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Cannabis-Associated Asthma and Allergies

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Abstract

Inhalation of cannabis smoke is its most common use and the pulmonary complications of its use may be the single most common form of drug-induced pulmonary disease worldwide. However, the role of cannabis consumption in asthma patients and allergic clinical situations still remains controversial. To review the evidence of asthma and allergic diseases associated with the use of marijuana, we conducted a search of English, Spanish, and Portuguese medical using the search terms asthma, allergy, marijuana, marihuana, and cannabis. Entries made between January 1970 and March 2017 were retrieved. Several papers have shown the relationship between marijuana use and increase in asthma and other allergic diseases symptoms, as well as the increased frequency of medical visits. This narrative review emphasizes the importance to consider cannabis as a precipitating factor for acute asthma and allergic attacks in clinical practice. Although smoking of marijuana may cause respiratory symptoms, there is a need for more studies to elucidate many aspects in allergic asthma patients, especially considering the long-term use of the drug. These patients should avoid using marijuana and be oriented about individual health risks, possible dangers of second-hand smoke exposure, underage use, safe storage, and the over smoking of marijuana.

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References

  1. OEA—Organizacion Estados Americanos. Annual prevalence drug use by regions and globally by drug types. http://www.unodc.org/documents/wdr2014/Statistics/pdfInforme 2015; accessed Feb 3rd. 2017

  2. United Nations Office on Drugs and Crime. World Drug Report 2016. United Nations publications, Sales No E 15 XI 6 2016;-https://www.unodc.org/documents/wdr2016/World_Drug_Report_2016.pdf

  3. Compton WM, Grant BF, Colliver JD, Glantz MD, Stinson FS (2004) Prevalence of marijuana use disorders in the United States: 1991-1992 and 2001-2002. JAMA 291(17):2114–2121

    Article  CAS  Google Scholar 

  4. Carliner H, Mauro PM, Brown QL, Shmulewitz D, Rahim-Juwel R, Sarvet AL et al (2017) The widening gender gap in marijuana use prevalence in the U.S. during a period of economic change, 2002–2014. Drug Alcohol Depend 170:51–58

    Article  Google Scholar 

  5. Kempker JA, Honig EG, Martin G (2015) The effects of marijuana exposure on respiratory health in US adults. Ann Am Thorac Soc 12:135–141

    Article  Google Scholar 

  6. Han B, Compton WM, Jones CM, Blanco C (2017) Cannabis use and cannabis use disorders among youth in the United States, 2002–2014. J Clin Psychiatry. https://doi.org/10.4088/JCP

  7. Han BH, Sherman S, Mauro PM, Martins SS, Rotenberg J, Palamar JJ (2016) Demographic trends among older cannabis users in the United States, 2006-13. Addiction. https://doi.org/10.1111/add.13670

  8. Tan WC, Lo C, Jong A, Xing L, Fitzgerald MJ, Vollmer WM et al (2009) Marijuana and chronic obstructive lung disease: a population-based study. CMAJ 180(8):814–820

    Article  Google Scholar 

  9. Health Canada, Rotermann M, Langlois K (2013) Prevalence and correlates of marijuana use in Canada, 2012. Stat Can Health Rep 26(4):1–15

    Google Scholar 

  10. Fonseca AM, Galduróz JC, Noto AR, Carlini EL (2010) Comparison between two household surveys on psychotropic drug use in Brazil: 2001 and 2004. Cien Saude Colet 15(3):663–670

    Article  Google Scholar 

  11. UNIFESP-Universidade Federal de São Paulo, INPAD-Instituto Nacional de Ciências e Tecnologias para Políticas Públicas do Álcool e outras Drogas. II Levantamento Nacional de Álcool e Drogas: Maconha (II LENAD-National Survey of Alcohol and Drugs). http://inpad.org.br accessed Jan 31, 2017 2017

  12. Mounteney J, Griffiths P, Sedefov R, Noor A, Vicente J, Simon R (2016) The drug situation in Europe: an overview of data available on illicit drugs and new psychoactive substances from European monitoring in 2015. Addiction 111(1):34–48

