Category: Substance Use

Categories : Mental Health Substance UseTags :

Suicide Attempts Show Increasing Exposures to Cannabis

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Analysis of US poison centre data has shown that suspected suicidal cannabis exposures have increased 17% annually, over a period of 12 years. According to the study published in the journal JAMA Network Open, more than 92%, involved other substances in addition to cannabis, and the data cannot show a direct causal link between cannabis and suicide attempts.

Still, the findings are cause for concern, the researchers said, especially since the increase was more pronounced among children and women during and after the pandemic.

“This study adds to already ample evidence that cannabis use, particularly by younger people, has significant implications for mental health,” said study co-author Tracy Klein, a WSU associate professor of nursing. “We don’t have evidence that cannabis alone was the primary driver of a suicide attempt, but we do know that cannabis can worsen certain mental health conditions and increase impulsivity.”

The researchers found 18,698 cases of intentional, suspected suicide cannabis exposures reported to U.S. poison centers from 2009 to 2021. Of these cases, 9.6% resulted in death or major outcomes such as permeant disability. The researchers noted that while more of these exposures involved younger people, severe consequences occurred more often among people 65 and older.  

U.S. poison centers take calls 24-hours a day from households and healthcare facilities to provide toxicology expertise in suspected poisoning cases. They also investigate the causes, often following up with patients and doctors to determine if patients took substances intentionally or not.

It is well known that accidental cannabis poisonings have been increasing since many states legalized cannabis. Some policies can help prevent these unintentional cases, Klein said, such as packaging guidelines so edible cannabis products are not mistaken for candy.

Intentional cannabis poisonings, on the other hand, have not been well studied, which is one of the reasons the researchers undertook this analysis, and their findings point to the need for more mental health services.

“We have a significant shortage of mental health and primary care providers in the United States,” Klein said. “We know that mental health needs not only changed but became even more acute during the COVID-19 emergency. Cannabis is one part of that.”

Other research has shown that cannabis use is associated with depression and anxiety in youth and that it may interfere with brain development as well. Recent studies have also suggested a link between suicidal ideation and cannabis use in young people. Given this evidence, it is especially important to limit youth access to cannabis, said Janessa Graves, first author and a WSU nursing associate professor.  

“Children and adolescents shouldn’t be able to purchase or access cannabis,” Graves said. “We also need to educate kids and parents around the risks of cannabis. I think many people just aren’t aware the impacts cannabis can have on brain development, and on behavioural and mental health, especially in adolescents and young adults.”

Source: Washington State University

Categories : Substance UseTags :

A Hormone Injection Sobers Up Drunk Mice

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Mouse
Photo by Kanasi on Unsplash

Researchers have found that a simple injection of hormone called fibroblast growth factor 21 (FGF21) protects mice against ethanol-induced loss of balance and righting reflex, effectively sobering them up.

“We’ve discovered that the liver is not only involved in metabolising alcohol but that it also sends a hormonal signal to the brain to protect against the harmful effects of intoxication, including both loss of consciousness and coordination,” says co-senior study author Steven Kliewer of the University of Texas Southwestern Medical Center, regarding the study results published in the journal Cell Metabolism.

“We’ve further shown that by increasing FGF21 concentrations even higher by injection, we can dramatically accelerate recovery from intoxication. FGF21 does this by activating a very specific part of the brain that controls alertness,” says Kliewer.

The consumption of ethanol produced by the natural fermentation of simple sugars in ripening fruits and nectars can cause intoxication, impairing mobility and judgement. Animals that consume fructose and other simple sugars have evolved liver enzymes to break down ethanol.

FGF21 is a hormone that is induced in the liver by a variety of metabolic stresses, including starvation, protein deficiency, simple sugars, and ethanol. In humans, ethanol is by far the most potent inducer of FGF21 described to date. Previous studies showed that FGF21 suppresses ethanol preference, induces water drinking to prevent dehydration, and protects against alcohol-induced liver injury.

In the new study, Kliewer and co-senior study author David Mangelsdorf of the University of Texas Southwestern Medical Center show that FGF21 plays a broader role in defending against the harmful consequences of ethanol exposure than previously thought. In mice, FGF21 stimulated arousal from intoxication without changing the breakdown of ethanol. Mice lacking FGF21 took longer than their littermates to recover their righting reflex and balance following ethanol exposure. Conversely, pharmacologic FGF21 administration reduced the time needed for mice to recover from ethanol-induced unconsciousness and lack of muscle coordination.

