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A new study shows that in the time after first trying cannabis or first misusing prescription drugs, the percentages of young people who develop the corresponding substance use disorder are higher among adolescents (ages 12-17) than young adults (ages 18-25). In addition, 30% of young adults develop a heroin use disorder and 25% develop a methamphetamine use disorder a year after first using heroin or methamphetamine. These findings, published in JAMA Pediatrics, emphasize the vulnerability of young people to developing substance use disorders.

The researchers found that the prevalence of past-year cannabis use disorder was higher for adolescents than young adults at all examined time frames since first use of the drug. For example, within 12 months since first cannabis use, 10.7% of adolescents had cannabis use disorder versus 6.4% of young adults.

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Arrhythmias, General Risk Factors and Prevention April 2021:  

A study of 2.4 million hospitalised cannabis users has found that those with an arrhythmia were 4.5 times more likely to die while in hospital than those without. The research is presented at EHRA 2021, an online scientific congress of the European Society of Cardiology (ESC).1

“People should be aware of this devastating outcome and be careful when using cannabis if they have a concomitant heart problem,” said study author Dr. Sittinun Thangjui of Bassett Healthcare Network, Cooperstown, US.

The researchers compared deaths between the two groups after adjusting for factors that could influence the relationship including age, sex, race, income, diabetes, heart failure, chronic kidney disease, obesity, and hospital location. Cannabis users with an arrhythmia had a 4.5 times higher odds of in-hospital mortality compared to those without an arrhythmia. Patients with an arrhythmia had a longer length of hospital stay (5.7 days) compared to those without (5.1 days).

Dr. Thangjui said: “Our study highlights that heart rhythm disorders may be a warning sign for an increased risk of death in people who use cannabis. More studies are needed to confirm our results. In the meantime, it seems sensible to screen these patients for arrhythmias if they present to hospital so that those with a heart rhythm problem can be closely monitored.”

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Doctors are being told not to use medicinal cannabis to treat patients with chronic pain, warning there is no solid evidence it is effective, as Australia’s medical regulator approves its 100,000th cannabinoid script.

The recommendation from the country’s peak pain advisory body to doctors is: “Do not prescribe currently available cannabinoid products to treat chronic non-cancer pain unless part of a registered clinical trial.”

The Faculty of Pain Medicine at the Australian and New Zealand College of Anaesthetists (ANZCA) says there is no robust evidence from gold-standard studies that proves cannabinoid products effectively treat these patients’ suffering. Cannabinoids are the active chemicals in cannabis.

But the Therapeutic Goods Administration (TGA) is allowing doctors to apply for special access to prescribe medicinal cannabis products. Proponents argue the substances should be given the benefit of the doubt and offered to patients on compassionate grounds.

Dean of ANZCA’s pain medicine faculty Professor Michael Vagg said medicinal cannabis products on the market “are not even close” to showing they are effective in the management of patients with complex chronic pain.

“The research available is either unsupportive of using cannabinoid products in chronic non-cancer pain or is of such low quality that no valid scientific conclusion can be drawn,” the pain specialist and physician said.

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Combined exposure to even low doses of alcohol with THC, HU-210, or CP 55,940 caused a greater incidence of birth defects, particularly of the eyes, than did either treatment alone. Consistent with the hypothesis that these defects are caused by deficient Shh, we found that CBs reduced Shh signaling by inhibiting Smoothened (Smo), while Shh mRNA or a CB1 receptor antagonist attenuated CB-induced birth defects. Proximity ligation experiments identified novel CB1-Smo heteromers, suggesting allosteric CB1-Smo interactions. In addition to raising concerns about the safety of cannabinoid and alcohol exposure during early embryonic development, this study establishes a novel link between two distinct signaling pathways and has widespread implications for development, as well as diseases such as addiction and cancer.

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DOI: 10.1097/EDE.0000000000001303

Abstract

Background: Male marijuana use has increased steadily over the last decade, but its effect on risk of spontaneous abortion to our knowledge has not been studied.

Results: Among 1535 couples who conceived during follow-up, 9% of men reported preconceptional marijuana use <1 time/week and 8% ≥1 time/week. Nineteen percent of pregnancies ended in spontaneous abortion. Compared with no use, adjusted hazard ratios (HRs) for male marijuana use were 1.1 (95% confidence interval [CI] = 0.64, 1.7) for <1 time/week and 2.0 (95% CI = 1.2, 3.1) for ≥1 time/week. The association for ≥1 time/week persisted after restricting to couples where the female partner did not use marijuana (HR = 2.0, 95% CI = 1.1, 3.3), and was stronger for losses at <8 weeks' gestation (HR = 2.5, 95% CI = 1.4, 4.3) and among males aged ≥35 years (HR = 4.1, 95% CI = 1.54, 11).

Conclusions: Couples with male partners who used marijuana ≥1 time/week during preconception had greater risk of spontaneous abortion than couples with males who did not use marijuana.

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International Academy on the Science and Impact of Cannabis

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