An Underrated Tool Against Alzheimer’s

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Dementia in general, and Alzheimer’s in particular, affects a lot of people, and probably even more than the stats show, because some (estimated to be: about half) will go undiagnosed and thus unreported:

Alzheimer’s: The Bad News And The Good

At 10almonds, we often talk about brain health, whether from a nutrition standpoint or other lifestyle factors. For nutrition, by the way, check out:

Brain Food? The Eyes Have It!

Today we’ll be looking at some new science for an underrated tool:

Bilingualism as protective factor

It’s well-known that bilingualism offers brain benefits, but most people would be hard-pressed to name what, specifically, those brain benefits are.

As doctors Kristina Coulter and Natalie Phillips found in a recent study, one of the measurable benefits may be a defense against generalized (i.e. not necessarily language-related) memory loss Alzheimer’s disease.

Specifically,

❝We used surface-based morphometry methods to measure cortical thickness and volume of language-related and AD-related brain regions. We did not observe evidence of brain reserve in language-related regions.

However, reduced hippocampal volume was observed for monolingual, but not bilingual, older adults with AD. Thus, bilingualism is hypothesized to contribute to reserve in the form of brain maintenance in the context of AD.❞

Read in full: Bilinguals show evidence of brain maintenance in Alzheimer’s disease

This is important, because while language is processed in various parts of the brain beyond the scope of this article, the hippocampi* are where memory is stored.

*usually mentioned in the singular as “hippocampus”, but you have one on each side, unless some terrible accident or incident befell you.

What this means in practical terms: these results suggest that being bilingual means we will retain more of our capacity for memory, even if we get Alzheimer’s disease, than people who are monolingual.

Furthermore, while we’re talking practicality:

❝…our subsample may be characterized as mostly late bilinguals (i.e., learning an L2 after age 5), having moderate self-reported L2 ability, and relatively few participants reporting daily L2 use (33 out of 119)❞

(L2 = second language)

This is important, because it means you don’t have to have grown up speaking multiple languages, you don’t even have to speak it well, and you don’t have to be using your second language(s) on a daily basis, to enjoy benefits. Merely having them in your head appears to be sufficient to trigger the brain to go “oh, we need to boost and maintain the hippocampal volume”.

We would hypothesize that using second language(s) regularly and/or speaking second language(s) well offers additional protection, and the data would support this if it weren’t for the fact that the sample sizes for daily and high-level speakers are a bit small to draw conclusions.

But the important part is: simply knowing another language, including if you literally just learned it later in life, is already protective of hippocampal volume in the context of Alzheimer’s disease.

Here’s a pop-science article about the study, that goes into it in more detail than we have room to here:

Bilingualism linked to greater brain resilience in older adults

Want to learn a new language?

Here are some options where you can get going right away:

Duolingo | Babbel | Lernu

If you are thinking “sounds good, but learning a language is too much work”, then that is why we included that third option there. It’s specifically for one language, and that language is Esperanto, arguably the world’s easiest language and specifically designed to be super quick and easy to get good at. Also, it’s free!

Do, kial ne lerni novan lingvon rapide kaj facile? 😉

Want to know more?

For ways to reduce your overall Alzheimer’s risk according to science, check out:

Reduce Your Alzheimer’s Risk

Take care!

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  • What’s the difference between heat exhaustion and heat stroke? One’s a medical emergency

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    When British TV doctor Michael Mosley died last year in Greece after walking in extreme heat, local police said “heat exhaustion” was a contributing factor.

    Since than a coroner could not find a definitive cause of death but said this was most likely due to an un-identified medical reason or heat stroke.

    Heat exhaustion and heat stroke are two illnesses that relate to heat.

    So what’s the difference?

