Pain Pill Abuse Higher in Adolescent CBD Oil Users

Adolescent users of cannabidiol (CBD) oil are far more likely to engage in risk-taking behaviors ― such as illegally taking prescription pain medications ― than peers who don’t use CBD, new research indicates.

The study, which included data on 200 youths aged 12 to 23 years, also suggests that 4 in 10 use CBD oil products. Users also reported experiencing increased anxiety over the prior 6 months, but the researchers couldn’t pinpoint whether CBD oil, which is marketed for anxiety relief, might contribute to participants’ anxiety levels.



Nicole Cumbo

“A lot of kids don’t talk to their clinicians about CBD” use, said study author Nicole Cumbo, BS, a third-year medical student at Penn State Milton S. Hershey Medical Center in Hershey, Pennsylvania.

“It’s important to ask kids if they’re using CBD, along with vaping and marijuana use, because it could be causing them more problems than it helps,” Cumbo told Medscape Medical News. “Monitoring for dangerous behaviors in their social history is important. Since we were able to see a correlation between risk-taking behaviors, we should ask kids about risk-taking behaviors as well.”

Touted as a panacea for conditions ranging from insomnia to muscle aches to low mood and more, CBD oil products have become ubiquitous across the United States, Cumbo noted. “Even if you go to a gas station, you see it,” she said. “It’s growing prevalence is apparent, but we weren’t sure what we’d see in our pediatric population.”

Cumbo and colleagues administered questionnaires to adolescents who presented for medical care to a level 1 pediatric trauma center/emergency department affiliated with a children’s hospital in central Pennsylvania. The questionnaire asked about demographics, risk-taking behaviors, and use of CBD oil products. The survey also asked participants about clinical symptoms experienced over the prior 6 months, along with their views on the perceived benefits of using CBD oil.

The average age of the participants was 17.6 years, and 63% were female. Forty percent reported CBD oil use. Compared to nonusers, among those who used CBD oil, there was significantly greater use of prescription medications without a prescription (19% vs 6%; P = .002), as well as greater use of cigarettes (40% vs 8%; P < .0001), chewing tobacco (18% vs 1%; P < .0001), and cigars (30% vs 3%; P < .0001).

No significant differences were found between CBD users and nonusers in symptoms such as chest pain, racing heart, difficulty breathing/cough, dizziness, abdominal discomfort, nausea/vomiting, headache, tremors, sleep disturbances, or dehydration over the prior 6 months.

However, those who used CBD were more likely to report experiencing an increase in anxiety over the prior 6 months (66% vs 47%; P = .009).

Regarding their perceived beliefs about CBD oil, 69% said it is “safer than other drugs,” 33% said it’s “just for fun,” and 48% said it can “help treat my medical illness.” Participants reported that myths about CBD oil include the notions that it’s a gateway drug and that it’s addictive.

“I think there’s a disconnect in

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DrugFacts: Marijuana as Medicine | National Institute on Drug Abuse (NIDA)

What is medical marijuana?

The term medical marijuana refers to using the whole, unprocessed marijuana plant or its basic extracts to treat symptoms of illness and other conditions. The U.S. Food and Drug Administration (FDA) has not recognized or approved the marijuana plant as medicine.

However, scientific study of the chemicals in marijuana, called cannabinoids, has led to two FDA-approved medications that contain cannabinoid chemicals in pill form. Continued research may lead to more medications.

Because the marijuana plant contains chemicals that may help treat a range of illnesses and symptoms, many people argue that it should be legal for medical purposes. In fact, a growing number of states have legalized marijuana for medical use.

Why isn’t the marijuana plant an FDA-approved medicine?

The FDA requires carefully conducted studies (clinical trials) in hundreds to thousands of human subjects to determine the benefits and risks of a possible medication. So far, researchers haven’t conducted enough large-scale clinical trials that show that the benefits of the marijuana plant (as opposed to its cannabinoid ingredients) outweigh its risks in patients it’s meant to treat.

