Gut Renovation – by Dr. Roshini Raj, with Sheila Buff
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Unless we actually feel something going on down there, gut health is an oft-neglected part of overall health—which is unfortunate, because invisible as it may often be, it affects so much.
Gastroenterologist Dr. Roshini Raj gives us all the need-to-know information, explanations of why things happen the way they do with regard to the gut, and tips, tricks, and hacks to improve matters.
She also does some mythbusting along the way, and advises about what things don’t make a huge difference, including what medications don’t have a lot of evidence for their usefulness.
The style is easy-reading pop-science, with plenty of high-quality medical content.
Reading between the lines, a lot of the book as it stands was probably written by the co-author, Sheila Buff, who is a professional ghostwriter and specializes in working closely with doctors to produce works that are readable and informative to the layperson while still being full of the doctor’s knowledge and expertise. So a reasonable scenario is that Dr. Raj gave her extensive notes, she took it from there, passed it back to her for medical corrections, and they had a little back and forth until it was done. Whatever their setup, the end result was definitely good!
Bottom line: if you’d like a guide to gut health that’s practical and easy to read, while being quite comprehensive and certainly a lot more than “eat probiotics and fiber”, then this book is a fine choice.
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How does cancer spread to other parts of the body?
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All cancers begin in a single organ or tissue, such as the lungs or skin. When these cancers are confined in their original organ or tissue, they are generally more treatable.
But a cancer that spreads is much more dangerous, as the organs it spreads to may be vital organs. A skin cancer, for example, might spread to the brain.
This new growth makes the cancer much more challenging to treat, as it can be difficult to find all the new tumours. If a cancer can invade different organs or tissues, it can quickly become lethal.
When cancer spreads in this way, it’s called metastasis. Metastasis is responsible for the majority (67%) of cancer deaths.
Cells are supposed to stick to surrounding tissue
Our bodies are made up of trillions of tiny cells. To keep us healthy, our bodies are constantly replacing old or damaged cells.
Each cell has a specific job and a set of instructions (DNA) that tells it what to do. However, sometimes DNA can get damaged.
This damage might change the instructions. A cell might now multiply uncontrollably, or lose a property known as adherence. This refers to how sticky a cell is, and how well it can cling to other surrounding cells and stay where it’s supposed to be.
If a cancer cell loses its adherence, it can break off from the original tumour and travel through the bloodstream or lymphatic system to almost anywhere. This is how metastasis happens.
Many of these travelling cancer cells will die, but some will settle in a new location and begin to form new cancers.
Some cells settle in a new location.
Scipro/ShutterstockParticular cancers are more likely to metastasise to particular organs that help support their growth. Breast cancers commonly metastasise to the bones, liver, and lungs, while skin cancers like melanomas are more likely to end up in the brain and heart.
Unlike cancers which form in solid organs or tissues, blood cancers like leukaemia already move freely through the bloodstream, but can escape to settle in other organs like the liver or brain.
When do cancers metastasise?
The longer a cancer grows, the more likely it is to metastasise. If not caught early, a patient’s cancer may have metastasised even before it’s initially diagnosed.
Metastasis can also occur after cancer treatment. This happens when cancer cells are dormant during treatment – drugs may not “see” those cells. These invisible cells can remain hidden in the body, only to wake up and begin growing into a new cancer months or even years later.
For patients who already have cancer metastases at diagnosis, identifying the location of the original tumour – called the “primary site” – is important. A cancer that began in the breast but has spread to the liver will probably still behave like a breast cancer, and so will respond best to an anti-breast cancer therapy, and not anti-liver cancer therapy.
As metastases can sometimes grow faster than the original tumour, it’s not always easy to tell which tumour came first. These cancers are called “cancers of unknown primary” and are the 11th most commonly diagnosed cancers in Australia.
One way to improve the treatment of metastatic cancer is to improve our ways of detecting and identifying cancers, to ensure patients receive the most effective drugs for their cancer type.
What increases the chances of metastasis and how can it be prevented?
If left untreated, most cancers will eventually acquire the ability to metastasise.
While there are currently no interventions that specifically prevent metastasis, cancer patients who have their tumours surgically removed may also be given chemotherapy (or other drugs) to try and weed out any hidden cancer cells still floating around.