    Studio Nut/Shutterstock

    A spectrum of conditions

    Heat-related illnesses range from mild to severe. They’re caused by exposure to excessive heat, whether from hot conditions, physical exertion, or both. The most common ones include:

    • heat oedema: swelling of the hands, feet and ankles
    • heat cramps: painful, involuntary muscle spasms usually after exercise
    • heat syncope: fainting due to overheating
    • heat exhaustion: when the body loses water due to excessive sweating, leading to a rise in core body temperature (but still under 40°C). Symptoms include lethargy, weakness and dizziness, but there’s no change to consciousness or mental clarity
    • heat stroke: a medical emergency when the core body temperature is over 40°C. This can lead to serious problems related to the nervous system, such as confusion, seizures and unconsciousness including coma, leading to death.

    As you can see from the diagram below, some symptoms of heat stroke and heat exhaustion overlap. This makes it hard to recognise the difference, even for medical professionals.

    Heat exhaustion vs heat stroke venn diagram
    CC BY-SA

    How does this happen?

    The human body is an incredibly efficient and adaptable machine, equipped with several in-built mechanisms to keep our core temperature at an optimal 37°C.

    But in healthy people, regulation of body temperature begins to break down when it’s hotter than about 31°C with 100% humidity (think Darwin or Cairns) or about 38°C with 60% humidity (typical of other parts of Australia in summer).

    This is because humid air makes it harder for sweat to evaporate and take heat with it. Without that cooling effect, the body starts to overheat.

    Once the core temperature rises above 37°C, heat exhaustion can set in, which can cause intense thirst, weakness, nausea and dizziness.

    If the body heat continues to build and the core body temperature rises above 40°C, a much more severe heat stroke could begin. At this point, it’s a life-threatening emergency requiring immediate medical attention.

    At this temperature, our proteins start to denature (like an egg on a hotplate) and blood flow to the intestines stops. This makes the gut very leaky, allowing harmful substances such as endotoxins (toxic substances in some bacteria) and pathogens (disease causing microbes) to leak into the bloodstream.

    The liver can’t detoxify these fast enough, leading to the whole body becoming inflamed, organs failing, and in the worst-case scenario, death.

    Who’s most at risk?

    People doing strenuous exercise, especially if they’re not in great shape, are among those at risk of heat exhaustion or heat stroke. Others at risk include those exposed to high temperatures and humidity, particularly when wearing heavy clothing or protective gear.

    Outdoor workers such as farmers, firefighters and construction workers are at higher risk too. Certain health conditions, such as diabetes, heart disease, or lung conditions (such as COPD or chronic obstructive pulmonary disease), and people taking blood pressure medications, can also be more vulnerable.

    Adults over 65, infants and young children are especially sensitive to heat as they are less able to physically cope with fluctuations in heat and humidity.

    Firefighters holding hose, aimed at bushfire
    Firefighters are among those at risk of heat-related illness. structuresxx/Shutterstock

    How are these conditions managed?

    The risk of serious illness or death from heat-related conditions is very low if treatment starts early.

    For heat exhaustion, have the individual lie down in a cool, shady area, loosen or remove excess clothing, and cool them by fanning, moistening their skin, or immersing their hands and feet in cold water.

    As people with heat exhaustion almost always are dehydrated and have low electrolytes (certain minerals in the blood), they will usually need to drink fluids.

    However, emergency hospital care is essential for heat stroke. In hospital, health professionals will focus on stabilising the patient’s:

    • airway (ensure no obstructions, for instance, vomit)
    • breathing (look for signs of respiratory distress or oxygen deprivation)
    • circulation (check pulse, blood pressure and signs of shock).

    Meanwhile, they will use rapid-cooling techniques including immersing the whole body in cold water, or applying wet ice packs covering the whole body.

    Take home points

    Heat-related illnesses, such as heat stroke and heat exhaustion, are serious health conditions that can lead to severe illness, or even death.

    With climate change, heat-related illness will become more common and more severe. So recognising the early signs and responding promptly are crucial to prevent serious complications.

