Marijuana found in breast milk up to six days after use

Researchers report 63 percent of breast milk samples from mothers using marijuana contained traces of the drug

August 27, 2018

Science Daily/University of California - San Diego

To better understand how much marijuana or constituent compounds actually get into breast milk and how long it remains, researchers conducted a study.

With the legalization of marijuana in several states, increased use for both medicinal and recreational purposes has been documented in pregnant and breastfeeding women. Although national organizations like the American Academy of Pediatrics recommend that breastfeeding mothers do not use marijuana, there has been a lack of specific data to support health or neurodevelopmental concerns in infants as a result of exposure to tetrahydrocannabinol (THC) or other components of marijuana via breast milk.

To better understand how much marijuana or constituent compounds actually get into breast milk and how long it remains, researchers at University of California San Diego School of Medicine conducted a study, publishing online August 27 in Pediatrics.

Fifty-four samples from 50 women who used marijuana either daily, weekly or sporadically -- with inhalation being the primary method of intake -- were examined. Researchers detected THC, the primary psychoactive component of marijuana, in 63 percent of the breast milk samples for up to six days after the mother's last reported use.

"Pediatricians are often put into a challenging situation when a breastfeeding mother asks about the safety of marijuana use. We don't have strong, published data to support advising against use of marijuana while breastfeeding, and if women feel they have to choose, we run the risk of them deciding to stop breastfeeding -- something we know is hugely beneficial for both mom and baby," said Christina Chambers, PhD, MPH, principal investigator of the study, professor in the Department of Pediatrics at UC San Diego School of Medicine and director of clinical research at Rady Children's Hospital-San Diego.

The World Health Organization recommends exclusive breastfeeding for up to six months. Early breastfeeding is associated with a reduced risk of obesity, asthma and sudden infant death syndrome and with improved immune health and performance on intelligence tests. In mothers, breastfeeding has been associated with lower risks for breast and uterine cancer and type 2 diabetes.

Cannabinoids -- marijuana's active compounds, such as THC -- like to bind to fat molecules, which are abundant in breast milk. This stickiness has suggested that, in women who use marijuana, these compounds can end up in breast milk, raising concerns about their potential effects on nursing babies.

"We found that the amount of THC that the infant could potentially ingest from breast milk was relatively low, but we still don't know enough about the drug to say whether or not there is a concern for the infant at any dose, or if there is a safe dosing level," said Chambers, co-director of the Center for Better Beginnings at UC San Diego. "The ingredients in marijuana products that are available today are thought to be much more potent than products available 20 or 30 years ago."

The samples of breast milk used for the study were obtained from mothers who joined the Mommy's Milk Human Milk Research Biorepository at UC San Diego, a program that focuses on looking at the numerous benefits of breast milk at the molecular level. Chambers and her research team collaborated with Skaggs School of Pharmacy and Pharmaceutical Sciences at UC San Diego to measure the levels of marijuana in the samples.

Chambers said the results are a stepping stone for future research. More studies need to be done, not only to determine the long-term impact of marijuana in breast milk for children, but more specifically: "Are there any differences in effects of marijuana in breast milk for a two-month-old versus a 12-month-old, and is it different if the mother smokes versus eats the cannabis? These are critical areas where we need answers as we continue to promote breast milk as the premium in nutrition for infants."

https://www.sciencedaily.com/releases/2018/08/180827080911.htm

In parasitic worm infection both the host and the worm produce cannabis-like molecules

August 22, 2018

Science Daily/University of California - Riverside

Like mammals, parasitic worms have an endocannabinoid system that may help the worm and the hosts it infects survive by reducing pain and inflammation in the host, according to a "wild" new discovery by an interdisciplinary research team at the University of California, Riverside.

The research, done on a mouse model, identifies cell signaling pathways associated with the endocannabinoid system that could be targeted to develop therapeutic treatments aimed at eliminating worm infection or improving infection outcomes.

Endocannabinoids are cannabis-like molecules made naturally by our own body to regulate several processes: immune, behavioral, and neuronal. As with cannabis, endocannabinoids can enhance feeding behavior and reduce pain and inflammation.

"Upon worm infection, the host's intestines produce these cannabis-like molecules maybe as a safety net to dampen pain response," said Nicholas V. DiPatrizio, an assistant professor of biomedical sciences at the UCR School of Medicine and co-leader of the research project. "What we now have found is that the worms, too, are producing these natural cannabinoids throughout the infection process and especially when the worms penetrate the skin, further dampening the host's pain response."

Study results appear in the journal Infection and Immunity.

"Until now, no one had investigated endocannabinoids in worm infection," said immunologist and senior author Meera G. Nair, an assistant professor of biomedical sciences in the UCR School of Medicine, who co-led the research project along with DiPatrizio. "We found that endocannabinoids are elevated following worm infection, and they contribute to optimal worm expulsion from the host's body. This is a protective pathway that operates within infection that we were unaware of before. To increase its chances of survival, the worm may use this pathway so the host increases its feeding behavior -- that is, eats more food -- and it can also reduce tissue damage that inflammation and pain cause."

The endocannabinoid system is present in all mammals, but recent studies suggest that it may be more primitive. Indeed, one study reported that black truffle mushrooms make anandamide, a type of endocannabinoid, possibly as a mechanism to attract truffle hogs that eat the truffles and disperse their spores. The worm C. elegans also has an endocannabinoid system that may operate to regulate its feeding.

"This system is known to dampen pain responses," said DiPatrizio, a physiologist specializing in endocannabinoid research. "Upon worm infection, the host's intestines produce these cannabis-like molecules maybe as a safety net to dampen pain response. What we now have found is that the worms, too, are producing these natural cannabinoids throughout the infection process and especially when the worms penetrate the skin, further dampening the host's pain response. This is advantageous to the worm because if the host could detect these parasites, it would respond to kill them. It's a pro-survival signaling pathway in the body that may have a therapeutic advantage in treating worm infection."

Parasitologist Adler R. Dillman, a co-author on the paper, was surprised to find helminths naturally producing cannabis-like molecules in their own bodies.

"We were taken aback by this finding," said Dillman, an assistant professor in the UCR Department of Nematology. "It may be important in other infections as well. Consider that the endocannabinoid pathway is present in almost all the worms we examined in this study. What it is telling us is that the pathway is evolutionarily conserved across a vast number of species. This clearly is an old and important system in the body that predates humans."

Dillman's lab found that N. brasiliensis, a gastrointestinal parasite of rats and a widely-studied helminth parasite, produces endocannabinoids, especially anandamide. A bioinformatic search of parasitic worm databases revealed this system is conserved within many parasitic nematodes, including the most prevalent helminths of man: roundworm and hookworm.

For Nair, this is the team's "wildest discovery, its biggest finding."

"It could impact behavior, pain, and host-helminth interactions," she said. "Without the endocannabinoid system, infected hosts would have bigger worm burdens. In the lab, when we inhibited this pathway in mice, they were worse off -- they ended up with more worms in their bodies."

Nair, DiPatrizio, and Dillman recently received a two-year, $275,000 grant from the National Institutes of Health to further pursue the research and investigate how the endocannabinoid system affects immune response.

"Our current study focused on hookworms; we are ready now to investigate other helminths," Nair said. "We will investigate whether the host and worm induce endocannabinoids so that the host may have less tissue inflammation and may have improved feeding behavior. Since the worms depletes the host of nutrients, it would make sense that they would trigger strategies to improve feeding."

