Do New Medical Marijuana Laws Reduce Opioid Prescriptions?

MedicalResearch.com Interview with:

Silvia S. Martins, MD, PHD Associate Professor of Epidemiology Department of Epidemiology Mailman School Of Public Health Columbia University New York, NY 10032

Dr. Silvia Martins

Silvia S. Martins, MD, PHD
Associate Professor of Epidemiology
Department of Epidemiology
Mailman School Of Public Health
Columbia University 

MedicalResearch.com: What is the background for this study?

Response: Prior studies have suggested t6hat medical marijuana legalization might play a role in decreasing opioid use.

We aimed to test this hypothesis using individual level data on nonmedical use of prescription opioids and opioid use disorder  from the US National Survey on Drug Use and Health.  Continue reading

Do New Medical Marijuana Laws Increase Teen Use of Cannabis?

MedicalResearch.com Interview with:

D. Mark Anderson, Ph.D. Associate Professor Department of Agricultural Economics and Economics Montana State University, IZA, and NBER

Dr. Anderson

D. Mark Anderson, Ph.D.
Associate Professor
Department of Agricultural Economics and Economics
Montana State University, IZA, and NBER

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Using data from the Youth Risk Behavior Surveys for the period 1993-2017, we explore the effect medical and recreational marijuana laws have on teen use.

We find that medical marijuana laws (MMLs) are not associated with teen marijuana consumption, but recreational marijuana laws (RMLs) are actually negatively associated with teen use. 

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Cognitive Brain Circuits Altered in Youth With Significant Cannabis Use

MedicalResearch.com Interview with:

Marilyn Cyr, Ph.D., Psy.D. Postdoctoral Research Scientist Division of Child and Adolescent Psychiatry New York State Psychiatric Institute Columbia University Medical Center New York, NY 10032

Dr. Cyr

Marilyn Cyr, Ph.D., Psy.D.
Postdoctoral Research Scientist
Division of Child and Adolescent Psychiatry
New York State Psychiatric Institute
Columbia University Medical Center
New York, NY 10032

MedicalResearch.com: What is the background for this study?

Response: A hallmark feature of problematic substance use is compulsive drug-seeking long after the drug is no longer experienced as pleasurable and despite the associated adverse consequences of this behavior. Disturbances in cognitive control—an ensemble of processes by which the mind governs behaviors, regulates impulses and guides decisions based on goals—are believed to be involved in the initiation and maintenance of the compulsive drug-seeking that characterizes problematic substance use. Most adults with problematic substance use began having problems with drugs and alcohol in adolescence, a developmental period during which the neural circuits underlying cognitive control processes continue to mature.

As such, the adolescent brain may be particularly vulnerable to the effects of substance use, and particularly cannabis, the most commonly used recreational drug by teenagers worldwide.

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Cannabis and Tobacco/Nicotine Co-Use Common Among Young Adults

MedicalResearch.com Interview with:

Joan S. Tucker, Ph.D.Senior Behavioral ScientistRAND CorporationSanta Monica, CA

Dr. Tucker

Joan S. Tucker, Ph.D.
Senior Behavioral Scientist
RAND Corporation
Santa Monica, CA

MedicalResearch.com: What is the background for this study?  

Response: In light of young adults’ expanding access to cannabis through legalization for recreational use, there has been growing interest in the co-use of cannabis with tobacco/nicotine products.  Although existing data show that young adults who use cannabis products also tend to use tobacco/nicotine products, little is known about how these products are typically used together.

Existing research on co-use has mostly focused on combustible products, not accounting for the recent proliferation in cannabis and tobacco/nicotine product types and methods of use (e.g., vaping). Further, not much is known about whether there are important differences between types of co-use (e.g., using both products on the same occasion, one right after another, but not mixing them vs. using both products by mixing them in the same delivery device) in terms of heaviness of use, consequences from use, or associations with young adult functioning.

This study was designed as an important first step toward understanding cannabis and tobacco/nicotine co-use behavior among young adults and addressing these gaps in the research literature.

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14% Drivers with Kids in the Car Tested Positive for Cannabis

MedicalResearch.com Interview with:
Angela Eichelberger, Ph.D.
Senior Research Scientist
Insurance Institute for Highway Safety

MedicalResearch.com: What is the background for this study?

Response: Dr. Romano and Dr. Kelley-Baker have previously studied the problem of child endangerment in alcohol-related crashes. In the United States, each year, about 200 children die and another 4,000 are injured while being driven by a drinking adult.

For this study, we wanted to take the opportunity to look at the prevalence of alcohol and cannabis use among drivers who participated in a roadside survey in Washington State. To our knowledge, this is the first study to examine cannabis use among drivers transporting a child.

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Does Marijuana Really Cause the Munchies?

