Type 2 diabetes mellitus results from a combination of insulin resistance and impaired insulin secretion. The aim of this study is to investigate the effect of endogenous and exogenous cannabinoids on insulin resistant cell lines, viz skeletal muscle (C2C12) and fat (3T3-L1), and to investigate the effects of these cannabinoids on insulin secretion in pancreatic β-cells (INS 1). Insulin resistance was induced in the cells using 20 ng/mL TNF-α (3T3-L1) and 100 nM insulin (C2C12). Insulin resistant cells were exposed to cannabinoids for 48 hours after which glucose uptake, RT-PCR and Western blot analysis was performed. Additionally, adipokine assays were performed on the 3T3-L1 cells. The insulin resistant 3T3-L1 and C2C12 cells had reduced glucose uptake, decreased IRS-1 and Glut-4 expression indicative of an insulin resistant state. The extract and THC significantly enhanced glucose uptake, IRS-1 and Glut-4 in 3T3-L1 and C2C12 cells. The extract and THC thus have the potential to be an insulin sensitizing agent. Interleukin-6 was significantly decreased by THC. INS 1 cells, cultured under normoglycemic conditions, were exposed to cannabinoids for 48 hours after which glucose-stimulated insulin secretion, radioimmunoassay, oxygen consumption, RT-PCR and Western blot analysis was performed. Insulin stimulatory index was not significantly affected after cannabinoid exposure, except by THC. The cannabinoids decreased insulin content, in a concentration dependent manner, but the inhibition mechanism remains elusive. The cannabinoid Treated cells showed insulin gene expression levels similar to the control, while only THC proved effective in significantly stimulating Glut-2 gene expression. Oxygen consumption studies showed levels lower than the control cells. Most of the cannabinoids inhibited insulin secretion under normoglycemia except THC, while the cannabinoids exhibited the potential to improve insulin resistant adipocyte and myocytes response to glucose and gene regulation.

Therapeutic benefits of medicinal cannabis are well documented in the treatment of a variety of medical conditions. There is not, however, a nationally consistent delivery system, which has prevented many patients from realizing these benefits. Using policy feedback theory as the foundation, the purpose of this general qualitative study was to better understand how state-level regulatory efforts in medicinal cannabis may provide guidance on formulating national public policies that are beneficial to patients. This study compared 3 core tenets of NORML, an authority in the cannabis industry, against the policies of 3 states with exemplary state medical cannabis programs. The tenets included access to whole-plant cannabis, wide latitude for doctors to decide treatment regimens, and the right to cultivation for personal use. Data collected from publicly available documents such as legislative archives, state government websites, cannabis coalition groups, and media coverage of medicinal cannabis legislation were deductively coded and subjected to a cross-case analysis procedure. Findings indicated a lack of full alignment with NORML's core tenets as well as significant gaps between research on the efficacy of medical cannabis and the regulatory systems governing delivery within the states. Future policy makers may consider these results in devising nationwide legislation to research and recognize the medicinal use of cannabis, thus addressing the identified need for a uniform delivery system in the US for patients in need of cannabis for medical purposes. This study may contribute to positive social change through recommendations to federal legislators for creating a national government model for patient access to medicinal cannabis.

