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Category Archives: Health

3 Bloody Health Risks of Being a Vampire

Major vitamin D deficiency. It doesn’t matter which vampire-ideology you subscribe to, most myths stick to this: Vampires and sunlight don’t mix. While some believe blood-suckers have a heightened sensitivity to sunshine, triggering extreme pain,Twilight’s Edward (and the rest of his vamp-fam, the Cullens) stick to dreary, dark locations because their extremely fair skin actually sparkles in the sunlight (which could out them as vampires, of course). Either way, there are real health risks to living sunshine-free. Daylight is a natural source of vitamin D, the powerful vitamin that promotes the body’s absorption of calcium — the mineral that keeps your teeth and bones strong. Without vitamin D, your risk of conditions such as osteoporosis skyrocket.

Fortunately for the Cullens, vitamin D supplements are available, and it can also be found in a number of foods, such as salmon, sardines, and dairy.

Sleep deprivation. No wonder vampires are so darn cranky! Twilight’s living dead never sleep (sounds like a big drawback to us, Bella); others walk the night (so we’re willing to bet their sleep habits aren’t very sound).

What does that mean for these fatigued freaks of nature? Along with about 30 percent of humans, vampires likely suffer some pretty hefty health problems due to insomnia. Skimping on zzzs is tied to a number of symptoms — from higher levels of depression and heart problems to lower sex drive and energy.

Dental issues. Just like the rest of the body, teeth need certain nutrients to stay healthy. Are those nutrients found in human blood? Nope — they’re found in foods like calcium-rich dairy, fruits, and veggies. In fact, dentists are so sure that vampires’ pearly whites are in terrible shape, the United Kingdom’s National Health Service (NHS) recently launched a dental health campaign around the idea. The video, aimed at dentist-evading teens, features a young woman about to be bitten by a vampire, when she suddenly pushes him away, repulsed by his awful breath and hideous teeth.

Alcohol Not Main Killer of Drinkers

Older people who drink heavily don’t necessarily have to fear dying of liver disease, a researcher said.

In a population-based Dutch study, only a handful of heavy drinkers in an older cohort died of liver-related causes, according to Jeoffrey Schouten, MD, of Erasmus Medical Center in Rotterdam, the Netherlands.

The major causes of death were cardiovascular disease and cancer, but not hepatocellular carcinoma, Schouten reported at the annual meeting of the American Association for the Study of Liver Diseases.

On the other hand, the study confirmed previous studies that suggest light and moderate drinking is protective, Schouten said.

He and colleagues followed 3,884 residents of Rotterdam — all 55 or older at the start of the study in 1990 — for a median of 15.2 years, until they died or until Dec. 31, 2008.

The participants were stratified by their drinking level, with the aim of understanding the causes of death for those who drank heavily, as well as the links between all-cause mortality and alcohol consumption.

Every four or five years, participants went through cycle of examinations, including clinical studies and questionnaires on various aspects of their lives, such as alcohol consumption. The clinical exams included blood work, anthropomorphic measurements, and imaging studies.

The study included the following:

  • 1,398 non-drinkers
  • 1,144 light drinkers (less than one gram of alcohol a day)
  • 963 moderate drinkers (between 10 and 30 grams daily)
  • 379 heavy drinkers (more than 30 grams a day)

Over the study period, Schouten reported, there were 1,825 deaths: 556 from cardiovascular disease, 496 from cancers, and 773 from a host of other causes, including three from alcohol-related liver disease.

Among the 188 heavy drinkers who died, 28% died of cardiovascular causes and 34% of cancer, he said. But only three cases of alcohol-related cancers and no cases of liver cancer were reported.

Only two of the heavy drinkers, or 1%, died of alcohol-related liver disease, he said.

A multivariate analysis showed that light and moderate drinkers fared better than both non-drinkers and heavy drinkers in terms of all-cause mortality.

Schouten said previous studies have showed similar patterns, but they were limited because older people were under-represented.

He added that doctors can use the findings to discuss the major risks among older patients who drink heavily, such as cardiovascular disease and cancer, rather than liver disease.

The findings, while not surprising, have some implications for how doctors counsel older patients about their drinking, according to Mack Mitchell, MD, of UT Southwestern Medical Center in Dallas, who was not part of the study, but who was one of the moderators of the session at which it was presented.

