Cannabis sativa finds application in the medical field as an opioid (medical marijuana) and as a recreational drug despite the fact that it is a prohibited drug substance in many countries. Currently, there are reports on the increasing trends in the number of deaths associated with the use of marijuana. Regardless of these dangers, some countries across the world have legalized the sale and use of marijuana for recreational and medicinal purposes. For these reasons, this review seeks to explore the emerging trends through which marijuana is consumed and the chemicals produced in the course of its use. Furthermore, the use of Cannabis sativa as medicine especially in the management of emerging diseases such a Corona virus disease-2019 (COVID-19) and the perceived harms have been reviewed. Relevant literature was identified from database search published between the period 2012 and 2020 in PubMed, Crossref, Google scholar, Cochrane and Web of Science. The articles were considered relevant if they addressed marijuana (Cannabis sativa) use, its impacts on users and non-users, carcinogenicity, medicinal value and COVID-19 management. A number of methods by which marijuana is used have been identified with each method producing different results among users. The chemicals released during smoking of marijuana and their carcinogenic potential and health effects are reported in this work. Further, Cannabis sativa has found significant use in the management of cancer and human immunodeficiency virus (HIV/ AIDS) to alleviate pain and improve appetite, respectively. Although marijuana is regarded as a prohibited and toxic drug substance, there is limited documentation in literature that extensively reports on its toxicological mechanisms especially its role as a cancer causing agent. On the contrary, most scientific studies have reported its use for medical reasons. Accordingly, there is need for further research on cannabis application as a medicinal drug, investigation on its possibility in the managing of the severe acute respiratory syndrome corona virus-2 (SARS-Cov-2) and its epidemiological concerns. Campaigns for the legalization of cannabis for use in clinical medicine are fundamentally recommended but must take into account possible toxicological concerns, health ethics and psychotic problems.
Cite this paper
Omare, M. O. , Kibet, J. K. , Cherutoi, J. K. and Kengara, F. O. (2021). Current Trends in the Use of Cannabis sativa: Beyond Recreational and Medicinal Applications. Open Access Library Journal, 8, e7132. doi: http://dx.doi.org/10.4236/oalib.1107132.
Archie, S.R. and Cucullo, L. (2019) Harmful Effects of Smoking Cannabis: A Cerebrovascular and Neurological Perspective. Frontiers in Pharmacology, 10, Article No. 1481. https://doi.org/10.3389/fphar.2019.01481
Borgan, F., Beck, K., Butler, E., McCutcheon, R., Veronese, M., Vernon, A., et al. (2019) The Effects of Cannabinoid 1 Receptor Compounds on Memory: A Meta-Analysis and Systematic Review across Species. Psychopharmacology, 236, 3257- 3270. https://doi.org/10.1007/s00213-019-05283-3
Köguel, C.C., López-Pelayo, H., Balcells-Olivero, M.M., Colom, J. and Gual, A. (2018) Constituyentes psicoactivos del cannabis y sus implicaciones clínicas: una revisión sistemática. Adicciones, 30, 140-151. https://doi.org/10.20882/adicciones.858
Cohen, K., Kapitány-Fövény, M., Mama, Y., Arieli, M., Rosca, P., Demetrovics, Z., et al. (2017) The Effects of Synthetic Cannabinoids on Executive Function. Psychopharmacology, 234, 1121-1134. https://doi.org/10.1007/s00213-017-4546-4
NIDA (2021) Is Marijuana Safe and Effective as Medicine?
https://www.drugabuse.gov/publications/research-reports/marijuana/marijuana-safe-effective-medicine
Ribeiro, L.I. and Ind, P.W. (2016) Effect of Cannabis Smoking on Lung Function and Respiratory Symptoms: A Structured Literature Review. NPJ Primary Care Respiratory Medicine, 26, Article No. 16071.
https://doi.org/10.1038/npjpcrm.2016.71
Koren, G. and Cohen, R. (2020) Medicinal Use of Cannabis in Children and Pregnant Women. Rambam Maimonides Medical Journal, 11, e0005.
https://doi.org/10.5041/RMMJ.10382
Wang, B., Kovalchuk, A., Li, D., Ilnytskyy, Y., Kovalchuk, I. and Kovalchuk, O. (2020) In Search of Preventative Strategies: Novel Anti-Inflammatory High-CBD Cannabis Sativa Extracts Modulate ACE2 Expression in COVID-19 Gateway Tissues. Aging (Albany NY), 12, 22425-22444.
