Teenage cannabis use and schizophrenia

With the growing wave of legalizing marijuana use across the US, it is important to fully understand the possible consequences of expected increase in it's unrestricted use, specially amongst the youth. A group of scientist at the Feinberg School of Medicine and Northwestern Memorial Hospital have conducted a study which has found a link between teenage Marijuana (Cannabis) use and schizophrenia. This study was published by Schizophrenia Bulletin

The brains of teenagers smoking cannabis daily for about three years showed significant structural changes affecting memory. Some of those changes appear very similar to those seen in the brains of schizophrenics.These youngsters also performed badly when tested on memory tasks, indicating poor memory functioning.


As reported by Marla Paul for Northwestern University on Futurity;

This is the first study to target key brain regions in the deep sub-cortical gray matter of chronic marijuana users with structural MRI and to correlate abnormalities in these regions with an impaired working memory.
Working memory is the ability to remember and process information in the moment and—if needed—transfer it to long-term memory. Previous studies have evaluated the effects of marijuana on the cortex, and few have directly compared chronic marijuana use in otherwise healthy individuals and individuals with schizophrenia.

According to the lead study author Mathew Smith an assistant research professor in psychiatry and behavioral sciences at Northwestern University Feinberg School of Medicine; 

“The study links the chronic use of marijuana to these concerning brain abnormalities that appear to last for at least a few years after people stop using it. With the movement to decriminalize marijuana, we need more research to understand its effect on the brain.”

 But in contrast to these findings another study conducted at the Institute of Psychiatry at King's College London, has shown a genetic link between cannabis use and schizophrenia. Kate Kelland  reports for Reuters that;

The results chime with previous studies linking schizophrenia and cannabis, but suggest the association may be due to common genes and might not be a causal relationship where cannabis use leads to increased schizophrenia risk. 

 "We know that cannabis increases the risk of schizophrenia. Our study certainly does not rule this out, but it suggests that there is likely to be an association in the other direction as well – that a pre-disposition to schizophrenia also increases your likelihood of cannabis use," said Robert Power, who led the study at the Institute of Psychiatry at King's College London.

But what become evident from both these recent studies is the clear connection between adolescent use of cannabis and the development of schizophrenia. Therefore it is important for parents to discourage their children from getting swept up in this growing wave of legal recreational use of marijuana. We need to educate ourselves and our children on the very real dangers and consequences of indiscriminate use of marijuana.
 



References:

Teen marijuana use linked with schizophrenia (Futurity-January 3, 2014)

Study finds genetic links between schizophrenia and cannabis use (Reuters-June 24, 2014)

Cannabis-Related Working Memory Deficits and Associated Subcortical Morphological Differences in Healthy Individuals and Schizophrenia Subjects  (Schizophrenia Bulletin-December 15, 2013)

Genetic predisposition to schizophrenia associated with increased use of cannabis (Molecular Psychiatry-June 24, 2014)

Here is why writing by hand should not be forgotten

Post by Health, Wellness and Mindfulness.

Air Pollution damaging not children's health but also their IQs

In a recent study at Columbia University School of Public Health, researchers have shown that air pollution might affect children's earning potential later in life. The study has been published in The Journal of Public Health Policy May issue.
The researchers gathered data by tracking poor and pregnant African American and Dominican mothers and their children til the age of five.
The results as also discussed by Sydney Brownstone in Fast Company Coexist section showed an inverse relationship in air quality (presence of neurotoxicants, such as polycyclic aromatic hydrocarbons (PAH) released to ambient air by combustion of fossil fuel and other organic material) and the children's IQ. Here are excerpts of the article;

Some of the biggest barriers blocking children's access to opportunity are also the most invisible. It’s no small difference either. If New York City were to reduce its pollution from sources like diesel fumes by even a quarter, affected children could earn an additional $215 million in their lifetimes.
It’s old news that some types of air pollution affect some groups more than others. Poor communities of color are most at risk, often housed in the polluted miasma next to highways, city dumps, landfills, power plants, and other undesirable places to live. New York City is no exception. In 2006, NYU researchers analyzed backpacks of South Bronx schoolchildren to link the borough’s heavy diesel-powered truck traffic to shockingly high rates of childhood asthma hospitalizations.

The Columbia researchers were able to see if pollution exposure correlated with academic performance and IQ. When they factored in the well-documented relationship between IQ and future earnings, the researchers calculated that if the city decreased PAH pollution by a quarter, each child could earn an additional $3,382 on average. Multiply that by the 63,500 kids exposed to this kind of pollution in the city, and the total comes to $215 million in lost dollars.

These findings have been supported by others studies and medical papers. Such as the 2012 paper published by the National Institute of Health in which Harvard Medical School Neurologist Dr. David C. Bellinger concluded that; 

Any effort to compare the neurodevelopmental burden associated with different risk factors is limited by the data available and the assumptions required. It was possible to estimate the total loss of FSIQ points in the population of 0- to 5-year-old U.S. children for a variety of risk factors, including three environmental chemicals: methylmercury, organophosphate pesticides, and lead. Despite the limitations of the approach, it appears that when population impact is considered, the contributions of chemicals to FSIQ loss in children are substantial, in some cases exceeding those of other recognized risk factors for neurodevelopmental impairment in children. The primary reason for this is the relative ubiquity of exposure.  

Although American industry will insist on more targeted and exact data to force any significant regulations to further reduce air pollution and other environmental pollutants, it is clear that harm is being done. If we want our children to have a fair chance at success and progress we need to take action now.