Surprisingly, FGF21 did not counteract sedation caused by ketamine, diazepam, or pentobarbital, indicating specificity for ethanol. FGF21 mediated its anti-intoxicant effects by directly activating noradrenergic neurons in the locus coeruleus region in the brain, which regulates arousal and alertness. Taken together, the results suggest that the FGF21 liver-brain pathway evolved to protect against ethanol-induced intoxication. According to the authors, this pathway may modulate a variety of cognitive and emotional functions to enhance survival under stressful conditions.

Whether activation of the noradrenergic system contributes to FGF21’s other effects is yet to be determined. Although both FGF21 and noradrenergic nervous system activity are induced by ethanol in humans, additional studies will also be required to determine whether FGF21’s anti-intoxicant activity translates to humans.

“Our studies reveal that the brain is the major site of action for FGF21’s effects,” Mangelsdorf says. “We are now exploring in greater depth the neuronal pathways by which FGF21 exerts its sobering effect.”

Source: Cell Press

Categories : General Interest Substance UseTags :

Concourt did not Legalise Weed in the Workplace – Labour Court Rules

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Photo by Thought Catalog on Unsplash

By Tania Broughton

The decriminalisation of cannabis for private use does not include the workplace, a Johannesburg Labour Court judge has ruled.

Judge Connie Prinsloo, in a recent ruling, said submissions by the National Union of Metalworkers of South Africa (NUMSA) that the Constitutional Court had ruled that cannabis was no longer a “drug” but just a “plant or a herb” were wrong.

She said the Concourt “Prince” judgment in 2018 did not offer any protection to employees against disciplinary action should they contravene company policies or disciplinary codes.

She said the apex court had not said cannabis was no longer a drug, as the union had argued, but had merely allowed for its personal consumption, in private, by adults.

Read the full judgment here.

The case before Judge Prinsloo was a review of the dismissal of two PFG Building Glass employees in October 2020 who had tested positive for cannabis while on duty. The National Bargaining Council for the Chemical Industry had found their dismissal to be fair. The union said it was unfair since cannabis was not a drug according to the Constitutional Court.

The company, through its witnesses, presented evidence that being under the influence of alcohol or drugs within the workplace was an offence for which dismissal was the prescribed sanction for the first offence.

This was because the company took workplace safety very seriously and it had a moral and legal duty to ensure that the working environment was safe.

On site, there was gas, large forklifts, extremely hot processes and dangerous chemicals used to make heavy glass which could potentially cut or crush someone.

The company followed the Occupational Health and Safety Act and had a zero-tolerance policy towards alcohol and drugs.

Referring to evidence at the bargaining council, Judge Prinsloo said it had been suggested by the employees that the company was “sticking to the old stigmatisation” of cannabis, whereas the Constitutional Court, in the Prince judgment, had said it was “just a plant … a herb” and could be legally possessed and used.

Company representatives, however, said it was still recognised as a drug and an employee was not permitted to be on site under the influence of alcohol or drugs.

One of the dismissed employees, Mr Nhlabathi, testified that he had used cannabis three days before he reported to work on the day he tested positive. He said he had been employed since 2016 and had “been smoking dagga and doing his job properly”. He disputed that the alcohol and drug policy related to cannabis but only to “alcohol and substances”.

His colleague, Mr Mthimkhulu, also relied on the Constitutional Court judgment that “dagga was a herb and not a substance”. Both claimed they were not aware that they could be fired for testing positive for cannabis.

Judge Prinsloo said the arbitrator had accepted that the company had a zero tolerance policy and that it treated cannabis as a drug because it was a “mind altering substance”.

The arbitrator had said the Prince judgment did not overrule the provisions of the Occupational Safety Act.

Judge Prinsloo said it was evident that the union and the employees had confused issues relating to the decriminalisation of the use of cannabis in private and the rights of employers to take disciplinary action against an employee who contravened a disciplinary code.

