Cannabis/Marijuana

2015 will be remembered as the year legalization hit bumps most supporters never anticipated.

For pro-health advocates that oppose marijuana legalization, it was a year of fantastic victories! Here are the top 10:

10. Big Marijuana is Real — and People are Writing About It.

When we started talking about Big Marijuana in 2013, many people laughed. Could marijuana even be compared with Big Tobacco in any credible way? But now, that’s ancient history. Several articles – even in legalization-friendly blogs like this one – mention the term. And the term is not just rhetoric — the most senior federal legalization lobbyist in the country resigned in protest because, in his words, “industry was taking over the legalization movement.” Not only was that heroic of him, it was historic for us.

9. Continuing Positive Press Coverage of Groups Opposing Legalization. 

With the exception of some very pro-pot columnists, this year represented one in which our side was represented just a little bit better than in the past. A profile of SAM was featured in the International Business Times, and other articles continued to broadcast our message to new audiences.

With the hiring of a new Communications Director in 2016, you can bet we won’t let up on this next year.

8. Several States Resisted Full-Blown Legalization. 

We entered 2014 after setbacks in Alaska and Oregon; but we stuck to winning messages and formed coalitions in a bloc of New England states that were all under attack in the early part of 2015. From Maine to Massachusetts to New Hampshire to Rhode Island, our partners and affiliates fought back —- and not one state legalized via legislature as the legalizers had promised. We’ll be taking this momentum into 2016.

7. Lawyering Up.

 Many of our friends made strong statements in court — “Colorado and other states cannot legalize in the face of federal law,” they argue. Of course we know they are right, and we know that regardless of legal outcomes the statement they sent was loud and clear. (We’re also happy that the Justice Department, in its opposition to the suit, solely argued against it on procedural grounds — they did not substantively come out in favor of legalization to the Solicitor General). The plaintiff’s bar should take notice—just like Big Tobacco became a big target for lawsuits, Big Marijuana and those who sell the drug will, too.

6. Marijuana Stores Banned in California, Washington, Colorado, Oregon, Michigan, and Elsewhere. 

Despite legalization in some states, we know that local ordinances are one of the key strategies to keeping marijuana out of communities. The majority of towns in most weed-friendly states have indeed banned stores altogether. Even in Detroit, up to half of Detroit’s roughly 150 medical marijuana dispensaries could close following a Detroit City Council vote to approve a restrictive zoning ordinance. We will keep pushing hard for more bans in 2016.

5. Legalizers Made No Gains in Congress This Year
.

 For the past decade, it seemed that every year we lost a little more in Congress. Not in 2015. Despite the most aggressive lobbying effort yet by pro-marijuana folks, they made no progress on key provisions:

· They wanted to give tax breaks to pot shops—just like Big Tobacco lobbies to lower taxes on cigarettes.

  • They wanted to allow pot businesses to leverage Wall Street money through the banking system.
  • They wanted to stop the Justice Department from enforcing the law in states with legalized recreational marijuana.
  • They wanted to give pot to our most vulnerable citizens to “treat” PTSD — even though science says marijuana makes PTSD, as well as other mental illness, worse.
  • They wanted Washington, DC, to become a mecca for Big Marijuana.

And we won – on every issue.

4. Continued Support from ONDCP, DEA, and NIDA.

2015 was a transitional year for key federal drug policy agencies. A new ONDCP Director was appointed — and even though we are still waiting for the Obama Administration to enforce federal law, it is clear where Director Botticelli’s heart is. Right after getting into office, the Director sat down with me for a one-to-one on-the-record interview where he blasted legal pot. And only a few weeks ago, he was featured on 60 Minutes talking about the harms of marijuana and the harms of the industry.

Additionally, we saw the appointment of a new DEA Administrator — this time from the FBI. Administrator Rosenberg has been an excellent leader by moving to support legitimate medical research over faux claims of “medical” marijuana.

And we continue to receive support from NIDA Director Nora Volkow, who headlined SAM’s summit last year, for her unwavering support of public health above profits. 

3. Real Progress on Researching the Medical Components of Marijuana.

 I’m proud that SAM took a bold stand this year to defend the legitimate research of medical components of marijuana. And our ground-breaking report paid off. The federal government has already adopted two of the report’s provisions — eliminating the Public Health Service review and getting rid of onerous CBD handling requirements. We will continue to fight for legitimate marijuana research, and to separate it from faux medicine-by-ballot-initiative. 

2. No States Legalized “Medical” Marijuana in 2015.

This is a big one, given where the country is on the “medical” marijuana issue. No state legalized the drug for medical purposes this year, despite several tries in key states. Even in Georgia, where legalizers have been emboldened by a few pot-friendly legislators, a government-convened panel voted to follow science and impose sensible restrictions on the drug. 

1. Ohio! 

Of course, the victory in Ohio tops the field. Despite being outspent 12-to-1, our affiliates and partners brought us a huge victory in November. We plan to build on this for 2016, but we need your help.

Despite the nonstop talking point of “inevitability,” we know that the 8% of Americans who use pot don’t speak for 92% of Americans that don’t want to see Big Tobacco 2.0, don’t want to worry about another drug impairing drivers on the road, and don’t want to think about keeping things like innocuous-looking “pot gummy bears” away from their kids. We know that the pot lobby will work hard for things like not only full-blown legalization in several more states next year, but also things like on-site pot smoking “bars” (they are really proposing these in Alaska and Colorado as we speak) and an expansion of pot edibles.

In 2016, let’s nip Big Marijuana in the bud.

Source: https://www.huffingtonpost.com/kevin-a-sabet-phd/top-10-antimarijuana-lega_b_8879338.html

Legalisation of cannabis is likely to lack priority for this new government.

There is one benefit to MMP, it is that the whackier campaign ideas tend to perish in the coalition negotiation process.

That hasn’t entirely been the case this time, the worst example being the Green Party’s promise to initiate a referendum on the subject of legalising cannabis (by 2020).

This would seem to be a case of a party formulating policy in the hope that it will garner votes as opposed to genuinely believing it will be beneficial. That view is reinforced by Green leader James Shaw’s assurance last week that he had never smoked cannabis, adding the illuminating comment, “It isn’t good for you, is it?”

“We know that cannabis is a carcinogenic, as is tobacco. Unlike tobacco, however, it is also linked, beyond dispute, with mental illness and poor academic achievement.”

Too right it isn’t. There is enough evidence to support that to stupefy an entire nation, which makes it all the more extraordinary that he would not only propose a referendum in the first place, but would stick to his guns when it came to striking a deal with Labour.

All the more extraordinary because Mr Shaw’s party is one of the leading lights in the drive to make New Zealand tobacco-free by 2025. (Presumably the term smoke-free is now redundant).

If all goes according to his plan, a substance that harms the physical health of the user will disappear just in time to be replaced by another substance that does even more damage, physically, emotionally and intellectually, than tobacco ever has.

We know that cannabis is a carcinogenic, as is tobacco. Unlike tobacco, however, it is also linked, beyond dispute, with mental illness and poor academic achievement. From there it can be held accountable for reducing the user’s ability to find employment, and everything that goes with that, including poverty, for themselves and their dependents.

The drive for legalisation has taken a turn (for the worse) this time around because of strident appeals to recognise its medicinal benefits. It might well dull pain – it certainly dulls most of the user’s senses – but there is a undoubtedly deliberate blurring of the lines by the drug’s supporters between medicinal cannabis, which does not include its mind-altering properties, and the ‘benefits’ to be gained by allowing its cultivation/possession and consumption in the traditional manner.

People have long waxed eloquent about cannabis as a pain killer, usually from the dock as they are in the process of being sentenced for growing the stuff. If personal experience of that is anything to go by, its fans tend to show all the signs of long-term use, which might make them happy but has reduced their role in society to that of passengers.

It might well be true that cannabis does not represent any great threat to the physical or mental health of a middle-aged dope smoker who indulges on an occasional basis. The same cannot be said for those who start young, and there, Mr Shaw, lies the rub.

We have been told for years, most often by the National Organisation for the Reform of Marijuana Laws (Norml – there’s an oxymoron for you) that legalisation would of course need to be accompanied by strict controls that would keep it out of the hands of young people.

That assurance has been given to the writer on numerous occasions, but no one has ever been able to explain how any such measures would stand any chance of success, given our experience with tobacco and alcohol.

Neither of those substances may be legally purchased or used by minors, but both are. No one in this country has yet been able to devise controls that prevent that, and the same, inevitably, will apply to cannabis. Prove to us that you have cracked that, Mr Shaw, and people might start listening to you.

The best reason for not legalising cannabis was offered to this newspaper some years ago by a teacher at Kaitaia College. He said the college was home to any number of bright, determined, ambitious young people who knew what they wanted to do with their lives, and had mapped out exactly how they were going to achieve their ambitions.

They knew that even a minor cannabis conviction would nobble those ambitions, and for that reason alone wouldn’t touch the stuff with a barge pole.

No one the writer knows has ever come up with a better reason for not legalising it. And no one will. If it is legalised future generations of bright, ambitious young people will assuredly dabble in it, to their (and our) cost.

Even if they don’t succumb to regular use it will rob them, to some degree, of their potential, to a far greater degree than flirting with alcohol or tobacco ever would.

We don’t hear Mr Shaw, or anyone else, suggesting that our children should have greater access than they already do to alcohol and tobacco, for good reason. How they can be prepared to countenance access to cannabis defies explanation.

Perhaps Mr Shaw’s political interest in this issue outweighs any concern he might have for future generations. Perhaps the legalising of cannabis has such appeal to his voter base that he can accept the inevitable collateral damage. Hopefully he is in a very small minority, and will remain so.

And don’t buy the hoary old story that our prisons are full of people who wouldn’t be there if cannabis was legal. Those who insist that this is true have either been doing too much personal research into the ‘benefits’ of sucking on cannabis cigarette all day or are deliberately trying to deceive.

No one is in jail in this country today purely because they have been caught using cannabis. One or two might be there because they were caught growing or dealing it on a substantial scale, but possession of cannabis, whatever the law might say, is no longer an imprisonable offence in this country, and hasn’t been for a very long time.

There will be some who are in jail on convictions that include possession of cannabis, but it won’t have been the drug that put them behind bars. They will have offended in other ways. To say that people are in jail because of personal possession is a blatant lie.

Some elements of the current debate are certainly worth pursuing, including that drug addiction in general should be regarded as a health issue rather than a criminal matter. And there is no doubt that drug treatment facilities are woefully inadequate. But again, this is where the pro-cannabis logic collapses.

We know the harm cannabis does; we know it leads to dependence on much harsher chemical substances; we know that people who become addicted, to whatever substance, are unlikely to get the help they need to get off it. And we know that the damage done, by cannabis and other drugs, is permanent. Dead brain cells don’t grow back.

Yet here we are talking about legalising it. It makes no sense whatsoever to even consider it. A handful of people might genuinely believe that it will ease their pain, or, in medical form, will reduce the severity of some far from common conditions (again, the use of medical marijuana is a separate issue), but legalising cannabis for all and sundry will not benefit society in any imaginable way.

There can be absolutely no question that legalising cannabis will, in fact, do enormous harm, and any politician who is unaware of that, or is prepared to trade that harm for electoral success, has no place in Parliament.

Source:http://www2.nzherald.co.nz/northland-age/opinion/news/article.cfm?c_id=1503399&objectid=11938825-

There is current research into the probable genotoxicity of marijuana and this has been likened to the harm to the foetus in the womb from the drug Thalidomide in the 1960’s.

In the annals of modern medicine, it was a horror story of international scope: thousands of babies dead in the womb and at least 10,000 others in 46 countries born with severe deformities. Some of the children were missing limbs. Others had arms and legs that resembled a seal’s flippers. In many cases, eyes, ears and other organs and tissues failed to develop properly. The cause, scientists discovered by late 1961, was thalidomide, a drug that, during four years of commercial sales in countries from Germany to Australia, was marketed to pregnant women as a miracle cure for morning sickness and insomnia.

The tragedy was largely averted in the United States, with much credit due to Frances Oldham Kelsey, a medical officer at the Food and Drug Administration in Washington, who raised concerns about thalidomide before its effects were conclusively known. For a critical 19-month period, she fastidiously blocked its approval while drug company officials maligned her as a bureaucratic nitpicker. Dr. Kelsey, a physician and pharmacologist later lauded as a heroine of the federal workforce, died Aug. 7 at her daughter’s home in London, Ontario. She was 101. Her daughter, Christine Kelsey, confirmed her death but did not cite a specific cause.

Dr. Kelsey did not single-handedly uncover thalidomide’s hazards. Clinical investigators and health authorities around the world played an important role, as did several of her FDA peers. But because of her tenacity and clinical training, she became the central figure in the thalidomide episode.

In July 1962, The Washington Post directed national attention on the matter — and on Dr. Kelsey — with a front-page article reporting that her “scepticism and stubbornness … prevented what could have been an appalling American tragedy.” [From 1962: ‘Heroine’ of FDA keeps bad drug off the market].

 

The global thalidomide calamity precipitated legislation signed by President John F. Kennedy in October 1962 that substantially strengthened the FDA’s authority over drug testing. The new regulations, still in force, required pharmaceutical companies to conduct phased clinical trials, obtain informed consent from participants in drug testing, and warn the FDA of adverse effects, and granted the FDA with important controls over prescription-drug advertising.

As the new federal law was being hammered out, Kennedy rushed to include Dr. Kelsey in a previously scheduled White House award ceremony honouring influential civil servants, including an architect of NASA’s manned spaceflight program.“In a way, they tied her to the moonshot in showing what government scientists were capable of,” said Stephen Fried, a journalist who investigated the drug industry in the book “Bitter Pills.” “It was an act of incredible daring and bravery to say we need to wait longer before we expose the American people to this drug.”

Dr. Kelsey became, Fried said, “the most famous government regulator in American history.”

‘I was the newest person there and pretty green’

Dr. Kelsey had landed at the FDA in August 1960, one of seven full-time medical officers hired to review about 300 human drug applications per year.The number of women pursuing careers in science was minuscule, but Dr. Kelsey had long been comfortable in male-dominated environments. Growing up in Canada, she spent part of her childhood in an otherwise all-boys private school. She had two daughters while shouldering the demands of medical school in the late 1940s.

In Washington, she joined a corps of reform-minded scientists who, although not yet empowered by the 1962 law that required affirmative FDA approval of any new drug, demanded strong evidence of effectiveness before giving their imprimatur.At the time, a drug could go on the market 60 days after the manufacturer filed an application with the FDA. If the medical officer determined that the submission was incomplete, the drug company could provide additional information, and the clock would start anew.

Meanwhile, pharmaceutical drug companies commonly supplied doctors with new drugs and encouraged them to test the product on patients, an uncontrolled and dangerous practice that relied almost entirely on anecdotal evidence. Thalidomide, which was widely marketed as a sedative as well as a treatment for pregnancy-related nausea during the first trimester of pregnancy, had proven wildly popular in Europe and a boon for its German manufacturer, Chemie Grünenthal.

By the fall of 1960, a Cincinnati-based drug company, William S. Merrell, had licensed the drug and began to distribute it under the trade name Kevadon to 1,200 U.S. doctors in advance of what executives anticipated would be its quick approval by the FDA.The government later estimated that more than 2.5 million tablets were given to about 20,000 patients, several hundred of whom were pregnant.

The Merrell application landed on Dr. Kelsey’s desk within weeks of her arrival at the agency. “I was the newest person there and pretty green,” she later said in an FDA oral history, “so my supervisors decided, ‘Well, this is a very easy one. There will be no problems with sleeping pills.’ ” Immediately the application alarmed her. Despite what she called the company’s “quite fulsome” claims, the absorption and toxicity studies were so incomplete as to be almost meaningless.

Dr. Kelsey rejected the application numerous times and requested more data. Merrell representatives, who had large potential profits riding on the application, began to complain to her bosses and show up at her office, with respected clinical investigators in tow, to protest the hold-up. Dr. Kelsey’s FDA superiors backed her as she conducted her research. By February 1961, she had found more evidence to support her suspicions, including a letter in the British Medical Journal by an English doctor who reported that his patients on thalidomide experienced a painful “tingling” in the arms and feet.

 

Dr. Kelsey also discovered that, despite warnings of side effects printed on British and German drug labels, Merrell had not notified the FDA of any adverse reactions.  Another reason for her concern was that the company had apparently done no studies on pregnant animals. At the time, a prevailing view among doctors held that the placental barrier protected the foetus from what Dr. Kelsey once called “the indiscretions of the mother,” such as abuse of alcohol, tobacco or illegal drugs. Earlier in her career, however, she had investigated the ways in which drugs did in fact pass through the placenta from mother to baby.

While Dr. Kelsey stood her ground on Kevadon, infant deaths and deformities were occurring at an alarming rate in places where thalidomide had been sold. The development of seal-like flippers, a condition known as phocomelia that previously affected an estimated 1 in 4 million infants, began to crop up by the dozens in many countries.

Clinical investigators, because of a variety of complications including spotty tracking systems, only belatedly made the link to thalidomide.  Grünenthal began pulling the drug from the market in Germany in late 1961. Health authorities in other countries issued warnings. Merrell waited until March 1962 to withdraw its U.S. application. By then, at least 17 babies were born in the United States with thalidomide-related defects, according to the FDA

Influence beyond thalidomide

Dr. Kelsey might have remained an anonymous bureaucrat if not for the front-page story in The Post. The newspaper had received a tip about her from staffers working for Sen. Estes Kefauver, a Tennessee Democrat who had been stalled in his years-long battle with the pharmaceutical industry to bolster the country’s drug laws. The coverage of Dr. Kelsey gave her — and Kefauver — a lift. As thousands of grateful letters flowed in to Dr. Kelsey from the public, the proposed legislation became hard to ignore or to water down. The new law was widely known as the Kefauver-Harris Amendments.

“She had a huge effect on the regulations adopted in the 1960s to help create the modern clinical trial system,” said Daniel Carpenter, a professor of government at Harvard University and the author of “Reputation and Power,” a definitive history of the FDA. “She may have had a bigger effect after thalidomide than before.”

In 1963, Dr. Kelsey was named chief of the FDA’s investigational drug branch. Four years later, she was named director of the new Office of Scientific Investigations, a position she held until 1995.  She spent another decade, until her retirement at 90, working at the FDA’s Center for Drug Evaluation and Research. In that role, she advised the director of its compliance office on scientific and medical issues and analyzed historical drug review issues.

According to historians of the FDA, she was instrumental in establishing the institutional review boards — a cornerstone of modern clinical drug development — that were created after abusive drug testing trials were exposed in prisons, hospitals and nursing homes. For decades, Dr. Kelsey played a critical role at the agency in enforcing federal regulations for drug development — protocols that were credited with forcing more rigorous standards around the world.

Name mistaken for a man’s

Frances Kathleen Oldham was born near Cobble Hill, on Vancouver Island, British Columbia, on July 24, 1914. Her father was a retired British army officer, and her mother came from a prosperous Scottish family.  The young “Frankie,” as she was called, grew up exploring the woods and shorelines, sometimes bringing home frogs for dissection. At McGill University in Montreal, she studied pharmacology — the effects of drugs on people — and received a bachelor’s degree in 1934 and a master’s degree in 1935.

A McGill professor urged her to apply for a research assistant job at the University of Chicago, where pharmacology professor Eugene Geiling accepted her without an interview. Geiling, who had mistaken the names Frances for the masculine Francis, addressed her by mail as “Mr. Oldham.”

“When a woman took a job in those days, she was made to feel as if she was depriving a man of the ability to support his wife and child,” Dr. Kelsey told the New York Times in 2010. “But my professor said: ‘Don’t be stupid. Accept the job, sign your name and put “Miss” in brackets afterward.’ ”

In Chicago, she helped Geiling investigate the 107 deaths that occurred nationwide in 1937 from the newly marketed liquid form of sulfanilamide, a synthetic antibacterial drug used to treat streptococcal infections. In tablet form, it had been heralded as a wonder-drug of the age, but it tasted unpleasant.Because the drug was not soluble in water or alcohol, the chief chemist of its manufacturer, S.E. Massengill Co. of Bristol, Tenn., dissolved the sulfanilamide with an industrial substance that was a chemical relative of antifreeze. He then added cherry flavouring and pink colouring to remedy the taste and appearance.

Massengill rushed the new elixir to market without adequately testing its safety. Many who took the medicine — including a high number of children — suffered an agonizing death.  At the time, the FDA’s chief mandate, stemming from an obsolete 1906 law, was food safety. At the agency’s request, Geiling joined the Elixir Sulfanilamide investigation and put Dr. Kelsey to work on animal testing of the drug. She recalled observing rats as they “shrivelled up and died.”

Amid national outrage over Elixir Sulfanilamide, Congress passed the Federal Food, Drug and Cosmetic Act of 1938, legislation that vastly expanded federal regulatory oversight over drugs and set a new benchmark for drug safety before marketing. Massengill’s owner ultimately was fined a maximum penalty of $26,000 for mislabelling and misbranding; by technical definition, an elixir contains alcohol.

‘We need to take precautions’

Dr. Kelsey received a doctorate from Chicago in 1938, then joined the faculty. In 1943, she wed a pharmacology colleague, Fremont Ellis Kelsey.  After graduating from Chicago’s medical school in 1950, Frances Kelsey taught pharmacology at the University of South Dakota medical school and was a fill-in doctor at practices throughout the state. She also became a U.S. citizen before arriving in Washington in 1960 when her husband was hired by the National Institutes of Health. He died in 1966 after a heart attack.

Survivors include their daughters, Susan Duffield of Shelton, Wash., and Christine Kelsey of London, Ontario; a sister; and two grandchildren. Dr. Kelsey moved to Ontario from suburban Maryland in 2014.

Babies who suffered from the effects of thalidomide and survived grew up with a range of impairment. Some required lifelong home care. Others held jobs and were not severely hindered by their disabilities. Many legal settlements were reached between drug companies and the victims of thalidomide, and new claims continue to surface. Grünenthal formally apologized to victims of thalidomide in 2012.

The drug, however, never disappeared entirely. Researchers have investigated thalidomide’s effects on H.I.V. and Crohn’s disease and have conducted clinical trials for on its use for rheumatoid arthritis and macular degeneration, a leading cause of blindness.

In 1998, the FDA approved the drug for the treatment of lesions from leprosy. In 2006, thalidomide was cleared for use with the medicine dexamethasone for certain cases of multiple myeloma, a cancer of the bone marrow.

The agency enforced strict safeguards, including pregnancy testing, for such new uses. “We need to take precautions,” Dr. Kelsey told an interviewer in in 2001, “because people forget very soon.”

Source:https://www.washingtonpost.com/national/health-science/frances-            oldham-kelsey-heroine-of-thalidomide-tragedy-dies-at-101/2015/08/07

Researchers at Western University have found a way to use pharmaceuticals to reverse the negative psychiatric effects of THC, the psychoactive chemical found in marijuana. Chronic adolescent marijuana use has previously been linked to the development of psychiatric diseases, such as schizophrenia, in adulthood. But until now, researchers were unsure of what exactly was happening in the brain to cause this to occur.

“What is important about this study is that not only have we identified a specific mechanism in the prefrontal cortex for some of the mental health risks associated with adolescent marijuana use, but we have also identified a mechanism to reverse those risks,” said Steven Laviolette, professor at Western’s Schulich School of Medicine & Dentistry.

In a study published online today in Scientific Reports the researchers demonstrate that adolescent THC exposure modulates the activity of a neurotransmitter called GABA in the prefrontal cortex region of the brain. The team, led by Laviolette and post-doctoral fellow Justine Renard, looked specifically at GABA because of its previously shown clinical association with schizophrenia.

“GABA is an inhibitory neurotransmitter and plays a crucial role in regulating the excitatory activity in the frontal cortex, so if you have less GABA, your neuronal systems become hyperactive leading to behavioural changes consistent with schizophrenia,” said Renard.

The study showed that the reduction of GABA as a result of THC exposure in adolescence caused the neurons in adulthood to not only be hyperactive in this part of the brain, but also to be out of synch with each other, demonstrated by abnormal oscillations called ‘gamma’ waves. This loss of GABA in the cortex caused a corresponding hyperactive state in the brain’s dopamine system, which is commonly observed in schizophrenia.

By using drugs to activate GABA in a rat model of schizophrenia, the team was able to reverse the neuronal and behavioural effects of the THC and eliminate the schizophrenia-like symptoms.

Laviolette says this finding is especially important given the impending legalization of marijuana in Canada. “What this could mean is that if you are going to be using marijuana, in a recreational or medicinal way, you can potentially combine it with compounds that boost GABA to block the negative effects of THC.”

The research team says the next steps will examine how combinations of cannabinoid chemicals with compounds that can boost the brains GABA system may serve as more effective and safer treatments for a variety of mental health disorders, such as addiction, depression and anxiety.

Source:  The Marijuana Report.Org, Sept. 2017

by  Elizabeth Stuyt, MD

For the past 27 years, working as an addiction psychiatrist, I have struggled with big industries that push their products more for their financial gain rather than the best interests of the clients they serve. The most disconcerting piece occurs when physicians or other treatment providers or governmental entities appear to be influenced by big industry, touting the party line and minimizing any downsides to the product. I have experienced this with the tobacco industry, the pharmaceutical industry and now with the marijuana industry.

It is clear to me that wherever it happens, the push to legalize medical marijuana is simply a back-door effort, by industry, to legalize retail marijuana. However, the lack of any regulations on the potency of THC in marijuana or marijuana products in Colorado has allowed the cannabis industry to increase the potency of THC to astronomical proportions, resulting in a burgeoning public health crisis.

The potency of THC in currently available marijuana has quadrupled since the mid-1990s. The marijuana of the 1980s had <2% THC, 4.5% in 1997, 8.5% in 2006 and by 2015 the average potency of THC in the flower was 17%, with concentrated products averaging 62% THC.

Sadly, the cannabidiol (CBD) concentrations in currently available marijuana have remained the same or decreased. CBD is the component of marijuana that appears to block or ameliorate the effects of THC. Plants that are bred to produce high concentrations of THC cannot simultaneously produce high CBD. Higher-potency THC has been achieved by genetically engineering plants to product more THC and then preventing pollination so that the plant puts more energy into producing cannabinoids rather than seeds. This type of cannabis is referred to as sinsemilla (Spanish for without seed). (It has also been referred to as “skunk” due to its strong smell.)

In my view, this is no different than when the tobacco industry increased the potency of nicotine by genetically engineering tobacco plants to produce more nicotine and then used additives like ammonia to increase the absorption of nicotine. Industry’s efforts to increase the potency of an addictive substance seem to be done purely with the idea of addicting as many people as possible to guarantee continued customers. This certainly worked for the tobacco industry. And we have increasing evidence that high potency THC cannabis use is associated with an increased severity of cannabis dependence, especially in young people.12

Although marijuana has been used for thousands of years for various medical conditions, we have no idea if the benefit comes from the THC or CBD or one of the other multiple cannabinoids present in marijuana, or a combination. And we have no idea how much is needed or how often. Most of the research indicates that it is likely the CBD that is more helpful but we obviously need research on this. There is no evidence that increasing the potency of THC has any medical benefits. In fact, a study on the benefits of smoked cannabis on pain actually demonstrated that too high a dose of THC can cause hyperalgesia – similar to what is seen with high dose opiates – meaning that the person becomes more sensitive to pain with continued use. They found that 2% THC had no effect on pain, 4% THC had some beneficial effects on chronic pain and 8% resulted in hyperalgesia.3

The discovery of the “active component” in marijuana that makes it so desirable is a fairly recent phenomenon. THC and CBD were first discovered in 1963 in Israel.4

Because cannabis was made a DEA schedule I drug in 1970, very little research has been done on cannabis in the United States and most of the indications for medical marijuana have very little good research backing up the use. The chemical that is made by the body and fits the receptor which accommodates THC was discovered in 1992.5

The researcher named the chemical anandamide which means “supreme joy” in Sanskrit.  However, it turns out that the endocannabinoid system plays a very significant role in brain development that occurs during childhood and adolescence. It controls glutamate and GABA homeostasis and plays a role in strengthening and pruning synaptic connections in the prefrontal motor cortex. The consequences of using the high potency THC products during this period, especially without the protective benefits of CBD, are multifaceted and include disturbance of the endocannabinoid system, which can result in impaired cognitive development, lower IQ and increased risk of psychosis.

There is also evidence that marijuana use contributes to anxiety and depression. A very large prospective study out of Australia tracked 1600 girls for 7 years and found that those who used marijuana every day were 5 times more likely to suffer from depression and anxiety than non-users.6

Teenage girls who used the drug a least once a week were twice as likely to develop depression as those who did not use. In this study, cannabis use prior to age 15 also increased the risk of developing schizophrenia symptoms.

While there definitely are people who can use marijuana responsibly without any untoward effects, similar to how some people can drink alcohol responsibly and not have any problems, there are people who are very sensitive to the effects of THC, and its use can precipitate psychosis. The higher the potency of THC the more likely this may happen and we have no idea how to predict who will be affected. In one of the first double blind randomized placebo controlled trials on smoked cannabis (maximum of 8% THC) for the treatment of pain, a cannabis naïve participant had a psychotic reaction to the marijuana in the study and this then required that all future study participants have some experience with smoking marijuana.7

This kind of makes it difficult to have “blind” unbiased participants.

A 2015 study out of London analyzed 780 people ages 18-65, 410 with first episode psychosis and 370 healthy controls, and found that users of high potency (“skunk-like”) cannabis (THC > 15%) are three times as likely to have a psychotic episode as people who never use cannabis, and the risk is fivefold in people who smoke this form of the drug every day.89 There was no association of psychosis with THC levels < 5%. Most of the marijuana in the U.S. is of the high-THC variety. Many retailers in Colorado sell strains of weed that contain 25 percent THC or more.

Sadly, Colorado has now joined several other states in approving PTSD as an indication for the use of medical marijuana. Marijuana does not “treat” PTSD any more than benzodiazepines or opiates “treat” PTSD. All these addictive drugs do is mask the symptoms, allowing the person to continue life unaffected by the memory of the trauma. However, the psychological trauma is never resolved and the individual has to continue to use the substance in order to cope. This sets the individual up for the development of addiction to the substance or the use of other addictive substances. There is absolutely no good research to support the use of marijuana for PTSD, and there is observational data that this would be a bad idea unless this use was supported by a lot more (and better-designed) longitudinal research.

In an excellent longitudinal, observational study from 1992 to 2011, 2,276 Veterans admitted to specialized VA treatment programs for PTSD had their symptoms evaluated at intake and four months after discharge.10

They found that those who never used marijuana or quit using while in treatment had the lowest levels of PTSD symptoms, while those who continued to use or started using marijuana after treatment had worse symptoms of PTSD. Those who started using the drug during treatment had higher levels of violent behavior too.

Those of us working in the trenches in Colorado are seeing the downsides of what our governor has called “one of the great social experiments of the 21st century.” Emergency room physicians are seeing a significant increase in people experiencing consequences from marijuana use since it was legalized. One such physician wrote a very poignant piece about his experience returning to his home town of Pueblo, Colorado where he is now practicing.11

His experiences are totally supported by the Rocky Mountain High Intensity Drug Trafficking Report, volume 4 from September 2016 which documents significant increases in marijuana related emergency department visits (49%) and hospitalizations related to marijuana (32%) compared to rates prior to retail legalization. This report also documents significant increases in the use of marijuana by youth, with Colorado youth “past month marijuana use” for 2013/2014 being 74% higher than the national average, compared with 39% higher in 2011/2012.

 

In Pueblo, Colorado, where I practice, it has developed into a perfect storm. According to the Healthy Kids Colorado Survey in 2015, we have the highest incidence of youth marijuana use in the state, with 30.1% reporting using marijuana in the last 30 days. The legalization of retail marijuana seems to be reflected in the increased abuse of opiates and heroin too. In addition to the highest rates of marijuana use by youth, Pueblo has the highest rates of heroin-related deaths in the state.

 

This is a very disturbing correlation that needs attention. I have definitely seen in my practice that marijuana acts as a gateway drug to opiates, and to relapse to opiates after treatment if the person goes back to using marijuana. The Smart Approaches to Marijuana status report, which assesses state compliance with federal marijuana enforcement policy, following what is known as the Cole memo, documents that Colorado, four years after legalization, has failed to meet the specific DOJ requirements on controlling recreational marijuana production, distribution and use. This report documents a significant increase in drugged driving crashes, youth marijuana use, a thriving illegal black market and unabated sales of alcohol, which supports the idea that people are not using marijuana instead of alcohol but rather in addition to alcohol.

In spite of all this information, powerful people in the government of Colorado have publicly minimized the consequences. Larry Wolk, MD, the Chief Medical Officer for the Colorado Department of Public Health and Environment, has reported that he has “not seen any significant problems” with the legalization of marijuana.

Governor Hickenlooper’s response to Attorney General Sessions recent questions about compliance with the Cole Memo minimized the adolescent use of marijuana by saying that youth marijuana use in Colorado has “remained stable since legalization.” This is not true for Pueblo, but in any event, any use of marijuana by youth in Colorado should not be minimized and should be a major concern for future generations.

While there are people who believe we need to enforce federal law and go back to making marijuana illegal, I am afraid the horse is already out of the barn and cannot be put back in as we already have several states with “legal” retail marijuana and multiple more with “medical marijuana.” I cannot conceive of any way this could be reversed at this point, when the majority of society supports the legalization of marijuana.

Solutions to our marijuana problems have to be realistic to our current situation/environment. The number one solution is more education. Many people seem to lack a true understanding of the drug and all the potential negative consequences of the higher-potency THC. This is why education is so important. Adults should have the right to make their own decisions but they need informed consent, just like with any drug.

The biggest concern is with adolescent use and the developing brain. This requires a lot more education and increased efforts at prevention, early intervention and treatment. I believe society would be truly served by a federal ban on all advertising of addicting drugs including alcohol, tobacco and marijuana, as well as all pharmaceutical drugs. The decision to use a pharmaceutical medication should be between the patient and the medical professional, not influenced by big industry. We clearly have the big industries— alcohol, tobacco and marijuana—doing everything they can to influence the public and convince them to use their product.

Since we only have anecdotal evidence at this point that marijuana can aid any medical condition, I recommend eliminating “medical marijuana” and just have retail marijuana with limits on THC and regulations similar to alcohol and tobacco. This could help take away the perception, which adolescents and others have, that because is it “medical” it must be “safe.” In order to be able to say it is medical, it should go through the same standards for testing the safety and efficacy of any prescription drug.

In this vein, I believe we do need more research and that marijuana should be reclassified as a schedule II drug so this can occur. Since marijuana has been used medicinally for thousands of years, I believe that the plant deserves some true research to determine if and what parts of the plant are helpful medicinally. The reports that marijuana use resulted in less than 10% becoming addicted to it were done back in the 1990s when THC levels were <5%. Since we are seeing significant increases in people developing marijuana use disorder with the higher doses of THC, perhaps the limits on THC should be <5%. Editor’s note: for more information, see the pdf of the author’s talk on this topic.     Show 11 footnotes

Source:  https://www.madinamerica.com/2017/09/unintended-consequences-colorado-social-experiment/  11th September 2017

And Addiction-Connected Carcinogenicity, Congenital Toxicity And Heritable Genotoxicity

Albert Stuart Reece, Gary Kenneth Hulse

Extracts from the above research.  Recommend readers go to source for complete study.

A B S T R A C T

The recent demonstration that massive scale chromosomal shattering or pulverization can occur abruptly due to errors induced by interference with the microtubule machinery of the mitotic spindle followed by haphazard chromosomal annealing, together with sophisticated insights from epigenetics, provide profound mechanistic insights into some of the most perplexing classical observations of addiction medicine, including cancerogenesis, the younger and aggressive onset of addiction-related carcinogenesis, the heritability of addictive neurocircuitry and cancers, and foetal malformations.

Tetrahydrocannabinol (THC) and other addictive agents have been shown to inhibit tubulin polymerization which perturbs the formation and function of the microtubules of the mitotic spindle. This disruption of the mitotic machinery perturbs proper chromosomal segregation during anaphase and causes micronucleus formation which is the primary locus and cause of the chromosomal pulverization of chromothripsis and downstream genotoxic events including oncogene induction and tumour suppressor silencing.

Moreover the complementation of multiple positive cannabis-cancer epidemiological studies, and replicated dose-response relationships with established mechanisms fulfils causal criteria. This information is also consistent with data showing acceleration of the aging process by drugs of addiction including alcohol, tobacco, cannabis, stimulants and opioids. THC shows a non-linear sigmoidal dose-response relationship in multiple pertinent in vitro and preclinical genotoxicity assays, and in this respect is similar to the serious major human mutagen thalidomide. Rising community exposure, tissue storage of cannabinoids, and increasingly potent phytocannabinoid sources, suggests that the threshold mutagenic dose for cancerogenesis will increasingly be crossed beyond the developing world, and raise transgenerational transmission of teratogenicity as an increasing concern.

CONCLUSION

As mentioned above high dose cannabis and THC test positive in many genotoxicity assays, albeit often with a highly non-linear threshold like effects above low doses. As long ago as 2004 it was said that 3–41% of all neonates born in various North American communities had been exposed to cannabis [172]. Since cannabis is addictive [187], is becoming more potent [77,83,86], quickly builds up in adipose tissues [62,82] and seems generally to becoming more widely available under fluid regulatory regimes [187,188], real concern must be expressed that the rising population level of cannabinoid exposure will increasingly intersect the toxic thresholds for major genotoxicity including chromosomal clastogenicity secondary to interference and premature aging of the mitotic apparatus.

Under such a conceptualization, it would appear that the real boon of restrictive cannabis regimes [189] is not their supposed success in any drug war, but their confinement in the populations they protect, to a low dose exposure paradigm which limits incident and transgenerational teratogenicity, ageing, mental retardation and cancerogenicity.

Source:   Mutation Research/Fundamental and Molecular Mechanisms of Mutagenesis Journal Homepage: www.elsevier.com/locate/molmut    January 2016

Background

On August 29, 2013, the U.S. Department of Justice (DOJ) issued guidelines to Federal prosecutors and law enforcement officials regarding where to focus their drug enforcement efforts in states that have passed laws legalizing the retail sales of marijuana. The so-called “Cole Memo” directs enforcement officials to focus resources, including prosecutions, “on persons and organizations whose conduct interferes with any one or more of [eight] priorities, regardless of state law.”

Per the memorandum, the eight DOJ priorities are:

● Preventing distribution of marijuana to minors

● Preventing marijuana revenue from funding criminal enterprises, gangs or cartels

● Preventing marijuana from moving out of states where it is legal

● Preventing use of state-legal marijuana sales as a cover for illegal activity

● Preventing violence and use of firearms in growing or distributing marijuana

● Preventing drugged driving or exacerbation of other adverse public health consequences associated with marijuana use

● Preventing growing marijuana on public lands

● Preventing marijuana possession or use on federal property

According to the Department of Justice, the Federal “hands-off” approach to marijuana enforcement enumerated in the Cole Memo is contingent on its expectation that “states and local governments that have enacted laws authorizing marijuana-related conduct will implement strong and effective regulatory and enforcement systems that will address the threat those state laws could pose to public safety, public health, and other law enforcement interests.

A system adequate to that task must not only contain robust controls and procedures on paper, it must also be effective in practice.”

Unfortunately, since Colorado and Washington became the first states to legalize the recreational sale of marijuana in 2012, evidence has emerged that regulations intended to control the sale and use of marijuana have failed to meet the promises made by advocates for legalization.

For example, states with legal marijuana are seeing an increase in drugged driving crashes and youth marijuana use. States that have legalized marijuana are also failing to shore up state budget shortfalls with marijuana taxes, continuing to see a thriving illegal black market, and are experiencing an unabated sales of alcohol, despite campaign promises from advocates promising that marijuana would be used as a “safer” alternative instead.

Moreover, state regulatory frameworks established post-legalization have failed to meet each of the specific DOJ requirements on controlling recreational marijuana production, distribution, and use.

While long-term studies and research on the public health and safety impacts of marijuana legalization are ongoing, this report provides a partial census of readily available information that demonstrates how Colorado, Oregon, and Washington State –

the jurisdictions with the most mature regulatory markets and schemes – have not fulfilled the requirements of the Cole Memo.

DOJ Guideline 1: “Preventing distribution of marijuana to minors”

● According to the nation’s largest and most comprehensive survey of drug use trends in the nation, past-month use of marijuana among 12 to 17-year-olds in Colorado increased significantly – from 9.82% to 12.56% after marijuana retail sales began (Colorado legalized marijuana in 2012 and implemented legal marijuana stores in 2014).

The same study notes that teens and adults in Colorado now use marijuana at a higher rate than the rest of the country. No other representative sample of drug users in Colorado has contradicted this sample.

● A 2017 study from the University of Colorado found that marijuana-related emergency room visits and visits to its satellite urgent care centers by teens in Colorado more than quadrupled after the state legalized marijuana.

● In Colorado, a new report from the state’s public safety agency reveals that after the state legalized the drug, marijuana-related arrests for black and Hispanic youth rose by 58% and 29% respectively, while arrest rates for white kids dropped by eight percent. School Resource Officers in Colorado have reported a substantial increase in marijuana-related offenses in Colorado schools after the state commercialized the drug.

● According to data from the State of Washington, there have been over 240 violations of legal marijuana sales to minors and of minors frequenting restricted marijuana sales areas as of July 2017. ● Youth use – among 8th and 10th graders at least – is increasing in Washington State. According to a special analysis of teenage drug use published in the peer-reviewed, highly regarded Journal of American Medical Association Pediatrics, the perceived  harmfulness of marijuana in Washington declined 14.2% and 16.1% among eighth and 10th graders, respectively, while marijuana use increased 2.0% and 4.1% from 2010-2012 to 2013-2015.

● According to the Washington State Office of the Superintendent of Public Instruction during 2013-2014, 48 percent of statewide student expulsions were for marijuana in comparison to alcohol, tobacco, and other illicit drugs. During the 2014-2015 school year, statewide student expulsions for marijuana increased to 60 percent. Marijuana related suspensions for the 2013-2014 school year reported 42 percent and for the 2014-2015 school year, suspensions increased to 49 percent.

● In Washington State, youth (12-17) accounted for 64.9% of all state marijuana seizures in 2015 as compared to 29.9% in 2010, according to data from the National Incident Based Reporting System (NIBRS).

● From 2012 to 2016, reported exposure calls for marijuana increased 105 percent in Washington. According to the 2016 Annual Cannabis Toxic Trends Report, of exposures related to children under the age of five, 73 percent occurred in those one to three years of age. The counties with the highest reported exposures for both 2015 and 2016 were: King, Spokane, Snohomish, and Pierce.

DOJ Guideline 2: “Preventing revenue of the sale of marijuana from going to criminal enterprises, gangs, and cartels”

● In June 2017, Colorado Attorney General Cynthia Coffman announced a takedown of a massive illegal marijuana trafficking ring in Colorado. The bust is the largest since legalization and indicted 62 individuals and 12 businesses in Colorado. The operation stretched into other states including Kansas, Texas, Nebraska, Ohio and Oklahoma.

● In March 2017, a leaked report from the Oregon State Police uncovered evidence from state officials that the black market for marijuana continues to thrive in the state. The 39-page report noted that, “The illicit exportation of cannabis must be stemmed as it undermines the spirit of the law and the integrity of the legal market…it steals economic power from the market, the government, and the citizens of Oregon, and furnishes it to criminals, thereby tarnishing state compliance efforts.”

Washington State Office of the Superintendent of Instruction. (2016, Jan. 26). Behavior Report. http://www.k12.wa.us/SafetyCenter/Behavior/default.aspx

Washington State Poison Center – Toxic Trends Report: 2016 Annual Cannabis Report

● In 2016, Seattle Police spokesman Sean Whitcomb noted that “large-scale illegal grow operations… are still prevalent in Seattle, and we do come across those with a degree of frequency.” DOJ Guideline 3: “Preventing the diversion of marijuana from states where it is legal under state law in some form to other states”

● In 2014, two states – Nebraska and Oklahoma – sued their neighbor state of Colorado by citing evidence of increased marijuana flowing into those states. Law enforcement officials have reported a substantial increase in marijuana flow across state borders into neighboring states.

● In 2016, there were multiple raids conducted by state law enforcement in Colorado, leading authorities to seize more than 22,0000 pounds of marijuana intended for sales outside of Colorado.

● According to the Oregon State Police, the state has an “expansive geographic footprint” on marijuana exports across the U.S. Several counties in Oregon including Jackson, Multnomah, Josephine, Lane, Deschutes and Washington “lead the way” in supplying marijuana to states where it is not legal.

● According to the Rocky Mountain High Intensity Drug Trafficking Area task force, “there were 360 seizures of marijuana in Colorado destined for other states. This is nearly a 600% increase in the number of individual stops in a decade, seizing about 3,671 pounds in 2014. Of the 360 seizures reported in 2014, 36 different states were identified as destinations, the most common being Kansas, Missouri, Illinois, Oklahoma and Florida.”

● Law enforcement officials report that since legalization in 2012, Washington State marijuana has been found to be destined for 38 different states throughout the United States. Between 2012 and 2017, 8,242.39 kilograms (18,171.35 pounds) have been seized in 733 individual seizure events across 38 states. From 2012 to 2016, 470 pounds of marijuana have been seized on Washington State highways and interstates. Since 2012, 320 pounds of Washington State-origin marijuana have been seized during attempted parcel diversions. DOJ Guideline 4: “Preventing state-authorized marijuana activity from being used as a cover or pretext for the trafficking of other illegal drugs or other illegal activity”

● According to Jorge Duque from the Colorado Department of Law, cartels operating in Colorado are now “trading drugs like heroin for marijuana,” and the trade has since opened the door to drug and human trafficking. Duque also explains that money 5 laundering is a growing problem as “cartels are often disguising their money through legally purchasing marijuana or buying houses and growing marijuana in it.”

● In June 2017, a former Colorado marijuana enforcement officer and a Denver-based marijuana entrepreneur were indicted for running a statewide marijuana trafficking ring that illegally produced and sold “millions of dollars worth of marijuana across state lines.” This trafficking organization obtained 14 marijuana licenses in order to present their activities as protected business endeavors, despite “never ma[king] a single legal sale of cannabis in their two years of operation.”

● In Oregon, State Police officials report that criminals are exploiting Oregon’s legal marijuana industry for financial crimes and fraud. In one example, according to the Oregon State Police report, “Tisha Silver of Cannacea Medical Marijuana Dispensary falsified licensing to solicit investors and worked with Green Rush Consulting to locate unwitting investors. Silver exploited the burgeoning cannabis industry in the state to entice investors to back an illegitimate company, securing a quarter of a million dollars in fraudulent gains. According to some analysts, cannabis investors fell prey to ‘pump and dump’ schemes and lost up to $23.3 billion in 2014 alone.”

● Officials in Oregon note that the U.S. Postal Service is being exploited to ship marijuana products and revenue. According to former Attorney General Eric Holder, “The Postal Service is being used to facilitate drug dealing,” a clear violation of federal law and a violation of the sanctity of the U.S. mailing system.

DOJ Guideline 5: “Preventing violence and the use of firearms in the cultivation and distribution of marijuana”

● While crime rates dropped or remained stable in many of the nation’s largest cities, Colorado’s crime rate increased. There has been an increase in rape, murder, robbery and auto thefts. While it is not possible to link legalization to a direct change in crime rates, officials in Colorado cited marijuana legalization as one of the reasons behind the rise.

● In Colorado, prosecutors are reporting an increase in marijuana-related homicides since the state legalized the drug.  This situation is detailed here: http://www.oregonlive.com/marijuana/index.ssf/2016/07/state_slaps_portland_dispensar.h tml.

Other instances of fraud have been discussed here: Sapient Investigations Newsletters (2015, Feb. 10) “High Times for Fraud,” available online at https://sapientinvestigations.com/spi-news/high-times-for-fraud/

● In Oregon, state police report that, “Cannabis is a lucrative target for robbery. As recently as December 2016, a state-licensed cannabis producer was targeted for a violent armed robbery. In the aforementioned case, a well-known cannabis grower in Jackson County was assaulted, bound, and his harvest was taken by armed assailants.”

● In Prince George’s County Maryland, Police Chief Henry Stawinski noted a significant rise in marijuana-related homicides since neighboring D.C. legalized the drug. Stawinski said 19 homicides in 2016 were related to marijuana.

DOJ Guideline 6:  “Preventing drugged driving and the exacerbation of other public health consequences associated with marijuana use”

● Drugged driving has increased in states with legal marijuana sales. According to a study published by the American Automobile Association, fatal drugged driving crashes doubled in Washington State after the state legalized marijuana. The Governors Highway Safety Association also notes a disturbing rise in drugged driving crashes even as alcohol-related crashes are declining.

● A Denver Post analysis found the number of marijuana-impaired drivers involved in fatal crashes in Colorado more than doubled since 2013, the year after the state voted to legalize recreational marijuana use. Colorado saw a 145 percent increase in the number of marijuana-impaired drivers involved in fatal crashes between 2013 and 2016. Marijuana is also figuring into more of Colorado’s fatal crashes overall: in 2013, marijuana-impaired drivers accounted for 10 percent of all fatal crashes, but by 2016 it reached 20 percent.

● According to a study published in the Annals of Emergency Medicine, poison control calls for children more than tripled after marijuana legalization. Much of this is linked to a boom in the sale of marijuana “edibles.” THC concentrate is mixed into almost any type of food or drink, including gummy candy, soda, and lollipops. Today, these edibles comprise at least half of Colorado’s marijuana market.

● In Washington State, the number of marijuana-involved DUIs are increasing with 38 percent of total cases submitted in 2016 testing above the five nanogram per milliliter of blood legal limit for those over the age of twenty-one. In addition, 10 percent of drivers involved in a fatal accident from 2010 to 2014 were THC-positive.

● A study by the Highway Loss Data Institute reveals that Colorado, Oregon, and Washington have experienced three percent more collision claims overall than would ( NWHIDTA Drug Threat Assessment For Program Year 2018)  have been expected without legalization.

Colorado witnessed the largest jump in claims. The state experienced a rate 14 percent higher than neighboring states.

● In Washington State, from 2012 to 2016, calls to poison control centers increased by 79.48%. Exposures increased 19.65% from the time of marijuana commercialization in 2014 to 2016. Of the marijuana calls answered by the Poison Center in 2016, youth under the age of 20 accounted for almost 40% of all calls.

According to the 2016 Annual Cannabis Toxic Trends Report, 42% of the calls reported were for persons aged 13 to 29. Additionally, among exposures related to children under the age of five, 73% involved children one to three years of age. The counties with the highest reported number of exposures for 2015 remained in the top four for 2016: King, Spokane, Snohomish, and Pierce.

DOJ Guideline 7: “Preventing the growing of marijuana on public lands and the attendant public safety and environmental dangers posed by marijuana on public lands”

● In Washington State, 373,778 marijuana plants were found growing illegally on public and private lands between 2012 and 2016. Of the illegal marijuana plants eradicated in 2016, 60% were being cultivated on state land, and the 58,604 illegal marijuana plants eradicated in 2016 consumed an estimated 43.2 million gallons of water over a full growing season (120-day cycle).

More than 400 pounds of fertilizers, chemicals, and pesticides were removed from illegal marijuana growing operations in 2016, and Furadan, a neurotoxin that is extremely dangerous to humans, was found in an illegal marijuana growing operation the same year.

● In June 2017, Colorado officials found more than 7,000 illegal plants on federal land in the state’s San Isabel National Forest. This was the fifth illegal grow found in that area alone since the year marijuana legalization passed, demonstrating legalization has not curbed the problem of grows exploiting public lands.

● In Oregon, the legalization of marijuana in the state has failed to eliminate illegal growing operations and public lands continue to be exploited despite a legal market. According to a report from state officials, “To date in Oregon, cannabis legalization has not had a noticeable influence on Mexican National [Drug Trafficking Organizations] illicit cannabis cultivation operations on public lands… leaving a lasting scar on Oregon’s unique ecosystems.

Illicit cannabis grows employ excessive amounts of pesticides, rodenticides, and herbicides, thereby threatening local wildlife habitats. Additionally, many illicit grow sites clear-cut timber, furthering soil erosion and water contamination. Research on the environmental impact of illicit cannabis grows indicates that grows tend to be bunched near water sources, resulting in disproportionate impacts on ecologically important areas…

Oregon is robbed of roughly 122 Olympic swimming pools 8 worth of water annually, or roughly 442,200 gallons of water daily during the growth season.”

DOJ Guideline 8: “Preventing marijuana possession or use on federal property”

● Advocates for legal marijuana frequently flout federal laws by possessing and using marijuana on federal properties purportedly in acts of civil disobedience. In January 2017, one group gave away free marijuana in Washington, D.C. to smoke on the National Mall during the inauguration of President Trump. On April 24, 2017, four activists were arrested after purposely flouting federal law and publicly using marijuana on U.S. Capitol grounds.

Conclusion and Key Recommendations

Federal resources should target the big players in the marijuana industry. Individual marijuana users should not be targeted or arrested, but large-scale marijuana businesses, several of which now boast of having raised over $100 million in capital, and their financial backers, should be a priority. These large businesses are pocketing millions by flouting federal law, deceiving Americans about the risks of their products, and targeting the most vulnerable.

They should not have access to banks, where their financial prowess would be expanded significantly, nor should they be able to advertise or commercialize marijuana.

These businesses target many of the marijuana products they sell toward kids, such as pot candies, cookies, and ice cream. And despite state regulations, these products continue to have problems with contamination. Recently, one of the largest, most sophisticated manufacturers of these pot “edibles” was forced to recall a number of products because they contained non-food-grade ingredients.

Additionally, the black market continues unabated in legalized states. A leaked report from Oregon police showed that at least 70 percent of that state’s marijuana market is illegal, despite legalization. In June 2017, Colorado Attorney General Cynthia Coffman said, “The black market for marijuana has not gone away since recreational marijuana was legalized in our state, and in fact continues to flourish.”

Further, state-legal businesses have acted as top cover for these illegal operations, as recent large-scale arrests in Colorado have shown. These large marijuana operations, which combine the tactics of Big Tobacco with black marketeering, should form the focus of federal law enforcement, not individual users.  Recalls are becoming more commonplace because of pesticides, moulds, and other issues.

See The Denver Post for news stories related to these recalls in legalized states: http://www.thecannabist.co/tag/marijuana-recall/

At the same time, the federal government along with non-government partners should implement a strong, evidence-based marijuana information campaign, similar to the truth ® campaign for tobacco, which alerts all Americans about the harms of marijuana and the deceitful practices of the marijuana industry.

Background:

Cannabis is increasingly available for the treatment of chronic pain, yet its efficacy remains uncertain.

Purpose: 

To review the benefits of plant-based cannabis preparations for treating chronic pain in adults and the harms of cannabis use in chronic pain and general adult populations.

Data Sources:

MEDLINE, Cochrane Database of Systematic Reviews, and several other sources from database inception to March 2017.

Study Selection: 

Intervention trials and observational studies, published in English, involving adults using plant-based cannabis preparations that reported pain, quality of life, or adverse effect outcomes.

Data Extraction: Two investigators independently abstracted study characteristics and assessed study quality, and the investigator group graded the overall strength of evidence using standard criteria.

Data Synthesis: From 27 chronic pain trials, there is low-strength evidence that cannabis alleviates neuropathic pain but insufficient evidence in other pain populations. According to 11 systematic reviews and 32 primary studies, harms in general population studies include increased risk for motor vehicle accidents, psychotic symptoms, and short-term cognitive impairment. Although adverse pulmonary effects were not seen in younger populations, evidence on most other long-term physical harms, in heavy or long-term cannabis users, or in older populations is insufficient.

Limitation: Few methodologically rigorous trials; the cannabis formulations studied may not reflect commercially available products; and limited applicability to older, chronically ill populations and patients who use cannabis heavily.

Conclusion: 

Limited evidence suggests that cannabis may alleviate neuropathic pain in some patients, but insufficient evidence exists for other types of chronic pain. Among general populations, limited evidence suggests that cannabis is associated with an increased risk for adverse mental health effects.

Source:  http://annals.org/aim/article/2648595/effects-cannabis-among-adults-chronic-pain-overview-general-harms-systematic#.WZXJbYbta0I.email

Arrests are up. We still have a black market. And people are in danger.

Last week, Senator Cory Booker introduced the Marijuana Justice Act in an effort to legalize marijuana across the nation and penalize local communities that want nothing to do with this dangerous drug. This is the furthest reaching marijuana legalization effort to date and marks another sad moment in our nation’s embrace of a drug that will have generational consequences.

Our country is facing a drug epidemic. Legalizing recreational marijuana will do nothing that Senator Booker expects. We heard many of these same promises in 2012 when Colorado legalized recreational marijuana.

In the years since, Colorado has seen an increase in marijuana related traffic deaths, poison control calls, and emergency room visits. The marijuana black market has increased in Colorado, not decreased. And, numerous Colorado marijuana regulators have been indicted for corruption.

In 2012, we were promised funds from marijuana taxes would benefit our communities, particularly schools. Dr. Harry Bull, the Superintendent of Cherry Creek Schools, one of the largest school districts in the state, said, “So far, the only thing that the legalization of marijuana has brought to our schools has been marijuana.”

In fiscal year 2016, marijuana tax revenue resulted in $156,701,018. The total tax revenue for Colorado was $13,327,123,798, making marijuana only 1.18% of the state’s total tax revenue. The cost of marijuana legalization in public awareness campaigns, law enforcement, healthcare treatment, addiction recovery, and preventative work is an unknown cost to date.

Senator Booker stated his reasons for legalizing marijuana is to reduce “marijuana arrests happening so much in our country, targeting certain communities – poor communities, minority communities.” It’s a noble cause to seek to reduce incarceration rates among these communities but legalizing marijuana has had the opposite effect.

According to the Colorado Department of Public Safety, arrests in Colorado of black and Latino youth for marijuana possession have increased 58% and 29% respectively after legalization. This means that Black and Latino youth are being arrested more for marijuana possession after it became legal.

Furthermore, a vast majority of Colorado’s marijuana businesses are concentrated in neighborhoods of color. Leaders from these communities, many of whom initially voted to legalize recreational marijuana, often speak out about the negative impacts of these businesses.

Senator Booker released his bill just a few days after the Washington Post reported on a study by the Review of Economic Studies that found “college students with access to recreational cannabis on average earn worse grades and fail classes at a higher rate.” Getting off marijuana especially helped lower performing students who were at risk of dropping out.

Since legalizing marijuana, Colorado’s youth marijuana use rate is the highest in the nation, 74% higher than the national average, according to the Rocky Mountain High Intensity Drug Trafficking Area Report. This is having terribly negative effects on the education of our youth.

If Senator Booker is interested in serving poor and minority communities, legalizing marijuana is one of the worst decisions. There is much work to be done to reduce incarceration and recidivism, but flooding communities with drugs will do nothing but exacerbate the problems.

The true impact of marijuana on our communities is just starting to be learned. The negative consequences of legalizing recreational marijuana will be felt for generations. I encourage Senator Booker to spend time with parents, educators, law enforcement, counsellors, community leaders, pastors, and legislators before rushing to legalize marijuana nationally. We’ve seen the effects in our neighborhoods in Colorado, and this is nothing we wish upon the nation.

Jeff Hunt is the Vice President of Public Policy at Colorado Christian University. Follow him on Twitter: @jeffhunt.

Source:  https://www.usatoday.com/story/opinion/2017/08/07/marijuana 

Key Points

Question  Are US state medical marijuana laws one of the underlying factors for increases in risk for adult cannabis use and cannabis use disorders seen since the early 1990s?

Findings  In this analysis using US national survey data collected in 1991-1992, 2001-2002, and 2012-2013 from 118 497 participants, the risk for cannabis use and cannabis use disorders increased at a significantly greater rate in states that passed medical marijuana laws than in states that did not.

Meaning  Possible adverse consequences of illicit cannabis use due to more permissive state cannabis laws should receive consideration by voters, legislators, and policy and health care professionals, with appropriate health care planning as such laws change.

Abstract

Importance  Over the last 25 years, illicit cannabis use and cannabis use disorders have increased among US adults, and 28 states have passed medical marijuana laws (MML). Little is known about MML and adult illicit cannabis use or cannabis use disorders considered over time.

Objective  To present national data on state MML and degree of change in the prevalence of cannabis use and disorders.

Design, Participants, and Setting  Differences in the degree of change between those living in MML states and other states were examined using 3 cross-sectional US adult surveys: the National Longitudinal Alcohol Epidemiologic Survey (NLAES; 1991-1992), the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; 2001-2002), and the National Epidemiologic Survey on Alcohol and Related Conditions–III (NESARC-III; 2012-2013). Early-MML states passed MML between NLAES and NESARC (“earlier period”). Late-MML states passed MML between NESARC and NESARC-III (“later period”).

Main Outcomes and Measures  Past-year illicit cannabis use and DSM-IV cannabis use disorder.

Results  Overall, from 1991-1992 to 2012-2013, illicit cannabis use increased significantly more in states that passed MML than in other states (1.4–percentage point more; SE, 0.5; P = .004), as did cannabis use disorders (0.7–percentage point more; SE, 0.3; P = .03).

In the earlier period, illicit cannabis use and disorders decreased similarly in non-MML states and in California (where prevalence was much higher to start with). In contrast, in remaining early-MML states, the prevalence of use and disorders increased.

Remaining early-MML and non-MML states differed significantly for use (by 2.5 percentage points; SE, 0.9; P = .004) and disorder (1.1 percentage points; SE, 0.5; P = .02). In the later period, illicit use increased by the following percentage points: never-MML states, 3.5 (SE, 0.5); California, 5.3 (SE, 1.0); Colorado, 7.0 (SE, 1.6); other early-MML states, 2.6 (SE, 0.9); and late-MML states, 5.1 (SE, 0.8). Compared with never-MML states, increases in use were significantly greater in late-MML states (1.6–percentage point more; SE, 0.6; P = .01), California (1.8–percentage point more; SE, 0.9; P = .04), and Colorado (3.5–percentage point more; SE, 1.5; P = .03).

Increases in cannabis use disorder, which was less prevalent, were smaller but followed similar patterns descriptively, with change greater than never-MML states in California (1.0–percentage point more; SE, 0.5; P = .06) and Colorado (1.6–percentage point more; SE, 0.8; P = .04).

Conclusions and Relevance

Medical marijuana laws appear to have contributed to increased prevalence of illicit cannabis use and cannabis use disorders. State-specific policy changes may also have played a role. While medical marijuana may help some, cannabis-related health consequences associated with changes in state marijuana laws should receive consideration by health care professionals and the public.

Source:  JAMA Psychiatry. 2017;74(6):579-588. doi:10.1001/jamapsychiatry.2017.0724

LONDON (Reuters) – People who smoke marijuana have a three times greater risk of dying from hypertension, or high blood pressure, than those who have never used the drug, scientists said on Wednesday. The risk grows with every year of use, they said.

The findings, from a study of some 1,200 people, could have implications in the United States among other countries. Several states have legalized marijuana and others are moving toward it. It is decriminalized in a number of other countries.

“Support for liberal marijuana use is partly due to claims that it is beneficial and possibly not harmful to health,” said Barbara Yankey, who co-led the research at the school of public health at Georgia State University in the United States.

“It is important to establish whether any health benefits outweigh the potential health, social and economic risks. If marijuana use is implicated in cardiovascular diseases and deaths, then it rests on the health community and policy makers to protect the public.”

Marijuana is also sometimes used for medicinal purposes, such as for glaucoma.

The study, published in the European Journal of Preventive Cardiology, was a retrospective follow-up study of 1,213 people aged 20 or above who had been involved in a large and ongoing National Health and Nutrition Examination Survey. In 2005–2006, they were asked if they had ever used marijuana.

For Yankey’s study, information on marijuana use was merged with mortality data in 2011 from the U.S. National Center for Health Statistics, and adjusted for confounding factors such as tobacco smoking and variables including sex, age and ethnicity.

The average duration of use among users of marijuana, or cannabis, was 11.5 years.

The results showed marijuana users had a 3.42-times higher risk of death from hypertension than non-users, and a 1.04 greater risk for each year of use.

There was no link between marijuana use and dying from heart or cerebrovascular diseases such as strokes.

Yankey said were limitations in the way marijuana use was assessed — including that researchers could not be sure whether people had used the drug continuously since they first tried it.

But she said the results chimed with plausible risks, since marijuana is known to affect the cardiovascular system.

“Marijuana stimulates the sympathetic nervous system, leading to increases in heart rate, blood pressure and oxygen demand,” she said.

Experts not directly involved in the study said its findings would need to be replicated, but already raised concerns.

“Despite the widely held view that cannabis is benign, this research adds to previous work suggesting otherwise,” said Ian Hamilton, a lecturer in mental health at Britain’s York University. Source:  https://www.reuters.com/article/us-health-marijuana-hypertension-idUSKBN1AP0JS   9th Aug.201

A string of recent deaths in New Zealand is being attributed to the rise of so-called synthetic cannabis is made to look like normal cannabis

A man in his 20s died on Tuesday night, bringing the number of fatalities this month linked to the illegal substance to eight.  The drug consists of dried plants sprayed with synthetic drugs – it triggers effects similar to cannabis but is more powerful and dangerous.  Synthetic cannabis has already caused huge concerns in the US and Europe.

In each of the eight deaths this month, the victim was thought to have used the drug before dying or was found with the drug on them.  The actual substance in the drug responsible for the deaths is not yet known.

All eight deaths have occurred in Auckland and authorities say there is a much higher number of non-fatal cases where people had to be taken to hospital.

Earlier this month, the Auckland City District Police issued a warning on Facebook over the drug use and the apparent link to the rising number of victims.

“This is not an issue unique to Auckland,” the statement warned. “Police are also concerned at the impact of synthetic cannabis in other communities in New Zealand.”

Auckland police also took the rare step of releasing CCTV footage of a man violently ill and barely able to stand after smoking synthetic cannabis.

“We have grave concerns as users don’t know what poisonous chemicals they are potentially putting into their bodies when they’re smoking this drug,” Det Insp Lendrum said.

 

What is synthetic cannabis?

§ Actual cannabis contains an active ingredient which interacts with certain receptors in the brain.

§ Synthetic cannabis is dried plant matter sprayed with chemicals that interact with the same receptors.

§ Produced and sold illegally, the chemicals used vary a lot. That means the effect of the drug is a lot less predictable, so a lot more dangerous.

§ Effects can be extreme, including increased heart rates, seizures, psychosis, kidney failure and strokes.

Cannabis-simulating substances – or synthetic cannabinoids – were developed more than 20 years ago in the US for testing on animals as part of a brain research programme.  But in the last decade or so they’ve become widely available to the public.

In the UK, synthetic cannabis was also temporarily legal, being sold under a variety of names most prominently Spice and Black Mamba.  The drugs were banned in 2016 but continue to cause widespread problems in the country.

Synthetic cannabis has also been banned in the US but continues to be widely available as an illegal drug.

