Abstract: Background: Cardiovascular anomalies are the largest group of congenital anomalies and the major cause of death in young children, with various data linking rising atrial septal defect incidence (ASDI) with prenatal cannabis exposure. Objectives / Hypotheses:  Is cannabis associated with ASDI in USA? Is this relationship causal?

Results: ASDI rose nationally three-fold from 27.4 to 82.8 / 10,000 births 1991–2014 during a period when tobacco and alcohol abuse were falling but cannabis was rising.

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Cannabinoids Exacerbate Alcohol Teratogenesis (Alcohol & Cannabis Toxic Combination for Developing Babies)

Scientific Reports volume 9, Article number: 16057 (2019)

Abstract: We tested whether cannabinoids (CBs) potentiate alcohol-induced birth defects in mice and zebrafish, and explored the underlying pathogenic mechanisms on Sonic Hedgehog (Shh) signaling. The CBs, Δ9-THC, cannabidiol, HU-210, and CP 55,940 caused alcohol-like effects on craniofacial and brain development, phenocopying Shh mutations. 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.

Fetal Alcohol Spectrum Disorder (FASD) is common; recent conservative prevalence rates range from 1–5%¹. Binge alcohol drinking (i.e. more than 4 or 5 drinks in two hours for women and men, respectively) is increasingly popular among young people, and is especially damaging to the embryo during the third to fourth weeks of pregnancy, when most pregnancies are unrecognized^2,3. Alcohol exposure during this period causes characteristic craniofacial malformations of Fetal Alcohol Syndrome (FAS) including small palpebral fissures (micropthalmia), a smooth philtrum, and brain malformations in the holoprosencephaly spectrum³.

ffMarijuana use is also rising⁴, and about 4% of pregnancies are marijuana-exposed⁵, through either recreational use or as an anti-nausea self-medication. However, some subgroups of pregnancies have considerably more exposure^6,7 and nearly 20% of a cohort of pregnant women in California, aged 18–24, report marijuana use⁸. As marijuana and other cannabinoids (CBs), such as cannabidiol (CBD), become increasingly legalized for medical or recreational purposes, and they remain perceived as low-risk substances⁹ safe to use during pregnancy, the incidence of CB-exposed pregnancies will rise even further. A recent study of births in Colorado found that the incidence of several birth defects has risen in the state during the period of marijuana legalization¹⁰.

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Research shows that use of tobacco, alcohol, or illicit drugs or misuse of prescription drugs by pregnant women can have severe health consequences for infants. This is because many substances pass easily through the placenta, so substances that a pregnant woman takes also reach the fetus.⁹¹ Recent research shows that smoking tobacco or marijuana, taking prescription pain relievers, or using illegal drugs during pregnancy is associated with double or even triple the risk of stillbirth.⁹² Estimates suggest that about 5 percent of pregnant women use one or more addictive substances.⁹³

Risks of Stillbirth from Substance Use in Pregnancy

• Tobacco use—1.8 to 2.8 times greater risk of stillbirth, with the highest risk found among the heaviest smokers
• Marijuana use—2.3 times greater risk of stillbirth
• Evidence of any stimulant, marijuana, or prescription pain reliever use—2.2 times greater risk of stillbirth
• Passive exposure to tobacco—2.1 times greater risk of stillbirth

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BBC News

A drug that was weaponised by the UK's most prolific rapist and the serial killer Stephen Port should be reclassified, says an official report

Currently GHB is in class C, with anabolic steroids and some tranquilisers.

• What is killer drug GHB?
• Stephen Port: The killer the police missed
• Gerald Matovu: The link between a Grindr murderer and a serial killer
• Reynhard Sinaga: The sexual predator who waited outside nightclubs

The official review was commissioned following calls for a change in the law by the children of a man who was murdered with the drug.

Eric Michels, a father of three from south London, was killed in 2018 by a GHB dealer who gave him a catastrophic overdose in order to steal from him.

His sons Sam and Josh campaigned for the drug to be reclassified.

"Today is a positive day," Sam Michels told the BBC but said he thought GHB should be a Class A drug.

Assessment of the harms of (GHB) gamma-hydroxybutyric acid, gamma-butyrolactone, and closely related compounds Research & Analysis:

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