marijuana

Cannabis and Arrhythmia Risk, Stroke and Race, Why Weight Loss Drugs Stop Working

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Within 180 days, 42 medical cannabis users and 107 control participants developed arrhythmia, most commonly atrial fibrillation/flutter. Medical cannabis users had a slightly elevated risk for new-onset arrhythmia compared with nonusers (180-day absolute risk, 0.8% vs 0.4%). The 180-day risk ratio with cannabis use was 2.07 (95% CI, 1.34-2.80), and the 1-year risk ratio was 1.36 (95% CI, 1.00-1.73). Adults with cancer or cardiometabolic disease had the highest risk for arrhythmia with cannabis use (180-day absolute risk difference, 1.1% and 0.8%).

Medical Cannabis for Chronic Pain Tied to Arrhythmia Risk – Medscape – January 12, 2024 — https://www.medscape.com/viewarticle/medical-cannabis-chronic-pain-tied-arrhythmia-risk

The overall incidence of stroke and ischemic stroke (IS) decreased among both White and Black people over the past two decades, results of an updated analysis of stroke trends in a representative US population showed.

However, the study showed persistent racial disparities, with incident stroke rates 50%-80% higher in Black people than in their White counterparts. Incident stroke also occurred at an earlier age in Black patients than in White patients (mean age, 62 years vs 71 years, respectively).

The findings were published online on January 10, 2024, in Neurology.

New Data on Stroke Incidence Rates by Race – Medscape – January 12, 2024 — https://www.medscape.com/viewarticle/new-data-stroke-incidence-rates-race

And my favorite Saturday morning medical update…

But studies also have shown that once people stop taking these drugs — either by choice, because of shortage, or lack of access — they regain most, if not all, the weight they lost. Arguably more frustrating is the fact that those who continue on the drug eventually reach a plateau, at which point, the body seemingly stubbornly refuses to lose more weight. Essentially, it stabilizes at its set point, said Fatima Cody Stanford, MD, MPH, MPA, MBA, an obesity medicine physician at Massachusetts General Hospital and associate professor at Harvard Medical School in Boston.

Every study of weight loss drugs done over the past 40 years or so shows a plateau, Stanford told Medscape Medical News. “If you look at the phentermine/topiramate studies, there’s a plateau. If you look at the bupropion/naltrexone studies, there’s a plateau. Or if we look at bariatric surgery, there’s a plateau. And it’s the same for the newer GLP-1 drugs.”

The reason? “It really depends on where the body gets to,” Stanford said. “The body knows what it needs to do to maintain itself, and the brain knows where it’s supposed to be. And when you lose weight and reach what you feel is a lower set point, the body resists.”When the body goes below its set point, the hunger hormone ghrelin, which is housed in the brain, gets reactivated and gradually starts to reemerge, she explained. GLP-1, which is housed in the distal portion of the small intestine and in the colon, also starts to reemerge over time.

Why Do GLP-1 Drugs Stop Working, and What to Do About It? – Medscape – January 12, 2024 — https://www.medscape.com/viewarticle/why-do-glp-1-drugs-stop-working-and-what-do-about-it

That’s it for this Saturday. Time to go to the Y and read a book later.

When Worlds Collide

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Remember when I posted about Oklahoma producing 64 times more marijuana than licensed users consume – The Oklahoman? Or about Rooms for Rent – Airbnb Crashes? Well, here’s a post about the best of both worlds.

If you noticed something about the people who were arrested I noticed the same thing. Mostly male.

But Both Are Legal…right? – Updated

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“We found that alcohol and THC together significantly reduced, and in some cases prevented, the ability of the prefrontal cortex in drug-exposed rats to undergo plasticity in the same way that the brains from control animals can,” said Linyuan Shi, a graduate student in the Gulley lab. “The effects were apparent in rats exposed to either drug alone, and they were most pronounced with co-exposure to both drugs. We also found the impaired plasticity was likely due to changes in signaling caused by gamma-aminobutyric acid, a chemical messenger in the brain. When we used a chemical that enhances GABA, it could rescue the deficits we saw in the animals that had been exposed to the drugs.”

Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign. “Combined use of alcohol and THC can affect rat brains, study finds.” ScienceDaily. ScienceDaily, 30 November 2023 — https://www.sciencedaily.com/releases/2023/11/231130121946.htm

I’m glad I am not a rat.

Young adults who simultaneously use alcohol and marijuana (SAM) consume more drinks, are high for more hours in the day, and report more negative alcohol-related consequences.

On SAM use days, participants consumed an average of 37% more drinks, with 43% more negative alcohol consequences, were high for 10% more hours, and were more likely to feel clumsy or dizzy, compared with non-SAM use days.