“Many people believe they should not drink alcoholic beverages above a certain age for health reasons,” he told MedPage Today, but the study showed that, “the mortality rate for those drinking in moderation was actually lower.”

So the message should not be to stop drinking but to stop drinking to excess, he said.

You Need to Know About This Product’s

Enfamil Newborn baby formula: Wal-Mart has pulled all 12.5-ounce cans of Enfamil Newborn powder with the lot number ZP1K7G, after a 10-day-old boy in Lebanon, Mo., died from what doctors believe was a rare bacterial infection.

It is not yet known whether the boy contracted the infection from the formula, but Wal-Mart spokeswoman Diana Gee says the company isn’t taking any chances. All cans have been removed from shelves, and refunds or exchanges are available for any consumers who purchased the product prior to the recall.

Formal investigations are pending by the Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC), but Enfamil manufacturer Mead Johnson Nutrition says that the batch in question tested negative for any bacteria before it was shipped. Public health officials will retest samples from the same lot and also look for other possible causes of the infection, such as the water used to prepare the formula or anything else the baby may have consumed.

Motrin: Johnson & Johnson has issued a voluntary recall of about 12 million bottles of Motrin pain relievers from stores. The reason? The caplets may not dissolve as quickly when they near their expiration dates, making them less effective — but not necessarily unsafe.

Consumers can continue taking the product as recommended, at no risk to theirhealth, but the company warns that there may be a delay in experiencing relief.

ShoulderFlex massagers: The FDA issued an alert on Wednesday warning that the ShoulderFlex massager, by King International, could cause strangulation — and possibly even death. One woman, Michelle Ferrari-Gegerson, 37, of Florida, was killed by the device last Christmas Eve after her necklace got tangled up in it, and at least one other person was injured in a similar incident.

“The ShoulderFlex massager poses serious risks,” said Steve Silverman, director of the Office of Compliance in the FDA’s Center for Devices and Radiological Health, in a statement. “Consumers should stop using this device, health care providers should not recommend it to their patients, and businesses should stop distributing and selling the device.”

The massager was actually recalled in August, but King International failed to properly alert stores and consumers and subsequently went out of business. Many Web sites still carry the product.

If you or someone you know owns a ShoulderFlex device, discontinue use immediately and dismantle it before throwing it away so no one else can use it and be hurt by it. The FDA recommends removing the massage fingers and power supply and disposing of each part separately.

Evidence Coffee Can Safe Your Heart

Coffee lovers, rejoice. There’s more evidence that your morning mug won’t harm your heart, according to a new study from Sweden.

In the study, researchers found that drinking coffee was not associated with an increased risk of a condition called atrial fibrillation, which is a type of irregular heartbeat, in either men or women.

“This is largest prospective study to date on the association between coffee consumption and risk of atrial fibrillation. We find no evidence that high consumption of coffee increases the risk of atrial fibrillation,” Susanna Larsson, an associate professor of epidemiology at the Karolinska Institute in Sweden and lead author on the study, said in a statement.

“This is important because it shows that people who like coffee can safely continue to consume it, at least in moderation, without the risk of developing this condition,” Larsson said.

The study comes on the heels of an earlier study from this year, which suggested that coffee may lower the risk of heart attacks.

In the new study, the researchers looked at data from about 42,000 men and nearly 35,000 women who were participating in two long-running studies, the Cohort of Swedish Men and the Swedish Mammography Cohort. In 1997, all the participants filled out questionnaires that asked about their health and diet, including how many cups of coffee they drank daily or weekly. During the 12-year follow-up period, the researchers used the Swedish Hospital Discharge Register to determine which patients developed atrial fibrillation.

The researchers found no association between coffee consumption and an increased risk of atrial fibrillation, though they did observe a slight increase in risk when they limited the analysis to men. However, this increase was not statistically significant (meaning it could have been due to chance), the researchers wrote.

“Whether men may be more sensitive to a high coffee or caffeine intake warrants further study,” the researchers wrote in their article, published today (Sept. 22) in the journal BioMed Central.

The researchers also did a meta-analysis, looking at six other studies on atrial fibrillation and coffee intake, which confirmed their results.

The researchers cautioned that although coffee does not appear to increase the risk of atrial fibrillation, it may increase risk for other types of irregular heartbeats.

