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Recent legalization of cannabis use: effects on sleep, health, and workplace safety

Authors Bowles NP , Herzig MX , Shea SA 

Received 21 September 2017

Accepted for publication 22 September 2017

Published 19 October 2017 Volume 2017:9 Pages 249—251

DOI https://doi.org/10.2147/NSS.S152231

Checked for plagiarism Yes



Nicole P Bowles, Maya X Herzig, Steven A Shea

Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, OR, USA

The recent legalization of cannabis for medical and recreational use in many states in the United States and internationally4,5 has resulted in a decrease in stigma and of perceived risk of cannabis use, more frequent use of cannabis, use of higher potency cannabis products, and increased dependence on cannabis use.6–8 Cannabis sativa and its derivatives are often used for improved sleep and relaxation; characteristics originally attributed to Indian hemp in the nineteenth century.1–3 Cannabis alters the sleep–wake cycle, increases the production of melatonin, and can inhibit the arousal system by activating cannabinoid type 1 (CB1) receptors in the basal forebrain and other wakepromoting centers.9–12 Investigations have shown that the major psychoactive compound in cannabis, Δ9-tetrahydrocannabinol (THC), can decrease sleep onset latency in naïve users or at low doses in experienced users (eg, 70 mg/day); however, higher doses in experienced users increased sleep latency and wake after sleep onset.9,13,14 Indeed, frequent cannabis users (≥5 uses/week for 3 months and lifetime use ≥2 years) are reported to have shorter total sleep duration, less slow wave sleep, worse sleep efficiency, and longer sleep onset compared to controls.15 The contrasting benefits of THC exposure may represent the biphasic influence of THC on CB1 receptors whereby acute use causes more activation of CB1 receptors and tendency toward sleep, but long-term use results in desensitization of the CB1 receptor and decreased downstream signaling.



Disclosure

The authors report no conflicts of interest in this work.

References

1.

Mechoulam R, Gaoni Y. A total synthesis of Dl-Delta-1-tetrahydrocannabinol, the active constituent of hashish. J Am Chem Soc. 1965;87: 3273–3275.

2.

Walsh Z, Callaway R, Belle-Isle L, et al. Cannabis for therapeutic purposes: patient characteristics, access, and reasons for use. Int J Drug Policy. 2013;24(6):511–516.

3.

Nunberg H, Kilmer B, Pacula RL, Burgdorf J. An analysis of applicants presenting to a medical marijuana specialty practice in California. J Drug Policy Anal. 2011;4(1):1.

4.

Goldsmith RS, Targino MC, Fanciullo GJ, et al. Medical marijuana in the workplace: challenges and management options for occupational physicians. J Occup Environ Med. 2015;57(5):518–525.

5.

Kilmer B, Pacula RL. Understanding and learning from the diversification of cannabis supply laws. Addiction. 2017;112(7):1128–1135.

6.

Kosterman R, Bailey JA, Guttmannova K, et al. Marijuana legalization and parents’ attitudes, use, and parenting in Washington State. J Adolesc Health. 2016;59(4):450–456.

7.

Schuermeyer J, Salomonsen-Sautel S, Price RK, et al. Temporal trends in marijuana attitudes, availability and use in Colorado compared to non-medical marijuana states: 2003–11. Drug Alcohol Depend. 2014;140:145–155.

8.

Cerdá M, Wall M, Keyes KM, Galea S, Hasin D. Medical marijuana laws in 50 states: investigating the relationship between state legalization of medical marijuana and marijuana use, abuse and dependence. Drug Alcohol Depend. 2012;120(1):22–27.

9.

Nicholson AN, Turner C, Stone BM, Robson PJ. Effect of Delta-9-tetrahydrocannabinol and cannabidiol on nocturnal sleep and early-morning behavior in young adults. J Clin Psychopharmacol. 2004;24(3):305–313.

10.

Lissoni P, Resentini M, Mauri R, et al. Effects of tetrahydrocannabinol on melatonin secretion in man. Horm Metab Res. 1986;18(1):77–78.

11.

Murillo-Rodriguez E, Blanco-Centurion C, Sanchez C, Piomelli D, Shiromani PJ. Anandamide enhances extracellular levels of adenosine and induces sleep: an in vivo microdialysis study. Sleep. 2003;26(8):943–947.

12.

Murillo-Rodriguez E, Millán-Aldaco D, Palomero-Rivero M, Mechoulam R, Drucker-Colín R. Cannabidiol, a constituent of Cannabis sativa, modulates sleep in rats. FEBS Lett. 2006;580(18):4337–4345.

13.

Tassinari CA, Ambrosetto G, Peraita-Adrado MR, Gastuat H. The neuropsychiatric syndrome of δ9-tetrahydrocannabinol and cannabis intoxication in naive subjects. Marihuana Med. 1999:649–664.

14.

Feinberg I, Jones R, Walker J, Cavness C, Floyd T. Effects of marijuana extract and tetrahydrocannabinol on electroencephalographic sleep patterns. Clin Pharmacol Ther. 1976;19(6):782–794.

15.

