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Teens Who Smoke Pot: At Risk For Mental Illness Later?

Teenagers and young adults who use marijuana may be messing with their heads in ways they don’t intend.

Evidence is mounting that regular marijuana use increases the chance that a teenager will develop psychosis, a pattern of unusual thoughts or perceptions, such as believing the television is transmitting secret messages. It also increases the risk of developing schizophrenia, a disabling brain disorder that not only causes psychosis, but also problems concentrating and loss of emotional expression.

In one recent study that followed nearly 2,000 teenagers as they became young adults, young people who smoked marijuana at least five times were twice as likely to have developed psychosis over the next 10 years as those who didn’t smoke pot.

Another new paper concluded that early marijuana use could actually hasten the onset of psychosis by three years. Those most at risk are youths who already have a mother, father, or sibling with schizophrenia or some other psychotic disorder.

Young people with a parent or sibling affected by psychosis have a roughly one in 10 chance of developing the condition themselves — even if they never smoke pot. Regular marijuana use, however, doubles their risk — to a one in five chance of becoming psychotic.

In comparison, youths in families unaffected by psychosis have a seven in 1,000 chance of developing it. If they smoke pot regularly, the risk doubles to 14 in 1,000. Read more »

*This blog post was originally published at Harvard Health Blog*

The “Street” Economics Of Drug Abuse

I’ve discovered over the years that I really like economics. I never took an econ class in my entire life, since I was pretty focused on the life sciences, but I’ve picked up a fair amount informally over the years. Fortunately I have a strong background in statistics and math, and I’ve done a lot of reading on economics. I wouldn’t say that I have any special level of understanding or credibility on the topic. Perhaps it should be noted that my wife took away the checkbook for good reason. But I enjoy it as a topic, as something to read about and a powerful tool for understanding how the world works.

One consequence of being an ER doc is that you are pretty close to “the street,” and I don’t mean Wall Street. I mean the folks living and scrounging on the streets. As a matter of functioning in the job, you learn the street jargon, you learn what drugs people are using and why, and what the effects of those drugs look like.

The other day I saw a middle-aged guy brought in for acting really weird. Though everything in his social history argued against it, he just looked like he was on meth. I checked a tox, and sure enough, it came back positive. He strenuously denied any drugs, but eventually gave in and admitted the meth use.

I remember in residency walking through downtown Baltimore with a fellow resident and our spouses, and we amazed them by serially identifying the likely drug of choice of the various street people we passed, based on casual observation of their behavior. It’s just what we do. Baltimore was a heroin town. Read more »

*This blog post was originally published at Movin' Meat*

The Game of Life & American Tragedy

A game worth learning

Three of my children love to play the game ‘Life,’ where players choose college or career and are paid, take out loans, pay taxes, have families and all the rest as they navigate towards retirement.  I especially love playing with them when they each become frantic, not for the highest income, but to finish the game with the most children.  Along the way, my daughter is even naming her kids as the tiny blue and pink pegs fill up her little plastic car.  (Talk about your parental validation!)

But after playing, then thinking back on my week at work, I fear that we could easily make a new game that was more familiar to many modern kids.  I suppose we’d have to call it ‘The Game of Death,’ or maybe just ‘The Game of Pain.’ Read more »

*This blog post was originally published at*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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