Health Agency

WELLINGTON, New Zealand (AP) -- A single joint of marijuana obstructs the flow of air as much as smoking up to five tobacco cigarettes, but long-term pot use does not increase the risk of developing emphysema, new research suggests.

The study by New Zealand's Medical Research Institute found that longtime pot smokers can develop symptoms of asthma and bronchitis, along with obstruction of the large airways and excessive lung inflation. The paper was released Tuesday ahead of its publication in the journal Thorax.

"The study shows that one cannabis joint causes a similar degree of lung damage as between 2.5 and five tobacco cigarettes," said lead author Sarah Aldington.

However, the researchers found that the progressive chronic lung disease emphysema, often associated with cigarette smoking, was uncommon among marijuana smokers. Only 1.3 percent of the long-term pot smokers were found to have signs of the disease compared to 16.3 percent of those who combined marijuana and tobacco, and 18.9 percent of those who only smoked tobacco.

Marijuana smokers had symptoms that included wheezing, coughing, chest tightness and phlegm - all of which were associated with tobacco smokers, except chest tightness.

The study, which used lung function tests, high-resolution X-rays and questionnaires, also revealed that among marijuana smokers damage occurred to the small, fine airways which are important for taking in oxygen and removing waste gases. The extent of damage rose in proportion to the number of joints smoked.

Last week, another study published in The Lancet medical journal suggested that using marijuana may increase the likelihood of becoming psychotic, with even infrequent use potentially raising the overall small risk by up to 40 percent.

The three-year Thorax study involved 339 people in New Zealand, where pot smoking is fairly common. An estimated 160 million people use marijuana worldwide.

Participants were recruited into four groups based on smoking habits - nonsmokers, tobacco-only smokers, tobacco and marijuana smokers, and marijuana-only smokers.

To qualify as a long-term marijuana user, participants had to have smoked a minimum of one joint a day for five years, said institute director Richard Beasley, who also participated in the study. Tobacco users had to have smoked a pack a day for one year.

Earlier studies have shown that smoking one joint results in three to five times more carbon monoxide and tar inhaled than smoking a cigarette of the same size. The New Zealand research also showed that the "products of combustion" in marijuana are very similar to tobacco, Beasley said.

Part of the reason for this is the way joints are smoked, with users often inhaling and holding the smoke in longer for a better hit. Marijuana joints typically do not have filters and they have shorter butts than cigarettes with a higher smoke temperature. Pot also is commonly smoked through various types of pipes.

Jeff Garrett, president of the Australia-New Zealand Thoracic Society, who was not involved in the study, said that although researchers found emphysema among marijuana smokers relatively rare, he emphasized that it does occur.

Hospital specialists also are seeing an increasing number of people with emphysema specifically related to marijuana smoking, he said.

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Associated Press Medical Writer Margie Mason contributed to this report from Hanoi, Vietnam.

© 2007 The Associated Press.

WASHINGTON (AP) -- After exhaustively compiling a list of the 237 reasons why people have sex, researchers found that young men and women get intimate for mostly the same motivations. It's more about lust in the body than a love connection in the heart.

College-aged men and women agree on their top reasons for having sex - they were attracted to the person, they wanted to experience physical pleasure and "it feels good," according to a peer-reviewed study in the August edition of Archives of Sexual Behavior. Twenty of the top 25 reasons given for having sex were the same for men and women.

Expressing love and showing affection were in the top 10 for both men and women, but they did take a back seat to the clear No. 1: "I was attracted to the person."

Researchers at the University of Texas spent five years and their own money to study the overlooked why behind sex while others were spending their time on the how.

"It's refuted a lot of gender stereotypes ... that men only want sex for the physical pleasure and women want love," said University of Texas clinical psychology professor Cindy Meston, the study's co-author. "That's not what I came up with in my findings."

Forget thinking that men are from Mars and women from Venus, "the more we look, the more we find similarity," said Dr. Irwin Goldstein, director of sexual medicine at Alvarado Hospital in San Diego. Goldstein, who wasn't part of Meston's study, said the Texas research made a lot of sense and adds to growing evidence that the vaunted differences in the genders may only be among people with sexual problems.

Meston and colleague David Buss first questioned 444 men and women - ranging in age from 17 to 52 - to come up with a list of 237 distinct reasons people have sex. They ranged from "It's fun" which men ranked fourth and women ranked eighth to "I wanted to give someone else a sexually transmitted disease" which ranked on the bottom by women.

Once they came up with that long list, Meston and Buss asked 1,549 college students taking psychology classes to rank the reasons on a one-to-five scale on how they applied to their experiences.

