Marijuana and Heart Disease: What are News?

MedexNews Teamhttps://www.medexnews.com/marijuana-heart-disease-news/

Why Do People Use Marijuana?Among people who used marijuana in the past year:

2

47%

30%

23%

For Fun For Medical Reasons For Fun and for Medical Reasons

Marijuana Use is Common Marijuana is the most commonly used illicit drug in the

U.S.

• Any use among general population age 12+ in past month:

• 2011: 7%

• 2008: 5.8% • Use is most common among people age 18-25 (19% of

population)

• 48% of adults in the US report having used marijuana at some time in their life

Marijuana: What is it?

• Dry, shredded mix of leaves, flowers, stems, and seeds, usually from Cannabis sativa or Cannabis indica plant

• Both are common subspecies of the hemp plant, which is common throughout the world

• Contains over 400 chemical compounds

• Common names: grass, weed, pot, reefer, Mary Jane, ganja

SOURCE: SAMHSA, 2012 (reference list).

Marijuana: What is it?

Dry, shredded mix of leaves, flowers, stems, and seeds, usually from Cannabis sativa or Cannabis indica plant

Both are common subspecies of the hemp plant, which is common throughout the world

Contains over 400 chemical compounds

Common names: grass, weed, pot, reefer, Mary Jane, ganja

SOURCE: SAMHSA, 2012 (reference list).

Marijuana: Immediate Effects

Effects can vary by strains Sativa: More euphoria, stress relief Indica: Relaxation, physical (especially pain) relief Sativa and Indica often combined, leading to variable effects

Altered Mood Reduced Anxiety

Cognitive Impairment(Attention, Judgment)

Sedation/Drowsiness

Altered Perception Sensory Intensification

Impaired coordination/balance Increased heart rate

Hunger Hallucinations (in large doses)

Cannabis use can lead to severe cardiovascular problems and sudden death, not only in people at increased cardiovascular risk, but also in young people without any medical history or risk factors.

Researchers analyzed three cases where recent and/or chronic use of marijuana led to severe cardiac dysfunction.

The first case presented with asystole and was found to have diffuse coronary vasospasm on coronary angiography in the hours after acute cannabis abuse.

Marijuana and Heart DiseaseIs recent cannabis use associated with acute coronary syndromes?

In the second case, an acute anterior infarction with occlusion of both the right coronary artery (RCA) and the left anterior descendens (LAD) was observed in a young patient without known cardiovascular risks but with chronic cannabis abuse. The third case presented at home with ventricular fibrillation presumably caused by an acute coronary syndrome due to left anterior descending (LAD) artery occlusion.

Read more news:

Is recent cannabis use associated with acute coronary syndromes? An illustrative case series. ActaCardiol. 2014 Apr;69(2):131-6.

Marijuana and coronary vasospasm

Cannabis-related cardiovascular complications reported to the Network from 2006 to 2010.

Details of cardiovascular history and risk factors could be determined for 16 of 35 cases (46%); researchers found that nine subjects had a personal CV history and seven a family history. In patients in whom body mass index was assessed (31%), 54% were of normal weight, 36% were overweight, and only one

was obese.

Cannabis Use: Signal of Increasing Risk of Serious Cardiovascular Disorders

There were 22 cardiac complications (20 ACS and two heart rate disorders), 10 extracardiacperipheral complications (lower limb or juvenile arteriopathies and Buerger-like diseases), and three extracardiac cerebral complications (acute cerebral angiopathy, transient cortical blindness, and spasm of cerebral artery).

Marijuana and Cardiac complications

In nine of 35 cases (26%), the event led to death. None of those who died made it to the hospital, but were rather found dead or unconscious, with cannabis use indicated by toxicology or bystander report.

While the numbers were small, they appear to be growing: the percentage of cannabis-related cardiovascular complications (of all cannabis-related reports) increased from 1.1% in 2006 to 3.6% in 2010 (five cases in 2006, increasing to 11 cases in 2010).