Nair, a hookworm expert, explained that hookworms bite the intestine and feed on blood, leading to micro-injuries and likely localized pain throughout the well-innervated intestine.

"Since endocannabinoids relieve pain and inflammation, local endocannabinoid production may be beneficial for the host, and perhaps the worm to still remain undetected by the host," she said. "We plan to investigate this further."

"The anti-inflammatory endocannabinoid system gives us insight into potential therapeutic targets for not only hookworm infection, but also celiac disease and inflammatory bowel disease," said DiPatrizio, whose laboratory is also the only one at UCR authorized to study the impact of cannabis exposure, which hijacks the endocannabinoid system, on a host of pathologies and behavior, including gastrointestinal function.

Dillman stressed that until now no one knew worms were manipulating the endocannabinoid pathway.

"Our work has provoked more interesting research questions for us to pursue, and could lead to promising treatments," he said. "We are at just the initial point of discovery."

Nair, DiPatrizio, and Dillman were joined in the research by UCR's Hashini M. Batugedara, Donovan Argueta, Jessica C. Jang, Dihong Lu, Jaspreet Kaur, and Shaokui Ge; and the University of Minnesota's Marissa Macchietto.

The research was supported by grants from the National Institutes of Health. The UCR School of Medicine provided additional support.

https://www.sciencedaily.com/releases/2018/08/180822164157.htm

Largest brain study of 62,454 scans identifies drivers of brain aging

Schizophrenia, cannabis use, and alcohol abuse are just several disorders that are related to accelerated brain aging

August 21, 2018

Science Daily/IOS Press

In the largest known brain imaging study, scientists from Amen Clinics (Costa Mesa, CA), Google, John's Hopkins University, University of California, Los Angeles and the University of California, San Francisco evaluated 62,454 brain SPECT (single photon emission computed tomography) scans of more than 30,000 individuals from 9 months old to 105 years of age to investigate factors that accelerate brain aging. SPECT tomography) evaluates regional cerebral blood flow in the brain that is reduced in various disorders.

Lead author, psychiatrist Daniel G. Amen, MD, founder of Amen Clinics, commented, "Based on one of the largest brain imaging studies ever done, we can now track common disorders and behaviors that prematurely age the brain. Better treatment of these disorders can slow or even halt the process of brain aging. The cannabis abuse finding was especially important, as our culture is starting to see marijuana as an innocuous substance. This study should give us pause about it."

The current study used brain SPECT imaging to determine aging trajectories in the brain and which common brain disorders predict abnormally accelerated aging. It examined these functional neuroimaging scans from a large multi-site psychiatric clinic from patients who had many different psychiatric disorders, including bipolar disorder, schizophrenia and attention deficit hyperactivity disorder (ADHD).

Researchers studied 128 brain regions to predict the chronological age of the patient. Older age predicted from the scan compared to the actual chronological age was interpreted as accelerated aging. The study found that a number of brain disorders and behaviors predicted accelerated aging, especially schizophrenia, which showed an average of 4 years of premature aging, cannabis abuse (2.8 years of accelerated aging), bipolar disorder (1.6 years accelerated aging), ADHD (1.4 years accelerated aging) and alcohol abuse (0.6 years accelerated aging). Interestingly, the researchers did not observe accelerated aging in depression and aging, which they hypothesize may be due to different types of brain patterns for these disorders.

Commenting on the study, George Perry, PhD, Chief Scientist at the Brain Health Consortium from the University of Texas at San Antonio, said, "This is one of the first population-based imaging studies, and these large studies are essential to answer how to maintain brain structure and function during aging. The effect of modifiable and non-modifiable factors of brain aging will further guide advice to maintain cognitive function."

Co-investigator Sachit Egan, Google Inc. (Mountain View, CA), said, "This paper represents an important step forward in our understanding of how the brain operates throughout the lifespan. The results indicate that we can predict an individual's age based on patterns of cerebral blood flow. Additionally, groundwork has been laid to further explore how common psychiatric disorders can influence healthy patterns of cerebral blood flow."

https://www.sciencedaily.com/releases/2018/08/180821112010.htm

Cannabis link to relieving intestinal inflammation explained

August 13, 2018

Science Daily/University of Massachusetts Medical School

Reports from cannabis users that the drug reduces the symptoms of inflammatory bowel disease (IBD) may finally be explained by new research from the University of Massachusetts Medical School and the University of Bath showing that endocannabinoids help control and prevent intestinal inflammation in mice.

This is the first-time scientists have reported a biological mechanism to explain why some marijuana users have reported beneficial effects from cannabis on intestine inflammation conditions such as ulcerative colitis and Crohn's disease. Researchers hope that their findings will lead to the development of drugs and treatments for gut disorders, which affect millions of people around the world and are caused when the body's immune defenses mistakenly attack the lining of the intestine.

The findings appear in the Journal of Clinical Investigation.

"There's been a lot of anecdotal evidence about the benefits of medical marijuana, but there hasn't been a lot of science to back it up," said Beth A. McCormick, PhD, vice chair and professor of microbiology & physiological systems at UMass Medical School. "For the first time, we have an understanding of the molecules involved in the process and how endocannabinoids and cannabinoids control inflammation. This gives clinical researchers a new drug target to explore to treat patients that suffer from inflammatory bowel diseases, and perhaps other diseases, as well."

The researchers discovered that gut inflammation is regulated by two important processes, which are constantly in flux and responding to changing conditions in the intestinal environment. The first process, identified in previous scientific research, promotes an aggressive immune response in the gut that destroys dangerous pathogens, but which can also damage the lining of the intestine when immune cells attack indiscriminately.

The second pathway, first described in this paper, turns off the inflammation response via special molecules transported across the epithelial cells lining the gut by the same process already known to remove toxins from these cells into the intestine cavity. Crucially, this response requires a naturally-produced molecule called an endocannabinoid, which is very similar to cannabinoid molecules found in cannabis.

If the endocannabinoid isn't present, inflammation isn't kept in balance and it can run unchecked, as the body's immune cells attack the intestinal lining.

McCormick and colleagues believe that because cannabis use introduces cannabinoids into the body, these molecules could help relieve gut inflammation, as the naturally produced endocannabinoids normally would.

"We need to be clear that while this is a plausible explanation for why marijuana users have reported cannabis relieves symptoms of IBD, we have thus far only evaluated this in mice and have not proven this experimentally in humans. We hope, however, that these findings will help us develop new ways to treat bowel diseases in humans" said professor Randy Mrsny from the University of Bath Department of Pharmacy and Pharmacology.

https://www.sciencedaily.com/releases/2018/08/180813173521.htm

How cannabis and cannabis-based drugs harm the brain

August 13, 2018

Science Daily/Instituto de Medicina Molecular

A new study led by Ana Sebastião, group leader at Instituto de Medicina Molecular João Lobo Antunes and Professor of Faculdade de Medicina of Universidade de Lisboa (iMM, FMUL; Portugal) and her team in collaboration with researchers from the University of Lancaster (UK), shows that the long-term use of either cannabis or cannabis-based drugs impairs memory. The study now published in the Journal of Neurochemistry reveals the implications for both recreational users and people who use the drug to combat epilepsy, multiple sclerosis and chronic pain.

Through the legalisation in several countries of cannabis or cannabis-based drugs, there is an increased number of long-term users and more potent varieties are available for recreational users. It is already known that heavy, regular cannabis use increases the risk of developing mental health problems including psychosis and schizophrenia. However, there is still little understanding of the potential negative side effects of long-term cannabinoid exposure.

