Cannabis Myths vs Reality

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Cannabis Myths vs Reality

We asked you for your (health-related) opinion on cannabis use—specifically, the kind with psychoactive THC, not just CBD. We got the above-pictured, below-described, spread of responses:

  • A little over a third of you voted for “It’s a great way to relax, without most of the dangers of alcohol”.
  • A little under a third of you voted for “It may have some medical uses, but recreational use is best avoided”.
  • About a quarter of you voted for “The negative health effects outweigh the possible benefits”
  • Three of you voted for “It is the gateway to a life of drug-induced stupor and potentially worse”

So, what does the science say?

A quick legal note first: we’re a health science publication, and are writing from that perspective. We do not know your location, much less your local laws and regulations, and so cannot comment on such. Please check your own local laws and regulations in that regard.

Cannabis use can cause serious health problems: True or False?

True. Whether the risks outweigh the benefits is a personal and subjective matter (for example, a person using it to mitigate the pain of late stage cancer is probably unconcerned with many other potential risks), but what’s objectively true is that it can cause serious health problems.

One subscriber who voted for “The negative health effects outweigh the possible benefits” wrote:

❝At a bare minimum, you are ingesting SMOKE into your lungs!! Everyone SEEMS TO BE against smoking cigarettes, but cannabis smoking is OK?? Lung cancer comes in many forms.❞

Of course, that is assuming smoking cannabis, and not consuming it as an edible. But, what does the science say on smoking it, and lung cancer?

There’s a lot less research about this when it comes to cannabis, compared to tobacco. But, there is some:

❝Results from our pooled analyses provide little evidence for an increased risk of lung cancer among habitual or long-term cannabis smokers, although the possibility of potential adverse effect for heavy consumption cannot be excluded.❞

Read: Cannabis smoking and lung cancer risk: Pooled analysis in the International Lung Cancer Consortium

Another study agreed there appears to be no association with lung cancer, but that there are other lung diseases to consider, such as bronchitis and COPD:

❝Smoking cannabis is associated with symptoms of chronic bronchitis, and there may be a modest association with the development of chronic obstructive pulmonary disease. Current evidence does not suggest an association with lung cancer.❞

Read: Cannabis Use, Lung Cancer, and Related Issues

Cannabis edibles are much safer than smoking cannabis: True or False?

Broadly True, with an important caveat.

One subscriber who selected “It may have some medical uses, but recreational use is best avoided”, wrote:

❝I’ve been taking cannabis gummies for fibromyalgia. I don’t know if they’re helping but they’re not doing any harm. You cannot overdose you don’t become addicted.❞

Firstly, of course consuming edibles (rather than inhaling cannabis) eliminates the smoke-related risk factors we discussed above. However, other risks remain, including the much greater ease of accidentally overdosing.

❝Visits attributable to inhaled cannabis are more frequent than those attributable to edible cannabis, although the latter is associated with more acute psychiatric visits and more ED visits than expected.❞

Note: that “more frequent” for inhaled cannabis, is because more people inhale it than eat it. If we adjust the numbers to control for how much less often people eat it, suddenly we see that the numbers of hospital admissions are disproportionately high for edibles, compared to inhaled cannabis.

Or, as the study author put it:

❝There are more adverse drug events associated on a milligram per milligram basis of THC when it comes in form of edibles versus an inhaled cannabis. If 1,000 people smoked pot and 1,000 people at the same dose in an edible, then more people would have more adverse drug events from edible cannabis.❞

See the numbers: Acute Illness Associated With Cannabis Use, by Route of Exposure

Why does this happen?

  • It’s often because edibles take longer to take effect, so someone thinks “this isn’t very strong” and has more.
  • It’s also sometimes because someone errantly eats someone else’s edibles, not realising what they are.
  • It’s sometimes a combination of the above problems: a person who is now high, may simply forget and/or make a bad decision when it comes to eating more.

On the other hand, that doesn’t mean inhaling it is necessarily safer. As well as the pulmonary issues we discussed previously, inhaling cannabis has a higher risk of cannabinoid hyperemesis syndrome (and the resultant cyclic vomiting that’s difficult to treat).

You can read about this fascinating condition that’s sometimes informally called “scromiting”, a portmanteau of screaming and vomiting:

Cannabinoid Hyperemesis Syndrome

You can’t get addicted to cannabis: True or False?

False. However, it is fair to say that the likelihood of developing a substance abuse disorder is lower than for alcohol, and much lower than for nicotine.

See: Prevalence of Marijuana Use Disorders in the United States Between 2001–2002 and 2012–2013

If you prefer just the stats without the science, here’s the CDC’s rendering of that:

Addiction (Marijuana or Cannabis Use Disorder)

However, there is an interesting complicating factor, which is age. One is 4–7 times more likely to develop a substance abuse disorder, if one starts use as an adolescent, rather than later in life:

See: Likelihood of developing an alcohol and cannabis use disorder during youth: Association with recent use and age

Cannabis is the gateway to use of more dangerous drugs: True or False?

