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Pain Pill Abuse Higher in Adolescent CBD Oil Users

Adolescent users of cannabidiol (CBD) oil are far more likely to engage in risk-taking behaviors ― such as illegally taking prescription pain medications ― than peers who don’t use CBD, new research indicates.

The study, which included data on 200 youths aged 12 to 23 years, also suggests that 4 in 10 use CBD oil products. Users also reported experiencing increased anxiety over the prior 6 months, but the researchers couldn’t pinpoint whether CBD oil, which is marketed for anxiety relief, might contribute to participants’ anxiety levels.



Nicole Cumbo

“A lot of kids don’t talk to their clinicians about CBD” use, said study author Nicole Cumbo, BS, a third-year medical student at Penn State Milton S. Hershey Medical Center in Hershey, Pennsylvania.

“It’s important to ask kids if they’re using CBD, along with vaping and marijuana use, because it could be causing them more problems than it helps,” Cumbo told Medscape Medical News. “Monitoring for dangerous behaviors in their social history is important. Since we were able to see a correlation between risk-taking behaviors, we should ask kids about risk-taking behaviors as well.”

Touted as a panacea for conditions ranging from insomnia to muscle aches to low mood and more, CBD oil products have become ubiquitous across the United States, Cumbo noted. “Even if you go to a gas station, you see it,” she said. “It’s growing prevalence is apparent, but we weren’t sure what we’d see in our pediatric population.”

Cumbo and colleagues administered questionnaires to adolescents who presented for medical care to a level 1 pediatric trauma center/emergency department affiliated with a children’s hospital in central Pennsylvania. The questionnaire asked about demographics, risk-taking behaviors, and use of CBD oil products. The survey also asked participants about clinical symptoms experienced over the prior 6 months, along with their views on the perceived benefits of using CBD oil.

The average age of the participants was 17.6 years, and 63% were female. Forty percent reported CBD oil use. Compared to nonusers, among those who used CBD oil, there was significantly greater use of prescription medications without a prescription (19% vs 6%; P = .002), as well as greater use of cigarettes (40% vs 8%; P < .0001), chewing tobacco (18% vs 1%; P < .0001), and cigars (30% vs 3%; P < .0001).

No significant differences were found between CBD users and nonusers in symptoms such as chest pain, racing heart, difficulty breathing/cough, dizziness, abdominal discomfort, nausea/vomiting, headache, tremors, sleep disturbances, or dehydration over the prior 6 months.

However, those who used CBD were more likely to report experiencing an increase in anxiety over the prior 6 months (66% vs 47%; P = .009).

Regarding their perceived beliefs about CBD oil, 69% said it is “safer than other drugs,” 33% said it’s “just for fun,” and 48% said it can “help treat my medical illness.” Participants reported that myths about CBD oil include the notions that it’s a gateway drug and that it’s addictive.

“I think there’s a disconnect in

COVID-19 ICU patients have higher risk for blood clots, study shows

Hospitalized COVID-19 patients face an increased risk of developing dangerous blood clots, a new review indicates.

The odds of a clot are highest for the most critically ill patients. Analysis of 66 studies found that 23% of COVID-19 patients in an intensive care unit developed a blood clot in the leg, known as a deep vein thrombosis, or DVT.

Overall prevalence of a DVT was 14% among ICU and non-ICU COVID-19 patients, and 8% among those with mild-to-moderate disease risk who were not admitted to the ICU.

The “numbers are surprisingly high when compared with other hospitalized patients,” said study author Dr. Cihan Ay.

Of great concern are blood clots in the legs that can break away and travel to the lungs. This is a life-threatening condition known as pulmonary embolism, or PE.

Nearly 4% of patients not admitted to the ICU developed a pulmonary embolism. And “we found a very high PE risk of 14% in patients treated at an intensive care unit,” said Ay, an associate professor in hematology and hemostaseology at the Medical University of Vienna in Austria.

According to the American Heart Association, DVT and PE are each a form of venous thromboembolism, or VTE, as both refer to a blood clot that originates in a vein.

VTE is estimated to affect between 300,000 and 600,000 Americans every year, the AHA notes. It is most frequently triggered by surgery, cancer, hospitalization or long-term immobilization.

To examine VTE risk related to COVID-19, Ay and his colleagues analyzed the findings of 66 studies, involving roughly 28,000 COVID-19 patients.