The best way to prevent metastasis is to diagnose and treat cancers early. Cancer screening initiatives such as Australia’s cervical, bowel, and breast cancer screening programs are excellent ways to detect cancers early and reduce the chances of metastasis.
The best way to prevent cancer spreading is to diagnose and treat them early.
Peakstock/ShutterstockNew screening programs to detect cancers early are being researched for many types of cancer. Some of these are simple: CT scans of the body to look for any potential tumours, such as in England’s new lung cancer screening program.
Using artificial intelligence (AI) to help examine patient scans is also possible, which might identify new patterns that suggest a cancer is present, and improve cancer detection from these programs.
More advanced screening methods are also in development. The United States government’s Cancer Moonshot program is currently funding research into blood tests that could detect many types of cancer at early stages.
One day there might even be a RAT-type test for cancer, like there is for COVID.
Will we be able to prevent metastasis in the future?
Understanding how metastasis occurs allows us to figure out new ways to prevent it. One idea is to target dormant cancer cells and prevent them from waking up.
Directly preventing metastasis with drugs is not yet possible. But there is hope that as research efforts continue to improve cancer therapies, they will also be more effective at treating metastatic cancers.
For now, early detection is the best way to ensure a patient can beat their cancer.
Sarah Diepstraten, Senior Research Officer, Blood Cells and Blood Cancer Division, Walter and Eliza Hall Institute and John (Eddie) La Marca, Senior Resarch Officer, Walter and Eliza Hall Institute
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Retrain Your Brain – by Dr. Seth Gillihan
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15-Minute Arabic”, “Sharpen Your Chess Tactics in 24 Hours”, “Change Your Life in 7 Days”, “Cognitive Behavioral Therapy in 7 weeks”—all real books from this reviewer’s shelves.
The thing with books with these sorts of time periods in the titles is that the time period in the title often bears little relation to how long it takes to get through the book. So what’s the case here?
You’ll probably get through it in more like 7 days, but the pacing is more important than the pace. By that we mean:
Dr. Gillihan starts by assuming the reader is at best “in a rut”, and needs to first pick a direction to head in (the first “week”) and then start getting one’s life on track (the second “week”).
He then gives us, one by one, an array of tools and power-ups to do increasingly better. These tools aren’t just CBT, though of course that features prominently. There’s also mindfulness exercises, and holistic / somatic therapy too, for a real “bringing it all together” feel.
And that’s where this book excels—at no point is the reader left adrift with potential stumbling-blocks left unexamined. It’s a “whole course”.
Bottom line: whether it takes you 7 hours or 7 months, “Cognitive Behavioral Therapy in 7 Weeks” is a CBT-and-more course for people who like courses to work through. It’ll get you where you’re going… Wherever you want that to be for you!
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The Collagen Cure – by Dr. James DiNicolantonio
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Collagen is vital for, well, most of our bodies, really. Where me most tend to feel its deficiency is in our joints and skin, but it’s critical for bones and many other tissues too.
You may be wondering: why a 572-page book to say what surely must amount to “take collagen, duh”?
Dr. DiNicolantonio has a lot more of value to offer us than that. In this book, we learn about not just collagen synthesis and usage, different types of collagen, the metabolism of it in our diet (if we get it—vegans and vegetarians won’t). We also learn about the building blocks of collagen (vegans and vegetarians do get these, assuming a healthy balanced diet), with a special focus on glycine, the smallest amino acid which makes up about a third of the mass of collagen (a protein).
Not stopping there, we also learn about the interplay of other nutrients with our metabolism of glycine and, if applicable, collagen. Vitamin C and copper are star features, but there’s a lot more going on with other nutrients too, down to the level of “So take this 75 minutes before this but after that and/but definitely not with the other”, etc.
The style is incredibly clear and readable for something that’s also quite scientifically dense (over 1000 references and many diagrams).
Bottom line: if you’re serious about maintaining your body as you get older, and you’d like a book about collagen that’s a lot more helpful than “take collagen, duh”, then this is the book for you.
Click here to check out The Collagen Cure, and take care of yours!
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Driving under the influence of marijuana: An explainer and research roundup
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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 2020Cannabis-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 2017Interaction 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.
- CDC’s main marijuana page.
- CDC’s marijuana data and statistics.