    Matthew Barton, Senior lecturer, School of Nursing and Midwifery, Griffith University and Michael Todorovic, Associate Professor of Medicine, Bond University

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • What Your Doctor Wants You to Know to Crush Medical Debt – by Dr. Virgie Ellington

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    First things first: this one’s really only of relevance to people living in the US. That’s most of our readership, but if it’s not you, then apologies, this one won’t be of interest.

    For the US Americans, though, Dr. Ellington starts strong with “you got a bill—now get the right bill”, and then gives a step-by-step process for finding the mistakes in your medical bills, fixing them, dealing with insurers who do not want to live up to their part of the bargain, and how to minimize what you need to pay, when you actually arrive at your final bill.

    The biggest strength of this book is the wealth of insider knowledge (the author has worked as a primary care physician as well as as a health insurance executive), and while this information won’t stay current forever, its relatively recent publication date (2022) means that little has changed since then, and once you’re up to speed with how things are now, it’ll be easy to roll with whatever changes may come in the future.

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    Click here to check out What Your Doctor Wants You to Know To Crush Medical Debt, and be armed with knowledge!

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  • Fix Chronic Fatigue & Regain Your Energy, By Science

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Chronic fatigue is on the rise. A lot of it appears to be Long COVID-related, but whether that’s the case for you or not, one thing that will make a big difference to your energy levels is something that French biochemist Jessie Inchauspé is here to explain:

    Mitochondrial management

    Inchauspé explains it in terms of a steam train; to keep running, it must have coal burning in its furnace. However, if more coal is delivered to the engine room faster than it can be put in the furnace and burned, and the coal just keeps on coming, the worker there will soon be overwhelmed trying to find places to put it all; the engine room will be full of coal, and the furnace will sputter and go out because the worker can’t even reach it on account of being buried in coal.

    So it is with our glucose metabolism also. If we get spikes of glucose faster than our body can deal with them, it will overload the body’s ability to process that energy at all. Just like the steam train worker, our body will try! It’ll stuff that extra glucose wherever it can (storing as glycogen in the liver is a readily available option that’s easy to do and/but also gives you non-alcoholic fatty liver disease and isn’t quickly broken down into useable energy), and meanwhile, your actual mitochondria aren’t getting what they need (which is: a reliable, but gentle, influx of glucose).

    You can imagine that the situation we described in the steam train isn’t good for the engine’s longevity, and the corresponding situation in the human body isn’t good for our mitochondria either (or our pancreas, or our liver, or… the list goes on). Indeed, damaged mitochondria affect exercise capacity and stress resilience—as well as being a long-term driver of cancer.

    The remedy, of course, is blood sugar management. Specifically, avoiding glucose spikes. She has a list of 10 ways to do this (small changes to how we eat; what things to eat with what, in which order, etc) that make a huge measurable difference. For your convenience, we’ve linked those ten ways below; first though, if you’d like to hear it from Inchauspé directly (her style is very pleasant), enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

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    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    There is a trend in psychology to “blame the parents” for “childhood trauma” that can result in problems later in life. Sometimes fairly, sometimes not. This book’s mostly not about that.

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    So, how does one heal from a trauma one never directly experienced, and just inherited the response to it? That’s what most of this book is about, after establishing how epigenetic trauma inheritance works.

    The author, a therapist, provides practical advice for how to do the things that can be done to rewrite the epigenetic code we inherited. Better late than never!

    Bottom line: it is well-established that trauma is inheritable. But unlike one’s eye color or the ability to smell asparagus metabolites in urine, we can rewrite epigenetic things, to a degree. This book explains how.

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    Don’t Forget…

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    Learn to Age Gracefully

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  • Driving under the influence of marijuana: An explainer and research roundup

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Update 1: On May 16, 2024, the U.S. Department of Justice sent a proposed rule to the Federal Register to downgrade marijuana from a Schedule I to a Schedule III drug. This is the first step in a lengthy approval process that starts with a 60-day comment period.

