Abstract
Cannabinoid use, particularly for recreational purposes, is increasing exponentially
across all age groups, especially in younger populations, due to its perceived low
risk and legalization. While cannabinoids may be largely considered as safe, there
is mounting evidence of increased risk of systemic and neurological complications
through their interaction with the poorly understood endocannabinoid receptor network
within the central nervous system and other organ systems. Acute cannabinoid exposure
can cause neuropsychiatric symptoms in addition to altering cerebral blood flow, leading
to cerebrovascular complications such as ischemic stroke, subarachnoid hemorrhage,
and reversible cerebral vasoconstriction syndrome (RCVS). Chronic use, particularly
among adolescents, may be associated with increased risk of long-term cognitive deficits,
schizophrenia, and other neuropsychiatric effects. Synthetic cannabinoids have increased
potency, with reports of causing profound neurological complications including coma,
seizures, posterior reversible encephalopathy syndrome, and RCVS. Despite increasing
evidence, the quality of literature describing neurologic complications with cannabinoids
remains limited to case series and retrospective cohort studies, with significant
confounding factors such as concomitant use of other illicit drugs, limiting interpretation.
In this review, we summarize the effect of cannabinoids on the neurologic system and
associated neurological complications.
Keywords
cannabis - THC - cannabinoids - neurological complications - substance abuse
