Highlighted in the 2022 World Drug Report by the U.N. Office on Drugs and Crime, cannabis remains the most widely used drug worldwide, with roughly 209 million people having used cannabis in 2020, a 23% increase from the 170 million people in 2010. As cannabis use and THC potencies increase, there has been a “notable increase” in related treatment admissions and psychiatric comorbidities. Cannabis was the most common substance reported in emergency rooms, where it was present in 26% of acute drug toxicity cases. In a study involving patients presenting first episode psychosis, cannabis use was associated with a three times greater likelihood of psychotic disorder. Daily use of high-potency cannabis increased the risk of psychotic disorder more than fourfold.
An employee who was fired after repeatedly testing positive for cannabis, in breach of company rules, has failed in their bid to be reinstated. The company had a zero-tolerance policy towards alcohol and drugs requiring employees to undergo regular tests. After failing several weekly tests the employee was charged with breaching the company’s Alcohol and Substance Abuse Policy and was fired. Johannesburg Labour Court Acting Judge Makosho Ntsoane held that the employee was at all times aware of the policy which had been applied consistently to all employees. He said in light of the dangerous environment, the company was entitled to its zero-tolerance policy and the Constitutional Court judgment on cannabis did not offer protection to employees who breach company policies.
Six children suffered from cannabis side effects between June 21 and 26, 2022, Dr Opass Putcharoen, head of Chulalongkorn University’s Emerging Infectious Diseases Clinical Centre, reveals. People have bought food, beverages and products with cannabis as an additive after the plant was legalised for medical and commercial use on June 9. “The legalization of cannabis has caused medical staff to work harder, especially psychiatrists and neurosurgeons, as many children and teenagers have begun to suffer from side effects,” Opass said. Citing the Royal College of Paediatricians of Thailand, cases included a 3-year-old girl suffering from “dizziness” after consuming cannabis cookies and a 16-year-old male who suffered from “confusion and tried to use a knife to harm himself” after smoking cannabis.
Cannabis use increases the risk for cardiovascular disease. Tetrahydrocannabinol (THC) (the psychoactive substance of cannabis) binds the CB1 receptors in blood vessels causing the release of pro-inflammatory cytokines involved in the development of atherosclerotic plaques and cardiovascular disease. This has been showed in plasma concentrations of patients smoking cannabis, cell lines and mice models. Genistein, a component of soybean, acts as a CB1-receptor antagonist and reduces and partially reverses the pro-inflammatory effects of THC, reducing atherosclerotic plaques in both cell lines and mice models. Genistein, however, does not cross the blood-brain barrier and has no influence on the neurobehavioral effects of THC.
Legalization of marijuana for medical purposes/recreational use coincides with a decrease in perceived harmfulness of the drug and increases adolescent use. 9% of children in grade 9-12 use marijuana daily/almost every day. Marijuana exposure in adolescence is associated with use of other illicit drugs and increased emergency unit visits in the pediatric population. 17% of youth using marijuana develop a cannabis use disorder, recognized in the DSM-V as physical dependence. 68% of youth presenting for treatment report dependence, tolerance and withdrawal. Marijuana intoxication may cause acute psychosis and adolescent exposure predicts a twofold increased risk of developing psychosis and schizophrenia in adulthood. There is also an association between chronic use and suicidal ideation/attempt. Adolescent use causes cognitive impairment and decreases academic performance. Pediatricians must be aware of the problem and incorporate questions about substance abuse and education/intervention in their consultations.
In November 2020, Oregon voters elected to decriminalize the possession of small amounts of drugs, including heroin and cocaine. State-wide treatment centres would enable addiction to be handled as a healthcare, rather than a law enforcement issue. Law enforcement officers now report a drug-driven increase in criminality including assaults, possession of illegal firearms and prostitution on Oregon streets. Officers report a single arrest during which 500 fentanyl pills, 44 firearms, two of which were machine guns, and 1,000 grams of methamphetamine were seized. Further, criminal organizations operating in these areas have been largely legitimized through the adopted measures and gun violence has increased, with drug legalization having created an environment in which criminality is tolerated and is able to flourish.
