| The medicinal value of cannabis has attracted hundreds of thousands of certified patients across the U.S., where 35 states and the District of Columbia have fully legalized commercial medical use. From chronic pain to seizures, cancer and terminal illness, cannabis has helped people suffer less. But all too often we hear about the health and safety concerns associated with adult-use legalization efforts. Many of the 35 states with medical programs have restrictive use, such as Ohio, where medical patients are banned from smoking flower—only vaporization is allowed. In New York, where the state’s new Cannabis Control Board just expanded its medical program to include whole flower earlier this week—seven years after legalization—there are 151,070 certified patients who benefit from the medicinal value of a plant. So, where have today’s reefer opponents gone mad? Questionable research complemented by mainstream media coverage may be part of the culprit. A study linking cannabis use among young adults to an increased risk of heart attacks was published in the Canadian Medical Association Journal Sept. 7. The next day, CNN ran an article with the headline, “Young adult cannabis consumers nearly twice as likely to suffer from a heart attack, research shows.” Fox News, as well as other major media outlets, also picked up the story. In summary, researchers analyzed health data from 33,173 adults aged 18 to 44, which they drew from U.S. Centers for Disease Control and Prevention-led surveys from 2017 and 2018. Among the 13.9% of adults who reported recent cannabis use, 1.3% (61 of 4,610 cannabis users) also had a history of myocardial infarction, or heart attack, compared to 0.8% (240 of 28,563) of non-cannabis users. But correlation does not always imply causation. The classic statistics 101 example points to the spurious relationship between ice cream sales and murder rates both peaking in July; while they correlate, a third variable, the heat of summertime, is what causes the spikes. Board-certified neurologist Ethan Russo, M.D., who’s devoted the last 25 years to studying the medicinal aspects of cannabis and the endocannabinoid system, told Cannabis Business Times Senior Digital Editor Melissa Schiller that the problem is that cannabis, particularly smoked, can raise heart rate and is a minor risk factor for those with pre-existing coronary artery disease. “But the epidemiology of risk does not support the contention that such activity has a substantial impact on morbidity or mortality,” Russo said. “These studies do a lousy job in assessing concomitant influences, especially cigarette smoking, where the risk contribution is considerable, possible use of cocaine and other pertinent factors. The trend of magnifying the dangers continues apace.” In short, the study doesn’t seem to be breaking any notable ground on linking cannabis use to heart attack rates. In fact, the researchers acknowledged specific limitations that prevented them from differentiating between participants who began using cannabis before having a heart attack and after. However, they assumed heart attacks leading to cannabis use (reverse causation) “is unlikely.” Also, the researchers said they designed the study to factor in comorbidities—the simultaneous presence of two or more diseases or medical conditions in a patient—but then noted the following in the results section: “Compared with nonusers, the prevalence of recent cannabis use was higher among males (62.9% vs. 49.3%), unmarried respondents (68% vs. 46.4%), current combustible cigarette users (31.6% vs. 13.2%), current e-cigarette users (18.1% vs. 5.1%) and heavy alcohol drinkers (17.4% vs. 5.2%).” Much of the mainstream media, including CNN, omitted that from their coverage. As Russo said, the trend of magnifying the dangers continues apace. -Tony Lange, Associate Editor | 