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Their observations and initial research show that marijuana use may affect patients’ responses to anesthesia on the operating table — and, depending on the patient’s history of using the drug, either help or hinder their symptoms afterward in the recovery room.
If pot users indeed need more anesthesia, are there increased risks for breathing problems during minor procedures? Are there higher costs with the use of more medication, if a second or third bottle of anesthesia must be routinely opened? And what does regular cannabis use mean for recovery post-surgery?

Conclusions: RWID and DUI are significantly associated with greater alcohol and marijuanause over time. This study highlights that teens may be at higher risk for problem substance use in the future even if they ride with someone who is impaired. Prevention and intervention efforts for adolescents need to address both driving under the influence and riding with an impaired driver to prevent downstream consequences.

FDA has determined that your “CBD Lotion,” “CBD Pain-Relief Patch,” “CBD Tincture,” and “CBD Disposable Vape Pen” products are unapproved new drugs sold in violation of sections 505(a) and 301(d) of the Federal Food, Drug, and Cosmetic Act (the FD&C Act), 21 U.S.C. 355(a) and 331(d). Furthermore, these products are misbranded drugs under section 502(f)(1) of the FD&C Act, 21 U.S.C. 352(f)(1). FDA has also determined that your “Bido CBD for Pets” products are unapproved new animal drugs that are unsafe under section 512(a) of the FD&C Act, 21 U.S.C. 360b(a), and adulterated under section 501(a)(5) of the FD&C Act, 21 U.S.C. 351(a)(5)

Cannabis legalization has led to significant health consequences, particularly to patients in emergency departments and hospitals in Colorado. The most concerning include psychosis, suicide, and other substance abuse. Deleterious effects on the brain include decrements in complex decision-making, which may not be reversible with abstinence.

ED and urgent care (UC) visits with cannabis-associated International Classification of Diseases (ICD) codes or positive urine drug screens for teenagers and young adults have increased since legalization, and the majority require behavioral health evaluation. A subsequent retrospective review by Wang et al. from 2005–2015 identified 4202 such visits for patients 13 to <21 years old to a tertiary-care children’s hospital system. Behavioral health evaluation was obtained for 2813 (67%) and a psychiatric diagnosis was made for the majority (71%) of the visits. 

Cannabis is known to induce DNA damage by several mechanisms including damage to chromosomes at the time of cell division, dramatic reductions in histone formation which form the core of the nucleosomes around which DNA is twined and are crucially involved in signalling to the transcription and epigenetic machinery to regulate gene expression, alteration of DNA methylation and many other processes 2-6. And genotoxic stress of many types is known to trigger DNA checkpoints and interfere with the normal process of meiotic and mitotic cell division; and are also known to trigger ageing and cellular senescence pathways.
That it has been linked with all four areas, in the context of its many other known harms – respiratory, driving, impaired developmental trajectory, reduction in IQ, hippocampal shrinkage, brain disconnection and immunopathies - implies directly that the cannabis legalization debate itself is non-viable and profoundly and inherently misleading.

Cannabis effects on fetal growth (eg, low birth weight and length) may be more pronounced in women who consume marijuana frequently, especially in the first and second trimesters.4 This study highlights the importance of screening and interventions for cannabis use among all pregnant women. 
This study highlights the importance of screening and interventions for cannabis use among all pregnant women.

The study looked at 1991-2017 U.S. federal health data on more than 200,000 high school students. It found that the number who said they'd used pot at least once over the past month rose 10-fold -- from 0.6% in 1991 to 6.3% by 2017.

In 2016 surveys, just 9% of medical schools had documented content on medical marijuana in the Association of American Medical Colleges Curriculum Inventory, and 85% of 258 surveyed residents and fellows reported having no education about medical marijuana in medical school or residency. Presented at a 2017 meeting, a single-site study of 51 resident physicians found that 76% did not know which category marijuana belonged to under the Controlled Substances Act (marijuana is currently categorized as a Schedule I drug, signifying a high potential for abuse and no accepted medical uses), and 38% believed that medical marijuana was a prescription drug approved by the US Food and Drug Administration. Other studies indicate that practicing physicians often have limited knowledge about marijuana’s health effects and want more training.”
That more than a third of the doctors surveyed in the small sample cited by Dr. Morris believed that marijuana is FDA-approved is shocking. I submitted a comment that was immediately published by JAMA. 
 

