Young cannabis users at increased risk of repeat stroke

According to a new study, young people with a history of stroke or TIA who regularly use cannabis are 50% more likely to experience a repeat stroke.

The adverse effect of cannabis use on health is well recognized, particularly in the young. It has associations with mental disorders, mood symptoms, and long-term psychotic illness.

Cannabis use disorder

CUD is “a relatively new diagnosis […] more of a physical and psychological dependence upon cannabis,” said Dr. Robert L Page II, professor in the Departments of Clinical Pharmacy and Physical Medicine at the University of Colorado in Aurora.

“[It] is different from recreation […] these individuals are using it on a regular basis, in a chronic fashion.”

The American Psychiatric Association classifies CUD as:

• taking large amounts over a long time
• wanting to control or cut down its use
• spending lots of time trying to get the drug or recover from using it
• failing to fulfill work or school tasks
• withdrawing from social, occupational, or recreational activities

Studies Trusted Source have shown that cannabis use in younger individuals is a risk factor for first-time stroke or transient ischemic attack(TIA)Trusted Source, also known as a mini-stroke.

However, scientists have not established the risk of subsequent strokes and TIAs in people who use cannabis until now.

Increased stroke in the young

A stroke or TIA occurs when the blood supply to the brain is reduced or cut off. It is a life threatening medical emergency that needs immediate hospital treatment.

In recent years, the number of strokes has reduced in the U.S. However, rates have increased in young adults ages 18–45 years, accounting for 10-15% of strokes in the U.S.

A recent study led by researchers at Mercy Catholic Medical Center in Philadelphia, PA, has shown young adults with a history of stroke or TIA and CUD have a 50% increased risk of recurrent stroke compared with those without CUD.

Speaking with Medical News Today, the lead author of the study Dr. Akhil Jain, explained:

“Since marijuana use is more common among younger people and is now legal in various U.S. states, we felt it was crucial to study the risk of re-stroke […] especially with the established first-time stroke risk in cannabis users. We used recreational dependent or chronic/habitual cannabis use for our study, i.e., cannabis use disorder.”

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Epidemiological association of cannabinoid- and drug- exposures &  sociodemographic factors with limb Reduction Defects

Limblessness: Cannabinoids Inhibit Key Embryonic Morphogens both Directly and Epigenomically

Dear Editor

The predominant questions to emerge from the striking findings that 45 of 62 (72.5%) congenital anomalies tracked longitudinally in USA [1] and 89 of 95 (93.7%) of congenital anomalies in Europe [2] could be related to various indices of cannabinoid exposure must surely be mechanistic: “How” and “Why?”. And in particular “Are cannabinoids inhibiting fundamental cellular processes to account for this significant multisystem panorganismal teratogenic effect?”

It is important to appreciate that most body tissues are formed by a complex interaction of declining key morphogen gradients that control and specify developmental cell type with great precision across the embryo. Hence the neuraxis (brain and spinal cord) is controlled in its anterior-posterior cell specification by sonic hedgehog coming form the ventral notocord (embryonic organizer) and bone morphogenetic proteins (BMP’s) and Wnt’s coming from the overlying epidermis dorsally. Similar gradients control proximal-distal, left-right and outside-inside cell growth, connection and specification.

The developing limb bud is controlled by gradients of retinoic acid (RA) and sonic hedgehog (shh) proximally vs fibroblast growth factors (FGF’s) and Wnt’s from the anterior epidermal ridge distally. Limb length is controlled by Meis and hox genes. Fingers grow under the influence of FGF8. Regression of tissue in the web spaces between fingers is controlled by BMP’s 2, 4 and 7 and RA amongst others. Shh signals to its receptor patched, and to gremlin and Hand2 [3].

Strong as the signal is for limb reduction anomalies in USA datasets (P=0.0134) it is much stronger in the European dataset making Europe the leading continent on which to study these severe deformities (P=8.20x10-65) [1, 2].

Research has recently discovered that both Δ9THC and cannabidiol, along with various synthetic cannabinoids inhibit shh signalling by blocking smoothened which acts downstream of the patched shh receptor. Moreover cannabinoids have also been shown to inhibit FGF, BMP, RA, notch, Wnt and hippo gradients [4].

Clearly broad spectrum disruption of the major morphogenic gradients of embryonic development can only be expected to have manifold severe embryotoxic outcomes.

A deeply insightful epigenomic study recently demonstrated in its 359-page Supplementary material that cannabinoid exposure can disrupt human sperm DNA methylation patterns at five key genes critically involved in limb morphogenesis [5]. Of these GLI3 (Gli family zinc finger 3), MEGF8 (multiple EGF-like domains 8), TMEM107 (transmembrane protein 107) and BMP4 are directly involved in mediating, interacting with or antagonising shh signalling.

Such vitally salient results indicate not only that cannabinoids can interfere with limb development directly but that they do so epigenomically. This critically important finding raises the stakes on cannabinoid-induced embryopathy enormously from merely the exposed infants potentially to multigenerational inheritable teratogenic effects.

Professor Albert S. Reece, 31 January 2022 (https://www.bmj.com/content/376/bmj.n3114/rapid-responses )

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Abstract: There are many concerns about the commercialization of high potency THC marijuana and concentrated cannabis products like BHO, shatter, dab, edibles in Colorado without any regulations on the potency limits. This article is about the downsides of this process. We do not "vote" on any other medication and people need to be educated about the consequences of this. There is really no difference between "medical" and recreational marijuana. One of the consequences of increasing the potency of a drug is a significant increase in the addictive potential of the drug. The cannabis industry has taken a page from the alcohol, tobacco and pharmaceutical industry playbooks. They need to create addicted users in order to make money. Buyer Beware.

Author, Psychiatrist  Elizabeth Stuyt, MD

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Are CBD and THC Valid Medicines?

Conclusion: After cannabis legalization, the prevalence of moderately injured drivers with a THC level of at least 2 ng per milliliter in participating British Columbia trauma centers more than doubled. The increase was largest among older drivers and male drivers. (Funded by the Canadian Institutes of Health Research.)

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(According to recently released data from The Victorian Institute of Forensic Medicine, Cannabis was present in 14.8 % of driver fatalities, almost as much as all combined stimulant involvement in driver fataliies at 17.3 %)