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Deficient Functioning of Frontostriatal Circuits During the Resolution of Cognitive Conflict in Cannabis-Using Youth

Author/s: 
Cyr, M., Tau, G.Z., Fontaine, M., Levin, F.R., Marsh, R.

Abstract

OBJECTIVE:

Disturbances in self-regulatory control are involved in the initiation and maintenance of addiction, including cannabis use disorder. In adults, long-term cannabis use is associated with disturbances in frontostriatal circuits during tasks that require the engagement of self-regulatory control, including the resolution of cognitive conflict. Understudied are the behavioral and neural correlates of these processes earlier in the course of cannabis use disentangled from effects of long-term use. The present study investigated the functioning of frontostriatal circuits during the resolution of cognitive conflict in cannabis-using youth.

METHOD:

Functional magnetic resonance imaging data were acquired from 28 cannabis-using youth and 32 age-matched healthy participants during the performance of a Simon task. General linear modeling was used to compare patterns of brain activation during correct responses to conflict stimuli across groups. Psychophysiologic interaction analyses were used to examine conflict-related frontostriatalconnectivity across groups. Associations of frontostriatal activation and connectivity with cannabis use measures were explored.

RESULTS:

Decreased conflict-related activity was detected in cannabis-using versus healthy control youth in frontostriatal regions, including the ventromedial prefrontal cortex, striatum, pallidum, and thalamus. Frontostriatal connectivity did not differ across groups, but negative connectivity between the ventromedial prefrontal cortex and striatum was detected in the 2 groups.

CONCLUSION:

These findings are consistent with previous reports of cannabis-associated disturbances in frontostriatal circuits in adults and point to the specific influence of cannabis on neurodevelopmental changes in youth. Future studies should examine whether frontostriatalfunctioning is a reliable marker of cannabis use disorder severity and a potential target for circuit-based interventions.

Copyright © 2018 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved

Keywords 
cannabis use frontostriatal circuits functional magnetic resonance imaging resolution of cognitive conflict youth

Does CBD Actually Work?

Author/s: 
Avins, Jenni

Perhaps you’ve heard a lot of people are using CBD.

The chemical compound, naturally occurring in cannabis plants, doesn’t get you high, but does have a wide swath of other purported effects making it very popular. Although clinical studies haven’t necessarily proven those results, many Americans are testing CBD (which stands for “cannabidiol”) for themselves. All over the US, people are rubbing CBD balm onto aching joints, dropping CBD tinctures under tired tongues, popping CBD gummies, and puffing on CBD oil-filled vaporizers in hopes of chilling out.

On Quartz’s behalf, Harris Poll recently surveyed more than 2,000 people in the US about their experience, knowledge, and opinions regarding CBD and found that more than 85% of Americans have heard of CBD, and of those, more than one in five have tried it.

Keywords 
CBD cannabis cannabidiol

Medical Marijuana Overview: Patient Care Considerations for all Primary Care Physicians

Author/s: 
Douglas, Chad

Objectives:

  • Recognize the difference between recommending and prescribing medication in regard to medical marijuana
  • Summarize components of the Oklahoma Medical Marijuana Rules and Regulations in regard to patient licensing and physician recommendations
  • Recognize that marijuana is still a Schedule I Controlled Dangerous Substance at the Federal level
  • Differentiate the pharmacology and toxicology of the cannabinoids THC and cannabidiol
  • Recognize potential drug-drug interactions of medical marijuana
  • Implement appropriate counseling of patients who are considering or currently using medical marijuana
Keywords 
marijuana medical marijuana

Lack of evidence for cannabis in adults with chronic neuropathic pain

Author/s: 
McAvoy, Brian R.

Bottom Line:

There was no high-quality evidence for the efficacy of any CBM (herbal cannabis, plant-derived tetrahydrocannabinol (THC) (dronabinol), synthetic THC (nabilone), plant-derived THC/cannabidiol (CBD) com bination) in any condition with chronic neuropathic pain. The studies were two to 26 weeks long and compared an oromucosal spray with a plant-derived combination of THC and CBD (10 studies), a synthetic cannabinoid mimicking THC (nabilone) (two studies), inhaled herbal cannabis (two studies) and plant-derived THC (dronabinol) (two studies) against placebo (15 studies) and an analgesic (dihydrocodeine) (one study). Herbal cannabis was not different from placebo in reducing pain and the number of people who dropped out due to side effects. Some adverse events (particularly somnolence or sedation, confusion, psychosis) might limit the clinical usefulness of cannabis-based medicines.

Keywords 
medical marijuana cannabis neuralgia neuropathic pain cannabidiol

Don't Get Burned! Legal Issues Associated with Medical Marijuana

Author/s: 
Loomis, Cori H.

In Conclusion

  • Evaluate carefully whether recommending medical marijuana is something you want to do and the risks and requirements associated with it.
  • Prepare and use appropriate informed consent forms and treatment agreements.
  • Notify your medical liability insurance carrier.
  • Check with your employer or facilities at which you have privleges.
Keywords 
cannabis medical marijuana legal issues

Oklahoma Medical Marijuana Authority: The Nuts & Bolts Physicians Need to Provide a Recommendation

Author/s: 
Heater, Buffy

Overview

  • Provide a brief history and the current status of the program
  • Provide an overview of the regulatory framework regarding physicians
  • Described the physician recommendation and patient application processes
  • Questions and Answers
Keywords 
cannabis medical marijuana
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