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    A Patchwork of Cannabis Laws Creates Health Risks, Study Finds

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    A new report calls for public education and closing of legal loopholes to keep the public safe.The NewsAs more states have legalized the sale of cannabis, a fractured and inconsistent legal framework has emerged across the country that has prioritized sales income and tax revenue over public health, a new report finds.The report, issued Thursday by the National Academies of Sciences, Engineering and Medicine, describes an “urgent need for a coordinated public health response.” The academies, a nonprofit advisory group of the nation’s leading scientists, said that such a response should include a federally led campaign to educate parents, children and others about the risks of a drug that is increasingly potent.Among the other suggestions, the report also calls for a lifting of research restrictions on cannabis. In recent years, many claims have been made about the medicinal and other health effects of the drug but often without substantiation from science.Even as a patchwork of laws and regulations have emerged, the potency of cannabis products has surged.Cindy Schultz for The New York TimesPotencyCurrently 24 states, the District of Columbia and two U.S. territories have legalized the sale of cannabis for recreational use, according to the National Conference on State Legislatures. In 13 other states, cannabis is legal for medicinal use.Even as a patchwork of laws and regulations have emerged, the potency of cannabis products has surged, as measured by the growing concentration of THC, the main psychoactive compound in cannabis. The rapid increases have left the public unaware of the health risks, particularly to young people, pregnant women and seniors, according to Yasmin Hurd, director of the Addiction Institute at the Icahn School of Medicine and the vice chair of the committee that issued the latest report.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Francisco Lopera, the ‘Country Doctor’ Who Upended Our Understanding of Dementia

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      Francisco Lopera defied rebels, cartels and vampire bats to become a pioneering researcher of Alzheimer’s disease.In 1978, Dr. Francisco Lopera did what recent medical school graduates in Colombia and much of Latin America have long done: He set out for an obligatory year of work in a remote part of the country, where an inexperienced médico rural might be the only physician for miles. Dr. Lopera, who was born in the Andean region of Antioquia and knew mostly mountains and farm life before medical school, carried out his service in the Darién Gap, on the Caribbean coast near Panama.There Dr. Lopera, a groundbreaking Colombian Alzheimer’s researcher who died this week at age 73, treated stabbings, snakebites, complicated births, burns and fevers in a hospital that had electricity for only half the day. On one occasion, he was kidnapped by Marxist guerrillas. Another time, he had to flee gunshots.When I met Dr. Lopera in 2017, to start research on a book about the families with Alzheimer’s that became his life’s work, he told me a story about two young brothers who had died one after the other in his hospital, of unknown causes. Lopera traveled to the family home in a remote jungle clearing, where he discovered that the boys’ surviving siblings had bites on their fingers from vampire bats. He sent the bodies to a pathology lab hours away by boat, and the pathologists confirmed rabies. When the government brought in a rabies expert to investigate, Dr. Lopera joined him.He left that experience — long nights in the rainforest, searching for hidden roosts, engrossed in the natural history of rabies and bats — wanting to become a rabies epidemiologist. But that was not to be. His interests were eclectic and quick to change, and a few years later he became a neurology resident in Medellín.In 1984, Dr. Lopera examined a farmer in his 40s who appeared to have dementia. Dr. Lopera took again the unusual step of traveling to the family home, in a mountain hamlet like the one where he had been born. Not just the farmer had symptoms of dementia, he saw — a brother also appeared to be affected. Dr. Lopera had discovered what would turn out to be the world’s largest family with early-onset Alzheimer’s disease. The family shared a genetic mutation, later nicknamed the paisa mutation, that was unique to their region of Colombia. Dr. Lopera spent the next four decades studying the family’s 6,000 members.Dr. Francisco Lopera, second from right, in Yarumal, Colombia, in 2010, with Oderis Villegas, center, who was showing signs of Alzheimer’s disease at age 50. A sister, María Elsy, left, had a more advanced case.Todd Heisler/The New York TimesWe are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Younger Adults Are Missing Early Warning Signs of Colon Cancer