- Marijuana Drug Facts from the National Institute on Drug Abuse.
- Health Effects of Marijuana from the CDC.
- Learn About Marijuana Risks from the Substance Abuse and Mental Health Services Administration.
- Marijuana and Lung Health from the American Lung Association.
- Substance Use Disorder 101 from the U.S. Department of Health & Human Services.
- What You Need To Know About Marijuana Use and Driving from the CDC.
- Does marijuana use affect driving? from the National Institute on Drug Abuse.
- Drug-Impaired Driving from the National Highway Traffic Safety Administration.
This article first appeared on The Journalist’s Resource and is republished here under a Creative Commons license.
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Eat To Beat Hyperthyroidism!
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
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
❝Would love to see more on eating vegan. I am allergic to soy in any form which seems to be in everything❞
There is a lot of it about, isn’t there? Happily, these days, a lot of meat and dairy alternatives are also made from other sources, for example pea protein is getting used a lot more nowadays in meat substitutes, and there are many kinds of alternatives to dairy (e.g. nut milks, oat milk, hemp milk, and—which is a branding nightmare but very healthy—pea milk).
You might like these previous main features of ours:
- Do We Need Animal Products To Be Healthy?
- The Whys and Hows of Cutting Down Meat Consumption
- Plant-Based Milks—What’s Best?
Also, if doing a whole foods plant-based diet, lentils (especially brown lentils) can be used as a great substitute for minced beef/lamb in recipes that call for such.
Boil the lentils (a liter of water to a cup of lentils is great; use a rice cooker if you have one!) along with the seasonings you will use (herbs appropriate to your dish, and then: black pepper is always good; you shouldn’t need to add salt; a teaspoon of low-sodium yeast extract is great though, or to really get the best nutritional benefits, nooch).
When it is done, you shouldn’t have excess water now, so just use as is, or if you want a slightly fatty kick, fry briefly in a little extra virgin olive oil, before using it however you were planning to use it.
Enjoy!
❝What foods should I eat for hyperthyroidism? My doctor tells me what foods to avoid, but not what to eat❞
Great question! We’ll have to do a main feature on hyperthyroidism one of these days, as so far we’ve only done features on hypothyroidism:
As for hyperthyroidism…
Depending on your medications, your doctor might recommend a low iodine diet. If so, then you might want to check out:
American Thyroid Association | Low Iodine Diet Plan
…for recommendations.
But in a way, that’s still a manner of “what to avoid” (iodine) and then the foods to eat to avoid that.
You may be wondering: is there any food that actively helps against hyperthyroidism, as opposed to merely does not cause problems?
And the answer is: yes!
Cruciferous vegetables (e.g. cabbage, sprouts, broccoli, cauliflower, etc) contain goitrin, which in immoderate quantities can cause problems for people with hypothyroidism because it can reduce thyroid hormone synthesis. If you have hyperthyroidism, however, this can work in your favor.
Read more: The role of micronutrients in thyroid dysfunction
The above paper focuses on children, but it was the paper we found that explains it most clearly while showing good science. However, the same holds true for adults:
Notwithstanding that the title comes from the angle of examining hypothyroidism, the mechanism of action makes clear its beneficence in the case of hyperthyroidism.
Selenium is also a great nutrient in the case of autoimmune hyperthyroidism, because it is needed to metabolize thyroid hormone (if you don’t metabolize it, it’ll just build up):
Selenium and Thyroid Disease: From Pathophysiology to Treatment
The absolute top best dietary source of selenium is Brazil nuts, to the point that people without hyperthyroidism have to take care to not eat more than a few per day (because too much selenium could then cause problems):
NIH | Selenium Fact Sheet for Health Professionals
(this contains information on the recommended amount, the upper limit amount, how much is in Brazil nuts and other foods, and what happens if you get too much or too little)
Note: after Brazil nuts (which are about 5 times more rich in selenium than the next highest source), the other “good” sources of selenium—mostly various kinds of fish—are also “good” source of iodine, so you might want to skip those.
Want more ideas?
You might like this from LivHealth:
Hyperthyroidism Diet: 9 Foods To Ease Symptoms
Enjoy!
