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Category: Adverse Drug Reactions

Unintended Consequences: Marijuana Use Tied to Changes in the Brain

Unintended Consequences: Marijuana Use Tied to Changes in the Brain

Over the past few decades, growing numbers of people in the U.S. have come to think about marijuana as harmless. Others have even embraced it as beneficial under certain circumstances, pointing to its purported medical value. So it’s not too surprising that long-running legalization efforts in some states have recently led to marijuana’s decriminalization and increased availability.  However, a study published in the Journal of Neuroscience sheds new light on the subject—and its findings come out against the commonly held belief that marijuana use is completely innocuous. Researchers at Northwestern University Feinberg School of Medicine have found that even casual use of marijuana can cause structural changes to areas of the brain that control emotion, motivation, and reward.

The study analyzed 40 students between the ages of 18 to 25 in the Boston area. Half of the subjects used marijuana recreationally—at least once a week—and the other half did not use it at all. Psychiatric interviews and tests revealed that none of the students met the criteria for drug dependence, and their cannabis use did not interfere with their studies, work, or social habits. However, when using MRI scans to study the students’ brains, the researchers found changes to the volume, shape, and density of the neurons in two important areas: the amygdala and the nucleus accumbens. The changes were found to be more pronounced in people who reported using marijuana more frequently during an average week. Study leader Dr. Hans Breiter said of the findings, “There was a direct, consistent relationship between how much marijuana they used and the abnormalities we saw.”

While the brain abnormalities and their relationship to marijuana use are clear, it’s less clear what these changes to the brain’s structure might actually mean for these individuals. Breiter continues, “These are two brain regions you do not want to mess around with. All parts of the brain are important, but some, like these, are more fundamental. It raises a very serious issue, given that we saw these changes in casual marijuana users.” Previous studies had revealed similar changes in brain structure among heavy users of cannabis, but this is the first study that indicates that even casual use can alter a person’s brain.

“The earlier the onset of marijuana use in a kid, the worse potential implications you could be seeing,” Breiter said. Another study author, Jodi Gilman of the Massachusetts General Hospital Center for Addiction Medicine, says, “We just don’t know how much is safe. It’s not harmless. We don’t know the harm, but it’s not free from harm.”

Breiter also commented that the concentrations of THC (the psychoactive component of cannabis) are not the same as they used to be: “Levels of THC are about sevenfold what they used to be. That’s a substantial change in the dosing of THC that these young people are getting. The experience of people in the ’60s and ’70s may not be the same experience as people today.”

Interestingly, some proponents of cannabis decriminalization have welcomed the research findings. Paul Armentano, deputy director of the pro-marijuana advocacy group NORML, says that his group presents an argument for legalizing marijuana but tightly regulating it, as alcohol, tobacco, and prescription drugs are. He says, “It’s precisely because of these consequences that these products are legally regulated, and their use is restricted to particular consumers and specific settings. A pragmatic regulatory framework that allows for the legal, licensed commercial production and retail adult sale of marijuana but restricts its use among young people—coupled with a legal environment that fosters open, honest dialogue between parents and children about cannabis’ potential harms—best reduces the risks associated with the plant’s consumption or abuse.”

Marijuana consumption in the Netherlands—where cannabis use has been condoned but controlled since the 1980s, just as Armentano recommends for the U.S.—certainly supports his case. Despite its availability, fewer than 26% of the Dutch population has ever tried marijuana, compared with 41.9% of Americans, and the Netherlands has the lowest problem drug rate in Europe.

But this is a touchy subject, with scientific and humanitarian arguments often clashing with economic interests and many people’s moral judgments about any type of drug use. The trend toward marijuana decriminalization in America—for both medical and recreational use—seems at this point to be irreversible. The one new issue this study brings to the already heated debate is that cannabis use is NOT necessarily without long-term impact, especially on young people. More studies are needed to determine exactly what the effects of this drug actually are so that society can balance the risks and manage the costs that will inevitably come with decriminalization. Whether it’s legal or illegal, though, it’s critical for people to understand the potential consequences of marijuana use.

