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Cannabis and Cars

The AHA! Team — Mon, 20 Jan 2025 06:40:50 +0000

Michael Greger M.D. FACLM via Nutrition Facts – Did traffic fatalities increase or decrease after cannabis legalization? Is cannabis-impaired driving a public health and safety concern? Well, the number of tickets for cannabis-impaired driving went up in Washington State after legalization, as did the proportion of drivers in fatal car crashes in Colorado who tested positive for marijuana use. But, in both cases, this “may simply reflect a general increase in marijuana use” overall. It doesn’t mean that cannabis is causing the crashes, as I discuss in my video The Effects of Marijuana on Car Accidents. There is a lot of evidence correlating marijuana use with car accidents, but who uses marijuana? Mostly young people and males. And guess who has a higher crash risk regardless of what they smoke? Young people and males. However, even taking that into account, it does seem that “roughly 20–30% of traffic crashes involving cannabis use occur because of the cannabis use.” But, to put that in perspective, that number is more like 85 percent when it comes to alcohol. Aren’t cannabis crashes low-velocity fender-benders from an impaired driver going like five miles an hour? “After a systematic review of the literature,” a compilation of studies “examining acute cannabis consumption and motor vehicle collisions…found a near doubling of the risk of a driver being involved in a motor vehicle collision resulting in serious injury or death.” So, that’s pretty serious, but alcohol is even worse. Cannabis may double or triple the risk of car crashes, but alcohol may multiply the risk 6- to 15-fold. The combination may be even worse—25 times the odds of a fatal car crash involvement when testing positive for both cannabis and alcohol. The “safety consequence of increased incidence of cannabis intoxication” when driving is listed as one of the “three primary reasons for concern about legalized cannabis….” Well, what happened in the U.S. states where marijuana was legalized? How much did traffic fatalities go up? They didn’t. In fact, they went down. What? “Why does legalizing medical marijuana reduce traffic fatalities?” Because of reduced alcohol consumption. It was found that “the legalization of medical marijuana is associated with reduced alcohol consumption, especially among young adults.” So, there was more drugged driving, but less drunk driving—and drunk driving is so much worse that fatalities went down overall. So, perhaps we’d also see less liver disease and less alcohol-induced brain damage, as cannabis substitutes for some of the alcohol use. Indeed, researchers argued that “cannabis was unlikely to produce as much harm as alcohol because, unlike alcohol, cannabis did not cause liver and other gastrointestinal diseases, it was not fatal in overdoses, it did not appear to be as neurotoxic as alcohol, and it was not as potent a cause of car crashes as alcohol.” “The health problems reported by cannabis dependent persons—e.g. bronchitis and impaired memory—are much less serious on average than those reported by persons who are alcohol dependent (e.g. delirium, liver disease, gastritis) but this does not mean that cannabis dependence is a minor problem.” When public health authorities bring that up, though, they may be criticized. In the 1940s and 1950s in the United States, for instance, after the repeal of Prohibition, we needed to warn people about the problems of heavy drinking, liver cirrhosis, and alcoholism, but some dismissed the concerns as if they were just “temperance propaganda.” We now see a similar situation, where the public health profession wants to educate people about the adverse health effects of cannabis but is dismissed as “reefer madness” hysterics. Still, it’s important to put these adverse health effects in perspective. How does the safety of cannabis stack up against alcohol and tobacco? According to the Centers for Disease Control and Prevention (CDC), “alcohol is linked to approximately 88,000 deaths per year,” whereas “there are no reported deaths due to cannabis.” (They’re from things like car accidents.) What’s more, they even go down when more people smoke pot because alcohol is so much worse. “With hindsight, we can clearly see the enormous problems that have been caused to many individuals and to society by tobacco and alcohol”—both legal drugs. “If asked to decide today which psychoactive drugs should be legal, cannabis (which rarely kills people) might well be judged as being comparatively benign” and may be much higher on the list. I have many other videos on cannabis if you’re interested. Check out the related posts below. I first released these videos in a webinar, and you can find them all on a digital download here. Key Takeaways After the legalization of marijuana, there was an increase in cannabis-impaired driving incidents and in the proportion of drivers in fatal crashes who tested positive for marijuana. However, this increase may reflect a general rise in marijuana use rather than directly causing more crashes. Although there is evidence correlating marijuana use with car accidents, it’s essential to note that young people and males, who are more likely to use marijuana, already have a higher risk of crashes. Cannabis use is estimated to be a factor in 20 to 30 percent of crashes involving its use, compared to about 85 percent for alcohol. A systematic review found that cannabis use nearly doubles the risk of serious injury or death in car crashes. However, alcohol poses a much greater risk, increasing the likelihood of crashes by 6 to 15 times. The risk is even higher when cannabis and alcohol are combined. Despite concerns, traffic fatalities did not increase in U.S. states where marijuana was legalized; they actually decreased. This reduction is attributed to a decrease in alcohol consumption, particularly among young adults, who may be substituting cannabis for alcohol. Cannabis is associated with fewer serious health problems compared to alcohol and tobacco. The CDC reports no direct deaths due to cannabis, whereas alcohol is linked to approximately 88,000 deaths per year. While cannabis dependence has health risks, they are generally less severe than those associated with alcohol dependence. To read the original article click here.