"None of the gender differences are all that great," Meston said. "Men were more likely to be opportunistic towards having sex, so if sex were there and available they would jump on it, somewhat more so than women. Women were more likely to have sex because they felt they needed to please their partner."

But this is among college students, when Meston conceded "hormones run rampant." She predicted huge differences when older groups of people are studied.

Since her study came out Tuesday, people are coming up with new reasons to have sex.

"Originally, I thought that we exhaustively compiled the list, but now I found that there should be some added," Meston said.

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On the Net:

University of Texas study "Why Humans Have Sex": http://tinyurl.com/ypzwvr

Cindy Meston's Sexual Psychophysiology Laboratory: http://www.mestonlab.com/

© 2007 The Associated Press.

LOS ANGELES (AP) -- The lawyer for a surgeon charged with prescribing excessive drugs to a disabled patient to speed up his death and harvest his organs says his client has been the subject of a "witch hunt."

Prosecutors in San Luis Obispo County said Dr. Hootan Roozrokh, 33, of San Francisco, gave a harmful drug and prescribed excessive doses of morphine and a sedative to 25-year-old Ruben Navarro, who died in 2006.

Roozrokh was charged Monday in the first such criminal case against a transplant doctor in the U.S., the county district attorney's office said.

M. Gerald Schwartzbach, Roozrokh's lawyer, called the charges "unfounded and ill-advised," saying his client "has unfairly been the subject of an 18-month witch hunt."

"Nothing that Dr. Roozrokh did or said at the hospital that night adversely affected the quality of Mr. Navarro's life or contributed to Mr. Navarro's eventual death," Schwartzbach said in a statement.

Roozrokh planned to surrender and post $10,000 bail, Schwartzbach said.

Navarro was taken in a coma to Sierra Vista Regional Medical Center, 150 miles northwest of Los Angeles, in 2006 after suffering respiratory and cardiac arrest. Although Navarro was found to have irreversible brain damage and was kept on a respirator, he was not considered brain dead because he still had limited brain function.

The day before Navarro died, his family gave approval for a surgical team to recover his organs for donation. That didn't happen, however, because Navarro didn't die within 30 minutes of being removed from life support. He died a day later.

Roozrokh, a surgeon at Kaiser Permanente's now-closed kidney transplant program, was working at the time on behalf of a group that procures and distributes organs. The prosecutor's office said in a statement that the drugs were prescribed "to accelerate Mr. Navarro's death in order to recover his organs."

State law prohibits transplant surgeons from being involved in the treatment of potential organ donors before they are declared dead.

Prosecutors did not pursue murder charges because witnesses said they did not believe the drugs caused Navarro's death.

The coroner's office this year determined Navarro died of natural causes. Last month, his mother, Rosa, filed a wrongful-death and medical malpractice lawsuit against Roozrokh and others, claiming her son was removed from life support without her permission and given lethal doses of drugs.

Navarro, who weighed about 80 pounds, was born with a neurological disorder known as adrenoleukodystrophy. He also had cerebral palsy and seizures.

Roozrokh was charged with felony counts of dependent adult abuse, administering a harmful substance and unlawful controlled substance prescription. If convicted of all three counts, he faces up to eight years in state prison or up to one year in jail and a $20,000 fine as a condition of probation.

© 2007 The Associated Press.

WASHINGTON (AP) -- The widely used diabetes drug Avandia should remain on the market, government health advisers recommended Monday, saying evidence of an increased risk of heart attack doesn't merit removal.

The nonbinding recommendation to the Food and Drug Administration came on a majority vote by the panel. The tally wasn't immediately available.

"We're being asked today to take a very draconian action based on studies that have very significant weaknesses and are inadequate for us to make that kind of decision," said Rebecca Killion, a Bowie, Md., diabetic and the panel's patient representative.

However, in an earlier 20-3 vote, the panelists said that available data show the drug does increase heart risks. Panelists said the drug's warning label should be updated and there should be additional study.

Earlier, FDA scientist Dr. David Graham told the joint panel of experts that the drug's heart risks, combined with its lack of unique short-term benefits in helping diabetics control blood sugar, meant continued sales were not justified.

The manufacturer, GlaxoSmithKline PLC, argued that there is no increased risk, citing its own analyses of studies of Avandia, also called rosiglitazone.

"The number of myocardial infarctions is small, the data are inconsistent and there is no overall evidence rosiglitazone is different from any other oral antidiabetes agents," said Dr. Ronald Krall, the company's senior vice president and chief medical officer.

The FDA convened the experts to consider whether Avandia should be restricted to use in select patients and branded with prominent warnings or removed altogether from sale. Previously, the FDA had said information from dozens of studies pointed to an increased risk of heart attack.