 

Opiates Ineffective for Chronic Back or Hip Pain

Opiates Ineffective for Chronic Back or Hip Pain

A new study just published in the Journal of the American Medical Association finds that opioids are not an effective solution for chronic pain.

In this article, researchers from the University of Minnesota studied 240 patients who had chronic back, hip, or knee arthritis pain. Half of the study subjects received opiates; the other half received non-opiate pain medications. Patient progress was evaluated at 3-months, 6-months, 9-months, and one year.

The study found:

  • There was no difference in pain-related function between the two groups.
  • At 12 months, the nonopioid patients had less pain than did those who received opiates.
  • “The opioid group had significantly more medication-related symptoms over 12 months than the nonopioid group”

The study authors write:

“Among patients with chronic back pain or hip or knee osteoarthritis pain, treatment with opioids compared with nonopioid medications did not result in significantly better pain-related function over 12 months. Nonopioid treatment was associated with significantly better pain intensity, but the clinical importance of this finding is unclear.”

Previous research has found that about 20% of patients with musculoskeletal pain are prescribed narcotic pain medications for their symptoms, and another recent study found that 36% of people who overdosed from opiates had their first opioid prescription for back pain.

Another recent study found that chiropractic patients are less likely to use opiates for their pain than are medical patients.

From this research, it seems clear that it’s risky to prescribe opiates for musculoskeletal pain. Chiropractic care is a proven safe and effective approach for both chronic and acute back pain.

Krebs EE, Gravely A, Nugent S, Jensen AC, DeRonne B, Goldsmith ES, Kroenke K, Bair MJ, Noorbaloochi S. Effect of Opioid vs Nonopioid Medications on Pain-Related Function in Patients With Chronic Back Pain or Hip or Knee Osteoarthritis Pain: The SPACE Randomized Clinical Trial. JAMA. 2018 Mar 6;319(9):872-882. doi: 10.1001/jama.2018.0899.

Drug-Resistant Illnesses—What You Should Know

Drug-Resistant Illnesses—What You Should Know

With the huge rise in the use of antibiotics over the past 70 years, some pathogens are now becoming resistant to the drugs that once easily eradicated the illnesses these pathogens cause. People who become infected with one of these drug-resistant organisms are at increased risk for longer, more costly hospital stays and are more likely to die from their infection.

Medical researchers and public health experts believe there are a few different causes for the emergence of drug-resistant bacteria. These include the widespread use of antibiotics in animals as well as and the overuse and misuse of antibiotics in humans.

Cattle, pigs and chickens are routinely given antibiotics to prevent illness and increase weight gain. However, 55 outbreaks of foodborne illness over the past 40 years have been caused by antibiotic-resistant pathogens. New York Congresswoman Louise M. Slaughter, a microbiologist, said “We have evidence that the practice of overusing antibiotics in food-animals is ruining these drugs’ effectiveness, and every day that the government stands idly by, we move closer to the nightmare scenario where routine infections can no longer be cured with antibiotic treatment.” Slaughter has proposed Preservation of Antibiotics for Medical Treatment Act (PAMTA), which would ban the use of 8 major classes of antibiotics from use on healthy animals, with exceptions only for animals who are actually ill.

Doctors are often pressured to prescribe antibiotics for illnesses that antibiotics are ineffective at treating, such as viruses. Parents of sick children have been shown to be particularly bad about exerting pressure on their doctor to give their children an antibiotic, no matter what the illness actually is. In the case of viruses (such as the one that causes the common cold, most coughs and the flu), antibiotics are useless. Antibiotics work against bacteria such as streptococcal bacteria (strep throat) and staphylococcal bacteria (skin infections). The bacterial infections most in danger of becoming resistant to all antibiotics include anthrax, gonorrhea, group B Streptococcus, Klebsiella, Methicillin-resistant Staphylococcus aureus (MRSA), Streptococcus pneumoniae, tuberculosis, typhoid fever, vancomycin-resistant enterococci (VRE) and the antimicrobial-resistant staph bacteria VISA and VRSA.

