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Cannabis Use is Common, But is it Safe?

Two current JAMA reports suggest that cannabis use is not only common, but that if heavily used may increase mortality rates.

Gellber et al reported in a cross-sectional study of 175 734 patients, 17% used cannabis in the last 3 months; with nearly 35% claiming moderate to high risk for cannabis.  Three-quarters reported using cannabis to manage a health symptom, but fewer (16%) patients self identified as medical cannabis users. Cannabis was used to manage pain (32%), stress (50%), and sleep (56%).  Cannabis use was higher among male patients than female patients (20% vs 14.7%) and younger patients (31.0%). Consumption was mostly edibles (62%) and smoking (52%). Routine screening of primary care patients for cannabis use is advised. 

Vallee reports that in a UK cohort study of 121,895 participants, CVD mortality was significantly higher among heavy cannabis users compared with never users; But this association was largely seen in women, and not among males. No association was observed among females or males for all-cause and cancer mortality. In this data set cannabis use was assessed by questionnaire (classed as heavy, moderate, low, and never). Among 2375 total deaths occurred, 1411 deaths were from CVD and 440 from cancer. Mortality rates were not increased in males (all cause mortality HR 1.28 (95% CI, 0.90-1.81), CV mortality HR 0.98 (95% CI, 0.43-2.25) and cancer mortality HR 1.09 (95% CI, 0.71-1.67).  By contrast women who were heavy users of cannabis had higher risk of CV mortality (HR 2.67; 95% CI, 1.19-4.32), but not all-cause and cancer mortality. 


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