    Article  Google Scholar 

  13. European Monitoring Centre for Drugs and Drug Addiction. Perspectives on drugs: health responses to new psychoactive substances; models for the legal supply of cannabis. http://www.emcdda.europa.eu/topics/pods/legal-supply-of-cannabis 2016; accessed Nov 30, 2016

  14. European Monitoring Centre for Drugs and Drug Addiction. Statistical Bulletin 2016. http://www.emcdda.europa.eu/ 2016

  15. Caponnetto P, Auditore R, Russo C, Alamo A, Campagna D, Demma S et al (2013) Dangerous relationships: asthma and substance abuse. J Addic Dis 32(2):158–167

    Article  Google Scholar 

  16. Tashkin DP (2013) Effects of marijuana smoking on the lung. Ann Am Thorac Soc 10(3):239–247

    Article  CAS  Google Scholar 

  17. Volkow ND, Baler RD, Compton WM, Weiss SR (2014) Adverse health effects of marijuana use. N Engl J Med 370(23):2219–2227

    Article  Google Scholar 

  18. Gaeta TJ, Hammock R, Spevack TA, Brown H, Rhoden K (1996) Association between substance abuse and acute exacerbation of bronchial asthma. Acad Emerg Med 3(12):1170–1171

    Article  CAS  Google Scholar 

  19. Self TH, Shah SP, March KL, Sands CW (2016) Asthma associated with the use of cocaine, heroin, and marijuana: a review of the evidence. J Asthma. https://doi.org/10.1080/02770903.2016.1259420

  20. Martinasek MP, McGrogan JB, Mayso A (2016) A systematic review of the respiratory effects of inhalational marijuana. Respir Care 61(11):1543–1551

    Article  Google Scholar 

  21. Chatkin JM, Zabert G, Chatkin G, Zabert I, Jimenes-Ruiz C, Granda JI et al. Pulmonary disorders associated to marijuana consumption. Arch Bronconeumol 2017; [Epub ahead of print]( doi: https://doi.org/10.1016/j.arbres.2017.03.019.)

  22. Hublet A, De Bacquer D, Boyce W, Godeau E, Schmid H, Vereecken C et al (2007) Smoking in young people with asthma. J Public Health 29(4):343–349

    Article  CAS  Google Scholar 

  23. Jones SE, Merkle S, Wheeler L, Mannino DM, Crossett L (2006) Tobacco and other drug use among high school students with asthma. J Adolesc Health 39:291–294

    Article  Google Scholar 

  24. Larsen K, Faulkner GE, Boak A, Hamilton HA, Mann RE, Irving HM et al (2016) Looking beyond cigarettes: are Ontario adolescents with asthma less likely to smoke e-cigarettes, marijuana, waterpipes or tobacco cigarettes? Respir Med 120:10–15

    Article  Google Scholar 

  25. Douglas IS, Albertson TE, Folan P, Hanania NA, Tashkin DP, Upson DJ et al (2015) Implications of marijuana decriminalization on the practice of pulmonary, critical care, and sleep medicine. A report of the American Thoracic Society Marijuana Workgroup. Ann Am Thorac Soc 12(11):1700–1710

    Article  Google Scholar 

  26. Lutchmansingh D, Pawar L, Savici D (2014) Legalizing cannabis: a physician’s primer on the pulmonary effects of marijuana. Curr Respir Care Rep 3:200–205

    Article  Google Scholar 

  27. Volkow ND, Swanson JM, Evins AE, DeLisi LE, Meier MH, Gonzalez R et al (2016) Effects of cannabis use on human behavior, including cognition, motivation, and psychosis: a review. JAMA Psychiatry 73(3):292–297

    Article  Google Scholar 

  28. Volkow ND, Hampson AJ, Baler RD (2017) Don’t worry, be happy: endocannabinoids and cannabis at the intersection of stress and reward. Annu Rev Pharmacol Toxicol 57:285–308

