Tag Archives: insomnia

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Marijuana update

https://newsroom.heart.org/news/marijuana-use-linked-with-increased-risk-of-heart-attack-heart-failure

Marijuana is still illegal at the federal level, but some states have legalized it. I agree with legalization but I don’t think of it as benign or safe at all. It’s clear that it can be addictive. A study of teens (with parental consent and where they paid the teens to try to quit for a month) showed that the teens that smoked daily had real trouble stopping, even when quite motivated. The U of WA Pain and Addiction telemedecine said that about half of daily users have “overuse syndrome” and have trouble quitting.

I worked with two people who were trying to quit. The big issues for them in quitting were insomnia and anxiety. Marijuana can suppress both anxiety and help with sleep. However, our brains do not really like that sort of daily interference. The neurons can remove receptors from the cell walls if they are feeling overwhelmed. It is like trying to listen to music with ear plugs. You turn the music up. The drug is the ear plug: when the earplugs are gone, the music is way too loud. We can’t really “turn the music down”, so it is not much fun letting the neurons recover.

With the edibles and THC vs the other one, it’s even more confusing. I had many patients taking edibles or tinctures to sleep. Some said, “Oh, it’s CBD, so it doesn’t make me high. So it is not addictive.” We do not know it that is true. With opioids, people can have opioid overuse syndrome without ever getting high, just from being on pain medicine as directed. And marijuana does not have only CBD and THC. There are over 300 different cannabinoids in the plants, and CBD and THC are just two of them. I have no idea if the edibles and tinctures have the other 298 or more and what they do to the cannibinoid receptors in our brains alone or in combination.

I don’t want to have any overuse syndrome: alcohol, opioids, gambling, marijuana, whatever. I know I can get off caffeine in 24 hours, though it involves an awful headache. I am nearly off coffee now, because my body only likes coffee when I have pneumonia. I quit coffee from 2014 to 2021 and now am quitting again.

The two studies in the article look at people who do not smoke tobacco and who are using marijuana. They are seeing an significant increase in heart disease, heart attacks, sudden death and congestive heart failure. Congestive heart failure is pump failure, where the heart does not pump correctly. This is a major problem, as you might guess.

Be careful out there.

I took the photograph at Fort Worden last week on a day where both the wind and the tide were howling.

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Don’t try this at home

https://news.ohsu.edu/2022/03/17/little-evidence-on-how-psilocybin-therapy-interacts-with-existing-psychiatric-treatments-review-finds?linkId=156952130

People are busily hopping on the psilocybin bandwagon. DON’T. Why not, you say, it’s NATURAL. Well, the death angel mushroom is also natural but it will kill you. So are red tides, poisonous snakes and sharks.

You wouldn’t take your buddy’s appendix out in your kitchen, would you? Don’t mess with your buddy’s brain either. Especially if there is already a behavioral health diagnosis and/or an addiction already on board. Either or both might get WORSE rather than better. Wait for the research.

And remember: one in four people meets diagnostic criteria for a behavioral health diagnosis at least once in their life. When there is also an addiction, we call it dual diagnosis.

And for pity’s sake, be careful with pot products, ok? It’s a total myth that they are not addictive. Yeah, people have told me for my entire career, over 30 years, “I am not addicted to (pot, heroin, alcohol, gambling, cocaine, meth, crack, whatever)”. ALL ALCOHOLICS say this the first time they are admitted for crashing a car or alcohol poisoning or vomiting blood or liver failure. “Not me. I am stopping today. I am NOT addicted. I do not need to talk to the substance abuse person.” We roll our eyes and send in the substance abuse person anyhow, because HEY, THE PERSON IS TOO ADDICTED AND IN DENIAL.

If you are going to use pot products, use them one or two times a week. Max three. Because a study of teens that paid them (with parental permission, consent, etc) to stop for a month found that almost none of the teens who used pot daily could stop. They relapsed. And they complained of anxiety and insomnia. And I have worked with adults trying to quit: again, anxiety and insomnia. The teens in the study who only used 2-3 days a week COULD stop for the month. The study monitored urine drug screens quite strictly.

And if you say, well, I can’t sleep without it. Um, yeah, that is addiction. I would wean. Reduce amounts and then start with one night a week without it. Good luck. Get help if you need it.

And don’t jump on the psilocybin bandwagon!!! Holy moly, humans are amazing, the ways they think up to hurt themselves and each other. If you want to be in a clinical trial, go find one. Don’t fool with Mother Nature, she can be a killer.

Happy solstice and blessings.

Here is the scientific paper for the science geeks like me:

https://link.springer.com/article/10.1007/s00213-022-06083-y

The picture is just a picture. No worries.