    Update 2: Two recent research studies were added to the “Studies on marijuana and driving” section of this piece on July 18, 2024.

    As marijuana use continues to rise and state-level marijuana legalization sweeps the U.S., researchers and policymakers are grappling with a growing public safety concern: marijuana-impaired driving.

    As of April 2023, 38 U.S. states had legalized medical marijuana and 23 had legalized its recreational use, according to the National Conference of State Legislatures. Recreational or medical marijuana measures are on the ballot in seven states this year.

    The issue of marijuana-impaired driving has not been an easy one to tackle because, unlike alcohol, which has well-established thresholds of impairment, the metrics for marijuana’s effects on driving remain rather elusive.

    “We don’t have that kind of deep knowledge right now and it’s not because of lack of trying,” says Dr. Guohua Li, professor of epidemiology and the founding director of the Center for Injury Science and Prevention at Columbia University.

    “Marijuana is very different from alcohol in important ways,” says Li, who has published several studies on marijuana and driving. “And one of them is that the effect of marijuana on cognitive functions and behaviors is much more unpredictable than alcohol. In general, alcohol is a depressant drug. But marijuana could act on the central nervous system as a depressant, a stimulant, and a hallucinogenic substance.”

    Efforts to create a breathalyzer to measure the level of THC, the main psychoactive compound found in the marijuana plant, have largely failed, because “the THC molecule is much bigger than ethanol and its behavior after ingestion is very different from alcohol,” Li says.

    Currently, the two most common methods used to measure THC concentration to identify impaired drivers are blood and saliva tests, although there’s ongoing debate about their reliability.

    Marijuana, a term interchangeably used with cannabis, is the most commonly used federally illegal drug in the U.S.: 48.2 million people, or about 18% of Americans reported using it at least once in 2019, according to the latest available data from the Centers for Disease Control and Prevention. Worldwide, 2.5% of the population consumes marijuana, according to the World Health Organization.

    Marijuana is legal in several countries, including Canada, where it was legalized in 2018. Despite state laws legalizing cannabis, it remains illegal at the federal level in the U.S.

    As states grapple with the contentious issue of marijuana legalization, the debate is not just about public health, potential tax revenues and economic interests. At the heart of the discussion is also the U.S. criminal justice system.

    Marijuana is shown to have medicinal qualities and, compared with substances like alcohol, tobacco, and opioids, it has relatively milder health risks. However, it’s not risk-free, a large body of research has shown.

    Marijuana consumption can lead to immediate effects such as impaired muscle coordination and paranoia, as well as longer-term effects on mental health and cognitive functions — and addiction. As its use becomes more widespread, researchers are trying to better understand the potential hazards of marijuana, particularly for younger users whose brains are in critical stages of development.

    Marijuana and driving

    The use of marijuana among drivers, passengers and pedestrians has increased steadily over the past two decades, Li says.

    Compared with the year 2000, the proportion of U.S. drivers on the road who are under the influence of marijuana has increased by several folds, between five to 10 times, based on toxicology testing of people who died in car crashes, Li says.

    A 2022 report from the National Transportation Safety Board finds alcohol and cannabis are the two most commonly detected drugs among drivers arrested for impaired driving and fatally injured drivers. Most drivers who tested positive for cannabis also tested positive for another potentially impairing drug.

    “Although cannabis and many other drugs have been shown to impair driving performance and are associated with increased crash risk, there is evidence that, relative to alcohol, awareness about the potential dangers of driving after using other drugs is lower,” according to the report.

    Indeed, many U.S. adults perceive daily marijuana use or exposure to its smoke safer than tobacco, even though research finds otherwise.

    Several studies have demonstrated marijuana’s impact on driving.

    Marijuana use can reduce the drivers’ ability to pay attention, particularly when they are performing multiple tasks, research finds. It also slows reaction time and can impair coordination.