    Article  CAS  Google Scholar 

  29. Biehl JR, Burnham EL (2015) Cannabis smoking in 2015: a concern for lung health? Chest 148(3):596–606

    Article  Google Scholar 

  30. Greydanus DE, Hawver EK, Greydanus MM, Merrick J (2013) Marijuana: current concepts. Front Public Health 42:1–17

    Google Scholar 

  31. Eisenberg E, Ogintz M, Almog S (2014) The pharmacokinetics, efficacy, safety, and ease of use of a novel portable metered-dose cannabis inhaler in patients with chronic neuropathic pain: a phase 1a study. J Pain Palliat Care Pharmacother 28(3):216–225

    Article  Google Scholar 

  32. National Institute on Drug Abuse (NIDA). Marijuana abuse. https://www.drugabuse.gov/drugs-abuse/marijuana 2015; accessed in Feb 10, 2016

  33. Wu TC, Tashkin DP, Djahed B, Rose JE (1988) Pulmonary hazards of smoking marijuana as compared with tobacco. N Engl J Med 318(6):347–351

    Article  CAS  Google Scholar 

  34. Huber GL, First MW, Grubner O (1991) Marijuana and tobacco smoke gas-phase cytotoxins. Pharmacol Biochem Behav 40(3):629–636

    Article  CAS  Google Scholar 

  35. Turcotte C, Blanchet M-R, Laviolette M, Flamand N (2016) Impact of cannabis, cannabinoids, and endocannabinoids in the lungs. Front Pharmacol 7:317–323

    Article  Google Scholar 

  36. Tashkin DP, Shapiro BJ, Frank IM (1973) Acute pulmonary physiologic effects of smoked marijuana and oral 9-tetrahydrocannabinol in healthy young men. N Engl J Med 289(7):336–341

    Article  CAS  Google Scholar 

  37. ElSohly MA, Mehmedic Z, Foster S, Gon C, Chandra S, Church JC (2016) Changes in cannabis potency over the last 2 decades (1995–2014): analysis of current data in the United States. Biol Psychiatry 79(7):613–619

    Article  CAS  Google Scholar 

  38. Murray RM, Quigley H, Quattrone D, Englund A, Di Forti M (2016) Traditional marijuana, high-potency cannabis and synthetic cannabinoids: increasing risk for psychosis. World Psychiatry 15(3):195–204

    Article  Google Scholar 

  39. Tsumura Y, Aoki R, Tokieda Y, Akutsu M, Kawase Y, Kataoka T et al (2012) A survey of the potency of Japanese illicit cannabis in fiscal year 2010. Forensic Sci Int 221(1–3):77–83

    Article  CAS  Google Scholar 

  40. Wu HD, Wright RS, Sassoon CS, Tashkin DP (1992) Effects of smoked marijuana of varying potency on ventilatory drive and metabolic rate. Am Rev Respir Dis 146(3):716–721

    Article  CAS  Google Scholar 

  41. Ocampo TL, Rans TS (2015) Cannabis sativa: the unconventional weed allergen. Ann Allergy Asthma Immunol 114:187–192

    Article  Google Scholar 

  42. Henderson RL, Tennant FS, Guerry R (1972) Respiratory manifestations of hashish smoking. Arch Otolaryngol 95:248–251

    Article  CAS  Google Scholar 

  43. Liskow B, Liss JL, Parker CW (1971) Allergy to marihuana. Ann Intern Med 75(4):571–573

    Article  CAS  Google Scholar 

  44. Mayoral M, Calderon H, Cano R, Lombardero M (2008) Allergic rhinoconjunctivitis caused by Cannabis sativa pollen. J Investig Allergol Clin Immunol 18:73–74

    CAS  PubMed  Google Scholar 

  45. Chopra GS (1973) Studies on psycho-clinical aspectsof long-term marihuana use in 124 cases. Int J Addict 8:1015–1026

    Article  CAS  Google Scholar 

  46. Tashkin DP (2015) How beneficial is vaping cannabis to respiratory health compared to smoking? Addiction 110(11):1706–1707