MedicalResearch.com Interview with:
"Chocolate Brownies" by Kurtis Garbutt is licensed under CC BY 2.0. To view a copy of this license, visit: https://creativecommons.org/licenses/by/2.0Jessica S. Kruger PhD
Clinical Assistant Professor
Department of Community Health and Health Behavior
School of Public Health and Health Professions
University of Buffalo
Daniel J. Kruger PhD
Adjunct Faculty Associate, Population Studies Center.
Michigan’s Population Studies Center 

MedicalResearch.com: What is the background for this study?

Response: The legal environment for cannabis is changing rapidly and an increasing proportion of people are using cannabis for medical and recreational purposes. All policy and practice should be informed by science, yet there is a large gap between evidence and existing practices, and the current scope of research on cannabis users is limited.

Public Health has the responsibility of protecting the public, maximizing benefits and minimizing harm in any area. However, the Public Health approach to cannabis has largely been limited to a focus on abstinence, and Federal regulations have restricted the scope of cannabis-related research.

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Marijuana Use During Pregnancy May Increase Risk of Psychosis in Offspring

MedicalResearch.com Interview with:

Jeremy FineB.A. in Philosophy, Neuroscience, and PsychologyWashington University in St. Louis, Class of 2019

Jeremy Fine

Jeremy Fine
B.A. in Philosophy, Neuroscience, and Psychology
Washington University in St. Louis, Class of 201

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Alongside increasingly permissive marijuana use attitudes and laws, the prevalence of marijuana use among pregnant mothers has increased substantially (by 75% between 2002 and 2016), with some evidence that pregnant women may be using cannabis to combat pregnancy-related nausea.

Our data came from the Adolescent Brain Cognitive Development (ABCD) Study, which included over 4,000 subjects with data on maternal marijuana use during pregnancy.

Our main finding was that the children of mothers who used marijuana after learning they were pregnant had a small but significant increase in risk for psychosis in their future.

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What Happens to Crime Rates When Marijuana Dispensaries Open in the Neighborhood?

MedicalResearch.com Interview with:

Lonnie M. Schaible PhD Associate Professor School of Public Affairs University of Colorado Denver, CO

Dr. Schaible

Lonnie M. Schaible PhD
Associate Professor
School of Public Affairs
University of Colorado
Denver, CO

MedicalResearch.com: What is the background for this study?

Response: Following legalization of recreational marijuana use in Colorado, strong — but unsubstantiated — claims were being made about crime surrounding marijuana dispensaries.  We wanted to know what the data would show.  We were especially interested in determining whether the addition of recreational facilities had any effects above and beyond those which might exist for medical dispensaries.  To better capture the dynamic landscape of marijuana legalization, this is the first study to control for the prior existence of medical dispensaries and assess how effects of both of these types of establishments changed over time.

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Medical Marijuana Users Preferred Cannabis to Pharmaceuticals

MedicalResearch.com Interview with:

Daniel J. Kruger, PhD Research Assistant Professor University of Michigan

Dr. Kruger

Daniel J. Kruger, PhD
Research Assistant Professor
University of Michigan

MedicalResearch.com: What is the background for this study?

Response: We study health-related behaviors, such as diet and the consumption of caffeine and alcohol.

Given the recent trends in legalization of cannabis for medical and even recreational purposes, we were concerned with the narrow focus of current public health efforts regarding cannabis. Although some in the field take a harm-reduction approach to substance use, too many efforts focus solely on abstinence. These programs are a legacy from the era of prohibition, and we know that there are disadvantages to such a restricted scope in public health.

For example, municipalities that eliminated or blocked accurate and effective sex education had increases in teenage pregnancy rates. There are so many public health-related aspects of cannabis, beyond risks and adverse effects, which need to be addressed by systematic scientific research. Because of the legal history of cannabis, there is little integration with the mainstream health care system.

The focus of the current study was investigating how medical cannabis users perceived medical cannabis in comparison to pharmaceutical drugs and other aspects of the mainstream health care system and how they navigated they relationships between these currently separate systems

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Glaucoma: CBD (cannabidiol) May Raise Pressure in Eye

MedicalResearch.com Interview with:

Alex Straiker PhD Senior Scientist Psychological & Brain Sciences Indiana University 

Dr. Straiker

Alex Straiker PhD
Senior Scientist
Psychological & Brain Sciences
Indiana University 

MedicalResearch.com: What is the background for this study?

Response: We’ve known for almost 50 years that cannabis can lower ocular pressure but the mechanism of action was still unknown.  Most of the work on this stopped well before the cannabinoid receptors were discovered in the early 1990s.

Over the last several years we have determined that three different cannabinoid receptors (CB1, GPR18, and GPR119) each can lower pressure in mice when activated.  Once this was established, it made sense to go back to THC (and CBD) to see how they act.

MedicalResearch.com: What are the main findings? 

