No, no, we said marijuana consumption by pregnant women! You need to chill for about 21 years, mini-Cheech!

A recent article by Storm Crow sheds light on a study that demonstrates a dramatic decrease in infant mortality rates for babies born testing positive for cannabinoids:

A total of 2,964 babies were drug-tested at birth to see if they were positive for drugs – cocaine, opioids or cannabis were studied. 44% of the infants tested positive for all varieties of drugs, including the 3 being studied. During the first two years of their lives, 44 babies from the original group died. Since statistics are a drag to slog through, I’ll cut right to the chase – the deaths per thousand live births – the numbers tell the story.

“No drugs at birth” deaths……. 15.7 deaths per 1000 live births

“Cocaine positive” deaths…….17.7 deaths per 1000 live births

“Opiate positive” deaths…….18.4 deaths per 1000 live births

“Cannabis positive” deaths…. 8.9 deaths per 1000 live births [5]

The cocaine and opiate babies have a higher death rate than the “No drugs” babies – that was to be expected. But look at the “cannabis” babies! Having extra cannabinoids in their bodies at birth (and likely later, from 2nd-hand exposure, or breast milk) seems to have some sort of a protective effect. The “cannabis” infants have a mortality rate almost half of what the “No drugs” infants have!

The study raises many interesting questions.  As I read, these are some of the first questions that came to mind, along with my current research on the topics.  I would have waited to post this until I could find more concrete information, but unfortunately, prohibition interferes with sound science on these issues, so I am just going to share my own thoughts and research with the hopes that it encourages more public outcry for further scientific study.  Much of this is conjecture and guesses, but it is worth asking these questions and evaluating the information currently available and pursuing further research:

1.  What further verification of this study can I find?  Much as I like the info, I know I need to find a credible source for verification and so that others will believe the information.

A credible source was found to document the truth of the data presented by Storm Crow:

Pediatrics:  Official Journal of the American Academy of Pediatrics, published July 1, 1997;

The above source only contained the summary of the study, and I wanted to see more of the data.  I have learned that statistics and percentages can be very misleading.  Before long, I found the complete study using student access to PSU , and found even more surprising numbers than the above quote by Storm Crow reveals.  The following table itemizes each category of test result; for instance, a positive test for cannabis could also include a positive test for opiates and/or cocaine, so this table further breaks out the categories into cannabis only, morphine (opiate) only, cocaine only and the “total” of all positive cannabis, morphine and cocaine tests (click links to view table and chart):

Infant Mortality Chart

The most interesting thing that stands out to me is that the drug-negative babies were technically MORE likely to die in the first two years of life.  This illustration helps shed light on why the study concludes that there is no significant difference between babies that test positive and those that test negative for maternal drug use, as there isn’t much of a difference between the 13.7 and 15.7 deaths per 1000 live births.

However, in this view of the information, the stark difference between the two cannabis categories and “morphine only” category as compared to the remaining categories is notable.  As a mother who is familiar with at least some of the drugs given at birth, I suspect that the “morphine only” category are those mothers that received some sort of drug during childbirth and/or pregnancy.  The presence of this drug only would most likely indicate proper drug use and not illicit drug use, since this drug is administered by a licensed physician – which could be why the mortality rate of these children is much lower than the other categories.

And the cannabis positive children are definitely in that same range with the morphine only infants.  However, when the two categories of cannabis-positive infants are divided into “cannabis only” and “cannabis positive” (indicating either opiates or cocaine were also present with the cannabis), the information is astonishing.  Of 338 infants born with cannabis in their systems at birth, only 3 total died in the first two years.  All three of those infants had either opiates or cocaine in their system as well, and not a single death was found in the two years after birth in the 157 infants that tested positive for ONLY cannabis!  These deaths include homicide, SIDS, illness, etc.  Not ONE death!

2.  Are infants born to cannabis-consuming mothers less likely to die in the first two years of life, or are the results of this study an anomaly?

I wish I could answer this question conclusively, but this information definitely indicates the need for further study!  I sought out more research on this subject, and could not find much.  I did find an article on the importance of endocannabinoids on pediatric development and disease, the critical role of the endogenous cannabinoids system on mouse pup suckling and growth, and a study on cannabis and breastfeeding that seems to use some good data to make some bad points.

