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      Legalización del consumo de cannabis recreativo en adultos y problemas de salud mentales Translated title: Legalization of recreational cannabis use in adults and mental health problems

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          Abstract

          Resumen Los problemas de salud mental hacen parte de las enfermedades no trasmisibles y se les atribuye, con otras enfermedades asociados al bienestar, hasta un 21 % de las muertes mundiales. Por ello, es necesario analizar y establecer la relación riesgo/beneficio de políticas relacionadas con la salud mental, caso de la legalización del consumo de cannabis recreativo en adultos. El cannabis es la droga “ilícita” de mayor consumo en los países occidentales, en esencia por incrementar la sociabilidad y la euforia. En la última década, varios países han promulgado normas orientadas a legalizar la comercialización de cannabis recreativo en adultos. En este sentido, existe controversia del efecto de este tipo de iniciativas, en el porcentaje de personas que consumen esta sustancia y en la salud de los mismos. Sin embargo, se podría esperar que este tipo de iniciativas favorezca un aumento en el porcentaje de personas que consumen esta sustancia. El aumento del consumo de marihuana puede favorecer una mayor prevalencia de problemas de salud mental, incluyendo psicosis y esquizofrenia. Se acepta la existencia de una asociación entre consumo de cannabis y psicosis (incluyendo esquizofrenia). En este marco, reconociendo los beneficios de las políticas de legalización del consumo de cannabis recreativo en adultos, orientadas a superar el enfoque prohibicionista y a buscar la reducción del daño, es conveniente evaluar y definir el efecto de las mismas. Además, estas iniciativas se deben acompañar de programas informativos y educativos, orientados a sintetizar los riesgos del consumo, incluyendo, la dependencia y problemas de salud mentales.

          Translated abstract

          Abstract Mental health problems are included in the non-communicable diseases and together to other problems associated with well-being, they are attributed up to 21 % of global deaths. Therefore, it is necessary to analyze and establish the risk/benefit ratio of policy related to mental health, for example, in the case of the legalization of recreational cannabis use in adults. Cannabis is the most widely used “illicit” drug in Western countries, essentially because it increases sociability and euphoria. In the last decade, several countries have endorsed policies aimed at legalizing the commercialization of recreational cannabis in adults. In this sense, there is controversy about the effect of this type of policy on the percentage of people who consume this substance and on their health. However, it could be expected that this type of initiative will improve the percentage of people who consume this substance. Increased marijuana use may lead to a higher prevalence of mental health problems, including psychosis and schizophrenia. The existence of an association between cannabis use and psychosis (including schizophrenia) is accepted. In this framework, recognizing the benefits of policies to legalize the use of recreational cannabis in adults, advancing from a drug prohibition approach to one focused on harm reduction, it is convenient to evaluate and define the effect of this type of policies. Also, this kind of policies should be linked to informative and educational programs to clarify the risks of consumption, including, dependence and mental health problems.

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          Most cited references33

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          Meta-analysis of the Association Between the Level of Cannabis Use and Risk of Psychosis.

          Cannabis use has been reported to induce long-lasting psychotic disorders and a dose-response relationship has been observed. We performed a systematic review of studies that investigate the association between the degree of cannabis consumption and psychosis and a meta-analysis to quantify the magnitude of effect. Published studies were identified through search of electronic databases, supplemented by manual searches of bibliographies. Studies were considered if they provided data on cannabis consumption prior to the onset of psychosis using a dose criterion (frequency/amount used) and reported psychosis-related outcomes. We performed random effects meta-analysis of individual data points generated with a simulation method from the summary data of the original studies. From 571 references, 18 studies fulfilled inclusion criteria for the systematic review and 10 were inserted in the meta-analysis, enrolling a total of 66 816 individuals. Higher levels of cannabis use were associated with increased risk for psychosis in all the included studies. A logistic regression model gave an OR of 3.90 (95% CI 2.84 to 5.34) for the risk of schizophrenia and other psychosis-related outcomes among the heaviest cannabis users compared to the nonusers. Current evidence shows that high levels of cannabis use increase the risk of psychotic outcomes and confirms a dose-response relationship between the level of use and the risk for psychosis. Although a causal link cannot be unequivocally established, there is sufficient evidence to justify harm reduction prevention programs.
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            Cannabis sativa: A comprehensive ethnopharmacological review of a medicinal plant with a long history

            Cannabis sativa L. (C. sativa) is an annual dioecious plant, which shares its origins with the inception of the first agricultural human societies in Asia. Over the course of time different parts of the plant have been utilized for therapeutic and recreational purposes, for instance, extraction of healing oils from seed, or the use of inflorescences for their psychoactive effects. The key psychoactive constituent in C. sativa is called Δ-9-tetrahydrocannabinol (D9-THC). The endocannabinoid system seems to be phylogenetically ancient, as it was present in the most primitive vertebrates with a neuronal network. N-arachidonoylethanolamine (AEA) and 2-arachidonoyl glycerol (2-AG) are the main endocannabinoids ligands present in the animal kingdom, and the main endocannabinoid receptors are cannabinoid type-1 (CB1) receptor and cannabinoid type-2 (CB2) receptor.
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              What is the prevalence and risk of cannabis use disorders among people who use cannabis? a systematic review and meta-analysis

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                Author and article information

                Journal
                ars
                Ars Pharmaceutica (Internet)
                Ars Pharm
                Universidad de Granada (Granada, Granada, Spain )
                2340-9894
                December 2023
                : 64
                : 4
                : 348-358
                Affiliations
                [2] Andalucía orgnameUniversidad de Granada orgdiv1Grupo de Investigación en Atención Farmacéutica Spain
                [1] Antioquía orgnameUniversidad de Antioquia orgdiv1Facultad de Ciencias Farmacéuticas y Alimentarias orgdiv2Departamento de Farmacia Colombia
                Article
                S2340-98942023000400004 S2340-9894(23)06400400004
                10.30827/ars.v64i4.28681
                627cc6d6-c1ef-42dc-ae96-946503c1dec2

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 19 September 2023
                : 06 July 2023
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 33, Pages: 11
                Product

                SciELO Spain

                Categories
                Artículos Especiales

                Uso de la Marihuana,Cannabis,Marijuana Use,Educación para la salud,Salud mental,Políticas, Planificación y Administración en Salud,Health education,Mental health,Health Policy, Planning and Management

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