| Health & Wellbeing
Medical pot laws no answer for US opioid deaths, study finds
cultivation at Loving Kindness Farms Jason Roberts checks one of his
marijuana plants in a grow room wearing green lights not to wake them
during their night cycle in Gardena, Calif. A new study shoots down the
notion that medical marijuana laws can prevent opioid overdose deaths.
(AP Photo/Richard Vogel, File)
Carla K. Johnson
A new study shoots down the notion
that medical marijuana laws can prevent opioid overdose deaths,
challenging a favorite talking point of legal pot advocates.
Researchers repeated an analysis
that sparked excitement years ago. The previous work linked medical
marijuana laws to slower than expected increases in state prescription
opioid death rates from 1999 to 2010. The original authors speculated
patients might be substituting marijuana for painkillers, but they
warned against drawing conclusions.
Still, states ravaged by painkiller
overdose deaths began to rethink marijuana, leading several to legalize
pot for medical use.
When the new researchers included
data through 2017, they found the reverse: States passing medical
marijuana laws saw a 23% higher than expected rate of deaths involving
Legalizing medical marijuana "is
not going to be a solution to the opioid overdose crisis," said Chelsea
Shover of Stanford University School of Medicine. "It would be wonderful
if that were true, but the evidence doesn't suggest that it is."
Shover and colleagues reported the
findings Monday in Proceedings of the National Academy of Sciences. It's
unlikely, they said, that medical marijuana laws caused first one big
effect and then the opposite. Any beneficial link was likely
coincidental all along.
"We don't think it's reasonable to
say it was saving lives before but it's killing people now," Shover
In the opioid crisis, dozens of
forces are playing out across the nation in different ways. How widely
available is the overdose antidote naloxone? Who has insurance? How
broadly does insurance cover addiction treatment?
What's more, prescription pills
once were involved in the largest share of overdose deaths, but that
changed as heroin and then fentanyl surged. The studies on marijuana
laws and opioid deaths don't account for that.
The new study undermines recent
policy changes in some states. Last week, New Mexico joined New York,
New Jersey and Pennsylvania in approving marijuana for patients with
"I was told my paper helped change
the law in New York. I was appalled," said Rosalie Liccardo Pacula of
the Rand Drug Policy Research Center. She co-authored a 2018 study on
marijuana laws and overdose deaths.
Experts agree evidence doesn't
support marijuana as a treatment for opioid addiction. Drugs like
buprenorphine, morphine and naltrexone should be used instead, Pacula
Authors of the original research
welcomed the new analysis.
"We weren't happy when a billboard
went up saying marijuana laws reduce overdose deaths," said Brendan
Saloner of Johns Hopkins Bloomberg School of Public Health. "That was
very hard for us to rein in."
Marijuana has been shown to help
ease chronic pain, and other studies have suggested medical marijuana
laws may reduce opioid prescribing. So there's still reason to believe
that for some people, marijuana can substitute for opioids as a pain
As for addiction and the overdose
crisis, "we should focus our research and policies on other questions
that might make a difference," Shover said.
Companies report progress on blood tests to detect cancer
In this Tuesday, April 28, 2015 file photo, a patient
has her blood drawn at a hospital in Philadelphia to monitor her
cancer treatment. Companies are trying to develop blood tests
that can look for signs of many types of cancer at once. (AP
Photo/Jacqueline Larma, File)
A California company says
its experimental blood test was able to detect many types of
cancer at an early stage and gave very few false alarms in a
study that included people with and without the disease.
Grail Inc. gave results in
a news release on Friday and reported them Saturday at the
American Society of Clinical Oncology meeting in Chicago. They
have not been published in a journal or reviewed by other
Many companies are trying
to develop early detection "liquid biopsy" tests that capture
bits of DNA that cancer cells shed into blood.
On Thursday, Johns Hopkins
University scientists launched a company called Thrive Earlier
Detection Corp. to develop its CancerSEEK test, which yielded
results similar to Grail's more than a year ago.
Grail is closely watched
because of the extraordinary investment it's attracted — more
than $1 billion from Jeff Bezos, Bill Gates and other
The new results included
2,300 people, 60% with cancer and 40% not known to have it. The
test detected 55% of known cancers and gave false alarms for 1%.
The detection rate was better — 76% — for a dozen cancers that
collectively account for nearly two thirds of cancer deaths in
the U.S., including lung, pancreatic, esophageal and ovarian.
The test found only about a
third of cancers at the very earliest stage but as many as 84%
that had started to spread but not widely.
It also suggested where the
cancer may be in 94% of cases and was right about that 90% of
That's the most encouraging
part because you don't want to tell people they may have cancer
and then need to do a lot of other tests to figure out where,
said Dr. Richard Schilsky, chief medical officer of the oncology
"They still have a long way
to go" to prove the test's worth as a screening tool, but these
results are encouraging, he said.