Bolla KI, Lesage SR, Gamaldo CE, et al. Sleep disturbance in heavy marijuana users. Sleep. 2008;31(6):901–908.

16.

Smart R, Caulkins JP, Kilmer B, Davenport S, Midgette G. Variation in cannabis potency and prices in a newly legal market: evidence from 30 million cannabis sales in Washington state. Addiction. Epub 2017 May 27.

17.

ElSohly MA, Mehmedic Z, Foster S, Gon C, Chandra S, Church JC. Changes in cannabis potency over the last 2 decades (1995–2014): analysis of current data in the United States. Biol Psychiatry. 2016;79(7):613–619.

18.

Ware MA, Wang T, Shapiro S, et al. Smoked cannabis for chronic neuropathic pain: a randomized controlled trial. CMAJ. 2010;182(14): E694–E701.

19.

Newmeyer MN, Swortwood MJ, Taylor ME, Abulseoud OA, Woodward TH, Huestis MA. Evaluation of divided attention psychophysical task performance and effects on pupil sizes following smoked, vaporized and oral cannabis administration. J Appl Toxicol. 2017;37(8):922–932.

20.

Monti JM. Hypnoticlike effects of cannabidiol in the rat. Psychopharmacology (Berl). 1977;55(3):263–265.

21.

Borodovsky JT, Crosier BS, Lee DC, Sargent JD, Budney AJ. Smoking, vaping, eating: Is legalization impacting the way people use cannabis? Int J Drug Policy. 2016;36:141–147.

22.

Daniulaityte R, Lamy FR, Barratt M, et al. Characterizing marijuana concentrate users: a web-based survey. Drug Alcohol Depend. 2017;178:399–407.

23.

Lankenau SE, Fedorova EV, Reed M, Schrager SM, Iverson E, Wong CF. Marijuana practices and patterns of use among young adult medical marijuana patients and non-patient marijuana users. Drug Alcohol Depend. 2017;170:181–188.

24.

Borgelt LM, Franson KL, Nussbaum AM, Wang GS. The pharmacologic and clinical effects of medical cannabis. Pharmacotherapy. 2013;33(2):195–209.

25.

Grotenhermen F. Pharmacokinetics and pharmacodynamics of cannabinoids. Clin Pharmacokinet. 2003;42(4):327–360.

26.

Bachhuber MA, Saloner B, Cunningham CO, Barry CL. Medical cannabis laws and opioid analgesic overdose mortality in the United States, 1999-2010. JAMA Intern Med. 2014;174(10):1668–1673.

27.

Haroutounian S, Ratz Y, Ginosar Y, et al. The effect of medicinal cannabis on pain and quality-of-life outcomes in chronic pain: a prospective open-label study. Clin J Pain. 2016;32(12):1036–1043.

28.

Perron BE, Bohnert K, Perone AK, Bonn-Miller MO, Ilgen M. Use of prescription pain medications among medical cannabis patients: comparisons of pain levels, functioning, and patterns of alcohol and other drug use. J Stud Alcohol Drugs. 2015;76(3):406–413.

29.

Center for Behavioral Health Statistics and Quality. Results from the 2015 National Survey on Drug Use and Health: Detailed Tables; 2016. Available from: http://www.samhsa.gov/data/. Accessed September 5 2017.

30.

Frone MR. Prevalence and distribution of illicit drug use in the workforce and in the workplace: findings and implications from a U.S. National survey. J Appl Psychol. 2006;91(4):856–869.

31.

Macdonald S, Hall W, Roman P, Stockwell T, Coghlan M, Nesvaag S. Testing for cannabis in the work-place: a review of the evidence. Addiction. 2010;105(3):408–416.

32.

Stringham C, Allard I, Knapp S, Minor M. Medical marijuana in the work place: keeping small business informed. Small Bus Inst J. 2017;13(1):16–29.

33.

Canadian Centre for Occupational Health and Safety. Workplace Strategies: Risk of Impairment from Cannabis. Ottawa: Canadian Centre for Occupational Health and Safety; 2017.

34.

Keith DR, Gunderson EW, Haney M, Foltin RW, Hart CL. Smoked marijuana attenuates performance and mood disruptions during simulated night shift work. Drug Alcohol Depend. 2017;178:534–543.

35.

Cavazos-Rehg PA, Krauss MJ, Sowles SJ, Zewdie K, Bierut L. Operating a motor vehicle after marijuana use: perspectives from people who use high potency marijuana. Subst Abus. 2017:1–6.

36.

Pollini RA, Romano E, Johnson MB, Lacey JH. The impact of marijuana decriminalization on California drivers. Drug Alcohol Depend. 2015;150:135–140.

37.

Aydelotte JD, Brown LH, Luftman KM, et al. Crash fatality rates after recreational marijuana legalization in Washington and Colorado. Am J Public Health. 2017;107(8):1329–1331.

38.

Rogeberg O, Elvik R. The effects of cannabis intoxication on motor vehicle collision revisited and revised. Addiction. 2016;111(8):1348–1359.

39.

Price JW. Marijuana and workplace safety: an examination of urine drug tests. J Addict Dis. 2014;33(1):24–27.

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