    “The combination is that you potentially have people who are noticing hazards later, braking slower and potentially not even noticing hazards because of their inability to focus on competing things on the road,” says Dr. Daniel Myran, an assistant professor at the Department of Family Medicine and health services researcher at the University of Ottawa.

    In a study published in September in JAMA Network Open, Myran and colleagues find that from 2010 to 2021 the rate of cannabis-involved traffic injuries that led to emergency department visits in Ontario, Canada, increased by 475%, from 0.18 per 1,000 traffic injury emergency department visits in 2010 to 1.01 visits in 2021.

    To be sure, cannabis-involved traffic injuries made up a small fraction of all traffic injury-related visits to hospital emergency departments. Out of 947,604 traffic injury emergency department visits, 426 had documented cannabis involvement.

    Myran cautions the increase shouldn’t be solely attributed to marijuana legalization. It captures changing societal attitudes toward marijuana and acceptance of cannabis use over time in the lead-up to legalization. In addition, it may reflect an increasing awareness among health care providers about cannabis-impaired driving, and they may be more likely to ask about cannabis use and document it in medical charts, he says.

    “When you look at the 475% increase in cannabis involvement in traffic injuries, rather than saying legalizing cannabis has caused the roads to be unsafe and is a public health disaster, it’s that cannabis use appears to be growing as a risk for road traffic injuries and that there seem to be more cannabis impaired drivers on the road,” Myran says. “Legalization may have accelerated this trend. Faced with this increase, we need to think about what are public health measures and different policy interventions to reduce harms from cannabis-impaired driving.”

    Setting a legal limit for marijuana-impaired driving

    Setting a legal limit for marijuana-impaired driving has not been easy. Countries like Canada and some U.S. states have agreed upon a certain level of THC in blood, usually between 1 to 5 nanograms per milliliter. Still, some studies have found those limits to be weak indicators of cannabis-impaired driving.

    When Canada legalized recreational marijuana in 2018, it also passed a law that made it illegal to drive with blood THC levels of more than 2 nanograms. The penalties are more severe for blood THC levels above 5 nanograms. The blood test is done at the police station for people who are pulled over and are deemed to be drug impaired.

    In the U.S., five states — Ohio, Illinois, Montana, Washington and Nevada — have “per se laws,” which set a specific amount of THC in the driver’s blood as evidence of impaired driving, according to the National Conference of State Legislatures. That limit ranges between 2 and 5 nanograms of THC per milliliter of blood.

    Colorado, meanwhile, has a “permissible inference law,” which states that it’s permissible to assume the driver was under the influence if their blood THC level is 5 nanograms per milliliter or higher, according to NCSL.

    Twelve states, most which have legalized some form of marijuana of use, have zero tolerance laws for any amount of certain drugs, including THC, in the body.

    The remaining states have “driving under the influence of drugs” laws. Among those states, Alabama and Michigan, have oral fluid roadside testing program to screen drivers for marijuana and other drugs, according to NCSL.

    In May this year, the U.S. Department of Transportation published a final rule that allows employers to use saliva testing for commercially licensed drivers, including truck drivers. The rule, which went into effect in June, sets the THC limit in saliva at 4 nanograms.

    Saliva tests can detect THC for 8 to 24 hours after use, but the tests are not perfect and can results in false positives, leading some scientists to argue against using them in randomly-selected drivers.

    In a 2021 report, the U.S. National Institute of Justice, the research and development arm of the Department of Justice, concluded that THC levels in bodily fluids, including blood and saliva “were not reliable indicators of marijuana intoxication.”

    Studies on marijuana and driving

    Over the past two decades, many studies have shown marijuana use can impair driving. However, discussions about what’s the best way to measure the level of THC in blood or saliva are ongoing. Below, we highlight and summarize several recent studies that address the issue. The studies are listed in order of publication date. We also include a list of related studies and resources to inform your audiences.

