America Addresses Two Epidemics: Cannabis and Coronavirus and their Interactions: An Ecological Geospatial Study

Albert S Reece; Gary K Hulse

Importantly the cannabis industry is known to have recently increased its activity significantly in USA following widespread relaxation of regulations pertaining to its use, and a 2018 study indicated that legalization was associated with an increase of more than 1,000,000 cannabis users and 500,000 cannabis-dependent people 11 . A large literature describes the immunosuppressive properties of several cannabinoids including Δ9tetrahydrocannabinol (THC), cannabidiol and cannabinol [12] [13] [14] [15] [16] [17] [18] [19] [20] . Cannabis users frequently inhale with deep breaths which are held for long period so that smoke can penetrate deeply into the lung 12, 21 . Moreover cannabis has been shown to be contaminated with foreign chemicals, viruses and fungal spores 22-25 so that concern has been expressed that patients can be relatively immunocompromised and at heightened risk of exposure to microorganisms placing them at increased risk of infection 26 .