Response: There are four main findings.

  • Probably the most interesting is that CBD raises ocular pressure in mice.  Ours isn’t the first study to show this but we do show how it works.
  • Our second major finding is that THC lowers pressure through a combination of CB1 and GPR18 receptors.
  • The third major finding is that the effect of THC is sex-dependent, with longer effects in male mice.
  • Lastly, CBD cancels out the pressure-lowering effects of THC, probably by blocking CB1 receptors.  

MedicalResearch.com: What should readers take away from your report?

Response: There are two main take-homes.

  • There is a real possibility that CBD elevates ocular pressure and therefore the risk of glaucoma as a side-effect. This is significant given the widespread (and growing) availability of CBD and its recent FDA approval as a treatment for Dravet’s Syndrome.  Second, the sex-dependence is significant in and of itself but also because the current AAO position that topical THC is ineffective as a glaucoma therapy is based on four studies, three of which were small mixed-sex subject pools.  If the sex-dependence holds for humans, then it is possible that those studies yielded a false-negative result. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: The question of whether CBD raises ocular pressure in humans should be revisited and should be monitored in patients being treated for Dravet’s Syndrome.

No disclosures.   

Citation:

Sally Miller, Laura Daily, Emma Leishman, Heather Bradshaw, Alex Straiker. Δ9-Tetrahydrocannabinol and Cannabidiol Differentially Regulate Intraocular Pressure. Investigative Opthalmology & Visual Science, 2018; 59 (15): 5904 DOI: 10.1167/iovs.18-24838

 

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The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.

 

When Asked, Teens Frequently Report Hallucinations, Paranoia or Anxiety with Marijuana Use

MedicalResearch.com Interview with:

Sharon Levy, MD, MPH Director, Adolescent Substance Use and Addiction Program Boston Children's Hospital Associate Professor of Pediatrics Harvard Medical School

Dr. Levy

Sharon Levy, MD, MPH
Director, Adolescent Substance Use and Addiction Program
Boston Children’s Hospital
Associate Professor of Pediatrics
Harvard Medical School 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: ​For this study we analyzed data that were collected as part of a larger survey study that recruited a sample of adolescents who were coming to the doctor’s office for routine medical care.  We asked them a lot of questions about their health, school, extracurricular activities, plans for the future, substance use patterns and problems associated with use among other things.

The main finding was that among the participants who reported marijuana use in the past year, many of them, more than 40%, said that they had experienced either an hallucination, or paranoia/anxiety related to their use.

Kids who used more frequently and those who met criteria for a substance use disorder were more likely to experience these symptoms, as were those who had symptoms of depression Continue reading

Youth with Conduct Problems More Likely To Use Cannabis

MedicalResearch.com Interview with:

Dan Romer PhD Research director, Annenberg Public Policy Center Director of its Adolescent Communication Institute University of Pennsylvania

Dr. Daniel Romer

Daniel Romer PhD
Annenberg Public Policy Center
The University of Pennsylvania
Philadelphia, PA

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Previous research has found some troubling relations between adolescent cannabis use and subsequent increases in conduct problems and other unhealthy consequences.  These studies were done in New Zealand in the late 90’s and we wanted to re-examine those relationships using more contemporary data in the US.

We had data on 364 adolescents who were followed from age 13 to 19 in Philadelphia that could provide a more up to date picture of the effects of using cannabis on one important outcome, conduct disorder.  We also wanted to use more sensitive methods than had been used in prior research that would enable us to examine reciprocal relations between cannabis use and c (CP).  That is, it might be the case that youth with CP are prone to using cannabis and that this helps to explain why there appears to be a relation over time between cannabis use and CP rather than cannabis use leading to CP.

Our findings supported that hypothesis.  There was no prospective relation between changes in cannabis use and subsequent changes in conduct problems.  Instead, changes in conduct problems were found to predict changes in use of cannabis.  Youth with conduct problems also affiliated more with peers who used cannabis, adding further to their own use.  There was also no evidence that youth who used cannabis sought out peers who used it apart from the effects of CP.

Finally, both use of cannabis and  conduct problems predicted subsequent development of a mild cannabis use disorder (CUD).  Continue reading

Asthma in Children Can Worsen From Allergy to Secondhand Marijuana

MedicalResearch.com Interview with:
"marijuana joint" by Torben Hansen is licensed under CC BY 2.0Bryce Hoffman, MD

Allergy & Immunology Fellow
National Jewish Health

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Secondhand marijuana exposure is expected to increase as personal cannabis use becomes legalized in more states and countries. Cannabis allergy from firsthand use has been reported in adults but allergy in young children exposed to secondhand smoke has not been previously reported. We present a case of a young child with difficult-to-control asthma who was found to have cannabis allergy after being exposed to secondhand marijuana smoke in his household. This child’s asthma improved after cannabis was removed from the environment.