Dr. Len Lichtenfeld,
interim chief medical officer of the American Cancer Society,
called the low rate of false alarms "remarkable."
"I have little doubt that
in the next several years we're going to have what is probably a
true early detection test" but the technology still needs to
improve and to be tried in large groups of people without known
cancers where the detection rate may not be as good, he said.
The biggest question, he
said, is "will it make a difference in outcomes" such as whether
it helps people live longer, the ultimate measure of a screening
Grail's test has not been
compared to mammography, colonoscopy or other screening tools
and is not intended to replace them, said the company's chief
scientific officer, Dr. Alex Aravanis. Many deadly cancers that
the Grail test detected have no screening tests now, he noted.
It's not clear what
evidence the U.S. Food and Drug Administration would require to
consider for approval. Sometimes tests can be sold through
looser lab accreditation pathways rather than by seeking FDA
Grail and Thrive already
have larger studies underway.
"We're not going to
diagnose every cancer," but may not need to because so many are
not found now until it's too late for effective treatment, said
Dr. Minetta Liu, a Mayo Clinic cancer specialist who is
presenting Grail's results at the cancer conference. (AP)
Drugs make headway against lung, breast, prostate cancers
age of 87, Roszell Mack, Jr., shown here in his office in May 2019 is
able to work nearly fulltime at the horse farm nine years after being
diagnosed with lung cancer that had spread to his bones and lymph nodes.
Mack helped test Merck's Keytruda, a therapy that helps the immune
system see and fight cancer. "I'm feeling well and I have a good quality
of life." The biggest drawback of these drugs: They often cost $100,000
or more a year, although what patients pay out of pocket varies by
insurance, income and other things. (Courtesy Roszell Mack, Jr. via AP)
Chicago (AP) — Newer drugs are substantially improving the
chances of survival for some people with hard-to-treat forms of lung,
breast and prostate cancer, doctors reported at the world's largest
Among those who have benefited is Roszell Mack Jr., who at age 87 is
still able to work at a Lexington, Kentucky, horse farm, nine years
after being diagnosed with lung cancer that had spread to his bones and
"I go in every day, I'm the first one there," said Mack, who helped
test Merck's Keytruda, a therapy that helps the immune system identify
and fight cancer. "I'm feeling well and I have a good quality of life."
The downside: Many of these drugs cost $100,000 or more a year,
although what patients pay out of pocket varies depending on insurance,
income and other criteria.
The results were featured Saturday and Sunday at the American Society
of Clinical Oncology conference in Chicago and some were published by
the New England Journal of Medicine. Companies that make the
drugs sponsored the studies, and some study leaders have financial ties.
Here are some highlights:
Immunotherapy drugs such as Keytruda have transformed the treatment
of many types of cancer, but they're still fairly new and don't help
most patients. The longest study yet of Keytruda in patients with
advanced lung cancer found that 23% of those who got the drug as part of
their initial therapy survived at least five years, whereas 16% of those
who tried other treatments first did.
In the past, only about 5% of such patients lived that long.
"I'm a big believer that it's not just about duration of life,
quality of life is important," said Dr. Leora Horn, of the
Vanderbilt-Ingram Cancer Center in Nashville, Tennessee. She enrolled
Mack in the 550-person study.
Mack said he had manageable side effects — mostly some awful itching
— after starting on Keytruda four years ago. He went off it last winter
and scans showed no active cancer; he and his doctor hope it's in
Last year, a smaller study reported five-year survival rates of 16%
for similar patients given another immunotherapy, Opdivo.
"From both studies we're getting a similar message: When these drugs
work, they can have a really durable effect," Horn said.
The risk of this rises with age, but about 48,000 cases each year in
the U.S. are in women under age 50. About 70% are "hormone-positive,
HER2-negative" — that is, the cancer's growth is fueled by estrogen or
progesterone and not by the gene that the drug Herceptin targets.
In a study of 672 women with such cancers that had spread or were
very advanced, adding the Novartis drug Kisqali to the usual hormone
blockers as initial therapy helped more than hormone therapy alone.
After 3 1/2 years, 70% of women on Kisqali were alive, compared to
46% of the rest. Side effects were more common with Kisqali.
This is the first time any treatment has boosted survival beyond what
hormone blockers do for such patients.
The options keep expanding for men with prostate cancer that has
spread beyond the gland. Standard treatment is drugs that block the male
hormone testosterone, which helps these cancers grow, plus chemotherapy
or a newer drug called Zytiga.
Now, two other drugs have proven able to extend survival when used
like chemo or Zytiga in men who were getting usual hormone therapy and
still being helped by it.
One study tested Xtandi, sold by Pfizer and Astellas Pharma Inc., in
1,125 men, half of whom also were getting chemo. After three years, 80%
of those given Xtandi plus standard treatments were alive, compared to
72% of men given the other treatments alone.
The other study involved 1,052 men who were given hormone therapy
with or without the Janssen drug Erleada. After two years, survival was
82% among those on Erleada and 74% among those who weren't.
