The Study of the Week analyzes a study on cannabis use disorder.i The sample size is in the millions. But there are lots of limitations. Causality is a high bar.
One of the downsides to the war on drugs and allowing it to be managed by the black market is a lack of good study and a product that has only gotten stronger and (I believe) more dangerouse over the ensuing decades.
I didn't want to waste my time by reading the article in order to find out what a "cannabis use disorder" might be. I guess we could just assume that anyone dumb enough to do something with cannabis that necessitates hospitalization will engage in other activities that may lead to premature death. Seems kind of obvious. Have to wonder how much time, money, and other resources were wasted on this nonsense.
As a side note and purely anecdotal, people who use cannabis regularly have lower heart rates than the general population. I have long observed this of sedated people, specifically young, healthy males. I have discussed it with many of my oral surgery colleagues and they report similar things. As we are all well aware, anecdotal evidence is rather weak. But I am waiting for someone to research this to see if it is a real effect of cannabis.
My read is that if you are going to be addicted to a substance, then you are better off choosing cannabis over the other drugs. Clearly it would be better to be addicted (or a heavy user) of nothing. But try telling that to people addicted to substances.
Canadians did this ‘study’? 😂😆 How about they try to research (correlation and a causation study) how their ‘treatment’ for anxiety, depression, insomnia (and a lot more serious conditions) etc etc - euthanasia relates to death outcome - and than publish it in MSM? And IF cannabis leads to stuff that will later be a qualification for euthanasia treatment (very good for cutting insurance expense) - that is a good trick to get all these people sick so they can than finally qualify for euthanasia.. no? No, because unlike vaccines (that would also lead to death or condition that qualifies for ‘cool’ euthanasia treatment) - pharmaceutic industry is not earning enough during this 5 years period on cannabis use .. pfff…
It is disappointing that studies like this make it into journals with decent banners.
The extent to which conclusions could have been drawn from such a study SHOULD have been clear to a medical student.
That the authors used the causal language they did, is appalling. That the editorialists left it unchallenged and in fact seconded it, is embarrassing. That the journal editor allowed all of this to stand, is egregious.
I’ve got a lot of work on cannabis. I see that cannabis can stop cancer and roll it back. I see how cannabis can help people sleep better than benzodiazepines can.
I see how cannabis can assist people in recovering from the symptoms of autism and Parkinson’s and many other neurological issues.
It’s an amazing miracle.
Of course people can overuse it and they can run it into trouble, but it’s remarkable how safe it really is.
It is so remarkably safe.
And you’re right this is a really stupid study.
One thing I was looking for was a study showing how people who take a lot of cannabis could have more strokes, but I didn’t find that evidence at all.
The study's lead author practice appears to treat people who have addictions. So, it is reasonable to believe he has a natural "bias" against any form of such drugs. So, seeing the world through that lens, it is not surprising that his study concludes that cannabis is dangerous. I think your analysis is helpful, but unless it gets read by the same people who will see the original research analysis and rely upon it to make societal rules to continue to justify criminalizing cannabis while letting alcohol use continue without change. That is so because the alcohol industry has a vast and powerful lobby.
These are all great points. I also do think that the data show that cannabis is not good for people long-term. This should be the take away of the study, and perhaps you are right we should do away with the sensationalist headlines.
Excellent. I would have otherwise used this study unwisely. However, what does common sense tell us when it comes to chronic use of any psychoactive drug in progressively higher doses? I’ll never believe it’s healthy and that it won’t make a difference.
Is the author’s point here even that important? Does whether cannabis is completely non-toxic and not chemically responsible for increased mortality even matter that much if being admitted to the hospital with cannabis use disorder is associated with increasing mortality. If cannabis use disorder is merely a marker for personality or psychiatric disregulation that puts someone at risk of heightened mortality, that would be important. Note this might mean that trying to “cure” them of their cannabis use might not even lower the risk.
TLDR: Whether it’s correlative or causative, it’s still almost certainly a marker for badness.
Thanks for another example of the hazards of suggesting causality in observational research. A pretty well described Cannabis Hyperemesis Syndrome exists in which usually heavy users present with intractable nausea and vomiting. I care for these patients not infrequently and the clear recommendation is to cut back or abstain from heavy intake. Much remains unknown about the health consequences of high volume users but hopefully we can get some RCT’s done and get some better understanding.
Thank you for mentioning Cannabis Hyperemesis Syndrome. It is a little known - and possibly deadly - syndrome that doctors, and even ER, are not aware of. It is a shame that cannabis use has not been trialed and studied, considering the extensive legalization that has occurred.
One of the downsides to the war on drugs and allowing it to be managed by the black market is a lack of good study and a product that has only gotten stronger and (I believe) more dangerouse over the ensuing decades.