MedicalResearch.com: What should readers take away from your report?

Response: Children exposed to secondhand marijuana smoke can become allergic to cannabis, which in turn may significantly worsen their asthma or allergy symptoms. This is particularly concerning as the cannabis may not be suspected as a cause. Parents and physicians should consider the possibility of cannabis allergy in any child with uncontrolled asthma who is being exposed to secondhand marijuana smoke. This includes any use of marijuana in the household where the patient lives. These children should be referred to an allergist for further work-up.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Further studies are needed to replicate these results with more patients in the future, and to optimize methods of testing for cannabis allergy. We need to better understand how secondhand allergy develops – is it from particles in the smoke, or plant particles left over in the environment? We also need to better characterize cannabis allergy and in particular its cross-reactivity with other plant foods and pollens. 

I have no disclosures.

Citation:Abstract MEETING American College of Allergy, Asthma and Immunology 2018 Annual Scientific Meeting

Abstract Title: Cannabis allergy in a young child with severe asthma exposed to secondhand marijuana smoke

Author: Bryce Hoffman, MD

[last-modified]

The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.

 

Prenatal Heavy Cannabis Exposure May Diminish Cognitive Functioning Into Adulthood

MedicalResearch.com Interview with:

Ryan J. McLaughlin, PhD Assistant Professor Department of Integrative Physiology & Neuroscience College of Veterinary Medicine Washington State University Pullman, WA 99164-7620

Dr. McLaughlin

Ryan J. McLaughlin, PhD
Assistant Professor
Department of Integrative Physiology & Neuroscience
College of Veterinary Medicine
Washington State University
Pullman, WA 99164-7620

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: The use of cannabis during pregnancy is a growing health concern, yet the long-term cognitive ramifications for developing offspring remain largely unknown. Human studies exploring the long-term effects of maternal cannabis use have been sparse for several reasons, including the length and cost of such studies, as well as the fact that experimentally assigning mothers to smoke cannabis during pregnancy is obviously ethically impractical. Animal models of maternal cannabis use have been advantageous in this respect, but they have been limited by the drugs used (synthetic cannabinoids vs. THC vs. cannabis plant) and the way that they are administered. In our study, we used a more translationally relevant animal model of maternal cannabis use that exposes pregnant rat dams to whole plant cannabis extracts using the intra-pulmonary route of administration that is most common to human users. Our preliminary data indicate that twice-daily exposure to a high-dose cannabis extract during pregnancy may produce deficits in cognitive flexibility in adult rat offspring. Importantly, these rats did not experience general learning deficits, as they performed comparably to non-exposed offspring when required to follow a cue in their environment that dictate reinforcer delivery. Instead, deficits were observed only when rats were required to disregard this previous cue-based strategy and adopt a new egocentric spatial strategy in order to continue receiving the sugar reinforcers.

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Is there an Association between Cannabis and Acute Kidney Injury in CKD Patients?

MedicalResearch.com Interview with:
"Big bags of medical #marijuana on Cannabis Culture News LIVE - watch now on www.pot.tv" by Cannabis Culture is licensed under CC BY 2.0Praveen Kumar Potukuchi, B.Pharm, MS
The University of Tennessee Health Science Center

MedicalResearch.com: What is the background for this study?

Response: Several case reports have indicated that synthetic cannabinoid use is associated with acute kidney injury (AKI). However, it is unclear whether similar adverse effects could occur with medicinal or recreational cannabis use. Previous research has shown that the use of medical marijuana /cannabis for an average of two weeks resulted in no serious adverse effects and no incidence of AKI.

However, there are no studies which investigated the effects of marijuana/cannabis use on the incidence of AKI in patients with advanced CKD.

Continue reading

Should You Get a Ticket For Driving Stoned?

MedicalResearch.com Interview with:

Prof. Mark A. R. Kleiman PhD Affiliated Faculty, NYU Wagner; Professor of Public Policy NYU Marron Institute of Urban Management

Prof. Kleiman

Prof. Mark A. R. Kleiman PhD
Affiliated Faculty, NYU Wagner; Professor of Public Policy
NYU Marron Institute of Urban Management

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: As state after state legalizes the sale of cannabis, the question of cannabis-impaired driving is getting more attention. There is evidence that the practice has become more common, both because cannabis use – and especially heavy, frequent use – has increased and because a distressingly large fraction of cannabis users believe, falsely, that stoned driving is safe.

The natural response to the problem is to treat cannabis on a par with alcohol: fairly severe criminal penalties for impaired driving, with impairment defined by a specific level of the drug in the body. The paper argues that this would be a mistake, for four independent reasons:

– While cannabis makes driving riskier, it does so by about a factor of two, with no strongly observed dependency on dosage. Alcohol, by contrast, has a steep dose-effect curve. At the legal limit of 0.08% blood alcohol content by weight, the relative risk of drunk driving is at least eight; at 0.15%, which is fairly common, the relative risk has been estimated at 30-50. So there is no justification for punishing stoned driving as severely as we punish drunk driving.

