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Pages 1-24

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From page 1...
... reported using cannabis in the past 30 days, and between 2002 and 2015 the percentage of past month cannabis users in this age range has steadily increased (CBHSQ, 2016)
From page 2...
... In conducting its work, the committee will conduct a comprehensive review of the evidence, using accepted approaches of literature search, evidence review, grading, and synthesis. Studies reviewed regarding health risks should be as broad as possible, including but not limited to epidemiology and clinical studies, and toxicology and animal studies when determined appropriate by the committee.
From page 3...
... The sponsors of this report include federal, state, philanthropic, and nongovernmental organizations, including the Alaska Mental Health Trust Authority; Arizona Department of Health Services; California Department of Public Health; CDC Foundation; Centers for Disease Control and Prevention (CDC) ; The Colorado Health Foundation; Mat-Su Health Foundation; National Highway Traffic Safety Administration; National Institutes of Health/National Cancer Institute; National Institutes of Health/National Institute on Drug Abuse; Oregon Health Authority; the Robert W
From page 4...
... In the end, the committee considered more than 10,700 abstracts for their relevance to this report. Given the large scientific literature on cannabis, the breadth of the statement of task, and the time constraints of the study, the committee developed an approach that resulted in giving primacy to recently published systematic reviews (since 2011)
From page 5...
... The committee's conclusions are based on the findings from the most recently published systematic review and all relevant fairand good-quality primary research published after the systematic review. Where no systematic review existed, the committee reviewed all relevant primary research published between January 1, 1999, and August 1, 2016.
From page 6...
... It is of note that several of the prioritized health endpoints discussed in Part III are also reviewed in Part II, albeit from the perspective of effects associated with using cannabis for primarily recreational, as opposed to therapeutic, purposes. Several health endpoints are discussed in multiple chapters of the report (e.g., cancer, schizophrenia)
From page 7...
... For other health effects: There is strong evidence from randomized controlled trials to support or refute a statistical association between cannabis or cannabinoid use and the health endpoint of interest. For this level of evidence, there are many supportive findings from good-quality studies with no credible opposing findings.
From page 8...
... NO OR INSUFFICIENT EVIDENCE TO SUPPORT THE ASSOCIATION For therapeutic effects: There is no or insufficient evidence to support the conclusion that cannabis or cannabinoids are an effective or ineffective treatment for the health endpoint of interest. For other health effects: There is no or insufficient evidence to support or re fute a statistical association between cannabis or cannabinoid use and the health endpoint of interest.
From page 9...
... The committee has put forth a substantial number of research conclusions on the health effects of cannabis and cannabinoids. Based on their research conclusions, the committee members formulated four recommendations to address research gaps, improve research quality, improve surveillance capacity, and address research barriers.
From page 10...
... • Characterize the health effects of cannabis on unstudied and understudied health endpoints, such as epilepsy in pediatric pop ulations; symptoms of posttraumatic stress disorder; childhood and adult cancers; cannabis-related overdoses and poisonings; and other high-priority health endpoints. Health Policy and Health Economics Research • Identify models, including existing state cannabis policy models, for sustainable funding of national, state, and local public health surveillance systems.
From page 11...
... , the Cen ters for Disease Control and Prevention, the Substance Abuse and Mental Health Services Administration, the Association of State and Territorial Health Officials, National Association of County and City Health Officials, the Association of Public Health Laboratories, and state and local public health depart ments should fund and support improvements to federal pub lic health surveillance systems and state-based public health surveillance efforts. Potential efforts should include, but need not be limited to: • The development of question banks on the beneficial and harm ful health effects of therapeutic and recreational cannabis use and their incorporation into major public health surveys, including the National Health and Nutrition Examination Survey, National Health Interview Survey, Behavioral Risk Factor Surveillance System, National Survey on Drug Use and Health, Youth Risk Behavior Surveillance System, National Vital Statistics System, Medical Expenditure Panel Survey, and the National Survey of Family Growth.
From page 12...
... Committee objec tives should include, but need not be limited to: • Proposing strategies for expanding access to research-grade mari juana, through the creation and approval of new facilities for growing and storing cannabis. • Identifying nontraditional funding sources and mechanisms to support a comprehensive national cannabis research agenda.
From page 13...
... (4-17) • Improving symptoms of posttraumatic stress disorder (nabi lone; a single, small fair-quality trial)
From page 14...
... There is limited evidence that cannabis or cannabinoids are ineffective for: • Improving symptoms associated with dementia (cannabi noids)
From page 15...
... There is no evidence to support or refute a statistical association between chronic effects of cannabis use and: • The increased risk of acute myocardial infarction (6-1b)
From page 16...
... There is limited evidence of a statistical association between cannabis smoking and: • An increased risk of developing chronic obstructive pul monary disease (COPD) when controlled for tobacco use (occasional cannabis smoking)
From page 17...
... There is moderate evidence of a statistical association between cannabis use and: • Increased risk of overdose injuries, including respiratory distress, among pediatric populations in U.S. states where cannabis is legal (9-4b)
From page 18...
... (10-3) There is insufficient evidence to support or refute a statistical association between maternal cannabis smoking and: • Later outcomes in the offspring (e.g., sudden infant death syndrome, cognition/academic achievement, and later sub stance use)
From page 19...
... among individuals with psychotic disorders (12-2c) There is limited evidence of a statistical association between cannabis use and: • An increase in positive symptoms of schizophrenia (e.g., hallucinations)
From page 20...
... • Initiating cannabis use at an earlier age is a risk factor for the development of problem cannabis use (13-2j) There is substantial evidence of a statistical association between: • Increases in cannabis use frequency and the progression to developing problem cannabis use (13-1)
From page 21...
... There is limited evidence that: • Childhood anxiety and childhood depression are risk factors for the development of problem cannabis use (13-2a) Chapter 14 Conclusions -- Cannaabis Use and the Abuse of Other Substances There is moderate evidence of a statistical association between cannabis use and: • The development of substance dependence and/or a sub stance abuse disorder for substances, including alcohol, tobacco, and other illicit drugs (14-3)
From page 22...
... • A diverse network of funders is needed to support cannabis and cannabinoid research that explores the beneficial and harmful health effects of cannabis use (15-3) • To develop conclusive evidence for the effects of cannabis use on short- and long-term health outcomes, improvements and standardization in research methodology (including those used in controlled trials and observational studies)
From page 23...
... Part I Introduction and Background


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