Now, the research group led by Ana Sebastião in collaboration with Neil Dawson and his team at Lancaster University studied the effects of a specific cannabinoid drug (named WIN 55,212-2) and found that mice exposed for long-term to the drug had "significant memory impairments" and could not even discriminate between a familiar and novel object. Also, brain imaging studies showed that the drug impairs function in key brain regions involved in learning and memory. Moreover, the long-term exposure to the drug impairs the ability of brain regions involved in learning and memory to communicate with each other, suggesting that this underlies the negative effects of the drug on memory.

"Importantly, our work clearly shows that prolonged cannabinoid intake, when not used for medical reasons, does have a negative impact in brain function and memory. It is important to understand that the same medicine may re-establish an equilibrium under certain diseased conditions, such as in epilepsy or multiple sclerosis, but could cause marked imbalances in healthy individuals. As for all medicines, cannabinoid-based therapies have not only beneficial disease-related actions, but also negative side effects," says Ana Sebastião. A previous study from the same team has showed that acute exposure to cannabinoids results in recognition memory deficits, an effect that can be prevented by the use of a drug of the family of caffeine. "These results are very important for the development of pharmacological strategies aiming to decrease cognitive side effects of currently used cannabinoid-based therapies, which proved effective against several nervous system disorders," explains Ana Sebastião.

"This work offers valuable new insight into the way in which long-term cannabinoid exposure negatively impacts on the brain. Understanding these mechanisms is central to understanding how long-term cannabinoid exposure increases the risk of developing mental health issues and memory problems; only its understanding will allow to mitigate them," says Neil Dawson.

https://www.sciencedaily.com/releases/2018/08/180813104221.htm

Can psychedelic drugs heal?

Psychologists explore potential benefits of hallucinogens for mental health disorders

August 9, 2018

Science Daily/American Psychological Association

Many people think of psychedelics as relics from the hippie generation or something taken by ravers and music festival-goers, but they may one day be used to treat disorders ranging from social anxiety to depression, according to research presented at the annual convention of the American Psychological Association.

"Combined with psychotherapy, some psychedelic drugs like MDMA, psilocybin and ayahuasca may improve symptoms of anxiety, depression and post-traumatic stress disorder," said Cristina L. Magalhaes, PhD, of Alliant International University Los Angeles, and co-chair of a symposium on psychedelics and psychotherapy. "More research and discussion are needed to understand the possible benefits of these drugs, and psychologists can help navigate the clinical, ethical and cultural issues related to their use."

Hallucinogens have been studied in the U.S. for their potential healing benefits since the discovery of LSD in the 1940s. However, research has mostly stalled since psychedelics were outlawed in the late 1960s.

A shift may be coming soon though, as MDMA, commonly known as ecstasy, is beginning its third and final phase of clinical trials in an effort to win Food and Drug Administration approval for treatment of post-traumatic stress disorder, said Adam Snider, MA, of Alliant International University Los Angeles, and co-chair of the symposium.

Findings from one study presented at the symposium suggested that symptoms of social anxiety in autistic adults may be treatable with a combination of psychotherapy and MDMA. Twelve autistic adults with moderate to severe social anxiety were given two treatments of pure MDMA plus ongoing therapy and showed significant and long-lasting reductions in their symptoms, the research found.

"Social anxiety is prevalent in autistic adults and few treatment options have been shown to be effective," said Alicia Danforth, PhD, of the Los Angeles Biomedical Research Institute at the HarborUCLA Medical Center, who conducted the study. "The positive effects of using MDMA and therapy lasted months, or even years, for most of the research volunteers."

Research discussed also explored how LSD, psilocybin (known colloquially as "magic mushrooms") and ayahuasca (a brew used by indigenous people of the Amazon for spiritual ceremonies) may benefit people with anxiety, depression and eating disorders.

Adele Lafrance, PhD, of Laurentian University, highlighted a study of 159 participants who reported on their past use of hallucinogens, level of spirituality and relationship with their emotions.

Using hallucinogens was related to greater levels of spirituality, which led to improved emotional stability and fewer symptoms of anxiety, depression and disordered eating, the study found.

"This study reinforces the need for the psychological field to consider a larger role for spirituality in the context of mainstream treatment because spiritual growth and a connection to something greater than the self can be fostered," said Lafrance.

Other research presented suggested that ayahuasca may help alleviate depression and addiction, as well as assist people in coping with trauma.

"We found that ayahuasca also fostered an increase in generosity, spiritual connection and altruism," said Clancy Cavnar, PhD, with Núcleo de Estudos Interdisciplinares sobre Psicoativos.

For people suffering from life-threatening cancer, psilocybin may provide significant and lasting decreases in anxiety and distress.

When combined with psychotherapy, psilocybin helped a study's 13 participants grapple with loss and existential distress. It also helped the participants reconcile their feelings about death as nearly all participants reported that they developed a new understanding of dying, according to Gabby Agin-Liebes, BA, of Palo Alto University, who conducted the research.

"Participants made spiritual or religious interpretations of their experience and the psilocybin treatment helped facilitate a reconnection to life, greater mindfulness and presence, and gave them more confidence when faced with cancer recurrence," said Agin-Liebes.

Presenters throughout the symposium discussed the need for more research to fully understand the implications of using psychedelics as an adjunct to psychotherapy as well as the ethical and legal issues that need to be considered.

https://www.sciencedaily.com/releases/2018/08/180809141223.htm

Positive policing changes after cannabis legalization

July 24, 2018

Science Daily/Washington State University

Washington State University researchers have found that marijuana legalization in Colorado and Washington has not hurt police effectiveness. In fact, clearance rates for certain crimes have improved.

Clearance rates -- the number of cases solved, typically by the arrest of a suspect -- were falling for violent and property crimes in the two states before they authorized retail sales of marijuana late in 2012. The rates then improved significantly in Colorado and Washington while remaining essentially unchanged in the rest of the nation, according to the researchers' analysis of monthly FBI data from 2010 through 2015.

"Our results show that legalization did not have a negative impact on clearance rates in Washington or Colorado," said David Makin assistant professor in WSU's Department of Criminal Justice and Criminology "In fact, for specific crimes it showed a demonstrated, significant improvement on those clearance rates, specifically within the realm of property crime."

Writing this month in the journal Police Quarterly the researchers said legalization created a "natural experiment" to study the effects of a sweeping policy change on public health and safety.

"If you think about our history, it's rare where you have something that is entirely illegal that then becomes legal," said Makin. "And we have an opportune moment to study to what extent that particular change had on society."

Citizens in 12 states have voted on marijuana legalization and proponents in all of them have argued that it would let police reallocate resources to property and violent crimes. The Colorado measure specifically says it is "in the interest of the efficient use of law enforcement resources" while the Washington one says it "allows law enforcement resources to be focused on violent and property crimes."

The WSU study bears that out. It finds that after legalization:

·     Arrest rates for marijuana possession dropped considerably. Following legalization in 2012, they dropped nearly 50 percent in Colorado and more than 50 percent in Washington.

·     Violent crime clearance rates shifted upward.

·     Burglary and motor vehicle theft clearance rates "increased dramatically."

·     Overall property crime clearance rates jumped sharply and reversed a down ward trend in Colorado.

The improvement in burglary clearance rates is particularly striking for Washington, Makin said, as the state's property crime rate is higher than most.

