Beyond “plant trees!”: UMBC research finds tree plantations encroaching on essential ecosystems

Trees planted in the tropics as part of nations’ reforestation commitments can have unintended consequences, sometimes degrading biodiversity hotspots, damaging ecosystems like grasslands, or encroaching on protected areas

Peer-Reviewed Publication

UNIVERSITY OF MARYLAND BALTIMORE COUNTY

 

IMAGE: TREES SUPPLY MANY BENEFITS, AND MANY NATIONS HAVE COMMITTED TO REFORESTING LARGE SWATHS OF LAND AS PART OF THEIR EFFORTS TO ADDRESS CLIMATE CHANGE. AS AN EXAMPLE, THIS IS A TEAK PLANTATION IN COSTA RICA. HOWEVER, NEW RESEARCH FROM UMBC FINDS THAT SOME TREES PLANTED IN THE TROPICS MAY DO MORE HARM THAN GOOD. THE AUTHORS FOUND THAT 92 PERCENT OF NEW TREE PLANTATIONS PLANTED IN THE TROPICS BETWEEN 2000 AND 2012 WERE IN BIODIVERSITY HOTSPOTS. FOURTEEN PERCENT WERE IN ARID BIOMES, WHERE TREES ARE UNLIKELY TO THRIVE AND LIKELY TO DAMAGE EXISTING ECOSYSTEMS LIKE GRASSLANDS, WHICH ARE HEROES OF CARBON SEQUESTRATION IN THEIR OWN RIGHT. TREE PLANTATIONS HAD ALSO ENCROACHED INTO 9 PERCENT OF ACCESSIBLE PROTECTED AREAS IN THE HUMID TROPICS, SUCH AS NATIONAL PARKS. “WE NEED TO BE COGNIZANT THAT NOT ALL TREE PLANTING IS BENEFICIAL FOR THE ECOSYSTEM INVOLVED,” SAYS MATTHEW FAGAN, THE LEAD AUTHOR ON THE NEW STUDY. “THE RIGHT TREE IN THE RIGHT PLACE IS THE RIGHT ANSWER.” view more 

CREDIT: MATTHEW FAGAN

Trees store carbon, filter the air, create habitat, and supply a host of other benefits for animals and people. Planting the right trees, in the right places, in consultation with local communities, can support goals like addressing climate change and improving lives. However, new research led by Matthew Fagan, assistant professor of geography and environmental systems at UMBC, finds that some trees planted in the tropics may be doing more harm than good.

The study, published in Nature Sustainability, examined the increase in tree cover across the global tropics between 2000 and 2012. Fagan and colleagues found that, surprisingly, tree cover gains during that period were equally attributable to natural forest regrowth and the creation of tree plantations. The most common tree plantation species were rubber, eucalyptus, and oil palm.

Tree plantations are not always harmful to the environment, and even much-maligned oil palm can be farmed sustainably, Fagan explains. However, the study found that 92 percent of new tree plantations were in biodiversity hotspots, threatening a range of plant and animal species. Also, 14 percent of plantations were in arid biomes, where trees are unlikely to thrive and likely to damage existing ecosystems. And tree plantations had encroached into 9 percent of accessible protected areas in the humid tropics, such as national parks.

“Ecologists have been sounding the alarm on this for over a decade,” Fagan says. “But no one’s had a hard number about how much this is actually happening.”

When tree planting is lose-lose

In recent years, dozens of nations have committed to restoring large areas of forest. Tree plantations make up 45 percent of commitments to the Bonn Challenge, an international initiative to restore degraded and deforested landscapes. But Fagan is concerned that these plantations may have unintended consequences.

For example, China has undertaken a massive tree-planting effort at the edge of the Gobi desert, and many African countries have committed to planting trees at the transition between the Sahara desert and Sahel grassland. The goal is to prevent desert expansion, but the plantings can cause harm. Disturbing the soil releases carbon, and trees are water hogs. They end up “killing off the grassland that was there, and then they often die of drought,” Fagan says. In these situations, tree planting is lose-lose.

Similarly, in Brazil, soy farmers moved out of the Amazon and into the Cerrado, one of the world’s largest savannas. Pine and eucalyptus tree farms followed. The Cerrado supports a wealth of biodiversity, and the carbon it stores underground rivals rainforest carbon sequestration, Fagan explains. Tree crops in the Cerrado may count toward Brazil’s reforestation commitment, but could actually be a step backward in mitigating climate change and biodiversity loss.

“In the U.S., we have a huge area of relatively wet woods, and we tend to idolize planting trees as sort of the ultimate environmental act,” Fagan says. “But there’s a lot of value in grasslands and savannas that we don’t necessarily see. And when you plant trees, you essentially destroy that ecosystem.”