– The lack of evidence of a strong dose-effect relationship suggests that a legal standard based on the content of cannabinoids in blood may not be appropriate.

– Even if a blood standard were valid, the lack of a breath test would make enforcing that standard nearly impossible as a practical matter.

– The long and unpredictable course of cannabis metabolism means that frequent users will be at risk of failing a drug test even when they are neither subjectively intoxicated nor objectively impaired. Worse, they would have no way of judging in advance whether or not driving would be legal. The result would be a re-criminalization of cannabis use through the back door.  Continue reading

Katexco Pharmaceuticals To Develop Cannabis Derivative CBD to Suppress Inflammatory Conditions

Jonathan Rothbard, MA, PhD Steinman Lab Stanford Medicine Co-founder Katexco Pharmaceuticals

Dr. Rothbard

MedicalResearch.com Interview with:
Jonathan Rothbard, MA, PhD
Steinman Lab Stanford Medicine
Co-founder Katexco Pharmaceuticals

MedicalResearch.com: What is the background for this new company? How did Katexco get its name?

Response: Researchers with Stanford University, Jonathan Rothbard and Lawrence Steinman, formed Katexco Pharmaceuticals. Katexco will focus on developing oral therapies for inflammatory diseases based on cannabis and nicotine receptors.

Katexco will work to develop the first drug to focus on a key receptor on immune cells that are involved in inflammatory disease. The first primary target indications include gastrointestinal disorders like Crohn’s disease, gout and multiple sclerosis.

Katexco is from the Greek word to restrain or regulate, and we are trying to restrain the immune system in inflammatory disease.

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Cannabis Improved Symptoms, but Not Inflammation of Crohn’s Disease

MedicalResearch.com Interview with:

“Cannabis sativa” by Manuel is licensed under CC BY 2.0

Timna Naftali MD
Specialist in Gastroenterology
Meir Hospital and Kupat Holim Clinic,
Tel Aviv University, Israel

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: In previous studies we could see that Crohn’s patients improve symptoms when taking cannabis but we did not have good data about actual inflammation.

So, in this study we added a colonoscopy to see if we can detect any change in inflammation. We also wanted to find a better mode of consuming cannabis, other than smoking.

MedicalResearch.com: What should readers take away from your report?

 Response: The take home massage would be that cannabis may help the patients feel better, but is not a replacement of conventional medical therapy. It should be used as an adjuvant to other treatments in appropriate cases.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Regarding future research, there are many points that should be addressed:

  • Cannabis in laboratory trials does have an anti-inflammatory effect. We have to find a way of translating this effect to clinical treatment
  • What is the best way of administering cannabis? (We certainly do not want to recommend smoking)
  • What is the best dose/combination?
  • What are the long term effects?
  • Which patients, if any, will benefit most?

Citation:

UEG 2018 abstract:
https://live.ueg.eu/week/
Cannabis induces clinical response but no endoscopic response in Crohn’s disease patients

[last-modified]

The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.

 

Outbreak of Synthetic Cannabinoid–Associated Bleeding Disorders in Illinois

MedicalResearch.com Interview with:

Dr. Amar Kelkar MD Clinical Fellow Division of Hematology & Oncology, Department of Medicine University of Florida College of Medicine, UF Health Shands Hospital

Dr. Kelkar

Dr. Amar Kelkar MD
Clinical Fellow
Division of Hematology & Oncology, Department of Medicine
University of Florida College of Medicine, UF Health Shands Hospital

MedicalResearch.com: What is the background for this study? What are synthetic cannabinoids?

Response: Starting in March 2018, patients began reporting to hospitals and clinics with unexplained and prolonged bleeding symptoms, first in Chicago, Illinois, and then spreading to Peoria, Illinois and elsewhere. This gained a lot of press because the initial identifying factor was that all the patients had reported recent use of synthetic cannabinoids. As the matter was studied further, it was determined that these patients were likely exposed to an anticoagulant poison mixed in with the synthetic cannabinoids.

Synthetic cannabinoids are lab-derived illicit drugs that target the cannabinoid receptors that are also targeted by marijuana. They go by many names including synthetic marijuana, K2, and Spice.

