One Toke Over the Line

A wave of recent research points to reasons for concern for older users, with cannabis-related emergency room visits and hospitalizations rising, and a Canadian study finding an association between such acute care and subsequent dementia. Older people are more apt than younger ones to try cannabis for therapeutic reasons: to relieve chronic pain, insomnia, or mental health issues, though evidence of its effectiveness in addressing those conditions remains thin, experts said. As Cannabis Users Age, Health Risks Appear To Grow https://kffhealthnews.org/news/article/cannabis-medical-use-older-adults-health-risks/

Then…

And now…

“Our brains are more sensitive to psychoactive substances as we age.” Dr. Benjamin Han

Don’t you know I’m just waiting for the train that goes home, sweet Mary.

Cannabis Dependence and Erectile Dysfunction

The short-term analysis included 29,442 patients with cannabis dependence matched to 29,442 patients without dependence. Cannabis dependence was significantly associated with an approximately 4-fold higher risk for ED and PDE5i prescription at 3 months to 1 year from diagnosis among all men and those aged 40 years and older and an approximately 3-fold higher risk for men aged 18-39 years, Dr Asanad’s team reported in The Journal of Sexual Medicine. The longer-term analysis included 17,211 men with cannabis dependence matched to 17,211 men without dependence. Cannabis dependence was significantly associated with an approximately 1.2-fold increased risk for ED among all adult men and those aged 40 years and older, the investigators reported. Cannabis Dependence Linked With Erectile Dysfunction, Testosterone Deficiencyhttps://www.renalandurologynews.com/news/erectile-dysfunction-testosterone-cannabis-dependence

Yikes.

Cannabis and Impaired Brain Development

The adolescent brain is particularly vulnerable to cannabis, especially today’s higher-potency products, which put teens at risk for impaired brain development; mental health issues, including psychosis; and cannabis use disorder (CUD).  That was the message delivered by Yasmin Hurd, PhD, director of the Addiction Institute at Mount Sinai in New York, during a May 6 press briefing at the American Psychiatric Association (APA) 2024 annual meeting

“We’re actually in historic times in that we now have highly concentrated, highly potent cannabis products that are administered in various routes,” Hurd told reporters. Tetrahydrocannabinol (THC) concentrations in cannabis products have increased over the years, from around 2%-4% to 15%-24% now, Hurd noted. High-Potency Cannabis Tied to Impaired Brain Development, Psychosis, CUD – Medscape – May 13, 2024. https://www.medscape.com/viewarticle/high-potency-cannabis-tied-impaired-brain-development-2024a1000935

Earlier posts on this topic:

Marijuana is Too Strong (THC turbocharged)

Cannabis Use and Psychosis Risk

Cannabis Use and Psychosis Risk (Aussie Version)

Reefer Madness

Marijuana is Too Strong (THC turbocharged)

For some, it can be dangerous. In the past few years, reports have swelled of people, especially teens, experiencing short- and long-term “marijuana-induced psychosis,” with consequences including hospitalizations for chronic vomiting and auditory hallucinations of talking birds. Multiple studies have drawn a link between heavy use of high-potency marijuana, in particular, and the development of psychological disorders, including schizophrenia, although a causal connection hasn’t been proved. “It’s entirely possible that this new kind of cannabis—very strong, used in these very intensive patterns—could do permanent brain damage to teenagers because that’s when the brain is developing a lot,” Keith Humphreys, a Stanford psychiatry professor and a former drug-policy adviser to the Obama administration, told me. Humphreys stressed that the share of people who have isolated psychotic episodes on weed will be “much larger” than the number of people who end up permanently altered. But even a temporary bout of psychosis is pretty bad. Marijuana Is Too Strong Nowhttps://www.theatlantic.com/ideas/archive/2024/08/high-potency-marijuana-regulation/679639/

Cannabis Use and Psychosis Risk (Aussie Version)

Professor Emmerson says Queensland’s Metro North Health — Australia’s largest public health service, based in north Brisbane and the surrounding region — is seeing increased presentations of psychosis due to medicinal cannabis.”The Metro North early psychosis service reports 10 per cent of their new presentations — so these are kids aged 16 to 21 — are people who’ve ended up on medicinal cannabis and are becoming psychotic,” the Brisbane-based psychiatrist says.