PhD, Faculty of Health Sciences, University of the Witwatersrand / Substance use is associated with mining accidents, increased health care utilisation, and economic loss. Although South Africa is a major mining country, paucity of data exists on substance use among mineworkers. To determine the prevalence of alcohol and cannabis use among mineworkers, the prevalence of accidents associated with substance use, and factors influencing substance use among this population, structured interviews of 1571 participants (involving breathalyser tests for alcohol and urine tests for cannabis), focus group discussions, and a record review of post-accident substance tests were carried out in seven mines. While structured interviews were carried out between March & October 2002, focus group discussions were carried out between May & June 2003, and record review was done between March & September 2004. Between 10.7% to 24.4% of participants across study mines, with a mean of 15.3%, are likely to be dependent on alcohol, while 4.6% to 21.5% of participants, with a mean of 9.1%, use cannabis. Between 0% and 5.9% of all breath samples, with a mean of 1.9%, contained alcohol ≥ 0.10mg/1000ml of breath, the legal limit for professional drivers. However, the majority of positive samples were collected on a Monday and day of sample collection was found to be a confounding factor. In mine P1 in 2003, 1% of samples tested in cases of accidents were positive for alcohol, and in 2002 and 2003, cannabis tests were positive in 4.9% and 3.9% of accident cases tested, respectively. v Low levels of education (p=0.020), low job categories (p=0.004) and lack of awareness of link between cannabis use and accidents (p=0.0001) were found to be positively associated with cannabis use. Being a full-time worker compared to a contract worker (p=0.004) was protective from cannabis use. While being married (p=0.001) was protective from alcohol use, there was no significant difference in the alcohol and cannabis use status of those who were married and lived with their wives at the mines and those who didn‟t live with their wives but visited them periodically. Findings of this study where alcohol use for fun (p=0.046) and relaxation (p=0.018) were associated with alcohol dependence, and where misconceptions about the energy-boosting attribute of cannabis, and perception that work is „most-times to always dangerous‟ (p=0.012) were associated with cannabis use and alcohol dependence, suggest the use of substances as a coping mechanism and highlight the link between social factors and substance use. Industry regulations employing a holistic approach and incorporating essential components, such as clear written individual mine policy, health promotion, monitoring and surveillance, Employee Assistance Programmes, disciplinary procedures and wellness programmes, can contribute towards substance use control among this population.

Cannabis is widely used for recreational and medicinal purposes. Inhalation of cannabis smoke is the predominant method of drug consumption, exposing the lungs to THC and CBD, as well as a plethora of toxic combustion products. Clinical observations suggest that cannabis smoking contributes to the development of respiratory symptoms and may play a role in the pathogenesis of inflammatory lung disease. However, the association between cannabis smoke, dysregulated pulmonary immunity, and the development of lung disease is inconclusive. To improve our understanding of this relationship, we developed novel mouse models to investigate the effect of cannabis smoke exposure on lung immunity. Using compositionally relevant cannabis strains, we established a mouse model of cannabis smoke exposure and validated that it delivers cannabis smoke by measuring cannabis smoke-associated metabolites in the blood. In our initial lung immune characterization, we demonstrated that acute cannabis smoke exposure induces modest changes to innate immune cellularity in the airways and lung tissue. Specifically, lung macrophage subpopulations were proportionally altered following smoke exposure. As well, we demonstrated that lung disease-associated mediators, including MDC, TARC, and VEGF, were dysregulated in cannabis smoke-exposed lung tissue. In addition to our initial characterization, we established a first-of-its-kind concurrent cannabis smoke exposure and influenza infection model. Using this model, we demonstrated that cannabis smoke exposure exacerbates weight loss following influenza infection. These increases in weight loss corresponded with dysregulated cellular responses and immune mediator expression. Cell types involved in early innate immune signaling, such as macrophages and dendritic cells, were significantly affected by concurrent exposure and infection. Additionally, anti-viral mediators. including IFNγ, IP-10, RANTES, and TNFα, were decreased in cannabis smoke-exposed, infected lung tissue. Collectively, we defined two novel models of cannabis smoke exposure that can be leveraged in future investigations on the inflammatory effects and associated health outcomes of cannabis smoke. / Thesis / Master of Science (MSc) / Cannabis is widely used for recreational and medical purposes. Smoking is the most popular method to consume the drug among users. However, little is understood about the effects of cannabis smoke on lung health, despite evidence suggesting that it may lead to negative health outcomes. To address this gap in knowledge, we developed two unique mouse models of cannabis smoke exposure. Using these models, we explored the effects of cannabis smoke on lung immune responses in healthy and influenza infected mice. Our findings suggested that lung immunity is altered following cannabis smoke exposure. Additionally, we found that overall health was worsened during influenza infection in cannabis smoke-exposed mice. This effect was associated with weakened viral immunity in the lungs. The models we developed and the findings using it thus far create the foundation for future studies on cannabis smoke and lung health.