I didn't want to waste my time by reading the article in order to find out what a "cannabis use disorder" might be. I guess we could just assume that anyone dumb enough to do something with cannabis that necessitates hospitalization will engage in other activities that may lead to premature death. Seems kind of obvious. Have to wonder how much time, money, and other resources were wasted on this nonsense.
As a side note and purely anecdotal, people who use cannabis regularly have lower heart rates than the general population. I have long observed this of sedated people, specifically young, healthy males. I have discussed it with many of my oral surgery colleagues and they report similar things. As we are all well aware, anecdotal evidence is rather weak. But I am waiting for someone to research this to see if it is a real effect of cannabis.
My read is that if you are going to be addicted to a substance, then you are better off choosing cannabis over the other drugs. Clearly it would be better to be addicted (or a heavy user) of nothing. But try telling that to people addicted to substances.
Canadians did this ‘study’? 😂😆 How about they try to research (correlation and a causation study) how their ‘treatment’ for anxiety, depression, insomnia (and a lot more serious conditions) etc etc - euthanasia relates to death outcome - and than publish it in MSM? And IF cannabis leads to stuff that will later be a qualification for euthanasia treatment (very good for cutting insurance expense) - that is a good trick to get all these people sick so they can than finally qualify for euthanasia.. no? No, because unlike vaccines (that would also lead to death or condition that qualifies for ‘cool’ euthanasia treatment) - pharmaceutic industry is not earning enough during this 5 years period on cannabis use .. pfff…
It is disappointing that studies like this make it into journals with decent banners.
The extent to which conclusions could have been drawn from such a study SHOULD have been clear to a medical student.
That the authors used the causal language they did, is appalling. That the editorialists left it unchallenged and in fact seconded it, is embarrassing. That the journal editor allowed all of this to stand, is egregious.
It’s as if FEAR is the driving force of everything these days. Even in undergrad we were DRILLED never to imply causality.
The following also appeared in my inbox today:
https://anandamide.substack.com/p/the-next-horse-paste-is-galloping
Any counterarguments?
I’ve got a lot of work on cannabis. I see that cannabis can stop cancer and roll it back. I see how cannabis can help people sleep better than benzodiazepines can.
I see how cannabis can assist people in recovering from the symptoms of autism and Parkinson’s and many other neurological issues.
It’s an amazing miracle.
Of course people can overuse it and they can run it into trouble, but it’s remarkable how safe it really is.
It is so remarkably safe.
And you’re right this is a really stupid study.
One thing I was looking for was a study showing how people who take a lot of cannabis could have more strokes, but I didn’t find that evidence at all.
The study's lead author practice appears to treat people who have addictions. So, it is reasonable to believe he has a natural "bias" against any form of such drugs. So, seeing the world through that lens, it is not surprising that his study concludes that cannabis is dangerous. I think your analysis is helpful, but unless it gets read by the same people who will see the original research analysis and rely upon it to make societal rules to continue to justify criminalizing cannabis while letting alcohol use continue without change. That is so because the alcohol industry has a vast and powerful lobby.
I understand that Israel has a robust cannabis research program.
These are all great points. I also do think that the data show that cannabis is not good for people long-term. This should be the take away of the study, and perhaps you are right we should do away with the sensationalist headlines.
Excellent. I would have otherwise used this study unwisely. However, what does common sense tell us when it comes to chronic use of any psychoactive drug in progressively higher doses? I’ll never believe it’s healthy and that it won’t make a difference.
Imply, not infer, please.
Is the author’s point here even that important? Does whether cannabis is completely non-toxic and not chemically responsible for increased mortality even matter that much if being admitted to the hospital with cannabis use disorder is associated with increasing mortality. If cannabis use disorder is merely a marker for personality or psychiatric disregulation that puts someone at risk of heightened mortality, that would be important. Note this might mean that trying to “cure” them of their cannabis use might not even lower the risk.
TLDR: Whether it’s correlative or causative, it’s still almost certainly a marker for badness.
Thanks for another example of the hazards of suggesting causality in observational research. A pretty well described Cannabis Hyperemesis Syndrome exists in which usually heavy users present with intractable nausea and vomiting. I care for these patients not infrequently and the clear recommendation is to cut back or abstain from heavy intake. Much remains unknown about the health consequences of high volume users but hopefully we can get some RCT’s done and get some better understanding.
Thank you for mentioning Cannabis Hyperemesis Syndrome. It is a little known - and possibly deadly - syndrome that doctors, and even ER, are not aware of. It is a shame that cannabis use has not been trialed and studied, considering the extensive legalization that has occurred.