The Prince judgment declared specific provisions of the Drugs and Trafficking Act to be inconsistent with the right to privacy and therefore invalid to the extent that they made the use or possession of cannabis in private, by an adult person, a criminal offence.

The Constitutional Court had held, however, that it was common cause that cannabis was a harmful drug.

“The court did not interfere with the definition of a drug, nor did it declare dagga to be a plant or a herb,” Judge Prinsloo said.

“The applicant’s understanding of the judgment was either very limited or totally wrong,” she said.

The company was entitled to set its own standards of conduct and dismissal was an appropriate sanction, she said, dismissing the review.

Republished from GroundUp under a under a Creative Commons Attribution-NoDerivatives 4.0 International License.

Source: GroundUp

Categories : Respiratory Diseases Substance UseTags :

Emphysema Found to be More Common in Marijuana Smokers

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Anatomical model of lungs
Photo by Robina Weermeijer on Unsplash

Airway inflammation and emphysema are more common in marijuana smokers than cigarette smokers, according to a study published in Radiology. Researchers said the difference may be due to the way that marijuana is smoked, which is usually inhaled more deeply and without a filter.

Marijuana is one of the most widely used psychoactive substances in the world and the most-commonly smoked substance after tobacco. Its use has increased in recent years amid legalisation of recreational marijuana in many countries. The growing use has created an urgent need for information on marijuana’s effects on the lungs, something that is currently lacking.

“We know what cigarettes do to the lungs,” said study author Giselle Revah, MD, a cardiothoracic radiologist and assistant professor at the University of Ottawa. “There are well researched and established findings of cigarette smoking on the lungs. Marijuana we know very little about.” 

To find out more, Dr Revah and colleagues compared chest CT results from 56 marijuana smokers with those of 57 non-smoking controls and 33 tobacco-only smokers.

Pulmonary emphysema in (A, B) marijuana and (C, D) tobacco smokers. (A) Axial and (B) coronal CT images in a 44-year-old male marijuana smoker show paraseptal emphysema (arrowheads) in bilateral upper lobes. (C) Axial and (D) coronal CT images in a 66-year-old female tobacco smoker with centrilobular emphysema represented by areas of centrilobular lucency (arrowheads). (Murtha, et al.)

Lack of filtering partly to blame

Three-quarters of the marijuana smokers had emphysema, a lung disease that causes difficulty with breathing, compared with 67% of the tobacco-only smokers. Only 5% of the non-smokers had emphysema. Paraseptal emphysema, which damages the tiny ducts that connect to the air sacs in the lungs, was the predominant emphysema subtype in marijuana smokers compared to the tobacco-only group.

Airway inflammation was also more common in marijuana smokers than non-smokers and tobacco-only smokers, as was gynecomastia, enlarged male breast tissue due to a hormone imbalance. Gynecomastia was found in 38% of the marijuana smokers, compared with 11% of the tobacco-only smokers and 16% of the controls. 

The researchers found similar results among age-matched subgroups, where the rates of emphysema and airway inflammation were again higher in the marijuana smokers than the tobacco-only smokers.

There was no difference in coronary artery calcification between age-matched marijuana and tobacco-only groups.

Dr. Revah said the results were surprising, especially considering that the patients in the tobacco-only group had an extensive smoking history.

“The fact that our marijuana smokers – some of whom also smoked tobacco – had additional findings of airway inflammation/chronic bronchitis suggests that marijuana has additional synergistic effects on the lungs above tobacco,” she said. “In addition, our results were still significant when we compared the non-age-matched groups, including younger patients who smoked marijuana and who presumably had less lifetime exposure to cigarette smoke.” 

The reasons for the differences between the two groups is likely due to several factors. Marijuana is smoked unfiltered, Dr Revah noted, while tobacco cigarettes are usually filtered. This results in more particulates reaching the airways from smoking marijuana.

In addition, marijuana is inhaled with a longer breath hold and puff volume than tobacco smoke.

“It has been suggested that smoking a marijuana joint deposits four times more particulates in the lung than an average tobacco cigarette,” Dr Revah said. “These particulates are likely airway irritants.”

The higher incidence of emphysema may also be due to the way that marijuana is smoked. Full inhalation with a sustained Valsalva manoeuvre, an attempt at exhalation against a closed airway, may lead to trauma and peripheral airspace changes. 