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Does Marijuana Affect Weight Gain or Bone Density?

The AHA! Team — Wed, 23 Oct 2024 08:19:02 +0000

Michael Greger M.D. FACLM via Nutrition Facts – Are the apparent adverse effects of heavy cannabis use on the bone just due to users being thinner? It’s been recognized for decades that cigarette smoking can have “a major effect” on bone health, “increasing the lifetime risk of hip fracture by about half.” It also appears to impair bone healing, so much so that surgeons ask if they should discriminate against smokers because their bone and wound-healing complication rates are so high. What about smoking marijuana? As I discuss in my video Effects of Marijuana on Weight Gain and Bone Density, “There is accumulating evidence to suggest that cannabinoids [cannabis compounds] and their receptors play important roles in bone metabolism by regulating bone mass, bone loss, and bone cell function.” Okay, but are they “friend or foe?” “Results from research on cannabinoids and bone mineral density in rodent models have been inconsistent. Some studies show increased bone formation, others have demonstrated accelerated bone loss, and yet others have shown no association. This variation in results may be due [in part] to differences in the mouse strain, sex, age…” If you can’t even extrapolate from one mouse to another, how can you extrapolate from mice to human beings? What if you just measure cannabis use and bone mineral density in people? Researchers tested thousands of adults and asked them about their cannabis use. There did not appear to be any link between the two, which is a relief. However, in this study, “heavy” cannabis use was defined as just five or more days of use in the previous 30 days. The researchers didn’t ask beyond that, so, theoretically, someone who smoked just five joints in their entire life could be categorized as a “heavy user” if they happened to use it five times in the last four weeks. How about cannabis use on 5,000 separate occasions over a lifetime? Now that’s a heavy user—decades of regular use. In that case, heavy use was “associated with low bone mineral density and an increased risk of fractures”—about double the fracture rate presumably due to lower bone density in the hip and spine, although heavy cannabis users were also thinner on average, and thinner people have lighter bones. Hip fracture risk goes down as our weight goes up. Nearly half of underweight women have osteoporosis, but less than 1 percent of obese women do, which makes total sense. Being obese forces our body to make our bones stronger to carry around all of that extra weight. That’s why weight-bearing exercise is so important to constantly put stress on our skeleton. When it comes to our bones, it’s use it or lose it. That’s why astronauts can lose a percent of their bone mass every month in “long-duration spaceflight.” Their bodies aren’t stupid. Why waste all that energy making a strong skeleton if you aren’t going to put any weight on it? So, maybe the reason heavy cannabis users have frailer bones is because they tend to be about 15 pounds lighter. Wait a second. Marijuana users are slimmer? What about the munchies? “The lower BMI that was observed in heavy cannabis users at first sight seems counterintuitive,” given marijuana’s appetite stimulation, but this isn’t the first time this has been noted. “Popular culture commonly depicts marijuana users as a sluggish, lethargic, and unproductive subculture of compulsive snackers,” and marijuana has indeed been found to increase food intake. A single hit can increase appetite, so you’d expect obesity rates to rise in states that legalized it. But, if anything, the rise in obesity appeared to slow after medical marijuana laws were passed, whereas it appeared to just keep rising in other states, as you can see in the graph below and at 3:45 in my video. The reason pot smokers may be slimmer is because of the effect of smoked marijuana on metabolism. We’ve known for more than nearly 40 years that within 15 minutes of lighting up, our metabolic rate goes up by about 25 percent and stays there for at least an hour, as you can see below and at 4:04 in my video. So, that may be playing a role. Is that why heavy cannabis use is associated with lower bone mineral density and increased risk of fractures? Because users just aren’t as overweight? No. Even when taking BMI into account, heavy cannabis use appears to be “an independent predictor” of weaker bones. I originally released a series of marijuana videos in a webinar and downloadable digital DVD. There are still a few videos coming out over the next year, but if you missed any of the already published ones, see the related posts below. For more on bone health, check out the related posts below. Key Takeaways Cigarette smoking is known to have a major negative effect on bone health, increasing the risk of hip fracture and impairing bone healing. Surgeons questioned whether they should discriminate against smokers due to higher complication rates. Cannabinoids and their receptors are implicated in bone metabolism, influencing bone mass, bone loss, and bone cell function. However, research on cannabinoids’ effects on bone mineral density in rodents has shown inconsistent results. Heavy cannabis use, defined as more than 5,000 separate occasions over a lifetime, is “associated with low bone mineral density and an increased risk of fractures.” This risk is about double compared to non-heavy users, potentially due to users’ lower bone density in the hip and spine. Heavy cannabis users, despite experiencing increased appetite (the munchies), tend to have lower BMI and are slimmer. The increased metabolic rate observed after smoking marijuana may contribute to this, but heavy cannabis use remains an independent predictor of weaker bones, even when considering BMI. To read the original article click here.

