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NFIA’s next podcast: Wilson Compton, MD, on predicting future marijuana problems
Wilson Compton, MD, is deputy director of the National Institute on Drug Abuse, an agency of the National Institutes of Health. NIDA supports most of the world’s research on the health aspects of drug abuse and addiction. Dr. Compton works with the director to provide scientific leadership of NIDA’s research portfolio.
Key Points 
  • What we don’t know
  • Our two legal drugs, nicotine and alcohol, are responsible for devastating morbidity and mortality.
  • What might the unintended consequences be of legalizing a third addictive drug?
  • Exposure to adolescents and prenatally
  • Teen vaping 
Listen here.
Up Next Week? Dr. Huestis on Marijuana Tolerance

Using weed regularly raises risk for heart problems in young people, studies find
Two studies presented at the American Heart Association Scientific Sessions this week show young people with cannabis use disorder are at increased risk of heart rhythm problems and those who are frequent marijuana users are at higher risk for a stroke.
Using data from the Nationwide Inpatient Sample, researchers found that 2.6 percent of patients hospitalized for a heart arrhythmia were regular marijuana users, tended to be younger (ages 15–24), male, and African American. They had 1.28 times higher odds of being hospitalized for this problem. Those ages 25 to 34 faced 1.52 times higher odds.
The other study looked at 43,000 adults who were part of the behavioral risk factor surveillance system between 2016 and 2017. Participants were ages 18 to 44 and had used marijuana in the past 30 days. They were typically younger, Hispanic, or African American. Those who used marijuana more than 10 days a month were nearly 2.5 times more likely to have a stroke compared to nonusers. Those who used marijuana and also smoked cigarettes or e-cigarettes were three times more likely.
This is an observational study, the researchers note, and cannot show causality, but they hope doctors will take this information into account when they talk to their patients.
Read CNN story here.
Pot-crashes in pot-legal states have soared
Colorado, Oregon, and Washington state have seen a combined 5.2% increase in the rate of police-reported crashes after these states legalized the recreational use of marijuana compared to neighboring states that have not legalized the drug. These findings are the result of an analysis done by the Insurance Institute for Highway Safety.
Auto-insurance collision claims increased by 6 percent in the three states, again compared to their nonlegal neighbors.
Complicating the dilemma is that no roadside test exists to denote marijuana impairment, like the alcohol breathalyzer device, which can measure impairment. Also, no uniform level of THC in the blood has been agreed upon as signaling impairment.
Read Bloomberg News story here.

Adult use, cannabis use disorder in adolescents and adults increases in pot-legal states
The proportion of 12- to 17-year-olds reporting past-year cannabis use disorder in the National Survey on Drug Use and Health increased from 2.18 percent to 2.72 percent after the enactment of recreational marijuana use. That increase was 25 percent higher than that for the same age group that lives in nonlegal states.
No such changes occurred among 18- to 25-year-olds, but those age 26 and older experienced increases in both past-month use (5.65 percent to 7.10 percent), past-month frequent use (2.13 percent to 2.62 percent), and past-year cannabis use disorder (0.90 percent to 1.23 percent).
The researchers say these data suggest a potential public-health concern.
Read JAMA Network abstract here.

