Cited by 127Cannabis and Cannabinoid ResearchSubstance Abuse Treatment and OutcomesForensic Toxicology and Drug Analysis

The blind men and the elephant: Systematic review of systematic reviews of cannabis use related health harms

Campeny, E., López-Pelayo, H., Nutt, D., Blithikioti, C., Oliveras, C., Nuño, L., Maldonado, R., Florez, G. +8 more·2020·European Neuropsychopharmacology

Abstract

Cannabis is the third most used psychoactive substance worldwide. The legal status of cannabis is changing in many Western countries, while we have very limited knowledge of the public health impact of cannabis-related harms. There is a need for a summary of the evidence of harms and risks attributed to cannabis use, in order to inform the definition of cannabis risky use. We have conducted a systematic review of systematic reviews, aiming to define cannabis-related harms. We included systematic reviews published until July 2018 from six different databases and following the PRISMA guidelines. To assess study quality we applied the AMSTAR 2 tool. A total of 44 systematic reviews, including 1,053 different studies, were eligible for inclusion. Harm was categorized in three dimensions: mental health, somatic harm and physical injury (including mortality). Evidence shows a clear association between cannabis use and psychosis, affective disorders, anxiety, sleep disorders, cognitive failures, respiratory adverse events, cancer, cardiovascular outcomes, and gastrointestinal disorders. Moreover, cannabis use is a risk factor for motor vehicle collision, suicidal behavior and partner and child violence. Cannabis use is a risk factor for several medical conditions and negative social consequences. There is still little data on the dose-dependency of these effects; evidence that is essential in order to define, from a public health perspective, what can be considered risky use of cannabis. This definition should be based on quantitative and qualitative criteria that informs and permits the evaluation of current approaches to a regulated cannabis market.

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Crossref · 10.1016/j.euroneuro.2020.02.003

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  • Other reviews have been limited in their level of detail about the relationship between cannabis use frequency and psychosis risk, commonly comparing frequent use to only infrequent or non-use.

    “Other reviews, however, have been limited in their level of detail about the relationship between cannabis use frequency and psychosis risk where, for example, frequent use is commonly compared to only infrequent or non-use (Campeny et al., 2020; Hasan et al., 2020; Kiburi et al., 2021; Marconi et al., 2016; Polkosnik et al., 2021; van der Steur et al., 2020).”

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Authors
Campeny, E., López-Pelayo, H., Nutt, D., Blithikioti, C., Oliveras, C., Nuño, L., Maldonado, R., Florez, G., Arias, F., Fernández-Artamendi, S., Villalbí, J. R., Sellarès, J., Ballbè, M., Rehm, J., Balcells-Olivero, M. M., & Gual, A.
Affiliations
  • Hospital Clínic de Barcelona (ES)
  • Imperial College London (GB)
  • Universitat Pompeu Fabra (ES)
  • Agencia de Salud Pública de Barcelona (ES)
  • Institut d'Investigació Biomédica de Bellvitge (ES)
  • Centre for Addiction and Mental Health (CA)
Corresponding author
Campeny, E.
Venue
European Neuropsychopharmacology
Publisher
Elsevier BV
Published
2020-04
Volume
33
Pages
1-35
ISSN
0924-977X (ISSN-L)
OpenAlex
W3011169996
Cited by
127
References
88
Citations by year
2026: 6 · 2025: 20 · 2024: 11 · 2023: 26 · 2022: 33 · 2021: 22 · 2020: 9
FWCI
2.94
Type
journal article
Language
en
Open access
closed
Locations
  • European Neuropsychopharmacology (publishedVersion)
  • PubMed (publishedVersion)
Funders
Instituto de Salud Carlos III
Topics
  • Health Sciences › Medicine › Pharmacology › Cannabis and Cannabinoid Research
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Forensic Toxicology and Drug Analysis
Keywords
cannabis use, cannabis-related harms, psychosis, mental health, personal injury, cardiovascular outcomes, respiratory adverse events, traffic accidents, suicidal behavior, violence, dose-response relationship, cannabis legalization
MeSH terms
Accidents, Systematic Reviews as Topic, Adolescent, Adult, Aged, Aged, 80 and over, Animals, Cannabis, Female, Humans, Male, Marijuana Smoking, Mental Health, Middle Aged, Young Adult

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