Marijuana users more prone to infections after knee, shoulder surgeries

https://consumer.healthday.com/marijuana-users-more-prone-to-infections-after-knee-shoulder-surgeries-2658453251.html

by bookofjoe • 4 years ago

62 97 4 years ago

consumer.healthday.com

brutusborn2• 4 years ago

I wonder if they controlled for Tobacco intake. In my experience most stoners mix their cannabis.

CommitSyn2• 4 years ago

What country are you referring to? I know that in the UK it's often mixed, but in (Midwestern) America almost no one I've known has mixed tobacco with their cannabis.

hunterb1232• 4 years ago

Sometimes if they are both smokers and cannabis users you'll see spliffs (blunts of half tobacco half weed) generally to get a head change, a buzz, a high, and to save on costs.

But spliff smokers are in the minority in the US. Was more prevalent in the past when more people smoked tobacco.

Nowadays most people use carts / pens for cannabis use anyway.

tstrimple2• 4 years ago

See spliff (mixed with tobacco) or blunt (wrapped in tobacco leaf). Though the US is one of the smallest countries for the practice. I didn't realize how severe the differences were until I looked it up based on your comment. In Italy, 94% of marijuana smokers mix with tobacco!

https://www.inverse.com/article/32064-america-europe-tobacco...

nullstyle• 4 years ago

Plenty of my friends will roll a blunt in a swisher sweets paper leaving some tobacco behind. It's very common in some communities in the US. We're a big culture :)

brutusborn2• 4 years ago

UK, Europe, South America and Australia. I haven't had the chance to smoke with any Midwesterners, maybe one day.

mschuster91• 4 years ago

German here. WTF, you smoke your high potency pot pure?!

jklinger410• 4 years ago

In my experience most stoners mix their cannabis.

This is such an interesting observation. It may be true that worldwide it is MORE common to mix cannabis with tobacco than to not. But we wouldn't think that in the United States, because it is much more rare here.

Older cannabis users are more familiar with spliffs, and there are some sub-cultures where it is common, but it is not the norm here.

awillen2• 4 years ago

Hah, yeah, in the US I feel like a marijuana smoker is likely to find a tobacco habit disgusting and unhealthy.

speedylight• 4 years ago

Stoners, in the US at least, view tobacco as disgusting and look down on other stoners who use it, which is really ironic given the stigma that surrounded (surrounds?) smoking weed.

Though people still roll “spliffs” which is a mix of tobacco and weed, but the people that do that are few and far in between. Though people do roll “blunts” and “Woods”, which is basically a gas station cigarillo (swisher, Blackwood, etc) that’s opened up to let out the tobacco and weed is put in there instead, but the wrapper itself is either tobacco leaf or very close it—and this is a much more popular option, but the quantity of the tobacco smoked is as thin as the wrapper itself and it’s also more extravagant than a joint or using a bong.

fdgsdfogijq• 4 years ago

This is a stretch. People that smoke weed are much more open to other substances, including tobacco, than the general population. Your social circle might be that way, but it doesnt represent weed smokers as a whole

Eupraxias• 4 years ago

This is current, but it wasn't always like this. And I suspect that this varies by location.

In the 80's and 90's where I lived (rural NE US), pot smokers who didn't smoke tobacco were rare and looked down on.

coinbasetwwa• 4 years ago

Hasn’t it been common knowledge and established science that marijuana suppresses the immune system? This doesn’t come as a surprise to me.

horsawlarway2• 4 years ago

Hasn’t it been common knowledge and established science that marijuana suppresses the immune system?

No - not really. It seems to be rather variable, depending on the disease in question.

Cannabis use was associated with much lower rates of COVID-19, for example: https://pubmed.ncbi.nlm.nih.gov/35007072/

It also seems to play an interesting part in inflammatory response (cannabis use is associated with anti-inflammatory agents) - which may or may not matter, depending on the disease. Ex - there are limited studies on cannabis and the impacts on the immune system in HIV patients, with most showing no effect, but the studies are very limited, and often flawed (https://www.ncbi.nlm.nih.gov/books/NBK425755/)

Basically - We don't know shit because of how the US scheduled the drug, and the near complete lack of decent research on it over the last 50 years.

