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 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.
- 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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Could Just Two Hours Sleep Per Day Be Enough?
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Polyphasic Sleep… Super-Schedule Or An Idea Best Put To Rest?
What is it?
Let’s start by defining some terms:
- Monophasic sleep—sleeping in one “chunk” per day. For example, a good night’s “normal” sleep.
- Biphasic sleep—sleeping in two “chunks” per day. Typically, a shorter night’s sleep, with a nap usually around the middle of the day / early afternoon.
- Polyphasic sleep—sleeping in two or more “chunks per day”. Some people do this in order to have more hours awake per day, to do things. The idea is that sleeping this way is more efficient, and one can get enough rest in less time. The most popular schedules used are:
- The Überman schedule—six evenly-spaced 20-minute naps, one every four hours, throughout the 24-hour day. The name is a semi-anglicized version of the German word Übermensch, “Superman”.
- The Everyman schedule—a less extreme schedule, that has a three-hours “long sleep” during the night, and three evenly-spaced 20-minute naps during the day, for a total of 4 hours sleep.
There are other schedules, but we’ll focus on the most popular ones here.
Want to learn about the others? Visit: Polyphasic.Net (a website by and for polyphasic sleep enthusiasts)
Some people have pointed to evidence that suggests humans are naturally polyphasic sleepers, and that it is only modern lifestyles that have forced us to be (mostly) monophasic.
There is at least some evidence to suggest that when environmental light/dark conditions are changed (because of extreme seasonal variation at the poles, or, as in this case, because of artificial changes as part of a sleep science experiment), we adjust our sleeping patterns accordingly.
The counterpoint, of course, is that perhaps when at the mercy of long days/nights at the poles, or no air-conditioning to deal with the heat of the day in the tropics, that perhaps we were forced to be polyphasic, and now, with modern technology and greater control, we are free to be monophasic.
Either way, there are plenty of people who take up the practice of polyphasic sleep.
Ok, But… Why?
The main motivation for trying polyphasic sleep is simply to have more hours in the day! It’s exciting, the prospect of having 22 hours per day to be so productive and still have time over for leisure.
A secondary motivation for trying polyphasic sleep is that when the brain is sleep-deprived, it will prioritize REM sleep. Here’s where the Überman schedule becomes perhaps most interesting:
The six evenly-spaced naps of the Überman schedule are each 20 minutes long. This corresponds to the approximate length of a normal REM cycle.
Consequently, when your head hits the pillow, you’ll immediately begin dreaming, and at the end of your dream, the alarm will go off.
Waking up at the end of a dream, when one hasn’t yet entered a non-REM phase of sleep, will make you more likely to remember it. Similarly, going straight into REM sleep will make you more likely to be aware of it, thus, lucid dreaming.
Read: Sleep fragmentation and lucid dreaming (actually a very interesting and informative lucid dreaming study even if you don’t want to take up polyphasic sleep)
Six 20-minute lucid-dreaming sessions per day?! While awake for the other 22 hours?! That’s… 24 hours per day of wakefulness to use as you please! What sorcery is this?
Hence, it has quite an understandable appeal.
Next Question: Does it work?
Can we get by without the other (non-REM) kinds of sleep?
According to Überman cycle enthusiasts: Yes! The body and brain will adapt.
According to sleep scientists: No! The non-REM slow-wave phases of sleep are essential
Read: Adverse impact of polyphasic sleep patterns in humans—Report of the National Sleep Foundation sleep timing and variability consensus panel
(if you want to know just how bad it is… the top-listed “similar article” is entitled “Suicidal Ideation”)
But what about, for example, the Everman schedule? Three hours at night is enough for some non-REM sleep, right?
It is, and so it’s not as quickly deleterious to the health as the Überman schedule. But, unless you are blessed with rare genes that allow you to operate comfortably on 4 hours per day (you’ll know already if that describes you, without having to run any experiment), it’s still bad.
Adults typically need 7–9 hours of sleep per night, and if you don’t get it, you’ll accumulate a sleep debt. And, importantly:
When you accumulate sleep debt, you are borrowing time at a very high rate of interest!
And, at risk of laboring the metaphor, but this is important too:
Not only will you have to pay it back soon (with interest), you will be hounded by the debt collection agents—decreased cognitive ability and decreased physical ability—until you pay up.
In summary:
- Polyphasic sleep is really very tempting
- It will give you more hours per day (for a while)
- It will give the promised lucid dreaming benefits (which is great until you start micronapping between naps, this is effectively a mini psychotic break from reality lasting split seconds each—can be deadly if behind the wheel of a car, for instance!)
