Marijuana users more prone to infections after knee, shoulder surgeries
consumer.healthday.com
consumer.healthday.com
As a former nicotine addict, the idea of any serious nicotine addict avoiding tobacco for "a period of time" is laughably naïve. Unless that period of time is less than a few hours.
For me, when I was smoking a pack an half a day, the idea of stopping temporarily was incomprehensible. I smoked through root canals, strep throat, countless head colds, you name it. All of my quit attempts, including the successful one 5 years ago were like a waking nightmares that made my life a living hell. Maybe your experience is different. Many people's are.
One cigarette is all it takes; it's not a slippery slope, it's sheer cliff.
Would like to see how the study controls for that, but didn't actually see a direct link.
The article basically acknowledges this. They have a ton of data - over a million surgeries and 22K marijuana users. However, there's no proof of cause-and-effect because they have no way of knowing if it's correlation of causation. All they can say for sure is that these patients are at increased risk.
https://www.inverse.com/article/32064-america-europe-tobacco...
But spliff smokers are in the minority in the US. Was more prevalent in the past when more people smoked tobacco.
Nowadays most people use carts / pens for cannabis use anyway.
I wonder if that's true or selection bias. Certainly we see more people with carts / pens, but I wonder if that's actually true of overall usage. Pens allow it to be less conspicuous and smelly which leads to more conspicuous usage, but flower smokers are still toking in basements and garages.
This is such an interesting observation. It may be true that worldwide it is MORE common to mix cannabis with tobacco than to not. But we wouldn't think that in the United States, because it is much more rare here.
Older cannabis users are more familiar with spliffs, and there are some sub-cultures where it is common, but it is not the norm here.
Either way, there were brain pops that were happening around inside my head that I did absolutely not like. Not sure how others describe the nicotine phenomenon. I just know I didn't like that one bit.
Do you mean head change? Basically a dizzy/foggy/rolling feeling mainly in the head.
It gets less extreme with tolerance, similar to cannabis highs.
Yah I never got a gentle dizzy rolling feeling.
Instead it felt like my brain was guitar strings and they were being plucked and vibrating. Then another. And another. They were very sudden, pluck/vibrate, and sped up the longer I smoked tobacco.
I did that pipe for about 20m. They sped up to about 3/second around the 10m mark. They finally quit at the 30m mark (10m after stopping).
I'm sure they slow down with tolerance. I just know I didn't like the feeling even starting.
Though people still roll “spliffs” which is a mix of tobacco and weed, but the people that do that are few and far in between. Though people do roll “blunts” and “Woods”, which is basically a gas station cigarillo (swisher, Blackwood, etc) that’s opened up to let out the tobacco and weed is put in there instead, but the wrapper itself is either tobacco leaf or very close it—and this is a much more popular option, but the quantity of the tobacco smoked is as thin as the wrapper itself and it’s also more extravagant than a joint or using a bong.
In the 80's and 90's where I lived (rural NE US), pot smokers who didn't smoke tobacco were rare and looked down on.
https://podcasts.apple.com/us/podcast/huberman-lab/id1545953...
I've smoked weed for about 50 years. During that time I had an ACL reconstruction on my left knee. I healed very well, no infection whatsoever, and went on to master double diamond snow skiing. Also while smoking cannabis routinely.
I haven't had a lot medical procedures, but I am in my 60s now and have had a couple of small surgeries.
I've never experienced any infection issues. I would say in general, I heal really well, and have a very healthy lifestyle (ran 6 miles yesterday).
I used tobacco only for a short while in high school and have never had any desire to pick it up again.
The rest of murica is dedicated to alcohol, tobacco and firearms like the little baby jesus intended. While they're generally the ones blowing their own brains out while shit drunk at 4am...
This whole treatment of cannabis like some kind of kryptonite is just plain nonsense...