"It demonstrates just how critical these types of policy changes can be," Makin said. "I would offer it truly demonstrates why we need empirical data to support these types of studies, so we can understand to what extent crime and communities are influenced as more and more states move to legalization."

As Makin describes, this research is not without its limitations. He offers "one of the pressing limitations within this study is that not all agencies equally report their clearance rates. It is entirely possible that as we expand our data collection to include additional years, more states, and a wider set of agencies, these results could change."

Makin also acknowledged that while he and his colleagues found a correlation between legalization and clearance rates, they do not have an explicit cause. The improvements could be the result of more overtime for law enforcement officers, new strategies or a focus on particular crimes. But Makin said he suspects that the loss of the specific reporting category of marijuana arrests prompted police departments to reevaluate their priorities, particularly in "boots on the ground" cases.

https://www.sciencedaily.com/releases/2018/07/180724110031.htm

Cannabinoids may have a vast array of anti-cancer effects

July 18, 2018

Science Daily/Wiley

Previous research has shown that cannabinoids can help lessen side effects of anti-cancer therapies. Now a new British Journal of Pharmacology review has examined their potential for the direct treatment of cancer.

Phytocannabinoids are the most notable type of cannabinoid, and they occur naturally in the cannabis plant. Studies have shown that cannabinoids may stop cancer cells from dividing and invading normal tissue, and they may block the blood supply to tumors. Some studies also indicate that cannabinoids may enhance the body's immune response against the growth and spread of tumors.

"There is still a need for additional anti-cancer drugs. In this context accumulating data from preclinical models suggest that cannabinoids elicit anti-cancer effects on several levels of cancer progression," said author Prof. Burkhard Hinz, of Rostock University Medical Center, in Germany. "Clinical studies are now urgently needed to investigate the impact of cannabinoids on cancer growth and progression in patients."

https://www.sciencedaily.com/releases/2018/07/180718082143.htm

How cannabis affects appetite: Brain changes

July 17, 2018

Science Daily/Society for the Study of Ingestive Behavior

New research on how cannabis use alters eating behavior could lead to treatments for appetite loss in chronic illness, according to experts at Washington State University. Using a new procedure to dose lab rats with cannabis vapor, the researchers found how the drug triggers hunger hormones. They also identified specific brain regions that shift to 'hungry' mode while under the influence, according to a report they shared this week at the Society for the Study of Ingestive Behavior, an international meeting of scientific experts on eating.

"We all know cannabis use affects appetite, but until recently we've actually understood very little about how or why," explained Jon Davis, Ph.D., researcher in the Department of Integrative Physiology and Neurosciences at Washington State. "By studying exposure to cannabis plant matter, the most widely consumed form, we're finding genetic and physiological events in the body that allow cannabis to turn eating behavior on or off."

A recent wave of cannabis legalization for both medical and recreational purposes has stimulated research on its therapeutic potential. A family of compounds called cannabinoids, particularly delta-9 tetrahydrocannabinol (THC), are responsible for its psychological effects. The ability of THC to stimulate appetite is valuable since many illnesses cause extreme appetite loss which reduces quality of life and slows recovery.

For these new studies the scientists designed a vapor exposure system to mimic how people often consume cannabis. This allowed precise control of dosage while rats' meals were closely monitored throughout the day. Brief exposure to cannabis vapor stimulated a meal even when rats had recently eaten, suggesting that inhaling cannabis tricks appetite circuits in the brain into hunger mode.

"We found that cannabis exposure caused more frequent, small meals," stated Davis. "But there's a delay before it takes effect." That delay provided a clue to how the drug may act. Ordinarily, when the stomach is empty it releases a hormone called ghrelin, a message to the brain that it's time to look for food. The researchers found that the cannabis dose triggered a ghrelin surge. When they gave a second drug which prevented the ghrelin surge, cannabis no longer triggered eating. They also found changes in how the brain responds to the message. In small region of the hypothalamus responsible for sensing ghrelin, cannabis changed the genetic activity of brain cells that respond to the hormone.

The researchers are optimistic that deciphering that ways cannabis acts in the body to alter appetite can lead to new treatments for illness-induced anorexia. Severe appetite loss is a common symptom of many chronic illnesses, and is especially problematic in cancer, HIV/AIDS, heart disease, and some metabolic disorders. A targeted treatment that offers the beneficial effects on appetite without the broader effects on the mind and body could increase quality of life and speed recovery.

https://www.sciencedaily.com/releases/2018/07/180717094747.htm

Daily cannabis use is on the rise among American adults

June 20, 2018

Science Daily/Columbia University's Mailman School of Public Health

Cannabis use may be decreasing among teens, but a new study by researchers at Columbia University's Mailman School of Public Health showed that American adults have increasingly used cannabis daily since 2007. The findings are published online in the Journal of Studies on Alcohol and Drugs.

The legal status of cannabis for medicinal and recreational use rapidly evolved between 2007 and 2014, with the number of states with medical cannabis laws doubling from 12 to 24. As of September 2017, 29 states and the District of Columbia had medical cannabis laws, and 8 states and the District of Columbia had recreational cannabis laws.

The study found that nondaily cannabis use decreased among those aged 12 to 2J and 35 to 49 before 2007, increased among all adults after 2007, particularly among adults 26 to 34 -- the latter by 4.5 percent. Daily cannabis use decreased among those 12 to 17 years of age before 2007 and increased among adults in general after 2007. Daily cannabis use was highest among 18 to 34-year-olds but overall, the rate of daily cannabis use increase did not differ significantly and ranged between one and two percentage points among adults 18 to 54.

"Increases in daily and nondaily cannabis use among adults after 2007 could be due to increasingly permissive cannabis legislation, attitudes, and lower risk perception," said Pia M. Mauro, PhD, assistant professor of Epidemiology at the Mailman School of Public Health and first author.

Using the National Survey on Drug Use and Health, a survey of individuals ages 12 and older, the researchers examined trends in cannabis use among six age categories between 2002 and 2014. They compared change over time to identify ages that may have disproportionately increased use of cannabis. Daily use was defined as 300 days or more in the past year.

"We saw a steady increase in more frequent use among people who reported cannabis use, including young people," Mauro noted. "We found significant increases in daily cannabis use across adult age categories after 2007 that contrasted with stable prevalence before 2007 and decreases among adolescents."

"Not all adults use cannabis at the same rate," said Silvia Martins, MD, PhD, Mailman School associate professor of Epidemiology and senior author. "Understanding the ages at which young people and adults use cannabis can help target appropriate reduction or prevention interventions."

Middle-age adults ages 50 to 64 were the only group with increases in nondaily cannabis use both before and after 2007. If trends continue, prevalence estimates of cannabis use among ages 50 to 64 could surpass those of adults ages 35 to 49.

"Research about the patterns and consequences of cannabis use in baby boomers in particular is needed, since use is high in this birth cohort and is expected to continue to increase," said Martins. "Moreover, significant increases in nondaily cannabis use among adults 65 and older defy perceptions that older adults do not use cannabis, although daily use in this age group remains rare."

The study was funded by the National Institute on Drug Abuse (grants T32DA031099, R01DA037866, and R01DA034244); and the New York State Psychiatric Institute. The authors report no competing interests.

