Accidents & Violence, Aging, Author Interviews, Cannabis, JAMA / 19.01.2024
Even older, regular users of cannabis should refrain from driving after cannabis use
MedicalResearch.com Interview with:
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Dr. Di Ciano[/caption]
Patricia Di Ciano, PhD
Scientist, Institute for Mental Health Policy Research, Centre for Addiction and Mental Health
Assistant Professor, Department of Pharmacology and Toxicology
University of Toronto
Campbell Family Mental Health Research Institute
Collaborative Program in Neuroscience
MedicalResearch.com: What is the background for this study?
Response: It is now fairly well established that cannabis has a detrimental effect on driving. The most consistently reported effect of cannabis on driving is to increase ‘weaving’ on the road. We know that cannabis use is on the rise in people over 65 years of age. In fact, over the past few years cannabis use is increasing the most in this age group.
Despite this, there are few studies of the effects of cannabis on people over 65; most studies have been conducted on younger adults. We know that there are important age-related changes in the way the body works that may alter the impact of cannabis on the body. Also, older adults may have more experience with cannabis and this can change the effects of cannabis.
Dr. Di Ciano[/caption]
Patricia Di Ciano, PhD
Scientist, Institute for Mental Health Policy Research, Centre for Addiction and Mental Health
Assistant Professor, Department of Pharmacology and Toxicology
University of Toronto
Campbell Family Mental Health Research Institute
Collaborative Program in Neuroscience
MedicalResearch.com: What is the background for this study?
Response: It is now fairly well established that cannabis has a detrimental effect on driving. The most consistently reported effect of cannabis on driving is to increase ‘weaving’ on the road. We know that cannabis use is on the rise in people over 65 years of age. In fact, over the past few years cannabis use is increasing the most in this age group.
Despite this, there are few studies of the effects of cannabis on people over 65; most studies have been conducted on younger adults. We know that there are important age-related changes in the way the body works that may alter the impact of cannabis on the body. Also, older adults may have more experience with cannabis and this can change the effects of cannabis.
Lauren C. Davis, MBS
Department of Medical Education
Geisinger Commonwealth School of Medicine
Scranton, PA 19409
MedicalResearch.com: What is the background for this study?
Response: Financial conflicts of interest (COIs) resulting from ties between academia and industry have been under scrutiny for their potential to hinder the integrity of medical research. COIs can lead to implicit bias, compromise the research process, and erode public trust (1-6). The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM), standardizes symptom criteria and codifies psychiatric disorders. This manual contributes to the approval of new drugs, extensions of patent exclusivity, and can influence payers and mental health professionals seeking third-party reimbursements. Given the implications of the DSM on public health, it is paramount that it is free of industry influence. Previous research has shown a high prevalence of industry ties among panel and task force members of the DSM-IV-TR and DSM-5, despite the implementation of a disclosure policy for the DSM-5 (7,8). This study (9) determined the extent and type of COIs received by panel and task-force members of the DSM-5-TR (2022) (10). As the DSM-5-TR did not disclose COI, we used the Center for Medicare and Medicaid Services Open Payments (OP) database (11) to quantify them.
Scott Kaplan PhD
Assistant Professor of Economics
United States Naval Academy
Annapolis, MD 21402
MedicalResearch.com: What is the background for this study?
Response: Sugar-sweetened beverages (colloquially known as SSBs), which include sodas, fruit drinks, sports drinks, energy drinks, and sweetened coffee drinks, are the leading source of added sugars in the American diet, according to the CDC. They are associated with serious negative health outcomes, including type 2 diabetes, obesity, heart disease, kidney disease,
Kalli Koukounas[/caption]
Kalli Koukounas, MPH
Dr. Lu Qi[/caption]
Lu Qi, MD, PhD, FAHA
Interim Chair, Department of Epidemiolog
HCA Regents Distinguished Chair and Professor
Tulane University School of Public Health and Tropical Medicine
Director, Tulane University Obesity Research Center
Director, Tulane Personalized Health Institute
New Orleans, LA 70112
MedicalResearch.com: What is the background for this study?
Response: Adding salt to foods is a behavior reflecting long-term preference to salty diets. High sodium intake is a major risk factor for chronic kidney disease.
In our previous studies, we have found that adding salt to foods at the table is related to various disorders including cardiovascular diseases, diabetes, and mortality.
Amy Kennalley[/caption]
Amy Kennalley, MBS
First Year Medical Student
Department of Medical Education
Geisinger Commonwealth School of Medicine
MedicalResearch.com: What is the background for this study?
Response: Opioid use disorder (OUD) is a major public health crisis in the United States. Despite the availability of effective treatments, including the medication-assisted treatment (MAT) with methadone, many individuals with OUD do not receive the care they need. Over the COVID-19 pandemic, there were several policy changes related to take-home doses of methadone, which may have impacted access to this lifesaving medication.
The Drug Enforcement Administration's (DEA)'s Automated Reports and Consolidated Ordering System (ARCOS) is a database that tracks the distribution of controlled substances, including methadone distributed to opioid treatment programs (OTPs). This data can be used to assess trends in methadone distribution over time. Additionally, the Medicaid State Drug Utilization Data (SDUD) database provides comprehensive information on methadone prescribing to Medicaid patients.
By analyzing data from both ARCOS and SDUD, we aimed to provide a comprehensive picture of methadone distribution for OUD treatment in the United States. These findings1 are important because drug overdose deaths, primarily involving opioids, increased substantially (49%) from 2019 (70,980) to 2021 (~106,000).2
Dr. Klompas[/caption]
Michael Klompas MD, MPH, FIDSA, FSHEA
Hospital Epidemiologist
Brigham and Women’s Hospital
Professor of Medicine and Population Medicine
Harvard Medical School and
Harvard Pilgrim Health Care Institute
MedicalResearch.com: What is the background for this study? Can teeth be safely brush in patients who are comatose, intubated or have NG tubes?
Response: Pneumonia is thought to occur when secretions from the mouth get into the lungs. Since there are many microbes in the mouth, there’s a risk that secretions from the mouth that get into the lungs will lead to pneumonia. Toothbrushing may lower this risk by decreasing the quantity of microbes in the mouth.
It is indeed safe and appropriate to brush the teeth of someone who is comatose, intubated, or who has an NG tube. Indeed, our study found that the benefits of toothbrushing were clearest for patients receiving mechanical ventilation.
Dr. Angélica Cifuentes Kottkamp[/caption]
Angélica
Dr. Brousseau[/caption]
David Brousseau, MD, MS
Chair of Pediatrics
Nemours Children’s Health, Delaware and the
Sidney Kimmel Medical College at Thomas Jefferson University
Prof. Rong Xu[/caption]
Rong Xu, PhD
Dr. Davaasambuu[/caption]
Dr Ganmaa Davaasambuu MD PhD
Associate Professor
Harvard T.H. Chan School of Public Health
MedicalResearch.com: What is the background for this study?
Response: The crucial role of vitamin D in facilitating calcium absorption from the diet and promoting calcium deposition in bones (known as 'mineralization') has been a long-established understanding. Furthermore, some observational studies have reported an association between low vitamin D levels and a heightened risk of bone fractures in children. This raised the possibility that vitamin D supplements could potentially play a role in decreasing fracture risk in children with initially low baseline levels. However, clinical trials assessing the causal link between low vitamin D status and reduced fracture risk were necessary, and such trials had not been conducted before.

