Acute Effects of Smoked and Vaporized Cannabis in Healthy Adults Who Infrequently Use Cannabis A Crossover Trial
Acute Effects of Smoked and Vaporized Cannabis in Healthy Adults Who Infrequently Use Cannabis A Crossover Trial
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DOI：
10.1001/jamanetworkopen.2018.4841
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发表时间：
2018-11-01
影响因子：
13.8
通讯作者：
Vandrey, Ryan
中科院分区：
文献类型：
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作者：
Spindle, Tory R.;Cone, Edward J.;Vandrey, Ryan
汽化是一种日益流行的大麻管理方法，政策变化大大增加了成年人获得大麻的机会。需要对目前不经常使用大麻的成年人（自上次使用大麻以来30天内）的大麻汽化情况进行对照检查。目的评价控制给药方式下烟熏和汽化大麻的急性剂量效应。设计、环境和参与者本研究于2016年6月至2017年1月在约翰霍普金斯大学医学院行为药理学研究部门进行了参与者内双盲交叉研究，包括17名健康成年人。6个烟熏和汽化门诊实验阶段（实验阶段之间有1周的洗脱期）被成组地完成（参与者之间的顺序平衡）；剂量顺序在每组中随机化。干预措施：每个参与者将含有δ 9-四氢大麻酚（THC）剂量为0毫克、10毫克和25毫克的大麻蒸发并吸食。主观药物作用、认知和精神运动表现、生命体征和血液四氢大麻酚浓度的基线评分变化。结果样本包括17名健康成人（平均[SD]年龄27.3[5.7]岁，男性9名，女性8名），前一个月未使用大麻（距最后一次使用大麻平均[SD]天，398[437]天）。吸入含有10毫克四氢大麻酚的大麻会产生区别性药物效应（100分视觉模拟量表的平均[SD]评分，吸烟：46[26]；蒸发：69[26]）和适度的认知功能损伤。25mg剂量产生了显著的药物效应（平均[SD]评分，吸烟：66[29]；汽化：78[29]），不良反应发生率增加，认知和精神运动能力明显受损（例如，与汽化条件下的安慰剂相比，任务表现显著下降）。与同等剂量的烟熏大麻（25毫克剂量：烟熏，10.2纳克/毫升；汽化，14.4纳克/毫升）相比，在大多数药效学结果中，汽化大麻的药物效果在质量上更强，血液中四氢大麻酚的峰值浓度更高。血液中四氢大麻酚浓度和心率在服用大麻后30分钟内达到峰值，并在3至4小时内恢复到基线水平。一些主观药物效应和观察到的认知和精神运动障碍平均持续长达6小时。结论及相关性大麻汽化和烟熏均产生剂量顺序的药物效应，汽化效果更强。这些数据可以为以前很少或没有大麻接触的成年人使用大麻的监管和临床决策提供信息。
IMPORTANCE Vaporization is an increasingly popular method for cannabis administration, and policy changes have increased adult access to cannabis drastically. Controlled examinations of cannabis vaporization among adults with infrequent current cannabis use patterns (>30 days since last use) are needed.OBJECTIVE To evaluate the acute dose effects of smoked and vaporized cannabis using controlled administration methods.DESIGN, SETTING, AND PARTICIPANTS This within-participant, double-blind, crossover study was conducted from June 2016 to January 2017 at the Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine, and included 17 healthy adults. Six smoked and vaporized outpatient experimental sessions (1-week washout between sessions) were completed in clusters (order counterbalanced across participants); dose order was randomized within each cluster.INTERVENTIONS Cannabis containing Delta 9-tetrahydrocannabinol (THC) doses of 0mg, 10mg, and 25mg was vaporized and smoked by each participant.MAIN OUTCOMES AND MEASURES Change from baseline scores for subjective drug effects, cognitive and psychomotor performance, vital signs, and blood THC concentration.RESULTS The sample included 17 healthy adults (mean [SD] age, 27.3 [5.7] years; 9 men and 8 women) with no cannabis use in the prior month (mean [SD] days since last cannabis use, 398 [437] days). Inhalation of cannabis containing 10mg of THC produced discriminative drug effects (mean [SD] ratings on a 100-point visual analog scale, smoked: 46 [26]; vaporized: 69 [26]) and modest impairment of cognitive functioning. The 25-mg dose produced significant drug effects (mean [SD] ratings, smoked: 66 [29]; vaporized: 78 [24]), increased incidence of adverse effects, and pronounced impairment of cognitive and psychomotor ability (eg, significant decreased task performance compared with placebo in vaporized conditions). Vaporized cannabis resulted in qualitatively stronger drug effects for most pharmacodynamic outcomes and higher peak concentrations of THC in blood, compared with equal doses of smoked cannabis (25-mg dose: smoked, 10.2 ng/mL; vaporized, 14.4 ng/mL). Blood THC concentrations and heart rate peaked within 30 minutes after cannabis administration and returned to baseline within 3 to 4 hours. Several subjective drug effects and observed cognitive and psychomotor impairments persisted for up to 6 hours on average.CONCLUSIONS AND RELEVANCE Vaporized and smoked cannabis produced dose-orderly drug effects, which were stronger when vaporized. These data can inform regulatory and clinical decisions surrounding the use of cannabis among adults with little or no prior cannabis exposure.