    Article  Google Scholar 

  47. Vachon L, FitzGerald MX, Solliday NH, Gould IA, Gaensler EA (1973) Single-dose effects of marihuana smoke. Bronchial dynamics and respiratory-center sensitivity in normal subjects. N Engl J Med 288(19):985–989

    Article  CAS  Google Scholar 

  48. D'Souza DC, Ranganathan M (2015) Medical marijuana: is the cart before the horse? JAMA 313(24):2431–2432

    Article  CAS  Google Scholar 

  49. Herzinger T, Schopf P, Przybilla B, Rueff F (2011) IgE-mediated hypersensitivity reactions to cannabis in laboratory personnel. Int Arch Allergy Immunol 156:423–426

    Article  CAS  Google Scholar 

  50. Stadtmauer G, Beyer K, Bardina L, Sicherer SH (2003) Anaphylaxis to ingestion of hempseed (Cannabis sativa). J Allergy Clin Immunol 112:216–217

    Article  Google Scholar 

  51. Ozyurt S, Muderrisoglu F, Ermete M, Afsar F (2014) Cannabis-induced erythema multiforme-like recurrent drug eruption. Int J Dermatol 53:22–23

    Article  Google Scholar 

  52. Decuyper I, van Gasse AL, Cop N, Sabato V, Faber MA, Mertens C et al (2017) Cannabis sativa allergy: looking through the fog. Allergy 72(2):201–206

    Article  CAS  Google Scholar 

  53. Gamboa P, Sanchez-Monge R, Sanz ML, Palacin A, Salcedo G, Diaz-Perales A (2007) Sensitization to Cannabis sativa caused by a novel allergenic lipid transfer protein, Can s 3. J Allergy Clin Immunol 120:1459–1460

    Article  CAS  Google Scholar 

  54. Azofeifa A, Mattson ME, Schauer G, McAfee T, Grant A, Lyerla R (2016) National estimates of marijuana use and related indicators—National Survey on Drug Use and Health, United States, 2002-2014. MMWR Surveill Summ 65(11):1–28

    Article  Google Scholar 

  55. Tessmer A, Berlin N, Sussman G, Leader N, Chung EC, Beezhold D (2012) Hypersensitivity reactions to marijuana. Ann Allergy Asthma Immunol 108(4):282–284

    Article  Google Scholar 

  56. Armentia A, Castrodeza J, Ruiz-Muñoz P, Martínez-Quesada J, Postigo I, Herrero M et al (2011) Allergic hypersensitivity to cannabis in patients with allergy and illicit drug users. Allergol Immunopathol (Madr) 39(5):271–279

    Article  CAS  Google Scholar 

  57. Armentia A, Herrero M, Martín-Armentia B, PeterRihs H, Postigo I, Martínez-Quesada J (2014) Molecular diagnosis in cannabis allergy. J Allergy Clin Immunol 2(3):351–352

    Article  Google Scholar 

  58. Larramendi CH, Lopez-Matas MA, Ferrer A, Huertas A, Pagan J, Navarro L et al (2013) Prevalence of sensitization to Cannabis sativa: lipid-transfer and thaumatin-like proteins and relevant allergens. Int Arch Allergy Immunol 162:115–122

    Article  CAS  Google Scholar 

  59. Ebo DG, Swerts S, Sabato V, Hagendorens MM, Bridts CH, Jorens PG et al (2013) New food allergies in a European non-Mediterranean region: is Cannabis sativa to blame? Int Arch Allergy Immunol 161(3):220–228

    Article  CAS  Google Scholar 

  60. Nayak AP, Green BJ, Sussman G, Berlin N, Lata H, Chandra S et al (2013) Characterization of Cannabis sativa allergens. Ann Allergy Asthma Immunol 111:32–37

    Article  CAS  Google Scholar 

  61. Larramendi CH, Carnes J, Garcia-Abujeta JL (2008) Sensitization and allergy to Cannabis sativa leaves in a population of tomato (Lycopersicon esculentum)-sensitized patients. Int Arch Allergy Immunol 146:195–202