Simultaneous Marijuana, Alcohol Use Linked to Worse Outcomes — https://www.medscape.com/viewarticle/996595?icd=login_success_gg_match_norm&isSocial

Hmmm…

But Both Are Legal…right?

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“We found that alcohol and THC together significantly reduced, and in some cases prevented, the ability of the prefrontal cortex in drug-exposed rats to undergo plasticity in the same way that the brains from control animals can,” said Linyuan Shi, a graduate student in the Gulley lab. “The effects were apparent in rats exposed to either drug alone, and they were most pronounced with co-exposure to both drugs. We also found the impaired plasticity was likely due to changes in signaling caused by gamma-aminobutyric acid, a chemical messenger in the brain. When we used a chemical that enhances GABA, it could rescue the deficits we saw in the animals that had been exposed to the drugs.”

Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign. “Combined use of alcohol and THC can affect rat brains, study finds.” ScienceDaily. ScienceDaily, 30 November 2023 — https://www.sciencedaily.com/releases/2023/11/231130121946.htm

I’m glad I am not a rat.

Emphysema More Common in Marijuana Smokers Than Cigarette Smokers

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“We know what cigarettes do to the lungs,” said study author Giselle Revah, M.D., a cardiothoracic radiologist and assistant professor at the University of Ottawa in Ottawa, Canada. “There are well researched and established findings of cigarette smoking on the lungs. Marijuana we know very little about.”

To find out more, Dr. Revah and colleagues compared chest CT results from 56 marijuana smokers with those of 57 non-smoking controls and 33 tobacco-only smokers.

Three-quarters of the marijuana smokers had emphysema, a lung disease that causes difficulty with breathing, compared with 67% of the tobacco-only smokers. Only 5% of the non-smokers had emphysema. Paraseptal emphysema, which damages the tiny ducts that connect to the air sacs in the lungs, was the predominant emphysema subtype in marijuana smokers compared to the tobacco-only group.

Radiological Society of North America. “Emphysema more common in marijuana smokers than cigarette smokers.” ScienceDaily. http://www.sciencedaily.com/releases/2022/11/221115113940.htm (originally accessed November 15, 2022).

Journal Reference

Luke Murtha, Paul Sathiadoss, Jean-Paul Salameh, Matthew D. F. Mcinnes, Giselle Revah. Chest CT Findings in Marijuana Smokers. Radiology, 2022; DOI: 10.1148/radiol.212611

The mean age of the MJ smokers in the study was 49.

The mean age of the tobacco smokers in the study was 60.

Oklahoma producing 64 times more marijuana than licensed users consume – The Oklahoman

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“The supply-to-demand ratio of regulated medical marijuana supply to regulated medical cannabis demand is 64:1,” the report states. “Using a general assumption that units of supply should not exceed two times the units of demand, the medical marijuana program has no less than 32 times more regulated marijuana necessary than licensed patient demand.”

The significant oversupply is likely funneling large amounts of marijuana out of state and adding to the illegal market, according to authority officials.

Oklahoma producing 64 times more marijuana than licensed users consume, report shows — https://www.oklahoman.com/story/news/state/2023/06/21/marijuana-oklahoma-overproducing-64-times-omma-report/70343452007/

The Truth behind the medical marijuana industry.

At least we know there may be a positive longevity effect to all of this excess supply.

Drive By Truckers 2.0

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Total drug violations reported into the clearinghouse in 2022, including positive tests and refusals to take a drug test, increased 18% to 69,668 compared with last year’s 59,011, according to the most recent statistics released this week by the Federal Motor Carrier Safety Administration. That rate almost doubled the 9.2% annual increase in drug violations reported in 2021. Much of the increase can be attributed to violations related to marijuana, the substance identified most in positive tests. Marijuana violations increased 31.6% in 2022 compared with 2021, to 40,916. That compares to a 5.3% increase between 2020 and 2021.

Truckers’ positive drug tests up 18% in 2022 — https://www.freightwaves.com/news/truckers-positive-drug-tests-up-18-in-2022

At least binge drinking prevalence is just 19%

Truck drivers have been reported as a highly vulnerable working population due to different risk factors [16,17,18] including hypertension, fatigue [19], obstructive sleep apnea (OSA) and sleep deprivation [20,21], and insufficient physical activity [22]. Other risk factors are exposure to diesel exhaust and risk of developing lung cancer [23], poor diet, obesity, dyslipidemia, and other metabolic disorders [24]. Furthermore, they are prone to risky behaviors and lifestyles such as smoking, drinking, using psychoactive substances, and having casual sexual contacts [25].