The term "marijuana dependence" suggests either bias in the diagnoses, or extremely heavy users. Smoking marijuana is still smoking, and I've always been under the impression that some (though far from all) of the risk from smoking tobacco was just because of inhaling smoke.
Also, as another comment mentions, I can't see anything indicating they controlled for tobacco smoking.
I wouldn’t dismiss it as bias. Marijuana dependence is a very real phenomenon, despite the pop culture “it’s not physically addictive” trope that tries to downplay drug dependence.
They’re looking at 22,000 out of 1.85 million patients, or around 1% of patients. They weren’t trying to look for casual or intermittent users.
Focusing on those diagnosed according to the criteria of marijuana dependence is the clearest way to remain objective and get a clear signal out of the study. Those with marijuana dependence are the people consuming frequently, and therefore likely to consume during the recovery period.
Yes, I accounted for that by mentioning the alternate possibility of extremely heavy users. A typical user ([edit: at most] a few nights a week) shouldn't pay much mind to this study, and likely neither should someone who primarily vapes or consumes edibles.
> The definition of marijuana (Cannabis) dependence (addiction) contains three critical elements. These are (a) preoccupation with the acquisition of marijuana, (b) compulsive use of marijuana, (c) relapse to or recurrent use of the marijuana.
It reminds me of the best description of alcoholism I read, via a charity, that pointed out it was a mistake to think of it in terms of heavy drinking but whether someone was able to control their drinking (or more accurately, themselves when drink is around). If you can't turn down a drink, or you find there are environments where you can't turn down a drink, you're not in control. That's what leads to heavy drinking but they're not the same thing.
Control is part of it, but there are other aspects as well. Many of them deal with control, but not all. Meaning you could ostensibly be “in control” and still be diagnosed with a substance abuse disorder.
- Taking the substance in larger amounts or for longer than you're meant to
- Wanting to cut down or stop using the substance but not managing to
- Spending a lot of time getting, using, or recovering from use of the substance
- Cravings and urges to use the substance
- Not managing to do what you should at work, home, or school because of substance use
- Continuing to use, even when it causes problems in relationships
- Giving up important social, occupational, or recreational activities because of substance use
- Using substances again and again, even when it puts you in danger
- Continuing to use, even when you know you have a physical or psychological problem that could have been caused or made worse by the substance
- Needing more of the substance to get the effect you want (tolerance)
- Development of withdrawal symptoms, which can be relieved by taking more of the substance
[1] https://www.verywellmind.com/dsm-5-criteria-for-substance-us...
The argument you’re making is flawed because it’s based on the users perception of a problem and not the standardized clinical definition. People (especially addicts) are not wholly rational. People will rationalize away a problem to suit their irrational biases. If a substance is detrimental to my health and I say “well, I don’t care. I could quit if I wanted to” it doesn’t negate the fact that it’s still detrimental to one’s health. It’s still a substance abuse problem by the clinical definition even if I’m claiming to be “in control”. If your doctor diagnoses you with obesity and you claim you can diet if you wanted to, it doesn’t make your obesity diagnosis moot. Your perception of self control doesn’t impact the objective diagnosis.
Your take is a bit like the way people say the best way to solve the problems with illegal drugs is to make drug use legal. (And FWIW I’m pretty libertarian on this issue) Sure, by definition it’s no longer a legal problem but it’s a bit of a hand wavy effort that leaves most of the residual problems intact. It just reframes it in a way that ignores them.
It’s also one of the problems with modern debate in that anyone can “do their own research” (which often means just reading an abstract that suits their confirmation bias without a grounded understanding of the full context). It devolves into rules-lawyering where people argue about what the definition of “is” is. We have standardized definitions for a reason.
It's a very strange assumption to make given we're discussing clinical diagnosis. Surely the most usual set of circumstances is that a user seeks help because they have (or perceive) a problem and a clinician diagnoses them. There certainly can be others that include self-diagnosis but you should really start from the usual, especially if you're going to avoid unintentionally building straw men.