5 Ways to Commemorate Steve Jobs

1. Forgo meat. Jobs was a pescetarian — which means he eliminated meat and chicken from his diet, but he indulged in fish and seafood. In fact, in 2006 the health-conscious CEO (who also headed Pixar Animation Studios), cut ties with McDonald’s, which promoted Pixar films’ characters in its Happy Meals, because he wasn’t keen on the health implications of the meat-happy fast food chain.

Ditching meat (at least every once in a while) could benefit you, too — especially if you have a few pounds to drop. In a scientific review published in Nutritional Reviews, researchers found that vegetarian diets not promote weight loss, they also decrease risks of heart disease, diabetes, and high blood pressure.

2. Indulge in ice cream. After his cancer treatment, the Apple co-founder turned to his favorite frozen treat when he wanted to gain weight after cancer treatment. “I’m eating like crazy,” he told a New York Times reporter. What was his guilty pleasure? “A lot of ice cream.”

3. Recycle your electronics. In 2005, Jobs responded to criticism of Apple’s poor recycling programs by announcing the company would take back iPods for free. Later, he expanded the program to include most Apple products. Apple now includes free shipping and environmentally friendly disposal of old systems. But he wasn’t always popular with environmentalists — in fact, he lashed out against his green critics at Apple’s annual meeting in Cupertino that year — but he listened, and eventually changed his tune.

4. Create something insanely great. Despite being a college dropout, Jobs was a consummate innovator. From his parents’ garage, he co-founded a company that would later develop “insanely great” devices — from iPods to iPhones to iPads — used by millions worldwide every day. “Considered the Thomas Edison of his generation, Jobs has been involved in more than 300 computer-related U.S. patents,” states hisobituary on International Business Times.

5. Raise pancreatic cancer awareness. Perhaps the greatest tribute you can make in the wake of Jobs’ death is a contribution to the fight against the cancer that claimed him (charities include the Pancreatic Cancer Action Network and the Lustgarten Foundation). Although Jobs is gone, the cancer is still very much among us — and it kills one in five of its victims within the first year.

In the years since his diagnosis, Jobs went public in the fight against pancreatic cancer, joining fellow celebrity Patrick Swayze. When Swayze’s wife announced the reintroduction of the Pancreatic Cancer Research and Education Act in Congress in February, Jobs voiced his public support. The bill would create a strategic research plan for pancreatic cancer every five years, peer into the deadliest cancers, establish at least two new specialized pancreatic cancer research centers, and provide a toolkit for patients and a program to educate primary care providers about the disease.

Stay Without Breaking the Bank

The buzz about health-care reform hasn’t died down since the Patient Protection and Affordable Care Act was signed by President Obama last year. But although the battle rages on, one thing is clear: The new law is not likely to curb health-care expenditures in the United States. In 2009, the total U.S. health-care bill was $2.5 trillion — about $8,000 dollars per person. And, partly as a result of the population aging, that figure is projected to be $4.5 trillion a year by 2019.

What does this mean for most Americans? A typical family of four covered by employer-provided health insurance now spends about $18,000 a year on medical expenses. And even for those lucky enough to have insurance, out-of-pocket expenses are steadily rising due to higher deductibles and copayments and other costs.

An Ounce of Prevention

It is possible to spend less and stay healthy, however. That’s the message of a new book co-authored by Cynthia Haines, MD, a family physician, professor at Saint Louis University School of Medicine, chief medical officer for the news service HealthDay, and a medical reviewer for Everyday Health. Written with Eric Metcalf, MPH, The New Prescription: How to Get the Best Health Care in a Broken System (Health Communications, 2011) focuses on real-life, common-sense preventive measures, rather than on treating illnesses after they’ve already developed.

“We practice medicine backwards,” Dr. Haines says. “We focus way too much on correcting illness than we do on preventing it in the first place and maintaining optimal health.”

Staying Healthy, One Small Step at a Time

Just as people put small amounts away for retirement and reap the rewards at a future date, Haines says, “with your health, it’s the little things you do day by day that will ensure you’re living healthy for years to come.” She also believes that “No matter what happens with health-care reform, we’re going to be shouldering the burden [of health-care costs], either as individuals, or as businesses, or through taxes. It’s in our own best interest to take charge of what we can control. It’s much cheaper in the long haul to spend your health-care dollars on preventive care.”