SAFE banking act shouldn’t harm children
Writing in the Washington Times, Diane Carlson, co-founder of Smart Colorado, points out that children’s health has been omitted from the Secure and Fair Enforcement Banking Act (SAFE) of 2019.
She points to what’s happening in Colorado that is affecting kids as a result of legalization:
  • a huge escalation in THC potency
  • the lung injury vaping crisis among high-school and college-age children
  • increase use of marijuana edibles, vaping, and dabbing among youth, and
  • youth suicides, which are nearly double the national average, with THC being the number-one substance found in their toxicology reports. 
She asks Congress to demand key safeguards for children that the marijuana industry has so far resisted.
“As Congress considers the SAFE Banking Act, let’s make sure children have a voice, too. After all,” she concludes, “they only have one chance to grow up.”
Read Washington Times op-ed here.
CDC: 2,172 lung injury cases,
42 deaths as of November 13, 2019
Laboratory testing of fluid samples from the vaping-injured lungs of 29 patients in 10 states found Vitamin E acetate in all of the samples. CDC therefore has identified Vitamin E acetate as a chemical of concern. The agency recommends:
  • No use of vaping products that contain THC, particularly any obtained from friends, family, or in-person or online dealers
  • Vitamin E acetate should not be added to any e-cigarette or vaping products
  • People should not add any substance to e-cigarette or vaping products that are not intended by the manufacturer, including products purchased through retail establishments
FDA: No single product has been found
in all lung injury cases
As of Nov. 13, 2019, 685 of the samples connected to patients have undergone some level of FDA testing; 443 samples have been found to contain THC
  • 48% of these THC products have been found to contain vitamin E acetate as a diluent. The concentration of vitamin E acetate determined in a smaller number of these samples has ranged from 23% to 88%
  • 24% of these THC products have been found to contain another diluent such as medium chain triglycerides 
As of Nov. 13, 2019, approximately 515 samples are directly linked to 63 patients with CDC case numbers and have been analyzed. Some 79% of these 63 patients include links to THC products
Of these:
  • 76% of cases included products with vitamin E acetate as a diluent
  • 32% included products with aliphatic esters as diluent (e.g., triglycerides)
  • 6% included products with polyethylene glycol as diluent 
It is important to stress that identifying any compounds present in the samples linked to patient cases is but one piece of the puzzle and will not necessarily answer questions about causality, which makes ongoing work critical at both the state and federal levels. Importantly, the variations of use patterns, products, or substances reportedly used and the samples being tested may mean there are multiple causes of these injuries.
Read CDC’s latest report here. Read FDA’s latest report here.

Trump retreats from flavor ban for e-cigarettes
During a September meeting with HHS Secretary Alex M. Azar II and others, including First Lady Melania Trump, President Trump told the nation that he was moving to ban the sale of most flavored e-cigarettes as teen vaping continued to rise.
But then, his advisers and lobbyists warned him there would be political repercussions among his base. Two months later, he has resisted moving ahead on any vaping action and the effort appears to be stalled.
This week, he tweeted that he would be meeting with representatives of the vaping industry, state representatives, and medical professionals to come up with an acceptable solution to the vaping crisis. The industry showed him battleground state polling results that show the issue is costing him political support.
Read New York Times article here.

About half of Illinois towns and cities have
banned marijuana sales thus far
Illinois recently legalized marijuana for recreational use, and the new law will become effective January 1, 2020. Nonetheless, 27 municipalities have voted to restrict or ban the sale of marijuana within their borders, while 30 are welcoming legal pot sales.
See a list of communities that have banned or approved marijuana sales in Illinois here.
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The Marijuana Report is a weekly e-newsletter published by National Families in Action in partnership with SAM (Smart Approaches to Marijuana).

Visit National Families in Action's website, The Marijuana Report.Org, to learn more about the marijuana story unfolding across the nation.

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The Marijuana Report Staff
Executive Editor
Sue Rusche
Nicole Carter
Harry Rusche, Professor Emeritus
IT Consultant
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Social Media Coordinator
Margarita Eberline
We are grateful to our Board of Directors and Senior Adviser for their support of National Families in Action, which produces The Marijuana Report website and e-newsletter.
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Board of Directors

William F. Carter, Chairman of the Board
Realtor Berkshire Hathaway HomeServices – Georgia Properties, Atlanta.
Sue Rusche, President and CEO, Atlanta.
Richard L. Brown, Secretary
Attorney (Ret.), Lakewood Ranch, Florida
Founder & Chairman, Sudden Cardiac Arrest Association 
Jeannine F. Adams, Director
President and CEO, J. Addams & Partners, Atlanta.
Jack L. Arbiser, MD, PhD, Director
Thomas J. Lawley Professor of Dermatology
Winship Cancer Institute, Emory University, Atlanta
William H. Avery, Director
Partner (Ret.), Alston & Bird, LLP, Atlanta.
Margarita Eberline, Director
Strategy Director, 360 Marketing Plus, Atlanta.
Robert Margolis, PhD, Director
Founder, Caron Solutions Intensive Outpatient Program, Roswell, Georgia.
Shannon Murphy, MD FAAP, Director
Birmingham, Alabama 
Senior Adviser
Kent “Oz” Nelson, Chairman and CEO (Ret.)
United Parcel Service, Atlanta.
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