I don’t know if the right argument to cut back, or even better, not smoke pot at all, would be vanity, sanity, pragmatism, or just plain common sense. For those of us who are pilots, we can add FAA and federal law to the argument. Part One last month was an attempt to appeal to sanity and common sense. This month I’ll appeal to vanity and pragmatism and talk about the negative impact of THC on heart health and also data showing that the use of pot can accelerate the aging process.
Let’s go for pragmatism first. By standards from a few years ago, the THC content in marijuana cigarettes has increased somewhere almost 100-fold. Highly potent synthetic cannabinoids with multiple, and unknown, street additives have become increasingly common, leading to an increased incidence of acute THC toxicity by about 3.5-fold. With this increased potency and use, especially among older adults, there has been a significant rise in THC-associated cardiovascular events, including heart attacks (myocardial infarction), cardiomyopathy (enlarged and weakened heart), cardiac arrhythmia (irregular heart rate), stroke, and cardiac arrest. These studies show that adults using pot daily increased their risk of myocardial infarction by about 50% and have a twofold-increased risk for stroke. Your heart rate can increase up to 120% above baseline—on average 20–50 more beats per minute—posing potential risks for users with preexisting cardiovascular conditions like coronary artery disease. Pot smokers also have a higher risk of developing atrial fibrillation (AF), a fast, irregular heart rate that’s associated with stroke and early death. I posted an in-depth review of AF and its risks a few months ago.
Youth was not much protection from THC-induced cardiac complications. One recent study of the medical records of over 67 million hospitalized patients found that the juvenile age risks are also significant even after adjusting for sex, race, and other conditions like alcohol and tobacco consumption and obesity. The incidence of cardiac events was 30% higher among 15- to 24-year-olds and 50% higher among 25- to 34-year-old individuals compared to non-users. The most common arrhythmia among young patients was also atrial fibrillation.
Cannabis use has also been shown to have adverse effects on blood pressure and can induce pretty significant changes that typically manifest within minutes of consumption and may persist for up to three hours. Effects can vary with an increase in BP initially followed by a more profound drop in pressure, particularly when changing positions. This is called “orthostatic hypotension” due to vasodilatation that can lead to dizziness or even fainting, especially for older adults or individuals with preexisting blood pressure conditions (high or low). These cardiovascular effects are primarily mediated through THC receptors that are found throughout the body, including the central and peripheral nervous system as well as the heart and blood vessels. The impact of pot on the vascular system may be sudden and unpredictable with abrupt vasoconstriction or vasodilation of both the coronary arteries and peripheral arteries. We’ve talked about the risks of coronary vasoconstriction in this space before that can lead to myocardial ischemia (heart attack) and cardiac arrhythmias. These responses are dependent on the type, dose, and duration of pot use. These studies show an obvious effect that the more frequent the use and the stronger the cocktail, the bigger the risk. There’s more evidence that pot can lead to the production of reactive oxygen radicals, which can result in inflammation and permanent damage to blood vessels. This causes “free radical” damage to all the arteries in the body—when it affects the coronary arteries the resultant injury leads to early onset of coronary artery disease. Clearly, none of this is good for you.
Let’s go to the vanity piece of this appeal I’m making to limit pot smoking. There’s something relatively recent in the medical world called “epigenetics.” It’s the study of how our environment influences our genes by changing the protective chemicals that coat genetic material (DNA) in our cells. The chemical process is pretty complicated; it’s something called “methylation” that can be used as a chemical marker of biological age. This material functions kind of like those little plastic tips on shoelaces that prevent your high-top laces from coming apart and wearing out. The role of this chemical in your cells is to slow up your DNA from fraying each time DNA strands get copied as cells replicate. Cells divide millions of times over our lifetime, and every time a cell divides and copies (transcribes) your chromosomes, you lose a tiny bit of the protection and DNA strands get shorter, literally fraying at the ends. Eventually they can get too short to do their job, leading to cell aging, cell death, and ultimately our own death. Longer DNA strands are linked to overall health while aging and DNA strand length is used as that “chemical marker” of biological age. Looking good is great, but your cells and your biological age tell the real story that chronological age is not necessarily matched to biological age.
Newborns have the most of this stuff and it decreases steadily as we get older for all the reasons I cited. Anything that accelerates the loss of this chemical protecting strands of DNA is associated with accelerating aging. Those “things” include everything we eat, drink, use in our daily lives, and inhale into our lungs. So, what’s all this have to do with smoking a spliff? It turns out that when you inhale “joints,” you’re taking in some hydrocarbon derivatives unique to burning THC that stick to your genes, pushing off the good stuff and accelerating loss of those important “plastic tips” protecting your DNA. Losing that shield impairs decoding DNA messages that guide assembly of proteins we need for health and well-being, thus accelerating the aging process. The study states, “Lifetime marijuana use predicted accelerated epigenetic aging, with effects remaining even after accounting for demographic factors and chronological age.” There’s also research that shows these chemically induced changes to DNA can be passed on from mother to fetus and can affect the mental health and development of children of pot users, thus causing generational behavioral problems. Another bad omen for future generations added to the ones listed last month.
Additional research suggests that these epigenetic chemical changes are particularly profound in the brain. This study “points toward cumulative THC effects on multimodal systems in the brain that are similarly affected during aging” like Alzheimer’s disease and dementia. In plain language, the more pot you smoke, the quicker you age and the sooner you die. A study published in The Lancet a couple of years ago confirms this, showing that people with long-term cannabis use had “worse measures of biological aging, health preparedness, financial preparedness, and social preparedness than those who had never used cannabis.” These effects on aging “worsen when subjects also used alcohol or cigarettes.”
I get it, THC has some legitimate medical uses and even makes some people feel good, but for all of you out there with your fingers quivering over your phones to send me rebuttals, testimonials, and counterarguments, I can only advise moderation. Occasional pot use is probably not a whole lot worse for you than occasional use of alcohol or smoking a cigarette once in a while, both of which are also pretty bad. Just remember that THC has no safe place in the cockpit, your brain, or your luggage compartment in the air or in your car. So stay smart, stay young, stay healthy, and as always, FLY SAFE!