Here are the basic steps Haines recommends to take charge of your health and get better care for less money:

  • Find a primary care provider you can stick with. “Every time you need to move to a new doctor, you pretty much have to start from scratch,” says Haines. “If you can find one primary care provider and stick with them, it helps because the doctor can really get to know you.” She also notes that in most instances, you won’t need to see a specialist first. “Your primary care physician can handle the bulk of health issues that you come across in your everyday life.”
  • Be a smart shopper. Choose a physician like you would choose any other service you’re paying for, says Haines. “If you’re not satisfied with your primary care physician, you may want to look around. Talk to your friends. Who likes their doctor, and why?” When you’re at the doctor’s office, ask questions about treatment options. Why are these tests necessary? How much will they cost? Ask about treatment options — is this the lowest-cost alternative? “Even if your insurance is paying for it today, it may not tomorrow,” notes Haines. If you’re prescribed a pricey drug, ask if there’s a generic equivalent that’s cheaper or even free (for example, some large supermarket chain pharmacies have programs that offer free or heavily discounted generic medications).
  • Do what you can to avoid chronic conditions. Chronic conditions like type 2 diabetes, high blood pressure, and heart disease account for a whopping 84 percent of all health-care spending in the United States. If you want to save money on health care, it’s more important than ever to make the lifestyle changes that can keep these illnesses at bay. “Chronic diseases are extremely expensive,” says Haines. Quitting smoking, maintaining a healthy weight, eating a good diet, and getting enough exercise are key.

    But if you’re not sure how to start, rather than making a sweeping overhaul that may not stick, try small tweaks you can live with — like swapping butter for olive oil, replacing meat with fatty fish a few times a week, giving up soda for flavored water or green tea, and improving the quality of your sleep. Haines says, “It’s the little things you do day by day that will ensure you’re living healthy for years to come.”

You Needed a Health Emergency Fund, But Why ?

Even with good health insurance, a health emergency or a prolonged illness can be a financial disaster. Health insurance deductibles, co-payments, emergency room costs, and other costs of illness can add up in a hurry.

A health savings account (HSA) is one way you can put aside tax-free money for a health emergency. HSAs were established in 2003. If you are covered by a type of insurance known as a high-deductible insurance plan, you can make tax-deductible contributions to an HSA. Your employer may also make tax-deductible contributions.

“An HSA account is very different from having a general emergency fund account,” says Joseph J. Porco, managing member of the Financial Security Group, LLC, in Newtown, Conn. “An emergency fund is about more than just out-of-pocket medical expenses. If possible, it’s a good idea to have both.”

How Much of an Emergency Fund Do You Need?

For an older adult, a health emergency might result in the need for long-term care, possibly for the rest of the senior’s life. For a young adult supporting a family, a medical emergency might be much more than just the cost of illness. Your health emergency could cause a disability that results in loss of income over an extended period. That means you should save enough to cover all your expenses.

“Most advisers would say you should have enough emergency funds saved to cover your family expenses for three to six months. I would recommend trying to put enough aside to cover all your expenses, not just health expenses, for 6 to 12 months,” says Porco.

How much you need for a health emergency and how much you can actually put into an emergency fund will depend on your family size, your income, your health status, and your age. But your first step is to understand your health insurance situation.

“The best way to start is to sit down with a financial adviser and figure out what your insurance actually covers and what it doesn’t cover. What are your insurance limits? What kind of medical bills might arise that you would be responsible for? Get some expert advice on how best to cover your actual needs,” advises Porco.

What Insurance May Not Cover

How much insurance companies actually pay for accidents, cancer treatment, or surgery depends on what kind of insurance you have, but there are usually limits. Here are some facts to consider:

  • Cost of illness. Most insurance companies have a cap on how much they will pay for a long-term illness. A recent survey found that 10 percent of people with cancer have hit their lifetime cap and are no longer covered by insurance. Looking forward, however, the new health care reform law will eliminate caps on lifetime insurance by 2014.
  • Emergency room cost. If you have an accident that requires emergency treatment and you end up in an emergency room outside your insurance network, you may not be covered. One study found that HMOs in California denied one out of every six claims for emergency room costs.
  • Surgical coverage. You may be surprised at what your insurance company considers non-covered surgery. There can be a big gray area between covered “reconstructive” surgery and uncovered “cosmetic” surgery. Even when surgery is covered, your deductible may be $500 or more, and you may still be responsible for up to 25 percent or more of surgical costs, depending on the specifics of your plan.

