LITERATURE REVIEW 1

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Literature Review: The Effect of Marijuana or Cannabis on Mental Health (The Side – Effects and Medical Benefits) “Should it be legalized in the society?”

Literature Review: The Effect of Marijuana or Cannabis on Mental Health (The Side – Effects and Medical Benefits) “Should it be legalized in the society?”

Search Strategy

Data Sources:

The electronic databases including MEDLINE, LILACS, CINAHL, PubMed, Cochrane, Google Scholar, WHOLIS and Web of Science systematically explored for researching the data related to pattern of Cannabis/Marijuana abuse among the addicted individuals and the adverse influence of these drugs on the mental health of the affected patients. The research articles within a tenure of 6 years (i.e. 2008 – 2016) explored in the context of analyzing the side effects and medical benefits of Cannabis/Marijuana and the scope of its legalization across the community environment.

Search Keywords:

The primary search terms that attribute to “cannabis use”, “marijuana use” and “Cannabis/Marijuana Mental Health” utilized for retrieving the desired information regarding the subject of study. The secondary search terms including “cannabis medical benefits”, “marijuana medical benefits”, “Cannabis Side Effects” and “Marijuana Side Effects” employed for evaluating the medical advantages as well as detrimental effects of Marijuana/Cannabis on the addicted-individuals. The search term “Legalization of Cannabis/Marijuana” utilized for exploring the probability of prospective legalization of Marijuana/Cannabis across the society.

Inclusion/Exclusion Criteria

  • Articles emphasizing the clinical manifestations of cannabis and marijuana among the addicted patients were shortlisted for their evaluation through the research methodology.

  • The articles that highlighted the attribution of cannabis and marijuana in terms of the elevation of risk of substance abuse disorders considered for their exploration across the electronic databases.

  • The primary and secondary articles presenting the quantitative as well as qualitative research interventions (including questionnaires and interview sessions) considered for evaluating the influence of cannabis and marijuana on the mental health pattern of the patient population.

  • The research studies emphasizing the medical advantages of marijuana and cannabis and the ways to legalize them across the community environment considered while exploring the significant information regarding cannabis and marijuana.

  • The research studies associated with elevated confounding factors, biased results and ethical violations were summary excluded from the search strategy.

Flow – Chart

(n=25650+)

The records explored through the selected databases and related to the patterns of cannabis/marijuana abuse, effectiveness of cannabis/marijuana on mental health and medical benefits of cannabis/marijuana and scope of their legalization

(n=15240) & (1250)

Records explored with the effective utilization of Google Scholar and references

Health advancement and Health promotion - literature reviewHealth advancement and Health promotion - literature review 1

Records evaluated while considering the inclusion criteria (n=1005) & (564)

Health advancement and Health promotion - literature review 2

Retrieval of records after the exclusion of duplicates (n=111) & (74)

Excluded articles with complete text and including the review studies and case reports on the implications of cannabis/marijuana use across the community environment (n=56) & (n=12)

Health advancement and Health promotion - literature review 3

Health advancement and Health promotion - literature review 4

(12 review analysis, 11 cross-sectional studies and 3 experimental studies for identifying the outcomes of cannabis/marijuana use among the individuals

Research studies requiring their inclusion in the analysis

Evidence on the Subject

  • Evidence-based research literature advocates the pattern of reciprocal relationship between the utilization of cannabis and decline in the cognitive abilities of individuals (Fernández-Artamendi, Fernández-Hermida, Secades-Villa, & García-Portilla, 2011).

  • The utilization of cannabis is the leading cause of substance abuse disorders across the community environment (Blanco, et al., 2016).

  • Cannabis consumption predominantly predisposes the addicted individuals in terms of the development of schizophrenia and psychosis (Shrivastava, Johnston, Terpstra, & Bureau, 2014). The findings of various longitudinal studies evidently indicate the adverse influence of prenatal exposure of cannabis on the mental, behavioral as well as psychosocial development of the growing children (Shrivastava, Johnston, Terpstra, & Bureau, 2014).

  • Research analysis by (Shrivastava, Johnston, & Tsuang, 2011) indicates the influence of marijuana abuse on individuals who remain genetically vulnerable to the development of psychosis and cognitive decline. The patients with a history of psychosocial disorders and behavioral complications experience the high risk of developing the psychotic manifestations after the consistent utilization of cannabis. However, the pattern of reciprocal relationship between the utilization of cannabis and the development of white matter abnormalities in the brain is not yet confirmed through the findings of the research studies.