Patterns of Harmful Alcohol Consumption among Truck Drivers: Implications for Occupational Health and Work Safety from a Systematic Review and Meta-Analysis — Int J Environ Res Public Health. 2018 Jun; 15(6): 1121.
Published online 2018 May 30. doi: 10.3390/ijerph15061121

I ask them why the industry has a 90 percent attrition rate within the first year. All instantly respond: “No money.” They describe a predatory apprenticeship system that conspires against new drivers seeking to enter the profession. The industry is made up of thousands of mostly small-fleet owners—95 percent of them with 20 trucks or fewer—but dominated by about two dozen giant companies that serve as its gatekeepers. These megacarriers often house schools where some 400,000 new truckers receive commercial driver’s licenses annually. The companies entice people with promises of financial plenty, even as they ensnare them in “training contracts”—binding agreements that require them to drive for the company at below-market wages for a year in exchange for training or else be hit with an exorbitant fee for that training, to be paid off at high interest. Many drivers stick around for the full year to avoid those fees, enduring what amounts to debt peonage. 

“I have panic attacks,” he says. “That’s why I drink.”


Life as a 21st-Century Trucker — https://www.wired.com/story/life-as-a-21st-century-trucker/

For the first post in this series see Drive By Truckers.

Reefer Madness

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Violence associated with psychosis has also been well-documented. Marijuana use may be associated with increased impulsivity on the same day and the following day relative to days when marijuana was not used. It is also associated with increased hostile behaviors and perceptions of hostility in others on the same day compared to days when marijuana was not used. Cannabis use disorder appears to increase the risk of aggression towards others, particularly among youths. There is also evidence of a moderate association between cannabis use and physical violence.

Psychosis can be caused by various conditions, including licit and illicit substances, particularly cannabis. Cannabis has a higher conversion rate to psychosis than other substances. 32 percent of patients with substance-induced psychosis convert to either bipolar or schizophrenia-spectrum disorders, with the highest conversion rate found with cannabis-induced psychosis (47 percent). There is debate about the causal relationship between cannabis and psychosis. However, this can be demonstrated using Bradford-Hill criteria. Despite this, psychosis is often multifactorial in many instances. Cannabis exposure increases the risk of psychosis, from transient psychotic states to chronic recurrent psychosis. In individuals with established psychosis, cannabis has a negative impact on the course and expression of the illness.

The dark side of cannabis: increased risk of psychosis — https://www.kevinmd.com/2023/01/the-dark-side-of-cannabis-increased-risk-of-psychosis.html

But really, Does Marijuana Have Any Bad Side Effects?

You must be joking about Cannabis and Psychosis, right?

Marijuana and hallucinogen use among young adults reached all-time high in 2021

Marijuana Tied to Ongoing, Subclinical Psychosis in Teens

Cannabis and Psychosis

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Californians voted to legalize recreational pot in 2016. Three years later, emergency room visits for cannabis-induced psychosis went up 54% across the state, from 682 to 1,053, according to state hospital data. For people who already have a psychotic disorder, cannabis makes things worse — leading to more ER visits, more hospitalizations, and more legal troubles, said Dr. Deepak Cyril D’Souza, a psychiatry professor at Yale University School of Medicine who also serves on the physicians’ advisory board for Connecticut’s medical marijuana program.

California May Require Labels on Pot Products to Warn of Mental Health Risks — https://khn.org/news/article/california-marijuana-warning-labels/

Listen to the article above here: https://www.npr.org/sections/health-shots/2022/06/17/1105494283/california-pot-warning-labels

Recreational cannabis use is linked to a heightened risk of emergency care and hospital admission for any cause, finds research published in the open access journal BMJ Open Respiratory Research.

Cannabis use linked to heightened emergency care and hospital admission risks — https://medicalxpress.com/news/2022-06-cannabis-linked-heightened-emergency-hospital.html

Cannabinoid Hyperemesis Syndrome

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It’s not entirely clear how cannabis hyperemesis syndrome occurs though there are several theories. One is that since cannabinoids have long-half lives and are lipid soluble, they accumulate in the brain and over time cause symptoms, particularly in young people who may have genetic variations in enzymes which lead to further accumulation. Another theory is that there is a thermoregulatory and autonomic imbalance in the limbic system caused by chronic use. Other suggestions are that with long-term consumption cannabis becomes a receptor antagonist, or that they become down-regulated or de-sensitised over time. This reverses the antiemetic effect of cannabis. It seems that chronic over-stimulation of receptors leads to dysregulation of the body’s control of nausea and vomiting, leading to CHS.

Owen Hibberd . What you need to know about Cannabinoid Hyperemesis Syndrome, Don’t Forget the Bubbles, 2022. Available at: https://doi.org/10.31440/DFTB.48627

I am so glad I never inhaled.