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Cannabis Users Have Increased Neural Activity, Even at Rest

MedicalResearch.com Interview with:

Dr. Francesca M. Filbey PhD Professor Program Head, Cognition and Neuroscience PhD Bert Moore Chair in BrainHealth UT Dallas

Dr. Filbey

Dr. Francesca M. Filbey PhD
Professor
Program Head, Cognition and Neuroscience PhD
Bert Moore Chair in BrainHealth
UT Dallas

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The cannabis literature has generally focused on changes in brain function when engaged in a task. We were interested in examining whether these differences are present when not engaged in a task (i.e., during resting state) to understand baseline functional organization of the brain. Changes to baseline functional organization may reflect changes in brain networks underlying cognition. We also wanted to investigate whether specific brain waves, as measured by electroencephalography (EEG), are associated with measures of cannabis use, such as craving.

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More Than 2 Million High School Students Have Used Marijuana in an E-Cigarette

MedicalResearch.com Interview with:

Katrina Trivers, PhD, MSP Lead author and lead epidemiologist Office on Smoking and Health CDC

Dr. Trivers

Katrina Trivers, PhD, MSP
Lead author and lead epidemiologist
Office on Smoking and Health
CDC

MedicalResearch.com: What is the background for this study?

Response: Although we’ve seen considerable declines in the use of regular cigarettes among U.S. youth over the past several decades, the tobacco product landscape is evolving, and the use of other tobacco products have become increasingly popular. For example, as of 2014, e-cigarettes have become the most commonly used tobacco product among US youth. During 2011-2015, e-cigarette use increased 900% among U.S. high school students before declining in 2016. No change was observed in 2017, with about 2 million youth, including 12% of high school students and 3% of middle school students, reporting they had used e-cigarettes in the past 30 days.

This is a public health concern because the use of any form of tobacco product is unsafe among youth, irrespective of whether it’s smoked, smokeless, or electronic. The U.S. Surgeon General has concluded that the aerosol emitted from e-cigarettes is not harmless. It can contain harmful ingredients, including nicotine, carbonyl compounds, and volatile organic compounds known to have adverse health effects. The nicotine in these products is of particular concern given that nicotine exposure during adolescence can cause addiction and can harm the developing adolescent brain.

In recent years, many youth have also been using other psychoactive substances in e-cigarettes, including cannabinoids and other illicit drugs. This could have been fueled, in part, by shifts in the social acceptability and access to cannabis as several states have or are considering legalized cannabis sales for adults. A previous CDC study found that in 2015, almost 1 in 3 students reported using e-cigarettes with non-nicotine substances. However, it wasn’t possible to identify what exactly those substances were based on the question. Given the high concurrent use of tobacco and other substances, including cannabis, a more detailed question was added to a future survey to assess the use of cannabis in e-cigarettes among U.S. youth. This study presents the findings from that question.

Continue reading

Breast Milk Can Contain THC From Cannabis For Almost a Week

MedicalResearch.com Interview with:

“Cannabis sativa” by Manuel is licensed under CC BY 2.0

cannabis

Christina Chambers, PhD, MPH
Principal investigator
Professor in the Department of Pediatrics
UC San Diego School of Medicine
Drector of clinical research at Rady Children’s Hospital
San Diego 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Although cannabis is one of the most common recreational drugs used by pregnant and breastfeeding women, there is little current research regarding potential exposure of the breastfed infant.  As a result, pediatricians are lacking concrete evidence to help support advice to breastfeeding mothers who use cannabis.  This is particularly important as cannabis products available today are substantially more potent than products available in years past.

Our group in the Department of Pediatrics at the University of California San Diego (UCSD) Center for Better Beginnings was interested in first determining how much if any of the ingredients in cannabis actually transfer into breastmilk and how long these metabolites might stay in the milk after the mom’s last use.  We invited mothers who are participating in our UCSD Human Milk Research Biorepository from across the U.S. and Canada to respond to questions about use of cannabis products over the previous 14 days and to provide a breast milk sample.

Fifty mothers participated in the study.  Samples were analyzed by investigators from the UCSD Skaggs School of Pharmacy.

Our major finding was that low, but measurable levels of THC, the main psychoactive ingredient in cannabis, were found in about 2/3 of the samples.  Although the number of hours after mother’s last use of cannabis that THC was still measurable varied widely, the longest time since mother’s last use that THC was still present was about 6 days.  Continue reading

Accelerated Aging Seen on Brain Imaging with Schizophrenia and Cannabis Use

MedicalResearch.com Interview with:

Dr. Daniel G. Amen MD Amen Clinics, Inc., Founder Costa Mesa, CA

Dr. Daniel Amen

Dr. Daniel G. Amen MD
Amen Clinics, Inc., Founder
Costa Mesa, CA

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: In the largest known brain imaging study, scientists evaluated 62,454 brain SPECT (single photon emission computed tomography) scans of more than 30,000 individuals from 9 months old to 105 years of age to investigate factors that accelerate brain aging.

SPECT was used to determine aging trajectories in the brain and which common brain disorders predict abnormally accelerated aging. It examined these functional neuroimaging scans from a large multi-site psychiatric clinic from patients who had many different psychiatric disorders, including bipolar disorder, schizophrenia and attention deficit hyperactivity disorder (ADHD).  Researchers studied 128 brain regions to predict the chronological age of the patient.