https://doi.org/10.20944/preprints202004.0315.v1
Hoffmann, M., Kleine-Weber, H., Schroeder, S., Krüger, N., Herrler, T, Erichsen, S., et al. (2020) SARS-CoV-2 Cell Entry Depends on ACE2 and TMPRSS2 and Is Blocked by a Clinically Proven Protease Inhibitor. Cell, 181, 271-280.E8.
https://doi.org/10.1016/j.cell.2020.02.052
Palmatier, R.W., Houston, M.B. and Hulland, J. (2018) Review Articles: Purpose, Process, and Structure. Journal of the Academy of Marketing Science, 46, 1-5.
https://doi.org/10.1007/s11747-017-0563-4
Franklin, R.M., Rosenthal, E. and Franklin, R.M. (2017) Method for Conducing Concentrated Cannabis Oil to Be Stable, Emulsifiable and Flavorless for Use in Hot Beverages and Resulting Powderized Cannabis Oil. US 20160243177.
Bruni, N., Della Pepa, C., Oliaro-Bosso, S., Pessione, E., Gastaldi, D. and Dosio, F. (2018) Cannabinoid Delivery Systems for Pain and Inflammation Treatment. Molecules, 23, Article No. 2478. https://doi.org/10.3390/molecules23102478
Holitzki, H., Dowsett, L.E., Spackman, E., Noseworthy, T., Clement, F. (2017) Health Effects of Exposure to Second- and Third-Hand Marijuana Smoke: A Systematic Review. CMAJ open, 5, E814-e822. https://doi.org/10.9778/cmajo.20170112
Ghasemiesfe, M., Barrow, B., Leonard, S., Keyhani, S. and Korenstein, D. (2019) Association between Marijuana Use and Risk of Cancer: A Systematic Review and Meta-Analysis. JAMA Network Open, 2, Article ID: e1916318.
https://doi.org/10.1001/jamanetworkopen.2019.16318
Callaghan, R.C., Allebeck, P., Akre, O., McGlynn, K.A. and Sidorchuk, A. (2017) Cannabis Use and Incidence of Testicular Cancer: A 42-Year Follow-Up of Swedish Men between 1970 and 2011. Cancer Epidemiology and Prevention Biomarkers, 26, 1644-1652. https://doi.org/10.1158/1055-9965.EPI-17-0428
Swenberg, J.A., Moeller, B.C., Lu, K., Rager, J.E., Fry, R.C. and Starr, T.B. (2013) Formaldehyde Carcinogenicity Research: 30 Years and Counting for Mode of Action, Epidemiology, and Cancer Risk Assessment. Toxicologic Pathology, 41, 181-189.
https://doi.org/10.1177%2F0192623312466459
Abdel-Shafy, H.I. and Mansour, M.S. (2016) A Review on Polycyclic Aromatic Hydrocarbons: Source, Environmental Impact, Effect on Human Health and Remediation. Egyptian Journal of Petroleum, 25, 107-123.
https://doi.org/10.1016/j.ejpe.2015.03.011
Nakajima, D. and Yagishita, M. (2018) Carcinogenicity/Mutagenicity. In: Hayakawa K., Ed., Polycyclic Aromatic Hydrocarbons, Springer, Singapore, 235-244.
https://doi.org/10.1007/978-981-10-6775-4_18
Tan, S.L.W., Chadha, S., Liu, Y., Gabasova, E., Perera, D., Ahmed, K., et al. (2017) A Class of Environmental and Endogenous Toxins Induces BRCA2 Haploinsufficiency and Genome Instability. Cell, 169, 1105-1118.E15.
https://doi.org/10.1016/j.cell.2017.05.010
Omare, M., Kibet, J., Cherutoi, J. and Kengara, F. (2020) A Review of the Current Trends on the Use of Cannabis Sativa for Recreational, Medicinal Applications, and Its Toxicological Health Impacts. Authorea, Preprints.
