Note from AAHPO Member Meroujan Maljian, MD, a forensic psychiatrist working in the New Jersey prison system: “I see a lot of substance use disorders among the prison inmate population. I mostly agree with the following article [from Johns Hopkins University] that Cannabis products are substances of abuse which can often be harmful. They are potentially addictive and can lead to medical complications, drug interactions, and mental health problems. I also agree that more research and data are needed to understand how legalization of recreational Marijuana affects patterns of drug use and associated drug-related crime in the community. The article seems to suggest that depending on what that data and research shows that recreational Marijuana is something that people can decide whether or not to have as a society, but I disagree with that notion. As a physician who has seen the harmful effects of casual Cannabis use and how it is often a gateway drug leading to the use of more harmful drugs like Heroin and Cocaine, I personally can only support the use of medical Marijuana with medical supervision as a society for treating specific illnesses like terminal cancer where it was shown to help symptoms like pain and appetite.”

On July 1, Maryland joined 23 other states (including New Jersey, New York and Connecticut) permitting anyone 21 and older to buy and use cannabis for both recreational and medicinal purposes. But as more states make cannabis legal, what are policymakers and government agencies doing to ensure its safety? What does the latest research on cannabis indicate that can help the public make informed decisions?

For answers, The Hub recently sat down with Ryan Vandrey, an experimental psychologist in the Department of Psychiatry and Behavioral Sciences at the Johns Hopkins School of Medicine, who works with an interdisciplinary team in the Cannabis Science Laboratory.

Q. As someone who spends day in and day out studying cannabis, what does the legalization mean to you?
A. People get harmed by drugs all the time, even prescription drugs, and cannabis is no exception. But if there wasn’t good reason to believe that some value would come from legalization, it wouldn’t have happened. On the benefits side, there’s been a clear demonstration that the long-lasting war on drugs has been largely ineffective and has marginalized subgroups of individuals. There’s also clear evidence that making cannabis illegal hasn’t stopped people from accessing it. This isn’t my area of expertise, but from a criminal justice perspective, it makes sense to try to establish quality control for this commodity and to pull manufacturing and revenue out of the hands of drug dealers and into the hands of responsible businesses.

But there’s always risk and some level of concern when you grant open access to the public of a substance that can produce intoxication and impairment. My biggest worry is with public education and the information about the risks and potential harms of using cannabis that might get lost in the excitement of legalization.

Q. What important research findings do you think are getting left out of the public conversation about cannabis?
A. [As a society,] we need an open dialogue and increased education about the risks and how to minimize the likelihood of harm for individual users. There just isn’t enough discussion currently. For example, research tells us that there are subgroups of people with certain health conditions who should not use products with high tetrahydrocannabinol (THC), the psychoactive component that produces the “high” in cannabis. These include individuals with a personal or family history of psychosis, who can end up in an acute psychotic state that lasts hours or days. Likewise, individuals with heart conditions or even asymptomatic cardiovascular disease can end up having a heart attack or heart failure, despite exhibiting no previous signs of trouble.

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Hearing loss is a common condition that affects millions of people worldwide. In the United States, one in eight people over age 12, and more than 65 percent of individuals over 60 years old, experience hearing loss, according to the National Institutes of Health.

The impact of hearing loss is not limited to difficulty hearing; it is also linked to other health issues such as cognition, dementia, social isolation, and depression.

Here are five important facts you may not know about hearing loss:

• Individuals with hearing loss are at higher risk of dementia
• Hearing loss can lead to depression and social isolation
• Hearing loss is not a normal part of aging and should be treated
• Treating hearing loss can improve cognition
• There are many steps you can take to prevent hearing loss

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Congratulations to Vicki Shoghag Hovanessian for being named Cultural Advisor to the Embassy of Armenia. Shoghag, as her friends call her, has been a long-time supporter of AAHPO, one of many causes she has championed. She is the widow of the late Raffy Hovanessian, MD, a beloved AAHPO Board Member for whom the AAHPO, Dr. Raffy Hovanessian Medical Education Program was named.

“Shoghag is a tremendous force for good. She has helped many people directly and indirectly through the numerous charitable causes she and her family have supported. AAHPO congratulates Shoghag on receiving this honor which she so well deserves. We are fortunate to have her as part of our community,” said AAHPO President Lawrence V. Najarian, MD.

The article, below, about Mrs. Hovanessian and her well-deserved appointment was published in the July 9 edition of the Newsletter of the Armenian News Hour of New Jersey. To read the Armenian Mirror Spectator coverage, click here.

Kudos to AAHPO Board Member Kim Hekimian, PhD, and AAHPO colleague Sharon Chekijian, MD, for their participation in the 6IMCA Medical Conference session on Emergency Medicine and Disaster Preparedness and the Outlook of Health Care in Armenia.