The FDA isn't required to follow the advice of its advisory committees but usually does.

About 1 million Americans with Type 2 diabetes use Avandia to control blood sugar by increasing the body's sensitivity to insulin. That sort of treatment has long been presumed to lessen the heart risks already associated with the disease, which is linked to obesity. News that Avandia might actually increase those risks would represent a "serious limitation" of the drug's benefit, according to the FDA.

© 2007 The Associated Press.

WASHINGTON (AP) -- Consider it the other drug problem: Millions of people don't take their medicine correctly - or quit taking it altogether - and the consequences can be deadly.

On average, half of patients with chronic illnesses like heart disease or asthma skip doses or otherwise mess up their medication, says a report being issued later this week that calls the problem a national crisis costing billions of dollars.

The government is preparing new steps to try to persuade patients and their doctors to do better.

But with contributors that range from too-hurried doctor visits to confusing pill bottles, there's no easy solution.

"We go into this with some humility," says Dr. Carolyn Clancy, director of the Agency for Healthcare Research and Quality, which is planning what she calls an "in your face" campaign to improve medication adherence. "It's really pretty appalling how badly we do."

This goes far beyond the issue of affording prescriptions. Often people buy their drugs but misunderstand what they're supposed to take, or how. Or forget doses. Or start feeling better and toss the rest of the bottle. Or skip doses for fear of side effects.

It's not just a problem of poverty or poor education. Even the rich and highly educated skip their medicine. Perhaps the most high-profile example is former President Clinton, who stopped taking his cholesterol-lowering statin drug at some point and later needed open-heart surgery to avoid a major heart attack. Statins offer significant heart protection, but about half of patients on statins quit using them within a year.

And remember the globe-trotting tuberculosis patient who was briefly quarantined in May after ignoring doctors' orders not to travel by airplane? He's out of the hospital now but, like all patients with hard-to-treat TB, must take his remaining antibiotics while health workers watch. So many TB patients skip their pills when they feel better - but before all the bacteria are wiped out - that health departments now enforce what's called "directly observed therapy."

For most diseases, however, patients must choose to take their medicines. The new report combs a decade of research to conclude people generally do a lousy job. Among findings from the nonprofit National Council on Patient Information and Education:

-Particularly at risk are people whose diseases are initially symptom-free. Although high blood pressure more than triples the risk of heart disease, for example, just 51 percent of patients stick with their prescribed antidote.

-Also at high risk are the elderly, but adherence is a problem for all ages. As few as 30 percent of teenagers correctly take drugs to prevent asthma attacks, for example.

-Dire consequences aren't always a deterrent. Among patients already blind in one eye from glaucoma, only 58 percent were protecting the other eye. Another study found 18 percent of kidney transplant recipients weren't following instructions to prevent organ rejection.

-Even doctors mess up, acknowledging in one study adhering to their own prescriptions just 79 percent of the time.

-Poor medication adherence can cost an extra $2,000 a year for each patient in extra doctor visits alone, and it's associated with as many as 40 percent of nursing home admissions, even more costly.

-Add preventable hospitalizations and premature death, and the report estimates that poor medication adherence could be costing the country $177 billion in medical bills and lost productivity.

Why is taking medicines correctly so tough? One reason is the general confusion surrounding drugs, says Dr. Ruth Parker of Emory University, a co-author of the new report who has studied the issue for the American College of Physicians Foundation.

When the pharmacy hands over your prescription, there are bunches of papers - stapled to the bag, outside the box, glued to the bottle - that all bear drug information, but often with different wording. Bottles are covered in warning stickers - such as "Take with food" or "Swallow whole" or "Don't use with XYZ other drug" - in so many colors that Parker compares pill containers to Christmas trees.

What in that jumble should patients pay most attention to?

Then there's the wording. Parker recently helped test the seemingly simple instruction "Take two tablets twice daily." Did that mean a total of two, or a total of four? A third of patients who were deemed literate got confused. A more clear instruction would be: "Take two tablets in the morning and two tablets at night."

Beyond literacy, poor eyesight plays a role. Pill-bottle instructions are pretty tiny.

Whatever the cause, Clancy hopes to make "take your medicine" a new priority. Her Agency for Healthcare Research and Quality is starting discussions with the new report's authors, the Food and Drug Administration and health groups about steps to do that. Options range from attention-grabbing ads about the dangers of misusing medicines to better drug labels.

And in October, the National Council on Patient Information and Education will release Web-based videos designed to train seniors about adhering to their meds.

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EDITOR'S NOTE - Lauran Neergaard covers health and medical issues for The Associated Press in Washington.

© 2007 The Associated Press.