America Addresses Two Epidemics – Cannabis and Coronavirus and their Interactions: An Ecological Geospatial Study

Reece, Albert Stuart; Hulse, Gary Kenneth

doi:10.1101/2020.04.17.20069021

Cited by 4 publications

(9 citation statements)

References 32 publications

(42 reference statements)

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“…Findings implicate all cannabinoids examined including THC, cannabigerol, cannabichromene, cannabinol and cannabidiol. In that ALL is well described as being due to formation of several protooncogenes and oncoproteins by a series of chromosomal translocations the present clear results add an important mechanistic dimension to the trisomy / monosomy series of defects previously described in association with prenatal cannabis use in addition to anaphase chromosomal mis-segregation [ 68 , 75 ]. Since pediatric cancer is known to be related to gestational genetic and epigenetic defects these transgenerational impacts add a further major dimension to the cannabis legalization debate which has not been widely considered [ 141 , 142 ].…”

Section: Discussionsupporting

confidence: 53%

“…Prenatal cannabis use was linked with Downs syndrome in offspring in an Hawaiian study published in 2007 [ 70 ], with Downs syndrome in Colorado, Canada and Australia [ 71 – 74 ] and more recently with Downs syndrome, Trisomies 13 and 18 and the monosomy Turners syndrome in the USA [ 75 ]. PCE has also been linked with Deletion 22q11.2 in the USA in spatiotemporal analyses and in odds ratio-based assessments [ 75 ].…”

Section: Discussionmentioning

confidence: 99%

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Cannabinoid exposure as a major driver of pediatric acute lymphoid Leukaemia rates across the USA: combined geospatial, multiple imputation and causal inference study

Reece

Hulse

2021

BMC Cancer

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Background Acute lymphoid leukaemia (ALL) is the commonest childhood cancer whose incidence is rising in many nations. In the USA, between 1975 and 2016, ALL rates (ALLRs) rose 93.51% from 1.91 to 3.70/100,000 < 20 years. ALL is more common in Caucasian-Americans than amongst minorities. The cause of both the rise and the ethnic differential is unclear, however, prenatal cannabis exposure was previously linked with elevated childhood leukaemia rates. We investigated epidemiologically if cannabis use impacted nationally on ALLRs, its ethnic effects, and if the relationship was causal. Methods State data on overall, and ethnic ALLR from the Surveillance Epidemiology and End Results databank of the Centre for Disease Control (CDC) and National Cancer Institute (NCI) were combined with drug (cigarettes, alcoholism, cannabis, analgesics, cocaine) use data from the National Survey of Drug Use and Health; 74.1% response rate. Income and ethnicity data was from the US Census bureau. Cannabinoid concentration was from the Drug Enforcement Agency Data. Data was analyzed in R by robust and spatiotemporal regression. Results In bivariate analyses a dose-response relationship was demonstrated between ALLR and Alcohol Use Disorder (AUD), cocaine and cannabis exposure, with the effect of cannabis being strongest (β-estimate = 3.33(95%C.I. 1.97, 4.68), P = 1.92 × 10− 6). A strong effect of cannabis use quintile on ALLR was noted (Chi.Sq. = 613.79, P = 3.04 × 10− 70). In inverse probability weighted robust regression adjusted for other substances, income and ethnicity, cannabis was independently significant (β-estimate = 4.75(0.48, 9.02), P = 0.0389). In a spatiotemporal model adjusted for all drugs, income, and ethnicity, cannabigerol exposure was significant (β-estimate = 0.26(0.01, 0.52), P = 0.0444), an effect increased by spatial lagging (THC: β-estimate = 0.47(0.12, 0.82), P = 0.0083). After missing data imputation ethnic cannabis exposure was significant (β-estimate = 0.64(0.55, 0.72), P = 3.1 × 10− 40). 33/35 minimum e-Values ranged from 1.25 to 3.94 × 1036 indicative of a causal relationship. Relaxation of cannabis legal paradigms had higher ALLR (Chi.Squ.Trend = 775.12, P = 2.14 × 10− 112). Cannabis legal states had higher ALLR (2.395 ± 0.039 v. 2.127 ± 0.008 / 100,000, P = 5.05 × 10− 10). Conclusions Data show that ALLR is associated with cannabis consumption across space-time, is associated with the cannabinoids, THC, cannabigerol, cannabinol, cannabichromene, and cannabidiol, contributes to ethnic differentials, demonstrates prominent quintile effects, satisfies criteria for causality and is exacerbated by cannabis legalization.

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Section: Discussionsupporting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Cannabinoid exposure as a major driver of pediatric acute lymphoid Leukaemia rates across the USA: combined geospatial, multiple imputation and causal inference study

Reece

Hulse

2021

BMC Cancer

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“…Downs syndrome has been linked with cannabis exposure in Hawaii, Colorado, Canada and Australia [ 54 – 57 ] and early termination of pregnancy for anomaly-corrected rates of Downs syndrome, trisomies 18 and 13, Turners syndrome and Deletion 22q11.2 in a space time and odds ratio analysis in the USA [ 58 ].…”

Section: Discussionmentioning

confidence: 99%

Causal inference multiple imputation investigation of the impact of cannabinoids and other substances on ethnic differentials in US testicular cancer incidence