Source:   http://www.bbc.co.uk/news/world-asia-40724390      26 July 2017

Legalizing marijuana not only harms public health and safety, it places a significant strain on local economies and weakens the ability of the American workforce to compete in an increasingly global marketplace.

Today, a growing class of well-heeled lobbyists intent on commercializing marijuana are doing everything they can to sell legal weed as a panacea for every contemporary challenge we face in America. Over the past several years we’ve been barraged by claims that legal pot can cure the opioid crisis, cure cancer, eliminate international drug cartels, and even solve climate change.

One seemingly compelling case made by special interest groups is that legal marijuana can boost our economy too: after all, marijuana businesses create jobs and bring in millions of dollars in much-needed tax revenue.

Yet, a closer look at the facts reveals a starkly different reality. The truth is, a commercial market for marijuana not only harms public health and safety, it also places a significant strain on local economies and weakens the ability of the American workforce to compete in an increasingly global marketplace.

We already know that drug use costs our economy hundreds of millions of dollars a year in public health and safety costs. The last comprehensive study to look at costs of drugs in society found that drug use cost taxpayers more than $193 billion – due to lost work productivity, health care costs, and higher crime. A new study out of Canada found that marijuana-impaired driving alone costs more than $1 billion. Laws commercializing marijuana only make this problem worse and hamper local communities’ ability to deal with the health and safety fallout of increased drug use.

“So far in Colorado, marijuana taxes have failed to shore up state budget shortfalls. The budget deficit there doubled in the last few years, despite claims that pot taxes could turn deficit into surplus.”

This isn’t just a theory – it’s already happening. As marijuana use has increased in states that have legalized it, so has use by employees, both on and off the job. Large businesses in Colorado now state that after legalization they have had to hire out-of-state residents in order to find employees that can pass a pre-employment drug screen, particularly for safety-sensitive jobs like bus drivers, train operators, and pilots.

And now drug using employees – supported by special interest groups – are organizing to make drug use a “right” despite the negative impacts we know it will have on employers and the companies that hire them.

And what about that promised tax revenue? So far in Colorado, marijuana taxes have failed to shore up state budget shortfalls. The budget deficit there doubled in the last few years, despite claims that pot taxes could turn deficit into surplus.

Collected pot taxes only comprise a tiny fraction of the Colorado state budget— less than one percent. After costs of enforcement and regulation are subtracted, the remaining revenue used for public good is very limited.

Even viewed solely in the context of Colorado’s educational needs, pot revenue is not newsworthy. The Colorado Department of Education indicates their schools require about $18 billion in capital construction funds alone. Marijuana taxes do not even make a dent in this gap.

In Washington State, half of the $42 million of marijuana tax money legalization advocates promised would reach prevention programs and schools by 2016 never materialized. We’ve seen this movie before: witness our experience with gambling, the lottery, and other vices.

We should also care about the human fallout of increased marijuana acceptance. Recent evidence demonstrates that today’s marijuana isn’t the weed of the 1960s. It is addictive and harmful to the human brain, especially when used by adolescents.

Moreover, in states that have already legalized the drug, there has been an increase in drugged driving crashes and youth marijuana use. States that have legalized marijuana also continue to see a thriving black market, and are experiencing a continued rise in alcohol sales despite arguing users will switch to a “safer” drug.

Over the past several months, the Trump Administration has signaled it is considering a crackdown on marijuana in states where it is legal. We don’t yet know what this policy change may look like, but one thing we know for sure is that incarcerating low-level, nonviolent offenders in federal prisons is not the answer. Individual users need incentives to encourage them to make healthy decisions, not handcuffs.

But we do need to enforce federal law. Indeed, by reasserting federal control over the exploding marijuana industry, we know we can make a positive difference in preventing the commercialization of a drug that will put profits over public health and fight every regulation proposed to control its sale and use. Marijuana addiction is real, and simply ignoring this health condition will only cost us down the road. We should assess marijuana users for drug use disorders as well as mental health problems, and assist those into recovery. This can’t happen in a climate that promotes use.

Source:  http://www.cnbc.com/2017/07/27/trump-should-crackdown-on-legal-weed-commentary.html

A new study provides credible evidence that marijuana legalization will lead to decreased academic success. (Elaine Thompson/AP)

The most rigorous study yet of the effects of marijuana legalization has identified a disturbing result: College students with access to recreational cannabis on average earn worse grades and fail classes at a higher rate. Economists Olivier Marie and Ulf Zölitz took advantage of a decision by Maastricht, a city in the Netherlands, to change the rules for “cannabis cafes,” which legally sell recreational marijuana. Because Maastricht is very close to the border of multiple European countries (Belgium, France and Germany), drug tourism was posing difficulties for the city. Hoping to address this, the city barred noncitizens of the Netherlands from buying from the cafes.

This policy change created an intriguing natural experiment at Maastricht University, because students there from neighboring countries suddenly were unable to access legal pot, while students from the Netherlands continued.

The research on more than 4,000 students, published in the Review of Economic Studies, found that those who lost access to legal marijuana showed substantial improvement in their grades. Specifically, those banned from cannabis cafes had a more than 5 percent increase in their odds of passing their courses. Low performing students benefited even more, which the researchers noted is particularly important because these students are at high-risk of dropping out. The researchers attribute their results to the students who were denied legal access to marijuana being less likely to use it and to suffer cognitive impairments (e.g., in concentration and memory) as a result.

Other studies have tried to estimate the impact of marijuana legalization by studying those U.S. states that legalized medicinal or recreational marijuana. But marijuana policy researcher Rosalie Pacula of RAND Corporation noted that the Maastricht study provide evidence that “is much better than anything done so far in the United States.”

States differ in countless ways that are hard for researchers to adjust for in their data analysis, but the Maastricht study examined similar people in the same location — some of them even side by side in the same classrooms — making it easier to isolate the effect of marijuana legalization. Also, Pacula pointed out that since voters in U.S. states are the ones who approve marijuana legalization, it creates a chicken and egg problem for researchers (i.e. does legalization make people smoke more pot, or do pot smokers tend to vote for legalization?). This methodological problem was resolved in the Maastricht study because the marijuana policy change was imposed without input from those whom it affected.

Although this is the strongest study to date on how people are affected by marijuana legalization, no research can ultimately tell us whether legalization is a good or bad decision: That’s a political question and not a scientific one. But what the Maastricht study can do is provides highly credible evidence that marijuana legalization will lead to decreased academic success — perhaps particularly so for struggling students — and that is a concern that both proponents and opponents of legalization should keep in mind.

Source:https://www.washingtonpost.com/news/wonk/wp/2017/07/25/these-       college-students-lost-access-to-legal-pot-and-started-getting-better-grades/?   

Werewolf in London? Or maybe it’s a Skunk.

Cannabis is now the most popular illicit drug in the world. Several US states have legalized cannabis for medical or recreational use and more are in the process of doing the same. Numerous prospective epidemiological studies have reported that use of cannabis is a modifiable risk factor for schizophrenia-like psychosis. In 2012, the Schizophrenia Commission in the UK concluded that research to quantify the link between cannabis use and serious mental illness should be pursued.

Between May 1, 2005, and May 31, 2011, researchers culled data from 410 patients with first-episode psychosis and 370 controls. The risk of individuals having a psychotic disorder was approximately three-fold higher among users of “skunk-like” cannabis, compared with those who never used cannabis (adjusted odds ratio [OR] 2•92, 95% CI 1•52–3•45, p=0•001). Further, daily use of skunk-like cannabis resulted in the highest risk of psychotic disorders, compared with no use of cannabis (adjusted OR 5•4, 95% CI 2•81–11•31, p=0•002).

The population attributable fraction of first episode psychosis for skunk use for the geographical area of south London was 24% (95% CI 17–31), possibly because of the high prevalence of high-potency cannabis (218 [53%] of 410 patients) in the study.

Clearly, and as seen elsewhere, availability of high potency cannabis in south London most likely resulted in a greater proportion of first onset psychosis than in previous studies where the cannabis is less potent.

Why Does this Matter?

Changes in marijuana potency and the increased prevalence of use by adolescents and young adults increases the risk of serious mental illness and the burden on the mental health system.

Chronic, relapsing psychotic illness produced by cannabis is similar to that produced naturally in Schizophrenia. However, treatment responses are not the same. Indeed, skunk use appears to contribute to 24% of cases of first episode psychosis in south London. Our findings show the importance of raising awareness among young people of the risks associated with the use of high-potency cannabis. The need for such public education is emphasized by the worldwide trend of liberalization of the constraints on cannabis and the fact that high potency varieties are becoming increasingly available.

Finally, in both primary care and mental health services, developing a simple screening instrument as simple as yes-or-no questions of whether people use skunk or other drugs will aid public health officials to identify epidemiological maps and “hot spots” of increased drug use and to develop interdiction, education and prevention efforts.

Source:  https://www.rivermendhealth.com/resources/cannabis-induced-psychosis-now-spreading-uk     July 2017

Cannabis is the most widely used illicit drug in the United States, and trends show increasing use in the general population. As cannabis consumption rises, there has been significant emerging evidence for cannabis-related risks to health.1

Numerous lines of evidence suggest a correlation between cannabis consumption and a variety of psychiatric conditions, including cannabis-induced psychosis (CIP). While it can be difficult to differentiate CIP from other psychoses, CIP holds distinguishing characteristics, which may aid in its diagnosis. Given the increasing push toward cannabis legalization, assessing CIP and employing timely treatments is critical.

Specifically in youth, there is a direct relationship between cannabis use and its risks. The lack of knowledge surrounding its detrimental effects, combined with misunderstandings related to its therapeutic effects, has potential for catastrophic results.

CASE VIGNETTE

Ms. J, a 19-year-old college sophomore, was admitted to the Early Psychosis Unit at the Centre for Addiction and Mental Health (CAMH) displaying signs of agitation and acute psychosis. Her roommates had noted that her behavior had become increasingly bizarre, and she had isolated herself over the past month. She began smoking marijuana at the age of 17 and since starting college used it daily.

Ms. J exhibited signs of paranoia, believing other students in her dorm were stealing from her and trying to poison her. She remained adamant that all her problems were rooted in the competitive environment of the university and that smoking marijuana aided in keeping her sanity. In a sense, she was self-medicating. Her clinical presentation was consistent with a diagnosis of CIP.

After the hospitalization, she received outpatient case management services in the Early Psychosis Program at CAMH, which included motivational interviewing to raise her awareness about the importance of abstaining from cannabis use. She has been abstinent from cannabis for more than a year with no evidence of psychosis; she recently returned to school to finish her degree.

Epidemiology of CIP

Reports have shown a staggering increase in cannabis-related emergency department (ED) visits in recent years. In 2011, the Substance Abuse and Mental Health Services Administration (SAMHSA) and Drug Abuse Warning Network (DAWN) estimated a total of 1.25 million illicit-drug–related ED visits across the US, of which 455,668 were marijuana related.2 A similar report published in 2015 by the Washington Poison Center Toxic Trends Report showed a dramatic increase in cannabis-related ED visits.3 In states with recent legalization of recreational cannabis, similar trends were seen.4

States with medicinal marijuana have also shown a dramatic rise in cannabis-related ED visits. Moreover, states where marijuana is still illegal also showed increases.5 This widespread increase is postulated to be in part due to the easy accessibility of the drug, which contributes to over-intoxication and subsequent symptoms. Overall, from 2005 to 2011, there has been a dramatic rise in cannabis-related ED visits among all age groups and genders.

Neurobiology of CIP

Cannabis is considered an environmental risk factor that increases the odds of psychotic episodes, and longer exposure is associated with greater risk of psychosis in a dose-

dependent fashion. The drug acts as a stressor that leads to the emergence and persistence of psychosis. While a number of factors play a role in the mechanism by which consumption produces psychosis, the primary psychoactive ingredient is considered to be delta 9-tetrahydrocannabinol (delta9-THC). Properties of delta9-THC include a long half-life (up to 30 days to eliminate the long-acting THC metabolite carboxy-THC from urine) and high lipophilicity, which may contribute to CIP.

During acute consumption, cannabis causes an increase in the synthesis and release of dopamine as well as increased reuptake inhibition, similar to the process that occurs during stimulant use. Consequently, patients with CIP are found to have elevated peripheral dopamine metabolite products.

Findings from a study that examined presynaptic dopaminergic function in patients who have experienced CIP indicate that dopamine synthesis in the striatum has an inverse relationship with cannabis use. Long-term users had reduced dopamine synthesis, although no association was seen between dopaminergic function and CIP.6 This observation may provide insight into a future treatment hypothesis for CIP because it implies a different mechanism of psychosis compared with schizophrenia. As cannabis may not induce the same dopaminergic alterations seen in schizophrenia, CIP may require alternative approaches—most notably addressing associated cannabis use disorder.

Polymorphisms at several genes linked to dopamine metabolism may moderate the effects of CIP. The catechol-o-methyltransferase (COMT Val 158Met) genotype has been linked to increased hallucinations in cannabis users.7Homozygous and heterozygous genetic compositions (Met/Met, Val/Met, Val/Val) for COMT Val 158Met have been studied in patients with CIP and suggest that the presence of Val/Val and Val/Met genotypes produces a substantial increase in psychosis in relation to cannabis use. This suggests that carriers of the Val allele are most vulnerable to CIP attacks.

There has been much controversy surrounding the validity of a CIP diagnosis and whether it is a distinct clinical entity or an early manifestation of schizophrenia. In patients being treated for schizophrenia, those with a history of CIP had an earlier onset of schizophrenia than patients who never used cannabis.8Evidence suggests an association between patients who have received treatment for CIP and later development of schizophrenia spectrum disorder. However, it has been difficult to distinguish whether CIP is an early manifestation of schizophrenia or a catalyst. Nonetheless, there is a clear association between the 2 disorders.

Assessment of CIP

DSM-5 categorizes cannabis-induced psychotic disorder as a substance-induced psychotic disorder. However, there are distinguishing characteristics of CIP that differentiate it from other psychotic disorders such as schizophrenia. Clear features of CIP are sudden onset of mood lability and paranoid symptoms, within 1 week of use but as early as 24 hours after use. CIP is commonly precipitated by a sudden increase in potency (eg, percent of THC content or quantity of cannabis consumption; typically, heavy users of cannabis consume more than 2 g/d). Criteria for CIP must exclude primary psychosis, and symptoms should be in excess of expected intoxication and withdrawal effects. A comparison of the clinical features of idiopathic psychosis versus CIP is provided in the Table.

When assessing for CIP, careful history taking is critical. Time of last drug ingestion will indicate if a patient’s psychotic symptoms are closely related to cannabis intoxication/withdrawal effects. While acute cannabis intoxication presents with a range of transient positive symptoms (paranoia, grandiosity, perceptual alterations), mood symptoms (anxiety), and cognitive deficits (working memory, verbal recall, attention), symptoms that persist beyond the effects of intoxication and withdrawal are better categorized as CIP, regardless of the route of administration (smoke inhalation, oral, intravenous). CIP has historically been associated with fewer negative symptoms than schizophrenia; however, without a clear timeline of use, distinguishing schizophrenia from CIP may prove difficult.

A diagnosis of primary psychosis (eg, schizophrenia) is warranted in the absence of heavy cannabis use or withdrawal (for at least 4 weeks), or if symptoms preceded onset of heavy use. The age at which psychotic symptoms emerge has not proved to be a helpful indicator; different studies show a conflicting median age of onset.

Clinical features of schizophrenia and CIP share many overlapping characteristics. However, compared with primary psychoses with concurrent cannabis abuse, CIP has been established to show more mood symptoms than primary psychosis. The mood symptom profile includes obsessive ideation, interpersonal sensitivity, depression, and anxiety. Of significance is the presence of social phobia: 20% of patients with CIP demonstrate phobic anxiety compared with only 3.8% of patients with primary psychosis with cannabis abuse.

Hypomania and agitation have also been found to be more pronounced in cases of CIP.9 Visual hallucinations are more common and more distinct in CIP than in other psychoses such as schizophrenia. Perhaps the most discriminating characteristic of CIP is awareness of the clinical condition, greater disease insight, and the ability to identify symptoms as a manifestation of a mental disorder or substance use. The presence of much more rapidly declining positive symptoms is another distinctive factor of CIP.

Finally, family history may help distinguish CIP from primary psychosis. Primary psychosis has a strong association with schizophrenia and other psychotic disorders in first- or second-degree relatives, whereas CIP has a weaker family association with psychosis.

Treatment of CIP

As with all substance-induced psychotic states, abstinence from cannabis may be the definitive measure to prevent recurrence. With limited research surrounding CIP, achieving symptomatic treatment during acute phases of CIP has proved to be difficult. The Figure suggests possible treatment progression for CIP.

Pharmacotherapeutic interventions include the second-generation antipsychotic drug olanzapine and haloperidol. While both are equally effective, their different adverse- effect profiles should be taken into consideration when treating a patient; olanzapine is associated with significantly fewer extrapyramidal adverse effects.

One report indicates that antipsychotics worsened the condition in some patients.10 Conventional antipsychotics failed to abate the symptoms of CIP in one 20-year old man. Trials of olanzapine, lithium, and haloperidol had little to no effect on his psychosis. Risperidone was tried but elicited temporal lobe epilepsy with auditory, somatic, and olfactory hallucinations. However, the use of valproate sodium markedly improved his symptoms and cognition, returning him to baseline.

Carbamazepine has also been shown to have rapid effects when used as an adjunct to antipsychotics.11 Use of anti-seizure medication in CIP treatment has been hypothesized to reduce neuroleptic adverse effects, resulting in better tolerance of antipsychotics.10,11 These results suggest the use of adjunctive anti-epileptics should be considered in CIP treatment strategies, although further studies in a broad range of patients with CIP are needed.

Abstaining from cannabis is the most beneficial and effective measure for preventing future CIP events; however, it is likely to be the most difficult to implement.

Psychosocial intervention has a significant impact on early-phase psychosis, and when the intervention is initiated plays a role in disease outcomes. A delay in providing intensive psychosocial treatment has been associated with more negative symptoms compared with a delay in administrating antipsychotic medication.12 Employing cannabis- focused interventions with dependent patients who present with first-episode psychosis can decrease use in a clinically meaningful way and subjectively improve patient quality of life.

Compared with the standard of care, motivational interviewing significantly increases number of days abstinent from cannabis and aids in decreasing short-term consumption.13 Patients who are treated with motivational interviewing in addition to standard of care (combination of antipsychotic medication, regular office-based psychiatric contact, psychoeducation) are reported to also have more confidence and willingness to reduce cannabis use.

Patients with CIP who are unwilling or unable to decrease cannabis consumption may be protected from psychotic relapse with aripiprazole (10 mg/d). Its use suppresses the re-emergence of psychosis without altering cannabis levels. However, no direct comparison has been made with aripiprazole and other antipsychotics in treating CIP. Clearly, well-controlled large studies of putative treatments for CIP are needed.

Conclusions

As more countries and states approve legalization, and marijuana becomes more accessible, CIP and other cannabis-related disorders are expected to increase. Efforts should be made by physicians to educate patients and discourage cannabis use. Just as there was an era of ignorance concerning the damaging effects of tobacco, today’s conceptions about cannabis may in fact be judged similarly in the future. The onus is on psychiatrists to take an evidence-based approach to this increasing problem.

Source:  http://www.psychiatrictimes.com/substance-use-disorder/cannabis-induced-psychosis-review  14th July

As the U.S. is facing its most challenging drug epidemic in history, the need to prevent adolescence drug misuse is imperative. For the past two years, Mentor Foundation USA and George Washington University have piloted an innovative drug prevention peer-to-peer initiative at three high schools in Columbia County, NY. The program, which engages youth through social media is showing some promising results in terms of shifts in attitudes towards drugs and intent to use.

The interactive “multi-media” initiative is called Living the Example (LTE), a program that incorporates messages for prevention specifically designed to counteract the misinformation adolescents have about drugs and alcohol.  Messages are framed to promote the benefits of prevention behaviors. “This approach to branding, an alternative, healthy behavior, or ‘counter-marketing’ as it has been termed in tobacco control, has been highly effective and is recognized as one of the main elements in successful prevention programs, such as in tobacco control,” says Principal Investigator, Dr. Doug Evans, a pioneer in the use of this strategy. Dr. Evans is a Professor of Prevention and Community Health & Global Health, with Milken Institute School of Public Health at George Washington University.

Youth Ambassadors are trained to create LTE branded prevention messages, disseminate them via social media platforms, and engage peers in their preferred social networks, with the intention of increasing peer interaction around the brand’s core messaging.  Positive receptivity to LTE messages was associated with some evidence of reduced self-reported drug use intentions, specifically for marijuana use, and reports of intent to use any drug. Among youth who reported exposure and receptivity to LTE, they reported a significant decrease in marijuana use intentions. The most common overall reason for drug use among all respondents was family stress (81.3%), boredom (40%) and academic stress (40%).

“Findings from the study suggest that peer-to-peer substance use prevention via social media is a promising strategy, especially given the low cost and low burden as an intervention channel, which schools, communities, and prevention programs can use as an approach, even in low resource settings,” says Michaela Pratt, President of Mentor Foundation USA. “Through our international network, Mentor Foundation shares over 20 years of global experience in best prevention practices, and Mentor Foundation USA has always been a pioneer in empowering young people to become their own advocates for drug prevention.”

This program was generously supported by The Conrad N. Hilton Foundation, Rip Van Winkle Foundation, among local foundations in Columbia County. Mentor Foundation USA is a member affiliate of Mentor International, which was founded in 1994 by Her Majesty Queen Silvia of Sweden and the World Health Organization and is the largest network of its kind for evidence based programs that prevent drug abuse among youth. Collectively, Mentor has implemented projects in over 80 countries impacting more than 6 million youth.  Mentor Foundation USA is a Delaware registered 501(c)3 non-profit organization.

SOURCE http://www.prnewswire.com/news-releases/200-dc-high-school-students-shatter-the-myths-around-substance-abuse-in-an-innovative-proven

An UdeM study confirms the link between marijuana use and psychotic-like experiences in a Canadian adolescent cohort. Credit: © Syda Productions / Fotolia

Going from an occasional user of marijuana to a weekly or daily user increases an adolescent’s risk of having recurrent psychotic-like experiences by 159%, according to a new Canadian study published in the Journal of Child Psychology and Psychiatry.

The study also reports effects of marijuana use on cognitive development and shows that the link between marijuana use and psychotic-like experiences is best explained by emerging symptoms of depression.

“To clearly understand the impact of these results, it is essential to first define what psychotic-like experiences are: namely, experiences of perceptual aberration, ideas with unusual content and feelings of persecution,” said the study’s lead author, Josiane Bourque, a doctoral student at Université de Montréal’s Department of Psychiatry. “Although they may be infrequent and thus not problematic for the adolescent, when these experiences are reported continuously, year after year, then there’s an increased risk of a first psychotic episode or another psychiatric condition.”

She added: “Our findings confirm that becoming a more regular marijuana user during adolescence is, indeed, associated with a risk of psychotic symptoms. This is a major public-health concern for Canada.”

What are the underlying mechanisms?

One of the study’s objectives was to better understand the mechanisms by which marijuana use is associated with psychotic-like experiences. Bourque and her supervisor, Dr. Patricia Conrod at Sainte Justine University Hospital Research Centre hypothesized that impairments in cognitive development due to marijuana misuse might in turn exacerbate psychotic-like experiences.

This hypothesis was only partially confirmed, however. Among the different cognitive abilities evaluated, the development of inhibitory control was the only cognitive function negatively affected by an increase in marijuana use. Inhibitory control is the capacity to withhold or inhibit automatic behaviours in favor of a more contextually appropriate behaviour. Dr. Conrod’s team has shown that this specific cognitive function is associated with risk for other forms of substance abuse and addiction.

“Our results show that while marijuana use is associated with a number of cognitive and mental health symptoms, only an increase in symptoms of depression — such as negative thoughts and low mood — could explain the relationship between marijuana use and increasing psychotic-like experiences in youth,” Bourque said.

What’s next

These findings have important clinical implications for prevention programs in youth who report having persistent psychotic-like experiences. “While preventing adolescent marijuana use should be the aim of all drug strategies, targeted prevention approaches are particularly needed to delay and prevent marijuana use in young people at risk of psychosis,” said Patricia Conrod, the study’s senior author and a professor at UdeM’s Department of Psychiatry.

Conrod is optimistic about one thing, however: the school-based prevention program that she developed, Preventure, has proven effective in reducing adolescent marijuana use by an overall 33%. “In future programs, it will be important to investigate whether this program and other similar targeted prevention programs can delay or prevent marijuana use in youth who suffer from psychotic-like experiences,” she said. “While the approach seems promising, we have yet to demonstrate that drug prevention can prevent some cases of psychosis.”

A large youth cohort from Montreal

The study’s results are based on the CIHR-funded Co-Venture project, a cohort of approximately 4,000 adolescents aged 13 years old from 31 high schools in the Greater Montreal area. These teens are followed annually from Grade 7 to Grade 11. Every year they fill out computerized questionnaires to assess substance use and psychiatric symptoms. The teens also complete cognitive tasks to allow the researchers to evaluate their IQ, working memory and long-term memory as well as their inhibitory control skills.

To do their study, the research team first confirmed results from both the United Kingdom and Netherlands showing the presence of a small group of individuals (in Montreal, 8%) among the general population of adolescents who report recurrent psychotic-like experiences. Second, the researchers explored how marijuana use between 13 and 16 years of age increases the likelihood of belonging to the 8%. Finally, they examined whether the relationship between increasing use of marijuana and increasing psychotic-like experiences can be explained by emerging symptoms of anxiety or depression, or by the effects of substance use on developing cognitive abilities.

Source:  University of Montreal. “Marijuana and vulnerability to psychosis.” ScienceDaily. ScienceDaily, 5 July 2017. www.sciencedaily.com/releases/2017/07/170705104042.htm.

 

Canada’s Liberal government has stated that marijuana will be decriminalized by July 2018. This means the removal, or at the least, a lessening of laws and restrictions related to marijuana use and associated pot services.

While people on both sides of the debate have strongly held and differing opinions, the protection of youth is an area of agreement.

Marijuana, also known as cannabis, has been illegal in Canada for close to 100 years. Marijuana can’t be produced, sold or even possessed. If caught, one faces fines, jail time or both.

Despite this, Canada has one of the highest rates of cannabis use in the world. Over 40 per cent of Canadians have used cannabis during their lifetime. Furthermore, studies conducted by Health Canada indicate that between 10.2 and 12.2 per cent of Canadians use cannabis at least once a year.

As changes in cannabis regulation occur, new research has been conducted. The findings are, in a word, alarming. According to published research, someone who uses marijuana regularly has, on average, less grey matter in the orbital frontal cortex of the brain. Other research has found increasing evidence of a link between pot and schizophrenia symptoms.

A major factor is the potency of cannabis, which has gone through the roof for the last two decades. In the 1960s, THC levels were reported to have been in the one-to-four-per-cent range. Research reported in the science journal, Live Science, in 21014 indicates that marijuana’s main psychoactive ingredient, THC, in random marijuana samples, rose from about four per cent in 1995 to about 12 per cent in 2014. In a more-recent article, the leader of the American Chemical Society stated: “We’ve seen potency values close to 30-per-cent THC, which is huge.”

Despite these clear and increasing dangers, the Government of Canada’s stated objective is to “legalize, strictly regulate and restrict access to cannabis for non-medical purposes.” Unfortunately, the government’s approach has serious flaws.  Most importantly, their approach lacks protections for youth, despite this being another specifically stated objective of the Canadian government’s new law.

While supporters of cannabis often compare it with alcohol, a legal, but carefully controlled substance in Canada, there is an important difference. Cannabis is commonly consumed by smoking, which leads to significant, second-hand affects and, as a result, second-hand structural changes in the brain.

In my neighbourhood, cannabis-users in one house, taking advantage of the decreasing legal response to cannabis in B.C. these days, happily smoke the substance on their back deck, only to have the blue smoke waft across to the trampoline next door, where my younger brother and his friends often play.

The government’s proposed new policy actually encourages youth exposure by making it legal for citizens to grow cannabis in their homes. There is no mention of the protection of children living in those residences, where cannabis is grown, consumed and potentially sold.

The Canadian Association of Chiefs of Police makes this point well. They warn that allowing home-grown cultivation will fuel the cannabis black market and that the four-plant limit proposed under the legislation is impossible to enforce. The chiefs further note that home cultivation is a direct contradiction to the government’s promise to create a highly regulated environment that minimizes youth access to the drug.

The biggest concern that the youth of Canada should have about the government’s approach to decriminalization is, however, drug quality — potentially with deadly results. The opportunity for tampering is obvious. A high school friend and classmate of mine casually uses cannabis and landed in the hospital for a few weeks. She believes that some of the cannabis she used was laced with another substance. I often wonder how close my friend came to dying like another of our fellow students at New Westminster Secondary School.

Canada isn’t ready for the decriminalization of cannabis. The Canadian government, and our health-care and legal systems, aren’t fully prepared for the problems and long-term effects that’ll have serious consequences for our youth. Important issues, including second-hand effects and basic safety, not to mention enforcement and legal implications, have yet to be fully defined and planned for. The federal government’s plan to decriminalize pot, as it stands now, doesn’t provide enough protection for Canada’s young people.

Mitchell Moir is a Grade 12 student at New Westminster Secondary.

Source:  http://vancouversun.com/opinion/op-ed/opinion-proposed-cannabis-policy-doesnt-do-enough-to-protect-youth   23rd June 2017

Today’s Reality

Even if you smoked pot 20+ years ago without harm, today’s situation is different.  We want our children to avoid marijuana because they care about the risks in marijuana itself.

Here’s the facts for raising your children today:

* Marijuana has been modified since 1994. The THC, which gives the high, is 3-10x stronger in the plants of today.  If a child begins using today’s pot , it’s like to learning to drink with grain alcohol, instead of beer or wine.  Also, youth today frequently use the potent “dabs” “wax” and “budder.”  These are extractions can have 40-80% THC.

* Marijuana is addictive, contrary to a popular myth, particularly with today’s stronger strains of pot.

* In states with medical marijuana, teen usage is much higher than in other states, and many teens who use pot get it from some marijuana cardholders.

* Those who begin in adolescence or their teens, have an addiction rate of 17 percent, as opposed to 9 percent for those who begin using marijuana as an adult. *Emergency Department hospitalizations from marijuana rose from 281,000 to 455,000 between 2004 and 2011, making it 2nd amongst the illegal drugs causing ER treatment.

* Individuals responses to marijuana can be vary greatly, and the potential for paranoia and psychotic reactions are real side effects, omitted in the pot propaganda.

* Marijuana is fat soluble and stays in the body for weeks, which is why some people have flashbacks.

* The  brain, which is 1/3 fat, isn’t fully developed until age 25 or later, and until it is, marijuana can cause irreversible damage.

* Marijuana is not as widely used as alcohol,  6-7% of the adult population, vs.  66% who drink, one reason the comparison doesn’t work. * Marijuana usage causes traffic deaths and it is not safe to combine with driving.

* More teens seek substance abuse treatment for pot than any other legal or illegal substance. * Marijuana is a gateway drug,  because nearly every young person who develops a drug addiction begins with marijuana.  Early pot users such as Robert Downey, Jr. (age 9), and Cameron Douglas  (age 13), prove that the stranglehold of drug addiction lasts for years.

* A multi-year study out of New Zealand, tracking marijuana users and through their mid-30s showed IQs decrease an 6-8 percentage points over time.  Again, we point to the medical studies summarized on this webpage.

* In a recent study, schizophrenics who have used marijuana had an onset of the disease 2-1/2 years earlier than those who did not use marijuana. * Marijuana can trigger psychotic symptoms and/or mental illness, and cognitive decline in youth, more quickly than alcohol, while tobacco does not.

* Since marijuana usage increases the odds of developing a mental illness, expansion of pot will expand mental health treatment needs.

* Efforts to legalize for age 21+  hide the motivation to attract young users and build big profits.  Legal pot mean more young users.

* Marijuana usage is associated with greater risk for testicular cancer in males.

* With universal health care, all of us will pay for the increase in medical care for those needing help from pot abuse.

* The number of pot-related hospitalizations in Colorado accelerated in 2009 and went out of control in the first half of 2014.

* Existing mental health issues, such as ADHD, anxiety and depression, greatly increase the use of drugs for self-medication.

Mental Health, Physical Health Alike

“We cannot promote a comprehensive system of mental health treatment and marijuana legalization, which increases permissiveness for a drug that directly contributes to mental illness,”  states former Congressman Patrick Kennedy, who fought tirelessly on behalf of parity for mental health treatment. Kennedy and policy expert Kevin Sabet promote  Smart Approaches to Marijuana.

* The National Alliance for Mental Illness lists four illegal drugs which cause psychosis: cannabis, LSD, methamphetamine and heroin and two classes of legal drugs, amphetamines and steroids. Pharmaceutical drugs are sold with warnings, while marijuana isn’t.

Sharon Levy, Chairwoman of the American Academy of Paediatrics committee on substance abuse, said “We’re losing the public health battle” and policy is being made by legalization advocates who might be misinformed about marijuana’s dangers.”

Source:  http://www.poppot.org/2016/08/08/latest-child-dangers-marijuana-edibles/

Smart Approaches to Marijuana’s 2017 publication references academic studies which suggest that marijuana primes the brain for other types of drug usage.  Here’s the summary on that subject from page 4, Marijuana and Other Drugs: A Link We Can’t Ignore :

MORE THAN FOUR in 10 people who ever use marijuana will go on to use other illicit drugs, per a large, nationally representative sample of U.S. adults.(1) The CDC also says that marijuana users are three times more likely to become addicted to heroin.(2)

Although 92% of heroin users first used marijuana before going to heroin, less than half used painkillers before going to heroin.

And according to the seminal 2017 National Academy of Sciences report, “There is moderate evidence of a statistical association between cannabis use and the development of substance dependence and/or a substance abuse disorder for substances including alcohol, tobacco, and other illicit drugs.”(3)

RECENT STUDIES WITH animals also indicate that marijuana use is connected to use and abuse of other drugs. A 2007 Journal of Neuropsychopharmacology study found that rats given THC later self -administered heroin as adults, and increased their heroin usage, while those rats that had not been treated with THC maintained a steady level of heroin intake.(4) Another 2014 study found that adolescent THC exposure in rats seemed to change the rodents’ brains, as they subsequently displayed “heroin-seeking” behaviour. Youth marijuana use could thus lead to “increased vulnerability to drug relapse in adulthood.”(5)

National Institutes of Health Report

The National Institutes of Health says that research in this area is “consistent with animal experiments showing THC’s ability to ‘prime’ the brain for enhanced responses to other drugs. For example, rats previously administered THC show heightened behavioral response not only when further exposed to THC, but also when exposed to other drugs such as morphine—a phenomenon called cross-sensitization.”(6)

Suggestions that one addictive substance replaces another ignores the problem of polysubstance abuse, the common addiction of today.

Additionally, the majority of studies find that marijuana users are often polysubstance users, despite a few studies finding limited evidence that some people substitute marijuana for opiate medication. That is, people generally do not substitute marijuana for other drugs. Indeed, the National Academy of Sciences report found that “with regard to opioids, cannabis use predicted continued opioid prescriptions 1 year after injury.  Finally, cannabis use was associated with reduced odds of achieving abstinence from alcohol, cocaine, or polysubstance use after inpatient hospitalization and treatment for substance use disorders” [emphasis added].(7)

Moreover, a three-year 2016 study of adults also found that marijuana compounds problems with alcohol. Those who reported marijuana use during the first wave of the survey were more likely than adults who did not use marijuana to develop an alcohol use disorder within three years.(8) Similarly, alcohol consumption in Colorado has increased slightly since legalization. (9)

Source:   http://www.poppot.org/2017/07/03/replacing-one-addiction-another-will-not-work/

Mass Illness from Marijuana Edibles in San Francisco There’s more potential for overdose from edibles than smoked marijuana, although the teen in Seattle who jumped to his death last December did it after smoking pot for the first time.  Two shocking incidents in California suggest that overdose emergencies will increase if that states vote to legalize marijuana in November.  Here’s a summary of recent cases of toxicity from edibles:

· 19 people were hospitalized in San Francisco on August 7 from THC, after attending a quinceañera party.  The source is believed be marijuana-infused candies, perhaps gummy bears. Several children were among those poisoned, one as young as six.  A 9-year-old had severe difficulty breathing.

· Pot brownies sent a bachelorette party to the emergency room in South Lake Tahoe over the weekend of July 30-31. Eight of the 10 women were admitted to the hospital according to the City of South Lake Tahoe’s website.

· A JAMA Paediatrics article explains the dramatic rise in children’s hospitalizations related to marijuana in Colorado since legalization.  In 10 cases, the product was not in a child-resistant container; in 40 scenarios (34%) there was poor child supervision or product storage.  Edible products were responsible for 51 (52% ) of exposures.  The report claimed that child-resistant packaging has not been as effective in reducing kids’ unintended exposure to pot as hoped.

· The report mentions the death of one child, an 11-month-old baby.  Nine of the children had symptoms so serious that they ended up in the intensive care unit of Colorado Children’s Hospital.  Two children needed breathing tubes.

· The state of Washington has a similar problem with edibles, as reported on the King County Health Department’s website.  From 2013 to May 2015, there were 46 cases of children’s intoxications related to marijuana edibles reported in Washington.  However, reporting is voluntary and the state estimates that number could be much higher.

·  In May, a father plead guilty to deliberately giving his 4-year-old daughter marijuana-laced cake in Vancouver, Washington.  He was sentenced to two years in prison.

Intoxication from marijuana edibles has risen steadily since legalization. Source: King County Department of Health. Top photo: AP

· In Hingham, MA, there was a 911 related to teen girl who ingested marijuana edibles.  The candies were in a package labelled Conscious Creations, which didn’t disclose ingredients.   Massachusetts has a medical marijuana program, but it is not clear how or to whom they were sold or dispensed.

 

· July, 2016: Two California teens were hospitalized after eating a marijuana-laced cookie. The teens reported purchasing the cookie from a third teenager who was subsequently arrested.

· July, 2016: A California man was arrested for giving candy laced with marijuana to a 6-year-old boy and an 8-year-old boy; the 6-year-old was hospitalized for marijuana poisoning.

· July, 2016: Police in Arizona arrested a mother for allegedly giving her 11- and 12-year-old children gummy candy infused with marijuana. Police say the marijuana-infused candy was originally purchased by an Arizona medical marijuana user, but was illegally transferred to the mother in question.  (State medical marijuana programs have poor track records of assuring the “medicine” goes to whom it is intended.)

· On April 27, a Georgia woman was arrested after a 5- year-old said he ate a marijuana cake for breakfast.  The child was taken to the hospital for treatment following the incident; according to officials, his pulse was measured at over 200 beats per minute.

· Last year there were more than 4,000 treatments at hospitals and poison center treatments in the US related to marijuana toxicity in children and teens.

Growth of marijuana edibles intoxication by age. Source: King County, Washington

Edible marijuana poses a “unique problem,” because “no other drug is infused into a palatable and appetizing form” – such as cookies, brownies and candy.    Many household items cause poisonings, but marijuana edibles are different because they’re made to look appealing and they appeal to children.

 

Source:  http://www.poppot.org/2016/08/08/latest-child-dangers-marijuana-e

It is vital that physicians—particularly psychiatrists who are on the frontlines with patients who struggle with cannabis use—are able to identify and characterize cannabis use disorders; provide education; and offer effective, evidence-based treatments. This article provides a brief overview of each of these topics by walking through clinical decision-making with a case vignette that touches on common experiences in treating a patient with cannabis use disorder.

A separate and important issue is screening for emerging drugs of abuse, including synthetic “marijuana” products such as K2 and spice. Although these products are chemically distinct from the psychoactive compounds in the traditional cannabis plant, some cannabis users have tried synthetic “marijuana” products because of their gross physical similarity to cannabis plant matter.

CASE VIGNETTE

Mr. M is a 43-year-old legal clerk who has been working in the same office for 20 years. He presents as a referral from his primary care physician to your outpatient psychiatry office for an initial evaluation regarding “managing some mid-life issues.” He states that while he likes his job, it is the only job he has had since graduating college and he finds the work boring, noting that most of his co-workers have gone on to law school or more senior positions in the firm. When asked what factors have prevented him from seeking different career opportunities, he states that he would “fail a drug test.” Upon further inquiry, Mr. M says he has been smoking 2 or 3 “joints” or taking a few hits off of his “vaping pen” of cannabis daily for many years, for which he spends approximately $70 to $100 a week.

He first used cannabis in college and initially only smoked “a couple hits” in social settings. Over time, he has needed more cannabis to “take the edge off” and has strong cravings to use daily. He reports liking how cannabis decreases his anxiety and helps him fall asleep, although he thinks the cannabis sometimes makes him “paranoid,” which results in his avoidance of family and friends.

More recently, he identifies conflict and regular arguments with his wife over his cannabis use—she feels it prevents him from being present with his family and is a financial burden. He admits missing an important awards ceremony for her work and sporting events for his children, for which he had to “come up with excuses,” but the truth is that he ended up smoking more than he had intended and lost track of the time.

Mr. M reports multiple previous unsuccessful attempts to reduce his use and 2 days when he stopped completely, which resulted in “terrible dreams,” poor sleep, sweating, no appetite, anxiety, irritability, and strong cravings for cannabis. Resumption of his cannabis use relieved these symptoms. He denies tobacco or other drug use, including use of synthetic marijuana products such as K2 or spice, and reports having a glass of wine or champagne once or twice a year for special occasions.

The diagnosis

In the transition from DSM IV-TR to DSM-5, cannabis use disorders, along with all substance use disorders, have been redefined in line with characterizing a spectrum of

pathology and impairment. The criteria to qualify for a cannabis use disorder remain the same except for the following:

1. The criterion for recurrent legal problems has been removed.

2. A new criterion for craving or a strong desire or urge to use cannabis has been added, and the terms abuse and dependence were eliminated.

To qualify as having a cannabis use disorder, a threshold of 2 criteria must be met. Severity of the disorder is characterized as “mild” if 2 or 3 criteria are met, “moderate” if 4 or 5 criteria are met, and “severe” if 6 or more criteria are met. Mr. M demonstrates 3 symptoms of impaired control: using longer than intended, unsuccessful efforts to cut back, and craving; 3 symptoms of social impairment: failure to fulfil home obligations, persistent problems with his wife, and reduced pursuit of occupational opportunities; 1 symptom of risky use: continued use despite paranoia; and 2 symptoms of pharmacological properties: tolerance and withdrawal. As such, he meets 9 criteria, which qualify him for a diagnosis of severe cannabis use disorder.

You summarize Mr. M’s 9 symptoms and counsel him about severe cannabis use disorder. He becomes upset and states that he was not aware one could develop an “addiction” to cannabis. He expresses an interest in treatment and asks what options are available.

Treatment options

Psychotherapeutic treatments, including motivational enhancement treatment (MET), cognitive behavioral therapy (CBT), and contingency management (CM), have demonstrated effectiveness in reducing frequency and quantity of cannabis use, but abstinence rates remain modest and decline after treatment. Generally, MET is effective at engaging individuals who are ambivalent about treatment; CM can lead to longer periods of abstinence during treatment by incentivizing abstinence; and CBT can work to enhance abstinence following treatment (preventing relapse). Longer duration of psychotherapy is associated with better outcomes. However, access to evidence-based psychotherapy is frequently limited, and poor adherence to evidence-based psychotherapy is common.

In conjunction with psychotherapy, medication strategies should be considered. Because there are no FDA-approved pharmacological agents for cannabis use disorder, patients should understand during the informed consent process that all pharmacotherapies used to treat this disorder are off-label. A number of clinical trials provide evidence for the off-label use of medications in the treatment of cannabis use disorder. The current strategies for the off-label treatment of cannabis use disorder target withdrawal symptoms, aim to initiate abstinence and prevent relapse or reduce use depending on the patient’s goals, and treat psychiatric comorbidity and symptoms that may be driving cannabis use. Here we focus on the evidence supporting these key strategies.

Targeting withdrawal and craving

Cannabis withdrawal is defined by DSM-5 as having 3 or more of the following signs and symptoms that develop after the cessation of prolonged cannabis use:

• Irritability, anger, or aggression

• Nervousness or anxiety

• Sleep difficulty

• Decreased appetite or weight loss

• Restlessness

• Depressed mood

• At least one of the following physical symptoms that causes discomfort: abdominal pain, shakiness/tremors, sweating, fever, chills, or headache

Withdrawal symptoms may be present within the first 24 hours. Overall, they peak within the first week and persist up to 1 month following the last use of cannabis. In the case of Mr. M, insomnia, poor appetite, and irritability as well as sweating are identified, which meet DSM-5 criteria for cannabis withdrawal during the 2 days he abstained from use. He also identifies strong craving and vivid dreams, which are additional withdrawal symptoms included on marijuana withdrawal checklists in research studies, although not included in DSM-5 criteria. These and other symptoms should be considered in clinical treatment.

Medication treatment studies for cannabis withdrawal have hypothesized that if withdrawal symptoms can be reduced or alleviated during cessation from regular cannabis use, people will be less likely to resume cannabis use and will have better treatment outcomes. Studies have shown that dronabinol and nabilone improved multiple withdrawal symptoms, including craving; and quetiapine, zolpidem, and mirtazapine help with withdrawal-induced sleep disturbances.1-5

Combining dronabinol and lofexidine (an alpha-2 agonist) was superior to placebo in reducing craving, withdrawal, and self-administration during abstinence in a laboratory model. However, in a subsequent treatment trial, the combined medication treatment was not superior to placebo in reducing cannabis use or promoting abstinence.6

Six double-blind placebo-controlled pharmacotherapy trials in adults with cannabis use disorder have looked at withdrawal as an outcome.7 Of these studies, only dronabinol, bupropion, and gabapentin reduced withdrawal symptoms.8-10 In addition to reducing withdrawal symptoms, nabiximols/Sativex (a combination tetrahydrocannabinol [THC] and cannabidiol nasal spray not available in the US) increased retention (while actively on the medication in an inpatient setting) but did not reduce outpatient cannabis use at follow-up.11

All of the medications available for prescription in the US can be monitored reliably with urine drug screening to assess for illicit cannabis use except dronabinol, which will result in a positive screen for cannabis. When using urine drug screening, remember that for heavy cannabis users the qualitative urine drug screen can be positive for cannabis up to a month following cessation. When selecting a medication, take into account the cost of the medication, particularly since insurance will likely not cover THC agonists such as dronabinol for this indication, and possible misuse or diversion of scheduled substances (eg, dronabinol, nabilone). In addition, monitoring for reductions in substance use and withdrawal symptoms is key.

Abstinence initiation and relapse prevention

Other clinical trials have looked at medications to promote abstinence by reducing stress-induced relapse, craving (not as a component of withdrawal), and the reinforcing aspects of cannabis. Of these trials, the following results show potential promise with positive findings: gabapentin reduced quantitative THC urine levels and improved cognitive functioning (in addition to decreasing withdrawal), and buspirone led to more negative urine drug screens for cannabis (although the difference was not significant compared with placebo).10,12 However, in a follow-up larger study, no differences were seen compared with placebo and women had worse cannabis use outcomes on buspirone.13

N-acetylcysteine resulted in twice the odds of a negative urine drug screen in young adults and adolescents (although there was no difference between adolescent groups in self-report of cannabis use).14 Gray and colleagues15 reported that no differences were seen between N-acetylcysteine and placebo (results of the trial are soon to be published). Topiramate resulted in significantly decreased grams of cannabis used but no difference in percent days used or proportion of positive urine drug screens.16 In a recent small clinical trial, reductions in cannabis use were seen with oxytocin in combination with MET.17 Studies with nabilone and long-term naltrexone administration reduced relapse and cannabis self-administration and subjective effects, respectively, which suggests promising avenues yet to be explored by clinical trials.2,18

Treatment of psychiatric comorbidity

Other studies have looked at the effects of treating common comorbid psychiatric disorders in adults with cannabis use disorder, postulating that if the psychiatric disorder is treated, the individual may be more likely to abstain or reduce his or her cannabis use. For example, if a person is less depressed, he may better engage in CBT for relapse prevention.

Fluoxetine for depression and cannabis use disorder in adolescents decreased cannabis use and depression, although there was no difference compared with placebo.19 A trial of venlafaxine for adults with depression and cannabis use disorder demonstrated less abstinence with greater withdrawal-like symptoms compared with placebo.20,21 These findings suggest that this antidepressant might not be beneficial for treatment-seeking individuals with cannabis use disorder and may actually negatively affect outcomes.

CASE VIGNETTE CONT’D

After discussing and presenting the different psychotherapy and medication treatment options to Mr. M, you and he decide to start CBT to help with abstinence initiation. In addition, you prescribe 20 mg of dronabinol up to 2 times daily in combination with 50 mg of naltrexone daily, to help globally target Mr. M’s withdrawal symptoms and prevent relapse once abstinence is achieved. However, a few days later, Mr. M calls to say that his insurance will not cover the prescription for dronabinol and he cannot afford the high cost. Given his main concerns of cannabis withdrawal symptoms, you select gabapentin up to 400 mg 3 times daily and continue weekly individual CBT.

Mr. M calls back several days later and reports that he has made some improvements in reducing the frequency of his cannabis use, which he attributes to the medication, but he thinks he needs additional assistance. After reviewing the treatment options again, he gives informed consent to start 1200 mg of N-acetylcysteine twice daily. After 10 weeks of this medication, his urine screens are negative.

You continue to provide relapse prevention CBT. He reports to you that his anxiety and insomnia are almost resolved, and you suspect that withdrawal was the cause of these symptoms. He reports significant improvement in his relationship with his family and recently received a promotion at work for “going above and beyond” on a project he was given the lead.

Over the next 6 months, he has 2 relapses that in functional analysis with you are determined to be triggered by unsolicited contact from his former drug dealer. Together, you develop a plan to block any further contact from the drug dealer. After several months, both the gabapentin and N-acetylcysteine are tapered and discontinued. Mr. M continues to see you for biweekly therapy sessions with random drug screens every 4 to 6 weeks.

Conclusion

Based on the available evidence, gabapentin, THC agonists, naltrexone, and possibly N-acetylcysteine show the greatest promise in the off-label treatment of cannabis use disorders. System considerations, such as medication cost, need to be factored into the decision-making as well as combination medication and psychotherapy approaches, which—as demonstrated in the case of Mr. M—may ultimately work best. Until further research elucidates the standard of medication practices for cannabis use disorder, the best off-label medication strategy should target any co-occurring disorders as well as any identified problematic symptoms related to cannabis use and cessation of use. When available, referral for evidence-based psychotherapy should be made.

Source:  (http://www.psychiatrictimes.com)  30th June 201

In The Lancet Psychiatry, Schoeler and colleagues present a study1 describing the mediating effect of medication adherence on the association between continued cannabis use and relapse risk in patients with first-episode psychosis.

They have previously reported a relapse rate of 36% in this patient group over a 2-year period.2 Acknowledging the potential risk of psychosis relapse related to the high proportion of patients continuing cannabis use after the onset of psychosis, the current study1 investigates the same patient group consisting of 245 patients, obtaining retrospective data on active cannabis use and medication adherence shortly after illness onset, as well as risk of relapse at 2-year follow-up. The authors find that relapse of psychosis associated with continued cannabis use is partly mediated through non-adherence to prescribed antipsychotic medication.

It is well established that cannabis use increases the risk of schizophrenia, not only from the early Swedish conscript studies3 but also from studies on people who use sinsemilla in London, UK, showing that high potency cannabis increases the risk of schizophrenia.4

Twin studies from Norway have shown that cannabis increases the risk of psychosis, even when controlling for genetic factors.5There has been discussion on the direction of the association, as none of these studies can rule out reverse causality, but it seems reasonable to conclude that cannabis is one of many stressors that can precipitate schizophrenia, at least in susceptible individuals.

The association between cannabis use and psychosis continues to interest clinicians and researchers. Cannabis does not precipitate psychosis in most users.3 What are the risk factors in the pathway from cannabis use to psychosis?

The use of cannabis in patients with psychosis can be divided into three groups: those not using cannabis, those using cannabis with few negative consequences, and those in whom cannabis use is followed by relapse and worsening of the disease. Too little effort has been put into studying people with psychosis who can use cannabis without many negative consequences.

Further research should also be put into different variants of cannabis. Strains cultured to produce high content of D-9 tetrahydrocannabinol (THC) are probably associated with higher risk for psychosis than those strains with less THC.4 In healthy participants, cannabidiol has been shown to inhibit THC-elicited paranoid symptoms and hippocampal-dependent memory impairment.6 The use of more balanced forms of cannabis could possibly be less detrimental to mental health.

Genetic predisposition is one factor that is related to the development of psychosis after the use of cannabis.5 However, there is still a long way to go in clarifying the interplay between genes and environmental factors in the cannabis–psychosis association. Therefore, we support the request for doing more studies to investigate the possible interaction between polygenic risk score for schizophrenia and cannabis use in causing psychosis.7

Furthermore, there is a need to examine the use of antipsychotic medication and investigate if some medications are particularly useful for patients with psychotic disorders who intend to continue to use cannabis. In a randomised trial comparing the effects of different antipsychotics,8 clozapine seemed to stand out in reducing craving for cannabis, a finding that is in need of replication.

Previous research has shown that stopping cannabis use after a first episode of psychosis has beneficial outcomes compared with continued use.9 A meta-analysis of observational studies published in 201710 compared adherence to antipsychotic medication between cannabis users and non-users, and found that cannabis use increases the risk of non-adherence to anti-psychotic medication and quitting cannabis may help adherence to antipsychotics. In the current study by Schoeler and colleagues,1 the authors found that adherence to medication was a possible mediator in the association between cannabis use and risk of psychosis relapse when taking potential confounders into account. They found that medication adherence partly mediated the effect of continued cannabis use on outcome, including risk of relapse (proportion mediated=26%, pindirecteffects=0·040, 95% CI 0·004–0·16), number of relapses (36%, pindirect effects=0·040, 0·003–0·14), time to relapse (28%, pindirect effects=0·051, −0·53 to 0·001), and care intensity (20%, pindirect effects=0·035, 0·004–0·11), but not length of relapse (6%, pindirect effects=0·35, −0·030 to 0·09).

Acknowledging the complexity of psychosis relapse prevention, the current findings point to reduction in cannabis use as an intervention target to improve medication adherence, thereby preventing psychosis relapse. The understanding of a triangular association of ongoing cannabis use with medication adherence and psychosis relapse may be a step forward in counteracting further psychotic episodes in some patients.

Source:   DOI: http://dx.doi.org/10.1016/S2215-0366(17)30254-7   Published: 10/7/17

Investigating the proposition that cannabis is worth bothering with, this hot topic looks at reports that stronger cannabis on the market is increasing harms to users, prospects of recovery from disorders and dependence, and the emerging response to synthetic forms of cannabis like ‘spice’.

CANNABIS IN THE LAW

A controlled ‘Class B’ substance, cannabis carries legal penalties for possession, supply, and production. Between 2004–2009 cannabis was reclassified as a ‘Class C’ substance, meaning for a brief period of time it carried lesser penalties for possession. In 2009, the Association of Chief Police Officers issued new guidance, advising officers to take an escalating approach to the policing of cannabis possession for personal use: • A warning • A penalty notice for disorder (PND) • Arrest

This three-tiered approach was designed to be “ethical and non-discriminatory”, but also reinforce the “national message that cannabis is harmful and remains illegal”.

In 1990s Britain a common reaction to allocating resources to treating cannabis users was, ‘Why bother? We have more than enough patients with problems with serious drugs like heroin.’ The typically calming use of the drug by adults was seen as preferable to the main alternative – alcohol and its associated violence and disorder. Calls for a treatment response were seen as pathologising what in many societies is both normal and in some ways desirable youth development: trying new experiences, challenging conventions, and exposing the hypocrisy of alcohol-drinking adults. In 1997 the Independent on Sunday launched a campaign to decriminalise cannabis, culminating in a mass ‘roll-up’, and 16,000-strong pro-cannabis march from Hyde Park to Trafalgar Square. Its Editor Rosie Boycott wrote in the paper about her own coming-of-age experience smoking cannabis, telling readers:

“I Rolled my first joint on a hot June day in Hyde Park. Summer of ’68. Just 17. Desperate to be grown-up. … My first smoke, a mildly giggly intoxication, was wholly anti-climatic. The soggy joint fell apart. I didn’t feel changed. But that act turned me – literally – into an outlaw. I was on the other side of the fence from the police – or the fuzz, as we used to call them. So were a great many of my generation.”

The campaign was explosive, but short-lived, apparently subsiding when Boycott left to take up her role as Editor of the Daily Express. A decade later, the Independent issued an apology for the campaign. ‘If only they had known then, what they knew now’, was the message of the article, referring to the reportedly damaging impact of the more potent strains of cannabis and its links to “mental health problems and psychosis for thousands of teenagers”.

Are stronger strains creating more problems?

There has been a long-standing, but controversial, association between cannabis strength and harm. Reading newspaper articles on the subject, it wouldn’t be unusual to see a headline drawing a straight line between ‘super-strength skunk’ and addiction, violence, deaths, or psychosis. In 2008, then Prime Minister Gordon Brown spoke in a similar vein, telling a breakfast-television viewing audience:

I have always been worried about cannabis, with this new skunk, this more lethal part of cannabis.

I don’t think that the previous studies took into account that so much of the cannabis on the streets is now of a lethal quality and we really have got to send out a message to young people – this is not acceptable.

Brown was warning of a dangerous new strain of cannabis on the market, that caused very severe harms to users – contrasting starkly with the common perception of cannabis as a ‘low harm’ or ‘no harm’ drug. The strength or potency of cannabis is determined by the amount of ‘THC’ it contains. THC produces the ‘high’ associated with cannabis, and another major component ‘CBD’ produces the sedative and anti-anxiety effects. As well as potency, the relative amounts of THC and CBD are important for understanding the effects of cannabis – something explored in a University College London study during the programme Drugs Live: Cannabis on Trial. The research team compared two different types of cannabis: the first had high levels of THC (approx. 13%) but virtually no CBD; and the second had a lower level of THC (approx. 6.5%) and substantial amounts of CBD (approx. 8%). They found that CBD had a moderating or protective effect on some of the negative effects of THC, and that “many of the effects that people enjoy are still present in low-potency varieties without some of the harms associated with the high-potency varieties”. At least in the US over the last two decades (between 1995–2014), potency has increased from around 4% to 12%, and the protective CBD content of cannabis has decreased, from around 28% to less than 15%, significantly affecting the ratio of THC to CBD, and with it, the nature and strength of the psychoactive effect of cannabis. Until the 1990s, herbal cannabis sold in the UK was predominantly imported from the Caribbean, West Africa, and Asia. After this time, it was increasingly produced in the UK, being grown indoors using intensive means (artificial lighting, heating, and control of day-length). A study funded by the Home Office analysed samples of cannabis confiscated by 23 police forces in England and Wales in 2008, and found that over 97% of herbal cannabis had been grown by intensive methods; its average potency of 16% compared with just 8% for traditional imported herbal cannabis. This matched other reports of home-grown cannabis being consistently (around 2–3 times) stronger than imported herbal cannabis and cannabis resin.

In 2015, observing a decrease in the use of cannabis in England and Wales, but parallel increase in demand for treatment, a UK study examined whether the trend could be explained by an increase in the availability of higher-potency cannabis. Over 2500 adults were surveyed about their use of different types of cannabis, severity of dependence, and cannabis-related concerns. The researchers found that higher potency cannabis was associated with a greater severity of dependence, especially in young people, and was rated by participants as causing more memory impairment and paranoia than lower potency types. However at the same time, it was reported to produce the best ‘high’, and to be the preferred type.

By definition cannabis is a psychoactive substance, which means it can change people’s perceptions, mood, and behaviour. Higher potency cannabis contains more of the psychoactive component, so it makes sense that higher potency cannabis could increase the risk of temporary or longer-term (adverse) problems with perceptions, mood, and behaviour. However, there is a particular concern that cannabis use could be linked to ‘psychosis’, a term describing a mental illness where a person perceives or interprets reality in a very different way to those around them, which can include hallucinations or delusions.

Whether cannabis causes psychosis, precipitates an existing predisposition, aggravates an existing condition, or has no impact at all on psychotic symptoms, has for decades been hotly contested. With our focus on evaluations of interventions, Drug and Alcohol Findings is in no position to pronounce on this issue, nor on the possibility that the drug might sometimes improve mental health, but some examples of research informing this debate are included below. A 2009 UK study examined whether daily use of high-potency cannabis was linked to an elevated risk of psychosis, comparing 280 patients in London presenting with a first episode of psychosis with a healthy control group. The patients were found to be more likely to smoke cannabis on a daily basis than the control group, and to have smoked for more than five years. Among those who used cannabis, 78% of the patients who had experienced psychosis used higher-potency cannabis, compared with 37% of those in the control group. The findings indicated that the risk of psychosis was indeed greater among the people who were using high potency cannabis on a frequent basis, but couldn’t show that the cannabis use caused the psychosis, or even that the cannabis use made the group more susceptible to psychosis. The wider literature on mental health and substance use would suggest that the association is more complex than this. A recently published paper from the University of York has demonstrated the complications of attributing any association between cannabis use and psychosis to a causal effect of cannabis use rather than other factors or a reverse causal effect. A calculation based on data from England and Wales helped to put this into perspective, indicating that even if cannabis did cause psychosis more than 20,000 people would need to be stopped using cannabis to prevent just one case of psychosis. The apparent steady increase in cannabis potency in the UK since the 1990s is important context for further research. Where higher potency cannabis is increasingly becoming the norm, and is the preference for cannabis users, it would be relevant to generate more evidence of the health-related problems with high potency cannabis, and the treatment and harm reduction solutions based around these health-related problems.

Cannabis accounts for half of all new drug treatment patients

The most widely used illegal drug in Europe, many seemingly enjoy cannabis without it leading to any significant negative social or health effects. However, numbers entering treatment for cannabis use problems have been on the rise (both in the UK, and the rest of Europe), while heroin treatment numbers have fallen  chart. According to Public Health England, this is not because more people are using cannabis, but perhaps because services relieved of some of the recent pressure of opiate user numbers are giving more priority to cannabis, because they are making themselves more amenable to cannabis users, and because of emerging issues with stronger strains of the drug. Whatever the causes, across the UK figures submitted to the European drug misuse monitoring centre show that the proportion of patients starting treatment for drug problems who did so primarily due to their cannabis use rose steadily from 11% in 2003/04 to 22% in 2011/12. With the caveat that data from 2013 onwards is not directly comparabledue to changes in methodology, in 2014 and 2015 the proportion of patients who entered treatment primarily because of a cannabis issue hovered above previous years at 26% (25,278 and 26,295 respectively). Among first ever treatment presentations, the increase from 2003/04 was more pronounced, from 19% to 37%. By 2013, cannabis use had become the main prompt for half the patients who sought treatment for the first time (at 49%), and stayed relatively constant at 47% in 2014, and 48% in 2015.

Showing that more users was not the reason for more starting treatment, over about the same period, in England and Wales the proportion of 16–59-year-olds who in a survey said they had used cannabis in the past year fell from about 11% to 7% in 2013/14, then stayed at that level in 2014/15 and 2015/16. The treatment figures largely reflect trends in England, where in 2013/14 the number of patients starting treatment with cannabis use problems had risen to 30,422, 21% of all treatment starters, up from 23,018 and 19% in 2005/06. Subsequently the number dropped to 27,965 in 2015/16, still around a fifth of all treatment starters. Among the total treatment population – starting or continuing in treatment – cannabis numbers rose from 40,240 in 2005/06 to peak at 64,407 in 2013/14 before falling back to 59,918 in 2015/16; corresponding proportions again hovered around a fifth. As a primary problem substance among under-18s cannabis dominated, accounting for three-quarters of all patients in treatment in 2015/16 and in numbers, 12,863. The dominance of cannabis increased from 2008/09 as numbers primarily in treatment for drinking problems fell.

‘All treatments appear to work’

According to the two main diagnostic manuals used in Europe and the USA, problem cannabis use can develop into a cannabis use disorder or cannabis dependence, identifiable by a cluster of symptoms including: loss of control; inability to cut down or stop; preoccupation with use; neglecting activities unrelated to use; continued use despite experiencing problems; and the development of tolerance and withdrawal. This level of clinical appreciation for cannabis use problems didn’t exist when researcher and writer William L. White entered the addictions field half a century ago:

“When I first entered the rising addiction treatment system in the United States nearly half a century ago, there existed no clinical concept of cannabis dependence and thus no concept of recovery from this condition. In early treatment settings, cannabis was not consider[ed] a “real” drug, the idea of cannabis addiction was scoffed at as remnants of “Reefer Madness,” and casual cannabis use was not uncommon among early staff working in addiction treatment programs of the 1960s. Many in the field remain sceptical of the idea of cannabis dependence, specifically whether problem users at the severe end experience physiological withdrawal. However, reviewing what they believe is mounting evidence, these authors suggest there can be confidence in the existence of a “true withdrawal syndrome” – albeit one that differs qualitatively from the “significant medical or psychiatric problems as observed in some cases of opioid, alcohol, or benzodiazepine withdrawals”. In the case of cannabis, the main symptoms are primarily emotional and behavioural, although appetite change, weight loss, and some physical discomfort are reported. A brief review aimed at practitioners in UK primary care provides guidance on how to manage symptoms of withdrawal among patients trying to stop or reduce their cannabis use.

Research has come a long way, says William L. White, with now “clear data supporting the dependency producing properties of cannabis, a clear conceptualization of cannabis use disorders (CUD) and cannabis dependence (CD)”, but until recently, very little evidence about the prospects of long-term recovery. Yet, key papers – found here and here – indicate that:

• Full remission from cannabis use disorders is not only possible, but probable.

• Stable remission takes time – an average of 33 months.

• Abstinence may not be initially realistic for heavy cannabis users – but those in  remission are usually able to reduce the intensity of their use and its  consequences.

At least in the United States, it seems dependence is more quickly overcome from cannabis than the main legal drugs. A survey of the US general adult population found that within a year of first becoming dependent, 3% each of smokers and drinkers were in remission and remained so until they were surveyed. For cannabis the figure was nearly 5% and for cocaine, nearly 9%. After ten years the proportions in remission had risen to 18% for nicotine, 37% for alcohol, 66% for cannabis and 76% for cocaine. About 26 years after first becoming dependent, half the people at some time dependent on nicotine were in remission, a milestone reached for alcohol after 14 years, for cannabis six years, and for cocaine, five.