    Article  Google Scholar 

  62. Williams C, Thompstone J, Wilkinson M (2008) Work-related contact urticaria to Cannabis sativa. Contact Dermatitis 58(62):3

    Google Scholar 

  63. Maloney E, Brodkey M (1940) Hemp pollen sensitivity in Omaha. Nebr Med J 25:190–191

    Google Scholar 

  64. Freeman GL (1983) Allergic skin test reactivity to marijuana in the Southwest. West J Med 138:829–831

    CAS  PubMed  PubMed Central  Google Scholar 

  65. Abbas S, Katelaris CH, Singh AB, Raza SM, Ajab Khan M, Rashid M et al (2012) World Allergy Organization study on aerobiology for creating first pollen and mold calendar with clinical significance in Islamabad, Pakistan: a project of World Allergy Organization and Pakistan Allergy, Asthma & Clinical Immunology Centre of Islamabad. World Allergy Organ J 5(9):103–110

    Article  Google Scholar 

  66. Decuyper I, Faber MA, Sabato V, Bridts CH, Hagendorens MM, Rihs HP et al. 2016 Where there’s smoke, there’s fire: cannabis allergy through passive exposure. J Allergy Clin Immunol Pract ; Epub ahead of print

  67. Tetrault JM, Crothers K, Moore BA, Mehra R, Concato J, Fiellin DA (2007) Effects of marijuana smoking on pulmonary function and respiratory complications: a systematic review. Arch Intern Med 167(3):221–228

    Article  Google Scholar 

  68. Abboud RT, Sanders HD (1976) Effect of oral administration of delta-tetrahydrocannabinol on airway mechanics in normal and asthmatic subjects. Chest 70(4):480–485

    Article  CAS  Google Scholar 

  69. Vidal C, Fuente R, Iglesias A, Sáez A (1991) Bronchial asthma due to Cannabis sativa seed. Allergy 46(8):647–649

    Article  CAS  Google Scholar 

  70. Grassin-Delyle S, Naline E, Buenestado A, Faisy C, Alvarez JC, Salvator H (2014) Cannabinoids inhibit cholinergic contraction inhuman airways through prejunctional CB1 receptors. Br J Pharmacol 171(11):2767–2777

    Article  CAS  Google Scholar 

  71. Moore BA, Augustson EM, Moser RP, Budney AJ (2005) Respiratory effects of marijuana and tobacco use in a US sample. J Gen Intern Med 20(1):33–37

    Article  Google Scholar 

  72. Tashkin DP (2001) Airway effects of marijuana, cocaine, and other inhaled illicit agents. Curr Opin Pulm Med 7(2):43–61

    Article  CAS  Google Scholar 

  73. Pletcher MJ, Vittinghoff E, Kalhan R, Richman J, Safford M, Sidney S et al (2012) Association between marijuana exposure and pulmonary function over 20 years. JAMA 307(2):173–181

    Article  CAS  Google Scholar 

  74. Ribeiro LI, Ind PW. Effect of cannabis smoking on lung function and respiratory symptoms: a structured literature review. NPJ Prim Care Respir Med 2016; 26:doi https://doi.org/10.1038/npjpcrm.2016.71

  75. Aldington S, Williams M, Nowitz M, Weatherall M, Pritchard A, McNaughton A et al (2007) Effects of cannabis on pulmonary structure, function and symptoms. Thorax 62:1058–1063

    Article  Google Scholar 

  76. No authors listed (2017) Smoking marijuana and the lungs. Am J Respir Crit Care Med 195(3):P5–P6. https://doi.org/10.1164/rccm.1953P5

  77. Polen MR, Sidney S, Tekawa IS, Sadler M, Friedman GD (1993) Health care use by frequent marijuana smokers who do not smoke tobacco. West J Med 158:596–601