References:

The Toxins That Threaten Our Brains(The Atlantic-May 18, 2014)

Air Pollution Is Lowering The IQs--And Earning Potential--Of New York City Children 

(Fast Company-CoExist May 12, 2014)

Prenatal exposure to airborne polycyclic aromatic hydrocarbons and IQ: Estimated benefit of pollution reduction (Journal Of Public Health Policy- May 8, 2014)

Air Pollution and Health Risk (EPA)
A Strategy for Comparing the Contributions of Environmental Chemicals and Other Risk Factors to Neurodevelopment of Children  (NIH April 1, 2012)
A Study Links Trucks’ Exhaust to Bronx Schoolchildren’s Asthma  (The New York Times- June 2, 2006)


 

The autism vs vaccines controversy

In 1998 an article published in the British Journal The Lancet claimed it found a causal connection between the MMR vaccine and autism. Although that article was widely disputed and later retracted, it has left behind a significant following, leading many parents to refuse MMR vaccination for their children. The anti-vaccine groups also stressed on the use of mercury-based preservative Thimerosal in vaccines as a suspected culprit. As a result the government has gradually removed it or reduced it to trace amounts in all vaccines in 2001, in spite of no scientific proof of its possible link to incidence of autism. As explained on the CDC website;

"Over the years, some people have had concerns that autism might be linked to the vaccines children receive. One vaccine ingredient that has been studied specifically is thimerosal, previously used as a preservative in many recommended childhood vaccines. However, in 2001 thimerosal was removed or reduced to trace amounts in all childhood vaccines except for one type of influenza vaccine, and thimerosal-free alternatives are available for influenza vaccine. Evidence from several studies examining trends in vaccine use and changes in autism frequency does not support such an association between thimerosal and autism. Furthermore, a scientific review by the Institute of Medicine (IOM) concluded that "the evidence favors rejection of a causal relationship between thimerosal–containing vaccines and autism." CDC supports the IOM conclusion that there is no relationship between vaccines containing thimerosal and autism rates in children.
The IOM also recently conducted a thorough review of the current medical and scientific evidence on vaccines and certain health events that may be observed after vaccination. It released a report in August 2011 on 8 vaccines given to children and adults that found the vaccines to be generally safe and serious adverse events following these vaccinations to be rare."

The 2012 National Immunization Survey  found that about 90% of children aged 19 to 35 months completed recommended vaccinations and less than 1% received no vaccines at all. But it also highlighted the fact that rates are varied by states and regions therefore leaving some areas vulnerable to outbreaks of measles and other vaccine preventable diseases. The resurgence of measles and whooping cough (Pertussis) in recent years after decades of almost complete extinction could possibly be the distressing consequence of an increasing number of parents refusing the MMR vaccine on grounds of its possible association to autism. 

As explained by Puneet Kollipara in The Washington Post article How the anti-vaccine movement is endangering lives (May 5, 2014).

A measles outbreak that struck a Texas megachurch community late last summer sickened 21 people. And just recently, at least 16 people got sick during a measles outbreak in Ohio. In fact, the Centers for Disease Control and Prevention recently reported 13 measles outbreaks so far in 2014 -- the most since 1996.

According to an article in JAMA News;

Overall, among 140 US residents who acquired measles, 117 (84%) were unvaccinated, and 11 (8%) had unknown vaccination status. Of those who were unvaccinated, 92 (79%) had philosophical objections to vaccination, and 15 cases (13%) occurred among infants younger than 12 months who were not eligible for vaccination.


Besides leading to prevention and saving lives, these vaccines are also economically beneficial, as pointed out by Kuneet Kollipara;

A new study from CDC researchers led by Anne Schuchat analyzed what happened to disease rates as childhood vaccination rates increased starting in the early 1990s. The researchers used these findings to model the resulting effect over the kids' lifetimes. In the analysis, the researchers factored in most routine vaccines recommended for children below age 6 (among them the MMR and whooping cough vaccines). Their findings: Routine childhood vaccinations given between 1994 and 2013 will save 732,000 lives and prevent 322 million cases of illness and 21 million hospitalizations over the course of the children's lifetimes. 

In 2009 alone, the researchers determined, each $1 spent on vaccines and their administration yielded $10 in benefits to society. And the vaccinations from 1994-2013, the researchers found, will save society a net $1.38 trillion, both directly (by reducing health expenses) and indirectly (via the economic activity that is saved from avoided illnesses). That's almost 10 percent of the U.S. economy's gross domestic product.

In the end vaccines may not be without fault but there is no clear cut evidence to their causal link to autism. And they are definitely effective and save lives if given to a significant percentage of the population.



References:
How the anti-vaccine movement is endangering lives (The Washington Post-May 5, 2014).

Vaccine Safety: Concern about Autism (CDC)

Vaccination Rates for US Children Remain Generally High, But Measles Outbreaks Underscore Shortfalls in Some Regions(JAMA News Spetember 2013) 

The serious and difficult outcomes of saving extremely premature babies.

According to the CDC 1 in every 8 babies born in the US is preterm (birth of an infant prior to 37 weeks of pregnancy). 35% of all infant deaths in 2009 were because of preterm related causes of death. The US health care system spent about $26 billion on preterm births in 2005.
But the statistic that should be raising concern is that 'preterm birth is also a leading cause of long-term neurological disabilities in children.'

With modern medicine and all our advances in medical sciences, we have made it possible to save babies born at 22-23 weeks of gestation.  But preterm births are associated with some serious short term and long term complications. Not only do these prevent the child from living a normal healthy life they can take a severe toll on the family and the community. 

In the article 'Nathan was born at 23 weeks. If I'd known then what I do now, I'd have wanted him to die in my arms' reporter Tracy McVeigh covers the story of Alexia Pearce mother of a three years old son who was born prematurely at 23 weeks and now lives a difficult life with cerebral palsy and chronic lung disease. Alexia loves her son deeply yet she asks if "we are always right to save premature babies". Here are excerpt of the story;

Alexia Pearce looks at her three-year-old son Nathan every day and feels the same rush of guilt. Guilt that she chose to let him live when he was born too early, just 23 weeks into her pregnancy. "If I'd known then what I know now about what extremely premature babies have to go though, I would not have chosen that for my little boy.

"I would have wanted them to give him to me and for him to pass away in my arms. I find the whole issue of what he has been put through, what he continues to be put through, very difficult. I feel very guilty that I took that decision, postponing the inevitable."

