our review found moderate certainty evidence that dry mouth, thirst, and fatigue are probably frequently experienced with inhaled cannabis use. Several other adverse events are also probable associated with inhaled cannabis use but were less common. Rigorously conducted cohort studies are needed to inform harms associated with inhaled medical cannabis for chronic pain. / Thesis / Master of Science (MSc) / Increasing recognition of harms associated with long-term opioid therapy for management of chronic pain has generated enthusiasm for alternatives, including medical cannabis which is often consumed through inhalation. This review assesses the harms associated with the use of inhaled cannabis for management of chronic pain. Among serious adverse events, we found that inhaled cannabis is likely associated with amnesia, disorientation, impaired coordination, hallucinations, confusion, dizziness, chronic wheeze, and shortness of breath. Inhaled cannabis may be associated with palpitations, paranoia, anxiety, and cannabis dependence. The effects of inhaled cannabis on lung cancer, depression, and psychosis were uncertain. Among less serious adverse events, we found that inhaled cannabis is likely associated with thirst, fatigue, increased appetite, nausea, mood changes, diarrhea, and dry mouth. Inhaled cannabis may be associated with red eyes, vomiting, phlegm, asthma, and cough. The effects of inhaled cannabis on euphoria and irritability were uncertain.

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