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Full Title

Full Title of Paper: The Effects of Science on Knowledge of Facts

Shortened Title

The Short Colon-free Title

Published Date

Month DD, YYYY

Copyright

This article is available for use in some ways according to the Laws of the Copyright

How available is the underlying data?

Link

https://doi.org/10.1001/jamanetworkopen.2018.4841

Authors

#	Author	Affiliation(s) at time of Publication	Link	Notes
1	Tory R. Spindle, PhD	Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine, Baltimore, Maryland
2	Edward J. Cone, PhD	Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine, Baltimore, Maryland
3	Nicolas J. Schlienz, PhD	Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine, Baltimore, Maryland
4	John M. Mitchell, PhD	RTI International, Research Triangle Park, North Carolina
5	George E. Bigelow, PhD	Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine, Baltimore, Maryland
6	Ronald Flegel, MS	Division of Workplace Programs, Substance Abuse and Mental Health Services Administration (SAMHSA), Rockville, Maryland
7	Eugene Hayes, PhD, MBA	Division of Workplace Programs, Substance Abuse and Mental Health Services Administration (SAMHSA), Rockville, Maryland
8	Ryan Vandrey, PhD	Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine, Baltimore, Maryland

Stated Goal(s)

Original

Question How does smoked and vaporized cannabis acutely influence subjective drug effects, cognitive and psychomotor performance, and cardiovascular measures in healthy adults who infrequently use cannabis (>30 days since last use)?

The goal of this study was to compare the pharmacodynamics and pharmacokinetics of smoked and vaporized cannabis in healthy adults. This study extends prior research by examining multiple doses of THC across inhalation methods, enrolling individuals with infrequent cannabis use patterns (defined here as no use in the past 30 days accompanied with a negative urine toxicology test result), and including a comprehensive pharmacodynamic test battery (ie, subjective drug effects, cognitive and psychomotor performance, and vital signs).

Stated Conclusion(s)

Original

In this study, participants experienced dose-orderly increases in subjective drug effects, cognitive and psychomotor impairment, acute cardiovascular effects, and blood THC concentrations following inhalation of smoked and vaporized cannabis. Notably, vaporized cannabis produced greater changes in study outcomes relative to smoked cannabis. As the legal cannabis marketplace continues to expand, future studies should further explore the effects of vaporizers and other novel methods for cannabis administration in users with different degrees of experience with cannabis, as the pharmacokinetic and pharmacodynamic profiles will likely differ substantially across products and users.

SLaG Notes

• Each participant did 6 sessions
  • 3 vaping sessions, different dose each session (0, 10, or 25mg THC), 10 minutes each, using Volcano Medic (Storz & Bickel) balloons
  • 3 smoking sessions, different dose each session (0, 10, or 25mg THC), 10 minutes each, using a "small handheld pipe ... fitted with a metal top" and a lighter
    • I wonder how this went for participants. I avoid these small pipes because there is no cooling or filtering and would have trouble emptying it without help in 10 minutes. The article says the pipes were "visually inspected" to confirm they smoked it all, and that the metal top "minimized drug loss owing to sidestream smoke" but I'm picturing a TON of coughing, partial hits due to not holding the carb opening correctly, and a bunch of residue on that metal top

• "Cannabis used in this study was obtained from the National Institute on Drug Abuse Drug Supply Program"
  • What are the requirements to get cannabis from this source?
• "Two participants vomited ... and another experienced hallucinations" after 25 mg doses
• "Notably, the highest dose of cannabis administered in this study (25 mg of THC: 0.19 g; 13.4% THC) is substantially smaller and has a lower THC concentration than what is typically contained in prerolled cannabis cigarettes available for purchase in cannabis dispensaries, which commonly contain roughly 1.0 g of cannabis with THC concentrations often exceeding 18%."
• "[H]olding THC dose constant, vaporizers appear to be a more efficient cannabis and THC delivery method"
• "Collectively, findings from this study and others indicate that blood THC concentrations are not a valid indicator of a user’s intoxication and/or impairment"
• "Dr Vandrey reported receiving personal fees and has served as a consultant or received honoraria from Zynerba Pharmaceuticals, Insys Therapeutics, Battelle Memorial Institute, and Canopy Health Innovations Inc outside the submitted work. Drs Vandrey and Spindle reported receiving grants from the Substance Abuse and Mental Health Services Administration (SAMHSA) during the conduct of the study. Dr Cone reported serving as a consultant for ConeChem Research, LLC and RTI during the conduct of the study. Dr Schlienz reported grants from the National Institute on Drug Abuse outside the submitted work. Dr Mitchell reported grants from SAMHSA during the conduct of the study. Dr Hayes reported receiving funding from the Department of Health and Human Services, SAMHSA, National Laboratory Certification Program, and RTI International during the conduct of the study. No other disclosures were reported."
• "This study was funded by the Substance Abuse and Mental Health Services Administration. The funder provided technical assistance on the design and conduct of the study; analysis and interpretation of the data; preparation, review, and approval of the manuscript; and decision to submit the manuscript for publication. The funders had no role in the collection or management of the study data."

Citation

Full

Spindle TR, Cone EJ, Schlienz NJ, Mitchell JM, Bigelow GE, Flegal R, Hayes E, Vandrey R. Acute Effects of Smoked and Vaporized Cannabis in Healthy Adults Who Infrequently Use Cannabis: A Cross-Over Trial. JAMA Netw Open. 2018; 1; e184841, 1-14. https://doi.org/10.1001/jamanetworkopen.2018.4841

Parenthetical

Spindle, Cone, Schlienz et al., 2018