More research is needed, Dr Revah said, with larger groups of people and more data on how much and how often people are smoking. Future research could also look at the impact of different inhalation techniques, such as through a bong, a joint or a pipe.

“It would be interesting to see if the inhalation method makes a difference,” Dr Revah said.

For More Information

Read the Radiology study, “Chest CT Findings in Marijuana Smokers,” and the related editorial.

Source: Radiological Society of North America

Categories : Substance Use VaccinesTags :

To Fight the Opioid Epidemic, Researchers Create a Vaccine that Blocks Fentanyl

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Researchers have developed a vaccine that blocks fentanyl’s to enter the brain, thus eliminating the dangerous synthetic opioid’s “high”. The breakthrough discovery, reported in the journal Pharmaceutics, could have major implications for the rampant problem of opioid addiction by becoming a relapse prevention agent for people trying to quit using opioids.

While Opioid Use Disorder (OUD) is treatable, studies estimate that 80% of those dependent on the drug suffer a relapse. Fentanyl is 50 times stronger than heroin and 100 times stronger than morphine. Consumption of about 2mg of fentanyl (the size of two grains of rice) is likely to be fatal depending on bodyweight. Current treatments for OUD are methadone, buprenorphine and naltrexone. Naloxone is given in opioid overdose situations and can temporarily reverse the effects of the opioids.

“We believe these findings could have a significant impact on a very serious problem plaguing society for years – opioid misuse. Our vaccine is able to generate anti-fentanyl antibodies that bind to the consumed fentanyl and prevent it from entering the brain, allowing it to be eliminated out of the body via the kidneys. Thus, the individual will not feel the euphoric effects and can ‘get back on the wagon’ to sobriety,” said lead author Colin Haile, a research associate professor of psychology at University of Houston.

No any adverse side effects from the vaccine were observed in trial animals. The team plans to start manufacturing clinical-grade vaccine in the coming months with clinical trials in humans planned soon.

Fentanyl is an especially dangerous threat because it is often added to street drugs like cocaine, methamphetamine and other opioids, such as oxycodone and hydrocodone/acetaminophen pills, and even to counterfeit benzodiazepines like Xanax. These counterfeit drugs laced with fentanyl add to the amount of fentanyl overdoses in individuals who do not ordinarily consume opioids.

“The anti-fentanyl antibodies were specific to fentanyl and a fentanyl derivative and did not cross-react with other opioids, such as morphine. That means a vaccinated person would still be able to be treated for pain relief with other opioids,” said Haile.

The vaccine tested contains an adjuvant derived from E. coli named dmLT. An adjuvant molecule boosts the immune system’s response to vaccines, a critical component for the effectiveness of anti-addiction vaccines.

Therese Kosten, professor of psychology and director of the Developmental, Cognitive & Behavioral Neuroscience program at UH, calls the new vaccine a potential “game changer.”

“Fentanyl use and overdose is a particular treatment challenge that is not adequately addressed with current medications because of its pharmacodynamics and managing acute overdose with the short-acting naloxone is not appropriately effective as multiple doses of naloxone are often needed to reverse fentanyl’s fatal effects,” said Kosten, senior author of the study.

Source: University of Houston

Categories : Substance UseTags :

ADHD Drug for Amphetamine Addiction Linked to Reduced Risks

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In a large registry-based study investigating medication use in people with substance use disorders, the ADHD medication lisdexamfetamine was associated with the lowest risk of hospitalisation and death in people with amphetamine addiction. The findings, which also showed drugs which worsened outcomes, were published in JAMA Psychiatry.

“Our results suggest that lisdexamfetamine is associated with the best outcomes, and encourage the conduction of randomised controlled trials to explore this further, says first author Jari Tiihonen, professor at Karolinska Institutet.

Worldwide, amphetamines are the second most used illicit drugs and hospitalisations related to its use are rising.

At present, there are no approved pharmacological interventions available for treating amphetamine or methamphetamine addiction. While certain medications have shown promising results, the studies so far have often been small and convincing evidence is lacking.

Registry-based study

In the present study, the researchers investigated the association between generally used medications among persons with substance use disorder and the risk of two primary outcomes in people with amphetamine or methamphetamine use disorder: 1) hospitalisation due to substance use disorder or 2) hospitalisation due to any cause, or death.