Read more about the various physical, mental, and behavioral effects of marijuana in our Marijuana DrugFacts.

Medical Marijuana Laws and Prescription Opioid Use Outcomes

A new study underscores the need for additional research on the effect of medical marijuana laws on opioid overdose deaths and cautions against drawing a causal connection between the two. Early research suggested that there may be a relationship between the availability of medical marijuana and opioid analgesic overdose mortality. In particular, a NIDA-funded study published in 2014 found that from 1999 to 2010, states with medical cannabis laws experienced slower rates of increase in opioid analgesic overdose death rates compared to states without such laws.1 

A 2019 analysis, also funded by NIDA, re-examined this relationship using data through 2017. Similar to the findings reported previously, this research team found that opioid overdose mortality rates between 1999-2010 in states allowing medical marijuana use were 21% lower than expected. When the analysis was extended through 2017, however, they found that the trend reversed, such that states with medical cannabis laws experienced an overdose death rate 22.7% higher than expected.2 The investigators uncovered no evidence that either broader cannabis laws (those allowing recreational use) or more restrictive laws (those only permitting the use of marijuana with low tetrahydrocannabinol concentrations) were associated with changes in opioid overdose mortality rates.

These data, therefore, do not support the interpretation that access to cannabis reduces opioid overdose. Indeed, the authors note that neither study provides evidence of a causal relationship between marijuana access and opioid overdose deaths. Rather, they suggest that the associations are likely due to factors the researchers did not measure, and they caution against drawing conclusions on an individual level from ecological (population-level) data. Research is still needed on the potential medical benefits of cannabis or cannabinoids.

Read more in our Marijuana Research Report.

What are cannabinoids?

Cannabinoids are chemicals related to delta-9-tetrahydrocannabinol

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How to Prevent Medicine Abuse in Your Home: Safe Storage & Disposal

It’s up to all of us to take action against medicine abuse. The best place to start is in your own home by storing medications safely and securely, and by talking with your kids about the dangers of medicine abuse.

Mind Your Meds

Two-thirds of teens and young adults who report abuse of prescription medicine are getting it from friends, family and acquaintances. Make sure the young people in your life don’t have access to any medications in your home. Follow these three steps to monitor, secure and properly dispose of unused and expired prescription and over-the-counter medicine in your home.

Step 1: Monitor

How aware are you of the prescription medications currently in your home? Would you know if some of your pills were missing? From this day forward, make sure you can honestly answer yes.

Start by taking note of how many pills are in each of your prescription bottles or pill packets, and keep track of refills. This goes for your own medicine, as well as for your kids and other members of the household. If you find you need to refill your medicine more often than expected, that could indicate a problem.

If your child has been prescribed medicine, be sure you control its use by monitoring dosages and refills. You need to be especially vigilant with medicine known to be addictive and commonly abused such as opioids (prescription pain relievers), benzodiazepines (sedatives and anti-anxiety medications) and stimulants (ADHD medications).

Make sure your friends, parents of your child’s friends, neighbors and relatives — especially grandparents — are also aware of the risks. Encourage them to regularly monitor the medicine in their homes as well.

Step 2: Secure

Approach securing your prescriptions the same way you would other valuables in your home, like jewelry or cash. There’s no shame in helping protect those items, and the same holds true for your medicine.

Remove prescriptions from the medicine cabinet and secure them in a place only you know about. If possible, keep all medicine, both prescription and over-the-counter, in a safe place, such as a locked cabinet your teen cannot access.

Step 3: Dispose

Safely disposing of expired or unused medicine is critical to helping protect your kids, family and home. And it decreases the opportunity for visitors in your home, like your kids’ friends, to abuse medicine as well.

The ideal way to do this is by participating in a safe drug disposal program – either a drug take-back day, an ongoing program in your community, a drug deactivation bag, or a drug mail-back program. To find a take-back location or event near you, visit the American Medicine Chest Challenge or the DEA website.

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