"He can't walk or talk. He's oxygen dependent, although hopefully that might change. He has chronic lung disease, cerebral palsy and global developmental delay. He has diabetes inspidus and his thermostat is a bit wonky so he gets hot and cold."
It is, says Pearce, a great taboo to wonder if she should have let her son go when he was born so fragile and weak, but one that she feels strongly that she should break. "More people need to be aware of what these little chaps go through," she said.
"I have no regrets that what has happened has happened. Now this most gorgeous little thing is here and I absolutely adore him. I am so glad I have got to know him. But that doesn't stop me knowing that all I have done is postpone the inevitable. He's not expected to live a very long life. I don't think he'll make it to his teens. He's so frail.

While the latest figures show that 39% of babies born at 24 weeks are now surviving with help from medical advances, the chances of those children suffering no serious ill-effects in later life are low – around six in 100.Last year, researchers from University College Hospital, London, found that premature babies were more sensitive to pain. All pre-term babies are more at risk of a lower IQ, poorer cognitive functioning, learning disabilities and behavioural problems such as attention deficit disorder than full-term babies.
Last year, researchers from University College Hospital, London, found that premature babies were more sensitive to pain. All pre-term babies are more at risk of a lower IQ, poorer cognitive functioning, learning disabilities and behavioural problems such as attention deficit disorder than full-term babies.
"You hear about 'miracle babies' or 'little fighters' and people have such a romantic view about premature babies – 'Oh, there's an incubator for a little while and then they go home and everything is rosy'. It's not."

"Obviously every life deserves a chance, every life. But you wouldn't put an adult through that. You wouldn't put an animal through it. If an adult required that level of medical intervention then someone would be taking the family aside and suggesting gently that the machines are switched off."
Pearce had no warning of her own premature birth, brought about by a sudden complication in the pregnancy, a placental abruption, and had none of the risk factors – she doesn't drink or smoke, isn't obese and her first son, Dominick, now five, was born at full term.

"Birth and death are the most natural processes a body can go through and Nathan's birth and treatment was so far removed from that. Strange birth, choices to be made, difficult bonding. I had to wait six weeks to hold my son and when I did he was still attached to a ventilator and I had many nurses around me. It was all so clinical."
An advocate or counsellor figure would, she feels, help the mother think more clearly about the situation.

But for Alexia Pearce, it's important for families to fully understand too that the difficult times do not end when the baby leaves the incubator. "When you go into labour that early, nobody is a winner," she said. "I'm not saying stop people from having their premature baby resuscitated. I'm not saying babies shouldn't be saved. I am saying that the myth that there is a happy ever after needs to be explored and it's important that we talk about it.

(Read Complete Article)

References:
'Nathan was born at 23 weeks. If I'd known then what I do now, I'd have wanted him to die in my arms' (The Guardian/The Observer)
CDC Reproductive Health- Preterm Births 
Preterm Births- Complications (Mayo Clinic) 

Neurodevelopmental, Health, and Family Outcomes for Infants Born Preterm

(NCBI- National Center for Biotechnology Information)

The damage caused by bullying persists much longer then the bullying itself

According to a longitudinal British study just published in the American Journal of Psychiatry, the detrimental effects of bullying can lasts for decades and influence a person's socioeconomic status, social relationships, often leading to a poorer quality of life as far out as in their 50s.
As reported by the researchers of the study;

The impact of bullying victimization was not limited to indicators of adult health. Children who  were frequently bullied had lower educational levels at midlife, and men in the labor market were  more likely to be unemployed and to earn less than their peers. Social relationships in adulthood were affected too; children who were bullied were at increased risk of living without a spouse or partner at age 50, were less likely to have met up with friends in the recent past, and were less  likely to have access to social support if they were sick. Bullying victimization also affected adult well-being; being bullied was associated with lower perceived quality of  life at age 50 and lower satisfaction with life so far. Cohort members who had been frequently bullied also anticipated less life satisfaction in the years to come. When  controlling for childhood confounders, bullying victimization became marginally associated with unemployment (for men), net pay (for men), and meeting friends in the  last 2 weeks. All other associations remained significant.
 
In this study data was collected from almost 98% of all births in one week of 1958 in Scotland, England and Wales, leading to about 18,000 participants. Subsequent follow-up were then carried out at age 7, 11 and 16 years in their childhood, and then at ages 23, 33, 42, and 50 years in adulthood. To assess presence and frequency of bullying during childhood researchers interviewed parents. Whereas the psychological distress resulting in adult life was assessed through various standardized test.

It is clear from these observations that in addition to effectively reducing incidents of childhood bullying efforts must be made to minimize its effect on mental, emotional and physical.

To learn more about bullying and to find help please check Stopbullying.gov


References:
Adult Health Outcomes of Childhood Bullying Victimization: Evidence From a Five-Decade Longitudinal British Birth Cohort (American Journal of Psychiatry)
Mental And Physical Toll Of Bullying Persists For Decades (Health News from NPR)
 

Green makes us all happier

A recent survey of 2500 individuals about anxiety, depression and stress conducted and analyzed by researchers at the University of Wisconsin- Madison. They also analyzed 229 neighborhoods for vegetation cover. The verdict; people who live close to a park and green spaces are happier!

These results were discussed on Co.Exist (Fast Company) by  Ben Schiller in his recent article, '

If You Live Near A Park, You're More Likely To Be Happy' 

Those places with more trees tended to be happier, and the association was "significant and sizable," according to a paper discussing the results. In fact, the relationship of happiness to trees was similar to well-known correlations, like unemployment. "The most interesting thing is that decreased symptoms attributed to green space were similar to decreases observed for other important determinants of mental health, including insurance status and income," wrote Kirsten Beyer, an assistant professor at the Medical College of Wisconsin, in an email.

The paper shows the difference in well-being levels between areas with zero tree canopy cover and 100% canopy cover was greater than the well-being difference between someone having and not having health insurance.