In response to his team’s new research, “I would really like to see governments around the world reassess their restoration plans,” Fagan says, “or at least be more transparent when their plans involve tree planting, especially in areas that may not be appropriate for planting trees.”

Park or plantation?

Fagan’s new paper also revealed the extent to which tree plantations are invading protected areas. The problem was so bad that he had to overhaul the algorithm his team used to differentiate between data representing natural forest regrowth and tree plantations.

Initially, the algorithm used park boundaries as a proxy for natural forest regrowth areas. But it wasn’t working. To figure out what was wrong, Fagan spot-checked 20 parks, and found that three had multiple plantations inside them. That got him curious.

Six weeks later, he had manually checked for plantations in every park in the tropics. When he found plantations, he either redrew the park’s boundaries or, if the park was too compromised, removed it from the data completely. Using the resulting new maps, the algorithm could detect natural forest regrowth versus tree plantations with more than 90 percent accuracy.

“It was very disturbing to see there were just so many parks that were compromised,” Fagan says.

The new maps allowed the team to find many more regrowth areas and plantations than expected from government estimates. Several UMBC undergraduates are authors on the paper because of their contributions to this data analysis. Each student manually checked at least 1,000 patches, some as many as 3,000.

“In the end, the tropics is a much more modified place than we were expecting,” Fagan says. “There’s a whole host of reasons that we see these encroachments, but they’re definitely happening all over the world. We see a steady erosion of these parks by plantations, and the industry is just getting started.”

Reason for hope

When setting out on this research, the team had a simple question: How many planted trees are there in the world? “It seemed like a strange thing not to know,” Fagan says. As the work progressed, they asked whether trees were being planted where they shouldn’t be and whether plantations were expanding into parks. They’ve found the results concerning, but they also have reason for hope.

Trees can do a lot of good, and planting more of them can be a significant factor in addressing the impacts of climate change. But it has to be done right. “This paper shows it’s possible to monitor natural forest versus plantation at a global scale,” Fagan says, “so we can encourage the results we want and discourage results we don’t want.”

He also hopes the results will inspire everyone to be more conscious of where their products—from paper to food to shampoo to tires—come from, and to demand that companies producing those products in tree plantations adopt more sustainable practices.

“If we make our choices en masse, it does shift the direction that these companies go in,” Fagan says. And despite our love for trees in the U.S., he notes, forests are not the only ecosystems that can help mitigate the effects of climate change and biodiversity loss. Savannas and prairies also have an important role to play.

“We need to be cognizant that not all tree planting is beneficial for the ecosystem involved,” Fagan says. “The right tree in the right place is the right answer.”

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JOURNAL

Nature Sustainability

DOI

10.1038/s41893-022-00904-w 

METHOD OF RESEARCH

Imaging analysis

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

The expansion of tree plantations across tropical biomes

ARTICLE PUBLICATION DATE

6-Jun-2022

Hubble Space Telescope captures largest near-infrared image to find universe’s rarest galaxies

Peer-Reviewed Publication

UNIVERSITY OF TORONTO

 

IMAGE: A PATCH OF SKY IMAGED BY 3D-DASH, SHOWING THE BRIGHTEST AND RAREST OBJECTS OF THE UNIVERSE LIKE MONSTER GALAXIES. view more 

CREDIT: GABE BRAMMER

TORONTO, ON – An international team of scientists today released the largest near-infrared image ever taken by NASA’s Hubble Space Telescope, enabling astronomers to map the star-forming regions of the universe and learn how the earliest, most distant galaxies originated. Named 3D-DASH, this high-resolution survey will allow researchers to find rare objects and targets for follow-up observations with the recently launched James Webb Space Telescope (JWST) during its decades-long mission.

A preprint of the paper to be published in The Astrophysical Journal is available on arXiv.

“Since its launch more than 30 years ago, the Hubble Space Telescope has led a renaissance in the study of how galaxies have changed in the last 10-billion years of the universe,” says Lamiya Mowla, Dunlap Fellow at the Faculty of Arts & Science’s Dunlap Institute for Astronomy & Astrophysics at the University of Toronto and lead author of the study. “The 3D-DASH program extends Hubble’s legacy in wide-area imaging so we can begin to unravel the mysteries of the galaxies beyond our own.”

For the first time, 3D-DASH provides researchers with a complete near-infrared survey of the entire COSMOS field, one of the richest data fields for extragalactic studies beyond the Milky Way. As the longest and reddest wavelength observed with Hubble – just past what is visible to the human eye – near-infrared means astronomers are better able to see the earliest galaxies that are the farthest away.

Astronomers also need to search a vast area of the sky to find rare objects in the universe. Until now, such a large image was only available from the ground and suffered from poor resolution, which limited what could be observed. 3D-DASH will help to identify unique phenomena like the universe’s most massive galaxies, highly active black holes, and galaxies on the brink of colliding and merging into one.

