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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  • Cupping: How It Works (And How It Doesn’t)

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    Good Health By The Cup?

    In Tuesday’s newsletter, we asked you for your opinion of cupping (the medical practice), and got the above-depicted, below-described, set of responses:

    • About 40% said “It may help by improving circulation and stimulating the immune system”
    • About 26% said “I have never heard of the medical practice of cupping before this”
    • About 19% said “It is pseudoscience and/or placebo at best, but probably not harmful
    • About 9% said “It is a good, evidence-based practice that removes toxins and stimulates health”
    • About 6% said “It is a dangerous practice that often causes harm to people who need medical help”

    So what does the science say?

    First, a quick note for those unfamiliar with cupping: it is the practice of placing a warmed cup on the skin (open side of the cup against the skin). As the warm air inside cools, it reduces the interior air pressure, which means the cup is now (quite literally) a suction cup. This pulls the skin up into the cup a little. The end result is visually, and physiologically, the same process as what happens if someone places the nozzle of a vacuum cleaner against their skin. For that matter, there are alternative versions that simply use a pump-based suction system, instead of heated cups—but the heated cups are most traditional and seem to be most popular. See also:

    National Center for Complementary and Integrative Health | Cupping

    It is a dangerous practice that often causes harm to people who need medical help: True or False?

    False, for any practical purposes.

    • Directly, it can (and usually does) cause minor superficial harm, much like many medical treatments, wherein the benefits are considered to outweigh the harm, justifying the treatment. In the case of cupping, the minor harm is usually a little bruising, but there are other risks; see the link we gave just above.
    • Indirectly, it could cause harm by emboldening a person to neglect a more impactful treatment for their ailment.

    But, there’s nothing for cupping akin to the “the most common cause of death is when someone gets a vertebral artery fatally severed” of chiropractic, for example.

    It is a good, evidence-based practice that removes toxins and stimulates health: True or False?

    True and False in different parts. This one’s on us; we included four claims in one short line. But let’s look at them individually:

    • Is it good? Well, those who like it, like it. It legitimately has some mild health benefits, and its potential for harm is quite small. We’d call this a modest good, but good nonetheless.
    • Is it evidence-based? Somewhat, albeit weakly; there are some papers supporting its modest health claims, although the research is mostly only published in journals of alternative medicine, and any we found were in journals that have been described by scientists as pseudoscientific.
    • Does it remove toxins? Not directly, at least. There is also a version that involves making a small hole in the skin before applying the cup, the better to draw out the toxins (called “wet cupping”). This might seem a little medieval, but this is because it is from early medieval times (wet cupping’s first recorded use being in the early 7th century). However, the body’s response to being poked, pierced, sucked, etc is to produce antibodies, and they will do their best to remove toxins. So, indirectly, there’s an argument.
    • Does it stimulate health? Yes! We’ll come to that shortly. But first…

    It is pseudoscience and/or placebo at best, but probably not harmful: True or False?

    True in that its traditionally-proposed mechanism of action is a pseudoscience and placebo almost certainly plays a strong part, and also in that it’s generally not harmful.

    On it being a pseudoscience: we’ve talked about this before, but it bears repeating; just because something’s proposed mechanism of action is pseudoscience, doesn’t necessarily mean it doesn’t work by some other mechanism of action. If you tell a small child that “eating the rainbow” will improve their health, and they believe this is some sort of magical rainbow power imbuing them with health, then the mechanism of action that they believe in is a pseudoscience, but eating a variety of colorful fruit and vegetables will still be healthy.

    In the case of cupping, its proposed mechanism of action has to do withbalancing qi, yin and yang, etc (for which scientific evidence does not exist), in combination with acupuncture lore (for which some limited weak scientific evidence exists). On balancing qi, yin and yang etc, this is a lot like Europe’s historically popular humorism, which was based on the idea of balancing the four humors (blood, yellow bile, black bile, phlegm). Needless to say, humorism was not only a pseudoscience, but also eventually actively disproved with the advent of germ theory and modern medicine. Cupping therapy is not more scientifically based than humorism.