Read on




References:

Longitudinal Effects on Mental Health of Moving to Greener and Less Green Urban Areas

(International Journal of Environmental Research and Public Health)

If You Live Near A Park, You're More Likely To Be Happy'

(Fast Company- Co.Exist) 

Older dads might increase the risk of mental health issues in their children

A child's health issues have often been linked to their mother's age at time of their birth. Now a study at University of Indiana has found evidence that a father's age can influence a child's risk of developing conditions such as autism, ADHD and bipolar disorder. The children of older fathers were also seen to be more likely to consider suicide.

As reported in The Independent by Ian Johnston in his article Children of older dads face more health problem;

Scientists at Indiana University found that a child born when their father is 45 was 3.5 times more likely to have autism, 13 times more likely to have ADHD and 25 times more likely to have bipolar disorder than the child of a 24-year-old man.
Suicidal behaviour and substance misuse was twice as likely, according to the study, which is published today in the journal JAMA Psychiatry.
Brian D’Onofrio, who led the research, told The Times: “We were shocked by the findings. The specific associations with paternal age were much, much larger than in previous studies.”
The researchers looked at information about everyone born in Sweden from 1973 until 2001, some 2,615,081 people.
Christopher Barratt, a professor of Reproductive Medicine at Dundee University, suggested younger men should consider freezing their sperm in case they want to have a child when they are in their 40s.

(Read on)


References:

Children of older dads face more health problems (The Independent- April 4, 2014) 

A Comprehensive Assessment of Parental Age and Psychiatric Disorders (JAMA Psychiatry) 

 

Several studies find further evidence of detrimental effects caused by marijuana smoking

Since this wave of legalization of use of recreational marijuana is spreading gradually but surely to more and more states in the United States, more and more studies funded by medical institutions and organizations are reporting on the very real dangers of frequent marijuana use. I am going to highlight only a few of the studies published on the subject in various medical journals in the past few years.

Journal of Neuroscience (April 16, 2014)

This study conducted by researchers from Harvard University and Chicago's Northwestern Medicine group, using a small sample of 40 individuals between the ages of 18-25 has shown that smoking cannabis ( also known as marijuana) once or twice a week can lead to major changes in brain areas associated with emotions and motivation.

In an article on this study, "Smoking cannabis could change the part of the brain dealing with motivation, according to one new study" published in The Independent ( April 16th 2014), health reporter Charlie Cooper writes;

The researchers used neuroimaging techniques to analyze the brains of cannabis users and non-users.

They found that the nucleus accumbens was unusually large in the cannabis users, while the amygdala also had noticeable abnormalities.
Anne Blood, assistant professor of psychiatry at Harvard Medical School said that the areas affected were "core, fundamental structures of the brain".
"They form the basis for how you assess positive and negative features about things in the environment and make decisions," she said.
The severity of abnormalities in these regions of the brain was directly related to the number of joints a person smoked per week, according to the study, published in the Journal of Neuroscience on Wednesday. The more joints a person smoked, the more abnormal the shape, volume and density of the brain regions, but the effect was noticeable even in those who smoked once or twice a week.
However, experts in the UK said that the study group was small and that more research was needed over a longer timescale to establish whether cannabis smoking caused the unusual brain features, or whether people with such brain features were more likely to smoke cannabis in the first place.
Around one million people aged between 16 and 24 use cannabis in the UK per year, according to the charity DrugScope. Its use has been reported to cause anxiety and paranoia in some users and in rarer cases may be a trigger for underlying mental health problems.
Dr Michael Bloomfield, clinical research fellow at the UK's Medical Research Council (MRC), said that the study added to the MRC's own research which found that heavy cannabis use in adolescence is associated with changes in chemical connections in the brain.

Schizophrenia Bulletin ( December 16, 2013)

Yet another study conducted by Northwestern Medicine and mainly funded by The National Institute of Mental Health and National Institute of Drug Abuse, has shown that heavy use of marijuana (daily for 3 years) in teen years can lead to abnormal changes in the brain structure related to memory. The teens in the study performed poorly on memory tasks.
According to lead study author Matthew Smith, an assistant research professor in psychiatry and behavioral sciences at Northwestern University Feinberg School of Medicine, " The study links the chronic use of marijuana to these concerning brain abnormalities that appear to last for at least a few years after people stop using it, with the movement to decriminalize marijuana, we need more research to understand its effect on the brain."
Chronic use of marijuana may contribute to changes in brain structure that are associated with having schizophrenia, the Northwestern research shows. Of the 15 marijuana smokers who had schizophrenia in the study, 90 percent started heavily using the drug before they developed the mental disorder. Marijuana abuse has been linked to developing schizophrenia in prior research.

As reported in 'Heavy marijuana users have abnormal brain structure and poor memory'

by Eureka Alert online science news service;

"The abuse of popular street drugs, such as marijuana, may have dangerous implications for young people who are developing or have developed mental disorders," said co-senior study author John Csernansky, M.D., chair of psychiatry and behavioral sciences at Northwestern University Feinberg School of Medicine and Northwestern Memorial Hospital. "This paper is among the first to reveal that the use of marijuana may contribute to the changes in brain structure that have been associated with having schizophrenia."
Chronic marijuana use could augment the underlying disease process associated with schizophrenia, Smith noted. "If someone has a family history of schizophrenia, they are increasing their risk of developing schizophrenia if they abuse marijuana," he said.
While chronic marijuana smokers and chronic marijuana smokers with schizophrenia both had brain changes related to the drug, subjects with the mental disorder had greater deterioration in the thalamus. That structure is the communication hub of the brain and is critical for learning, memory and communications between brain regions. The brain regions examined in this study also affect motivation, which is already notably impaired in people with schizophrenia.
"A tremendous amount of addiction research has focused on brain regions traditionally connected with reward/aversion function, and thus motivation," noted co-senior study author Hans Breiter, M.D., professor of psychiatry and behavioral sciences and director of the Warren Wright Adolescent Center at Feinberg and Northwestern Memorial. "This study very nicely extends the set of regions of concern to include those involved with working memory and higher level cognitive functions necessary for how well you organize your life and can work in society."