3. Are pregnant mothers less likely to continue their use of marijuana when becoming pregnant, compared to other drugs?

I also noticed that a substantial difference is noted in the positive test results, compared to the usage rates suggested in a study by the U.S. Department of Health and Human Services.  According to their data for 2002-2009, marijuana has much higher usage rates than all other drugs (ie in 2008, 41% of the study used marijuana in their lifetime, and 10.3% had used it in the past year; contrast that with the total for all drug use (including marijuana) of 47% in their lifetime, and 14.2% in the past year.  Cocaine use was 14.7% in their lifetime and 2.1% in the last year and all other drugs, excluding marijuana, was 30.3% in their lifetime and 8.0% in the last year).  For comparison’s sake, I merged that data into the earlier table side by side with the comparable number (although it is worth noting that the SAMHSA data is both male and female, whereas the Meconium Drug Screen data is only pregnant females, so any gender variances would not be taken into account, as well as other confounding factors).  However, this data is still rather enlightening:

It is complete conjecture, but it appears that pregnant mothers are more likely to give up marijuana than cocaine.  The total positive and negative percentages of drug use, however, were quite comparable.  But cocaine was far more dominant in pregnant mothers than marijuana – unlike the overall usage statistics which seem to show the inverse (a much higher usage rate for marijuana than cocaine).

While this is just conjecture based on these data, it could be concluded that marijuana was not as addictive and mothers were likely to significantly reduce their use and/or quit smoking marijuana all together, as compared to cocaine.  I presume the higher percentage of cocaine positive tests in the pregnant mothers’ results as compared to the general population is probably linked to more risky behaviors resulting in pregnancy among cocaine-addicted women – resulting in a larger percentage of pregnant cocaine users than the general population of cocaine users – but again this is pure conjecture.

4. What is the overlap in concurrent drug use, ie how many cocaine-using mothers were also using opiates and/or cannabinoids?

The first table above gives two categories for each drug, ie cannabis positive and cannabis only.  The cannabis only number is included into the cannabis positive category.  For an easier interpretation of the data, I created another chart using the same mortality rate data, but with more information from the student access of the study.  Some of these numbers are calculated based on the percentages noted in the study, so the “exact” numbers given here may not be as precise as it appears (for instance, the total participants in the study was 2964, but these numbers add to 2961 – these are just rounding errors):

5.  For babies born to cannabis-using mothers, who did not use any other drugs, what is the mortality rate?

I was amazed that I was finally able to access this data, and even more astonished that my initial conjecture that there would be zero deaths among the cannabis only infants is correct.  Not a single death in the first two years of life for the babies that tested positive for cannabis.  Using the data for the drug-negative babies, it would be reasonable to see 3 deaths among this group.  It is possible that this is just coincidence, but it could also indicate a protective effect of cannabis, particularly when considering some of the other studies mentioned above.

6. Should cannabis be included in such a study to evaluate mortality rate in the first two years of life of “drug exposure?”  Or does cannabis skew the results?

Cannabis appears to seriously skew the results of the above study.  Clearly cannabis is starkly different than the other drug categories tested for, and while I wouldn’t throw cannabis out of the studies, I would certainly be looking at cannabis from a different perspective, inquiring about the potential BENEFITS for mothers.  Indeed, cannabis was used for centuries for morning sickness, cramping, and birthing pain – and with the above study in mind – it is definitely worth considering the potential benefits of cannabis in light of scientific advances and understanding.

Few things about the marijuana issue inflame me more than workplace and student drug testing.  I’m still trying to imagine how, if you had a time machine, we could visit Thomas Jefferson and the other hemp farmers discussing our Bill of Rights and explain to them in America of the future, employers routinely seize citizens’ urine to determine their fitness for employment and discriminate against them if hemp shows up in their system.  I think Ben Franklin would actually LOL.

Of course we all know that cannabis metabolites show nothing about one’s current impairment and will remain in one’s system for weeks or months following cessation of use.  We’ve talked about the perverse incentive this creates to use alcohol and other toxic addictive drugs that clear from one’s system in two to three days.  And now, this information from the American Psychiatric Association leads me to better understand why we’re seeing such an uptick in prescription drug abuse.

Medical News: APA: Drug Test Results Often Flawed – in Meeting Coverage, APA from MedPage Today.

NEW ORLEANS — That poppy seeds can lead to false-positive results on tests for opioid abuse is not just an urban legend, researchers said [at the American Psychiatric Association's annual meeting last May].

Another example is that most standard drug tests don’t screen for the opioid drug oxycodone, as well as a handful of other opioids including methadone and fentanyl, noted Smith, who conducted the research while he was at Boston Medical Center.

Opioid tests screen for morphine and codeine, which are two of the most common metabolites of many — but not all — opioids. They’re not metabolites of oxycodone, methadone, fentanyl, tramadol (Ultram), and buprenorphine (Subutex, Suboxone), Smith said.

Similarly, only certain metabolites of benzodiazepines are detected on most assays. That means diazepam, nordiazepam, and oxazepam (Serax) will be detected, but alprazolam (Xanax), lorazepam (Ativan), and clonazepam (Klonopin) aren’t frequently screened.

