San Francisco Medical Examiner Issues Marijuana Warnings
Nikolas Lemos, UCSF School of Medicine Clinical Professor and Chief Toxicologist & Forensic Lab Director for the San Francisco Office of the Chief Medical Examiner, said cannabis may one day need the “black box” warning labels found on other common drugs like Viagra or codeine.
“If you have a heart condition, ask your doctor before taking this drug”
The medical examiner’s office has been for over a decade looking into cases involving cannabis in San Francisco – from homicides, to suicides, natural deaths, “everything”.
Using a multi-million dollar LC-MS analyzer funded by the city, Lemos focused on 1,338 past-year cases that came to the Chief Medical Examiner’s office, looking in the blood for active THC, the main active ingredient in marijuana, as well as delta-11-THC – which is associated with eating but not smoking weed – and also the metabolite THC-COOH, as well as more rare cannabinoids cannabidiol (CBD) and cannabinol (CBN).
On average, eight percent of the sample population tested positive for cannabis. The average person who has cannabis in their toxicology is 40 years of age. “It’s not a drug associated with teenagers,” he said.
Lemos’ study of natural deaths in San Francisco revealed a troubling association between cannabis use and larger heart size, regardless of patient weight. The average heart weight for a person is 350 grams, but for those who died of natural disease with cannabis in their system their hearts averaged 520 grams, he said. Cannabis users had hearts that were “very significantly elevated for their weight,” Lemos said.
Everyone’s heart gets bigger and less efficient as they age, but an oversized heart is called cardiomegaly. Lemos said his research found “significant statistical differences” in the heart weight of women who used cannabis and died of natural causes. The average weight of a female human heart is 380 grams. That average went to 676 for women who died a natural death and screened positive for cannabis.
“That’s a very profound cardiomegaly,” he said.
It suggests women who have cardiomegaly, “if they take medical marijuana while they’re alive, they are at greater of risk of suffering a natural death.”
Cannabis can be rough on the circulatory system, Lemos said. Users sometimes report elevated pulse, for example.
“I’m wondering whether we will come to a point where women who may be thinking about marijuana are told ‘If you have a heart problem, you might not want to take this’.”
People with high blood pressure, hardening of the arteries, or cardiomegaly, all of those may be pretty big contra-indications for marijuana now, he said.
“The research is preliminary,” Lemos said. But when he presented the findings recently at two big conferences – the conference of the American Academy of Forensic Sciences, and the International Association of Forensic Toxicologists in Portugal in August, “it made the entire toxicology field pay attention.”
“Do not combine with alcohol”
Cannabis is on a long list of drugs that should not be combined with alcohol, Lemos adds.
Research by the National Highway Traffic Safety Administration conducted in The Netherlands found that people with a 0.04 blood-alcohol content level given a low-dose of cannabis showed physiological effects equivalent of “more than .09 BAC”. A high dose of cannabis turned tipsy .04 tipplers to a virtual drunks with effects equaling .14 BAC. “They multiply each other,” Lemos said.
And the once-rare, but now highly sought-after cannabidiol-rich marijuana “has a lot of sedative properties,” Lemos said. Consequently, he’s seeing it in DUI cases.
“Alcohol gets really strongly potentiated by even the mere small presence of cannabis.”
http://blog.sfgate.com/smellthetrut...o-medical-examiner-issues-marijuana-warnings/
Nikolas Lemos, UCSF School of Medicine Clinical Professor and Chief Toxicologist & Forensic Lab Director for the San Francisco Office of the Chief Medical Examiner, said cannabis may one day need the “black box” warning labels found on other common drugs like Viagra or codeine.
“If you have a heart condition, ask your doctor before taking this drug”
The medical examiner’s office has been for over a decade looking into cases involving cannabis in San Francisco – from homicides, to suicides, natural deaths, “everything”.
Using a multi-million dollar LC-MS analyzer funded by the city, Lemos focused on 1,338 past-year cases that came to the Chief Medical Examiner’s office, looking in the blood for active THC, the main active ingredient in marijuana, as well as delta-11-THC – which is associated with eating but not smoking weed – and also the metabolite THC-COOH, as well as more rare cannabinoids cannabidiol (CBD) and cannabinol (CBN).
On average, eight percent of the sample population tested positive for cannabis. The average person who has cannabis in their toxicology is 40 years of age. “It’s not a drug associated with teenagers,” he said.
Lemos’ study of natural deaths in San Francisco revealed a troubling association between cannabis use and larger heart size, regardless of patient weight. The average heart weight for a person is 350 grams, but for those who died of natural disease with cannabis in their system their hearts averaged 520 grams, he said. Cannabis users had hearts that were “very significantly elevated for their weight,” Lemos said.
Everyone’s heart gets bigger and less efficient as they age, but an oversized heart is called cardiomegaly. Lemos said his research found “significant statistical differences” in the heart weight of women who used cannabis and died of natural causes. The average weight of a female human heart is 380 grams. That average went to 676 for women who died a natural death and screened positive for cannabis.
“That’s a very profound cardiomegaly,” he said.
It suggests women who have cardiomegaly, “if they take medical marijuana while they’re alive, they are at greater of risk of suffering a natural death.”
Cannabis can be rough on the circulatory system, Lemos said. Users sometimes report elevated pulse, for example.
“I’m wondering whether we will come to a point where women who may be thinking about marijuana are told ‘If you have a heart problem, you might not want to take this’.”
People with high blood pressure, hardening of the arteries, or cardiomegaly, all of those may be pretty big contra-indications for marijuana now, he said.
“The research is preliminary,” Lemos said. But when he presented the findings recently at two big conferences – the conference of the American Academy of Forensic Sciences, and the International Association of Forensic Toxicologists in Portugal in August, “it made the entire toxicology field pay attention.”
“Do not combine with alcohol”
Cannabis is on a long list of drugs that should not be combined with alcohol, Lemos adds.
Research by the National Highway Traffic Safety Administration conducted in The Netherlands found that people with a 0.04 blood-alcohol content level given a low-dose of cannabis showed physiological effects equivalent of “more than .09 BAC”. A high dose of cannabis turned tipsy .04 tipplers to a virtual drunks with effects equaling .14 BAC. “They multiply each other,” Lemos said.
And the once-rare, but now highly sought-after cannabidiol-rich marijuana “has a lot of sedative properties,” Lemos said. Consequently, he’s seeing it in DUI cases.
“Alcohol gets really strongly potentiated by even the mere small presence of cannabis.”
http://blog.sfgate.com/smellthetrut...o-medical-examiner-issues-marijuana-warnings/