CAPTION

Galaxies from the last 10 billion years witnessed in the 3D-DASH program, created using 3D-DASH/F160W and ACS-COSMOS/F814W imaging.

CREDIT

Lamiya Mowla

“I am curious about monster galaxies, which are the most massive ones in the universe formed by the mergers of other galaxies. How did their structures grow, and what drove the changes in their form?” says Mowla, who began work on the project in 2015 while a grad student at Yale University. “It was difficult to study these extremely rare events using existing images, which is what motivated the design of this large survey.”

CAPTION

Lamiya Mowla, Dunlap Fellow at the Faculty of Arts & Science’s Dunlap Institute for Astronomy & Astrophysics at the University of Toronto and lead author of the study.

CREDIT

Courtesy of Lamiya Mowla

To image such an expansive patch of sky, the researchers employed a new technique with Hubble known as Drift And SHift (DASH). DASH creates an image that is eight times larger than Hubble’s standard field of view by capturing multiple shots that are then stitched together into one master mosaic, similar to taking a panoramic picture on a smartphone.

DASH also takes images faster than the typical technique, snapping eight pictures per Hubble’s orbit instead of one picture, achieving in 250 hours what would previously have taken 2,000 hours.

“3D-DASH adds a new layer of unique observations in the COSMOS field and is also a steppingstone to the space surveys of the next decade,” says Ivelina Momcheva, head of data science at the Max Planck Institute for Astronomy and principal investigator of the study. “It gives us a sneak peek of future scientific discoveries and allows us to develop new techniques to analyze these large datasets.”

3D-DASH covers a total area almost six times the size of the moon in the sky as seen from Earth. This record is likely to remain unbroken by Hubble’s successor JWST, which is instead built for sensitive, close-up images to capture fine detail of a small area. It is the largest near-infrared image of the sky available to astronomers until the next generation of telescopes launch in the next decade, such as the Nancy Grace Roman Space Telescope and Euclid.

3D-DASH depth map (IMAGE)

UNIVERSITY OF TORONTO

CAPTION

Zoomed-in panels on the 3D-DASH depth map reveal the wealth of bright objects that can be studied.

CREDIT

Mowla et al. 2022

3D-DASH mosaicing video (VIDEO)

UNIVERSITY OF TORONTO

CAPTION

The Hubble Space Telescope captured the entire COSMOS field by stitching together multiple images into one master image, a process called mosaicing

CREDIT

Ivelina Momcheva

Until then, professional astronomers and amateur stargazers alike can explore the skies using an interactive, online version of the 3D-DASH image created by Gabriel Brammer, professor at the Cosmic Dawn Center in the Niels Bohr Institute, University of Copenhagen.

The Hubble Space Telescope is a project of international cooperation between NASA and European Space Agency (ESA). NASA's Goddard Space Flight Center manages the telescope in Greenbelt, Maryland. The Space Telescope Science Institute (STScI) in Baltimore, Maryland, conducts Hubble science operations. STScI is operated for NASA by the Association of Universities for Research in Astronomy in Washington, D.C.

The full image is available at the Mikulski Archive for Space Telescopes.

-30-

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JOURNAL

The Astrophysical Journal

DOI

10.1021/acs.est.2c01204 

METHOD OF RESEARCH

Imaging analysis

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

3D-DASH: The Widest Near-Infrared Hubble Space Telescope Survey

How species form: What the tangled history of polar bear and brown bear relations tells us

It’s complicated. Rather than simple splitting events, the species histories of polar and brown bears, like those of humans, hide convoluted stories of divergence and interbreeding, study finds

Peer-Reviewed Publication

UNIVERSITY AT BUFFALO

 

IMAGE: A MOTHER POLAR BEAR AND HER 2-YEAR-OLD CUBS IN NORTHWESTERN GREENLAND. view more 

CREDIT: CREDIT: ØYSTEIN WIIG

BUFFALO, N.Y. — A new study is providing an enhanced look at the intertwined evolutionary histories of polar bears and brown bears.

Becoming separate species did not completely stop these animals from mating with each other. Scientists have known this for some time, but the new research draws on an expanded dataset — including DNA from an ancient polar bear tooth — to tease out more detail.

The story that emerges reveals complexities similar to those that complicate human evolutionary history.

“The formation and maintenance of species can be a messy process,” says Charlotte Lindqvist, PhD, associate professor of biological sciences in the University at Buffalo College of Arts and Sciences, and an expert on bear genetics. “What’s happened with polar bears and brown bears is a neat analog to what we’re learning about human evolution: that the splitting of species can be incomplete. As more and more ancient genomes have been recovered from ancient human populations, including Neanderthals and Denisovans, we’re seeing that there was multidirectional genetic mixing going on as different groups of archaic humans mated with ancestors of modern humans. Polar bears and brown bears are another system where you see this happening.”