On average, the COVID-19 patients were about 63 years old, and six in 10 were men. About one-fifth had been admitted to an ICU.

None of the studies looked at clotting risk among COVID-19 patients who had not received hospital treatment. So the findings do not speak to DVT or PE risk among such patients, said Ay, although “it seems that the risk of clots is low in patients with a mild clinical course of COVID-19.”

Early in the pandemic, it became clear that blood clot risk seemed elevated in patients with COVID-19 compared to other diseases. To prevent clotting, “physicians worldwide intensified dosing of blood thinners for COVID-19 patients,” Ay said.

This created another potential problem, however, since blood thinners increase the risk of bleeding.

The study authors hope their review will offer clinicians more insight into clotting risk profiles, offering guidance as to which patients truly need preventive clot treatment, Ay said.

As to why COVID-19 might drive up clotting risk in the first place, Ay said experts can only speculate based on available data.

“First, the clinical course in such patients is often severe, which by itself increases the thrombosis [clotting] risk,” he said. “Second, researchers found that COVID-19 interacts with the blood clotting system and the blood vessels, which might explain the increased risk in those patients.”

Dr. Gregg Fonarow is director of the University of California, Los Angeles Cardiomyopathy Center. He offered some additional specifics

Several New York zip codes are reporting infection rates five times higher than statewide rate

New York has reported several Covid-19 clusters that have created “hotspot” zip codes, the governor said, with a positivity rate about five times more than statewide.



a person taking a selfie in a car: Medical technicians work at a drive-thru coronavirus disease (COVID-19) testing facility at the Regeneron Pharmaceuticals company's Westchester campus in Tarrytown, New York, U.S. September 17, 2020. Picture taken September 17, 2020. Brendan McDermid/Reuters


© Brendan McDermid/Reuters
Medical technicians work at a drive-thru coronavirus disease (COVID-19) testing facility at the Regeneron Pharmaceuticals company’s Westchester campus in Tarrytown, New York, U.S. September 17, 2020. Picture taken September 17, 2020. Brendan McDermid/Reuters

The new clusters are a “stark reminder” that the state is still not out of the woods when it comes to the pandemic, Gov. Andrew Cuomo said.

“We’ve had clusters in the past stemming from factories, churches, bars and other locations,” Cuomo said . “We’re quite familiar with this, and when there’s a cluster, we are very aggressive on it and we’re oversampling in the clusters.”

Cuomo’s announcement comes as states across the US have begun reporting alarming Covid-19 trends in recent days — and after experts warned of a coming surge in cases.

Wisconsin reported its highest number of Covid-19 hospitalizations on record, with patients nearly doubling in the state since September 18, according to hospital officials. The governor of Illinois is tightening restrictions in one part of the state after an increase in positivity rates. And in Kentucky, Gov. Andy Beshear urged the state needs to stop a recent “escalation” of cases after reporting more than 1,000 new infections for the second day in a row.

At least 27 states have reported more new cases since the previous week and only nine are reporting a decline, according to data from Johns Hopkins University. Nationwide, more than 7.2 million people have been infected and more than 206,000 Americans have died.

When a vaccine could be available to US population

On Wednesday, Moderna CEO Stéphane Bancel said if their Covid-19 vaccine is proven safe and effective, it could be available to the general population by late March or early April.

Moderna began their Phase 3 clinical trial for Covid-19 in the US in July. It’s one of four companies that have begun Phase 3 Covid-19 vaccine trials in the US — the others include Johnson & Johnson, Pfizer/BioNTech and AstraZeneca. The AstraZeneca trial was paused after an unexplained illness in a volunteer, and US health authorities are still considering crucial questions that remain around the injections of the experimental vaccine.

“I think a late Q1, early Q2 approval is a reasonable timeline, based on what we know from our vaccine,” Bancel said at a conference hosted by the Financial Times.

But there are several steps that will have to come before that.

If the safety and efficacy data checks out, Bancel says he expects Moderna will be able to file a Biologics License Application (BLA) with the US Food and Drug Administration by late January or early February. That application asks the FDA to consider fully licensing a drug, while an emergency use authorization (EUA) expedites a drug candidate for use on an emergency basis.

Moderna could file for an EUA as early as November 25 for