False, generally speaking. Of course, for any population there will be some outliers, but there appears to be no meaningful causal relation between cannabis use and other substance use:

Is marijuana really a gateway drug? A nationally representative test of the marijuana gateway hypothesis using a propensity score matching design

Interestingly, the strongest association (where any existed at all) was between cannabis use and opioid use. However, rather than this being a matter of cannabis use being a gateway to opioid use, it seems more likely that this is a matter of people looking to both for the same purpose: pain relief.

As a result, growing accessibility of cannabis may actually reduce opioid problems:

Some final words…

Cannabis is a complex drug with complex mechanisms and complex health considerations, and research is mostly quite young, due to its historic illegality seriously cramping science by reducing sample sizes to negligible. Simply put, there’s a lot we still don’t know.

Also, we covered some important topics today, but there were others we didn’t have time to cover, such as the other potential psychological benefits—and risks. Likely we’ll revisit those another day.

Lastly, while we’ve covered a bunch of risks today, those of you who said it has fewer and lesser risks than alcohol are quite right—the only reason we couldn’t focus on that more, is because to talk about all the risks of alcohol would make this feature many times longer!

Meanwhile, whether you partake or not, stay safe and stay well.

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  • Practical Programming for Strength Training – by Mark Rippetoe & Andy Baker

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    Strength training is an important part of overall health maintenance, but it can be hard to find a good guide to progressive strength improvement that isn’t a bodybuilding book.

    This one gives a ground-upwards approach, explaining small details to even quite basic things, before taking the reader through to more advanced progressions, and how to get the most strength-building out of each exercise over time.

    As such, this is a good book for anyone of any level from beginner to quite experienced, and you can hop in at any point since there are always catch-up summaries and/or reiterations of the previous concepts that we’re now building on from.

    The authors do also talk nutrition, hormones, and so forth, but most of it is about the exercises and the progressions thereof.

    There is a slightly patronizing chapter towards the end, about “special populations”, for example offering “novice and intermediate training for women”, but it doesn’t take away from the majority of the book, as the exercises don’t care about your gender. Muscles are muscles, and we all start from wherever we are. Yes, testosterone boosts muscle mass, but let’s face it, there are a lot of women in the world who are stronger than a lot of men.

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  • 16/8 Intermittent Fasting For Beginners

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    Health Insider explains in super-simple fashion why and how to do Intermittent Fasting (IF), which is something that can sound complicated at first, but becomes very simple and easy once understood.

    What do we need to know?

    Intermittent fasting (IF) is a good, well-evidenced way to ease your body’s metabolic load, and
    give your organs a chance to recover from the strain of digestion and its effects. That’s not just your gastrointestinal organs! It’s your pancreas and liver too, amongst others—this is about glucose metabolism as much as it is about digestion.

    This, in turn, allows your body some downtime to do its favorite thing, which is: maintenance!

    This maintenance takes the form of enhanced cellular apoptosis and autophagy, helping to keep cells young and cancer-free.

    In other words, with well-practised intermittent fasting, we can reduce our risk of metabolic disease (including heart disease and diabetes) as well as cancer and neurodegeneration.

    You may be wondering: this sounds miraculous; what’s the catch? There are a couple:

    • While fasting from food, the body’s enhanced metabolism requires more water, so you’ll need to take extra care keep on top of your hydration (this is one reason why Ramadan fasting, while healthy for most people, is not as healthy as IF—because Ramadan fasting means abstaining from water, too).
    • If you are diabetic, and especially if you have Type 1 Diabetes, fasting may not be a safe option for you, since if you get a hypo in the middle of your fasting period, it’s obviously not a good idea to wait another many hours before fixing it.

    Extra note on that last one: it’s easy to think “can’t I just lower my bolus insulin instead of eating?” and while superficially yes that will raise your blood sugar levels, it’s because the sugar will be sticking around in your blood, and not actually getting released into the organs that need it. So while your blood glucose monitor may say you’re fine, you will be starving your organs and if you keep it up they may suffer serious damage.

    Disclaimer: our standard legal/medical disclaimer applies, and this is intended for educational purposes only; please do speak with your endocrinologist before changing anything you usually do with regard to your blood sugar maintenance.

    Ok, back onto the cheerier topic at hand:

    Aside from the above: for most people, IF is a remarkably healthful practice in very many ways.

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    Want to know more?

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    Intermittent Fasting: Mythbusting Edition

    Enjoy!

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  • Debate over tongue tie procedures in babies continues. Here’s why it can be beneficial for some infants

    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 increasing media interest about surgical procedures on new babies for tongue tie. Some hail it as a miracle cure, others view it as barbaric treatment, though adverse outcomes are rare.

    Tongue tie occurs when the tissue under the tongue is attached to the lower gum or floor of the mouth in a way that can restrict the movement or range of the tongue. This can impact early breastfeeding in babies. It affects an estimated 8% of children under one year of age.

    While there has been an increase in tongue tie releases (also called division or frenotomy), it’s important to keep this in perspective relative to the increase in breastfeeding rates.