    CAS  PubMed  PubMed Central  Google Scholar 

  78. Kumar R, Gupta N (2013) A case of bronchial asthma and allergic rhinitis exacerbated during cannabis pollination and subsequently controlled by subcutaneous immunotherapy. Indian J Allergy Asthma Immunol 27:143–146

    Article  CAS  Google Scholar 

  79. Sauvaget E, Dellamonica J, Arlaud K, Sanfiorenzo C, Bernardin G, Padovani B et al (2010) Idiopathic acute eosinophilic pneumonia requiring ECMO in a teenager smoking tobacco and cannabis. Pediatr Pulmonol 45:1246–1249

    Article  Google Scholar 

  80. Taylor DR, Poulton R, Moffitt TE, Ramankutty P, Sears MR (2000) The respiratory effects of cannabis dependence in young adults. Addiction 95:1669–1677

    Article  CAS  Google Scholar 

  81. Tashkin DP, Coulson AH, Clark VA, Simmons M, Bourque LB, Duann S et al (1987) Respiratory symptoms and lung function in habitual heavy smokers of marijuana alone, smokers of marijuana and tobacco, smokers of tobacco alone, and nonsmokers. Am Rev Respir Dis 135(1):209–216

    CAS  PubMed  Google Scholar 

  82. Robinson PD, King GG, Sears MR, Hong CY, Hancox RJ (2017) Determinants of peripheral airway function in adults with and without asthma. Respirology 22(6):1110–1117

    Article  Google Scholar 

  83. Weitzman ER, Ziemnik RE, Huang Q, Levy S (2015) Alcohol and marijuana use and treatment nonadherence among medically vulnerable youth. Pediatrics 136(3):450–457

    Article  Google Scholar 

  84. Baxter JD, Samnaliev M, Clark RE (2008) Patterns of health care utilization for asthma treatment in adults with substance use disorders. J Addict Med 2(2):79–84

    Article  Google Scholar 

  85. Baxter JD, Samnaliev M, Clark RE (2009) The quality of asthma care among adults with substance-related disorders and adults with mental illness. Psychiatr Serv 60(1):43–49

    Article  Google Scholar 

  86. Hancox RJ, Poulton R, Ely M, Welch D, Taylor DR, McLachlan CR et al (2010) Effects of cannabis on lung function: a population-based cohort study. Eur Respir J 35(1):42–47

    Article  CAS  Google Scholar 

  87. Belendiuk KA, Baldini LL, Bonn-Miller MO (2015) Narrative review of the safety and efficacy of marijuana for the treatment of commonly state-approved medical and psychiatric disorders. Addict Sci Clin Pract:10(10)

  88. Schrot RJ, Hubbard JR (2016) Cannabinoids: medical implications. Ann Med 48(3):128–141

    Article  CAS  Google Scholar 

  89. Whiting PF, Wolff RF, Deshpande S, Di Nisio M, Duffy S, Hernandez AV et al (2015) Cannabinoids for medical use: a systematic review and meta-analysis. JAMA 313(24):2456–2473

    Article  CAS  Google Scholar 

  90. Tashkin DP (2014) Increasing cannabis use: what we still need to know about its effects on the lung. Respirology 19(5):619–622

    Article  Google Scholar 

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  1. Division of Respiratory Diseases, School of Medicine Pontificia Universidade Catolica do Rio Grande do Sul, Av Ipiranga 6680 Room 501, Porto Alegre, 90610-000, Brazil

    J. M. Chatkin & L. Zani-Silva

  2. Respirology Division, McMaster University, 399 Bathurst St, Toronto, ON, M5T2S8, Canada

    I. Ferreira

  3. Department of Medicine, Division of Respiratory Diseases, University of Toronto, 399 Bathurst St, Toronto, ON, M5T2S8, Canada

    N. Zamel

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Chatkin, J.M., Zani-Silva, L., Ferreira, I. et al. Cannabis-Associated Asthma and Allergies. Clinic Rev Allerg Immunol 56, 196–206 (2019). https://doi.org/10.1007/s12016-017-8644-1

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