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      The LatestColorectal cancer rates are rapidly rising among adults in their 20s, 30s and 40s, and the most common warning sign for the disease is passing blood in the stool, according to a new scientific review.Rectal bleeding is associated with a fivefold increased risk of colorectal cancer, according to the new analysis, which looked at 81 studies that included nearly 25 million adults under 50 from around the world.Abdominal pain, changes in bowel habits and anemia are other common warning signs of the disease and should not be ignored, said the researchers, who published the paper on Thursday in the journal JAMA Network Open.A light micrograph of a colon biopsy from a colonoscopy.Choksawatdikorn/Science SourceWhy It MattersColon and rectal cancer rates have risen among younger adults as rates have declined among older people, who are far more likely to get colonoscopies that can catch cancers and precancerous lesions called polyps.But though millennials born around 1990 are at almost twice the risk of colon cancer compared with people born in the 1950s, and have a risk of rectal cancer that is four times as high, young people without a strong family history of colon cancer aren’t eligible for colonoscopies until the age of 45.Doctors may also miss the warning signs. Anecdotal evidence suggests that because physicians are less likely to suspect malignancies in younger people, they may attribute a symptom like rectal bleeding to a benign condition like hemorrhoids, rather than cancer, said Joshua Demb, a cancer epidemiologist at the University of California, San Diego, and one of the paper’s lead authors.From the time younger adults first go to a caregiver with a complaint about a symptom until they receive a diagnosis can take four to six months on average, the analysis found. Because the diagnosis is often delayed, younger adults tend to have more advanced disease that is harder to treat.“We need to facilitate early detection, and one way is identifying these red flags,” Dr. Demb said.What We Don’t KnowThe causal factors driving the rise in colon and rectal cancers in younger adults were not addressed in the new analysis, and are not well understood.Colorectal cancer has long been associated with obesity, smoking, a sedentary lifestyle, high alcohol intake and diets that are rich in red meat, processed food and sugary drinks.New research exploring the rapid rise in colorectal cancer in younger adults is examining other possible causes, including environmental exposures, changes in gut bacteria and the use of some medications, such as antibiotics. More

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      Legalized Weed is Landing More Seniors in the E.R.

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      In Canada, cannabis poisonings rose sharply among people 65 and older after the country legalized the drug, a new study found.The NewsAs more places legalize marijuana, policymakers and health officials have worried about the health risks that the drug may pose to adolescents. But a new study suggests that an additional demographic is at risk: seniors.The study, published Monday in JAMA Internal Medicine, found that after Canada legalized marijuana, the number of emergency room visits for cannabis poisoning rose sharply among people ages 65 and older. Poisonings doubled after Canada legalized sale of the cannabis flower, and then tripled just 15 months later, when Canada legalized the sale of edibles.“It’s often a baked good, a chocolate or a gummy,” said Dr. Nathan Stall, a geriatrician at Mount Sinai Hospital and researcher at Women’s College Hospital in Toronto, and lead author on the study. Dr. Stall noted that researchers and emergency room doctors were finding that seniors used drugs intentionally but also sometimes by accident, when edibles were mistaken for regular food or snacks.Symptoms of cannabis poisoning can include dizziness, confusion, nausea, loss of coordination and balance, drowsiness and hallucinations.The findings were consistent with other research published in the United States, Dr. Stall said, and showed that more attention needed to be paid to drug use by seniors, and to the health effects.“It’s somewhat in the shadows, and there is some ageism and bias in thinking that older adults aren’t using drugs,” Dr. Stall said.Edible marijuana samples at a cannabis testing laboratory in Santa Ana, Calif.Chris Carlson/Associated PressThe StudyThe study looked at 2,322 emergency room visits for cannabis poisoning among people 65 and older in Ontario. The visits spanned 2015 through 2022, allowing researchers to see what happened before and after October 2018, when Canada legalized the sale of dried cannabis, and January 2020, when the sale of edibles was legalized.In 2015, there were 55 emergency room visits caused by cannabis poisoning. That figure rose steadily to 462 by 2021, and then fell off slightly to 404 in 2022.Dr. Stall said he was motivated to undertake the study after being called into the emergency room to consult on an octogenarian who was experiencing severe confusion. The patient was barely conscious and showed strokelike symptoms. Multiple tests revealed no clear cause, until Dr. Stall ordered a toxicology test and found cannabis in the patient’s urine.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Widening Racial Disparities Underlie Rise in Child Deaths in the U.S.