In their review, the researchers found that drug tests generally have a sensitivity of 90% to 95%, and a specificity of 85% to 90%. These numbers are a “pretty good basis” for making clinical decisions, Smith said, but that means “one in 20 [tested patients] are going to have inaccurate results, and those are more likely to be false positive than false negative.”

Many substances aside from poppy seeds cause these false-positives. Cold medications can give a positive read on amphetamines, as can bupropion (Wellbutrin) and tricyclic antidepressants.

Sertraline (Zoloft) and oxaprozin (Daypro) can alert physicians to a benzodiazepine problem when there is none.

The HIV medication efavirenz (Sustiva) can come up as a positive for marijuana use, and dextromethorphan, rifampin, and quinolones could show as an opioid problem.

There is a Jackson’s Food Store – a gas station / convenience store chain out West – that is two blocks from my home.  I walk my dog there every day as I pick up my fountain Diet Coke refill for lunch.  I’ve gotten to speak with most of the employees about marijuana – my pot leaf hat leads to lots of these conversations.  One of the kids pumping gas there is a sweet young man who is a migraine sufferer whom I’ve told would be a shoo-in for a medical marijuana card.

Then one day recently I notice that there are a whole bunch of new workers.  I find out that the store had come up $1,800 short in an audit, so in response, Jackson’s was drug testing all their employees.  Three employees admitted to occasional marijuana use and now they are unemployed.  There is no evidence that any of them were filching cash from register and since the firings the shortages from the till haven’t ceased.  But Jackson’s feels better, I guess, for having some scapegoats to blame.

Ironically, the one young man who could really use medical marijuana still has his job.  ”I only toke a tiny bit and only if the pain is just unbearable,” he told me, “because I just can’t lose this job – I have to take care of my wife and kid.  Luckily I hadn’t had a bad migraine for a few weeks, so I was able to pass the test.”  Even if he had a medical marijuana card, his job wouldn’t be protected.  My wife, a migraine patient herself, volunteered that her regular use of cannabis has turned what used to be weekly migraines to seasonal migraines – maybe four a year – and when they do come, they are moderate and not “drill a hole in my head” painful like before.

Now some would say, “Well, they knew the rules on drug testing; they don’t have to work there.”  Keep in mind that Portland, Oregon is suffering some >10% unemployment.  And then try to imagine your life if finding aspirin or ibuprofen or acetaminophen or naproxen in your system meant the end of your job and you have a splitting headache.

(WOAI.com) SAN ANTONIO — Controversy is brewing over a patch used for pain relief. At least two people in San Antonio have died after using the Fentanyl patch, and their families are blaming what they say is a defect.

Like most medicinal patches, Fentanyl is used by peeling off a sticky side and placing it against the skin of a patient. The patch is left on the skin for up to 72 hours and is supposed to provide the exact amount of medication needed.

However, the families of two San Antonio women who died say the patch they were prescribed to relieve their pain ended up killing them.

According to lawsuits filed by family members, both women suffered chronic pain. So, their doctors suggested Fentanyl patches.

Fentanyl is stronger than morphine. When it is applied to the skin, it then delivers a certain amount of Fentanyl into the patient.

While wearing the patches, Donna Singleton and Ellen Burks died. Their families say both suffered an overdose of Fentanyl because the patches were defective.

Similar patches have been recalled before because a cut along the side of the patch allowed too much Fentanyl to leak and cause a possible overdose.

Wait a minute, didn’t the Food & Drug Administration approve the use of these Fentanyl patches?  Why, doesn’t that mean it’s safe?  We know for sure that the FDA wouldn’t let people stick a patch on their body loaded with a Schedule II drug if it weren’t safe, even if this Fentanyl is just one isomer short of being Schedule I “China White” heroin.

We know this because they protect us from that evil Schedule I medical marijuana that never killed anybody in 5,000 years.

» Morphine-cannabis combo may boost painkilling response – Thaindian News
London, Aug 12 (ANI): U.S. researchers have come up with an idea of using the combination of morphine and cannabis so as to better the painkilling responses.

Joseph Holtman and Peter Crooks at the University of Kentucky College of Medicine in Lexington say that teaming them up could allow doses to become smaller, reducing the possibility of addiction.

However, combining the drug had some drawbacks, reports New Scientist.

A simple mixture of the drugs produces unpredictable results because the body absorbs them at different rates.

To overcome that limitation, the researchers came up an idea of binding the two drugs together using a linking molecule such as an ester.

When the body snips this linking group, both drugs are released at the site where they are needed.
That should ensure both drugs would be absorbed at the same rate, making it easier to work out doses for patients. (ANI)

We’ve heard of other research showing cannabis can increase the efficacy of other pain-killing drugs, but this is especially good to read because of the added benefit of reducing dosage of highly-addictive morphine.

Oh, cannabis, is there anything you can’t do?