I would still say inhaling smoke of any kind is almost certainly not good for you, but we have a real lack of data here... which is a shame.

MichaelCollins2• 4 years ago

Inhaled smoke being harmful is beyond obvious, I would want very strong evidence to believe otherwise for any kind of smoke, particularly sooty smoke from burning organics. Soot in lungs is obviously bad, that should the default assumption of any kind of smoke until proven otherwise. I doubt there is any study specifically about the impact of Abies yuanbaoshanensis smoke on the lungs, but obviously it isn't good for you. Until there are studies proving otherwise, don't breath smoke is the sane default.

The more interesting matter is what effect cannabis might have when it isn't smoked.

LatteLazy• 4 years ago

Thing correlates with thing, has effect.

Worried well worried, well.

delecti5• 4 years ago

In the study, the researchers used a national insurance claims database, identifying more than 1.1 million knee patients and nearly 748,000 shoulder patients. Nearly 22,000 of the patients had been diagnosed with marijuana dependence.

The term "marijuana dependence" suggests either bias in the diagnoses, or extremely heavy users. Smoking marijuana is still smoking, and I've always been under the impression that some (though far from all) of the risk from smoking tobacco was just because of inhaling smoke.

Also, as another comment mentions, I can't see anything indicating they controlled for tobacco smoking.

PragmaticPulp• 4 years ago

The term "marijuana dependence" suggests either bias in the diagnoses, or extremely heavy users.

I wouldn’t dismiss it as bias. Marijuana dependence is a very real phenomenon, despite the pop culture “it’s not physically addictive” trope that tries to downplay drug dependence.

They’re looking at 22,000 out of 1.85 million patients, or around 1% of patients. They weren’t trying to look for casual or intermittent users.

Focusing on those diagnosed according to the criteria of marijuana dependence is the clearest way to remain objective and get a clear signal out of the study. Those with marijuana dependence are the people consuming frequently, and therefore likely to consume during the recovery period.

delecti5• 4 years ago

Marijuana dependence is a very real phenomenon, despite the pop culture “it’s not physically addictive” trope that tries to downplay drug dependence

Yes, I accounted for that by mentioning the alternate possibility of extremely heavy users. A typical user ([edit: at most] a few nights a week) shouldn't pay much mind to this study, and likely neither should someone who primarily vapes or consumes edibles.

awillen2• 4 years ago

But the title of the study is misleading as a result - marijuana users is a larger population than people who are dependent on marijuana, which is a subset of the larger population. It's incorrect to draw conclusions about the broader population of all users based on a non-representative sample of that population.

2devnull• 4 years ago

I might agree with your general thought pattern here, but I suspect that those who are diagnosed with marijuana dependence are not representative of the population of daily marijuana users. Self censorship is a problem in other lines of research too, it’s not just street drugs. People don’t accurately self report diet, alcohol consumption, cigarette use, domestic violence etc… Science can’t get at certain things, and we have to deal with that reality. Truth is much bigger than the science of the day, and science doesn’t benefit from being overhyped.

nerdponx2• 4 years ago

Not just the physically damaging effects of smoking, but I also wonder if being a heavy marijuana user is correlated with other features that are causal for infection risk, e.g. unhealthy diet, inconsistent sleep, lack of exercise.

j0hnyl• 4 years ago

I don't think there's good documentation for any of these features having correlation with marijuana use besides being pop culture tropes.

sd232• 4 years ago

being a heavy marijuana user is correlated with other features that are causal for infection risk, e.g. unhealthy diet, inconsistent sleep, lack of exercise.

FYI, I've smoked weed every day for 44 years straight.

Today, I am at, or near the peak, of my physical health (180 lb, 6'2, daily swimmer), I sleep like a baby and wake up every day at 8 am. And I swim every day.

eganist• 4 years ago

Also, as another comment mentions, I can't see anything indicating they controlled for tobacco smoking.

Give it a bit; it was just discussed at a conference and not even the preprint is out.