- It is unequivocally bad for the health and we do not recommend it
Bottom line:
Some of the claimed benefits are real, but are incredibly short-term, unsustainable, and come at a cost that’s far too high. We get why it’s tempting, but ultimately, it’s self-sabotage.
(Sadly! We really wanted it to work, too…)
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The Immunostimulant Superfood
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Eat These Greens!
Chlorella vulgaris, henceforth “chlorella”, is a simple green algae that has a lot of health benefits.
Note: most of the studies here are for Chlorella vulgaris specifically. However, some are for other species of the Chlorella genus, of which Chlorella vulgaris is by far the most common, hence the name (vulgaris = common). The relevant phytochemical properties appear to be the same regardless.
Superfood
While people generally take it as a supplement rather than a food item in any kind of bulk, it is more than 50% protein and contains all 9 essential amino acids.
As you might expect of a green superfood, it’s also full of many antioxidants, most of them carotenoids, and these pack a punch, for example against cancer:
It also has a lot of vitamins and minerals, and even omega-3.
Which latter also means it helps improve lipids and is thus particularly…
Heart healthy
❝Daily consumption of Chlorella supplements provided the potential of health benefits reducing serum lipid risk factors, mainly triglycerides and total cholesterol❞
Its heart-healthy benefits don’t stop at lipids though, and include blood pressure management, as in this study that found…
❝GABA-rich Chlorella significantly decreased high-normal blood pressure and borderline hypertension, and is a beneficial dietary supplement for prevention of the development of hypertension. ❞
About that GABA, if you’re curious about that, check out:
GABA Against Stress, Anxiety, & More
May remove heavy metals
We’re going with “may” for this one as we could only find animal studies so far (probably because most humans don’t have megadoses of heavy metals in them, which makes testing harder).
Here’s an example animal study, though:
Enhanced elimination of tissue methyl mercury in [Chlorella]-fed mice
Immunostimulant
This one’s clearer, for example in this 8-week study (with humans) that found…
❝Serum concentrations of interferon-γ (p<0.05) and interleukin-1β (p<0.001) significantly increased and that of interleukin-12 (p<0.1) tended to increase in the Chlorella group.
The increments of these cytokines after the intervention were significantly bigger in the Chlorella group than those in the placebo group. In addition, NK cell activities (%) were significantly increased in Chlorella group, but not in Placebo group.
The increments of NK cell activities (%) were also significantly bigger in the Chlorella group than the placebo group.
Additionally, changed levels of NK cell activity were positively correlated with those of serum interleukin-1β (r=0.280, p=0.047) and interferon-γ (r=0.271, p<0.005).❞
tl;dr = it boosts numerous different kinds of immune cells
PS, if you click though to the study, you may be momentarily alarmed by the first paragraph of the abstract that says “However, there were no direct evidences for the effect of Chlorella supplementation on immune/inflammation response in healthy humans“
this is from the “Background” section of the abstract, so what they are saying is “before we did this study, nobody had done this yet”.
So, be assured that the results are worthwhile and compelling.
Is it safe?
Based on the studies, it has a good safety profile. However, as it boosts the immune system, you may want to check with your doctor if you have an autoimmune disorder, and/or you are on immunosuppressants.
And in general, of course always check with your doctor/pharmacist if unsure about any potential drug interactions.
Want some?
We don’t sell it, but here for your convenience is an example product on Amazon
Enjoy!
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The Complete Anti-Inflammatory Diet for Beginners – by Dorothy Calimeris and Lulu Cook
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First, about the authors: notwithstanding the names, Calimeris is the cook, and Cook is the nutritionist (and an RDN at that).
As for the book: we get a good primer on the science of inflammation, what it is, why it happens, what things are known to cause/trigger it, and what things are known to fight it. They do also go outside of nutrition a bit for this, speaking briefly on other lifestyle factors too, but the main focus is of course nutrition.
As for the recipes: while distinctly plants-forward (as one might expect of an anti-inflammatory eating book), it’s not outright vegan or even vegetarian, indeed, in the category of main dishes, there are sections for:
- Vegetarian and vegan
- Fish and shellfish
- Poultry and meat
…as well as, before and after those, sections for breakfast and brunch and snacks and sweets. As well as a not-to-be-underestimated section, for sauces, condiments, and dressings. This is important, because those are quite often the most inflammatory parts of an otherwise healthy meal! So being able to make anti-inflammatory versions is a real boon.
The recipes are mostly not illustrated, but the steps are very clearly described and easy to follow.
Bottom line: if inflammation is currently on your to-tackle list, this book will be an excellent companion in the kitchen.
