Cardiovascular
Cardiovascular disease risk may increase with cannabis use disorder
Sep
- A new study found that adults with cannabis use disorder were about 60% more likely to experience cardiovascular problems.
- Experts say the findings underline the importance of understanding the mechanisms at play when it comes to cannabis use disorder and cardiovascular disease.
- With cannabis legalization widespread, experts say it’s crucial for people to consult with their doctors to make sure they’re using safely and responsibly.
Researchers are reporting that people who have been diagnosed with cannabis use disorder are more likely to develop cardiovascular disease.
In research published today in the medical journal Addiction, researchers analyzed data from five Canadian health databases to assess the risks of cannabis use disorder.
In all, researchers said that in people who hadn’t previously experienced cardiovascular disease, those with cannabis use disorder were about 60% more likely to experience a heart attack, stroke, or cardiovascular event.
While the findings emphasize the importance of safe and responsible cannabis use, the data comes with some caveats, according to an expert interviewed by Medical News Today.
Dr. Anees Bahji, a clinical assistant professor in the Department of Psychiatry at the University of Calgary in Canada, was the lead author of the study.
He told Medical News Today that researchers anticipated an association between cannabis use disorder and adverse cardiovascular events, but the magnitude of the increased risk was surprising.
“It’s important to be aware of the potential impact on cardiovascular health and to consider moderation and regular health check-ups,” he emphasized. “Additionally, people should be cautious about mixing cannabis with other substances, such as alcohol, as this may amplify the risks.”
Bahji said the findings also point to a need for further research to better understand the mechanisms at play, adding that he plans to explore other health outcomes related to cannabis use disorder.
With cannabis legalization becoming increasingly widespread, Bajhi said it’s more important than ever for policymakers and healthcare providers to have accurate information about potential risks and benefits.
“Addressing cannabis use within a broader context of mental health and substance use is vital for comprehensive care and support for affected individuals,” he explained.
While adults in many states can now easily and legally purchase cannabis, it’s important to remember that the substance was almost wholly illegal for much of the past century.
As such, some of the language and criteria surrounding cannabis is informed by a pre-legalization mindset.
Dr. Peter Grinspoon, an instructor at Harvard Medical School in Massachusetts and board member of Doctors for Cannabis Regulation, is the author of the book “Seeing through the Smoke: A Cannabis Specialist Untangles the Truth about Marijuana.”
He told Medical News Today that the current definition of cannabis use disorder is broken and stems from a punitive mindset that dates back to the War on Drugs launched in the early 1970s.
“To get the diagnosis of cannabis use disorder, you only need to get two out of 11 criteria, one of which is tolerance and the other which is withdrawal,” he explained. “When we discuss addiction to opiates or benzodiazepines, we don’t use tolerance or withdrawal as criteria because everyone who takes these substances gets tolerance and withdrawal, and these alone are not sufficient to diagnose an addiction.”
Grinspoon said that while people do get addicted to cannabis, most of the harm comes from those with a severe addiction – generally defined as continued use despite negative consequences.
“If you’re driving when you’re high, if you’re not able to fulfill your adult responsibilities, if it’s affecting your school or your job, then I would say you’re addicted,” he said. “But it has nothing to do with tolerance and withdrawal, as those are just physiological things.”
The study is associational, which doesn’t prove causality – a point the authors bring up in their research.
Still, what could account for the nearly 60% increased risk of cardiovascular disease in people with cannabis use disorder?
One factor may be the fact that combusting, or smoking, is the most common way to consume cannabis – and, as any doctor will tell you, inhaling any kind of smoke is unhealthy.
“There’s no question that combustion products are bad for you and smoking anything is bad for you,” said Grinspoon. “You get polycyclic aromatic hydrocarbons, you get tar, you get benzene. Cannabis could potentially cause coronary disease, but I just don’t think it’s really been shown to cause coronary disease except in these big associational studies, which could have a million other things explaining the causal relationship.”
Another possible factor is the fact that, in some people, cannabis use can trigger anxiety.
“The last thing you want to have is an anxiety attack, with your heart pumping and your blood pressure high, so I think cannabis can trigger coronary events but they’re really avoidable with proper patient selection and with education,” Grinspoon explained. “I don’t think the kind of heart problems that were demonstrated in the study necessarily had anything to do with cannabis.”
“Cannabis users should be mindful of the potential health risks associated with cannabis use, particularly if they use it frequently or have developed problematic patterns of use,” Bahji said.
Grinspoon says that cannabis addiction can become a problem, which points to a need for dialogue between doctor and patient.
“I treat people with cannabis addiction and it can really be horrible, but it needs to be treated with skill, empathy, and compassion,” he said.
