title: [Cannabis--Position Paper of the German Respiratory Society (DGP)].
abstract: In this position paper, the adverse health effects of cannabis are reviewed based on the existing scientific literature; in addition possible symptom-relieving effects on some diseases are depicted. In Germany, cannabis is the most widely used illicit drug. Approximately 600,000 adult persons show abusive or addictive cannabis consumption. In 12 to 17 year old adolescents, cannabis use increased from 2011 to 2014 from 2.8 to 6.4%, and the frequency of regular use from 0.2 to 1.5%. Currently, handling of cannabinoids is much debated in politics as well as in general public. Health aspects have to be incorporated into this debate. Besides analysing mental and neurological side effects, this position paper will mainly focus on the influences on the bronchopulmonary and cardiovascular system. There is strong evidence for the induction of chronic bronchitis. Allergic reactions including asthma are known, too. Associations with other diseases like pulmonary emphysema, lung cancer and pneumonia are not sufficiently proven, however cannot be excluded either. In connection with the use of cannabis cardiovascular events such as coronary syndromes, peripheral vascular diseases and cerebral complications have been noted. Often, the evidence is insufficient due to various reasons; most notably, the overlapping effects of tobacco and cannabis use can frequently not be separated adequately. Empirically, early beginning, high-dosed, long-lasting and regular cannabis consumption increase the risk of various psychological and physical impairments and negatively affect age-based development. Concerns therefore relate especially to children and adolescents. There is only little scientific evidence for medical benefits through cannabis as a remedy; systematic research of good quality, in particular prospective, randomised, placebo-controlled double-blinded studies are rare. The medical societies signing this position paper conclude that cannabis consumption is linked to adverse health effects which have to be taken into consideration in the debate about the social attitude towards cannabinoids. The societies agree that many aspects regarding health effects of cannabis are still uncertain and need clarification, preferably through research provided by controlled studies.
authors.affiliation: Pneumologie und Beatmungsmedizin, Thoraxklinik, Universitätsklinikum Heidelberg.
authors.forename: M
authors.initials: M
authors.lastname: Kreuter
authors.affiliation: Arbeits-, Sozial- und Umweltmedizin, Klinikum der Universität München.
authors.forename: D
authors.initials: D
authors.lastname: Nowak
authors.affiliation: Klinik für Psychiatrie und Psychotherapie, Klinikum der Universität München, Campus Innenstadt, München.
authors.forename: T
authors.initials: T
authors.lastname: Rüther
authors.affiliation: Klinik und Poliklinik für Psychiatrie und Psychotherapie, Klinikum der Universität München, Campus Innenstadt, München.
authors.forename: E
authors.initials: E
authors.lastname: Hoch
authors.affiliation: Deutsches Zentrum für Suchtfragen des Kindes- und Jugendalters, Universitätsklinikum Hamburg-Eppendorf.
authors.forename: R
authors.initials: R
authors.lastname: Thomasius
authors.affiliation: Klinik u. Poliklinik f. Kinder- u. Jugendmedizin, Abteilung Kinderpneumologie/Allergologie, Universitätsklinikum Carl Gustav Carus, Dresden.
authors.forename: C
authors.initials: C
authors.lastname: Vogelberg
authors.affiliation: Gesundheitsamt Berlin-Mitte, Berufsverband für Kinder- und Jugendärzte.
authors.forename: M
authors.initials: M
authors.lastname: Brockstedt
authors.affiliation: Zentrum für Pneumologie und Onkologie am Diako Augsburg, Bundesverband der Pneumologen, Schlaf- und Beatmungsmediziner.
authors.forename: A
authors.initials: A
authors.lastname: Hellmann
authors.affiliation: Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin, Innere Medizin & Pneumologie, Missionsärztliche Klinik, Würzburg.
authors.forename: H
authors.initials: H
authors.lastname: Gohlke
authors.affiliation: Deutsche Gesellschaft für Kardiologie und Deutsche Herzstiftung.
authors.forename: B
authors.initials: B
authors.lastname: Jany
authors.affiliation: Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin, Berlin.
authors.forename: R
authors.initials: R
authors.lastname: Loddenkemper
mesh_terms: D002188:Cannabis / Q000009:adverse effects*; D019317:Evidence-Based Medicine; D005858:Germany; D008171:Lung Diseases / Q000209:etiology* / Q000517:prevention & control; D002189:Marijuana Abuse / Q000209:etiology*; D008385:Marijuana Smoking / Q000009:adverse effects*; D064086:Medical Marijuana / Q000009:adverse effects*; D017410:Practice Guidelines as Topic; D015272:Pulmonary Medicine / Q000592:standards; D018570:Risk Assessment; D016896:Treatment Outcome
chemical_list: D064086:Medical Marijuana