Alcohol is rapidly expelled from the system and is addictive only in large doses — at least to those … whose genetic make-up has been influenced by the millennia of winemaking.” Furthermore, “the effects of cannabis remain for days, and it is both more addictive and more radical, leading not just to temporary alterations of the mind but to permanent or semi-permanent transformations of personality, and in particular to a widely observed loss of moral sense.” 

It also has many physical effects, such as greater carcinogenic harm than smoking cigarettes. Unlike consuming a foodstuff in moderation, the consumption of cannabis immediately affects the functioning of the brain, an effect compounded over time, especially for adolescents. In fact, marijuana usage can permanently alter the brain, leading to a great risk of psychosis, psychological problems, and lower I.Q. scores. Further, one of the most frightening discoveries shows that consuming marijuana alters DNA, creating harmful mutations that will be passed down to children and future generations. 

Many producers of products containing CBD are making unfounded medical claims regarding their products’ ability to cure or alleviate many diseases and conditions.
The FDA has very strict regulations on such activity and has issued warnings to some organizations that are selling CBD products. Unfortunately, enforcement is rare. And products with very high CBD concentrations are widely available.

Adolescent Marijuana Use increases in Florida

She quit marijuana completely for three months and was symptom-free. Then she tried CBD, hoping there was some form of cannabis she could enjoy. One day she took 200 milligrams of CBD in capsules. That night, she ended up in the ER.   cannabinoid hyperemesis syndrome, or CHS.

The study authors consider high-potency cannabis to be products with more than 10 percent tetrahydrocannabinol or THC, the compound responsible for the drug's psychoactive effects. The fact that consuming high-THC cannabis products has a greater risk is concerning, Lisdahl says, because these products are more common in the market now.

Now a new study published Tuesday in the The Lancet Psychiatry shows that consuming pot on a daily basis and especially using high-potency cannabis increases the odds of having a psychotic episode later.

It is the latest in a long line of evidence that marijuana is not an innocent relaxation drug. “Smoking high-potency cannabis, used daily, has been linked to diagnosis of conditions like schizophrenia, paranoia and other psychosis disorders, new findings say. About 50 percent of new cases of psychosis disorders diagnosed in Amsterdam were linked to use of high-potency cannabis, according to a study published Tuesday in The Lancet.

Significant effects of prenatal cannabis exposure have been found on children's sleep, cognitive functions (memory and scholastic skills), as well as on executive (frontal lobe) functions (reasoning, attention, impulsivity, and motivation), and affective (depression) and anxiety symptoms throughout the stages of development. Following the presentation of two case vignettes, we integrate the published information on outcomes of maternal use of cannabis during pregnancy on the developing fetus and the "soft" neurological deficits and neuro-behavioral disturbances manifested by them from early childhood and evolving to peaks in adolescence. Taken together, these data serve to define what we call a heretofore unspecified "fetal cannabis spectrum disorder".

Researchers say psychoactive compounds in marijuana easily cross the placenta, exposing the fetus to perhaps 10 percent of the THC — tetrahydrocannabinol — that the mother receives, and higher concentrations if the mom uses pot repeatedly.

CONCLUSIONS:
Early cannabis use is associated with psychosis-related outcomes in young adults. The use of sibling pairs reduces the likelihood that unmeasured confounding explains these findings. This study provides further support for the hypothesis that early cannabis use is a risk-modifying factor for psychosis-related outcomes in young adults.

The authors discovered several interesting things. First, all elements of both alcohol and cannabis use increase annually across the various levels of frequency of use, with the exception of daily alcohol use. Second, the effects of cannabis are considerably greater than those of alcohol. Third, there appear to be both concurrent and lagged effects of cannabis use on several cognitive domains. Thus, use of cannabis has persistent effects that are also exacerbated by continued use.

