2010 January

NHS Statistics on Drug Misuse: England, 2009.


The following extracts are taken from the NHS Statistics on Drug Misuse: England, 2009. It is quite difficult to compare many of the statistics from the body of the report – some relate to age groups 16-59, others to 16-24 year olds, others to 11-15 year olds. Some give information from l996, others mention 2001, some relate to 2007/08 and others to 2008/09. Some mention an ‘overall decrease’ but when you delve into the detail you find that this overall decrease does not apply to some groups where there is an increase. Particularly disturbing is the information that the highest levels of drug use in the last year for all age groups were in the 16-19 and 20-24 year olds.

In the age group 16-24, 22% had used drugs in the previous year, 18% used cannabis in the previous year.

The report states that between l996 and 2008 the use of Class A drugs rose as follows:

25 – 29 years of age – 3.9% – 8.4%
30 – 34 “ “ “ – 1.9% – 5.2%
35 – 44 “ “ “ – 0.5% – 1.7%

And between 2007/8 to 2008/9 the rises were:

16 – 24 years of age – 6.9% – 8.1%
25 – 29 “ “ “ – 6.4% – 8.4%
30 – 34 “ “ “ – 3.8% – 5.2%

Note the differing age groups which make total comparisons difficult.
The report then makes a statement which is impossible to understand:

‘However, Class A drug use rose from 6.9% to 8.1% between 2007/08 and 2008/09; hence Class A drug use among young people is now stable over the long term’ ??

The most notable figure, repeated in the report in several places were:
7.9% of adults used cannabis in the past year (2008/9). This figure hardly agrees with media pronouncements and ‘accepted facts’ that cannabis use is endemic throughout the population. It might be very common in the younger age groups but this report suggests that over 92% of the adult population are non-users of cannabis. Ergo restrictive drug policies work.

Main findings:

Drug misuse among adults (16 – 59 years) In England and Wales:

• In 2008/09, 10.1% of adults had used one or more illicit drug within the last year,
compared with 9.6% in 2007/08. However, over the longer term this shows an overall
decrease from 11.1% in 1996.

• In 2008/09, 3.7% of adults had used Class A drugs in the last year, compared with 3.0% in 2007/08. Over the longer term this also shows an increase from 2.7% in 1996.

• Consistent with previous findings, cannabis is the type of drug most likely to be used by adults; 7.9% of 16-59 year olds used cannabis in the last year in 2008/09.

• There have been some decreases over the longer term in the use of non-Class A drugs; between 1996 and 2008/09 use of cannabis, amphetamines and anabolic steroids within the last year among adults declined.

Drug misuse among young adults (16 – 24 years) In England and Wales:

• In 2008/09, around 22.6% of young adults had used one or more illicit drug in the last year, which shows no change from 2007/08. This shows a long term decrease from 1996 when it was 29.7%.

• In 2008/09, 8.1% of young adults had used Class A drugs in the last year, compared with 6.9% in 2007/08. Over the long term, Class A drug use among young people has stabilised since 1996.

• Cannabis remains the drug most likely to be used by young people; 18.7% of
respondents aged 16-24 had used cannabis in the last year in 2008/09.

Drug misuse among children (11 – 15 years) In England:

• There has been an overall decrease in drug use reported by 11- 15 year olds since 2001. The prevalence of lifetime drug use fell from 29% in 2001 to 22% in 2008.

• There were also decreases in the proportion of pupils who reported taking drugs in the last year; from 20% in 2001 to 15% in 2008.

• Reported drug use was more common among older pupils; for example, 4% of 11 year olds said they had used drugs in the last year, compared with 29% of 15 year olds in 2008.

• Cannabis was the most widely used drug in 2008; 9.0% of pupils reported taking it in the last year, a long term decrease from 13.4% in 2001.

• Pupils who had truanted or been excluded from school were more likely to report taking drugs at least once a month than those who had not truanted or been excluded (11% and 1% respectively) in 2008
.
• There was an overall decrease in the proportion of pupils being offered drugs from 42% in 2001 to 33% in 2008. Cannabis was the most commonly offered drug followed by volatile substances and poppers.

• Older pupils were more likely to have been offered drugs, with 11% of 11 year olds
having been offered them compared with 57% of 15 year olds in 2008.

Health outcomes

Individuals who take illicit drugs face potential health risks, as the drugs are not controlled or supervised by medical professionals. As well as health risks, drugs can become addictive and lead to long term damage to the body. Illicit drug users are also at risk of being poisoned by drugs, and overdosing which can lead to a fatality.
In England (unless otherwise stated):

• In 2008/09, there were 5,668 admissions to hospital with a primary diagnosis of a drug-related mental health and behavioural disorder. This number is 15.1% less than in 2007/08 when there were 6,675 admissions. There were more male than female
admissions (3,997 and 1,671 respectively).

• Where primary or secondary diagnosis was recorded there were 42,170 admissions in 2008/09 compared with 40,421 in 2007/08, which shows an increase of 4.3%. There were more male than female admissions in 2008/09 (28,289 and 13,875 respectively).

• Where a primary diagnosis of poisoning by drugs was recorded, 11,090 admissions were reported during 2008/09, an increase of 47.2% from 1998/99 when the number of such admissions was 7,533. This has remained stable since 2007/08. There were more male than female admissions (6,076 and 5,014 respectively).

• The Strategic Health Authorities (SHAs) with the most admissions for drug related mental health and behaviour disorders as the primary or secondary diagnosis were North West SHA (155 admissions per 100,000 population) and Yorkshire and The Humber SHA (98 admissions per 100,000 population).

• During 2008/09, there were 207,580 people in contact with structured drug treatment services (those aged 18 and over). This is a 10.4% increase from the 2007/08 figures, where the number was 187,978.

• In 2008/09, a larger number of men accessed treatment services than women (151,064 men compared to 56,516 women aged 18 or over).

• Those taking opiates only (which includes heroin) was the main type of drug for which people received treatment (48% of all treatments), with a further 31% of treatments for those who have taken both opiates and crack in 2008/09.

• There were 60,386 discharged episodes of treatment by the end of 2008/09 and there were 24,656 (41%) of clients exiting treatment who were no longer dependent on the substances that brought them into treatment; a further 9,002 (15%) were referred on for further interventions outside of community-structured treatment.

• The total number of deaths related to drug misuse in England and Wales was 1,738 in 2008; 78% of those who died were male. The most popular underlying cause of death was from accidental poisoning for both males and females (597 and 166 respectively).

The key findings from Chapter 2 of the BCS (British Crime Survey) report show that:

• Around one in three (36.8%) had ever used illicit drugs, one in ten had used drugs in the last year (10.1%) and around one in 20 (5.9%) had done so in the last
month.

• Levels of Class A drug use were, unsurprisingly, lower than overall drug use, with 15.6% having used a Class A drug at least once in their lifetime, 3.7% having done so in the last year and 1.8% in the last month.

• Consistent with previous findings, cannabis is the type of drug most likely to be used; 7.9% of 16-59 year olds used cannabis in the last year.

• Use of any illicit drug during the last year has shown an overall decrease from 11.1% in 1996 to 10.1% in 2008/09, due in part to successive declines in the use of cannabis between 2003/04 and 2007/08.

• Despite this long-term overall decline, there has been an increase in the number 16-59 year olds who have used Class A drugs within the last year between 1996 (2.7%) and 2008/09 (3.7%).

• Class A drug usage has remained generally stable over this period: year-on-year changes were not statistically significant until most recently; however there was a slight underlying upward trend, which is now significant over the long term.

• The increase in Class A drug usage since 1996 can be understood in terms of an increase in the number of people who have used cocaine powder within the last year (from 0.6% to 3.0%), partly offset by a decrease over the same period in the use of LSD (from 1.0% to 0.2%).

• In 2008/09 methamphetamine was included for the first time but this has no visible impact on the overall prevalence of Class A drug use in that survey year.

• There have been some decreases over the longer term in the use of non-Class A drugs; between 1996 and 2008/09 use of cannabis, amphetamines and anabolic
steroids within the last year among 16-59 year olds declined. Looking at more recent years, key changes between 2007/08 and 2008/09 showed:

• The overall proportion of 16-59 year olds who have used any illicit drug within the last year remained stable (9.6% in 2007/08 compared with 10.1% in 2008/09) but there was an increase in Class A drug use within the last year (from 3.0% to 3.7%).

• For individual types of drug, increases were seen in the use within the previous year of cocaine powder, ecstasy, tranquillisers,anabolic steroids and ketamine.

1.3 Young people
Chapter 3 on pages 19-33 of the BCS report focuses on the use of illicit drugs by
young people aged 16-24 years old.

Figure 3.1 on page 20 shows the percentages of 16-24 year olds who have used Class A drugs either in the last year, the last month or ever for 2008/09. Related
information showing these percentages as a time series can be found in Tables 3.1-
3.3 on pages 27-29 and similar information showing actual numbers for 2008/09 can
be found in Tables 3.4- 3.6 on pages 30-32.
Figures 3.2-3.5 on pages 21-24 show the proportion of drugs used in the last year for 16-24 year olds by various drug breakdowns or as a time series. Figure 3.6 on page 25 shows the proportion of this age group classified as frequent drug users
as a time series. Related information on frequent drug use in the last year among
16-24 year olds can be found in Tables 3.7 and 3.8 on page 33 as a time series for any drug and by drug type for 2008/09.

The key findings from Chapter 3 of the BCS report show that:

• Around two in five young people(42.9%) have ever used illicit drugs, nearly one in four had used one or more illicit drugs in the previous year (22.6%) and around one in eight in the last month (13.1%).

• Levels of Class A drug use were, unsurprisingly, lower than overall drug use, with 16.9% of young people having ever used a Class A drug, 8.1% having done so within
the last year and 4.4% in the last month.

• Cannabis remains the drug most likely to be used by young people; 18.7% of respondents aged 16-24 had used cannabis in the previous year. Long and short-term trends for young people aged 16-24 show:

• The proportion of 16-24 year olds having used drugs in the last year fell from 29.7% in 1996 to 22.6% in 2008/09, due in large part to the gradual decline in cannabis use.
Latest figures show no change between 2007/08 and 2008/09.

• The general trend for having used Class A drugs in the last year for young people shows a slight decline since 1996.

• However, Class A drug use rose from 6.9% to 8.1% between 2007/08 and 2008/09; hence Class A drug use among young people is now stable over the long term. In
2008/09 methamphetamine was included for the first time but this has no visible impact on the overall prevalence of Class A drug use in that survey year. Recent trends in types of drugs used show that between 2007/08 and 2008/09:

• There was an increase in use of cocaine powder within the last year (from 5.1% to 6.6%) and ketamine (from 0.9% to 1.9%).

• Use of methadone within the last year, and hence opiates, fell (these figures are based on small numbers).

The key findings from Chapter 4 in the BCS report show that:

• The youngest age groups (16-19 and 20-24 year olds) reported the highest levels of drug use in the last year (22.2% and 22.9% respectively) compared with all older age groups.

• A broadly similar pattern can be seen for Class A drug use, but with the peak for drug use in the last year shifting slightly later to also include the 25-29 age group, with usage then decreasing with increasing age.

• Men continued to report higher levels (around twice as high) than women of drug use in the last year of any illicit drug or any Class A drug use. Looking at trends since the survey began, the self-report drug use data collection in 1996 shows there is a decrease in drug use in the last year for the 16-19 year olds which decreased from 31.7% in 1996 to 22.2% in 2008/09 and, for those aged 20- 24, fell from 28.1% to the latest figure of 22.9%. In general, between 1996 and 2008/09, year-on-year changes in levels of Class A drug use in the last year use were not statistically significant until most recently; however, there was a slight underlying upward trend which is now significant over the long term. There were increases in Class A drug use within the following age groups between 1996 and 2008/09: 25-29 year olds (3.9%
to 8.4%), 30-34 year olds (1.9% to 5.2%) and 35-44 year olds (0.5% to 1.7%).
Looking at change over the last year:

• There were no statistically significant changes in prevalence of any drug use overall in the last year between 2007/08 and 2008/09 for any age group.

• There was a statistically significant rise between 2007/08 and 2008/09 in the proportion of 16-24 (6.9% to 8.1%), 25-29 (6.4% to 8.4%) and 30-34 year olds (3.8% to 5.2%) who took Class A drugs in the last year.

Drug-related mental health and behavioural disorders

During 2008/09 more people aged 25-34 were admitted with a primary diagnosis of drug-related mental health and behaviour disorders than any other age group. This age group accounted for nearly 40% of all such admissions in that year.

Table 3.4 shows that there were 42,170 admissions where there was a primary or
secondary diagnosis of drug-related mental health and behavioural disorders in 2008/09, which is 4.3% higher than 40,421 admissions in 2007/08

England Numbers
Total Under 16 16-24 25-34 35-44 45-54 55-64 65-74 75+

1998/99 24,236 266 7,236 10,850 4,066 1,220 258 141 162
1999/00 24,974 273 7,028 11,027 4,634 1,363 271 144 196
2000/01 25,683 292 6,904 11,357 5,112 1,426 254 116 137
2001/02 28,063 329 7,136 12,355 6,034 1,543 290 151 146
2002/03 31,490 358 7,399 13,772 7,324 1,899 412 118 146
2003/04 34,957 374 7,861 15,061 8,670 2,137 418 156 194
2004/05 35,737 396 7,547 14,872 9,388 2,414 598 204 235
2005/06 38,005 445 7,495 15,752 10,314 2,817 688 181 197
2006/07 38,170 402 6,983 15,330 10,941 3,158 793 232 183
2007/08 40,421 350 7,348 15,540 11,792 3,664 924 270 191
2008/09 42,170 318 6,721 15,817 12,815 4,385 1,181 272 212

Table 3.10 NDTMS clients in treatment, by gender and age, 2008/09

England Numbers / percentages
Total Male Female

All clients 207,580 100 151,064 100 56,516 100
18-24 29,848 14 19,656 13 10,192 18
25-29 43,778 21 31,026 21 12,752 23
30-34 44,713 22 33,031 22 11,682 21
35-39 39,215 19 29,649 20 9,566 17
40+ 50,026 24 37,702 25 12,324 22

Source:

Statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2008 – 31
March 2009. National Treatment Agency for Substance Misuse (NTA)
1. National Drug Treatment Monitoring System (NDTMS).
2. Percentages are rounded to the nearest per cent. Totals may not add up to 100 due to rounding

3. Age is calculated at year midpoint (30th September 2008).

Table 3.13 shows the reasons why clients were discharged from treatment. A discharge is classed as successful if an individual is said to have completed their course of treatment (whether drug free or otherwise), or if the individual is referred to another agency

Table 3.13 Treatment exit reasons for individuals not retained in treatment reported to NDTMS, 2008/09

Numbers %

Total (episodes discharged) 60,386 100
Total successful completions 24,656 41

Treatment completed free of dependency 15,676 26
Treatment completed drug free 8,980 15
Referred on 9,002 15
Dropped out/ left 14,822 25
Prison 4,383 7
Treatment declined 1,769 3
Treatment withdrawn 1,328 2
Moved away 1,870 3
Died 905 1
Other 980 2
Not known 159 0
No appropriate treatment 512 1

Source:
Statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2008 – 31
March 2009. National Treatment Agency for Substance Misuse (NTA)
Copyright © 2009, re-used with the permission of the National Treatment Agency for Substance Misuse
Copyright © 2009. Health and Social Care Information Centre, Lifestyle Statistics. All rights
Reserved

Snippets

• Drug users aged 16-34 were more likely to have used three or more illicit
drugs in the last year com

The BCS report shows an overall prevalence rate of 4% for use of more than one illicit drug (polydrug use) in the last year amongst adults aged 16-59.

There was little difference between adult drug users who were single or cohabiting in terms of taking three or more illicit drugs in the last year (both 23%) and both groups were considerably more likely to take three or more illicit drugs than those who were married (married couples accounting for 8% of those who used three or more illicit drugs in the last year).

Reported drug use was more common among older pupils; for example, 4% of 11
year olds said they had used drugs in the last year, compared with 29% of 15 year
olds.

Regular smokers and pupils who have consumed more units of alcohol in the
previous week were very much more likely to have used drugs in the last year..

Deaths related to drug misuse. In 2008, there were1,738 deaths reported as being due to drug misuse. Of those who died, 78% were male. Compared to 1993 the number of male deaths has increased by around 136% in 2008 compared to a 48% increase for females. In recent years however no overall trend is apparent. The highest numbers of deaths due to drug misuse occurred in the 30 to 39 age group for both males and females (490 and 112 respectively).

Filed under: Social Affairs (Papers) :

Neurofeedback in Treatment of Substance Abuse


Editor’s Note: This article is the first in a two-part series on Neurofeedback in the Treatment of Substance Abuse. This article presents evidence of the neurological basis, specifically EEG dysfunction, underlying addiction that makes it such a complicated condition to treat, and explains how neurofeedback addresses cognitive, emotional and physical symptoms. The second part of this article will include a discussion of the efficacy models of neurofeedback and a review of the research applying neurofeedback to substance abuse treatment, as well as address the possible mechanisms of its effectiveness in addiction.
Over the last two decades a new research and clinical approach—neurofeedback—has shown promise in the treatment of substance abuse. This article addresses how it works, what makes it so effective, why it is a potentially important tool in addiction, the neurophysiological issues it might address, the existing promising research and, most importantly, that neurofeedback can be a significant adjunct to the therapeutic and counseling process with addicts.

The category of disorders associated with substance abuse is the most common psychiatric set of conditions affecting an estimated 22 million people in this country (SAMHSA, 2004). Furthermore, the disorder is accompanied by serious impairments of cognitive, emotional and behavioral functioning. These conditions and symptoms so significantly alter a person’s brain and its functioning, that we often refer to the drug as hijacking the brain, making it very difficult to think logically and appropriately weigh the consequences of the drug related behavior.

Detoxified addicts have been shown to have significant alterations in brain electroencephalographic (EEG) patterns and children of addicts also exhibit EEG patterns that are significantly different than normal (Sokhadze et al., 2008, for review). This indicates that, not only are we dealing with the neurological consequences of drug-related behavior, but there appears to be a genetic pattern as well, that places certain people at greater risk for addictive behaviors. The complexity of these factors makes the treatment of addiction one of the most difficult areas of mental, emotional and physical rehabilitation.

Multiple factors in addiction
Treating addiction is compounded by the many factors contributing to its onset and maintenance. Furthermore, the addiction itself masks many other clinical conditions that become more evident once the drug user becomes abstinent. In fact, it is frequently other psychiatric problems that lead to drug abuse as the addict attempts self-medication. It has also been shown that people with cognitive disabilities are more vulnerable, and more likely to have a substance abuse disorder (Moore, 1998). These impairments appear to include attentional issues as well as the hypo-functioning of the frontal cortex, sometimes referred to as the executive brain, where decision making takes place (Fowler, et al., 2007).
As a result, we are learning that no one approach has all the answers. Multiple mechanisms require multiple considerations and approaches. In addition, addicts are a diverse group, resulting in the need for many tools and approaches. It appears that programs offering the most diversified array of treatment modalities are the most effective (Vaccaro & Sideroff, 2008). That is also why, for example, most programs urge the inclusion of a 12-step program for ongoing support.

But how do you address the biological and genetic aspects while also addressing the traumatic and emotional factors, the social cognitive and attentional factors? How do you deal with the apparent “procedural memory” and conditioned factors that cause an abstinent addict, on his or her way home from work, to all of a sudden take an inappropriate turn and end up at the drug dealer? Neurofeedback appears to be a tool, a training that has the facility to address many of these factors associated with addiction.

History of promising treatmentsOver the years, there have been a number of developments that have been promising in the treatment of addiction. Each time a new approach is identified, it is immediately seen as being the long sought after “silver bullet” that will solve the addiction problem. This occurred with the development of methadone, and later Levo-Alpha Acetyl Methadol (LAAM). When I entered the field in 1976, as a post-doctoral fellow of the National Institute of Drug Abuse, Naltrexone was gaining popularity. Naltrexone is a long-acting opiate antagonist that blocks the effects of opiates, such as morphine, heroin and codeine.