Doctors warn of significant increase in people hospitalized with psychosis after being prescribed medicinal cannabishttps://www.abc.net.au/news/2024-07-21/medicinal-cannabis-psychosis-harm-risk-prescription-marijuana/104116952

Cannabis Use and Psychosis Risk

The investigators found that cannabis use was significantly associated with psychotic disorders during adolescence (adjusted hazard ratio [aHR], 11.2; 95% CI, 4.6 to 27.3), but not during young adulthood (aHR, 1.3; 95% CI, 0.6 to 2.6). Adolescents who used cannabis also had a substantially higher risk for hospitalizations and emergency department visits (aHR, 26.7; 95% CI, 7.7 to 92.8), while there was no substantial risk observed in young adulthood (aHR, 1.8; 95% CI, 0.6 to 5.4). Growing Evidence Supports the Link Between Cannabis Use and Psychosis Risk https://www.psychiatryadvisor.com/news/cannabis-use-and-psychosis-risk/

Have you read the book The Dangerous Truth About Today’s Marijuana by Laura Stack? https://johnnysambassadors.org/book/

If you have small children I highly recommend this book.

Cannabis and Kids

Epidemiologic research suggests that cannabis use may be a significant risk factor for psychotic disorders. A meta-analysis of longitudinal studies estimated that lifetime cannabis users had an odds ratio of 2.58 (95% CI 1.08–6.13) for psychotic disorders compared to non-users (Moore et al., Reference Moore, Zammit, Lingford-Hughes, Barnes, Jones, Burke and Lewis2007). Another meta-analysis found an odds ratio of 3.90 (95% CI 2.84–5.34) for psychotic disorders among the most frequent cannabis users compared to non-users, suggesting dose–response (Marconi, Di Forti, Lewis, Murray, & Vassos, Reference Marconi, Di Forti, Lewis, Murray and Vassos2016). Whether cannabis use is causally related to psychotic disorders continues to be debated, with recent genetic studies raising uncertainty about the directionality of the relationship and the magnitude of association (Ganesh & D’Souza, Reference Ganesh and D’Souza2022; Gillespie & Kendler, Reference Gillespie and Kendler2021).

This study provides new evidence of a strong but age-dependent association between cannabis use and risk of psychotic disorder, consistent with the neurodevelopmental theory that adolescence is a vulnerable time to use cannabis. The strength of association during adolescence was notably greater than in previous studies, possibly reflecting the recent rise in cannabis potency. Age-dependent association of cannabis use with risk of psychotic disorder Psychological Medicine , First View , pp. 1 – 11 https://doi.org/10.1017/S0033291724000990

Daily Marijuana Use Now Exceeds Daily Alcohol Use

Reported cannabis use declined to a nadir in 1992, with partial recovery through 2008, and substantial increases since then, particularly for measures of more intensive use. Between 2008 and 2022, the per capita rate of reporting past-year use increased by 120%, and days of use reported per capita increased by 218% (in absolute terms from the annual equivalent of 2.3 to 8.1 billion days per year). From 1992 to 2022, there was a 15-fold increase in the per capita rate of reporting daily or near daily use. Whereas the 1992 survey recorded 10 times as many daily or near daily alcohol as cannabis users (8.9 vs. 0.9 M), the 2022 survey, for the first time, recorded more daily and near daily users of cannabis than alcohol (17.7 vs. 14.7 M). Far more people drink, but high-frequency drinking is less common. In 2022, the median drinker reported drinking on 4–5 days in the past month, versus 15–16 days in the past month for cannabis. In 2022, past-month cannabis consumers were almost four times as likely to report daily or near daily use (42.3% vs. 10.9%) and 7.4 times more likely to report daily use (28.2% vs. 3.8%).

Long-term trends in cannabis use in the United States parallel corresponding changes in cannabis policy, with declines during periods of greater restriction and growth during periods of policy liberalization. A growing share of cannabis consumers report daily or near daily use, and their numbers now exceed the number of daily and near daily drinkers. Changes in self-reported cannabis use in the United States from 1979 to 2022https://doi.org/10.1111/add.16519

Cannabis Use Linked to Elevated Myocardial Infarction and Stroke Risk

Cannabis use may increase the risk of myocardial infarction and stroke independent of tobacco use, according to recent findings in the Journal of the American Heart Association. Compared with nonusers, daily cannabis consumers had 25% higher odds of myocardial infarction and 42% higher odds of stroke. More frequent use was associated with a greater possibility of adverse cardiovascular outcomes regardless of whether cannabis was smoked, eaten, or vaporized. AMA. 2024;331(14):1172. doi:10.1001/jama.2024.2075 — https://jamanetwork.com/journals/jama/fullarticle/2816618