Experts define addiction as continued marijuana use despite negative consequences in a person's life, such as issues relating to their family, job, or relationships.
People who use marijuana regularly and then stop abruptly can experience some withdrawal symptoms.

Given today's concerns about maintaining a healthy body eating organic foods, low carb diets, ... reading all the labels to verify safety and good health, it is ironic the same standards are not demanded by those that consume marijuana.  Dog food is safer than marijuana!

For example, smoking pot is widely supposed to diminish the nausea associated with chemotherapy. But, the panel pointed out, “there are no good-quality randomized trials investigating this option.” We have evidence for marijuana as a treatment for pain, but “very little is known about the efficacy, dose, routes of administration, or side effects of commonly used and commercially available cannabis products in the United States.” The caveats continue. Is it good for epilepsy? “Insufficient evidence.” Tourette’s syndrome? Limited evidence. A.L.S., Huntington’s, and Parkinson’s? Insufficient evidence. Irritable-bowel syndrome? Insufficient evidence. Dementia and glaucoma? Probably not. Anxiety? Maybe. Depression? Probably not.

“dose-response relationship”... non-existent!

Large-scale, longitudinal studies of humans whose mothers smoked marijuana once or more per week and experimental work on rodents exposed to cannabinoids in utero have yielded remarkably consistent intellectual and behavioral correlates of fetal exposure to this drug. Some exposed individuals exhibit deficits in memory, cognition, and measures of sociability. These aberrations appear during infancy and persist through adulthood and are tied to changes in the expression of multiple gene families, as well as more global measures of brain responsiveness and plasticity. Researchers currently consider these perturbations to be mediated by changes to the endocannabinoid system caused by the active compounds in cannabis. 

In summary, when approaching how to define the threshold to report a family to a child welfare system, we must first take into account our state laws. Our medical opinion, however, must be directed by many other factors, including an understanding of the circumstances and the motivation of the parent. Child welfare systems rely on medical providers to make clear statements regarding our medical opinion about whether a child has been abused or neglected. This is a powerful role. We might also use this case to advocate for a change in state laws or policies regarding the well-intentioned use of marijuana in dire circumstances such as the ones that this mother faced.

The advisory mentions the following risks:
1. Marijuana is addictive. Approximately one in eleven individuals who use marijuana will become addicted. The risk is greater in youth. One in six teenagers who use marijuana will become addicted, and the risk for developing a marijuana substance use disorder further increases for those who use marijuana frequently.....

• Marijuana is addictive. Approximately one in 11 adults who use marijuana will become addicted, and the risk of addiction is greater among youth.  
• Marijuana now available is more potent with greater levels of tetrahydrocannabinol, or THC, the primary psychoactive substance in Cannabis than marijuana available in previous decades. The long-term health or developmental consequences of exposure to these high concentrations of marijuana are unknown.
• Marijuana use is associated with adverse health outcomes including development of psychoses like schizophrenia and increased risk of motor vehicle crashes.....

When mothers use marijuana during the first 12 years of their child's life, their cannabis-using children are more likely to start at an earlier age than children of non-using mothers, according to a new study from the Harvard T.H. Chan School of Public Health published in the American Journal of Preventive Medicine. This study is the first to establish a relationship between maternal cannabis use during a child's lifetime and earlier initiation in a nationally-representative, longitudinal cohort and examine the role of race, gender, and other social environmental factors.

There was more alarming news. Use of illegal drugs, including cocaine, marijuana, and opioids by pregnant women increased significantly between 2015 and 2017. About 7 percent of pregnant women reported using marijuana. Three percent said they used it daily. 

McCance-Katz says marijuana use is linked to fetal growth problems, preterm births, stillbirths, hyperactivity and impaired cognition in newborns. 