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Marijuana and Schizophrenia?

The AHA! Team — Fri, 31 May 2024 05:31:56 +0000

Michael Greger M.D. FACLM via Nutrition Facts – The evidence linking cannabis use to psychotic disorders is considered strong enough to warrant a public health warning. “Even as proponents of [cannabis] legalization contend that smoked marijuana is a harmless natural substance that improves the quality of life, a growing body of evidence links it in a small but significant number of users to…the induction or aggravation of psychosis.” “Psychotic disorders are arguably the most serious of mental illnesses, the best known being schizophrenia.” “Schizophrenia, an illness that is characterized by delusions, hallucinations, and odd behavior, is among the top 10 leading causes of disability in the United States. It affects approximately 1% of the general population.” Can cannabis cause it? Schizophrenia… affects approximately 1% of the general population As I discuss in my video Does Marijuana Cause Schizophrenia?, over the last half-century, “nearly 2,000 studies have been published on this topic…and the pro-psychotic effects of cannabis have dominated media reporting about this drug. But how clear is the link?” Population studies have “consistently demonstrated a strong, positive, and dose-dependent association between cannabis use and the risk of psychotic disorders.” Indeed, studies have shown that the more cannabis people use, the more likely they are to be psychotic, as seen in a chart below and at 1:10 in my video. However, that doesn’t mean cannabis is the cause. It could just be a correlation or even a consequence of the disease. “The link between cannabis and psychosis is well established,” but it may be the case that patients with mental health problems self-medicate and “use cannabis to relieve their distress.” The link between cannabis and psychosis is well established… As you can see below and at 1:38 in my video, there isn’t only a link between cannabis and psychosis in snapshot-in-time cross-sectional studies, but in cohort studies as well, where people are followed over time. Research has shown that cannabis use often precedes psychosis, not the other way around. Now, it goes without saying that “the vast majority of people who use cannabis do not develop psychotic disorders such as schizophrenia, and many people diagnosed with such disorders have never used cannabis.” But, overall, these studies are considered to be “strong enough evidence to warrant a public health message that cannabis use can increase the risk of psychotic disorders.” There is another potential explanation: Even though cannabis use precedes schizophrenia, could it be that whichever genes drive schizophrenia also make it more likely you start smoking pot? The biggest strike against the cannabis-schizophrenia link is country-by-country ecological studies that don’t seem to show more disease in areas where there’s more use. And, overall, schizophrenia rates seem to have remained stable or even gone down worldwide since the 1960s, even though there’s been a big bump in cannabis use since then. If about 10 percent of schizophrenia cases are attributable to marijuana use and there’s been a fourfold increase in use, why hasn’t there been a 40 percent increase in the prevalence of schizophrenia? The problem with that argument is “there is little reliable evidence on the temporal [true] trends in the incidence of schizophrenia, so it is difficult to know whether this statement is true or not.” Perhaps it’s more of an issue with potency rather than just cannabis in general. Indeed, “the incidence of schizophrenia is higher in countries…where high-potency cannabis has taken over the market compared with countries…where more traditional forms of cannabis are smoked.” The bottom line is you don’t know until you put it to the test. You can’t just randomize kids to cannabis, but, in a way, Nature set up a natural experiment for us. There are genes that kids randomly get that can increase their likelihood of smoking pot. Do those kids then go on to have a higher risk of schizophrenia? Yes, research “findings strongly support” all of those population studies that suggest “cannabis plays a causal [cause-and-effect] role in the development of schizophrenia.” Okay, but by how much? Let’s break it down. Even if cannabis use doubles the risk, that would mean only going from a 7-in-1,000 chance of developing a psychosis to 14 in 1,000. So, going from a 1 in 140 chance to a 1 in 70 chance. It would be different if schizophrenia runs in your family, where a doubling of risk could mean going from a one-in-ten chance to one in five, but, on a population scale, it could take thousands of cannabis users quitting to prevent a single case of schizophrenia. So, from a public health standpoint, “addiction is a far more common problem.” Researchers “estimate that people who try cannabis are ninefold more likely to become addicted to it”—even though that itself is relatively rare—“than to develop psychosis in their lifetime.” I have an entire series of videos on cannabis, which I originally released in a webinar and downloadable digital DVD. Key Takeaways Although some proponents of cannabis legalization argue that marijuana is a “harmless natural substance that improves the quality of life,” it has been linked “in a small but significant number of users to…the induction or aggravation of psychosis.” Schizophrenia, a psychotic disorder characterized by hallucinations, odd behavior, and delusions, affects about 1 percent of the general population. Studies have found that the more cannabis people use, the more likely they are to be psychotic, but that could just be a correlation or even a consequence of the disease. Individuals with mental health problems may self-medicate and use cannabis to relieve distress, for example. Research has found that cannabis use often precedes psychosis, not the other way around. Overall, there appears to be “strong enough evidence to warrant a public health message that cannabis use can increase the risk of psychotic disorders.” There does not seem to be more disease in regions with greater cannabis use. Overall, schizophrenia rates appear to have remained stable or even declined worldwide since the 1960s, despite a large jump in cannabis use since then. Potency may be a bigger issue. In countries with higher potency cannabis, the incidence of schizophrenia is higher than in countries with “more traditional forms.” Some genes can increase our likelihood of using cannabis, and kids who randomly get them have been found to have a higher risk of schizophrenia. Research suggests that cannabis may have a cause-and-effect role in the development of that psychosis. Even if cannabis use doubles the risk, however, that would just mean a 1-in-70 chance of developing a psychosis without a family history of schizophrenia. From a public health standard, the far more common problem is addiction. To read the original article click here.

