BACKGROUND: Cannabinoids are among the psychoactive substances considered as alternatives to opioids for the alleviation of acute pain. We examined whether self-reported marijuana use was associated with decreased use of prescription opioids following traumatic musculoskeletal injury.
METHODS: Our analysis included 500 patients with a musculoskeletal injury who completed a survey about their marijuana use and were categorized as (1) never a user, (2) a prior user (but not during recovery), or (3) a user during recovery. Patients who used marijuana during recovery indicated whether marijuana helped their pain or reduced opioid use. Prescription opioid use was measured as (1) persistent opioid use, (2) total prescribed opioids, and (3) duration of opioid use. Persistent use was defined as the receipt of at least 1 opioid prescription within 90 days of injury and at least 1 additional prescription between 90 and 180 days. Total prescribed opioids were calculated as the total morphine milligram equivalents (MME) prescribed after injury. Duration of use was the interval between the first and last opioid prescription dates.
CONCLUSIONS: Our data indicate that self-reported marijuana use during injury recovery was associated with an increased amount and duration of opioid use. This is in contrast to many patients' perception that the use of marijuana reduces their pain and therefore the amount of opioids used.
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Earlier this year, our laboratory published work demonstrating that rats whose mothers were given low-dose THC (or an analogous synthetic cannabinoid) while pregnant showed significant changes in synaptic plasticity and altered levels of several important proteins lasting well into adulthood. We found that the consequences of these changes manifested as a reduced sociability in the exposed offspring. Male rats in particular were much less likely to approach, play with, or sniff other rats.4
These findings parallel sociobehavioral changes seen in young adult humans exposed to cannabis during gestation. And scientists are now linking those effects to changes in the brain that are similar to what we observed in rats. Using functional MRI technology, for example, researchers participating in the Ottawa Prenatal Prospective Study observed a reduction in activity in the prefrontal cortices of adult offspring of mothers who smoked marijuana during pregnancy. This drop was associated with decreased working memory, echoing the attentional problems and memory dysfunction seen as early as infancy.5
Cannabis is also likely to affect the amygdala, which is critical for emotional development. In 2004, Yasmin Hurd of the Karolinska Institute and colleagues identified a significant reduction in dopamine D2 receptor mRNA in the amygdalae of fetal brains that correlated with the reported quantity of cannabis consumed by their mothers.6 (The fetuses were all between 18 and 22 weeks of gestation and donated by women who underwent voluntary abortions.) Given the known role of amygdala dopamine signaling in the regulation of mood and emotion, these findings could explain the increased depressive-like symptoms observed in children following cannabis exposure in utero, as well as these kids’ propensity towards inattention and impulsivity.
The problem of infant cannabis exposure extends well beyond pregnancy. THC and its lipophilic cannabinoid analogs are readily transferred through breast milk of humans and other mammals, and animal studies have pointed to these compounds’ influence on development throughout the pre-weaning period. Worse yet, given that these cannabinoids linger in the body for weeks, the “pump-and-dump” approach often employed to avoid feeding alcohol-laden milk to an infant isn’t as effective for cannabis users—a Friday night joint can continue to deliver active cannabinoids through breast milk throughout the weekend and into the next week.
For complete study and comprehensive analysis go to THE SCIENTIST 2019 and Marijuana for Morning Sickness a Mistake!
Cannabidiol (CBD) and cannabidivarin (CBDV) are natural cannabinoids which are consumed in increasing amounts worldwide in cannabis extracts, as they prevent epilepsy, anxiety, and seizures. It was claimed that they may be useful in cancer therapy and have anti-inflammatory properties. Adverse long-term effects of these drugs (induction of cancer and infertility) which are related to damage of the genetic material have not been investigated.
Therefore, we studied their DNA-damaging properties in human-derived cell lines under conditions which reflect the exposure of consumers. Both compounds induced DNA damage in single cell gel electrophoresis (SCGE) experiments in a human liver cell line (HepG2) and in buccal-derived cells (TR146) at low levels (≥ 0.2 µM). Results of micronucleus (MN) cytome assays showed that the damage leads to formation of MNi which reflect chromosomal aberrations and leads to nuclear buds and bridges which are a consequence of gene amplifications and dicentric chromosomes. Additional experiments indicate that these effects are caused by oxidative base damage and that liver enzymes (S9) increase the genotoxic activity of both compounds.
Our findings show that low concentrations of CBD and CBDV cause damage of the genetic material in human-derived cells. Furthermore, earlier studies showed that they cause chromosomal aberrations and MN in bone marrow of mice. Fixation of damage of the DNA in the form of chromosomal damage is generally considered to be essential in the multistep process of malignancy, therefore the currently available data are indicative for potential carcinogenic properties of the cannabinoids.
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April 9, 2019 -- When he arrived at the hospital by ambulance, the 70-year-old man said he felt like he was dying. He was pale, nauseated, and reported severe chest pain. "He had had hallucinations at home," says his doctor, Alexandra Saunders, MD, chief medical resident for Dalhousie University in St. John, New Brunswick, Canada. Soon, the medical team confirmed he’d had a heart attack.
He had eaten a marijuana-laced lollipop, given to him by a friend who thought it might help him sleep. "I don’t know if we can say it caused the heart attack,'' Saunders says, citing the patient's pre-existing heart disease. ''We don't have enough guidance to say what a safe dose would be."
Other health experts share her concern over CBD edibles, including chocolates, brownies and other baked goods, snacks, drinks, and even pizza.
The concern over marijuana edibles is from getting too much THC. In Colorado, where recreational use of marijuana is legal, researchers reviewed more than 2,500 cannabis-related emergency room visits from 2012 through 2016 and found that the percentage of visits was higher for inhaled cannabis, but that those using edibles were more likely to have psychiatric and cardiovascular problems.
Product labeling is an issue, too, for both hemp and marijuana CBD edibles, experts say. Consumers can't be sure that what the label lists is actually in the CBD edible. In a 2015 study, researchers evaluated 75 marijuana edibles and found only 17% accurately labeled.
Despite the popularity, neither type of CBD edible -- from hemp or marijuana -- is considered legal in the eyes of the federal government…the FDA says, it is not lawful to introduce food with added CBD or THC into interstate commerce, or to market the products either as dietary supplements or as an addition to them.
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Researchers at the University of Arkansas for Medical Science recently rolled up their sleeves to investigate CBD hepatotoxicity in mice. What they found was while this cannabis derivative is gaining significant recognition as of late in the world of wellness, people that use CBD are at an elevated risk for liver toxicity.
The findings, which were published earlier this year in the journal Molecules, suggest that while people may be using CBD as a safer alternative to conventional pain relievers, like acetaminophen, the compound may actually be just as harmful to their livers.
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