It doesn't matter who's making the decision about control. Even if a doctor thinks you're capable of controlling your diet, it doesn't make their clinical diagnosis of obesity go away. It takes more than control to alleviate the problem (e.g., knowledge about diet, access to healthy food, motivation etc. are also necessary). Either you meet the clinical definition or not. If you have the utmost ability to control your diet but still have a BMI of 60 because you lack those other factors, guess what, you've still got an obesity problem. That's why the clinical definition has multiple diagnostic factors.
The point is clinical definitions matter. If you don't think so, try to get an insurance company to pay for rehab based on your personal definition without having a clinical diagnosis of substance abuse.
> A definitive diagnosis entails confirming the presence of addictive behavior by identifying a preoccupation, compulsivity and relapse relative to the drug
Preoccupation is a lack of control.
Compulsivity(sic) is a lack of control.
Relapse is a lack of control.
In fact, the authors of that paper wrote a book about alcohol abuse[1] that is littered with quotes about control, like “These criteria reflect the loss of control over alcohol that is central to the diagnosis of alcoholism” or “The loss of control over the self and the alcoholic is present in the enabler as it is present in the alcoholic”, or my favourite:
> The behavioral criteria describe the loss of control over alcohol that leads to the adverse consequences
As to this claim by you:
> Even if a doctor thinks you're capable of controlling your diet, it doesn't make their clinical diagnosis of obesity go away"
They're not (or haven't been) capable of controlling their diet, that's why they're obese, and that's why they're getting help from a professional, but regardless, you've chosen a poor analogy. Someone with an addiction to eating or sugar would be much better, as obesity is a consequence of their actions, just as "Not managing to do what you should at work, home, or school because of substance use" would be an possible consequence of marijuana dependency.
[1] https://books.google.com.au/books?id=NrHzBwAAQBAJ&q=control#...
>I provided the definition, and I also provided a paper
Yes, but did you notice that the paper you cited is from 1989? And that I cited the more modern DSM V, which did not exist when that paper was published? Also note that you keep using the term "dependence" and I'm using "substance use". This is because the terminology was deliberately changed in the DSM V. It was updated to combine both "use" and "dependence" and merged them into a the category of "substance use". This includes the criteria that are not specifically related to the locus of control. This is what I mean about drawing strong conclusions from a paper when you don't know the fuller context.
I don't think you're understanding my point about control so I'll try one last time. I've already agreed that control is part of the definition; so I don't think we disagree there. But I am saying the definition goes beyond just the idea of control. I get the impression you also agree here because you’re couching your statements to now include the “critical” (I.e., non-exhaustive) elements. It's possible to have the capability of control, but not exercise that control or not have the other elements to get a specific outcome. That doesn't make the clinical diagnosis go away.
Keeping with the obesity analogy, consider a sumo wrestler who is, by clinical definition, morbidly obese. They could very well have phenomenal willpower to control their diet, but choose not to because their chosen profession gets a benefit from being larger than their opponent. In some sense, they choose to be obese. A clinician will still say they have an obesity problem. (It seems like you're assuming that, by the nature of their diagnosis, they are trying to fix it. i.e. 'trying to get help from a doctor'. That's assumption is not included in the distinction I'm making.)
Now transfer that to an addict. Many choose to chase a high at the cost of their family, career, and/or health. To them, it's a worthy tradeoff. And the way substances affect/change the manner that we decide those tradeoffs is very real. Even if they could stop cold-turkey, they still have a clinical substance abuse problem. Your assumption is that they want to stop because of those ramifications and can't. I'm saying that they may not want to stop. They're still addicts. That's the pernicious part of your definition; just because they're doing it willfully doesn't make the problem go away any more than legalizing drugs makes society's drug problems magically go away.
That would be very convenient for you so I'm glad I could help, I'd hate for you to challenge your preconceptions. I certainly wouldn't be able to think the same in return. How could it be so!