It was around this time that the importance of addiction-related stimuli was becoming widely recognized (Wikler, 1984). In research examining the conditioned aspects of addiction, it was found that stimuli associated with the drug using behavior could serve as conditioned stimuli that would trigger an unconditioned psychophysiological response that had similarities to withdrawal and included anxiety, fear and physiological arousal (e.g. Sideroff & Jarvik, 1980). This conditioned patterning of response lead to the proposal that relapse liability might be determined by exposing addicts to these conditioned stimuli and monitoring their responses (Sideroff, 1980).

Following this conditioning model, one potential mechanism of Naltrexone treatment would be the behavioral extinction of some of the conditioned associations of addiction. In other words, if the addict attempted to get high while on Naltrexone, the lack of reinforcing effect might lessen the conditioned effects of drug related stimuli. This, in turn, might reduce readdiction liability. All that needed to happen was for the addict to use, without experiencing any effect; a perfectly reasonable theoretical assumption. So, not only was Naltrexone expected to be successful in keeping addicts from using, but it also could address conditioned aspects of addiction.

When I arrived at UCLA and the Veterans Administration at Brentwood in 1976, I was surprised to discover that the treatment program to which I had been awarded a fellowship, was already eliminated—almost before it began. With the help of the director of the methadone clinic, I started a new experimental Naltrexone treatment program, drawing recruits from the VA’s metha¬done maintenance population.

Unfortunately, Naltrexone did not meet its high expectations. While many methadone patients expressed interest in using Naltrexone, the long process of withdrawing from methadone—necessary in order to begin taking the opiate antagonist—eliminated more than 80 percent of volunteers. Also, as we enrolled volunteers, we found that 90 percent of the addicts who began using Naltrexone never used opiates while on the antagonist; and the 10 percent who did use, only used once. It was as if the addict immediately experienced this “no reward” condition and thus didn’t bother to waste his money. This, in itself, was an interesting finding, as it showed this population to be able to demonstrate impulse control under certain circumstances (Sideroff et al., 1978). As a result, we never had the opportunity to test our theory of extinction.
The use of Naltrexone for opiate addiction has subsequently been viewed as an unworkable model. Yet, for the small fraction of individuals who were able to detox and begin taking Naltrexone, it did change their lives.

Typically, the “Silver Bullet” has been thought of in terms of a drug; something that could either eliminate craving or eliminate the high of the drug of abuse. What have become most useful, have been drugs of substitution, such as buprenorphine, (Johnson, et al., 2000), as we continue to search for an effective treatment combination that includes psychotherapy.

EEG and addiction
The EEG is one objective representation of how the brain is functioning. The EEG is recorded from scalp electrodes, and is a representation of electrical activity produced by the collective firing of populations of neurons in the brain, in the vicinity of the electrode. Figure 1 presents a chart of brain wave frequencies and the primary functions associated with their production. It should be pointed out that this is a gross representation and that more precise differences—beyong the scope of this article – can be found when you look at specific single frequencies within each range. While all frequencies and frequency ranges are important and necessary, problems arise when there is too much or too little of a particular type of brain wave; there is difficulty shifting in response to changing needs; or the EEG is to reactive.

For example, in a healthy functioning brain, if we look at the amount of theta being produced and we compared it (using 4-8 Hz) with beta frequencies between 13 and 21 Hz (cycles per second), there is approximately a 2 to 1 ratio. When we assess the EEGs of people with Attention Deficit Disorder (ADD), we see ratios that are 3 to 1 and much higher (Lubar, 2003).

These higher ratios indicate that the brain is producing too much of the slow waves relative to the beta waves, where the beta waves represent a more focused and engaged brain. In other words, these brains are under-activated. On the other hand, if we look at the EEG patterns of people with anxiety, worry and tension, there is typically too much activity occurring in the higher frequencies, usually between 24 and 35 Hz. The EEGs of people with substance abuse problems can show both of these patterns.

It has been demonstrated that the EEGs of addicts show specific abnormalities when compared to normative data. Studies of detoxified alcoholics indicate an increase in absolute and relative power in the higher beta range, along with a decrease in alpha and delta/theta power (Saletu, et al., 2002). Low voltage fast desynchronized patterns (high beta) may be interpreted as demonstrating a hyper arousal of the central nervous system (Saletu-Z et al., 2004); and Bauer, showed a worse prognosis for the patient group with a more pronounced frontal hyper-arousal (Bauer, 2001).
The fact that these EEG patterns as well as alcohol dependence itself are highly inheritable further supports the biological nature of this disease (Gabrielli et al., 1982; Schuckit & Smith, 1996; Van Beijsterveldt & Van Baal, 2002).

These specific abnormalities show both a worse prognosis and a predisposition to development of alcoholism. Indivi¬duals with a family history of alcoholism were found to have reduced relative and absolute alpha power in occipital and frontal regions and increased relative beta in both regions compared with those with a negative family history of alcoholism. In another study, these abnormalities also were associated with risk for alcoholism (Finn & Justus, 1999).

It is a common belief that at least part of the cause of addiction is an attempt at feeling better—self-medicating. When someone with reduced or an absence of synchronous alpha rhythm takes a drink of alcohol, it results in the generation of an alpha rhythm or what is referred to as alpha synchrony, which a normal functioning brain has much greater capacity to produce (Pollock et al., 1983). Thus, it appears that the alcohol is helping the addicted person compensate for their brain’s inability to produce an alpha rhythm which is associated with a state of calmness. This mechanism helps to explain the use of alcohol by this group of addicts.

In related research on abstinent heroin-dependent subjects, it is interesting to note similar abnormalities of deficits in alpha frequencies, along with excessive high beta EEG activity (Franken et al. 2004; Polunina & Davydov, 2004). Although it appears that in some studies, these changes found in early abstinence normalize after several months of abstinence (Shufman et al., 1966; Polunina & Davydov, 2004). Cocaine-dependent subjects may show similar increases in beta activity, but in addition show increases in frontal alpha (Herning, et al., 1994). These changes, specifically the elevation of fast beta activity, appear to be correlated with relapse in cocaine abuse (Bauer, 2001). In contrast, meth¬amphetamine abusers have been shown to have significant increases in delta and theta frequency bands (Newton et al, 2003).

There are many questions that this research does not answer with regard to the relationship between abnormal EEG patterns and addiction. For example, it is not known if these dysfunctional elements are coincidental or causal. In addition, these EEG patterns are found in many mental disorders, some that are typically coincident with substance abuse. These questions do not minimize the probable conclusions that the EEG dysfunction creates specific vulnerabilities of these subjects. For example, frontal alpha, which is also found with some types of ADD, results in impairment of executive functions, such as decision making; and excessive fast beta activity can result in excess emotional and physical tension as well, as obsessive qualities.

Other substances of abuse have also been shown to correlate with abnormal EEG patterns. For example, studies have demonstrated that subjects with a chronic history of marijuana use demonstrate EEG patterns of frontal elevations of alpha frequencies. (Struve, Manno, Kemp, Patrick, & Manno 2003). This is referred to as “alpha hyper-frontality.” Another common feature of the EEG of chronic users is a reduction of alpha mean frequency, which may indicate some deficits in intellectual functioning.

Neurofeedback
Neurofeedback, as a subset of biofeedback, monitors a subject’s brain waves and feeds back selective information about these brain waves, in order to gain control over these patterns. Neurofeedback programs typically allow for the setting of thresholds within specific frequency bands or ranges so that when the EEG either rises above the threshold or drops below the threshold, some form of signal or reinforcement is presented to the subject. This feedback lets the brain know when it has been successful, thus, in an operant conditioning model, encourages this rewarded brain wave response. When the goal is to have the signal go above a threshold, we refer to this as “up training” or rewarding. When the goal is to reinforce signals that drop below a threshold, we refer to this as “down training,” or inhibiting this component of the EEG.

Joe Kamiya, a researcher at the University of Chicago, was the first researcher to discover that when a subject was informed that he was producing alpha brain wave frequencies, he would then be able to learn to detect, on his own, when he was in alpha (Kamiya, 1968). As a result of this finding, he designed a study in which he similarly gave feedback to the subjects as to their production of alpha, with the instruction to produce alpha. He found that when given this feedback, subjects were able to increase their production of synchronous alpha waves (Nowlis & Kamiya, 1970). Interestingly, his success led to the popularity of alpha training in mass culture, which coincided with its loss of credibility in the academic ¬community.

Neurofeedback research and its acceptance took on a new impetus when Sterman, working with cats, was able to train these animals using a similar operant conditioning model, to increase the amount of synchronous spindle activity in the 14 Hz frequency range (Sterman, 2000). Since these spindles occurred over the sensorimotor cortex, he labeled them sensorimotor rhythm (SMR). These studies confirmed that the production of these brain waves—associated with motoric stillness—resulted in animals that were more resistant to the triggering of seizures. Sterman, then adapted this EEG biofeedback procedure with epileptic patients and demonstrated its effectiveness in reducing the frequency and intensity of seizures.

When a subject produces SMR activity, he is mentally alert with relaxed muscles (lower muscle tone). Lubar, working in Sterman’s laboratory, recognized the potential of this discovery, and in a series of research studies, he and his colleagues were able to train children with hyperactive disorder to increase their production of SMR activity with feedback, resulting in reduced hyperactivity (Lubar, 1985).

The training procedures have evolved so that in addition to reinforcing SMR frequencies, the training of ADD also typically reinforces slightly higher frequencies of either 15 to 18, or 15 to 20 Hz activity, and at the same time, down trains the slower (theta) frequencies. The protocols address the ratio be¬tween the slower (theta) brain waves, with the faster brain waves, with a goal of training greater activation of the brain, which translates into improved attention. In one follow up study, Lubar and associates were able to demonstrate that gains made in variables of attention were maintained in subjects 10 years following training (Lubar, 1995; 2003).

At the same time that neurofeedback was being used to address attentional and cognitive deficits, primarily by training the activation of the brain, it also was being used to help people relax and establish autonomic and neuromuscular balance. With populations demonstrating aspects of anxiety, obsessive compulsive disorder and tension, the procedure has been to train increases in alpha frequencies (8-12 Hz) or a combination of alpha and theta (Moore, 2000). In these cases, the process is one of training a lowering of activation of the brain. A wide range of neurofeedback protocols have now been applied to cognitive, emotional and physical symptoms and conditions with a growing range of positive results. A bibliography covering these studies is available (Hammond 2008).

Acknowledgement: The author wishes to express his appreciation to Eleanor Criswell, Jay Gunkelman, David Kaiser and Hugh Baras for their helpful comments.

Dr. Stephen Sideroff, PhD, is a licensed clinical psychologist, consultant and Assistant Professor in the Psychiatry Department at UCLA and one of the Clinical Directors at Moonview Sanctuary. Dr. Sideroff is an internationally recognized expert in behavioral medicine, biofeedback and peak performance, and wa the founder and former clinical director of Santa Monica Hospital’s Stress Strategies, which presented programsfor individuals and corporations to better cope with stress.

References
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Finn, P.R., and Justus, A. (1999). Reduced EEG alpha power in the male and female offspring of alcoholics. Alcoholism: Clinical and Experimental Research, 23, 256–262.
Fowler, J.S., Volkow N.D., Kassed, C.A. & Chang, L. (2007). Imaging the addicted human brain. Sci Pract Perspect 3(2):4–16, 2007.
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Saletu-Zyhlarz, G.M., Arnold, O., Anderer, P., Oberndorfer, S., Walter, H., Lesch, O.M., (2004). Differences in brain function between relapsing and abstaining alcohol-dependent patients, evaluated by EEG mapping. Alcohol & Alcoholism, 39, 233–240.
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Source:www.counselormagazine.com Nov 2009

Filed under: Prevention (Papers) :

The DEA Position On Marijuana (2006)

The campaign to legitimize what is called “medical” marijuana is based on two propositions: that science views marijuana as medicine, and that DEA targets sick and dying people using the drug. Neither proposition is true. Smoked marijuana has not withstood the rigors of science – it is not medicine and it is not safe. DEA targets criminals engaged in cultivation and trafficking, not the sick and dying. No state has legalized the trafficking of marijuana, including the twelve states that have decriminalized certain marijuana use.

SMOKED MARIJUANA IS NOT MEDICINE
There is no consensus of medical evidence that smoking marijuana helps patients. Congress enacted laws against marijuana in 1970 based in part on its conclusion that marijuana has no scientifically proven medical value. The Food and Drug Administration (FDA) is the federal agency responsible for approving drugs as safe and effective medicine based on valid scientific data. FDA has not approved smoked marijuana for any condition or disease. The FDA noted that “there is currently sound evidence that smoked marijuana is harmful,” and “that no sound scientific studies supported medical use of marijuana for treatment in the United States, and no animal or human data supported the safety or efficacy of marijuana for general medical use.” 2
In 2001, the Supreme Court affirmed Congress’s 1970 judgment about marijuana in United States v. Oakland Cannabis Buyers’ Cooperative et al., 532 U.S. 438 (2001), which held that, given the absence of medical usefulness, medical necessity is not a defense to marijuana prosecution. Furthermore, in Gonzales v. Raich, 125 S.Ct. 2195 (2005), the Supreme Court reaffirmed that the authority of Congress to regulate the use of potentially harmful substances through the federal Controlled Substances Act includes the authority to regulate marijuana of a purely intrastate character, regardless of a state law purporting to authorize “medical” use of marijuana.
The DEA and the federal government are not alone in viewing smoked marijuana as having no documented medical value. Voices in the medical community likewise do not accept smoked marijuana as medicine:
The American Medical Association has rejected pleas to endorse marijuana as medicine, and instead has urged that marijuana remain a prohibited, Schedule I controlled substance, at least until more research is done. 3

• The American Cancer Society “does not advocate inhaling smoke, nor the legalization of marijuana,” although the organization does support carefully controlled clinical studies for alternative delivery methods, specifically a THC skin patch. 4

• The American Academy of Pediatrics (AAP) believes that “[a]ny change in the legal status of marijuana, even if limited to adults, could affect the prevalence of use among adolescents.” While it supports scientific research on the possible medical use of cannabinoids as opposed to smoked marijuana, it opposes the legalization of marijuana. 5

• The National Multiple Sclerosis Society (NMSS) states that studies done to date “have not provided convincing evidence that marijuana benefits people with MS,” and thus marijuana is not a recommended treatment. Furthermore, the NMSS warns that the “long-term use of marijuana may be associated with significant serious side effects.” 6

• The British Medical Association (BMA) voiced extreme concern that down-grading the criminal status of marijuana would “mislead” the public into believing that the drug is safe. The BMA maintains that marijuana “has been linked to greater risk of heart disease, lung cancer, bronchitis and emphysema.” 7 The 2004 Deputy Chairman of the BMA’s Board of Science said that “[t]he public must be made aware of the harmful effects we know result from smoking this drug.”8

• The American Academy of Pediatrics asserted that with regard to marijuana use, “from a public health perspective, even a small increase in use, whether attributable to increased availability or decreased perception of risk, would have significant ramifications.” 9
In 1999, The Institute of Medicine (IOM) released a landmark study reviewing the supposed medical properties of marijuana. The study is frequently cited by “medical” marijuana advocates, but in fact severely undermines their arguments.
After release of the IOM study, the principal investigators cautioned that the active compounds in marijuana may have medicinal potential and therefore should be researched further. However, the study concluded that “there is little future in smoked marijuana as a medically approved medication.” 10

• For some ailments, the IOM found “…potential therapeutic value of cannabinoid drugs, primarily THC, for pain relief, control of nausea and vomiting, and appetite stimulation.” 11 However, it pointed out that “[t]he effects of cannabinoids on the symptoms studied are generally modest, and in most cases there are more effective medications [than smoked marijuana].”12

• The study concluded that, at best, there is only anecdotal information on the medical benefits of smoked marijuana for some ailments, such as muscle spasticity. For other ailments, such as epilepsy and glaucoma, the study found no evidence of medical value and did not endorse further research. 13

• The IOM study explained that “smoked marijuana . . . is a crude THC delivery system that also delivers harmful substances.” In addition, “plants contain a variable mixture of biologically active compounds and cannot be expected to provide a precisely defined drug effect.” Therefore, the study concluded that “there is little future in smoked marijuana as a medically approved medication.” 14

• The principal investigators explicitly stated that using smoked marijuana in clinical trials “should not be designed to develop it as a licensed drug, but should be a stepping stone to the development of new, safe delivery systems of cannabinoids.” 15
Thus, even scientists and researchers who believe that certain active ingredients in marijuana may have potential medicinal value openly discount the notion that smoked marijuana is or can become “medicine.” DEA has approved and will continue to approve research into whether THC has any medicinal use. As of May 8, 2006, DEA had registered every one of the 163 researchers who requested to use marijuana in studies and who met Department of Health and Human Services standards. 16
One of those researchers, The Center for Medicinal Cannabis Research (CMCR), conducts studies “to ascertain the general medical safety and efficacy of cannabis and cannabis products and examine alternative forms of cannabis administration.”17 The CMCR currently has 11 on-going studies involving marijuana and the efficacy of cannabis and cannabis compounds as they relate to medical conditions such as HIV, cancer pain, MS, and nausea.18
At present, however, the clear weight of the evidence is that smoked marijuana is harmful. No matter what medical condition has been studied, other drugs already approved by the FDA, such as Marinol – a pill form of synthetic THC – have been proven to be safer and more effective than smoked marijuana.
MARIJUANA IS DANGEROUS TO THE USER AND OTHERS
Legalization of marijuana, no matter how it begins, will come at the expense of our children and public safety. It will create dependency and treatment issues, and open the door to use of other drugs, impaired health, delinquent behavior, and drugged drivers. This is not the marijuana of the 1970′s; today’s marijuana is far more powerful. Average THC levels of seized marijuana rose from less than one per cent in the mid-1970′s to a national average of over eight per cent in 2004. 19
And the potency of “B.C. Bud” is roughly twice the national average – ranging from 15 per cent to as high as 25 per cent THC content.20
Dependency and Treatment:
o Adolescents are at highest risk for marijuana addiction, as they are “three times more likely than adults to develop dependency.” 21
This is borne out by the fact that treatment admission rates for adolescents reporting marijuana as the primary substance of abuse increased from 32 to 65 per cent between 1993 and 2003.22 More young people ages 12-17 entered treatment in 2003 for marijuana dependency than for alcohol and all other illegal drugs combined.23

• “Research shows that use of [marijuana] can lead to dependence. Some heavy users of marijuana develop withdrawal symptoms when they have not used the drug for a period of time. Marijuana use, in fact, is often associated with behavior that meets the criteria for substance dependence established by the American Psychiatric Association.” 24

• Of the 19.1 million Americans aged 12 or older who used illicit drugs in the past 30 days in 2004, 14.6 million used marijuana, making it the most commonly used illicit drug in 2004. 25

• Among all ages, marijuana was the most common illicit drug responsible for treatment admissions in 2003, accounting for 15 per cent of all admissions — outdistancing heroin, the next most prevalent cause. 26

• In 2003, 20 per cent (185,239) of the 919,833 adults admitted to treatment for illegal drug abuse cited marijuana as their primary drug of abuse.27
Marijuana as a Precursor to Abuse of Other Drugs:
o Marijuana is a frequent precursor to the use of more dangerous drugs, and signals a significantly enhanced likelihood of drug problems in adult life. The Journal of the American Medical Association reported, based on a study of 300 sets of twins, “that marijuana-using twins were four times more likely than their siblings to use cocaine and crack cocaine, and five times more likely to use hallucinogens such as LSD.” 28
• Long-term studies on patterns of drug usage among young people show that very few of them use other drugs without first starting with marijuana. For example, one study found that among adults (age 26 and older) who had used cocaine, 62 per cent had initiated marijuana use before age 15. By contrast, less than one per cent of adults who never tried marijuana went on to use cocaine. 29