The study enrolled nearly 14 000 individuals aged 16 to 64 years in Sweden with a registered first-time diagnosis of amphetamine or methamphetamine use disorder from July 2006 to December 2018. Individuals with schizophrenia or bipolar disorder were excluded.

Patients were followed from diagnosis until they died, emigrated, were diagnosed with schizophrenia or bipolar disorder or the study ended. The median follow-up time was 3.9 years.

Comparing effects in the same individual

The researchers looked at how the risk of hospitalisation or death for each individual differed depending on whether they were on or off the medication at that time.

”Our results show that lisdexamfetamine, a medication approved for treating ADHD and in some countries also for binge eating, was the only specific medication associated with reduced risk of hospitalisation and death,” says first author Milja Heikkinen, researcher at the University of Eastern Finland and Niuvanniemi Hospital.

The risk of hospitalisation due to substance use disorder was 18% lower and the risk of hospitalisation due to any cause or death was 14% lower during periods of lisdexamfetamine use, compared to periods without the ADHD medication.

The combination of two or more different medications for substance use disorder was also associated with a lower risk of hospitalisation or death.

Some medications linked to worse outcomes

Use of benzodiazepines was associated with poorer outcomes; 17% higher risk of hospitalisation due to substance use disorder and 20% higher risk of hospitalisation due to any cause or death, during periods of use compared to periods of non-use. The use of antidepressants was also associated with slightly worse outcomes than non-use.

The researchers note that pharmacological treatments are often discontinued when the clinical state has improved, and are started when the clinical state deteriorates. Therefore, the results may underestimate the putative beneficial effect of treatments. To control for this phenomenon, the researchers conducted analyses by omitting the first 30 days of use. The results were then in line with the main analyses.

Source: Karolinska Institutet

Categories : Healthcare Politics and Regulations Substance UseTags :

Liquor Amendment Bill Might be Further Toughened up

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Source: Pixabay CC0

By Marecia Damons

Information about alcohol abuse gathered during the COVID lockdown may prompt further changes to the Liquor Amendment Bill, says the Department of Trade, Industry and Competition. The Bill has been on hold since 2018.

The Bill seeks to amend the National Liquor Act of 2003, by tightening alcohol restrictions and advertising and regulating where alcohol is sold.

Spokesperson Bongani Lukhele said the Bill was under review by the department.

“During the Covid-19 pandemic, it became more apparent that the problem of liquor abuse is quite huge in South Africa and requires more concerted measures, and that the Bill may not address the scale of the problem as the problem requires a concerted effort in government,” said Lukhele.

He said the department would reintroduce the bill to Parliament. Lukhele said as well as legislation to address liquor use, there was a need for health, education and behaviour issues to be addressed as well.

“Provincial laws must also be reviewed as it impacts directly on the retail trade,” Lukhele added.

Meanwhile, lobby groups are growing impatient with delays in the implementation of the bill.

Maurice Smithers, director of the Southern African Alcohol Policy Alliance in South Africa, said the Liquor Act had been reviewed in 2015 and found to be inadequate and inconsistent with the World Health Organisation’s Global Strategy to reduce the harmful use of alcohol. The Global Strategy suggests three priorities: reducing the availability of alcohol, increasing its cost, and limiting or banning marketing.

As a result, changes were proposed in the Liquor Bill, drafted in 2016, including:

  • restricting advertising of alcohol on public platforms;
  • increasing the legal drinking age from 18 to 21 years;
  • regulating specific trading days and hours for alcohol to be distributed and manufactured; and
  • placing liability on alcohol retailers and manufacturers for harm related to the contravention of regulations.

The amendments also propose banning alcohol advertising on radio and television at certain times and on billboards less than 100 metres away from junctions, street corners and traffic circles.

The bill was approved by Cabinet for public comment in 2016.

Smithers told GroundUp that the socio-economic and health problems associated with alcohol would worsen over time if the Bill and other legislation was not passed.

“The overall cost to society of such harm will continue to burden the state and divert resources from other delivery areas. Some specific consequences are that petrol stations are now applying for licences, something they would not be able to do if the bill were passed.”

