Cannabis terminology can lead to confusion
DEAR DR. ROACH: What can you tell me about cannabis products containing delta-8 THC? -- M.O.
ANSWER: Cannabis products have many active chemicals. The ones that have been best studied are the tetrahydrocannabinols (THC) and cannabidiol (CBD). THCs are psychoactive, and the term THC generally refers to the delta-9 isomer, but several others, including delta-8, may also be found naturally in plants, in small amounts. Delta-8 has been reported to be less active than delta-9; however, it has not been studied as much as the delta-9 isomer. Cannabis that has less than 0.3% total THC may be sold as "hemp," and is not psychoactive (does not cause a "high"). CBD itself is also not psychoactive, although some products sold as CBD may be contaminated with THC.
CBD can be converted synthetically to delta-8 THC. According to a recent Centers for Disease Control and Prevention health alert, "this conversion process, used to produce some marketed products, may create harmful byproducts that presently are not well-characterized." These additional chemicals may be responsible for the increasing reports of toxicity among recreational users of products labeled as "delta-8 THC." In addition, the CDC speculated that the use of the words "diet" or "light" on the label might have misled buyers into thinking they were buying CBD, not realizing they were buying a product that has psychoactive effects. In other cases, edible products ("gummies") were inadvertently consumed by children. This led to deep sedation and slowed breathing with initially increased heart rate, progressing to slowed heart rate and decreased blood pressure. Other toxicities reported from delta-8 THC products included lethargy, uncoordinated movements, slurred speech, difficulty breathing, sedation, and coma.
Serious toxicity from cannabis in experienced recreational users is uncommon, but the labeling of THC-8 products may confuse some buyers. Cannabis, or any form of THC, should never be used by children (outside rare cases prescribed for childhood epilepsy).
DEAR DR. ROACH: I recently read that 80% of people who died from COVID-19 were obese. Is this true? -- K.W.
ANSWER: No, that number is not correct. In the general population, about 43% are obese and another 29% are overweight. Among people who died from COVID-19, 46% were obese and 27% were overweight. It is true that being obese is a risk factor for severe COVID-19, but it is a modest risk factor at best for people who are overweight. Having complicated high blood pressure, diabetes and just being male are additional risk factors. In people who are very obese (defined as a BMI over 45 -- that's a 6-feet-tall man weighing over 330 pounds), the risk of dying from COVID is double compared with a person of normal weight.
I would also say that the original statement seems to blame the victims of this terrible pandemic, and possibly to falsely reassure people of normal weight that they have little to fear from COVID-19. People of every age and body weight are at risk from COVID-19 and its complications, including death and long-term disability. All would benefit from the vaccine.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.
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