• Columbia University’s National Center on Addiction and Substance Abuse reports that teens who used marijuana at least once in the last month are 13 times likelier than other teens to use another drug like cocaine, heroin, or methamphetamine, and almost 26 times likelier than those teens who have never used marijuana to use another drug. 30

• Marijuana use in early adolescence is particularly ominous. Adults who were early marijuana users were found to be five times more likely to become dependent on any drug, eight times more likely to use cocaine in the future, and fifteen times more likely to use heroin later in life. 31

• In 2003, 3.1 million Americans aged 12 or older used marijuana daily or almost daily in the past year. Of those daily marijuana users, nearly two-thirds “used at least one other illicit drug in the past 12 months.” More than half (53.3 per cent) of daily marijuana users were also dependent on or abused alcohol or another illicit drug compared to those who were nonusers or used marijuana less than daily. 32

• Healthcare workers, legal counsel, police and judges indicate that marijuana is a typical precursor to methamphetamine. For instance, Nancy Kneeland, a substance abuse counselor in Idaho, pointed out that “in almost all cases meth users began with alcohol and pot.” 33
Mental and Physical Health Issues Related to Marijuana:
John Walters, Director of the Office of National Drug Control Policy, Charles G. Curie, Administrator of the Substance Abuse and Mental Health Services Administration, and experts and scientists from leading mental health organizations joined together in May 005 to warn parents about the mental health dangers marijuana poses to teens. According to several recent studies, marijuana use has been linked with depression and suicidal thoughts, in addition to schizophrenia. These studies report that weekly marijuana use among teens doubles the risk of developing depression and triples the incidence of suicidal thoughts. 34

• Dr. Andrew Campbell, a member of the New South Wales (Australia) Mental Health Review Tribunal, published a study in 2005 which revealed that four out of five individuals with schizophrenia were regular cannabis users when they were teenagers. Between 75-80 per cent of the patients involved in the study used cannabis habitually between the ages of 12 and 21. 35 In addition, a laboratory-controlled study by Yale scientists, published in 2004, found that THC “transiently induced a range of schizophrenia-like effects in healthy people.”36

• Smoked marijuana has also been associated with an increased risk of the same respiratory symptoms as tobacco, including coughing, phlegm production, chronic bronchitis, shortness of breath and wheezing. Because cannabis plants are contaminated with a range of fungal spores, smoking marijuana may also increase the risk of respiratory exposure by infectious organisms (i.e., molds and fungi). 37

• Marijuana takes the risks of tobacco and raises them: marijuana smoke contains more than 400 chemicals and increases the risk of serious health consequences, including lung damage. 38

• According to two studies, marijuana use narrows arteries in the brain, “similar to patients with high blood pressure and dementia,” and may explain why memory tests are difficult for marijuana users. In addition, “chronic consumers of cannabis lose molecules called CB1 receptors in the brain’s arteries,” leading to blood flow problems in the brain which can cause memory loss, attention deficits, and impaired learning ability. 39

• Carleton University researchers published a study in 2005 showing that current marijuana users who smoke at least five “joints” per week did significantly worse than non-users when tested on neurocognition tests such as processing speed, memory, and overall IQ. 40

Delinquent Behaviors and Drugged Driving:
o In 2002, the percentage of young people engaging in delinquent behaviors “rose with [the] increasing frequency of marijuana use.” For example, according to a National Survey on Drug Use and Health (NSDUH) report, 42.2 per cent of youths who smoked marijuana 300 or more days per year and 37.1 per cent of those who did so 50-99 days took part in serious fighting at school or work. Only 18.2 per cent of those who did not use marijuana in the past year engaged in serious fighting. 41

• A large shock trauma unit conducting an ongoing study found that 17 per cent (one in six) of crash victims tested positive for marijuana. The rates were slightly higher for crash victims under the age of eighteen, 19 per cent of whom tested positive for marijuana. 42

• In a study of high school classes in 2000 and 2001, about 28,000 seniors each year admitted that they were in at least one accident after using marijuana. 43

• Approximately 15 per cent of teens reported driving under the influence of marijuana. This is almost equal to the percentage of teens who reported driving under the influence of alcohol (16 per cent). 44

• A study of motorists pulled over for reckless driving showed that, among those who were not impaired by alcohol, 45 per cent tested positive for marijuana. 45

• The National Highway Traffic Safety Administration (NHTSA) has found that marijuana significantly impairs one’s ability to safely operate a motor vehicle. According to its report, “[e]pidemiology data from road traffic arrests and fatalities indicate that after alcohol, marijuana is the most frequently detected psychoactive substance among driving populations.” Problems reported include: decreased car handling performance, inability to maintain headway, impaired time and distance estimation, increased reaction times, sleepiness, lack of motor coordination, and impaired sustained vigilance. 46
Some of the consequences of marijuana-impaired driving are startling:
The driver of a charter bus, whose 1999 accident resulted in the death of 22 people, had been fired from bus companies in 1989 and 1996 because he tested positive for marijuana four times. A federal investigator confirmed a report that the driver “tested positive for marijuana when he was hospitalized Sunday after the bus veered off a highway and plunged into an embankment.” 47

• In April 2002, four children and the driver of a van died when the van hit a concrete bridge abutment after veering off the freeway. Investigators reported that the children nicknamed the driver “Smokey” because he regularly smoked marijuana. The driver was found at the crash scene with marijuana in his pocket. 48

• A former nurse’s aide was convicted in 2003 of murder and sentenced to 50 years in prison for hitting a homeless man with her car and driving home with his mangled body “lodged in the windshield.” The incident happened after a night of drinking and taking drugs, including marijuana. After arriving home, the woman parked her car, with the man still lodged in the windshield, and left him there until he died. 49

• In April 2005, an eight year-old boy was killed when he was run over by an unlicensed 16 year-old driver who police believed had been smoking marijuana just before the accident. 50

• In 2001, George Lynard was convicted of driving with marijuana in his bloodstream, causing a head-on collision that killed a 73 year-old man and a 69 year-old woman. Lynard appealed this conviction because he allegedly had a “valid prescription” for marijuana. A Nevada judge agreed with Lynard and granted him a new trial. 51 The case has been appealed to the Nevada Supreme Court.52

• Duane Baehler, 47, of Tulsa, Okalahoma was “involved in a fiery crash that killed his teenage son” in 2003. Police reported that Baehler had methamphetamine, cocaine and marijuana in his system at the time of the accident. 53
Marijuana also creates hazards that are not always predictable. In August 2004, two Philadelphia firefighters died battling a fire that started because of tangled wires and lamps used to grow marijuana in a basement closet. 54

MARIJUANA AND INCARCERATION
Federal marijuana investigations and prosecutions usually involve hundreds of pounds of marijuana. Few defendants are incarcerated in federal prison for simple possession of marijuana.
o In 2001, there were 24,299 offenders sentenced in federal court on drug charges. Of those, only 2.3 per cent (186 people) were sentenced for simple possession. 55
In addition, it is important to recognize that many inmates were initially charged with more serious crimes but negotiated reduced charges to simple possession through plea agreements.56

• According to the latest survey data in a 2005 ONDCP study, marijuana accounted for 13 per cent of all state drug offenders in 1997, and of the inmates convicted of marijuana offenses, only 0.7 per cent were incarcerated for marijuana possession alone. 57
THE FOREIGN EXPERIENCE
The Netherlands
o Due to international pressure on permissive Dutch cannabis policy and domestic complaints over the spread of marijuana “coffee shops,” the government of the Netherlands has reconsidered its legalization measures. After marijuana became normalized, consumption nearly tripled – from 15 per cent to 44 per cent – among 18 to 20 year-old Dutch youth. 58
As a result of stricter local government policies, the number of cannabis “coffeehouses” in the Netherlands was reduced – from 1,179 in 199759 to 737 in 2004, a 37 per cent decrease in 7 years.60

• About 70 per cent of Dutch towns have a zero-tolerance policy toward cannabis cafes.61

• In August 2004, after local governments began clamping down on cannabis “coffeehouses” seven years earlier, the government of the Netherlands formally announced a shift in its cannabis policy through the United National International Narcotics Control Board (INCB). According to “an inter-ministerial policy paper on cannabis, the government acknowledged that ‘cannabis is not harmless’ – neither for the abusers, nor for the community.” Netherlands intends to reduce the number of coffee shops (especially those near border areas and schools), closely monitor drug tourism, and implement an action plan to discourage cannabis use. This public policy change brings the Netherlands “closer towards full compliance with the international drug control treaties with regard to cannabis.” 62

• Dr. Ernest Bunning, formerly with Holland’s Ministry of Health and a principal proponent of that country’s liberal drug philosophy, has acknowledged that, “there are young people who abuse soft drugs . . . particularly those that have a high THC [content]. The place that cannabis takes in their lives becomes so dominant they don’t have space for the other important things in life. They crawl out of bed in the morning, grab a joint, don’t work, smoke another joint. They don’t know what to do with their lives.” 63
Switzerland
Liberalization of marijuana laws in Switzerland has likewise produced damaging results. After liberalization, Switzerland became a magnet for drug users from many other countries. In 1987, Zurich permitted drug use and sales in a part of the city called Platzpitz, dubbed “Needle Park.” By 1992, the number of regular drug users at the park reportedly swelled from a “few hundred at the outset in 1987 to about 20,000.” The area around the park became crime-ridden, forcing closure of the park. The experiment has since been terminated. 64
Canada:
After a large decline in the 1980s, marijuana use among teens increased during the 1990s as young people became “confused about the state of federal pot law” in the wake of an aggressive decriminalization campaign, according to a special adviser to Health Canada’s Director General of drug strategy. Several Canadian drug surveys show that marijuana use among Canadian youth has steadily climbed to surpass its 26-year peak, rising to 29.6 per cent of youth in grades 7-12 in 2003. 65
United Kingdom:
In March 2005, British Home Secretary Charles Clarke took the unprecedented step of calling “for a rethink on Labour’s legal downgrading of cannabis” from a Class B to a Class C substance. Mr. Clarke requested that the Advisory Council on the Misuse of Drugs complete a new report, taking into account recent studies showing a link between cannabis and psychosis and also considering the more potent cannabis referred to as “skunk.” 66

• In 2005, during a general election speech to concerned parents, British Prime Minister Tony Blair noted that medical evidence increasingly suggests that cannabis is not as harmless as people think and warned parents that young people who smoke cannabis could move on to harder drugs. 67
THE LEGALIZATION LOBBY
The proposition that smoked marijuana is “medicine” is, in sum, false – trickery used by those promoting wholesale legalization. When a statute dramatically reducing penalties for “medical” marijuana took effect in Maryland in October 2003, a defense attorney noted that “there are a whole bunch of people who like marijuana who can now try to use this defense.” The attorney observed that lawyers would be “neglecting their clients if they did not try to find out what ‘physical, emotional or psychological’” condition could be enlisted to develop a defense to justify a defendant’s using the drug. “Sometimes people are self-medicating without even realizing it,’” he said. 68

Ed Rosenthal, senior editor of High Times, a pro-drug magazine, once revealed the legalizer strategy behind the “medical” marijuana movement. While addressing an effort to seek public sympathy for glaucoma patients, he said, “I have to tell you that I also use marijuana medically. I have a latent glaucoma which has never been diagnosed. The reason why it’s never been diagnosed is because I’ve been treating it.” He continued, “I have to be honest, there is another reason why I do use marijuana . . . and that is because I like to get high. Marijuana is fun.” 69

• A few billionaires-not broad grassroots support-started and sustain the “medical” marijuana and drug legalization movements in the United States. Without their money and influence, the drug legalization movement would shrivel. According to National Families in Action, four individuals – George Soros, Peter Lewis, George Zimmer and John Sperling – contributed $1,510,000 to the effort to pass a “medical” marijuana law in California in 1996, a sum representing nearly 60 per cent of the total contributions. 70

• In 2000, The New York Times interviewed Ethan Nadelmann, Director of the Lindesmith Center. Responding to criticism that the medical marijuana issue is a stalking horse for drug legalization, Mr. Nadelmann stated: “Will it help lead toward marijuana legalization? . . . I hope so.” 71

• In 2004, Alaska voters faced a ballot initiative that would have made it legal for adults age 21 and older to possess, grow, buy, or give away marijuana. The measure also called for state regulation and taxation of the drug. The campaign was funded almost entirely by the Washington, D.C.-based Marijuana Policy Project, which provided “almost all” the $857,000 taken in by the pro-marijuana campaign. Fortunately, Alaskan voters rejected the initiative. 72

• In October 2005, Denver voters passed Initiative 100 decriminalizing marijuana based on incomplete and misleading campaign advertisements put forth by the Safer Alternative For Enjoyable Recreation (SAFER). A Denver City Councilman complained that the group used the slogan “Make Denver SAFER” on billboards and campaign signs to mislead the voters into thinking that the initiative supported increased police staffing. Indeed, the Denver voters were never informed of the initiative’s true intent to decriminalize marijuana. 73

• The legalization movement is not simply a harmless academic exercise. The mortal danger of thinking that marijuana is “medicine” was graphically illustrated by a story from California. In the spring of 2004, Irma Perez was “in the throes of her first experience with the drug ecstasy” when, after taking one ecstasy tablet, she became ill and told friends that she felt like she was “going to die.” Two teenage acquaintances did not seek medical care and instead tried to get Perez to smoke marijuana. When that failed due to her seizures, the friends tried to force-feed marijuana leaves to her, “apparently because they knew that drug is sometimes used to treat cancer patients.” Irma Perez lost consciousness and died a few days later when she was taken off life support. She was 14 years old. 74
STILL, THERE’S GOOD NEWS
Continued Declines in Marijuana Use among Youth
In 2005, the Monitoring the Future (MTF) survey recorded an overall 19.1 per cent decrease in current use of illegal drugs between 2001 and 2005, edging the nation closer to its five-year goal of a 25 per cent reduction in illicit drug use in 2006. Specific to marijuana, the 2005 MTF survey showed:
Between 2001 and 2005, marijuana use dropped in all three categories: lifetime (13%), past year (15%) and 30-day use (19%). Current marijuana use decreased 28 per cent among 8th graders (from 9.2% to 6.6%), and 23 per cent among 10th graders (from 19.8 per cent to 15.2%). 75
Increased Eradication
As of September 20, 2005, DEA’s Domestic Cannabis Eradication/Suppression Program supported the eradication of 3,054,336 plants in the top seven marijuana producing states (California, Hawaii, Kentucky, Oregon, Tennessee, Washington and West Virginia). This is an increase of 315,628 eradicated plants over the previous year. 76

• For the 2005 eradication season, a total of 5 million marijuana plants have been eradicated across the United States. This is a one million plant increase over last year. The Departments of Agriculture and Interior combined have eradicated an estimated 1.2 million plants during this 2005 eradication season. 77
APPENDIX A
Acronyms used in “The DEA Position on Marijuana”
AAP American Academy of Pediatrics
ACS American Cancer Society
AMA American Medical Association
BBC British Broadcasting Company
B.C. Bud British Columbia Bud
BMA British Medical Association
CB1 Cannabinoid Receptor 1: one of two receptors in the brain’s endocannabinoid (EC) system associated with the intake of food and tobacco dependency.
CMCR Center for Medicinal Cannabis Research
DASIS Drug and Alcohol Services Information System
DEA Drug Enforcement Administration
FDA Food and Drug Administration
HIV Human Immunodeficiency Virus
INCB International Narcotics Control Board
IOM Institute of Medicine
IOP Intraocular Pressure
LSD Diethylamide-Lysergic Acid
MS Multiple Sclerosis
NHTSA National Highway Traffic Safety Administration
NIDA National Institute on Drug Abuse
NMSS National Multiple Sclerosis Society
NORML National Organization for the Reform of Marijuana Laws
NSDUH National Survey of Drug Use and Health
ONDCP Office of National Drug Control Policy
TEDS Treatment Episode Data Set
THC Tetrahydrocannabinol

ENDNOTES
1 As of April 2006, the eleven states that have decriminalized certain marijuana use are Arizona, Alaska, California, Colorado, Hawaii, Maine, Montana, Nevada, Oregon, Rhode Island, Vermont, and Washington. In addition, Maryland has enacted legislation that recognizes a “medical marijuana” defense
2 “Inter-Agency Advisory Regarding Claims That Smoked Marijuana Is a Medicine.” U.S. Food and Drug Administration, April 20, 2006. <

http://www.fda.gov/bbs/topics/NEWS/2006/NEW01362.html>.

3 “Policy H-95.952 ‘Medical Marijuana.’” American Medical Association. See also, American Medical Association, Featured Council on Scientific Affairs. “Medical Marijuana (A-01).” June 2001. In 2001, the AMA updated their policy regarding medical marijuana reflecting the results of this study. It should be noted that a few medical organizations have offered limited support to the concept of “medical” marijuana. For example, the American Academy of Family Physicians has said that it opposes the use of marijuana “except under medical supervision and control, for specific medical indications.” Largely at the urging of one activist – a lobbyist and former Board member of NORML – the American Nurses Association has endorsed “medical” marijuana under “appropriate prescriber supervision,” and the American Academy of HIV Medicine, a group of about 1,800 members founded in 2000, has taken the view that marijuana should not only be made available for “medical” use, but should be excluded altogether as a Schedule I drug
4 “Experts: Pot Smoking Is Not Best Choice to Treat Chemo Side-Effects.” American Cancer Society. 22 May 2001.