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Antibiotics? Think Thrice
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Antibiotics: Useful Even Less Often Than Previously Believed (And Still Just As Dangerous)
You probably already know that antibiotics shouldn’t be taken unless absolutely necessary. Not only does taking antibiotics frivolously increase antibiotic resistance (which is bad, and kills people), but also…
It’s entirely possible for the antibiotics to not only not help, but instead wipe out your gut’s “good bacteria” that were keeping other things in check.
Those “other things” can include fungi like Candida albicans.
Candida, which we all have in us to some degree, feeds on sugar (including the sugar formed from breaking down alcohol, by the way) and refined carbs. Then it grows, and puts its roots through your intestinal walls, linking with your neural system. Then it makes you crave the very things that will feed it and allow it to put bigger holes in your intestinal walls.
Don’t believe us? Read: Candida albicans-Induced Epithelial Damage Mediates Translocation through Intestinal Barriers
(That’s scientist-speak for “Candida puts holes in your intestines, and stuff can then go through those holes”)
And as for how that comes about, it’s like we said:
See also: Candida albicans as a commensal and opportunistic pathogen in the intestine
That’s not all…
And that’s just C. albicans, never mind things like C. diff. that can just outright kill you easily.
We don’t have room to go into everything here, but you might like to check out:
Four Ways Antibiotics Can Kill You
It gets worse (now comes the new news)
So, what are antibiotics good for? Surely, for clearing up chesty coughs, lower respiratory tract infections, right? It’s certainly one of the two things that antibiotics are most well-known for being good at and often necessary for (the other being preventing/treating sepsis, for example in serious and messy wounds).
But wait…
A large, nationwide (US) observational study of people who sought treatment in primary or urgent care settings for lower respiratory tract infections found…
(drumroll please)
…the use of antibiotics provided no measurable impact on the severity or duration of coughs even if a bacterial infection was present.
Read for yourself:
And in the words of the lead author of that study,
❝Lower respiratory tract infections tend to have the potential to be more dangerous, since about 3% to 5% of these patients have pneumonia. But not everyone has easy access at an initial visit to an X-ray, which may be the reason clinicians still give antibiotics without any other evidence of a bacterial infection.❞
So, what’s to be done about this? On a large scale, Dr. Merenstein recommends:
❝Serious cough symptoms and how to treat them properly needs to be studied more, perhaps in a randomized clinical trial as this study was observational and there haven’t been any randomized trials looking at this issue since about 2012.❞
This does remind us that, while not a RCT, there is a good ongoing observational study that everyone with a smartphone can participate in:
Dr. Peter Small’s medical AI: “The Cough Doctor”
In the meantime, he advises that when COVID and SARS have been ruled out, then “basic symptom-relieving medications plus time brings a resolution to most people’s infections”.
You can read a lot more detail here:
Antibiotics aren’t effective for most lower tract respiratory infections
In summary…
Sometimes, antibiotics really are a necessary and life-saving medication. But most of the time they’re not, and given their great potential for harm, they may be best simultaneously viewed as the very dangerous threat they also are, and used only when those “heavy guns” are truly what’s required.
Take care!
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Pneumonia: Prevention Is Better Than Cure
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Pneumonia: What We Can & Can’t Do About It
Pneumonia is a significant killer of persons over the age of 65, with the risk increasing with age after that, rising very sharply around the age of 85:
While pneumonia is treatable, especially in young healthy adults, the risks get more severe in the older age brackets, and it’s often the case that someone goes into hospital with one thing, then develops pneumonia, which the person was already not in good physical shape to fight, because of whatever hospitalized them in the first place:
American Lung Association | Pneumonia Treatment and Recovery
Other risk factors besides age
There are a lot of things that can increase our risk factor for pneumonia; they mainly fall into the following categories:
- Autoimmune diseases
- Other diseases of the immune system (e.g. HIV)
- Medication-mediated immunosuppression (e.g. after an organ transplant)
- Chronic lung diseases (e.g. asthma, COPD, Long Covid, emphysema, etc)
- Other serious health conditions ← we know this one’s broad, but it encompasses such things as diabetes, heart disease, and cancer
See also:
Why Chronic Obstructive Pulmonary Disease (COPD) Is More Likely Than You Think
Things we can do about it
When it comes to risks, we can’t do much about our age and some of the other above factors, but there are other things we can do to reduce our risk, including:
- Get vaccinated against pneumonia if you are over 65 and/or have one of the aforementioned risk factors. This is not perfect (it only reduces the risk for certain kinds of infection) and may not be advisable for everyone (like most vaccines, it can put the body through its paces a bit after taking it), so speak with your own doctor about this, of course.