Journal of Chemical Research in Toxicology (May 18, 2009)

The study Dr. Michael Bloomfield mentions was conducted by  Leicester University’s Rajinder Singh, Jatinderpal Sandhu, Balvinder Kaur, Tina Juren, William P. Steward, Dan Segerback and Peter B. Farmer from the Cancer Biomarkers and Prevention Group, Department of Cancer Studies and Molecular Medicine and Karolinska Institute, Sweden. This research was funded by MRC, European Union Network of Excellence (ECNIS) and Cancer Research UK. The findings were published in the Journal of Chemical Research in Toxicology.
In this case researchers found "convincing evidence" that cannabis smoke damages DNA in ways that could potentially increase the risk of cancer development in humans.  

Lead author Dr Singh said:
“There have been many studies on the toxicity of tobacco smoke. It is known that tobacco smoke contains 4000 chemicals of which 60 are classed as carcinogens. Cannabis in contrast has not been so well studied. It is less combustible than tobacco and is often mixed with tobacco in use. Cannabis smoke contains 400 compounds including 60 cannabinoids. However, because of its lower combustibility it contains 50% more carcinogenic polycyclic aromatic hydrocarbons including naphthalene, benzanthracene, and benzopyrene, than tobacco smoke.” 
The authors added: “It is well known that toxic substances in tobacco smoke can damage DNA and increase the risk of lung and other cancers. Scientists were unsure though whether cannabis smoke would have the same effect. Our research has focused on the toxicity of acetaldehyde, which is present in both tobacco and cannabis.”
The researchers add that the ability of cannabis smoke to damage DNA has significant human health implications especially as users tend to inhale more deeply than cigarette smokers, which increases respiratory burden.
"These results provide evidence for the DNA damaging potential of cannabis smoke," the researchers conclude, "implying that the consumption of cannabis cigarettes may be detrimental to human health with the possibility to initiate cancer development."

Although in each case marijuana use supporters will argue the sample sizes are too small or the study was biased, the results of each of these researches were very real. If anything further promotion of the idea that recreational use of marijuana is completely harmless should be discouraged more aggressively.


References:

Cannabis Use is Quantitatively Associated with Nucleus Accumbens and Amygdala Abnormalities in Young Adult

Recreational Users (The Journal of Neuroscience-April 16, 2014)

Smoking cannabis could change the part of the brain dealing with motivation, according to one new study(The Independent April 16, 2014)
Cannabis use increases cancer risk study suggests (MRC News & Publications)
Marijuana May Hurt The Developing Teen Brain(Health News NPR-March 3, 2014)
Heavy Marijuana Use Alters Teenage Brain Structure(Psychology Today-March 30, 2014)

Heavy marijuana users have abnormal brain structure and poor memory (Northwestern University on Eureka Alert-December 16, 2013)

Cannabis-Related Working Memory Deficits and Associated Subcortical Morphological Differences in Healthy Individuals and Schizophrenia Subjects (Schizophrenia Bulletin- Published 12/15/13) 

Evaluation of the DNA Damaging Potential of Cannabis Cigarette Smoke by the Determination of Acetaldehyde Derived N²-Ethyl-2′-deoxyguanosine Adducts(Chemical Research in Toxicology-May 18, 2009)

 

A Survey for all parents of teenagers : Monitoring the Future 2013 Survey Results

I am sharing some informational posters on NIDA ( National Institute on Drug Abuse) to help all parents better understand the degree to which our kids are exposed to drugs and how prevalent the use of illicit drugs in youngsters is. Knowledge and information are power, the more we understand the seriousness of this problem, the less likely we will be to support such crazy legislation as the legalization of Marijuana. Please if you come across this post, do share it with your teenagers and middle schoolers.

Description: Monitoring the Future is an annual survey of 8th, 10th, and 12th-graders conducted by researchers at the University of Michigan, Ann Arbor, under a grant from the National Institute on Drug Abuse, part of the National Institutes of Health. Since 1975, the survey has measured drug, alcohol, and cigarette use and related attitudes in 12th-graders nationwide. Eighth and 10th graders were added to the survey in 1991. Overall, 41,675 students from 389 public and private schools participated in the 2013 survey.

Description: Last Two Decades of Alcohol, Cigarette, and Illicit Drug Use*
*Past 30 day use.
This graphic illustrates past 30 day alcohol, cigarette, and illicit drug use among 8th, 10th, and 12th graders from 1993 through 2013. In general, alcohol and cigarette use has decreased, and illicit drug use, which declined in the late 1990s and early 2000s, has been increasing in recent years.

Description: Marijuana: As Perceived Harm Drops, Use Goes Up
* Past-year use in 12th graders.
Three points in time are shown—1993, 2003, 2013— for marijuana use and the perception of risk (saw great risk in smoking marijuana occasionally) among 12th graders.

 Description: 60% of high school seniors do not view regular marijuana use as harmful, which is nearly double from 20 years ago. The potency of marijuana, as measured by THC content, has steadily increased over the last few years, which means that daily use of today’s marijuana may have greater health consequences than use of marijuana from 10 to 20 years ago.

Description: Prescription/Over-the-Counter vs. Illicit Drugs
After marijuana, prescription and over-the-counter medications account for most of the top drugs abused by 12th graders in the past year.

Description: Abuse of Some Synthetic Drugs is Down.
These are substances that are chemically similar to and/or mimic the effects of illicit drugs. This year, 7.9% of high school seniors reported past-year use of K2/Spice (sometimes called synthetic marijuana), down from last year’s number of 11.3%. Past-year use of the substances called “bath salts” was low for all three grades - at or below 1%.

P.S:Monitoring the Future 2013 Survey Results(NIDA)

The truth about addiction; ruthless, honest, and extremely insightful....

"The mind of a heroin addict: the struggle to get clean and stay sober" on The Guardian is a collection of comments by recovering sober addicts and some using addicts on how they struggle and how Philip Seymour Hoffman's death from heroin overdose after 23 years of sobriety affected them. 