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Why Adult ADHD Often Leads To Anxiety & Depression
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ADHD’s Knock-On Effects On Mental Health
We’ve written before about ADHD in adult life, often late-diagnosed because it’s not quite what people think it is:
In women in particular, it can get missed and/or misdiagnosed:
Miss Diagnosis: Anxiety, ADHD, & Women
…but what we’re really here to talk about today is:
It’s the comorbidities that get you
When it comes to physical health conditions:
- if you have one serious condition, it will (usually) be taken seriously
- if you have two, they will still be taken seriously, but people (friends and family members, as well as yes, medical professionals) will start to back off, as it starts to get too complicated for comfort
- if you have three, people will think you are making at least one of them up for attention now
- if you have more than three, you are considered a hypochondriac and pathological liar
Yet, the reality is: having one serious condition increases your chances of having others, and this chance-increasing feature compounds with each extra condition.
Illustrative example: you have fibromyalgia (ouch) which makes it difficult for you to exercise much, shop around when grocery shopping, and do much cooking at home. You do your best, but your diet slips and it’s hard to care when you just want the pain to stop; you put on some weight, and get diagnosed with metabolic syndrome, which in time becomes diabetes with high cardiovascular risk factors. Your diabetes is immunocompromising; you get COVID and find it’s now Long COVID, which brings about Chronic Fatigue Syndrome, when you barely had the spoons to function in the first place. At this point you’ve lost count of conditions and are just trying to get through the day.
If this is you, by the way, we hope at least something in the following might ease things for you a bit:
- Stop Pain Spreading
- Managing Chronic Pain (Realistically!)
- Eat To Beat Chronic Fatigue (While Having The Limitations Of Chronic Fatigue)
- When Painkillers Aren’t Helping, These Things Might
- The 7 Approaches To Pain Management
It’s the same for mental health
In the case of ADHD as a common starting point (because it’s quite common, may or may not be diagnosed until later in life, and doesn’t require any external cause to appear), it is very common that it will lead to anxiety and/or depression, to the point that it’s perhaps more common to also have one or more of them than not, if you have ADHD.
(Of course, anxiety and/or depression can both pop up for completely unrelated reasons too, and those reasons may be physiological, environmental, or a combination of the above).
Why?
Because all the good advice that goes for good mental health (and/or life in general), gets harder to actuate when one had ADHD.
- “Strong habits are the core of a good life”, but good luck with that if your brain doesn’t register dopamine in the same way as most people’s do, making intentional habit-forming harder on a physiological level.
- “Plan things carefully and stick to the plan”, but good luck with that if you are neurologically impeded from forming plans.
- “Just do it”, but oops you have the tendency-to-overcommitment disorder and now you are seriously overwhelmed with all the things you tried to do, when each of them alone were already going to be a challenge.
Overwhelm and breakdown are almost inevitable.
And when they happen, chances are you will alienate people, and/or simply alienate yourself. You will hide away, you will avoid inflicting yourself on others, you will brood alone in frustration—or distract yourself with something mind-numbing.
Before you know it, you’re too anxious to try to do things with other people or generally show your face to the world (because how will they react, and won’t you just mess things up anyway?), and/or too depressed to leave your depression-lair (because maybe if you keep playing Kingdom Vegetables 2, you can find a crumb of dopamine somewhere).
What to do about it
How to tackle the many-headed beast? By the heads! With your eyes open. Recognize and acknowledge each of the heads; you can’t beat those heads by sticking your own in the sand.
Also, get help. Those words are often used to mean therapy, but in this case we mean, any help. Enlist your partner or close friend as your support in your mental health journey. Enlist a cleaner as your support in taking that one thing off your plate, if that’s an option and a relevant thing for you. Set low but meaningful goals for deciding what constitutes “good enough” for each life area. Decide in advance what you can safely half-ass, and what things in life truly require your whole ass.
Here’s a good starting point for that kind of thing:
When You Know What You “Should” Do (But Knowing Isn’t The Problem)
And this is an excellent way to “get the ball rolling” if you’re already in a bit of a prison of your own making:
Behavioral Activation Against Depression & Anxiety
If things are already bad, then you might also consider:
- How To Set Anxiety Aside and
- The Mental Health First-Aid That You’ll Hopefully Never Need ← this is about getting out of depression
And if things are truly at the worst they can possibly be, then:
How To Stay Alive (When You Really Don’t Want To)
Take care!
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