- See also: Vaccine Mythbusting
- Avoid contagion. While pneumonia itself is not spread person-to-person, it is caused by bacteria or viruses (there are numerous kinds) that are opportunistic and often become a secondary infection when the immune system is already busy with the first one. So, if possible avoid being in confined spaces with many people, and do wash your hands regularly (as a lot of germs are transferred that way and can get into the respiratory tract because you touched your face or such).
- See also: The Truth About Handwashing
- If you have a cold, or flu, or other respiratory infection, take it seriously, rest well, drink fluids, get good immune-boosting nutrients. There’s no such thing as “just a cold”; not anymore.
- Look after your general health too—health doesn’t exist in a vacuum, and nor does disease. Every part of us affects every other part of us, so anything that can be in good order, you want to be in good order.
This last one, by the way? It’s an important reminder that while some diseases (such as some of the respiratory infections that can precede pneumonia) are seasonal, good health isn’t.
We need to take care of our health as best we can every day along the way, because we never know when something could change.
Want to do more?
Check out: Seven Things To Do For Good Lung Health!
Take care!
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How Much Can Hypnotherapy Really Do?
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Sit Back, Relax, And…
In Tuesday’s newsletter, we asked you for your opinions of hypnotherapy, and got the above-depicted, below-described, set of responses:
- About 58% said “It is a good, evidenced-based practice that can help alleviate many conditions”
- Exactly 25% said “It is a scam and sham and/or wishful thinking at best, and should be avoided by all”
- About 13% said “It works only for those who are particularly suggestible—but it does work for them”
- One (1) person said “It is useful only for brain-centric conditions e.g. addictions, anxiety, phobias, etc”
So what does the science say?
Hypnotherapy is all in the patient’s head: True or False?
True! But guess which part of your body controls much of the rest of it.
So while hypnotherapy may be “all in the head”, its effects are not.
Since placebo effect, nocebo effect, and psychosomatic effect in general are well-documented, it’s quite safe to say at the very least that hypnotherapy thus “may be useful”.
Which prompts the question…
Hypnotherapy is just placebo: True or False?
False, probably. At the very least, if it’s placebo, it’s an unusually effective placebo.
And yes, even though testing against placebo is considered a good method of doing randomized controlled trials, some placebos are definitely better than others. If a placebo starts giving results much better than other placebos, is it still a placebo? Possibly a philosophical question whose answer may be rooted in semantics, but happily we do have a more useful answer…
Here’s an interesting paper which: a) begins its abstract with the strong, unequivocal statement “Hypnosis has proven clinical utility”, and b) goes on to examine the changes in neural activity during hypnosis:
Brain Activity and Functional Connectivity Associated with Hypnosis
It works only for the very suggestible: True or False?
False, broadly. As with any medical and/or therapeutic procedure, a patient’s expectations can affect the treatment outcome.
And, especially worthy of note, a patient’s level of engagement will vastly affect it treatment that has patient involvement. So for example, if a doctor prescribes a patient pills, which the patient does not think will work, so the patient takes them intermittently, because they’re slow to get the prescription refilled, etc, then surprise, the pills won’t get as good results (since they’re often not being taken).
How this plays out in hypnotherapy: because hypnotherapy is a guided process, part of its efficacy relies on the patient following instructions. If the hypnotherapist guides the patient’s mind, and internally the patient is just going “nope nope nope, what a lot of rubbish” then of course it will not work, just like if you ask for directions in the street and then ignore them, you won’t get to where you want to be.
For those who didn’t click on the above link by the way, you might want to go back and have a look at it, because it included groups of individuals with “high/low hypnotizability” per several ways of scoring such.
It works only for brain-centric things, e.g. addictions, anxieties, phobias, etc: True or False?
False—but it is better at those. Here for example is the UK’s Royal College of Psychiatrists’ information page, and if you go to “What conditions can hypnotherapy help to treat”, you’ll see two broad categories; the first is almost entirely brain-stuff; the second is more varied, and includes pain relief of various kinds, burn care, cancer treatment side effects, and even menopause symptoms. Finally, warts and other various skin conditions get their own (positive) mention, per “this is possible through the positive effects hypnosis has on the immune system”:
RCPsych | Hypnosis And Hypnotherapy
Wondering how much psychosomatic effect can do?
You might like this previous article; it’s not about hypnotherapy, but it is about the difference the mind can make on physical markers of aging:
Aging, Counterclockwise: When Age Is A Flexible Number
Take care!
Don’t Forget…
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