Co-authors are Hannah Carliner, Qiana Brown, and Melanie Wall, Mailman School of Public Health; Deborah Hasin, Mailman School of Public Health and New York State Psychiatric Institute; Dvora Shmulewitz, Reanne Rahim-Juwel, and Aaron Sarvet, New York State Psychiatric Institute and Department of Psychiatry, Columbia University Irving Medical Center.

https://www.sciencedaily.com/releases/2018/06/180620125904.htm

Religious involvement deters recreational and medical marijuana use

June 19, 2018

Science Daily/Florida State University

Researchers have found that individuals who regularly attend church and report that religion is very important in their daily decision making are less likely to use marijuana recreationally and medically.

Although marijuana use for medical and recreational purposes is at an all-time high in the United States, a team of researchers led by a Florida State University professor has found those who hold strong religious beliefs are choosing to stay away from weed.

FSU Associate Professor Amy Burdette and her team found that individuals who regularly attend church and report that religion is very important in their daily decision making are less likely to use marijuana recreationally and medically. The study was recently published in the Journal of Drug Issues.

"Our study confirms previous studies of recreational marijuana use," Burdette said. "However, I believe ours is the first to examine the association between religiosity and medical marijuana use."

The study used data from 2016 National Survey on Drug Use and Health, a random sample of the U.S. adult population. Although many studies have focused on the association between religion and substance use in adolescence and young adulthood, few studies have focused on marijuana use in adulthood.

"We know various forms of substance use have increased among older adults as well, Burdette said. "So, we need to know what's going on among people in their 30s, 40s and 50s in terms of their substance use."

In the study, researchers examined three focal variables -- religious salience, religious service attendance and self-rated health.

Levels of religious attendance ranged from never attending services to attending more than once a week. Researchers found with every level of increased attendance the odds of being a recreational marijuana user reduced by 13 percent. The study found the likelihood of recreational marijuana use decreased by 20 percent as religious salience levels increased.

Researchers also examined the association between religious involvement and marijuana use of adults in poor health. They found that religious involvement was less effective in deterring marijuana use among sickly adults whether recreational or medically prescribed.

"You have two big institutions coming against each other when you're suffering and in poor health," Burdette said. "You might have your pastor highly stigmatizing its use, saying 'it's bad, it's a drug, you shouldn't do this.' While your doctor says, 'try this, it could help your pain and suffering.'"

With the impact of religion in society starting to decline, Burdette said perhaps more people are deferring to a medical authority.

Researchers said further study could include personality types and the religious affiliation of individuals. They also noted that the data is based on self-reports and people were potentially more likely to avoid reporting socially undesirable behaviors.

Co-authors include FSU doctoral candidate Noah Webb; and associate professors Jason A. Ford, University of Central Florida; Stacy Hoskins Haynes, Mississippi State University; and Terrence D. Hill, University of Arizona.

https://www.sciencedaily.com/releases/2018/06/180619173550.htm

Cannabis does not increase suicidal behavior in psychiatric patients

June 13, 2018

Science Daily/McMaster University

McMaster University researchers have found there is no significant association between cannabis use and suicidal behavior in people with psychiatric disorders.

The study findings contrast with pre-existing data that shows the drug is linked to an increased chance of suicidal behavior in the general population.

However, based on a small subset of participants, researchers did note the heaviness of cannabis use increased risk of suicidal behavior in men, suggesting a closer follow-up by medical professionals of those patients.

The study was published online this week in the journal Biology of Sex Differences.

"In what we believe to be a first, this study seeks to understand how cannabis use impacts suicide attempts in men and women with psychiatric disorders who are already at a heightened risk of attempting suicide," said Zainab Samaan, lead author and an associate professor in the Department of Psychiatry and Behavioural Neurosciences at McMaster.

"We know there is a high rate of cannabis use among this population and wanted to better understand any potential correlation to suicidal behavior."

Cannabis is the most commonly-used illicit substance worldwide, and its consumption is expected to increase as more jurisdictions, including Canada, legalize its recreational use.

The team of researchers, predominantly based in Hamilton, merged data collected for two studies based in Ontario. These included a prospective cohort study of opioid use disorder using structured scales to assign psychiatric diagnoses, and a case-control study on suicidal behavior using the same diagnostic methods to reach a psychiatric diagnosis including substance use.

Data was analyzed from a total of 909 psychiatric patients, including 465 men and 444 women. Among this group, 112 men and 158 women had attempted suicide. The average age was 40 years.

"While there was no clear link between cannabis and suicide attempts, our findings did show that among participants with psychiatric disorders, having a mood disorder or being a woman correlates with an increased risk of suicide attempt," said Leen Naji, the study's first author and a family medicine resident at McMaster. "Meanwhile, having a job is protective against suicide attempts."

Naji said that further research is needed, considering Canada's changing laws on cannabis use, and the Mental Health Action Plan of the World Health Organization which has the aim to reduce the rate of suicide by 10 per cent by 2020.

"Our study is both timely and relevant, especially in light of the impeding legalization of recreational cannabis with an expected increase in access in Canada, and there remains uncertainty about the full effect of cannabis on those living with psychiatric disorders," she said.

Samaan added that the study findings may serve to educate health professionals when assessing patients' risk of suicide. She said the results also reinforce suggested benefits of supporting patients with psychiatric disorders in job placements and skills development.

https://www.sciencedaily.com/releases/2018/06/180613162658.htm

Psychedelic drugs promote neural plasticity in rats and flies

June 12, 2018

Science Daily/Cell Press

Psychedelic drugs may have mind-altering powers in the physical sense, too. A new study, published June 12 in the journal Cell Reports, found psychedelics, specifically DOI, DMT, and LSD, can change brain cells in rats and flies, making neurons more likely to branch out and connect with one another. The work supports the theory that psychedelics could help to fight depression, anxiety, addiction, and post-traumatic stress disorder.

"These are some of the most powerful compounds known to affect brain function, it's very obvious to me that we should understand how they work," says senior author David E. Olson, assistant professor in the Department of Chemistry and the Department of Biochemistry & Molecular Medicine at the University of California, Davis.

The idea that depression stems from imbalanced brain chemistry remains popular, but recent studies have revealed evidence that depression manifests as structural changes in brain circuits or atrophy in parts of the brain. This doesn't mean neurons die off during depression, but that neurites retract. Neurites are the sections -- either axons or dendrites -- of a neuron that project out to bridge the gap between two neurons at the synapse to facilitate communication.

"One of the hallmarks of depression is that the neurites in the prefrontal cortex -- a key brain region that regulates emotion, mood, and anxiety -- those neurites tend to shrivel up," says Olson. These brain changes also appear in cases of anxiety, addiction, and post-traumatic stress disorder.

In their paper, Olson and colleagues tested psychedelics from the amphetamine, tryptamine, and ergoline drug classes. In both test tube and animal experiments, the psychedelics showed functional and structural changes like those promoted by ketamine in cortical neurons. Psychedelics increased both the density of dendritic spines and the density of synapses. Some psychedelics tested, including LSD, proved to be more potent and efficacious than ketamine in promoting neurite growth.

The researchers did not do any human experiments, but experiments in both vertebrates and invertebrates showed psychedelics produced similar effects across species. This indicates the biological mechanisms that respond to psychedelics have remained the same across eons of evolution and that psychedelics will likely have the same brain growth (neural plasticity) effects in humans.

