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Archive for the ‘Clinical studies’ Category

High Blood Pressure in Young Adults LIkely to Go Undiagnosed

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A significant percentage of college students continue to smoke tobacco products despite overwhelming evidence of the health hazards incurred.  Although many are sporadic smokers, or prefer to use tobacco products through hookah which studies indicate is even more hazardous), they are at risk for developing nicotine dependency and a life long smoking habit.

The prospective cohort study in Japan gives a clear number of years of life lost as a result of smoking.  If risk of COPD and cancer is not sufficient to dissuade young adults from using cigarettes, perhaps the likelihood of a 15% shorter life span will?

A Third of College Students Smoke

A Prospective Cohort Study on the Impact of Smoking on Mortality and Life Expectancy

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This article summary is worth sharing with college health providers and staff, as well as students.

Hookah smoking has been shown to actually be more hazardous than cigarette smoking, something most students are unaware of.

Hookah Smoking Increasingly Common

 

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This opinion article brings up some important points relevant to how we might approach treatment of college students’ sleep issues–

Rethinking Sleep–New York Times 9/23/12

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Persistent Cannabis users show neuropsychological decline from childhood to midlife  

This recent study published in the Proceedings of the National Academy of Sciences warrants attention among college health providers who are seeing nearly a third of their student-patients using cannabis in various forms within the previous thirty days, primarily for recreational purposes, but increasingly as legal treatment for medical diagnoses.

if you believe the extremely vocal marijuana proponents, cannabis can treat almost any condition under the sun, and in a number of states now is being prescribed and encouraged for everything from anxiety to insomnia to sinusitis to asthma to arthritis to headaches to premenstrual syndrome.  If you are simply alive, there is a good chance you have at least one symptom that warrants a medical marijuana card. It is a fine example of not-so-modern snake oil, as it has been around for thousands of years, except now we have multiple state legislative bodies putting their stamp of approval on it.  I’m concerned our nation’s overwhelming drug abuse statistics will not decline with the legalization of the possession of small amounts of marijuana for medicinal purposes,  in addition to open marketing, sale and distribution.  We are simply bringing the dealers and pushers out of the shadows–not a bad thing if we can all agree that a staggering percentage of the population, including our brain-development-vulnerable adolescents, suffer symptoms deemed worthy of being medicated with a mood altering substance well known to cause dependency, not to mention a host of psychiatric problems including new onset panic disorder, dissociative symptoms and psychosis in vulnerable individuals.

Patients who have antipathy for the pharmaceutical industry or for government agencies responsible for studies of drug safety and effectiveness seem to lose their skepticism when confronting the for-profit motivation of marijuana growers, brokers and storefront sellers.  These patients prefer to trust a physician/chiropractor/naturopath sitting in a temporary booth at a Hemp Fest willing to pocket $150 cash for a ten minute assessment of symptoms in exchange for a signature on a medical marijuana card. Many choose not to be followed by responsible health care providers who might actually take a thorough history, do a complete examination and lab tests including drugs of abuse testing, possibly order confirmatory imaging studies, and might actually recommend treatment that is proven in multiple controlled studies to be effective.

In my university health center clinic I’ve been asked by several otherwise healthy teenage college students if I would prescribe medical marijuana for their stress-related headaches.  These young people have friends who have gotten their medical marijuana card elsewhere so they can “smoke whenever they need to” without fear of being found in possession by law enforcement.  They want the “get out of jail free” card, or better yet, “never get arrested to begin with” card.  They have symptoms, as all of us do, but none of these are patients with chronic disease found unresponsive to other treatment.   These are patients who have never had more than a cursory headache evaluation, never had a trial of non-pharmaceutical modalities like relaxation techniques or massage, or prophylaxis with non-addictive medication.  Yet they are willing to sign on to a substance that has, at best, a shadowy origin with no quality standards in production, distribution or dosing, is traditionally and most expediently used only by inhaling smoke or vapor, and has well-studied adverse effects on short and long term memory, focus and reaction time.   All this defies logic, especially in a college student who needs every neuron at the ready to absorb, retain and process complex information, something marijuana has proven ability to impair.  I’m perplexed at how easily these leaves of grass are given a pass by young and old, rich and poor, professional and blue collar, liberal and conservative.

Certainly marijuana is the “least” of the problem recreational drugs, not as physically devastating nor by itself  responsible for overdose fatalities like alcohol, benzodiazepines, cocaine, methamphetamines, or opiates, but it still has the potential to ruin lives.   In its twenty first century ultra high concentrated version,  far more powerful than the weed of the sixties and seventies, it renders people so much less alive and engaged with the world.   They are anesthetized to all the opportunities and challenges of life.  You can see it in their eyes and hear it in their voices.  In a young person who uses regularly, which a significant percentage choose to do in their fervent belief in its touted “safety”, it can mean more than temporary anesthesia to the unpleasantness of every day hassles.  They never really experience life in its full emotional range from joy to sadness, learning the sensitivity of becoming vulnerable, the lessons of experiencing discomfort and coping, and the healing balm of a resilient spirit.  Instead, it is all about avoidance, emotional anesthesia and getting high.

Benumbed, blunted, and stunted.  Surely yet another indication for the prescription of medical marijuana.

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Weekly updates of college health issues in the news as found on Medline on nlm.nih.gov
ADHD and CollegeVideo (08/17/2012, HealthDay)
More College Women Smoking Hookahs (07/30/2012, HealthDay)
Colleges and Communities Can Reduce Alcohol-Related Harm to StudentsFrom the National Institutes of Health (07/23/2012, National Institute on Alcohol Abuse and Alcoholism)
Other interesting college health related articles in the media

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