In conclusion, cannabis use is common in people with chronic non-cancer pain who have been prescribed opioids, and interest in medicinal use of cannabis is increasing. We found no evidence that cannabis use improved patient outcomes; those who used cannabis had greater pain and lower self-efficacy in managing pain. Furthermore, we found no evidence that cannabis use reduced pain interference or exerted an opioidsparing effect.

Over the past several years, FDA has issued several warning letters to firms that market unapproved new drugs that allegedly contain cannabidiol (CBD). As part of these actions, FDA has tested the chemical content of cannabinoid compounds in some of the products, and many were found to not contain the levels of CBD they claimed to contain. It is important to note that these products are not approved by FDA for the diagnosis, cure, mitigation, treatment, or prevention of any disease. Consumers should beware purchasing and using any such products.

The importance of the published findings and the emerging research regarding the potential negative effects of marijuana on brain development are a cause for concern despite the limited research and are the basis for the following recommendations:

1. Women who are considering becoming pregnant or who are of reproductive age need to be informed about the lack of definitive research and counseled about the current concerns regarding potential adverse effects of THC use on the woman and on fetal, infant, and child development. Marijuana can be included as part of a discussion about the use of tobacco, alcohol, and other drugs and medications during pregnancy.
2. As part of routine anticipatory guidance and in addition to contraception counseling, it is important to advise all adolescents and young women that if they become pregnant, marijuana should not be used during pregnancy.
3. Pregnant women who are using marijuana or other cannabinoid-containing products to treat a medical condition or to treat nausea and vomiting during pregnancy should be counseled about the lack of safety data and the possible adverse effects of THC in these products on the developing fetus and referred to their health care provider for alternative treatments that have better pregnancy-specific safety data.
4. Women of reproductive age who are pregnant or planning to become pregnant and are identified through universal screening as using marijuana should be counseled and, as clinically indicated, receive brief intervention and be referred to treatment.
5. Although marijuana is legal in some states, pregnant women who use marijuana can be subject to child welfare investigations if they have a positive marijuana screen result. Health care providers should emphasize that the purpose of screening is to allow treatment of the woman’s substance use, not to punish or prosecute her.
6. Present data are insufficient to assess the effects of exposure of infants to maternal marijuana use during breastfeeding. As a result, maternal marijuana use while breastfeeding is discouraged. Because the potential risks of infant exposure to marijuana metabolites are unknown, women should be informed of the potential risk of exposure during lactation and encouraged to abstain from using any marijuana products while breastfeeding.
7. Pregnant or breastfeeding women should be cautioned about infant exposure to smoke from marijuana in the environment, given emerging data on the effects of passive marijuana smoke.
8. Women who have become abstinent from previous marijuana use should be encouraged to remain abstinent while pregnant and breastfeeding.
9. Further research regarding the use of and effects of marijuana during pregnancy and breastfeeding is needed.
10. Pediatricians are urged to work with their state and/or local health departments if legalization of marijuana is being considered or has occurred in their state to help with constructive, nonpunitive policy and education for families.

A Canadian love-fest for Florida pot companies continues to blossom with a $93 million deal that includes a Ruskin-based grower yet to begin selling marijuana products.
 
In your recent article, Canadian firm strikes a deal to enter Florida marijuana market with Ruskin grower, you have a picture of medical marijuana in a pill bottle and with a prescription pad.  MEDICAL MARIJUANA in this form IS NOT A PRESCRIPTION AND IS NOT FDA APPROVED.. NOR DO ANY MEDICAL ASSOCIATIONS SUPPORT THIS FORM OF MEDICATION.  Please show it for what it is a bag of pot with a label 'medicine'.  #FasleHope #FakeMedicine

First and foremost, marijuana is already associated with more abuse and dependency (now called substance abuse disorder) than all other illegal drugs combined. Roughly four out of seven problem usersof illegal drugs are using marijuana. This is a dangerous blind spot exploited by many legalization advocates (although some of them are now warning about the growing risk of heavy marijuana use under legalization)....

The preliminary figures show that 959 people died in Colorado last year from drug poisoning, a figure that includes both intentional and unintentional overdoses. In 2016, 912 people died. In 2000, for comparison, drug poisonings claimed fewer than 400 lives.