As to your next paragraph about the DSM where you've criticised the cited paper yet ignored the provision of the actual DSM-5 criteria in the following comment. The updates you point to were made to improve the capture of abuse in the diagnostic criteria, and that does not downplay the control aspect or go beyond it (or whatever strange angle you wish to provide). The idea that dependence does factor in control but abuse doesn't is absurd.
> This includes the criteria that are not specifically related to the locus of control
There are no criteria that do not relate to control.
> I don't think you're understanding my point about control so I'll try one last time.
Again, so convenient, but I'm very happy to see the words one last time, we'll see if your self control reaches that far.
> I get the impression you also agree here because you’re couching your statements to now include the “critical” (I.e., non-exhaustive) elements
Is that your impression? I'm amazed at how all of these insights into my intentions always align with your convenience. Funny that! What a run you're on.
Regardless, I started with the critical elements, you brought up the other elements, it makes no difference to my point either way.
> It's possible to have the capability of control,
Everyone without a pre-existing disorder has the capability of control.
> …but not exercise that control
So they're not in control then.
> That doesn't make the clinical diagnosis go away.
It wouldn't, because they're not in control. If they were, they wouldn't have a problem and wouldn't be able to meet any but one - if that - of the criteria on the list. Lack of control is a pre-condition.
> Keeping with the obesity analogy, consider a sumo wrestler
Here you repeat the faults of the previous attempt at this analogy, it's a restatement that does nothing to fundamentally improve it.
> A clinician will still say they have an obesity problem
Because obesity is a problem because of its negative health consequences despite any self control. A sumo's job is not affected, it is their job. It doesn't concern legal problems or wanting to stop etc, it concerns known health risks that they are (hopefully) aware of and decide to take on in full control. There's no compulsion from inside or out.
An addict is *not in control*. They don't make a trade off as they unable to choose another path, there's no trade going on, hence why the criteria are what they are, and hence your analogy being incredibly poor.
Your analogy would hold where someone with a known predisposition to some illness (mental or physical) or who has or had a illness decided to imbibe marijuana and this affect their health, like someone with COPD lighting up. But they wouldn't fulfil the marijuana dependence nor substance abuse criteria, they're in control. They'd still get a clinical diagnosis like that of the sumo but for their COPD, not substance abuse.
> Your assumption is that they want to stop because of those ramifications and can't. I'm saying that they may not want to stop.
How did you read my mind yet again? You didn't. Their desire to stop or continue are irrelevant, they can't stop.
> Even if they could stop cold-turkey, they still have a clinical substance abuse problem
They would possibly only fulfil one criteria (cravings and urges to use the substance), so no, they wouldn't. Objectively and according to the DSM, IV or 5.
I believe my wish to convenience your faultless mental processes has reached its limit.
Edit: I realized I said nothing about amount. I go through approximately 1/2 to 1 gram daily.
Give it a bit; it was just discussed at a conference and not even the preprint is out.
This is why I hate the scientific press; everyone jumps the gun, and people who want more information are left hanging until the study no longer has public attention.
Respectfully, objecting to "marijuana dependence" suggests bias on your part. What else would you call heavy users who loath going a day without it, even though it's having a deleterious effect on their life? There has long been a popular stigma against recognizing the existence of marijuana dependence, backlash to DARE-style anti-drug propaganda I think, but let's be real. There are a lot of people who use it habitually and heavily and feel unable or unwilling to stop even though it's negatively effecting their relationships, work, etc.
Sure it's not chemically addictive in the same was as alcohol or heroin, but dependence is a broader phenomenon than that.
FYI, I've smoked weed every day for 44 years straight.
Today, I am at, or near the peak, of my physical health (180 lb, 6'2, daily swimmer), I sleep like a baby and wake up every day at 8 am. And I swim every day.
Swimmers, in general, are optimistic and far more tolerant of misery, and you haven't accounted for that bias.