How to Save for a Health Emergency

Once you know what your insurance actually covers and how much you need to put away for an emergency, the next question is where to put it. “Money that you put aside for a health emergency needs to be liquid and secure,” says Porco. “That means you need to be able to get it when you need it.”

And your money needs to remain liquid. “Those who fail to set up an emergency fund may find themselves running up credit card debts to cover their expenses. The last thing you need is to be paying interest on your emergency,” warns Porco.

Examples of places to put your emergency fund include an interest-bearing checking or savings account, money market fund, or bond fund. Don’t tie your money up in anything that would penalize you for early withdrawals or any investment or account that has the potential for loss.

Walking May Helps Your Heart and Brain

Regular aerobic exercise such as walking may protect the memory center in the brain, while stretching exercise may cause the center — called the hippocampus — to shrink, researchers reported.

In a randomized study involving men and women in their mid-60s, walking three times a week for a year led to increases in the volume of the hippocampus, which plays an important role in memory, according to Dr. Arthur Kramer, of the University of Illinois Urbana-Champaign in Urbana, Ill., and colleagues.

On the other hand, control participants who took stretching classes saw drops in the volume of the hippocampus, Kramer and colleagues reported online in theProceedings of the National Academy of Sciences.

The findings suggest that it’s possible to overcome the age-related decline in hippocampal volume with only moderate exercise, Kramer told MedPage Today, leading to better fitness and perhaps to better spatial memory. “I don’t see a down side to it,” he said.

The volume of the hippocampus is known to fall with age by between 1 percent and 2 percent a year, the researchers noted, leading to impaired memory and increased risk for dementia.

But animal research suggests that exercise reduces the loss of volume and preserves memory, they added.

To test the effect on humans, they enrolled 120 men and women in their mid-sixties and randomly assigned 60 of them to a program of aerobic walking three times a week for a year. The remaining 60 were given stretch classes three times a week and served as a control group.

Their fitness and memory were tested before the intervention, again after six months, and for a last time after a year. Magnetic resonance images of their brains were taken at the same times in order to measure the effect on the hippocampal volume.

The study showed that overall the walkers had a 2 percent increase in the volume of the hippocampus, compared with an average loss of about 1.4% in the control participants.

The researchers also found, improvements in fitness, measured by exercise testing on a treadmill, were significantly associated with increases in the volume of the hippocampus.

On the other hand, the study fell short of demonstrating a group effect on memory – both groups showed significant improvements both in accuracy and speed on a standard test. The apparent lack of effect, Kramer told MedPage Today, is probably a statistical artifact that results from large individual differences within the groups.

Analyses showed that that higher aerobic fitness levels at baseline and after the one-year intervention were associated with better spatial memory performance, the researchers reported.

But change in aerobic fitness was not related to improvements in memory for either the entire sample or either group separately, they found.

On the other hand, larger hippocampi at baseline and after the intervention were associated with better memory performance, they reported.

The results “clearly indicate that aerobic exercise is neuroprotective and that starting an exercise regimen later in life is not futile for either enhancing cognition or augmenting brain volume,” the researchers argued.

Markers for prostate cancer death

Prostate cancer (PC) is the second leading cause of male cancer death in the United States with an estimated 26,000 deaths in 2016. Two-thirds of all PC deaths observed in the US are men with localized disease who developed metastasis. Several markers for dying from prostate cancer exist, but whether these are markers for telling who is likely to die early from any cause, and how their performance compares, is unknown. Identifying such a marker is important because we can then identify which men may benefit from new, more aggressive treatments for prostate cancer.

Researchers at Brigham and Women’s Hospital found that a prostate specific antigen (PSA) nadir (the lowest level a PSA drops after treatment) greater than 0.5 ng/mL following radiation and androgen deprivation therapy (anti-hormone therapy), appears to identify men prior to PSA failure who are at high-risk for dying early as a result of treatment failure for their prostate cancer. The findings are published in the January 12 edition ofJAMA Oncology.