http://www.cancer.org/docroot/NWS/content/update/NWS_1_1xU_

Experts__Pot_Smoking_Is_Not_Best_Choice_to_Treat_Chemo_Side_Effects.asp
(9 March 2005).
5 Committee on Substance Abuse and Committee on Adolescence. “Legalization of Marijuana: Potential Impact on Youth.” Pediatrics Vol. 113, No. 6 (6 June 2004): 1825-1826. See also, Joffe, Alain, MD, MPH, and Yancy, Samuel, MD. “Legalization of Marijuana: Potential Impact on Youth.” Pediatrics Vol. 113, No. 6 (6 June 2004): e632-e638h.
6 National MS Society. “Information Sourcebook.” National MS Society. December 2004. <
www.nationalmssociety.org/pdf/sourcebook/marijuana.pdf> (1 April 2005).
7 “Doctors’ Fears at Cannabis Change.” BBC News. 21 January 2004.
8 Manchester Online. “Doctors Support Drive Against Cannabis.”
Manchester News. 21 January 2004. <

http://www.manchesteronline.co.uk/

news/s/78/78826_doctors_support_drive_against_cannabis.html> (25 March 2005).
9 Joffe, Alain, MD, MPH, Yancy, Samuel W., MD, the Committee on Substance Abuse and the Committee on Adolescence, Technical Report: “Legalization of Marijuana: Potential Impact on Youth”, American Academy of Pediatrics, 6 June 2004.
10 Institute of Medicine. “Marijuana and Medicine: Assessing the Science Base.” (1999). Summary. <
http://www.nap.edu/html/marimed> (12 April 2005).
11 Id.
12 Institute of Medicine. “Marijuana and Medicine: Assessing the Science Base.” (1999). Executive Summary. <
http://www.nap.edu/html/marimed> (11 January 2006).
13 Institute of Medicine. “Marijuana and Medicine: Assessing the Science Base.” (1999). Summary. <
http://www.nap.edu/html/marimed> (11 January 2006).
14 Institute of Medicine. “Marijuana and Medicine: Assessing the Science Base.” (1999). Summary. <
http://www.nap.edu/html/marimed> (11 January 2006).
15 Benson, John A., Jr. and Watson, Stanley J., Jr. “Strike a Balance in the Marijuana Debate.” The Standard-Times. 13 April 1999.
16 DEA, Office of Diversion Control. 8 May 2006.
17 “CMCR Mission Statement.” Center for Medicinal Cannabis Research. <
http://www.cmcr.ucsd.edu/geninfo/mission.htm> (3 February 2005).
18 DEA, Office of Diversion Control. 6 January 2006.
19 Marijuana Potency Monitoring Project. “Quarterly Report #87.” Marijuana Potency Monitoring Project. 8 November 2004.
20 “BC Bud: Growth of the Canadian Marijuana Trade.” Drug Enforcement Administration, Intelligence Division. December 2000.
21 “Teens at High Risk for Pot Addiction.” The Seattle Post-Intelligencer. 6 January 2004.
22 Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Office of Applied Studies. Treatment Episode Data Set (TEDS) 1993-2003: National Admissions to Substance Abuse Treatment Services. November 2005, Table 5.1b. <
http://wwwdasis.samhsa.gov/teds03/teds_2003_rpt.pdf> (12 January 2006).
23 Id.
24 “Marijuana Myths & Facts: The Truth Behind 10 Popular Misperceptions.” Office of National Drug Control Policy. <
http://www.whitehousedrugpolicy.gov/publications/marijuana_myths_facts/index.html> (12 January 2006).
25 Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Office of Applied Studies. Overview of Findings from 2004 National Survey on Drug Use and Health. September 2005.
26 Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Office of Applied Studies. Treatment Episode Data Set (TEDS) 1993-2003: National Admissions to Substance Abuse Treatment Services. November 2005. Page 74; Table 2.1b. <
http://wwwdasis.samhsa.gov/teds03/teds_2003_rpt.pdf> (12 January 2006).
27 Id., Tables 2.1a and 5.1a. There were 284,361 primary marijuana admissions in 2003, with 99,122 of those being juvenile marijuana admissions, meaning that there were 185,239 adult marijuana admissions.
28 “What Americans Need to Know about Marijuana.” Office of National Drug Control Policy. October 2003.
29 Gfroerer, Joseph C., et al. “Initiation of Marijuana Use: Trends, Patterns and Implications.” Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Office of Applied Studies. July 2002. Page 71.
30 “Non-Medical Marijuana II: Rite of Passage or Russian Roulette?” CASA Reports. April 2004. Chapter V, Page 15.
31 “What Americans Need to Know about Marijuana,” 9.
32 Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Office of Applied Studies. “Daily Marijuana Users.” The NSDUH Report. 26 November 2004.
33 Furber, Matt. “Threat of Meth-’the Devil’s Drug’-increases.” Idaho Mountain Express and Guide. 28 December 2005.
34 “Drug Abuse; Drug Czar, Others Warn Parents that Teen Marijuana Use can Lead to Depression.” Life Science Weekly. 31 May 2005.
35 Kearney, Simon. “Cannabis is Worst Drug for Psychosis.” The Australian. 21 November 2005.
36 Curtis, John. “Study Suggests Marijuana Induces Temporary Schizophrenia-Like Effects.” Yale Medicine. Fall/Winter 2004.
37 “Marijuana Associated with Same Respiratory Symptoms as Tobacco,” YALE News Release. 13 January 2005. <
http://www.yale.edu/opa/newsr/05-01-13-01.all.htm> (14 January 2005). See also, “Marijuana Causes Same Respiratory Symptoms as Tobacco,” January 13, 2005, 14WFIE.com.
38 “What Americans Need to Know about Marijuana,” page 9.
39 “Marijuana Affects Brain Long-Term, Study Finds.” Reuters. 8 February 2005. See also: “Marijuana Affects Blood Vessels.” BBC News. 8 February 2005; “Marijuana Affects Blood Flow to Brain.” The Chicago Sun-Times. 8 February 2005; Querna, Elizabeth. “Pot Head.” US News & World Report. 8 February 2005.
40 “Neurotoxicology; Neurocognitive Effects of Chronic Marijuana Use Characterized.” Health & Medicine Week. 16 May 2005.
41 Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA), Office of Applied Sciences. “Marijuana Use and Delinquent Behaviors Among Youths.” The NSDUH Report. 9 January 2004.
42 “Drugged Driving Poses Serious Safety Risk to Teens; Campaign to Urge Teens to ‘Steer Clear of Pot’ During National Drunk and Drugged Driving (3D) Prevention Month.” PR Newswire. 2 December 2004.
43 O’Malley, Patrick and Johnston, Lloyd. “Unsafe Driving by High School Seniors: National Trends from 1976 to 2001 in Tickets and Accidents After Use of Alcohol, Marijuana and Other Illegal Drugs.” Journal of Studies on Alcohol. May 2003.
44 Id.
45 “White House Drug Czar Launches Campaign to Stop Drugged Driving.” Office of National Drug Control Policy Press Release. 19 November 2002.
46 Couper, Fiona, J., Ph.D., page 11.
47 Orange County Register. “Nation: Drug Test Positive for Driver in Deadly Crash.” Orange County Register. 14 May 1999.
48 Edmondson, Aimee. “Drug Tests Required of Child Care Drivers – Fatal Crash Stirs Change; Many Already Test Positive.” The Commercial Appeal. 2 July 2003.
49 McDonald, Melody and Boyd, Deanna. “Jury Gives Mallard 50 Years for Murder; Victim’s Son Forgives but Says ‘Restitution is Still Required.’” Fort Worth Star Telegram. 28 June 2003.
50 “Boy, 8, Who Was Struck While Riding Bike Dies.” The Dallas Morning News. 25 April 2005.
51 “Lastest News in Brief from Northern Nevada.” The Associated Press State & Local Wire. 30 April 2005.
52 Washoe County District Attorney’s Office. 6 January 2006.
53 The Associated Press. “Police: Driver in Fatal Crash had Drugs in System.” The Associated Press. 1 June 2003.
54 The Associated Press. “Murder Charges Filed in Blaze that Killed Two Firefighters.” The Associated Press. 21 August 2004.
55 Office of National Drug Control Policy. “Who’s Really in Prison for Marijuana?” May 2005. Page 22.
56 “Marijuana Myths & Facts.” Page 22.
57 “Who’s Really in Prison for Marijuana? Page 20.
58 “What Americans Need to Know about Marijuana,” ONDCP, Page 10.
59 Dutch Health, Welfare and Sports Ministry Report. 23 April 2004.
60 INTRAVAL Bureau for Research & Consultancy. “Coffeeshops in the Netherlands 2004.” Dutch Ministry of Justice. June 2005. <

http://www.intraval.nl/en/b/b45.html>.

61 Id.
62 International Narcotics Control Board. “INCB Welcomes ‘Crucial and Significant Change in Dutch Cannabis Policy.’” United Nations Information Service. 2 March 2005. The action plan to discourage cannabis use includes elements such as drug prevention campaigns, mass-media anti-drugs campaign, increased treatment efforts to cannabis users, and encouragement of administrative and criminal law enforcement efforts. See also: “International Narcotics Control Board Annual Report Focuses on Need to Integrate Drug Demand, Supply Strategies.” SOC/NAR/924 Press Release. 3 February 2005. <
http://www.un.org/News/Press/docs/2005/socnar924.doc.htm> (18 March 2005); “Press Briefing by International Narcotics Control Board.” 3 January 2005. (18 March 2005).
63 Collins, Larry. “Holland’s Half-Baked Drug Experiment.” Foreign Affairs Vol. 73, No. 3. May-June 1999: Pages 87-88.
64 Cohen, Roger. “Amid Growing Crime, Zurich Closes a Park it Reserved for Drug Addicts.” The New York Times. 11 February 1992.
65 Adlaf, Edward M. and Paglia-Boak, Angela, Center for Addiction and Mental Health, Drug Use Among Ontario Students, 1977-2005, CAMH Research Document Series No. 16. The study does not contain data on marijuana use among 12th graders prior to 1999. See also: Canadian Addiction Survey, Highlights (November 2004) and Detailed Report (March 2005), produced by Health Canada and the Canadian Executive Council on Addictions; Youth and Marijuana Quantitative Research’ 2003 Final Report, Health Canada; Tibbetts, Janice and Rogers, Dave. “Marijuana Tops Tobacco Among Teens, Survey Says: Youth Cannabis Use Hits 25-Year Peak,” The Ottawa Citizen, 29 October 2003.
66 Koster, Olinka, Doughty, Steve, and Wright, Stephen. “Cannabis Climbdown.” Daily Mail (London). 19 March 2005. See also. Revill, Jo, and Bright, Martin. “Cannabis: the Questions that Remain Unanswered.” The Observer. 20 March 2005; Steele, John and Helm, Toby. “Clarke Reviews “Too Soft” Law on Cannabis.” The Daily Telegraph (London). 19 March 2005; Brown, Colin. “Clarke Orders Review of Blunkett Move to Downgrade Cannabis.” The Independent (London). 19 March 2005.
67 “Blair’s ‘Concern’ on Cannabis.” The Irish Times. 4 May 2005. See also, Russell, Ben. “Election 2005: Blair Rules Out National Insurance Rise.” The Independent (London). 4 May 2005.
68 Craig, Tim. “Md. Starts to Allow Marijuana Court Plea; Penalty Can be Cut for Medicinal Use.” The Washington Post. 1 October 2003, sec B.
69 From a videotape recording of Mr. Rosenthal’s speech, as shown in “Medical Marijuana: A Smoke Screen.”
70 “A Guide to Drug Related State Ballot Initiatives.” National Families in Action. 23 April 2002. <
http://www.nationalfamilies.org/guide/california215.html> (31 March 2005).
71 Wren, Christopher S. “Small But Forceful Coalition Works to Counter U.S. War on Drugs.” The New York Times, 2 January 2000.
72 Brant, Tataboline. “Marijuana Campaign Draws in $857,000.” The Anchorage Daily News. 30 October 2004.
73 Gathright, Alan. “Pot Backers Can’t Stoke Hickenlooper.” Rocky Mountain News. 27 October 2005.
74 Stannard, Matthew B. “Ecstasy Victim Told Friends She Felt Like She Was Going to Die.” The San Francisco Chronicle, 4 May 2004. The Chronicle reported that Ms. Perez was given ibuprofen and “possibly marijuana,” but DEA has confirmed that the drug given to her was indeed marijuana.
75 Monitoring the Future, 2005. Supplemented by information from the Office of National Drug Control Policy press release on the 2005 MTF Survey, December 19, 2005.)
76 DEA Domestic Cannabis Eradication/Suppression Program, 2005 eradication season.
77 Id.
Source: DrugWatch International January 2010

Filed under: Medicine and Marijuana :

Motivational interviewing


Motivational interviewing can yield excellent results and the basic skills and techniques are easy to learn. Dr Malcolm Thomas sets out the basics of promoting behaviour change

Helping patients or clients to change their behaviour can be frustrating. As professionals, we can get into a cycle of giving advice and making suggestions, only to feel that everything we suggest is being rejected. Specialist workers often have some training in more effective techniques – this article is aimed at frontline staff, most of whom will not have had such training.
There is now rather compelling evidence that the approach known as motivational interviewing produces better results than standard care (also called ‘business as usual’ or ‘finger wagging’). A full motivational interview takes between
45 and 60 minutes. The necessary training takes two, three or more days so it’s not surprising that this has been the preserve of specialists. However, the insights and techniques of motivational interviewing are available to ‘ordinary’ practitioners. I work for a training company and it’s our contention that everyone whose job includes counselling patients or clients regarding behaviour
change can enhance their professional effectiveness with some understanding, and judicious use, of relevant techniques.
Each of the following techniques takes no more than a few minutes to use and frontline practitioners can use them flexibly in relevant professional conversations. Regard the list as a toolkit from which the relevant tool can be unpacked as needed.

Many clients exhibit two or more behaviours that may profitably be changed, such as alcohol, drug use and diet. Usually it’s the professional who chooses which one to talk about, but allowing the client to choose the focus may enhance motivation. This can be achieved by running verbally through the options as the professional sees them and inviting the client to choose, such as:
‘It looks there are three things we could talk about today. Firstly your drug use, secondly your drinking and thirdly your diet. Does that sound right?’ Then, if the client agrees: ‘OK, so which would you like us to focus on today?’ People can be a bit vague about their habits. A typical answer to ‘how much alcohol do you drink’ is likely to be something like ‘Well, that’s a good question. It’s hard to say. Depends on this and that.’ It’s usually profitable to clarify what is going on at an early stage in your
professional relationship. A recommended technique is the ‘typical day’ question. For example, ‘I wonder if I could spend a couple of minutes learning more about your drinking? Can I ask you to talk me through a typical day, starting when you wake up
and finishing when you go to bed? Tell me where you go, what you do and where your drinking fits in.’ Variations on this include asking about a specific day (yesterday, last Saturday) or a typical week (which can be better for some behaviours). It’s normally very helpful to gauge the client’s readiness to change or consider changing. This may be apparent from things they have said and it certainly can emerge naturally from the conversation, but this is not always the case. While it’s rare for there to be no real clue, it can often be very unclear just how much readiness there is to change. It’s helpful to break readiness to change down into two components – importance and confidence. One strategy is to ask specifically about these in turn, using ‘scaling questions’. For example, ‘Can I just ask you a couple of questions? On a scale of one to ten, how important is it for you to cut down your drug use?’ Say the client responds with ‘Oh, I don’t know. Maybe around a three,’ your response could be ‘I see – thanks. Can I ask a similar question? On a scale of one to ten, if you decided to cut down, how confident would you be that you could make the change?’ Their response might be: ‘That’s a good question. Maybe six-ish. I cut down quite well for a while once. I think I could do that again.’

One advantage of this approach is that you can use it as a launch pad for further exploration, such as: ‘You told me you were at three or four for importance. So can I ask you why three and not one or two?’ ‘Well, it does sometimes get me into trouble. I’d like to think I had a bit more control over it and that it didn’t dominate my life quite so much.’ ‘Alright, so what would have to happen to move that score up to say five or six?’ ‘Well, if I got properly sick with it, I think that might do it.’ People aren’t daft. They indulge in unhealthy behaviours because there’s a payoff. Being overweight is a side effect of eating, which is usually pleasurable. Substance users get some sort of ‘high’ from their substance, or a relief from withdrawal effects if dependent. Behaviours have a social context and many people enjoy doing things with friends, whether smoking, drinking or injecting.
An axiom of motivational interviewing is that our client can see pros and cons to their behaviour. Rather than offering our professional opinion, we can help by allowing the client to bring these out into the open – and then feed it back to them: ‘Can I just try to understand a bit better? Can I ask you about the pros and cons of your marijuana use? First, what are the pros of smoking it from your point of view, the things you like about smoking marijuana? ‘Well, it relaxes me a bit, you know. And when I light up a joint with my mates, we have a good laugh. And to be honest, I prefer a smoke to a drink because you don’t
get the hangovers – you know what I mean?’ ‘Yes, I think I see that. Ok, what about the cons? The things you don’t like so much?’ ‘Well, it sometimes costs me quite a bit you know. And if I get really stoned, then I miss half the day, which isn’t right. And my girlfriend isn’t keen – I think she might not stand for it forever.’ ‘Can I recap then? You’re telling me that it relaxes you, that you do it with your mates and that you prefer it to alcohol. On the other hand, it can cost a lot, you sometimes miss half a day and your girlfriend doesn’t like it?’ ‘That’s about right, yeah.’ ‘Where does that leave you today?’ This can really help in our efficient use of interview time. The client response usually tells us if they are ready to go further and get involved in change talk – or alternatively it may be clear that it isn’t profitable to take things any further today.

At any point in the discussion, resistance may emerge. It is tempting to meet resistance with reasoned argument – pointing out all the scientific reasons on the side of a behaviour change. Unfortunately, this usually has the effect of stiffening resistance. For example, ‘You really need to lose weight you know.’ ‘I guess so.’ ‘I think you should go on a diet.’ ‘I can’t because…’ This is known as negative self-talk. It has been shown that an increase in the amount of negative self-talk in an interview is associated with a lower chance of behaviour change occurring. It seems prudent to avoid provoking such statements. For example, ‘I get the impression I may be pushing you a bit too far here. Shall we stop talking about this today?’ ‘No… It’s ok, go on. It’s just that this is difficult for me to get my head around.’ This is known as ‘rolling with resistance’. It can be a very effective tactic to
prevent the emergence of negative self-talk. It demands that professionals should be on the lookout for signs of resistance at pretty much any stage in a behaviour change discussion.

Most of us who work with clients develop a well-polished series of mini-lectures by way of explaining all the regular things that come up and need explaining. Unfortunately, these mini-lectures may not really be wanted. Or else, we may fail to address important questions on the mind of the client. A mini-seminar might be better. A useful way of looking at this is ‘elicit – provide – elicit’. Elicit any questions or information needs and provide answers or information in response. When it comes to action talk, it is better to provide a range of options to be chosen from. Finally, elicit a response – find out how your information has been received. An example: ‘Can I explain anything to you, answer any questions?’ ‘Well, have you got any information about how many units are in my various drinks. And what do you think I should do to cut down?’ ‘Ok. Let’s see. This leaflet is good for information about units. How does this look?’ ‘Very clear, actually. Can I have that?’ ‘Definitely – it’s for you to take away. Anything catch your eye?’ ‘Yes. Look at this about glasses of wine. I had no idea there were so many units.’ This approach can lead to more effective use of professional time, while again minimising the risk of negative self-talk developing. Motivational interviewing gives better results than ‘business as usual’ and many of the individual skills and techniques are easy enough to learn and can be used in routine conversations with patients or clients. I’ve outlined and demonstrated a range of the most useful
micro-skills, with examples of how they might fit into your conversations but a very readable and immensely practical textbook I’d recommend to any DDN reader is Health Behavior Change – a guide for practitioners by Stephen Rollnick, Chris Butler
and Pip Mason (Churchill Livingstone) – despite the spelling, it’s a British book.

Dr Malcolm Thomas is director of national training provider Effective Professional
Interactions Ltd. www.effectivepi.co.uk

Source: drinkanddrugsnews Jan 2010

Filed under: Treatment :

Legally High – Internet Drugs


The last few months have seen a dramatic increase in use of –
and media interest in – ‘legal highs’, especially mephedrone or ‘miaow/meow’.
David Gilliver takes a look at a legislative minefield

When the government announced its intention last year to ban a range
of ‘legal highs’ and make them class C drugs, Release accused it of
‘chasing its tail’ in an attempt to ‘stay ahead of the demand for drugs
and those who supply them’ (DDN, 7 September 2009, page 4).
The chemicals were BZP and related piperazines, GBL and a related chemical
and the synthetic cannabinoids used to make smoking products like Spice.
Release’s accusation seemed to be vindicated very quickly, however. Anecdotal
evidence soon started to filter through about a sharp increase in use of the
stimulant mephedrone (4-methylmethcathinone), known as ‘miaow’. After the drug was implicated in the death of a young woman in Brighton late last year, there was a rash of mephedrone stories in the press, followed – a couple of weeks later – by stories about how that coverage had led to a huge boost in sales, with many online suppliers selling out altogether. Luci Hammond is a young person’s alcohol worker at Brighton-based service ruok? She started to notice a very sharp increase in miaow use in the second half of last year. ‘It just hit very quickly,’ she says. ‘We started getting reports of it being used by young people and we had parents and professionals asking questions about it, but since then we’ve had a lot of young people coming to us themselves.’

There has been much talk about the drug’s growing use in clubs, with people
turning to it because of the poor quality of available ecstasy and cocaine – as little as 2 per cent purity in the latter case (DDN, 21 September 2009, page 5).
However, what Hammond has found – and what the press has been quick to pick
up on – is the worrying popularity of the drug among children. So far, her youngest client to have used miaow is 12. The majority are 14 and up, but ‘14 is common’ she says. Where are they taking it – presumably they can’t get into nightclubs? ‘The majority of them can’t, but there are under-18 nights where they use it, as well as at parties and out on the streets. They’ll sit in parks and cemeteries, so they’re putting themselves at risk just through the location.’
And what about other legal highs? ‘This is the big one. We’re hearing bits about
BZP and Spice but nothing compared to this.’ John Ramsey runs the TICTAC drug-testing database at St. George’s, University of London, and has seen a dramatic increase in the use of legal highs. ‘We analyse the contents of club amnesty bins and we test purchase stuff from websites – that’s how we come to be pretty up-to-date on new and emerging compounds,’ he says. ‘We’ve been doing this for ten or 15 years and at one time it was really unusual to find anything new. Now we find something new virtually weekly. We go to Glastonbury each year and there were huge amounts of mephedrone there last
time – there was one seizure of 120g. Two or three years ago there wasn’t any.’
Legal highs are available in ‘head’ shops but anecdotal evidence – and the
scale of use being reported – would suggest that most people are buying them
quickly and easily online. Indeed, many of the press mephedrone stories have
practically been guides to getting hold of the drug, couched in obligatory
disapproving language. ‘If you go online and put in ‘legal highs’ you get hundreds of results,’ says Renato Masetti, training coordinator at Suffolk DAAT, who puts on conference workshops to essentially it’s an online phenomenon – you’ve got comments, forums, you can write in and say which one was good and which wasn’t, just like on Amazon. There’s a whole community out there – the online forums have gone mad.’