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      New research finds that the death rate among Black youths soared by 37 percent, and among Native American youths by 22 percent, between 2014 and 2020, compared with less than 5 percent for white youths.The NewsThanks to advancements in medicine and insurance, mortality rates for children in the United States had been shrinking for decades. But last year, researchers uncovered a worrisome reversal: The child death rate was rising.Now, they have taken their analysis a step further. A new study, published Saturday in The Journal of the American Medical Association, revealed growing disparities in child death rates across racial and ethnic groups. Black and Native American youths ages 1 to 19 died at significantly higher rates than white youths — predominantly from injuries such as car accidents, homicides and suicides.Dr. Coleen Cunningham, chair of pediatrics at the University of California, Irvine, and the pediatrician in chief at Children’s Hospital of Orange County, who was not involved in the study, said the detailed analysis of the disparities documented “a sad and growing American tragedy.”“Almost all are preventable,” she said, “if we make it a priority.”Flowers for Karon Blake, 13, who was shot and killed in Washington, D.C., in January 2023. Gun-related deaths were two to four times higher among Black and Native American youth than among white youth.Carolyn Kaster/Associated PressSome Context: A frightening trend examined more closely.Researchers at Virginia Commonwealth University and Children’s Hospital of Richmond had previously revealed that mortality rates among children and adolescents had risen by 18 percent between 2019 and 2021. Deaths related to injuries had grown so dramatically that they eclipsed all public health gains.The group, seeking to drill deeper into the worrying trend, obtained death certificate data from the Centers for Disease Control and Prevention’s public WONDER database and stratified it by race, ethnicity and cause for children ages 1 to 19. They found that Black and American Indian/Alaska Native children were not only dying at significantly higher rates than white children but that the disparities — which had been improving until 2013 — were widening.The data also revealed that while the mortality rates for children overall took a turn for the worse around 2020, the rates for Black, Native American and Hispanic children had begun increasing much earlier, around 2014.Between 2014 and 2020, the death rates for Black children and teenagers rose by about 37 percent, and for Native American youths by about by about 22 percent — compared with less than 5 percent for white youths.“We knew we would find disparities, but certainly not this large,” said Dr. Steven Woolf, a professor of family medicine at the V.C.U. School of Medicine, who worked on the research. “We were shocked.”We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Mental Health and Substance Use Disorders Often Go Untreated for Parents on Medicaid

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      The NewsFor parents struggling with mental health or substance use disorders, access to treatment can often mean the difference between keeping and losing their children. But a new analysis of health and child welfare records found that a significant portion of those who were eligible for Medicaid coverage for such treatment were not getting it.The analysis, published Friday by researchers at the nonprofit institute RTI International and the Department of Health and Human Services, found that fewer than half of parents on Medicaid who had substance use disorders and had been referred to authorities over suspicions of child abuse or neglect had received treatment.A temporary shelter in Brooklyn.Hiroko Masuike/The New York Times Some Context: Experts say bad situations can often be reversed with treatment.Both mental health and drug addiction crises have been roiling the country, and the effects of parental drug use and mental illness can quickly trickle down to their children. Public health experts say substance use disorders can incapacitate a previously diligent parent and lead to the involvement of child protective services.In 2021 alone, more than seven million children were referred to authorities over worries of maltreatment, according to a federal report, and more than 200,000 were removed from their homes. But research shows that when parents seek treatment for psychiatric and substance use disorders, they are far less likely to experience family separation.The Numbers: What the researchers found.To calculate treatment rates among parents on Medicaid, the health insurance program for low income people, Tami Mark, a health economist at RTI, who led the research, and her colleagues drew from a new publicly available data set that used de-identified social security numbers to link child welfare records in Florida and Kentucky with corresponding Medicaid claims records from 2020.For comparison, they also analyzed a random sample of Medicaid recipients who had no records in the child welfare system. (The study didn’t capture any counseling or medication given outside the Medicaid system, nor any cases of mental health or substance use disorders that were undiagnosed.)We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Bacteria That Cause Meningitis Are Spreading Again, C.D.C. Warns