Olson and colleagues also set out to test how these psychedelics promoted neural plasticity, meaning they explored which biological pathways psychedelics activate that lead to neural growth. Ketamine's neural plasticity effects were previously shown to be dependent on a protein called brain-derived neurotrophic factor (BDNF). When the researchers blocked BDNF signaling, psychedelics lost their ability to promote neurite growth. BDNF binds to a receptor, called TrkB, that is part of a signaling pathway that includes mTOR, which is known to play a key role in the production of proteins necessary for the formation of new synapses. When the researchers experimented by inhibiting mTOR, it also completely blocked the psychedelics' ability to promote neurite growth. Olson thinks identifying the signaling pathways at play in psychedelic-induced brain changes will help future research identify compounds that could be developed into depression treatments.

"If we fully understand the signaling pathways that lead to neural plasticity, we might be able to target critical nodes along those pathways with drugs that are safer than ketamine or psychedelics," says Olson.

Although most psychedelics aren't considered to be addictive in the same way that cocaine is, they do produce hallucinations. Olson doesn't expect psychedelics to become prescription drugs for depression. "But a compound inspired by psychedelics very well could," he says.

https://www.sciencedaily.com/releases/2018/06/180612185207.htm

Psychedelic drug use associated with reduced partner violence in men

Psychedelics may help improve emotion regulation and keep violent tendencies at bay

June 6, 2018

Science Daily/University of British Columbia Okanagan campus

In a new study published in the Journal of Psychopharmacology, researchers from UBC's Okanagan campus have discovered that men who have used psychedelic drugs in the past have a lower likelihood of engaging in violence against their intimate partners.

"Although use of certain drugs like alcohol, methamphetamine or cocaine is associated with increased aggression and partner violence, use of psychedelics appears to have the opposite effect," says clinical psychology graduate student and study lead author Michelle Thiessen. "We found that among men who have used psychedelics one or more times, the odds of engaging in partner violence was reduced by roughly half. That's significant."

Psychedelic drugs act on serotonin receptors in the brain. Classic psychedelics include lysergic acid diethylamide (LSD), psilocybin (magic mushrooms), mescaline, and dimethyltryptamine (DMT). The effects vary but can produce mystical experiences and changes in perception, emotion, cognition and the sense of self. Classic psychedelics are not considered to be addictive.

"Previous research from our lab that looked at men in the criminal justice system found that hallucinogen users were substantially less likely to perpetrate violence against their intimate partners," notes UBC professor and supervising author Zach Walsh. "Our new study is important because it suggests that these effects might also apply to the general population"

Thiessen, Walsh and colleagues Adele LaFrance and Brian Bird from Laurentian University based their results on an anonymous online survey of 1,266 people recruited from universities and through social media. Respondents were asked to disclose their lifetime use of LSD and psilocybin mushrooms and then complete a questionnaire that assessed multiple aspects of their emotion regulation.

"Past research found a clear association between psychedelic drug use and reduced partner violence, but the reasons for this effect remained unclear," says Thiessen. "We found that better ability to manage negative emotions may help explain why the hallucinogen users were less violent."

Thiessen says that her results could one day lead to novel treatments to reduce violence.

"These findings add to the literature on the positive use of psychedelics and suggest that future research should explore the potential for psychedelic therapies to help address the international public health priority of reducing domestic violence."

The study was published with funding in part from the Social Sciences and Humanities Research Council of Canada.

https://www.sciencedaily.com/releases/2018/06/180606093701.htm

Faster test for cannabis quality

New method to help meet increasing demand for cannabis potency testing

May 17, 2018

Science Daily/University of British Columbia Okanagan campus

Researchers have developed a new method of measuring phytocannabinoids -- the primary bioactive molecules in cannabis -- that will lead to faster, safer and more accurate information for producers, regulators and consumers alike.

With the coming legalization of cannabis in Canada, producers are increasingly looking for quick and accurate means of determining the potency and quality of their products.

Researchers at UBC's Okanagan campus have developed a new method of measuring phytocannabinoids -- the primary bioactive molecules in cannabis -- that will lead to faster, safer and more accurate information for producers, regulators and consumers alike.

"There is growing demand on testing labs from licensed cannabis growers across the US and Canada who are under pressure to perform potency testing on ever-increasing quantities of product," says Matthew Noestheden, PhD chemistry student under Prof. Wesley Zandberg at UBC's Okanagan campus. "Traditional tests can take upwards of 20 minutes to perform, where we can do it in under seven. It will save a great deal of time and money for producers with enormous greenhouses full of thousands of samples requiring testing."

Noestheden says that not only can he test the substance in record time, but he can also test for a virtually limitless number of phytocannabinoid variants.

"Most people are familiar with THC as the primary bioactive compound in cannabis. But in reality, there are more than 100 different phytocannabinoid variants, many with their own unique biological effects," says Noestheden. "The problem is that it's very difficult to differentiate between them when testing cannabis potency."

The research team overcame the problem by using high-pressure liquid chromatography -- an instrument that isolates each phytocannabinoid to measure them independently. They were able to discern the potency of 11 unique phytocannabinoids in cannabis extracts, which is important for determining the safety and authenticity of cannabis products.

"We tested twice as many phytocannabinoids compared to what most labs are testing for now, and more than twice as fast," says Noestheden. "We limited our tests to 11 variants because these were the only ones commercially available at the time. We could just as easily test for 50 or even all 100 variants, including some synthetic cannabinoids that can be added to products to increase potency."

Noestheden says his method was designed to be rolled out in labs around the world. Having worked with Rob O'Brien, president of Supra Research and Development, a cannabis testing lab and industry partner of this study, Noestheden now hopes his new method can be put straight to good use by helping researchers connect variation in phytocannabinoids with the pharmacological effects of various cannabis products.

"It's an elegant solution because any cannabis testing lab with the appropriate instrumentation should be able to adopt the new method with minimal additional investment, making the whole process cheaper and faster."

The study was published in the journal Phytochemical Analysis with funding from MITACS, the University Graduate Fellowship and the Walter C. Sumner Memorial Fellowship.

https://www.sciencedaily.com/releases/2018/05/180517102254.htm

Cannabidiol significantly reduces seizures in patients with severe form of epilepsy

Study looked at two doses of cannabis-derived medication's effectiveness in Lennox-Gastaut syndrome

May 16, 2018

Science Daily/NYU Langone Health / NYU School of Medicine

Cannabidiol (CBD), a compound derived from the cannabis plant that does not produce a "high" and has been an increasing focus of medical research, was shown in a new large-scale, randomized, controlled trial to significantly reduce the number of dangerous seizures in patients with a severe form of epilepsy called Lennox-Gastaut syndrome.

In the new study comparing two doses of CBD to a placebo, the researchers reported a 41.9 percent reduction in "drop seizures" -- a type of seizure that results in severe loss of muscle control and balance -- in patients taking a 20 mg/kg/d CBD regimen, a 37.2 percent reduction in those on a 10 mg/kg/d CBD regimen, and a 17.2 percent reduction in a group given a placebo.

The phase III trial was led by principal investigator and study first co-author Orrin Devinsky, MD, a professor of neurology, neurosurgery, and psychiatry at NYU School of Medicine and director of NYU Langone's Comprehensive Epilepsy Center, and was published online May 17 in The New England Journal of Medicine.

"This new study adds rigorous evidence of cannabidiol's effectiveness in reducing seizure burden in a severe form of epilepsy and, importantly, is the first study of its kind to offer more information on proper dosing," says Dr. Devinsky. "These are real medications with real side effects, and as providers we need to know all we can about a potential treatment in order to provide safe and effective care to our patients."