Older age predicted from the scan compared to the actual chronological age was interpreted as accelerated aging.  The study found that a number of brain disorders and behaviors predicted accelerated aging, especially schizophrenia, which showed an average of 4 years of premature aging, cannabis abuse (2.8 years of accelerated aging), bipolar disorder (1.6 years accelerated aging), ADHD (1.4 years accelerated aging) and alcohol abuse (0.6 years accelerated aging).  Interestingly, the researchers did not observe accelerated aging in depression and aging, which they hypothesize may be due to different types of brain patterns for these disorders.

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Brain Imaging Reveals How Prolonged Intermittent Cannabis Can Induce Memory Deficits

MedicalResearch.com Interview with:

Dr. Italia V. Rolle, PhD and Dr. Tim McAfee, MD Office on Smoking and Health National Center for Chronic Disease Prevention and Health Promotion CDC

Ana Maria Sebastião, PhD
Professor of Pharmacology and Neurosciences
Director Institute of Pharmacology and Neurosciences, Faculty of Medicine and
Francisco Mouro, PhD
Unit of Neurosciences, Institute of Molecular Medicine
University of Lisbon, Portugal

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: There is pressing need to comprehend how cannabinoid exposure impacts brain functioning. While cannabinoid-related research has increased exponentially in the last decade, the mechanisms through which cannabinoids affect brain functioning are still elusive. Specifically, we need to know how prolonged cannabinoid exposure affects important cognitive processes, such as memory, and also find the roots of those effects. This is particularly relevant considering that several countries have already approved cannabis-based medicines.

In this sense, our work sheds new light into the mechanisms underlaying the memory-deficits provoked by a continuous exposure to a cannabinoid drug. More precisely, using brain imaging techniques, we found that long-term exposure to a synthetic cannabinoid drug impairs the ability of key brain regions involved in learning and memory to communicate with each other. Our data points to the necessity of considering cannabinoid actions in a broader perspective, including brain circuitry and communication.  Continue reading

Study finds Cannabis Use Not Associated With Increased Suicide Risk in Patients with Psychiatric Disorders

MedicalResearch.com Interview with:

“Cannabis sativa” by Manuel is licensed under CC BY 2.0

Leen Naji, BHSc, MD
Family Medicine Resident
McMaster University

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Cannabis use has consistently been linked to suicide attempt in the general population, but little data exists linking the association between cannabis use and suicide attempt amongst patients with psychiatric disorders. This is important data as we know that patients with psychiatric disorders are both more likely to use cannabis and to attempt suicide. Therefore, our goal was to study the association between cannabis use and suicide attempt amongst patients with psychiatric disorders. Additionally, since we know that women are more likely to suffer from mental health disorders, are more likely to attempt suicide and are more likely to incur the deleterious consequences of drug use at lower doses, we sought to compare the association between cannabis use and suicide attempt in men and women amongst our study population.

We conducted our analysis on a large sample of over 900 adults with psychiatric disorders (465 men, 444 women), of whom 112 men and 158 women had attempted suicide. The average age of our study sample was 40 years.

We found that cannabis use is not associated with an increased risk of suicide in patients with psychiatric disorders, though this association may vary when looking at specific subpopulations and/or amount of cannabis use. For instance, we found that heavier cannabis use is associated with an increased risk of suicide attempt amongst men with psychiatric disorders. Specifically, there was a 3% increased risk of suicide attempt for every day of cannabis use per month in men with psychiatric disorders. We also found that amongst those with psychiatric conditions, women, unemployed individuals and those with a mood disorder were at increased risk of suicide attempt.   Continue reading

Age of First Pot Smoking Does Matter

MedicalResearch.com Interview with:
Natalie Castellanos Ryan, PhD

École de Psychoéducation
Université de Montréal
Outremont Canada 

MedicalResearch.com: What is the background for this study?

Response: Our study followed a group of boys living in low socioeconomic neighbourhoods in Montreal (N=1030) from early childhood to 28 years of age to investigate:

1) whether the age at which one starts to use cannabis across adolescence is associated with the risk of developing drug abuse by early adulthood, when one controls for  arrange of known risk factors for cannabis use and problems assessed across development (risk factors in childhood, adolescence and early adulthood); and

2) the developmental pathways from early risk factors to drug abuse problems.

To examine these associations, the study collected  self-reported cannabis use information from these boys annually from ages 13 to 17 years and drug abuse symptoms at 28 years, as well as teacher, parent and child reported information on a number of environmental (family and friend) and child characteristics (e.g., impulsivity, delinquency, school performance) across childhood and adolescence. Alcohol and other drug use was also assessed across adolescence and early adulthood.

