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Background: Prevalence of nitrous oxide (N2O) use appears to be increasing in numerous countries worldwide, and excessive use has been associated with physical and mental problems. Because there currently is no consensus whether N2O has addictive potential, we aimed to evaluate the evidence for the presence and prevalence of DSM‐5 substance use disorder (SUD) symptoms in N2O users. Analysis: A literature search was conducted to assess the evidence for the presence of any of the 11 DSM‐5 SUD symptoms in N2O users and the prevalence experiencing those symptoms. A substantial part of the studied N2O users use more than intended (i.e. 46% to 98%) and spend a substantial amount of time using N2O. At least some of the studied N2O users experience interpersonal problems (i.e. 13% to 80%) and use N2O in risky situations, such as driving under the influence. Evidence for the other criteria is either insufficient or inconclusive. Conclusions: The literature base for the presence and prevalence of DSM‐5 substance use disorder (SUD) symptoms in nitrous oxide (N2O) users is limited and largely consists of qualitative studies and case studies, but it provides consistent evidence for the presence of at least four SUD criteria in heavy N2O users. N2O could well be addictive and should be treated as a potentially addictive substance until systematic assessments can provide evidence‐based guidance to users, healthcare professionals and legislators. [ABSTRACT FROM AUTHOR]

The article argues for increasing awareness and research on the influence of cannabis contexts on processes underlying cannabis use disorder and associated outcomes in order to determine variations for measuring and embracing regional similarities and differences. It points out differences in routes of administration throughout regions and its impact on the bioavailability of cannabinoids. It also discusses the effect of the interplay of legal policies and social attitudes on cannabis use.

Aims: Cognitive and motivational processes are thought to underlie cannabis use disorder (CUD), but research assessing how cognitive processes [e.g. interference control (IC)] interact with implicit [e.g. attentional bias (AB)] and explicit motivation (i.e. craving) is lacking. We assessed the presence of AB in cannabis users with varying use severity and tested models of moderation, mediation and moderated mediation to assess how AB, craving and IC interact in their association with measures of cannabis use. Design: A cross‐sectional study design was used. Setting and participants: Eight studies performed by our laboratory in the Netherlands including never‐sporadic, occasional (≤ 1/month) and regular cannabis users (≥ 2/week), and individuals in treatment for CUD were combined (n = 560; 71% male). Measurements Studies included a classic Stroop task (IC), a cannabis Stroop task (AB) and measures of session‐induced and average session craving. Both heaviness of cannabis use (grams/week) and severity of use related problems were included. Findings Only those in treatment for CUD showed an AB to cannabis (P = 0.019) and group differences were only observed when comparing CUD with never‐sporadic users (P = 0.007). In occasional and regular users, IC was negatively associated with heaviness (β = 0.015, P < 0.001), but not severity of use. Average session craving (exploratory), but not session‐induced craving (confirmatory), mediated this association between AB and heaviness (β = 0.050, P = 0.011) as well as severity of use (β = 0.083, P = 0.009); higher AB was associated with heavier use and more severe problems through increased craving. Conclusions: Attentional bias only appears to be present in cannabis users with the most severe problems and craving appears to mediate the association between attentional bias and both heaviness and severity of use in occasional and regular users. The association of interference control with heaviness but not severity of use may point to subacute intoxication effects of cannabis use on interference control. [ABSTRACT FROM AUTHOR]

The authors argue for urgent government action to address nitrous oxide (N2O) addiction and related harms. Emphasis is given on the importance of treating N2O as a potentially addictive substance to highlight the urgency for additional research and evidence-based regulation and to encourage education about its risks and the accessibility of healthcare. The authors call for research funding to increase knowledge on the addictive potential of N2O and signs and symptoms of N2O use disorder.

Aims: To summarize and evaluate our knowledge of the relationship between heavy cannabis use, cannabis use disorder (CUD) and the brain. Methods: Narrative review of relevant literature identified through existing systematic reviews, meta‐analyses and a PubMed search. Epidemiology, clinical representations, potential causal mechanisms, assessments, treatment and prognosis are discussed. Results: Although causality is unclear, heavy and dependent cannabis use is consistently associated with a high prevalence of comorbid psychiatric disorders and learning and memory impairments that seem to recover after a period of abstinence. Evidence regarding other cognitive domains and neurological consequences, including cerebrovascular events, is limited and inconsistent. Abstinence after treatment is only achieved in a minority of cases; treatment targeted at reduction in use appears have some success. Potential moderators of the impact of CUD on the brain include age of onset, heaviness of use, CUD severity, the ratio of ∆9‐tetrahydrocannabinol to cannabidiol and severity of comorbid disorders. Conclusions: Current evidence of long‐term effects of daily cannabis use and cannabis use disorder on brain‐related outcomes is suggestive rather than conclusive, but use is associated with psychiatric morbidity and with cognitive impairments that recover after a period of abstinence. [ABSTRACT FROM AUTHOR]

The iCann Toolkit is an important step towards standardized measurement of cannabis consumption in both clinical and research settings. However, there are still significant challenges caused by regional differences in cannabis potency and cultural differences in methods of administration that will need to be addressed. [ABSTRACT FROM AUTHOR]