THE HIGH AND LOWS OF CANNABIS

Ricardo Jimenez, MD

Cannabis, also known as Marijuana, remains the most used illegal drug in the United States. National estimates suggest that 22.2 million people 12 years or older are current users of Cannabis. The primary cannabinoids in cannabis are 9-Tetrahydrocannabinol (THC) and cannabinol (CBD). THC is primarily responsible for the psychoactive properties of cannabis. Cannabinoids are thought to exert their pharmacological activity via several mechanisms. The most studied  is the receptor mediated mechanism that includes two receptors, Cannabinoid-binding receptor 1 (CB1) and Cannabinoid-binding receptor 2 (CB2). CB1 receptors are located throughout the central nervous system (CNS) and CB2 are only found in the peripheral tissues. Stimulation of the receptors in the CNS produces hallucinations, memory loss, dyskinesia, and sedation. The actions of CB2 are receptors are not yet clear. 

            The increase in legalization, availability, and marketing of cannabis, correlates to an increase in unintentional pediatric exposures. Pediatric exposures to cannabis rose from 148% from 2006 to 2013. Since the decriminalization of cannabis, there has been an explosion of dispensaries that have catapulted cannabis to be a major industry generating $ 2.3 billion dollars in sales in Colorado alone. Part of this growth has included expansion in the available forms of cannabis, including edible products, concentrated tinctures, and e-cigarettes. Many commercial cannabis-infused edibles are produced in the form of cookies, cakes, candy bars, and even drinks, which are indistinguishable to children from their non-cannabis counterparts. Edibles have become the most common form of unintentional cannabis exposure in pediatrics. 

Safe Sleep and Sudden Unexpected Infant Death-Preparing for Safe Sleep Awareness Month in October

Sarah Lazarus, MD

The Center for Disease Control and Prevention (CDC) defines sudden unexpected infant death (SUID) as “the sudden death of an infant under 1 year of age that cannot be explained after a thorough investigation.” SUID is routinely classified as: 1) sudden infant death syndrome (SIDS), 2) accidental suffocation and strangulation in bed (ASSB), or 3) death from unknown causes. Each year, around 4,000 U.S. babies die from SUID, making it an important topic to understand and effect change. In Georgia, there are three deaths every week from SUID. Between 1990 and 1999, the SUID rate drastically declined following numerous safe sleep campaigns, the most notable being the “Back to Sleep” campaign in 1994. In 2012, the AAP expanded their focus to include environmental recommendations (such as sleep location and environment) and renamed it the “Safe to Sleep” campaign. Since 1997, SIDS deaths have become less common; however, rates of infant death due to unknown causes and ASSB are stagnant. With proper safe sleep education and adherence to the American Academy of Pediatrics (AAP) safe sleep recommendations, the risk of sleep-related infant death can be reduced.