    On the placebo side of things, there probably is a little more to it than that; much like with acupuncture, a lot of it may be a combination of placebo and using counter-irritation, a nerve-tricking method to use pain to reduce pain (much like pressing with one’s nail next to an insect bite).

    Here’s one of the few studies we found that’s in what looks, at a glance, to be a reputable journal:

    Cupping therapy and chronic back pain: systematic review and meta-analysis

    It may help by improving circulation and stimulating the immune system: True or False?

    True! It will improve local circulation by forcing blood into the area, and stimulate the immune system by giving it a perceived threat to fight.

    Again, this can be achieved by many other means; acupuncture (or just “dry needling”, which is similar but without the traditional lore), a cold shower, and/or exercise (and for that matter, sex—which combines exercise, physiological arousal, and usually also foreign bodies to respond to) are all options that can improve circulation and stimulate the immune system.

    You can read more about using some of these sorts of tricks for improving health in very well-evidenced, robustly scientific ways here:

    The Stress Prescription (Against Aging!)

    Take care!

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  • Heart Health Calculator Entry Issue

    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.

    It’s Q&A Day at 10almonds!

    Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!

    In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

    As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

    So, no question/request too big or small

    ❝I tried to use your calculator for heart health, and was unable to enter in my height or weight. Is there another way to calculate? Why will that field not populate?❞

    (this is in reference to yesterday’s main feature “How Are You, Really? And How Old Is Your Heart?“)

    How strange! We tested it in several desktop browsers and several mobile browsers, and were unable to find any version that didn’t work. That includes switching between metric and imperial units, per preference; both appear to work fine. Do be aware that it’ll only take numerical imput, though.

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  • Why You’re Tired & How To Fix It

    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.

    This is Sadia Badiei. A dietician by academic and professional background, she’s nowadays hung up her lab coat for a chef’s jacket, and is best known for her “Pick Up Limes” brand. Today, we’ll be taking her advice on managing energy levels with what’s on our plates!

    Quick note: our usual medical/legal disclaimer applies, and this article cannot diagnose you from afar, and thus neither can it make any certain prescription; this is for educational purposes, and aimed at being applicable to most of our readers.

    There are many possible things that can cause chronic fatigue, and not all of them can be fixed by diet. Your doctor will have access to tests and such that we, being a humble health science publication, do not.

    You may recognize her; we’ve featured her videos occasionally, mostly recently:

    Pick Up A Zest For Life: 10 Lessons For A Healthy Mind & Body

    But, what does she want us to know about living life with more energy?

    It starts with balance

    Badiei makes the case that we should strive for a nutritionally-balanced diet; that may not come as much of a revelation, but what does that look like for a vegan (Badiei advocates for plant-based eating)?

    She recommends that our diet consist of:

    • About 50% fruits and vegetables
    • About 25% grains and starches
    • About 25% proteins
    • Modest amounts of fats
    • A little of well-chosen dairy substitutions
    • Finally, a few judicious supplements to top it off

    That does add up to more than 100%, but 1) we did say “About n%” and 2) this is not a bad thing to note, actually, since Badiei advocates (as we do) for focussing more on what we add into our diet, rather than what we take out.

    Breaking it down a little further, she recommends making sure to get “the foundational seven”, which is a little like “Dr. Greger’s Daily Dozen”, but in this case it’s counted on a per-food-type basis.

    Thus, she recommends:

    1. Dark green leafy vegetables
    2. Assorted other non-starchy vegetables (your choice what kind)
    3. Fruit, of any kinds (unlike Dr. Greger separating berries)
    4. Grains and starches (so for example, potatoes are lumped in with rice here, botanically very different, but often fulfil a similar culinary role)
    5. Nuts and seeds
    6. Legumes
    7. Fortified dairy alternatives

    For full details including how much of each, and “what counts”, etc, see:

    Pick Up Limes | The Nourish Method

    Time your carbs

    Slow-release carbohydrates, those with the most fiber, are best most of the time, giving us more sustained fuel, keeping us energized for longer after meals—even if we would rather sleep:

    She cites: Fiber and Saturated Fat Are Associated with Sleep Arousals and Slow Wave Sleep

    Quick-release carbohydrates, those with what’s generally considered a less favorable carb:fiber ratio, are best if we’re going to eat nearer to bedtime. We know, eating before bed is often considered a bit of a no-no, but Badiei bids us indulge if we so desire, as the quicker-absorbed carbohydrates support tryptophan reaching our brain more efficiently, and thus promote sleep onset.