This is why I hate the scientific press; everyone jumps the gun, and people who want more information are left hanging until the study no longer has public attention.

noasaservice5• 4 years ago

So many problems with that "study".

"marijuana dependence" - there is no chemical dependence with cannabis. None. Nada. Zilch.

smoking tobacco was just because of inhaling smoke

The danger is inhaling burnt plant matter along with the slew of crap companies spray on tobacco. Straight tobacco has a VERY DIFFERENT taste and "cleaner". Still not great for you.

And most cannabis is vaped these days. In that way, it's with the THC oil with terpenes. And that profile is very different than burning plant matter, since in a vape it's vaporized oils (and some metal from the ceramic/metal filament).

JoeAltmaier2• 4 years ago

As observed in other comments, physical dependence is not the only kind.

rascul5• 4 years ago

And most cannabis is vaped these days.

I'm not sure if that's the case. Anecdotally, I see very little vaping and a large amount of smoking in a state where it's not legal recreationally. In another state where it is legal recreationally, I see a healthy mix of vaping and smoking and I can't say that I've seen one more than another there. I wonder if someone has collected numbers for this, I would be interested to see.

"marijuana dependence" - there is no chemical dependence with cannabis. None. Nada. Zilch.

I don't know what it's called but if I stop smoking then the next few days I have appetite and sleeping issues.

kerblang• 4 years ago

The article makes it pretty clear that the suspected element in cigarettes is the nicotine, not "smoke", as many noxious chemicals as there are in the latter.

MichaelCollins2• 4 years ago

The term "marijuana dependence" suggests either bias in the diagnoses, or extremely heavy users.

Respectfully, objecting to "marijuana dependence" suggests bias on your part. What else would you call heavy users who loath going a day without it, even though it's having a deleterious effect on their life? There has long been a popular stigma against recognizing the existence of marijuana dependence, backlash to DARE-style anti-drug propaganda I think, but let's be real. There are a lot of people who use it habitually and heavily and feel unable or unwilling to stop even though it's negatively effecting their relationships, work, etc.

Sure it's not chemically addictive in the same was as alcohol or heroin, but dependence is a broader phenomenon than that.

sanman811• 4 years ago

Slightly off topic but I would recommend this podcast from Andrew Huberman on the Effects of Cannabis. I learned a lot from it.

https://podcasts.apple.com/us/podcast/huberman-lab/id1545953...

adnmcq999• 4 years ago

Infection rate increases by 1%. Even if that’s a doubling, I feel like it’s such a small increase that you can hardly claim correlation, much less causation. As for the DVT, that was a tenth of a percent increase. That’s gotta be within the error bars. And even if it isn’t, I think you’d expect more DVT with more infection, so is it directly due to marijuana?

Spivak2• 4 years ago

There are ~1 mil of these kinds of surgeries annually a 1% increase is 10,000 infections that could be prevented by just telling patients not to smoke for a bit. This should be touted as a huge win. Correlation and effect size are independent. You can have extremely strong correlation but a small effect size.

obpe• 4 years ago

Yeah, except there were only 22,000 cannabis users so it's actually 220 people, not 10,000.

Spivak2• 4 years ago

This shouldn't be a surprising result. The marijuana defense task force doesn't really need to come out on this one. Before basically any surgery every doctor will tell you to discontinue recreational drugs, alcohol, tobacco and a long ass list of supplements and medications before and after the surgery. Knowing more precisely the interactions it has with the body is a good thing and can only help -- even more so as more places legalize it so the number of users increases.

gdubs• 4 years ago

One obvious thing I'd be curious about is why those people are heavy users in the first place. E.g., if people with certain conditions are already using more cannabis than the rest of the population to deal with pain management, etc, then a correlation like this wouldn't be that surprising.

Would like to see how the study controls for that, but didn't actually see a direct link.

3minus1• 4 years ago

"I think the evidence is pretty good that there is an increased risk," Reznik said, but the association does not prove a cause-and-effect relationship.

The article basically acknowledges this. They have a ton of data - over a million surgeries and 22K marijuana users. However, there's no proof of cause-and-effect because they have no way of knowing if it's correlation of causation. All they can say for sure is that these patients are at increased risk.

standardUser2• 4 years ago

Strelzow suggested doctors could ask patients to give up marijuana for a period of time, as they do with tobacco smokers.

