Resumo em Inglês:

Abstract Introduction Cannabis is probably the most commonly used illicit drug. It is often regarded as a relatively nonharmful experience, even though evidence indicates otherwise. Legalization of non-medical cannabis, which has already taken place in several countries, is currently a controversial issue. Objective To provide an up-to-date overview of current models and policies and their outcomes that can inform future political decisions regarding non-medical cannabis use. Methods PubMed/MEDLINE and Google Scholar scientific databases were searched for articles written in English, Spanish, and Portuguese published between 1990 and December 2020. The reference lists of these articles were similarly used as bibliography sources. Gray literature was also included. Results While non-medical cannabis has been decriminalized in many countries, it has only been legalized in Uruguay, Canada, and some U.S. states. Several benefits of legalization were identified: decreases in cannabis-related crimes, law-enforcement and judicial costs; reduction in synthetic cannabis supply; decline in black economies and possible diminution of other illegal drug buying; and tax revenue increases. Reported legalization problems included: increases in cannabis use; cannabis-related disorders; and cannabis-related accidents and hospitalizations. Harm-reduction strategies are available in the scientific literature. Conclusion Growing, although incomplete, evidence exists to guide policy makers, minimize cannabis-related harm, and positively contribute to public health, if the legalization path is to be followed. Dialogue between legislators and science should be encouraged. There are more than a few legalization pathways, with diverse economic, social and health wellbeing effects. Public health-driven, instead of profit-driven models, seem to offer the most benefits regarding non-medical cannabis legalization. Most of the true public health effects of cannabis legalization are still unknown, for we are still in the early stages of these policies and their implications. Future studies should address the medium-to-long-term social, economic, and health consequences of legalization policies.

Resumo em Inglês:

Abstract Introduction Varying public views on cannabis use across countries may explain the variation in the prevalence of use, policies, and research in individual countries, and global regulation of cannabis. This paper aims to describe the current state of cannabis use, policies, and research across sixteen countries. Methods PubMed and Google Scholar were searched for studies published from 2010 to 2020. Searches were conducted using the relevant country of interest as a search term (e.g., “Iran”), as well as relevant predefined keywords such as “cannabis,” “marijuana,” “hashish,” “bhang “dual diagnosis,” “use,” “addiction,” “prevalence,” “co-morbidity,” “substance use disorder,” “legalization” or “policy” (in English and non-English languages). These keywords were used in multiple combinations to create the search string for studies’ titles and abstracts. Official websites of respective governments and international organizations were also searched in English and non-English languages (using countries national languages) to identify the current state of cannabis use, policies, and research in each of those countries. Results The main findings were inconsistent and heterogeneous reporting of cannabis use, variation in policies (e.g., legalization), and variation in intervention strategies across the countries reviewed. European countries dominate the cannabis research output indexed on PubMed, in contrast to Asian countries (Thailand, Malaysia, India, Iran, and Nepal). Conclusions Although global cannabis regulation is ongoing, the existing heterogeneities across countries in terms of policies and epidemiology can increase the burden of cannabis use disorders disproportionately and unpredictably. There is an urgent need to develop global strategies to address these cross-country barriers to improve early detection, prevention, and interventions for cannabis use and related disorders.

Resumo em Inglês:

Abstract Objectives To evaluate the relationship between age at onset of cannabis use and cannabis abuse in a sample of Portuguese cannabis users, testing the mediating role of the number of friends using cannabis and comparing these relationships between male and female subsets. Method A sample of 529 Portuguese cannabis users comprising 276 males and 244 females aged from 14 to 21 years completed a sociodemographic questionnaire, the Cannabis Abuse Screening Test (CAST), and answered four questions related to cannabis use. Data were analyzed using the PROCESS macro in SPSS version 26.0. Results Age at onset of cannabis use was negatively related to the number of friends using cannabis, while the number of friends using cannabis had a positive relationship with cannabis abuse. As predicted, the number of friends using cannabis seems to have a mediating role in the relationship between cannabis onset age use and cannabis abuse, since the indirect effect was found to be significant. The pattern of the relationships among the variables observed was found to be similar for both male and female subsets of the sample. However, males reported higher cannabis abuse than females. Conclusion The results highlight the mediating role of friends’ use of cannabis in the relationship between age at onset of cannabis use and users’ abuse. These results highlight the importance of early intervention in cannabis use. In particular, the pattern of the relationships observed among the studied variables emphasizes the need to monitor and conduct peer training interventions or interventions to promote of social skills.

Resumo em Inglês:

Abstract Introduction Substance use disorder consists of the presence of cognitive, behavioral, and physiological symptoms, indicating continuous use of one or more substances by the individual. The literature points to the existence of a relationship between impulsive behavior, in which individuals tend to act thoughtlessly and with a lower level of planning, and consumption of substances including cannabis. Objectives To examine the presence and severity of impulsivity in individuals with cannabis use disorder and investigate associations between sociodemographic and clinical characteristics and impulsivity. Method Participants completed a sociodemographic data sheet and the Barratt Impulsiveness Scale (BIS-11). A total of 122 subjects with a diagnosis of cannabis use disorder participated, with a mean age of 34.46 years (standard deviation = 9.62). Results The prevalence of high levels of impulsivity in the sample ranged from 30 to 33%; the BIS-11 total score was significantly associated with cohabitation and alcohol use. The BIS-11 scores for motor impulsivity and attentional impulsivity were also associated with consumption of alcohol. No associations were found between impulsivity and the variables age, education, use of tobacco, or use of cocaine/crack. Conclusion This study contributes to understanding of substance dependence, especially cannabis. It found presence of impulsive behavior among individuals with cannabis use disorder, which is corroborated by reports in the literature.