Cannabis and Psychosis

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

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.

Long Term Cannabis Use and Lung Damage

The findings come from the long-running Dunedin Multidisciplinary Health and Development Study, which has documented cannabis use and measured lung function throughout adult life up to age 45 in more than 1000 individuals born in Dunedin in 1972/73.

University of Otago. “How long-term cannabis use can damage lungs.” ScienceDaily. http://www.sciencedaily.com/releases/2022/02/220203192317.htm (accessed February 4, 2022).

Inhaling hot smoke into your lungs over a long period of time. What could possibly go wrong?

Got DM1? Don’t do Pot

Abstract

OBJECTIVE We examined the frequency of diabetic ketoacidosis (DKA) in cannabis users compared with nonusers in the T1D Exchange clinic registry (T1DX).

RESEARCH DESIGN AND METHODS The association between cannabis use by total substance score for cannabis (TSC) and DKA in the past 12 months was examined using a logistic regression model adjusted for potential confounders among adults in the T1DX.

RESULTS Of 932 adults with type 1 diabetes, 61 had a TSC >4, which classified them as moderate cannabis users. Adjusting for sex, age at study visit, and HbA1c, cannabis use was associated with a twofold increase in risk for DKA among adults with type 1 diabetes (odds ratio 2.5 [95% CI 1.0–5.9]).

CONCLUSIONS Cannabis use was associated with an increased risk for DKA among adults in the T1DX. Providers should inform their patients of the potential risk of DKA with cannabis use.

© 2019 by the American Diabetes Association.

Cannabis Use Is Associated With Increased Risk for Diabetic Ketoacidosis in Adults With Type 1 Diabetes: Findings From the T1D Exchange Clinic Registry

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.

Does Marijuana Have Any Bad Side Effects?

Read a quick history lesson here.

Read about psychosis risk here.

Pass the doobie please.

Regardless of the century, physicians throughout the ages have known that real medicines carry risks. Any truly medicinal substance is able to give a little whack to one or more bodily processes. The goal is to whack the body back into normal functioning. That’s basically what medicine is all about – strategically whacking our physiology. But anything capable of whacking (which is to say any real medicine) is capable of harming at least a few of the many patients who would take it. This fact is so non-negotiable that we have a name for doctors who claim to have discovered effective medicines that don’t have any risks: we call them quacks.

Does Legal Marijuana Increase the Number of Car Accidents?

Crashes are up by as much as 6 percent in Colorado, Nevada, Oregon and Washington, compared with neighboring states that haven’t legalized marijuana for recreational use, new research from the Insurance Institute for Highway Safety (IIHS) and Highway Loss Data Institute (HLDI) shows.

Source article.

Insurance Agent:

“Why do you need a marijuana questionnaire?”

Underwriter:

“Confidential medical information.  Besides, I’ve seen her driving record and you haven’t.”

Insurance agent:

Silence.

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.

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.