Kudos to AAHPO Board member John Bilezikian, MD, for his participation as a Plenary Speaker at 6IMCA. Doctors participating in the 6th International Medical Congress of Armenia not only bear professional responsibility to Artsakh and Armenia, but also bear political responsibility.

In the framework of the 6th IMCA, through the US ambassador to Armenia, the American Armenian doctors urged the US government to put pressure on Azerbaijan.

The members of the delegation of doctors told NEWS.am, the information partner of the Congress, about the meeting held at the US Embassy.

Already we are experiencing soaring summer temperatures. Extreme heat can pose a significant health risk– especially for the elderly, young children and those with chronic medical conditions. Notably, anyone participating in strenuous activities in high temperatures is at a significant risk for heat-related illnesses.

Follow these tips to stay safe in the summer heat:

• Stay hydrated. Drink plenty of water throughout the day – don’t wait until you feel thirsty. Avoid coffee, alcohol or sugary drinks before going in the sun.
• Protect against sunburn. Sunburn affects your body’s ability to cool itself, so protect yourself with broad-spectrum sunscreen, even if you’re only in the sun periodically.
• Pay attention to warnings on medications. Check the provided information on any medicines you may be taking for warnings about heat-related problems. Many common medications can affect the body’s ability to stay hydrated or dissipate heat.
• Take it easy during the hottest parts of the day. Only exercise or perform physical labor during cooler parts of the day, such as early morning or late evening. In the middle of the day, take regular breaks in air-conditioned spaces.
• Wear loose-fitting, lightweight clothing. Wearing excess clothing or clothing that fits tightly won’t allow your body to cool properly. Dark clothing also traps heat (When wearing less clothing, don’t forget the sunscreen!).

When spending time in the sun, always monitor for signs of heat exhaustion, including headache, dizziness, nausea, and heat rash. Anyone experiencing these symptoms should immediately try cooling measures such as drinking cold water, taking a cool shower or applying wet towels to exposed skin. If symptoms do not improve, seek medical attention.

Experts advise checking air quality alerts regularly. AirNow.gov enables people to track air quality by entering their ZIP codes.

AirNow generated the chart shown at left, showing exact air quality conditions in a location in Pennsylvania.

Many smartphones have apps that also track air quality.

Experts recommend that people stay indoors as much as they can, with doors and windows closed. That includes avoiding activities like outdoors exercise, which can cause stress on the lungs.

People with dry eyes or irritated eyes may find relief with use of artificial tears.

If one must go outside, wear a KN 95 or N 95 mask to block harmful particulates in the air.

“The small particulate matters of 10 micrometers or less are most dangerous since they can enter the lung and even translocate into circulation if smaller than 2.5 micrometers,” noted Philippe Chahinian, MD, a doctor of internal medicine and an oncologist. “Exposure to such particles affects the lung (causing irritation, asthma, cough, bronchitis) and heart (causing irregular heartbeat, even heart attacks).”

People with respiratory-related health conditions, including asthma, should monitor their symptoms closely, and make sure their medications, like inhalers, are available or not expired.

People with asthma should use their rescue inhaler 15 minutes before they go outside.

Anyone experiencing shortness of breath or respiratory difficulties should contact their healthcare provider or seek emergency care.

Learn more from the Centers for Disease Control and Prevention

We are all aware of the smoke drifting into the Northeastern U.S. from Canadian wildfires, and the related alerts about poor air quality.

“US areas including the Northeast have experienced an unprecedented degree of air pollution, with New York City reaching the highest pollution level in the world by June 7, 2023, with an Air Quality Index (AQI) close to the maximum level of 500,” noted Philippe Chahinian, MD, a doctor of internal medicine and an oncologist.

How does poor air quality harm one’s health?
Many of the health issues people see from poor air quality, in general, can overlap with health issues people see from wildfire smoke. Air pollution from wildfire smoke can make breathing difficult for anyone, but especially for young children, older adults, pregnant women and people with asthma or other pre-existing respiratory conditions.

In the short term, wildfire smoke can cause irritation to the eyes, nose, throat and lungs, as well as an increased risk of respiratory infection. Studies have also found that short-term exposure to small particulate matter increases the risk of a range of cardiovascular and respiratory diseases.

Longer term, exposure to air pollution is associated with several chronic health conditions, including:

• Severe asthma
• Preterm birth
• Heart disease
• Stroke
• Lung cancer
• Dementia
• Lower IQ in children

Smoke can be especially dangerous for pregnant women because they usually have diminished lung capacities due to their growing bellies. Exposure to air pollution during the first and second trimesters may also be associated with gestational diabetes, according to a study published in March.