  • The findings of the non-experimental research studies confirm the dose-related outcomes of cannabis administration in terms of the development of hallucinations, confusion, excitement, illusions, depersonalization, paranoid ideation and restlessness among the affected individuals (Radhakrishnan, Wilkinson, & D’Souza, 2014).

  • The research findings by (Filbey, et al., 2014) indicate the pattern of neuroadaptive manifestations of long – term cannabis uses among the addicted individuals. Neural complications of marijuana abuse related to the binding of its psychoactive component on the cannabinoid receptors of human brain. This binding pattern leads to the development of neuronal damage that adversely influences the behavioral patterns and brain functionality of the affected patients.

  • The pattern of elevated intoxication of cannabis among schoolchildren leads to the deterioration of their academic performance and development of suicidal ideation across the community environment (Anonymous, 2011). The consistent use of cannabis also leads to the development of psychotic decompensation and depressive episodes among the addicted individuals.

  • The pathophysiological manifestations of the chronic cannabis abuse attribute to the development of cardiovascular symptoms, hypertension, respiratory complications, elevated appetite, dry mouth and conjunctival redness among the affected patients (Sharma, Murthy, & Bharath, 2012).

  • Evidence-based research literature describes cannabis use as the causative factor for the development of bipolar disorder among the addicted individuals (Khan & Akella, 2009). The case study presented by (Khan & Akella, 2009) reveals the adverse influence of ∆9-THC component of cannabis for tenure of 30 days on the mental functioning of the addicted individuals. The cannabis addicts might also experience the development of antisocial traits and grandiosity after the prolonged administration of cannabis across the community environment.

  • The research findings by (Schoeler & Bhattacharyya, 2013) do not substantiate the dose dependent development of psychotic disorders among the individuals affected with cannabis abuse pattern. Indeed, the regular administration of cannabis leads to the development of tolerance against the clinical complications across the patient population. The ingredients of cannabis plant initiate the pattern of neuromodulator deterioration leading to the acute decline in learning abilities of the affected individuals.

  • The findings in the evidence-based research literature advocate the therapeutic efficacy of cannabis in treating the clinical manifestations like depression, pain, sleep disorders, asthma and spasm (Grotenhermen & Müller-Vahl, 2012). The presence of cannabinoid (CB1) receptors across the peripheral system facilitates the elevation of psychotropic effect of cannabis among the treated patients. Cannabis also exhibits the anti-inflammatory, neuroprotective and antiemetic properties that possess the potential of controlling episodes of vomiting and neuropathologic manifestations among the cancer patients (Grotenhermen & Müller-Vahl, 2012).

  • Regulatory as well as legislative complications do not allow the legalization of marijuana administration to the eligible subjects in relation to its medicinal benefits (Marcoux, Larrat, & Larrat, 2013). Physicians require considering various legal parameters as well as risks while prescribing marijuana to the patient population for acquiring the desirable goal oriented clinical outcomes. However, the legalization of cannabis use in the society warrants the elimination of legal ambiguities and the effective configuration of necessary conventions for eliminating the scope of inappropriate utilization of this drug by individuals across the community environment.

  • The scope of legalization of cannabis in society is influenced by the pattern of its socio-political approval and medical benefits for treating various debilitating conditions (Rubens, 2014).

Evidence-Based Conclusions

  • Community environment affected with the inappropriate utilization of marijuana, thereby leading to the development of the pattern of substance abuse and associated psychosocial complications.

  • Regular consumers of marijuana remain highly predisposed towards the development of schizophrenia and other disorders of mental development.

  • Cannabis addiction influences cognitive abilities and intelligent quotient of the patient population.

  • Schoolchildren experience severe mental conditions under the influence of marijuana abuse.

  • Cannabis administration influences the cannabinoid receptors in human brain and disrupts the neurophysiological adaptability of the affected individuals.

  • Cannabis offers several medical benefits requiring scientific validation in the context of exploring its scope of legalization across the community environment.

  • The consideration of evidence-based parameters, rather than socio-political context is necessarily warranted in advocating the legal administration of cannabis to the eligible subjects.

Study Objectives in the Context of Evidence

  • The evaluation of the extent of mental deterioration following the administration of cannabis required to track the extent of development of neuropathological manifestations among the addicted patients.

  • The identification of intensity of neuroadaptive manifestations in relation to the short-term administration of cannabis among the treated patients required for determining the frequency of these adverse effects of marijuana.

  • The exploration of the relationship of marijuana dosage with the development of psychotic manifestations necessarily required for determining a safe dose of this drug for public awareness.

