Prevalence of mortality in cannabis consumer motorcyclists: meta-analysis of international studies

Lower-Risk Cannabis Use Guidelines (LRCUG) for reducing health harms from non-medical cannabis use: A comprehensive evidence and recommendations update

BACKGROUND

Cannabis use is common, especially among young people, and is associated with risks for various health harms. Some jurisdictions have recently moved to legalization/regulation pursuing public health goals. Evidence-based 'Lower Risk Cannabis Use Guidelines' (LRCUG) and recommendations were previously developed to reduce modifiable risk factors of cannabis-related adverse health outcomes; related evidence has evolved substantially since. We aimed to review new scientific evidence and to develop comprehensively up-to-date LRCUG, including their recommendations, on this evidence basis.

METHODS

Targeted searches for literature (since 2016) on main risk factors for cannabis-related adverse health outcomes modifiable by the user-individual were conducted. Topical areas were informed by previous LRCUG content and expanded upon current evidence. Searches preferentially focused on systematic reviews, supplemented by key individual studies. The review results were evidence-graded, topically organized and narratively summarized; recommendations were developed through an iterative scientific expert consensus development process.

RESULTS

A substantial body of modifiable risk factors for cannabis use-related health harms were identified with varying evidence quality. Twelve substantive recommendation clusters and three precautionary statements were developed. In general, current evidence suggests that individuals can substantially reduce their risk for adverse health outcomes if they delay the onset of cannabis use until after adolescence, avoid the use of high-potency (THC) cannabis products and high-frequency/-intensity of use, and refrain from smoking-routes for administration. While young people are particularly vulnerable to cannabis-related harms, other sub-groups (e.g., pregnant women, drivers, older adults, those with co-morbidities) are advised to exercise particular caution with use-related risks. Legal/regulated cannabis products should be used where possible.

CONCLUSIONS

Cannabis use can result in adverse health outcomes, mostly among sub-groups with higher-risk use. Reducing the risk factors identified can help to reduce health harms from use. The LRCUG offer one targeted intervention component within a comprehensive public health approach for cannabis use. They require effective audience-tailoring and dissemination, regular updating as new evidence become available, and should be evaluated for their impact.

Global estimates of the attributable risk of alcohol consumption on road injuries

BACKGROUND

Alcohol consumption is one of the main risk factors for death by road injuries, but little is known about the global distribution of the population-attributable risk (PAR) of alcohol use for death by road injuries.

METHODS

We used publicly available data from the 2019 Global Burden of Disease Study (GBD) to estimate the PAR of alcohol use for 5 types of road injury, globally and individually for available countries, by socio-demographic index (SDI), and by age, sex, and year from 1990 to 2019.

RESULTS

6.6% of all road injuries in 2019 were attributable to alcohol consumption, with large variations worldwide; the highest burden was in Europe and among countries classified in the high-middle SDI. PAR was higher in men than in women, and among younger individuals. Important variations in PAR of alcohol were also observed by road injury type, with motorcyclist road injuries having the highest PAR. Overall, PAR showed a small increase during 1990-2019; younger (<39 years old) men showed an increasing trend during this period, while older women had a decreasing trend in PAR.

CONCLUSIONS

PAR for alcohol and road injuries is not homogenous. Large PAR for alcohol and road deaths was found in Europe, among men, young adults, and motorcyclists. These results could help public health agencies, law enforcement, and the public guide efforts to reduce these deaths.

A meta-analysis study of worldwide prevalence of mortality in cocaine-consuming motorcyclists

For this meta-analysis, the aim is to estimate the prevalence and to determine the factors associated with changes in this prevalence in the world. A systematic review of PubMed/Medline, ISI Web of Knowledge, Scopus, and Science Direct, SID, and Google Scholar from 2011 to April 2020 was performed. Point prevalence was analyzed with a 95% confidence interval. The variances of each study were calculated using a two-sentence distribution formula, and the heterogeneity between the studies was assessed by the Q-Cochran test with a significance level of less than 0.1. Also, the index of changes attributed to I² was examined. Due to the heterogeneity between the studies, the random-effects model was used to combine the results of the studies. All statistical analyses were performed by the STATA software version 11 using Meta-Analysis commands. The significance level of the tests was considered to be P < 0.05. The prevalence of mortality in motorcyclists in six studies was reported to be 12% (0.05-0.18 = 95% CI). We stratified this study by participant geographical region and age group. In this study, the highest prevalence of mortality was in the under-30 age group. Furthermore, planning educational campaigns and advertisements by state authorities that are pointing out the harmful effects of motorcyclists' cocaine and/or other substances consumption is necessary.