Epidemiology and Health Consequences of Marijuana Blunt Smoking

Marijuana blunts are rolled using empty cigar shells.

Marijuana ‘blunts’ are a potentially harmful way of consuming cannabis in which the plant material is rolled inside a hollowed-out cigar or ‘blunt’ wrap (i.e., a sheet of tobacco paper). Originating in the United States around the 1990s, blunts are smoked by more than 50% of past-30 day marijuana users of high school age. While there is pretty convincing evidence from animal studies that mixing these two drugs together increases their rewarding effects and harm potential, little is known about the causes, mechanisms, and consequences of this drug combination in humans. My research seeks to describe blunt smoking behavior in the population, including factors that might increase the risk of smoking blunts (e.g., prior cigar use), the likelihood of potential harm (e.g., quantifying nicotine exposure from blunts), trajectories of blunt smoking over time, and the health consequences of blunt smoking (e.g., tobacco and cannabis dependence). Learn more…

Blunts are smoked by more than 50% of past-30 day marijuana users of high school age.

Medical Marijuana and Impacts of Evolving Marijuana Policy

Medical marijuana is available in at least 24 states and the District of Columbia.

The number of places in the United States where marijuana is legally available for medical and non-medical (a.k.a., “recreational”) purposes is ever increasing over time (see Legality of Cannabis by US Jurisdiction). Advocates for more lenient marijuana laws cite medical necessity and benefit, overblown public health fears, and the injustice of marijuana arrests that is particularly biased towards racial/ethnic minority marijuana users. While debate continues as to the extent smoked marijuana and cannabinoid compounds benefit patients with specific symptoms and conditions, and whether liberal marijuana laws reduce racial disparities in drug enforcement, there is well-documented evidence that acute and chronic marijuana use is not without risks. How this evolving and patchwork system of laws and policies towards marijuana will impact both patients who use marijuana medically and the wider public that consumes marijuana non-medically will need to be adequately studied. An estimated 2.7 million people in the US use medical marijuana annually. My interest in this area has been to understand how medical marijuana use has changed over time in the US and who is more likely to use medical marijuana in the population. Learn more…

An estimated 2.7 million people in the US use medical marijuana annually.

Marijuana, Depression, and Implications for Prevention and Treatment

Marijuana affects mood – but for better or worse?

Mood disorders, including depression, are the leading mental health contributors to global disease burden in terms of health impairment and economic costs. In the US alone, antidepressants are the third most commonly prescribed medication. Despite this, a majority of people with depression go under-treated or untreated, and therefore there remains a considerable treatment gap. This gap may lead individuals with depression to self-medicate their low mood and other psychosomatic symptoms with substances like marijuana; a considerable proportion of medical marijuana patients cite depressed mood as a common reason for its use. As jurisdictions in the United States and elsewhere make marijuana increasingly available for psychiatric problems (e.g., depression, anxiety, post-traumatic stress disorder) we need to fully understand the potential therapeutic benefit but also the health risks to these patients. While several studies indicate that early, chronic marijuana use may increase the risk of developing depression, less is known about the consequences of smoking marijuana among people already with depression. My recent work has sought to identify features of depression history and other clinical correlates (e.g., severity, age-of-onset, recurrence, anxiety disorder, and functional impairments) that are associated with marijuana use and frequency. Learn more…