  • The consideration of scientific evidence for legalizing the administration of marijuana necessarily warranted in the context of systematizing the potential pharmacotherapeutic benefits of this drug for the patient population.

  • The organization of educational campaigns and awareness sessions for minimizing the inappropriate use of marijuana in the society warranted in the context of reducing the burden of associated psychosocial manifestations across the community environment.

  • Cannabis addiction among schoolchildren is a serious community problem requiring attention and consideration of the clinicians, nurses, scientists and other healthcare professionals for reducing the scope of its establishment and progression in the society.

  • Regulatory guidelines and legislative conventions regarding marijuana use require earnest reconsideration by the regulatory bodies as well as governmental agencies for optimizing the administration of this drug to the eligible patients in the context of accomplishing the desirable clinical goals and treatment outcomes.

  • Research professionals and clinicians require restructuring the definition of marijuana-abuse while understanding its clinical efficacy and undertake evidence-based strategies for ceasing inappropriate utilization of this drug across the community environment.

Prospective Research

  • The organization of prospective research studies necessarily warranted in the context of determining the definitive pattern of relationship between the administration of cannabis and development of psychosocial disorders among the affected individuals.

  • Quantitative studies on the evaluation of the true pharmacological potential of cannabis require execution for the benefit of the human subjects.

  • The statistical analysis of the epidemiology of marijuana abuse needed to identify and evaluate the quantity of healthcare resources requiring deployment in reducing the burden of cannabis abuse from the society.

  • Unauthorized cannabis use by the people of various age groups is a potential health issue that requires serious debates across the research community and governmental agencies in effectively re-configuring the conventions and legislative protocols for the evidence-based utilization of this drug by the eligible subjects.

References

Anonymous. (2011). Adverse effects of cannabis. Prescrire International, 20(112), 18-23. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/21462790

Blanco, C., Hasin, D. S., Wall, M. M., Flórez-Salamanca, L., Hoertel, N., Wang, S., . . . Olfson, M. (2016). Cannabis Use and Risk of Psychiatric Disorders: Prospective Evidence From a US National Longitudinal Study. JAMA Psychiatry, 388-395. doi:10.1001/jamapsychiatry.2015.3229

Fernández-Artamendi, S., Fernández-Hermida, J. R., Secades-Villa, R., & García-Portilla, P. (2011). Cannabis and mental health. Actas Espanolas De Psiquiatria, 39(3), 180-190. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/21560079

Filbey, F. M., Aslan, S., Calhoun, V. D., Spence, J. S., Damaraju, E., Caprihan, A., & Segallc, J. (2014). Long-term effects of marijuana use on the brain. PNAS, 111(47), 16913–16918. doi:10.1073/pnas.1415297111

Grotenhermen, F., & Müller-Vahl, K. (2012). The Therapeutic Potential of Cannabis and Cannabinoids. Deutsches Arzteblatt International, 109(29-30), 495–501. doi:10.3238/arztebl.2012.0495

Khan, M. A., & Akella, S. (2009). Cannabis-Induced Bipolar Disorder with Psychotic Features. Psychiatry, 6(12), 44-48. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2811144/

Marcoux, R. M., Larrat, E. P., & Larrat, F. R. (2013). Medical Marijuana and Related Legal Aspects. Pharmacy and Therapeutics, 38(10), 615-619. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3875249/

Radhakrishnan, R., Wilkinson, S. T., & D’Souza, D. C. (2014). Gone to Pot – A Review of the Association between Cannabis and Psychosis. Frontiers in Psychiatry. doi:10.3389/fpsyt.2014.00054

Rubens, M. (2014). Political and medical views on medical marijuana and its future. Social Work in Public Health, 29(2), 121-131. doi:10.1080/19371918.2013.821351

Schoeler, T., & Bhattacharyya, S. (2013). The effect of cannabis use on memory function: an update. Substance Abuse and Rehabilitation, 11-27. doi:10.2147/SAR.S25869

Sharma, P., Murthy, P., & Bharath, M. M. (2012). Chemistry, Metabolism, and Toxicology of Cannabis: Clinical Implications. Iranian Journal of Psychiatry, 7(4), 149-456. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3570572/

Shrivastava, A., Johnston, M., & Tsuang, M. (2011). Cannabis use and cognitive dysfunction. Indian Journal of Psychiatry, 53(3), 187-191. doi:10.4103/0019-5545.86796

Shrivastava, A., Johnston, M., Terpstra, K., & Bureau, Y. (2014). Cannabis and psychosis: Neurobiology. Indian Journal of Psychiatry, 56(1), 8-16. doi:10.4103/0019-5545.124708