    See also: Should You Go Light Or Heavy On Carbs?

    About that fat

    We mentioned (or rather, Badiei’s citation mentioned) saturated fat. It is indeed linked with difficulty falling asleep, and/but omega-3 fatty acids, on the other hand, promote better sleep.

    She cites: The relationship between sleep duration, sleep quality and dietary intake in adults

    While you’re enjoying those nuts and seeds (for the omega-3 fatty acids), you might also note that several also star in Badiei’s list of plant-based foods that are rich in tryptophan, such as soy, cashews, pumpkin seeds, sunflower seeds, beans, green vegetables, and mushrooms.

    Micronutrients

    Badiei’s focus here is on B-vitamins, iron, magnesium, selenium, and zinc. We imagine most of our readers here are taking steps to ensure to get a full daily coverage of vitamins and minerals anyway, but you might want to read what she has to say about iron on a plant-based diet, because the numbers may be different than you think.

    The reason for this is that while animal products contain mostly heme iron, which is easier to absorb but associated with a risk increase in some diseases, plant-based foods usually* contain only non-heme iron, which is healthier but not as bioavailable, so if eating only plants, we need more of it:

    Pick Up Limes | Iron on a Plant-Based Diet

    *If you eat a carnivorous plant, guess what, it’ll have heme iron in it, tangling that food web.

    “What if I know I have chronic fatigue for non-dietary reasons?”

    Well, that sucks, and we’re not going to pretend the above will magically fix it. However, there are still things that can at least relatively improve your experience:

    Eat To Beat Chronic Fatigue! Yes, Even When Fatigued Chronically

    (it’s a good guide to being able to consistently eat healthily when your energy levels are consistently at minimal, meaning that a lot of common advice becomes unusable)

    Take care!

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  • The Conquest of Happiness – by Bertrand Russell

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    When we have all our physical needs taken care of, why are we often still not happy, and what can we do about that?

    Mathematician, philosopher, and Nobel prizewinner Bertrand Russell has answers. And, unlike many of “the great philosophers”, his writing style is very clear and accessible.

    His ideas are simple and practical, yet practised by few. Rather than taking a “be happy with whatever you have” approach, he does argue that we should strive to find more happiness in some areas and ways—and lays out guidelines for doing so.

    Areas to expand, areas to pull back on, areas to walk a “virtuous mean”. Things to be optimistic about; things to not get our hopes up about.

    Applying Russell’s model, there’s no more “should I…?” moments of wondering which way to jump.

    Bottom line: if you’ve heard enough about “how to be happy” from wishy-washier sources, you might find the work of this famous logician refreshing.

    Click here to check out The Conquest of Happiness, and see how much happier you might become!

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  • Younger Next Year: The Exercise Program – by Chris Crowley & Dr. Henry Lodge

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    We previously reviewed the same authors’ original “Younger Next Year”, and now here’s the more specific book about exercise for increasing healthspan and reversing markers of biological aging, going into much more detail in that regard.

    How much more? Well, it’s a very hand-holding book in the sense that it walks the reader through everything step-by-step, tells not only what kind of exercise and how much, but also how to do, what things to do to prepare, how to avoid not erring in various ways, what metrics to keep an eye on to ensure you are making progress, and more.

    There are also whole sections on specific common age-related issues including osteoporosis and arthritis, as well as how to train around injuries (especially of the kind that basically aren’t likely to ever fully go away).

    As with the previous book, there’s a blend of motivational pep talk and science—this book is heavily weighted towards the former. It has, however, enough science to keep it on the right track throughout. Hence the two authors! Crowley for motivational pep and training tips, and Dr. Lodge for the science.

    Bottom line: if you’d like to be biologically younger next year, that exercise will be an important component of that, and this book is really quite comprehensive for its relative brevity (weighing in at 176 pages).