We found that among young recreational cannabis users, a regular dose of cannabis had no effect on simple and learned tasks, but its use led to significant impairments on complex and novel driving-related tasks, as well as perceived driving ability and safety, for up to 5 hours after use. The present finding that the first 5 hours after cannabis use affected driving-related performance substantiates the recommendations of Canada’s Lower-Risk Cannabis Use Guidelines, which recommend waiting 6 hours after cannabis use before driving.30
 

During the same time period that cigarette smoking around children came down more than 7%, marijuana smoking around children went up nearly 5%. With more and more states legalizing marijuana for recreational use, that number is likely to continue going up.
This is not good. Besides the fact that we don’t want children getting high, or exposed to the dangers of inhaled secondhand marijuana smoke, there is the additional concern about long-term effects on the brain. While research is still ongoing, there is evidence to suggest that when youth and young adults (whose brains are still developing) are exposed to marijuana, it may have permanent effects on executive function, memory, and even IQ.

When we talk about legalizing marijuana, we must acknowledge that we are talking about legalizing a mind-altering substance that affects the brain by impairing cognition, judgment, and reflexes. We need to discuss the science and data behind the consequences of marijuana consumption on our youth and their developing brains, as this is an issue that is far-too-often overlooked.

Teens have taken a technology that was supposed to help grownups stop smoking and invented a new kind of bad habit, molded in their own image.

“Juul is already a massive public-health disaster—and without dramatic action it’s going to get much, much, much worse.”

Winickoff believes that the vape industry is co-opting the national wellness trend—“when, in fact, vaping can cause something called bronchiolitis obliterans, or popcorn lung,” he said. Popcorn lung has been linked to diacetyl, an organic compound that some companies use in their e-liquid, and that has been detected as a by-product of e-cigarette vapor. But diacetyl has also been detected in cigarette smoke, at a level hundreds of times greater, and no feasible amount of smoking has been found to cause popcorn lung. (Juul does not use diacetyl in its liquid, and, in tests, the company has found no measurable amounts of diacetyl in the vapor emitted by its devices.)

"Marijuana doctors were 2.8 times as likely as other doctors to have been disciplined by the Board of Medicine, and 2.4 times as likely to have been charged with a crime. Altogether, 108 of them were responsible for $69.4 million in malpractice judgments and settlements, some for maiming or killing patients. Some of the doctors have been fined, suspended or stripped of their licenses in other states. They’ve misdiagnosed conditions, falsified records and written prescriptions for people they never saw. They’ve been jailed for domestic violence. A few have sexually abused patients, including those as young as 14 and 16."

Researchers had two women conduct "mystery caller" phone conversations with employees at 400 dispensaries across the state, telling them that they were eight weeks pregnant and suffering from morning sickness. During the majority of those calls, the employees recommended the women use cannabis products.

I'm here to tell you this is not a safe drug," McCance-Katz said during a town hall event at "NatCon18," the National Council for Behavioral Health's annual conference.
"Americans have a right to know that and we should be telling them that," she continued.
And while tobacco and alcohol rates have declined among pregnant women in recent years, illicit drugs -- mainly marijuana but also opioids -- have increased from 78,000 women in 2015 to 111,000 in 2016, she said.
On the contrary, "marijuana use was associated with substantially increased risk of addiction and overdose for opioids," she said, citing research from Mark Olfson, MD, MPH, and colleagues in the American Journal of Psychiatry.
 
 

(TIME)  April 20, also known as “420,” is a day popular with many marijuanasmokers who see it as a “national holiday” of sorts and celebrate by getting high. The term “420” originated in the 1970s with a group of California high schoolers who would regularly meet after school at 4:20 p.m. to smoke weed.
 

Conclusions: Our findings disconfirm the hypothesis that a population-level negative correlation between medical marijuana use and prescription drug harms occurs because medical marijuana users are less likely to use prescription drugs, either medically or nonmedically. Medical marijuana users should be a target population in efforts to combat nonmedical prescription drug use.