    State Driving Under the Influence of Drugs Laws
    Alexandra N. Origenes, Sarah A. White, Emma E. McGinty and Jon S. Vernick. Journal of Law, Medicine & Ethics, July 2024.

    Summary: As of January 2023, 33 states and D.C. had a driving under the influence of drugs law for at least one drug other than cannabis. Of those, 29 states and D.C. had a law specifically for driving under the influence of cannabis, in addition to a law for driving under the influence of other drugs. Four states had a driving under the influence of drug laws, excluding cannabis. Meanwhile, 17 states had no law for driving under the influence of drugs, including cannabis.  “The 17 states lacking a DUID law that names specific drugs should consider enacting such a law. These states already have expressed their concern — through legislation — with drug-impaired driving. However, failure to name specific drugs is likely to make the laws more difficult to enforce. These laws may force courts and/or law enforcement to rely on potentially subjective indicators of impairment,” the authors write.

    Associations between Adolescent Marijuana Use, Driving After Marijuana Use and Recreational Retail Sale in Colorado, USA
    Lucas M. Neuroth, et al. Substance Use & Misuse, October 2023.

    Summary: Researchers use data from four waves (2013, 2015, 2017 and 2019) of the Healthy Kids Colorado Survey, including 47,518 students 15 and older who indicated that they drove. They find 20.3% of students said that they had used marijuana in the past month and 10.5% said they had driven under the influence of marijuana. They find that the availability of recreational marijuana in stores was associated with an increased prevalence of using marijuana one to two times in the past month and driving under the influence of marijuana at least once. “Over the study period, one in ten high school age drivers engaged in [driving after marijuana use], which is concerning given the high risk of motor vehicle-related injury and death arising from impaired driving among adolescents,” the authors write.

    Are Blood and Oral Fluid Δ9-tetrahydrocannabinol (THC) and Metabolite Concentrations Related to Impairment? A Meta-Regression Analysis
    Danielle McCartney, et al. Neuroscience & Biobehavioral Reviews, March 2022.

    Summary: Commonly used THC measurements may not be strong indicators of driving impairment. While there is a relationship between certain biomarkers like blood THC concentrations and impaired driving, this correlation is often weak. The study underscores the need for more nuanced and comprehensive research on this topic, especially as cannabis usage becomes more widespread and legally accepted.

    The Effects of Cannabis and Alcohol on Driving Performance and Driver Behaviour: A Systematic Review and Meta-Analysis
    Sarah M. Simmons, Jeff K. Caird, Frances Sterzer and Mark Asbridge. Addiction, January 2022.

    Summary: This meta-analysis of experimental driving studies, including driving simulations, confirms that cannabis impairs driving performance, contrary to some beliefs that it might enhance driving abilities. Cannabis affects lateral control and speed — typically increasing lane excursions while reducing speed. The combination of alcohol and marijuana appears worse than either alone, challenging the idea that they cancel each other out.

    Cannabis Legalization and Detection of Tetrahydrocannabinol in Injured Drivers
    Jeffrey R. Brubacher, et al. The New England Journal of Medicine, January 2022.

    Summary: Following the legalization of recreational marijuana in Canada, there was a notable increase in injured drivers testing positive for THC, especially among those 50 years of age or older. This rise in cannabis-related driving incidents occurred even with new traffic laws aiming to deter cannabis-impaired driving. This uptick began before legalization became official, possibly due to perceptions that cannabis use was soon-to-be legal or illegal but not enforced. The data suggests that while legalization has broad societal impacts, more comprehensive strategies are needed to deter driving under the influence of cannabis and raise public awareness about its risks.

    Cannabis and Driving
    Godfrey D. Pearlson, Michael C. Stevens and Deepak Cyril D’Souza. Frontiers in Psychiatry, September 2021.

