bullous disease in cannabis users

tallaght01

Just saw this article in the journal "Respirology".

They're claiming earlier onset of emphysematous chages in cannabis users than smokers.

It's never been an area that's been particularly well researched. However, I find the claims that....

"Marijuana smoking leads to asymmetrical bullous disease, often in the setting of normal CXR and lung function. In subjects who smoke marijuana, these pathological changes occur at a younger age (approximately 20 years earlier) than in tobacco smokers."

...to be a bit premature, because of the small sample size.


However, it's interesting data, nonetheless, as we know very little about this area, and I'm sick of not having of good data to hand when teenagers tell me how safe cannabis is.

Also, i wonder if the subjects also smaked tobacco? Presumably they also didn't use filters.

Sadly my athens account won't let me access the full article. Has anyone else read it?

Comments? Thoughts?

Here's the link to the abstract........

http://www.blackwell-synergy.com/doi/abs/10.1111/j.1440-1843.2007.01186.x

Chunky Monkey

I often wonder how they can carry out these studies. A cannabis user could also be a cigarette smoker. They could smoke one joint every day or they could be someone who smokes six or seven now and then at a party. Is it the marijuana itself or the smoking without a filter the problem? What about smokers who smoke tobacco without a filter. What about the different methods of consumption, do they make a difference and what about the difference between weed and hash.

tallaght01

Most studies of this type would be pretty detailed in the information they would require from participants, though. A good study would seperate the various confounding factors.

But it's very difficult to study illegal drug use. People often don't trust the anonymity etc.
Plus you can't randomise people to groups, so you're usually relying on retrospective studies, case series and questionnaire studies.

The last time I was reading research on drug abuse in Ireland, we didn't even have a grasp on the number of heroin addicts in the country. And that would be a bigger issue than cannabis use.

Chunky Monkey

It's legal in Bangladesh apparently. Maybe they should carry out a study there instead or somewhere like Brazil. But I suppose other factors might come into it then like quality of air and possibly diet/lifestyle?

eth0_

It would be difficult to research this subject; many cannabis users make joints with tobacco in, some use it on its own in bongs, some use it with pipes or with a vaporiser. Some people use all of those methods. So how can you isolate whether the tobacco has caused the disease, or the cannabis? Bear in mind you take a much deeper 'drag' on a joint than you would on a cigarette.

2Scoops

The study is what it is: a limited case report on 10 individuals. No more, no less.

It's mildly suggestive of an effect but this specific investigation is very far from conclusive simply due to the observational nature of the design. Disappointing how they wrote their conclusion - the reviewers who let that go through unedited should hang their heads in shame...:rolleyes:

sportswear

there are far to many variables and confounders in this bad boy, and nowhere near enough detail regarding the smoking habits of the subjects.

With 10 people im surprised it got published.

tallaght01

sportswear wrote: »

there are far to many variables and confounders in this bad boy, and nowhere near enough detail regarding the smoking habits of the subjects.

With 10 people im surprised it got published.

I'm not particularly surpirised that it got published. I haven't been able to access the whole article, so I don't know about it's quality.

But it wouldn't be unusual for a case series of 10 people to get published. Individual cases with just the one patient are published all the time.

My problem, like 2scoops has said, is that their conclusions are way too premature for what it is.

2Scoops

sportswear wrote: »

there are far to many variables and confounders in this bad boy, and nowhere near enough detail regarding the smoking habits of the subjects.

Actually, they have a quite a bit of detail on smoking habits, albeit self-reported. As much as is typical in nearly all smoking studies. Even if they had taken more information (fave brand? ) they wouldn't have been able to do any thing with it, statistically or otherwise.

sportswear wrote: »

With 10 people im surprised it got published.

Well, Respirology is hardly the most pretigous journal you're ever going to see. And the study itself is certainly worth publishing... as preliminary data to support doing a proper investigation. You can publish a case report with a single person. It's just they don't really present this as a case report when they really should have, IMO.