Overcoming Pain

Why people experience chronic pain, and the power they have to de-intensify it

Colorado: The Land of Pot-Smokers and Busy Cardiologists?

Going to Colorado With a Pacer in My Heart

A May 31, 2014 article in the New York Times included this:

“There is the Denver man who, hours after buying a package of marijuana-infused Karma Kandy from one of Colorado’s new recreational marijuana shops, began raving about the end of the world and then pulled a handgun from the family safe and killed his wife, the authorities say. Some hospital officials say they are treating growing numbers of children and adults sickened by potent doses of edible marijuana. Sheriffs in neighboring states complain about stoned drivers streaming out of Colorado and through their towns.

“I think, by any measure, the experience of Colorado has not been a good one unless you’re in the marijuana business,” said Kevin A. Sabet, executive director of Smart Approaches to Marijuana, which opposes legalization. “We’ve seen lives damaged. We’ve seen deaths directly attributed to marijuana legalization. We’ve seen marijuana slipping through Colorado’s borders. We’ve seen marijuana getting into the hands of kids.””

Many years ago, James Patrick and Robert Plant wrote that Led Zeppelin song about “Going to California”:

“Smoked my stuff… Going to California with an aching in my heart.”

A French study, the results of which were published earlier this year in the “Journal of the American Heart Association,” appears to signal that we need to worry about something more than overdosing on marijuana candies, and maybe even the end of the world: It appears marijuana use may increase the risk of cardiovascular events, particularly in younger adults, with fatal consequences.

A review of reports made to the French Addictovigilance Network between 2006 and 2010 indicated that almost 2% of reported events associated with marijuana use concerned cardiovascular complications. Interestingly, the average age of the patients with these cardiovascular complications was 34, significantly younger than what you would typically see in a cardiologist’s waiting room. And the number of cardiovascular complications tripled over the course of those five years or so of data collection.

The types of cardiovascular complications included acute coronary syndromes (20 of 35 events), including chest pain and myocardial infarction, and heart-rate disorders (two events). Ten patients experienced peripheral vascular events, and three patients experienced cerebral-artery events. These events should not be considered trivial: Nine subjects died of their cardiovascular event (eight from an acute coronary syndrome, and one of a heart-rate related complication). There were, not surprisingly, few other heart disease risk factors in these patients. Thus, vasospasm, which has been linked with cannabis use in experimental settings, could be the culprit here; something in the marijuana may be causing the arteries to constrict. Unfortunately, even a brief constriction can be enough to cut off critical blood flow to the heart or the head, with devastating results.

Many individuals use marijuana to deal with chronic pain and illness. I have written about this in prior blogs. It must be remembered that there is much we do not know about this drug. Just because we don’t know, we should not ignore.

Mark Borigini, M.D., is a board-certified rheumatologist who has devoted his career to treating illnesses that cause chronic pain and disability.

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