Jefferson Investigates: Cannabis and ADHD, Improving Recovery for Opioid Use Disorder, Small RNAs in COPD
Exploring the interactions between cannabis and ADHD, Philadelphia’s treatment system for people with opioid use disorder, and the role of small RNAs in progression of COPD.
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Cannabis, Maybe, for Attention Problems
Cannabis — whether marijuana itself or various products containing cannabinoids and/or THC, the main psychoactive compound in weed – have been touted as panaceas for everything from anxiety and sleep problems to epilepsy and cancer pain.
Nursing researcher Jennie Ryan, PhD, at Thomas Jefferson University, studies the effects of cannabis on symptoms of attention deficit hyperactivity disorder (ADHD). Current medical guidelines for ADHD include medications such as Adderall and cognitive behavioral therapy. As with most treatments, the benefits can be accompanied by downsides. “Parents are interested in cannabidiol, which does not contain THC,” Dr. Ryan says. “But we don’t have the science yet to back recommendations.”
In a recent review paper, Dr. Ryan and her colleagues plumbed the scientific literature to compile evidence, which is generally suggestive of interactions between cannabis and ADHD. The researchers focused on how cannabis use affects ADHD symptoms. Furthermore, the human body produces its own cannabinoids – the endocannabinoid system – which led the researchers to wonder how might this endogenous system influence ADHD? They scrutinized clinical and preclinical findings, which together suggest that cannabis affects the endocannabinoid system in a variety of ways to affect attention, hyperactivity and anxiety.
“A relationship is there,” Dr. Ryan says. However, the picture is complicated by the sheer variety of cannabis products used, the many types of endocannabinoids and their biological pathways and the variability of ADHD presentation in people. Teasing all these factors apart, she says, “is super complicated.” In addition, cannabis researchers are hobbled by legal restrictions around marijuana.
Co-author Brooke Worster, MD, who specializes in pain management and palliative care, says she suspected the published evidence would be sparse. When that was indeed what they found, “I wasn’t super surprised,” she says. “Still, it is shocking how many holes there are. We have a lot of work ahead.”
Drs. Ryan and Worster plan to publish results from a second survey of cannabis use in adults with ADHD.
By Jill Adams
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Building a Better Path to Recovery for OUD
A new study led by Thomas Jefferson University researchers highlights critical healthcare gaps that hinder long-term recovery for people living with opioid use disorders (OUD) in Philadelphia.
The researchers conducted 13 focus groups with 70 participants accessing various types of OUD treatment. Participants reported several challenges, such as lengthy and restrictive assessment processes, inadequate operating hours and lack of sufficient withdrawal management. Participants also reported broader socio-economic needs, such as housing and income support, as barriers to their recovery.
Meghan Reed, PhD, MPH, senior author of the study and harm reduction researcher, says “Doing qualitative work with the people who are most impacted by local policies, the drug supply, and understanding how these things interact can help us to understand somebody’s risk for overdose or opportunities for treatment.”
Lara Carson Weinstein, MD, MPH, a study co-author, emphasized that a key area for improvement is reducing the places where patients slip through the cracks during multiple handoffs, for example, from emergency departments to recovery programs. “We need to find more seamless ways to connect patients with care.”
The study indicates the need for a larger workforce with lived experience and improved access to expanded OUD treatment services. One promising approach the researchers suggest involves having certified peer recovery specialists engage with patients early and throughout their treatment journey, particularly during the most vulnerable period of withdrawal.
Moving forward, the research team plans to evaluate Philadelphia’s grassroots responses to the opioid epidemic to identify scalable solutions, reduce transitions between providers and ensure continuity of care through trusted relationships. This study is part of a mixed-methods investigation, including Geographic Information Systems (GIS) mapping analysis and surveys that found that Philadelphia’s OUD treatment system is fragmented and difficult to navigate.
Erin Kelly, PhD, another co-author of the study, suggests that an ideal treatment system should address an individual’s overall needs, including their physical and mental health. “Hopefully, this project is providing some data on some of the barriers that have been keeping people from being able to more fully engage with treatment,” Dr. Kelly says.
By Queen Muse
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Small RNAs might drive COPD progression
Chronic obstructive pulmonary disease (COPD) affects nearly 12 million people in the U.S. alone and is the third leading cause of death worldwide. High levels of immune molecules known as cytokines, which can damage the lungs, are a hallmark of COPD. Now, molecular biologist Yohei Kirino, PhD and lung disease expert Deepak Deshpande, PhD have teamed up in a new study to discover a molecular smoking gun behind the rise of cytokines in COPD.
The link seems to be another class of small molecules known as short non-coding RNAs, or simply sncRNAs, whose levels can change in response to infection or environmental pollutants.
Dr. Kirino and researchers in his laboratory have developed a “very simple trick” to detect all the sncRNAs in a sample. Standard sequencing methods rely on two chemical features on sncRNA molecules (known as 5’ phosphate and 3’ hydroxyl ends), which many sncRNAs do not have. So, the researchers first treated the samples with an enzyme that equipped every RNA molecule with these features. Dr. Kirino and colleagues were then able to sequence all the sncRNAs in people with COPD and compare them with those in healthy people.
The researchers had previously shown that one type of scRNA, called 5’-tRNAValCAC half, is a potent activator of the immune system in general, causing increased levels of cytokines. The current study, spearheaded by first-author Megumi Shigematsu, PhD, looked specifically at people with COPD and found they have high levels of the scRNA 5’-tRNAValCAC half. The findings suggest that this scRNA might be responsible for the rise of cytokines in COPD, driving lung damage and inflammation. “The results illuminate this possibility for the first time,” says Dr. Kirino.
Altogether, the research paves the way for potential new diagnostics and therapies. The sncRNA, 5’-tRNAValCAC half, could be a biomarker for COPD, for example. “COPD is often underdiagnosed because of a lack of sensitive and reliable diagnostic markers, despite its high prevalence,” says Dr. Deshpande.
“If we can suppress the activity of 5’-tRNAValCAC half and it mitigates the effects of COPD,” adds Dr. Kirino, “that suggests it can be a therapeutic target.”
By Roni Dengler