Specialised treatment programmes for cannabis users in European countries

Generally for people with cannabis use problems, the European Monitoring Centre for Drugs and Drug Addiction concluded in 2015, and before that in 2008, that “all treatments appear to work”. For adults, effective treatments include motivational interviewing, motivational enhancement therapy and cognitive-behavioural therapy, and for younger people, family-based therapies seem most beneficial. Less important than the type of treatment is the treatment context and the individual’s determination to overcome their problems through treatment. And there is “no firm basis for a conclusion” that cannabis-specific interventions (designed around the risks and harms associated with cannabis) are more effective than general substance use treatment tailored to the individual needs of the cannabis user seeking treatment chart. In some studies brief interventions have been found to work just as well as more intensive treatment, but when the patients are heavily dependent, and the most difficult cases are not filtered out by the research, longer and more individualised therapies can have the advantage. When the World Health Organization trialled its ASSIST substance use screening and brief advice programme in Australia, India, the United States, and Brazil, just over half the identified patients (all had to be at moderate risk of harm but probably not dependent) were primarily problem cannabis users. Among these, risk reduction in relation to this drug was significantly greater among patients allocated to a brief advice session than among those placed on a three-month waiting list for advice. In each country too, risk reduction was greater among intervention patients, except for the USA, where the order was reversed. Suggesting that severity of use was not a barrier to reacting well to brief intervention, only patients at the higher end of the moderate risk spectrum further reduced their cannabis use/risk scores following intervention. The ASSIST study was confined to adults, but young people in secondary schools in the USA whose problem substance use focused mainly on cannabis also reacted well to brief advice.

The relative persistence of opiate use problems versus the transitory nature of those primarily related to cannabis seemed reflected in an analysis of treatment entrants in England from 1 April 2005 to the end of 2013/14, the last time this particular analysis was published. At the end of this period just 7% of primary cannabis users were still in or back in treatment compared to the 30% overall figure and 36% for primary opiate users. The figure peaked at 43% for users of opiates and crack. Over half – 53% – of primary cannabis users had left treatment as planned, apparently having overcome their cannabis problems, compared to 27% of primary opiate users and just 20% with dual opiates and crack use problems. Another 40% of cannabis users had left treatment in an unplanned manner, a slightly higher proportion than among opiate users. The figures tell a tale of relatively high level of success which enables cannabis users to leave treatment, though even in the absence of recorded success, few stay long-term.

However, the forms patients in England complete with their keyworkers while in treatment seem to tell a different story. Compared to how they started treatment, around six months later 45% of primary cannabis users were assessed as using just as often (including a few using more), compared to 30% of opiate users and 42% whose main problem drugs were both opiates and crack, suggesting more rapid and/or more complete remission for opiate users than for cannabis users. One interpretation is that the widespread use of substitute drugs like methadone more reliably reduced the illegal opiate use of opiate users and also helped retain them in treatment, while cannabis users tended quickly to leave treatment, having done well or not. However, these figures relate only to patients who completed the forms at their six-month review, which in practice could have happened anywhere from about one to six months after their assessment for treatment. What proportion of primary cannabis users were still in treatment at that point and available to complete the forms is not clear, but they may have been the patients whose problems were deep seated enough to require extended treatment.

Enjoyable and trouble-free for many, but not without harms Harm reduction – the “set of practical strategies and ideas aimed at reducing negative consequences associated with drug use” – is mostly associated with ‘harder’ drugs like heroin, for which blood-borne viruses and drug-related deaths are clear and severe risks. Yet while “many people experience cannabis as enjoyable and trouble free”, there are also varying degrees of harm with this drug depending on the characteristics of the person using, the type of the cannabis, and the way they consume it. Many formal cannabis harm reduction programmes borrow from the fields of alcohol and tobacco. Advice includes:

• safer modes of administration (eg, on the use of vaporisers, on rolling safer joints, on less risky modes of inhaling) Many people experience cannabis as enjoyable and trouble free … some people require help to reduce or stop

• skills to prevent confrontation with those who disapprove of use

• encouraging users to moderate their use

 

• discouraging mixing cannabis with other drugs

• drug driving prevention and controls

• reducing third-party exposure to second-hand smoke

• education about spotting signs of problematic use

• self-screening for problematic use

In some parts of the UK, National Health Service tobacco smoking cessation services incorporated cannabis into their interventions with adults; and Health Scotland, also addressing the risks of tobacco and cannabis smoking, published a booklet for young people titled Fags ‘n’ Hash: the essential guide to cutting down the risks of using tobacco and cannabis.

Vaporising or swallowing cannabis offers a way to avoid respiratory risks, but only a minority of cannabis do this, most choosing to smoke cannabis joints (or cannabis and tobacco joints). While not all will know about the different health risks, cannabis users may choose against safer consumption methods anyway for a range of reasons (including their own thoughts about safe use):

• Users may find it easier to control the effects (eg, severity, length of effect) of cannabis when inhaling in the form of a joint or spliff

• Preparing and sharing joints can be an enjoyable part of the routine, or part of a person’s social activities

• Alternative methods of smoking (eg, bongs and vaporisers) may be inconvenient to use, or expensive to buy

 

Most harm reduction advice is delivered informally long before users come into contact with drugs professionals – for example through cannabis magazines, websites, and headshops – highlighting the importance of official sources engaging with non-official sources to promote the delivery of accurate, evidence-based harm reduction messages.

A new high

In May 2016 the Psychoactive Substances Act placed a ‘blanket ban’ on new psychoactive substances (previously known as ‘legal highs’), including synthetic cannabinoids (synthetic forms of cannabis). Prior to this, in 2014, there had been 163 reported deaths from new psychoactive substances in the UK, and 204 the year after. The average age was around 28, younger than the average age for other drug misuse deaths of around 38. The fact that these psychoactive substances – which produced similar effects to illicit drugs like cannabis, cocaine, and ecstasy – could be bought so easily online or on the high street, appeared inconsistent; and each fatality prompted “an outcry for something to be done to prevent further tragedies”. This was the context (and arguably the political trigger) for the introduction of the Psychoactive Substances Act. While possession of a psychoactive substance as such wasn’t criminalised;, production, supply, offer to supply, possession with intent to supply, import or export were – with a maximum penalty of seven years’ imprisonment.

Just seven months after the Act came into effect, the Home Office labelled it a success, with a press release stating that nearly 500 people had been arrested, 332 shops around the UK had been stopped from selling the substances, and four people had been sent to prison. But did the Psychoactive Substances Act have the presumably desired effect of limiting access to psychoactive substances (and reducing deaths), or did it just push the drugs the way of dealers? It is perhaps too early to tell, but former chair of the Advisory Council on the Misuse of Drugs Professor Nutt had warned before the Act came into effect that the ‘blanket ban’ would make it harder (not easier) to control drugs. And while Chief executive of DrugWise Harry Shapiro had said the new law would make new psychoactive substances harder to obtain, he also agreed that sale of the drugs would not cease, but merely be diverted to the illicit market: “The same people selling heroin and crack will simply add this to their repertoire.” The paper “From niche to stigma” examined the changing face of the new psychoactive substance user between 2009 and 2016, focusing on people using the synthetic cannabis known as ‘spice’. It looked at the transition of (then) ‘legal highs’ from an “experimental and recreational” scene associated with a “niche middle class demographic”, to “those with degrees of stigma”, especially homeless, prison, and socially vulnerable youth populations (including looked after children, those involved in or at risk of offending, and those excluded or at risk of exclusion from mainstream education). In 2014, the DrugScope Street Drug Survey also observed a problem among these particular groups, recording a “rapid rise in the use of synthetic cannabinoids such as Black Mamba and Exodus Damnation by opiate users, the street homeless, socially excluded teenagers and by people in prison”.

‘SPICE’ AND OTHER SYNTHETICS

Cannabis contains two key components:

• ‘THC’ (tetrahydrocannabinol), which produces the ‘high’

• ‘CBD’ (cannabidiol), which produces the sedative and anti-anxiety effects

Synthetic forms of cannabis contain chemicals that aim to copy the effects of ‘THC’ in cannabis. But the effects of synthetic cannabis can be quite different (and often stronger): firstly, because synthetic production makes it easier to manipulate the amount of the THC-like chemical; and secondly, because of the absence of the moderating equivalent of ‘CBD’. Some synthetics are purposely designed to resemble herbal cannabis, and can be consumed in the same ways (eg, smoked or inhaled). The names also often have deliberate cannabis connotations. The risk of this is that people wishing to take cannabis may be initially unaware that they have been sold the synthetic form, or may believe from the look of it that it will produce similar sought-after effects. The greater intensity of synthetic cannabis at lower dose levels ( box) ensures that it has an appeal in terms of potency and affordability, but may put those with fewer resources at greater harm.

In 2014, the prison inspectorate for England and Wales raised concerns about the rise in the use of psychoactive substances in prisons, in particular synthetic cannabis. A study set in an English adult male prison found that the nature of the market was posing significant challenges to the management of offenders. There, the primary motivation for consumption was being able to take a substance without it being detected. Given this motivation, and the greater likelihood of harms from synthetic versus natural cannabis, the researchers concluded that it was imperative for mandatory drug-testing policies to be revised, and instead rooted in harm reduction – something which would also apply to people on probation subject to mandatory drug-testing.

Cannabis throws up a range of issues rather different from those associated with the drugs treatment in the UK has normally focused on. If current trends continue, understanding the findings will become yet more important to British treatment services.

Source:   http://findings.org.uk/PHP/dl.php?file=cannabis_treat.    Last revised 10 July 2017. 

INTRODUCTION

Drug addiction is a chronic and relapsing disease that often begins during adolescence.

Epidemiological evidence documents an association between marijuana use during adolescence and subsequent abuse of drugs such as heroin and cocaine (1, 2). While many factors including societal pressures, family, culture, and drug availability can contribute to this apparent `gateway’ association, little is known about the neurobiological basis underlying such potential vulnerability.

Of the neural substrates that have been investigated, the enkephalinergic opioid system is  consistently altered by developmental marijuana exposure (3–5), perhaps reflecting neuroanatomical interactions between cannabinoid receptor type 1 and the enkephalinergic system (6, 7).

Debates exist, however, regarding the relationship between proenkephalin (Penk) dysregulation and opiate susceptibility. We previously reported that adult rats exposed to Δ9-tetrahydrocannabinol (THC; primary psychoactive component of marijuana) during adolescence exhibit increased heroin self administration (SA) as well as increased expression of Penk, the gene encoding the opioid neuropeptide enkephalin, in the nucleus accumbens shell (NAcsh), a mesolimbic structure critically involved in reward-related behaviors (3).

Although these data suggest that increased NAcsh Penk expression and heroin SA behavior are independent consequences of adolescent THC exposure, they do not address a possible causal relationship between THCinduced  Penk upregulation in NAcsh and enhanced behavioral susceptibility to opiates.

Moreover, insights regarding the neurobiological mechanisms by which adolescent THC exposure maintains upregulation of Penk into adulthood remain unknown.

Here, we take advantage of viral-mediated gene transfer strategies to show that adulthood addiction-like behaviors induced by adolescent THC exposure are dependent on discrete regulation of NAcsh Penk gene expression. A number of recent studies have demonstrated an important role for histone methylation in the regulation of drug-induced behaviors and transcriptional plasticity, particularly alteration of repressive histone H3 lysine 9 (H3K9) methylation at NAc gene promotors (8, 9).

We report here that one mechanism by which adolescent THC exposure may mediate Penk upregulation in adult NAcsh is through reduction of H3K9 di- and trimethylation, a functional consequence of which may be decreased transcriptional repression of Penk.

ABSTRACT

Background

Marijuana use by teenagers often predates the use of harder drugs, but the neurobiological underpinnings of such vulnerability are unknown. Animal studies suggest enhanced heroin self-administration (SA) and dysregulation of the endogenous opioid system in the nucleus accumbens shell (NAcsh) of adults following adolescent Δ9-tetrahydrocannabinol (THC) exposure. However, a causal link between Penk expression and vulnerability to heroin has yet to be established.

Methods

To investigate the functional significance of NAcsh  Penk tone, selective viral mediated knockdown and overexpression of Penk was performed, followed by analysis of subsequent heroin SA behavior. To determine whether adolescent THC exposure was associated with chromatin alteration, we analyzed levels of histone H3 methylation in the NAcsh via ChIP atfive sites flanking the Penk gene transcription start site.

Results

Here, we show that regulation of the proenkephalin (Penk) opioid neuropeptide gene in NAcsh directly regulates heroin SA behavior. Selective viral-mediated knockdown of Penk in striatopallidal neurons attenuates heroin SA in adolescent THC-exposed rats, whereas Penk overexpression potentiates heroin SA in THC-naïve rats. Furthermore, we report that adolescent THC exposure mediates Penk upregulation through reduction of histone H3 lysine 9 (H3K9) methylation in the NAcsh, thereby disrupting the normal developmental pattern of H3K9 methylation.

Conclusions

These data establish a direct association between THC-induced NAcsh Penk upregulation and heroin SA and indicate that epigenetic dysregulation of Penk underlies the long term effects of THC.

Source:  Biol Psychiatry. 2012 November 15; 72(10): 803–810. doi:10.1016/j.biopsych.2012.04.026.

Cannabis has recently been legalised in many US states

Cannabis itself is harmful to cardiovascular health and increases the chance of early death regardless of related factors such as smoking tobacco, new research reveals.

Data taken from more than 1,000 US hospitals found that people who used the drug had a 26 per cent higher chance of suffering a stroke than those who did not, and a 10 per cent higher chance of having a heart attack.

The findings held true after taking into account unhealthy factors known to affect many cannabis smokers, such as obesity, alcohol misuse and smoking.

‘This leads us to believe that there is something else going on besides just obesity or diet-related cardiovascular side effects’ Dr Aditi Kalla, Einstein Medical Center, Philadelphia

They indicate there is something intrinsic about cannabis which can damage the proper functioning of the human heart.

“Even when we corrected for known risk factors, we still found a higher rate of both stroke and heart failure in these patients, so that leads us to believe that there is something else going on besides just obesity or diet-related cardiovascular side effects,” said Dr Aditi Kalla, Cardiology Fellow at the Einstein Medical Center in Philadelphia and the study’s lead author.

“It’s important for physicians to know these effects so we can better educate patients.”

Previous research in cell cultures has shown that heart muscle cells have cannabis receptors relevant to contractility, or squeezing ability, suggesting that those receptors might be one mechanism through which marijuana use could affect the cardiovascular system.

The research team analysed more than 20 million records of young and middle-aged patients aged between 18 and 55 who were discharged from 1,000 hospitals in 2009 and 2010, when marijuana use was illegal in most states.

It identified 316,000 patients – 1.5 per cent – where marijuana use was diagnosed in the notes.  Their cardiovascular disease rates were compared to those who shunned the drug.

The research was published yesterday at a meeting of the American College of Cardiology in Washington DC.

Source:  http://www.telegraph.co.uk/science/2017/03/09/cannabis-boosts-risk-stroke-heart-attack-independent-tobacco/  

Findings From A UK Birth Cohort

ABSTRACT

Background

Evidence on the role of cannabis as a gateway drug is inconsistent. We characterise patterns of cannabis use among UK teenagers aged 13–18 years, and assess their influence on problematic substance use at age 21 years.

Methods

We used longitudinal latent class analysis to derive trajectories of cannabis use from self-report measures in a UK birth cohort. We investigated (1) factors associated with latent class membership and (2) whether latent class membership predicted subsequent nicotine dependence, harmful alcohol use and recent use of other illicit drugs at age 21 years.

Results

5315 adolescents had three or more measures of cannabis use from age 13 to 18 years. Cannabis use patterns were captured as four latent classes corresponding to ‘non-users’ (80.1%), ‘late-onset occasional’ (14.2%), ‘early-onset occasional’ (2.3%) and ‘regular’ users (3.4%).

Sex, mother’s substance use, and child’s tobacco use, alcohol consumption and conduct problems were strongly associated with cannabis use.

At age 21 years, compared with the non-user class, late-onset occasional, early-onset occasional and regular cannabis user classes had higher odds of nicotine dependence (OR=3.5, 95% CI 0.7 to 17.9; OR=12.1, 95% CI 1.0 to 150.3; and OR=37.2, 95% CI 9.5 to 144.8, respectively); harmful alcohol consumption (OR=2.6, 95% CI 1.5 to 4.3; OR=5.0, 95% CI 2.1 to 12.1; and OR=2.6, 95% CI 1.0 to 7.1, respectively); and other illicit drug use (OR=22.7, 95% CI 11.3 to 45.7; OR=15.9, 95% CI 3.9 to 64.4; and OR=47.9, 95% CI 47.9 to 337.0, respectively).

Conclusions

One-fifth of the adolescents in our sample followed a pattern of occasional or regular cannabis use, and these young people were more likely to progress to harmful substance use behaviours in early adulthood.

Source:  http://dx.doi.org/10.1136/jech-2016-208503

It comes as no surprise that the prevalence of marijuana use has significantly increased over the last decade. With marijuana legal for recreational use in four states and the District of Columbia and for medical use in an additional 31 states, the public perception about marijuana has shifted, with more people reporting that they support legalization. However, there is little public awareness, and close to zero media attention, to the near-doubling of past year marijuana use nationally among adults age 18 and older and the corresponding increase in problems related to its use. Because the addiction rate for marijuana remains stable—with about one in three past year marijuana users experiencing a marijuana use disorder—the total number of Americans with marijuana use disorders also has significantly increased. It is particularly disturbing that the public is unaware of the fact that of all Americans with substance use disorders due to drugs other than alcohol; nearly 60 percent are due to marijuana. That means that more Americans are addicted to marijuana than any other drug, including heroin, cocaine, methamphetamine, and the nonmedical use of prescription drugs.

Stores in Colorado and Washington with commercialized marijuana sell innovative marijuana products offering users record-high levels of THC potency. Enticing forms of marijuana, including hash oil used in discreet vaporizer pens and edibles like cookies, candy and soda are attractive to users of all ages, particularly those underage. The legal marijuana producers are creatively and avidly embracing these new trends in marijuana product development, all of which encourage not only more users but also more intense marijuana use.

Yet despite the expansion of state legal marijuana markets, the illegal market for marijuana remains robust, leaving state regulators two uncomfortable choices: either a ban can be placed on the highest potency—and most enticing—marijuana products which will push the legal market back to products with more moderate levels of THC, or the current evolution to ever-more potent and more attractive products can be considered acceptable despite its considerable negative health and safety consequences. If tighter regulations are the chosen option, the illegal market will continue to exploit the desire of marijuana users to consume more potent and attractive products. If state governments let the market have its way, there will be no limit to the potency of legally marketed addicting marijuana products.

The illegal marijuana market thrives in competition with the legal market by offering products at considerably lower prices because it neither complies with regulations on growth and sale, nor pays taxes on sales or their profits. Unsurprisingly, much of the illegal marijuana in the states with legalized marijuana is diverted from the local legal marijuana supply. It is troubling that in response to the decline in demand for Mexican marijuana, Mexican cartels are increasing the production of heroin, a more lucrative drug.

When alcohol prohibition ended in 1933, bootlegged alcohol gradually and almost completely disappeared. Those who favour drug legalization are confident that the same will occur in the market for drugs; they argue that legalizing drugs will eliminate the illegal market with all its negative characteristics including violence and corruption. The initial experience with marijuana legalization shows that this is dangerous, wishful thinking. Why doesn’t legalization now work for marijuana as it did for alcohol 80 years ago? One obvious reason is that there is little similarity between the bootleg industry of alcohol production that existed during prohibition and contemporary drug trafficking organizations. Today’s illegal drug production and distribution system is deeply entrenched, highly sophisticated, and powerfully globalized. Traffickers are resourceful and able to rapidly to adjust to changes in the market, including competing with legal drugs.

The legalization of marijuana or any other drug is making a bargain with the devil. All drugs of abuse, legal and illegal, including marijuana, produce intense brain reward that users value highly—so highly that they are willing to pay high prices and suffer serious negative consequences for their use. Marijuana users’ brains do not know the difference between legal and illegal marijuana, but, as with other drugs, the brain prefers higher potency products. Drug suppliers, legal and illegal, are eager to provide the drugs that users prefer.

The challenge of drug policy today is to find better ways to reduce drug use by using strategies that are cost-effective and compatible with modern values. Legalization fails this test because it encourages drug use. Most of the costs of drug use are the result of the drug use itself and not from efforts to curb that use. It is hard to imagine a drug user who would be better off with having more drugs available at cheaper prices. Supply matters. More supply means more use. Drug legalization enhances drug supply and reduces social disapproval of drugs.

Our nation must prepare itself for the serious negative consequences both to public health and safety from the growth of marijuana use fuelled by both the legal and the illegal marijuana markets.

Source: http://www.rivermendhealth.com/resources/marijuana-legalization-led-use-addiction-illegal-market-continues-thrive/    June 2017  Author: Robert L. DuPont, M.D.

Cannabis Use, Gender and the Brain

Cannabis is the most widely used illicit drug in the U.S. and, as a result of legalization efforts for both medical remedy and for recreational use, is now the second leading reason (behind alcohol) for admission to addiction treatment in the U.S. The health consequences, cognitive changes, academic performance and numerous neuroadaptations have been debated ad nauseam. Like other drugs and medications, effects are different if exposure occurs in the young vs. the old or in males vs. females. Exposure in utero, early childhood, adolescence-young adult, adult and elderly may have different effects on the brain and outcomes. Yet the best available independent research shows that marijuana use is associated with consistent regionally specific alterations to important brain circuitry in the striatum and pre-frontal and post orbital regions. In this study, Chye and colleagues have investigated the association between marijuana use and the size of specific brain regions that are vitally important in goal-directed behavior, focus and learning within in the orbitol frontal cortex (OFC) and caudate. This investigation suggests that marijuana dependence and recreational use have distinct and region-specific effects.

Why Does This Matter?

This is an important finding, but distinction between cannabis use, abuse and dependence is not always clear, objective, linear or well understood. However, dependence-related medial OFC volume reduction was robust and highly significant. Lateral OFC volume reduction was associated with monthly marijuana use. Greater reductions in brain volume of specific regions were stronger among females who were marijuana dependent. This finding correlates with previous evidence of gender-dependent differences towards the various physiological, behavioral and the reinforcing effect of marijuana for both recreational use and addiction.

The results highlight important neurological distinctions between occasional cannabis use and addiction. Specifically, Chye and colleagues found that smaller medial OFC volume may be driven by marijuana addiction-related mechanisms, while smaller lateral OFC volume may be due to ongoing exposure to cannabinoids. The results highlight a distinction between cannabis use and dependence and warrant future examination of gender-specific effects in studies of marijuana use and dependence.

Source: http://www.rivermendhealth.com/resources/cannabis-use-gender-brain/   June 2017  Author: Mark Gold, MD

Today, Dr. Kevin Sabet, president of Smart Approaches to Marijuana (SAM), a national group promoting evidence-based marijuana laws, issued the following statement regarding medical marijuana legislation introduced by Senators Booker (D-NJ) and Gillibrand (D-NY) and Rep. Steve Cohen (D-TN):

“No one wants to deprive chronically ill patients of medication that could be helpful for them, but that’s not what the legislation being introduced today is about. We wouldn’t allow Pfizer to bypass the FDA – why would we let the marijuana industry? This bill would completely undermine the FDA approval process, and encourage the use of marijuana and marijuana products that have not been proven either safe or effective. The FDA approval process should set the standard for smart, safe, and sound healthcare in our country, so we can be sure that patients are receiving the best treatments that do more help than harm,” said SAM President and former senior White House drug policy advisor Kevin Sabet.

“Raw marijuana is not medicine, so marijuana in crude form should not be legal, but the medicinal components properly researched, purified, and dosed should be made available through compassionate research programs, as outlined in SAM’s six-point plan entitled “Researching Marijuana’s Medical Potential Responsibly.” We understand the FDA process can seem cumbersome to those suffering from intractable diseases, but early access programs to drugs in development are already available.

“Also, while FDA approval is the long-term goal, seizure patients shouldn’t have to go to the unregulated market to get products full of contaminants. Responsible legislation that fast-tracks these medications for those truly in need should be supported, rather than diverting patients to an unregulated CBD market proven to be hawking contaminated or mislabeled products as medicine, as this bill would endorse. In 2015 and 2016 the FDA sent multiple warning letters to numerous CBD manufacturers, outlining these concerns. We support the development of FDA-approved CBD medications, like Epidolex, which is in the final stages of approval.”

News media requesting a one-one-one interview with a representative from SAM can contact anisha@learnaboutsam.org.

 About SAM

Smart Approaches to Marijuana (SAM) is a nonpartisan, non-profit alliance of physicians, policy makers, prevention workers, treatment and recovery professionals, scientists, and other concerned citizens opposed to marijuana legalization who want health and scientific evidence to guide marijuana policies. SAM has affiliates in more than 30 states. For more information about marijuana use and its effects, visit http://www.learnaboutsam.org.

SPOKANE, Wash. – The release of more data on the effects of marijuana on a baby has led researchers to the conclusion that moms should think twice before using pot during and after pregnancy.

Many moms turn to marijuana for relief of symptoms such as nausea and anxiety, yet scientific research is emerging that identifies associated risks.

Confusion over the safety of these products prompted multiple agencies, including the Spokane Regional Health District, to launch a new component to its Weed to Know campaign: Weed to Know for Baby and You.

The campaign educates families and caregivers about harms associated with marijuana use while pregnant, breastfeeding, or caring for children. The campaign stresses the results of several peer-reviewed studies, which revealed: Marijuana use before pregnancy could:  -Cause a baby to be born before his or her body and brain are ready. This  could mean serious health problems at birth and throughout life.

-Change how a baby’s brain develops. These changes may cause life-long  behavior problems like trouble paying attention or following rules.  for them to do well in school. Marijuana use during breastfeeding is associated with these risks:  -Feeding problems, as THC, the active ingredient in marijuana, can lower milk  supply.

-Increased risk for sudden infant death syndrome

Using marijuana can affect a person’s ability to safely care for a baby or other children. Marijuana use decreases a person’s ability to concentrate, impairs judgment, and slows response time.

“We hear all the time from mothers who feel they used marijuana ‘successfully’ in previous pregnancies, or know someone who did, but it is also likely the child is not old enough yet to exhibit the long-term health consequences,” said Melissa Charbonneau, a public health nurse in the health district’s Children and Youth with Special Health Care Needs program. “To be on the safe side, your best bet is to avoid marijuana altogether while you’re expecting.”

Source: http://www.kxly.com/news/local-news/marijuana-use-during-pregnancy-associated-with-many-risks-studies-reveal/531202931

Marijuana sales have created an economic boom in U.S. states that have fully or partially relaxed their cannabis laws, but is the increased cultivation and sale of this crop also creating escalating environmental damage and a threat to public health?

In an opinion piece published by the journal Environmental Science and Technology, researchers from the University of North Carolina at Chapel Hill and Lancaster University in the U.K. have called on U.S. federal agencies to fund studies that will gather essential environmental data from the legal cultivation farms and facilities.

This information could then be used to help U.S. states minimize any environmental and public health damage caused by this burgeoning industry and aid legal marijuana growers in making their business environmentally sustainable.

State-by-state legalization is effectively creating a new industry in U.S., one that looks set to rival all but the largest of current businesses. In Colorado alone, sales revenues have reached $1 billion, roughly equal to that from grain farming in the state. By 2020 it is estimated that country-wide legal marijuana sales will generate more annual revenue than the National Football League.

But the article, titled “High Time to Assess the Environmental Impacts of Cannabis Cultivation” co-authored by William Vizuete, associate professor of environment sciences and engineering at UNC’s Gillings School of Global Public health and Kirsti Ashworth, research fellow at Lancaster University’s Lancaster Environment Centre say that this expanded cultivation carries with it serious environmental effects.

Their article points out that cannabis is an especially needy crop requiring high temperatures (25-30 °C for indoor operations), strong light, highly fertile soil and large volumes of water — around twice that of wine grapes. In addition, the authors state that the few available studies of marijuana cultivation have uncovered potentially significant environmental impacts due to excessive water and energy demands and local contamination of water, air, and soil.

For example, a study of illegal outdoor grow operations in northern California found that rates of water extraction from streams threatened aquatic ecosystems. High levels of growth nutrients, as well as pesticides, herbicides and fungicides, also found their way back into the local environment, further damaging aquatic wildlife.

Controlling the indoor growing environment requires considerable energy with power requirements estimated to be similar to that of Google’s massive data centers. No significant data has been collected on the air pollution impacts on worker’s public health inside these growing facilities or the degradation of outdoor air quality due to emissions produced by the industrial scale production of marijuana.

The authors emphasize, however, much of the data on marijuana cultivation to date has come from monitoring illegal cannabis growing operations.

Dr Ashworth of Lancaster Environment Centre said: “The illegal status of marijuana has prevented us from understanding the detrimental impacts that this industrial scale operation has on the environment and public health.”

“This is an industry undergoing a historic transition, presenting an historic opportunity to be identified as a progressive, world-leading example of good practice and environmental stewardship.”

The continued expansion of legalization by the states does offer significant opportunities for the US Department of Agriculture, Environmental Protection Agency (EPA), National

Institutes of Health (NIH, and Occupational Safety and Health Administration (OSHA) to fund research into legal cannabis cultivation to protect the environment.

“Generating accurate data in all the areas we discussed offers significant potential to reduce energy consumption and environmental harm, protect public health and ultimately, improve cultivation methods,” said Dr Vizuete . “There are also significant potential public health issues caused by emissions from the plants themselves rather than smoking it. These emissions cause both indoor and outdoor air pollution.”

Story Source: Materials provided by Lancaster University. Note: Content may be edited for style and length.

Journal Reference:

K. Ashworth, W. Vizuete. High Time to Assess the Environmental Impacts of Cannabis Cultivation. Environmental Science & Technology, 2017; 10.1021/acs.est.6b06343DOI:

Source:   ScienceDaily, 21 February 2017. <www.sciencedaily.com/releases/2017/02/170221081736.htm>.

Illicit cannabis use and cannabis use disorders increased at a greater rate in states that passed medical marijuana laws than in other states, according to new research at Columbia University’s Mailman School of Public Health and Columbia University Medical Center. The findings will be published online in JAMA Psychiatry.

Laws and attitudes regarding cannabis have changed over the last 20 years. In 1991, no Americans lived in states with medical marijuana laws, while in 2012, more than one-third lived in states with medical marijuana laws, and fewer view cannabis use as entailing any risks.

The new study is among the first to analyze the differences in cannabis use and cannabis use disorders before and after states passed medical marijuana laws, as well as differentiate between earlier and more recent periods and additionally examine selected states separately.

The researchers used data from three national surveys collected from 118,497 adults: the 1991-1992 National Longitudinal Alcohol Epidemiologic Survey, the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions and the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III.

Overall, between 1991-1992 and 2012-2013, illicit cannabis use increased significantly more in states that passed medical marijuana laws than in other states, as did cannabis use disorders. In particular, between 2001-2002 and 2012-2013, increases in use ranged from 3.5 percentage points in states with no medical marijuana laws to 7.0 percentage points in Colorado. Rates of increase in the prevalence of cannabis use disorder followed similar patterns.

“Medical marijuana laws may benefit some with medical problems. However, changing state laws — medical or recreational — may also have adverse public health consequences, including cannabis use disorders,” said author Deborah Hasin, PhD, associate professor of Epidemiology at the Mailman School of Public Health and in the Department of Psychiatry at Columbia University Medical Center. “A prudent interpretation of our results is that professionals and the public should be educated on risks of cannabis use and benefits of treatment, and prevention/intervention services for cannabis disorders should be provided.”

While illicit use of marijuana decreased and marijuana use disorder changed little between 1991-1992 and 2001-2002, both use and disorder rates increased between 2001-2002 and 2012-2013. In 1991-1992, predicted prevalence of use and disorder were higher in California than other states with early-medical marijuana laws (use: 7.6 percent vs. 4.5 percent; disorder: 2 percent vs. 1.15 percent). However, the predicted prevalence of past year use in California did not differ significantly from states that passed laws more recently. In contrast, the prevalence of use and disorder increased in the other 5 states with early medical marijuana laws.

“Future studies are needed to investigate mechanisms by which increased cannabis use is associated with medical marijuana laws, including increased perceived safety, availability, and generally permissive attitudes,” Dr. Hasin also noted.

Journal Reference:

   Melanie M. Wall, PhD et al. US Adult Illicit Cannabis Use, Cannabis Use Disorder, and Medical Marijuana Laws: 1991-1992 to 2012-2013. JAMA Psychiatry, April 2017 DOI: 10.1001/jamapsychiatry.2017.0724

 

Source:     ScienceDaily, 26 April 2017. <www.sciencedaily.com/releases/2017/04/170426111917.htm:

One in 5 adolescents at risk of tobacco dependency, harmful alcohol consumption and illicit drug use

Researchers from the University of Bristol have found regular and occasional cannabis use as a teen is associated with a greater risk of other illicit drug taking in early adulthood.   The study by Bristol’s Population Health Science Institute, published online in the Journal of Epidemiology & Community Health, also found cannabis use was associated with harmful drinking and smoking.

Using data from the Avon Longitudinal Study of Parents and Children (ALSPAC), the researchers looked at levels of cannabis use during adolescence to determine whether these might predict other problematic substance misuse in early adulthood — by the age of 21.

The researchers looked at data about cannabis use among 5,315 teens between the ages of 13 and 18. At five time points approximately one year apart cannabis use was categorised as none; occasional (typically less than once a week); or frequent (typically once a week or more).

When the teens reached the age of 21, they were asked to say whether and how much they smoked and drank, and whether they had taken other illicit drugs during the previous three months. Some 462 reported recent illicit drug use: 176 (38%) had used cocaine; 278 (60%) had used ‘speed’ (amphetamines); 136 (30%) had used inhalants; 72 (16%) had used sedatives; 105 (23%) had used hallucinogens; and 25 (6%) had used opioids.

The study’s lead author, Dr Michelle Taylor from the School of Social and Community Medicine said:

“We tend to see clusters of different forms of substance misuse in adolescents and young people, and it has been argued that cannabis acts as a gateway to other drug use. However, historically the evidence has been inconsistent.

“I think the most important findings from this study are that one in five adolescents follow a pattern of occasional or regular cannabis use and that those individuals are more likely to be tobacco dependant, have harmful levels of alcohol consumption or use other illicit drugs in early adulthood.”

In all, complete data were available for 1571 people. Male sex, mother’s substance misuse and the child’s smoking, drinking, and behavioural problems before the age of 13 were all strongly associated with cannabis use during adolescence. Other potentially influential factors were also considered: housing tenure; mum’s education and number of children she had; her drinking and drug use; behavioural problems when the child was 11 and whether s/he had started smoking and/or drinking before the age of 13.

After taking account of other influential factors, those who used cannabis in their teens were at greater risk of problematic substance misuse by the age of 21 than those who didn’t.

Teens who regularly used cannabis were 37 times more likely to be nicotine dependent and three times more likely to have a harmful drinking pattern than non-users by the time they were 21. And they were 26 times more likely to use other illicit drugs.

Both those who used cannabis occasionally early in adolescence and those who starting using it much later during the teenage years had a heightened risk of nicotine dependence, harmful drinking, and other illicit drug use. And the more cannabis they used the greater was the likelihood of nicotine dependence by the age of 21.

This study used observational methods and therefore presents evidence for correlation but not does not determine clear cause and effect — whether the results observed are because cannabis use actually causes the use of other illicit drugs. Furthermore, it does not identify what the underlying mechanisms for this might be. Nevertheless, clear categories of use emerged.

Dr Taylor concludes:

“We have added further evidence that suggests adolescent cannabis use does predict later problematic substance use in early adulthood. From our study, we cannot say why this might be, and it is important that future research focuses on this question, as this will enable us to identify groups of individuals that might as risk and develop policy to advise people of the harms.

“Our study does not support or refute arguments for altering the legal status of cannabis use — especially since two of the outcomes are legal in the UK. This study and others do, however, lend support to public health strategies and interventions that aim to reduce cannabis exposure in young people.”

Journal Reference:

1. Michelle Taylor, Simon M Collin, Marcus R Munafò, John MacLeod, Matthew Hickman, Jon Heron. Patterns of cannabis use during adolescence and their association with harmful substance use behaviour: findings from a UK birth cohort. Journal of Epidemiology and Community Health, 2017; jech-2016-208503 DOI: 10.1136/jech-2016-208503

Source:   www.sciencedaily.com/releases/2017/06/170607222448<.htm>. 7 June 2017.

Highlights

· •Cannabidiol appears often in Norwegian THC-positive blood samples.

· •Cannabidiol does not appear to protect against THC-induced impairment.

· •Cannabidiol may be detected in blood for more than 2 h after cannabis intake.

· •Hashish has revealed far lower THC/cannabidiol ratios than marijuana in Norway.

Abstract

Background and aims

Several publications have suggested increasing cannabis potency over the last decade, which, together with lower amounts of cannabidiol (CBD), could contribute to an increase in adverse effects after cannabis smoking. Naturalistic studies on tetrahydrocannabinol (THC) and CBD in blood samples are, however, missing. This study aimed to investigate the relationship between THC- and CBD concentrations in blood samples among cannabis users, and to compare cannabinoid concentrations with the outcome of a clinical test of impairment (CTI) and between traffic accidents and non-accident driving under the influence of drugs (DUID)-cases. Assessment of THC- and CBD contents in cannabis seizures was also included.

Methods

THC- and CBD concentrations in blood samples from subjects apprehended in Norway from April 2013–April 2015 were included (n = 6134). A CTI result was compared with analytical findings in cases where only THC and/or CBD were detected (n = 705). THC- and CBD content was measured in 41 cannabis seizures.

Results

Among THC-positive blood samples, 76% also tested positive for CBD. There was a strong correlation between THC- and CBD concentrations in blood samples (Pearson’s r = 0.714, p < 0.0005). Subjects judged as impaired by a CTI had significantly higher THC- (p < 0.001) and CBD (p = 0.008) concentrations compared with not impaired subjects, but after multivariate analyses, impairment could only be related to THC concentration (p = 0.004). Analyzing seizures revealed THC/CBD ratios of 2:1 for hashish and 200:1 for marijuana.

Conclusions

More than ¾ of the blood samples testing positive for THC, among subjects apprehended in Norway, also tested positive for CBD, suggesting frequent consumption of high CBD cannabis products. The simultaneous presence of CBD in blood does, however, not appear to affect THC-induced impairment on a CTI. Seizure sample analysis did not reveal high potency cannabis products, and while CBD content appeared high in hashish, it was almost absent in marijuana.

Source:  http://www.fsijournal.org/article/  July 2017 Volume 276, Pages 12–17

Warfarin. A single published case report describes an interaction with a patient taking warfarin who also regularly smoked tobacco and marijuana. The patient had multiple comorbidities and was taking at least 10 other medications. On at least two occasions, the patient’s international normalized ratio (INR) increased to values over 10 with episodes of bleeding. The only change reported for both occasions was an increase in the amount and frequency of marijuana smoking.[24] Patients who take warfarin and use marijuana regularly should receive close INR monitoring for any potential interaction.

Antiepileptic drugs (AEDs). A recent study examined baseline serum AED levels to identify drug-drug interactions between CBD and 19 AEDs during an open-label safety study in 81 patients (39 adults, 42 children) with refractory epilepsy.[25] As doses of CBD were increased, the researchers noted an increase in the serum levels of topiramate (P<.01), rufinamide (P<.01), and desmethylclobazam (P<.01) and a decrease in the levels of clobazam (P<.01) in both adult and pediatric patients. In adult patients, a significant increase in the serum levels of zonisamide (P=.02) and eslicarbazepine (P=.04) was observed with increasing CBD dose. No other drug interactions among the 19 AEDs were noted.   The authors recommended monitoring serum AED levels in patients receiving CBD, as drug-drug interactions may be correlated with adverse events and laboratory abnormalities.

Patients using marijuana should be educated to avoid drugs that affect associated CYP450 enzymes. When these drugs cannot be avoided, and marijuana use is expected to continue, the patient should be monitored closely for potential drug interactions.   Be Aware and Educate Patients

Smoking more than two joints weekly is likely to increase the risk for drug-related interactions.[5,10] No data exist monitoring large-scale marijuana use in the United States. However, in Washington, a state in which marijuana use is legal, the average user is estimated to smoke two to three joints per week.[26]  With growing legalization and use throughout the nation, healthcare professionals must exercise heightened caution in the situation of concomitant use of medications and marijuana.

Source:: Stirring the Pot: Potential Drug Interactions With Marijuana – Medscape – Jun 08, 2017.  http://www.medscape.com/viewarticle/881059#vp

Study Finds Users Are 26 Times More Likely To Turn To Other Substances By The Age Of 21

Study is first clear evidence that cannabis is gateway to cocaine and heroin

Teen marijuana smokers are 37 times more likely to be hooked on nicotine

Findings from Bristol University provide authoritative support for those warning against the liberalisation of drugs laws

Teenagers who regularly smoke cannabis are 26 times more likely to turn to other drugs by the age of 21.

The study of the lives of more than 5,000 teenagers produced the first resounding evidence that cannabis is a gateway to cocaine, amphetamines, hallucinogens and heroin.

It also discovered that teenage cannabis smokers are 37 times more likely to be hooked on nicotine and three times more likely to be problem drinkers than non-users of the drug.

The findings from Bristol University provide authoritative support for those warning against the liberalisation of drugs laws.

Medical researchers have argued for years that cannabis is far from harmless and instead carries serious mental health risks.

Dr Michelle Taylor, who led the study, said: ‘It has been argued that cannabis acts as a gateway to other drug use. However, historically the evidence has been inconsistent.

‘The most important findings from this study are that one in five adolescents follow a pattern of occasional or regular cannabis use and that those individuals are more likely to be tobacco dependent, have harmful levels of alcohol consumption or use other illicit drugs in early adulthood.

‘Our study does not support or refute arguments for altering the legal status of cannabis use.

‘This study and others do, however, lend support to public health strategies and interventions that aim to reduce cannabis exposure in young people.’

The Bristol evidence was gathered from a long-term survey of the lives of young people around the city, the Avon Longitudinal Study of Parents and Children.

The survey, which was published in the Journal of Epidemiology & Community Health, examined 5,315 teenagers between the ages of 13 and 18. One in five used cannabis.

Dr Tom Freeman of King’s College London said: ‘This is a high quality study using a large UK cohort followed from birth. It provides further evidence that early exposure to cannabis is associated with subsequent use of other drugs.’

The study of the lives of more than 5,000 teenagers produced the first resounding evidence that cannabis is a gateway to cocaine amphetamines, hallucinogens and heroin .

Ian Hamilton, who is a mental health researcher at York University, said: ‘It adds to evidence that cannabis acts as a gateway to nicotine dependence, as the majority of people using cannabis in the UK combine tobacco with cannabis when they roll a joint.

‘This habit represents one of the greatest health risks to the greatest number of young people who use cannabis.  It suggests that adolescent cannabis use serves as a gateway to a harmful relationship with drugs as an adult.’

The report said: ‘After taking account of other influential factors, those who used cannabis in their teens were at greater risk of problematic substance misuse by the age of 21.

‘Teens who regularly used cannabis were 37 times more likely to be nicotine dependent and three times more likely to have a harmful drinking pattern than non-users by the time they were 21. And they were 26 times more likely to use other illicit drugs.

‘Both those who used cannabis occasionally early in adolescence and those who started using it much later during the teenage years had a heightened risk of nicotine dependence, harmful drinking, and other illicit drug use.

‘And the more cannabis they used the greater was the likelihood of nicotine dependence by the age of 21.’

Source:  http://www.dailymail.co.uk/news/article-4582548/Proof-cannabis-DOES-lead-teenagers-harder-drugs.html   8th June 2017

 

Changes may increase risk of continued drug use and addiction

ANN ARBOR, Mich. — Most people would get a little ‘rush’ out of the idea that they’re about to win some money. In fact, if you could look into their brain at that very moment, you’d see lots of activity in the part of the brain that responds to rewards.

But for people who’ve been using marijuana, that rush just isn’t as big – and gets smaller over time, a new study finds.

And that dampened, blunted response may actually open marijuana users up to more risk of becoming addicted to that drug or others.

The new results come from the first long-term study of young marijuana users that tracked brain responses to rewards over time. It was performed at the University of Michigan Medical School.

Published in JAMA Psychiatry, it shows measurable changes in the brain’s reward system with marijuana use – even when other factors like alcohol use and cigarette smoking were taken into account.

“What we saw was that over time, marijuana use was associated with a lower response to a monetary reward,” says senior author and U-M neuroscientist Mary Heitzeg, Ph.D. “This means that something that would be rewarding to most people was no longer rewarding to them, suggesting but not proving that their reward system has been ‘hijacked’ by the drug, and that they need the drug to feel reward — or that their emotional response has been dampened.”

Watching the reward centers

The study involved 108 people in their early 20s – the prime age for marijuana use. All were taking part in a larger study of substance use, and all had brain scans at three points over four years. Three-quarters were men, and nearly all were white.

While their brain was being scanned in a functional MRI scanner, they played a game that asked them to click a button when they saw a target on a screen in front of them. Before each round, they were told they might win 20 cents, or $5 – or that they might lose that amount, have no reward or loss.

The researchers were most interested at what happened in the reward centers of the volunteers’ brains – the area called the nucleus accumbens. And the moment they cared most about was that moment of anticipation, when the volunteers knew they might win some money, and were anticipating performing the simple task that it would take to win.

In that moment of anticipating a reward, the cells of the nucleus accumbens usually swing into action, pumping out a ‘pleasure chemical’ called dopamine. The bigger the response, the more pleasure or thrill a person feels – and the more likely they’ll be to repeat the behavior later.

But the more marijuana use a volunteer reported, the smaller the response in their nucleus accumbens over time, the researchers found.

While the researchers didn’t also look at the volunteers’ responses to marijuana-related cues, other research has shown that the brains of people who use a high-inducing drug repeatedly often respond more strongly when they’re shown cues related to that drug.

The increased response means the drug has become associated in their brains with positive, rewarding feelings. And that can make it harder to stop seeking out the drug and using it.

If this is true with marijuana users, says first author Meghan Martz, doctoral student in developmental psychology at U-M, “It may be that the brain can drive marijuana use, and that the use of marijuana can also affect the brain. We’re still unable to disentangle the cause and effect in the brain’s reward system, but studies like this can help that understanding.

Change over time

Regardless, the new findings show that there is change in the reward system over time with marijuana use. Heitzeg and her colleagues also showed recently in a paper in Developmental Cognitive Neuroscience that marijuana use impacts emotional functioning.

The new data on response to potentially winning money may also be further evidence that long-term marijuana use dampens a person’s emotional response – something scientists call anhedonia.

“We are all born with an innate drive to engage in behaviors that feel rewarding and give us pleasure,” says co-author Elisa Trucco, Ph.D., psychologist at the Center for Children and Families at Florida International University. “We now have convincing evidence that regular marijuana use impacts the brain’s natural response to these rewards. In the long run, this is likely to put these individuals at risk for addiction.”

Marijuana’s reputation as a “safe” drug, and one that an increasing number of states are legalizing for small-scale recreational use, means that many young people are trying it – as many as a third of college-age people report using it in the past year.

But Heitzeg says that her team’s findings, and work by other addiction researchers, has shown that it can cause effects including problems with emotional functioning, academic problems, and even structural brain changes. And, the earlier in life someone tries marijuana, the faster their transition to becoming dependent on the drug, or other substances.

“Some people may believe that marijuana is not addictive or that it’s ‘better’ than other drugs that can cause dependence,” says Heitzeg, who is an assistant professor of psychiatry at the U-M Medical School and member of the U-M Addiction Research Center. “But this study provides evidence that it’s affecting the brain in a way that may make it more difficult to stop using it. It changes your brain in a way that may change your behavior, and where you get your sense of reward from.”

She is among the neuroscientists and psychologists leading a nationwide study called ABCD, for Adolescent Brain Cognitive Development. That study will track thousands of today’s pre-teens nationwide over 10 years, looking at many aspects of their health and functioning, including brain development via brain scans. Since some of the teens in the study are likely to use marijuana, the study will provide a better chance of seeing what happens over time.

Source: JAMA Psychiatry, doi:10.1001/jamapsychiatry.2016.1161

A Colorado children’s hospital reports visits by teens to its emergency department and satellite urgent care centers more than quadrupled after the state legalized marijuana, a new study finds.

Researchers examined the hospital’s records for 13- to 21-year-olds between 2005 and 2015.

Colorado legalized medical marijuana in 2010 and recreational marijuana in 2014.

The annual number of visits related to marijuana or involving a positive marijuana urine drug screen more than quadrupled, from 146 in 2005 to 639 in 2014, the researchers found.

They will present their research at the 2017 Paediatric Academic Societies Meeting in San Francisco.

“The state-level effect of marijuana legalization on adolescent use has only begun to be evaluated,” lead author George Sam Wang, MD said in a news release. “As our results suggest, targeted marijuana education and prevention strategies are necessary to reduce the significant public health impact of the drug can have on adolescent populations, particularly on mental health.”

Source:  https://www.ncadd.org/blogs/in-the-news/teen-marijuana-related-visits-to-colorado-er-rose-rapidly-after-legalization   8th May 2017

A new study suggests smoking high-potency marijuana may cause damage to nerve fibers responsible for communication between the brain’s two hemispheres.

The study included MRI scans of 99 people, including some who were diagnosed with psychosis, HealthDay reports.  The researchers found an association between frequent use of high-potency marijuana and damage to the corpus callosum, which is responsible for communication between the brain’s left and right hemispheres.

The corpus callosum is especially rich in cannabinoid receptors. THC, the psychoactive ingredient in marijuana, acts on these receptors.

Today’s high-potency marijuana has been shown to contain higher proportions of THC compared with a decade ago. Scientists have known that the use of marijuana with higher THC content has been associated with greater risk and earlier onset of psychosis, the researchers noted. This study is the first to examine the effect of marijuana potency on brain structure, according to a news release from Kings’s College London.

Frequent use of high-potency marijuana significantly affected the structure of the corpus callosum in patients with or without psychosis, the researchers report in Psychological Medicine.    The more high-potency marijuana a person smoked, the greater the damage.

“There is an urgent need to educate health professionals, the public and policymakers about the risks involved with cannabis use,” said senior researcher Dr. Paola Dazzan of the Institute of Psychiatry, Psychology & Neuroscience at King’s College London. “As we have suggested previously, when assessing cannabis use it is extremely important to gather information on how often and what type of cannabis is being used.

These details can help quantify the risk of mental health problems and increase awareness on the type of damage these substances can do to the brain.’

Source:  https://www.ncadd.org/about-addiction   Dec. 2015

Researchers at Canada’s Waterloo University studied what happens to academic goals, engagement, preparedness, and performance when high school students shift from no marijuana use to marijuana use. Their sample included 26,475 students in grades 9-12 in the COMPASS study, Canada’s largest survey of youth substance use. The researchers found that compared to students who do not use marijuana, those who use it at least once a month were:

· four times more likely to skip class,

· two to four times less likely to complete homework,

· two to four times less likely to value getting good grades, and

· half as likely to actually get good grades.

Moreover, half of those who smoked marijuana daily were less likely to report plans to attend college compared to nonusers. “We found that the more frequently students started using the drug, the greater their risk for poor school performance and engagement,” says Karen Patte, lead author of the study. Read more here.

Source: srusche@nationalfamilies.org  National Families in Action’s The Marijuana Report 17TH May 2017

Prescribing medicinal cannabis for patients with chronic non-cancer pain is not going to revolutionise their treatment and should not be supported until there is substantial proof of its effectiveness, according to a leading pain specialist.

Professor Milton Cohen is presenting Medicinal cannabis for chronic non-cancer pain: promise or pothole? at the Australian and New Zealand College of Anaesthetists (ANZCA) annual scientific meeting in Brisbane on Saturday May 13. “There is no reason to be enthusiastic about cannabinoids in the treatment of non-cancer related chronic pain,’’ Professor Cohen said.

‘‘On the basis of what we know about cannabis as a treatment it’s not going to revolutionise the field of chronic pain management.’’

Professor Cohen is a specialist pain medicine physician in Sydney and Director of Professional Affairs for ANZCA’s Faculty of Pain Medicine. The Faculty does not support the use of cannabinoids in chronic non-cancer pain ‘’until such time as a clear therapeutic role for them is identified in the scientific literature.’’

Professor Cohen said he was concerned that ‘’anecdote and clamour’’ and ‘’community enthusiasm’’ had preceded science on the issue of prescribing medicinal cannabis for patients who suffered chronic non-cancer pain. As a result, a culture of ‘’false hope’’ based on the elusive idea of a ‘’magic pill’’ was driving community misinformation about medicinal cannabis as a treatment for such patients.

The Federal government last year legalised a pathway for access of patients to Australian-grown and manufactured medicinal cannabis, subject to state and territory government regulations. In New Zealand, the use of cannabis-based products for medicinal purposes is available only on prescription authorised by the Ministry of Health.

‘’It’s a classic example of the cart being put before the horse with a political imperative to facilitate access to an unproven medicine,’’ Professor Cohen said. International studies that have assessed the effectiveness of medicinal cannabis for non-cancer chronic pain have revealed very ‘’modest’’ effects, he said.

‘’The international data on which one could make an informed decision about the effect of medicinal cannabis on chronic non-cancer pain is in fact very poor. The conclusions have been oversold,’’ he said.

Professor Cohen said the management of chronic non-cancer pain is complex as it required consideration of a range of factors including the medical, physical, psychological and social.

‘’We know that chronic pain is a much more complex phenomenon which requires a holistic approach to management that is tailored to the individual’s circumstances. To rely only on medicines is just not going to work.

‘’If doctors are to prescribe substances—that is if they are to be available on doctors’ prescriptions—they should be proven substances,’’ Professor Cohen explained.

Professor Cohen cited an ongoing study of 1500 people who had been prescribed opioids for chronic non-cancer pain, undertaken by the National Drug and Alcohol Research Centre at the University of New South Wales. Almost half of those surveyed said they had used cannabis for recreational purposes, one in six admitted to using cannabis in search of pain relief and one quarter said they would use cannabis in search of pain relief if they could.

‘’We know that cannabis is freely available but we also know that drugs are not the mainstay of managing chronic pain,’’ Professor Cohen said.

Professor Cohen said that, given the legislative changes introduced by the Federal government and some states and territories, the introduction of individualised trials of medicinal cannabis for patients with chronic non-cancer pain to monitor and evaluate its effectiveness and adverse effects might be considered. This would require the development of a patient register, similar to an approach introduced in Israel, to ensure that the trial was properly monitored and managed.

‘’Given the reality of the situation – these substances are going to be produced in Australia and will be marketed — so there now is an opportunity for individual, personalised clinical studies to ascertain if there is a benefit from this treatment,’’ Professor Cohen said.

About FPM 

The Faculty of Pain Medicine is a world-leading professional organisation for pain specialists that sets standards in pain medicine and is responsible for education and training in the discipline in Australia and New Zealand. Pain medicine is multidisciplinary, recognising that the management of severe pain requires the skills or more than one area of medicine. Chronic pain affects about one in five people in Australia and New Zealand. Specialists also manage acute pain (post-operative, post-trauma, acute episodes of pain in medical conditions) and cancer pain.

Source:  http://www.scoop.co.nz/stories/GE1705/S00087/false-hope-driving-claims-medicinal-cannabis-is-magic-pill.htm   13th May 2917

During the 2015 election, the Liberals campaigned on a plan to greenlight marijuana for recreational use to keep it out of the hands of children and the profits out of the hands of criminals.

The party’s election platform said Canada’s current approach — criminalizing people for possession and use — traps too many Canadians in the justice system for minor offences.

Last month, the government spelled out its plans in legislation, setting sweeping policy changes in motion.  The new law proposes setting the national minimum age to legally buy cannabis at 18 years old. It will be up to the provinces should they want to restrict it further.

Is it true, as Wilson-Raybould and the Liberals suggest, that legalization will in fact keep cannabis out of the hands of kids?

Spoiler alert: The Canadian Press Baloney Meter is a dispassionate examination of political statements culminating in a ranking of accuracy on a scale of “no baloney” to “full of baloney” (complete methodology below)

This one earns a lot of baloney — the statement is mostly inaccurate but contains elements of truth. Here’s why:

THE FACTS

There is no doubt cannabis is in the hands of young people today.

In fact, Canada has one of the highest rates of teenage and early-age adulthood use of marijuana, says Dr. Mark Ware, the vice-chair of the federally-appointed task force on cannabis and a medicinal marijuana researcher at McGill University.

“We don’t anticipate that this is going to eliminate it; but the public health approach is to make it less easy for young adolescents, young kids, to access cannabis than it is at the moment,” he said.

Bonnie Leadbeater, a psychology professor at the University of Victoria who specializes in adolescent behaviour, said as many as 60 per cent of 18-year-olds have used marijuana at some point in their lives.

The aim of a regulated, controlled system of legalized cannabis is to make it more difficult for kids to access pot, Ware said, noting the principle goal is to delay the onset of use.

So will a recreational market for adults coupled with a regulatory regime really keep pot out of the hands of kids?

THE EXPERTS

Public health experts — including proponents of legalization — say that probably won’t happen.

“I don’t exactly know what they are planning to do to keep it out of the hands of young people and I think some elaboration of that might be helpful,” Leadbeater said. “It is unlikely that it will change … it has been very, very accessible to young people.”

Benedikt Fischer, a University of Toronto psychiatry professor and senior scientist with the Centre for Addiction and Mental Health, agrees the expectation that legalization will suddenly reduce or eliminate use among young people is counter-intuitive and unrealistic to a large extent.

“The only thing we could hope for is that maybe because it is legal, all of a sudden it is so much more boring for young people that they’re not interested in it anymore,” he said.

Increasing penalties for people who facilitate access to kids will help discourage law-abiding Canadians from doing so, says Steven Hoffman, director of a global strategy lab at the University of Ottawa Centre for health law, policy and ethics.

“That being said, when there’s a drug, there’s no foolproof way of keeping it out of the hands of all children,” Hoffman said. “For sure, there will still be children who are still consuming cannabis.”

Cannabis will not be legal for people of all ages under the legislation, he added, noting this means there may still be a market for criminal activity for cannabis in the form of selling it to children.

In Colorado, officials thought there would be an increase in use as a result of legalization, according to Dr. Larry Wolk, chief medical officer at the Department of Public Health and Environment, but he said there’s been no increase among either youth or adults.    Nor has there been a noticeable decrease.

“What it looks like is folks who may have been using illicitly before are using legally now and teens or youth that were using illicitly before, it’s still the same rate of illicit use,” he said.

THE VERDICT

Donald MacPherson, executive director of the Canadian Drug Policy Coalition, said the Liberal government could provide a more nuanced, realistic message about its plans to legalize marijuana.

“To suddenly go over to the rhetoric … that strict regulation is going to keep it out of the hands of young people doesn’t work,” he said.

“There’s a better chance of reducing the harm to young people through a … public health, regulatory approach. That’s ideally what they should be saying.”

Careful messaging around legalized marijuana — like the approach taken by the Netherlands — could make cannabis less of a tempting forbidden fruit for young people, said Mark Haden, an adjunct professor at the University of British Columbia.

“What we know is that prohibition maximizes the engagement of youth, so if we did it well and skillfully and ended prohibition with a wise approach and made cannabis boring, it would keep it out of the hands of kids,” he said.

“It isn’t completely baloney, it just hasn’t gone far enough in terms of a rich, real discussion. It is just political soundbites.”

For this reason, Wilson-Raybould’s statement contains “a lot of baloney.”

METHODOLOGY

The Baloney Meter is a project of The Canadian Press that examines the level of accuracy in statements made by politicians. Each claim is researched and assigned a rating based on the following scale:

· No baloney – the statement is completely accurate

· A little baloney – the statement is mostly accurate but more information is required

· Some baloney – the statement is partly accurate but important details are missing

· A lot of baloney – the statement is mostly inaccurate but contains elements of truth

· Full of baloney – the statement is completely inaccurate

Source:   http://www.ctvnews.ca/politics/fact-check-will-legalizing-pot-keep-it-out-of-the-hands-of-kids-1.3397542   4th May 2017

The first to die was the family’s pet duck, killed in an attempt to rid the house of evil.

By then, Raina Thaiday had already been on a cleaning frenzy for a week, scrubbing the ceilings of her Cairns home and tossing possessions out into the yard in a bid to “cleanse” the house.  But it was when she heard a dove’s call, which she interpreted as a sign from God, that she decided she must “kill her children in order to save them”.

The Mental Health Court of Queensland last month ruled, in a decision not made public until Thursday, that Raina Mersane Ina Thaiday was of unsound mind when she stabbed to death seven of her children and a niece in her home on December 19, 2014.

In 2009, Raina Thaiday was interviewed thanking paramedics for safely delivering her child in the back of an ambulance. Photo: Nine News

“To her way of thinking at the time, what she was doing was the best thing she could do for her children. She was trying to save them,” Justice Jean Dalton said, exempting the mother from trial and confining her to mental health treatment.

Along the way the court heard details of the 40-year-old’s descent into “schizophrenia at its very depths”, likely exacerbated by years of heavy cannabis use, and culminating in her being in a psychotic state when she killed eight children under the age of 15.

A week before the killing, her then-20-year-old son, Lewis Warria found Mrs Thaiday stressed and serious, spending large amounts of time lecturing him about God, the court heard.  She went on a mission to “cleanse” her house, which Justice Dalton noted went far beyond a “normal spring clean”.

“All the furniture from the house was taken outside and put in the yard,” she said.”Inside the house was cleaned, in a most unusual way, including scrubbing the ceilings and the walls and a lot of Mrs Thaiday’s possessions were thrown away.  “And a lot of them were quite valuable.”

Things deteriorated still further the night of December 18. Her eldest daughter, niece and godchild had gone out shopping and did not return at 10pm as she had requested. Mrs Thaiday walked up and down the street, “preaching” to neighbours about their use of drugs and alcohol.  Agitated, she slept outside on a mattress dragged out in the cleaning.

Justice Dalton said with the benefit of hindsight, the things neighbours heard as Mrs Thaiday walked up and down the street, talking to herself or on the phone, were “clearly psychotic”.  “She was saying things like ‘I am the chosen one’,” the judge said.

“‘I have the power to kill people and to curse people. You hurt my kids, I hurt them first. You stab my kids, I stab them first. If you kill them, I’ll kill them’.”

At 11.40am on December 19, Mr Warria arrived home to find his mother slumped on the front verandah, covered in approximately 35 self-inflicted stab wounds that included a punctured lung. His siblings and cousin were dead inside.

Nearly two-and-a-half years later Mr Warria was in the courtroom inside Brisbane’s Queen Elizabeth II Courts of Law as a judge heard the opinions of six psychiatrists who had painstakingly analysed his mother’s mental state.

The court heard when police and paramedics arrived Mrs Thaiday immediately admitted she had killed the children inside. “Papa God” had been speaking to her, she told

psychiatrists, describing herself as the “anointed one” at risk from demons, who had to rid her Cairns home of an evil presence.

Psychiatrist Dr Angela Voita treated Mrs Thaiday from the day she came into The Park, one of Australia’s largest mental health facilities, on Christmas Eve 2014, five days after the mass killing.  She assessed her more than 50 times and, along with three other psychiatrists who gave evidence to the hearing, unanimously agreed she was mentally ill at the time of the offences.

After examining reams of evidence and interviews, Dr Voita said her patient was not capable of telling right from wrong or being able to control her actions at the time of the killings.  Assisting psychiatrist Dr Frank Varghese described the “unique” crime as “a horrendous case, the likes of which I have never seen before, and hopefully will never see (again).”   This is not ordinary schizophrenia,” he advised the judge.

“This is schizophrenia at its very depths and at its worst in terms of the terror for the patient as well as for the consequences for the individuals killed as a result of psychotic delusions.”

Mrs Thaiday had no psychiatric history or previous contact with mental health services outside of counselling at a local indigenous health service.  Independent psychiatrist Dr Pamela van de Hoef said there was some evidence that in 2007 she was also very disturbed.

“She had cut all her own hair off and threatened to kill one of the children with an axe.”

In 2011, she had ideas to drown herself and similar thoughts two weeks out from the 2014 killing, the psychiatrist said. The court heard cannabis was commonly linked to the onset of schizophrenia in those already vulnerable to the illness.

Ms Thaiday kicked a 10-20 cone a day habit in the months before the slaughter, leading psychiatrists to question whether her “psychosis” was a form of withdrawal, before mostly rejecting the notion.

Instead, Dr Jane Phillips and Dr Donald Grant agreed it was more likely the illness began to affect her while she was still using cannabis, causing to her to develop “religious delusions” that “forced her to live a clean life”.

“Altogether it amounts to a very convincing body of evidence that Mrs Thaiday was psychotic at the time of the killing,” Justice Dalton said.

She ruled Mrs Thaiday had the defence of unsoundness of mind available to her and issued a forensic order for ongoing mental health treatment.

Source: http://www.brisbanetimes.com.au/queensland/schizophrenia-at-its-very-depths-drove-mother-to-kill-eight-children-20170503-gvyf42.html   4th May 2017

SAN FRANCISCO – Visits by teens to a Colorado children’s hospital emergency department and its satellite urgent care centers increased rapidly after legalization of marijuana for commercialized medical and recreational use, according to new research being presented at the 2017 Paediatric Academic Societies Meeting in San Francisco.

The study abstract, “Impact of Marijuana Legalization in Colorado on Adolescent Emergency Visits” on Monday, May 8 at the Moscone West Convention Center in San Francisco.

Colorado legalized the commercialization of medical marijuana in 2010 and recreational marijuana use in 2014. For the study, researchers reviewed the hospital system’s emergency department and urgent care records for 13- to 21-year-olds seen between January 2005 and June 2015.

They found that the annual number of visits with a cannabis related diagnostic code or positive for marijuana from a urine drug screen more than quadrupled during the decade, from 146 in 2005 to 639 in 2014.

Adolescents with symptoms of mental illness accounted for a large proportion (66%) of the 3,443 marijuana-related visits during the study period, said lead author George Sam Wang, M.D., FAAP, with psychiatry consultations increasing from 65 to 442. More than half also had positive urine drug screen tests for other drugs. Ethanol, amphetamines, benzodiazepines, opiates and cocaine were the most commonly detected.

Dr. Wang, an assistant professor of paediatrics at the University of Colorado Anschutz Medical Campus, said national data on teen marijuana use suggest rates remained roughly the same (about 7%) in 2015 as they’d been for a decade prior, with many concluding no significant impact from legalization. Based on the findings of his study, however, he said he suspects these national surveys do not entirely reflect the effect legalization may be having on teen usage.

“The state-level effect of marijuana legalization on adolescent use has only begun to be evaluated,” he said. “As our results suggest, targeted marijuana education and prevention strategies are necessary to reduce the significant public health impact of the drug can have on adolescent populations, particularly on mental health.”

Dr. Wang will present the abstract, “Impact of Marijuana Legalization in Colorado on Adolescent Emergency Department (ED) Visits,” from 8 a.m. to 10 a.m. Numbers in this news release reflect updated information provided by the researchers. The abstract is available at https://registration.pas-meeting.org/2017/reports/rptPAS17_abstract.asp?abstract_final_id=3160.11.