Reece

Hulse

2021

BMC Pharmacol Toxicol

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Background Ethnic differences in testicular cancer rates (TCRs) are recognized internationally. Cannabis is a known risk factor for testicular cancer (TC) in multiple studies with dose-response effects demonstrated, however the interaction between ancestral and environmental mutagenic effects has not been characterized. We examined the effects of this presumed gene-environment interaction across US states. Methods State based TCR was downloaded from the Surveillance Epidemiology and End Results (SEER) website via SEERStat. Drug use data for cigarettes, alcohol use disorder, analgesics, cannabis and cocaine was taken from the National Survey of Drug Use and Health a nationally representative study conducted annually by the Substance Abuse and Mental Health Services Administration (SAMHSA) with a 74.1% response rate. Cannabinoid concentrations derived from Drug Enforcement Agency publications. Median household income and ethnicity data (Caucasian-American, African-American, Hispanic-American, Asian-American, American-Indian-Alaska-Native-American, Native-Hawaiian-Pacific-Islander-American) was from the US Census Bureau. Data were processed in R using instrumental regression, causal inference and multiple imputation. Results 1975–2017 TCR rose 41% in African-Americans and 78.1% in Caucasian-Americans; 2003–2017 TCR rose 36.1% in Hispanic-Americans and 102.9% in Asian-Pacific-Islander-Americans. Ethnicity-based scatterplot-time and boxplots for cannabis use and TCR closely mirrored each other. At inverse probability-weighted interactive robust regression including drugs, income and ethnicity, ethnic THC exposure was the most significant factor and was independently significant (β-estimate = 4.72 (2.04, 7.41), P = 0.0018). In a similar model THC, and cannabigerol were also significant (both β-estimate = 13.87 (6.33, 21.41), P = 0.0017). In additive instrumental models the interaction of ethnic THC exposure with Asian-American, Hispanic-American, and Native-Hawaiian-Pacific-Islander-American ethnicities was significant (β-estimate = − 0.63 (− 0.74, − 0.52), P = 3.6 × 10− 29, β-estimate = − 0.25 (− 0.32, − 0.18), P = 4.2 × 10− 13, β-estimate = − 0.19 (− 0.25, − 0.13), P = 3.4 × 10− 9). After multiple imputation, ethnic THC exposure became more significant (β-estimate = 0.68 (0.62, 0.74), P = 1.80 × 10− 92). 25/33 e-Values > 1.25 ranging up to 1.07 × 105. Liberalization of cannabis laws was linked with higher TCR’s in Caucasian-Americans (β-estimate = 0.09 (0.06, 0.12), P = 6.5 × 10− 10) and African-Americans (β-estimate = 0.22 (0.12, 0.32), P = 4.4 × 10− 5) and when dichotomized to illegal v. others (t = 6.195, P = 1.18 × 10− 9 and t = 4.50, P = 3.33 × 10− 5). Conclusion Cannabis is shown to be a TC risk factor for all ethnicities including Caucasian-American and African-American ancestries, albeit at different rates. For both ancestries cannabis legalization elevated TCR. Dose-response and causal relationships are demonstrated.

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“…Con respecto al cannabis, al igual que el tabaco, su consumo se ha relacionado con consecuencias negativas en relación con la COVID-19. En el estudio multivariante y de geolocalización de Reece & Hulse (2020), la variable de respuesta fue la "tasa de incidencia del coronavirus". Los autores ajustaron diversos modelos, en uno de ellos consideraron el efecto de: los viajes internacionales, grupo étnico, ingreso, población, densidad poblacional y consumo de drogas.…”

Section: Cannabisunclassified

Covid-19 Y Su Repercusión en Las Adicciones

Sixto-Costoya

Domínguez²,

Calatayud

2021

HAAJ

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Objetivo. Indagar acerca de la literatura científica emergente a nivel internacional sobre la repercusión de la pandemia por COVID-19 en las adicciones. Metodología. La base de datos Web of Science se utilizó para analizar la literatura científica sobre la pandemia por COVID-19 y la influencia que ésta pueda tener en el ámbito de las adicciones. Resultados. Se identificaron 320 documentos, de los cuales 38 cumplieron los criterios de inclusión. Sobresalieron tres problemáticas: el consumo de tabaco, opioides y alcohol. Según la literatura incipiente, entre los consumidores de opiáceos existe el riesgo de aumento de las sobredosis, así como un empeoramiento del binomio estrés-alcohol y un peor pronóstico de la enfermedad COVID-19 para los fumadores de tabaco. Destaca la preocupación por la disminución de servicios sanitarios focalizados en las adicciones y la salud mental. Conclusiones. La literatura es muy reciente y es necesaria más evidencia científica que arroje luz. Se pone de manifiesto la preocupación por el alcohol, opioides y tabaco, pero se constata la escasez de referencias a adicciones sin sustancia (nuevas tecnologías, juego online) o a los hipnóticos y las benzodiacepinas.

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America Addresses Two Epidemics – Cannabis and Coronavirus and their Interactions: An Ecological Geospatial Study

Cited by 4 publications

References 32 publications

Cannabinoid exposure as a major driver of pediatric acute lymphoid Leukaemia rates across the USA: combined geospatial, multiple imputation and causal inference study

Cannabinoid exposure as a major driver of pediatric acute lymphoid Leukaemia rates across the USA: combined geospatial, multiple imputation and causal inference study

Causal inference multiple imputation investigation of the impact of cannabinoids and other substances on ethnic differentials in US testicular cancer incidence

Covid-19 Y Su Repercusión en Las Adicciones

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