The best way to help reduce the spread of drug-resistant illnesses is to refrain from pressuring your doctor to prescribe antibiotics when it is not appropriate, and when antibiotics are called for, to take them according to directions. Be sure to complete the full course of the antibiotic regimen prescribed, even if you are feeling well again. If you don’t, some bacteria may linger and develop a resistance to the drug you are taking, potentially making that antibiotic ineffective for you in the future. Do not skip any doses, share your antibiotics with anyone else, or use antibiotics that have been prescribed for someone else.

In general, the symptoms of a virus disappear in about a week or so. In contrast, bacterial infections tend to linger. So if you have been feeling ill for more than two weeks, consult with your physician to see if antibiotics may be appropriate for treating of your illness. If not, he or she can prescribe other effective ways to treat your condition.

Health Update: Close-Up on Adverse Drug Reactions

Health Update: Close-Up on Adverse Drug Reactions

medical theme – doctors desk with documents and stethoscope

You can’t switch on a television these days without seeing a commercial for some new pharmaceutical that will cure whatever may ail you (or cure you from an illness you never knew you had). If you pay attention to it, you will notice that nearly half the ad time is taken up with a long list of possible side effects and adverse reactions that may accompany taking the drug. The possibilities often include everything from slight fatigue to death.

An estimated 4.5 million Americans visit their doctor or the ER each year due to adverse reactions to prescription drugs. These adverse side effects are also suffered by an additional 2 million people each year who are already in the hospital being supervised by medical professionals. The CDC estimates that 82% of Americans are taking at least one drug, and 29% are taking five or more drugs.

The US Food and Drug Administration (FDA) is in charge of approving pharmaceutical drugs for sale in the US. However, their methods for approval are based on the drug companies providing their own scientific studies on the safety of the drug. The FDA does no independent testing. The FDA will usually approve a drug if its benefits are believed to outweigh its dangers. Even assuming the drug companies’ studies have been well-conducted and show that a drug is relatively safe, no drug is completely free from side effects for everyone, even those drugs that are “natural.” A person’s age, weight, gender, overall health and genetic profile have a lot to do with how an individual will respond to a drug.

The most common side effects are gastrointestinal problems, as most drugs are processed via the digestive tract. These problems include nausea, vomiting, constipation and diarrhea. Other common side effects are drowsiness, fatigue and mild skin reactions. Although dizziness may not seem like a dangerous side effect, it can be particularly risky for seniors. According to the Centers for Disease Control and Prevention (CDC), falls among seniors are the leading cause of injury-related death. A quarter of all seniors who fall and break a hip will die within six months of receiving the injury.

Death is of course the most serious side effect of all. Allergic reactions that cause anaphylaxis can be deadly. Some drugs, such as those that treat type 2 diabetes (Actos and Avandia, for example) can cause a stroke or heart attack. Antidepressants can actually increase suicidal thoughts. Some drugs can cause pain and total or partial paralysis, such as the cholesterol-lowering drug Lipitor. Some drugs increase your risk of cancer. Ironically, the drug Tamoxifen, prescribed to treat breast cancer, actually increases the risk of uterine cancer. Memory loss, hallucinations, loss of taste and loss of sight are other common side effects of pharmaceuticals.

Although there is no doubt that some pharmaceuticals are far more useful than they are dangerous (antibiotics, for example), if you want to avoid the harmful side-effects that many drugs may produce, try to keep as healthy as possible. Eat right, get regular exercise and visit your Billings Chiropractor Dr. Greg Oblander to keep your body in top condition.

 

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