The Paediatric Academic Societies (PAS) Meeting brings together thousands of individuals united by a common mission: to improve child health and well-being worldwide. This international gathering includes paediatric researchers, leaders in academic paediatrics, experts in child health, and practitioners. The PAS Meeting is produced through a partnership of four organizations leading the advancement of paediatric research and child advocacy: Academic Paediatric Association, American Academy of Paediatrics, American Paediatric Society, and Society for Paediatric Research. For more information, visit the PAS Meeting online at www.pas-meeting.org, follow us on Twitter @PASMeeting and #pasm17, or like us on Facebook. For additional AAP News coverage, visit http://www.aappublications.org/collection/pas-meeting-updates.

Source:   http://www.aappublications.org/news/2017/05/04/PASMarijuana050417

Background:

Cannabis use (CU) has recently been legalized in several states for medicinal purposes and remains the most commonly used illicit drug. Cardiovascular effects of CU are not well established as studies thus far have been limited by size. We therefore utilized a large national database to examine the incidence of cardiovascular risk factors and events amongst patients with CU.

Methods:

Patients aged 18-55 years with CU were identified in the Nationwide Inpatient Sample 2009-2010 database using the Ninth Revision of International Classification of Disease (ICD) code 304.3. Demographics, risk factors, and cardiovascular event rates were collected on these patients and compared to general population data.

Results:

Incidence of heart failure (HF), cerebrovascular accident (CVA), coronary artery disease (CAD), sudden cardiac death, and hypertension (HTN) were significantly higher in patients with CU. After multivariate regression adjusting for age, gender, diabetes mellitus, HTN, CAD, tobacco use, and alcohol use, CU remained an independent predictor of both HF (OR=1.1 [1.03-1.18], p<0.01) and CVA (OR=1.24 [1.14-1.34], p<0.001).

Conclusions:

CU independently predicted the risks of HF and CVA in individuals 18-55 years old. With continued legalization of cannabis, potential cardiovascular effects and their underlying mechanisms need to be further investigated.

1187-055 – Cannabis Use Predicts Risks of Heart Failure and Cerebrovascular Accidents: Results from the National Inpatient Sample

Background: Cannabis use (CU) has recently been legalized in several states for medicinal purposes and remains the most commonly used illicit drug. Cardiovascular effects of CU are not well established as studies thus far have been limited by size. We therefore utilized a large national database to examine the incidence of cardiovascular risk factors and events amongst patients with CU.

Methods: Patients aged 18-55 years with CU were identified in the Nationwide Inpatient Sample 2009-2010 database using the Ninth Revision of International Classification of Disease (ICD) code 304.3. Demographics, risk factors, and cardiovascular event rates were collected on these patients and compared to general population data.

Results: Incidence of heart failure (HF), cerebrovascular accident (CVA), coronary artery disease (CAD), sudden cardiac death, and hypertension (HTN) were significantly higher in patients with CU. After multivariate regression adjusting for age, gender, diabetes mellitus, HTN, CAD, tobacco use, and alcohol use, CU remained an independent predictor of both HF (OR=1.1 [1.03-1.18], p<0.01) and CVA (OR=1.24 [1.14-1.34], p<0.001).

Conclusions: CU independently predicted the risks of HF and CVA in individuals 18-55 years old. With continued legalization of cannabis, potential cardiovascular effects and their underlying mechanisms need to be further investigated.

Source: http://ativsoftware.com/appinfo.php?page=Inthtml&project=ACC17&server=ep70.eventpilot.us&id=2545   March 2017

by David Sergeant  of The Bow Group

The Bow Group is a leading conservative think tank based in London. Founded in 1951, the Bow Group is the oldest conservative think tank in the UK and exists to publish the research of its members, stimulate policy debate through an events programme and to provide an intellectual home to conservatives. Although firmly housed in the conservative family, the Bow Group does not take a corporate view and represents all strands of conservative opinion. The Group’s Patrons are The Rt Hon. The Lord Lamont of Lerwick, The Rt Hon. The Lord Tebbit of Chingford CH, Dr David Starkey CBE & Professor Sir Roger Scruton.  The Group’s Parliamentary Board consists of The Rt Hon. The Lord Tebbit of Chingford CH, The Rt Hon. David Davis MP, Sir Gerald Howarth MP, Geoffrey Clifton-Brown MP FRICS, Daniel Hannan MEP, The Rt Hon. Dominic Grieve QC MP, David Rutley MP, The Rt Hon. John Redwood MP, Dr. Phillip Lee MP and Adam Afriyie MP.

 INTRODUCTION

The evidence couldn’t be clearer. Cannabis is a hugely damaging drug that causes misery, particularly for our poorest citizens. Our aim should be its eradication and that can never be achieved through legalised capitulation. According to a report published last November by the Adam Smith Institute, our drug policy is: ‘An embarrassment.’ (Laven-Morris, 2016, para. 1) Commenting on the report, Steve Moore, Director of ‘Volteface’ concurred, insisting that: ‘The global movement towards legalisation, regulation and taxation of cannabis is now inexorable.’ (Laven-Morris, 2016, para. 16)

While this supposed ‘inexorability’ may have political and social elites jumping for joy, it’s yet another step toward greater suffering for those vulnerable individuals at risk of damage from the mind-altering drug, as well as for families and communities who are, and will increasingly, be forced to pick up the pieces. Within this paper, I will seek to address some of the primary points of contention and concern surrounding cannabis and counter the myths and assertions propounded by ideologues, corporate lobbyists, and the liberal media, each dogmatic in their pursuit of recreational cannabis legalisation. I will conclude that the consistent application of the meaningful criminal penalties already legislatively available, aggressive and rigorous policing across the socio-economic spectrum, the use of evidence based education, conferring the real health-risks of the drug and well-funded, compassionate, abstinence-based treatment for those who have become dependent on cannabis can, deliver its eradication.

 1) HARM 

Forgive my scepticism, but when that all-knowing beacon of progress and morality, billionaire Richard Branson insisted that, ‘most of us’ could smoke skunk without it doing us ‘any harm,’ I was not immediately convinced. (Holehouse, 2015, para. 2) The problem is that most of the people that Mr Branson has ever met are wealthy, expensively educated elites, who likely have access to the private health insurance he’s so keen for ‘Virgin Healthcare’ to bestow on the rest of us. Even if Mr Branson was right and cannabis, for most, presented no tangible health risks, this would still not be sufficient moral rationale for its legalisation. If we care about all our fellow citizens we cannot sacrifice the mental health of some for the recreational pleasure of ‘most.’

Correspondingly, also in support of legalisation is Amanda Fielding, Countess of Wemyss and March and founder of the pro-drug Beckley Foundation – located at Fielding’s Oxfordshire Tudor estate. The foundation boldly assert in their book: ‘Cannabis Policy: Moving beyond Stalemate,’ that with regards to cannabis: ‘Those harms at the population level are modest in comparison with alcohol or cocaine.’ (Beckley Foundation, 2009, para. 2) While there is no doubt that both alcohol and cocaine can create as much if not more misery than cannabis, its possible nature as a ‘slightly lesser’ evil is no cause for its celebration. Long gone are the 3 days in which advocates could claim that the effects of cannabis were ‘modest.’ This well perpetuated myth of ‘harmlessness’ has now been comprehensively medically discredited.

There is an increasingly diverse research consensus that cannabis use is directly connected to serious mental health issues. Timms and Atakin (2014) revealed that Adolescents who use cannabis daily are ‘five times more likely to develop depression and anxiety later in life,’ (para. 36) while Hall & Degenhardt’s (2011) strong body of evidence indicates that: ‘cannabis precipitates schizophrenia in vulnerable people.’ (p. 511) Further, Hall & Degenhardt discovered that, for those with a family history of psychosis, regular cannabis use doubles the likelihood of development from one in ten, to one in five. (2011, p. 512)

When we look at expectant mothers who smoke cannabis we see a direct correlation. The more they smoke, the greater the likelihood that their children will report feelings of depression and anxiety at the age of ten. (Goldschmidta, Richardson, Cornelius & Dayb, 2004, p. 526) Moreover, a huge American study, utilising the latest technology in brain-scanning equipment discovered that cannabis users had: ‘abnormally low blood flow in virtually every area of the brain.’ This means that users are at considerably higher risk of developing diseases such as Alzheimer’s. (Tatera, 2016, para. 1)   Even Professor Nutt, a well-known proponent of legalisation, concedes that cannabis smokers are ‘2.6 times more likely to have a psychotic-like experience than non-smokers.’ (Nutt, 2009, para. 7).

In addition to the real danger cannabis poses to mental health, research suggests that the use of cannabis doubles the risk of infertility in men under the age of 30. (Connor, 2014, para. 1) The mind is complicated beyond the possibility of human comprehension. A cautious and respectful approach to its potential damage is surely wise, as once it is lost it must be an exceedingly difficult thing to get back. There are few more disturbing things than seeing a friend or relative struggle with mental health issues – a daily battle not with the world but with themselves. Indeed, youngsters who use cannabis daily are seven times more likely to commit suicide. (Laccino, 2014, para. 1) So, while Mr Branson might encourage you to smoke cannabis with your children, (Janssen, 2016, para 4) the evidence would suggest that doing so could be very damaging indeed.

 2) USAGE RATES AND CANNABIS AS A GATEWAY DRUG 

Those who back legalisation might argue that it is they who truly care about cannabis users and they who truly want to reduce the drug’s harmful impacts. This, they insist, will be made possible by the reduction in usage rates that a legalised market will deliver. Indeed, the entire foundation of the argument for legalisation rests on its ability to decrease the numbers of people using cannabis. The facts and evidence stand comprehensibly against this assertion. Every single location in which there has been meaningful analysis of usage rates before and after legalisation or decriminalisation, including Portugal, Colorado, Southern Australia and Amsterdam, show an upsurge in the number of people using the drug. (Hughes and Steven, 2010, p. 1005), (Korf, 2002 pp. 854-856), (Single, Christie & Ali para. 25), (Keyes, 2015) Even within individual nations, the difference between usage rates in jurisdictions with varying legislative approaches is stark. 15.6% of citizens in the Netherlands have used cannabis compared to 36.7% of residents in Amsterdam. (Korf, 2002, p. 854-856) In fact, following the mainstream promotion of coffee-shops in Amsterdam, the rate of regular cannabis use among 18-to-20-year-olds more than doubled. (MacCoun and Reuter, 2010 as cited in Mineta, n.d para. 8) Furthermore, legal cannabis would mean cheaper cannabis. Prohibition drives up the price of the drug by ‘at least’ 400%. (Mineta, n.d, para. 7) Studies have shown that when cigarettes are reduced in price by 10% their consumption shoots up by 7-8%.(Mineta, n.d, para. 7)

While its proponents might have you believe ‘everyone’s getting high nowadays,’ it’s worth remembering that only 5% of our population regularly smoke cannabis. (Dunt 2013 para. 1) This compared to 19% who smoke tobacco (Ash, 2016, para. 1) and 58% of adults who regularly drink alcohol. (Drinkaware, n.d, para. 10) For some advocates of legalisation who, either genuinely believe or pretend to believe that legalisation will lead usage rates to decline, this evidence will, of course, be somewhat inconvenient.

For others, it brings only adulation. In the US state of Colorado, the CEO of the Harvest Company dispensary, rejoiced that: ‘People who would never have considered pot before are now popping their heads in.’ (Keyes, 2015, para. 7) Likewise, when asked why he believed cannabis use had increased in the state since its legalisation, Henson, President of the Colorado Cannabis Chamber of Commerce, argued that more people felt at ease with the drug: ‘They don’t see it as something that’s bad for them.’ (Keyes, 2015, para. 6) What’s more, with regards to the gateway theory, the evidence is clear. Cannabis is a gateway drug. A 25-year longitude study revealed that in 86% of cases of those who had taken two or more illegal drugs, cannabis had been the substance they had used first. (Fergusson. D, Boden. J & Horwood. J 2011, p. 556)

Moreover, those who used cannabis weekly were a staggering 59 times more likely to use other illegal drugs than those who did not use cannabis at all. (Fergusson, D. & Horwood J. 2000, pp. 505–520) In the United States, research revealed that only 7% of young people who had never used cannabis had indulged in other illegal drug use, compare this to 33% of the young people who reported using cannabis regularly and 84% of those who used it daily. (Kandel, 1984, pp. 200 – 209)

Advocates of legalisation, while often conceding the gateway theory, insist that this can easily be countered through legalisation that would disentangle legal cannabis from the illegal ‘hard drug’ black market. However, cannabis users are not using other drugs because their dealers are forcing them down their throats or up their noses. Rather: ‘the biochemical changes induced by marijuana in the brain result in a drug-seeking, drug-taking behaviour, which in many instances will lead the user to experiment with other pleasurable substances.’ (Nahas, 1990, p. 52) Thus, cannabis users will likely seek to experiment with other illegal drugs regardless of the legal status of cannabis. Legalisation would result only in more cannabis users and thus a higher secondary demand for and entanglement within the remaining illegal drug market.

 3) MONEY: A PRICE WORTH PAYING?

The Adam Smith Institute have promised the UK one billion pounds in additional annual tax revenue. All we must do is legalise the drug. However, we can see by examining the cost of alcohol

abuse that any additional tax revenue would be dwarfed by the hugely increased medical and social costs brought about by increased usage. The taxes raised from alcohol cover only a tiny percentage of the societal cost brought about by alcohol misuse. Indeed, while there are no similar statistics available in the UK, a 2002 analysis of alcohol-related costs in America was estimated to be 184 billion dollars annually. (Mineta, n.d. para 10) But surely the billions of dollars raised in taxes more than covered it? Not quite! Taxes on alcohol raised only 8.3 billon dollars in the same timeframe, just 4.5% of costs. (Mineta, n.d. para 10)

In addition, we can be sure that where there is profit to be made, there will be also be predatory capitalism. The aggressive commercialisation of cannabis has already begun, with ‘big tobacco’ companies investing considerable funding in their next project for the betterment of humanity. Similarly, Microsoft have unashamedly announced their partnership with ‘Kind financial,’ a business that ‘logistically supports’ cannabis growers. (Becker, 2016, para. 1) By definition, the purpose of dope companies within legal markets is to sell as much cannabis to as many people as possible and crucial to this pursuit is persuading new users to try their product. In the US there is growing concern these companies have already begun to target a young, impressionable audience with their advertisement.

Likewise, disingenuous associations between cannabis and wellness and barefaced lies regarding the non-existent curative potential of the drug are becoming common-place. According to Vara, the aim is simple. Make as much money as possible by making: ‘Pot seem as all American as an ice-cold beer.’ (Vara, 2016, para. 1)

4) SOCIAL MOBILITY and PUBLIC OPINION 

Inevitably, it is working class young people who are least able to afford the damage that cannabis wreaks on their focus, self-belief and motivation, as well as on their education and career opportunities. It’s well known that cannabis users have lower levels of dopamine in the striatum part of their brains, meaning lower levels of motivation and aspiration. (Bergland, 2013, para. 1) Even after a wide ranging and comprehensive allowance for confounding factors, a Christchurch study observing 1265 children found a strong link between educational underachievement and the use of cannabis. (Fergusson, Horwood & Beautrais, 2003, p. 1682) Those who had used the drug one hundred times or more before the age of sixteen were three times more likely than those who had never used cannabis to leave education without any qualifications. (Fergusson, Horwood & Beautrais, 2003, p. 1690)

In addition, the numbing effect the drug has on the brain of a user and its ability to concentrate and remember things can continue for days after usage. This means that, for regular users, they may never be able to operate at the best of their ability and fulfil their potential. (National Institute on Drug Abuse, 2016, p. 1) Overall then, after adjustment for confounding factors, Fergusson & Boden conclude that cannabis usage between the ages of 14 and 18 was ‘Associated significantly’ with ‘lower levels of life and relationship satisfaction, lower income and higher levels of unemployment and welfare dependency.’ (2011, p. 974)

Nevertheless, unlike many prominent proponents of legalisation, I’m a true believer in democracy. If working-class communities genuinely believe that the best way to combat cannabis is through legalisation, then who am I to argue. The reality is quite the contrary. While many, like Lib Dem

Norman Lamb falsely claim that Brits want cannabis to be legalised. (Doward, 2016, para. 1) A comprehensive poll showed that the British public oppose cannabis legalisation by forty-nine to thirty-two percent. (Jordan, 2015, para. 7) Moreover, various surveys show that those groups who are amongst the hardest hit by cannabis, namely the poor and ethnic 6 minorities, often hold the toughest legal views. In 2010 30% of intermediate non-manual workers had used cannabis compared to 10% of unskilled manual workers. (Park, Curtice & Thompson, 2007, p. 127) Likewise, ‘restrictive views’ on cannabis were higher among those with lower educational attainment. In 2001, just 25% of those with a degree held ‘restrictive’ views compared to 40% of those with A levels as highest qualification and 61% with no qualifications. (Park, Curtice &Thompson, 2007, p. 126)

Even an Ipsos Mori poll which found a slight majority of the overall public in favour of decriminalisation, found that this was supported by only 25% of Asians and 41% of blacks, compared to 55% of whites. (Ames & Worsley, 2013, p. 17) Is this really surprising? After all, the dark world of drug-related crime, violence and addiction hit harder in the streets of Hull than they do in Hampstead. If we as a society, truly care about those who suffer the most at the hands of cannabis, maybe we should take the revolutionary approach of listening to what they think we should do about it.

 5) SOLUTIONS AND PROPOSALS

Having demonstrated the toxic and damaging effects of cannabis on our society we must consider how we can best eradicate it. In 1999, The Runciman report was published, calling for the decriminalisation of cannabis and concluding that … ‘The present law on cannabis produces more harm than it prevents.’ (Runciman Report, 1999). This paper fully agrees that the present laws produce more harm than they prevent. However, this is not due to our nation’s refusal to give in to the drug completely, but because we refuse to properly confront it. Law enforcement Insisting the only way to tackle drug criminality in working class communities is to capitulate to those terrorising them by legalising their product is defeatist madness. The legislative framework and established penalties for the possession of cannabis are, in theory, suitable and rigorous. The maximum sentence for cannabis possession stands at five years’ imprisonment. It is not therefore the theoretical legislative provision that is at fault, we require no new dramatic laws or hard-line legislation. To eradicate cannabis, we require only the practical application of existing legal provision by responsible judges and a police service, uniformly educated in and committed to this endeavour.

The Runciman report itself acknowledged that: ‘almost no one is given an immediate custodial sentence solely for possession of cannabis.’ (Runciman Report, 1999, p. 105) Real deterrence in the form of strict criminal penalties must be consistently enforced to stem the demand side of the trade. Police forces in the United Kingdom should operate a zero-tolerance approach to cannabis possession, with every case leading to arrest and a formal criminal record. In addition, the criminal justice system ought to implement a ‘two strikes’ policy. Upon a second arrest for cannabis possession the individual must always be given a prison sentence of meaningful length. This can be enforced in several ways. Rigorous, visible and aggressive policing can drive up the price of cannabis while mitigating the drug’s negative secondary societal consequences. Community policing must, once again, be the focus of our law enforcement.

Areas synonymous with youth cannabis usage must be visibly policed  and dimly lit, urban, cannabis ‘trouble spots’ should be provided, where possible, with better lighting provision and mainstream

public access. The two-tier, confused policing of cannabis must also be immediately halted, while drug-snobbery and police profiling stamped out. Why are extensive bag searches and sniffer dogs common place at music festivals whose attendees are predominantly working class, such as Creamfields, while glittercovered Home County revellers at Glastonbury can visibly consume drugs without consequence?

The message that drugs are ok so long as secondary behaviour does not cause a nuisance must end – replaced by the message that taking drugs is wrong full-stop. Similarly, distinctions between supposed ‘hard’ and ‘soft’ drugs are largely unhelpful. The consumption of any illegal drug is morally wrong and so the use of all drugs must be discouraged with equal vigour. Equally as important is the insistence that our police force consistently and fairly enforce the law and that certain, politically motivated members of the police hierarchy, who have sought to enact a backdoor decriminalisation process, stop.

In a 2013 study, 103 officers out of 150 interviewed admitted they did not always arrest for cannabis possession. (Warburton May & Hough, 2005, p. 118) One officer stated: ‘I never nick anyone for cannabis, and never will, unless it’s a van load.’ (Warburton May & Hough, 2005, p. 119) Nowhere is this problem better illustrated as in County Durham, who’s Police Chief Constable, Mick Barton, has taken it upon himself to give criminals in the county permission to grow skunk for their own consumption. (Evans, 2015, para. 1)

Sweden provides a useful case study into the potential effectiveness of this approach. Largely considered to have the toughest cannabis laws in Europe, few consider the drug ‘soft.’ Police have pursued a zero-tolerance approach with the vast majority of instances of possession leading to prosecution. This, coupled with the visible and proactive ‘disturb and annoy’ tactics of the national police force (Mapes, 2016, p. 1) have delivered a cannabis usage rate of just 3%. Lower than any other nation in Northern, Western or Southern Europe, with the exception of Lithuania, on 2%. (European monitoring centre for drugs and drug addiction, 2016)

Treatment and education

Further, we must counter the false claim that only legalisation can allow for effective and compassionate treatment for those who have become mentally dependent. Judgement-free, abstinence based assistance for those struggling, but willing to cease their habitual high should be well funded and available. This should be coupled with early intervention for those who have developed mental health problems. Likewise, we cannot be seen to be shying away from the debate on drugs, why would we? The facts and the evidence regarding the harmfulness of cannabis stand in our support. Education, countering fanciful claims that cannabis is ‘twenty-two thousand’ times less dangerous than alcohol ,should be comprehensive. Of course, there could indeed be occasional situations in which cannabis might be a small force for good. Whilst it possesses no curative potential, it is reasonable to conduct a serious and evidence based debate on the merits of tightly-regulated, prescriptive cannabinoids medication for the relief of specific symptoms in exceptional circumstances. In certain situations, morphine is of invaluable  medical assistance. Using heroin recreationally is of great societal and personal damage. Nonetheless, this tiny element of cannabis usage has long been hijacked by those dogmatic in their pursuit of legalised recreational usage and until this ends, progress will be difficult.

Similarly, this paper is not an attack on the middle class in general, or even all those members of the middle class who smoke the drug. While sensible support networks and access to early intervention may help many navigate the pitfalls of cannabis, schizophrenia and depression respect not income nor family stability. It’s our societal responsibility to safeguard all our people from a drug that may not, but may well, ruin their life.

 CONCLUSION 

However, most of those pushing for cannabis legalisation aren’t doing so because they truly believe it is in the best interests of anyone’s health or even finances. They’re doing so because a world that gets high, is a world that appeals to them. If cannabis was legalised it would be a monumental mistake impossible to reverse. We owe it to everyone to resist, with all our might, the ‘inevitable’ social normalisation and legislative legalisation of cannabis.

ABOUT THE AUTHOR David Sergeant read Politics at Durham University and is an Intern and Research Contributor at the Bow Group. He Co-Chaired the High Peak Constituency ‘Vote Leave’ group, sits on the Australian Monarchist League’s New South Wales Committee and is Treasurer of Conservatives Abroad – Sydney.

Source:  https://www.bowgroup.org/sites/bowgroup.uat.pleasetest.co.uk/files/David%20Sergeant%20-%20Cannabis%20paper%20evidence_0.pdf

Abstract

Marijuana (Cannabis sativa) is the most commonly used illicit drug by pregnant women, but information is limited about the effects of prenatal cannabis exposure on foetal development. The present study evaluated the influence of early maternal marijuana use on foetal growth.

Women electing voluntary saline-induced abortions were recruited at a mid-gestational stage of pregnancy (weeks 17-22), and detailed drug use and medical histories were obtained. Toxicological assays (maternal urine and foetal meconium) were used in conjunction with the maternal report to assign groups. Subjects with documented cocaine and opiate use were excluded.

Main developmental outcome variables were foetal weight, foot length, body length, and head circumference; ponderal index was also examined. Analyses were adjusted for maternal alcohol and cigarette use. Marijuana (n=44)- and non-marijuana (n=95)-exposed foetuses had similar rates of growth with increased age. However, there was a 0.08-cm (95% CI -0.15 to -0.01) and 14.53-g (95% CI -28.21 to 0.86) significant reduction of foot length and body weight, respectively, for marijuana-exposed foetuses.

Moreover, foetal foot length development was negatively correlated with the amount and frequency of marijuana use reported by the mothers. These findings provide evidence of a negative impact of prenatal marijuana exposure on the mid-gestational foetal growth even when adjusting for maternal use of other substances well known to impair foetal development. PMID: 15734273    DOI: 10.1016/j.ntt.2004.11.002

Source:  https://www.ncbi.nlm.nih.gov/pubmed/15734273

Beery points to 50 deaths in 2016, most linked to drugs

Dr. Jeff Beery doesn’t agree with those who think marijuana is a relatively harmless drug that carries medicinal qualities and should even be winked at for recreational purposes.

But Beery doesn’t just think marijuana is a gateway to more dangerous drugs.

“It’s a gateway to hell,” he says flatly.

Beery’s perspective is based on four years serving as Highland County coroner, with more than a decade before that as a deputy coroner. He provided statistics this week from 2016 on 50 fatalities he investigated last year that he deemed suspicious, or at least unusually odd or interesting.

Beery said there has been a steady increase in deaths related one way or another to drugs, raising fatalities connected to illicit drugs to alarming proportions. He said the word “epidemic” is not sufficient to describe the toll being taken on Highland County.  “It’s a craze, not an epidemic,” he said, adding that “epidemic” implies something beyond people’s control.

The 50 cases provided by Beery from 2016 range from deaths by car crashes, burns, gun shots, heart attacks, hyperthermia and suicides to asphyxia and embolisms. But most of them have a common denominator, he said – the presence of drug use, or a history of drug use.

At least eight cases out of the 50 cited by Beery include marijuana as a factor contributing to the fatalities, in his opinion. Six fatalities were connected to heroin, three to cocaine, eight to amphetamines, including methamphetamine, and several to drugs like Xanax, Valium, Clonazepam and, especially, Fentanyl, which has been increasingly found mixed with heroin.

Beery blames a lax attitude by society and particularly by elected officials, including at the state and federal level, for contributing to the rise in drug-related deaths. He said former U.S. Attorney General Eric Holder’s decision not to pursue marijuana charges at the federal level “opened the door to the wild progression of illicit drugs.”

Holder consistently expressed views on marijuana that were opposed to treating the drug as seriously as other narcotics. In a 2016 PBS interview, after he was no longer attorney general, Holder said, “It’s hard for me to imagine ever decriminalizing crack cocaine, drugs like that. But the whole question of should marijuana be decriminalized, I mean, that’s a conversation I think that we should engage in.”

Beery is aware of the fierce pushback among many people and organizations to his stand on marijuana. Groups like the National Organization for the Reform of Marijuana Laws (NORML) – whose mission is “to move public opinion sufficiently to legalize the responsible use of marijuana by adults, and to serve as an advocate for consumers to assure they have access to high quality marijuana that is safe, convenient and affordable,” according to its website – have won referendums and convinced legislatures to at least legalize marijuana for medicinal purposes.

Many patients suffering from certain serious illnesses or chronic pain insist that marijuana is the only effective relief they have found. Beery disagrees, saying marijuana has no medicinal qualities. He blames Ohio’s Republican-led “so-called conservative” legislature for caving in on the medical marijuana issue, even though the consequences of marijuana use and cultivation are obvious, especially in southern Ohio, he said.

“Just look at Pike County,” said Beery, referring to the murders last year of the Rhoden family, where a large marijuana growing operation worth hundreds of thousands of dollars on the street was found.  Beery said a lax attitude about border security and drugs also contributes to the problem.

Beery said that while investigating deaths in recent years, “I would see other things,” ranging from marijuana to heroin to cocaine that, to him, were obvious contributors not just to overdoses but to car wrecks, gun shots, homicides, burns and suicides.

Source: http://timesgazette.com/news/13879/highland-county-coroner-marijuana-is-gateway-to-hell

March 2017

A new study released today by JAMA Psychiatry found that rates of marijuana use and marijuana addiction increased significantly more in states that passed medical marijuana laws as compared to states that have not. Examining data from 1992 to 2013, researchers concluded that medical marijuana laws likely contributed to an increased prevalence of marijuana and marijuana-addicted users.

“Politicians and pro-pot special interests are quick to tout the benefits of medical marijuana legalization, but it’s time to see through the haze —     medical marijuana has gone completely unregulated,” said SAM President Kevin Sabet. “More people in these states are suffering from an addiction to marijuana that harms their lives and relationships, while simultaneously more have begun using marijuana. No one wants to see patients denied something that might help them, but this study underscores the fact that “medical” and “recreational” legalization are blurred lines. Smoked marijuana is not medicine, and has not been proven safe and effective as other FDA-approved medications have.”

The study’s researchers wrote that increases in marijuana use in states with medical marijuana laws “may have resulted from increasing availability, potency, perceived safety, [or] generally permissive attitudes.” They conclude that “changing state laws (medical or recreational) may also have adverse public health consequences.”  Evidence demonstrates that marijuana —     which has skyrocketed in average potency over the past decades —     is addictive and harmful to the human brain, especially when used by adolescents. Moreover, in states that have already legalized the drug, there has been an increase in drugged driving crashes and youth marijuana use. States that have legalized marijuana have also failed to shore up state budget shortfalls with marijuana taxes, continue to see a thriving black market, and are experiencing a continued rise in alcohol sales.

Source:  http://www.learnaboutsam.org.  Alexandria, VA, April 26, 2017

About SAM

Smart Approaches to Marijuana (SAM) is a nonpartisan, non-profit alliance of physicians, policy makers, prevention workers, treatment and recovery professionals,  scientists, and other concerned citizens opposed to marijuana legalization who want health and scientific evidence to guide marijuana policies. SAM has affiliates in more than 30 states. For more information about marijuana use and its effects, visit http://www.learnaboutsam.org.

Alzheimer’s and Marijuana ?

An estimated 200,000 people in the United States under age 65 are living with younger-onset Alzheimer’s disease. And hundreds of thousands more are coping with mild cognitive impairment, a precursor to Alzheimer’s and other dementias.

“It’s beyond epidemic proportions. There truly is a tidal wave of Alzheimer’s disease,” said Dr. Vincent Fortanasce, a clinical professor of neurology in Southern California who is also a renowned Catholic bioethicist, author and radio host.

Fortanasce, a member of Legatus’ San Juan Capistrano Chapter, for several years has studied Alzheimer’s disease, its underlying causes and treatments. Through his research, he believes there may be a link between chronic use of marijuana — especially when started at a young age — and Alzheimer’s.

Finding the link

Fortanasce notes that medical research shows chronic users of marijuana, in particular the kind with high quantities of THC, have reduced volume in the hippocampus, the region of the brain responsible for memory and learning. In Alzheimer’s disease, Fortanasce said, medical researchers have also noticed reduced hippocampus volume with increased B-amyloid plaques and neurofibrillary tangles.

Taking into account other factors, such as skyrocketing obesity rates and lack of exercise, Fortanasce argues that chronically smoking marijuana and consuming products laced with cannabis are harming the long-term mental health of millions of young Americans. He is trying to convince the American Academy of Neurology to conduct a major survey to see if people diagnosed with dementia have also smoked marijuana.

Source: :  http://legatus.org/kicking-pot-curb/  April 9th 2017

In 2014, recreational cannabis use was legalized in Colorado, and seven other states have since followed suit. With an ever-expanding part of the population using marijuana to cure a number of ailments, researchers at Colorado State University have investigated its effects on mood. The researchers – led by Lucy Troup, assistant professor in the university’s Department of Psychology – publish their findings in the journal PeerJ.

They note that the “relationship between cannabis use and symptomatology of mood and anxiety disorders is complex,” adding that although “a great deal of research exists and continues to grow, the evidence remains contradictory.” Troup and colleagues point to a large international survey published in 2013, in which 5.2 percent of respondents reported that they used cannabis to alleviate depressive symptoms. Meanwhile, a survey of medical marijuana users in California revealed that 26.1 percent of participants reported therapeutic benefits for depression, and 37.8 percent reported benefits for anxiety.

“This trend of self-medication for conditions other than the one prescribed is too large to ignore when investigating the associations between cannabis use and mood disorders,” write the Colorado State University researchers.

They add that this increases “the need to include recreational users for research, especially when the casual user group are most likely recreational users and seem to sustain the greatest deficits in mood.”

Is cannabis used correctly for self-medication? For their study, Troup and colleagues wanted to focus on Colorado, which was the first state to legalize recreational marijuana.

As such, they conducted an in-depth, questionnaire-based study of 178 legal cannabis users who were aged 18-22.

They divided their participants into three groups based on self-reported use: a control group who never used cannabis, a casual user group, and a group of chronic users.

Interestingly, the participants who were categorized with subclinical depression, and who also used cannabis to treat their depressive symptoms, scored lower on anxiety symptoms than on their depressive symptoms. In short, they were more depressed than anxious.

The researchers also say that the self-reported anxiety sufferers were found to be more anxious than depressed.

Study co-author Jacob Braunwalder, a researcher in Troup’s laboratory, says that “if they were using cannabis for self-medication, it wasn’t doing what they thought it was doing.”

The questionnaire used in the study was developed by co-author Jeremy Andrzejewski. Called the Recreational Cannabis Use Evaluation, the questionnaire delved into users’ habits, including whether they smoked cannabis or used stronger products such as hash oils or edibles.

The researchers say that inconsistencies in previous studies are better understood when considering how cannabis use is reported. “Phytocannabinoid type and strength is not consistent between studies,” they say, “and there have been significant changes in the strength of these products post-legalization.”

‘Infrequent users have stronger relationship with negative mood’

Troup and colleagues say that it is important to point out that they looked at the residual effects of cannabis use, not administration of specific doses.

However, they do note that their results “suggested that cannabis use had an effect on measurements of mood disorder symptomatology. In particular, those who used cannabis less frequently, the casual user group, had the strongest correlations with overall score and negative effect on the CES-D [Center for Epidemiological Studies depression scale].”

Interestingly, the researchers did not observe a relationship with pre-anxiety symptoms in the cannabis user groups, compared with controls.

The researchers emphasize that their study does not conclude that cannabis causes depression or anxiety. It also does not show that cannabis cures these conditions. However, they add that their analysis displays a need for further study regarding how cannabis affects the brain.

Andrzejewski adds that “there is a common perception that cannabis relieves anxiety,” but this has not been fully backed by research.

“It is important not to demonize cannabis, but also not to glorify it,” adds Troup. “What we want to do is study it, and understand what it does. That’s what drives us.”

Concluding their study, the researchers write:

“Our data indicate that infrequent users have a stronger relationship with negative mood. Our data suggested that those that use cannabis casually scored higher on the CES-D scale for depression, and consequently could be at greater risk for developing pre-depression symptomology compared to both chronic users and controls.”

It is important to note that the study has limitations, including:

  •  Sample size
  •  Control for phytocannabinoids in terms of strength and type
  •  Confounding variables such as multiple drug use and alcohol consumption
  •  The self-report design
  • A limited interpretation of depression due to lack of clinical evaluation.

Still, the researchers say that their study “provides a starting point from which to design controlled experiments to further investigate the relationship between mood and cannabis use in a unique population.”

Source:  http://www.medicalnewstoday.com/articles/314823.php   Dec. 2014

ABSTRACT

Background

It has long been established that smoking tobacco during pregnancy causes increased risk of miscarriage, increased placental problems, reduction of birth weight, and a variety of birth defects [1].

In light of the recent legalization of marijuana in Colorado, Washington, Alaska and Washington, D.C., we felt it important to establish and publicize the causative relationship between cannabis usage and embryological outcomes. The main psychoactive cannabinoid in marijuana is delta-9-tetrahydrocannabinol (THC), which has a half-life of approximately 8 days in fat deposits and can be detected in blood for up to 30 days before becoming entirely eliminated from the blood [2]. These characteristics act as a direct risk factor to the developing embryo, as the maternal tissues act as reservoirs for THC and other cannabinoids.

Certain drugs cross the placenta to reach the embryo in the same manner as oxygen and other nutrients [3]. Drugs consumed during pregnancy can act directly on the embryo, or they can alter placental function, which is critical for normal growth and development.

Ingestion of drugs can interfere with these functions, resulting in compromised fetal development and growth [3]. THC readily crosses the placenta, which, in conjunction with slow fetal clearance, results in prolonged fetal exposure to THC, even after consumption is discontinued [2].

The use of marijuana in early pregnancy is associated with many of the same risks as tobacco, including miscarriage, congenital malformations, and learning disabilities [4]. Adverse effects of marijuana use during pregnancy have been exacerbated over the years, as THC levels in marijuana have increased nearly 25-fold since 1970 [5]. This paper looks to examine recent studies on cannabinoids and embryonic development in order to establish the mechanisms through which these cannabinoids act.

Source:  Friedrich, Joseph et al. “The Grass Isn’t Always Greener: The Effects of Cannabis on Embryological Development.” BMC Pharmacology & Toxicology 17 (2016): 45. PMC. Web. 21 Apr. 2017.

Kuei Y. Tseng was awarded $1.95 million by NIH for a five-year study of “Adolescent Maturation of the Prefrontal Cortex: Modulation by Cannabinoids.” Regular marijuana use by teens can stop the brain from maturing, according to a new study by scientists at Rosalind Franklin University of Medicine and Science, North Chicago, IL. Published March 4 in the journal Molecular Psychiatry, the study is the first to establish a causal link between repeated cannabinoid exposure during adolescence and an interruption of the normal maturation processes in the prefrontal cortex, a region in the brain’s frontal lobe, which regulates decision making and working memory and undergoes critical development during adolescence.

The findings apply to natural cannabinoids, including those in marijuana, and a new generation of more potent, synthetic cannabinoid products. THC, the compound in marijuana that produces feelings of euphoria, is of particular concern. The chemical can be manipulated, resulting in varying concentrations between marijuana strains – from 2 to 28 percent. A higher concentration of THC and increasing use by younger teens poses a greater risk for long term negative effects, the study finds. Kuei Y. Tseng, MD, PhD, associate professor of cellular and molecular pharmacology at the Chicago Medical School at RFUMS and principal investigator of the study, blames the CB1 cannabinoid receptor, which governs neuronal communication, for the drug’s long -lasting effect.

Tseng and his team of researchers used rat models in testing the effect of cannabinoid exposure during narrow age windows and analyzed the way information is later processed by the adult prefrontal cortex. They discovered that when CB1 receptors are repeatedly activated by cannabinoids during early adolescence, development of the prefrontal cortex stalls in that phase. The window of vulnerability represents two thirds of the span of adolescence. Test animals showed no such effect when exposure occurred in late adolescence or adulthood.

“We have conclusively demonstrated that an over activation of the CB1 receptor during the window equivalent to age 11 to 17 in humans, when the prefrontal cortex is still developing, will inhibit its maturation and have a long lasting effect on its functions,” Tseng said.

The study shows how chronic cannabis use by teens can cause persistent behavioral deficits in adulthood, including problems with attention span and impulse control. The findings also add to prior research that draws a correlation between adolescent marijuana abuse and the development of schizophrenia.

The discovery, which comes as a growing number of states are considering legalization of marijuana for both medicinal and recreational use, calls for the attention of physicians who prescribe medical marijuana and policy makers who, according to Tseng, “will have to establish regulations to take advantage of the beneficial effects of marijuana while minimizing its detrimental potential.”

Researchers are focusing on developing outcome measures to reveal the degree of frontal lobe maturation and history of drug exposure. The challenge now, Tseng said, is to find ways to return the frontal lobe back to a normal state either through pharmacological or cognitive interventions.

“Future research will tell us what other mechanisms can be triggered to avoid this type of impairment of the frontal lobe,” Tseng said. “Ultimately, we want to restore the prefrontal cortex.”

Supported by RFUMS, the research was funded primarily through NIH Grant R01-MH086507 to Tseng and also by a 2012 seed grant from the Brain Research Foundation.

Source:  https://www.rosalindfranklin.edu/news/profiles/study-shows-marijuana-use-interrupts-adolescent-brain-development/   4th March 2017

I am not a long-time user.  I used casually for about six months, but then suddenly had a terrible experience with marijuana-induced psychosis.   I had moved from a state where is was illegal, to Washington.  A dispensary sold me something incredibly strong just recently, in March.   It was a joint mixed with a marijuana wax- I didn’t even know what that was.  I was SO naive, but there is literally NOTHING out there that lets consumers know that ANYthing even remotely bad can happen.

As long as I didn’t drive under the influence, what could go wrong?   I thought all pot was “safe.”    The irony is that I am nearly 40, a stay-at-home mom with honor roll kids, no history, ZERO history with drug usage, or ANY depression, mental illness etc etc.. NONE.  I never used marijuana before I moved to Washington. I literally just set out to listen to music and unwind while I got the house clean….awaiting the arrival of my husband who was gone on a business trip.   My kids were on Spring break, at a friend’s house.

About halfway through I felt very dizzy and unbalanced… So I thought I just needed to sit down, or maybe eat.. I looked at the glass of wine I had poured… and dumped it in the drain…. Then I had a sudden disturbing image of myself biting THROUGH the wine glass… It came over and over.  Bite the glass….. the words wouldn’t leave my head…. I’m biting glass.  My heart began to race, my hands began to shake. I felt freezing cold, yet was sweating. Then I was feeling a sudden surge of Adrenalin and was panic stricken.  I began having suicidal ideations, in MINUTES…

Shooting Myself and Biting Glass

Over and over and over… shoot yourself… bite through the glass… shoot yourself…and much worse.. it was as if a tape of my worst nightmares were playing over and over and over again in my head…and it was just as physical as it was psychological….. With absolute sincerity, I tell you that I barely made it through that night alive, and even the subsequent days and weeks… I still suffered terrible suicidal ideation……….

NEVER, ever did I have suicidal thoughts or feelings in my life. I am happy, well-adjusted, and a warm, outgoing person with lots of friends and a solid marriage.

Within days I began researching, because I KNEW what I had experienced was from smoking…again, I reiterate, I had nothing else in my system or history to indicate otherwise….and there it was.. All the research indicating that it WAS the pot.. Marijuana-induced psychosis is a proven thing and all too common. There is ZERO safety put in place in these recreational pot stores.  They don’t warn a consumer about strength, concentration or side effects.  It as if you are buying a glass of milk to them!! I later found out that marijuana wax is known as a “dab” and I am still unsure of what they really are…

No Warnings Against Psychosis! The ER in Olympia Washington sees on average TWO cases of marijuana-induced psychosis a DAY!! Yet we don’t hear of this!? Why not? I would have NEVER tried any medicine or drink that could even remotely do this to me, but thought I was using something as harmless as a glass of wine because they say it is.   I can’t even fully describe the horror of that night as it’s very, very hard to revisit. Thank you for warning people.  I am glad I was able to use some of the resources and information you have shared to help recover…….People need to know.  Marijuana can be deadly.   I almost lost everything to very casual use.

I am lucky to have health insurance and lucky that my husband could be with me.  My husband had to take an entire week off to stay home with me! Again how fortunate I am and I’m in the position to have someone that could do that.

I am lucky in that I am NOT an addict or addicted to it. So not using isn’t an issue….. I would never smoke pot again, but the suicidal ideation was so intense and such a terrible and traumatic experience…. It is hard to describe how horrific it is was and I’d rather be tortured than ever experience that again…. I just never thought that was even possible….    From BK, Washington

Source:  http://www.poppot.org/2017/04/14/biting-glass-biting-my-way-delirium/

Please share this post with every concerned parent you know! The Parents Against Pot website has many very useful and interesting articles and testimonies and we would thoroughly recommend anyone interested in the arguments for and against the use of marijuana (pot) to log on to: http://www.poppot.org

Marijuana Legalization Proposals Die in Committee

[Alexandria, VA, April 12, 2017] –  Yesterday, an alliance of concerned citizens, public health experts, and safety officials soundly defeated two marijuana legalization bills in Maryland. The bills, which would have permitted commercial pot shops in communities throughout the state, died without a vote in the Maryland Senate last night. SAM Executive Vice President Jeff Zinsmeister and Maryland-based neuroscientist and SAM Science Advisor Dr.Christine Miller testified in Annapolis last month, urging the legislature to reject marijuana legalization and commercialization. AAA Mid-Atlantic also testified against the bills, citing traffic safety concerns due to drugged driving increases in states that have legalized marijuana.

“This is a major victory in the effort to put public health and common sense before special interests,” said SAM Executive Vice President Jeff Zinsmeister. “The costs of legalization, including more stoned drivers on the roads causing fatalities, more people being driven into treatment for addiction, and higher regulatory costs far outweighed any benefit Maryland would see. The Big Marijuana lobbyists came into Maryland touting the notion that marijuana legalization would fix our criminal justice system and rake in millions – but Maryland smartly concluded that legalization actually exacerbates these issues. All they had to do was look to Colorado, where more minority youth are being arrested for marijuana and the state deficit is growing.”

“We believe that science and research, not profit, should drive what marijuana laws look like in our state,” said Dr. Christine Miller, a Maryland neuroscientist and member of SAM’s Science Advisory Board.  “The pro-marijuana lobby was looking to profit by selling a harmful, addictive substance that would harm our communities and endanger public safety. I’m proud that evidence-based policy putting health first prevailed in Maryland yesterday.”

Evidence demonstrates that marijuana – which has skyrocketed in average potency over the past decades – is addictive and harmful to the human brain, especially when used by adolescents. Moreover, in states that have already legalized the drug, there has been an increase in drugged driving crashes and youth marijuana use. States that have legalized marijuana have also failed to shore up state budget shortfalls with marijuana taxes, continue to see a thriving black market, and are experiencing a continued rise in alcohol sales.

Source: info@learnaboutsam.org  April 2017

Highlights

* Cannabis collisions resulted in 75 deaths and 4407 injuries in 2012.

* There were up to 24,879 victims of property damage only cannabis collisions in 2012.

* Cannabis collisions costs ranged from $1.09 to $1.28 billion CAD in 2012.

* Cannabis collision harms were particularly high amongst those ages 16–34 years old.

Abstract

Introduction

In 2012, 10% of Canadians used cannabis and just under half of those who use cannabis were estimated to have driven under the influence of cannabis. Substantial evidence has accumulated to indicate that driving after cannabis use increases collision risk significantly; however, little is known about the extent and costs associated with cannabis-related traffic collisions. This study quantifies the costs of cannabis-related traffic collisions in the Canadian provinces.

Methods

Province and age specific cannabis-attributable fractions (CAFs) were calculated for traffic collisions of varying severity. The CAFs were applied to traffic collision data in order to estimate the total number of persons involved in cannabis-attributable fatal, injury and property damage only collisions. Social cost values, based on willingness-to-pay and direct costs, were applied to estimate the costs associated with cannabis-related traffic collisions. The 95% confidence intervals were calculated using Monte Carlo methodology.

Results

Cannabis-attributable traffic collisions were estimated to have caused 75 deaths (95% CI: 0–213), 4407 injuries (95% CI: 20–11,549) and 7794 people (95% CI: 3107–13,086) were involved in property damage only collisions in Canada in 2012, totalling $1,094,972,062 (95% CI: 37,069,392–2,934,108,175) with costs being highest among younger people.

Discussion

The cannabis-attributable driving harms and costs are substantial. The harm and cost of cannabis-related collisions is an important factor to consider as Canada looks to legalize and regulate the sale of cannabis. This analysis provides evidence to help inform Canadian policy to reduce the human and economic costs of drug-impaired driving.

Source:  Estimating the harms and costs of cannabis-attributable collisions in the Canadian provinces     Drug & Alcohol Dependence , Volume 173 , 185 – 190

Abstract

Cannabis use remains a critical issue in the United States.  In 2014, an estimated 22 million US residents used cannabis,1 double the number from 10 years age.

As of December 2016, 28 states and the District of Columbia have implemented or have voted to authorize medical cannabis programs, and 8 states and the District of Columbia have legalized recreational cannabis.

Health care professionals often are concerned about whether cannabis use will lead to psychiatric illnesses such as substance use disorders, anxiety disorders, or mood disorders among their patients. Many stakeholders are concerned that an association between cannabis use and psychiatric illnesses will lead to a steady increase in these illnesses as more states implement medical or recreational cannabis legalization policies. Given these trends and concerns, it has become increasingly important to obtain longitudinal data to clarify the relationship between cannabis use and subsequent psychiatric disorders.

Source:  JAMA. 2017;317(10):1070-1071. doi:10.1001/jama.2016.19706

The country with the biggest weed habit?    That might surprise you

Though cannabis is not actually legal in the Netherlands, it can be widely consumed in the country’s infamous coffee shops.

However, despite the ubiquity of the drug, Dutch citizens are not the world’s biggest tokers: according to the United Nations Office on Drugs and Crime (UNODC), that dubious distinction goes to Iceland.

Top 30 cannabis consuming countries

1. Iceland – 18.3% (prevalence of use as percentage of population)

2. US – 16.2%

3. Nigeria – 14.3%

4. Canada – 12.7%

5. Chile – 11.83%

6. France – 11.1%

7. New Zealand – 11%

8. Bermuda – 10.9%

9. Australia – 10.2%

10. Zambia – 9.5%

11. Uruguay – 9.3%

12. Spain – 9.2%

13. Italy – 9.2%

14. Madagascar – 9.1%

15. Czech Republic – 8.9%

16. Israel – 8.88%

17. St Lucia – 8.87%

18. Belize – 8.45%

19. Barbados – 8.3%

20. Netherlands – 8%

21. Greenland – 7.6%

22. Jamaica – 7.21%

23. Denmark – 6.9%

24. Switzerland – 6.7%

25. Egypt – 6.24%

26.UK – 6.2%

27. Ireland – 6%

28. Estonia – 6%

29. Bahamas – 5.54%

30. Sierra Leone – 5.42%

The UNODC’s data suggests that cannabis is used by 18.3 per cent of Iceland’s population (aged 15-64). The US (16.2 per cent) and Nigeria (14.3 per cent) had the second and third highest rates of consumption; the UK came 26th on the list, followed by Ireland. And the Netherlands? It came 20th.

Data is not available for all of the world’s countries – and some figures have been updated more recently than others – meaning caution should be exercised when drawing comparisons.

Source:  http://www.telegraph.co.uk/travel/maps-and-graphics/mapped-the-countries-that-smoke-the-most-cannabis/    1st Dec. 2016

Whether it’s knocking on a nearby door, making a quick call, or agreeing a deal on the way to school, there’s no ID necessary and no questions asked: teenagers in London never have to venture too far to find skunk.

In fact, they find the highly potent form of the Class B drug cannabis much easier to buy than both alcohol and cigarettes, where regulation steps in and requires them to prove that they are old enough.  No such barriers seem to exist when it comes to buying cannabis.

The country’s most popular illicit drug, the average age people start smoking it is 14.

But, for most young people today, it is the stronger, more harmful and seemingly ubiquitous variety of cannabis, high in the cannabinoid THC and low in CBD, and known universally as skunk, that is finding its way into their hands.  To investigate how easy it is for young people to buy cannabis and the risks that come with this, Volteface carried out a nationwide survey and spoke to a group of users and non-users, aged 15-17, from London.

Without chemical analysis, we can’t know for certain what type of cannabis young people are consuming, but we could find out what they thought it was, and the overwhelming majority of people said they used skunk, with many reporting that was the only form of cannabis they could get. And when it comes to getting skunk, it is very easy for young people, particularly in urban areas, to get hold of it.

Indeed, when asked how easy it is to buy cannabis, how often they smoked it or whether any of them had ever had any trouble getting the drug because of their age, the teenagers Volteface interviewed collapsed into laughter at how “ridiculous” these questions were.

In their world, these aren’t things they need to think much about, they’re a given.

The cannabis most commonly smoked in the UK in and before the 1990s was the low-potency hash. This changed as the decade progressed and the development of high potency strains such as skunk came to dominate the market in the Netherlands – a trend which found its way here.

With this in mind, Volteface’s research raises important questions about how much autonomy young people living in areas like London really have when it comes to the cannabis they are smoking.

Unlike previous generations, skunk and closely related strains, high in THC and low in CBD, is perhaps all they will have known, with these varieties accounting for 80-95 percent of the cannabis sold illegally on Britain’s streets according to most recent analyses.

How clued-up are today’s young cannabis users as to where and how to find regular weed and safer strains and the benefits of why they might want to do this?

Under the Misuse of Drugs Act 1971, anyone caught in possession of cannabis could (in theory, but rarely in practice) face five years in prison or an unlimited fine.  Deterrence and censure – the law’s intentions are clear, and young people are well aware of the prohibition. Nevertheless, this doesn’t stop them from wanting to buy cannabis.  76 percent of those who completed Volteface’s survey, and several of the teenagers interviewed, said they were worried about getting into trouble with the police.

But, one 16-year-old Volteface spoke to was still smoking it, despite one occasion on which “I went straight to the cells for having 0.6 grams of weed on me” and his mother being called to collect him.

It appears that the only real barrier when it comes to young people getting cannabis is money.

The rest, they don’t have to worry about – the supply comes to them.  “If you’ve got the money, you can get cannabis, no problem,” said a 17-year-old user from London.  A 16-year-old added: “When we’re walking to school people come up and ask if we want to buy weed.  “If they think you’re the kind of person who smokes weed, they might just come up to you and ask you to take their number and then you just call them,” said another.

One teenager said that if a group are seen smoking cigarettes, they could be approached by cannabis dealers.  Although those interviewed in London for our research said cigarettes were seen as the most “socially acceptable” substance, most said it was still much easier to buy cannabis than tobacco.

As regulated products with a minimum age requirement, young people wanting to buy alcohol and cigarettes from any retail outlet must be able to show they are at least 18.

With cannabis, no such difficulty gets in the way.

96 percent of those who completed Volteface’s nationwide survey and said it was “extremely easy” for them to find cannabis were from cities.  “Getting tobacco is harder than getting cannabis, 100 percent,” said one of the group interviewed.   “It’s too easy.”“Knock on a door,” said one 16-year-old.

“It’s legit if you have the money. There’s times when you got the money for tobacco, but you’re not going to get served inside the shop as you’re too young.”  “Weed is the easiest thing out of cannabis, cigarettes and alcohol to get because you don’t have to have ID.”

Some of the teenagers said they sometimes tried their luck by asking an older young person standing outside the shop to go in and buy some drinks for them, but that this was rare.

In any case, as some of them pointed out, shops shut.

Dealers don’t close for business at 11pm on a Friday night.

Cannabis, more than cigarettes and alcohol, is seen as a greater part of the ‘every day’ lives of the young people smoking it, our research showed.

“You don’t need a motive to smoke it” is how one 16-year-old from London summed up its popularity.

“When I wake up, at lunch… any time I can” said another teenager about when they smoked it. “If I’m not doing anything and I’ve got money, I’ll buy some and smoke it”.  “It just chills you out,” another added.

Whereas, other drugs such as LSD, ecstasy and magic mushrooms, as well as alcohol, are used by young people “every few weeks” at parties or on nights out, the young people we interviewed said they often smoked a joint while listening to music, gaming, relaxing by themselves or with friends.

Most of the teenagers we spoke to in London said they smoked cannabis more commonly on weekends and week nights, but some said they smoked it during school hours, with one 16-year-old stating: “I smoke when I wake up”.

On average, the group spent £30 every three days on the drug. In fact, this seemed to be the group’s biggest problem with cannabis, someone commenting “If I think about all the money I could have saved by now…”

Another added: “We get deals init, so our dealers bus us a gram for £10, a z [ounce] for £200, should be £240.”

The most striking finding confirmed by Volteface’s research was the extent to which young people, to their knowledge at least, are smoking skunk, rather than any other form of weed.

The majority of the teenagers Volteface interviewed in London said they smoked skunk, which has come to dominate the market as the cheapest way to get really high.

Cannabis, made from a natural plant, contains two important ingredients: THC (tetrahydrocannabinol) and CBD (cannabidiol). THC gets smokers ‘high’. It has also been correlated, particularly when consumed in high concentrations, with greater incidence of psychosis and development of dependence. CBD while not psychoactive itself, modified the effects of THC, including reducing its anxiety and paranoia inducing effects. It also, crucially, drastically lessens both the incidence of psychosis when people consume it alongside THC, and seems to make cannabis less dependence forming.

Whereas other forms of weed often contain the two substances in more equal ratios, skunk tends to contain solely high amounts of THC and hardly any CBD.

Significantly, the teenagers Volteface interviewed were aware of the distinction between weed and skunk, and the difference in their potential harmfulness, but the sheer ease of availability of the latter meant they were continuing to smoke it. Convenience trumps effort.

“We don’t smoke weed, we smoke skunk. But skunk is more available,” one 16-year-old said. “Skunk is bare chemicals and THC to make it stronger. It’s much more available,” another added. One 17-year-old said: “I don’t even think it’s that great, but it’s all you can get, there’s just bare THC in it.”

“My mum thinks I should smoke Thai because skunk will make you crazy,” said another 17-year-old.  A 16-year-old agreed: “My mum says I should smoke high grade rather than skunk because it’s gonna turn me mental.”

“When you first start buying weed, you don’t actually know what you’re buying. Now you can ask them what it is and they’ll tell you,” another teenager added.

In a 2015 study published in The Lancet Psychiatry, scientists from Kings College London found that 24 percent of all new cases of psychosis are associated with the use of skunk and the risk of psychosis was three times higher for skunk users and five times higher for those who use it every day. No increased risk of psychosis was found for those regularly smoking other forms of cannabis.

The causality between cannabis use and psychosis has been questioned though, with the possibility that those more likely to take the drug are also more prone to psychosis in the first place.

When asked whether they worried about the effects of skunk on their mental health, one teenager said: “Yeah – it’s when I’m older isn’t it? Long-term effects.”  But another added: “I can’t see myself getting something like depression.”

Some said they could feel cannabis having a negative effect on their physical health, with their ability to run and play sports affected.

After getting stopped by the police, parents were the second biggest concern for young cannabis users who participated in Volteface’s research, but this was mainly the case in non-urban areas and those outside of London.

For most of the young cannabis users interviewed in London, their parents were not so concerned as to stop them smoking it, although they did try to advise their children against smoking stronger strains.  “I think part of the reason my mum is okay with me smoking is because I do well in school,” one 17-year-old told us.

Another said: “They lecture me about it but they don’t try and stop me taking it. If my mum found weed in my room she probably wouldn’t take it.”

Skunk is in the lives of young people because it’s in the dealers’ interest to keep it there.

The environment in which they are operating, particularly in urban areas such as London, mean teenagers are regularly smoking a highly potent strain of a drug, which can result in severe mental health problems in later life, even though much less harmful strains are available.

As Volteface’s research suggests, young people today don’t have much control over the quality or type of the cannabis they are smoking. They only know the dealers they know, many of whom will have targeted them specifically.

When something is so easy, the incentive to look elsewhere and acquire knowledge about other options diminishes. We are also creatures of habit – the behaviours we start with and become accustomed to, we come to accept as a part of our lives. Particularly if any adverse effects of these behaviours fail to manifest themselves in the here and now. Make hay while the sun shines.

In young people, dealers seem to have found an ideal target market to push skunk and make a tidy profit, all within a context which runs counterintuitive to what many of us may believe: that making something illegal is keeping us safer.  Teenagers may be laughing at our ignorance on this issue now, but it’s skunk’s dexterous dealers who may well be having the last laugh in the end.

Source:  http://volteface.me/features/easy-young-people-access-skunk-uk/   April 2017

(Extracts from above paper shown below – log-on to source document to read whole paper).

Abstract

Data from the 2013 Canadian Tobacco, Alcohol and Drugs Survey, and  two other surveys are used to determine the effects of cannabis use on self-reported physical and mental health. Daily or almost daily marijuana use is shown to be detrimental to both measures of health for some age groups but not all. The age group specific effects depend on gender. Males and females respond differently to cannabis use.

The health costs of regularly using cannabis are significant but they are much smaller than those associated with tobacco use. These costs are attributed to both the presence of delta9-tetrahydrocannabinol and the fact that smoking cannabis is itself a health hazard because of the toxic properties of the smoke ingested. Cannabis use is costlier to regular smokers and age of first use below the age of 15 or 20 and being a former user leads to reduced physical and mental capacities which are permanent.

These results strongly suggest that the legalization of marijuana be accompanied by educational programs, counselling services, and a delivery system, which minimizes juvenile and young adult usage. access to marijuana for all individuals under the age of 18.

Adolescents need to be encouraged not to use marijuana and strict government control over its production and distribution is needed to protect them. Price, THC content, and advertising also have to be regulated. At a more general level public policy should promote caution and awareness of the harmful consequences of marijuana use.

Source:  Hassunah, R and  McIntosh, J. (2016)  Quality of Life and  Cannabis Use: Results from Canadian Sample Survey Data Health,  8, 1576-1588. http://dx.doi.org/10.4236/health.2016.814155

Highlights

* •The THC content in French cannabis resin has risen continuously for the last 25 years.

* •The emergence of a new high potency cannabis resin in France is shown by the monitoring of THC content and THC/CBD ratio.

* •The THC content in French herbal cannabis has known three stages of growth for the last 25 years.

* •The rise of potency and freshness of French herbal cannabis may be correlated to the increase of domestic production.

Abstract

Cannabis contains a unique class of compounds known as the cannabinoids. Pharmacologically, the principal psychoactive constituent is Δ9-tetrahydrocannabinol (THC). The amount of THC in conjunction with selected additional cannabinoid compounds (cannabidiol/CBD, cannabinol/CBN), determines the strength or potency of the cannabis product. Recently, reports have speculated over the change in the quality of cannabis products, from nearly a decade, specifically concerning the increase in cannabinoid content. This article exploits the analytical data of cannabis samples analyzed in the five French forensic police laboratories over 25 years. The increase potency of both herbal and resin cannabis in France is proved through the monitoring of THC content.

For cannabis resin, it has slowly risen from 1992 to 2009, before a considerable increase in the last four years (mean THC content in mid-2016 is 23% compared to 10% in 2009). For herbal cannabis, it has known three main stages of growth (mean THC content is 13% in 2015 and mid-2016 compared to 7% in 2009 and 2% in 1995). The calculation of THC/CBD ratios in both herbal and resin samples confirms the recent change in chemotypes in favor of high potency categories. Finally, the CBN/THC ratios in marijuana samples were measured in order to evaluate the freshness of French seized hemp.

Source: source: http://dx.doi.org/10.1016/j.forsciint.2017.01.007 March 2017Volume 272, Pages 72–80 

Filed under: Cannabis/Marijuana,Europe :

Once again, the echo chamber nature of press releases serves to promote misleading science and health clickbait.  This time it is with headlines like “Tobacco, but not pot, boosts early stroke risk.”

First, it is an imprecise conclusion based on the newly published study.  Second, the research it refers to downplays the significant flaws and limitations of its own work.

Let’s break down the findings for you to draw accurate (and your own) conclusions.  The goal of the work was to determine whether there is an “association between cannabis use and early-onset stroke, when accounting for the use of tobacco and alcohol.”

Who was studied and how was the data acquired? (1)

* Population-based cohort study comprised of 49,321 Swedish men (born between 1949 and 1951) aged 18-20 years old during 1969/70 when conscripted into military service

* All men— at time of conscription— underwent 2-day screening procedure inclusive of a health examination and completion of 2 questionnaires: 1) substance use, 2) social and behavioral factors

* In 1969/70, the conscripts were asked about cannabis, alcohol and tobacco smoking habits.  Vital signs and a physician assessment were performed then and those with Diabetes Mellitus and Migraines were documented.  The researchers linked their data with parental records to assess parental history of death by cardiovascular disease (CVD) and socioeconomic status in childhood based on the father’s occupation.

* Information on stroke events up to around 60 years of age was obtained from national databases; this includes strokes experienced before 45 years of age

* Participants were followed to assess the initial occurrence of strokes (fatal or nonfatal) from 1971-2009 (between roughly ages 20-59) by collecting information through national public hospital and death record databases.

How was the data analyzed?

* After computation of crude models, the authors estimated a model adjusting for body mass index, systolic and diastolic blood pressure along with the other original (from 1969/70) parameters, additionally adjusting for indicators of socioeconomic status until young adulthood, and additionally adjusting for tobacco smoking and alcohol consumption What does Cannabis, Tobacco, Alcohol Use, and the Risk of Early Stroke:  A Population-Based Cohort Study of 45,000 Swedish Men in the journal STROKE claim?

* We found no evident association between cannabis use in young adulthood and stroke, including strokes before 45 years of age.  Tobacco smoking, however, showed a clear, dose-response shaped association with stroke.  In multivariate-adjusted models, the elevated hazards were attenuated both in relation to heavy cannabis use and high alcohol consumption

CONTRADICTION:  “Cannabis use showed no association with stroke before 45 years of age” “Crude models demonstrated that the hazard of ischemic stroke until 59 years of age was almost 2 times higher among men who were heavy cannabis users in young adulthood than among nonusers.”

* Although an almost doubled risk of ischemic stroke (2) was observed in those with cannabis use >50 times, this risk was attenuated when adjusted for tobacco usage.

*

* Smoking more than or equal to 20 cigarettes per day was clearly associated both with strokes before 45 years of age (more than 6 times higher than nonsmokers) and with strokes throughout the follow-up.

*

* 1037 first-time strokes occurred during the follow-up period until 59 years of age, before age 45 specifically there were 192.  Ischemic strokes were significantly more common than hemorrhagic in all categories.

*

* Most common factors of men with stroke before age 60:  parental history of CVD, overweight, poor cardiorespiratory fitness, low socioeconomic position in childhood, short schooling, heavy smoking, high alcohol consumption (in those before 45 risk 4 times higher than nondrinkers).

*

* High blood pressure and heavy cannabis use seemed to be more prevalent among men having a stroke before 45 years of age but did not differ to the same extent between men with and without stroke when followed until age 60

The many FLAWS in this study…

* The researchers lacked the knowledge of adulthood levels of abuse or use of cannabis, tobacco and alcohol (or other drugs) along with environmental exposures during the military service and after in their respective occupations and lifestyles.

*

* No life long or adult disease diagnoses or medication use were included or known (migraine and diabetes were “estimated”

* )

* Basically, there was no follow-up data to the baseline 1969/70 figures.

*

* Such statistics are vital to understanding contributions to strokes in later life outside of adolescence.

*

* Their early data required substance abuse self-reporting which is traditionally under-reported and demonstrated lower norms than the previous and subsequent year anonymous data they had from other conscript surveys.

*

* This report makes no reference to the varying ingredients and changes in modern day cannabis or tobacco and so on to those of that era or the intervening time period

* Only military young men were studied.  The data may not be able to be generalized to other populations.

*

* MAIN PROBLEM:  The cannabis users were routinely tobacco and alcohol users as well— sometimes tobacco is added to cannabis cigarettes (aka joints).  The authors used “crude modeling” to eliminate those confounding factors which reflects math magic more than actual reality.  Multi-drug use is a challenge to the attainment of sufficient data to interpret.  The ideal study would compare full-on abstainers as a control group to only cannabis users to only tobacco users to only alcohol abusers by quantifying their varying degrees of use.

