Effects of Habitual Use of Marijuana and/or Cocaine on the Lung

Dp, Tashkin; Fligiel, Suzanne E. G.; Wu, Tong; Gong, Henry; Rg, Barbers; Ah, Coulson; Ms, Simmons; Tf, Beals

doi:10.1037/e496372006-006

Cited by 23 publications

(25 citation statements)

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“…Increases in nonspecific airway hyperresponsivity (AHR) to methacholine challenge have been observed at the level of the small airways and alveoli among tobacco smokers, and the risk of AHR appears to increase in a dose-dependent manner for this exposure (19,24,29,30). On the other hand, habitual marijuana smoking is also associated with chronic respiratory symptoms but causes functional impairment predominantly in large airways and AHR to methacholine challenge is less marked than that seen for tobacco (17,18,20,24). In contrast, free-basing cocaine (crack) is associated with acute respiratory symptoms, including chest pain, discolored sputum, and hemoptysis, but there are conflicting data on whether smoking cocaine is associated with increased AHR or alterations in lung function (20,24,(26)(27)(28).…”

Section: Discussionmentioning

confidence: 99%

“…Studies among HIVseronegative subjects have shown that each of these substances has independent effects on lung morbidity, respiratory symptoms, pulmonary function, and tracheobronchial and alveolar histopathology (17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28). Those exposures may have an additive effect on risk of pulmonary dysfunction, but there is no evidence of multiplicative interactions (18)(19)(20)24). Tobacco smoking is associated with chronic respiratory symptoms and poor lung function.…”

Section: Discussionmentioning

confidence: 99%

“…Significant inflammatory responses have been described in association with lung exposure to tobacco and marijuana smoke, including increased number of alveolar macrophages (20) and altered macrophage form, function, and motility in vivo and in vitro (31)(32)(33)(34)(35)(36)(37)(38). The mechanisms involved in the inflammatory response in the lungs are not well understood but may include cellular activation by physicochemical irritants or antigenic stimulation leading to the release of chemotactic mediators, release of enzymes, or generation of toxic oxygen radicals (20,(36)(37)(38)(39).…”

Section: Discussionmentioning

confidence: 99%

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Drug smoking, Pneumocystis carinii pneumonia, and immunosuppression increase risk of bacterial pneumonia in human immunodeficiency virus-seropositive injection drug users.

Caiaffa¹,

Vlahov²,

Graham

et al. 1994

Am J Respir Crit Care Med

123

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To examine the risk factors for the first episode of bacterial pneumonia among human immunodeficiency virus (HIV)-seropositive injection drug users (IDUs), medical record review was performed on IDUs participating in a cohort study from January 1988 to June 30, 1992. HIV-seropositive IDUs with a first episode of bacterial pneumonia (n = 40) were matched with up to five HIV-seropositive control subjects without bacterial pneumonia (n = 197) by date of entry (+/- 3 mo) and length of follow-up. Odds ratios (OR) were estimated using conditional logistic regression. The incidence of bacterial pneumonia was 1.93 in 100 person-years in HIV seropositive and 0.45 in 100 person-years in HIV seronegative subjects (relative incidence = 4.3; 95% CI 2.4 to 7.5). In univariate analyses, CD4 lymphocyte count < 200 cells/microliters previous episode of Pneumocystis carinii pneumonia (PCP), age between 30 and 40 yr and smoking illicit drugs (marijuana, cocaine, or crack) were associated with bacterial pneumonia. Cigarette smoking was associated with an increased odds of bacterial pneumonia (OR = 2.0), but this was not statistically significant because it was nearly universal in this cohort. In multivariate analysis, CD4 < 200 cells/microliters (OR = 6.75, 95% CI 2.13 to 21.42) and smoking illicit drugs (OR = 2.24, 95% CI 1.03 to 4.89) remained significantly associated with bacterial pneumonia. The odds ratio for cigarette smoking in the final model remained at 2.08 but was still not significant (95% CI 0.49 to 8.70). Smoking illicit drugs had the strongest effect on risk of bacterial pneumonia among HIV-seropositive IDUs with a previous history of PCP (OR = 22.94; 95% CI 2.18 to 241.10).

