Annals of Tropical Medicine and Public Health

LETTER TO EDITOR
Year
: 2017  |  Volume : 10  |  Issue : 3  |  Page : 749--750

Planning a concerted effort to minimize the adverse consequences of cannabis: Public health perspective


Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy 
 Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Chennai, Tamil Nadu, India

Correspondence Address:
Saurabh R Shrivastava
3rd Floor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai Village, Thiruporur -Guduvanchery Main Road, Sembakkam Post, Kanchipuram, Tamil Nadu
India




How to cite this article:
Shrivastava SR, Shrivastava PS, Ramasamy J. Planning a concerted effort to minimize the adverse consequences of cannabis: Public health perspective.Ann Trop Med Public Health 2017;10:749-750


How to cite this URL:
Shrivastava SR, Shrivastava PS, Ramasamy J. Planning a concerted effort to minimize the adverse consequences of cannabis: Public health perspective. Ann Trop Med Public Health [serial online] 2017 [cited 2019 Nov 18 ];10:749-750
Available from: http://www.atmph.org/text.asp?2017/10/3/749/188502


Full Text



Dear Sir,

Globally, cannabis has been identified as one of the most frequently used psychoactive substances.[1] The current estimates reflect that in the year 2013, almost 182 million people in the age group of 15–64 years used it for nonmedical reasons worldwide.[1] Even though, it has been abused universally, it is maximum in Australasia and North America, followed by South and East Asia.[1] However, the current estimates still remain incomplete and incomparable due to the absence of surveys of drug use in various nations, no periodicity of surveys, and even if performed, it is done in a variable manner among different age groups or utilizes different criteria.[1],[2]

Furthermore, around 13 million people are dependent on cannabis worldwide, with higher prevalence being observed in high-income nations, male gender, and in the 20–24 years age group.[1] The consequences on health are variable depending on its short-term (like euphoria, anxiety, impact on the consciousness–cognition–behavior, etc.) or long-term (such as dependence, cognitive impairment, depression, suicidal tendencies, involvement of cardiovascular or respiratory system, malignancies, etc.) usage.[1],[3],[4] However, in contrast to men, women tend to have an accelerated progression of the substance use disorder after its first usage.[1]

A wide range of potential factors like drug availability, use of tobacco or alcohol at an early age, social norms permitting usage of alcohol or drug use, vulnerable social groups, antisocial behavior in childhood, family attributes (like strained parent–child relation, parental conflict, or parent/sibling drug use), male gender, personality traits, desire to experience sensations, school dropouts or scholastic backwardness, peer pressure, and role of media, have been identified, which influences the likelihood of initiation.[1],[2],[3],[4] On the contrary, factors like early onset, extensive or persistent use, low self-esteem or self-control, poor socioeconomic status, and history of any psychiatric or substance use disorder, accelerate the progression of substance use to dependence.[1],[2],[3],[4]

Acknowledging the universal distribution, magnitude of the problem, health consequences, impact on the quality of life of the individuals, and increase in the demand for the treatment of substance use or dependence, it is the need of the hour to focus on its prevention, scale up existing interventions, and call for coordinated efforts through involvement of international partners.[1],[2] The planned interventions should target different stakeholders, like families (positive family environments, ensuring effective monitoring, discipline, reward systems, reinforcement), schools (activities to improve social skills, self-esteem, refusal skills, and identify high-risk situations, peer-led counseling, etc.), and vulnerable youths (measures to promote life skills development, team-building content, interpersonal communication skills, and introspective learning, etc.).[1],[2],[5]

In addition, interventions in the form of having a healthy environment at family level and at the workplace, and treatment of existing mental disorders, should be planned to prevent the relapse after cessation of cannabis.[5] At the same time, having a better monitoring on the cannabis production and distribution, and encouraging research on the prevalence of substance use or associated social costs, methods to further expand prevention activities, and standardized treatment approach, is also expected to improve the likelihood of a better outcome.[1],[2],[5]

To conclude, cannabis has been associated with adverse public health consequences and thus there is an extensive need to prevent its initiation among high-risk adolescents through active targeted interventions.

ACKNOWLEDGEMENTS

SRS contributed in the conception or design of the work, drafting of the work, approval of the final version of the manuscript, and agreed for all aspects of the work.

PSS contributed in the literature review, revision of the manuscript for important intellectual content, approval of the final version of the manuscript, and agreed for all aspects of the work.

JR contributed in revising the draft, approval of the final version of the manuscript, and agreed for all aspects of the work.

Financial support and sponsorship

Nil

Conflicts of interest

There are no conflicts of interest.

References

1World Health Organization. The health and socixal effects of nonmedical cannabis use. Geneva: WHO Press; 2016. p.1-77.
2Bone M, Seddon T. Human rights, public health and medicinal cannabis use. Crit Public Health 2016;26:51-61.
3Volkow ND, Swanson JM, Evins AE, DeLisi LE, Meier MH, Gonzalez R. Effects of cannabis use on human behavior, including cognition, motivation, and psychosis: A review. JAMA Psychiatry 2016;73:292-7.
4Hamilton I. The need for health warnings about cannabis and psychosis. Lancet Psychiatry 2016;3:322.
5Kirst M, Kolar K, Chaiton M, Schwartz R, Emerson B, Hyshka E. A common public health-oriented policy framework for cannabis, alcohol and tobacco in Canada?. Can J Public Health 2016;106:e474-6.