Take Home Messages…

Epidemiological studies are routinely flawed as associations can be mathematically fit into the desired framework.  Otherwise stated, when we look for something we tend to find it.  The notion that the method used to eliminate for tobacco or alcohol use, for example, in assessing the cannabis issue as an effective strategy is not one to which I subscribe. Even an author of the study, Dr. Anna-Karin Danielsson of Karolinska Institute in Stockholm, revealed to Reuter’s Health:

“The almost doubled risk of ischemic stroke following heavy cannabis use that was observed in our study disappeared when we controlled for tobacco smoking.”  But, she added, the fact that almost all the pot smokers were also tobacco smokers makes it hard “to rule out possible associations between cannabis and stroke.”

There is no doubt —which the authors of this study appreciate— that more research needs to be done on the health effects of cannabis.  There is a growing existing body of literature linking cannabis use to stroke especially in young adults. (3)  Typically, these are in current or heavy users who also are tobacco smokers.  A United States study deemed “cannabis use was associated with a 17% increase in the risk of hospitalization because of acute ischemic stroke, even if both tobacco and amphetamine use constituted bigger risks” while another found its abuse or dependence was linked to ischemic, not hemorrhagic stroke.  (4)  The National Institute on Drug Abuse is a valuable resource, click here.

Once again, exercising, eating and sleeping well, maintaining an optimal weight, pursuing education, and avoiding such substances as marijuana, tobacco smoking along with heavy and binge alcohol consumption will likely best serve all of us and our well-being.  As the laws begin changing with respect to marijuana legality and accessibility, the necessary work needs to be done to determine the genuine risks of its use and abuse so as to most aptly inform the public.

NOTES: (1)  The bullet point answers are direct or paraphrased quotes from the study itself.

(2)  This paper explored ischemic and hemorrhagic strokes, more so the former.  Ischemic ones occur when something blocks the flow of blood to the brain like a clot, for example, so that that region of the brain gets deprived of proper nourishment

and oxygen and is injured as a result.  Hemorrhagic is when too much blood or a massive bleed injures the brain tissue.

Source:  National Families in Action’s The Marijuana Report <srusche=nationalfamilies.org@mail116.atl11.rsgsv.net>; 11th January 2017

Researchers who tested marijuana sold in Northern California found multiple bacterial and fungal pathogens that can cause serious infections. The study was published this month in the journal Clinical Microbiology and Infection.

The mould and bacteria was so widespread and potentially dangerous that the UC Davis academics concluded that they cannot recommend smoking raw or dried weed. “We cannot recommend inhaling it,” says George Thompson III, an associate professor of clinical medicine at the university who helped conduct the cannabis research.

The findings might also apply to indoor, hydroponic marijuana popular at Southern California collectives, according to Thompson. Using pot in baked goods such as brownies might be “theoretically” safer because the products could be heated enough to kill bacteria and fungus, he says.

Asked if concentrates such as wax, honey oil, dabs and shatter would be safe because heat is involved in the production process of “butane extraction,” Thompson says he isn’t sure.

The key finding of the research  is that patients with weak immune systems, such as those with HIV or cancer, should avoid smoking raw and dried pot. Though Thompson told the Sacramento Bee that “for the vast majority of cannabis users, this is not of great concern,” he stresses that there really isn’t a safe way to smoke marijuana buds, even for those who are healthy.

He says it’s possible that filters used with tobacco cigarettes could help with marijuana: Tobacco and all natural plant products have these kinds of bacterial and fungal issues. Irradiated marijuana, though unappealing, also could be an answer, he adds.

Researchers sampled weed samples from Northern California dispensaries and found they tested positive for the fungi Cryptococcus, Mucor and Aspergillus, and for the bacteria E. coli, Klebsiella pneumoniae and Acinetobacter baumannii. The academics said these can lead to serious and lethal illness, noting that smoking the mould and bacteria can embed them directly where they can do the most damage — the lungs.

“Infection with the pathogens we found in medical marijuana could lead to serious illness and even death,” Joseph Tuscano, a professor of internal medicine at UC Davis, said in a statement. “Inhaling marijuana in any form provides a direct portal of entry deep into the lungs, where infection can easily take hold.” The state Department of Public Health is working on guidelines for marijuana testing with the goal that both medical and recreational pot sold next year at permitted dispensaries would be labelled as safe. It’s not clear how this research will affect those guidelines. Thompson says he has reached out to state officials to share his findings.

“We are aware of the study, and while it’s certainly concerning, this is exactly why we need regulation,” Alex Traverso, spokesman for the state Bureau of Medical Cannabis Regulation, said via email. “The Bureau is working with the Department of Public Health to develop strong standards for testing because patient safety is extremely important to us all.”

Source: http://www.laweekly.com/news/marijuana-is-not-safe-to-smoke-researchers-say-7927826 Wednesday, Feb. 14, 2017

During her pregnancy, Stacey never drank alcohol or had a cigarette. But nearly every day, then 24, she smoked marijuana.

With her fiancé’s blessing, she began taking a few puffs in her first trimester to quell morning sickness before going to work at a sandwich shop. When sciatica made it unbearable to stand during her 12-hour shifts, she discreetly vaped marijuana oil on her lunch break.

“I wouldn’t necessarily say, ‘Go smoke a pound of pot when you’re pregnant,’” said Stacey, now a stay-at-home mother in Deltona, Fla., who asked that her full name be withheld because street-bought marijuana is illegal in Florida. “In moderation, it’s O.K.”

Many pregnant women, particularly younger ones, seem to agree, a recent federal survey shows. As states legalize marijuana or its medical use, expectant mothers are taking it up in increasing numbers — another example of the many ways in which acceptance of marijuana has outstripped scientific understanding of its effects on human health.

Often pregnant women presume that cannabis has no consequences for developing infants. But preliminary research suggests otherwise: Marijuana’s main psychoactive ingredient — tetrahydrocannabinol, or THC — can cross the placenta to reach the foetus, experts say, potentially harming brain development, cognition and birth weight. THC can also be present in breast milk.

“There is an increased perception of the safety of cannabis use, even in pregnancy, without data to say it’s actually safe,” said Dr. Torri Metz, an obstetrician at Denver Health Medical Center who specializes in high-risk pregnancies. Ten percent of her patients acknowledge recent marijuana use. In the federal survey, published online in December, almost 4 percent of mothers-to-be said they had used marijuana in the past month in 2014, compared with 2.4 percent in 2002. (By comparison, roughly 9 percent of pregnant women ages 18 to 44 acknowledge using alcohol in the previous month.)

Stacey’s son just had his first birthday. He’s walking, talking and breast-feeding, and she isn’t worried about his development. Credit Jennifer Sens for The New York Times

Young mothers-to-be were particularly likely to turn to marijuana: Roughly 7.5 percent of 18- to 25-year-olds said they had used pot in the past month in 2014, compared with 2 percent of women ages 26 to 44.

Evidence on the effects of prenatal marijuana use is still limited and sometimes contradictory. Some of the most extensive data come from two sets of researchers, in Pittsburgh and in Ottawa, who have long studied children exposed to THC in the womb.

In Pittsburgh, 6-year-olds born to mothers who had smoked one joint or more daily in the first trimester showed a decreased ability to understand concepts in listening and reading. At age 10, children exposed to THC in utero were more impulsive than other children and less able to focus their attention.

Most troubling, children of mothers who used marijuana heavily in the first trimester had lower scores in reading, math and spelling at age 14 than their peers.

“Prenatal exposure can affect the adolescent pretty significantly,” said Dr. Lauren M. Jansson, the director of paediatrics at the Center for Addiction and Pregnancy at the Johns Hopkins University School of Medicine.

Several studies have found changes in the brains of foetuses, 18 to 22 weeks old, linked to maternal marijuana use. In male foetuses that were exposed, for instance, researchers have noted abnormal function of the amygdala, the part of the brain that regulates emotion.

“Even early in development, marijuana is changing critical circuits and neurotransmitting receptors,” said Dr. Yasmin Hurd, a neuroscientist and the director of the addiction center at Icahn School of Medicine at Mount Sinai in Manhattan. “Those are important for regulation of emotions and reward, even motor function and cognition.”

It is already well documented that the developing brains of teenagers can be altered with regular marijuana use, even eventually reducing I.Q.

“The effects are not dramatic, but that doesn’t mean they are not important,” said Jodi Gilman, an assistant professor of psychiatry at Harvard Medical School who studies adolescent users of cannabis. “It could make the difference between getting an A and getting a B.”

“You could imagine that a similar subtle effect may be present in those who were exposed prenatally to marijuana,” she added. The American Academy of Paediatrics and the American College of Obstetricians and Gynaecologists both advise against prenatal cannabis use because of its links to cognitive impairment and academic underachievement. But many state and federal agencies avoid the topic.

Of five federal agencies, only the National Institute on Drug Abuse had any information about prenatal marijuana use on its website as of last February, according to a study published online in December in the journal Substance Abuse. Only 10 state health departments did. Until recently, the Centers for Disease Control and Prevention offered nothing.

“I don’t think public health officials should be alarming people,” said Marian Jarlenski, the study’s lead author and an assistant professor at the University Of Pittsburgh Graduate School Of Public Health. “They just have to say, ‘There have been studies done, and there is some risk.’”

In a statement, C.D.C. officials expressed concern about memory and attention problems among children exposed to THC in utero.

“While current evidence on health consequences is inconsistent, some studies have found risks associated with marijuana use during pregnancy, such as low birth weight or preterm birth,” the agency said. Dr. Marie McCormick, a paediatrician and the chairwoman of a new report on cannabis from the National Academies of Sciences, Engineering and Medicine, said smoking cannabis “does confer, in terms of birth weight, the same risk as cigarettes.”

Some of the gathering evidence is reassuring. So far, prenatal cannabis exposure does not appear to be linked to obvious birth defects. “That’s why some providers and lay

people alike think there’s no effect,” said Dr. Erica Wymore, a neonatologist at Children’s Hospital Colorado. But she warned, “Just because they don’t have a major birth defect or overt withdrawal symptoms doesn’t mean the baby’s neurological development is not impacted.”

Most research in this area was done when the drug was far less potent. Marijuana had 12 percent THC in 2014, while in 1995 it was just 4 percent, according to the National Institute on Drug Abuse.

“All those really good earlier studies on marijuana effects aren’t telling us what we need to know now about higher concentration levels,” said Therese Grant, an epidemiologist and director of the University of Washington’s foetal alcohol and drug unit. “We need to do a whole lot more research now.”

There are two additional problems with studies of maternal cannabis use. Research is often based on reports by pregnant women — instead of, say, tests of urine or the umbilical cord — and they consistently underreport their use. (Researchers know of underreporting because samples reveal discrepancies.) And pregnant women who roll joints also tend to smoke tobacco or drink alcohol; it can be hard to tease out the risks of cannabis itself.

Few realize that THC is stored in fat and therefore can linger in a mother’s body for weeks, if not months. It’s not known whether the foetus’s exposure is limited to the hours a woman feels high.

The American College of Obstetricians and Gynaecologists advises clinicians to ask pregnant women about marijuana use and to urge them to quit. To find out whether that’s happening, Dr. Judy Chang, an obstetrician-gynaecologist at the University of Pittsburgh, and her colleagues recorded more than 450 first visits with pregnant patients.

Medical staff were more likely to warn patients that child protective services might be called if they used marijuana, the researchers found, than to advise them of potential risks. When mothers-to-be admitted to marijuana use, almost half of obstetric clinicians did not respond at all.  Pregnant women aren’t eager to discuss it, either, because they are afraid of legal repercussions or a lecture. Depression, anxiety, stress, pain, nausea and vomiting were the most common reasons women reported using marijuana in a 2014 survey of low-income mothers getting federal nutrition help in Colorado. Roughly 6 percent were pot users; a third were pregnant. “Women are thinking of this as medical marijuana in that they are treating some condition,” said Elizabeth Nash, a policy analyst at the Guttmacher Institute who researches substance abuse in pregnancy.  “If you’re going to consider it like medicine,” she said, “then treat it like medicine and talk to your doctor about it.” Stacey’s son just had his first birthday. He’s walking, talking and breast-feeding, and she isn’t worried about his development.  She still smokes pot — indeed, her son plays on a rug emblazoned with a marijuana leaf. But the severe cramps that plagued her before pregnancy are easing now.  “I don’t have to smoke as much anymore,” she said.

Source: https://www.nytimes.com/2017/02/02/health/marijuana-and-pregnancy.

SACRAMENTO (KPIX 5) – Did the medicine contribute to the patient’s death? That was the question facing doctors when a California man died from a relatively rare fungal infection.

“It started with a couple patients that were undergoing very intensive chemotherapy and a stem cell therapy, and those patients were very immune compromised,” explained Dr. Joseph Tuscano of the University of California, Davis Cancer Center.  Those patients were already in a very serious cancer fight when that fight suddenly became much more complicated with a relatively rare but particularly lethal fungal infection.

“We thought it was strange to have cases of such a bad fungal disease in such a short amount of time,” said Dr. George Thompson, a fungal infection expert with UC Davis Medical Center.

The patients were relatively young, in winnable cancer battles. For one of them, it was the fungal infection that proved deadly. So the doctors set out to find that killer, and right away, they had a suspect.

“What struck me is both of these gentlemen were at least medicinal marijuana users, that helped them with nausea and appetite issues that come with the treatment,” said Tuscano, who joined with Thompson to investigate further.  Only problem, federal law prohibited them from doing that research at UC Davis, so they joined forces with Steep Hill Laboratories in Berkeley.

“We kind of go on the credo of  ‘do no harm,’” said Dr. Donald Land, who has been analyzing contaminated marijuana for over a decade.

“We sometimes see 20 or 30 percent of our samples coming through the lab significantly contaminated with molds,” said Land, who had plenty of experience finding mold and fungus strains, but this time, he and his team went deeper.

They gathered 20 samples of medical marijuana from across California and took them apart, pulling out a range of dangerous bacteria and fungi which they analyzed right down to their DNA.  Even Land was surprised by the results. “We were a little bit startled that ninety percent of those samples had something on them. Some DNA of some pathogen,” he told KPIX 5.

These weren’t just any pathogens, they were looking at the very fingerprints of a killer. “The cannabis was contaminated with many bacteria and fungi, some of which was compatible with the infections that I saw in my patients,” Tuscano said.

“Klebsiella, E.coli, Pseudomonas, Acinetobacter, these are all very serious infections for anybody in the hospital. But particularly in that population, the cancer population,” Thompson.

One of questions this raises is whether the risk is made worse by smoking, which could send pathogens directly into the lungs, which are particularly vulnerable.  Truth is, there’s really isn’t much research on any of this.  “But we think now,” Thompson says, “with some of these patients, it’s really unknowingly self-inflicted form cannabis use.”

Cannabis, labelled medicinal, that could pose a lethal threat to already vulnerable patients.

When this research is published it will suggest more warnings for patients with weakened immune systems, because, as Dr. Tuscano explains, “the problem in my opinion is that there’s this misconception that these dispensaries produce products that have been tested to be safe for patients, and that’s not necessarily the case.”

Source: sanfrancisco.cbslocal.com/2017/02/06/medical-marijuana-fungus-death-uc-davis-medical-center/  6th Feb. 2017

UC Davis researcher Dr. George Thompson advises cancer patients and others with weakened immune systems to avoid vaping or smoking marijuana.

In uneasy news for medical marijuana users, UC Davis researchers have identified potentially lethal bacteria and mold on samples from 20 Northern California pot growers and dispensaries, leading the doctors to warn patients with weakened immune systems to avoid smoking, vaping or inhaling aerosolized cannabis.

“For the vast majority of cannabis users, this is not of great concern,” said Dr. George Thompson, professor in the UC Davis Department of Medical Microbiology and Immunology. But those with weakened immune systems – such as from leukemia, lymphoma, AIDS or cancer treatments – could unwittingly be exposing themselves to serious lung infections when they smoke or vape medical marijuana.

“We strongly advise them to avoid it,” Thompson said.

The study’s findings were published online in a research letter in the journal Clinical Microbiology and Infection.  It comes as California and a majority of states have eased laws on medical and recreational marijuana use, and a majority of U.S. doctors support the use of medical marijuana to relieve patients’ symptoms, such as pain, nausea and loss of appetite during chemotherapy and other treatments.

Typically, patients with lower-functioning immune systems are advised to avoid unwashed fruits or vegetables and cut flowers because they may harbor potentially harmful bacteria and mold, or fungi. Marijuana belongs in that same risk category, according to Thompson.

“Cannabis is not on that list and it’s a big oversight, in our opinion,” Thompson said. “It’s basically dead vegetative material and always covered in fungi.”

The study began several years ago after Dr. Joseph Tuscano, a UC Davis blood cancer specialist, began seeing leukemia patients who were developing rare, very severe lung infections. One patient died.

Suspecting there might be a link between the infections and his patients’ use of medical marijuana, Tuscano teamed with Thompson to study whether soil-borne pathogens might be hiding in medical marijuana samples.

The marijuana was gathered from 20 Northern California growers and dispensaries by Steep Hill Labs, a cannabis testing company in Berkeley. It was distilled into DNA samples and sent to UC Davis for analysis, which found multiple kinds of bacteria and fungi, some of which are linked to serious lung infections.

There was a “surprisingly” large number of bacteria and mold, said Donald Land, a UC Davis chemistry professor who is chief scientific consultant for Steep Hill Labs. The analysis found numerous types of bacteria and fungi, including organic pathogens that can lead to a particularly deadly infection known as Mucor.

“There’s a misconception by people who think that because it’s from a dispensary, then it must be safe. That’s not the case,” said UC Davis’ Tuscano. “This is potentially a direct

inoculation into the lungs of these contaminated organisms, especially if you use a bong or vaporization technique.”

Patients with compromised immune systems are especially susceptible to infections, usually acquired in their environment or in the hospital. But given the testing results, Tuscano said, it’s possible that even some of the more common infections, such as aspergillus, could also be attributed to contaminated medical marijuana.   Tuscano emphasized that until more research is done, he can’t be 100 percent assured that contaminated cannabis caused the infections, but “it’s highly suspicious.” Under California’s Proposition 64, the voter-approved initiative that eased restrictions on personal marijuana use, the state is expected to have cannabis testing regulations in place for medical marijuana by Jan. 1.

“Patient safety is one of our chief concerns in this process,” said Alex Traverso, spokesman for the state Bureau of Medical Cannabis Regulation, in an email. He said the state’s new medical-marijuana testing standards will soon be available for public review. “We welcome everyone’s input to ensure that testing standards are as strong as we need them to be.”

Until then, consumers are largely on their own.  The vast majority of cannabis sold in California is not tested, according to Land.

“You can’t tell what’s in (a marijuana product) by looking at it, smelling it, feeling it, or a person in a dispensary telling you it’s safe or clean,” he said. “The only way to ensure you have a safe, clean product is to test it and be sure it’s handled according to good manufacturing practices.”

Some medical marijuana clinics already do voluntary testing of their products. Kimberly Cargile, director of A Therapeutic Alternative, a medical marijuana clinic in Sacramento, said a sample from every incoming pound of pot is sent to a local, independent testing lab.

“It’s for consumer protection. It’s a healthy first step,” Cargile said.

To avoid the risk of exposure to severe lung infections, Thompson and Tuscano advise cancer patients and others with hampered immune systems to avoid smoking, vaping or inhaling aerosolized cannabis altogether. Cannabis edibles, such as baked cookies or brownies, could be a safer alternative.  Theoretically, Thompson said, the consumption of cooked edibles seems safer than smoking or vaping, but it’s not scientifically proven.

“I give that advice with a caveat: We don’t know it’s safer; we think it probably is,” he said.

For patients heeding the UC Davis advice to avoid smoking or vaping medical marijuana, “it’s always better to err on the side of caution,” said medical marijuana advocate Cargile. There are plenty of alternatives, she noted, including cannabis salves, lotions, sprays, tinctures and suppositories.

Source:  http://www.sacbee.com/news/local/health-and-medicine/article131391629.html Feb.2017

Outdoor cannabis cultivation in northern California has damaged forestlands and their inhabitants. Will legalization of recreational marijuana make things worse or better?

A visit to a marijuana farm in Willow Creek, the heart of northern California’s so-called Emerald Triangle feels like strolling through an orchard. At 16 feet high and eight feet around, its 99 plants are too overloaded with cannabis buds to stand on their own. Instead each plant has an aluminium cage for support.

Welcome to America’s “pot basket.” The U.S. Drug Enforcement Administration estimates 60 percent of cannabis consumed nationwide is grown in California. According to the Department of Justice, the bulk of that comes from the three upstate counties of the Emerald Triangle: Mendocino, Humboldt and Trinity. Conditions here are said to be perfect for outdoor marijuana cultivation. But that has proved to be a very mixed blessing for the region, bringing with it a litany of environmental disturbances to local waterways and wildlife. Creek diversions threaten fish habitat and spur toxic algal blooms. Road building and clear-cuts erode soil and cloud streams. Deep within, illegal “guerilla grows” pepper forestlands with banned rodent poisons that are intended to eradicate crop pests but are also fatal to other mammals.

On November 8 voters in four states—Massachusetts, Maine, California and Nevada—legalized recreational marijuana. These states join Colorado, Washington, Oregon and Alaska, along with the District of Columbia, where one can already legally buy the drug for recreational use. Will this expanded market mean more environmental damage? Or will legalization pave the way for sounder regulation?

In 1996 California legalized marijuana for medical use, providing the first legal space for pot cultivation since the federal government’s blanket ban on the crop some 60 years before. As grow operations in the state flourished, California Department of Fish and Wildlife biologist Scott Bauer analyzed satellite imagery to examine the impact of cultivation on water levels in four Emerald Triangle watersheds. His study, published in PLoS ONE in 2015, found that in three of the four watersheds, “water demand for marijuana cultivation exceeds stream flow during the low-flow [summer] periods.”

The real problem is not marijuana’s overall water consumption, which still falls far short of California staples like walnuts or almonds, explains environmental scientist Van Butsic of the University of California, Berkeley. Rather it is an issue of where and when pot is

grown. Analyzing aerial imagery of 4,428 grow sites in 60 Humboldt county watersheds, Butsic found that one in 20 grow sites sat within 100 meters of fish habitat and one in five were located on steep land with a slope of 17 degrees or more. “The problem is that cannabis is being grown in the headwaters, and much of the watering is happening in the summer,” Butsic says.

If that arrangement goes on unchecked, U.C. Berkeley ecologist Mary Powers warns, summer plantations could transform local rivers from cool and “salmon-sustaining” to systems full of toxic cyanobacteria. Over eons of evolution native salmon species have adapted to “deluge or drought” conditions, she says. But the double whammy of climate change and water extraction could prove to be a game-changer.

Powers spelled out the unprecedented stresses in a 2015 conference paper focused on the Eel River that flows through Mendocino and southern Humboldt. She and her team found riverbed-scouring floods in winter, followed by dry, low-flow conditions in summer, led to warm, stagnant, barely connected pools of water. That is bad news for salmon, but ideal for early summer algal blooms. The algae then rot, creating an oxygen-deficient paradise for toxic cyanobacteria, which have been implicated in the poisoning deaths of 11 dogs along the Eel River since 2002.

Dogs are not the only terrestrial creatures endangered by the grow operations. Between 2008 and 2013 Mourad Gabriel, then a doctoral candidate at the University of California, Davis, Veterinary Genetics Lab, carried out a study of the American fisher, a small carnivorous mammal that is a candidate for the endangered species list. He wanted to suss out the threats to fisher populations in northern California. So he radio-tagged fishers from Trinity County’s Hoopa Valley Reservation and public lands near Yosemite National Park to track their movements. Between 2006 and 2011, 58 of the fishers Gabriel and his team tracked turned up dead. Gabriel studied the necropsies and found that 46 of the animals had been exposed to anticoagulant rodenticides—rat poisons that block liver enzymes, which enable blood clotting. Without the enzyme the exposed mammals bled to death from flesh wounds.

The finding puzzled Gabriel at first, because rat poison is more common in agricultural and urban settings than in remote forests. But then he started visiting the remnants of guerilla grows that had been busted under the guidance of lawmen such as Omar Brown, head of the Narcotics Division at the Trinity County Sheriff’s Office. “We have found [anticoagulant rodenticides] carbofuron on grows in the national forest,” Brown reports. “These are neurotoxin-laced pesticides that have been banned in the U.S. since 2011. And even for allowed pesticides, we’ve found instances where trespass grows are using them in illegally large quantities.” The poisons hit female fishers particularly hard, because the early, pest-prone phase of marijuana cultivation coincides with the fishers’ nesting season, when pregnant females are actively foraging.

Gabriel, now director of the Integral Ecology Research Center based in Humboldt County, says other states may be dealing with rodenticides, water diversions and other problems from guerilla grows, too. “The climate in Colorado, Oregon and Washington is conducive for marijuana cultivation,” he observes. But “there just isn’t the scientific data to prove whether other states have these problems because there has not been research funding put towards answering these questions.”

In California headwater ecosystems could get a reprieve if a greatly expanded legalized pot industry moves to the Central Valley, where production could take place indoors and costs would be less. In pot-growing pioneer states like Colorado or Washington much of the production has moved indoors, where temperatures can be more closely managed. But other factors may hinder that move. “Bud and pest problems are always worse indoors, which biases farmers toward a chemically intensive regime,” says Marie

Peterson of Downriver Consulting, a Weaverville, Calif.–based firm that helps growers fill out the paperwork for state and county permits as well as assesses water management plans for their plantations. And besides, the Central Valley already suffers from prolonged drought.

Of the eight states that legalized the cultivation of recreational marijuana, only Oregon and California allow outdoor grows. But regulating open-air pot plantations in these states remains challenging, even though legal operations for medical marijuana have been around since 1998 and 1996, respectively. In 2015 California passed the Medical Marijuana Regulation and Safety Act, which calls on the state’s departments of Food and Agriculture, Pesticide Regulation, and Fish and Wildlife, along with the state’s Water Board—to oversee environmental impacts of the industry. The board came up with a list of requirements for a marijuana plantation water permit, which in turn became a necessary condition for a license to grow medical pot in any of the three Emerald Triangle counties. Counties have until January 2018 to decide whether to create similar stipulations for recreational marijuana growing permits.

Butsic is optimistic about a more regulated future for the marijuana industry in California. “I think five years from now things will be more sustainable. Permitting shows growers that the state is interested in water use and their crop.”

Source:  https://www.scientificamerican.com/article/burgeoning-marijuana-market-prompts-concerns-about-crop-rsquo-s-environmental-impact/  2nd Feb. 2017

GW intends to advance oncology research and development efforts

GW Pharmaceuticals plc (Nasdaq:GWPH) (“GW,” “the Company” or “the Group”), a biopharmaceutical company focused on discovering, developing and commercializing novel therapeutics from its proprietary cannabinoid product platform, today announced positive top-line results from an exploratory Phase 2 placebo-controlled clinical study of a proprietary combination of tetrahydrocannabinol (THC) and cannabidiol (CBD) in 21 patients with recurrent glioblastoma multiforme, or GBM. GBM is a particularly aggressive brain tumour, with a poor prognosis. GW has received Orphan Drug Designation from the U.S. Food and Drug Administration (FDA) and the European Medicines Agency (EMA) for THC:CBD in the treatment of glioma.

The study showed that patients with documented recurrent GBM treated with THC:CBD had an 83 percent one year survival rate compared with 53 percent for patients in the placebo cohort (p=0.042). Median survival for the THC:CBD group was greater than 550 days compared with 369 days in the placebo group. THC:CBD was generally well tolerated with treatment emergent adverse events leading to discontinuation in two patients in each group. The most common adverse events (three patients or more and greater than placebo) were vomiting (75%), dizziness (67%), nausea (58%), headache (33%), and constipation (33%). The results of some biomarker analyses are still awaited.

“The findings from this well-designed controlled study suggest that the addition of a combination of THC and CBD to patients on dose-intensive temozolomide produced relevant improvements in survival compared with placebo and this is a good signal of potential efficacy,” said Professor Susan Short, PhD, Professor of Clinical Oncology and Neuro-Oncology at Leeds Institute of Cancer and Pathology at St James’s University Hospital and principal investigator of the study. “Moreover, the cannabinoid medicine was generally well tolerated. These promising results are of particular interest as the pharmacology of the THC:CBD product appears to be distinct from existing oncology medications and may offer a unique and possibly synergistic option for future glioma treatment.”

We believe that the signals of efficacy demonstrated in this study further reinforce the potential role of cannabinoids in the field of oncology and provide GW with the prospect of a new and distinct cannabinoid product candidate in the treatment of glioma.

These data are a catalyst for the acceleration of GW’s oncology research interests and over the coming months, we expect to consult with external experts and regulatory agencies on a pivotal clinical development program for THC:CBD in GBM and to expand our research interests in other forms of cancer.

The study, designed to evaluate a number of safety and efficacy endpoints, comprised an initial phase where the safety of THC:CBD in combination with dose-intense temozolomide (an oral alkylating agent that is a standard first-line treatment for GBM) was assessed in 2 cohorts of 3 patients each.  Following a satisfactory independent safety evaluation, the study then entered a randomized placebo-controlled phase where 12 patients were randomized to THC:CBD as add-on therapy compared with 9 patients randomized to placebo (plus standard of care).

Beginning in 2007 and prior to initiating this study, GW conducted substantial pre-clinical oncologic research on several cannabinoids in various forms of cancer including brain,

lung, breast, pancreatic, melanoma, ovarian, gastric, renal, prostate and bladder. These studies have resulted in approximately 15 publications and show the multi-modal effects of cannabinoids on a number of the key pathways associated with tumour growth and progression. Cannabinoids have been shown to promote autophagy (the process of regulated self-degradation by cells) via several distinct mechanisms, including acting on the AKT/mTOR pathway, an important intracellular signalling pathway that is overactive in many cancers.

In glioma, THC and CBD appear to act via distinct signalling pathways. The combination of THC and CBD showed good efficacy in various animal models of glioma, particularly when used in combination with temozolomide. Initial in vitro studies showed that the combined administration of THC and CBD led to a synergistic reduction in the viability of U87MG glioma cells when compared to the administration of each cannabinoid individually. The co-administration of temozolomide with THC and CBD had further synergistic effects, causing a significant reduction in cell viability. These pre-clinical studies justified the initiation of the Phase 2 clinical study.

GW’s portfolio of intellectual property related to the use of cannabinoids in oncology includes a number of issued patents and pending applications in both the U.S. and Europe. This portfolio is designed to protect the use of various cannabinoids individually or in combination, in the treatment of a variety of oncology-specific disorders and product formulations.

About GBM

Gliomas are tumours that arise from glial cells mainly in the brain but can also be found within the spinal cord. Within the category of Glioma there are multiple different tumor types. GBM is the most common Glioma and is one of the most common primary brain tumors, accounting for 15.6% of all primary brain tumors (Ostrom et al. 2013). They are also the most aggressive with only 28.4% of patients surviving one year and only 3.4% surviving to year five (Brodbelt et al. 2015). Studies of patients with high-grade gliomas showed that headache was the most common initial presenting symptom. These headaches can be persistent lasting more than six months and are often associated with other symptoms, including seizures, visual disturbances, cognitive impairment and nausea and vomiting depending on the location and growth rate of the tumor.

About GW Pharmaceuticals plc

Founded in 1998, GW is a biopharmaceutical company focused on discovering, developing and commercializing novel therapeutics from its proprietary cannabinoid product platform in a broad range of disease areas. GW is advancing an orphan drug program in the field of childhood epilepsy with a focus on Epidiolex® (cannabidiol), which is in Phase 3 clinical development for the treatment of Dravet syndrome, Lennox-Gastaut syndrome, Tuberous Sclerosis Complex and Infantile Spasms. GW commercialized the world’s first plant-derived cannabinoid prescription drug, Sativex® (nabiximols), which is approved for the treatment of spasticity due to multiple sclerosis in 31 countries outside the United States. The Company has a deep pipeline of additional cannabinoid product candidates which includes compounds in Phase 1 and 2 trials for glioma, schizophrenia and epilepsy. For further information, please visit www.gwpharm.com.

Original press release: http://ir.gwpharm.com/releasedetail.cfm?ReleaseID=1010672

Source:  https://www.newcannabisventures.com/gw-pharma  17th Feb. 2017

Since the state legalized marijuana for recreational use, the Colorado Department of Public Health and Environment has issued a report on marijuana and health every two years. Colorado legalized recreational pot in 2012 to go into effect in 2014. This is the second health report. The report contains a huge amount of data. An executive summary appears on pages 1-6. The most startling data about the consequences of legalization are the number of marijuana-related hospitalizations that have occurred from 2000, the year Colorado legalized marijuana for medical use to September 2015, 21 months after recreational legalization began. A graph showing rates of these hospitalizations by age is pictured below. They are rates per 100,000 and have nearly doubled among adolescents and quintupled among young adults. A graph of the data broken down by race on page 291 of the report are equally stunning. Read report here.

Source:  http://themarijuanareport.org/  Feb.2017

Jamaica’s recent decriminalization of possession of up to two ounces of ganja is contributing to a dangerous practice that officials warn needs urgent attention.

Disturbing findings in the 2016 National Drug Prevalence Survey show that one in six males and 17 females drive under the influence, with most admitting to using ganja since it has been decriminalized.

Executive director of the National Council on Drug Abuse Michael Tucker has raised a red flag about the data, which he said highlights the fact that people behind the wheel as well as non-drivers are in serious danger.

He told the Jamaica Gleaner: “This is very troubling, as potentially these persons are not only a harm to themselves, but to other users of the road. Many times they might be carrying passengers, including children.”

More than 4,500 people across Jamaica participated in the survey conducted in April and July last year which sought to find out the pattern of substance abuse among citizens between 12 and 65, and attitudes towards ganja decriminalization, among other things. Tucker was particularly concerned that some of the frequent road users, including the drivers of public transport, were among the offenders.

“We don’t want to raise any alarm on a particular group of persons, but if you look at the population, I would assume that a reasonable number of them, (respondents) would have come from that group (bus drivers),” he said.

At the same time, vice-chairman of the National Road Safety Council Dr Lucien Jones lamented that the problems associated with drug use were often misunderstood and underestimated.  Pointing to police data, he noted that distracted driving has been identified as one of the main causes of accidents.

“It goes back to the basic problem we have on the road, which is indiscipline. It’s a mindset, which we are definitely trying to change. So it’s one other issue, apart from just driving recklessly on the road. It’s a major concern for us that people don’t understand the problems, which are associated with drug use,” Jones told The Gleaner.

Health Minister Dr Christopher Tufton has suggested that educating citizens about the effects of substance abuse is a key way to tackle the problem.

He noted that while Jamaica is positioning itself to be a major player in the marijuana industry, government would ensure that the drug is not misused or abuse.

Source:  http://www.caribbean360.com/news/jamaica_news/influence-jamaicans-driving-high#ixzz4WEiVvycI   Caribbean360 – January 18, 2017

Germany’s lower house of parliament has passed a law legalising the use of cannabis for medicinal purposes.

People with serious illnesses, such as multiple sclerosis and chronic pain, or a lack of appetite or nausea, could be offered marijuana under the law.  Patients will only have the right to be treated with cannabis “in very limited exceptional cases” and they will not be allowed to grow their own cannabis, according to the bill.

The health minister, Hermann Gröhe, said: “Those who are severely ill need to get the best possible treatment and that includes health insurance funds paying for cannabis as a medicine for those who are chronically ill if they can’t be effectively treated any other way.”

A health ministry spokeswoman said cannabis would only be used as a last resort. She said a scientific study would simultaneously be carried out to assess the effects of cannabis use in such cases.  Until now, patients have only been able to access cannabis for medicinal purposes by special authorisation, making the process complicated. Now they will be able to get a prescription from their doctor and a refund for the upfront cost from their health insurance, she said.

The spokeswoman said the law was likely to take effect in March after a procedural reading by the upper house of parliament.  Until state-supervised cannabis plantations are set up in Germany cannabis will be imported.

Other European countries that allow cannabis to be used for medical purposes include Italy and the Czech Republic.

Source:  https://www.theguardian.com/society/2017/jan/19/german-mps-vote-to-legalise-cannabis-for-medicinal-purposes

A medical marijuana patient in Lower Sackville, N.S., said he’s worried after the marijuana he consumed for nearly a year was recalled by Health Canada because it was grown with two pesticides that, if heated, can emit hydrogen cyanide.

John Percy, 67, smokes, vapes and bakes his cannabis to control pain in his hip caused by osteoarthritis. The former Green Party leader had been ordering his medical marijuana from OrganiGram in Moncton, N.B., the only licensed producer in Atlantic Canada.

He said his pain was an “eight out of 10.”

“I was shocked,” said Percy, when he first learned of the voluntary recall in late December. The letter said the marijuana he consumed “tested positive for bifenazate and/or myclobutanil, both unapproved pesticides and not registered for use on marijuana.”

“I assumed like most patients that the product would be organic,” he said.

According to Health Canada hydrogen cyanide interferes with how oxygen is used in the body and may cause headaches, dizziness, nausea, and vomiting. Larger concentrations may cause gasping, irregular heartbeats, seizures, fainting, and even death.

‘I got angry’

He said he was willing to take a wait-and-see approach. But less than two weeks later, there was another, higher-level recall notice from OrganiGram saying all products manufactured since February had been recalled.

“That’s when I got angry and I started to consider what the effects on me have been,” said Percy, who also sits on the board of Maritimers Unite for Medical Marijuana.

He said he plans to talk to his doctor about whether the recalled medical marijuana he’d been consuming, about three grams a day, has adversely affected his health.

‘Patient safety at risk’

Percy said he’s upset that Health Canada did not issue a mandatory recall. Health Canada said no cases of adverse reactions have been reported.

“Putting patient safety at risk is unacceptable, and for a government department that is supposed to take care of people’s safety, I think they’ve fallen down on the job,” said Percy.

He said he’s written to the health minister and to members of Parliament. He believes Health Canada should test marijuana for more than 13 compounds to ensure it’s safe for consumption.

Percy said he and other licensed medical marijuana patients have discussed starting a class-action lawsuit.

Without a licensed producer, he’s going to an illegal dispensary — and paying 30 per cent more for his medication. There’s no compassionate pricing at the illegal spot, so his monthly marijuana budget has shot up to about $850 from $600. “It hurts, it hurts,” he said.

He said getting a prescription filled for another one of the 30-plus licensed producers in Canada would take months, but didn’t want to wait in pain.

Source:  https://ca.news.yahoo.com/medical-marijuana-user-shocked-recall-120500202.html

Abstract

The objective of the present research was to examine the association between lifetime cannabis use disorder (CUD), current suicidal ideation, and lifetime history of suicide attempts in a large and diverse sample of Iraq/Afghanistan-era veterans (N = 3233) using a battery of well-validated instruments.

As expected, CUD was associated with both current suicidal ideation (OR = 1.683, p = 0.008) and lifetime suicide attempts (OR = 2.306, p < 0.0001), even after accounting for the effects of sex, posttraumatic stress disorder, depression, alcohol use disorder, non-cannabis drug use disorder, history of childhood sexual abuse, and combat exposure.

Thus, the findings from the present study suggest that CUD may be a unique predictor of suicide attempts among Iraq/Afghanistan-era veterans; however, a significant limitation of the present study was its cross-sectional design. Prospective research aimed at understanding the complex relationship between CUD, mental health problems, and suicidal behavior among veterans is clearly needed at the present time.

Source:  https://www.ncbi.nlm.nih.gov/pubmed/28129565 J Psychiatr Res. 2017 Jan 5;89:1-5. doi: 10.1016/j.jpsychires.2017.01.002. [Epub ahead of print]

Abstract

Cannabis use is observationally associated with an increased risk of schizophrenia, but whether the relationship is causal is not known.

Using a genetic approach, we took 10 independent genetic variants previously identified to associate with cannabis use in 32,330 individuals to determine the nature of the association between cannabis use and risk of schizophrenia. Genetic variants were employed as instruments to recapitulate a randomized controlled trial involving two groups (cannabis users vs nonusers) to estimate the causal effect of cannabis use on risk of schizophrenia in 34 241 cases and 45 604 controls from predominantly European descent.

Genetically-derived estimates were compared with a meta-analysis of observational studies reporting ever use of cannabis and risk of schizophrenia or related disorders. Based on the genetic approach, use of cannabis was associated with increased risk of schizophrenia (odds ratio (OR) of schizophrenia for users vs nonusers of cannabis: 1.37; 95% confidence interval (CI), 1.09-1.67; P-value=0.007). The corresponding estimate from observational analysis was 1.43 (95% CI, 1.19-1.67; P-value for heterogeneity =0.76).

The genetic markers did not show evidence of pleiotropic effects and accounting for tobacco exposure did not alter the association (OR of schizophrenia for users vs nonusers of cannabis, adjusted for ever vs never smoker: 1.41; 95% CI, 1.09-1.83). This adds to the substantial evidence base that has previously identified cannabis use to associate with increased risk of schizophrenia, by suggesting that the relationship is causal. Such robust evidence may inform public health messages about cannabis use, especially regarding its potential mental health consequences.

Source:Molecular Psychiatry advance online publication, 24 January 2017; doi:10.1038/mp.2016.252.

FRAMINHAM, Mass. – A Framingham middle school student was hospitalized Monday after he and another student ate a marijuana edible on the school bus, according to a letter released by Fuller Middle School.   School officials are trying to find out who brought the edibles on the bus and how to make sure it doesn’t happen again.

Stacy Velasquez says her 12-year-old son was riding the bus to school Monday morning when he found a container of gummy bears that got him very sick.   He called her crying.

“He said, ‘I ate something.’ I said, ‘what did you eat?’ He said candy. Where did you get it? He said he found it on the bus,” Velasquez explained.   When she arrived at Fuller Middle School, she says he was in a trance-like state, barely able to speak. She rushed him to the emergency room, snapping a video of his behavior.

“Once the tox screen came back, they said they’d never seen this before in a child so small, like an overdose so to speak of marijuana, but basically it would run its course and he would sleep it off.  And that’s what he did last night,” said Velasquez.

The district superintendent says they have no comment in regards to what happened, just that the police are now investigating.   Though marijuana is now legal in the state of Massachusetts, it’s not legal for anyone under the age of 21 to handle or ingest the drug.

“I would just like someone to make sure the school is doing their part and the bus drivers are doing their part to make sure the children get to and from school safely and that something like this doesn’t happen to someone else’s child,” Velasquez said. “I think the teenager involved [should be charged], because right now, it’s expected to be one of the high schoolers.”

Velasquez said her son is doing fine, he’s just embarrassed about what happened.   As for possible charges, police are looking through video taken on the bus to see who the edibles link back to.

Source:  http://www.fox25boston.com/news/framingham-middle-schooler-hospitalized-after-eating-marijuana-edible-on-school-bus/483211673?utm_source=January 11th 2017

As well as targeting children with ‘marijuana edibles’ children’s books are now being used as ‘a tool in (his) campaign for legalisation’.  Cannabis is addictive and the younger a person is when they begin to use the more likely they are to have problems later.

The author of ‘Hairy Pothead’ and ‘Green Buds and Hash’ explains why children’s books are the perfect way to make weed approachable.

When marijuana activist Dana Larsen first started writing his pot-themed fan fiction, he just thought it would be fun for other cannabis users to read. But after years of selling thousands of copies of his parody children’s stories like Green Buds and Hash and Hairy Pothead and the Marijuana Stone, Larsen realized they could be more: a tool in his campaign for legalization.

In Canada, where Larsen lives, a nationwide legalization policy probably isn’t far off. Possessing and selling weed is still illegal across the country, but this spring, the Canadian government will propose new laws that could make it the first major country to legalize marijuana across the board. Marijuana activists hope that this shift in regulation up north will trickle down to the United States—and eventually the rest of the world—in a major victory against the war on drugs.

That’s where Larsen believes his books come in. And he’s not the only one: An emerging collection of books—from It’s Just a Plant to If a Peacock Finds a Pot Leaf—are looking to make marijuana part of children’s literature. We talked to Larsen about how he believes his children’s book parodies can open up new dialogues about cannabis and can help usher in a new era of legalized, normalized weed.

This interview has been edited for length and clarity.

VICE: So how did this all start?

Dana Larsen: Well, I wrote the Hairy Pothead book quite a few years ago. It came out in 2008, and it’s been re-published a couple of times since then. I read the Harry Potter books to my daughter and thought they were quite good. When I was reading them, I could just see this whole parallel world of it all being cannabis related. I just wrote it all down, and people liked it. I’ve got a sequel to that coming out, but it’s taking a bit. I’m hoping to put out  Hairy Pothead and the 420 Code next year sometime. I wrote the Green Buds and Hash poem quite a few years ago, and I just posted it online. It picked up a lot of traction, and I thought, Well, this should be a book.

Are these books meant to be for children?

I didn’t really write them for kids. I write them because they amuse me, and I enjoy them. What actually struck me—especially with the Green Buds and Hash book—is how many parents do read it to their kids, and often it’s because either the parent or the child is a medical-marijuana user. It’s a way for them to have this dialogue in a non-judgmental way with their kid. There are plenty of children who I know that who have epilepsy and use cannabis medicinally or their parents do, and I’ve had some kids send me drawings of characters from the book that say, “My daddy’s medicine,” or something. That’s not what I expected when I wrote it. I don’t really write these for kids,

but I don’t see any harm in anybody of any age reading a story or thinking about these ideas. I don’t think that an eight-year-old is going to read this book and start lighting up a joint or whatever.

Are you hoping your market shifts toward more children in the future?

I have had many parents tell me they read my books to their kids, or that they’re buying them for their kids to read. But usually those kids are teenagers or older, and not children. If I had written Green Buds and Hash for children, I wouldn’t have had lines like, “Do you suffer from sclerosis, epilepsy, or neurosis?” I doubt many pre-teens know what those words mean. However, that book does get read to some young children, and it does please me to know that some parents are using my books—and that one especially—as a way of talking to their kids and teaching them about marijuana medicine. Especially when parent or child is a medical cannabis user themselves.

I don’t think reading Hairy Pothead will make someone start smoking pot, any more than reading Harry Potter will make them start practicing witchcraft. Right now, I have four books, and I do see an age progression in them. Green Buds and Hash is the early reader; The Pie Eyed Piper is for elementary school age. Hairy Pothead and the Marijuana Stone is for teens, and the Cannabis in Canada history book is for young adults and up.

If children are reading these books, how does that help normalize weed?

Much of the information that we get about cannabis is government and corporate propaganda against it. Cannabis and cannabis users are regularly demonized and mocked in the mainstream media. Even pro-cannabis media often portray cannabis users as dopey, lazy, and ignorant. In my stories, cannabis users are usually a little smarter than non-users—like they’re part of a secret group that has extra insight and wisdom. My stories portray cannabis as a magical substance with many uses and transformative powers, which I think is a valid assessment. Although the stories are fantastical, the cannabis information is accurate, and the stories can be educational.

The first Hairy Pothead book is 242 pages long—that’s close to the same length as the original. How long did that take you to do?

It took me about a year to write it. The sequel has been taking me a while because it should be about double the length. I’m also working on a new series coming out next year called, The Hash-tastic Voyages of Sinbad the Strain Hunter. He goes around finding giant cannabis plants that are hundreds of feet tall or finding little, tiny microscopic ones or other crazy adventures that sort of parallel all those stories from The Arabian Nights. I’ve got Jack and the Hemp Stalk and Little Green Riding Hood. I’m hoping to put out some of those stories next year as well.

Are you smoking pot every time you sit down to write?

Yeah. I smoke pot all day, every day, pretty much. I’m a very chronic cannabis user and have been for the past 20 years or so. I run dispensaries in Vancouver and do a lot of political activism work, so writing is not really my main focus. Most of my work is more like, I led a big referendum campaign in 2013 to collect signatures to try to force a vote here. We didn’t hit the signature target because it’s brutally hard in British Columbia compared to any American state. I work with the New Democratic Party; I do a lot of political stuff, and I’m a big part of the dispensary movement here in Canada.

What are your goals for legalization, and how do you see it playing out?

I think that legalizing cannabis is going to be the first step in a bigger shift to ending the whole global war on drugs. I think it’s going to take many years for all of this to play out, but to me, the war on drugs is really a war on the world’s best, most medicinal and culturally relevant plants—opium, poppy, coco, mushrooms, peyote, cactus, cannabis flowers, etc. These are things that are safest and most beneficial in their natural forms, and it’s really prohibition that makes them dangerous. My work has been focused on cannabis because although users of other drugs might have it worse in some ways, most of the policing, most of the enforcement, most of the money in the war on drugs goes against cannabis users because there’s more of us. I think that comes out in my fiction a lot, where a lot of my fairy tales end up in a transformative kind of way where everything changes because the metaphor of prohibition in that story is eliminated in some way.

It’s really a testament that Canada [could be] the first major country [to legalize marijuana nationally]. People will look to Canada and see what we do here, and it will definitely have an influence around the world with what other models come out there. Canada will hopefully be an example, and we’ll keep pushing here. Once it starts to happen, it’s going to happen everywhere.

Do you think educational tools like your books will help transform the overall perspective on pot over time?

Yeah. These things can be dangerous and risky, but they can also be wonderful and positive. I think a thing to compare that to, in a way, is sex. You want to be honest with your kids about sex and want them to understand how it works. We have sex-education classes in school. You might tell your children that abstinence is better, and you’d prefer them to be abstinent, but if you’re going to have sex, it’s better in a loving relationship, and it’s better if you use condoms or birth control. I don’t see any dichotomy or contradiction between those things, between encouraging abstinence and also saying, “If you’re going to do it, here’s a way to not kill yourself and to be safer.” With cannabis and drug use, that message can be there, too. You might not want your kid taking anything, but if you’re going to use something, cannabis is a lot safer than other substances.

I hope that my books and stories help normalize cannabis, because cannabis is normal. Especially in the Hairy Pothead book, as Hairy goes through his time at Hempwards School of Herbcraft and Weedery, you learn along with him. You learn a lot about hemp and cannabis and extracts and all the different classes. I sneak in a lot of learning and information in there. If people learn a little bit while they’re laughing and enjoying my stories, that is exactly what I want.

Source:  https://www.vice.com/en_us/article/childrens-books-are-the-new-frontier-in-weed-normalization

Earlier this week, the Journal of the American Academy of Child & Adolescent Psychiatry (JAACAP), released a study that claims a 24 percent decline in marijuana-related problems among teenagers, such as becoming dependent on the drug or having trouble in school and in relationships. The researchers also claim there is an association between drops in problems related to cannabis and reductions in behavioural issues, such as fighting, property crimes and selling drugs. Pro-marijuana bloggers have picked this up as “proof” that legalization is not harmful to kids, but an editorial in the very same journal says that “no such inference is warranted.”

At first blush this study seems encouraging, however, there are several facts that are not consistent with media headlines and interpretations:

* The study examines data from 2002 to 2013, and thus does not examine any time period with retail marijuana legalization even though researchers state that they did look at legalization policies. Legalization was not in place until late 2012 in two states only, and retail sales started in 2014. Also, data show that marijuana use declined from 2002 to 2009, but increased after.

* The findings of this study contradict data from the US Department of Health and Human Services, National Survey on Drug Use and Health, and the US Monitoring the Future Study which all show an increase in kids using marijuana and needing treatment.

* The article lumps together all states and does not differentiate between those with less restrictive “medical” marijuana policies and those with stricter controls. * Finally, as Hopfer discusses in his editorial, it is possible “a decrease in conduct problems accounted for the decrease in the development of marijuana use disorders. Although this is not proof of a causal effect, one potential inference is that as marijuana use becomes more acceptable, more individuals without conduct or adult antisocial problems will use marijuana and that the risk of developing a use disorder is lower in individuals without comorbid conduct or adult antisocial problems.”

The legalization lobby will try and tout this research as proving that legalization works. In reality, legalization is ushering in the advent of marijuana candies and other kid-friendly items by big business. Colorado is the top state in the nation for youth marijuana use. Problems related to marijuana in Colorado and Washington are mounting, as evidenced here, with an out-of-control marijuana industry focused on hooking kids and retaining lifelong customers. The World Health Organization report on marijuana found several negative effects for teens, including “several components of cognitive function, with the most robust effects on short term episodic and working memory, planning and decision-making, response speed, accuracy and latency.” The report also detailed studies that found “heavy cannabis use over several decades produced substantial declines in cognitive performance that may not be wholly reversible… (and) an association between poorer verbal memory and sustained daily use of cannabis throughout adult life.”

Source:  https://learnaboutsam.org/despite-study-marijuana-still-linked-problems-among-teenagers/

Does Medical Marijuana Have a ‘Visit Florida’ Future? Check Out the New Las Vegas

Las Vegas has changed, folks. I couldn’t believe how much since I last visited. And I’m not talking about the glitzy hotels or the towering slot machines or the raving nightlife. I’m talking about changes you can see on the airport concourse two minutes after you deplane. I’m talking about medical marijuana. OMG.

Could this be Any Florida Airport in 2020?

You know how you used to walk down the moving walkway toward baggage claim, past casino show ads, and you’d hear a flutter of jokes from resident comedians? Now the jokes are gone. Most of the show ads are still there, but the posters directing visitors to medical marijuana will knock your eyes out.

Ads for businesses like Las Vegas ReLeaf, a 3,700-square-foot “pharm” that bills itself as “the Bellagio of dispensaries.” Or, if you prefer, set your GPS for Dr. Green Relief. Or, Sahara Wellness. Or, The Travel Joint.   On the other hand, once you reach the strip, you can always keep an eye out for the “Cannabus,” run by 420 Tours, Las Vegas’ first cannabis tour company. It’s more an SUV than a bus, but its promise is, “We take people looking for a medical marijuana card and legal pot from street corner to dispensary in less than an hour.”

I have to admit, it sounds wilder and woollier than it actually is. Las Vegas isn’t Colorado or California or Oregon yet. There are strict rules about how dispensaries can advertise in the city limits, for one thing. But it has a proposition on the November ballot similar to United for Care’s in Florida. That’s all cannabis entrepreneurs are waiting for to put doctors in charge and get the government out. Then, they say, medical marijuana will be snuggled in right next to — probably even part of — every corner of the Vegas tourist scene. They are so ready to set up shop in a bigger way. You can feel it in the air.

I saw one ad on television — shot in what amounted to a greenhouse, or a grow house, with all the “plant attendants” wearing white coats, soft music playing in the background. Strangest ad I ever saw. Memorable, somehow.

At any rate, right now it’s tough for long-suffering Nevadans with conditions that might be helped with pot to get it. They have to stumble through the state’s months-long red tape to get a medical marijuana card. Meanwhile, entrepreneurs are cashing in on the state’s reciprocity laws. In 2015 Nevada became the first state to allow non-resident reciprocity, giving medical marijuana cardholders from other states the legal ability to buy medical marijuana in Nevada.

To explain further:

The Las Vegas Sun reports the Nevada Legislature legalized medical marijuana dispensaries in 2013. Although lawmakers undeniably had fiscal considerations in mind, they wanted to make it easier for patients with cancer, AIDS, seizures and other serious conditions to find legal relief from pain and chronic suffering. Medical marijuana itself had been legalized in 2000 in Nevada, but it was pretty much a bust. Patients had to grow their own supply and had few legal options for obtaining seeds or clones. 

Medical marijuana cards in Nevada are valid for one year, but because of the state’s lengthy processing time, by the time many patients receive their card, it often is valid for only eight or nine months.

“Just in case you haven’t waited long enough for your card, you have that much less time before you have to reapply,” Andrew Jolley, owner of the Source dispensary, told the Sun.

Nevada Organic Remedies’ grow house in Las Vegas

While Nevada law states that a medical marijuana patient’s application should be processed in fewer than 30 days, it almost always takes longer, explains Pam Graber, a spokeswoman for the state Division of Public and Behavioral Health. The process, which includes a background check, often takes state officials 33 to 35 days to finish. 

And that’s for only a portion of what’s required. That timeframe doesn’t include the time needed to process a prospective patient’s original application request to the state, nor does it account for getting a signed physician statement or completing the last step — making a trip to the DMV.

In other pot-friendly states, such as California, Washington and Oregon, patients need only a doctor’s note to load up at dispensaries, including those in Nevada.

The lawmaker who championed the medical marijuana cause in the Nevada Legislature, Sen. Tick Segerblom, told the Sun the reciprocity law, which has attracted “thousands” of out-of-state patients, is part of a move to increase tourism in the state.

“We encourage the convention authority to promote that for our visitors,” Segerblom said.

Why would residents of California or Oregon buy their meds in Las Vegas instead of at home? One dispenser claims it’s because “people just don’t want to travel with their meds because it’s still a federal crime.”

In some ways, I understand casino magnate Sheldon Adelson’s hostility toward medical marijuana. He’s a very savvy billionaire who can see the future. He doesn’t want visitors spending their money in dispensaries instead of his casinos. Anyway, by Nevada law, casinos aren’t allowed to get into the cannabis business, and so therefore have little incentive to back legalized marijuana.

Many people are nevertheless optimistic that soon enough, Nevada will allow everyone — locals and visitors alike — to use marijuana. That includes longtime local marijuana activist Jason Sturtsman. The International Business Times writes that while Sturtsman advocates for patient rights as a part of the organization Wellness Education Cannabis Advocates of Nevada and is lobbying to keep testing requirements reasonable as a member of the state’s Independent Lab Advisory Committee, he’s also working as a part-time manager at Las Vegas ReLeaf and welcomes the Las Vegas-ification of cannabis. Even if that means exacting regulations and an industry dominated by the rich and powerful, he believes the payoff nationwide will be worth it. 

Oh, yes, and there are 43 pending medical marijuana business licenses in Clark County, and more than a dozen more pending in the county seat Las Vegas and in Henderson and Reno. There are eight production facilities, 21 cultivation facilities and five testing labs operating in Clark County.  I walked the Strip this past weekend, from MGM Grand to Harrah’s, and at more than half a dozen spots along the way, smoke from the weed — legal or not — was clearly wafting in the air. I make that walk every trip, and the unmistakable aroma of cannabis there, in cold light of day, was a first in my experience.

I felt as if I were getting a vision of things to come — the changing face of tourism — not just in Sin City, but eventually in Florida. Florida is a tourism state, too. In fact, a state with more cities than Nevada to attract out-of-state visitors, many of them carrying notes from their doctors. Miami, Fort Lauderdale, West Palm Beach, Tampa and Orlando for starters. Walt Disney World might be a family-friendly Magic Kingdom now, but I can see it developing another identity down the road. And it has nothing to do with casinos.

Source:  Nancy Smith at nsmith@sunshinestatenews.com or at 228-282-2423.

 Twitter: @NancyLBSmith   April 21st 2016

See more at: http://www.sunshinestatenews.com/story/does-medical-marijuana-have-visit-florida-future-check-out-new-las-vegas?utm_source=Constant%20Contact&utm_medium=email&utm_campaign=Morning%20Lead&utm_source=April+22%2C+2016&utm_campaign=Morning+Lead+3%2F10%2F2016&utm_medium=email#sthash.VQZl60Jo.dpuf

 

Regularly smoking cannabis may damage users’ eyesight by triggering an abnormality in the retina, a new study has found.   Researchers in France tested 28 cannabis smokers and 24 people who did not use the drug to see how well their retinal cells responded to electrical signals.

A small but significant delay was found in the time taken for the signals to be processed by the retina of the marijuana users by comparison with the control group.  “This finding provides evidence for a delay of approximately 10 milliseconds in the transmission of action potentials evoked by the retinal ganglion cells,” the researchers wrote in the JAMA Ophthalmology.

“As this signal is transmitted along the visual pathway … to the visual cortex, this anomaly might account for altered vision in regular cannabis users. Our findings may be important from a public health perspective since they could highlight the neurotoxic effects of cannabis use on the central nervous system as a result of how it affects retinal processing.”

A statement issued by the Journal of the American Medical Association described the study as “small” and “preliminary”.  But the researchers, led by Dr Vincent Laprevote, of the Pole Hospitalo-Universitaire de Psychiatrie du Grand Nancy, added: “Independent of debates about its legalisation, it is necessary to gain more knowledge about the different effects of cannabis so that the public can be informed.   “Future studies may shed light on the potential consequences of these retinal dysfunctions for visual cortical processing and whether these dysfunctions are permanent or disappear after cannabis withdrawal.”

In a related article commenting on the research, Dr Christopher Lyons, of the University of British Columbia in Vancouver, and Dr Anthony Robson, of Moorfields Eye Hospital, London, wrote that it dealt with “an important and neglected issue, namely the possible toxic effects of cannabis, with all its implications for the many users of this ubiquitous drug”.

“Addressing this issue through the visual system, as the authors have done, is an elegant concept. Any deleterious effect on the visual system would also have implications for driving, work and other activities and thus warrants further study,” they added.

“Electrophysiology can provide reliable and reproducible measurements of retinal and visual pathway function and is useful in the investigation and localisation of dysfunction, including that caused by toxicity.

“However, the conclusion that cannabis causes retinal ganglion cell dysfunction cannot be made with any degree of certainty based on the evidence provided in the current study.

Source:  http://www.independent.co.uk/news/science/cannabis-eyesight-vision-damage-toxic-effects-study-a7463331.html

Randomised controlled trial 

Battistella G, et al. PLoS One. 2013.

Abstract

Marijuana is the most widely used illicit drug, however its effects on cognitive functions underlying safe driving remain mostly unexplored.

Our goal was to evaluate the impact of cannabis on the driving ability of occasional smokers, by investigating changes in the brain network involved in a tracking task. The subject characteristics, the percentage of Δ(9)-Tetrahydrocannabinol in the joint, and the inhaled dose were in accordance with real-life conditions.

Thirty-one male volunteers were enrolled in this study that includes clinical and toxicological aspects together with functional magnetic resonance imaging of the brain and measurements of psychomotor skills. The fMRI paradigm was based on a visuo-motor tracking task, alternating active tracking blocks with passive tracking viewing and rest condition.

We show that cannabis smoking, even at low Δ(9)-Tetrahydrocannabinol blood concentrations, decreases psychomotor skills and alters the activity of the brain networks involved in cognition. The relative decrease of Blood Oxygen Level Dependent response (BOLD) after cannabis smoking in the anterior insula, dorsomedial thalamus, and striatum compared to placebo smoking suggests an alteration of the network involved in saliency detection.

In addition, the decrease of BOLD response in the right superior parietal cortex and in the dorsolateral prefrontal cortex indicates the involvement of the Control Executive network known to operate once the saliencies are identified. Furthermore, cannabis increases activity in the rostral anterior cingulate cortex and ventromedial prefrontal cortices, suggesting an increase in self-oriented mental activity.

Subjects are more attracted by intrapersonal stimuli (“self”) and fail to attend to task performance, leading to an insufficient allocation of task-oriented resources and to sub-optimal performance. These effects correlate with the subjective feeling of confusion rather than with the blood level of Δ(9)-Tetrahydrocannabinol. These findings bolster the zero-tolerance policy adopted in several countries that prohibits the presence of any amount of drugs in blood while driving.

Source:  PLoS One. 2013;8(1):e52545. doi: 10.1371/journal.pone.0052545. Epub 2013 Jan 

THE level of people being hospitalised after taking cannabis and related ‘legal highs’ has reached a 10-year peak, according to official figures from the Scottish Government.  More than 900 acute stays in general hospitals – as opposed to psychiatric admissions – involved the drug last year.

The Scottish Tories said the data showed cannabis was not the benign drug some claimed.

The latest figures show that in 2015-16 there were 7537 hospital stays in Scotland with a diagnosis of drug misuse, involving 5922 people, some admitted more than once.

Of these stays, 913 or 12 per cent, involved “cannabinoids”, which include synthetic highs such as Spice as well as the plant form of cannabis.   This was the highest percentage involving cannabinoids since 13 per cent in 2005-06.

Cannabinoids were the most common cause of drug stays among children – accounting for 45 per cent of cases involving under-15s.

The health boards with the most stays were NHS Greater Glasgow and Clyde (306), NHS Lothian (165) and NHS Lanarkshire (106).  Although still sometimes called a legal high, synthetic cannabis was criminalised last May, with its production and sale made punishable by up to seven years in prison.

Hospital admissions associated with cannabis were almost double those linked to cocaine.

Acute stays involving cocaine were at their highest since 2008-09 last year, but involved 553 admissions, or 7 per cent of all general drug-related cases.

The drugs most associated with hospital admissions were opioids, such as heroin, morphine, oxycodone and fentanyl.

Last year, opioids were behind 4656 stays, or 62 per cent of the drug-related total.  The number and prevalence of opioid admissions has increased hugely in the last 20 years.  In 1996-97, opioids accounted for just 791 stays, then equal to 34 per cent of drug admissions.

Scottish Tory justice spokesman Douglas Ross criticised campaigns to decriminalise cannabis and Police Scotland taking a soft touch approach to its use.  The force said in 2015 it might give people caught with cannabis on-the-spot recorded warnings as an alternative to prosecution.   Mr Ross said: “It’s quite alarming that quite so many people are being hospitalised through using cannabis, a drug many people feel authorities are going soft on.

“Not only is it dangerous in its own right, as these statistics prove, but it’s a gateway drug to even more harmful substances.

“We have a massive fight on our hands in Scotland both with illegal drugs and so-called legal highs.   “Now is not the time to give in and wave the white flag.  “We need to crack down on those circulating drugs of all kinds on our streets, and reinforce the message about just how damaging taking these substances can be.”

Scottish LibDem health spokesman Alex Cole-Hamilton said it was a concern that the figures were rising, but said the Conservatives’ solution was “completely wrong and regressive”.  He said: “If anything these figures show that the LibDems have been right in calling for this dark market to be brought out of the shadows.  “If the Tories had their way then they would drive the market further underground exposing people to more dangerous drugs and endangering more lives leading to more hospitalisations.

“The answer is to educate and regulate not to punish as the Tories want to do.”

Health Secretary Shona Robison said drug use continued to fall in the general population.  She said: “We have greatly reduced drug and alcohol waiting times with 94 per cent of people now being seen within three weeks of being referred.

“We have also invested over £630m to tackle problem alcohol and drug use since 2008 and over £150m over five years to improve mental health services in Scotland.”

Source: http://www.heraldscotland.com/news/15005884.Hospital_stays_linked_to_cannabis_at_10_year_high/   Jan,2017

ASK THE DOCTOR  column –  – by Dr. Robert Ashley – Erie Times-News, December 30, 2016

Q:  Marijuana seems to be increasingly accepted in our country.  But I worry about my kids using it.  Is it addictive?

A:  Marijuana has gained greater acceptance in this country, not in small part because its medical use can stimulate appetite, control nausea and control pain.  One potential problem with this degree of acceptance is how adolescents view the drug.

In 2015, 70 percent of high school seniors viewed marijuana as not harmful, according to the National Institute on Drug Abuse’s Monitoring the Future survey;  in 1990, only 20 percent felt this way.

Perhaps the biggest risk with marijuana is how it affects the adolescent brain.  The endocannabinoid system, a vast system of receptors within the brain, spinal cord and smaller nerves, affects multiple brain and body functions.  The system continues to develop in humans until the age of 21 or so.