Additionally, air pollution can harm a developing fetus and increase the risk of low birth weight, miscarriage and stillbirth. A global analysis found that air pollution likely contributed to nearly 6 million premature births in 2019.

Learn more from the Centers for Disease Control and Prevention

Navigating the intricacies of allogeneic transplants is a specialty of Dr. Nelli Bejanyan (shown at left in photo at left) The program leader of Blood and Marrow Transplant and the head of the Leukemia/Myeloid Section of the Department of Blood and Marrow Transplant and Cellular Immunotherapy at Moffitt Cancer Center is renowned for her expertise in transplanting healthy donor (allogeneic) stem cells into patients with blood cancers such as acute leukemia.

It’s a skill and an expertise that isn’t available everywhere around the globe. But with the specialized BMT training program at Moffitt, Dr. Bejanyan hopes to change that. She wants to start with her home country of Armenia.

This year, Dr. Bejanyan invited hematologist Dr. Nerses Ghahramanyan (both shown in photo, top left) from Yeolyan Hematology Center in Yerevan, Armenia, to learn as much as he can about allogenic transplantation at Moffitt. The goal is to take that knowledge and experience back to Armenia, where adult patients have no access to curative allogeneic bone marrow transplants.

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AAHPO President Lawrence V. Najarian, MD, has written a letter to our members, colleagues, families and friends about AAHPO’s activities regarding the Artsakh Blockade. Here is a summary for your convenience:

• The blockade has created a heart-breaking humanitarian crisis that is being largely ignored by the rest of the world.
• AAHPO is committed to helping address the medical needs of 120,000 Armenians who live in Artsakh and are directly impacted by the blockade.
• AAHPO has joined with Armenian Medical International Committee (AMIC) to raise funds that will be used to purchase medical supplies desperately needed by Artsakh physicians.
• The first fund-raising effort was a telethon hosted by our colleagues in California on May 7. If you were not able to donate to that effort, you are urged to donate now.
• The program to purchase medical supplies is being conducted with the highest level of transparency and accountability.
• The blockade has prevented Artsakh physicians from traveling to Yerevan for essential continuing medical education (CME) funded for 13 years by the AAHPO, Dr. Raffy Hovanessian Medical Education Program.
• Our fearless director of this CME in Armenia, Dr. Hambardzum Simonyan, has developed online CME programs, which are being provided to Artsakh physicians at this time.

Click here to read the entire letter from Dr. Najarian.

Editor’s note: AAHPO Board Member Vahe Tateosian, MD (photo at left) is in Armenia now, leading a Medical Mission staffed with anesthesiologists and surgeons from the medical center at State University of New York at Stony Brook. This mission took years to plan and coordinate, and AAHPO thanks Dr. Tateosian for his efforts! He will be sending photos and updates, which we will share with you. Below is Dr. Tateosian’s first submission, written before the Mission departed for Armenia.

I have been fortunate to create and organize a multidisciplinary team of both anesthesiologists and surgeons to come to Yerevan and work with our Armenian colleagues and health care professionals. For years, I have established a working relationship with the administration and faculty at Arabkir Medical University and have now invited subspecialists from the State University of New York at Stony Brook to create a bilateral dialogue and exchange of both ideas and practices. We will be conducting a medical/surgical mission of approximately 8-10 days which encompasses consultations, discussions as well as working together on a number of operations on children in Yerevan. One of our main objectives is to foster collaboration through building and maintaining professional relationships.

For our current mission, we will be consulting on and working together with our colleagues from Armenia on pediatric surgeries of many different subspecialties. We have been in contact with our Armenian physicians the preceding few months to discuss various cases and clinical scenarios prior to our trip abroad, and have made many introductions via video conference calls. We will also be providing a number of hands-on workshops on various topics as well have created a lecture series to provide them with didactic teaching while we are there. We hope to make this an educational experience for both the Armenians in Yerevan as well as Americans that are on the mission. For our American medical missionaries, it is a multifaceted experience. Most notably, it allows for not only an experience in international medicine, but also serves as an introduction to the health care system and culture of Armenia as well. The idea is to create a sustainable program that will have health care providers from both sides participate in education and training. I happen to be the only Armenian in the group and am leading a team of 5 non-Armenian health care specialists, which include a pediatric anesthesiologist, pediatric surgeon and 3 chief residents of anesthesiology.

Another connection to AAHPO’s continued support for health care professions in Armenia is the fact that we continue to train Fund for Armenia Relief (FAR) fellows from the various hospitals and region, which continue to participate in as many of the activities such as lecture and didactic teachings. This helps to serve as a bridge to the current and ongoing support of the AAHPO, Dr. Raffy Hovanessian Medical Education Program, which FAR helped to found, and is a current partner with AAHPO.