DEAR DR. ROACH: I am a 56-year-old male in relatively good health. Over the past few years, I’ve developed difficulty sleeping. I’ve tried all the tips, but nothing really helped until I tried legally available THC drinks. I sleep great after consuming one of these beverages with zero side effects. My question is: Are these drinks safe for long-term use, or should I be limiting my intake? — Anon.

ANSWER: I really can’t answer the long-term safety of THC when used for sleep. There just aren’t reliable long-term data for me to answer with any certainty. There are data for long-term heavy users of recreational cannabis, and in them, the rate of psychiatric diagnoses (psychosis and cognitive impairment) is increased.

Long-term heavy users can also get cannabis use disorder, where people use cannabis more than the intended dosage, and it adversely affects various aspects of their life. Cannabis use disorder is similar in some ways to opioid use disorder and alcohol use disorder. I think that both serious psychiatric illness and cannabis use disorder are unlikely when taking a single dose at bedtime, especially one with a relatively small dose of THC.

Since you haven’t had side effects yet, it seems unlikely that you will develop them, but it depends on the dose. Some THC drinks contain 2-5 mg of THC, while others contain much more, as high as 100-200 mg. I would advise using the lowest dose that helps you sleep. I would also consider using THC every other day if you are concerned about dependence on THC.

Some cannabis products contain both THC and CBD. CBD has been found to lower anxiety. If what you are using now has CBD, consider changing to CBD only or a lower dose of THC to find the lowest effective dose. Be sure you know what you are getting; a third-party analysis is ideal.

DEAR DR ROACH: I’m a 67-year-old male who recently had a calcium score test, and my results came in at 513. Needless to say, I was quite shocked at the results. I have always been an active individual and am not overweight. I have never had high cholesterol nor high blood pressure. I am, however, a diabetic.

I have an appointment with a cardiologist in the near future. I also understand that one cannot lower the score. Is there a possibility that these numbers could have been skewed or interpreted wrongly? Do you recommend a repeat test? Could you give some insight on this test? — S.C.

ANSWER: A coronary calcium score uses a very fast CT scanner to take pictures of the blood vessels that supply the heart muscle with blood. There really isn’t room for misinterpretation, and unless they scanned someone else they thought was you, there isn’t room for error.

Many people who get a heart attack do not have traditional risk factors such as high cholesterol or high blood pressure. Unfortunately, diabetes is a risk factor, but the better the control of the diabetes, the less likely a person will develop complications.

A high calcium score is not a guarantee that you have or will get blockages in the heart arteries, but it does make blockages more likely. Using a decision analysis tool like the MESA calculator (MESA-NHLBI.org/researchers/tools/mesa-score-risk-calculator) can help you and your doctor decide whether a medication is worthwhile to reduce your risk of a heart attack or stroke.

I want to emphasize that medicines like statin drugs can still reduce the risk of a heart attack in people with normal cholesterol and blood pressure levels.