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Today’s Marijuana Is Much More Dangerous, and That’s Leading to Addiction and Psychotic Episodes

AHA Publisher — Fri, 30 Sep 2022 07:22:24 +0000

News Staff CBN News – Today’s marijuana is nothing like the pot used by previous generations. It’s much, much stronger. Decades ago the THC content was three percent. Today it’s anywhere from 15 to 30 percent. A recent study in a major medical journal found high potency marijuana is linked to a greater risk of addiction. The detailed research paper by mental health experts also warns about those higher concentrations of THC and the chemical’s terrible impact on the mind, including depression, anxiety, addiction, and more. The authors explained that people who used cannabis with higher THC levels were more likely to have a “psychotic episode.” On this week’s Healthy Living program, CBN News Medical Reporter Lorie Johnson talked to a young man who not only became addicted to marijuana but also suffered from cannabis-induced psychosis. Zach Plant told Healthy Living how using cannabis gave him a mental disorder. “In my experience, cannabis-induced psychosis is something that happened for me from smoking way too much marijuana,” he said. “And it triggered my brain to go into a mode where I was very manic, I had very manic thinking and a lot of paranoid thinking in a short amount of time.” During the interview, Plant said this paranoid thinking included fears of others trying to attack him. “Whenever I was induced psychosis by cannabis, I had thoughts of other people wanting to hurt me,” Plant told CBN News. “Thoughts of the only way of being safe was to end my own life. It went very quickly to suicidal thinking.” He recalled that he even operated a vehicle while under the effects of cannabis and was in total blackout mentally. “I don’t remember getting to where I needed to go, but somehow just ending up there,” Plant said. “I do have brief memories of swerving on the road and things like that. It’s really just a miracle that I’m still alive after an experience like that.” The young man explained his cannabis tolerance became so high that he would have to smoke more to feel its effects for 30 minutes to an hour. “At first, I would smoke one time and the effects would last for several hours,” Plant said. “My tolerance had been so high at that point, I was ingesting a lot more.” This led to a manic episode. “My manic episode was thinking that I had all the answers for what was wrong in the world,” he said. As several U.S. states have legalized the recreational use of marijuana, drug-related issues have risen. Arkansas voters will decide on the question on Nov. 8 after the state Supreme Court ruled Issue 4, the Marijuana Legalization Initiative could appear on the ballot. David Cox, assistant director of the Arkansas-based Family Council told American Family News (AFN) that voters need to look at the problems caused by cannabis use that several of those other states are just now finding out about. “For example … in Oregon legalization of marijuana hasn’t weakened the drug cartels, but it has actually emboldened them,” he said. “In other states, we see youth marijuana use and youth drug use increase with legalization.” Cox also noted that the social cost to the local community is too high to support the legalized retail sales of cannabis. “If you start selling marijuana retail in a community, obviously you see drug use increase – and so there is a social cost here that we feel is just too high. That is one of the reasons why we oppose the legalization of marijuana.” Others who support the legalization of pot argue it will bring in more revenue to the Natural State through sales taxes. But Cox argues it’s not as much in revenue as people think due to the low amount of taxes that will be levied on marijuana due to Issue 4. “So, a lot of people may think that ‘hey, we’ll legalize marijuana in Arkansas, it will bring this windfall to the state, we’ll get all this tax revenue,'” he told AFN. “The reality is the taxes in this amendment are very low and your elected officials will not be able to raise those taxes without having to actually change the state constitution.” As CBN News reported in November of 2018 when Massachusetts became the first state on the U.S. East Coast to legalize marijuana and begin commercial sales, the legalization of the drug comes at a cost. A report released ahead of Massachusetts’ action outlined economic and social effects in the wake of marijuana legalization in Colorado. The findings by the Colorado Christian University’s (CCU) Centennial Institute are pretty stark: For every dollar gained in tax revenue, Coloradans spent roughly $4.50 to mitigate the adverse effects of legalization. The largest costs of legalizing the drug are related to the health care system and high school dropouts. Calls to poison control have increased dramatically since legalization. Long-term use can lead to reduced cognitive ability. Jeff Hunt serves as vice president of public policy at CCU and director of the Centennial Institute. He said the report is an important first step in “giving researchers and policymakers a sense of the breadth of costs associated with commercial marijuana.” To read the original article click here.