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Less Restrictive Marijuana Laws Linked To Reduced Opioid Prescriptions

MedicalResearch.com Interview with:

Dr. Italia V. Rolle, PhD and Dr. Tim McAfee, MD Office on Smoking and Health National Center for Chronic Disease Prevention and Health Promotion CDC

Marijuana plant

Hefei Wen, PhD
Assistant Professor, Department of Health Management & Policy
University of Kentucky College of Public Health 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Marijuana is one of the potential, non-opioid alternatives that can relieve pain at a relatively lower risk of addiction and virtually no risk of overdose. Medical and adult-use marijuana laws, has made marijuana available to more Americans. Yet no study to date has focused on the effect of medical and adult-use marijuana laws on opioid prescribing in particular.

Our study provides some of the first empirical evidence that the implementation of medical and adult-use marijuana laws between 2011 and 2016 was associated with lower opioid prescribing rates and spending among Medicaid enrollees.   Continue reading

States with Medical Cannabis Dispensaries Had Bigger Drop in Opioid Prescriptions

MedicalResearch.com Interview with

“Cannabis sativa” by Manuel is licensed under CC BY 2.0

David Bradford, Ph.D.
Busbee Chair in Public Policy
Department of Public Administration and Policy
University of Georgia
Athens, GA 30602

MedicalResearch.com: What is the background for this study?

Response: To give you some background, in 2016, part of our research team (Bradford and Bradford) published the first study to directly examine the impact that medical cannabis laws (MCLs) may be having on prescription use. We used yearly physician-level Medicare Part D data, looked at nearly all prescription drugs used to treat 9 broad categories of illness/diagnoses, and found substantial reductions in prescriptions. We published a follow-up study in 2017, this time using data from Medicaid Fee-for-Service.

Again, we found significant substitution away from prescription medications. In both of these studies, pain was included in the list of conditions for which cannabis may be used in patients, and in both studies, pain prescriptions fell. One of the unanswered questions from both of those studies, though, was what *type* of pain medications were being reduced.  From a public health standpoint, when we’re worried about opioid overdose, it matters whether the substitution away from pain medications is coming from substitutions away from things like NSAIDs or whether there is substitution away from opioids.

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Teen Marijuana Use Did Not Increase After Passage of Medical Marijuana Laws

MedicalResearch.com Interview with:
“medical marijuana : strains and varieties” by torbakhopper is licensed under CC BY 2.0Professor Deborah Hasin PhD
Department of Epidemiology in Psychiatry
Mailman School of Public Health
Columbia University

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: We began to think about this study after we published an earlier report (Hasin et al., The Lancet Psychiatry 2015) showing that after state medical marijuana laws (MML) were passed, U.S. teen marijuana use did not increase compared to the period before the laws were passed and to overall national trends. However, people continued to question whether MML led to teen increases in marijuana use. Therefore, in the present study, we combined findings from 11 large-scale national studies of teens to provide a more definite answer.

The findings were clear that teen marijuana use did not increase after passage of medical marijuana laws. Medical marijuana is widely available from stores like kush guys, yet despite this prevalence, there is no conclusive evidence of abuse. Rather the benefits are plain to see. Continue reading

More Car Crashes on 4/20 Marijuana Celebration Day

MedicalResearch.com Interview with:
Dr. John A Staples, MD, FRCPC, MPH Scientist, Centre for Health Evaluation and Outcome Sciences Clinical Assistant Professor University of British ColumbiaDr. John A Staples
MD, FRCPC, MPH
Scientist, Centre for Health Evaluation and Outcome Sciences
Clinical Assistant Professor
University of British Columbia

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Around 64 million Americans live in states that have legalized recreational marijuana. Many policymakers are trying to figure out what that means for traffic safety.

On April 20th, some Americans participate in an annual “4/20” counterculture holiday that celebrates and promotes the use of cannabis. Some 4/20 events such as those in Denver and San Francisco involve thousands of participants. Much like celebrations at midnight on New Year’s eve, public 4/20 events sometimes mark 4:20 p.m. by a countdown followed by synchronized mass consumption of cannabis. We thought this was a perfect natural experiment to evaluate the influence that cannabis intoxication has on the risk of motor vehicle crash.

To examine this question, we analyzed 25 years of data on all fatal traffic crashes in the United States. We compared the number of drivers in crashes between 4:20 p.m. and midnight on April 20th to the number of drivers in crashes during the same time interval on control days one week earlier and one week later.

We found that the risk of crash involvement was 12% higher on April 20th than on control days. In the subgroups of drivers younger than 21 years of age, the risk of crash involvement was 38% higher on April 20th than on control days.

Assuming fewer than 12% of Americans celebrate 4/20, our results suggest that substance use at April 20th celebrations more than doubles the risk of fatal crash.

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