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AMERICAN COLLEGE OF PHYSICIANS INTERNAL MEDICINE MEETING

By Stephanie Viguers
Source/Disclosures
Source:

Franson K. Cannabis: Harmful or healing? Presented at: ACP Internal Medicine
Meeting; April 28-30, 2022; Chicago.

Disclosures: Franson reports being a consultant for Teva Pharmaceuticals.

Read next
Mind-body skills intervention may help treat depression in adolescents
Read next
Depression, substance use increasing among former smokers
April 30, 2022
2 min read
Save


‘THERE’S A REAL RISK THERE’: CANNABIS USE EXACERBATES DEPRESSION

By Stephanie Viguers
Source/Disclosures
Source:

Franson K. Cannabis: Harmful or healing? Presented at: ACP Internal Medicine
Meeting; April 28-30, 2022; Chicago.

Disclosures: Franson reports being a consultant for Teva Pharmaceuticals.
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CHICAGO — Cannabis has been approved by state legislators across the United
States for more than 50 medical indications, according to a speaker at the ACP
Internal Medicine Meeting.

Kari L. Franson, PharmD, PhD, BCPP, a professor of clinical pharmacy at the
University of Southern California, said these indications include Alzheimer’s
disease (n = 15 states), epilepsy/seizures (n = 31 states), nausea (n = 20
states), amyotrophic lateral sclerosis (n = 22 states), pain (n = 30 states),
autism (n = 14 states), Parkinson’s disease (n = 15 states), cachexia (n = 24
states), hepatitis C (n = 11 states), peripheral neuropathy (n = 11 states),
cancer (n = 30 states), HIV/AIDS (n = 31 states), PTSD (n = 30 states), Crohn’s
disease (n = 20 states), multiple sclerosis (n = 22 states), Tourette’s syndrome
(n = 7 states) and glaucoma (n = 27 states).

Cannabis has been approved by state legislators across the United States for
more than 50 medical indications, according to a speaker at the ACP Internal
Medicine Meeting. Source: Adobe Stock.

“I’ll tell you right now, [cannabis] doesn’t work for glaucoma,” Franson said
during the presentation. “Isn’t it funny that 27 states have it as something
that it is legal for? So, it’s not evidence based. It’s based on compassion.”

For the most part, Franson said that she only considers recommending medical
cannabis when patients ask about it. Among all the indications, only pediatric
seizures, MS and pain have “reasonable data” to suggest cannabis is beneficial,
she added.

“The evidence for using THC-type cannabis for pain is quite good,” Franson said.

The short-term effects associated with THC-type cannabis include dizziness,
disorientation, euphoria, dry mouth, somnolence, nausea/vomiting, fatigue,
depression and anxiety. Less is known about the long-term effects, Franson said.
But evidence suggests that it can cause cannabinoid hyperemesis syndrome,
stroke, acute myocardial infarction, impaired cognitive functioning and
psychiatric effects such as insomnia, anxiety, cannabis use disorder, psychosis
and depression.

Although recent research has shown that cannabis can reduce depression in the
short term, the symptoms appear to worsen over time. This was demonstrated in a
naturalist study conducted in Canada. Most patients (89%) who reported feeling
stressed, anxious or depressed had a 50% reduction in depression after 20
minutes of cannabis use, and 94% had a 58% reduction in anxiety, according to
Franson. However, baseline symptoms of depression exacerbated gradually.

“This is the thing that I really would love to see imprinted in your brains when
you all walk out of here,” Franson told attendees. “I see a lot of patients who
use cannabis chronically and really struggle with depression. I can’t stress to
you enough how difficult it is to talk to a patient about their depression
symptoms when they’re utilizing cannabis and they are convinced how much it
makes them feel better.”

The risk for depression — and other poor outcomes — is particularly evident in
adolescents, Franson said.

A previous meta-analysis of 11 longitudinal and prospective studies showed that
adolescents who used cannabis were more likely than nonusers to attempt suicide
(OR = 3.46; 95% CI, 1.53-7.84), experience suicidal ideation (OR = 1.5; 95% CI,
1.11-2.03), and develop depression (OR = 1.37; 95% CI, 1.16-1.62) or anxiety (OR
= 1.18; 95% CI, 0.84-1.67).

“There’s a real risk there,” Franson said.

REFERENCES:

Cuttler C, et al. J Affect Disord. 2018;doi:10.1016/j.jad.2018.04.054.

Franson K. Cannabis: Harmful or healing? Presented at: ACP Internal Medicine
Meeting; April 28-30 2022; Chicago.

Read next
Mind-body skills intervention may help treat depression in adolescents
Depression, substance use increasing among former smokers

Gobbi G, et al. JAMA Psychiatry. 2019;doi:10.1001/jamapsychiatry.2018.4500.


READ MORE ABOUT

cannabis
university of southern california
depression
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AMERICAN COLLEGE OF PHYSICIANS INTERNAL MEDICINE MEETING

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