Titre de l'écran-titre (visionné le 12 janvier 2024) / Cette étude aborde des aspects essentiels du Cannabis (Cannabis sativa L.), une plante historiquement significative et culturellement importante pour l'humain. La culture du Cannabis a été confrontée à des défis considérables en raison de décennies de prohibition et de production clandestine, entraînant un manque de connaissances et de pratiques établies dans cette industrie. Cette étude visait à libérer le plein potentiel de cette plante en exploitant sa diversité importante et en caractérisant un germoplasme fondateur pour mettre les bases d'un programme d'amélioration génétique chez le Cannabis. D'une part, nous avons exploré l'important débat taxonomique du genre Cannabis, suggérant que le genre Cannabis est en réalité composé d'une espèce monotypique hautement diversifiée. Ensuite, nous avons caractérisé un panel diversifié de 176 lignées de Cannabis représentant le marché légal canadien, où une riche diversité phénotypique a été observée au sein de traits agronomiques, morphologiques et biochimiques. Une méthode optimale de germination dans un essai en serre a été déterminé comme étant le semis direct (SD). Cette étude a mis en évidence une diversité remarquable parmi les 176 lignées de Cannabis analysées. L'analyse des traits agronomiques essentiels tels que le temps de maturation sexuelle (dtsm), le temps d'atteinte aux premières fleurs (dtf), le temps de maturation à partir du semis/bouturage (dtmp) et la biomasse fraîche (fb) a révélé des variations significatives. De plus, les traits morphologiques clés tels que l'index de croissance de hauteur (gih), l'index de croissance des entre-nœuds (giinl) et le nombre de nœuds à la récolte (nodeNH) ont également montré des différences notables. Il a été constaté que les traits giinl, dtsm, dtf et dtmp influencent de manière significative le potentiel en cannabinoïdes. Enfin, la source et l'origine des plantes ont eu un impact majeur sur les phénotypes de différents traits clés, suggérant que la sélection précise de ces facteurs joue un rôle crucial dans la définition du phénotype. Cette étude souligne l'importance de comprendre la diversité du Cannabis pour propulser sa culture de l'avant sur le marché légal. / This study addresses a crucial aspect of Cannabis (Cannabis sativa L.) phenotypic diversity, a historically significant and culturally important plant. The cultivation of Cannabis has faced considerable challenges due to decades of prohibition and clandestine production, resulting in a lack of established knowledge and practices within this industry. This study aimed to unlock the full potential of this plant by harnessing its significant diversity and characterizing foundational germplasm to establish the basis for a genetic improvement program in Cannabis. On one hand, we delved into the pivotal taxonomic debate surrounding the Cannabis genus, suggesting that it is actually comprised of a highly diverse monotypic species. Subsequently, we characterized a diverse panel of 176 Cannabis accessions representing the Canadian legal market, where rich phenotypic diversity was observed across agronomic, morphological, and biochemical traits. An optimal germination method for greenhouse cultivation was determined as the direct sowing approach. This study highlighted remarkable diversity among the 176 Cannabis accessions that were analyzed. Analysis of important agronomic traits such as days to sexual maturity (dtsm), days to first flower (dtf), days to maturity from planting/cutting (dtmp), and fresh biomass (fb) unveiled significant variation. Moreover, key morphological traits including growth index of height (gih), growth index of inter-node (giinl), and node count at harvest (nodeNH) also exhibited notable differences. Traits giinl, dtsm, dtf, and dtmp were found to significantly influence cannabinoid profile. Finally, the source and origin of plants had a major impact on phenotypic value of various key traits, suggesting that precise selection of these factors plays a crucial role in defining the phenotype. This study underscores the importance of understanding Cannabis diversity to propel its cultivation forward in the legal market.

The purpose of this thesis is to examine the nature of the relationships that exist between women and their use of cannabis. Currently, women’s use of cannabis is legally permitted within a federal, medical system of access; however, cannabis’ consumption outside of that framework is categorized as a criminal act. As a result, women are subjected to differing forms of cannabis stigmatization and surveillance across many socio-political contexts, often resultant in women’s losses of power and position. As Canada prepares to enact a legal cannabis framework, it is crucial that society and institutions understand the relationships which women have developed through cannabis use. Otherwise, the legalization of cannabis use will not -- in and of itself -- alleviate the systemic forms of stigmatization and oppression which continue to impact the lives of certain women because of their use of cannabis. A review of existing literature demonstrated that there is limited research which discusses the nature of women’s use of cannabis outside of a medical context. Using postmodern feminist and intersectional analysis, I conducted qualitative, semi-structured interviews with six women to gain insights into their experiences of using cannabis. Contrary to the medical and/or criminal cannabis discourse, the women’s stories reveal examples of unique and overlapping instances of cannabis use which differed from the traditional cannabis dichotomy. The findings of the women’s interviews create an alternative cannabis discourse, in which women’s use of cannabis is experienced as a fluid, multi-functional act with effects that satisfy experiences differently across diverse iv contexts, which extends our existing knowledge base. In relation to existing social work policies and practices, the finding implications are discussed. Ultimately, the thesis identifies opportunities for collaboration between social work and women, many of which could serve to disrupt the perpetuation of women’s stigmatization and surveillance in a legal cannabis framework. / Thesis / Master of Social Work (MSW)