The study included an investigational liquid, oral formulation of CBD called Epidiolex. The product is manufactured by GW Pharmaceuticals, which operates in the U.S. as Greenwich Biosciences; GW Pharmaceuticals funded the clinical trial.

Safety of Two CBD Doses Studied

Lennox-Gastaut syndrome is a rare and severe form of epilepsy characterized by frequent drop seizures and severe cognitive impairment. Six medications are approved to treat seizures in patients with the syndrome, but disabling seizures occur in most patients despite these treatments.

Researchers enrolled 225 patients (age 2 to 55) with Lennox-Gastaut syndrome across 30 international sites in a randomized, double-blind, placebo-controlled trial to assess the efficacy and safety of two doses of CBD: Seventy-six patients received 20 mg/kg/d CBD, 73 received 10 mg/kg/d CBD, and 76 were given a placebo. All medications were divided into two doses per day for 14 weeks. The number of seizures were monitored beginning four weeks prior to the study for baseline assessment, then tracked throughout the 14-week study period and afterwards for a four-week safety check.

Side effects occurred in 94 per of patients in the 20 mg CBD group, 84 percent in the 10 mg CBD group, and 72 percent of those taking placebo. Side effects were generally reported as mild or moderate in severity and those that occurred in more than 10 percent of patients included: sleepiness, decreased appetite, diarrhea, upper respiratory infection, fever, vomiting, nasopharyngitis, and status epilepticus. Fourteen patients taking CBD experienced dose-related, elevated liver enzymes that were reversible. Seven participants from the CBD group withdrew from the trial due to side effects compared to one participant in the placebo group.

"This landmark study provides data and evidence that Epidiolex can be an effective and safe treatment for seizures seen in patients with Lennox Gastaut Syndrome, a very difficult to control epilepsy syndrome," adds study co-first author, Anup Patel, MD, chief of Neurology at Nationwide Children's Hospital.

A study led by Dr. Devinsky published in last May's New England Journal of Medicine showed a 39 percent drop in seizure frequency in patients with a different rare form of epilepsy, Dravet syndrome. Those findings represented the first large-scale, randomized clinical trial for the compound. Open label CBD studies led by Dr. Devinsky also have shown positive results for treatment-resistant epilepsies.

In April, a U.S. Food and Drug Administration advisory panel unanimously voted to recommend approval of a new drug application for Epidiolex cannabidiol oral solution, following a meeting where researchers, including Dr. Devinsky, presented their findings. The FDA will decide whether to approve the medication in late June.

"While the news gives hope for a new treatment option to the epilepsy community, more research remains imperative to better determine the effects of CBD and other similar cannabis-derived compounds on other forms of the disease and in more dosing regimens," says Dr. Devinsky.

https://www.sciencedaily.com/releases/2018/05/180516172255.htm

Cannabis use up among parents with children in the home

Study finds combined use of cigarettes and marijuana may increase children's exposure to second-hand smoke

May 14, 2018

Science Daily/Columbia University's Mailman School of Public Health

Cannabis use increased among parents who smoke cigarettes, as well as among non-smoking parents, according to a latest study from researchers at Columbia University's Mailman School of Public Health and City University of New York. Cannabis use was nearly four times more common among cigarette smokers compared with non-smokers. Until now, little had been known about current trends in the use of cannabis among parents with children in the home, the prevalence of exposure to both tobacco and cannabis, and which populations might be at greatest risk. The findings will be published online in the June issue of Pediatrics.

"While great strides have been made to reduce children's exposure to second-hand cigarette smoke, those efforts may be undermined by increasing use of cannabis among parents with children living at home," said Renee Goodwin, PhD, in the Department of Epidemiology at the Mailman School of Public Health, and corresponding author.

Analyzing data from the National Survey on Drug Use and Health from 2002 to 2015, the researchers found past-month cannabis use among parents with children at home increased from 5 percent in 2002 to 7 percent in 2015, whereas cigarette smoking declined from 28 percent to 20 percent. Cannabis use increased from 11 percent in 2002 to over 17 percent in 2015 among cigarette-smoking parents and from slightly over 2 percent to 4 percent among non-cigarette-smoking parents. Cannabis use was nearly 4 times more common among cigarette smokers versus nonsmokers (17 percent vs 4 percent), as was daily cannabis use (5 percent vs 1 percent). The overall percentage of parents who used cigarettes and/or cannabis decreased from 30 percent in 2002 to 24 percent in 2015.

"While use of either cigarettes or cannabis in homes with children has declined, there was an increase in the percent of homes with both. Therefore, the increase in cannabis use may be compromising progress in curbing exposure to secondhand smoke," noted Goodwin, who is also at the Graduate School of Public Health and Health Policy at CUNY.

Cannabis use was also more prevalent among men who also smoked compared to women (10 percent vs 6 percent) and among younger parents with children in the home (11 percent) compared with those 50 and older (4 percent). The strength of the relationship between current cannabis use and cigarette smoking was significant and similar for all income levels.

"The results of our study support the public health gains in reducing overall child secondhand tobacco smoke but raise other public health concerns about child exposure to secondhand cannabis smoke and especially high risk for combined exposures in certain subpopulations," observed Goodwin.

Noteworthy, according to Goodwin, is that there remains a lack of information on the location of smoking, whether it occurs in the house or in the proximity of children. Unlike cigarettes, smoking cannabis outdoors and in a range of public areas is illegal in most places. Therefore, there is reason to believe that cannabis use is even more likely to occur in the home than cigarette smoking given their differences in legal status.

"Efforts to decrease secondhand smoke exposure via cigarette smoking cessation may be complicated by increases in cannabis use," said Goodwin. "Educating parents about secondhand cannabis smoke exposure should be integrated into public health education programs on secondhand smoke exposure."

The study was funded by the National Institutes of Health and National Institute on Drug Abuse (DA20892).

Co-authors are Melanie Wall, Deborah Hasin, and Samantha Santoscoy, Mailman School of Public Health; Keely Cheslack-Postava, Columbia University College of Physicians and Surgeons; Nina Bakoyiannis, CUNY; and Bradley Collins and Stephen Lepore, Temple University.

https://www.sciencedaily.com/releases/2018/05/180514083935.htm

Prenatal marijuana use can affect infant size, behavior

May 10, 2018

Science Daily/University at Buffalo

Smoking during pregnancy has well-documented negative effects on birth weight in infants and is linked to several childhood health problems. Now, researchers at the University at Buffalo Research Institute on Addictions have found that prenatal marijuana use also can have consequences on infants' weight and can influence behavior problems, especially when combined with tobacco use.

"Nearly 30 percent of women who smoke cigarettes during pregnancy also report using marijuana," says Rina Das Eiden, PhD, RIA senior research scientist. "That number is likely to increase with many states moving toward marijuana legalization, so it's imperative we know what effects prenatal marijuana use may have on infants."

Through a grant from the National Institute on Drug Abuse, Eiden studied nearly 250 infants and their mothers. Of these, 173 of the infants had been exposed to tobacco and/or marijuana during their mothers' pregnancies. None were exposed to significant amounts of alcohol.

Eiden found that infants who had been exposed to both tobacco and marijuana, especially into the third trimester, were smaller in length, weight and head size, and were more likely to be born earlier, compared to babies who were not exposed to anything. They also were more likely to be smaller in length and weight compared to babies exposed only to tobacco in the third trimester. The results were stronger for boys compared to girls.