As I read this post, I was not only shocked and troubled by the very truthful and blatantly honest responses but also got a better understanding of how they struggle or relapse and how terribly hard it is to fight the addict inside them. I am not totally unaware of what goes into rehabilitation, I worked with addicts during my one year psychiatry job. Yet I found these comments revealing and poignant. 

One of the comments which stood out to me was by Danny from Ireland, who has been ten years sober; "My father died from addiction, we lost a cousin, I myself had numerous overdoses and helped prevent siblings from OD-ing (all of who are now clean thanks to the process of one addict helping another that Russell Brand spoke of). Hearing about Hoffman affects me the same way as if it were a friend. I didnt know he was an addict untill he died, but when I heard of his story and addiction I immediatly identified with him. We work the same way in our minds. I know what happened to him before he picked up. I know how he felt. I'm pretty sure it started the same way most relapses do. "

Read all the responses...

Some drug facts in the US:

According to NIDA ( National Institute on Drug Abuse) "Illicit drug use in America has been increasing. In 2012, an estimated 23.9 million Americans aged 12 or older—or 9.2 percent of the population—had used an illicit drug or abused a psychotherapeutic medication (such as a pain reliever, stimulant, or tranquilizer) in the past month. This is up from 8.3 percent in 2002. The increase mostly reflects a recent rise in the use of marijuana, the most commonly used illicit drug."

 Most people use drugs for the first time when they are teenagers. There were just over 2.8 million new users (initiates) of illicit drugs in 2012, or about 7,898 new users per day. Half (52 per-cent) were under 18.

More than half of new illicit drug users begin with marijuana. Next most common are prescription pain relievers, followed by inhalants (which is most common among younger teens).

In 2009, there were nearly 4.6 million drug-related Hospital Emergency Department (ED) visits nationwide. These visits included reports of drug abuse, adverse reactions to drugs, or other drug-related consequences. Almost 50 percent were attributed to adverse reactions to pharmaceuticals taken as prescribed, and 45 percent involved drug abuse.

The majority of drug-related ED visits were made by patients 21 or older (80.9 percent, or 3,717,030 visits). Of these, slightly less than half involved drug abuse. Patients aged 20 or younger accounted for 19.1 percent (877,802 visits) of all drug-related visits in 2009; about half of these visits involved drug abuse.

In 2009, almost one million visits involved an illicit drug, either alone or in combination with other types of drugs. The rates of ED visits involving cocaine, marijuana, and heroin were higher for males than for females. Rates for cocaine were highest among individuals aged 35–44, rates for heroin were highest among individuals aged 21–24, stimulant use was highest among those 25–29, and marijuana use was highest for those aged 18–20.

 Illicit drug use among teenagers remains high, largely due to increasing popularity of marijuana. Marijuana use by adolescents declined from the late 1990s until the mid-to-late 2000s, but has been on the increase since then. In 2013, 7.0 percent of 8th graders, 18.0 percent of 10th graders, and 22.7 percent of 12th graders used marijuana in the past month, up from 5.8 percent, 13.8 percent, and 19.4 percent in 2008. Daily use has also increased; 6.5 percent of 12th graders now use marijuana every day, compared to 5 percent in the mid-2000s.

P.S:

The mind of a heroin addict: the struggle to get clean and stay sober

Trends and Statistics on Addiction (NIDA)

Millions living with leprosy in spite of being curable

On January 26th The World Day of Leprosy, I saw a video on The Guardian global development news page by Maria Zupello  titled Leprosy in Brazil: Uncovering a hidden disease. Realizing that leprosy is still around was rather disturbing, especially because this is a curable disease and therefore there should be no such thing as living with leprosy in these times, but after doing some research it became apparent that is not the case.

WHO: Leprosy Statistics:

According to the World Health Organization's latest stats on leprosy in the world, there are still around 200,000 reported new cases of leprosy every year in the world. Also known as Hansen's Disease, leprosy is endemic in 91 countries around the world. The highest concentration of reported new cases (at the start of 2012) being in South East Asia (117,147). The majority of which are in India. The second highest incidence is in the Americas (34,801),  of these reported new cases the majority are from Brazil. But because of its long incubation period and the lack of tools to allow early detection leading to late diagnosis, the exact prevalence of Hansen's disease is not clear.

India:
Although the Indian Government declared it has eliminated leprosy in 2005. It has since then become clear that the claim was premature. Of the total leprosy cases in the world 55% are in India, and about 127,000 new cases were reported between 2010-2011. Besides lack of access to basic healthcare services, leprosy patients also suffer socioeconomic isolation as a result of the stigma and discrimination that still exists in India.

Brazil: 
Leprosy is more prevalent in Brazil than in any other country except India. More than 30,000 new cases are diagnosed each year. Despite economic development, expansion of public healthcare, and efforts of the leprosy control program in the past 30 years, this disease has not been eliminated, and new cases are still being detected. The leprosy control program in Brazil distributes free drugs as part of the World Health Organization multidrug regimen for treatment of leprosy. Unfortunately health care services are not available in rural parts of the country. The amazon region of Brazil where leprosy has been endemic for more than a century is almost deprived of such health services.

Leprosy is particularly prevalent among the poorest and most marginalised communities due to their lack of access to healthcare, poor sanitation and congested living spaces. - See more at: http://www.tlmindia.org/index.php/about-leprosy/facts#sthash.zlOMnaBW.dpuf

Government statistics under estimate the extent of leprosy according to research organisations, NGOs and some medical personnel who argue that leprosy cases are on the rise - See more at: http://www.tlmindia.org/index.php/about-leprosy/facts#sthash.zlOMnaBW.dpuf

Government statistics under estimate the extent of leprosy according to research organisations, NGOs and some medical personnel who argue that leprosy cases are on the rise - See more at: http://www.tlmindia.org/index.php/about-leprosy/facts#sthash.zlOMnaBW.dpuf

Government statistics under estimate the extent of leprosy according to research organisations, NGOs and some medical personnel who argue that leprosy cases are on the rise - See more at: http://www.tlmindia.org/index.php/about-leprosy/facts#sthash.zlOMnaBW.dpuf

To understand why the stigmatization, socioeconomic isolation, discrimination leading to leprosy communities in countries like India and Brazil is so wrong, here are some basic facts about Leprosy( Hansen's Disease);

What is Leprosy?