If used frequently in adolescence, marijuana can rewire many of these nerve pathways.  These changes aren’t seen as much in the adult brain and, if they surface, can be easily reversed by stopping use.  In adolescents, however, this rewiring of the nervous system may create addiction.  According to the NIDA, only 9 percent of people who try marijuana become addicted.  However, this number increases to 16 percent among those who start using marijuana in adolescence.  It increases further if marijuana is used daily in adolescence.

Marijuana not only causes short–term memory loss, it also affects mental abilities for days after its use.  That means a person’s ability to plan, organize, solve problems and make decisions is impaired, which has significant ramifications for adolescents trying to retain information learned in school.

Further, for those predisposed to schizophrenia, marijuana can induce psychosis and, in younger users, can decrease the age of schizophrenia’s onset.  People with a familial predisposition to schizophrenia should certainly avoid use.

Send your questions to askthedoctors@mednet.ucla.edu,, or Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles CA  90095.

Since marijuana is currently illegal in all but physician-approved circumstances, there have been no properly constructed clinical trials of smoking this drug in Canada, writes Lawrie McFarlane of the Victoria Times .

The greatest public-health disaster our species ever brought upon itself began in Europe 400 years ago — the introduction and use of tobacco.

In the 20th century alone, 100 million people died from cigarette smoking worldwide. And while the incidence rate has fallen in western countries, it remains high in Third World nations. Six million tobacco users still die each year. The cause of smoking deaths is not, primarily, the active ingredient in tobacco — nicotine. Rather it is the chemicals that comprise tobacco smoke — among them various tars, ammonia, hydrogen cyanide and formaldehyde.  Collectively, these chemicals cause a host of fatal maladies, including cancer, heart disease and emphysema. In short, a perfect horror show.

Now at this point, you’re probably saying: Tell me something I didn’t know. Well, here it is: Many of those same chemicals form marijuana smoke, and we are about to legalize the consumption of this drug. It’s not clear yet which forms of use might be authorized. If smoking is not among them, we might yet avoid another public-health calamity.

True, there are worrisome effects that come with consuming marijuana by other means, among them elevated pulse rates and memory loss. But these are minor matters, by comparison.

However, if smoking marijuana is blessed for general use, we might have an entirely different situation on our hands. For here is what is currently known with medical certainty about the health impacts of lighting up a joint: Nothing.  Since marijuana is currently illegal in all but physician-approved circumstances, there have been no properly constructed clinical trials of smoking this drug.

For the same reason, there have been no robust after-market research projects, in which users are tracked down years later, and their health status compared with that of non-users. Yet this is an essential process in revealing whether drugs that appear safe at first blush turn out to have serious side-effects downstream.  There have been suggestions that marijuana might act as a gateway drug to such potent narcotics as heroin and fentanyl. But whether these are anecdotal or fact-based, no one really knows.

There is also the matter of what is called the dose effect. Cigarettes have a high dose effect, meaning the risk of illness increases exponentially the more you consume. Hence the toxicology maxim: “The dose is the poison.”  So what is the dose effect of smoking marijuana? Again, we simply do not know and this is no small concern.

Generally speaking, it seems fair to assume that making an addictive substance more readily available will increase consumption rates. So what happens if people begin smoking 20 marijuana joints a day?  What happens if manufacturers find ways to strengthen the active ingredient — THC — while making their product less harsh? That’s what cigarette companies did.

In short, we are on the brink of approving a form of drug use, the medical consequences of which remain uncertain, but which might involve inhaling carcinogens. You would think the history of tobacco might have taught us something about fooling with addictive substances before we know the facts. In particular, you might think we would have learned how difficult, if not impossible, it is to close a Pandora’s box like this after it has been opened.

Once a government-sanctioned infrastructure of production, marketing and distribution is erected around marijuana, and millions of additional users are recruited, there will be no going back, regardless of whatever medical verdict is finally rendered. That’s principally why we continue to license tobacco production, despite its many ills.

I recognize we already turn a blind eye to occasional or “recreational” use of marijuana. But between turning a blind eye and conferring on this drug an official stamp of approval lies a world of unknown harm.

— Lawrie McFarlane is a columnist for the Victoria Times Colonist

Source:   http://theprovince.com/opinion/little-research-on-marijuanas-dangers  2nd Jan 2017

November 28, 2016

This shows a sample case of a visual 3-D rendering of a baseline SPECT scan of a long standing marijuana user compared to a control subject. The marijuana user has multiple perfusion defects with lower perfusion shown as scalloping and gaps …more

As the U.S. races to legalize marijuana for medicinal and recreational use, a new, large scale brain imaging study gives reason for caution. Published in the Journal of Alzheimer’s Disease, researchers using single photon emission computed tomography (SPECT), a sophisticated imaging study that evaluates blood flow and activity patterns, demonstrated abnormally low blood flow in virtually every area of the brain studies in nearly 1,000 marijuana compared to healthy controls, including areas known to be affected by Alzheimer’s pathology such as the hippocampus.

Hippocampus, the brain’s key memory and learning center, has the lowest blood flow in marijuana users suggesting higher vulnerability to Alzheimer’s. As the U.S. races to legalize marijuana for medicinal and recreational use, a new, large scale brain imaging study gives reason for caution. Published in the Journal of Alzheimer’s Disease, researchers using single photon emission computed tomography (SPECT), a sophisticated imaging study that evaluates blood flow and activity patterns, demonstrated abnormally low blood flow in virtually every area of the brain studies in nearly 1,000 marijuana compared to healthy controls, including areas known to be affected by Alzheimer’s pathology such as the hippocampus.

All data were obtained for analysis from a large multisite database, involving 26,268 patients who came for evaluation of complex, treatment resistant issues to one of nine outpatient neuropsychiatric clinics across the United States (Newport Beach, Costa Mesa, Fairfield, and Brisbane, CA, Tacoma and Bellevue, WA, Reston, VA, Atlanta, GA and New York, NY) between 1995-2015. Of these, 982 current or former marijuana users had brain SPECT at rest and during a mental concentration task compared to almost 100 healthy controls. Predictive analytics with discriminant analysis was done to determine if brain SPECT regions can distinguish marijuana user brains from controls brain. Low blood flow in the hippocampus in marijuana users reliably distinguished marijuana users

from controls. The right hippocampus during a concentration task was the single most predictive region in distinguishing marijuana users from their normal counterparts. Marijuana use is thought to interfere with memory formation by inhibiting activity in this part of the brain.

According to one of the co-authors on the study Elisabeth Jorandby, M.D., “As a physician who routinely sees marijuana users, what struck me was not only the global reduction in blood flow in the marijuana users brains , but that the hippocampus was the most affected region due to its role in memory and Alzheimer’s disease. Our research has proven that marijuana users have lower cerebral blood flow than non-users. Second, the most predictive region separating these two groups is low blood flow in the hippocampus on concentration brain SPECT imaging. This work suggests that marijuana use has damaging influences in the brain – particularly regions important in memory and learning and known to be affected by Alzheimer’s.”

Dr. George Perry, editor in chief of the Journal of Alzheimer’s Disease said, “Open use of marijuana, through legalization, will reveal the wide range of marijuana’s benefits and threats to human health. This study indicates troubling effects on the hippocampus that may be the harbingers of brain damage.”

According to Daniel Amen, M.D., Founder of Amen Clinics, “Our research demonstrates that marijuana can have significant negative effects on brain function. The media has given the general impression that marijuana is a safe recreational drug, this research directly challenges that notion. In another new study just released, researchers showed that marijuana use tripled the risk of psychosis. Caution is clearly in order.”

More information: Daniel G. Amen et al. Discriminative Properties of Hippocampal Hypo perfusion in Marijuana Users Compared to Healthy Controls: Implications for Marijuana Administration in Alzheimer’s Dementia, Journal of Alzheimer’s Disease (2016). DOI: 10.3233/JAD-160833

Source:http://medicalxpress.com/news/2016-11-marijuana-users-bloodbrain.html#nRlv

A most detailed and valuable research study printed as a letter in the journal Nature, Vol. 539 – available online.

This study demonstrates that at least one G-protein-coupled receptor present on mitochondrial membranes modulates high brain functions such as memory formation through the modulation of intra-mitochondrial G-protein signalling. Considering that G proteins play a central role in the brain, the present data will probably pave the way for a new field of research that deals with the acute effects of mitochondrial activity on brain functioning.

Cannabinoid drugs have several therapeutic potentials30, unfortunately limited by important side effects, such as impairment of memory5,6. The present data suggest that selective targeting of specific subcellular populations of CB1 receptors in the brain might assist in development of safer therapeutics against several brain disorders.

Source: 2 4 November 2 0 1 6 | VO L 5 3 9 | N AT U RE | 5 5 5

Examining the data closely and correctly.

By:  By DAVID W. MURRAY, BRIAN BLAKE, JOHN P. WALTERS

The closing reports on the Obama administration’s drug policy were delivered this week. Drug-induced deaths for the year 2015 were reported by the Centers for Disease Control (CDC) on December 8, and the youth school survey of drug use for 2016, Monitoring the Future (MTF), was just released by the National Institutes on Drug Abuse (NIDA). The findings document Obama’s eight years of unbroken failure.

Simply put, it appears inescapable that the two sets of findings are related, in that the flood of commercial, high-potency marijuana unleashed by legalization in the states has served as a “gateway” to the opioid problem, both by priming greater drug use by those who initiate with heavy, developmentally early marijuana use, and further by empowering the illicit drug market controlled by criminal cartels.

Both data releases were somewhat muddled in the offering, neither of them being presented with public briefings at venues such as the National Press Club, as was common in the past.

Instead, the MTF data were only presented in a teleconference for reporters, while the CDC at the last minute determined that the official data for drug overdoses would not be ready until next year, instead directing researchers and the press to their online data system, WONDER, where searchers could uncover them for themselves.

These data releases are bookends—the youth survey showing us the likely future patterns of drug misuse as the high-school-aged cohort ages through adulthood, while the CDC overdose death data are retrospective, revealing where the worst drug epidemic in American experience was more than a year ago.

Data on deaths for 2016, which by all indications from states and municipalities are accelerating upward even more sharply, have not even been analyzed yet (their release is scheduled for December 2017), and will no doubt surface as a further shock in a succeeding administration.

Because there has yet to be a formal report of 2015 final numbers, the precise CDC figures for overdoses by drug remain troublingly vague. That said, the increases are shocking. There were 52,404 overall drug-induced deaths for 2015. That figure has climbed from about 38,000 (and stable) as recently as 2008. For 2015, fully 33,091 deaths were attributable to the opioids, alone (up from 28,647 in 2014, the toll rising most steeply dating from 2010).

Regarding the recent increase, the head of death statistics at the CDC stated; “I don’t think we’ve ever seen anything like this. Certainly not in modern times.”

For the MTF survey, marijuana use rose between 2015 and 2016. High school seniors saw their past month (or current) use rise to a rate of 23 percent, (up from 21 percent in 2015), while past year use rose to 36 percent (up from 35 percent). For the past year category, the rise since 2007 exceeds a 12 percent increase, but most of that rise took place earlier in the Obama years, peaking in 2011-2012 and then stabilizing at the higher level.

Somewhat surprisingly, given the anticipated impact of commercial legalization of marijuana in some states in 2014, with yet other states being added in this last election cycle, the overall impact on youth marijuana use appears modest, especially when compared to the wider data showing steep increases in young adults and those 26 and older, from other national surveys.

There are two immediate cautions in reading these data, however. The first is that many teens are now consuming marijuana in forms other than smoking; that is, as edibles and drinks, which this survey has difficulty detecting. In other words, there may be a hidden dimension of use of what is now a drug of unprecedented potency and availability. The second caveat is the known impact of marijuana use on high-school drop-out rates, pushing them higher. The effect is that the very students most at risk of heavy use are no longer captured in this school-based survey, which might be systematically understating actual prevalence increases because we have lost our ability to capture them.

The real drug use stunner lies elsewhere, largely in the CDC overdose data. The United States is in the grip of a wide and deepening drug use crisis, the most visible alarm being the opioid overdose contribution to the overall drug-induced death data, which by 2015 were sufficient to show up in general health data as driving a decrease in American life-expectancy tables.

Moreover, it is clear that the situation will worsen quickly, for both opioids and for newly resurgent cocaine use, which also registered as an increase in drug overdose deaths, and in recent measures of college-age youth, where use of cocaine, after steep declines, suddenly shot up 63 percent in a single year, 2013-2014, and remained high.

Coupled with the nationwide spread of adult commercial marijuana use and the still surging methamphetamine crisis, the situation is dire across all the major illicit drugs.

The opioid crisis has two dimensions, only one of which has received administration attention. The epidemic has been driven by misuse of prescription opioids, which climbed steadily for several years, and by the emergence of surging illicit drugs, both heroin and new synthetics like fentanyl and its analogs, from illicit rogue labs and smuggled into the United States.

Curiously, even though production increases of heroin and of cocaine have shot up in source countries such as Mexico and Colombia, and as synthetic opioid seizures have rocketed up in border seizures, the administration and the press seem seized by the prescription overdose dimension, which has begun to slow and even abate.

For instance, outlets such as the Washington Post continue to misstate the actual data. In a recent editorial, they insist that “the prescription opioid category accounted for the largest share of deaths, at 17,536.” Accordingly, they urge further policy attention to doctor prescribing practices.

But the latest data show otherwise. According to the CDC WONDER database, there were 19,885 deaths from illicit opioid production, heroin/illicit fentanyl and analogs. And that latter category is the one surging, rising 23 percent for heroin and a stunning 73 percent for synthetics from 2014 to 2015, while strictly prescription deaths rose only 4 percent.

Apparently, the blind spot for the administration (and the press) is that to address the real engine of overdose deaths, they must confront international and cross-border production and smuggling, an understanding of the problem that the Obama administration has abjured, since it requires the forces of law enforcement, national security, and reductions in illicit drug supply.

Two final notes on the 2015 opioid data, which are but harbingers for the hurricane of use and deaths already being seen in the states for 2016.

First, the steep line of ascent for overdose deaths can be closely paralleled by the administration’s mainstay, the insistent distribution and use of naloxone, the opioid overdose antidote medication. Without that reversal drug being deployed, the true death toll would be much worse. But it also means that simply giving out more and more naloxone cannot be a solution to the crisis, as deaths have accelerated away in spite of a reliance on such measures, which prove ineffectual in the long run and faced with new potencies.

The second sobering realization can be found in an analysis we published on the crisis in November, where we noted that for 2014, heroin overdose deaths were now comparable to those from gun homicides nationwide, both standing at 10,500 per year. The point may have been an inspiration for the Washington Post article on CDC WONDER data for 2015, proclaiming that heroin overdoses now exceeded gun homicide deaths (12,989 to 12,979, respectively).

The fact is true, but what is remarkable is the deep parallel in the rise of the respective figures in a single year, both keeping pace by climbing at a nearly identical rate.

It’s almost as if the trafficking in heroin driving the overdoses is itself tied to the emergent gun homicide crisis surging in our major cities. Those who lived through the violent 1980s and early 1990s will remember the connection well.

The Obama drug policy began with unilateral executive action opening the floodgates to marijuana commercial legalization and it is closing with never-before-seen death rates from drug use. The Trump administration faces a drug death epidemic worse than the crisis the Reagan administration inherited from President Jimmy Carter—and that contributed to even greater levels of violence and addiction before the Carter legacy was reversed.

David W. Murray and Brian Blake are senior fellows at Hudson Institute’s Center for Substance Abuse Policy Research; both served in the Office of National Drug Control Policy during the George W. Bush administration. John P. Walters is Hudson’s chief operating officer and former director of drug control policy for President George W. Bush.

Source:  WEEKLY STANDARD  DEC 15, 2016

Hippocampus, the brain’s key memory and learning center, has the lowest blood flow in marijuana users suggesting higher vulnerability to Alzheimer’s. As the U.S. races to legalize marijuana for medicinal and recreational use, a new, large scale brain imaging study gives reason for caution. Published in the Journal of Alzheimer’s Disease, researchers using single photon emission computed tomography (SPECT), a sophisticated imaging study that evaluates blood flow and activity patterns, demonstrated abnormally low blood flow in virtually every area of the brain studies in nearly 1,000 marijuana compared to healthy controls, including areas known to be affected by Alzheimer’s pathology such as the hippocampus.

All data were obtained for analysis from a large multisite database, involving 26,268 patients who came for evaluation of complex, treatment resistant issues to one of nine outpatient neuropsychiatric clinics across the United States (Newport Beach, Costa Mesa, Fairfield, and Brisbane, CA, Tacoma and Bellevue, WA, Reston, VA, Atlanta, GA and New York, NY) between 1995-2015. Of these, 982 current or former marijuana users had brain SPECT at rest and during a mental concentration task compared to almost 100 healthy controls.

Predictive analytics with discriminant analysis was done to determine if brain SPECT regions can distinguish marijuana user brains from controls brain. Low blood flow in the hippocampus in marijuana users reliably distinguished marijuana users from controls.

The right hippocampus during a concentration task was the single most predictive region in distinguishing marijuana users from their normal counterparts. Marijuana use is thought to interfere with memory formation by inhibiting activity in this part of the brain.

According to one of the co-authors on the study Elisabeth Jorandby, M.D., “As a physician who routinely sees marijuana users,  what struck me was not only the global reduction in blood flow in the marijuana users brains, but that the hippocampus was the most affected region due to its role in memory and Alzheimer’s disease.

Our research has proven that marijuana users have lower cerebral blood flow than non-users. Second, the most predictive region separating these two groups is low blood flow in the hippocampus on concentration brain SPECT imaging.

This work suggests that marijuana use has damaging influences in the brain – particularly regions important in memory and learning and known to be affected by Alzheimer’s.”

Dr. George Perry, Editor in Chief of the Journal of Alzheimer’s Disease said, “Open use of marijuana, through legalization, will reveal the wide range of marijuana’s benefits and threats to human health.  This study indicates troubling effects on the hippocampus that may be the harbingers of brain damage.”

According to Daniel Amen, M.D., Founder of Amen Clinics, “Our research demonstrates that marijuana can have significant negative effects on brain function. The media has given the general impression that marijuana is a safe recreational drug, this research directly challenges that notion.  In another new study just released, researchers showed that marijuana use tripled the risk of psychosis. Caution is clearly in order.”

Source: Press http://content.iospress.com/articles/journal-of-alzheimers-disease/jad160833 – DOI: 10.3233/JAD-160833

Abstract

INTRODUCTION:

The social developmental processes by which child maltreatment increases risk for marijuana use are understudied. This study examined hypothesized parent and peer pathways linking preschool abuse and sexual abuse with adolescent and adult marijuana use.

METHODS:

Analyses used data from the Lehigh Longitudinal Study. Measures included child abuse (physical abuse, emotional abuse, domestic violence, and neglect) in preschool, sexual abuse up to age 18, adolescent (average age=18years) parental attachment and peer marijuana approval/use, as well as adolescent and adult (average age=36years) marijuana use.

RESULTS:

Confirming elevated risk due to child maltreatment, path analysis showed that sexual abuse was positively related to adolescent marijuana use, whereas preschool abuse was positively related to adult marijuana use. In support of mediation, it was found that both forms of maltreatment were negatively related to parental attachment, which was negatively related, in turn, to having peers who use and approve of marijuana use. Peer marijuana approval/use was a strong positive predictor of adolescent marijuana use, which was a strong positive predictor, in turn, of adult marijuana use.

CONCLUSIONS:

Results support social developmental theories that hypothesize a sequence of events leading from child maltreatment experiences to lower levels of parental attachment and, in turn, higher levels of involvement with pro-marijuana peers and, ultimately, to both adolescent and adult marijuana use. This sequence of events suggests developmentally-timed intervention activities designed to prevent maltreatment as well as the initiation and progression of marijuana use among vulnerable individuals.

Source:  Addict Behav. 2016 Nov 17;66:70-75. doi: 10.1016/j.addbeh.2016.11.013. 

 

A man holds a sheet of THC concentrate known as “shatter,” in Denver, Colorado. (Brennan Linsley/Associated Press)

An emergency psychiatrist in Victoria warns that a dramatic increase in severe mental illness cases may be connected to use of a powerful, relatively new drug called “shatter.” Dr, Kiri Simms told On the Island host Gregor Craigie she treated 10 patients needing hospitalization in the past year after using shatter or other highly concentrated marijuana-based products made from butane hash oil.

“They’re coming in with symptoms of depression, anxiety and sometimes psychosis, which for a psychiatrist means a break from reality, hallucinations, delusions,” Simms said.

Marijuana psychosis previously rare

In the past, when most marijuana use involved smoking dried leaves and buds, she said the infrequent cases of marijuana-related psychosis usually were patients with a family history of schizophrenia.  “Most people did not become psychotic from marijuana alone.” Simms said.

Several medical marijuana stores in Victoria openly advertise shatter and related marijuana products which an emergency psychologist links to an increasing number of cases of severe psychosis. (CBC)

That has changed. Now, most of the patients she currently sees are regular users of different marijuana products, often what she calls butane hash oil products. Those include shatter, wax and a gooey substance called honey or butter or oil, she said.

Simms said she has personally seen 10 people in the past year, “very, very ill and with the kind of psychotic experience that requires a stay in our psychiatric intensive care or on one of our in-patient wards.”    She said it’s not like the ‘old days’ when symptoms of psychosis would pass in a few hours or days.  “Now, sometimes it’s taking weeks before there is a clearing and occasionally it’s taking months and the patients are not cleared yet,” Simms said.   “Almost all of our patients, even our young patients tell us they can easily obtain these products in the local dispensaries.”

Shatter is openly advertised online by a number of medical marijuana storefront businesses in Victoria.Dana Larsen, the director of the Vancouver Dispensary Society, acknowledged that products such as shatter are too strong for inexperienced users but he does not support new rules or regulations for selling it.

“I think perhaps there should be better labelling and warnings on how to use cannabis products,” Larsen said. “I don’t think this is inherently more dangerous than other cannabis products.”

Source:  http://www.cbc.ca/news/canada/british-columbia/illicit-drugs-shatter-victoria-mental-illness-1.3862535    22nd  Nov. 2016

Homeless people in the streets are a staple of the landscape in downtown areas of Colorado Springs, Denver and most other Colorado communities. Visitors from other states are struck by the dilemma, even when visiting from large cities on the coasts. Experts on homelessness point to marijuana.

The Department of Housing and Urban Development on Thursday confirmed a homeless phenomenon anyone can see.

HUD ranks Colorado fourth behind California, Washington and the District of Columbia for its absolute increase in the homeless population this year. All four jurisdictions have legalized recreational pot.

Colorado’s growth in homeless veterans leads the nation, at 24 percent. Other states averaged a decrease of 17 percent in veteran homeless populations. They are leaving other states and moving to Colorado.

To put this in perspective, compare Colorado and New York. Colorado has a general population of 5.4 million. New York has general population of 20 million. The number of homeless veterans is nearly identical in the two states.

“While most states saw their homeless veteran populations drop an average of 17 percent in the past year to a total of 39,471, Colorado was one of only eight states going in the opposite direction with increasing numbers,” explained The Denver Post.

Daniel Warvi, spokesman for the Department of Veterans Affairs, told the Post how veterans come to Colorado hoping to work in the marijuana industry. Few come here knowing they must prove a year of residence before the law allows them to work in marijuana-related jobs.

“They don’t have a plan B,” Warvi told the Post. Those who find employment typically cannot afford the state’s soaring housing costs.

Larry Smith, executive director of Catholic Charities of Denver, said his staff sees “a direct correlation” between marijuana migration and increasing homelessness. Smith oversees the 380-bed Samaritan House homeless shelter, three other major homeless shelters in northern Colorado, single-family shelters and multiple food pantries and soup kitchens.

“It’s epidemic,” Smith told The Gazette. “We’ve never seen the kind of street living, and camping, that we’re seeing. It is exploding this year, and it is a different type of homeless population. They won’t come in. They won’t take a bed and a shelter, and there are beds available. It’s a different behavior and mentality. They are more aggressive, much more agitated. A large part of that is due to marijuana. This is insanity.”

Even impassioned advocates of legalization should be concerned when professionals link marijuana to increasing homelessness. If the connection is proved, the marijuana industry should take responsibility for some of the social costs.

When states determined the tobacco industry strained Medicaid resources, Big Tobacco agreed to mitigate burdens associated with its trade. In a settlement, states won a minimum $206 billion settlement and concessions that curtail the industry’s marketing practices.

Colorado has long attracted the homeless, for reasons it attracts other demographics. It would be a stretch to blame all new homelessness on legal marijuana. It is reasonable to heed the increasingly impassioned warnings of social workers who say marijuana plays a big role in the recent surge.

When the General Assembly convenes in January, legislators should cooperate to commission a nonpartisan study that assesses the suspected link between marijuana and homelessness. From there, non-profits, politicians and businesses can determine the scope of a constructive and compassionate response.

The Gazette editorial board

Source:  http://gazette.com/editorial-experts-link-homeless-surge-to-pot/article/1590734 Nov. 22nd  2016

Current brain science is suggesting strong plausibility that the opiate and heroin epidemic will continue to worsen with commercializing and industrializing production and sales of marijuana at levels the likes of tobacco, alcohol and prescription drugs. With more 21st century marijuana in our communities, opiate and heroin use rises. The brain science is beginning to explain why this is. We are, with marijuana research, where we were in the 1920s and 30s with tobacco research linking smoking to cancer.

Studies are revealing that the cannabinoid-opioid systems of the brain are intimately connected.

In the areas of the brain where cannabinoids bind, opioids bind as well, and if you modify one system, you automatically change the other. Specifically, there is a functional interaction between the mu and Cb1 receptors of the brain; these receptors commonly exist together on brain cells. The mechanism is not yet well understood; more research is needed. But ultimately cannabinoids and opioids are known to strictly interact in many physiological and pathological functions, including addiction. Overall, evidence confirms a neurobiological convergence of the cannabinoid and opioid systems that is manifest at both receptor and behavioral levels.

What does this mean? We are learning that brain cross-talk between the endocannabinoid and endogenous opioid systems may cause, if there has been early brain exposure to marijuana, changes in the sensitivity to other drugs of abuse such as heroin.

Specifically, the sensitivity may be blunted, which would cause a greater risk for abuse and addiction. This new science supports the plausibility that a person who uses marijuana as a teenager may be increasing his/her risk of opiate addiction later in life. For example, a 20 year old who takes an opiate pain killer for a skiing injury or wisdom tooth removal may become much more at risk of becoming addicted to that pain killer as a result of his or her earlier marijuana use – no matter how insignificant that earlier use may seem. To be clear, this does not mean every teen marijuana user will be challenged with opioid addiction when they take an opiate-based pain killer later in life, as certainly, not every cigarette smoker ends up with lung cancer. Nor does this remove the enormous accountability opioid medications have in the current opiate crisis. It does put some teeth behind that old-school term “gateway drug” as now there is clear scientific evidence of a neuropathway link between opioids and cannabinoids in the brain. Perhaps “pathway drug” is a more accurate term.

The opioid-marijuana brain cross talk is very real and the newest research shows very important experimental evidence on “epigenetics.” A study in rodents showed that somehow, sperm or ova evade genetic cleansing during reproduction and epigenetic modifications triggered by THC are carried forward to the next generation. These changes were produced by THC exposure during adolescence, and yet persisted during reproduction in adulthood long AFTER exposure ended. The research needs to be reproduced in humans but there are others studies on trans-generational effects of other drugs in humans that appear to be consistent with discoveries in rodents.

This research is indicating that with more 21st century marijuana use, we are not only exposing more people to a serious decline in cognitive & mental-health functioning, but we conceivably are also priming populations for more opiate addiction and brain changes. And alarmingly, this priming can take place in utero, even if marijuana use ceases prior to childbearing years.

So frankly, it may not be a coincidence that the states with highest rates of youth marijuana use are also experiencing a soaring heroin epidemic – a trend we are seeing rise across the United States.

This science-based possibility that marijuana exposures in the brain are a foundational feature of the opiate addiction crisis deserves to be weighed heavily in the current decision-making process in how best to change marijuana law – especially given our nation’s tobacco history and tobacco’s impact on health and healthcare costs.  We will learn more about all of this opioid-cannabinoid brain connection, and very soon. with what this science is revealing, if it takes 50 years like it did with tobacco to confirm smoking cigarettes causes lung cancer, our species may be facing a profound and permanent decline in cognitive functioning.

Those in the field of substance abuse and drug use prevention are grateful to our esteemed researchers in Massachusetts and throughout our nation working diligently every day to not only figure out this opioid-cannabinoid neuropathway link, but to explain it to the rest of us so we begin to truly understand what is at stake as the marijuana lobby pushes for full government protection to engineer, produce, market and sell marijuana products in every community for recreational use, like tobacco.

Source:   http://marijuana-policy.org/marijuana-and-opiateheroin-epidemic-brain-science-explains-a-connection/ Feb.2016     By Heidi Heilman, Founder and CEO Massachusetts Prevention Alliance (MAPA); Founder and CEO, Edventi  

The Marijuana Policy Initiative

Don’t Legalize. We Change Minds About Marijuana Legalization/Commercialization

A volunteer non-partisan coalition of people from across the US and Canada who have come to understand the negative local-to-global public health and safety implications of an organized, legal, freely-traded, commercialized and industrialized marijuana market.

With special thanks to Dr. Bertha Madras, Dr. Sion Harris, and Dr. Sharon Levy for their work in translating the complexities of the latest brain science. ___

References (partial list of a lengthy list)

1. Ellgren M, Spano SM, Hurd YL. Adolescent cannabis exposure alters opiate intake and opioid limbic neuronal populations in adult rats. Neuropsychopharmacology. 2007 Mar;32(3):607-15

2. Spano MS, Ellgren M, Wang X, Hurd YL. Prenatal cannabis exposure increases heroin seeking with allostatic changes in limbic enkephalin systems in adulthood. Biol Psychiatry. 2007 Feb 15;61(4):554-63.

3. Ellgren M, Artmann A, Tkalych O, Gupta A, Hansen HS, Hansen SH, Devi LA, Hurd YL. Dynamic changes of the endogenous cannabinoid and opioid mesocorticolimbic systems during adolescence: THC effects. Eur Neuropsychopharmacol. 2008 Nov;18(11):826-34.

4. DiNieri JA, Wang X, Szutorisz H, Spano SM, Kaur J, Casaccia P, Dow-Edwards D, Hurd YL. Maternal cannabis use alters ventral striatal dopamine D2 gene regulation in the offspring. Biol Psychiatry. 2011 Oct 15;70(8):763-9.

5. Spano MS, Ellgren M, Wang X, Hurd YL. Prenatal cannabis exposure increases heroin seeking with allostatic changes in limbic enkephalin systems in adulthood. Biol Psychiatry. 2007 Feb 15;61(4):554-63.

(Medical Xpress)—An international team of researchers has found what they believe is the source of memory loss in people who smoke marijuana—disruption to mitochondria. In their paper published in the journal Nature, the group describes their study of receptor activation due to exposure to active ingredients in cannabis and its impact on mitochondria.

A mitochondrion is an organelle located inside of most cells—it is commonly referred to as the part of the cell responsible for energy regulation. In this new effort, the researchers looked into the impact of cannabis on mitochondria in brain cells to find out if it may play a role in immobility, catalepsy (onset of seizures or a trance-like state) or memory loss due to use of the controversial drug.

Prior research has shown that CB1 receptors are located in the plasma membrane that surrounds typical brain cells. Other research has also shown that chronic use of cannabis can cause memory loss and other problems and that substances in it bind to CB1 receptors on nerve terminals, which, in turn, can cause a disruption in the transmissions of messages between cells. The net result is memory loss, catatonic states or blackouts. In this new effort, the researchers found that chemicals in cannabis also caused activation of CB1 receptors in mitochondria in brain cells located in the hippocampus, which is where most memory processing occurs. This, they claim, suggests memory loss due to use of cannabis can be sourced to the impact it has on the organelles.

The team came to this conclusion by removing the CB1 receptors in mitochondria in mice brain cells and testing the mice to see if they continued to experience memory loss due to the introduction of the cannabis chemicals. The team reports they did not, which suggests that interactions between cannabis chemicals and mitochondria plays a major role in memory loss and likely other negative health effects associated with chronic use of marijuana. They suggest their findings indicate that chronic use of the drug could cause permanent damage to mitochondria, leading to long-term or permanent memory loss and other health problems.

The researchers also suggest their findings indicate that there may be a way to modify medical cannabis used to treat diseases such as glaucoma so that it does not cause memory loss or other associated health problems, by removing its impact on mitochondria.

Source:http://medicalxpress.com/news/2016-11-memory-loss-due-cannabis-mitochondria.html

More information: Etienne Hebert-Chatelain et al. A cannabinoid link between mitochondria and memory, Nature (2016). DOI: 10.1038/nature20127

Abstract  Cellular activity in the brain depends on the high energetic support provided by mitochondria, the cell organelles which use energy sources to generate ATP.

Acute cannabinoid intoxication induces amnesia in humans and animals, and the activation of type-1 cannabinoid receptors present at brain mitochondria membranes (mtCB1) can directly alter mitochondrial energetic activity. Although the pathological impact of chronic mitochondrial dysfunctions in the brain is well established, the involvement of acute modulation of mitochondrial activity in high brain functions, including learning and memory, is unknown.

Here, we show that acute cannabinoid-induced memory impairment in mice requires activation of hippocampal mtCB1 receptors. Genetic exclusion of CB1 receptors from hippocampal mitochondria prevents cannabinoid-induced reduction of mitochondrial mobility, synaptic transmission and memory formation. mtCB1 receptors signal through intra-mitochondrial Gαi protein activation and consequent inhibition of soluble-adenylyl cyclase (sAC).

The resulting inhibition of protein kinase A (PKA)-dependent phosphorylation of specific subunits of the mitochondrial electron transport system eventually leads to decreased cellular respiration. Hippocampal inhibition of sAC activity or manipulation of intra-mitochondrial PKA signalling or phosphorylation of the Complex I subunit NDUFS2 inhibit bioenergetic and amnesic effects of cannabinoids. Thus, the G protein-coupled mtCB1 receptors regulate memory processes via modulation of mitochondrial energy metabolism. By directly linking mitochondrial activity to memory formation, these data reveal that bioenergetic processes are primary acute regulators of cognitive functions.

The risk of developing psychosis is more than tripled for those who abuse cannabis, according to results from a new twin study.

Researchers from the Norwegian Institute of Public Health (NIPH), together with colleagues from Virginia Commonwealth University, examined the relationship between cannabis and psychosis using psychiatric interviews of Norwegian twins. The interviews reveal whether the twins had symptoms of psychosis and cannabis abuse.

“Previous research has shown that patients with psychotic disorders use cannabis more often than the general population. However research has been divided over whether cannabis use was the cause of the psychotic disorders,” says Ragnar Nesvåg, senior researcher at NIPH and the main author of the study.

Genetic factors influence both cannabis abuse and psychosis and the same genes may lead to an increased risk for both problems. “The relative importance of genes in the causes of a disease is known as heritability, and we know from previous studies at the NIPH that cannabis abuse is very heritable, explains Eivind Ystrom, senior researcher at NIPH. “In order to determine whether cannabis abuse can lead to psychosis, it is important to account for genetic risk,” he adds.

The researchers therefore tested both the hypotheses that cannabis use causes psychotic symptoms and that psychotic symptoms lead to cannabis abuse.

Abuse increased the risk by 3.5

The hypothesis best suited to the data was that cannabis abuse caused symptoms of psychosis. Within a twin pair, the twin with symptoms of cannabis abuse had a 3.5 times higher risk of developing symptoms of psychosis compared with the twin who did not have symptoms of cannabis abuse.

“Our analyses showed a significant association between cannabis abuse and symptoms of psychosis in the general population. We also tested the hypothesis that symptoms of psychosis caused cannabis abuse, but the hypothesis was less suited to the data. Therefore, it appears that cannabis abuse can be a cause of psychosis,” says Ystrom.

Confirmed high heritability

Previous studies have shown that cannabis abuse is very heritable, which was also confirmed in this study. As much as 88 per cent of the causes of why some people abused cannabis, yet others did not, could be attributed to some people having risk genes.  Despite this, the researchers found that a common genetic risk could not explain the entire association with symptoms of psychosis. Even after genetic risk and risk of childhood environment were taken into account, people with cannabis abuse still had a multiplied risk of developing symptoms of psychosis. Nesvåg says that psychosis is associated with huge costs to society. These findings should be considered when evaluating the cost of policies for increased cannabis availability, such as decriminalisation or legalisation.

About twin studies

Investigating whether a particular risk factor causes disease requires studies where you look at two people who are otherwise identical, where one is exposed to a risk factor and the other is not. The effects on their health can be investigated. For obvious reasons, these experiments are neither practical, ethical or legally feasible.

Studying twins is a viable option because they have genetic similarity, they have grown up in the same family, and they have the same socioeconomic background.

More information: Ragnar Nesvåg et al. Genetic and Environmental Contributions to the Association Between Cannabis Use and Psychotic-Like Experiences in Young Adult Twins,

Source:  Schizophrenia Bulletin (2016). DOI: 10.1093/schbul/sbw101  Provided by: Norwegian Institute of Public Health

If Marijuana is Medicine, How Come it Makes People So Sick?

There’s a great irony that comes from the pot industry’s claims that marijuana is medical and it’s supposed to help with nausea.   It’s called Cannabis Hyperemesis, and it hits with a vengeance.

This past week a parent wrote to PopPot, saying: “Parents should watch for red flags of pot use in their children including frequent, long hot showers; weight loss; unexplained nausea and vomiting.”

“I took my teen to the doctor assuming the stress of a rigorous course load combined with the demands of an after school sport were taking a physical toll on my child, ” the mom wrote.  “In hindsight, these were the signs of escalating pot use as described in this Pub Med article about cannabinoid hyperemesis. Unfortunately many in the medical community are ignorant of the detrimental effects of pot use on our young people —  ranging from psychotic breaks to debilitating gastrointestinal symptoms.”

From another mother in Pueblo, Colorado who also wrote this past week:  “Last week I met a 14-year-old girl suffering from Cannabis Hyperemesis Syndrome.  When I met her, at first I thought she had an addiction to meth because she was so very thin and malnourished.  She was asking me how can she return to live with her parents who are marijuana users when marijuana is so toxic for her.”

Incidences of this severe illness appear to be on the rise since the rollout of legal weed.  The high THC content of today’s weed — 5x the amount in the 1980s — seems to be involved also.  Because of misdiagnosis or denial of drug use by patients, this syndrome is going undetected.  Furthermore, users self-medicate and exacerbate this severe illness, as a medical marijuana patient was doing for more than eight months.

From veterans hospitals to addiction specialists as well as gastroenterologists, there’s suddenly an increased interest in and diagnoses of this condition.  Further research into this mysterious illness turns up numerous medical journal articles on the link between excessive and/or long-term cannabis use and hyperemesis.

Cannabis Hyperemesis: How to Know if You or Someone You Love is Afflicted

This syndrome is still largely unknown throughout the medical profession and even among cannabis users. The most prominent cases are among long-term users that started using the drug at a very early age and have used daily for over 10 years, according to the MedScape article, Emerging Role of Chronic Cannabis Use and Hyperemesis Syndrome. The article goes on to say that it can also effect newer users and even non-daily users.

In Practical Gastroenterology, there’s a case of a 19 year old Hispanic man who contracted the problem within only two years of marijuana use.  Symptoms reported in a Current Psychiatry article include cyclic vomiting, abdominal pain, nausea, gastric pain and compulsive hot bathing or showers to ease pain.  Frequent bathing and vomiting can also lead to dehydration and excessive thirst. Mild fever, weight loss, and a drop in blood pressure upon standing are other symptoms.

Sufferers find they need to take many showers or baths a day just to get relief from the chronic nausea and vomiting. The bouts of illness are so severe and frightening they lead to frequent trips to the emergency room. And finally, this debilitating illness can be very disruptive to life and relationships. The many absences from work lead to job loss and the inability to hold down a job.

Parents may mistake this situation as bulimia, particularly if the teens hide the vomiting.  Another common way this disease is misdiagnosed as cyclic vomiting syndrome. According to the Current Psychiatry article, 50% of those diagnosed with CVS are daily cannabis users.  Another common misreading by doctors of the compulsive habit of frequent hot baths is as Obsessive Compulsive Disorder.

Further complicating matters, doctors find that even when cannabis use is consistent, the bouts of hyperemesis come and go, which further serves to keep the patient in denial about the connection to their drug use.

In Spite of Cannabis Hyperemesis, Addiction is a Stronghold

Complete cessation of marijuana use is the only known cure for Cannabis Hyperemesis Syndrome.

Sadly, even those who have greatly suffered over a long period of time, still want to be able to consume marijuana. The claim by the industry that marijuana is not addictive is easily disproved when you see the comments to a High Times article, What is Cannabinoid Hyperemesis Syndrome?  Not only do many commenters admit they suffer from this detrimental effect of this drug, they confess they still love marijuana. The commenters lament having to give up their stoner lifestyle even after years of disabling illness! A number of them state that once they are well, they plan to return to the habit, albeit to a lesser degree.

Source:  http://www.poppot.org/2016/11/19/cannabis-hyperemesis-toxic-side-effect-of-dangerous-drug/   19th Nov. 2016

Nora D. Volkow, Aidan J. Hampson, and Ruben Baler

Abstract:

INTRODUCTION

The search for a state of mental relaxation and well-being is one of the factors driving the widespread consumption of cannabis. The most frequently abused illicit substance worldwide, cannabis is consumed regularly by about 2.4% of the world population (approximately 181 million people in 2013) (1).

The principal psychoactive component of cannabis is_9-tetrahydrocannabinol (THC), which acts as an orthosteric agonist for cannabinoid receptors and mediates both the positive and negative effects of cannabis. The cannabinoid receptors are part of the brain’s endocannabinoid system (ECS), which modulates multiple neurobiological processes including reward and stress, a fact that is relevant for understanding not just the recreational use of cannabis but also its therapeutic potential.

This review focuses on the role of the ECS in the modulation of stress responses, its interaction with the reward system in the brain, and the implications of this emerging understanding for cannabis abuse, mental illnesses, and therapeutics.

CONCLUSIONS

Cannabis has been used for centuries across the globe. However, the recent changes in laws regarding legalization of recreational or medicinal cannabis, along with the availability of cannabis with increasingly higher THC levels (94, 163), are generating a sense of urgency for understanding the potential adverse effects of cannabis exposure as well as its purportedly medicinal actions.

Although many studies have been published on deleterious effects of chronic cannabis vis-´a-vis cognition, emotion, and psychiatric symptoms, the findings are inconsistent, which has made it easier for proponents of cannabis legalization to dismiss them and wrongly claim that cannabis use has no harmful effects. At the same time, major advances in our understanding of ECS neurobiology have opened exciting new opportunities for the development of novel, smarter medications for psychiatric and neurological disorders.

Source:     Annu. Rev. Pharmacol. Toxicol. 2017. 57:2.1–2.23

By Dr. Carlton E. Turner

As the former Drug Czar under President Ronald Reagan, with an extensive background in marijuana research, I thought I should share some of my thoughts about ‘medical’ marijuana.

From 1970 to 1981, I held various positions at the Research Institute of Pharmaceutical Sciences, School of Pharmacy at the University of Mississippi. During this time, I published over 100 original papers, chapters in books, patents, and two large Marijuana Bibliographies covering marijuana research starting in the 1880s. I also served as the Director of the federal government’s Marijuana Project.

That research project was funded by the National Institute of Mental Health and the National Institute on Drug Abuse. The project grew Cannabis sativa L. plants from seeds obtained from over 100 sites worldwide. We processed the plant material into marijuana and supplied this standardized research marijuana to researchers throughout the world. All of the marijuana shipped was analyzed by a procedure developed at the University and recognized as the world standard by the United Nations Narcotic Laboratory.

Now that you know a bit of my background let me give you the facts about marijuana:

Marijuana is a very crudely prepared drug comprised of the dried leaves, small stems, and flowers of the Cannabis plant. Marijuana contains unique chemicals called cannabinoids. Cannabinoids have biological activity and have been the subject of thousands of research studies since the 1970s. Some cannabinoids can be medicinal and have been regulated by the FDA, and prescribed by licensed physicians since 1985.

The synthetic form of the major psychoactive ingredient in marijuana, Delta-9-THC (Delta-9-tetrahydrocannabinol), known as Marinol®, is prescribed daily by physicians for nausea, vomiting, as an appetite stimulant for AIDS patients, and to ease the pain in multiple sclerosis patients. Another drug, which has been approved by the FDA is the Nabilone, a synthetic cannabinoid, which is prescribed for vomiting in patients undergoing cancer treatment.

Pro-drug groups, marijuana users, the media, politicians, and those wanting to profit from marijuana sales distort the truth about FDA-approved cannabinoid drugs and all cannabinoid research findings. They claim that society should not use marijuana derivative drugs approved by the FDA. That only “natural” marijuana should be used as medicine. To further cloud the facts, medical reporters claim marijuana works for many ailments, but in reality, they are referring to cannabinoid drugs.  The marijuana legalization advocates want to confuse the public to accept that ‘natural’ marijuana as a panacea for any human condition, and falsely claim it is safe to use as an unregulated “medicine.” But this so-called “medical marijuana” is a fraud and a con job.

The fact is that marijuana is a dirty drug with so many different side effects that it will never pass the required safety and efficacy testing for medicine. Marijuana can contain over 700 individual chemicals, and when smoked the number of chemicals expand to the thousands. The smoke contains 50 percent to 70 percent more cancer-causing compounds than tobacco. To argue that the “natural” plant form of marijuana should be used over FDA approved marijuana derivatives is like telling a mother whose child is suffering from a bacterial infection that she should offer her child moldy bread instead of penicillin. Think about the life expectancy when people took herbs for medical conditions compared to the life expectancy with modern medicines. Marijuana is not, and will never be medicine. * Carlton E. Turner, Ph.D., served as Deputy Assistant to President Ronald Reagan for Drug Abuse Policy and as Director of the White House Drug Abuse Policy Office. Turner is considered one of the nation’s leading experts on the pharmacology of marijuana.

Source:  : brent@brentbeleskey.com  American Center for Democracy  19th November 2016

ABOUT ACD American Center for Democracy is a New York-based not-for-profit organization, which monitors and exposes the enemies of freedom and their modus operandi, and explores pragmatic ways to counteract them.

The new data confirms mounting body of scientific evidence highlighting problems with rising marijuana use; SAM Honorary Advisor Patrick Kennedy to speak as part of report’s official release

[ALEXANDRIA, VA] – A new report, released today by the office of the U.S. Surgeon General, adds to the mounting body of scientific evidence highlighting the dangers of marijuana use and emphasizing prevention as essential for protecting youth. It also stands as a further warning of the large impending public health costs of marijuana legalization policies, which permit the marijuana industry to profit from the patterns of heavy marijuana use that pose the greatest threat to public health and safety.

Among the report’s findings:

* Long-term health consequences of marijuana use:  mental health problems, chronic cough, frequent respiratory infections, increased risk for cancer, and suppression of the immune system.

* Other serious health-related issues stemming from marijuana use: breathing problems; increased risk of cancer of the head, neck, lungs, and respiratory tract; possible loss of IQ points when repeated use begins in adolescence; babies born with problems with attention, memory, and problem solving (when used by the mother during pregnancy).

* Increased risk for traffic accidents:  Marijuana use “is linked to a roughly two-fold increase in accident risk.”

* Increased risk of schizophrenia:  “[T]he use of marijuana, particularly marijuana with a high THC content, might contribute to schizophrenia in those who have specific genetic vulnerabilities.

* Increased risk of addiction from high-potency marijuana available in legalized states:  “Concern is growing that increasing use of marijuana extracts with extremely high amounts of THC could lead to higher rates of addiction among marijuana users.”

* Permanent Loss of IQ:  “One study followed people from age 13 to 38 and found that those who began marijuana use in their teens and developed a persistent cannabis use disorder had up to an eight point drop in IQ, even if they stopped using in adulthood.”

“Once again, the scientific community has spoken loud and clear on the numerous, and serious health risks of marijuana,” said Kevin Sabet, President of SAM. “The more we know about marijuana, the worse it appears for public health and safety. Policymakers, especially those in the incoming Presidential administration and Congress, should read this report closely and heed the advice of the scientific community.”

“In particular, the Surgeon General’s report underscores the serious problems with patterns of heavy marijuana use — the same patterns that furnish the pot industry with the vast majority of its revenues,” commented Jeffrey Zinsmeister, SAM’s Executive Vice President. “As we seek to avoid the mistakes we made with Big Tobacco, we should be aware that the pot industry profits off of the very types of marijuana use that most harm public health and safety.”

Source:     http://www.learnaboutsam.org.  Press release  17th Nov.2016   Email: austin.galovski@curastrategies.com

Authors: Daniela Vergara1 *, L. Cinnamon Bidwell2 , Reggie Gaudino3 , Anthony Torres3 , Gary Du3 , Travis C. Ruthenburg3 †, Kymron deCesare3 , Donald P. Land3 , Kent E. Hutchison4 and Nolan C. Kane1 * Affiliations: 1 University of Colorado Boulder, Department of Ecology and Evolutionary Biology. 2 University of Colorado Boulder, Institute of Cognitive Science. 3 Steep Hill Labs Inc. 1005 Parker Street, Berkeley, CA 94710. 4 University of Colorado Boulder, Department of Psychology and Neuroscience. *Correspondence to: daniela.vergara@colorado.edu or nolan.kane@colorado.edu University of Colorado Boulder 1900 Pleasant Street Boulder, CO 80309 †Current address: SC Laboratories Inc. 4000 Airport Way South, Seattle, WA 98108.

Abstract: 

As the most widely used illicit drug, the basis of the fastest growing major industry in the US, and as a source of numerous under-studied psychoactive compounds, understanding the psychological and physiological effects of Cannabis is essential. The National Institute on Drug Abuse (NIDA) is designated as the sole legal producer of Cannabis for use in US research studies. We sought to compare the chemical profiles of Cannabis varieties that are available to consumers in states that have state-legalized use versus what is available to researchers interested in studying the plant and its effects.

Our results demonstrate that the federally produced Cannabis has significantly less variety and lower concentrations of cannabinoids. Current research, which has focused on material that is far less diverse and less potent than that used by the public, limits our understanding of the plant’s chemical, biological, psychological, medical, and pharmacological properties. Investigation is urgently needed on the diverse forms of Cannabis used by the public in state-legal markets.

Introduction:

The United States has witnessed enormous changes concerning public acceptance of marijuana. Use has more than doubled since 2002, across all genders, ethnicities and socioeconomic status

Considering changes on the cultural, political, and legal fronts, research on the effects of Cannabis products that are consumed though legal outlets in states that have legalized is urgently needed. The Cannabis plant is unique in producing a diversity of cannabinoids, a terpenoid chemical compound that interacts with the endocannabinoid system in the brain and nervous system

One of the primary cannabinoids produced, Δ-9-tetrahydrocannabinolic acid (THCA), is converted to the neutral form Δ-9-tetrahydrocannabinol (THC) when heated, e.g. by smoking. THC interacts with the endocannabinoid system producing a wide range of physiological and neurological effects. Studies have found that marijuana’s effects on mood, reward, and cognitive dysfunction appear to follow a dose dependent function based on the THC content

Due to this and other purported psychotropic effects, THCA has been actively selected for by the Cannabis industry and varieties containing more than 30% THCA by weight have been cultivated  In addition to THC, marijuana’s effects are likely related to a number of other compounds including nearly 74 different cannabinoids present at varying ratios across strains. For example, another cannabinoid produced by the plant, is converted to cannabidiol (CBD) when heated. CBD may mitigate the effects of THC and may have other beneficial effects

Demand for high CBDA plants has increased, due to potential therapeutic uses for cancer 19 and  epilepsy.    Other important cannabinoids produced by the plant include cannabigerol (CBG cannabichrome (CBC)  and Δ-9-tetrahydocannabivarin (THCV)

Because research universities across the nation have national grants and must verify compliance with federal law, scientists at these institutions are restricted to research with the only federally legal source of Cannabis. Our current understanding of the effects of marijuana in humans (e.g. on mood, cognition, or pain) has therefore relied exclusively on government-grown marijuana, often administered in a laboratory setting,

Thus, nearly all published US laboratory studies have used Cannabis material obtained from the National Institutes of Health/National Institute on Drug Abuse (NIDA) supply, the only federally legal source for Cannabis plant material. At the same time, dispensary-grade Cannabis available to consumers in state-regulated markets is becoming increasingly potent and diverse. Strains differ substantially in potency and cannabinoid content, and hence, are likely to differ in terms of their effects .

Strains bred for high THCA content are thought to result in greater levels of intoxication as well as differing psychological and physiological effects compared to strains bred for high CBDA content. Accordingly, NIDA has recently developed plant material with varying levels of cannabinoids for research purposes, but the extent to which government cannabis is consistent with cannabis produced in the private market is not clear. To address the critical question of whether the potency and variety of NIDA-provided cannabis reflects products available to consumers through state-regulated markets, we compared the cannabinoid variation and potency from plants from four different cities in the US where peer-reviewed cannabis is legal for medical or recreational reasons (Denver, Oakland, Sacramento, and Seattle; cannabinoid data provided by Steep Hill Labs Inc.) to the cannabinoid content of plants supplied for research purposes by NIDA, using the data publicly available on their website 28.

Results 

NIDA differs from all other locations except Seattle in production of CBD (fig. 1A), and differs significantly from all other locations in production of THC. NIDA has the lowest CBD and THC percent with a mean and s.d. of 6.16 ± 2.43%, and 5.15 ± 2.60% respectively.

Sacramento has the highest percent CBD with 12.83 ± 4.73% and Seattle has the highest percent THC with 19.04 ± 4.43%. There are significant differences between the percent of both CBD and THC between US city locations, in addition to differences with NIDA (fig. 1A). CBG production does not differ in any location.

Cannabis plants grown in all locations produce very little CBG, particularly NIDA with only a single sample producing more than 1% CBG (fig. 1B). THC-V is also produced in low quantities in all locations. The only statistically significant difference is between Denver, whose mean and s.d is 1.12 ± 0.13%, and Oakland 2.35 ± 0.68%

Source:  http://biorxiv.org/content/biorxiv/early/2016/10/26/083444.full.pdf

Ben Cort, an addiction treatment specialist from Colorado, speaks in opposition to Proposition 64 during a panel about the legalization of marijuana at the Anaheim Convention Center.

An addiction expert from Colorado, where marijuana is legal, Cort is drowning in a sea of concern over Proposition 64, California’s ballot initiative that would allow recreational weed.

Once an addict himself, Cort can’t believe the Golden State appears on the verge of legalizing something that terrifies him. Though he’s no fan of pot, it’s not so much the plant that scares Cort. What worries him is that science allows THC – the active ingredient in marijuana that gets you high – to become nuclear-charged.

A little THC wax or oil, he cautions, can go a very long way, especially when it’s ingested.

“We’re the canary in the coal mine,” says Cort, a manager with the University of Colorado Hospital’s rehab program. “We’re treating more addicts for cannabis than we are for opiates.”

Cort says he’s seen THC levels in so-called gummy bears 20 times higher than levels that are legal in Oregon, another state where recreational marijuana is law but where THC percentages are controlled.

Prop. 64, Cort says, will legalize dangerously high THC. That’s not Snoop Dogg cool. That’s emergency room serious.

The federal National Institute on Drug Abuse reports, “These extracts can deliver extremely large amounts of THC to users, and their use has sent some people to the emergency room.” Such high THC levels, institute officials warn, also can turn what many consider a relatively benign drug into something addictive.

UNICORN PROMISES

While writing about marijuana, I’ve interviewed doctors, lawyers, pot growers, medical marijuana dispensary owners, officials with the National Organization for the Reform of Marijuana Laws and patients in pain.

Until I attended a two-hour informational panel discussion Tuesday sponsored by the Anaheim Police Department, I figured I knew all about pot. Speakers included Cort; Police Chief John Jackson of the Greenwood Village, Colo., Police Department; Chief Justin Nordhorn of the Washington State Liquor and Cannabis Board; Attorney Robert Bovett of Oregon Counties Legal Counsel; Lauren Michaels, legislative affairs manager

for the California Police Chiefs’ Association; and Nate Bradley, executive director of the California Cannabis Industry Association.

When a speaker asked who had read Prop. 64, only one hand went up and it wasn’t mine. So to prepare for this column I also read – OK, I skimmed some chunks – all 62 pages. A lot of Prop. 64 is wonky and details who can do what and where. But some reads more like dreams of fairies and unicorns than reality.

“Incapacitate the black market,” the proposal promises “and move marijuana purchases into a legal structure with strict safeguards against children accessing it.”

Untrue, said Jackson, who stressed that illegal sales continue in Colorado.

“Revenues will,” Prop. 64 predicts, “provide funds to invest in public health programs that educate youth to prevent and treat serious substance abuse.”

Wrong, Jackson said. More teens in Colorado are being sent to emergency rooms because of THC-laced edibles.

Revenues will pay to “train local law enforcement to enforce the new law with a focus on DUI enforcement.”

Incorrect again. Jackson said his department is busier than ever dealing with more drivers high on weed and handling more THC-related traffic fatalities.

Other parts of Prop. 64 are just dumb and dumberer.   Like allowing radio and television advertising.

“Make no mistake,” Jackson said of Prop. 64. “This whole thing is about money.

“A drug dealer in a suit is still a drug dealer.”

‘NECESSARY REFORM’

Once marijuana became legal in Washington in 2012, Nordhorn said, children and teens considered it less harmful, and that had ripple effects.

With the advent of vaping, for example, young people inhale THC without anyone knowing if they are taking in an innocent type of e-juice or marijuana.

“Legal marijuana,” Nordhorn said, “is not a silver bullet to get rid of marijuana problems.”

Bovett echoed other panelists, saying that Oregon also has seen an increase in impaired driving, although he added that has been going up since the state approved medical marijuana.

The Oregon Poison Center also reports increases in marijuana-related calls.

Even Bradley, the lone pro-Prop. 64 voice on the panel, admitted he’s concerned about edibles.

Instead of THC levels, Bradley focused on dollars. He said the initiative will take $100 million out of the hands of criminals and the measure will generate $300 million for law enforcement to focus on such things as protecting children.

Bradley has plenty of backers. Among the most visible are Gavin Newsom, lieutenant governor, and Rep. Dana Rohrabacher, R-Costa Mesa. Our local representative has said, “Current marijuana laws have undermined many of the things conservatives hold dear – individual freedom, limited government and the right to privacy.”

Rohrabacher went on to say, “This measure is a necessary reform which will end the failed system of marijuana prohibition in our state, provide California law enforcement the resources it needs to redouble its focus on serious crimes while providing a policy blueprint for other states to follow.”

‘SEED TO SALE’

The most sobering speaker was Michaels of the chiefs’ association. She simply defended California’s newly revamped medical marijuana policies.

Called “seed to sale,” three new laws inked last year shoot down the need for Prop. 64, Michaels said. She stated California now has an enhanced working system to distribute medicinal marijuana legally.

California, Michaels said, already allows local control, protects current producers and includes checkpoints at distribution.

In contrast, she said, Prop. 64 is vertically integrated, favors big business and independent distribution, appoints the state as sole actor for operating licenses and ensures regulatory confusion. Research, learn, vote. Contact the writer: dwhiting@scng.com

Source:   http://www.ocregister.com/articles/marijuana-731244-thc-prop.html   5th October 2016

Introduction

Within Jamaica there is a cultural belief that cannabis use is associated with enhanced creativity, improved concentration [1] and even improved reflexes [2]. These mythical beliefs have resulted in high rates of cannabis use, particularly among the youth, despite cannabis use being illegal in Jamaica.

A 1987 survey of patterns of substance misuse among post primary Jamaican students identified a 19.8% lifetime prevalence for cannabis use, while a 2000 Jamaican National School’s Survey found the lifetime prevalence to have increased to 26.9% [3]. Research findings have suggested that cannabis use may impair neuro-cognitive functioning [4-6].

However, some researchers have suggested that the residual effects of heavy cannabis use on cognitive functions are reversible, lasting only a few days after cessation [7].

Results from one longitudinal study found that cannabis use does not have a long-term negative impact on intelligence [9], while others have found that heavy cannabis users had memory and  learning impairments even after six weeks of supervised abstention [8].

There is a paucity of research on cannabis and neuro-cognitive performance in the Caribbean Region, including Jamaica.   Given the widespread use of cannabis and its easy availability for Jamaican adolescents, it is important to identify if there are any neuro-cognitive effects  associated  with cannabis use, among the youth population. This study therefore investigates whether cannabis use among Jamaican adolescent males will result in lowered performances on neurocognitive tasks.

Metabolites of cannabis in their urine, were excluded from the study. Cannabis users were required to abstain from using for a period of 24 – 48 hours prior to participating in the testing.

Of the 35 participants initially recruited for the cannabis use group, 3 were expelled from school and 2 chose to withdraw from the study. Of the 35 participants in the non-user control group, 3 were excluded from the study because their urine contained metabolites of cannabis. A total of 30 cannabis users and 32 non-users were inter viewed for the study. version 14 (SPSS v.14) and t-tests were conducted to assess if there were any significant differences between the performances of cannabis users and non-users.

Discussion

The mean age of cannabis initiation in this study was found to be early adolescence as seen in other Caribbean studies [3,11].  As adolescence is the developmental period  for

experimentation and risky behaviours,  along with the cultural acceptability of cannabis use during adolescence is a cause for serious concern as the adolescent brain is still undergoing neural development and may be susceptible to impairments in neuro-cognitive functioning.

Cannabis users exhibited lower scores on all assessed neuropsychological functions as compared to non-users. However, the greatest mean differences were observed  through significantly lowered Verbal Comprehension as well as Digit Span scores.  This finding implicates cannabis use during adolescence with impairing the neurocognitive functions of working memory, attention, concentration, mental manipulation, language  development and verbal intelligence. Cannabis users also had significantly lower visual,  verbal and working memory scores than those of non-cannabis users with the largest differences being seen on the delayed subtests. The observance of significantly lower  scores on the delayed subtests implies that the long term memory of cannabis user  may be more susceptibility to neurocognitive decline.

Cannabis users had lower scores on all tests of learning, attention and memory than non-users. This is consistent with findings from previous research neuropsychological performance [13-18]. A meta-analytic study by Grant, et al. [19] also identified impairment in the ability of chronic users of cannabis to recall new information, though findings by Schwartz [20] and Lyons [21] indicate an absence of long-term residual effects of cannabis use on cognitive abilities. Traditionally, Jamaicans view cannabis use as providing many benefits.  These findings are an important step in providing empirical evidence for possible cognitive impairment from cannabis use, among the adolescent population. Further research is needed to determine dose-related, in addition to long-term residual effects of cannabis use on neuropsychological performance in the Caribbean. Understanding the relationship between the complex factors that influence neurocognitive performance of cannabis users should further help to inform the development of public policy and legislation in Jamaica and the Caribbean.

Limitations

The sample size of 30 for the user group even though deemed sufficient, was still small and the present study consisted of male participants only. It would be of interest to know if there is a gender difference in cannabis users’ in performance on neurocognitive tests of memory.

Conclusion

The findings suggest that there is a significant difference in performance between Jamaican male adolescent cannabis users and non-users on neuro-cognitive tests. Users of cannabis displayed cognitive deficits on all tests of memory, intelligence, language and attention that were conducted. The present findings lend new support to the notion that cannabis use may impair neurocognitive functioning.

There are implications for poor school performance by adolescent users of cannabis in Jamaica. These results support the need for public health policies aimed at targeting early prevention strategies, demand reduction, identification and treatment of adolescent cannabis users in Jamaica.

Source:     Ment Health Addict Res, 2016 doi: 10.15761/MHAR.1000118  

Karyl Powell-Booth1,et al

The marijuana industry would rather you didn’t know this nasty truth about weed use before and during pregnancy.

Nine states are carrying measures to legalize marijuana on the Nov. 8 ballot — California, Nevada, Maine, Arizona, Massachusetts, Florida, Arkansas, Montana, and North Dakota. Pot peddlers claim the industry will boost jobs and grow the economy.

But the marijuana industry isn’t interested in the occasional or casual adult user. Like any drug industry, this group is interested in addicts — people who start using early and make it a lifetime habit. Maybe that’s why they don’t care about how their drugs are affecting babies — and why they occasionally take measures to market their products to pregnant women.

Between 7 and 10 percent of newborns at the [Pueblo] hospital are testing positive for THC, the mind-altering ingredient in cannabis.

The data is only now starting to roll in. Recently, 237 physicians from Pueblo, Colorado, banded together to detail some of the health risks associated with marijuana legalization. In particular, Dr. Steven Simerville, a paediatrician at St. Mary-Corwin Hospital, has found that between 7 and 10 percent of newborns at the hospital are testing positive for THC, the mind-altering ingredient in cannabis.

Researchers have found that THC levels in babies lead to decreased spatial reasoning, I.Q., learning, and memory, as well as an increased risk for suicide and later drug use.

Marijuana use in pregnancy takes a toll, said Pamela McColl of British Columbia. She has eyewitness proof. Her sister, who was married to a longtime marijuana user, had a newborn baby who suffered a cerebral haemorrhage at three weeks old. Her sister’s two other children also experienced complications, including reproductive abnormalities and heart defects.

A 2015 study from the University of Copenhagen confirmed that male use of marijuana damages sperm and can lead to birth defects. “So nobody is going to tell me that this isn’t related to marijuana,” she told LifeZette. McColl has been working for years as national director of Smart Approaches to Marijuana in British Columbia in order to spread awareness of the health risks of marijuana. Related: The Heavy Price of Persistent Pot Smoking

Women have been a target market for marijuana use for a while. Whoopi Goldberg and Maya Elisabeth have been instrumental in pushing marijuana as a solution for menstrual cramps — and many government officials are listening. States such as New Jersey are moving to add menstrual cramps to the list of medically approved maladies that could be addressed with marijuana usage. Dispensaries and midwives have been peddling marijuana as a cure-all for morning sickness.

Warning labels on prescription medications, cigarette boxes, and other hazardous products help women understand the risks of casual usage during pregnancy. Pot products carry no such warning.

But using marijuana during pregnancy can lead to a myriad of health problems, including cerebral haemorrhage, spina bifida, Down syndrome — even babies who are born with only half a brain. Research from the University of Adelaide in South Australia shows that marijuana use even before conception can damage the foetus.

“The risk to the foetus is not only cognitive development damage, which shows up in the early preschool years, but also in DNA studies,” McColl explained. “So we’re seeing preliminary research now that shows that use of marijuana by men or women is detrimental to chromosomal health. You can see generational damage here. This is really quite terrifying. People who use marijuana — it may not just be their own children but their grandchildren. This is a 100-year problem we may now be facing.”

By not requiring warning labels on cannabis products, the government is leaving itself open to lawsuits. Warning labels on prescription medications, cigarette boxes, and other hazardous products help women understand the risks of casual usage during pregnancy. Marijuana products carry no such warning.