    Click here to check out Younger Next Year: The Exercise Program, and make that progress!

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  • You can’t reverse the ageing process but these 5 things can help you live longer

    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.

    At this time of year many of us resolve to prioritise our health. So it is no surprise there’s a roaring trade of products purporting to guarantee you live longer, be healthier and look more youthful.

    While an estimated 25% of longevity is determined by our genes, the rest is determined by what we do, day to day.

    There are no quick fixes or short cuts to living longer and healthier lives, but the science is clear on the key principles. Here are five things you can do to extend your lifespan and improve your health.

    1. Eat a predominantly plant-based diet

    What you eat has a huge impact on your health. The evidence overwhelmingly shows eating a diet high in plant-based foods is associated with health and longevity.

    If you eat more plant-based foods and less meat, processed foods, sugar and salt, you reduce your risk of a range of illnesses that shorten our lives, including heart disease and cancer.

    Plant-based foods are rich in nutrients, phytochemicals, antioxidants and fibre. They’re also anti-inflammatory. All of this protects against damage to our cells as we age, which helps prevent disease.

    No particular diet is right for everyone but one of the most studied and healthiest is the Mediterranean diet. It’s based on the eating patterns of people who live in countries around the Mediterranean Sea and emphases vegetables, fruits, wholegrains, legumes, nuts and seeds, fish and seafood, and olive oil.

    2. Aim for a healthy weight

    Another important way you can be healthier is to try and achieve a healthy weight, as obesity increases the risk of a number of health problems that shorten our lives.

    Obesity puts strain on all of our body systems and has a whole myriad of physiological effects including causing inflammation and hormonal disturbances. These increase your chances of a number of diseases, including heart disease, stroke, high blood pressure, diabetes and a number of cancers.

    In addition to affecting us physically, obesity is also associated with poorer psychological health. It’s linked to depression, low self-esteem and stress.

    One of the biggest challenges we face in the developed world is that we live in an environment that promotes obesity. The ubiquitous marketing and the easy availability of high-calorie foods our bodies are hard-wired to crave mean it’s easy to consume too many calories.

    3. Exercise regularly

    We all know that exercise is good for us – the most common resolution we make this time of year is to do more exercise and to get fitter. Regular exercise protects against chronic illness, lowers your stress and improves your mental health.

    While one of the ways exercising helps you is by supporting you to control your weight and lowering your body fat levels, the effects are broader and include improving your glucose (blood sugar) use, lowering your blood pressure, reducing inflammation and improving blood flow and heart function.

    While it’s easy to get caught up in all of the hype about different exercise strategies, the evidence suggests that any way you can include physical activity in your day has health benefits. You don’t have to run marathons or go to the gym for hours every day. Build movement into your day in any way that you can and do things that you enjoy.

    4. Don’t smoke

    If you want to be healthier and live longer then don’t smoke or vape.

    Smoking cigarettes affects almost every organ in the body and is associated with both a shorter and lower quality of life. There is no safe level of smoking – every cigarette increases your chances of developing a range of cancers, heart disease and diabetes.

    Even if you have been smoking for years, by giving up smoking at any age you can experience health benefits almost immediately, and you can reverse many of the harmful effects of smoking.

    If you’re thinking of switching to vapes as a healthy long term option, think again. The long term health effects of vaping are not fully understood and they come with their own health risks.

    5. Prioritise social connection

    When we talk about living healthier and longer, we tend to focus on what we do to our physical bodies. But one of the most important discoveries over the past decade has been the recognition of the importance of spiritual and psychological health.

    People who are lonely and socially isolated have a much higher risk of dying early and are more likely to suffer from heart disease, stroke, dementia as well as anxiety and depression.

    Although we don’t fully understand the mechanisms, it’s likely due to both behavioural and biological factors. While people who are more socially connected are more likely to engage in healthy behaviours, there also seems to be a more direct physiological effect of loneliness on the body.

    So if you want to be healthier and live longer, build and maintain your connections to others.

    Hassan Vally, Associate Professor, Epidemiology, Deakin University

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

    The Conversation

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