    Summary: Cannabis-impaired driving is a growing public health concern, and studies show that such drivers are more likely to be involved in car crashes, according to this review paper. Drivers are less affected by cannabis than they are by alcohol or cocaine, but the problem is expected to escalate with increasing cannabis legalization and use. Unlike alcohol, THC’s properties make it challenging to determine direct impairment levels from testing results. Current roadside tests lack precision in detecting genuine cannabis-impaired drivers, leading to potential wrongful convictions. Moreover, there is a pressing need for research on the combined effects of alcohol and cannabis on driving, as well as the impact of emerging popular forms of cannabis, like concentrates and edibles. The authors recommend public awareness campaigns about the dangers of driving under the influence of cannabis, similar to those against drunk driving, to address misconceptions. Policymakers should prioritize science-based decisions and encourage further research in this domain.

    Demographic And Policy-Based Differences in Behaviors And Attitudes Towards Driving After Marijuana Use: An Analysis of the 2013–2017 Traffic Safety Culture Index
    Marco H. Benedetti, et al. BMC Research Notes, June 2021.

    Summary: The study, based on a U.S. survey, finds younger, low-income, low-education and male participants were more tolerant of driving after marijuana consumption. Notably, those in states that legalized medical marijuana reported driving after use more frequently, aligning with studies indicating a higher prevalence of THC detection in drivers from these states. Overall, while the majority perceive driving after marijuana use as dangerous, not all research agrees on its impairment effects. Existing studies highlight that marijuana impacts motor skills and executive functions, yet its direct correlation with crash risk remains debated, given the variations in individual tolerance and how long THC remains in the system.

    Driving Under the Influence of Cannabis: A Framework for Future Policy
    Robert M. Chow, et al.Anesthesia & Analgesia, June 2019.

    Summary: The study presents a conceptual framework focusing on four main domains: legalization, driving under the influence of cannabis, driver impairment, and motor vehicle accidents. With the growing legalization of cannabis, there’s an anticipated rise in cannabis-impaired driving cases. The authors group marijuana users into infrequent users who show significant impairment with increased THC blood levels, chronic users with minimal impairment despite high THC levels, and those with consistent psychomotor deficits. Current challenges lie in the lack of standardized regulation for drivers influenced by cannabis, primarily because of state-to-state variability and the absence of a federal statutory limit for blood THC levels. European nations, however, have established thresholds for blood THC levels, ranging from 0.5 to 50.0 micrograms per liter depending on whether blood or blood serum are tested. The authors suggest the combined use of alcohol and THC blood tests with a psychomotor evaluation by a trained professional to determine impairment levels. The paper stresses the importance of creating a structured policy framework, given the rising acceptance and use of marijuana in society.

    Additional research

    Cannabis-Involved Traffic Injury Emergency Department Visits After Cannabis Legalization and Commercialization
    Daniel T. Myran, et al. JAMA Network Open, September 2023.

    Driving Performance and Cannabis Users’ Perception of Safety: A Randomized Clinical Trial
    Thomas D. Marcotte, et al. JAMA Psychiatry, January 2022.

    Medicinal Cannabis and Driving: The Intersection of Health and Road Safety Policy
    Daniel Perkins, et al. International Journal of Drug Policy, November 2021.

    Prevalence of Marijuana Use Among Trauma Patients Before and After Legalization of Medical Marijuana: The Arizona Experience
    Michael Levine, et al. Substance Abuse, July 2021.

    Self-Reported Driving After Marijuana Use in Association With Medical And Recreational Marijuana Policies
    Marco H. Benedetti, et al. International Journal of Drug Policy, June 2021.

    Cannabis and Driving Ability
    Eric L. Sevigny. Current Opinion in Psychology, April 2021.

    The Failings of per se Limits to Detect Cannabis-Induced Driving Impairment: Results from a Simulated Driving Study
    Thomas R. Arkell, et al. Traffic Injury Prevention, February 2021.

    Risky Driving Behaviors of Drivers Who Use Alcohol and Cannabis
    Tara Kelley-Baker, et al. Transportation Research Record, January 2021.