Leprosy is a chronic bacterial disease caused by Mycobacterium leprae and Mycobacterium lepromatosis. This infection primarily affects the skin, peripheral nerves and upper airway. It is well known that leprosy is not spread through casual contact. 

About 95% of human beings are naturally immune making leprosy the 'least contagious communicable disease'. The World Health Organization suggests that it is transmitted through moisture from the nose and mouth during frequent and close contact with an untreated leprosy-affected person. It might also happen if you are exposed to other nasal fluids (also known as secretions). Droplets and other secretions can contain the bacteria that cause Hansen’s disease. If you breathe these in, you can become sick with the disease.

According to the CDC,  as incubation period of the bacteria is long , it may take up to 2-10 years for signs and symptoms to appear. The disease mainly affects the skin, nerves and the mucous membranes. Common signs and symptoms include; disfiguring skin sores, lumps, or bumps that do not go away after several weeks or months. The skin sores are pale-colored. Nerve damage can lead to loss of feeling in arms and legs and muscle weakness. Without treatment, leprosy can permanently damage your skin, nerves, arms, legs, feet, and eyes.

Treatment of Leprosy

Leprosy can be cured. In the last two decades, more than 14 million people with leprosy have been cured. The World Health Organization provides free treatment for all people with leprosy.

Treatment depends on the type of leprosy that you have. It is treated with a combination of antibiotics. The treatment may last anywhere from 6 months to 2 years. People with severe leprosy may need to take antibiotics longer. Antibiotics cannot treat the nerve damage.

Anti-inflammatory drugs are used to control swelling related to leprosy. This may include steroids, such as prednisone.

Patients with leprosy may also be given thalidomide, a potent medication that suppresses the body's immune system. It helps treat leprosy skin nodules. Thalidomide is known to cause severe, life-threatening birth defects and should never be taken by pregnant women.

According to the WHO 'Access to information, diagnosis and treatment with multidrug therapy (MDT) remain key elements in the strategy to eliminate the disease as a public health problem, defined as reaching a prevalence of less than 1 leprosy case per 10,000 population. Only a couple of endemic countries have still to achieve this goal at the national level; most are now applying the same elimination strategy at regional, district and sub-district levels. MDT treatment has been made available by WHO free of charge to all patients worldwide since 1995, and provides a simple yet highly effective cure for all types of leprosy.

Most countries that were previously highly endemic for leprosy have achieved elimination at the national level and are intensifying their efforts at regional and district levels.'

Information campaigns about leprosy in high risk areas are crucial so that patients and their families, who were historically ostracized from their communities, are encouraged to come forward and receive treatment. The most effective way of preventing disabilities in leprosy, as well as preventing further transmission of the disease, lies in early diagnosis and treatment with MDT. (WHO)

P.S: 
The Leprosy Mission India 
The Leprosy Mission Canada  
Hansen's Disease (CDC) 
Leprosy (WebMD)
Leprosy Today (WHO) 
National Hansen's Disease Program (HRSA) 
Watch Video: Leprosy in Brazil: Uncovering a hidden disease (The Guardian)

Watch Video: Battling leprosy in Brazil(BBC World)

Watch Video: Leprosy: India's Hidden Disease (The Guardian)

Photo Gallery: Colonia Antonio Alexio - Leprosy community in Manaus, Brazil (Photojournalist: Sharon Steinmann)

High Incidence of Diseases Endemic to the Amazon Region of Brazil, 2001–2006 (CDC)

 

We must bring back family mealtime chatting!

I grew up in a family where almost every meal was a sit down with the family and chat time. Although as we grew up it became less and less possible at breakfast and lunch, everyone had different schedules but dinner time stayed the same. Everyone had to show up at the dinner table at the same time, any late arrivals were expected to provide good reason.

But it wasn't just eating together, it was more talking to each other that was special. We talked about school, about issues with friends, family plans for the coming weekend or holidays, extended family updates, dad's job news, mom's social news, current affairs, and just anything and everything. We knew all the names of my mom's friends, dad's colleagues, and each others friends, enemies and frenemies too! And our parents were aware of what was happening in each of our lives. We shared, supported, discussed, advised, joked and teased throughout dinner. Basically we bonded and were constantly reminded that we were together and never alone.
Interestingly when I used to mention chatter at my house to friends, it became quite clear that this wasn't prevalent in every household. The friends who didn't get to sit down to eat and talk with family everyday expressed envy and unhappiness. That made me appreciate those family mealtimes at home even more!
That is also why it was no surprise, when today I read this piece of news 'Talking at mealtimes boosts children's confidence' on BBC World News, announcing that after studying about 35,000 UK children, they had come to the conclusion that eating meals together with family while chatting with each other was a confidence booster. I can only hope that when they do sit down to eat and talk to each other, the kids and parents leave their electronic devices in some other room! :)

P.S:
Talking at mealtimes boosts children's confidence

Obesity spreads to developing countries

A UK think tank The Overseas Development Institute  report concludes that number of obese and overweight adults in the developing world has  almost quadrupled to about one billion since 1980.
According to the report, there are almost as many overweight or obese adults in North Africa, Middle East and Latin America as there are in Europe. It also highlights the fact that one in three adults in the world (1.46 billion) were overweight or obese in 2008, up by 23% since 1980.
 If these figure are not enough to make us realize that obesity is no longer a rich countries' problem instead is more of a worldwide health issue, then I do not know what is going to!
A major change seen in worldwide diets is the increasing consumption of sugar and sweeteners, which has risen by over 20% per person between 1961 and 2009. One big culprit for that is the increased consumption and marketing of processed foods everywhere.
In countries with emerging economies, people are making bigger incomes and hence now can chose more varied foods and change diets. A huge majority of these individuals in developing countries live in highly congested urban settings and get very little exercise.

