Cannabinoids and the Heart-a psychiatrist's Perspective

Overview

Journal Herz

Specialty Cardiology & Vascular Diseases

Date 2024 Sep 27

PMID 39331072

Authors

Johannes Kramer

Gabi Koller

Oliver Pogarell

Affiliations

Soon will be listed here.

Abstract

The partial legalization of cannabis in Germany in 2024 will affect both medical and recreational use of cannabis. Tetrahydrocannabinol (THC), the main psychoactive component of the cannabis plant, influences heart rate and blood pressure through the endocannabinoid system. Acute and chronic use can pose cardiovascular risks. There is evidence of a link between cannabis use and cardiovascular events such as stroke and myocardial infarction, although studies show conflicting results. The non-psychoactive cannabidiol (CBD) could have anti-inflammatory and antioxidant effects. Smoking cannabis poses additional cardiovascular risks similar to tobacco. Given these risks, cardiologists should routinely ask their patients about possible cannabis use and inform them about the potential cardiovascular dangers. The article also highlights the psychiatric risks of cannabis use, including dependence and psychosis, and emphasizes the need for interdisciplinary collaboration between cardiologists and psychiatrists to effectively manage cannabis-related health problems.

References

Kalant H . Medicinal use of cannabis: history and current status. Pain Res Manag. 2002; 6(2):80-91. DOI: 10.1155/2001/469629. View

Di Marzo V, Piscitelli F . The Endocannabinoid System and its Modulation by Phytocannabinoids. Neurotherapeutics. 2015; 12(4):692-8. PMC: 4604172. DOI: 10.1007/s13311-015-0374-6. View

Pacula R, Powell D, Heaton P, Sevigny E . Assessing the effects of medical marijuana laws on marijuana use: the devil is in the details. J Policy Anal Manage. 2015; 34(1):7-31. PMC: 4315233. DOI: 10.1002/pam.21804. View

Legare C, Raup-Konsavage W, Vrana K . Therapeutic Potential of Cannabis, Cannabidiol, and Cannabinoid-Based Pharmaceuticals. Pharmacology. 2022; 107(3-4):131-149. DOI: 10.1159/000521683. View

Volkow N, Baler R, Compton W, Weiss S . Adverse health effects of marijuana use. N Engl J Med. 2014; 370(23):2219-27. PMC: 4827335. DOI: 10.1056/NEJMra1402309. View

Hasan A, von Keller R, Friemel C, Hall W, Schneider M, Koethe D . Cannabis use and psychosis: a review of reviews. Eur Arch Psychiatry Clin Neurosci. 2019; 270(4):403-412. DOI: 10.1007/s00406-019-01068-z. View

Crean R, Crane N, Mason B . An evidence based review of acute and long-term effects of cannabis use on executive cognitive functions. J Addict Med. 2011; 5(1):1-8. PMC: 3037578. DOI: 10.1097/ADM.0b013e31820c23fa. View

Pacher P, Steffens S, Hasko G, Schindler T, Kunos G . Cardiovascular effects of marijuana and synthetic cannabinoids: the good, the bad, and the ugly. Nat Rev Cardiol. 2017; 15(3):151-166. DOI: 10.1038/nrcardio.2017.130. View

Tashkin D . Effects of marijuana smoking on the lung. Ann Am Thorac Soc. 2013; 10(3):239-47. DOI: 10.1513/AnnalsATS.201212-127FR. View

10.

Daling J, Doody D, Sun X, Trabert B, Weiss N, Chen C . Association of marijuana use and the incidence of testicular germ cell tumors. Cancer. 2009; 115(6):1215-23. PMC: 2759698. DOI: 10.1002/cncr.24159. View

11.

Crume T, Juhl A, Brooks-Russell A, Hall K, Wymore E, Borgelt L . Cannabis Use During the Perinatal Period in a State With Legalized Recreational and Medical Marijuana: The Association Between Maternal Characteristics, Breastfeeding Patterns, and Neonatal Outcomes. J Pediatr. 2018; 197:90-96. DOI: 10.1016/j.jpeds.2018.02.005. View

12.

Orr C, Spechler P, Cao Z, Albaugh M, Chaarani B, Mackey S . Grey Matter Volume Differences Associated with Extremely Low Levels of Cannabis Use in Adolescence. J Neurosci. 2019; 39(10):1817-1827. PMC: 6407302. DOI: 10.1523/JNEUROSCI.3375-17.2018. View

13.

Heinz A, Gul Halil M, Gutwinski S, Beck A, Liu S . [ICD-11: changes in the diagnostic criteria of substance dependence]. Nervenarzt. 2021; 93(1):51-58. PMC: 8763741. DOI: 10.1007/s00115-021-01071-7. View

14.

Gobbi G, Atkin T, Zytynski T, Wang S, Askari S, Boruff J . Association of Cannabis Use in Adolescence and Risk of Depression, Anxiety, and Suicidality in Young Adulthood: A Systematic Review and Meta-analysis. JAMA Psychiatry. 2019; 76(4):426-434. PMC: 6450286. DOI: 10.1001/jamapsychiatry.2018.4500. View

15.

Albaugh M, Ottino-Gonzalez J, Sidwell A, Lepage C, Juliano A, Owens M . Association of Cannabis Use During Adolescence With Neurodevelopment. JAMA Psychiatry. 2021; . PMC: 8209561. DOI: 10.1001/jamapsychiatry.2021.1258. View

16.

Sontate K, Kamaluddin M, Naina Mohamed I, Pakri Mohamed R, Shaikh M, Kamal H . Alcohol, Aggression, and Violence: From Public Health to Neuroscience. Front Psychol. 2022; 12:699726. PMC: 8729263. DOI: 10.3389/fpsyg.2021.699726. View

17.

Peacock A, Leung J, Larney S, Colledge S, Hickman M, Rehm J . Global statistics on alcohol, tobacco and illicit drug use: 2017 status report. Addiction. 2018; 113(10):1905-1926. DOI: 10.1111/add.14234. View

18.

Degenhardt L, Ferrari A, Calabria B, Hall W, Norman R, McGrath J . The global epidemiology and contribution of cannabis use and dependence to the global burden of disease: results from the GBD 2010 study. PLoS One. 2013; 8(10):e76635. PMC: 3811989. DOI: 10.1371/journal.pone.0076635. View

19.

Hall W, Lynskey M . Assessing the public health impacts of legalizing recreational cannabis use: the US experience. World Psychiatry. 2020; 19(2):179-186. PMC: 7215066. DOI: 10.1002/wps.20735. View

20.

Cerda M, Mauro C, Hamilton A, Levy N, Santaella-Tenorio J, Hasin D . Association Between Recreational Marijuana Legalization in the United States and Changes in Marijuana Use and Cannabis Use Disorder From 2008 to 2016. JAMA Psychiatry. 2019; 77(2):165-171. PMC: 6865220. DOI: 10.1001/jamapsychiatry.2019.3254. View