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International Journal of Mental Health and Addiction
Published in: International Journal of Mental Health and Addiction 5/2021

01-10-2021 | Opioids | Original Article

A Scoping Review of the Use of Cannabis and Its Extracts as Potential Harm Reduction Strategies: Insights from Preclinical and Clinical Research

Authors: James Siklos-Whillans, Alia Bacchus, Laurie A. Manwell

Published in: International Journal of Mental Health and Addiction | Issue 5/2021

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Abstract

Cannabis as a harm reduction strategy (HRS) is supported by evidence demonstrating its efficacy for pain relief and as a substitution for alcohol, illicit drugs, and pharmaceuticals. Animal models show cannabinoids reduce the effects of opiate withdrawal, which contribute to drug-seeking behavior. This scoping review assessed cannabis and its extracts as HRS while identifying critical gaps in preclinical and clinical research. Halas et al.'s (British Medical Journal Open, 5, e006643, 2015) five-stage scoping review methodology was used focusing primarily on “harm reduction” and “harm reduction strategies” related to “cannabis” or “marijuana” and its derivatives “THC” and “cannabidiol.” Across 33 countries, 57 articles were identified demonstrating that cannabinoids (i) enhance opioid analgesia while reducing tolerance and dependence, (ii) interrupt dependence on cocaine, alcohol, and nicotine, and (iii) can be vaporized or eaten to reduce harms associated with smoking. Critical gaps in research include (i) discrepancies due to species and route of administration differences and (ii) the legal status of cannabis. Future research on HRS should examine access to cannabis and its extracts, the effects of varying cannabinoid concentrations, limiting selection bias by recruiting more authorized medicinal and recreational cannabis users, and the various methods cannabis is consumed in humans and animal models of drug dependence.
Footnotes
1
For example, whereas some physicians are opposed or reluctant to prescribe medical cannabis, others actively and publicly promote it (Nussbaum et al. 2011). Legal gray areas also create “backdoor” legal access through memberships in medical cannabis dispensaries. For example, in Vancouver, one can typically obtain a membership in less than an hour and in one case just 65 s (Hager 2014; Kelley 2015). There are also many illegal dispensaries around Canada and online that do not require any membership at all and customers with a valid ID can purchase legal and illegal cannabis products within seconds. Individuals who may be more likely to access cannabis through such dispensaries may also be those in which medical cannabis is contraindicated or with substance use disorders (Kahan and Srivastava 2014).
 
2
There is also a growing field of research on cannabis and exercise that could also help uncover how cannabis impacts motivation, obesity, wellbeing, and mental and physical health (Fuss et al. 2015; Gillman et al. 2015; Le Strat and Le Foll 2011; Lorente et al. 2005; Muguruza et al. 2019; Renaud and Cormier 1986; York-Williams et al. 2019). More research on cannabis and motor vehicle incidents/impairment is also required as there is conflicting evidence (Brands et al. 2019; Drummer et al. 2003; Ramaekers et al. 2004, 2009).
 
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Metadata
Title
A Scoping Review of the Use of Cannabis and Its Extracts as Potential Harm Reduction Strategies: Insights from Preclinical and Clinical Research
Authors
James Siklos-Whillans
Alia Bacchus
Laurie A. Manwell
Publication date
01-10-2021
Publisher
Springer US
Published in
International Journal of Mental Health and Addiction / Issue 5/2021
Print ISSN: 1557-1874
Electronic ISSN: 1557-1882
DOI
https://doi.org/10.1007/s11469-020-00244-w

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Psychology Student Attitudes and Beliefs Toward Cannabis for Mental Health Purposes: a Cross National Comparison