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Drug smoking, Pneumocystis carinii pneumonia, and immunosuppression increase risk of bacterial pneumonia in human immunodeficiency virus-seropositive injection drug users.

Caiaffa¹,

Vlahov²,

Graham

et al. 1994

Am J Respir Crit Care Med

123

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“…Tan et al surveyed 878 patients and found that concurrent use of a lifetime dose of [ 50 marijuana cigarettes and smoking tobacco was associated with increased risk of COPD than only smoking tobacco or marijuana alone [1]. A longitudinal cohort of 299 patients followed by 10 years by Tashkin et al [16] found a higher prevalence of chronic bronchitis amongst patients who continued to smoke marijuana and/or tobacco compared to ex-and non-smokers. In our study, we found 94 % of the illicit drug smokers that had spirometry had evidence of COPD and that they were younger than those that had only smoked tobacco.…”

Section: Discussionmentioning

confidence: 97%

Hospital Readmissions with Exacerbation of Obstructive Pulmonary Disease in Illicit Drug Smokers

Yadavilli

Collins

Ding

et al. 2014

Lung

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“…Because of the disruption of this molecular mechanism by delta-9-tetrahydrocannabinol, it has not been possible to separate the adverse effects of delta-9-tetrahydrocannabinol and marijuana from their therapeutic properties. 10 Adverse effects of chronic marijuana usage have been described upon the respiratory 11,12 and cardiovascular 10 systems. Questions remain regarding its effects upon reproductive systems 13 and cellular and humoral immune systems.…”

Section: Introductionmentioning

confidence: 99%

Possible hepatotoxicity of chronic marijuana usage

2004

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CONTEXT: Hepatotoxicity is a potential complication from the usage of various illicit drugs, possibly consequent to their liver metabolism, but information on this is scarce in the medical literature. OBJECTIVE:To study the occurrence of clinical and laboratory hepatic alterations in chronic marijuana users, from the use of marijuana on its own or in association with other legal or illicit drugs. TYPE OF STUDY: transversal studySETTING: Hospital Espírita de Marília, Marília, São Paulo, Brazil PARTICIPANTS:The study was made among 123 patients interned in the Hospital Espírita de Marília from October 1996 to December 1998, divided into 3 groups: 26 (21%) using only marijuana, 83 (67.5%) using marijuana and crack, and 14 (11.4%) consuming marijuana and alcohol. PROCEDURES AND MAIN MEASUREMENTS:Patients were examined clinically with special emphasis on types of drugs used, drug intake route, age when consumption began, length and pattern of usage, presence of tattooing, jaundice, hepatomegaly and splenomegaly. Serum determinations of total proteins, albumin, globulin, total and fractions of bilirubin, aspartate (AST) and alanine (ALT) aminotransferases, alkaline phosphatase (AP), gamma-glutamyltransferase and prothrombin activity were performed. RESULTS:Among users of only marijuana, hepatomegaly was observed in 57.7% and splenomegaly in 73.1%, and slightly elevated AST (42.3%), ALT (34.6%) and AP (53.8%). The three groups did not differ significantly in the prevalence of hepatomegaly, splenomegaly and hepatosplenomegaly. The group using both marijuana and alcohol showed the highest prevalence of alterations and highest levels of aminotransferases. Mean AP levels were above normal in all groups. CONCLUSIONS:Chronic marijuana usage, on its own or in association with other drugs, was associated with hepatic morphologic and enzymatic alterations. This indicates that cannabinoids are possible hepatotoxic substances.

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Effects of Habitual Use of Marijuana and/or Cocaine on the Lung

Cited by 23 publications

References 0 publications

Drug smoking, Pneumocystis carinii pneumonia, and immunosuppression increase risk of bacterial pneumonia in human immunodeficiency virus-seropositive injection drug users.

Drug smoking, Pneumocystis carinii pneumonia, and immunosuppression increase risk of bacterial pneumonia in human immunodeficiency virus-seropositive injection drug users.

Hospital Readmissions with Exacerbation of Obstructive Pulmonary Disease in Illicit Drug Smokers

Possible hepatotoxicity of chronic marijuana usage

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