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      The NewsFederal officials are warning health care providers to be on the lookout for invasive meningococcal disease, a rare but potentially deadly illness that has increased in prevalence in recent years and requires prompt treatment with antibiotics to prevent long-term disability or death.Colonies of Neisseria meningitidis bacteria, which cause meningococcal disease.Brodsky/CDC, via Associated PressBy the Numbers: A rising fatality rate.The illness is caused by infection with a bacterium called Neisseria meningitidis. Last year, 422 cases of invasive meningococcal disease were reported in the United States, the highest number since 2014, according to the Centers for Disease Control and Prevention.But as of Monday, 143 cases have been reported to the C.D.C. so far this year, 62 more than the number of cases reported last year during the same period.The illness is extremely dangerous. Even with appropriate treatment, 10 to 15 percent of patients who develop meningococcal disease will die. Many recent cases were caused by an unusual strain of N. meningitidis called ST-1466. This strain caused 17 deaths among 94 patients whose outcomes are known, a fatality rate of 18 percent.Survivors of meningococcal disease may be left with long-term disability, deafness, amputations or brain damage.The Mystery: What’s causing the outbreaks?A majority of people affected in the recent outbreaks were Black people and adults ages 30 to 60.Others who are susceptible to the infection include people living with H.I.V., who account for 15 percent of patients; individuals who have had their spleens removed; people with sickle cell disease; and patients with certain rare immune conditions.A meningitis vaccine that protects against four of six N. meningitidis types — including group Y, which includes ST-1466 — is recommended for adolescents as well as those with medical conditions like H.I.V. Most older adults have not received the vaccine.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Use of Abortion Pills Has Risen Significantly Post Roe, Research Shows

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      The NewsOn the eve of oral arguments in a Supreme Court case that could affect future access to abortion pills, new research shows the fast-growing use of medication abortion nationally and the many ways women have obtained access to the method since Roe v. Wade was overturned in June 2022.The DetailsPackages of abortion pills being prepared to send to patients.Sophie Park for The New York TimesA study, published on Monday in the medical journal JAMA, found that the number of abortions using pills obtained outside the formal health system soared in the six months after the national right to abortion was overturned. Another report, published last week by the Guttmacher Institute, a research organization that supports abortion rights, found that medication abortions now account for nearly two-thirds of all abortions provided by the country’s formal health system, which includes clinics and telemedicine abortion services.The JAMA study evaluated data from overseas telemedicine organizations, online vendors and networks of community volunteers that generally obtain pills from outside the United States. Before Roe was overturned, these avenues provided abortion pills to about 1,400 women per month, but in the six months afterward, the average jumped to 5,900 per month, the study reported.Overall, the study found that while abortions in the formal health care system declined by about 32,000 from July through December 2022, much of that decline was offset by about 26,000 medication abortions from pills provided by sources outside the formal health system.“We see what we see elsewhere in the world in the U.S. — that when anti-abortion laws go into effect, oftentimes outside of the formal health care setting is where people look, and the locus of care gets shifted,” said Dr. Abigail Aiken, who is an associate professor at the University of Texas at Austin and the lead author of the JAMA study. The co-authors were a statistics professor at the university; the founder of Aid Access, a Europe-based organization that helped pioneer telemedicine abortion in the United States; and a leader of Plan C, an organization that provides consumers with information about medication abortion. Before publication, the study went through the rigorous peer review process required by a major medical journal.The telemedicine organizations in the study evaluated prospective patients using written medical questionnaires, issued prescriptions from doctors who were typically in Europe and had pills shipped from pharmacies in India, generally charging about $100. Community networks typically asked for some information about the pregnancy and either delivered or mailed pills with detailed instructions, often for free.Online vendors, which supplied a small percentage of the pills in the study and charged between $39 and $470, generally did not ask for women’s medical history and shipped the pills with the least detailed instructions. Vendors in the study were vetted by Plan C and found to be providing genuine abortion pills, Dr. Aiken said.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More