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The goal of this study is to systematically determine whether the cannabis response in human females is related to SH fluctuations throughout the menstrual cycle.
Cannabis consumption is increasing globally due to legalization and therapeutic use, prompting concerns about its impact on daily functioning and long-term effects. While research has explored cannabis' risks, the heightened vulnerability of females to its adverse effects has been overlooked. Women experience stronger acute negative reactions and progress to cannabis use disorder faster than men. This gender disparity is likely due to sex hormone (SH) fluctuations related to menstrual cycles, emphasizing the need to study cannabis' differential impact on females to address gender-specific risks and inform treatment approaches. Acute influences of cannabis (300 μg THC/kg bodyweight) on subjective state and cognition will be assessed at three different stages of the menstrual cycle, and compared to a placebo condition in a double-blind, randomized, within-subject study in occasional cannabis using biological females.
Primary Objective: To assess the acute subjective drug effects (good/bad drug effect, drug liking/wanting, anxiety), cognition (attention, working memory, information processing speed, verbal memory, verbal fluency, motor inhibition), and pharmacokinetics of cannabis in females across 3 different phases of the menstrual cycle, compared to a placebo condition.
Secondary Objective(s): to assess the acute effects of cannabis on interoception and pain, in females across 3 different phases of the menstrual cycle, compared to a placebo condition.
Tertiary Objective(s): to assess the acute effects of cannabis on metacognition and expression of inflammatory markers in females across 3 different phases of the menstrual cycle, compared to a placebo condition.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Cannabis | Experimental | All participants will receive cannabis on 3 separate occasions during different phases of the menstrual cycle. |
|
| Knaster hemp | Placebo Comparator | All participants will receive knaster hemp on 3 separate occasions during different phases of the menstrual cycle. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Cannabis | Drug | Bedrobinol (13.5% THC) resulting in 300 μg/kg bodyweight THC, administered via a Storz and Bickel Mighty Medic vaporiser. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Subjective drug effects | Subjective drug effects will be measured via the drug effect questionnaire | Immediately upon inhalation, up to 3.5 hours post administration |
| THC concentration in blood | Blood sample will be taken to assess THC concentration in blood. | Baseline (-0.5 hour) and at set time periods up to 3.5 hours post administration |
| Retrospective rating of drug effects | Retrospective rating of drug effects will be measured via subjective reports on the 5-dimensional altered states of consciousness rating scale | Immediately upon inhalation, up to 3.5 hours post administration |
| Sensitivity to cannabis reinforcement | Measured via the sensitivity to cannabis reinforcement questionnaire, | Immediately upon inhalation, up to 3.5 hours post administration |
| Marijuana Craving | Measured via the marijuana craving questionnaire | Immediately upon inhalation, up to 3.5 hours post administration |
| Anxiety | Measured via the State-Trait anxiety inventory | Immediately upon inhalation, up to 3.5 hours post administration |
| Measure | Description | Time Frame |
|---|---|---|
| Interoception | The Heart rate discrimination task will be used to assess interoception. | +1 hr 15 minutes after administration |
| Subjective experience of pain | The cold pressor task will be used. Pain is assessed via how many seconds participants can keep their hand in the water. |
| Measure | Description | Time Frame |
|---|---|---|
| Metacognition | Before and after each task, participants will be shown full text prompts explaining the task, and asking them how well they believe they will do on the task, and upon completion, how well they think they performed. | Immediately upon inhalation, up to 3.5 hours post administration |
| Inflammatory cytokines |
Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Maastricht University | Recruiting | Maastricht | Netherlands |
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| ID | Term |
|---|---|
| D002189 | Marijuana Abuse |
| ID | Term |
|---|---|
| D019966 | Substance-Related Disorders |
| D064419 | Chemically-Induced Disorders |
| D001523 | Mental Disorders |
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| ID | Term |
|---|---|
| C587251 | nabiximols |
| D013759 | Dronabinol |
| ID | Term |
|---|---|
| D002186 | Cannabinoids |
| D013729 | Terpenes |
| D006838 | Hydrocarbons |
| D009930 | Organic Chemicals |
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Cannabis and placebo will be administered in an AB or BA sequence, with half of the participants following sequence AB and the other half following sequence BA. This will be done across the two menstrual cycles, meaning that each participant will receive the same treatment (either THC or placebo) consistently within one menstrual cycle. This translates to a participant receiving either THC three times in a row or placebo three times in a row during one cycle. In the next cycle, they will receive the opposite treatment. There will be a washout period of 7 days between treatments.
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Random allocation of participants to the treatment order will be done using Sealed Envelope software, by one experimenter who does not come in direct contact with the participants. The study will be double blind to the subject and the testing experimenter. One experimenter will be respond for preparing the drug treatment. If a subject is withdrawn from the study, the replacement subject will be allocated to the same treatment sequence as the subject they are replacing. Following completion of all data collection the study will be fully unblinded.
| Knaster Hemp | Drug | Placebo will consist of knaster hemp, a freely sold aromatic herbal mixture for smoking. Participants will receive a dose of 50 mg of knaster hemp, administered via a Storz and Bickel Mighty Medic vaporiser. |
|
| +2.5 hours after administration |
| Attention | attention will be assessed via the psychomotor vigilance test | Immediately upon inhalation, up to 3.5 hours post administration |
| Information processing speed | Will be assessed via the digit symbol substitution test | Immediately upon inhalation, up to 3.5 hours post administration |
| Verbal Memory | Will be assessed via the Immediate and Delayed Verbal Memory Test | Immediately upon inhalation, up to 3.5 hours post administration |
| Verbal fluency | Will be assessed via the animal fluency test | Immediately upon inhalation, up to 3.5 hours post administration |
| Motor Inhibition | Assessed via the stop signal task | Immediately upon inhalation, up to 3.5 hours post administration |
| Pain threshold | To assess changes in pain threshold, the pressure pain threshold task will be used. | +2.5 hours post administration |
Blood samples will be collected to measure inflammatory cytokine levels |
| At baseline (-0.5) and 3.5 hours after treatment administration |