“We find evidence for interbreeding between polar bears and brown bears that predates an ancient polar bear we studied,” she says. “And, moreover, our results demonstrate a complicated, intertwined evolutionary history among brown and polar bears, with the main direction of gene flow going into polar bears from brown bears. This inverts a hypothesis suggested by other researchers that gene flow has been unidirectional and going into brown bears around the peak of the last ice age.”

The study will be published the week of June 6 in the Proceedings of the National Academy of Sciences. It was led by Lindqvist at UB in the U.S.; Luis Herrera-Estrella at the National Laboratory of Genomics for Biodiversity (LANGEBIO) in Mexico and Texas Tech University in the U.S.; and Kalle Leppälä at the University of Oulu in Finland. Tianying Lan, PhD, a former UB postdoctoral researcher now at Daicel Arbor Biosciences, was co-first author with Leppälä.

The concept of Arctic-adapted polar bears capturing genetic material from brown bears, which are adapted to life in lower latitudes, is one of several findings of possible interest for scientists concerned with climate change impacts on threatened species.

As the world warms and Arctic sea ice declines, polar bears and brown bears may run into each other more frequently in places where their ranges overlap. This makes their shared evolutionary history a particularly intriguing subject of study, Lindqvist says.

CAPTION

An adult male polar bear in northwestern Greenland.

CREDIT

Credit: Øystein Wiig

Splitting of species can be a messy process

As Lindqvist explains, scientists once thought modern humans and Neanderthals simply split into separate species after evolving from a common ancestor. Then, researchers found Neanderthal DNA in modern Eurasian people, implying that modern human populations received an influx of genes from Neanderthals at some point in their shared evolutionary history, she says.

Only later did scientists realize that this genetic intermingling also supplemented Neanderthal populations with modern human genes, Lindqvist adds. In other words, interbreeding can be complex, not necessarily a one-way street, she says.

The new study on bears reveals a remarkably similar story: The analysis finds evidence of hybridization in both polar bear and brown bear genomes, with polar bears in particular carrying a strong signature of an influx of DNA from brown bears, researchers say. Earlier research proposed the inverse pattern only, Lindqvist says.

“It’s exciting how DNA can help reveal ancient life history. Gene flow direction is harder to determine than merely its presence, but these patterns are vital to understanding how past adaptations have transferred among species to give modern animals their current features,” says Leppälä, PhD, postdoctoral researcher in the research unit of mathematical sciences at the University of Oulu.

“Population genomics is an increasingly powerful toolbox to study plant and animal evolution and the effects of human activity and climate change on endangered species,” says Herrera-Estrella, PhD, President’s Distinguished Professor of Plant Genomics and director of the Institute of Genomics for Crop Abiotic Stress Tolerance in the Texas Tech Department of Plant and Soil Science. He is also a professor emeritus at LANGEBIO. “Bears don’t provide simple speciation stories any more than human evolution has. This new genomic research suggests that mammalian species groups can hide complicated evolutionary histories.”

CAPTION

The subfossil jawbone of a polar bear that lived 115,000 to 130,000 years ago in Norway’s Svalbard archipelago. A genomic study includes an analysis of DNA extracted from a tooth attached to this jawbone, which is now housed at the Natural History Museum at the University of Oslo.

CREDIT

Credit: Photo by Karsten Sund, Natural History Museum (NHM), University of Oslo

CAPTION

The subfossil jawbone of a polar bear that lived 115,000 to 130,000 years ago in Norway’s Svalbard archipelago. A genomic study includes an analysis of DNA extracted from a tooth attached to this jawbone, which is now housed at the Natural History Museum at the University of Oslo.

CREDIT

Credit: Photo by Karsten Sund, Natural History Museum (NHM), University of Oslo

Evidence from modern bear genomes — and DNA from an ancient tooth

The study analyzed the genomes of 64 modern polar and brown bears, including several new genomes from Alaska, a state where both species are found.

The team also produced a new, more complete genome for a polar bear that lived 115,000 to 130,000 years ago in Norway’s Svalbard archipelago. DNA for the ancient polar bear was extracted from a tooth attached to a subfossil jawbone, which is now housed at the Natural History Museum at the University of Oslo.

Using this dataset, researchers estimate that polar bears and brown bears started to become distinct species about 1.3 to 1.6 million years ago, updating prior assessments made by some of the same scientists. The age of the split has been and remains a topic of scientific debate, with past interbreeding and limited fossil evidence for ancient polar bears among factors that make the timing hard to pinpoint, Lindqvist says.