As a former nicotine addict, the idea of any serious nicotine addict avoiding tobacco for "a period of time" is laughably naïve. Unless that period of time is less than a few hours.

rascul5• 4 years ago

I could give up cannabis if I had to but even with the patch I can't go more than a few waking hours without tobacco.

Gud2• 4 years ago

I am a serious nicotine addict and I disagree! I thought the same as you, but over the years I’ve managed to quit easily for months and years at a time. The hard part is not starting again which at least for me usually coincide with too much stress

standardUser2• 4 years ago

Addiction works differently for everyone. I drink coffee constantly but I can stop with ease. Maybe an occasional headache. I have a friend who describe her ordeal of quitting caffeine and it sounded almost as bad as my struggle when I quit nicotine.

For me, when I was smoking a pack an half a day, the idea of stopping temporarily was incomprehensible. I smoked through root canals, strep throat, countless head colds, you name it. All of my quit attempts, including the successful one 5 years ago were like a waking nightmares that made my life a living hell. Maybe your experience is different. Many people's are.

FeloniousHam• 4 years ago

I have a similar experience: I can quit in three days provided I'm relatively stress-free and not the companion of a regular smoker. I can stay quit for months, even years, but particular stresses knock me off the wagon.

One cigarette is all it takes; it's not a slippery slope, it's sheer cliff.

dathinab2• 4 years ago

AFIK smoking in general no matter what has increased risk of infection, so has bad health caused by physical and/or mental distress

Most people take Marijuana by smoking it, sometimes in combination with tabaco.

Most people which take marijuana very frequent do so because they had and in many cases still have some form of physical and/or mental distress.

So......

Isn't this a relatively clear cut case of correlation without causation?

Or do I miss something?

happyopossum• 4 years ago

Most people which take marijuana very frequent do so because they had and in many cases still have some form of physical and/or mental distress.

I'd like to see the work on that one - most frequent users I know are simply stoners

lampshades• 4 years ago

You think they aren’t self medicating? I know I am.

feet• 4 years ago

What makes someone want to be a stoner biologically?

joxel• 4 years ago

But why are they stoners

dathinab2• 4 years ago

Pretty much all stoners I meet had to fight with some form of mental issues when they became stoners like parental neglect, PTSD, or anxiety.

Most people I meet which didn't had problems and still often took marijuana due to group dynamics also pretty much only took it in that group dynamics and stopped frequent consumption after a year or two at most. But this kind of frequent consumers where in my experience very very rare.

ARandomerDude• 4 years ago

Clicked on the comments section expecting it to be nothing but pothead defending their precious weed. Wasn't disappointed.

aaomidi• 4 years ago

Yeah I mean…it reduces inflammation..

spoonjim• 4 years ago

I wonder if it’s related to the marijuana itself or the characteristics of heavy marijuana smokers.

chairmanmow• 4 years ago

Yeah, when I read this my thought was that is probably the act of coughing somewhat uncontrollably after surgery probably doesn't help things heal properly. I wonder if the results would hold if they limited it to people who consume edibles exclusively.

cullinap• 4 years ago

those more prone to knee and shoulder injuries smoke marijuana?

johnea• 4 years ago

This isn't my experience.

I've smoked weed for about 50 years. During that time I had an ACL reconstruction on my left knee. I healed very well, no infection whatsoever, and went on to master double diamond snow skiing. Also while smoking cannabis routinely.

I haven't had a lot medical procedures, but I am in my 60s now and have had a couple of small surgeries.

I've never experienced any infection issues. I would say in general, I heal really well, and have a very healthy lifestyle (ran 6 miles yesterday).

I used tobacco only for a short while in high school and have never had any desire to pick it up again.

The rest of murica is dedicated to alcohol, tobacco and firearms like the little baby jesus intended. While they're generally the ones blowing their own brains out while shit drunk at 4am...

This whole treatment of cannabis like some kind of kryptonite is just plain nonsense...

Marijuana users more prone to infections after knee, shoulder surgeries

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