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A recent study investigates links between cannabis use and repeat strokes. Alba Vitta/Stocksy
  • Cannabis is the most commonly used drug in the United States.
  • 3 in 10 people who use the drug have cannabis use disorder, which amounts to 4 million people in the U.S.
  • According to a new study, young people with a history of stroke or TIA who regularly use cannabis are 50% more likely to experience a repeat stroke.

Cannabis is a plant-based drug and is the most widely used illicit drug in the world. Its use inhibits the release of neurotransmitters in the brain, altering normal brain function.

Some studies have linked occasional use in young people to “educational problems” and regular use with increased use of other drugs.

The adverse effect of cannabis use on health is well recognized, particularly in the young. It has associations with mental disorders, mood symptoms, and long-term psychotic illness.

According to the Centers for Disease Control and Prevention (CDC), over 48.2 million people in the United States use cannabis, and around 3 in 10 cannabis users have cannabis use disorder (CUD).

CUD is “a relatively new diagnosis […] more of a physical and psychological dependence upon cannabis,” said Dr. Robert L Page II, professor in the Departments of Clinical Pharmacy and Physical Medicine at the University of Colorado in Aurora.

“[It] is different from recreation […] these individuals are using it on a regular basis, in a chronic fashion.”

The American Psychiatric Association classifies CUD as:

  • taking large amounts over a long time
  • wanting to control or cut down its use
  • spending lots of time trying to get the drug or recover from using it
  • failing to fulfill work or school tasks
  • withdrawing from social, occupational, or recreational activities

Studies have shown that cannabis use in younger individuals is a risk factor for first-time stroke or transient ischemic attack(TIA), also known as a mini-stroke.

However, scientists have not established the risk of subsequent strokes and TIAs in people who use cannabis until now.

A stroke or TIA occurs when the blood supply to the brain is reduced or cut off. It is a life threatening medical emergency that needs immediate hospital treatment.

In recent years, the number of strokes has reduced in the U.S. However, rates have increased in young adults ages 18–45 years, accounting for 10-15% of strokes in the U.S.

A recent study led by researchers at Mercy Catholic Medical Center in Philadelphia, PA, has shown young adults with a history of stroke or TIA and CUD have a 50% increased risk of recurrent stroke compared with those without CUD.

Speaking with Medical News Today, the lead author of the study Dr. Akhil Jain, explained:

“Since marijuana use is more common among younger people and is now legal in various U.S. states, we felt it was crucial to study the risk of re-stroke […] especially with the established first-time stroke risk in cannabis users. We used recreational dependent or chronic/habitual cannabis use for our study, i.e., cannabis use disorder.”

The team will present the study at the American Stroke Association International Stroke Conference (ISC). The scientists used information from the National Inpatient Sample database to look at the risk of repeat stroke and TIA in patients with CUD.

This data “included 161,390 people, ages 18-44 years, who had been in the hospital for any reason between October 2015 and 2017, and whose health records indicated a previous stroke or TIA.” Dr. Jain told MNT.

The researchers compared the number of recurrent strokes and TIA in 4,690 people with CUD to 156,700 people without CUD.

They found that 6.9% of people with CUD were admitted to the hospital for a recurrent stroke compared with 5.4% without CUD.

Dr. Jain explained that after adjusting for demographic factors and relevant pre-existing medical conditions … people with CUD were 48% more likely to have been hospitalized for recurrent stroke than those without it.”

The study showed young males from low-income neighborhoods were at the highest risk of CUD, and hospitals in the northeast and southern regions of the U.S. recorded the highest rates of recurrent stroke with CUD.

Overall, the research showed that young adults with a history of stroke or TIA and CUD had a 50% increased risk of recurrent stroke.

The study does have certain limitations. For instance, the scientists did not have data on the amount of cannabis that participants used or information about how long they had used cannabis.

Likewise, the study could not follow individuals over time; the data are from a single time point.

Nevertheless, Dr. Jain hopes that the study results will encourage people to “take into consideration the increased risk of re-stroke with cannabis usage.”

He hopes that it will help “increase awareness among younger adults of the adverse impact of chronic, habitual use of cannabis, especially if they have established cardiovascular disease risk factors or previous stroke episodes.”

When asked about the future of the work, Dr. Jain replied, “More research is required to look deeply into this concerning clinical question.”

Most importantly, he would like to examine “the impact of various doses, duration, forms of cannabis abuse, and the use of medicinal cannabis on the occurrence of recurrent strokes.”