In any case: After becoming their own species, polar bears endured dramatic population decline and a prolonged genetic bottleneck, leaving these bears with much less genetic diversity than brown bears, the new study concludes. The findings confirm past research pointing to the same trends, and add evidence in support of this hypothesis.

Together with the analysis of gene flow, these findings are providing new insights into the messy, intertwined evolutionary history of polar bears and brown bears.

The international research team included scientists from UB, LANGEBIO, Texas Tech, the University of Oulu, the Far Northwestern Institute of Art and Science, the Alaska Department of Fish and Game, the Natural History Museum at the University of Oslo, Nanyang Technological University, University of Helsinki, and Aarhus University.

The research was funded by the National Fish and Wildlife Foundation, U.S. National Science Foundation, Alaska Department of Fish and Game, and U.S. Geological Survey.

CAPTION

Genomes analyzed in a new study on bears include that of this bear, pictured here in 1995 on Alaska's North Slope. Scientists had wondered if this bear might be a brown bear-polar bear hybrid, but the new research finds that, “This bear is not a hybrid, but simply a light-colored brown bear,” says University at Buffalo biologist Charlotte Lindqvist.

CREDIT

Credit: Richard Shideler, Division of Wildlife Conservation, Alaska Department of Fish and Game

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JOURNAL

Proceedings of the National Academy of Sciences

Cannabis-related products demonstrate short-term reduction in chronic pain

OHSU researchers find thin evidence in federally funded systematic review of scientific literature

Peer-Reviewed Publication

OREGON HEALTH & SCIENCE UNIVERSITY

Evidence behind the effectiveness of cannabis-related products to treat chronic pain is surprisingly thin, according to a new systematic evidence review by researchers at Oregon Health & Science University.

The federally funded review, which will be updated on an ongoing basis, was published today in the Annals of Internal Medicine.

Researchers did find evidence to support a short-term benefit in treating neuropathic pain – caused by damage to peripheral nerves, such as diabetic neuropathy resulting in pain described as burning and tingling, involving two FDA-approved synthetic products with 100% tetrahydrocannabinol, or THC: dronabinol (under the trade name Marinol) and nabilone (Cesamet). Both products also lead to notable side effects including sedation and dizziness, according to the review.

Another product, a sublingual spray of equal parts THC and cannabidiol, or CBD, extracted from the cannabis plant, known as nabiximols, also showed evidence of some clinical benefit for neuropathic pain, although that product is not available in the U.S. This product also led to side effects, such as nausea, sedation and dizziness.

“In general, the limited amount of evidence surprised all of us,” said lead author Marian S. McDonagh, Pharm.D., emeritus professor of medical informatics and clinical epidemiology in the OHSU School of Medicine. “With so much buzz around cannabis-related products, and the easy availability of recreational and medical marijuana in many states, consumers and patients might assume there would be more evidence about the benefits and side effects.

“Unfortunately, there is very little scientifically valid research into most these products,” she said. “We saw only a small group of observational cohort studies on cannabis products that would be easily available in states that allow it, and these were not designed to answer the important questions on treating chronic pain.”

Voters in Oregon, Washington and 20 other states have legalized medical and recreational marijuana, however the researchers found many of the products now available at U.S. dispensaries have not been well studied.

“For some cannabis products, such as whole-plant products, the data are sparse with imprecise estimates of effect and studies had methodological limitations,” the authors write.

This situation makes it difficult to guide patients.

“Cannabis products vary quite a bit in terms of their chemical composition, and this could have important effects in terms of benefits and harm to patients,” said co-author Roger Chou, M.D., director of OHSU’s Pacific Northwest Evidence-based Practice Center. “That makes it tough for patients and clinicians since the evidence for one cannabis-based product may not be the same for another.”

The living review, including a visual abstract summary of the findings, will also be shared on a new web-based tool launched by OHSU and VA Portland Health Care System early this year to help clinicians and researchers evaluate the latest evidence around the health effects of cannabis. Known as Systematically Testing the Evidence on Marijuana, or STEM, the project includes “clinician briefs” to help health care workers translate the clinical implications.

“This new living evidence review is exactly the type of resource clinicians need to clarify for patients the areas of potential promise, the cannabis formulations that have been studied and, importantly, the major gaps in knowledge,” said co-author Devan Kansagara, M.D., M.C.R., professor of medicine in the OHSU School of Medicine and a staff physician at the VA Portland.

Reviewers searched more than 3,000 studies in the scientific literature as of January of this year and landed on a total of 25 with scientifically valid evidence – 18 randomized controlled studies and seven observational studies of at least four weeks.

The effects of cannabis and related products are based on their ability to mimic the body’s own endocannabinoid system. The system is comprised of receptors and enzymes in the nervous system that regulate bodily functions and can affect the sensation of pain.  In the evidence review, researchers sorted the types of product into high, comparable and low ratios of THC to CBD and compared their reported benefits and side effects.

