OPEN LETTER on Decriminalization of Drugs 2020.pdf

JAMA Pediatr. Published online January 19, 2021. doi:10.1001/jamapediatrics.2020.5494

Question  Is cannabis use disorder associated with heightened risk of self-harm, suicide, and mortality among youths with mood disorders?

Findings  This population-based cohort study of Medicaid-enrolled youths with mood disorders found that the presence of cannabis use disorder was significantly associated with an increased risk of nonfatal self-harm, all-cause mortality, and death by unintentional overdose and homicide.

Meaning  Cannabis use disorder is common among adolescents and young adults with mood disorders and is associated with an elevated risk of self-harm, overall mortality, and death by unintentional overdose and homicide in this already vulnerable population.

Abstract

Importance  Cannabis use and cannabis use disorder (CUD) are common among youths and young adults with mood disorders, but the association of CUD with self-harm, suicide, and overall mortality risk is poorly understood in this already vulnerable population.

Objective  To examine associations of CUD with self-harm, suicide, and overall mortality risk in youths with mood disorders.

Results  This study included 204 780 youths (133 081 female participants [65.0%]; mean [SD] age at the time of mood disorder diagnosis, 17.2 [4.10] years). Cannabis use disorder was documented for 10.3% of youths with mood disorders (n = 21 040) and was significantly associated with older age (14-18 years vs 10-13 years: adjusted risk ratio [ARR], 9.35; 95% CI, 8.57-10.19; and 19-24 years vs 10-13 years: ARR, 11.22; 95% CI, 10.27-12.26), male sex (ARR, 1.79; 95% CI, 1.74-1.84), Black race (ARR, 1.39; 95% CI, 1.35-1.44), bipolar or other mood disorders (bipolar disorders: ARR, 1.24; 95% CI, 1.21-1.29; other mood disorders: ARR, 1.20; 95% CI, 1.15-1.25), prior history of self-harm (ARR, 1.66; 95% CI, 1.52-1.82), previous mental health outpatient visits (ARR, 1.26; 95% CI, 1.22-1.30), psychiatric hospitalizations (ARR, 1.66; 95% CI, 1.57-1.76), and mental health emergency department visits (ARR, 1.54; 95% CI, 1.47-1.61). Cannabis use disorder was significantly associated with nonfatal self-harm (adjusted hazard ratio [AHR], 3.28; 95% CI, 2.55-4.22) and all-cause mortality (AHR, 1.59; 95% CI, 1.13-2.24), including death by unintentional overdose (AHR, 2.40; 95% CI, 1.39-4.16) and homicide (AHR, 3.23; 95% CI, 1.22-8.59). Although CUD was associated with suicide in the unadjusted model, it was not significantly associated in adjusted models.

Conclusions and Relevance  Cannabis use disorder is a common comorbidity and risk marker for self-harm, all-cause mortality, and death by unintentional overdose and homicide among youths with mood disorders. These findings should be considered as states contemplate legalizing medical and recreational marijuana, both of which are associated with increased CUD.

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 Women who use marijuana could have a more difficult time conceiving a child than women who do not use marijuana, suggests a study by researchers at the National Institutes of Health. Marijuana use among the women’s partners — which could have influenced conception rates — was not studied. The researchers were led by Sunni L. Mumford, Ph.D., of the Epidemiology Branch in NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development. The study appears in Human Reproduction.

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(So why not a QUIT Cannabis Campaign too? Hmmm, the cognitive dissonance continues)

WHO today launches a year-long global campaign for World No Tobacco Day 2021 - “Commit to Quit."  The new WHO Quit Challenge on WhatsApp and publication “More than 100 reasons to quit tobacco" are being released today to mark the start of the campaign.

The COVID-19 pandemic has led to millions of tobacco users saying they want to quit. The campaign will support at least 100 million people as they try to give up tobacco through communities of quitters. 

“Commit to Quit” will help create healthier environments that are conducive to quitting tobacco by advocating for strong tobacco cessation policies; increasing access to cessation services; raising awareness of tobacco industry tactics, and empowering tobacco users to make successful quit attempts through “quit & win” initiatives. 

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