“By identifying and enrolling these men in clinical trials immediately, the hope is to take a prostate cancer that appears to be incurable and make it curable” stated Trevor J. Royce, MD, senior resident in the department of Radiation Oncology at BWH, and corresponding author of the study.

Using data from a randomized trial of 206 men treated with either radiation or, radiation and six months of hormonal therapy, researchers compared early markers of prostate cancer death to identify men at risk of dying early.

“This study’s results can have practice changing implications on how future prostate cancer trials are designed in terms of identifying the men for these studies who are at high risk for early death due to ineffective initial treatment for their prostate cancer,” stated Anthony Victor D’Amico, MD, PhD, chief, Genitourinary Radiation Oncology, Brigham and Women’s Hospital and senior author of the study.

Marijuana’s Health Effects

It can almost certainly ease chronic pain and might help some people sleep, but it may also raise the risk of getting schizophrenia and trigger heart attacks.

Those are among the conclusions about marijuana reached by a federal advisory panel in a report released Thursday.

The experts also called for a national effort to learn more about marijuana and its chemical cousins, including similarly acting compounds called cannabinoids.

The current lack of scientific information “poses a public health risk,” said the report , from the National Academies of Sciences, Engineering and Medicine. Patients, health care professionals and policy makers need more evidence to make sound decisions, it said.

For marijuana users or those considering it, “there’s very little to guide them” on amounts and health risks, said Dr. Marie McCormick of the Harvard School of Public Health, who headed the committee.

Several factors have limited research. While the federal government has approved some medicines containing ingredients found in marijuana, it still classifies marijuana as illegal and imposes restrictions on research. So scientists have to jump through bureaucratic hoops that some find daunting, the report said.

A federal focus on paying for studies of potential harms has also hampered research into possible health benefits, the report said. The range of marijuana products available for study has also been restricted, although the government is expanding the number of approved suppliers.

Twenty-eight states and the District of Columbia have legalized marijuana for a variety of medical uses, and eight of those states plus the district have also legalized it for recreational use.

The report lists nearly 100 conclusions about marijuana and its similarly acting chemical cousins, drawing on studies published since 1999. Committee members cautioned that most conclusions are based on statistical links between use and health, rather than direct demonstrations of cause and effect.

The review found strong evidence that marijuana can treat chronic pain in adults and that similar compounds ease nausea from chemotherapy, with varying degrees of evidence for treating muscle stiffness and spasms in multiple sclerosis.

Limited evidence says marijuana or the other compounds can boost appetite in people with HIV or AIDS, and ease symptoms of post-traumatic stress disorder, the report concluded. But it said there’s not enough research to say whether they’re effective for treating cancers, irritable bowel syndrome, epilepsy, or certain symptoms of Parkinson’s disease, or helping people beat addictions.

There may be more evidence soon: a study in Colorado is investigating the use of marijuana to treat PTSD in veterans.

Turning to potential harms, the committee concluded:

– Strong evidence links marijuana use to the risk of developing schizophrenia and other causes of psychosis, with the highest risk among the most frequent users.

– Some work suggests a small increased risk for developing depressive disorders, but there’s no evidence either way on whether it affects the course or symptoms of such disorders, or the risk of developing post-traumatic stress disorder.

– There’s a strong indication that using marijuana before driving increases the risk of a traffic accident, but no clear link to workplace accidents or injuries, or death from a marijuana overdose.

– There’s limited evidence for the idea that it hurts school achievement, raises unemployment rates or harms social functioning.

– For pregnant women who smoke pot, there’s a strong indication of reduced birthweight but only weak evidence of any effect on pregnancy complications for the mother, or an infant’s need for admission to intensive care. There’s not enough evidence to show whether it affects the child later, like sudden infant death syndrome or substance use.

– Some evidence suggests there’s no link to lung cancer in marijuana smokers. But there’s no evidence, or insufficient evidence, to support or rebut any link to developing cancers of the prostate, cervix, bladder, or esophagus.

– Substantial evidence links pot smoking to worse respiratory symptoms and more frequent episodes of chronic bronchitis.

– There’s a weak suggestion that smoking marijuana can trigger a heart attack, especially for people at high risk of heart disease. But there’s no evidence either way on whether chronic use affects a person’s risk of a heart attack.

– Some evidence suggests a link between using marijuana and developing a dependence on or abuse of other substances, including alcohol, tobacco and illicit drugs.