Dronabinol and nabilone fit into the high THC to CBD ratio category, with 100% THC (no CBD), showing   the most benefit among the products studied, with meta-analysis of the six randomized controlled studies demonstrating statistically valid benefits for easing neuropathic pain compared to a placebo.

“Honestly, the best advice is to talk to your primary care physician about possible treatments for chronic pain,” McDonagh said. “If you want to consider cannabis, you need to talk to your doctor.”

In addition to McDonagh, Chou and Kansagara, co-authors included Benjamin J. Morasco, Ph.D., Jesse Wagner, M.A., Azrah Y. Ahmed, B.A., and Rongwei Fu, Ph.D.

The project was funded by Agency for Healthcare Research and Quality of the U.S. Department of Health and Human Services, contract number 75Q80120D00006. Statements in the report should not be construed as endorsement by the AHRQ or the Department of Health and Human Services.

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JOURNAL

Annals of Internal Medicine

DOI

10.7326/M21-4520 

METHOD OF RESEARCH

Literature review

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Cannabis-Based Products for Chronic Pain. A Systematic Review

ARTICLE PUBLICATION DATE

6-Jun-2022

Some cannabis products associated with short-term chronic pain improvements, but side effects a concern

Peer-Reviewed Publication

AMERICAN COLLEGE OF PHYSICIANS

1. Some cannabis products associated with short-term chronic pain improvements, but side effects a concern

Abstract: https://www.acpjournals.org/doi/10.7326/M21-4520      

Editorial: https://www.acpjournals.org/doi/10.7326/M22-1512 

URLs go live when the embargo lifts

A review of 25 trials and studies assessing cannabinoids has found that oral synthetic cannabis products with high THC-to-CBD ratios and extracted cannabis products with comparable tetrahydrocannabinol (THC)-to-cannabidiol (CBD) ratios were associated with moderate, short-term chronic pain improvements. However, these products were associated with higher risks for adverse events and few benefits in overall functioning. The findings are published in Annals of Internal Medicine.

Approximately 100 million Americans are living with chronic pain. While opioids are frequently prescribed to manage chronic pain, they demonstrate little affect on pain overall and are associated with significant adverse effects. Cannabinoid products are a potential alternative and can come from multiple sources, including synthetic, extract, or whole plant. The term “cannabinoid” references compounds that are active in cannabis, such as THC and CBD. These compounds have previously demonstrated pain-relief properties that vary depending on the ratio of THC to CBD.

Researchers from Oregon Health & Science University reviewed 18 randomized, placebo-controlled trials, comprising 1,740 participants, and 7 cohort studies, comprising 13,095 participants, to evaluate the benefits and harms of cannabinoids for chronic pain.  They found that synthetic products with high THC-to-CBD ratios were associated with moderate improvement in pain severity and response but were also associated with an increased risk for sedation and dizziness. The authors also found that small improvements in overall function were demonstrated for products with comparable THC-to-CBD ratios, but no improvements were demonstrated for products with high THC-to-CBD ratios. However, they determined that evidence for whole-plant products, CBD, and other cannabinoids was limited by serious imprecision and lack of ability to assess consistency and study methodological limitations. The authors also note that reviewed studies did not evaluate harm outcomes including psychosis, cannabis use disorder, and cognitive deficits, and studies did not include patients who were at higher risk for harms.

An accompanying editorial by authors from the University of Michigan Medical School advises clinicians to be willing to provide compassionate guidance to patients who use cannabis products by using a strategy of pragmatism and knowledge of patient experience, known cannabinoid effects, and harm reduction. The authors highlight that this review can offer information to clinicians on routes of administration, the effects of CBD versus THC, dosing, and potential adverse effects.  

Media contacts: For an embargoed PDF or to speak with editorialist Christine Laine, MD, MPH, please contact Angela Collom at acollm@acponline.org. To speak with the lead author Marian S. McDonagh, PharmD, please email Erik Robinson at robineri@ohsu.edu.

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2. New co-prescription of opioids and benzodiazepines decreased by nearly 60% between 2016 and 2019

Abstract: https://www.acpjournals.org/doi/10.7326/M21-4656  

URL goes live when the embargo lifts

A study of national opioid and benzodiazepine prescription trends found that number of patients with concurrent opioids and benzodiazepines declined significantly since 2016, particularly among young adults. The research report is published in Annals of Internal Medicine.

Opioids and benzodiazepines can lead to synergistic respiratory depression when taken together, which increases overdose risk. The percentage of all opioid overdose deaths involving benzodiazepines increased from 8.7% in 1999 to 21% in 2017, and benzodiazepines were involved in 1 out of every 3 prescription opioid overdose deaths in 2017.

