Addiction Policy Forum Blog

7 min read

We know vaping can cause serious lung problems. A new study says it might also cause cancer.

By Mark Gold, MD on December 19, 2019

In a study published this week, researchers asked tens of thousands of individuals over 12 years of age about their use of tobacco products, e-cigarettes, and their health, and conducted follow-up questions over three years.1 They found the development of lung problems like emphysema, bronchitis, asthma, and chronic obstructive pulmonary disease in individuals who had used e-cigarettes in the past or currently use them. Combined use of e-cigarette and tobacco products dramatically increased lung disease risks by an incredible 330 percent. The researchers concluded that, “Use of e-cigarettes is an independent risk factor for respiratory disease in addition to combustible tobacco smoking.” The study’s senior author, Stanton Glantz, told CNN, "I was a little surprised that we could find evidence on incident lung disease in the longitudinal study, because three years is a while but most studies that look at the development of lung disease go over 10 to 20 years.”

The Centers for Disease Control (CDC) reports that, as of December 10, 2019, there are 2,409 hospitalization cases of vaping-related lung injuries in the U.S., resulting in 52 deaths across 26 states and Washington, D.C.2 The FDA has found THC in most of the samples it’s studying from these cases and has highlighted Vitamin E acetate as a chemical linked to some of the lung injuries. But the CDC warns that it still does not know how many other chemicals and products may be involved, and says that, “the best way for people to ensure that they are not at risk while the investigation continues is to consider refraining from the use of all e-cigarette, or vaping, products.” NIDA just reported that 3.5 percent of 12th graders and 3 percent of 10th graders say they vape on a daily basis, with 14 percent of 12th graders also saying that they vaped marijuana in the previous month. That figure is twice as large as it was last year. 

Though federal officials have reportedly backed away from banning flavored vaping products3, some states have implemented such restrictions. And other national lawmakers are still considering similar options to confront the vaping epidemic.4 Dr. Scott Gottlieb, the former FDA Commissioner, has now recommended banning all cartridge-based e-cigarette products, which would include popular devices like Juul.5 Gottlieb, along with other experts, is worried about the epidemic of youth vaping, nicotine use and dependence which can lead to the use of tobacco-based products, the number one cause of preventable death, and other substances later in life. 

Stories about vaping-related severe lung diseases, the epidemic of youth use, and public policy responses are important for patients, families, medical professionals, and consumers to follow. But we should also continue to monitor research that paints an even more distressing picture of e-cigarette products. In a recent study, researchers looked at the association between e-cigarette use and cancer.

Continue Reading
6 min read

Can CBD be used to treat Angelman syndrome? Here’s what new UNC research says

By Mark Gold, MD on October 17, 2019

Cannabidiol (CBD) is a “phytocannabinoid” part of cannabis, or an element created from the cannabis plant. According to a recent New York Times article, “The CBD industry is flourishing, conservatively projected to hit $16 billion in the United States by 2025. Already, the plant extract is being added to cheeseburgers, toothpicks and breath sprays."1 The FDA has approved Epidiolex, a CBD oral solution, for prescriptions to patients two years of age and older to treat certain intense forms of epilepsy, Lennox-Gastaut syndrome or Dravet syndrome, marking the first official go-ahead for a marijuana-derived substance.2 CBD, in short, makes headlines. Yet some consumers buying a CBD product sold over-the-counter have had difficulty finding a label and knowing what they’re actually getting.3 For other potential consumers, the biggest questions aren’t about a buzzy new wellness trend—they’re about failing a drug test after acquiring impure CBD or THC in a purchase.4 

Consumers try to balance these fears with the purported benefits CBD. It is true that Epidiolex has been life-changing for the seizures associated with Lennox-Gastaut syndrome and Dravet syndrome. For parents and children coping with these conditions, all other treatments have failed. CBD may have benefits for other patients with rare or difficult-to-treat neurological diseases. In a recent study, researchers at the University of North Carolina wondered if CBD might help treat individuals with another condition involving severe seizures, Angelman syndrome. 

