Opiods + Marijuana = Bad

Cannabis Plus Opioids in Chronic Pain: Not a Great Combo

Previous research by Humphreys and colleagues showed that people who used medical cannabis also had higher rates of opioid use and misuse. “This is one of many examples where claims about the benefits of medical cannabis are not supported by evidence,” Humphreys told MedPage Today.  The current study had several limitations: it relied on cross-sectional, self-reported data and was subject to possible selection bias and confounding. It also did not assess the frequency or quantity of cannabis or opioid use, or the type of chronic pain.

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Dual Receipt of Prescription Opioids From the Department of Veterans Affairs and Medicare Part D and Prescription Opioid Overdose Death Among Veterans: A Nested Case–Control Study

Among veterans enrolled in VA and Part D, dual use of opioid prescriptions was independently associated with death from prescription opioid overdose. This risk factor for fatal overdose among veterans underscores the importance of care coordination across health care systems to improve opioid prescribing safety.

Full abstract at this link.

Secret police study finds crime networks could have laundered over $1B through Vancouver homes in 2016 — Global News

A study of more than 1,200 luxury real estate purchases in B.C.’s Lower Mainland in 2016 found that more than 10 per cent were tied to buyers with criminal records. Continue reading →

via Secret police study finds crime networks could have laundered over $1B through Vancouver homes in 2016 — Global News

Is Marijuana Safe?

A new study confirms that cannabis use is related to impaired and lasting effects on adolescent cognitive development.

To understand the relationship between alcohol, cannabis use and cognitive development among adolescents at all levels of consumption (abstinent, occasional consumer or high consumer), the research team followed a sample of 3,826 Canadian adolescents over a period of four years. Using a developmentally sensitive design, the authors investigated relationships between year-to-year changes in substance use and cognitive development across a number of cognitive domains, such as recall memory, perceptual reasoning, inhibition and working memory. Multi-level regression models were used to simultaneously test vulnerability and concurrent and lasting effects on each cognitive domain. The study found that vulnerability to cannabis and alcohol use in adolescence was associated with generally lower performance on all cognitive domains.

Yikes.  Read the full story here.

What the News Left Out About K2

As a psychiatrist, I have encountered countless individuals in the emergency room who come through and do not want help. “What K2? I don’t use that stuff.” They will deny it, laugh it off, or scoff at me. They threaten to commit suicide if I don’t let them stay the night, and demand extra sandwiches and clothes. These individuals have the ability to decipher their options.  If the person’s thinking suddenly clears and there is no sign of physical instability, he or she can just walk out the emergency room almost minutes after presenting. In the dead of night, I’ve had unconscious patients who wake up abruptly only to demand to leave. I have no choice but to discharge them “home” to no particular address, since none are listed.

Here’s the link to the full article.

 

America’s Invisible Pot Addicts

Public-health experts worry about the increasingly potent options available, and the striking number of constant users. “Cannabis is potentially a real public-health problem,” said Mark A. R. Kleiman, a professor of public policy at New York University. “It wasn’t obvious to me 25 years ago, when 9 percent of self-reported cannabis users over the last month reported daily or near-daily use. I always was prepared to say, ‘No, it’s not a very abusable drug. Nine percent of anybody will do something stupid.’ But that number is now [something like] 40 percent.” They argue that state and local governments are setting up legal regimes without sufficient public-health protection, with some even warning that the country is replacing one form of reefer madness with another, careening from treating cannabis as if it were as dangerous as heroin to treating it as if it were as benign as kombucha.

But cannabis is not benign, even if it is relatively benign, compared with alcohol, opiates, and cigarettes, among other substances. Thousands of Americans are finding their own use problematic in a climate where pot products are getting more potent, more socially acceptable to use, and yet easier to come by, not that it was particularly hard before.

Read the entire Atlantic article here.

A new study in the journal Addiction finds that, after legalization, the use of marijuana among students at an Oregon college increased relative to that of students in states where the drug is still illegal. But, in a twist, the rise was mainly seen among those students who had also reported drinking heavily recently. The Oregon students who binge drank were 73 percent more likely to also report using marijuana, compared to binge-drinking students in states that didn’t legalize marijuana.

Interestingly, though, this study does suggest that legal marijuana, at least among college kids, does not seem to have much of a substitution effect. Contrary to the predictions of some legalization enthusiasts, teens don’t seem to be foregoing binge drinking—arguably a more physically harmful practice—in order to smoke weed. Instead, they’re doing both.

Read another Atlantic article on the topic here.

Binge drinking AND smoking pot.  A fine combination.