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CBD, THC Use During Early Pregnancy Can Disrupt Fetal Development

AHA Publisher — Sat, 16 Nov 2019 08:00:13 +0000

University of North Carolina School of Medicine via Newswise – UNC School of Medicine researchers are the first to show in animal models that components of marijuana, including its cannabinoids THC and CBD, can cause brain and facial birth defects if used during the first trimester of pregnancy. Newswise — CHAPEL HILL, NC – A new study published in Scientific Reports, a Nature Research journal, shows how a one-time exposure during early pregnancy to cannabinoids (CBs) – both synthetic and natural – can cause growth issues in a developing embryo. This is the first research to show such a connection in mammals. The study was performed in mice, which are very accurate models for the development that occurs during early pregnancy, according to the study’s senior author, Scott Parnell, PhD, assistant professor of cell biology and physiology in the UNC School of Medicine. “The development of the embryo in this time period is very similar across all vertebrates,” said Parnell, a member of the UNC Bowles Center for Alcohol Studies. “In this study we also test a synthetic cannabinoid in zebrafish that yielded similar growth deformations as the natural CBs. Having the same results across animal models reinforces our findings.” In this study, the brain and facial developmental effects caused by one-time exposure to CBs – CBD and THC (the primary ingredients of marijuana) – are very similar to what is seen in fetal alcohol syndrome (FAS). Parnell and colleagues also found that when CBs and alcohol were used together, the likelihood of these birth defects more than doubled. They went on to show that these drugs may be causing defects by interacting on a basic cellular level and disrupting signaling between molecules and cells that control growth and development. “The interaction between alcohol and CBs we witnessed is very concerning,” said the study’s first author, Eric Fish, PhD, research associate in the UNC School of Medicine Bowles Center for Alcohol Studies. “Previous studies have shown that CBs and alcohol are frequently used together, and for pregnant women we’re learning that could be very dangerous to a developing child.” In the study CBs, and CBs with alcohol, were given in varying amounts on day eight of pregnancy, which is comparable to the third and fourth weeks of pregnancy in humans. This time period is when alcohol and CB exposure is especially damaging to a developing embryo, and is before some women know they are pregnant. The CBD amounts administered were within what is considered a therapeutic range for humans. The THC concentration administered was similar to levels reached by a person smoking marijuana. “It is concerning how little we know about the use of marijuana, its CBs, and products like CBD oil during pregnancy,” Parnell said. “We know that there is no safe period to drink alcohol during a pregnancy, and I think this research shows the same is likely true of marijuana use.” With the results of these one-time exposures, Parnell and Fish are planning to now test smaller, multiple exposures throughout a pregnancy that better mimics real-life usage in human pregnancy. To read the original article click here.

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