By not condemning the marijuana movement, the U.S. government violates the United Nations Drug Control Conventions and betrays its allies. “When I was at the U.N. in April, they reamed out the Americans, saying, ‘You cannot do this. We all agreed,’” McColl said. Sweden, Zimbabwe, Nigeria, and numerous other countries are worried that the U.S. drug industry would leak across to their borders and pose public health problems for their rising generations.

Nobody knows what will happen to the babies who are born THC-positive. Previous studies in the 1970s on THC-positive infants had levels around 2.5 percent; many of these infants today are measuring around 15 percent. “We don’t know what it means now,” Dr. Simerville said in a press conference about the marijuana crisis. He explained the brain doesn’t finish developing until the late twenties — and early exposure to cannabis will have devastating neurological effects on the developing brain.

There may not be enough research to document exactly what neurological trauma will occur for some of these babies. But McColl confirmed that the 20,000-plus scientific studies have shown clearly that cannabis is “unsafe for human consumption” and could cost taxpayers billions of dollars down the road in health care costs.

Source:  http://www.lifezette.com/healthzette/littlest-most-vulnerable-going-to-pot/  6th Nov.2016A

Teens who take opioid painkillers without a prescription also often use cannabis, according to a new study.

Researchers analyzed information from more than 11,000 children and teens ages 10 to 18, in 10 U.S. cities. Participants were asked whether they had used prescription opioids in the past 30 days, and whether they had ever used cannabis.

Overall, about 29 percent of the teens said they had used cannabis at some point in their lives. But among the 524 participants who said they had used prescription opioids in the past 30 days, nearly 80 percent had used cannabis. The findings show that among young opioid users, the prevalence of cannabis use is high, said Vicki Osborne, a doctoral student in epidemiology at the University of Florida. Osborne presented the study Oct. 31 at the meeting of the American Public Health Association in Denver.

Among teens who said they used opioids without a prescription (meaning they obtained the drugs through a friend, family member or other avenue), about 88 percent had used cannabis, compared with 61 percent of those who did have a prescription for the opioids they used.

The study also found that the teens who reported having used alcohol or tobacco in addition to opioids were much more likely to use cannabis as well. Of the participants who had used opioids, those who also reported recent alcohol use were nearly 10 times more likely to have used cannabis, compared with those who didn’t use alcohol recently. And those who currently smoked tobacco were 24 times more likely to have used cannabis than those who were not tobacco users, the study found.

Efforts to prevent young people who use opioid painkillers from also using cannabis should target those who use alcohol and tobacco, Osborne said. Efforts should also target males, who were more likely to report using cannabis than females were, she said.

Interventions should also target young people who use opioids without a prescription, Osborne said. Even though such use of opioids among youth is not as high as it is among adults, the proportion of youth using opioids without a prescription is still concerning, she said.

The researchers plan to study the data further, and look at when young people start using cannabis versus when they start using opioids, Osborne said. Previous studies have found that legalizing medical marijuana actually appears to lead to a reduction in opioid use among adults. However, Osborne said the new findings among youth may be different from those in adults, because even in states that have legalized the use of marijuana, the drug is still illegal for teens to use.

Source:  http://www.livescience.com/56784-teen-opioid-cannabis-use.html  7 Nov16

correspondence should be addressed; Norwegian Institute of Public Health, Department of Mental Disorders, PO Box 4404, Nydalen, N-0403 Oslo, Norway; tel: +47-21078373, fax: +47-22118470, e-mail: ragnar.nesvag@fhi.no

Abstract

To investigate contributions of genetic and environmental risk factors and possible direction of causation for the relationship between symptoms of cannabis use disorders (CUD) and psychotic-like experiences (PLEs), a population-based sample of 2793 young adult twins (63.5% female, mean [range] age 28.2 [19–36] y) were assessed for symptoms of CUD and PLEs using the Composite International Diagnostic Interview.

Latent risk of having symptoms of CUD or PLEs was modelled using Item Response Theory. Co-twin control analysis was performed to investigate effect of familiar confounding for the association between symptoms of CUD and PLEs.

Biometric twin models were fitted to estimate the heritability, genetic and environmental correlations, and direction for the association.

Lifetime use of cannabis was reported by 10.4 % of the twins, and prevalence of PLEs ranged from 0.1% to 2.2%. The incidence rate ratio of PLEs due to symptoms of CUD was 6.3 (95% CI, 3.9, 10.2) in the total sample and 3.5 (95% CI, 1.5, 8.2) within twin pairs.

Heritability estimates for symptoms of CUD were 88% in men and women, and for PLEs 77% in men and 43% in women. The genetic and environmental correlations between symptoms of CUD and PLEs were 0.55 and 0.52, respectively. The model allowing symptoms of CUD to cause PLEs had a better fit than models specifying opposite or reciprocal directions of causation. The association between symptoms of CUD and PLEs is explained by shared genetic and environmental factors and direct effects from CUD to risk for PLEs.

Source:  http://schizophreniabulletin.oxfordjournals.org/content/early/2016/07/18/schbul.sbw101

In this new era of legalized marijuana, far too little research has been conducted on the effect of cannabis on the development of human embryos, say researchers at Georgetown University Medical Center who scoured medical literature on the topic and found what they say is worrisome animal research.

Their study, in the journal BioMed Central (BMC) Pharmacology and Toxicology, suggests an urgent need for human epidemiological and basic research that examines the link between maternal cannabinoid use, either smoked or eaten in candy bars, and the health of newborns. Cannabinoids are chemicals like THC, the primary psychoactive compound in marijuana, that act on cannabinoid receptors in neurons, repressing the normal release of neurotransmitters.

“We know from limited human studies that use of marijuana in early pregnancy is associated with many of the same risks as tobacco, including miscarriage, birth defects, developmental delays and learning disabilities, but animal research suggests the potential for many more developmental issues linked with the drug,” says the study’s senior investigator, G. Ian Gallicano, PhD, associate professor of biochemistry and molecular & cellular biology at Georgetown.

Gallicano says one reason for limited research is that the classification of marijuana as a Schedule I drug creates challenges to conducting research.

“All of the model systems point to the notion that cannabinoids affects many aspects of human development because THC and other chemicals alter molecular pathways that shouldn’t be disrupted during development of a fetus,” he says. “We also know that THC is a promising agent for treating cancer, because it negatively affects tumor growth and can cause the death of cancer cells. Embryo development has similarities to tumor formation – it turns on growth pathways that are necessary for development,” Gallicano says. “The fact that THC seems to stop cancer growth suggests how damaging the chemical could be for a fetus.”

The study grew from a project of four current Georgetown medical students (Joseph Friedrich, Dara Khatib, Keon Parsa, and Ariana Santopietro) for a course, Sexual Development and Reproduction, taught by Gallicano. They undertook the analysis given that although four states have legal recreational marijuana use and 24 allow use of medical marijuana, little research has been conducted on outcomes from use of the drug in pregnancy and biological mechanisms that cause these issues.

The students reviewed the scientific literature for studies on cannabinoids and embryonic development published between 1975 and 2015. They cite the following findings:

* THC lasts in the body for weeks, especially in maternal tissues that act as reservoirs for THC and other cannabinoids, according to studies of pregnant dogs. Human cells studies have shown that THC has a half-life of eight days in fat deposits and can be detected in blood for up to 30 days;

* THC readily crosses the human placenta, which can slow clearance of the drugs while prolonging fetal exposure;

* THC levels in smoked marijuana have increased nearly 25-fold since 1970, and can be substantially stronger in edible preparations of cannabis; * THC and other cannabinoids interfere with use of folic acid (vitamin B9), which has long been known to be essential for normal development and growth of the human

placenta and embryo. Deficiencies in folic acid are linked to low human birth weight, increased risk of spontaneous abortion, and neural tube defects such as spina bifida.

* Cannabinoid signaling plays important roles in development of a mouse embryo. It is required for proper pre-implantation development, embryo transport to the uterus, and implantation.

* In post-implantation development, cannabinoid signaling functions in a multitude of pathways, including, but not limited to blood vessel growth, fate of embryonic stem cells, and normal cognitive development. For example, disruption of one key neural pathway, BDNF, has been linked to increased risk of congenital malformations and impaired cognition, including autism and low IQ in humans.

The authors also say the harms found in animal studies cited in this study do not include the damaged induced from the act of smoking marijuana.

No funding for the study was provided or sought. Article: The grass isn’t always greener: The effects of cannabis on embryological development, Joseph Friedrich, Dara Khatib, Keon Parsa, Ariana Santopietro and G. Ian Gallicano, BMC Pharmacology and Toxicology, doi: 10.1186/s40360-016-0085-6, published 29 September 2016.

Thanks to advances in science, we have never known so much about the effects marijuana use has on the human body, particularly, the fragile brain. Yet, in a political era when scientific research is regularly marshalled to end public policy debates, the powerful, growing scholarship on marijuana has largely been ignored or dismissed. Indeed, marijuana use seems to be one of the glaring areas in modern life where wishful thinking reigns over rationality.

Yet, as the lesson of tobacco demonstrates, when Americans are given the scientific facts about serious threats to their health, they adjust their behavior and insist on measures to safeguard their communities. In the instance of marijuana, the public can be forgiven for not knowing the true threat. With the assistance of a sympathetic media, marijuana legalization advocates, many seeking to profit off the drug, continue to sell romantic falsehoods and outright lies. They casually dismiss the growing list of serious concerns about marijuana emerging from scientific scholarship and survey research, or just cry “reefer madness” without examining the evidence.

Amidst the current marijuana public policy discussion, more than ever, concerned citizens, community leaders, lawmakers, educators, and parents need to better understand the growing body of research about this drug. What follows is a compilation and discussion of the latest research, including reports that are beginning to come in on the effects legalization has had in Colorado and neighbouring states—including increased criminal activity even with legalization. While all research has limitations, what we do know is becoming clearer by the day, and it will make many question what they thought they knew about this drug of abuse.

Key Recent Findings:

Journal of the American Medical Association: “There is little doubt about the existence of an association between substance use and psychotic illness…studies suggest that the association between cannabis use and later psychosis might be causal, a conclusion supported by studies showing that cannabis use is associated with an earlier age at onset of psychotic disorders, particularly schizophrenia.”

Society for the Study of Addiction: “Regular cannabis use in adolescence approximately doubles the risks of early school-leaving and of cognitive impairment and psychoses in adulthood. Regular cannabis use in adolescence is also associated strongly with the use of other illicit drugs

World Psychiatric Association: “Evidence that is a component cause of psychosis is now sufficient for public health messages outlining the risk, especially of regular use of high-potency cannabis and synthetic cannabinoids.”

American Academy of Paediatrics: “The adverse effects of marijuana have been well documented” and include “impaired short-term memory, decreased concentration, attention span, and problem solving” which “interfere[s] with learning.”

American Psychological Association: “Heavy marijuana use in adolescence or early adulthood has been associated with a dismal set of life outcomes including poor school performance, higher dropout rates, increased welfare dependence, greater unemployment and lower life satisfaction.”

Proceedings of the National Academy of Sciences: “Persistent adolescent-onset cannabis users” showed “an average 8-point IQ decline from childhood to adulthood.”

Clinical Psychological Science Journal: Duke University and UC Davis researchers “found that those dependent on cannabis experienced more financial difficulties, such as paying for basic living expenses and food, than those who were alcohol dependent.”

Journal of Drug and Alcohol Dependence: States that have legalized “medical” marijuana find an association with higher 12th grade drop-out rates, lessened college attainment, and increases in daily smoking. Further, there is a dose/response relationship between adverse impact and years of increased exposure under legalization.

U.S. Department of Health and Human Services, SAMHSA: Since legalizing marijuana, Colorado climbed to number one among states for both youth (12-17) and college age adults (18-25) marijuana use.

Discussion:

The further acceptance of marijuana legalization and commercialization in some states will lead to a greater availability of the drug. Greater availability and acceptance will lead to greater use of marijuana, both in the sense of more users, and likely further in the sense of more frequent and greater consumption.

In states that have legalized already there is strong evidence that adult use has surged upward. There is further evidence that use by youth will also increase.

Youth use of marijuana in states that have now commercialized sales was already more extensive than national norms, however, reports since the first commercialization began in January, 2014, indicate growing use amongst all age groups.

As marijuana use intensifies, the consequences of such use and abuse accelerates. These consequences are considerable, and will impose significant costs, both personal and economic, on health and social well-being.

Finally, and perversely, evidence is strong that the consequences will include not only continued, but intensified and entrenched criminal activity associated with drug use. Indications are clear that the criminal and violent black market capitalizes on increased marijuana availability and use. Marijuana commercialization/legalization is advancing both a public health and a public safety disaster.

We shall review recent evidence of the health-related consequences in this document. In a later accompanying document we will assess the impact on use of drugs beyond marijuana, as well as the impact on further criminal drug markets.

Though comparisons between marijuana and other substances of abuse are frequently made to the effect that marijuana is not proportionally lethal, there are nevertheless other measures of the drug’s dangers. Former National Institute on Drug Abuse Director Dr. Bob DuPont has termed marijuana “the most dangerous drug,” in part because of the sheer prevalence of what is the most widely used illegal substance in the world, and in part because the effects are not always felt or experienced by those affected. They can nevertheless be measured and are real. In some instances, research shows that they appear irreversible, even after abstinence.

Among the more troubling findings are those showing a relationship between marijuana use and psychotic episodes, diminished memory, verbal skill, and other cognitive performance, lowered life achievements, criminal and anti-social behavior, school leaving and academic failure, and even lowered life satisfaction.

Most concerning, perhaps, are the findings that heavy, early marijuana use is associated with a loss of intelligence over the life course. Specific supporting citations for other statements will be found below.

Further, Dr. Wayne Hall’s twenty-year review of the literature in the journal Addiction, as we will present in greater detail in the review, showed a clear relationship between youth marijuana use and subsequent use of other drugs. As Hall has argued:

The relationships between regular cannabis use and other illicit drug use have persisted after statistical adjustment for the effects of confounding variables in both longitudinal studies and discordant twin studies… The order of involvement with cannabis and other illicit drugs, and the increased likelihood of using other illicit drugs, are the most consistent findings in epidemiological studies of drug use in young adults.

In general, the health risks of marijuana use are reasonably well known, and based on long-standing research that now consists in multiple studies across many nations, exploring many dimensions of what is a very complex drug.

The last decade has witnessed an intensification of concern and stimulated even more studies of marijuana’s manifold impact, involving several areas of the body and the mind. The comprehensive nature of the physiological impact mirrors, to some extent, the widespread dispersal of the body’s naturally-occurring endocannabinoid receptor system.

There are additional physiological concerns, many based on smoking as the manner of consumption, focused on its effects on the cardiac and respiratory systems. These threats are real and mounting.

But the most compelling investigations regarding risk are emerging from studies of the brain, however the drug is consumed. These include both the structure and the functioning of the neurophysiology of the brain, and they further extend into discoveries regarding the consequences of brain activity, as we have mentioned, such as cognition, memory, learning, executive performance, and general behavior. Moreover, they also include examinations of drug dependency and what is termed “marijuana use disorder.”

That is, both the brain as an organ as well as “the mind,” the very personhood, of the individual are affected by the chemistry of the drug. Most concern is focused on the principle intoxicating element, THC , which shows signs of being actively toxic to the nervous system, the potency of which in modern forms is escalating dramatically under marijuana commercialization.

We must acknowledge that many studies demonstrate a risk that is emergent, and not fully known; multiple factors and confounders do coincide and must be accounted for before we argue “causation” for the effects that have been shown. Nevertheless, a substantial and repeated body of research that, taken piece by piece, showing “associations” or “correlations” or “predispositions,” must now be seen as sufficient, when taken together, to establish a clear and present danger.

In some measure, the worst effects are contingent, in the sense that not all forms of use by all individuals will produce the direst impact. But by now the evidence is compelling that certain forms of use, under certain circumstances, is deeply damaging.

Simply put, any honest observers must accept that the preponderance of evidence, as suggested by our review of recent literature which follows, demonstrates a high risk from marijuana use that is now overwhelming.

What we find is research from several related lines of inquiry, all pointing in the same direction. The risks are only worsening with time, in each line of inquiry, serving to confirm a congruence with the findings from other arena.

Studies of various marijuana disorders of behavior are being underpinned and given a basis by studies of the brain and its performance; showing consistent patterns from several interrelated domains of impact. Moreover, as over time the tools brought to bear have become more sophisticated and able to measure subtle and consequential effects, the sense of concern over what we are doing to youth is only mounting.

Though all users, even adult non-frequent users, have been shown to suffer some deficits through marijuana intoxication, and though there are further indications that even young adult casual users undergo structural brain changes, the evidence is far more robust and more worrying in other circumstances.

Danger increases, that is, when any of the following conditions are co-present with marijuana use: the existence of co-morbidities (or even predispositions), especially collateral substance dependencies or psychological deficits; certain genetic profiles that confer greater susceptibility; heavy, frequent use (daily use being the most threatening), especially of high-potency varieties; and especially exposure at a developmentally young age, during periods of highly consequential brain formation and calibration, generally ranging from prenatal or paediatric exposure up to young adulthood.

Where more than one of these factors is present, the risks escalate; where the developmentally young smoke high-potency cannabis frequently for an extended period – most markedly those with predisposing psychological deficits – the effects can be catastrophic in their lives, including dramatic “psychotic breaks.” These effects appear to be, in some cases, largely irreversible.

And it is this “worst-case scenario” that, perversely, is being fostered by state legalization and commercialization measures, thereby ensuring the greatest magnitude of damage.

A further implication of these facts concerns our emerging knowledge of the risks, given that most longitudinal studies showing long-term adult impacts were carried out without an appreciation of how the various factors above conferred greater vulnerability.

Often, studies that failed to find major impact were based on samples of adults, not adolescents, who were not exposed to heavy, frequent, newly-potent doses. Yet the commercialization of marijuana has resulted in marijuana potency that eclipses anything we have ever previously seen, in some cases by orders of magnitude. Highly potent “edibles” and concentrated cannabis extractions, like “shatter” are taking potency levels once common in the two- to three-percent range up to 80 percent. The consequence is that most everything we thought we knew about marijuana’s risks needs to be re-assessed under contemporary conditions, and most every danger, as we progressively uncover them, turns out to be heightened.

These finding are warnings of grave danger, with the promise of yet more to be discovered. Not all is “proven,” and not all establishes independent causation, but the evidence is strong enough, and growing daily, to activate in public policy a “precautionary principle.” That is, the evidence is strong enough to warrant a clear directive not to proceed further. Simply put, the pathway of legalization must not be pursued.

Recent Research and Findings: An Annotated Review

What has research over the past two decades revealed about the adverse health effects of recreational cannabis use? (full article), Addiction, (2014).

“Regular cannabis use in adolescence approximately doubles the risks of early school-leaving and of cognitive impairment and psychoses in adulthood. Regular cannabis use in adolescence is also associated strongly with the use of other illicit drugs.”

Unintentional Pediatric Exposures to Marijuana in Colorado: 2009-2015, Pediatrics, (2016).

“Annual pediatric marijuana cases increased more than 5-fold from 2009 (9) to 2015 (47). Colorado had an average increase in cases of 34% (P < .001) per year while the remainder of the United States had an increase of 19% (P < .001).”

Wants Marijuana Products to Have Warnings Against Use in Pregnancy, National Council on Alcoholism and Drug Dependence, (2015).

The American Medical Association seeks warnings against marijuana use in pregnancy.

Cannabis Use and Earlier Onset of Psychosis, Psychiatry, (2011).

“There is little doubt about the existence of an association between substance use and psychotic illness. National mental health surveys have repeatedly found more substance use, especially cannabis use, among people with a diagnosis of a psychotic disorder. There is a high prevalence of substance use among individuals treated in mental health settings,6 and patients with schizophrenia are more likely to use substances than members of the wider community. Prospective birth cohort and population studies suggest that the association between cannabis use and later psychosis might be causal, a conclusion supported by studies showing that cannabis use is associated with an earlier age at onset of psychotic disorders, particularly schizophrenia.”

The Impact of Marijuana Policies on Youth: Clinical, Research, and Legal Update, American Academy of Pediatrics, (2015).

“The adverse effects of marijuana have been well documented, and studies have demonstrated the potential negative consequences of short- and long-term recreational use of marijuana in adolescents. These consequences include impaired short- term memory and decreased concentration, attention span, and problem solving, which clearly interfere with learning. Alterations in motor control, coordination, judgment, reaction time, and tracking ability have also been documented; these may contribute to unintentional deaths and injuries among adolescents (especially those associated with motor vehicles if adolescents drive while intoxicated by marijuana).

Negative health effects on lung function associated with smoking marijuana have also been documented, and studies linking marijuana use with higher rates of psychosis in patients with a predisposition to schizophrenia have recently been published, raising concerns about longer-term psychiatric effects. New research has also demonstrated that the adolescent brain, particularly the prefrontal cortex areas controlling judgment and decision-making, is not fully developed until the mid-20s, raising questions about how any substance use may affect the developing brain. Research has shown that the younger an adolescent begins using drugs, including marijuana, the more likely it is that drug dependence or addiction will develop in adulthood. A recent analysis of 4 large epidemiologic trials found that marijuana use during adolescence is associated with reductions in the odds of high school completion and degree attainment and increases in the use of other illicit drugs and suicide attempts in a dose-dependent fashion that suggests that marijuana use is causative.”

American Academy of Pediatrics Reaffirms Opposition to Legalizing Marijuana for Recreational or Medical Use, American Academy of Pediatrics, (2015).

The American Academy of Pediatrics () reaffirms its opposition to legalizing marijuana, citing the potential harms to children and adolescents.

Half-Baked — The Retail Promotion of Marijuana Edibles, New England Journal of Medicine, (2015).

“Edibles that resemble sugary snacks pose several clear risks. One is over-intoxication….At high doses, can produce serious anxiety attacks and psychotic-like symptoms. This problem is augmented by differences in the pharmacokinetic and metabolic effects of marijuana when it is ingested rather than smoked. In addition, case reports document respiratory insufficiency in young children who have ingested marijuana.”

Adverse Health Effects of Marijuana Use, New England Journal of Medicine, (2014).

A review of the current state of the science related to the adverse health effects of the recreational use of marijuana, focusing on those areas for which the evidence is strongest.

A New England Journal of Medicine Article about Marijuana, Psychology Today, (2014) summarizes the adverse health effects as published in the New England Journal of Medicine.

UN: cannabis law changes pose ‘very grave danger to public health’, The Guardian, (2014).

United Nations International Narcotics Control Board warns of “very grave danger” from legalizing marijuana.

Damaging Effects of Cannabis Use on the Lungs, Advances in Experimental Medicine and Biology, (2016).

“Cannabis smoke affects the lungs similarly to tobacco smoke, causing symptoms such as increased cough, sputum, and hyperinflation. It can also cause serious lung diseases with increasing years of use. Cannabis can weaken the immune system, leading to pneumonia. Smoking cannabis has been further linked with symptoms of chronic bronchitis. Heavy use of cannabis on its own can cause airway obstruction. Based on immuno-histopathological and epidemiological evidence, smoking cannabis poses a potential risk for developing lung cancer.”

Marijuana use in adolescence may increase risk for psychotic symptoms, American Journal of Psychiatry, (2016).

Regular marijuana use significantly increased risk for subclinical psychotic symptoms, particularly paranoia and hallucinations, among adolescent males.

Heavy, persistent pot use linked to economic, social problems at midlife: Study finds marijuana not ‘safer’ than alcohol, Clinical Psychological Science, (2016).

Science Daily’s review of a research study that followed children from birth up to age 38 has found that people who smoked cannabis four or more days of the week over many years ended up in a lower social class than their parents, with lower-paying, less skilled and less prestigious jobs than those who were not regular cannabis smokers. These regular and persistent users also experienced more financial, work-related and relationship difficulties, which worsened as the number of years of regular cannabis use progressed.

The impact of adolescent exposure to medical marijuana laws on high school completion, college enrolment and college degree completion, Drug & Alcohol Dependence, (2016).

States that have legalized marijuana find an association with higher 12th grade drop out rates, lessened college attainment, and increases in daily smoking. Further, there is a dose/response relationship between adverse impact and years of increased exposure under legalization.

Early marijuana use associated with abnormal brain function, lower IQ, Lawson Health Research Institute, (2016).

“Previous studies have suggested that frequent marijuana users, especially those who begin at a young age, are at a higher risk for cognitive dysfunction and psychiatric illness, including depression, bipolar disorder and schizophrenia.”

Marijuana Users Have Abnormal Brain Structure and Poor Memory, Northwestern Medicine, (2013).

“Teens who were heavy marijuana users — smoking it daily for about three years — had abnormal changes in their brain structures related to working memory and performed poorly on memory tasks, reports a new Northwestern Medicine® study. A poor working memory predicts poor academic performance and everyday functioning. The brain abnormalities and memory problems were observed during the individuals’ early twenties, two years after they stopped smoking marijuana, which could indicate the long-term effects of chronic use. Memory-related structures in their brains appeared to shrink and collapse inward, possibly reflecting a decrease in neurons.”

Young adult sequelae of adolescent cannabis use: an integrative analysis, Lancet Psychiatry, (2014).

Adolescent cannabis use has adverse consequences in young adulthood:

“We recorded clear and consistent associations and dose-response relations between the frequency of adolescent cannabis use and all adverse young adult outcomes. After covariate adjustment, compared with individuals who had never used cannabis, those who were daily users before age 17 years had clear reductions in the odds of high-school completion…and degree attainment…, and substantially increased odds of later cannabis dependence…, use of other illicit drugs…, and suicide attempt.”

Traditional marijuana, high-potency cannabis and synthetic cannabinoids: increasing risk for psychosis, World Psychiatry, (2016).

“Evidence that [THC] is a component cause of psychosis is now sufficient for public health messages outlining the risk, especially of regular use of high-potency cannabis and synthetic cannabinoids.”

Monitoring Marijuana Use in the United States; Challenges in an Evolving Environment, (2016).

“Use of marijuana or any of its components, especially in younger populations, is associated with an increased risk of certain adverse health effects, such as problems with memory, attention, and learning, that can lead to poor school performance and reduced educational and career attainment, early-onset psychotic symptoms in those at elevated risk, addiction in some users, and altered brain development.”

Marijuana use and use disorders in adults in the , 2002–14: analysis of annual cross-sectional surveys, Lancet Psychiatry, (2016).

Commenting on this study to the Associated Press, Dr. Wilson Compton, Deputy Director of said, “if anything, science has shown an increasing risk that we weren’t as aware of years ago.” He added that other research has increasingly linked marijuana use to mental impairment, and early, heavy use by people with certain genes to increased risk of developing

psychosis.

Prenatal marijuana exposure, age of marijuana initiation, and the development of psychotic symptoms in young adults, Psychological Medicine, (2015).

Prenatal marijuana exposure linked to bad childhood outcomes; if effect is further “mediated” through early onset marijuana use, strong association with negative adult outcomes, such as arrest, low educational performance, unemployment.

One in six children hospitalized for lung inflammation positive for marijuana exposure, American Academy of Pediatrics, (2016).

Colorado: 16% of exposed children admitted to hospital for lung inflammation tested positive for MJ metabolite.

Cannabis use increases risk of premature death, American Journal of Psychiatry, (2016).

Cannabis use in youth increases the risk of early death.

Scientists Call for Action Amidst Mental Health Concerns, The Guardian, (2016).

“Most research on cannabis, particularly the major studies that have informed policy, are based on older low-potency cannabis resin.” According to Sir Robin Murray, professor of psychiatric research at King’s College London: “It’s not sensible to wait for absolute proof that cannabis is a component cause of psychosis. There’s already ample evidence to warrant public education around the risks of heavy use of cannabis, particularly the high-potency varieties. For many reasons, we should have public warnings.””

Marijuana use in adolescence may increase risk for psychotic symptoms, American Journal of Psychiatry, (2016).

Chronic marijuana use in adolescent boys increases risk of developing persistent subclinical psychotic symptoms (hallucinations, paranoia). “For each year adolescent boys engaged in regular marijuana use … subsequent symptoms increased by 21% and… paranoia or hallucinations increased by 133% and 92%, respectively. This effect persisted even when [study] participants stopped using marijuana for 1 year.”

Heavy, persistent pot use linked to economic, social problems at midlife, Clinical Psychological Science, (2016).

“Regular long-term [marijuana] users also had more antisocial behaviors at work, such as stealing money or lying to get a job, and experienced more relationship problems, such as intimate partner violence and controlling abuse.”

Effects of Cannabis Use on Human Behavior, Including Cognition, Motivation, and Psychosis: A Review, Psychiatry, (2016).

This longitudinal study documented adolescent-onset (but not adult-onset) persistent cannabis users showed neuropsychological decline ages 13 to 38 years. “Longitudinal investigations show a consistent association between adolescent cannabis use and psychosis. Cannabis use is considered a preventable risk factor for psychosis… strong

physiological and epidemiological evidence supporting a mechanistic link between cannabis use and schizophrenia… raise[s] the possibility that our current, limited knowledge may only apply to the ways in which the drug was used in the past.”

Marijuana use disorder is common and often untreated, National Institute of Health/NESARC, (2016).

“People with marijuana use disorder are vulnerable to other mental health disorders … onset of the disorder was found to peak during late adolescence. …People with marijuana use disorder…experience considerable mental disability. …Previous studies have found that such disabilities persist even after remission of marijuana use disorder.”

The health and social effects of nonmedical cannabis use, World Health Organization, (2016).

“There is a worrying increasing demand for treatment for cannabis use disorders and associated health conditions in high- and middle-income countries, and there has been increased attention to the public health impacts of cannabis use and related disorders in international policy dialogues.”

AKT1 genotype moderates the acute psychotomimetic effects of naturalistically smoked cannabis in young cannabis smokers, Translational Psychiatry, (2016).

“Smoking cannabis daily doubles an individual’s risk of developing a psychotic disorder, yet indicators of specific vulnerability have proved largely elusive. Genetic variation is one potential risk modifier.”

What’s That Word? Marijuana May Affect Verbal Memory, Internal Medicine, (2016).

Researchers found a “dose-dependent independent association between cumulative lifetime exposure to marijuana and worsening verbal memory in middle age.”

Adolescent Cannabinoid Exposure Induces a Persistent Sub-Cortical Hyper-Dopaminergic State and Associated Molecular Adaptations in the Prefrontal Cortex., Cerebral Cortex, (2016).

“We report that adolescent, but not adult, exposure induces long-term neuropsychiatric-like phenotypes similar to those observed in clinical populations…. findings demonstrate a profound dissociation in relative risk profiles for adolescent versus adulthood exposure to in terms of neuronal, behavioral, and molecular markers resembling neuropsychiatric pathology.”

Cannabis increases the noise in your brain, Biological Psychiatry, (2015).

“At doses roughly equivalent to half or a single joint, ∆9- produced psychosis-like effects and increased neural noise in humans. The dose-dependent and strong positive relationship between these two findings suggest that the psychosis-like effects of cannabis may be related to neural noise which disrupts the brain’s normal information processing activity.”

Marijuana Use: Detrimental to Youth, American College of Pediatricians, (2016).

“Marijuana is the leading illicit substance mentioned in adolescent emergency department admissions and autopsy reports, and is considered one of the major contributing factors leading to violent deaths and accidents among adolescents.”

Chronic Adolescent Marijuana Use as a Risk Factor for Physical and Mental Health Problems in Young Adult Men, Psychology of Addictive Behaviors, (2015).

Evidence suggests that youth who use marijuana heavily during adolescence may be particularly prone to health problems in later adulthood (e.g., respiratory illnesses, psychotic symptoms).

Developmental Trajectories of Marijuana Use among Men, Journal of Research in Crime and Delinquency, (2015).

“Young men who engage in chronic marijuana use from adolescence into their 20s are at increased risk for exhibiting psychopathic features, dealing drugs, and enduring drug-related legal problems in their mid-30s.”

Appraising the Risks of Reefer Madness, Cerebrum, (2015).

“Cannabis is generally accepted as a cause of schizophrenia (though less so in North America, where this topic has received little attention),” notes Dr. R. Murray, an Oxford University Professor of Psychiatry.

Prenatal exposure to cannabinoids evokes long-lasting functional alterations by targeting CB1 receptors on developing cortical neurons, Adán de Salas-Quiroga, (2015).

“Prenatal exposure to cannabinoids evokes long-lasting functional alterations by targeting CB1 receptors on developing cortical neurons.” “This study demonstrates that remarkable detrimental consequences of embryonic exposure on adult-brain function, which are evident long after withdrawal, are solely due to the impact of on CB1 receptors located on developing cortical neurons.” Embryonic exposure increased seizures in adulthood and the consequences of prenatal were lifelong; even though the cannabinoid receptors after withdrawal appear normal, there is an apparent impact on connectivity.

Association Between Use of Marijuana and Male Reproductive Hormones and Semen Quality: A Study Among 1,215 Healthy Young Men, American Journal of Epidemiology, (2015).

“Regular marijuana smoking more than once per week was associated with a 28% … lower sperm concentration and a 29% … lower total sperm count after adjustment for confounders.”

Is Marijuana Use Associated With Health Promotion Behaviors Among College Students? Health-Promoting and Health-Risk Behaviors Among Students Identified Through Screening in a University Student Health Services Center, Journal of Drug Issues, (2015).

“Results showed marijuana users were more likely to use a variety of substances and engage in hazardous drinking than non-users.”

Psychosocial sequelae of cannabis use and implications for policy: findings from the Christchurch Health and Development Study, Social Psychiatry and Psychiatric Epidemiology, (2015).

“Findings…suggest that individuals who use cannabis regularly, or who begin using cannabis at earlier ages, are at increased risk of a range of adverse outcomes, including: lower levels of educational attainment; welfare dependence and unemployment; using other, more dangerous illicit drugs; and psychotic symptomatology.”

Young brains on cannabis: It’s time to clear the smoke, Clinical Pharmacology and Therapeutics, (2015).

“There is certainly cause for concern about the amount and frequency of cannabis use among youth….Recent evidence shows that early and frequent use of cannabis has been linked with deficits in short-term cognitive functioning, reduced IQ, impaired school performance, and increased risk of leaving school early – all of which can have significant consequences on a young person’s life trajectory….Heavy cannabis use in adolescence is also a risk factor for psychosis….Youth aged 15-24 spent the largest number of days in a hospital for a primary diagnosis of mental and behavioral disorders due to the use of cannabinoids.”

Association Between Lifetime Marijuana Use and Cognitive Function in Middle Age and Long-term Marijuana Use and Cognitive Impairment in Middle Age, Internal Medicine, (2016).

“These studies have generally shown reduced activity in those with long-term marijuana use in brain regions involved in memory and attention, as well as structural changes in the hippocampus, prefrontal cortex, and cerebellum.”

Denial of Petition To Initiate Proceedings To Reschedule Marijuana, Federal Register/DEA Review of “Scientific Evidence of [Marijuana’s] Pharmacological Effects, If Known”, (2016).

“Individuals with a diagnosis of marijuana misuse or dependence who…initiated marijuana use before the age of 15 years, showed deficits in performance on tasks assessing sustained attention, impulse control, and general executive functioning compared to non-using controls. These deficits were not seen in individuals who initiated marijuana use after the age of 15 years…. Additionally, in a prospective longitudinal birth cohort study of 1,037 individuals, marijuana dependence or chronic marijuana use was associated with a decrease in IQ and general neuropsychological performance compared to pre-marijuana exposure levels in adolescent onset users.

The decline in adolescent-onset users’ IQ persisted even after reduction or abstinence of marijuana use for at least 1 year…. The deficits in IQ seen in adolescent-onset users increased with the amount of marijuana used. Moreover, when comparing scores for measures of IQ, immediate memory, delayed memory, and information-processing speeds to pre-drug-use levels, the current, heavy, chronic marijuana users showed deficits in all three measures.”

The health and social effects of nonmedical cannabis use, World Health Organization, (2016).

“Cannabis is globally the most commonly used psychoactive substance under international control. In 2013, an estimated 181.8 million people aged 15−64 years used cannabis for nonmedical purposes globally (uncertainty estimates 128.5–232.1 million) (UNODC, 2015). There is a worrying increasing demand for treatment for cannabis use disorders and associated health conditions in high- and middle-income countries, and there has been increased attention to the public health impacts of cannabis use and related disorders in international policy dialogues.[…] This publication builds on contributions from a broad range of experts and researchers from different parts of the world. It aims to present the current knowledge on the impact of nonmedical cannabis use on health.”

Source:  https://hudson.org/research/12975-marijuana-threat-assessment-part-one-recent-evidence-for-health-risks-of-marijuana-use

In  2014, an estimated 22.2 million Americans aged 12 years or older had used marijuana in the past month.1

Under federal law, marijuana is considered an illegal Schedule I drug. However, over the last 2 decades, more than half of the states have allowed limited access to marijuana or its components, Δ9-tetrahydrocannabinol (THC) and cannabidiol, for medical reasons.2 More recently, 4 states and the District of Columbia have legalized marijuana for recreational purposes.

Currently, evidence for the therapeutic benefits of marijuana are limited to treatment and improvements to certain health conditions (eg, chronic pain, spasticity, nausea).3 Recreational use of marijuana is established by patterns of individual behaviors and lifestyle choices. In either case, use of marijuana or any of its components, especially in younger populations, is associated with an increased risk of certain adverse health effects, such as problems with memory, attention, and learning, that can lead to poor school performance and reduced educational and career attainment, early-onset psychotic symptoms in those at elevated risk, addiction in some users, and altered brain development.4- 7

In September 2016, the Substance Abuse and Mental Health Services Administration and the Centers for Disease and Control and Prevention (CDC) released an issue of the CDC’s Morbidity and Mortality Weekly Report—Surveillance Summary describing historical trends in marijuana use and related indicators among the non-institutionalized civilian population aged 12 years or older using 2002-2014 data from the National Survey on Drug Use and Health (NSDUH).8

During the last 13 years, marijuana access (ie, perceived availability) and use (ie, past-month marijuana use) have steadily increased in the United States, particularly among people aged 26 years or older, increasing from 54.9% in 2002 to 59.2% in 2014 and from 4.0% in 2002 to 6.6% in 2014, respectively. The factors associated with the national behavior patterns of marijuana use cannot be attributed solely to the heterogeneous body of state laws and policies that vary considerably with respect to year of enactment, implementation lag time, and access stipulations.

However, as state laws and policies continue to evolve, these data will be useful as a baseline to monitor changes in patterns of use and associated variables. Monitoring behavioral patterns is important given the possible increased risk of adverse health consequences due to potency changes—higher concentrations of THC (the psychoactive compound)—of the cannabis plant in the United States in the last 2 decades.9

Estimates from NSDUH data suggest that in 2014, 2.5 million persons aged 12 years or older had used marijuana for the first time within the past 12 months; this projected estimate suggests that there is an average of about 7000 new users each day (approximately 1000 more new users each day in 2014 compared with in 2002). In 2014, mean age at first use of marijuana was 19 years among persons aged 12 years or older and was 15 years among persons aged 12 to 17 years.8

During 2002-2014, the estimated prevalence of marijuana use in the past month, in the past year, and daily or almost daily increased among persons aged 18 years or older but

not among those aged 12 to 17 years, while the perceived risk from smoking marijuana decreased across all age groups. Conversely, the estimated prevalence of past-year marijuana dependence decreased from 1.8% in 2002 to 1.6% in 2014 among all persons aged 12 years or older and from 16.7% in 2002 to 11.9% in 2014 among past-year marijuana users.

Overall, the perceived availability to obtain marijuana among persons aged 12 years or older increased, and acquiring marijuana by buying the drug and growing it increased vs obtaining marijuana for free and sharing the drug. The percentage of persons aged 12 years or older perceiving that the maximum legal penalty for the possession of 1 oz or less of marijuana in their state of residence is a fine and no penalty increased vs perceptions that penalties included probation, community service, possible prison sentence, and mandatory prison sentence.8

These findings on perceived availability to obtain marijuana and fewer punitive legal penalties (eg, no penalty) for the possession of marijuana for personal use may play a role in the observed increased prevalence in use among adults in the United States. However, surveillance data do not reveal causal relationships; therefore, more granular research is needed.

As states adopt policies that increase legal access to marijuana, new indicators will be needed to understand trends in marijuana use and the risk of health effects. Questions regarding mode of use (eg, smoked, vaped, dabbed, eaten, drunk), frequency of use, potency of marijuana consumed, and reasons for use (ie, medical use, recreational use, or both) could be added to existing surveillance systems or launched in new systems.

Traditionally, understanding factors underlying the trends in marijuana use have been assessed by looking at 1 or 2 indicators (eg, perception of harm risk or dependence or abuse). A multivariable approach that includes environmental (eg, law enforcement, laws/policies) and cultural (eg, religion, individual choice) factors might be required to understand the relationship between the perceptions and attitudes toward marijuana and use behavior.

The health effects associated with marijuana use are still widely debated. Nonetheless, marijuana use during early stages of life, when the brain is developing, poses potential public health concerns, including reduced educational attainment, addiction in some users, poor education outcomes, altered brain structure and function, and cognitive impairment.4- 7

Given these potential health and social consequences of marijuana use, additional data sources at the federal and state levels may be required to assess the public health effects of marijuana use. These sources may include data from sectors such as health care (eg, emergency department data), criminal justice (eg, law enforcement data), education (eg, school attendance and performance data), and transportation (eg, motor vehicle injury data).

Assessing the prevalence and public health effects of marijuana use in the United States remains important given the evolving policies for marijuana for medical or recreational use at the state level. Therefore, it is vital to continue to monitor key traditional marijuana indicators but also to enhance public health surveillance to include monitoring of indicators that assess emerging issues so that public health actions could prevent adverse health consequences.

Given that legislation, types of products, use patterns, and evidence for potential harms and benefits of marijuana and its compounds are all evolving, clinicians need to understand the magnitude of marijuana use and associated behaviors so they can provide informed answers to patient questions, screen, counsel, treat, and refer patients to community treatment or counseling centers if abuse or adverse effects are identified.

Source: JAMA. 2016;316(17):1765-1766. doi:10.1001/jama.2016.13696

* Cannabis impairs cognitive and psychomotor performances.

* An 8-h delay after maximal effects is recommended for cannabis self-treatment.

* Blood THCCOOH level >40 μg/l suggests regular cannabis use and long-term impairment.

* No correlation was found between psychomotor task performance and THC blood levels.

* Acute cannabis consumption nearly doubles the risk of a collision.

Abstract

Traffic policies show growing concerns about driving under the influence of cannabis, since cannabinoids are one of the most frequently encountered psychoactive substances in the blood of drivers who are drug-impaired and/or involved in accidents, and in the context of a legalization of medical marijuana and of recreational use.

The neurobiological mechanisms underlying the effects of cannabis on safe driving remain poorly understood. In order to better understand its acute and long-term effects on psychomotor functions involved in the short term ability and long-term fitness to drive, experimental research has been conducted based on laboratory, simulator or on-road studies, as well as on structural and functional brain imaging.

Results presented in this review show a cannabis-induced impairment of actual driving performance by increasing lane weaving and mean distance headway to the preceding vehicle. Acute and long-term dose-dependent impairments of specific cognitive functions and psychomotor abilities were also noted, extending beyond a few weeks after the cessation of use.

Some discrepancies found between these studies could be explained by factors such as history of cannabis use, routes of administration, dose ranges, or study designs (e.g. treatment blinding). Moreover, use of both alcohol and cannabis has been shown to lead to greater odds of making an error than use of either alcohol or cannabis alone. Although the correlation between blood or oral fluid concentrations and psychoactive effects of THC needs a better understanding, blood sampling has been shown to be the most effective way to evaluate the level of impairment of drivers under the influence of cannabis. The blood tests have also shown to be useful to highlight a chronic use of cannabis that suggests an addiction and therefore a long-term unfitness to drive. Besides blood, hair and repeated urine analyses are useful to confirm abstinence

Source:  Elsevier Journal Alerts Volume 268, Pages 92–102  November 2016

A research team from the University of Edinburgh examined data from 284 adults who attended primary care centers in the United Kingdom between 2011 and 2013.  Some 170 were marijuana users, 114 smoked cigarettes but did not use marijuana. Heavy users had smoked marijuana 47,000 times in their lifetime; occasional users averaged about 1,000 times. Using a special x-ray process, researchers examined study participants’ bone density and found the heavy marijuana users had a 5 percent lower bone density than nonusers.  “We have known for a while that the components of cannabis can affect bone cell function, but we had no idea up until now of what this might mean to people who use cannabis on a regular basis. Our research has shown that heavy users of cannabis have quite a large reduction in bone density compared with nonusers, and there is a real concern that this may put them at increased risk of developing osteoporosis and fractures later in life,” said the team’s leader, Professor Stuart Ralston. The team says more research is needed to confirm this association.

Source:  National Families in Action’s The Marijuana Report srusche=nationalfamilies.org@mail145.atl121.mcsv.net   19th Oct 2016

This November, several states will vote on whether to legalize marijuana for recreational use, and the proponents of legalization have seized on a seemingly clever argument: marijuana is safer than alcohol.  The Campaign to Regulate Marijuana Like Alcohol, an effort of the Marijuana Policy Project (or MPP), has taken this argument across the country.  Their latest strategy is labelled Marijuana vs. Alcohol.  It is a very misleading, even dangerous, message, based on bad social science and sophistic public deception. Citing out-of-date studies that go back ten years and more, even using that well-known scientific journal, Wikipedia, the MPP never references current research on the harms of today’s high potency and edible marijuana, studies that come out monthly if not more frequently.  Indeed, their Marijuana vs. Alcohol page concludes with a 1988 statement about the negligible harms of marijuana—but that is a marijuana that simply does not exist anymore, neither in mode nor potency.  Today’s marijuana is at least five times more potent, and sold in much different form.  And the science of marijuana and its effects on the brain have come some distance since 1988 as well.

So out-of-date is the science and knowledge of marijuana from thirty years ago, it would be malpractice in any other field to suggest that kind of information about a drug having any contemporary relevance at all.  One almost wonders if the MPP thinks public health professors still instruct their students on how to use microfiche to perform their research as they prepare to write their papers on 5k memory typewriters.

It is simply misleading in a public health campaign to cite dated research while at the same time ignore a larger body of current evidence that points in the opposite direction of a desired outcome.  At great potential peril to our public health, political science (in the hands of the marijuana industry) is far outrunning medical science.  But the danger is clear: with the further promotion, marketing, and use of an increasingly known dangerous substance, public health and safety will pay the price.

Consider three basic problems with the industry’s latest campaign:

I.  Comparisons of relative dangers of various drugs are simply impossible and can often lead to paradoxical conclusions.  It is impossible to compare a glass of chardonnay and its effects on various adults of various weights and tolerance levels with the inhalation or consumption of a high-potency marijuana joint or edible.  Is the joint from the 5 percent THC level or the 25 percent level?  How about a 30 mg—or stronger—gummy bear?  A glass of wine with dinner processes through the body in about an hour and has little remaining effect.  A marijuana brownie or candy can take up to 90 minutes to even begin to take effect.

Consider a consumer of a glass of wine who ate a full meal and waited an hour or more before driving and a consumer of a marijuana edible taking the wheel of a plane, train, automobile, or anything else.  The wine drinker would likely be sober, the marijuana consumer would just be getting high, and, given the dose, possibly very high at that.

True, marijuana consumption rarely causes death, but its use is not benign.  Last year, an ASU professor took a standard dose of edible marijuana, just two marijuana coffee beans. The effect?  “Episodes of convulsive twitching and jerking and passing out” before the paramedics were called.  Such episodes are rare for alcohol, but they are increasingly happening with marijuana.

Beyond acute effects, the chronic impact of marijuana is also damaging.  Approximately twice the percentage of regular marijuana users will experience Marijuana Use Disorder than will alcohol users experience Alcohol Use Disorder—both disorders categorized by the Diagnostic Statistics Manual (DSM).[1]   Marijuana is also the number one substance of abuse for teens admitted to treatment, far higher than the percentage who present with alcohol problems.  In fact, the most recent data out of Colorado shows 20 percent of teens admitted for treatment have marijuana listed as their primary substance of abuse compared to less than one percent for alcohol.

Still, the Campaign persists in its deceptions—as if they have not even read their own literature.  One online marketing tool it recently deployed was the “Consume Responsibly” campaign.  Delve into that site and you will find this warning: “[Smoked marijuana] varies from person to person, you should wait at least three to four hours before driving a vehicle.”  And: “Edible marijuana products and some other infused products remain in your system several hours longer, so you should not operate a vehicle for the rest of the day after consuming them.”  Who has ever been told that they should not operate a vehicle for four hours, much less for the rest of the day, if they had a glass of wine or beer?  Safer than alcohol?  This is not even true according to the MPP’s own advice.

Beyond unscientific dose and effect comparisons, there is a growing list of problems where marijuana use does, indeed, appear to be more harmful than alcohol.  According to Carnegie Mellon’s Jonathan Caulkins: “Marijuana is significantly more likely to interfere with life functioning” than alcohol and “it is moderately more likely to create challenges of self-control and to be associated with social and mental health problems.” Additionally, a recent study out of UC Davis revealed that marijuana dependence was more strongly linked to financial difficulties than alcohol dependence and had the same impacts on downward mobility, antisocial behavior in the workplace, and relationship conflict as alcohol.

II.  The marijuana industry pushes and promotes the use of a smoked or vaped substance, but never compares marijuana to tobacco.  Indeed, the two substances have much more in common than marijuana and alcohol, especially with regard to the products themselves and the method of consumption (though we are also seeing increasing sales of child-attractive marijuana candies).  But why is the comparison never made?  The answer lies in the clear impossibility.

Consider: Almost every claim about marijuana’s harms in relation to alcohol has to do with the deaths associated with alcohol.  But, hundreds of thousands more people die from tobacco than alcohol.  Based on their measures of mortality, which is safer: alcohol or tobacco?  Can one safely drink and drive?  No.  Can one smoke as many cigarettes as one wants while driving?  Of course. So, what’s the more dangerous substance?  Mortality does not answer that question.

Alcohol consumption can create acute problems, while tobacco consumption can create chronic problems.  And those chronic problems particularly affect organs like the lungs, throat, and heart.  But what of the chronic impact on the brain?  That’s the marijuana risk, and, seemingly, society is being told that brains are less important than lungs.  Nobody can seriously believe that, which is why these comparisons simply fail scrutiny.

This illustrates but one of the problems in comparing dangerous substances. As Professor Caulkins recently wrote:

The real trouble is not that marijuana is more or less dangerous than alcohol; the problem is that they are altogether different….The country is not considering whether to switch the legal statuses of alcohol and marijuana. Unfortunately, our society does not get to choose either to have alcohol’s dangers or to have marijuana’s dangers. Rather, it gets to have alcohol’s dangers…and also marijuana’s dangers. Further, marijuana problems are associated with alcohol problems.  New research out of Columbia University reveals that marijuana users are five times more likely to have an alcohol abuse disorder.  Society doesn’t just switch alcohol for marijuana—too often, one ends up with use of both, compounding both problems.

The larger point for voters to understand:  The marijuana legalization movement is not trying to ban or end alcohol sales or consumption; rather, it wants to add marijuana to the dangerous substances already available, including alcohol.  This is not about marijuana or alcohol, after all.  It’s about marijuana and alcohol. We can see this effect in states like Colorado, with headlines such as “Alcohol sales get higher after weed legalization.”  And, according to the most recent federal data [2], alcohol use by teens, as well as adults, has increased in Colorado since 2012 (the year of legalization). If alcohol is the problem for the MPP, in their model state–Colorado–alcohol consumption has increased with marijuana legalization.  Legalizing marijuana will, in the end, only make alcohol problems worse. III.  The legalization movement regularly cites to one study in the Journal of Scientific Reports to “prove” that marijuana is safer than alcohol.  But this study leads to odd conclusions in what the authors, themselves, call a “novel risk assessment methodology.”  For instance, the researchers find that every drug, from cocaine to meth to MDMA to LSD, is found to be safer than alcohol. (See this graph).  By the MPP standard, we should thereby make these substances legal as well.  But, seeing such data in its full light, we all know this would be nonsensical.

Further, the authors specifically write that they only looked at acute effects and did not analyze “chronic toxicity,” and cannot judge marijuana and “long term effects.”  Indeed, they specifically write in their study the toxicity of marijuana“may therefore be underestimated” given the limitations of their examination.  Yet legalizers ignore these statements.  Always.  It simply does not fit their narrative. What long-term effects are we talking about?  To cite the New England Journal of Medicine: “addiction, altered brain development, poor educational outcomes, cognitive impairment,” and “increased risk of chronic psychosis disorders.”  Now think about what it will mean to make a drug with those adverse effects more available, and for recreational use.

Finally, the very authors of the much-cited Journal of Scientific Reports study specifically warn their research should be “treated carefully particularly in regard to dissemination to lay people….especially considering the differences of risks between individuals and the whole population.”  But this is precisely what commercialization is about—not individual adult use but making a dangerous drug more available to “the whole population.”

Given what we know in states like Colorado, we clearly see that legalization creates more availability which translates into more use, affecting whole populations—Colorado college-age use, for example, is now 62 percent higher than the national average. [See FN2, below]. And the science is coming in, regularly.  Indeed, the same journal the MPP points to in its two-year old “novel” study, just this year published another study and found:

Neurocognitive function of daily or near daily cannabis users can be substantially impaired from repeated cannabis use, during and beyond the initial phase of intoxication. As a consequence, frequent cannabis use and intoxication can be expected to interfere with neurocognitive performance in many daily environments such as school, work or traffic.

That is why these comparisons of safety and harm are—in the end—absurd and dangerous.  In asking what is safer, the true answer is “neither.”  And for a variety of reasons.  But where one option is impossible to eliminate (as in alcohol), society should not add to the threat that exists:  One doesn’t say because a playground is near train tracks you should also put a highway there.  You fence off the playground.

That, however, is not the choice the MPP has given us.  They are not sponsoring legislation to reduce the harms of alcohol, they are, instead, saying that with all the harms of alcohol, we should now add marijuana.  But looking at all the problems society now has with substance abuse, the task of the serious is to reduce the problems with what already exists, not advance additional dangers.

If the MPP and its Campaigns to Regulate Marijuana Like Alcohol are serious about working on substance abuse problems, we invite them to join those of us who have labored in these fields for years.  One thing we do know: adding to the problems with faulty arguments, sloppy reasoning, and questionable science, will not reduce the problems they point to.  It will increase them.  And that, beyond faulty argument and sloppy reasoning, is public policy malfeasance. [1] See http://archpsyc.jamanetwork.com/article.aspx?articleid=2464591 compared to http://archpsyc.jamanetwork.com/article.aspx?articleid=2300494

Source:  http://amgreatness.com/2016/09/25/lie-travels-comparing-alcohol-marijuana/  Sept 25th 2016

If you smoke weed for five years or more, on a daily basis, prepare to lose your eloquence. A study by a team of researchers from the University of Lausanne in Switzerland, published earlier this year, found that people who smoked marijuana on a daily basis for a long period of time had poorer verbal memory in their middle age, than others.

This occurred when controlling for a number of other factors, such as age, education, other substance use and mental health issues.  The team found that the relationship between marijuana use and memory problems was fairly direct – that the more pot people smoked, the worse they performed in memory tests.

Although the difference wasn’t stark over five years – the more years for which you smoke daily the more you compound the issue.  However, few people reach these levels of exposure – of the 3,385 study subjects, only 311 had more than five marijuana years’ (if you smoke pot every day for a year) worth of exposure.

The upshot? Other cognitive abilities didn’t seem to be significantly affected by heavy cannabis use, such as ability to focus and problem solving speed.  Testimony from people who have decided to quit the drug has previously supported these findings. Stuart Angel told news.com.au:

Even when I smoked, I always had a great long term memory.

But my short term memory has really suffered. When I was smoking, I would say something, and then get distracted. I couldn’t focus when I smoked, not even for 10 minutes. Now I can focus for much longer periods of time. A reddit user also posted on the r/trees subreddit a lengthy post explaining his motives for quitting:

I’ve missed a lot of things because of it. Chief among these is my memory: often, when discussing a film with people, I’ve had to admit that I couldn’t really remember it because I was stoned when I watched it the first time. Often, when watching television with my girlfriend, I would ask, ‘Who the hell is this character?’ and she would reply, ‘That’s the protagonist. It’s the main character.’ Oops. I guess I was in my own world.

You are your memories, your past experiences, and an enormously high percentage of my memories were stoned. Thus, even when I wasn’t high, weed was affecting who I was, and who I could become.

Source: https://www.indy100.com/article/what-happens-when-you-smoke-weed-every-day-for-5-years-7347796     Oct.2010

1.  Marijuana use creates neurocognitive impairments and cannabis intoxication in both frequent and infrequent users. –Journal of Scientific Reports, May 2016. (Cannabis and Tolerance: Acute Drug Impairment as a Function of Cannabis Use History).

2. Prevalence of cannabis use is expected to increase if cannabis is legal to use and legally available. –International Journal of Drug Policy, May 2016 (Correlates of Intentions to Use Cannabis among US High School Seniors in the Case of Cannabis Legalization).

3. Regular exposure to cannabis is associated with neuroanatomic alterations in several brain regions. –Journal of Biological Psychiatry, April 2016  (The Role of Cannabinoids in Neuroanatomic Alterations in Cannabis Users).

4. Marijuana is addicting, has adverse effects upon the adolescent brain, is a risk for both cardio-respiratory disease and testicular cancer, and is associated with both psychiatric illness and negative social outcomes. –Statement of the American College of Pediatricians, April 2016 (Marijuana Use: Detrimental to Youth).

5. Marijuana use has significant neuropharmacologic, cognitive, behavioral, and somatic   consequences. –Statement of the American Academy of Pediatrics, March 2015 (The Impact of Marijuana Policies on Youth: Clinical, Research, and Legal Update).

6. Marijuana use is associated with increased incidence and worsened course of psychotic, mood, anxiety, and substance use disorders across the lifespan….and marijuana’s deleterious effects on adolescent brain development, cognition, and social functioning may have immediate and long-term implications. –Statement of the American Academy of Child & Adolescent Psychiatry, 2014 (AACAP Marijuana Legalization Policy Statement).

7. Marijuana use may cause impairment in memory, concentration, and executive  functioning…and may lead to permanent nervous system toxicity. –Statement of the American Academy of Neurology (Position Statement: Use of Medical Marijuana for Neurologic Disorders).

8. There is a strong association of cannabis use with the onset of psychiatric disorders. Adolescents are particularly vulnerable to harm, given the effects of cannabis on neurological development. –Statement of the American Psychiatric Association (Position Statement on Marijuana as Medicine).

9. Both marijuana-related hospitalizations and ED visits have increased substantially in recent years. –Newsletter of the American College of Physicians, January 2016 (Public Health Researchers Look at Rise in Marijuana-related Hospitalizations).

10. Cannabis dependence is not associated with fewer harmful economic and social

problems than alcohol dependence. –Journal of Clinical Psychological Science, June 2016 (Persistent Cannabis Dependence and Alcohol Dependence Represent Risks for Midlife Economic and Social Problems:  A Longitudinal Cohort Study.)

11. Repeated exposure to cannabis during adolescence may have detrimental effects on brain resting functional connectivity, intelligence, and cognitive function. –Journal of the Cerebral Cortex, February 2016 (Adverse Effects of Cannabis on Adolescent Brain Development: A Longitudinal Study).

12. Negative health effects of marijuana use can include addiction, abnormal brain development, psychosis, and other negative outcomes. –New England Journal of Medicine, June 2014 (Adverse Health Effects of Marijuana Use).

13. One in six infants and toddlers admitted to a Colorado hospital with coughing, wheezing and other symptoms of bronchiolitis tested positive for marijuana exposure. –American Academy of Pediatrics, April 2016 (One in Six Children Hospitalized for Lung Inflammation Positive for Marijuana Exposure).

14. Study respondents who were high had higher odds driving while intoxicated (on either marijuana or alcohol). –Journal of Health Education Research, April 2016 (Association Between Self-reports of Being High and Perceptions About the Safety of Drugged and Drunk Driving).

15. Cannabis use during adolescence increases the risk of developing a psychiatric disorder in adulthood, including anxiety, depression, and schizophrenia. –Frontiers in Neuroscience, November 2014.  (Long-term Consequences of Adolescent Cannabinoid Exposure in Adult Psychopathology).

16. Childhood exposure to marijuana increases in marijuana friendly states and can lead to coma, decreased breathing, or seizures. –Journal of Clinical Pediatrics, June 2015, (Marijuana Exposure Among Children Younger Than Six Years in the United States).

17. Use of marijuana in adolescence found to increase developing psychosis, schizophrenia, anxiety, and depression in adulthood. –Boston Children’s Hospital/Harvard Medical School, 2014 (Marijuana 101, Dr. Sharon Levy).

18. Cannabis use may cause enduring neuropsychological impairment that persists beyond the period of acute intoxication. –Proceedings of the National Academy of Sciences, July 2012. (Persistent Cannabis Users Show Neuropsychological Decline from Childhood to Midlife).

19. Cannabis use disorder is prevalent, associated with comorbidity and disability, and largely untreated. –The American Journal of Psychiatry, March 2016. (Prevalence and Correlates of DSM-5 Cannabis Use Disorder, 2012-2013: Findings from the National Epidemiologic Survey on Alcohol and Related Conditions–III).

20. We recorded clear and consistent associations and dose-response relations between the frequency of adolescent cannabis use and all adverse young adult outcomes. –The Lancet-Psychiatry, September 2014.  (Young Adult Sequelae of Adolescent Cannabis Use: An Integrative Analysis).

21. While marijuana may be safer than alcohol in some respects, there are important dimensions along which marijuana appears to be the riskier substance. –Carnegie Mellon Research/Jonathan P. Caulkins, October 2014. (Is Marijuana Safer than Alcohol? Insights from Users’ Self-Reports).

22. Potential impacts of recreational marijuana include not only increased availability, resulting in ED visits for acute intoxicating effects of marijuana use, but also effects on mental health disorders and psychiatric-related illnesses. –American College of Emergency Physicians/ACEP NOW, October 2014. (How Legalizing Marijuana Has Impacted Colorado).

23. Marijuana changes the structure and function of the adolescent brain. –Bertha Madras, Professor of Psychobiology, Harvard University, May 2014.  (Marijuana and Opioids Risks for the Unborn, the Born).

24. Dramatic increase in newborns testing positive for marijuana in Colorado hospitals.

–Parkview Medical Center, St. Mary-Corwin Medical Center, Pueblo Community Health Center, April 2016. (Recreational Retail Marijuana Endangers Health of Community & Drains Precious Health Resources).

25. Casual use of marijuana is related to major brain changes. –Journal of Neuroscience, April 2014.  (Cannabis Use Is Quantitatively Associated with Nucleus Accumbens and Amygdala Abnormalities in Young Adult Recreational Users).

26. It needs to be emphasized that regular cannabis use, defined here as once a week, is not safe and may result in addiction and neurocognitive damage, especially in youth. –Journal of Current Addiction Reports, April 2014. (Considering Cannabis: The Effects of Regular Cannabis Useon Neurocognition in Adolescents and Young Adults).

27. Exposure to cannabis in adolescence is associated with a risk for later psychotic disorder in adulthood. –Journal of Current Addiction Reports, June 2014.  (Impact of Cannabis Use on the Development of Psychotic Disorders).

28. Marijuana is not benign and there’s a mountain of scientific evidence, compiled over nearly 30 years, to prove it poses serious risks, particularly for developing brains.

–Diane McIntosh, Professor of Psychiatry-University of British Columbia, April 2016.  (You Can’t Deny Marijuana Is Dangerous For Developing Minds).

28. Marijuana may actually worsen PTSD symptoms or nullify the benefits of specialized, intensive treatment. Cessation or prevention of use may be an important goal of treatment. –Journal of Clinical Psychiatry, September 2015.  (Marijuana Use is Associated With Worse Outcomes in Symptom Severity and Violent Behavior in Patients With Posttraumatic Stress Disorder).

29. Converging epidemiological data indicate that adolescent cannabis abusers are more likely to develop psychosis and PFC-related cognitive impairments later in life. –Journal of Molecular Psychiatry, March 2014. (CB1 Cannabinoid Receptor Stimulation During Adolescence Impairs the Maturation of GABA Function in the Adult Rat Prefrontal Cortex).

30. Regular cannabis use in adolescence approximately doubles the risk of being diagnosed with schizophrenia or reporting psychotic symptoms in adulthood. –Journal of Addiction, January 2015. (What Has Research Over the Past Two Decades Revealed About the Adverse Health Effects of Recreational Cannabis Use).

**This is a sample of 30 studies and statements, of over 20,000, on the harms of marijuana.  More found here.

Source:  https://noprop205.com/research/    2016

Like the viral dance move of the same name, using marijuana by “dabbing” is having a moment.

The latest marijuana-consumption craze has users chasing bigger highs through a process called “flash vaporization.” But unlike the dance, marijuana dabbing poses some major health and safety risks, according to both anecdotal evidence and experts, and is illegal in some states. Dabbing is when you take a marijuana concentrate, a waxy or butter-like substance that contains highly concentrated amounts of tetrahydrocannabinol (THC) — the psychoactive ingredient in weed — apply it to a hot surface to create smoke, and inhale to get high. There are countless ways to heat the material, from burning in it an electronic vaporizer to lighting it on fire with a blowtorch over a glass bong piece called a nail, and it’s up to user preference.

When the internet tells you dabbing gets you high, it means really, really high. The potency of dabs can cause users to pass out, become uncomfortably stoned, or even experience psychedelic effects that border on hallucinations, with one too many rips from a bong. Marijuana concentrates pack a punch no matter how you ingest them. They’re made from blasting a solvent, like butane or carbon dioxide, through marijuana plant matter to extract the THC, then letting the solvent evaporate. The yellow, gooey substance that remains has a THC concentration that’s four times stronger than the plant itself, The New York Times reports.

“Marijuana is the beer of THC, as dabbing is to vodka,” as one New York City teenager seen dabbing down Fifth Avenue put it to The Times.

In pot-friendly Colorado, where weed is sold legally for recreational purposes, concentrates make up about one-third of overall marijuana sales, the Marijuana Business Daily reports. Some industry insiders are calling concentrates “the future of the industry.”

Not everyone is on board with the dabbing craze.

For starters, dousing marijuana in butane, a highly flammable gas, can cause explosions when it meets an ignition source. As dabbing becomes popular, more amateurs turn to the internet for DIY tutorials on how to extract concentrates. But these at-home operations have led to explosions and deaths in recent years, especially when run indoors without proper ventilation.

Dabbing itself appears to be less dangerous than making the supplies, though the risks are still known. Research on how marijuana concentrates affect the body is slim.

“There is some evidence to suggest that the outcomes, like the effects, may be supercharged,” Emily Feinstein, director of health law and policy for the National Center on Addiction and Substance Abuse, tells The Times. “Side effects can include: a rapid heartbeat, blackouts, psychosis, paranoia, and hallucinations that cause people to end up in psychiatric facilities.”