But presumably most 13 and 14-year-olds aren’t buying the drugs online,
unless they’re using their parents’ credit cards? ‘A lot of our young people are
getting it from friends, but we’re hearing of dealers specialising in miaow and
selling it to school-age children,’ says Hammond. ‘They’re buying it in bulk online,
possibly cutting it, and selling it on. We’ve also heard reports of young people
dealing because they think it’s risk-free, a legal substance. At the start the reports were “you get no comedown, it’s all legal”. It was seen as pure – everything sounded lovely. Now it’s being used more frequently we’ve discovered it’s not so lovely.’ She’s started to see behaviour change in her clients, like paranoia, aggression and anxiety, and even signs of dependency. ‘We’ve heard about shakes and poor co-ordination with withdrawal,’ she says. How widespread is the problem in Brighton? ‘I would say in terms of speaking to young people, it’s probably about five a day,’ she says. ‘One young person will tell us that their friends are doing it, or a teacher will ring up and say that the whole class is talking about it. I’m a young person’s alcohol worker but almost all my clients have tried miaow, even the ones who’ve always said “I’d never do drugs”,
because it isn’t considered a dangerous drug. This is the message we’re trying to
get across – that it does seem to be a dangerous drug.’ How are they taking it? ‘Most are snorting, which is what we’re trying to advise against – if you are going to use it we’d rather it was bombed [swallowed]. We’ve had people smoking it as well, in a bong or cone. But it’s really painful to snort, and we’re hearing of nosebleeds that recur for days afterwards, as well as spinal and joint ache. And miaow isn’t enough now – they want to do it with ketamine or acid or nitrous oxide. There seems to be a cocktail culture out there.’

Clubbers of the ’80s and ’90s were sometimes described as the ‘guinea pig
generation’, as no one really knew what effects long-term ecstasy use might have. But with mephedrone and other legal highs – anecdotal chat room accounts aside – there really is no information, because there’s been no research. ‘How can there be – who’s going to pay for it?’ says John Ramsey. ‘For example the cannabinoids in things like Spice are completely untested and yet they clearly work – the legislation has got to control about 240 of the things. Who can research 240 new chemical compounds?’ Indeed even the names seem something of a moveable feast, with a variety of drugs passed off as miaow depending on who’s selling it and in what part of the country. ‘There are fewer dealers in the chain and there does seem to be some evidence of people selling allegedly illegal drugs which when they’re tested are found to be legal, so you have this fascinating phenomenon of the illegal market pinching from the legal market and pretending it’s illegal – because people think illegal stuff is better,’ says Masetti. ‘We’ve been told that miaow can be made up of different compounds, and it’s also being mixed with stuff now,’ says Hammond. ‘It started off a few months ago at £15 per gram and now it’s £3.50. You can get pure mephedrone but you don’t really know from mix to mix what you’re getting.’ However the miaow John Ramsey has tested has been consistent. ‘Every time we’ve analysed it it’s been 4-methylmethcathinone, and there appear to be vast amounts of it about. I get a lot of calls from police officers who are being asked what they’re going to do about it. Of course the answer is “nothing”, because it’s not illegal.’

The legal status does really appear to mean that many people think the drugs
are safe and harmless. ‘We’ve had parents saying “we’re telling our kids not to do
illegal things” and they’re saying “but it’s not illegal” says Hammond. ‘I don’t think many teenagers would think that they could buy something from a high street head shop that’s going to cause them to end up in an A&E department,’ says Ramsey. ‘They wouldn’t think people would be allowed to sell things that would do that.’ And A&E, it seems, is not an exaggeration. Luci Hammond visits regularly and whereas before her clients were there through drink or illegal drugs, now it’s often miaow. ‘We’re starting to see people coming in with miaow overdoses – anxiety, excessive aggression, disturbed sleep, being sick. One parent brought her child in because he was screaming and shaking in his sleep and they put that down to a miaow overdose. One client did it at a party and kept collapsing – his knees would just buckle underneath him.’ ‘I’ve seen a couple of forums where there was talk about it causing blue knees and blue elbows,’ adds John Ramsey. ‘That means it could be an inhibitor of muscle metabolism – that’s not beyond the realms of possibility.’ Does he think the government is really chasing its tail when it comes to legislating on legal highs? Won’t the chemists just come up with a slightly different compound? ‘To some extent, but the new legislation includes piperazines – BZP and that whole family – and it is proper generic classification, not a list of compounds, so it should cut off the piperazines as a family. While there’s always scope for somebody to innovate something that hasn’t been foreseen, it makes it much more difficult to do that. But obviously the legislation completely ignores the cathinones, like mephedrone, which haven’t even been risk-assessed yet. The alternative is to do nothing, but you’ve got teenagers buying chemicals which are completely untested for safety and using them as drugs – you’ve got to try and prevent that.’ ‘It’s an interesting challenge,’ says Renato Masetti. ‘I think we need to be creative about other responses, rather than just straight legislation. You’ve got the example of GHB and GBL – GHB was made class C a while back and yet you found the same amount of seizures of GHB as GBL. The fact that you’ve classified doesn’t seem to have made much difference. Legislation is a very heavy hammer, and it’s too clumsy with chemicals that can be altered quickly. Legislation becomes really difficult because if it’s too broad it captures useful products in industry.’ He’s also unconvinced that people are switching to these drugs on a large scale because of the declining quality of cocaine and ecstasy. ‘That upshares/downshares has been going on for ages – purity rates go up and down. I think to some extent this
is probably a separate thing – experimental people who don’t wish to break the law and are looking for legal alternatives. This happened years ago when there was a big ‘herbal highs’ thing, but they were awful, caffeine-based things. I think people have been quite surprised this time – they’ve found that actually they’re effective.’

In the myriad of online forums, the effects of mephedrone are often described
as a kind of mix of amphetamine and MDMA, but with a shorter-lasting effect than the latter. ‘The chemical structures are based on the khat plant, but the
compounds have nothing to do with the plant – they’re modifications of a molecule derived from the plant – so from a chemical point of view you’d predict that it’s going to be a stimulant,’ says Ramsey. ‘I can’t see how it’s likely to be
empathogenic like MDMA, it’s more likely to be like amphetamine or even
methylamphetamine. But it’s never been used as a drug before so there’s no data
on its half-life, its potency or anything.’ The similarity with methylamphetamine/ methamphetamine is borne out by the behaviour of Hammond’s clients. ‘We’re hearing of people aged 14 or 15 who are doing three-day binges, seven-day binges. They’re not able to go to school and we’ve had people saying “I feel like I’m dying, I can’t stop.” We’ve had people who’ve used illegal drugs saying this is the most addictive thing they’ve ever had.’

So what’s the answer – is it better education? ‘Absolutely, but it’s a fine line
between educating and promoting,’ says Ramsey. ‘We’re used to that in the drug
field, but we do need some sort of generic education.’ What about the FRANK ‘crazy chemist’ campaign launched last year? (DDN, 5 October 2009, page 4). ‘That’s not based on any sound knowledge,’ he says. ‘Just anecdotal observations.’ ‘I’m a trainer so I’m biased but I think training is really important,’ says Masetti. ‘It’s important for drug teams to know the specifics about these drugs, but not because treatment is going to be any different from what they’re doing already – it’s more around confidence-building. I’d like to see awareness-raising in services so they can engage with these clients who don’t see themselves as traditional illegal drug users. We know very little about these drugs but because they’re synthetic mimickers that work similarly to the illegal drugs they’re mimicking, the treatments will be very similar – you don’t need to learn any special techniques. But we do need to get some research going on these drugs asap, along with general harm reduction advice.’ Late last year two members of the Advisory Council on the Misuse of Drugs (ACMD) told The Times that the council had serious concerns about drugs like mephedrone and was proposing a more rapid system of appraisal, and the ACMD had in fact constituted a working group on cathinone compounds of which John Ramsey was a member. ‘But all of that’s collapsed now because everybody’s resigned,’ he says. Sacked ACMD chair Prof David Nutt has said his new organisation, the Independent Council on Drug Harms, plans to produce guidance on legal highs, but they will be operating outside of government (see page 4). ‘It’s definitely getting to the “something must be done” stage,’ says Ramsey. ‘It’s not going to go away, and it’s not likely to be controlled by the Misuse of Drugs Act in the foreseeable future as they can’t legislate under that without ACMD.

ACMD would normally conduct a risk assessment and then recommend control or
non-control but, given the disarray ACMD seems to be in, the alternative is the
same process through the EMCDDA in Lisbon. They’ve collected information about
these compounds, and it may well be that they’ll do a risk assessment and
recommend control throughout Europe, with all member states expected to follow.’ In fact the EMCDDA has called Britain the online capital of Europe for legal highs, with 37 per cent of all retailers operating from the UK compared to just 14 per cent in the Netherlands. ‘True, but we bought some from a website that had a UK address – the credit card was debited in France and the material was shipped from New Zealand,’ says Ramsey. ‘But one thing is certain – there’s very big money in it.
Source: drinkanddrugsnews 18 January 2010

What is miaow drug?

What is miaow drug?

A 14 year old girl, Gabi Price, has died after apparently taking a new drug, known as miaow.

Gabi Price died after apparently taking a new drug, known as miaow “Miaow” is sold as plant food on the internet where it is described as being not for human consumption.

It was made illegal in Sweden, Norway, Denmark, Finland and Israel due to growing evidence of harm, including a reported possible cause of death.

Apart from the euphoria and alertness it is said to induce anxiety, paranoia and a risk of fits. It is known as a “legal high” and its popularity is increasing sharply because it is legal to buy.

Police forces are aware of its existence, but because of its recent emergence onto the market are unsure of how widespread its use is.
Some internet forum users have described it as “the saviour of clubland” should it not be outlawed soon.

Source:http://www.telegraph.co.uk/news/uknews/6645673/14-year-old-girl-dies-after-taking-legal-drug-at-party.html

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Taxing Marijuana


California is capturing national media coverage as the state debates the issue of legalizing and taxing marijuana. A legislative bill (AB 390) and three potential ballot initiatives propose different strategies to allegedly profit financially from marijuana. Promotion of those measures rely on a biased study. The study suggesting potential revenue gains is not only questionable, but also neglects to identify societal costs associated with marijuana.

In a written response to an article published by the Sacramento Bee, Police Chief Scott C. Kirkland addresses what the pro-drug lobby and the study they promote have neglected. His response may have been written to specifically address issues in California, but his points are relevant to other states considering similar measures.

Can your state afford to gamble on legalizing marijuana? After reading what Chief Kirkland has to say, I think you will agree the answer is NO; our nation cannot afford the damaging cost such efforts would have on society.

On August 6, 2009, the Sacramento Bee published an editorial by F. Aaron Smith entitled, “Legalized pot is more than a tax bonanza.” I would like the opportunity to present the other side.

My name is Scott C. Kirkland and I am currently the Police Chief in El Cerrito. I am on the Board of Directors for the California Police Chiefs Association as well as the California Peace Officers’ Association. Moreover, I am currently the Chair Person of the California Police Chiefs Medical Marijuana Task Force. The task force is comprised of representatives from the California Peace Officers’ Association, California Police Chiefs Association, California State Sheriff Association, California District Attorneys’ Association, California Narcotics Association, and other interested parties.

The purpose of this article is to write specifically about the financial aspect of the issue. I would be more than happy to contribute other articles that discuss the Assembly Bill specifically, the substance itself, or any other aspect of this issue should you so desire.

The advocates on this issue have once again selected a very well crafted message to the public. In essence, they are saying that the State of California should legalize and tax marijuana and that this action would allow the State to remain solvent. The argument would then be that with a solvent State, police officers, firefighters, and teachers will not be laid off. Mr. Smith states that there would be $1.4 billion in new tax revenue available to solve the state budget crises. But, let us examine those numbers and see if the State of California could afford such a gamble.

Yes, the Board of Equalization did identify a potential revenue stream from the sale of marijuana but are those numbers accurate? In their bill analysis, the sole report that is cited as the basis of their revenue projections is entitled, Marijuana Production in the United States (2006). The report was written by Jon Gettman, who served as President for the National Organization for the Reform of Marijuana Laws. He writes the “Cannabis Column” for the HighTimes.com. Mr. Gettman owns DrugScience.com which he cites six times in his report. Upon reading the report and comparing the report to various law enforcement data that is published, his estimates of marijuana crops are more than twice as high.

I believe it is and was irresponsible for the individuals that wrote the bill analysis not to have known who the author of the report was and to have questioned his credibility. In this day of Internet usage I have become in the habit of doing a “Google” search on authors upon reading their work. It is important to me to know where the author is coming from and it should be important for those who complete a bill analysis. It took me ten minutes to glean information about Mr. Gettman. I believe it is important for all who delve into this emotional issue to fully research it and failure to do so results in a slanted and inaccurate analysis.

Since the Bill Analysis is utilizing a study that shows double the estimates of any other law enforcement data, the Board of Equalization’s initial projections are simply wrong. I believe it is this type of financial forecasting that has caused the State of California so much trouble today.

In May of 2009, the National Center on Addiction and Substance Abuse (CASA) at Columbia University released a report entitled, “Shoveling Up II: The Impact of Substance Abuse on Federal, State and Local Budgets.” This one hundred and seventy-six (176) page report documents for the first time the costs of the two legal substances that are abused today (Alcohol and Tobacco). The costs are substantial!

In 2005, the State of California spent $19.9 billion dollars on substance abuse and addiction or $545.09 per capita (population of 36.5 million). Once again I am talking specifically about Alcohol and Tobacco. But, the State of California collected $1.4 billion dollars of tax revenue or $38.69 per capita on the sale of Alcohol and Tobacco products. Yes, the costs far exceeded the revenue!

I believe it is also worth mentioning that as of June 19, 2009, California’s Carcinogen Identification Committee of the Office of Environmental Health and Assessment Science Advisory Board issued a ruling that listed marijuana smoke as causing cancer. This is just another reason why the financial analysis of the bill does not make economic sense. From a public health stand point, why would we, residents of California, want to legalize a crude substance that is known to cause cancer when the costs of substance abuse of the psychoactive drug will far outweigh the amount of monies the state receives? Are we that short sighted? How is the State of California going to find the monies to pay for the costs of abuse, treatment, and damage to youth? These are all unanswered questions that must be addressed in order for there to be a fair and impartial analysis that voters rely on when they go to the polls.

Source: Source: Save Our Society From Drugs Oct 2009

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Alcohol death toll to reach 9,080 a year, study predicts


Experts call for urgent action to reduce ‘unacceptably high’ death toll from diseases directly linked to drinking
Alcohol will claim more than 90,000 lives over the next decade without urgent action to tackle the country’s increasingly ruinous relationship with drinking, experts warn today.
They predict that 90,800 people will be killed by diseases directly linked to drinking, such as alcoholic liver disease and chronic hepatitis, and alcohol poisoning.
Deaths due to drinking have trebled over the last 25 years as per capita consumption has risen to become one of the highest in Europe, according to research by Prof Martin Plant, of the University of the West of England, one of the UK’s leading authorities on alcohol-related harm.
If recent trends continue, the number of people each year who die because their body can no longer cope with alcohol will reach 9,080, a study by Plant and colleagues shows. That is more than one fatality per hour every day of the year. The figure does not include people who die as a result of alcohol-related accidents, such as drink-driving, or those in whom alcohol has exacerbated their ill-health, such as various forms of cancer.
“This is an unacceptably high death toll and the worst part is that all of these deaths are avoidable,” said Don Shenker, of Alcohol Concern, which commissioned the research. Currently 8,724 deaths a year are directly attributable to alcohol, according to the Office of National Statistics.
Alcohol-related deaths have risen in every age group since 1990, with 55- to 74-year-olds seeing the highest mortality rates and steepest increase, Plant’s research reveals. He and his team analysed alcohol consumption per head and drink deaths over the last 25 years. They say their findings prove definitively that the more people drink, the more deaths will follow.
Plant said the government needed to make reducing drink-related deaths the top priority of its alcohol strategy. The report prompted fresh calls from medical leaders for ministers to implement tough measures to curb consumption, such as introducing a minimum price per unit of alcohol, as recommended by the National Institute for Health and Clinical Excellence (Nice) last week. Gordon Brown has ruled out such a move, but the minority SNP government at Holyrood is exploring its introduction in Scotland.
“Over the next decade alcohol misuse is set to kill more people than the population of a city the size of Bath,” said Prof Ian Gilmore, president of the Royal College of Physicians. “Much of this tragic loss of life, often in young and otherwise productive people, could be prevented if our policymakers followed the evidence for what works. Confronting the culture of low prices and saturation advertising, along with investments in accessible, effective treatments for harmful and dependent drinkers could make a big impact on what is becoming a public health emergency.”
Dr Peter Carter, head of the Royal College of Nursing, said: “For 90,000 lives to be thrown away as a result of excessive drinking would be an absolute tragedy. All political parties … must think carefully about the steps needed to … prevent the predicted devastation from becoming a reality.”
The public health minister, Gillian Merron, said: “Any death from alcohol is a death too many. Although the majority of people who drink alcohol drink responsibly, we must take action to reduce the health and social harm caused by those who don’t.
“That’s why the government is working harder than ever to reduce alcohol-related hospital admissions and to help those who regularly drink too much or are dependent on alcohol.”
Source: www.guardianco.uk 19th Oct 2009

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The genetics of addiction

One of the challenges about addiction is the difficulty we have in putting it into a particular “box”. Is it a learned behaviour? is it down to environmental and social influences? Is it a disease?
I am most comfortable with calling addiction a bio-psycho-social condition and taking the complexities on the chin.
The genetics of addiction are beginning to unravel, though it is a not an easy area. Twin studies point towards a genetic component. Adoption studies show that if you are born to an alcoholic parent your personal risk of developing alcoholism is increased.
If both your parents are alcoholics, the risk goes up again. That risk stays with you, even if you are adopted at birth into a non-alcoholic family, suggesting that there is more than learned behaviour and social influence at play.
It appears that some of us are more vulnerable to addiction because of our genetic makeup with around ten genes being strongly implicated and dozens more being associated.
Believe it or not, we have genes for risk taking too, meaning some of us are more willing to try ‘dangerous’ drugs or drink in a riskier way than others.
We also know that there is an overlap across substances. If your twin is addicted to one drug, the chances are you will be vulnerable to that too, but you will also be more vulnerable to other substances. It’s often unhelpful to think in terms of the drug being the problem, it’s more accurate to think that ADDICTION is the problem.
In an abstinence service like ours we can’t quantify that risk, but experience suggests it is significant and we suggest abstinence to all our clients for illicit drugs and alcohol.
But, as I say, it is not simple, it’s a complex interaction between genes and environment with trauma in earlier life being a powerful predictor of later addiction.
Newspapers and some individuals tend to subscribe to the moral model of addiction which goes ‘addicts are bad people with no will power who do bad things’. This model has the advantage of being really simple and easy to understand, but it has a flaw. It is wrong.
The days of that model are numbered as we discover more and more about the complex interactions which generate addiction and open pathways to help those who suffer from addiction (and isn’t addiction true suffering?) find recovery.