Authors from the Centers for Disease Control and Prevention (CDC) and Boston Medical Center studied data from a national database containing prescription records from a sample of approximately 49,900 retail pharmacies that dispense nearly 92% of retail pharmacy prescriptions in the United States to examine trends in patients receiving concurrent opioid and benzodiazepine prescriptions from 2016 to 2019 at national and state levels. They found that the number of patients newly initiated with concurrent prescriptions declined 59 percent from 2016 to 2019 and only accounted for 28.5 percent of total patients with concurrent prescriptions in 2019, indicating that far fewer patients started treatment with opioids and benzodiazepines together. According to the authors, their findings highlight the need for continued public health and clinical actions, including greater adherence to evidence-based prescribing guidelines, more patient education, and alternative pain-management options. They add that these data highlight the need for evidence-based protocols to safely de-prescribe opioids and/or benzodiazepines for patients already exposed.

Media contacts: For an embargoed PDF or to speak with someone from ACP, please contact Angela Collom at acollom@acponline.org. To speak with the corresponding author, Kun Zhang, PhD, please contact Helen Kingery at wzq8@cdc.gov.

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JOURNAL

Annals of Internal Medicine

DOI

10.7326/M21-4520 

METHOD OF RESEARCH

Systematic review

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Cannabis-Based Products for Chronic Pain

ARTICLE PUBLICATION DATE

7-Jun-2022

The deadly cost of pandemic politics

People in Republican counties were more likely to die from COVID-19, new UMD-led analysis shows

Peer-Reviewed Publication

UNIVERSITY OF MARYLAND

 

IMAGE: CUMULATIVE COVID-19 DEATHS PER 100,000 PEOPLE, BY COUNTY PROPORTION OF REPUBLICAN PRESIDENTIAL POPULAR VOTE IN THE 2020 ELECTION, JANUARY 1, 2020–OCTOBER 31, 2021 view more 

CREDIT: NEIL JAY SEHGAL ET AL EXHIBIT 2 FROM HEALTH AFFAIRS JUNE 2022 PAPER THE ASSOCIATION BETWEEN COVID-19 MORTALITY AND THE COUNTY-LEVEL PARTISAN DIVIDE IN THE UNITED STATES

The partisan divide in the United States throughout the COVID-19 pandemic stretched beyond differences in attitudes about masking, social distancing and vaccines. According to a new study led by a University of Maryland researcher, it also is tied to a clear difference in mortality rates from the virus.

In the study, published today in Health Affairs, Neil Jay Sehgal, assistant professor of health policy and management in UMD’s School of Public Health, and co-authors from UMD and the University of California, Irvine Program in Public Health compared the number of COVID-19 deaths through October 2021 with counties’ voting behavior in the 2020 presidential election. Their analysis controlled for other characteristics likely to influence COVID-19 transmission and mortality such as age, race/ethnicity, chronic disease and access to health care.

They found that Republican counties (where 70% or more voted Republican) experienced nearly 73 more COVID-19 deaths per 100,000 people compared to Democratic counties (where less than 30% voted Republican). 

“People living in states and counties with more conservative voters are dying at higher rates from a largely preventable disease,” Sehgal said. “COVID-19 vaccine uptake only explained 10% of the difference in mortality between red and blue counties. The vaccine-only approach to public health isn’t doing enough to combat the continued toll we are paying.”

The disparity in mortality rates between Republican and Democratic counties was due largely to structural, policy and behavioral differences in the more conservative counties. 

“Voting behaviors at the county level are likely to represent the compliance or lack of compliance with mask mandates, vaccine uptake and use of other protective policies to mitigate the impacts of the pandemic,” said senior author Dylan Roby, associate professor of health, society and behavior in the UC Irvine Program in Public Health.  

Since the United States surpassed 1 million deaths from COVID-19 earlier this spring and infection rates are up in many states, these policies could help prevent infections and reduce the chance of serious outcomes among those who do get infected, including death or the lingering symptoms known as long COVID, which may affect as many as 30% of people who have been infected.

“The impact of partisanship doesn’t only impact people of one political stripe,” Sehgal said. “Not everyone who lives in a Republican county votes Republican. In very few of these counties was there 70% or greater vote share. Even in the reddest counties, you have people who aren’t able to vote or aren’t able to leave, and yet are subject to the policies and behaviors that surround them. If they are older, immunocompromised or an essential worker, that puts them at greater risk of death or disability.”