“The current proposals in the Basic Education Laws Amendment Bill which will allow schools to have alcohol at schools and at school functions off school premises for fund-raising purposes would also not be allowed if the bill were passed,” said Smithers.

Basic Education Minister Angie Motshekga has said the department supports zero tolerance of alcohol at schools, but schools do sell alcohol during fund-raising and do hire out halls for functions where alcohol is consumed. She said the clauses in the Basic Education Laws Amendment Act are intended only to regulate this.

Onesisa Mtwa, innovation manager at the DG Murray Trust, told GroundUp that stronger regulations were necessary to address and reduce harmful patterns of consumption such as heavy and binge drinking.

In its 2018 Global Survey on Alcohol and Health, the WHO indicated that in 2016, South African drinkers over the age of 15 years consumed, on average, 64.6 grams of pure alcohol per day.

The data further showed that South African drinkers over 15 years old consumed 29.9 litres of pure alcohol in a year —the third highest consumption in Africa.

Citing a 2017  by economics-based consulting firm Genesis Analytics, Mtwa said the Bill could reduce alcohol consumption by between 3.2% and 7.4% which would, in turn, reduce public health costs by R1.9 billion per year.

“Despite the industry’s claims that this Bill will destroy the industry,” Mtwa said, the impact assessment suggested that South Africa’s gross domestic product would drop by less than 1%.

A study by the University of Cape Town and the Medical Research Council found that alcohol bans during COVID were strongly associated with a large drop in unnatural deaths (murders, vehicle collisions, suicides and accidents).

Researchers looked at death data during alcohol restrictions and curfews under the national lockdown from the end of December 2019 to late April 2021. The drop in unnatural deaths associated with a full alcohol ban ranged from 42 deaths per day under a curfew of 4 to 7 hours to 74 per day under hard lockdown.

Mtwa said implementing the bill would need “extensive” national and provincial cooperation.

“Some areas of regulation such as retail sales and liquor licences lie with provinces, while liability issues, manufacturers and the drinking age would be regulated by the national government. This highlights the need for a whole-of-government approach to reducing alcohol-related harm,” she adds.

Smithers said although the bill is not a silver bullet, it would send a signal to society that the government is serious about addressing the issue of alcohol-related harm.

“It’s not a perfect bill and it won’t result in a perfect act, but it is a step in the right direction,” he said.

Republished from GroundUp under a Creative Commons Attribution-NoDerivatives 4.0 International License.

Source: GroundUp

Categories : Cardiovascular Disease Substance UseTags :

Marijuana and other Substances Linked to Atrial Fibrillation

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Photo by Towfiqu Barbhuiya on Pexels

A new longitudinal study of more than 23 million people in the US concludes that some commonly used and abused drugs pose previously unidentified risks for the development of atrial fibrillation (AF). The results appeared in the European Heart Journal.

The researchers analysed data from diagnostic codes from every hospital admission, emergency room visit and medical procedure in California for the years 2005 through 2015, identifying nearly one million people without preexisting AF, but who later developed AF during these years.

They found 132 834 patients used cannabis, 98 271 used methamphetamine, 48 700 used cocaine, and 10 032 used opiates. In the study, the researchers found that marijuana users had a 35% increased likelihood of later developing AF.

“Despite exhibiting a weaker association with incident AF than the other substances, cannabis use still exhibited an association of similar or greater magnitude to risk factors like dyslipidaemia, diabetes mellitus, and chronic kidney disease. Furthermore, those with cannabis use exhibited similar relative risk of incident AF as those with traditional tobacco use,” the study authors reported.

“To my knowledge, this is the first study to look at marijuana use as a predictor of future atrial fibrillation risk,” said principal investigator Gregory Marcus, MD, MAS, a UCSF professor of Medicine with the Division of Cardiology.

AF is an abnormally disordered pumping rhythm arising from electrical disturbances in the atria. In severe cases of faulty atrial pumping, clots may form in the atria, and then break off into the bloodstream and cause deadly strokes. AF-related strokes cause more than 150 000 US deaths each year.

Unlike cocaine or methamphetamine use, both stimulants previously known to sometimes lead to sudden cardiac death due to profound disruptions in the orderly electrical signalling and pumping within ventricles there is no demonstrated mechanism whereby marijuana use causes heart arrhythmias.