In 2021 there were over 76,975 overdose deaths attributed to opioids (CDC) in the United States. Opioid deaths have increased nationwide in recent years the CDC reports that “…increases in synthetic opioid-involved deaths are being driven by increases in fentanyl-involved overdose deaths.” Fentanyl deaths are now on the rise among teens. According to a study conducted by JAMA, adolescent drug rates didn’t change much over the last decade (+ 0.2 percent between 2010 and 2020). Yet, overdose deaths among teens grew exponentially, with the overdose mortality increasing by 94.03% from 2019 to 2020 and then again by 20.05% from 2020 to 2021. The study found that fentanyl use among adolescents was “identified in 77.14% of adolescent overdose deaths.”.
In 2020 cannabis use among college students reached its highest level during the 21st Century. The National Institute on Drug Abuse’s 2020, Monitoring the Future study, tracking substance use in adults between the ages of 19 and 22, revealed that in 2020 44% of college students used cannabis in the last year, compared with 38% in 2015. Of that number 8% admitted to “heavy” usage. Cannabis use is likely to increase among this and younger age groups, as it has become legal in many states. Nearly half of people 12 years old or older in the United States have used cannabis at least once in their lives, according to NIDA statistics, and almost 17% of all adults are current users.
USA – New study: when teens use pot, drug addiction more likely to follow.
A new study published in JAMA Pediatrics shows Teens who try marijuana or other drugs are at greater risk of developing a drug addiction than those who wait a few years before experimenting with drugs. Co-lead author Dr Nora Volkow, director of the U.S. National Institute on Drug Abuse (NIDA) has said in a news release, “This study provides further evidence that delaying substance exposure until the brain is more fully developed may lower risk for developing a substance use disorder.” The study analysed data from the U.S. National Surveys on Drug Use and Health to assess the proportion of adolescents (aged 12 to 17) and young adults (aged 18 to 25) who had an addiction at various intervals since the first time they used or misused one of nine different drugs.
Rates of past-year cannabis use disorder were greater among teens than young adults at all the time points since first use of the drug. For example, within 12 months since first cannabis use, nearly 11% of adolescents had the disorder, compared with just over 6% of young adults. According to study co-author Emily Einstein, “Research has shown that brain development continues into a person’s 20s, and that age of drug initiation is a very important risk factor for developing addiction.” More
USA – Methamphetamine users more susceptible to have medical, mental, and substance use issues
A new study published in the Journal of General Internal Medicine shows people who use methamphetamine experienced a combination of medical, mental, and substance use issues, including all three simultaneously. The most common illnesses associated with methamphetamine use were liver disease (hepatitis or cirrhosis), lung disease (COPD or asthma), and HIV/AIDS. Methamphetamine is a commonly trafficked drug known for its illicit recreational usage, with few medical uses to treat obesity or attention deficit hyperactive disorder (ADHD) that remain rare due to concerns over neurotoxicity. It is a highly addictive and potent stimulant affecting the central nervous system, causing higher focus and energy levels when consumed at low concentrations but can induce psychosis, skeletal muscle breakdown, and brain bleeding at higher concentrations. More, Study.
Colorado – Using drugs, alcohol and tobacco at a young age increase premature heart problems
The numbers of young adults with heart disease (atherosclerotic cardiovascular disease) have been increasing. A new study published in the journal Heart shows that drinking, smoking, and using drugs — even recreationally — is linked to premature heart disease in young people, especially women. Due to biology, women are more susceptible than men are. They add that young adults need to be educated about the long-term effects of substance use because many feel they are invincible. Using information from the 2014–2015 nationwide Veteran’s Affairs healthcare database and the Veterans with Premature Atherosclerosis (VITAL) registry, researchers looked at recreational use of tobacco, cannabis, alcohol, and drugs such as cocaine and amphetamines.
“We knew that substances like alcohol, tobacco, and illicit drugs played a role in the development of atherosclerotic cardiovascular diseases (ASCVD), but we did not know that use had such profound effects in the development of premature ASCVD, particularly in women,” Dr. Robert Ochsner, chief medical officer of Colorado-based rehab facilities Sandstone Care, told Healthline. More, Study.
South Africa – Study: factors that influence drug use among youth in rural SA
Associate professor in the University of Missouri School of Health Professions grew up in a rural village in Zimbabwe seeing first-hand as a child the lack of educational opportunities that were easily accessible and how that impacted the youth in his village. Prof Wilson Majee found in a recent study that young people that a lack of educational opportunities, combined with other factors – such as a lack of motivation, absent adult role models and few recreational activities – compound to create feelings of hopelessness and despair in young people. These feelings can influence drug use and other risky behaviours. More, Study.