    Direct and Indirect Effects of Marijuana Use on the Risk of Fatal 2-Vehicle Crash Initiation
    Stanford Chihuri and Guohua Li. Injury Epidemiology, September 2020

    Cannabis-Impaired Driving: Evidence and the Role of Toxicology Testing
    Edward C. Wood and Robert L. Dupont. Cannabis in Medicine, July 2020.

    Association of Recreational Cannabis Laws in Colorado and Washington State With Changes in Traffic Fatalities, 2005-2017
    Julian Santaella-Tenorio, et al. JAMA Internal Medicine, June 2020.

    Marijuana Decriminalization, Medical Marijuana Laws, and Fatal Traffic Crashes in US Cities, 2010–2017
    Amanda Cook, Gregory Leung and Rhet A. Smith. American Journal of Public Health, February 2020.

    Cannabis Use in Older Drivers in Colorado: The LongROAD Study
    Carolyn G. DiGuiseppi, et al. Accident Analysis & Prevention, November 2019.

    Crash Fatality Rates After Recreational Marijuana Legalization in Washington and Colorado
    Jayson D. Aydelotte, et al. American Journal of Public Health, August 2017.

    Marijuana-Impaired Driving: A Report to Congress
    National Highway Traffic Safety Administration, July 2017

    Interaction of Marijuana And Alcohol on Fatal Motor Vehicle Crash Risk: A Case–Control Study
    Stanford Chihuri, Guohua Li and Qixuan Chen. Injury Epidemiology, March 2017.

    US Traffic Fatalities, 1985–2014, and Their Relationship to Medical Marijuana Laws
    Julian Santaella-Tenorio, et al. American Journal of Public Health, February 2017.

    Delays in DUI Blood Testing: Impact on Cannabis DUI Assessments
    Ed Wood, Ashley Brooks-Russell and Phillip Drum. Traffic Injury Prevention, June 2015.

    Establishing Legal Limits for Driving Under the Influence of Marijuana
    Kristin Wong, Joanne E. Brady and Guohua Li. Injury Epidemiology, October 2014.

    Cannabis Effects on Driving Skills
    Rebecca L. Hartman and Marilyn A. Huestis. Clinical Chemistry, March 2014.

    Acute Cannabis Consumption And Motor Vehicle Collision Risk: Systematic Review of Observational Studies and Meta-Analysis
    Mark Asbridge, Jill A. Hayden and Jennifer L. Cartwright. The BMJ, February 2012.

    Resources for your audiences

    The following resources include explainers from federal agencies and national organizations. You’re free to use images and graphics from federal agencies.

    This article first appeared on The Journalist’s Resource and is republished here under a Creative Commons license.

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  • The Twenty-Four Hour Mind – by Dr. Rosalind Cartwright

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    We’ve reviewed books about sleep before, and even about dreaming, so what does this one have to offer that’s new?

    Quite a lot, actually! Before Dr. Cartwright, there were mainly two models of sleep and dreaming:

    • The “top-down” model of psychoanalysts: our minds shape our dreams which in turn reveal things about us as people
    • The “bottom-up” model of neuroscientists: our brains need to go through regular maintaince cycles, of which vivid hallucinations are a quirky side-effect.

    And now, as Dr. Cartwright puts it:

    ❝I will lay out a new [horizontal] psychological model of the twenty-four hour mind; that is, how the predominantly conscious (waking) and unconscious (sleeping) forms of mental behavior interact through the brain’s regular, but differently organized, states of waking, sleeping, and dreaming.❞

    This she does in the exploratory style of a 224-page lecture, which sounds like it might be tedious, but is actually attention-grabbing and engaging throughout. This book is more of a page-turner than soporific bedtime reading!

    Bottom line: if you’d like to know more about the effect your waking and sleeping brain have on each other (to include getting in between those and making adjutments as appropriate), this is very much an elucidating read!

    Click here to check out The Twenty-Four Hour Mind, and learn more about yours!

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