Source: WiredIn Community Blog 21sxt Oct.2009

A clear danger from cannabis

By Robin Murray
Classification isn’t all-important. What’s crucial is that we recognise cannabis does increase the risk of schizophrenia.
The Advisory Council on the Misuse of Drugs (ACMD), on which Professor David Nutt sits, has an unfortunate history in relation to cannabis. In 2002, it boobed by advising David Blunkett, then home secretary, that there were no serious mental health consequences of cannabis use; the council had done a sloppy job of reviewing the evidence. Since that time, they have been trying to regain credibility, and now accept that heavy use of cannabis is a risk factor for psychotic illnesses including schizophrenia. However, Professor Nutt’s comments demonstrate how difficult it has been for some members of the committee to accept their error.
Professor Nutt states that, in 2007, the ACMD were asked to review the situation again because “supposedly, skunk use had been increasing and it was getting stronger”. In fact, the ACMD itself concluded that street cannabis was getting more potent and a Department of Health survey has shown that skunk has been taking an ever-larger share of the market.
Professor Nutt states that “there has been a lot of commentary and some research as to whether cannabis is associated with schizophrenia.” It is crystal clear that people with schizophrenia use more cannabis than the general population; there is no dispute about this. The question is whether the use of cannabis contributes to the onset of psychosis including schizophrenia in a causal manner. Here the evidence, although not yet conclusive, has been mounting steadily over the past six years.
Professor Nutt contrasts a 2.6 fold increase in risk of psychosis carried by using cannabis with a twentyfold increase in risk of lung cancer if one smokes cigarettes. Unfortunately, he is not comparing like with like. The twentyfold increased risk is not carried by just being a cigarette smoker but rather by being a long-term heavy smoker. For cannabis, the risk of psychosis goes up to about six times if one is a long-term heavy cannabis smoker.
Next Professor Nutt claims that the incidence of schizophrenia is falling while consumption of skunk has been rising. Sadly, the paper he points to is a study of diagnosis in general practice and we know that GP records on psychosis are far from accurate. The only good longitudinal data on the incidence of schizophrenia in the UK comes from south London, where the incidence doubled between 1964 and 1999. There are probably several factors contributing to this but abuse of drugs is likely to be one.
Personally, I care little whether cannabis is classified as a class B or class C drug. Fourteen year olds starting daily cannabis use do not agonise over its exact classification; many do not even think it is a drug and few have any knowledge of its hazards. By comparison, most adults in the UK drink alcohol in moderation, but do so in the knowledge that drinking a bottle of vodka a day is likely to be injurious to health, and few are in favour of daily drinking from age 14 years.
Both Professor Nutt and I agree that what we need is a major educational campaign to inform the public about the risks associated with heavy use of cannabis particularly in early adolescence. Fortunately, there has been some progress in public understanding and, as a consequence, use of cannabis has been falling for the past five years.
Source: guardian.co.uk, Thursday 29 October 2009

Radical scheme using ex-offenders to help prisoners is huge success

A radical pilot scheme that uses ex-offenders to rehabilitate prisoners has almost trebled the rate of those going into work or training on release.
The first evaluation of the Scottish Government-supported scheme revealed that more than 2000 prisoners signed up to the pilot project, which uses reformed inmates to provide advice and support and ensure prisoners are put in touch with health and education services on release.
The scheme was open to those serving sentences of four years or less and managed to get almost one in five into training or employment – a significant figure, considering that most of those involved had committed violent offences and that traditionally fewer than 7% of those leaving prison go into work or education.
Of the 2861 who signed up to the project in prison, almost half continued meeting their life coach in the community. Only 25 of them had been in work before they were locked up, and more than half had 10 or more previous convictions.
The Routes Out Of Prison project, run by the Wise Group, uses reformed ex-offenders to meet people at the prison gates on release and to act as a bridge between them and housing, health and drugs rehabilitation services.
The life coaches meet the prisoner at the gates and offer them support and advice
Lawrie Russell, chief executive of the Wise Group Early results with just a small number of the prisoners involved indicated that they were not offending six months after release.
The results are expected to come under close scrutiny by ministers who are desperate to cut Scotland’s re-offending rates. Cara Jardine, one of the authors of the report, done by Edinburgh University, said: “Overall we felt that the evaluation was encouraging and that the model is an effective way of reaching a client group that is often difficult to engage with due to their often chaotic lifestyles and previous experiences of the criminal justice system.
“Re-offending rates are something we will try to get some measure of in this next phase of the evaluation.”The pilot began in 2006 in four prisons in the west of Scotland, including HMP Barlinnie. The prison service said it has had positive results and is now being rolled out across seven jails.
The report states: “Only 21% of clients stated that their offending was their only ‘barrier’ to desistance from crime, while the remaining 79% had at least one other issue in their lives. For 38%, their secondary barrier was drug misuse; for 34% it was alcohol misuse; in 31% of cases it was a health issue; and for 27% it was homelessness.
“Two-thirds of clients had been in prison at least once before, while around a fifth had been imprisoned on 10 or more occasions. The vast majority also had numerous convictions with 59% having 10 or more previous convictions.” Official figures show that Scotland locks up more people per capita than almost any other European country, and almost two-thirds of them reoffend within two years. Research has shown that the two biggest factors in reducing re-offending are having a job and being in a stable relationship.
In the first two years, the pilot received £1 million from the Scottish Government, £200,000 from the European Structural Fund, and £60,000 from Glasgow City Council. It is currently funded through the Big Lottery Fund and local authorities.
Lawrie Russell, chief executive of the Wise Group, said: “The project provides a bridging service to link people to the services they need on release. The life coaches offer to meet the prisoner at the gates and then offer them support and advice in the community whilst making sure they have access to the services they need. We hope to roll it out across Scotland.”
Jamie carries the scars of his past on his face. They’re as indelible as his prison record, but he is hoping to make a different mark with the remainder of his life. He is 37 and cannot remember how many times he has been to prison. In the past few weeks, he has stabilised his drug use and next week plans to begin an intensive detox. He would like to try to help others who have come through a similar situation.
Jamie, one of more than 2000 Scottish prisoners who have been through Routes Out Of Prison, was in his final weeks at Barlinnie when he heard about the project and met Jason Meechan, the life coach who now sits next to him.
“I’d heard that they could help with housing and thought why not? A lot of people knock it back – even the chance of an interview – but I thought I’d try it. I’m getting old and I want to see my family. A lot of people don’t want help. Without the support I’ve had though, I don’t know what I would have done.” Jamie says one of his greatest regrets lies in not attending secondary school. He started taking cannabis when he was 13 and slipped too easily into a cycle of gangs, residential schools, and secure units.
He spent his 16th birthday in Polmont Young Offenders’ Institute. He cannot remember receiving the scar that still splits his cheek in two.“I needed Jason to motivate me,” he says. “I really clicked with him and I listen to all his advice. It helped that he knows where I’m coming from.”
Mr Meechan, like most of the life coaches, is an ex-prisoner. He was in and out of jail for almost 10 years before he realised he needed to change. Most of the charges related to assault and robbery. He was addicted to alcohol and drugs.“They say you become your own best customer,” he says. “When my son was born, I was shocked into changing. I got help with my addiction and started up a construction business but realised I had a real passion for helping people. Now I’m paid to do something I love.
“It is about empowering the client to take decisions and getting them the help they need by putting them in touch with the right agencies. Going back into the prisons felt strange at first but it’s not an issue anymore. It helps that I can say to clients I have been there too.”
Source: Herald Scotland 9th Nov.2009

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Legal Stimulant Mephedrone Gains Popularity as Club Drug in U.K.


Mephedrone — a stimulant that is currently legal in both the U.K. and the U.S. — has gained recent and surprising popularity among club-goers in the U.K., according to Britain’s National Addiction Center.
The BBC reported Jan. 14 that the drug, also known as meph, 4-MMC, MCAT, Drone, Meow or Bubbles, was the fourth-most popular drug cited by readers of Mixmag, a popular British dance magazine.
“It’s come from nowhere to become very popular,” said researcher Adam Winstock. “For a drug that’s been around for a relatively short amount of time, mephedrone has certainly made a big impact on the dance drug scene.”
Users describe the drug’s high as falling somewhere between that of ecstasy and cocaine. The drug is sold legally in the U.K. as a plant food; it is a powder that can be taken in pill form, snorted, mixed with liquid or even injected.
Side effects include headaches, heart palpitations, and nausea.
Source: BBC 14th Jan 2010

Genetic Risk for Cocaine Addiction Identified

People with a certain gene variant appear to be at higher risk of cocaine addiction, according to researchers from the Institute of Psychiatry.
Medical News Today reported March 13 that some people have a gene that stops the production of DAT, which regulates removal of extra dopamine in the brain. Cocaine works by limiting DAT, overloading the brain with dopamine.
People who have the DAT-limiting gene were found to be more likely to become addicted to cocaine; those with two copies of the gene were at even higher risk.
“This study is the first large-scale search for a genetic variant influencing the risk of developing cocaine addiction or dependence,” said lead researcher Gerome Breen. “The target we investigated, DAT, is the single most important in the development of cocaine dependence. It made sense that variation within the gene encoding DAT would influence cocaine dependence.”
Source: Proceedings of the National Academy of Sciences.March 2006

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Study Shows Gene Changes in Brain Caused by Cocaine

Long-term cocaine use can alter the function of genes in the brain, leaving “pleasure circuits” stuck in the open position and increasing craving for the drug, according to a new animal study conducted by researchers at the Mount Sinai School of Medicine.
Reuters reported Jan. 9 that researcher Ian Maze and colleagues found that the gene 9A — which produces an enzyme responsible for switching other genes on and off — was repressed in the brains of mice given repeated doses of cocaine. Researchers also found that restoring the activity of gene 9A reversed cocaine preference and craving in lab mice.
“This finding is opening up our understanding about how repeated drug use modifies in long-lasting ways the function of neurons,” said Nora Volkow, director of the National Institute on Drug Abuse.
Source: Science. Jan. 8, 2010

NIAAA Identifies Five Subtypes of Alcohol Dependence

For the first time, federal researchers have broken down the disease of alcoholism into five distinct subtypes, which experts say should help provide more targeted treatment for problem drinkers.
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) reported June 28 that the five new subtypes include “Young Adult,” “Young Antisocial,” “Functional,” “Intermediate Familial,” and “Chronic Severe.”
“Our findings should help dispel the popular notion of the ‘typical alcoholic,’” said study lead author Howard B. Moss, M.D., associate director of NIAAA’s Clinical and Translational Research division. “We find that young adults comprise the largest group of alcoholics in this country, and nearly 20 percent of alcoholics are highly functional and well-educated with good incomes. More than half of the alcoholics in the United States have no multigenerational family history of the disease, suggesting that their form of alcoholism was unlikely to have genetic causes.”
“Clinicians have long recognized diverse manifestations of alcoholism, and researchers have tried to understand why some alcoholics improve with specific medications and psychotherapies while others do not,” added NIAAA Director Ting-Kai Li, M.D. “The classification system described in this study will have broad application in both clinical and research settings.”
Moss and colleagues developed their subtypes based on survey respondents’ family history of alcoholism, age of onset of regular drinking and alcohol problems, symptom patterns of alcohol dependence and abuse, and the presence of additional addictive and mental disorders.
They found that 31.5 percent of alcoholics in the U.S. fall under the Young Adult subtype, who have relatively low rates of other drug or mental-health problems, low rates of family alcoholism, and rarely seek help for their drinking. The Young Antisocial subtype accounts for 21 percent of alcoholics, the researchers said; this category includes drinkers in their mid-20s who tend to have early onset of drinking, a family history of alcoholism, mental-health problems, and co-occurring tobacco or illicit-drug use. This group was more likely to have sought help for drinking than the Young Adult subtype.
Members of the Functional subtype, accounting for 19.5 percent of alcoholics, are typically middle-aged and well-educated, with stable jobs and families. They are relatively likely to have a family history of alcoholism and a personal history of major depressive illness in their lives, and about half are smokers. A similar percentage (19 percent) of American alcoholics fall into the Intermediate subtype, who are middle-aged and more likely to have a family history of alcoholism and mental illness than the Functional subtype. Most are smokers, problems with other drug use is relatively common, and about a quarter have sought help for their drinking.
The final subtype identified by Moss and colleagues, Chronic Severe, covers 9 percent of alcoholics. Most are middle-aged, with early onset drinking, high rates of antisocial personality disorders and criminality, and a strong family history of alcoholism. This subtype is typified by the highest rates of mental-health problems, smoking, and illicit-drug use, and two-thirds of this group has sought treatment for their drinking problems
Source: Drug and Alcohol Dependence. June 2007

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Second hand Smoke a Killer, Institute of Medicine Report Says

Research Summary
There is compelling evidence that second hand smoke can trigger heart attacks, according to a new report from the Institute of Medicine (IOM), and people with heart conditions are urged to avoid exposure to tobacco smoke, the Associated Press reported Oct. 15.
The report, requested by the U.S. Centers for Disease Control and Prevention (CDC), said there is no safe level of exposure to second hand smoke, and that people with cardiovascular disease could risk heart attack with less than an hour’s exposure to environmental tobacco smoke, which restricts blood vessels and increases clotting.
“If you have heart disease, you really need to stay away from second hand smoke. It’s an immediate threat to your life,” said researcher Neal Benowitz of the University of California at San Francisco.
Benowitz added that everyone, in fact, should avoid second hand smoke, since many people who have heart disease are not aware of the problem if they have never had a heart attack. “Even if you think you’re perfectly healthy, second hand smoke could be a potential threat to you,” he said.
“The evidence is clear,” said CDC head Thomas Frieden. “Smoke-free laws don’t hurt business … but they prevent heart attacks in non-smokers.”
Researchers found “clear and consistent” evidence that smoking bans cut the rate of heart attacks, according to statistician Stephen Feinberg of Carnegie Mellon University, a member of the IOM committee that compiled the report.
Source: Associated Press Oct.15th 2009

Filed under: Health,Nicotine :

Secondhand Smoke May Cause Liver Disease

Research Summary
A recent University of California at Riverside study found that second hand smoke from tobacco can lead to nonalcoholic fatty liver disease (NAFLD), which can cause fat to accumulate in the liver of people even if they drink moderately or don’t drink alcohol at all.
Researchers studied mice exposed to second hand smoke for a year and found that fat accumulated in their liver cells, a sign of NAFLD.
The researchers focused their attention on two main fat metabolism regulators that are also found in human cells: the protein that stimulates synthesis of fatty acids in the liver and AMPK (adenosine monophosphate kinase), which regulates that protein. They found that AMPK activity is inhibited when exposed to second hand smoke, leading the other protein to synthesize more fatty acids. The result is NAFLD, according to the report.
“Our study provides compelling experimental evidence in support of tobacco smoke exposure playing a major role in NAFLD development,” said Manuela Martins-Green, who led the study.
Source: Journal of Hepatology September 2009.

Filed under: Health,Nicotine :

Video Case Studies: Helping Patients Who Drink Too Much

These video case studies are part of a free online course from the National Institute on Alcohol Abuse and Alcoholism (NIAAA) that demonstrates quick and effective strategies for screening patients for heavy drinking and helping them to cut down or quit.
Based on the NIAAA Clinician’s Guide, the course features four 10-minute video case scenarios, each led by an expert clinician who offers insights and engages viewers in considering different strategies for treatment and followup. The course is designated through Medscape® for 1.5 credit hours for physicians, and for nurses, 1.5 nursing contact hours (0.25 hours in pharmacology).
• Free CME/CE credit for physicians or nurses through Medscape®
• Four interactive 10-minute video cases
• Evidence-based clinical strategies
• Patients with different levels of severity and readiness to change
http://www.niaaa.nih.gov/Publications/EducationTrainingMaterials/VideoCases.htm 2008
Source: National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Website: http://www.niaaa.nih.gov/
Email: niaaaweb-r@exchange.nih.gov

Electrical Brain Stimulation Shows Promise for Cocaine Treatment,

Research Summary
Using electrical charges to stimulate the subthalmic nucleus region of the brain may mitigate cocaine addiction without disrupting the dopamine system like current anti-addiction medications, according to French researchers.
The Los Angeles Times reported Dec. 28 that researchers reported that deep brain stimulation performed on cocaine-addicted lab rats resulted in the rats exhibiting less self-administration of the drug than an untreated control group.
Researchers also found that the treated rats seemed to break the association with an area where cocaine had been distributed, preferring to instead linger in an area where food was provided.
Source: Proceedings of the National Academy of Sciences (PDF). Dec.2009

Smoking Ban Credited for Big Percent Drop in U.K. Heart Attacks

The heart attack rate fell 10 percent in England and 14 percent in Scotland after the U.K. countries imposed bans on public smoking, the Similar results are expected from a study in Wales.
“We always knew a public smoking ban would bring rapid health benefits, but we have been amazed by just how big and how rapid they are,” said John Britton, director of the U.K. Center for Tobacco Control Studies at Nottingham University. The research is expected to boost calls for further curbs on secondhand smoke, such as banning smoking in cars with children.
“Exposure to cigarette smoke induces rapid changes in blood chemistry, making it much more prone to clotting,” explained Ellen Mason, a senior cardiac nurse at the British Heart Foundation. “In someone who has narrowed or damaged coronary arteries, smoke exposure can tip the balance and cause a heart attack.”
The findings echo those in other nations where public smoking has been banned, such as France, Ireland and Italy.

Source: Sunday Times reported Sept. 13th.2009

Filed under: Health,Nicotine :

Childhood Exposure to Secondhand Smoke Linked to Lung Cancer

Research Summary
A genetic study has found that children who were exposed to secondhand smoke are more likely to develop lung cancer as adults, according to researchers from the National Cancer Institute and the Mayo Clinic.
Childhood exposure to secondhand smoke raised lung-cancer risk even among study subjects who never smoked themselves. Researchers drew their conclusions in part from analysis of a gene called MBL2, known to increase susceptibility to respiratory diseases.
Source: Cancer Epidemiology, Biomarkers and Prevention. December 2009

Daily Marijuana Use Could Cause Permanent Brain Damage, Researcher Says

Animal studies show that daily marijuana use could permanently alter serotonin and norepinephrine levels in the brain, raising the risk of depression and anxiety, according to researcher Gabriella Gobbi of McGill University.
The Canadian Press reported Dec. 17 that Gobbi studied the brain chemistry of 18 adolescent lab rats exposed daily to marijuana and found that they had decreased levels of mood-controlling serotonin and higher levels of the stress hormone norepinephrine.
Gobbi said that the effects were magnified because the adolescent brain is still developing. “These permanent changes in the brain are also linked to certain mental illnesses, like schizophrenia,” she said. “And we showed that even if we stopped the cannabis use at the end of adolescence, the changes were still detectable in adulthood.”
A future study will concentrate on adolescent marijuana use among humans.
Source: Neurobiology of Disease. 5th Dec.2009

Comments on above article:

Posted by JBrennan on 08 Jan 10 07:25 PM EST
I smoked marijuana daily at 17 years old and have felt different ever since stopping that, I ended up having more difficulty relaxing, sleeping, and finding energy than I did before daily marijuana use. Today I take amino acids that increase the amount of serotonin and norepinephrine, and it makes me feel normal again. It’s true that my one case doesn’t necessarily prove or disprove anything about marijuana, but I find it funny that there are people who immediately dismiss evidence of marijuana’s harmful affects while immediately claiming that marijuana is harmless, as if the brain is so easy to figure out that they already know everything there is to know about marijuana’s affects on the brain.
Posted by Paula D. Gordon on 09 Jan 10 04:30 AM EST
For additional information and perspectives on the harmfulness of marijuana, see http://gordondrugabuseprevention.com and http://spiritualharmofmarijuana.com It is interesting to note that there are references to work on both website that speak about the long term effects of marijuana use.

Posted by jgogek on 08 Jan 10 03:24 PM EST
The conclusions of this research would not surprise me at all. I find it disturbing when I read the comments in JoinTogether from advocates of recreational and medical marijuana immediately trying to denigrate any new finding on neurologic and other impacts of marijuana. Caring people should be concerned about the possible health impacts of commonly used substances — if not for themselves then at least for other people. Personal beliefs about marijuana use should be trumped by public health concerns. The science on marijuana impact continues to unfold and it should guide public policy. Personal wishes about individual marijuana use should not affect public policy.