Doctorat en Sciences de la santé publique / info:eu-repo/semantics/nonPublished

This thesis is an anthropological exploration of the first legal Canadian Grow Cup (3 years after legalization (October 17, 2018)). It takes a sensory anthropology approach to 'knowing' from practical activity. This approach acknowledges that senses/sensing do not belong to one category, instead, "our sensory perception is inextricable from the cultural categories that we use to give meaning to sensory experiences in social and material interactions" (Pink 2015, 7). Taking this approach aims to address the current legal framework that reduces cannabis to its molecular compounds. The methodological approach is centred around an apprenticeship with an experienced home grower, whom I met online and who agreed to guide me throughout my participation in the grow cup. The organization of the thesis follows my movements through the apprenticeship situated both online and in my mentor's garden in West Ottawa, Ontario. Having to abide by winning criteria based on THC and Terpene metrics, this thesis offers arguments and critique of the current conjoint legal/ public health/ industry framework. The latter framework is in line with mainstream pharmacology, which advocates the need to use purified substances as they are considered more specific and safe. However, I critique this approach of 'knowing' cannabis through the cannabis cup as the "effects" and quality of whole derived cannabis products are quantified and standardized based on a percentage number associated with two out of 100+ molecular compounds. This creates a new phenomenon, shaping cultivation practices focused on single molecule percentage numbers. Therefore, I ask how does a skilled home grower know/sense cannabis, and how does the contest criteria constrain (or not) the home grower's ways of knowing/ sensing cannabis? Answering these questions aims to understand the sensorial ways of knowing cannabis. As such, this thesis does not deal with standardization or metrics directly. Instead, attention is oriented towards what escapes the contest-winning criteria and standardization, my curiosity resting in ways of 'knowing' directly from what is evoked through practical activity.

The purpose of this study was to investigate whether cannabis use can affect cognitive functions. The method that was chosen to answer the purpose of the study was a general literature review. Article search occurred in the databases PsycINFO and PubMed. Nine articles were selected based on the study’s inclusion criteria. These studies was then analysed to see that they matched the criterias that were selected in the study regarding study quality. The results show that cannabis use can affect cognitive functions. Though it is not certainly established that the use of cannabis always leads to a negative impact on cognitive functions, two of the nine included studies showed that this was not the case. It was possible to see that cannabis use can lead to a change in activity in regions of the brain that are associated with cognitive function. Seven out of nine studies showed that cannabis use leads to a negative impact on cognitive functions, particularly in the form of memory impairment.

Cannabis social clubs (CSCs) in Spain are non-profit organizations that associate cannabis users. According to the Spanish criminal law drug consumption itself, as well as possession of a drug, is not considered a crime but rather an administrative offence. Yet, social club activities could possibly lower the health risk of cannabis among its users, mainly because they are avoiding the black market and they can control the drug quality as well as the amount of drug intake relating to the fixed consumption limit (Barriuso, 2005; Barriuso, 2011). The aim of the research conducted for this thesis was to reveal how Spanish CSCs function on daily basis from their members'perspective and how the cannabis cultivation and distribution is carried out. Although this is an explorative research, in addition it could indicate the possible weaknesses and strengths of this model as well as possible risks and benefits for its members. The open explorative qualitative study design was used. For data gathering qualitative data was chosen in a semi-structured focus group method (Miovský, 2006; Morgan 2001). One of the important joint activities of the social club members is cultivation of cannabis plants and sparing of the harvest just for their own consumption. As such, it's members can avoid the black market and...