    The World Health Organization recommends exclusive breastfeeding for the first six months of life, with breastfeeding recommended into the second year of life and beyond for the health of mother and baby as well as optimal growth. Global rates of breastfeeding infants for the first six months have increased from 38% to 48% over the past decade. So, it is not surprising there is also an increase in the number of babies being referred globally with breastfeeding challenges and potential tongue tie.

    An Australian study published in 2023 showed that despite a 25% increase in referrals for tongue tie division between 2014 and 2018, there was no increase in the number of tongue tie divisions performed. Tongue tie surgery rates increased in Australia in the decade from 2006 to 2016 (from 1.22 per 1,000 population to 6.35) for 0 to 4 year olds. There is no data on surgery rates in Australia over the last eight years.

    Tongue tie division isn’t always appropriate but it can make a big difference to the babies who need it. More referrals doesn’t necessarily mean more procedures are performed.

    chomplearn/Shutterstock

    How tongue tie can affect babies

    When tongue tie (ankyloglossia) restricts the movement of the tongue, it can make it more difficult for a baby to latch onto the mother’s breast and painlessly breastfeed.

    Earlier this month, the International Consortium of oral Ankylofrenula Professionals released a tongue tie position statement and practice guideline. Written by a range of health professionals, the guidelines define tongue tie as a functional diagnosis that can impact breastfeeding, eating, drinking and speech. The guidelines provide health professionals and families with information on the assessment and management of tongue tie.

    Tongue tie release has been shown to improve latch during breastfeeding, reduce nipple pain and improve breast and bottle feeding. Early assessment and treatment are important to help mothers breastfeed for longer and address any potential functional problems.

    baby with open mouth shows tongue tie under tongue
    The frenulum is a band of tissue under the tongue that is attached to the gumline base of the mouth. Akkalak Aiempradit/Shutterstock

    Where to get advice

    If feeding isn’t going well, it may cause pain for the mother or there may be signs the baby isn’t attaching properly to the breast or not getting enough milk. Parents can seek skilled help and assessment from a certified lactation consultant or International Board-Certified Lactation Consultant who can be found via online registry.

    Alternatively, a health professional with training and skills in tongue tie assessment and division can assist families. This may include a doctor, midwife, speech pathologist or dentist with extended skills, training and experience in treating babies with tongue tie.

    When access to advice or treatment is delayed, it can lead to unnecessary supplementation with bottle feeds, early weaning from breastfeeding and increased parental anxiety.

    Getting a tongue tie assessment

    During assessment, a qualified health professional will collect a thorough case history, including pregnancy and birth details, do a structural and functional assessment, and conduct a comprehensive breastfeeding or feeding assessment.

    They will view and thoroughly examine the mouth, including the tongue’s movement and lift. The appearance of where the tissue attaches to the underside of the tongue, the ability of the tongue to move and how the baby can suck also needs to be properly assessed.

    Treatment decisions should focus on the concerns of the mother and baby and the impact of current feeding issues. Tongue tie division as a baby is not recommended for the sole purpose of avoiding speech problems in later life if there are no feeding concerns for the baby.

    baby breastfeeding and holding mother's finger
    A properly qualified lactation consultant can help with positioning and attachment. HarryKiiM Stock/Shutterstock

    Treatment options

    The Australian Dental Association’s 2020 guidelines provide a management pathway for babies diagnosed with tongue tie.

    Once feeding issues are identified and if a tongue tie is diagnosed, non-surgical management to optimise positioning, latch and education for parents should be the first-line approach.

    If feeding issues persist during follow-up assessment after non-surgical management, a tongue tie division may be considered. Tongue tie release may be one option to address functional challenges associated with breastfeeding problems in babies.

    There are risks associated with any procedure, including tongue tie release, such as bleeding. These risks should be discussed with the treating practitioner before conducting any laser, scissor or scalpel tongue tie procedure.

    Post-release support by a certified lactation consultant or feeding specialist is necessary after a tongue tie division. A post-release treatment plan should be developed by a team of health professionals including advice and support for breastfeeding to address both the mother and baby’s individual needs.

    We would like to acknowledge the contribution of Raymond J. Tseng, DDS, PhD, (Paediatric Dentist) to the writing of this article.

    Sharon Smart, Lecturer and Researcher (Speech Pathology) – School of Allied Health, Curtin University; David Todd, Associate Professor, Neonatology, ANU Medical School, Australian National University, and Monica J. Hogan, PhD student, ANU School of Medicine and Psychology, Australian National University

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

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    The terms are sometimes used incorrectly, but have quite different meanings. Dr. Julie Smith, psychologist, explains in this short video:

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    You may also notice that that list of symptoms has quite a bit of overlap with the symptoms of a heart attack, which a) does not help people to calm down b) can, on the flipside, cause a heart attack to be misdiagnosed as a panic attack.

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    We’ve reviewed books about the mind-gut connection before, so what makes this one stand out?

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  • Sarah Raven’s Garden Cookbook – by Sarah Raven

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