Men now have a choice of four drugs that give similar benefits, and
no studies yet have compared them against each other, said Dr. Ethan
Basch, a prostate specialist at the University of North Carolina's
Lineberger Comprehensive Cancer Center who has no financial ties to any
Cost and side effects may help patients decide, he said. Chemo can
cause numbness and tingling in the hands and feet and may not be good
for men with diabetes who already are at higher risk for this problem.
Zytiga must be taken with a steroid; Xtandi and Erleada can cause
falling and fainting.
Chemo has more side effects but costs much less and requires only
four to six intravenous treatments. The other three drugs are pills that
cost more than $10,000 a month and are taken indefinitely.
"I have patients who refuse to take these drugs because of cost,"
Basch said. "Patients have more choice, but it isn't clear more benefit
is being provided" beyond what chemo gives, he said.
‘Zombie cells’ buildup in your body may play role in aging
This microscope photo shows two senescent human
fibroblast cells, above, next to normal cells. (Matthew Yousefzadeh, Mariah
Witt/University of Minnesota via AP)
New York (AP) —
Call them zombie cells — they refuse to die.
As they build up in
your body, studies suggest, they promote aging and the conditions that come
with it like osteoporosis and Alzheimer’s disease. Researchers are studying
drugs that can kill zombie cells and possibly treat the problems they bring.
Basically the goal is
to fight aging itself, which hopefully will in turn delay the appearance of
age-related disease and disabilities as a group, says geriatrics specialist
Dr. James Kirkland of the Mayo Clinic in Rochester, Minnesota. That’s in
contrast to playing a “whack-a-mole game” of treating one disease only to
see another spring up, he said.
The research has been
done chiefly in mice. Earlier this year, the first test in people was
published and provided some tantalizing results.
Zombie cells are
actually called senescent cells. They start out normal but then encounter a
stress, like damage to their DNA or viral infection. At that point, a cell
can choose to die or become a zombie, basically entering a state of
The problem is that
zombie cells release chemicals that can harm nearby normal cells. That’s
where the trouble starts.
What kind of trouble?
In mouse studies, drugs that eliminate zombie cells — so-called senolytics —
have been shown to improve an impressive list of conditions, such as
cataracts, diabetes, osteoporosis, Alzheimer’s disease, enlargement of the
heart, kidney problems, clogged arteries and age-related loss of muscle.
Mouse studies have also
shown a more direct tie between zombie cells and aging. When drugs targeting
those cells were given to aged mice, the animals showed better walking
speed, grip strength and endurance on a treadmill. Even when the treatment
was applied to very old mice, the equivalent of people ages 75 to 90, it
extended lifespan by an average of 36 percent.
Researchers have also
shown that transplanting zombie cells into young mice basically made them
act older: their maximum walking speed slowed down, and their muscle
strength and endurance decreased. Tests showed the implanted cells converted
other cells to zombie status.
Kirkland and colleagues
this year published the first study of a zombie-cell treatment in people. It
involved 14 patients with idiopathic pulmonary fibrosis, a generally fatal
disease that scars the lining of the lungs. Risk rises with age, and the
lungs of patients show evidence of zombie cells.
In the preliminary
experiment, after three weeks of treatment, patients improved on some
measures of physical fitness, like walking speed. Other measures did not
Overall, the results
are encouraging and “it really raises enthusiasm to proceed with the more
rigorous studies,” said Dr. Gregory Cosgrove, chief medical officer of the
Pulmonary Fibrosis Foundation, who played no role in the study.
The field of zombie
cells is still young. But Kirkland estimates at least a dozen companies have
formed or have launched efforts to pursue treatments. He holds shares in
Apart from age-related
diseases, anti-zombie drugs might be useful for treating premature aging
among cancer survivors that brings on the early appearance of some diseases,
said Laura Niedernhofer of the University of Minnesota.
Some of these drugs
have been approved for other uses or are even sold as supplements. But
Niedernhofer and Kirkland stress that people should not try them on their
own, nor should doctors prescribe them, for the uses now under study because
more research has to be done first.
Niedernhofer said the
best drugs may be yet to come. The goal is not to prevent stressed cells
from turning into zombies, she said, because they may become cancerous
instead. The aim is to trigger death of cells that have already transformed,
or to limit the harm they do.
And what about giving
them to healthy people who want to ward off aging? That’s possible but a
long way off, after studies have established that the drugs are safe enough,
“We may not get there,”
In any case, experts
are impressed by the research so far.
“I think this is very
exciting,” said Dr. George Kuchel of the University of Connecticut Center on
Aging in Farmington. The results from animal studies are “very spectacular.
It’s very compelling data.”
Nir Barzilai, a
researcher of aging at the Albert Einstein College of Medicine in New York,
said he believes targeting zombie cells will play a role in the overall
effort to delay, stop and maybe reverse aging.
So much research
suggests they promote aging that “we know that it should be true,” he said.