Also there are plenty of other athletes who swear by marijuana usage, you aren't even unique in that! My point is that the stereotype of a heavy marijuana user is very different from you, and that said stereotype could provide an alternative causal mechanism that we need to be accounted for in research.
"marijuana dependence" - there is no chemical dependence with cannabis. None. Nada. Zilch.
> smoking tobacco was just because of inhaling smoke
The danger is inhaling burnt plant matter along with the slew of crap companies spray on tobacco. Straight tobacco has a VERY DIFFERENT taste and "cleaner". Still not great for you.
And most cannabis is vaped these days. In that way, it's with the THC oil with terpenes. And that profile is very different than burning plant matter, since in a vape it's vaporized oils (and some metal from the ceramic/metal filament).
I'm not sure if that's the case. Anecdotally, I see very little vaping and a large amount of smoking in a state where it's not legal recreationally. In another state where it is legal recreationally, I see a healthy mix of vaping and smoking and I can't say that I've seen one more than another there. I wonder if someone has collected numbers for this, I would be interested to see.
> "marijuana dependence" - there is no chemical dependence with cannabis. None. Nada. Zilch.
I don't know what it's called but if I stop smoking then the next few days I have appetite and sleeping issues.
Lets be clear what this "psychological dependence" is.
Alcohol and Benzos can kill you, so when people talk about physical dependence, they usually mean them. I feel like this is often used to obfuscate the fact that because ____ can't kill you it must not be addictive.
Then there is psychological addiction: Anything that makes you "feel good" and "want more" falls in this category.
So amphetamine, weed, sweets, and coffee, for example are generally cited as addictive because they are easy rushes to feeling good irrespective of their harm.
Where cannabis gets deserved flack is that proponents are downplaying the harm and addictiveness by comparing it to "chewing your nails"
Here is a very good source that illustrates the benefits and harms of medical cannabis.
https://accpjournals.onlinelibrary.wiley.com/doi/10.1002/pha...
This is pretty obvious, and it takes a certain strained logic to ignore it. I suspect folks who over-react to the suggestion that strong chemicals can become a detrimental habit, have perhaps some vested interest in believing it.
Most people take Marijuana by smoking it, sometimes in combination with tabaco.
Most people which take marijuana very frequent do so because they had and in many cases still have some form of physical and/or mental distress.
So......
Isn't this a relatively clear cut case of correlation without causation?
Or do I miss something?
I'd like to see the work on that one - most frequent users I know are simply stoners
Most people I meet which didn't had problems and still often took marijuana due to group dynamics also pretty much only took it in that group dynamics and stopped frequent consumption after a year or two at most. But this kind of frequent consumers where in my experience very very rare.
Worried well worried, well.
No - not really. It seems to be rather variable, depending on the disease in question.
Cannabis use was associated with much lower rates of COVID-19, for example: https://pubmed.ncbi.nlm.nih.gov/35007072/
It also seems to play an interesting part in inflammatory response (cannabis use is associated with anti-inflammatory agents) - which may or may not matter, depending on the disease. Ex - there are limited studies on cannabis and the impacts on the immune system in HIV patients, with most showing no effect, but the studies are very limited, and often flawed (https://www.ncbi.nlm.nih.gov/books/NBK425755/)
Basically - We don't know shit because of how the US scheduled the drug, and the near complete lack of decent research on it over the last 50 years.
I would still say inhaling smoke of any kind is almost certainly not good for you, but we have a real lack of data here... which is a shame.
The more interesting matter is what effect cannabis might have when it isn't smoked.
I do think the mixed findings around the immune system need a lot of work right now. We're basically 50 years behind where we should be - Given that the original comment I responded to is not entirely wrong either, we do have some evidence that cannabinoids suppress the immune system in helpful ways for some autoimmune diseases (such as Crohn's/IBD) which I believe is why there was interest in evaluating the impact in HIV patients, where the results were inconclusive.