The expansion of the sanctioned use of marijuana for recreational and medical purposes has exploded in recent years and warrants a critical appraisal of the primary care physician’s role in providing advice to and counseling patients.
Understanding the potential reactions that can occur from cannabis and synthetic cannabinoids can help emergency physicians recognize these effects in patients who may present to the emergency department.
A group of investigators posing as pregnant patients called marijuana dispensaries in Colorado to determine whether the stores’ staff recommended it for nausea and vomiting, if there were risks in pregnancy, and if providers should be consulted. The results were enlightening.
In a double-blind study, 120 children and young adults with the Dravet syndrome and medically refractory seizures were assigned randomly to receive either cannabidiol or placebo, as well as their usual antiepileptic drugs/therapies. The primary finding was a significant decrease in convulsive seizure frequency during the 14-week treatment period for patients receiving cannabidiol compared to those receiving placebo.
No associations between cannabis use in young adulthood and strokes later in life were found in multivariable models. An almost doubled risk of ischemic stroke was observed in those with cannabis use > 50 times; this risk was attenuated when adjusted for tobacco usage. Smoking ≥ 20 cigarettes per day was clearly associated both with strokes before 45 years of age and with strokes throughout the follow-up.