Technology new gateway into treatment for problem alcohol use

For Immediate Release – January 5, 2010 – (Toronto) – A recent evaluation by the Centre for Addiction and Mental Health (CAMH) shows that online interventions for problem alcohol use can be effective in changing drinking behaviours and offers a significant public health benefit.
In the first evaluation of its kind, the study published in Addiction found that problem drinkers provided access to the online screener www.CheckYourDrinking.net, reduced their alcohol consumption by 30% — or six to seven drinks weekly – rates that are comparable to face-to-face interventions. This result was sustained in both the three and six month follow-up.
Source: www.camh.net 5 Jan.2010

Unemployment ‘drives youngsters to drugs’

A new study suggests that young people without jobs often have the risk of poor health throughout their lives, with one out of ten blaming drug or alcohol addiction on unemployment.
The Prince’s Trust survey of more than 2,000 unemployed people aged between 16 and 25 also found that they could receive “permanent psychological scars” due to constantly feeling ashamed, rejected and unloved.
Nearly one out of four jobless youngsters believed their unemployed statues led to arguments between them and their parents or other family members. Almost the same number of people exercised less and blamed unemployment for an unhealthy lifestyle, while 15percent said their life had no direction. One in three youngsters without a job felt low or depressed and one out of 10 felt almost no one loved them.
“Unemployment has a knock-on effect on a young person’s self-esteem, their emotional stability and overall wellbeing. The longer the period a young person is unemployed for, the more likely they are to experience this psychological scarring,” the Daily Express quoted economist Professor David Blanchflower, as saying in the report. “This means an unhappy and debilitated generation of young people who – as a result – becomes decreasingly likely to find work in the future,” he added. “The implications of youth unemployment stretch beyond the dole queue. The emotional effects on young people are profound, long-term and can become irreversible. We must act now to prevent a lost generation of young people before it is too late,” Martina Milburn, chief executive of the Prince’s Trust, said.
She added: “Young people bore the brunt of the recession last year, with one in five 16-to-24 year olds out of work today. The result is a generation of undiscovered skills and talents. We must invest in these young people, re-building their self-esteem, to ensure that today’s unemployed do not become tomorrow’s unemployable.”
Source: http://blog.taragana.com/health/2010/01/04

British drinking habits too costly, report says

Just as Britons brew black coffee to cope with holiday hangovers, they are also digesting a new report that warns the country’s notorious drinking culture is putting an unacceptable strain on hospitals and medical staff.

The cash-strapped National Health Service — the U.K.’s taxpayer-funded medical system — now spends 2.7 billion pounds ($4.4 billion) a year treating patients for drink-related problems, double the amount five years ago, the report said. Total funding for the health care system is currently around 100 billion pounds a year.

The report — published by the NHS Confederation, a health-care providers organization, and the Royal College of Physicians, which represents doctors — warns that about 10.5 million adults in Britain drink above sensible limits, and 1.1 million people have some form of alcohol addiction. The government currently recommends that men should not drink more than three or four units of alcohol a day, and women should not drink more than two or three. A small glass of wine or beer has just over one unit.

One study at a hospital in Leeds, northeast England, found that one-fifth of all emergency-room admissions over four months were for alcohol-related conditions, the report said.

Professor Ian Gilmore, president of the Royal College of Physicians, said the National Health Service could not afford to continue treating alcohol-related problems at current levels, and that health-care providers must be more proactive in preventing people from drinking too much.
Source:. – Erie Times-News, Erie, Pa. January 03 2010

Marijuana Damages DNA And May Cause Cancer, New Test Reveals

Using a highly sensitive new test, scientists in Europe are reporting “convincing evidence” that marijuana smoke damages the genetic material DNA in ways that could increase the risk of cancer.

Researchers note that toxic substances in tobacco smoke can damage DNA and increase the risk of lung and other cancers. However, there has been uncertainty over whether marijuana smoke has the same effect. Scientists are especially concerned about the toxicity of acetaldehyde, present in both tobacco and marijuana. However, it has been difficult to measure DNA damage from acetaldehyde with conventional tests.
The research was carried out by Rajinder Singh, Jatinderpal Sandhu, Balvinder Kaur, Tina Juren, William P. Steward, Dan Segerback and Peter B. Farmer from the Cancer Biomarkers and Prevention Group, Department of Cancer Studies and Molecular Medicine and Karolinska Institute, Sweden.
Raj Singh said: “Parts of the plant Cannabis sativa, also known as marijuana, ganja, and various street names, are commonly smoked as a recreational drug, although its use for such purposes is illegal in many countries.
The scientists describe development and use of a modified mass spectrometry method that showed clear indications that marijuana smoke damages DNA.
“There have been many studies on the toxicity of tobacco smoke. It is known that tobacco smoke contains 4000 chemicals of which 60 are classed as carcinogens. Cannabis in contrast has not been so well studied. It is less combustible than tobacco and is often mixed with tobacco in use. Cannabis smoke contains 400 compounds including 60 cannabinoids. However, because of its lower combustibility it contains 50% more carcinogenic polycyclic aromatic hydrocarbons including naphthalene, benzanthracene, and benzopyrene, than tobacco smoke.”
The authors added: “It is well known that toxic substances in tobacco smoke can damage DNA and increase the risk of lung and other cancers. Scientists were unsure though whether cannabis smoke would have the same effect. Our research has focused on the toxicity of acetaldehyde, which is present in both tobacco and cannabis.”
The researchers add that the ability of cannabis smoke to damage DNA has significant human health implications especially as users tend to inhale more deeply than cigarette smokers, which increases respiratory burden. “The smoking of 3-4 cannabis cigarettes a day is associated with the same degree of damage to bronchial mucus membranes as 20 or more tobacco cigarettes a day,” the team adds.
“In conclusion, these results provide evidence for the DNA damaging potential of cannabis [marijuana] smoke, implying that the consumption of cannabis cigarettes may be detrimental to human health with the possibility to initiate cancer development,” the article states. “The data obtained from this study suggesting the DNA damaging potential of cannabis smoke highlight the need for stringent regulation of the consumption of cannabis cigarettes, thus limiting the development of adverse health effects such as cancer.”

Source Chemical Research in Toxicology, 2009; 22 (6): 1181 DOI: 10.1021/tx900106y

Marijuana Smoke Contains Higher Levels Of Certain Toxins Than Tobacco Smoke

Here’s another reason to “keep off the grass.” Researchers in Canada report that marijuana smoke contains significantly higher levels of several toxic compounds — including ammonia and hydrogen cyanide — than tobacco smoke and may therefore pose similar health risks.

David Moir and colleagues note that researchers have conducted extensive studies on the chemical composition of tobacco smoke, which contains a host of toxic substances, including about 50 that can cause cancer. However, there has been relatively little research on the chemical composition of marijuana smoke.
In this new study, researchers compared marijuana smoke to tobacco smoke, using smoking machines to simulate the smoking habits of users. The scientists found that ammonia levels were 20 times higher in the marijuana smoke than in the tobacco smoke, while hydrogen cyanide, nitric oxide and certain aromatic amines occurred at levels 3-5 times higher in the marijuana smoke, they say. The finding is “important information for public health and communication of the risk related to exposure to such materials,” say the researchers.
The study, “A Comparison of Mainstream and Sidestream Marijuana and Tobacco Cigarette Smoke Produced under Two Machine Smoking Conditions,” is scheduled for the Dec. 17 issue of ACS’ Chemical Research in Toxicology.

Source: ScienceDaily. Retrieved December 29, 2009, from http://www.sciencedaily.com /releases/2007/12/071217110328.htm

Growing Evidence Of Marijuana Smoke’s Potential Dangers

In a finding that challenges the increasingly popular belief that smoking marijuana is less harmful to health than smoking tobacco, researchers in Canada are reporting that smoking marijuana, like smoking tobacco, has toxic effects on cells.

Rebecca Maertens and colleagues note that people often view marijuana as a “natural” product and less harmful than tobacco. As public attitudes toward marijuana change and legal restrictions ease in some countries, use of marijuana is increasing.
Scientists know that marijuana smoke has adverse effects on the lungs. However, there is little knowledge about marijuana’s potential to cause lung cancer due to the difficulty in identifying and studying people who have smoked only marijuana.
The new study begins to address that question by comparing marijuana smoke vs. tobacco smoke in terms of toxicity to cells and to DNA. Scientists exposed cultured animal cells and bacteria to condensed smoke samples from both marijuana and tobacco. There were distinct differences in the degree and type of toxicity elicited by marijuana and cigarette smoke.
Marijuana smoke caused significantly more damage to cells and DNA than tobacco smoke, the researchers note. However, tobacco smoke caused chromosome damage while marijuana did not.

Source: The Genotoxicity of Mainstream and Sidestream Marijuana and Tobacco Smoke Condensates. Chemical Research in Toxicology, Online July 17, 2009 DOI: 10.1021/tx9000286

Smoking Marijuana Impairs Cognitive Function In MS Patients

People with multiple sclerosis (MS) who smoke marijuana are more likely to have emotional and memory problems, according to new research.

“This is the first study to show that smoking marijuana can have a harmful effect on the cognitive skills of people with MS,” said study author Anthony Feinstein, MPhil, PhD, of the University of Toronto. “This is important information because a significant minority of people with MS smoke marijuana as a treatment for the disease, even though there are no scientific studies demonstrating that it is an effective treatment for emotional difficulties.”
Feinstein noted that MS itself can cause cognitive problems. “In addition, cognitive problems can greatly affect the quality of life for both patients and their caregivers,” he said.
For the study, researchers interviewed 140 Canadian people with MS. Of those, 10 people had smoked marijuana within the last month and were defined as current marijuana users. The marijuana users were then each matched by age, sex, the length of time they had MS, and other factors to four people with MS who did not smoke marijuana.
The researchers then evaluated the participants for emotional problems such as depression, anxiety and other psychiatric disorders. They also tested the participants’ thinking skills, speed at processing information, and memory.
The study found marijuana smokers performed 50 percent slower on tests of information processing speed compared to MS patients who did not smoke marijuana. There was also a significant association between smoking marijuana and emotional problems such as depression and anxiety.
People with MS have higher rates of depression and suicide compared to the general population. “Since marijuana can induce psychosis and anxiety in healthy people, we felt it was especially important to look at its effects on people with MS,” Feinstein said.

Source: the online edition of Neurology, February 13, 2008

Daily Pot Smoking May Hasten Onset of Psychosis

Progression to daily marijuana use in adolescence may hasten the onset of symptoms leading up to psychosis, an Emory University study finds. The study was published in the November issue of the American Journal of Psychiatry.

The researchers analyzed data from 109 hospitalized patients who were experiencing their first psychotic episode. The results showed that patients who had a history of using marijuana, or cannabis, and increased to daily pot smoking experienced both psychotic and pre-psychotic symptoms at earlier ages.
“We were surprised that it wasn’t just whether or not they used cannabis in adolescence that predicted the age of onset, rather it was how quickly they progressed to becoming a daily cannabis user that was the stronger predictor,” said Michael Compton, lead author and assistant professor of psychiatry in the Emory School of Medicine.
The study also found a gender difference: The female subjects who progressed to daily pot smoking had a greater increased risk for the onset of psychosis than the males.
Marijuana is the most abused illicit substance among people with schizophrenia, the most extreme form of psychosis, and previous research has shown that smoking pot is likely a risk factor for the disease.
The Emory study also focused on what is known as the prodromal period, when a person has symptoms such as unusual sensory experiences, which are often precursors to frank hallucinations and delusions. Prodromal symptoms can occur months, or years, before a diagnosis of psychosis. About 30 to 40 percent of prodomal teenagers will eventually develop schizophrenia or another psychotic disorder.
“The prodromal period is especially important because it’s considered to be a critical time for preventive intervention,” says Elaine Walker, a co-investigator of the study and professor of psychology and neuroscience at Emory.
The study also involved researchers from Emory’s Rollins School of Public Health and Georgia State University. It was funded by the National Institute of Mental Health.

Source: American Journal of Psychiatry, 2009; 166 (11): 1251 DOI: 10.1176/appi.ajp.2009.09030311

Marijuana Use Associated with a Subtype of Testicular Cancer

Testicular germ cell tumors (TGCTs) are the most common type of cancer in American men between the ages of 15 and 34. For the last 50 years, the incidence of TGCTs has increased yearly in the United States and many other Western countries. A corresponding increase in marijuana abuse during this time period has been suggested as a potential causative factor. Chronic marijuana use is known to affect the body’s hormone and reproductive systems, disruption of which can potentially lead to cancer development. To test this hypothesis, researchers funded by NIDA interviewed 371 men aged 18 to 44 in Seattle and Puget Sound, Washington who had been treated for an invasive TGCT between 1999 and 2006, and 979 men from the same area who had not had testicular cancer. The researchers asked all participants about their lifetime marijuana and hashish use, as well as cigarette, alcohol, and other recreational drug use. They also collected data on other suspected risk factors for TGCT, including cryptorchidism (an undescended testicle) and a family history of TGCT. The researchers found that current marijuana use was associated with a 70 percent increased risk of nonseminoma TGCTs, but was not associated with risk of seminoma. (Seminoma and nonseminoma are the two subtypes of TGCT.) For nonseminoma tumors, the risk increased more for frequent (at least weekly) marijuana use and for use beginning in adolescence. This increased risk was independent of any other measured risk factor. The authors conclude that additional studies are needed to confirm these results, and to understand the biological processes that may link marijuana use to an increase in risk for nonseminoma TGCTs.

Daling JR, Doody DR, Sun X, Trabert BL, Weiss NS, Chen C, Biggs ML, Starr JR, Dey SK, Schwartz SM. Association of marijuana use and the incidence of testicular germ cell tumors. Cancer. 2009 Mar 15;115(6):1215-23.

Source: NIDA Addiction Research News December 11, 2009

http://www.drugabuse.gov/newsroom/09/NS-12.html

Imaging Study Shows Awareness Deficit in Marijuana Abusers

A new study funded by NIDA has used brain-imaging technology to show that during a decision game, chronic marijuana users show less activity in an error-processing part of their brains than peers who do not use marijuana. These results provide preliminary evidence in the debate on whether substance abusers willfully ignore their problem or whether cognitive deficits prevent them from fully understanding their addiction and its potential consequences. Functional magnetic resonance imaging (fMRI) of 16 heavy marijuana users and 16 non-drug-using peers provided real-time pictures of brain activity during the decision game. The marijuana abusers in the study did not make more mistakes during the game than participants who did not use the drug, but they were significantly less likely to recognize that they had made the mistakes. Non-marijuana-using participants were aware of 91 percent of their mistakes during the game, and marijuana abusers were aware of only 77 percent of their mistakes. fMRI revealed that when they made errors that they did not consciously recognize, the marijuana abusers showed less activity than the other participants in an area of the brain called the anterior cingulate cortex (ACC). The authors caution that marijuana withdrawal may have played some role in the lack of error awareness, as higher scores in several categories on a marijuana craving questionnaire were associated with poorer error awareness. However, if drug abusers cannot monitor their behavior accurately, this deficit in awareness may contribute to their continued use of a drug despite the consequences or to their continued associations with situations that make them liable to relapse.

Hester R, Nestor L, Garavan H. Impaired Error Awareness and Anterior Cingulate Cortex Hypoactivity in Chronic Cannabis Users. Neuropsychopharmacology. 2009 Jun 24. [Epub ahead of print]

Source: NIDA Addiction Research News December 11, 2009

http://www.drugabuse.gov/newsroom/09/NS-12.html

NIDA director, Nora Volkow, discusses cannabis addiction

Clinical studies, like those by Barbara Mason at Scripps Institute, have documented a marijuana withdrawal syndrome among a minority of users. Are we prepared to say that marijuana is addictive? Why didn’t we identify this syndrome years ago?

Nora Volkow: Absolutely, there is no doubt that some users can become addicted to marijuana. In fact, well over half of the close to 7 million Americans classified with dependence or abuse of an illicit drug are dependent on or abuse marijuana. It is important to clarify that while withdrawal is one of the criteria used to diagnose an addiction (which also includes compulsive use in spite of known adverse consequences), it is possible for an individual to suffer withdrawal symptoms without he or she being addicted to an abused substance.

Now, to answer your specific question, the reason for the relatively late realization that people who abuse marijuana can develop a cannabis withdrawal syndrome (CWS) if they try to quit is probably the result of at least two factors. First is the fact (which you hint at already) that a clinically relevant cannabis withdrawal syndrome may only be expected in a subgroup of cannabis-dependent patients. This may be partially explained by marijuana’s uptake into and slow release from fat cells, which can occur over days or weeks after last use. Thus, cessation of marijuana use may not be so abrupt, and could thereby diminish signs of withdrawal. The second factor relates to the small to negligible associations between recalled and prospectively assessed withdrawal symptoms, which may have precluded many previous, recall-based studies from detecting or properly characterizing CWS. It is also worth pointing out that other addictions (e.g., cocaine) were also not initially thought of as capable of triggering withdrawal symptoms.”
Source: http://addiction-dirkh.blogspot.com/2009/12/q-with-nora-volkow.html?

Filed under: Addiction,Cannabis :

Daily Consumption Of Cannabis Predisposes To Appearance Of Psychosis And Schizophrenia, Study Finds

The daily consumption of cannabis predisposes to the appearance of psychosis and schizophrenia, and those episodes of psychosis which are fruit of this substance present certain specific characteristics, both before their appearance and in the clinical presentation of the psychosis.

This is one of the conclusions of the doctoral thesis “Neurodevelopment and environmental stress in initial psychosis: transversal analysis of the ESPIGAS study”, carried out by researcher Miguel Ruiz Veguilla, of the Institute of Neurosciences of the University of Granada (Spain) and supervised by professors Manuel Gurpegui Fernández de Legaria and Jorge Cervilla Ballesteros. Ruiz Veguilla is also the person in charge fo the Unit of Development Neuropsychiatry of Jaén (Spain).
This work has studied the risk factors associated with schizophrenia, identifying and characterizing in depth those psychosis associated with a continual consumption of cannabis. They carried out a study with 92 subjects, 50 of which had developed a psychosis without presenting signs of an “abnormal neurodevelopment”, this is, they had been doing well academically, they had a group of friends (no social isolation) and they presented a good motor coordination. In addition, these subjects did not show a family history of episodes of psychosis in first or second degree.

Identifying a new type of psychosis
The research work carried out by Miguel Ruiz Veguilla has identified a connection between cannabis consumption and psychosis in subjects with a good premorbid performance, and without signs of minor neurological alterations, which in his opinion might point out “a psychopathological way associated with psychosis in subjects with less predisposition”.
Thus, 66% of the patients with psychosis who participated in the study and had a normal neurodevelopment admitted to have consumed cannabis daily or almost every day, whereas 43% of the participants with markers of an abnormal neurodevelopment (those already indicated: bad previous social and academic behaviour, a family history and a “clumsier” attitude when they carry out tasks of motor coordination and complex motor acts) were drug users too.
In the light of the results of his doctoral thesis, the researcher of the University of Granada says that, after having identified a type of psychosis where the environmental factor plays a more relevant role, we should now answer the question of which is the prognosis, in the long term, of those subjects with a good previous behaviour, whose psychosis is associated with a high consumption of cannabis.
The results of this research work have been published in the journals Schizophrenia Research and European Psychiatry.

Source: December 29, 2009, from http://www.sciencedaily.com/releases/2009/03/090325132328.htm

Cannabis Damages Young Brains More Than Originally Thought, Study Finds

Canadian teenagers are among the largest consumers of cannabis worldwide. The damaging effects of this illicit drug on young brains are worse than originally thought, according to new research by Dr. Gabriella Gobbi, a psychiatric researcher from the Research Institute of the McGill University Health Centre. The new study, published in Neurobiology of Disease, suggests that daily consumption of cannabis in teens can cause depression and anxiety, and have an irreversible long-term effect on the brain.