"We also found that lower birth weight and size predicted a baby's behavior in later infancy," Eiden says. "Babies who were smaller were reported by their mothers to be more irritable, more easily frustrated and had greater difficulty calming themselves when frustrated. Thus, there was an indirect association between co-exposure to tobacco and marijuana and infant behavior via poor growth at delivery."

Furthermore, women who showed symptoms of anger, hostility and aggression reported more stress in pregnancy and were more likely to continue using tobacco and marijuana throughout pregnancy. Therefore, due to the co-exposure, they were more likely to give birth to infants smaller in size and who were more irritable and easily frustrated. The infants' irritability and frustration is also linked to mothers who experienced higher levels of stress while pregnant.

"Our results suggest that interventions with women who smoke cigarettes or use marijuana while pregnant should also focus on reducing stress and helping them cope with negative emotions," Eiden says. "This may help reduce prenatal substance exposure and subsequent behavior problems in infants."

The study appeared in the March/April issue of Child Development and was authored by Pamela Schuetze, PhD, Department of Psychology, Buffalo State College, with co-authors Eiden; Craig R. Colder, PhD, UB Department of Psychology; Marilyn A. Huestis, PhD, Institute of Emerging Health Professions, Thomas Jefferson University, Philadelphia; and Kenneth E. Leonard, PhD, RIA director.

https://www.sciencedaily.com/releases/2018/05/180510145924.htm

Many oncologists recommend medical marijuana clinically despite not feeling sufficiently knowledgeable to do so

Researchers identified a discrepancy between oncologists' self-reported knowledge base and their clinical practices and beliefs regarding medical marijuana

May 10, 2018

Science Daily/Dana-Farber Cancer Institute

While a wide majority of oncologists do not feel informed enough about medical marijuana's utility to make clinical recommendations, most do in fact conduct discussions on medical marijuana in the clinic and nearly half recommend it to their patients, say researchers who surveyed a population-based sample of medical oncologists.

The study, published today in the Journal of Clinical Oncology, is the first nationally-representative survey of medical oncologists to examine attitudes, knowledge and practices regarding the agent since medical marijuana became legal on the state level in the U.S. Medical marijuana refers to the non-pharmaceutical cannabis products that healthcare providers recommend for therapeutic purposes. A significant proportion of medical marijuana products are whole-plant marijuana, which contains hundreds of active ingredients with complicated synergistic and inhibitory interactions. By contrast, cannabinoid pharmaceuticals, which are available with a prescription through a pharmacy, contain no more than a couple of active ingredients. While considerable research has gone into the development of cannabinoid pharmaceuticals, much less has been completed on medical marijuana's utility in cancer and other diseases. The researchers speculate that the immature scientific evidence base poses challenges for oncologists.

"In this study, we identified a concerning discrepancy: although 80% of the oncologists we surveyed discussed medical marijuana with patients and nearly half recommended use of the agent clinically, less than 30% of the total sample actually consider themselves knowledgeable enough to make such recommendations," said Ilana Braun, MD, chief of Dana-Farber Cancer Institute's Division of Adult Psychosocial Oncology. "We can think of few other instances in which physicians would offer clinical advice about a topic on which they do not feel knowledgeable. We suspect that this is at least partly due to the uncomfortable spot in which oncologists find themselves. Medical marijuana is legal in over half the states, with cancer as a qualifying condition in the vast majority of laws, yet the scientific evidence base supporting use of medical marijuana in oncology remains thin."

The mailed survey queried medical oncologists' attitudes toward medical marijuana's efficacy and safety in comparison with standard treatments; their practices regarding medical marijuana, including holding discussions with patients and recommending medical marijuana clinically; and whether they considered themselves sufficiently informed regarding medical marijuana's utility in oncology. Responses indicated significant differences in attitudes and practices based on non-clinical factors, for instance regional location in the U.S.

"Ensuring that physicians have a sufficient knowledge on which to base their medical recommendations is essential to providing high quality care, according to Eric G. Campbell, PhD, formerly a professor of medicine at the Massachusetts General Hospital, now a professor at the University of Colorado School of Medicine. "Our study suggests that there is clearly room for improvement when it comes to medical marijuana."

To date, no randomized clinical trials have examined whole-plant medical marijuana's effects in cancer patients, so oncologists are limited to relying on lower quality evidence, research on pharmaceutical cannabinoids or research on medical marijuana's use in treating diseases other than cancer.

Of note, additional findings of the current study suggest that nearly two-thirds of oncologists believe medical marijuana to be an effective adjunct to standard pain treatment, and equally or more effective than the standard therapies for symptoms like nausea or lack of appetite, common side effects of cancer treatments such as chemotherapy.

https://www.sciencedaily.com/releases/2018/05/180510162925.htm

Correlation between secondhand marijuana and tobacco smoke exposure and children ED visits

New research examines the impact of second hand smoke from tobacco to understand marijuana's impact on children

May 5, 2018

Science Daily/Pediatric Academic Societies

Marijuana is the most commonly used illicit substance in the US. Secondhand marijuana smoke (SHMS) exposure and its subsequent impact on child health have not been studied. The objective of this study was to determine association between SHMS exposure and rates of emergency department visitation, and rates of tobacco sensitive conditions (asthma, otitis media and viral respiratory infections).

Children exposed to the combination of marijuana and tobacco smoke have increased emergency department (ED) visitation and otitis media episodes compared to children with no smoke exposure, according to a new survey being presented during the Pediatric Academic Societies (PAS) 2018 Meeting. This association was not seen in children exposed to only marijuana smoke or to only tobacco smoke. This is the first study to demonstrate the notable impact between second hand marijuana smoke exposure and child health.

Marijuana is the most common illicit substance in the U.S. The goal of this study was to determine association between second hand marijuana smoke (SHMS) exposure and rates of ED visitation, and rates of tobacco sensitive conditions: asthma, otitis media and viral respiratory infections.

The research included a cross-sectional survey of caregivers of children presenting to the ED of an urban, tertiary care, academic children's hospital in Colorado. Data collected included caregiver demographics and use of tobacco and/or marijuana, along with index child medical history, number of overall ED visits and number of tobacco sensitive conditions in the prior year. Caregivers were classified into four categories depending on use: marijuana use only, tobacco use only, both tobacco and marijuana use, and neither marijuana nor tobacco use (control group). Poisson regression models were created to determine differences in overall ED visitation, as well as tobacco sensitive conditions. Results were expressed using incident rate ratios (IRR) and 95% confidence intervals. A total of 1,500 caregivers completed the survey.

The survey found that overall, 140 caregivers (9.2 percent, 95%CI = 7.7-10.7 percent) reported regularly smoking marijuana, and 285 caregivers (19 percent, 17.1-21.1 percent) reported regularly smoking tobacco. Exposure groups included: marijuana only (n=62, 4.1 percent), tobacco only (n=213, 14.2 percent), marijuana and tobacco (n=75, 5percent), and unexposed (n=1147, 76.6 percent). When compared against each other, all groups had a similar rate of ED visitation other than the marijuana and tobacco group which had a significantly higher rate of ED visits compared to the controls. Children in the marijuana + tobacco group also had a statistically significant increase in otitis media episodes compared to controls (IRR = 1.81, 95%CI = 1.38, 2.35); differences were not elicited among the other groups or for other tobacco sensitive conditions.

https://www.sciencedaily.com/releases/2018/05/180505091833.htm