Why Not Pot? A Review of the Brain-based Risks of Cannabis
Conclusion Evaluating the potential harms of a commonly used drug—especially a complex substance like marijuana—is a challenging but vital task. Fully informed awareness of both the potential and proven benefits and the potential and proven harms of marijuana are necessary in order to have rational discussions with patients, teens, and decision makers regarding marijuana use. Based on a review of the current literature, we suggest the mnemonic DDUMB (dependence, driving, underachievement, mental illness, and “bad to worse”) as a tool that captures several of the more well-supported, brain-based risks associated with marijuana. Using this mnemonic, we reviewed five research-supported harms related to marijuana use. First, cannabis dependence (addiction) is real. Second, driving while under the influence of marijuana is unsafe. Third, marijuana use has a strong association with global underachievement. Fourth, marijuana elevates the risk of developing a psychotic illness and worsens the course of several serious mental health conditions in certain individuals. Fifth, though proving causality is complex, evidence supports a “bad to worse” or “gateway” role of cannabis in the development of other substance use disorders. Important to note, most of these harms are more likely to be present when marijuana use is frequent and starts early (i.e., in adolescence). Though we don’t always heed George Santayana’s aphorism about ...
CONCLUSIONS: Gaps in memory and various memory types were common after ICU admission, whose prevalence waned over time. Compared with nightmares and fearful memories, gaps in memories were most strongly associated with poor mental health and quality of life. Identifying patients with gaps in memories might be an objective way of planning interventions to improve their long-term outcomes.
CONCLUSIONS: Several anatomical, epidemiologic, and physiologic risk factors for clinically relevant paroxysmal sympathetic hyperactivity can be identified on ICU admission. These features help characterize paroxysmal sympathetic hyperactivity as a clinical-pathophysiologic phenotype associated with worse outcomes after traumatic brain injury.
CONCLUSIONS: These recommendations are intended to assist researchers in the design, conduct, selection of endpoints, and reporting of clinical trials involving sedative medications and/or sedation protocols for adult ICU patients who require mechanical ventilation. These recommendations should be viewed as a starting point to improve clinical trials and help reduce methodological heterogeneity in future clinical trials.
OBJECTIVES: We performed a comprehensive health assessment in mechanically ventilated coronavirus disease 2019 survivors to assess the impact of respiratory and skeletal muscle injury sustained during ICU stay on physical performance at 3 months following hospital discharge. DESIGN: Preregistered prospective observational cohort study. SETTING: University hospital ICU. PATIENTS: All mechanically ventilated coronavirus disease 2019 patients admitted to our ICU during the first European pandemic wave. MEASUREMENTS AND MAIN RESULTS: At 3 months after hospital discharge, 46 survivors underwent a...
If it hurts – take notice, and avoid it. Learn from it. If there are other people around, make sure your behaviour is noticeable so they take care of you and don’t do what you just did. If they look after you, you’ll probably do the same thing again when you hurt, if they don’t you probably won’t. This is one description of pain behaviour and how it works. It’s the only part of our pain experience that we can share directly with one another (actions and words). The “doing” part is also the part that is most affected by pain – even distress is signalled to others &nd...
Last week, I became involved in two situations of pain between the eyes that seemed to potentially be presentations of very serious medical conditions. Autumn took a call from her sister late on Friday afternoon. Her sister had been tested for COVID the day before and told Autumn she instantly felt a severe pain betweenRead more …The art and uncertainty of triage originally appeared inKevinMD.com.
Hi, I was wondering if anyone knows of any pain management docs in Scranton, PA or surrounding area (private practice or hospital employed). I'm looking to learn more about local market and network. Thank you.
Hello, I usually dislike these posts, but I am having a huge amount fo anxiety regarding this and want to talk more about it with people who might have some honest input. I am an American Med student interested in general surgery (but also very open to OBGYN yet general surgery comes first). I have done great in my preclinicals and then life happened: 1) I really did not do well on my step 1 (literally barely passed so keep that in mind). 2) I failed my Family med shelf. Otherwise I am... Read more
I've been getting a variety of lectures about various SCS waveforms from my faculty during fellowship, industry events, and society meetings. I think neuromodulation in general (not just SCS) is a fascinating therapy and has a lot of promise. However, I've become a bit disillusioned by the influence of industry in our understanding of these therapies that WE prescribe and implant into our patients. I've heard a lot about the novel mechanisms of action of the various different waveforms... Read more
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