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JOURNAL

Health Affairs

METHOD OF RESEARCH

Observational study

SUBJECT OF RESEARCH

People

ARTICLE TITLE

The Association Between COVID-19 Mortality And The County-Level Partisan Divide In The United States

ARTICLE PUBLICATION DATE

6-Jun-2022

COVID-19 conspiracy theories associated with depression

Reports and Proceedings

EUROPEAN PSYCHIATRIC ASSOCIATION

The Global COVID-19 pandemic has been marked by a significant minority of people expressing conspiratorial beliefs. Now a new study has shown that these beliefs may be harmful, especially to those who are prone to anxiety and depression. This work is presented at the European Congress of Psychiatry, with simultaneous peer-reviewed publication*.

Surveys have shown that huge numbers of people are open to conspiratorial beliefs about COVID-19. Survey in the US found that around a quarter of Americans believe that the outbreak was “intentionally planned by powerful people”. In major European counties (Germany, France, Italy and the UK), between 30% and 40% of people believe that government is taking the chance to control citizens, or working with the pharmaceutical industry to conceal vaccine effects**. 

“These polls show that tens of millions of people are open to belief in some level of conspiracy as a result of the COVID epidemic” said lead researcher Dr Paweł Dębski (Medical University of Silesia in Katowice, Poland). “Our work now shows for the first time that these people are more at risk of more serious anxiety or depression symptoms than the rest of the population. And as the WHO has indicated, false beliefs may also put the rest of the population at risk”.

The research group, from several Polish Universities, recruited nearly 700 volunteers (585 female, 110 male, 5 other, average age 24.8) and asked them about their beliefs. They developed and validated a new way of measuring belief in COVID-19 conspiracy theories, the COVID-19 Conspiratorial Beliefs Scale. The researchers used this in conjunction with other questionnaires such as the Generic Conspiracist Beliefs Scale (which measures how much one believes in general conspiracy theories, such as major international decisions being taken a secret group, or covering up evidence of aliens), and the Hospital Anxiety and Depression Scale (which measured the level of anxiety and depression). Combining the analysis enabled them to see how belief in COVID conspiracies is higher in those who believe in other conspiracies, and also to correlate belief in COVID conspiracies with levels of anxiety and depression***.

Dr Debski continued, “We see that the severity of anxiety can be increased in those who express a belief in conspiracy theories. However there is a very significant increase in the severity of depression symptoms. At this stage, we are unable to say whether a belief in conspiracy theories cause more anxiety and depression, or whether people who are more anxious and depressed are more attracted to these theories”.

The COVID-19 Conspiratorial Beliefs Scale suggests a series of 10 scenarios and asks the volunteers to rate their belief from 1-5. The most widely believed COVID-19 conspiracy theories (in order of belief) were:

1. SARS-CoV-2 tests are unreliable, they may be positive in the case of infection with another virus (with 3.114 out of a possible 5 points maximum)
2. Governments deliberately spread false information about COVID-19 in order to conceal the actual state of the pandemic (3.034 out of 5)
3. Vitamins and minerals supplementation can cure SARS-CoV-2 infection (2.616 out of 5)

Pawel Dębski said, “This is a fast moving field. COVID has only struck us in the last couple of years, and developing the tools to evaluate the mental health effects takes time. Our recruitment was via the internet, and we need to develop better recruitment methods. Our next steps are to see whether beliefs are related to specific psychological traits, and whether any pro-health messages can help”.

Commenting, Professor Umberto Volpe (Università Politecnica delle Marche, Ancona, Italy), Chair of the European Psychiatric Association section on Digital Psychiatry said:

“Conspiracy theories and misinformation during infectious outbreaks are nothing new, as they have always proliferated in the history of human epidemics. However, during the COVID-19 pandemic, the exponential growth of digitalization and social media has made new ‘virtual spaces’ available. Social media have been important in compensating for the lack of personal contact, but the wider use of digital media may also have helped spread misinformation more rapidly, and to amplify harmful messages. This ‘Infodemic’ may be generally stressful, as well as causing people to doubt public health messages, but, as this study highlights, it may pose also an additional mental health risk for those who are more prone to false beliefs”.

This is an independent comment; Professor Volpe was not involved in this work.

Notes

*This work is published in the peer-reviewed journal, Frontiers in Psychiatry, to coincide with the presentation at the European Congress of Psychiatry. This paper will be available at: https://www.frontiersin.org/articles/10.3389/fpsyt.2022.870128/abstract. For advance access, please contact the press officer, details below.

** For US data see https://www.pewresearch.org/fact-tank/2020/07/24/a-look-at-the-americans-who-believe-there-is-some-truth-to-the-conspiracy-theory-that-covid-19-was-planned/ . For European data see https://www.theguardian.com/world/2021/feb/22/covid-pandemic-leaves-europeans-more-likely-to-believe-conspiracy-theories-study

***probability levels predicting the severity of symptoms of anxiety (p=0.021) and depression (p<0.001) by the intensity of the tendency to conspiratorial beliefs.

ENDS