Marijuana and Cardiac death

"Despite the known underreporting, the rate of cannabis-related cardiovascular complications reported steadily rose during the past 5 years...The majority consisted of acute coronary syndromes and peripheral arteriopathies," consistent with previous findings and strengthening the conclusion that "cannabis use may be responsible for serious complications, in particular on the cardiovascular system.

Read more:

Jouanjus E, Lapeyre-Mestre M, Micallef J; The French Association of the Regional Abuse and Dependence Monitoring Centres (CEIP-A) Working Group on Cannabis Complications. J Am Heart Assoc. 2014 Apr 23;3:e000638 doi: 10.1161/JAHA.113.000638.

Cannabis-related cardiovascular complications

Cannabis may produce adverse effects on the cardiovascular system; because cannabis and THC cause a dose‐dependent increase in heart rate, concern exists about adults with cardiovascular disease. Cannabis use can cause an increase in the risk of myocardial infarction 4.8‐fold in the hour after use, and provokes angina in patients with heart disease.

Read more:

http://www.unodc.org/documents/drug-prevention-and-treatment/cannabis_review.pdf

Cannabis and myocardial infarction

Because cannabis is frequently smoked, bronchial and lung diseases are not uncommon.

Cannabis smoke is composed of many of the same ingredients that are present in tobacco smoke (e.g., carbon monoxide, cyanide), with the exception of THC in cannabis, and nicotine in tobacco.

Infrequent cannabis users may experience burning and stinging of the mouth and throat, along with a heavy cough, and regular cannabis smokers often have many of the same respiratory problems as tobacco smokers, including daily cough and phlegm production, frequent acute chest illness, and an increased risk of lung infections and pneumonia.

Cannabis and the Respiratory and Cardiovascular Systems

How Can Marijuana be a Medicine?

Marijuana affects:

Pleasure/relaxation

Memory/thinking

Coordination

Pain Control

Appetite

Vomiting Reflex

What medical problems do you think this would this be helpful for?

Marijuana’s Medical Potential: Research Evidence

Reduces nausea

Stimulates appetite

Pain relief

Controls muscle pain, spasms

Reduces tics (Tourette’s Syndrome)

Reduces convulsions (epilepsy)

Marijuana’s Medical Potential:Ongoing Clinical Trials

Studying potential of marijuana and marijuana-based medications to treat: Multiple Sclerosis High Heart Rate Non-Cardiac Chest Pain Chronic Obstructive Pulmonary Disease Sickle Cell Disease Spinal Cord Injury Pain Inflammatory Bowel Disease (Crohn’s disease) Liver Problems Cancer-Related Pain Brain Tumors Dementia

Many of these trials on individuals with multiple physical and/or mental health problems

SOURCE: U.S. National Institutes of Health, 2013. ClinicalTrials.gov.

Different Kinds of Marijuana-Based Medicine

Botanical cannabis (plant): “Medical Marijuana”

Synthetic THC medications available in U.S. for nausea/appetite stimulation:

Dronabinol (Marinol®) (FDA approved for HIV)

Nabilone (Cesamet®) (FDA approved for cancer; HIV off-label)

Other medications not available in U.S.:

Nabiximols (Sativex®) THC/cannabidiol mouth spray for pain relief, muscle spasms; currently being investigated by FDA

Rimonabant (Accomplia®, Zimulti®) for treatment of obesity and nicotine dependence (selective cannabinoid receptor-1 blocker)

Medical Marijuana vs. THC Medications: Is Medical Marijuana Better?

THC medications still have psychoactive effects (make you high)

There are chemicals in medical marijuana that moderate THC’s psychoactive effects

These chemicals are not present in medications

Medical marijuana is cheaper

Not made/patented by pharmaceutical industry

Smoked medical marijuana takes effect in minutes; THC medications take over an hour

Instant feedback allows users to take more if needed for relief

Due to rapid relief, may consume less if smoked

When swallowed, THC absorption is more erratic, and less concentrated

THC effects more unpredictable and variable, possibly less effective

Medical Marijuana vs. THC Medications: Is Medical Marijuana Better?