“We wanted to know what happens in the brains of teenagers when they use cannabis and whether they are more susceptible to its neurological effects than adults,” explained Dr. Gobbi, who is also a professor at McGill University. Her study points to an apparent action of cannabis on two important compounds in the brain — serotonin and norepinephrine — which are involved in the regulation of neurological functions such as mood control and anxiety.
“Teenagers who are exposed to cannabis have decreased serotonin transmission, which leads to mood disorders, as well as increased norepinephrine transmission, which leads to greater long-term susceptibility to stress,” Dr. Gobbi stated.
Previous epidemiological studies have shown how cannabis consumption can affect behaviour in some teenagers. “Our study is one of the first to focus on the neurobiological mechanisms at the root of this influence of cannabis on depression and anxiety in adolescents,” confirmed Dr. Gobbi. It is also the first study to demonstrate that cannabis consumption causes more serious damage during adolescence than adulthood.
Dr. Gabriella Gobbi is a researcher at the neuroscience axis of the Research Institute of the McGill University Health Centre and also a psychiatrist and associate professor at the Department of Psychiatry, McGill University.

Source:
McGill University Health Centre (2009, December 20). Cannabis damages young brains more than originally thought, study finds. ScienceDaily. Retrieved December 29, 2009, from http://www.sciencedaily.com¬ /releases/2009/12/091217115834.htm

Alcohol in Pregnancy Linked to Child Behavior Problems

A new study from Perth’s Telethon Institute for Child Health Research has found evidence that the amount and timing of alcohol consumption in pregnancy affects child behaviour in different ways.

The study has just been published online in the international journal Addiction.
Lead author Colleen O’Leary said the analysis was drawn from a random sample of more than 2000 mothers who completed a questionnaire three months after the baby’s delivery, and were then followed up when the child was 2, 5 and 8 years of age.

“Mothers who reported what we would classify as heavy drinking in the first trimester of pregnancy were nearly three times as likely to report that their child suffered with anxiety and/or depression or somatic complaints,” Ms O’Leary said. “Those who drank moderately during that first trimester were twice as likely to report those types of behavioural issues for their child.

“Exposure to moderate or heavy levels of alcohol in late pregnancy increased the risk of aggressive types of behaviours in the child.“This research suggests that both the timing and the intensity of alcohol exposure in the womb affect the type of behaviour problems expressed.”In this study low levels of alcohol did not increase the risk of harm to the baby. However, the evidence clearly shows that the risk to the baby increases with increasing amounts consumed.

“It should also be noted that in this study moderate exposure is classified as drinking 3-4 standard drinks per occasion- that’s about two normal glasses of wine-and no more than a bottle of wine drunk over a week.” Heavy drinking included women who were drinking the equivalent of more than a bottle of wine per week. It is important that women who had consumed alcohol while pregnant are not panicked by the findings.

“Not every smoker gets lung cancer despite them being at higher risk – and in this case, not every child will be affected by prenatal exposure to alcohol. However it is important that women have this information about increased risk so that they can make informed decisions to give their child the best start to life,” Ms O’Leary said.

The National Health and Medical Research Council recommend that the safest choice for women who are pregnant or planning a pregnancy is to abstain from alcohol.
Ms O’Leary said health professionals can assist by talking to women of child bearing age about their alcohol consumption and encouraging pregnant women and women planning a pregnancy to abstain from alcohol.
Source: O’Leary et al. Evidence of a complex association between dose, pattern and timing of prenatal alcohol exposure and child behaviour problems. Addiction, November 2009

1 In 25 Adults Aged 15-64 Years Worldwide Using Cannabis, Despite Adverse Health Effects

In 2006, it was estimated that 166 million adults worldwide aged 15-64 years (1 in 25 people in that age range) had used cannabis, despite the risks of its adverse effects on health. The issues surrounding cannabis use are discussed in a Review in this week’s edition of The Lancet, written by Professor Wayne Hall, School of Population Health, University of Queensland, Brisbane, Australia, and Professor Louisa Degenhardt, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.

The estimates on cannabis use come from the UN Office on Drugs and Crime. Use was highest in the USA, Australia and New Zealand, followed by Europe. Because of their large populations, 31%, 25% and 24% of the world’s cannabis users are estimated to be from Asia, Africa, and the Americas respectively, with Europe next on 18% and Oceania on 2%.

Trends in cannabis use are highly variable within and between regions. Although Australia and New Zealand are in the highest use category (>8% of the population aged 15-64 years are users), in both countries use is declining; similar trends have been reported in Western Europe. In contrast, use may be increasing in some low and middle income countries, a trend that has been reported in Latin America and several countries in Africa.

North American research has shown 10% of ever-users of cannabis become daily users, while 20-30% become weekly users. Use typically begins in teenage years, peaks in early and middle 20s, before declining as young people enter full-time employment, marry, and have children.

The active component of cannabis, tetrahydrocannabinol (THC), leaves users with a mild euphoric high, occurring around 30 minutes after smoking and typically lasting 1-2 hours. Between 5% and 24% of the ‘smoked’ THC reaches the brain. Acute adverse effects include anxiety, panic reactions and psychotic symptoms, most commonly reported by those new to the drug. Concerns exist regarding increasing THC content in cannabis, but evidence on this issue is very limited. Over the past three decades some research has suggested that THC content in seized cannabis products may have risen over that time.

Cannabis use slows reaction time, information processing, and co-ordination-increasing the risk of road accidents for intoxicated users. Cannabis use impairs driving ability more modestly than alcohol use, since cannabis-affected drivers drive more slowly and take fewer risks. But studies suggest cannabis use at least doubles the risk of a road accident, with some suggesting an even steeper increase. A French study estimated that 2.5% of fatal accidents could be attributed to cannabis, compared to 29% to alcohol. Use of cannabis in pregnancy could reduce birthweight, but does not appear to cause birth defects.

Around 9% of people who ever use cannabis will become dependent , with 1-2% of adults affected in any one year. The equivalent lifetime risks are 32% for nicotine, 23% for heroin, 17% for cocaine, 15% for alcohol, and 11% for stimulant users. Some cannabis users seek help to stop report withdrawal symptoms, which include anxiety, insomnia, appetite disturbance, and depression. Cognitive behavioural therapy reduces cannabis use and cannabis-related issues, but only 15% of people remain abstinent 6-12 months after treatment.

Regular cannabis smokers report more symptoms of chronic bronchitis (wheeze, sputum production, and chronic coughs) than do non-smokers. Cannabis smoke contains many of the same carcinogens as does tobacco smoke, with some present in higher concentrations. Case-control studies of lung cancer have found associations with cannabis use but their interpretation is uncertain because of confounding: most frequent and long-term cannabis users also smoke tobacco.

Deficits in verbal learning, memory, and attention are most consistently reported in heavy cannabis users, but these have been variously related to duration and frequency of use, and cumulative dose of THC. More functional brain imaging studies on larger samples of long-term users are needed to see if cognitive impairments in long-term users are correlated with structural changes in brain areas implicated in memory and emotion.

Cannabis use is associated with poor educational attainment, but the cause and effect of this relationship is unclear. The most plausible hypothesis is that impaired educational outcomes are attributable to a combination of higher pre-existing risk, effects of regular cannabis use on cognitive performance, increased affiliation with peers who reject school, and a strong desire to make an early transition into adulthood.

In the USA, Australia, and New Zealand, regular cannabis users are much more likely to use other illicit drugs later on, including heroin and cocaine, and the earlier the age at which a young person uses cannabis, the more likely they are to use heroin and cocaine. This could be for a number of reasons: cannabis users have more opportunities to use other illicit drugs because cannabis is supplied by the same black market; those who are early cannabis users are more likely to use other illicit drugs for reasons that are unrelated to their cannabis use; and pharmacological effects of cannabis increase the propensity to use other illicit drugs. This issue remains the subject of considerable debate.

Cannabis can have an effect on the mental health of users. Studies suggest the risk of schizophrenia more than doubles in those who have tried cannabis by age 18. A meta-analysis reported in The Lancet in 2007 showed a 40% increase in risk of psychotic symptoms or disorders in people who had ever used cannabis, with the highest risk among regular users, and particularly among those with a vulnerability to psychosis. In the case of depressive disorders and suicide, the relationship with cannabis is uncertain.

The authors say that the public health burden of cannabis use is probably modest compared with that of alcohol, tobacco, and other illicit drugs. A recent Australian study estimated that cannabis use caused 0.2% of total disease burden in Australia-a country with one of the highest reported rates of cannabis use. Cannabis accounted for 10% of the burden attributable to all illicit drugs (including heroin, cocaine, and amphetamines). It also accounted for around 10% of the proportion of disease burden attributed to alcohol (2.3%), but only 2.5% of that attributable to tobacco (7.8%).

They conclude: “The most probable adverse effects [of cannabis] include a dependence syndrome, increased risk of motor vehicle crashes, impaired respiratory function, cardiovascular disease, and adverse effects of regular use on adolescent psychosocial development and mental health.”

Source: The Lancet

http://www.medicalnewstoday.com/articles/167873.php Oct.2009

Comments on this article below:
When 96 percent of humanity is doing the right thing, i.e., not using cannabis, it’s time to celebrate civilization but, of course, the Lancet may not see it this way.

Most nations of the world prohibit the production and distribution of cannabis. Few prohibit beverage alcohol and do so mostly, if not exclusively, for religious, not health, reasons. Reportedly, an estimated 2 billion people worldwide use beverage alcohol regularly. This represents approximately 29.9 percent of the estimated 6.7 billion persons on Earth. Using the logic of the Lancet’s analysis, almost eight times as many persons consume beverage alcohol on a regular basis, despite adverse health effects, than consume cannabis on a regular basis, despite adverse health effects. (Note: This metric would be slightly lower if we could remove from the analysis the number of under-15 years of age persons who consume beverage alcohol on a regular basis. We were unable to do this on a global basis.)

Conclusion? Prohibition works!

Thanks, Lancet, for making the case for the Single Convention and domestic cannabis controls.

Source: John Coleman Drugwatch International Nov.2009

Enhancement of cocaine’s abuse liability in methadone maintenance patients

ABSTRACT
The present study was conducted to determine whether methadone maintenance alters the pharmacodynamic effects of single doses of cocaine. Twenty-two current users of IV cocaine who were not seeking treatment for their illicit cocaine use participated while living on a research unit.
Eleven were maintained on methadone 50 mg PO daily as treatment for their opioid abuse; 11 were opioid abusers who were not physically dependent on opioids and who provided opioid-free urines throughout the study. Each subject received acute cocaine challenge doses of 0, 12.5, 25, and 50 mg intravenously in random order under double-blind conditions in separate test sessions.
Physiologic and subject-rated responses were measured before injection and for 2 h after. In the methadone maintenance group, cocaine challenge sessions occurred 15.5 h after the daily methadone dose. There were significant differences between the methadone-dependent and nondependent groups: 1) baseline differences related to chronic methadone administration and not associated with cocaine administration (lower respiration rates and pupil diameter; higher skin temperature) and 2) differences in response to cocaine administration; cocaine-induced increases in subject ratings of Drug Effect, Rush, Good Effects, Liking, and Desire for Cocaine and in heart rate were greater in the methadone maintenance patients compared to the non-dependent group.
These results indicate that the positive subjective effects and some physiological effects of cocaine are enhanced in methadone-maintained individuals, suggesting a pharmacological basis for the high rates of cocaine abuse among methadone maintenance patients.

Source: Psychopharmacology (Berl) 1996 Jan;123(1):15-25

Researchers Identify Clues About Marijuana Effects

Scientists have been studying cannabinoids, substances that are chemically related to the ingredients found in marijuana, for more than two decades, hoping to learn more about how the drug produces its effects–both therapeutic and harmful. Marijuana has been reported effective in the treatment of multiple sclerosis, glaucoma, nausea caused by chemotherapy and wasting caused by AIDS. However, like all drugs, it also causes numerous unwanted side effects, including hypothermia, sedation, memory impairment, motor impairment and anxiety. Research on cannabinoids could someday yield new, more effective drugs or drug combinations.

At Temple University’s School of Pharmacy and Center for Substance Abuse Research (CSAR), one of only a few centers in the nation focused on the basic science of substance abuse, several researchers are investigating how cannabinoids produce pharmacological effects in rats.
One such study, “L-NAME, a nitric oxide synthase inhibitor, and WIN 55212-2, a cannabinoid agonist, interact to evoke synergistic hypothermia,” published in the February issue of the Journal of Pharmacology and Experimental Therapeutics, reveals how cannabinoids produce one of the drug’s most robust actions, hypothermia, or decreased body temperature.
According to lead author Scott Rawls, Ph.D., assistant professor of pharmacodynamics at Temple’s School of Pharmacy, “To operate at maximum efficiency, the body needs to maintain a stable, normal temperature. When the body’s temperature is altered, as in hypothermia, normal body functions, such as blood pressure and circulation, are impaired.”
Marijuana operates via two receptors in the body. One receptor, called CB1, is located in the brain and produces the drug’s psychoactive effects, including euphoria and dizziness. The other receptor, CB2, is found throughout the body and impacts the immune system. Substances in marijuana bind to one of these receptors and set off a chemical process that leads to an effect, such as hypothermia. Scientists have focused on this chemical process at the molecular level to pinpoint the exact molecules involved.
Knowing that the molecule nitric oxide (NO) plays an important role in the regulation of body temperature, the Temple researchers set out to determine what role it might play in cannabinoid-induced hypothermia. By combining a cannabinoid with a substance that blocked NO synthesis, they found that cannabinoid-induced hypothermia increased more than two-fold.
“This demonstrates the possibility that NO plays a part in regulating the impact of cannabinoids on body temperature and other cannabinoid-mediated actions,” said Rawls. “These findings could be helpful in determining the mechanisms that underlie some of the pharmacological actions of marijuana,” he added.
Rawls’ research team is currently investigating the impact of cannabinoids on other physiological systems, such as analgesia and movement, and the brain neurotransmitters that mediate those systems.

Source: . ScienceDaily. Retrieved July 18, 2008, from http://www.sciencedaily.com¬ /releases/2004/03/040309071927.htm

Nicotine Hinders Chemotherapy, Study Finds

Research Summary
Continuing to use nicotine patches or gums after cancer surgery — to say nothing of smoking — makes chemotherapy less effective, according to researchers at the University of South Florida.
The Associated Press reported April 2 that a study of lung-cancer patients found that nicotine appears to protect cancer cells from chemotherapy drugs like gemcitabine, cisplatin, and taxol. Srikumar Chellappan of the University of South Florida and colleagues studied the impact of nicotine on non-small cell lung cancer, the most common form of the disease.
“Our findings are in agreement with clinical studies showing that patients who continue to smoke have worse survival profiles than those who quit before treatment,” the study noted. “They also raise the possibility that nicotine supplementation for smoking cessation might reduce the response to chemotheraputic agents.”
Source: The research appears in the online edition of Proceedings of the National Academy of Sciences. Reported in Join Together April 2006

Filed under: Health,Nicotine :

Use Of Cannabinoids Could Help Post-traumatic Stress Disorder Patients

This research study is very encouraging – showing another area of illness where cannabinoids ( extracts of cannabis) may be able to be used medicinally Reputable scientists and researchers, and companies like G W Pharmaceuticals, are excited by the possible use of extracts of cannabis as treatments for some illnesses.
Please note however, this is not a recommendation for smoking raw cannabis – any substance taken into the body via smoking is harmful and can lead to severe health problems.
Use of cannabinoids (marijuana) could assist in the treatment of post-traumatic stress disorder patients. This is exposed in a new study carried out at the Learning and Memory Lab in the University of Haifa’s Department of Psychology.

The study, carried out by research student Eti Ganon-Elazar under the supervision of Dr. Irit Akirav, was published in the Journal of Neuroscience.

In most cases, the result of experiencing a traumatic event — a car accident or terror attack — is the appearance of medical and psychological symptoms that affect various functions, but which pass. However, some 10%-30% of people who experience a traumatic event develop post-traumatic stress disorder, a condition in which the patient continues to suffer stress symptoms for months and even years after the traumatic event. Symptoms include reawakened trauma, avoidance of anything that could recall the trauma, and psychological and physiological disturbances. One of the problems in the course of treating trauma patients is that a person is frequently exposed to additional stress, which hinders the patient’s overcoming the trauma.

The present study, carried out by Dr. Akirav and research student Eti Ganon-Elazar, aimed to examine the efficiency of cannabinoids as a medical treatment for coping with post-traumatic stress. The researchers used a synthetic form of marijuana, which has similar properties to the natural plant, and they chose to use a rat model, which presents similar physiological responses to stress to that of humans.

The first stage of the research examined how long it took for the rats to overcome a traumatic experience, without any intervention. A cell colored white on one side and black on the other was prepared. The rats were placed in the white area, and as soon as they moved over to the black area, which they prefer, they received a light electric shock. Each day they were brought to the cell and placed back in the white area. Immediately following exposure to the traumatic experience, the rats would not move to the black area voluntarily, but a few days later after not receiving further electric shocks in the black area, they learned that it is safe again and moved there without hesitation.

Next, the researchers introduced an element of stress. A second group of rats were placed on a small, elevated platform after receiving the electric shock, which added stress to the traumatic experience. These rats abstained from returning to the black area in the cell for much longer, which shows that the exposure to additional stress does indeed hinder the process of overcoming trauma.

The third stage of the research examined yet another group of rats. These were exposed to the traumatic and additional stress events, but just before being elevated on the platform received an injection of synthetic marijuana in the amygdala area of the brain — a specific area known to be connected to emotive memory. These rats agreed to enter the black area after the same amount of time as the first group — showing that the synthetic marijuana cancelled out the symptoms of stress. Refining the results of this study, the researchers then administered marijuana injections at different points in time on additional groups of rats, and found that regardless of when exactly the injection was administered, it prevented the surfacing of stress symptoms.

Dr. Akirav and Ganon-Elazar also examined hormonal changes in the course of the experiment and found that synthetic marijuana prevents increased release of the stress hormone that the body produces in response to stress. According to Dr. Akirav, the results of this study show that cannabinoids can play an important role in stress-related disorders. “The results of our research should encourage psychiatric investigation into the use of cannabinoids in post-traumatic stress patients,” she concludes.

Source: University of Haifa (2009, November 4). Use Of Cannabinoids Could Help Post-traumatic Stress Disorder Patients. ScienceDaily. Retrieved November 12, 2009, from http://www.sciencedaily.com¬ /releases/2009/11/091104091726.htm

Methamphetamine Abuse Linked To Underage Sex, Smoking And Drinking

Children and adolescents who abuse alcohol or are sexually active are more likely to take methamphetamines (MA), also known as ‘meth’ or ‘speed’. New research reveals the risk factors associated with MA use, in both low-risk children (those who don’t take drugs) and high-risk children (those who have taken other drugs or who have ever attended juvenile detention centres).

MA is a stimulant, usually smoked, snorted or injected. It produces sensations of euphoria, lowered inhibitions, feelings of invincibility, increased wakefulness, heightened sexual experiences, and hyperactivity resulting from increased energy for extended periods of time. According to the lead author of this study, Terry P. Klassen of the University of Alberta, Canada, “MA is produced, or ‘cooked’, quickly, reasonably simply, and cheaply by using legal and readily available ingredients with recipes that can be found on the internet”.
Because of the low cost, ready availability and legal status of the drug, long-term use can be a serious problem. In order to assess the risk factors that are associated with people using MA, Klassen and his team carried out an analysis of twelve different medical studies, combining their results to get a bigger picture of the MA problem. They said, “Within the low-risk group, there were some clear patterns of risk factors associated with MA use. A history of engaging in behaviors such as sexual activity, alcohol consumption and smoking was significantly associated with MA use among low-risk youth. Engaging in these kinds of behaviors may be a gateway for MA use or vice versa. A homosexual or bisexual lifestyle is also a risk factor.”
Amongst high-risk youth, the risk factors the authors identified were, “growing up in an unstable family environment (e.g., family history of crime, alcohol use and drug use) and having received treatment for psychiatric conditions. Among high-risk youth, being female was also a risk factor”.

Source: BMC Pediatrics (2008, October 29). Methamphetamine Abuse Linked To Underage Sex, Smoking And Drinking. ScienceDaily. Retrieved November 12, 2009, from http://www.sciencedaily.com

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