South Korea's Health Wellness efforts at a national level have resulted in a 300% increase in fruit and 10% increase in vegetable consumption.  Major campaigns by the government and nutrition specialists to advertise and teach the public that the traditional diet which is low fat is a healthy diet. The most common ingredients in Korean traditional cuisine are vegetables along with use of ginger, garlic, herbs, and various condiments, the health benefits of which are well-known.  The educational and campaigning efforts also focused on providing new approaches to maintaining a traditional yet contemporary Korean diet. These efforts to improve the national diet has helped South Korea keep its obesity rate at 4%. This is the lowest in the OECD (The Organisation for Economic Co-operation and Developmen) but unfortunately it too is rising gradually and is expected to increase by about 5% in ten years.

I am sure that reasons and solutions as well, are far more complex and numerous then the ones I list, but it is clear that if we do not take major steps to change these dangerous dietary and lifestyle trends for the better, we are heading for a disastrous worldwide health catastrophe.


P.S:

• Obesity quadruples to nearly one billion in the developing world(BBC World)
• Overseas Development Institute(Website)
•  The unique aspects of the nutrition transition in South Korea: the retention of healthful elements in their traditional diet (Public Health Nutrition Publication)

What are the real benefits of antibacterial soaps, if any?

Probably because of my medical background I have always worried about the indiscriminate use of antibiotics, which can consequently create antibiotic-resistant bacteria called 'Super Bacteria'. Treating the infections caused by these super bacteria can be a nightmare, often leading to disastrous outcomes, even death.

It is in the same vein, I have always been a bit skeptical of the antibacterial soaps sold to consumers. Since antibacterial soaps are supposed to be killing everyday bacteria we end up collecting on our hands, they are also indirectly creating super bacteria. And besides that these antibacterial soaps are also killing off the normal bacterial flora on our hands. 

What is normal bacterial flora on our hands?

According to the 'WHO Guidelines on Hand Hygiene in Health Care: First Global Patient Safety Challenge Clean Care Is Safer Care.' and Medical Microbiology. 4th edition :
The bacteria found on our hands can be divided into two types; namely resident and transient. The resident bacteria being the ones normally residing on our hands, these predominantly include Gram-positive organisms (e.g., staphylococci, micrococci, diphtheroids). The resident flora primarily plays a protective role by providing microbial antagonism and the competition for nutrients in the ecosystem. Hence the resident flora rarely causes infections.
The transient bacteria are the one we acquire through contact with infected individuals or surfaces. These can lead to infections and spread from person to person. This transfer of bacteria through direct contact is highest in health care workers. In fact their hands may constantly become colonized by some pathogenic flora such as Staphylococcus Aureus and Gram-negative bacilli.

The main bacteria killing ingredient in majority antibacterial soaps is Triclosan. Although Triclosan is meant to rid our hands of the transient kind of bacteria, over time it indiscriminately also kills the resident kind. 

What is Triclosan?

According to the FDA Consumer Update on Triclosan:

'Triclosan is an ingredient added to many consumer products to reduce or prevent bacterial contamination. It may be found in products such as clothing, kitchenware, furniture, and toys. It also may be added to antibacterial soaps and body washes, toothpastes, and some cosmetics—products regulated by the U.S. Food and Drug Administration (FDA).'

'Triclosan is not currently known to be hazardous to humans. But several scientific studies have come out since the last time FDA reviewed this ingredient that merit further review.

Concerns about Triclosan:

According to the FDA Consumer Update on Triclosan:

'Animal studies have shown that triclosan alters hormone regulation. However, data showing effects in animals don’t always predict effects in humans. Other studies in bacteria have raised the possibility that triclosan contributes to making bacteria resistant to antibiotics.

In light of these studies, FDA is engaged in an ongoing scientific and regulatory review of this ingredient. FDA does not have sufficient safety evidence to recommend changing consumer use of products that contain triclosan at this time.

For some consumer products, there is clear evidence that triclosan provides a benefit. In 1997, FDA reviewed extensive effectiveness data on triclosan in Colgate Total toothpaste. The evidence showed that triclosan in this product was effective in preventing gingivitis. 

For other consumer products, FDA has not received evidence that the triclosan provides an extra benefit to health. At this time, the agency does not have evidence that triclosan in antibacterial soaps and body washes provides any benefit over washing with regular soap and water.

We are engaged in a comprehensive scientific and regulatory review of all the available safety and effectiveness data. This includes data relevant to the emerging safety issues of bacterial resistance and endocrine disruption due to triclosan in FDA-regulated products.'

On December 16  2013, FDA finally came out with the verdict FDA Taking Closer Look at 'Antibacterial' Soap.  Colleen Rogers, Ph.D., a lead microbiologist at FDA stated that "there currently is no evidence that over-the-counter (OTC) antibacterial soap products are any more effective at preventing illness than washing with plain soap and water." She goes on to say "New data suggest that the risks associated with long-term, daily use of antibacterial soaps may outweigh the benefits."

The update states "In light of these data, the agency issued a proposed rule on Dec. 16, 2013 that would require manufacturers to provide more substantial data to demonstrate the safety and effectiveness of antibacterial soaps. The proposed rule covers only those consumer antibacterial soaps and body washes that are used with water. It does not apply to hand sanitizers, hand wipes or antibacterial soaps that are used in health care settings such as hospitals.

According to Rogers, the laboratory tests that have historically been used to evaluate the effectiveness of antibacterial soaps do not directly test the effect of a product on infection rates. That would change with FDA's current proposal, which would require studies that directly test the ability of an antibacterial soap to provide a clinical benefit over washing with non-antibacterial soap, Rogers says."

In the end, it seems to be wise to continue washing our hands with just plain ol' soap and water, and postpone the use of these fancy antibacterial soaps till further notice. 



References:
Dangers of Antibiotic Resistance
WHO Guidelines on Hand Hygiene in Health Care: First Global Patient Safety Challenge Clean Care Is Safer Care.
Medical Microbiology. 4th edition 
FDA Consumer Update on Triclosan
FDA Taking Closer Look at 'Antibacterial' Soap.