Continue Reading
8 min read

Substance use disorders take a toll on more than just health

By Mark Gold, MD on October 10, 2019

Many Americans are aware of the United States’ current overdose and addiction epidemic. For patients, families, friends, and loved ones, the tragic health and behavioral effects of substance use disorders (SUDs) are readily recognizable at a level of intimate, granular detail. Among individuals who have used substances, not all have SUDS, but many have spent money on illicit substances. SUD-related discussions frequently focus on survival or addiction, sometimes looking past another elephant in the room: finance. A recent RAND report for the Office of National Drug Control Policy (ONDCP) sheds an important light on how much money we pay for illegal drugs by highlighting Americans’ expenditures on methamphetamine, marijuana, heroin, and cocaine.

Continue Reading
6 min read

Now What? THC Exposure and the Adolescent Brain

By Mark Gold, MD on August 29, 2019

As more states move to decriminalize or legalize marijuana and THC-related products, researching potential harms associated with cannabis use is an even more important field of study. In certain cases, such as marijuana-related medications, there is sound evidence. Usually, the manufacturer of a drug has to do clinical trials, called FDA trials, to demonstrate dose, safety, and efficacy for a particular problem or illness. The FDA did approve the first drug comprised of an active ingredient derived from marijuana to treat rare, severe forms of epilepsy. This was a well-conceived and logical trial and process. It resulted in the approval of Epidiolex (cannabidiol, or CBD) oral solution for the treatment of seizures associated with two rare and severe forms of epilepsy, Lennox-Gastaut syndrome and Dravet syndrome, in patients two years of age and older. This was the first FDA-approved drug that contains a purified drug substance derived from marijuana. It was also the first FDA approval of a drug for the treatment of patients with Dravet syndrome. Notably, however, the FDA did not approve a crude plant or marijuana, but CBD. CBD does not cause intoxication or euphoria, the “high” that comes from marijuana’s tetrahydrocannabinol (THC). In this case, we know that the medication is safe, we know its formulation and composition, and we know the dose. We also know that before this treatment, there were no good alternatives.

According to pediatricians and research scientists, there’s no scientific evidence supporting the acceptability of adolescent marijuana use, and products sold in dispensaries pose considerable risks to children and teens.1 The situation with cannabis, vaping THC, and other preparations is considerably different from that of an FDA-approved medication. In these cases, sadly, we are doing the research after the fact. We know that laws are meant to prevent children from using and smoking marijuana, but the public appears confused about safety warnings when children and adolescents seem like they are safely given cannabis for seizures. Recent data shows that use is increasing among young people. A SAMHSA report found that marijuana is teens’ most widely used illicit drug.2 Frequent marijuana use, in both youth (aged 12-17 years) and young adults, appears to be associated with risk for opioid use, heavy alcohol use, and major depressive episodes. Youth have access to the legal cannabis and related product markets, as well as the thriving illicit marketplace for drugs. Health problems linked to vaping may be in the headlines, as many of those with reported lung damage have vaped THC, but it is not the only problem facing teen users.3 

What does the latest research tell us about the effects of cannabis on the adolescent brain, and do we know enough to make recommendations? 

Science has not shown that cannabis is performance-enhancing like amphetamines, psychostimulants, or medications like methylphenidate given to people with learning problems. Research has clearly shown that adult cannabis use can affect a person’s memory, performance and ability to learn. Recently, Gorey et. al. conducted a systematic review of 21 human and animal studies to investigate whether age influenced the effects of cannabis on the brain, and found preliminary evidence that suggested it does. Further understanding the differences between how cannabis affects the adult brain versus the adolescent one could help us create better messaging and education for youth about how cannabis could affect them.  

Continue Reading
3 min read

Can CBD Help in the Treatment of and Recovery from Opioid Use Disorder?

By Mark Gold, MD on June 13, 2019

The physiological cravings that accompany addiction, along with memory cues and environment triggers specific to each patient can cause a recurrence of use or relapse. As such, effective treatment needs to address a person’s behavioral health and help them learn how to cope with stress and environmental triggers.

Continue Reading
3 min read

With edible marijuana, kids are at risk.

By Casey Elliott on April 20, 2019

From edibles appealing to children to increased use among parents, youth are on the frontlines as America grapples with loosened marijuana access

Continue Reading