Source: University of California San Francisco

Categories : Paediatrics Substance UseTags :

Prenatal Cannabis Exposure Impacts Persist to Pre-adolescence

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Children
Photo by Ben Wicks on Unsplash

Children who were exposed to cannabis in the womb continue to show elevated rates of symptoms of psychopathology (depression, anxiety and other psychiatric conditions), even as they reach pre-adolescence (aged 11–12), according to research published in JAMA Pediatrics.

The study, led by Ryan Bogdan, associate professor at Washington University in St. Louis, is a follow-up to 2020 research from the Bogdan lab that revealed younger children who had been prenatally exposed to cannabis were slightly more likely to have had, inter alia, sleep problems, lower birth weight and lower cognitive performance.

In both cases, the effect is strongest when looking at exposure to cannabis after the pregnancy is known. To find out whether or not these associations persisted as the children aged, David Baranger, a postdoctoral researcher in the BRAIN Lab, revisited the more than 10 500 children from the 2020 analysis, who were an averaged of 10 years old in 2020.

The data on the children and their mothers came from the Adolescent Brain and Cognitive Development Study (ABCD Study), an ongoing study of nearly 12 000 children, beginning in 2016 when they were 9–10 years old, and their parents or caregivers.

This seemingly small change in age – from 10 to 12 – is an important one. “During the first wave, they were just children. Now they’re edging up on adolescence,” Baranger said. “We know this is a period when a large proportion of mental health diagnoses occur.”

An analysis of the more recent data showed no significant changes in the rate of psychiatric conditions as the children aged; they remain at greater risk for clinical psychiatric disorders and problematic substance use as they enter the later adolescent years.

“Once they hit 14 or 15, we’re expecting to see further increases in mental health disorders or other psychiatric conditions – increases that will continue into the kids’ early 20s,” Baranger said.

Source: University of Washington in St. Louis

Categories : Medical Research & Technology Substance UseTags :

Opioid Respiratory Depression Reversed with Electrical Pulses

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Opioid use is a significant cause of premature death, caused by supressing respiratory activity. New research, published in The Journal of Physiology, points to a novel treatment for respiratory depression associated with opioid use that administers electrical pulses to the back of the neck, helping patients regain respiratory control following high dosage opioid use.

Breathing problems can occur after opioid use or post-operative complications from anaesthesia because opioids desensitise the brain stem to rises in carbon dioxide. This can cause respiratory failure, which can be fatal. Current treatments, such as manual lung inflation and medication, can work in the short term to combat breathing problems following opioid use, but getting patients to breathe independently remains a challenge. Therefore, this new research, which administers epidural electrical stimulation (EES) offers an alternative, non-pharmacological treatment.

EES administered at the cervical spinal cord, which is located at the back of the neck, activates a network of neurons in the brainstem that stimulates and coordinates respiratory muscles and improves the rate and depth of breathing.

Researchers from the University of California, Los Angeles (UCLA), targeted sensory-motor circuits in the cervical spinal cord of 18 patients with degenerative spine diseases who were anaesthetised for surgical treatment. They delivered 30 Hertz of EES to the cervical spinal cord continuously for no longer than 90 seconds.

They found that short periods of continuous low-intensity EES not only increased the volume of breath but also actively controlled the frequency and rhythm during opioid-induced breathing problems. The rhythmic breathing pattern was sustained briefly after the EES stopped in the presence of high-dose opioids.

Senior author Dr Daniel Lu, UCLA professor and vice chair of neurosurgery, said: “Our results provide proof of principle that cervical EES could improve respiration following opioid use. We can compare the human body to a car, our goal is to jump start the body so it can run by itself without periodic pushes. We hope to use EES to provide novel approaches to restore breathing for healthcare providers as we are now using defibrillation devices for restoring cardiac activities.”

Future human trials with larger cohorts will be conducted to further assess the practical application and impact of EES to determine whether EES can alleviate or reduce the need for ventilator support in acute pathological conditions such as OIRD, stroke, and traumatic brain, brain stem or spinal cord injury. Experimental studies in mice will be carried out to further investigate the role specific neurons play in response to EES.

Source: Physiological Society