INTERESTING TIMES

If you live and Portland and haven't picked up a copy of this month's Willamette Week (free news weekly, online here: http://www.wweek.com/portland/index.php), this issue is likely to get snapped up. They've named it the 420 Issue and it is all about the businesses and culture incurred by the recent legalization of cannabis in Washington and soon Oregon. What struck me initially is the amount of wordplay around the subject, and the generation of witty new phrases, words and hashtags that accompanies the surge in businesses and products containing cannabinoids. There is great excitement about the new availability and openness that comes with legalization.

I for one am OK with recreational and medical use. I think that the risks to society of adults using cannabinoids are fairly minimal. It certainly doesn't make people drive dangerously the way alcohol does. It does have a whole set of risks that aren't covered in this issue, and that really need to be kept high in our awareness as this drug becomes widely acceptable.

One risk that is coming into focus these days is of extreme overdoses. Back when folks just inhaled smoke, coughing stopped them from partaking too much. Vaporizers now make inhalation gentler and it is easy to overdose when consuming edibles. With either method you can't tell how much intoxicant is in there. With humans ingeniously extracting and concentrating the active principles, it could be very strong, or contaminated with solvents. With edibles the effect takes time to kick in. It is terribly easy to overdose for folks who are experimenting for the first time, and who have no tolerance at all.

The conventional media take on overdose--blaming it for many deaths and claiming that it is deadly--is probably overblown. It takes a massive amount of pot to kill, perhaps more than anybody is likely to actually reach because unlike opioids it is so unpleasant getting there. It is however a relative unknown: having been illegal for so long, we don't have scientific studies about overdose. We hardly have science to justify all the medical uses that have already been approved. We are going to find out now.

Another risk is incurred by the fact that edibles make the drug palatable to people who would never smoke it. It is tempting to children as candy. There is the danger that children, teens and early 20-somethings will enjoy sugary yummies containing cannabinoids and permanently alter their brain development. Later on in life there is still a brain changing effect, but in early life when the brain is still forming, the effect can be severe.

On top of these new risks due to the availability of edibles, there is the old risk of respiratory injuries resulting in sinusitis and bronchitis, and risk of more dangerous conditions like pneumonia and COPD. There is also the fact that marijuana increases heart rate significantly in most individuals. Folks who already have hypertension or heart palpitations might give themselves a heart attack.

I suppose my main message in the light of all this 420 excitement is BE CAUTIOUS and PROTECT YOUR CHILDREN because there is a lot we don't know. I believe in freedom and individual discretion as most Americans do, and I also know that people can be terribly foolish and injure themselves and others, especially when intoxicants are involved. I cannot protect the whole world from poor choices, but I do hope that this warning is heard widely. Please take care of each other and if you are going to play with the newly legalized products, start very small.

In 2007-8 the mean daily intake of sodium was measured at 3266mg based on a N of 7227. We're supposed to limit it to 2300mg or less, barring health conditions like HTN which would suggest a limit more like 1500mg. Ten foods provided 44% of the salt: bread, cold cuts and cured meats, pizza, poultry, soups, sandwiches, cheese, pasta mixed dishes, meat mixed dishes, and savory snacks. Store-bought foods provided over 70% of the sodium consumed.

SOURCE
http://www.medscape.com/viewarticle/758428?src=mpnews&spon=34

fascinating factoid per Drs Szabat & Ambrose: scutellaria inhibits expression of IL6, 6/2011

Family: Labiatae (MINT family)
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Lots of new info in this article from Mercola. For example: fructose increases your absorption of glucose.

nice opthalmo teaching website: http://www.kellogg.umich.edu/theeyeshaveit/index.html
( Dr Rich Barrett speaks with a high speed review of the basics of the exam and pathologies you may detect. My notes incomplete because I could not keep up. )

MIDTERM EXAM REVIEW--questions we missed
and then a lecture on DIETARY APPROACHES TO STOP HYPERTENSION

FOR DIET EVAL ASSIGNMENT
he says use Kraus' older editions of book, good index
don't use programs in library, they're too complicated
assignment due week 9, 2 weeks from today
( notes )

Red Rice Yeast
mainstay of Chinese medicine since ancient times
now available OTC as supplement for lowering cholesterol
promoted as alternative to statins
docs may recommend it when someone can't tolerate statins dt muscle pain
derived from a fungus that grows on rice
eaten as a dietary staple some places in Asia
BUT: RYR is a statin drug too w/ same SEs
( notes )