The DOI matches its Crossref record; 85 of the 88 references it cites were found in a registry or an index.
The blind men and the elephant: Systematic review of systematic reviews of cannabis use related health harms
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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“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).”
From Risk-thresholds for the association between frequency of cannabis use and the development of psychosis: a systematic review and meta-analysis (2023) · cites this paper as Campeny et al., 2020
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Fischer, B., Robinson, T., Bullen, C., Curran, V., Jutras-Aswad, D., Medina-Mora, M. E., Pacula, R. L., Rehm, J., Room, R., Brink, W. V. D., et al. (2022) · International Journal of Drug Policy · doi:10.1016/j.drugpo.2021.103381 · Cited by 236
Manthey, J., Freeman, T. P., Kilian, C., López‐Pelayo, H., & Rehm, J. T. (2021) · The Lancet Regional Health - Europe · doi:10.1016/j.lanepe.2021.100227 · Cited by 184
Matheson, J., & Foll, B. L. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.591979 · Cited by 85
Robinson, T., Ali, M. U., Easterbrook, B., Coronado‐Montoya, S., Daldegan‐Bueno, D., Hall, W., Jutras‐Aswad, D., & Fischer, B. (2022) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2022.109582 · Cited by 81
Zeraatkar, D., Cooper, M. A., Agarwal, A., Vernooij, R. W. M., Leung, G., Loniewski, K., Dookie, J., Ahmed, M. M., Hong, B. Y., Hong, C. J. H., et al. (2022) · BMJ Open · doi:10.1136/bmjopen-2021-054282 · Cited by 87
Metadata
- 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.
- ORCID
- 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 (medical) › 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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