https://doi.org/10.22541/au.159318524.43742889
Russo, C., Ferk, F., Misík, M., Ropek, N., Nersesyan, A., Mejri, D., et al. (2019) Low Doses of Widely Consumed Cannabinoids (Cannabidiol and Cannabidivarin) Cause DNA Damage and Chromosomal Aberrations in Human-Derived Cells. Archives of Toxicology, 93, 179-188. https://doi.org/10.1007/s00204-018-2322-9
Radhakrishnan, R., Wilkinson, S.T. and D’Souza, D.C. (2014) Gone to Pot—A Review of the Association between Cannabis and Psychosis. Frontiers in Psychiatry, 5, Article No. 54. https://doi.org/10.3389/fpsyt.2014.00054
Groce, E. (2018) The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research. Journal of Medical Regulation, 104, 32. https://doi.org/10.30770/2572-1852-104.4.32
Cohen, K, Weizman, A. and Weinstein, A. (2019) Positive and Negative Effects of Cannabis and Cannabinoids on Health. Clinical Pharmacology & Therapeutics, 105, 1139-1147. https://doi.org/10.1002/cpt.1381
Byers, C. (2017) Marijuana Smoking and the Risk of Developing COPD, Lung Cancer, and/or Chronic Respiratory Symptoms: A Systematic Review. Canadian Medical Association Journal, 180, 797-798. https://doi.org/10.1503%2Fcmaj.090142
Wang, X., Derakhshandeh, R., Liu, J., Narayan, S., Nabavizadeh, P., Le, S., et al. (2016) One Minute of Marijuana Secondhand Smoke Exposure Substantially Impairs Vascular Endothelial Function. Journal of the American Heart Association, 5, Article ID: e003858. https://doi.org/10.1161/JAHA.116.003858
Bloomfield, M.A., Ashok, A.H., Volkow, N.D. and Howes, O.D. (2016) The Effects of Δ9-Tetrahydrocannabinol on the Dopamine System. Nature, 539, 369-377.
https://doi.org/10.1038/nature20153
Wolff, V. and Jouanjus, E. (2017) Strokes Are Possible Complications of Cannabinoids Use. Epilepsy & Behavior, 70, 355-363.
https://doi.org/10.1016/j.yebeh.2017.01.031
Sharma, P., Murthy, P. and Bharath, M.S. (2012) Chemistry, Metabolism, and Toxicology of Cannabis: Clinical Implications. Iranian Journal of Psychiatry, 7, 149-156.
Ahmed, C., Lee, A., Campbell, A., Garber, G., Palmisiano, N.D. and Worster, B. (2020) The Financial and Psychosocial Impact of Medicinal Cannabis. Thomas Jefferson University, Sydney.
de Carvalho Reis, R., Almeida, K.J., da Silva Lopes, L., de Melo Mendes, C.M. and Bor-Seng-Shu, E. (2020) Efficacy and Adverse Event Profile of Cannabidiol and Medicinal Cannabis for Treatment-Resistant Epilepsy: Systematic Review and Meta-Analysis. Epilepsy & Behavior, 102, Article ID: 106635.
https://doi.org/10.1016/j.yebeh.2019.106635
Perisetti, A., Rimu, A.H., Khan, S.A., Bansal, P. and Goyal, H. (2020) Role of Cannabis in Inflammatory Bowel Diseases. Annals of Gastroenterology, 33, 134-144.
Birdsall, S.M., Birdsall, T.C. and Tims, L.A. (2016) The Use of Medical Marijuana in Cancer. Current Oncology Reports, 18, Article No. 40.
https://doi.org/10.1007/s11912-016-0530-0
Millar, S.A., Stone, N.L., Yates, A.S. and O’Sullivan, S.E. (2018) A Systematic Review on the Pharmacokinetics of Cannabidiol in Humans. Frontiers in Pharmacology, 9, Article No. 1365. https://doi.org/10.3389/fphar.2018.01365
Klumpers, L.E. and Thacker, D.L. (2019) A Brief Background on Cannabis: From Plant to Medical Indications. Journal of AOAC International, 102, 412-420.
https://doi.org/10.5740/jaoacint.18-0208
Lucas, C.J., Galettis, P. and Schneider, J. (2018) The Pharmacokinetics and the Pharmacodynamics of Cannabinoids. British Journal of Clinical Pharmacology, 84, 2477-2482. https://doi.org/10.1111/bcp.13710
Kis, B., Ifrim, F.C., Buda, V., Avram, S., Pavel, I.Z., Antal, D., et al. (2019) Cannabidiol—From Plant to Human Body: A Promising Bioactive Molecule with Multi- Target Effects in Cancer. International Journal of Molecular Sciences, 20, Article No. 5905. https://doi.org/10.3390/ijms20235905