The negative side effects often last longer than the high.

Dr. Michael Miller, the ex-president of the American Society of Addiction Medicine, tells L.A. Weekly that if you have a predisposition for addiction, the intensity and swift kick of the high that dabbing produces may trigger cravings and cues to use again.

More research around the health risks of dabbing is required, along with better regulation to squash the at-home operations that threaten to undermine the industry’s legitimacy.

Even the name, dabbing, has caused confusion among some.

When a news reporter asked two Seattle Seahawks football players, “Do either of you guys dab?” at a press conference in January, they tripped and fumbled over their answers.

“That’s illegal in, in … no, actually it’s legal in Washington!” Michael Bennett exclaimed.

Of course, the reporter was referring to the viral dance move, made popular by Carolina Panthers quarterback Cam Newton. It looks like you’re sneezing in your arm.

Source:  http://uk.businessinsider.com/what-is-marijuana-dabbing-2016-9?r=US&IR=T  2nd Oct. 2016

To watch the video  ‘This is how long drugs actually stay in your system’ click on thesource link above and then scroll down to the bottom of the page to find the video.

Chelsea Clinton recently suggested that marijuana might be deadly when taken with other drugs. But is this really true?

Although marijuana can interact with other drugs, there do not appear to be any reports of deaths that directly resulted from taking marijuana in combination with other drugs.

While speaking in Ohio on Sept. 24, Clinton was asked whether her mother, Hillary Clinton, supports changing the way marijuana is categorized by the Drug Enforcement Administration so that it would be easier for researchers to conduct studies on the drug. Chelsea Clinton replied that her mother does support research on marijuana. Then, she added, “But we also have anecdotal evidence now from Colorado, where some of the people who were taking marijuana for those purposes, the coroner believes, after they died, there was drug interactions with other things they were taking.”

A spokesperson for Clinton later said Clinton “misspoke about marijuana’s interaction with other drugs contributing to specific deaths,” according to The Huffington Post.

By itself, marijuana is not known to have direct lethal effects. According to the U.S. Drug Enforcement Administration, no overdose deaths from marijuana have been reported in the United States.

In addition, the evidence that marijuana may interact with other drugs is limited, according to a 2007 review paper in the American Journal of Health-System Pharmacy.

Still, marijuana does appear to interact with a number of drugs, the review said. If marijuana is taken with alcohol, benzodiazepines (drugs that treat anxiety) or muscle relaxants, the combination can result in “central nervous system depression,” the review said, which means that people can experience decreased breathing and heart rate, and loss of consciousness. [How 8 Common Medications Interact with Alcohol]

There also have been reports of people experiencing a rapid heart rate and delirium after using marijuana while taking older forms of antidepressants (known as tricyclic antidepressants), the review said.

Marijuana may also interact with drugs that are broken down by enzymes in the liver known as cytochrome P450 enzymes, according to the Mayo Clinic. That’s because a compound in marijuana called cannabidiol can inhibit these enzymes. Therefore, marijuana may prevent other drugs from being broken down properly, and as a result,

levels of these other drugs may be increased in the blood, which “may cause increased effects or potentially serious adverse reactions,” the Mayo Clinic says.

One example is the drug sildenafil, commonly known by the brand name Viagra, which is broken down by cytochrome P450 enzymes. In 2002, researchers in the United Kingdom reported that a 41-year-old man had a heart attack after taking marijuana and Viagra together. This report could not prove that the marijuana-Viagra combination was definitely the cause of the man’s heart attack. However, the researchers said that doctors “should be aware” of the effects of inhibiting cytochrome P450 enzymes when prescribing Viagra.

Still, Live Science could not find any scientific or news reports of people who have died as a result of marijuana interacting with another drug.

But that doesn’t mean marijuana is harmless — the drug can impair coordination and slow down reaction time, and it has been linked with fatal car crashes, according to the National Institute on Drug Abuse (NIDA). A 2011 study found that people who reported driving within 3 hours of using marijuana, or drivers who tested positive for the drug, were more than twice as likely to be involved in a car crash compared with other drivers.

The Mayo Clinic says marijuana can increase the drowsiness caused by some drugs, including diazepam (Valium), codeine, antidepressants and alcohol, and so people need to be cautious if they drive or operate machinery after using these drugs with marijuana.

People who take high doses of marijuana may experience anxiety attacks or hallucinations, according to the NIDA. In some rare cases, intoxication with marijuana has been linked with suicide. In 2014, researchers from Germany reported that two men died from heart problems that were brought on by smoking cannabis. But marijuana may have a benefit in terms of reducing deaths from opioid painkillers. A 2014 study found that rates of overdose death from opioids were lower in states where medical marijuana is legal. Another study, published earlier this month, found that rates of opioid use decreased among younger adults in states that had legalized medical marijuana. It’s possible that people are substituting medical marijuana for opioids to treat chronic pain, the researchers said.

Source:http://www.livescience.com/56356-marijuana-drug-interactions.html

3rd Oct.2016

Heavy marijuana use alters adolescent brain structure and impairs brain function for people of all ages. On March 10, Colorado launched its Drive High, Get a DUI campaign. Colorado was the first state to legalize recreational marijuana use and is the first state to roll out public service announcements warning marijuana users about driving when you’re high.

The latest marijuana statistics are noteworthy. Marijuana consumption has increased over 30 percent since 2006. From 2006 through 2012, about half of drivers involved in fatal car accidents were tested for drugs and about 11 percent of those drivers tested positive for marijuana. In a September 2014 Colorado survey, 21 percent of respondents reported consuming marijuana and then driving at some point in the past month.

The Colorado Department of Transportation is now airing three television ads as part of its Drive High, Get a DUI campaign. The public service announcements target men ages 21-34, the demographic that tends to have the highest number of DUIs.

In another PSA, a man finishes installing a new flat screen TV on the wall, gives his partner a high five, and a moment later the TV falls off the wall and shatters on the floor. “Installing your TV while high is now legal,” reads the text in the ad … “Driving to get a new one isn’t.” The campaign also includes tourist outreach to rental car companies and dispensaries about marijuana driving laws in Colorado.

One Trillion Dollars of Illegal Drugs A March 2014 study on national drug use found the amount of marijuana consumed by Americans increased by more than 30 percent from 2006 to 2010. The report was compiled for the White House Office of National Drug Control Policy and was conducted by researchers affiliated with the RAND Drug Policy Research Center.

“Having credible estimates of the number of heavy drug users and how much they spend is critical for evaluating policies, making decisions about treatment funding and understanding the drug revenues going to criminal organizations,” said Beau Kilmer, the study’s lead author and co-director of the RAND Drug Policy Research Center. “This work synthesizes information from many sources to present the best estimates to date for illicit drug consumption and spending in the United States.”

The researchers say that because the study only includes data through 2010 the report doesn’t address the recent reported spike in heroin use or the consequences of marijuana legalization in Colorado and Washington. The report also does not try to explain the causes behind changes in drug use or evaluate the effectiveness of drug control strategies.

Researchers say that drug users in the United States spent around $100 billion annually on cocaine, heroin, marijuana and methamphetamine throughout the decade. While the amount remained stable from 2000 to 2010, the spending shifted. While much more was spent on cocaine than on marijuana in 2000, the opposite was true by 2010.

“Our analysis shows that Americans likely spent more than one trillion dollars on cocaine, heroin, marijuana and methamphetamine between 2000 and 2010,” Kilmer said. The surge in marijuana use is related to an increase in the number of people who reported using the drug on a daily or near-daily basis.

Source: https://www.psychologytoday.com/blog/the-athletes-way  March 2016

Highlights

* •Motives for cannabis use can predict problematic use and use-related problems.

* •A MET/CBT intervention was associated with significant reductions in motives.

* •Reductions in a subset of motives significantly predicted change in outcomes.

Abstract

Background

Heavy cannabis use has been associated with negative outcomes, particularly among individuals who begin use in adolescence. Motives for cannabis use can predict frequency of use and negative use-related problems. The purpose of the current study was to assess change in motives following a motivational enhancement therapy (MET) and cognitive behavioral therapy (CBT) intervention for adolescent users and assess whether change in motives was associated with change in use and self-reported problems negative consequences.

Methods

Participants (n = 252) were non-treatment seeking high school student cannabis users. All participants received two sessions of MET and had check-ins scheduled at 4, 7, and 10 months. Participants were randomized to either a motivational check-in condition or an assessment-only check-in. Participants in both conditions had the option of attending additional CBT sessions. Cannabis use frequency, negative consequences, and motives were assessed at baseline and at 6, 9, 12, and 15 month follow-ups.

Results

There were significant reductions in motives for use following the intervention and reductions in a subset of motives significantly and uniquely predicted change in problematic outcomes beyond current cannabis use frequency. Change in motives was significantly higher among those who utilized the optional CBT sessions.

Conclusions

This study demonstrates that motives can change over the course of treatment and that this change in motives is associated with reductions in use and problematic outcomes. Targeting specific motives in future interventions may improve treatment outcomes.

Source: http://www.drugandalcoholdependence.com/article   1st October 2016

Highlights

* Childhood sleep problems may be prospectively linked to adolescent substance use.

* Less sleep predicted earlier onset of alcohol and cannabis involvement.

* Worse sleep quality predicted earlier onset of alcohol and cannabis involvement.

* These associations generally held after accounting for various covariates.

* Childhood sleep is a promising target for reducing adolescent substance use risk.

Abstract

Background

Although an association between adolescent sleep and substance use is supported by the literature, few studies have characterized the longitudinal relationship between early adolescent sleep and subsequent substance use. The current study examined the prospective association between the duration and quality of sleep at age 11 and alcohol and cannabis use throughout adolescence.

Methods

The present study, drawn from a cohort of 310 boys taking part in a longitudinal study in Western Pennsylvania, includes 186 boys whose mothers completed the Child Sleep Questionnaire; sleep duration and quality at age 11 were calculated based on these reports. At ages 20 and 22, participants were interviewed regarding lifetime alcohol and cannabis use. Cox proportional hazard analysis was used to determine the association between sleep and substance use.

Results

After accounting for race, socioeconomic status, neighborhood danger, active distraction, internalizing problems, and externalizing problems, both the duration and quality of sleep at age 11 were associated with multiple earlier substance use outcomes. Specifically, less sleep was associated with earlier use, intoxication, and repeated use of both alcohol and cannabis. Lower sleep quality was associated with earlier alcohol use, intoxication, and repeated use. Additionally, lower sleep quality was associated with earlier cannabis intoxication and repeated use, but not first use.

Conclusions

Both sleep duration and sleep quality in early adolescence may have implications for the development of alcohol and cannabis use throughout adolescence. Further studies to understand the mechanisms linking sleep and substance use are warranted.

Source:  http://www.drugandalcoholdependence.com/article/S0376-8716(16)30246-0/pdf 9th August 2016

Filed under: Cannabis/Marijuana,Youth :

Cannabis is bad for you, cannabis is good for you – confused?

That’s not surprising. Complicated and controversial, cannabis is revealed by recent science to have a dual personality, with a dark side and a more positive one. Radio 4’s PM programme is this week running a whole series on cannabis, and the debate surrounding it.

Key to understanding this strange plant are two of the ingredients that make it up, known by their initials as THC and CBD.

I asked Prof Val Curran of University College London to describe how they work and she came up with a memorable answer:  “In a way, THC and CBD are a bit like yin and yang. The THC makes you stoned, but it can also make you anxious. It can also make you feel a bit psychotic, and it will seriously impair your memory.  10% of people who use it will become addicted to the drug.  The other side of the yin/yang is CBD, which has almost the opposite effects. CBD calms you down, it has anti-psychotic properties and it also offsets the effects on memory, so that on CBD-containing cannabis you’re less likely to forget what’s going on.”

So the first step to understanding cannabis is to realise how it can vary, how different types contain very different quantities of these polar opposites, with dramatically different outcomes.

Changing risks

The weed so familiar to many of my generation was characterised by a relatively balanced amount of THC and CBD.

Today, the vast majority of cannabis on sale on the streets is unrecognisably stronger.

Known as skunk, it contains a far higher proportion of THC – as much as 15% – which produces a much more powerful high, making it more appealing for users.

But, at the same time, because it hardly contains any of the CBD that might lessen its effects, the risks are correspondingly greater.

Prof Curran is among those worried about its potency.

“What concerns me is that on this high-THC skunk, people will experience more memory problems, which could affect how well they do at school. And in terms of addiction, 10% of people who use it will become addicted to the drug.”

According to a study by two researchers at UCL, Dr Tom Freeman and Dr Adam Winstock, the strongest cannabis increases the risk of addiction, along with memory loss and paranoia.

If you smoke high-potency skunk at all, then you are three times more likely to be psychoticProf Robin Murray, King’s College London

And in a trial to explore ways of helping addicts, they are giving drug users medication based on cannabis itself. The hope is that administering doses of CBD, the more benign ingredient of cannabis, might make it easier for habitual users to wean themselves off the lure of the more potent element, THC.

Dr Freeman told the BBC: “We think that CBD can reverse long-term changes which happen when you smoke cannabis repeatedly, and in people who smoke a lot of cannabis it’ll help them quit.  It blocks the effects of THC and it reduces anxiety and paranoia. If this trial is successful, then we will have found the first effective drug treatment for cannabis dependence.”

Meanwhile, new evidence has surfaced that will stir the long-running debate over whether – or to what extent – cannabis can trigger psychosis.  New research published this week in the Lancet Psychiatry suggests a connection, a finding which is most relevant to people already vulnerable to mental illness.  The study, conducted in south London, involved some 800 people – about half of them users, the rest not.

One of the authors, Prof Sir Robin Murray of King’s College London, says it’s clear that regular use of highly potent skunk has a real impact.

“We found that smoking cannabis, particularly of the high-potency forms, was associated with an increased risk.  If you smoke high-potency skunk at all, then you are three times more likely to be psychotic. If you smoke high-potency cannabis every day, you are five times more likely to be psychotic.”

Cautious optimism

And at this point we come back to that yin and yang of cannabis. While this new research finds that the strongest cannabis, laden with THC, can be linked to psychosis, it turns out that the gentler twin, CBD, might possibly be useful in treating it.

Prof Murray, though cautious, highlights recent studies.

“If you give THC to normal volunteers, you can make them psychotic, but if you pre-treat them with CBD, you can prevent that happening.  So this made us think – would it be possible to actually treat psychosis with CBD? So there’s one encouraging study, which suggests that CBD is useful in the treatment of psychosis, but it’s still very early days yet.”

So running in parallel with concerns about cannabis is another world of optimism about its uses.

In Colorado, there is much excitement about a medication called Charlotte’s Web, derived from cannabis and named after a girl who took it as a treatment for her epilepsy.

It may open up a completely new avenue of treatment options for patients with epilepsyDr Richard Chin, University of Edinburgh

Such is the potential of what’s seen as a wonder drug that the Mattison family sold up their business in Tennessee and moved to Colorado purely so that their daughter Millie, who’s two years old and epileptic, could receive Charlotte’s Web.

Her seizures, soon after birth, were so severe that she had been given very little chance of surviving. But her mother Nicole told me that the drug proved immediately beneficial, transforming Millie’s life almost at a stroke.  “It’s miraculous. The first time we gave her oil, within 15 minutes her eyes were open, and I almost felt like I was in a movie. It was crazy, you wouldn’t believe it unless you saw it.”

Here in the UK, the only legal medicine derived from cannabis is for sufferers of multiple sclerosis (MS), a product called Sativex made by GW Pharma.  But now the company,

the only one with a licence to grow cannabis in the UK, has developed another formulation which is being tested to treat epileptic conditions like Millie’s.

Early days

The trial, with 80 patients, is now in its second stage and is being run by the University of Edinburgh.

The scientist in charge of the process, Dr Richard Chin, says that so far the results look promising, not just to control seizures but – remarkably – to prevent them as well.

“One of the interesting things about cannabidiol (CBD) is that it shows not just anti-seizure effects, but it also curiously seems to have an effect on cognitive and behavioural problems, which are very highly represented in people with epilepsy.

“So it doesn’t seem, on preliminary data, as if it’s just an anti-seizure medication. It may actually be an anti-epilepsy medication in its wider sense, and what I would hope is that it may open up a completely new avenue of treatment options for patients with epilepsy.”

For thousands of years cannabis was used medically. But only now is research revealing why that’s possible and how it can be put to best use.

These are relatively early days but, on the horizon, researchers see potential for the CBD in cannabis to help with everything from easing the pain of cancer to tackling autism.

At the same time, science is also unpicking the full implications of the potent stuff being dealt on our streets.

Source:  18th Feb 2018

 September 12, 2016
Gaining scientific proof of adverse effects of cannabis, a world first
Suppression of thalamocortical projection by chronic administration of Δ9-THC (cannabinoid, active ingredient of marijuana). Photomicrograph of cerebral cortex from transgenic mice expressing GFP in thalamocortical axons at postnatal day 7 (P7). (left) : Normal thalamocortical projections. In the middle layer (layer 4), blobs of GFP showing dense termination of thalamocortical axons can be seen (under number 1~5). (right): Thalamocortical projection at P7 from a mouse received chronic administration of Δ9-THC (P2~7). Massive retraction of thalamocortical projections including middle layer (layer 4) can be observed. Credit: Osaka University

Researchers have clarified important mechanisms involved in the formation of neural circuits in the brain. This group also discovered that delta-9-tetrahydrocannabinol (THC), a psychoactive substance also found in cannabis, causes disruption of neural circuits within the cortex. These results explain why cannabis may be harmful and have potential to find application in the functional recovery of brain injury and in cases of dementia.

Neural activity is known to play an important role in the formation of neural circuits. However, we still do not know much about what kind of neural activities are involved in this formation process. This process is especially complex in projections from the thalamus to the cortex, of which so far we only knew that as these projections develop, unnecessary projections are eliminated, thereby leaving only correct projections.

A group of researchers led by Fumitaka Kimura, associate professor at the Department of Molecular Neuroscience, Graduate School of Medicine, Osaka University, has now clarified the involvement of several mechanisms in the formation of this neural circuit. The researchers also put forth scientific evidence that cannabis intake causes the unnecessary trimming of neural connections, leading to a breakdown of neural circuits (Figure 1).

In their study, this group of researchers discovered that in a different section of the cortex, the rule (Spike Timing-Dependent Plasticity: STDP) by which synaptic strength (a functional measure of connections) between neurons was determined suddenly changed at a certain point in development. Building on this finding, the group examined whether a similar STDP change occurred in the projection from the thalamus and the cortex as well. They found that initially, the synapses were strengthened due to the synchronized activities of the pre- (thalamic) and post- (cortical) synaptic neurons. But after the projections had spread widely, the synchronized activities weakened all but some synapses, thereby eliminating unnecessary projections to enable more systematic ones. As the synapses are weakened, endogenous cannabinoid is released from neural cells via these synchronized activities, leading to a regression of unnecessary neuron projections (Figure 2). The researchers also confirmed such regression when cannabinoid was taken in externally.

The researchers also confirmed such regression when cannabinoid was taken in externally.

Gaining scientific proof of adverse effects of cannabis, a world first
Endogenous cannabinoid regulates the termination area of thalamocortical axons.(left): Normal thalamocortical projection terminates within a square area in layer 4 (barrel, indicated in red), revealed by visualization of individual thalamocortical axons at P12.(left): Disorganized projections of thalamocortical axons at P12 in animals in which gene of cannabinoid receptor was knocked out. Thalamocortical axons overshoot layer 4 and invade upper layers (layer 2/3); the axons seem to ignore barrels boundaries. Credit: Osaka University

These findings may have an impact on further research focused on advancing our understanding of the mechanisms involved in the formation of neural circuits and have the potential to lead to the development of new therapies to improve recovery from brain damage and dementia. In addition, the findings provide for the adverse effects of cannabis consumption on brain development and therefore may help to decrease abuse of marijuana.

This research was featured in the electronic version of Journal of Neuroscience on June 29, 2016.

More information: C. Itami et al, Developmental Switch in Spike Timing-Dependent Plasticity and Cannabinoid-Dependent Reorganization of the Thalamocortical Projection in the Barrel Cortex,Journal of Neuroscience (2016). DOI: 10.1523/JNEUROS

Source:  http://medicalxpress.com/news/2016-09-adverse-effects-cannabis-scientifically.html 12 Sept 2016

50-year study finds causal link between cannabis and subsequent violent behavior  New research published on-line in advance of print in the journal Psychological Medicine, concludes that continued use of cannabis causes violent behavior as a direct result of changes in brain function that are caused by smoking weed over many years.

Researchers have long debated a possible link between use of marijuana and violent crime.  In contrast to alcohol, meth, and many other illegal drugs, the mellowing effects of cannabis seem unsuited to promoting violent behavior.  However, ample previous research has linked marijuana use to increased violent behavior.  The sticky problem in such studies are the many confounding factors involved in interpreting this correlation.

It is very difficult to determine whether any statistical correlation between marijuana use and violent behavior are causally linked, or instead the two are associated through some other factor, such as socioeconomic status, personality traits, or many other variables that are related to the propensity to use marijuana.  Moreover, the causal relation between smoking pot and violent behavior could be in exactly the opposite direction.  That is, individuals who are involved in violence or who commit criminal offenses may also be people who are more open to using marijuana.

After all, marijuana is an illegal substance in most places, so people with antisocial personality traits and those with tendencies toward lawlessness may be the type of individuals inclined to be more open to obtaining and using the illegal substance.  Not so, conclude neuroscientist Tabea Schoeler at Kings College London, and her colleagues, “Together, the results of the present study provide support for a causal relationship between exposure to cannabis and subsequent violent outcomes across a major part of the lifespan.”  Let’s examine the evidence provided by this new study. What makes this new study more compelling than previous studies is that the researchers followed the same individuals for over 50 years from a young age to adulthood.  This is precisely what one needs to solve the chicken or egg riddle with respect to cannabis and violence:  just look and see which one happens first.

These subjects were in the Cambridge Study in Delinquent Development, comprised of 411 boys who were born around 1953 and living in working-class urban neighborhoods of London.  97% of them were Caucasian and all of them were raised in two parent households.  The researchers took into consideration other factors, including antisocial traits as assessed by the Antisocial Personality Scale, alcohol use, other drug use, cigarette smoking, mental illnesses, and family history.

Heres’s what they found:  Most of the participants never used cannabis and they were never reported to have violent behavior.  38% of the participants did try cannabis at least once in their life.  Most of them experimented with cannabis in their teens, but then stopped using it. However, 20% of the boys who started using pot by age 18 continued to use it through middle age (32-48 years).  One fifth of those who were pot smokers (22%) reported violent behavior that began after beginning to use cannabis, whereas only 0.3% reported violence before using weed.  Continued use of cannabis over the life-time of the study was the strongest predictor of violent convictions, even when the other factors that contribute to violent behavior were considered in the statistical analysis.

In conclusion, the results show that continued cannabis use is associated with a 7-fold greater odds for subsequent commission of violent crimes.  This level of risk is similar to the increased risk of lung cancer from smoking cigarettes over a similar duration (40 years).  The authors suggest that impairments in neurological circuits controlling behavior may underlie impulsive, violent behavior, as a result of cannabis altering the normal neural functioning in the ventrolateral prefrontal cortex.

Source:  https://www.psychologytoday.com/blog/the-new-brain/201603/marijuana-use-increases-violent-behavior     March 2016

“Many studies have linked marijuana use with early onset of psychosis. The question is, does smoking marijuana cause earlier psychosis? A new review of 83 studies involving more than 22,000 participants seeks an answer.

The meta-analysis found that people who smoked marijuana developed psychotic disorders an average 2.7 years earlier than people who did not use cannabis.

 
Context

A number of studies have found that the use of cannabis and other psychoactive substances is associated with an earlier onset of psychotic illness.
Objective

To establish the extent to which use of cannabis, alcohol, and other psychoactive substances affects the age at onset of psychosis by meta-analysis.

 
Data Sources

Peer-reviewed publications in English reporting age at onset of psychotic illness in substance-using and non–substance-using groups were located using searches of CINAHL, EMBASE, MEDLINE, PsycINFO, and ISI Web of Science.

 
Study Selection

Studies in English comparing the age at onset of psychosis in cohorts of patients who use substances with age at onset of psychosis in non–substance-using patients. The searches yielded 443 articles, from which 83 studies met the inclusion criteria.

 
Data Extraction

Information on study design, study population, and effect size were extracted independently by 2 of us.

 
Data Synthesis

Meta-analysis found that the age at onset of psychosis for cannabis users was 2.70 years younger (standardized mean difference = –0.414) than for nonusers; for those with broadly defined substance use, the age at onset of psychosis was 2.00 years younger (standardized mean difference = –0.315) than for nonusers. Alcohol use was not associated with a significantly earlier age at onset of psychosis. Differences in the proportion of cannabis users in the substance-using group made a significant contribution to the heterogeneity in the effect sizes between studies, confirming an association between cannabis use and earlier mean age at onset of psychotic illness.

 
Conclusions.

The results of meta-analysis provide evidence for a relationship between cannabis use and earlier onset of psychotic illness, and they support the hypothesis that cannabis use plays a causal role in the development of psychosis in some patients. The results suggest the need for renewed warnings about the potentially harmful effects of cannabis.

 

 
Matthew Large, BSc(Med), MBBS, FRANZCP; Swapnil Sharma, MBBS, FRANZCP; Michael T. Compton, MD, MPH; Tim Slade, PhD; Olav Nielssen, MBBS, MCrim, FRANZCP

 
Source: Arch Gen Psychiatry. Published online February 7, 2011. doi:10.1001/archgenpsychiatry.2011.5

Filed under: Cannabis/Marijuana,Health :

Imagine for a minute a world in which marijuana is available in a vending machine or corner grocery store near you — like any other snack machine — pot-infused lollipops, gummy candies, baked goods and beverages available at the push of a button.

As futuristic as this farfetched tale sounds, this is Colorado’s reality, a state with the dubious distinction of becoming the first to legalize marijuana, which has helped spawn legalization efforts across the U.S., including in New Jersey.   And while Colorado’s experiment has sparked heated debate over drug legalization, a critical and unbiased look at the data clearly shows that marijuana legalization has serious and far-reaching consequences that far outweigh any of its alleged benefits.

Strong emotions on both sides of this issue should not obscure the facts. Marijuana is an addictive substance that is harmful to users, especially to its younger users. As a teen’s brain development is disturbed by chronic marijuana use, the risk for physical and psychological dependency grows exponentially.

In addition to permanently affecting brain functioning, marijuana use can lead to a wide array of negative consequences, ranging from lower grades and isolation from family to an increased risk of psychotic symptoms, depression and suicide.

According to the Office of National Drug Control Policy, legalization will cause a substantial increase in economic and social costs.  The expansion of drug use will increase crime committed under the influence of drugs, as well as family violence, vehicular crashes, work-related injuries and a variety of health-related problems. These new costs will far outweigh any income from taxes on drugs.

Few would argue that a drug that can cause such destruction is something that we should counsel people to avoid. However, legalization efforts do just the opposite. In fact, experience has shown that when drugs are legalized, drug use increases because the perception of harm is reduced.

Moreover, the Drug Enforcement Agency has estimated that legalization could double or even triple the amount of marijuana users.

While it is hard to fathom the societal impact of an additional 17 million to 34 million marijuana users, it is safe to assume that those who profit from legalization have calculated the impact on their bottom line.

Those in favor of legalization often fail to tell you that levels of drug use have gone down substantially since the 1970s when the “war” on drugs began. This is not to say that our drug laws, including those governing marijuana, are not in need of reform.

For instance, the effort to place more drug users into treatment instead of prison is a positive development, both for those struggling with addiction and for taxpayers.

However, reforming and improving our drug laws does not mean we should abandon our fight against the use of illegal drugs like marijuana.

On the contrary, the more we learn about effective methods of combating drug use, the more we learn that legalization is not the answer, and is, in fact, very much part of the problem.

Source:  Source:  www.njassemblyrepublicans.com  Daily Record 13 Apr 2014

 

Despite the increasing use of cannabis among adolescents, there are little and often contradictory studies on the long-term neurobiological consequences of cannabis consumption in juveniles.

Adolescence is a critical phase for cerebral development, where the endocannabinoid system plays an important role influencing the release and action of different neurotransmitters.

Therefore, a strong stimulation by the psychoactive component of marijuana, delta-9-tetrahydrocannabinol (THC), might lead to subtle but lasting neurobiological changes that can affect adult brain functions and behaviour.

The literature here summarized by use of experimental animal models, puts forward that heavy cannabis consumption in adolescence may induce subtle changes in the adult brain circuits ending in altered emotional and cognitive performance, enhanced vulnerability for the use of more harmful drugs of abuse in selected individuals, and may represent a risk factor for developing schizophrenia in adulthood.

Therefore, the potential problems arising in relation to marijuana consumption in adolescence suggest that this developmental phase is a vulnerable period for persistent adverse effects of cannabinoids.

Source: Mol Cell Endocrinol. 2008 Apr 16;286

 

Given that the health of American youth is in question and that so many states base their policies on reports issued by the State of Colorado, it is important to understand what the 2015 Healthy Kids Colorado Survey (HKCS) actually tells us.

The survey’s results are gleaned from voluntarily self-reported information collected every other year from Colorado middle-school and high-school students. It is produced by a partnership of the Colorado Department of Education, Colorado Department of Human Services, the Colorado Department of Public Health and the Environment and the University of Colorado.



News organizations tracking the impact of marijuana on Colorado since voters sanctioned the drug for medical and recreational use are understandably quick to report the survey’s findings — but they’re unfortunately just as quick to deliver inaccurate and misleading information. Coverage of the 2015 survey results was especially poor. Dozens of news organizations — including The Denver PostFox News, the Washington PostTimeScientific American and Reuters — should correct and clarify their work.

Why? Because for many reasons, the 2015 survey’s data do not support claims that marijuana use among Colorado teenagers has remained flat or has declined. Examination of the survey’s aggregate data, segmented by grade and geographic region, tells a different story than the Marijuana Infographic and some passages of the executive summary distributed by state officials.

New reporting should inform the public about youth marijuana use rates in several Colorado regions — particularly where marijuana is most heavily commercialized.

Here are some important things to know about the 2015 survey:

Because of its methodology and sample size, this survey is a snapshot in time that represents no one other than the Colorado youth who took it. It is inaccurate to present or describe the 2015 survey as a “state survey” or to present its findings as average use rates among Colorado youth. The 2015 survey does not include data from El Paso County (home to the state’s second largest city, Colorado Springs), Jefferson and Douglas counties (home to two of the state’s largest school districts) and Weld County. It is also important to note that Colorado’s private and parochial schools do not participate in this survey and that only students attending school are surveyed. Students with drug problems are less likely to be in school — and, therefore, less likely to be surveyed.

Differences in methodology make it difficult to compare the 2015 survey to previous HKC surveys. The randomly selected sample size dropped from 40,206 in 2013 to 15,970 in 2015. Similarly, the high school response rate dropped from 58 percent in 2013 to 46.5 percent in 2015. Counties participating in the survey also changed from 2013 to 2015. Clearly, something in the survey methods changed from 2013 to 2015, making direct comparisons risky. But if state officials and journalists insist on making these direct comparisons, there are significant increases in youth marijuana use to report from 2013 to 2015 — as detailed below. They should report this information to the public.

Because of differences in methodology, Colorado survey results should not be directly compared to other national studies of adolescent marijuana-use rates, such as the Centers for Disease Control’s Youth Risk Behavior Survey (YRBS). These surveys are different. For example, the YRBS requires a response rate of at least 60 percent. If student responses fall below that mark, the YRBS states the results “represent only the students participating in the survey.” Of note, the HKCS did not reach this threshold for high school students in either 2013 or 2015. Therefore, direct comparisons of the two studies is risky. Such differences in methodology also make it risky to compare the Colorado data and other national studies, such as the Substance Abuse and Mental Health Service Administration’s National Survey on Drug Use and Health and the Monitoring the Future (MTF), a survey from the National Institute on Drug Abuse run by contract through the University of Michigan. Further, the 2015 state report’s comparisons to a “national average” of youth marijuana use are also problematic. Please review explanations here and here from David Murray, a former chief scientist of the White House Office of National Drug Control Policy, who now serves as a senior fellow analyzing drug policy at the Hudson Institute. Among his observations:

“What is the possible source for deriving that ‘national average’? There is one genuinely national sample of youth drug use, that from the National Survey on Drug Use and Health (NSDUH) that covers all states. But this cannot be the basis for the (State of Colorado’s) claim. In their latest 2014 estimates, NSDUH reported that 7.2 percent of adolescents aged 12 to 17 across the nation used marijuana in the past month – that figure, not 21.7 percent, would be the youth ‘national average.’ Moreover, the NSDUH specifically declared that Colorado had the nation’s highest rates. Adolescent marijuana use ranged from 4.98 percent in Alabama to 12.56 percent in Colorado. Worse, the NSDUH showed for youth that from 2009, when medical marijuana took off in Colorado, there has been a stunning rise of 27 percent through 2014 (from 9.91 percent to 12.56 percent). So Colorado youth use rates in the NSDUH are not only higher than the national average, but, after freer access to marijuana, have been steeply climbing.”

To examine drug-use trends from year to year and make comparisons between states, the NSDUH is more reliable (not perfect, but more reliable). The NSDUH interviews youth who are in and out of school. It is conducted in every state — and, unlike the current version of the Colorado Healthy Kids survey, it has data from before 2013. Unfortunately, as Murray notes above, this survey shows the prevalence of past-month marijuana use among Colorado youth has increased, with Colorado ranked first among 12-17 year olds in 2014.

One strength of the HKCS is that it offers some county-level data. It is helpful to have a fine-grain look at what is happening at a local level. So, if we must compare 2013 and 2015 survey results, it is best to limit comparisons to the responses of specific regions as defined by the survey. You can find a map of those regions here. Because there are many differences between high school freshmen and seniors, combining their class data — especially given that 18-year-olds in Colorado can purchase medical marijuana legally — can give false impressions about “teen use” rates. So, it is important to segment students by grade for a more accurate look at marijuana use rates.

Remember: Because of significant differences in methodology and sample size, the 2015 HKCS shouldn’t be compared to its 2013 predecessor or any national survey — but if state officials and journalists insist on doing so, let’s all consider this closer look at student respondents by grade and region. It suggests adolescent marijuana use rates has reached levels worth considering a serious health problem in some parts of the state.

For a full breakdown of the regional data, please see this chart (produced with the significant help of Christine Miller, a Ph.D. pharmacologist and Colorado native). Among the findings:


Region 16 (Boulder, Broomfield): High school seniors in this region reported the highest rate of past-month use among 12th graders in the state. In 2015, 42.2 percent of high school seniors reported past-month use, versus 28.5 in 2013. That’s a 48.1 percent increase. The use rate among high school juniors in this region jumped from 22.3 percent to 33.4 percent, a 49.8 percent increase.

Region 20 (Denver): Use among high school seniors increased from 30 percent in 2013 to 33 percent in 2015, a jump of 10 percent. Among juniors, the use rate increased from 29 percent to 37.7 percent, an increase of 30 percent.

Region 12: Western Corridor (Summit, Eagle-Vail): Use among high school seniors increased 90 percent from 20.1 percent in 2013 to 38.2 percent in 2015. As a curious side note, this region also reported a 2.3 percent decrease in past-month marijuana use among high school juniors and a 54.7 percent increase among its high school sophomores.

Region 11: Northwest (Steamboat Springs, Craig): Marijuana use among this region’s high school students rose in grades 9-12. Among seniors the rate increased 57.3 percent from 22.5 percent in 2013 to 35.4 percent in 2015. Among juniors, use rose 18.8 percent from 18.1 percent to 21.5 percent. Among sophomores, use rose 72 percent from 8.2 percent in 2013 to 14.1 percent in 2015. Among freshmen, use rose 22.2 percent from 8.1 to 9.9 percent.

Region 19: (Mesa County/Grand Junction): Use among freshmen jumped to 13.7 percent, an increase of 57.5 percent from 2013. Use among sophomores increased 50.6 percent from 26.2 percent from 17.4 percent in 2013. The use rate among high school seniors rose to 24.4 percent, an increase of 20.8 percent.

Region 7: Pueblo: Although there was little change in use rates, the rates remain stubbornly high. They are higher than the state average for all grades; ranges from double the state average for high school freshmen to 31 percent greater than the state average for high school seniors.

A common theme among these regions is a high level of marijuana commercialization in the forms of retail and medical stores. Other commonalities should be investigated to determine the most appropriate interventions.

Analysis of the 2015 survey also found some good news — particularly in regions 8 (San Luis Valley), 10 (West Central, including Gunnison, Hinsdale and Montrose ) and 17 (Central, including Gilpin and Teller).The reasons for these reported declines in past-month use should be explored. For example, are the declines because of an effective intervention, or are they related to a change in the survey methodology from 2013 to 2015? Based on the findings, protocols for prevention and intervention should be implemented to encourage similarly favorable results in other school districts throughout the state.

This entry for DrThurstone.com was co-written by Dr. Christian Thurstone and Christine Tatum. He is an associate professor of addiction psychiatry and the director of medical training of the addiction psychiatry fellowship program at the University of Colorado. She is a longtime journalist, former national president of the Society of Professional Journalists and Dr. Thurstone’s wife. Together, they also wrote Clearing the Haze: Helping Families Face Teen Addiction(Rowman & Littlefield, 2015).

 

Source:  http://drthurstone.com/healthy-kids-colorado-survey-2015/    5th July 2016

The California National Guard on Monday joined more than a dozen other agencies to help the Yurok tribe combat rampant marijuana grows that have threatened the reservation’s water supply, harmed its salmon and interfered with cultural ceremonies.

Law-enforcement officers began serving search warrants at about 9 a.m. in the operation, which came at the request of Yurok officials and targeted properties in and near the reservation along the Klamath River.

The Humboldt County Sheriff’s Drug Enforcement Unit coordinated the raid and was joined by, among others, the Bureau of Indian Affairs, Bureau of Land Management, California Department of Justice’s North State Marijuana Investigation Team, and Yurok police.

State environmental scientists were standing by to enter the properties and survey for damage once the sites were secured.

Yurok Tribal Chairman Thomas O’Rourke joined officers as they staged at a hillside fire station Monday morning and thanked them for assisting in what was dubbed “Operation Yurok.”

“They’re stealing millions and millions of gallons of water and it’s impacting our ecosystem,” he told the officers. “We can no longer make it into our dance places, our women and children can’t leave the road to gather. We can’t hunt. We can’t live the life we’ve lived for thousands of years.”

California’s largest tribe has sought help combating marijuana grows in the past but until now never received such a vigorous response. Then the drought hit.

The strains on dual water systems that serve 200 households and rely entirely on surface water became apparent last summer, when residents began complaining of plummeting pressure.

When tribal staff surveyed the land from a U.S. Coast Guard helicopter, they were startled at the number of grows. By this summer they had tripled, officials estimated. And when the marijuana crop was planted in late spring, community water gauges once again swung low.

This time, creeks ran dry.

“Streams I’ve seen in prior years with more severe droughts where water ran, there’s no water now,” said O’Rourke.

To strengthen its enforcement abilities, the tribal council last fall approved a new controlled-substance ordinance that allow for civil forfeiture in circumstances where cultivation has harmed the environment.

(All growing on the reservation is illegal, as the Yurok tribe does not honor state medical-marijuana law.)

The breakthrough came in April when staffers from the governor’s office were discussing the drought with tribal officials. Gov. Jerry Brown, tribal officials were told, had pressed for California National Guard assistance with marijuana eradication and specifically urged the Office of the Adjutant General to assist in the Yurok operation, said Capt. Pat Bagley, operations officer in charge at the scene.

He was expecting to haul out two miles of irrigation hose at one grow alone.

For the Yurok, the damage is broad. Sediment and chemical runoff have suffocated juvenile fish, and warmer, shallower water has triggered an increase in the parasite Ceratomyxa shasta, which targets salmon.

Rodenticide has poisoned the Humboldt marten and weasel-like fisher, which the Yurok consider sacred. The danger of encroaching on a guarded grow site has made it unwise to gather medicine, acorns and materials for baskets, or to prepare sites for ceremonial dances.

Source:  www.seattletimes.com  21st July 2014

A study by doctors from the National Institute of Drug Abuse found that people who smoked marijuana had changes in the blood flow in their brains even after a month of not smoking. The marijuana users had PI (pulsatility index) values somewhat higher than people with chronic high blood pressure and diabetes, which suggests that marijuana use leads to abnormalities in the small blood vessels in the brain. These findings could explain in part the problems with thinking and remembering found in other studies of marijuana users.

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.

Source: drugabuse.gov

More than 200 people in Colorado who smoked synthetic marijuana during a 1-month period last summer developed altered mental status severe enough to require emergency care, according to a state public health investigation.

 

The investigation was prompted by several hospitals that contacted the Colorado Department of Public Health and Environment (CDPHE). Increasing numbers of patients had come to their emergency departments with aggression, agitation, confusion, and other symptoms after smoking the synthetic drug. The CDPHE asked all Colorado emergency departments to report through a Web-based system any patients treated with altered mental status who used synthetic marijuana between August 21 and September 18.

Source:   JAMA. 2014;311(5):457. doi:10.1001/jama.2014.47.

On July 28 and July 29, agents of the Humboldt County Sheriff’s Office assisted by the Campaign Against Marijuana Planting (CAMP) and the United States Forest Service (USFS) responded to USFS property on Brush Mountain, Gainor Peak and Oak Knob in eastern Humboldt County after sighting marijuana being cultivated on USFS land. The deputies were also accompanied by three scientists, two from Integral Ecology Research Center, and one associated with UC Davis and Hoopa Tribal Wildlife Ecologist.

During the two days deputies seized 3,760 marijuana plants ranging in size from 18 inches to four feet. Deputies and scientists located water diversion, mounds of trash and 24 pounds of rodenticides, of which nine pounds were peanut butter flavored and 15 pounds were second generation rodenticide. Malathion and fertilizers were also located at the scenes. No suspects were located in the area of the trespass marijuana grows, however deputies obtained evidence from the scenes that is being processed and the investigation is ongoing.

The spring fed water sources, which had been diverted and used to water marijuana plants, flow into the South Fork of the Trinity River. The springs were part of a network of subterranean water sources. The scientists reported that impacts from the water diversions and chemicals used on the grows could affect Coho salmon, Chinook salmon, steelhead, foothill yellow-legged frogs and the western pond turtles.

The scientists reported the rodenticides could potentially kill fishes, Northern spotted owls, American black bears, black tailed deer and Humboldt martens.

Below are some quotes from Dr. Mourad Gabriel of the UC Davis Wildlife Ecologist/Integral Ecology Research Center, who was present with the deputies and USFS agents.

“The removal of this massive amount of killing agents within prime spotted owl and fisher habitat is pertinent for the conservation of these species.”                                                        

“The illegal diversion of this amount of water prohibits the flow of cool water into tributaries that support our salmon populations.”

In light of the current drought and high water temperatures, this represents another blow to our already taxed watersheds.”

“The remediation efforts are crucial in protecting our forest ecosystems.”

Anyone with information for the Sheriff’s Office regarding this case or related criminal activity is encouraged to call the Sheriff’s Office at 707-445-7251 or the Sheriff’s Office crime tip line at 707-268-2539.

Redwood Times  Posted:   08/11/2014

http://www.redwoodtimes.com/news/ci_26315593/trespass-grows-found-usfs-land

 

 

 

A study that followed children from birth to midlife found that heavy marijuana users who smoked for years often fared worse as adults than their parents: Many ended up in jobs that paid less, required fewer skills and were less prestigious.

That wasn’t so much the case for other people.

“The rest of the people in the study who were not regular and persistent cannabis users ended up in a higher social class than their parents,” said Magdalena Cerda, lead investigator and associate professor at the University of California, Davis.

The study, published Wednesday in the journal Clinical Psychological Science, also found that marijuana users who smoked at least four times a week experienced more financial difficulties, such as problems with debt and food insecurity, than their parents. Their lives were fraught with more social problems, too.

“They experienced more antisocial behaviour at work such as lying to get a job or stealing money and more relationship problems such as intimate partner violence or controlling behaviour towards their partner,” Cerda said.

Other studies have associated heavy and persistent marijuana use with problems in adulthood but haven’t always ruled out other factors. This research tried to do that by tracking and comparing variables such as intelligence, family structure, gender, ethnicity, parental substance abuse, criminal convictions and antisocial behaviour and depression in childhood.

In accounting for so many variables, researchers made the study’s conclusions stronger, Cerda said, acknowledging that there may be unknown factors that they didn’t track.

Dr. Colin Roberts, a paediatric neurologist at Oregon Health & Science University and a member of Oregon’s Cannabis Research Task Force created to study medical marijuana, said the findings are worth considering.

“It’s a good study,” Roberts said. “They established an association that’s pretty compelling.”

The study’s sample size, almost 950 people, also gives it heft, he said.

The study is based on four decades of data collected in New Zealand, where marijuana is illegal. Investigators have been following people born between 1972 and 1973 in Dunedin, the second largest city on the South Island. The participants in the study come from a range of socio-economic classes, from professionals to unskilled labourers, who had physical, psychological, social and financial assessments at birth and ages 3, 5, 9, 11, 13, 15, 18, 21, 26, 32 and 38.

“There was a large number of people that were looked at which is really important,” Roberts said. “We can’t do studies like this in the U.S. because it’s really hard to collect information on people over that period of time. We don’t have a central source for people’s medical records.”

The study analyzed the data from the childhood evaluations to determine pre-existing conditions that might cause financial or social problems later in life. Then it evaluated the marijuana use of people starting at age 18 through 38 and financial and social problems at age 38. It found that 15 percent were frequent users, which they defined as smoking marijuana four or more times a week.

The longer those people smoked, the worse their problems in midlife.

That’s consistent with what professionals like Dr. Kevin Hill see in their practices. He’s the author of “Marijuana: The Unbiased Truth about the World’s Most Popular Weed” and an addiction psychiatrist at McLean Hospital, an affiliate of Harvard Medical School in Massachusetts.

“This paper supports what we see clinically,” Hill said. “If you’re using at a level that’s consistent with cannabis addiction, you will have problems in multiple spheres – work, school and relationships.”

Not everyone who smoked marijuana four times or more a week for years experienced downward mobility and not everyone who abstained fared better than their parents. But a higher proportion of the former group – nearly 52 percent – had a worse outcome compared with 14 percent of the latter.

The study also looked at alcohol use. Those with an alcohol dependency experienced more social problems than their parents and landed lower-paying jobs. But the marijuana users who were dependent on the drug had even more financial worries than those addicted to alcohol.

“Those of us in the field know that cannabis is potentially dangerous but the same argument should be made with alcohol,” Hill said. “We have 22 million Americans who used cannabis last year and yet we rarely talk about cannabis being dangerous and we should.”

Yet he cautioned that people who are dependent on marijuana remain in the minority, just as those who abuse alcohol are.

Alcohol remains the bigger problem because it’s more widespread, Cerda said, but she added that the increasing acceptance of marijuana could increase the cost to society. Oregon is one of 23 states where marijuana is legal for medical use and four states that have approved recreational marijuana use.

The study points to a need for investment in prevention and treatment, she said.

“If we do that, it may have long-term consequences for the potential burden that this may place on communities, families and on the broader social welfare system,” Cerda said.

Source:  http://www.oregonlive.com/marijuana   23rd March 2016

The nature of the teenage brain makes users of cannabis amongst this population particularly at risk of developing addictive behaviours and suffering other long-term negative effects, according to researchers at the Univ. of Montreal and Icahn School of Medicine at Mount Sinai.

 

“Of the illicit drugs, cannabis is most used by teenagers since it is perceived by many to be of little harm. This perception has led to a growing number of states approving its legalization and increased accessibility. Most of the debates and ensuing policies regarding cannabis were done without consideration of its impact on one of the most vulnerable population, namely teens, or without consideration of scientific data,” write Prof. Didier Jutras-Aswad of the Univ. of Montreal and Yasmin Hurd of Mount Sinai. “While it is clear that more systematic scientific studies are needed to understand the long-term impact of adolescent cannabis exposure on brain and behaviour, the current evidence suggests that it has a far-reaching influence on adult addictive behaviours particularly for certain subsets of vulnerable individuals.”

 

The researchers reviewed over 120 studies that looked at different aspects of the relationship between cannabis and the adolescent brain, including the biology of the brain, chemical reaction that occurs in the brain when the drug is used, the influence of genetics and environmental factors, in addition to studies into the “gateway drug” phenomenon. “Data from epidemiological studies have repeatedly shown an association between cannabis use and subsequent addiction to heavy drugs and psychosis (i.e. schizophrenia). Interestingly, the risk to develop such disorders after cannabis exposure is not the same for all individuals and is correlated with genetic factors, the intensity of cannabis use and the age at which it occurs.

When the first exposure occurs in younger versus older adolescents, the impact of cannabis seems to be worse in regard to many outcomes such as mental health, education attainment, delinquency and ability to conform to adult role,” Jutras-Aswad says.

 

Although it is difficult to confirm in all certainty a causal link between drug consumption and the resulting behaviour, the researchers note that rat models enable scientists to explore and directly observe the same chemical reactions that happen in human brains. Cannabis interacts with our brain through chemical receptors (namely cannabinoid receptors such as CB1 and CB2.) These receptors are situated in the areas of our brain that govern our learning and management of rewards, motivated behavior, decision-making, habit formation and motor function. As the structure of the brain changes rapidly during adolescence (before settling in adulthood), scientists believe that the cannabis consumption at this time greatly influences the way these parts of the user’s personality develop. In adolescent rat models, scientists have been able to observe differences in the chemical pathways that govern addiction and vulnerability – a receptor in the brain known as the dopamine D2 receptor is well known to be less present in cases of substance abuse.

 

Only a minority (approximately one in four) of teenage users of cannabis will develop an abusive or dependent relationship with the drug. This suggests to the researchers that specific genetic and behavioural factors influence the likelihood that the drug use will continue. Studies have also shown that cannabis dependence can be inherited through the genes that produce the cannabinoid receptors and an enzyme involved in the processing of THC. Other psychological factors are also likely involved. “Individuals who will develop cannabis dependence generally report a temperament characterized by negative affect, aggressivity and impulsivity, from an early age. Some of these traits are often exacerbated with years of cannabis use, which suggests that users become trapped in a vicious cycle of self-medication, which in turn becomes a dependence” Jutras-Aswad says.

 

The researchers stress that while a lot remains unknown about the mechanics of cannabis abuse, the body of existing research has clear implications for society. “It is now clear from the scientific data that cannabis is not harmless to the adolescent brain, specifically those who are most vulnerable from a genetic or psychological standpoint. Identifying these vulnerable adolescents, including through genetic or psychological screening, may be critical for prevention and early intervention of addiction and psychiatric disorders related to cannabis use. The objective is not to fuel the debate about whether cannabis is good or bad, but instead to identify those individuals who might most suffer from its deleterious effects and provide adequate measures to prevent this risk” Jutras-Aswad says.

 

“Continuing research should be performed to inform public policy in this area. Without such systematic, evidenced-based research to understand the long-term effects of cannabis on the developing brain, not only the legal status of cannabis will be determined on uncertain ground, but we will not be able to innovate effective treatments such as the medicinal use of cannabis plant components that might be beneficial for treating specific disorders,” Hurd says.

 

Source:  Tue, 08/27/2013 – Univ. of Montreal and Icahn School of Medicine at Mount Sinai.

  • Participants in study who smoked drug daily for around three years had abnormally shaped hippocampus brain region which is vital to memory

  • They also performed around 18 per cent worse in long-term memory tests than individuals who had never touched cannabis

  • Results were uncovered using sophisticated brain-mapping scans taken two years after participants stopped smoking cannabis   

 

Teenagers who smoke cannabis for just three years could be damaging their long- term memory, researchers have warned.

Participants in a study who had used the drug daily for around three years in their teens had an abnormally shaped hippocampus – a region of the brain vital to memory – by the time they were in their early 20s.

They also performed around 18 per cent worse in long-term memory tests than individuals who had never touched the drug. The results were uncovered using sophisticated brain-mapping scans taken two years after they stopped smoking cannabis.

Professor John Csernansky, from Northwestern University in the US, who co-led the research, said: ‘The memory processes that appear to be affected by cannabis are ones that we use every day to solve common problems and to sustain our relationships with friends and family.’

cannabis-smoking

Those who took part in the Northwestern University study who smoked cannabis in their teens performed around 18 per cent worse in long-term memory tests than individuals who had never touched the drug.

The study is one of the first to suggest that abnormally shaped brains in heavy cannabis users are directly related to memory impairment. The longer a participant had been exposed to cannabis the more misshapen their hippocampus appeared on scans. This could mean brain regions related to memory may be more susceptible to the effects of the drug the longer the abuse occurs.

In total, 97 people took part in the study, including some who started smoking cannabis daily between the ages of 16 and 17 and continued for around three years. At the time of the study, they had been cannabis-free for around two years. The scientists used new computer software to fine-map MRI scans of the hippocampus.

Beforehand participants had taken a memory test in which they listened to a series of stories for around one minute before recalling as much of the content as possible 20 to 30 minutes later.

Results of the memory test were correlated with the scans and cannabis use for each individual. Lei Wang, a senior author of the study and assistant professor of psychiatry and behavioural sciences at the university, said: ‘Advanced brain mapping tools allowed us to examine detailed and sometimes subtle changes in small brain structures.’

The study also found that young adults with schizophrenia who abused cannabis in their teens performed about 26 per cent worse on memory tests than young adults with schizophrenia who had never smoked cannabis.

Previous research by the same team has linked poor short- term and working memory performance to abnormal shapes of three other brain regions: the striatum, globus pallidus and thalamus.

Co-author Dr Matthew Smith, whose study is published in journal Hippocampus, said: ‘Both our recent studies link the chronic use of marijuana during adolescence to these differences in the shape of brain regions that are critical to memory and that appear to last for at least a few years after people stop using it.

‘It is possible that the abnormal brain structures reveal a pre-existing vulnerability to marijuana abuse.

‘But evidence that the longer the participants were abusing marijuana, the greater the differences in hippocampus shape suggests marijuana may be the cause.’

Source:http://www.dailymail.co.uk/news/article-2990806/Smoking-cannabis-three-years-teens-ruin-long-term-memory-Using-drug-daily-changes-shape-brain-linked-recall.html#ixzz3XVpmGmKI 

 

Pot for the poor! That could be the new slogan of marijuana legalization advocates.

In 1996, California became the first state to legalize the use of medical marijuana. There are now 25 states that permit the use of marijuana, including four as well as the District of Columbia that permit it for purely recreational use.

Colorado and Washington were the first to pass those laws in 2012. At least five states have measures on the ballot this fall that would legalize recreational use. And that number is only likely to rise with an all-time high (no pun intended) of 58 percent of Americans (according to a Gallup poll last year) favoring legalization.

The effects of these new laws have been immediate. One study, which collected data from 2011-12 and 2012-13, showed a 22 percent increase in monthly use in Colorado. The percentage of people there who used daily or almost daily also went up. So have marijuana-related driving fatalities. And so have incidents of children being hospitalized for accidentally ingesting edible marijuana products.

But legalization and our growing cultural acceptance of marijuana have disproportionately affected one group in particular: the lower class.

A recent study by Steven Davenport of RAND and Jonathan Caulkins of Carnegie Mellon notes that “despite the popular stereotype of marijuana users as well-off and well-educated . . . they lag behind national averages” on both income and schooling.

For instance, people who have a household income of less than $20,000 a year comprise 19 percent of the population but make up 28 percent of marijuana users. And even though those who earn more than $75,000 make up 33 percent of the population, 25 percent of them are marijuana users. Having more education also seems to make it less likely that you are a user. College graduates make up 27 percent of the population but only 19 percent of marijuana users.

The middle and upper classes have been the ones out there pushing for decriminalization and legalization measures, and they have also tried to demolish the cultural taboo against smoking pot. But they themselves have chosen not to partake very much. Which is not surprising. Middle-class men and women who have jobs and families know that this is not a habit they want to take up with any regularity because it will interfere with their ability to do their jobs and take care of their families.

But the poor, who already have a hard time holding down jobs and taking care of their families, are more frequently using a drug that makes it harder for them to focus, to remember things and to behave responsibly.

Legalization and our growing cultural acceptance of marijuana have disproportionately affected one group in particular: the lower class.

The new study, which looked at use rates between 1992 and 2013, also found that the intensity of use had increased in this time. The proportion of users who smoke daily or near daily has increased from 1 in 9 to 1 in 3. As Davenport tells me, “This dispels the idea that the typical user is someone on weekends who has a casual habit.”

Sally Satel, a psychiatrist and lecturer at Yale, says that “it is ironic that the people lobbying for liberalized marijuana access do not appear to be the group that is consuming the bulk of it.” Instead, it’s “daily and near-daily users, who are less educated, less affluent and less in control of their use.”

In fact, the typical user is much more likely to be someone at the bottom of the socioeconomic ladder, whose daily life is driven, at least in part, by the question of how and where to get more marijuana. Just consider the cost. Almost a third of users are spending a tenth of their income on marijuana. And 15 percent of users spend nearly a quarter of their income to purchase the drug. The poor have not only become the heaviest users, but their use is making them poorer.

To all the middle-class professionals out there reading this: Do you know anyone who spends a quarter of their income on pot? Of course not. But these are the people our policies and attitudes are affecting.

As the authors of the study note, marijuana use today actually more closely resembles tobacco use than alcohol use. Cigarette smoking has completely fallen off among the educated and well-off, while the poor and working class have continued their habits. Even as far back as 2008, a Gallup poll found that the rate of smoking among people making less than $24,000 a year was more than double that of those making $90,000 or more.

But at least the rates have been going down for everyone. Thanks to a cultural shift on the acceptability of smoking, awareness campaigns about its dangers and a variety of legal measures regarding smoking in public facilities, smoking is significantly less popular. You could object to some of these public policies on the grounds that the government should mind its own business. But the truth is that Americans across all incomes are now less likely to suffer from the harmful effects of smoking.

Maybe the upper classes in this country have some romantic notion of what marijuana can do to the mind (though we once thought cigarettes were terribly classy too). But it is time to get over such silliness and consider the real effects of our attitudes.

As Manhattan Institute fellow and psychiatrist Theodore Dalrymple says, this is like the 1960s all over again. He tells me, “I’m afraid I can’t hear all that stuff about ‘tune in, drop out’ without being infuriated because the people affected really deleteriously [are] people at the bottom.”

Source: http://nypost.com/2016/08/20/legalized-pot-is-making-americas-lower-class-poorer-and-less-responsible/

Abstract

It has been shown that cosmetic treatment like bleaching and perming may lead to an important decrease of drugs of abuse content in hair. Currently, hair straightening has become a regular hair treatment especially for women. The aim of this preliminary study was to investigate the effect of in vitro treatment of hair with heat straightener on cannabis and cocaine concentrations in hair.

17 positive cannabis and 7 positive cocaine hair samples were treated in vitro with a hair straightener. During this treatment hair was put sequentially 30 times in contact with heated iron plates at 200 °C during 2 s corresponding to a total time of contact of 1 min. THC and Cannabinol (CBN) were analysed in cannabis positive hair and cocaine, benzoylecgonin (BZE) and cocaethylene were analysed in cocaine positive hair. Analyses were performed with routine methods using GC/MS in electron impact mode.

Regarding cannabis results a decrease of THC concentrations was found in 11 of 17 hair samples after thermal treatment, whereas in 6 cases an increase was shown. In all the hair samples CBN concentrations was explicitly higher after the in vitro treatment. Regarding cocaine results cocaine and cocaethylene concentrations decreased after treatment in all seven hair samples; in contrast, higher concentrations of BZE were determined.

The strong increase of CBN and BZE content in hair after thermal treatments may be due to the fact that THC is converted by heat into CBN and cocaine into BZE, thus changing the respective ratios of the analysed substances. In conclusion, thermal straightening should be considered as other cosmetic hair treatments for a correct interpretation of hair results.

Source:  http://www.fsijournal.org/    August 2016   Volume 265, Pages 13–16 DOI: http://dx.doi.org/10.1016/j.forsciint.2016.01.002

COBURG, Ore.  Serenity Lane says they’re seeing a growing number of people battling “Marijuana Use Disorder.” Many people have become habitual users to start their day by using the drug In Oregon, marijuana is legal for recreational and medical use, but one local drug rehab facility is concerned about pot addiction. Serenity Lane is an alcohol and drug treatment facility in Coburg.  Staff members said they’re seeing an increase in people with what they call “Marijuana Use Disorder.”

Manager Jerry Gjesvold at Serenity Lane said they see addiction trends years in advance. “Just like the opioid epidemic”, Gjesvold , “said we are seeing the beginning stages of a growing marijuana addiction”.

“Well, we know now that in the DSM-5, which is the manual that’s used to diagnose substance use disorders, there’s a specific marijuana use disorder diagnosis,” said Gjesvold.   Gjesvold said they see more patients as young as 18 years old even though the legal age for recreational marijuana use is 21.

“[Marijuana use] has become a much more acceptable, and because of that there’s more people that are using it,” Gjesvold said.   He said youth tend to be at higher risk for addiction. It’s because they use devices like vaping and assortments of marijuana like hash oil.

Products with higher THC concentration are more dangerous, but are easier to hide from parents.  “The universal response on the part of parents is that, ‘I had no clue,'” Gjesvold said.

The interim medical director, Paul Steier, at Serenity Lane says highly concentrated levels of THC can have a negative impact on the developing brains of young people. “They have trouble sequencing, doing numbers, word recollection,” Steier said.

Steier said in some cases it creates schizophrenic types of behavior. He said side effects from marijuana use disorder persist for a minimum of five months.  “But there clearly is a withdrawal experience from cannabis, especially in the habitual users, who are the people who sort of wake and bake,” said Steier.

Steier said the withdrawal experience is the same as other addictions causing changes in heart rate, blood pressure, and body temperature.

Source:  http://kval.com/news/local/rehab-facility-says-more-people-are-battling-marijuana-use-disorder    11th July 2016

Dr. Raj Waghmare says Cannabinoid Hyperemesis syndrome is stomach pain and nausea that can be helped by hot baths or stopping cannabis use.

Marijuana is having a moment. The once recreational-use-only drug is now considered by many as a medicine, an anti-nauseant and pain reliever, even an epilepsy medication.

But some long-term “pot heads” are finding the drug they once loved can suddenly turn on them and become almost toxic.   These users are developing a little-understood condition called cannabinoid hyperemesis syndrome that brings on unrelenting vomiting, nausea and stomach pain.

Standard medications do not relieve it, smoking more marijuana only seems to worsen it, and some doctors say they are seeing a lot more cases of it.

It was intense stomach pains that brought Dave to his doctors four months ago. The 45-year-old from southern Ontario (who’d prefer not to use his full name) knew he needed help when intense cramping left him balled up on the sofa, unable to work.  “I really wasn’t able to function much at all. I was constantly having to lie down with a constant pain,” he told CTVNews.ca by phone.

Even after Dave’s doctor ordered reams of ultrasounds, CT scans, and colonoscopies, no one could find anything wrong with him, leaving Dave frustrated.  “It was starting to take a toll on me after a few months. I was doing all these tests and not knowing what was wrong with me or who to turn to,” he says.  Dave finally turned to the internet, where he stumbled on discussions about cannabinoid hyperemisis, a condition he had never heard of.

History of hyperemesis

The first mention of the syndrome appeared in 2004, when a doctor in Australia published an article in the journal Gut describing several patients with a “cyclical vomiting illness” (or hyperemesis). All the patients had a history of “chronic cannabis abuse” and all seemed to find relief from their symptoms by taking multiple hot showers or baths a day.

“Everything I read about this CHS fit the picture,” Dave says.

“The only thing I didn’t have was the vomiting. But I had nausea and constant stomach pain and I was getting relief with hot baths and showers,” he said.

Dave also had a 25-year history of daily pot smoking. He had recently switched to smoking “shatter,” a marijuana concentrate high in THC, that he believes made things worse. Though Dave had told his doctor about his drug use, he connect his symptoms to

CHS. In fact, the physician may have never seen another patient with CHS. Emergency room doctors such as Dr. Raj Waghmare are seeing them, however. Waghmare recently wrote a blog post about the first time hediagnosed a patient with CHS, just under two years ago.

The well-dressed man had come into his ER with non-stop vomiting and abdominal pain. Like Dave, this man’s blood and urine test came out normal, yet no matter what drug Waghmare offered him, nothing seemed to quell his nausea.

Then the man mentioned that hot baths helped to dull the pain. That’s when Waghmare recognized CHS from an article he had read about in a Canadian medical journal.

It’s a condition that can’t be easily diagnosed, since there is no one test that can spot it. It’s only after everything else has been ruled out and a history of pot use has been established that doctors are left with CHS.

Waghmare says he’s since seen dozens more patients with CHS come through the doors of Southlake Regional Health Centre where he works.

“I probably see this every week in the ER,” he says. “if we were to go through all the charts from a full week, I’m sure we’d see at least a case of day among all the doctors.”

Most of the patients Waghmare sees had no idea that the drug they used every day could suddenly become toxic to them.  “People don’t know that this exists,” he says.

What actually causes CHS remains a mystery. The THC (tetrahydrocannabinol) in marijuana causes the drug’s high by stimulating the brain’s cannabinoid receptors, but one theory is that in some patients, those receptors eventually become overloaded.

“So it will work for nausea in the beginning, but then it will totally desensitize the receptors so that people will just feel nauseated all the time,” says Waghmare.

Why some patients develop the syndrome and others don’t remains a mystery; the condition hasn’t been the subject of rigorous scientific study. It appears to develop in those who smoke weed several times a day for a decade or so. But there is some evidence that people who begin daily pot use at a young age are more at risk.

The majority of CHS patients coming to see Waghmare are young men who have been smoking marijuana since high school. By the time they reach their mid-20s, they have a decade of use under their belts.

And yet many refuse to believe the pot is the problem.

When Waghmare tells young pot users the only thing that will end their vomiting and pain is to quit smoking weed for good, they often stop listening.  “A lot of these patients who come in are ‘frequent flyers,’ They’ve heard it before and they refuse to believe it. They refuse to give it up,” he says.

But older patients often take his advice and quit cold turkey, as the patient who Waghmare wrote about promised he would do. As an ER doc, however, he has no way of following up. At least one Facebook group has also been formed in which users discuss their symptoms and experiences.

As for Dave, he says has stopped smoking both marijuana and shatter. In fact, he wishes he never tried shatter at all, since he suspects that is what triggered his symptoms. Now, after three months of pain, he’s finally beginning to feel better. He’s also found a new doctor and has begun a new drug regimen for his Type 2 diabetes, which is also helping him feel better.

But doctors like Waghmare says there needs to be more awareness that this syndrome can develop in some pot users.

With all the recent discussions about the medicinal uses for marijuana, and the ongoing discussion about legalization, Waghmare says many pot users assumes the drug is benign, that it relieves pain and nausea, that there’s no way it could cause it.

“There’s this belief that (marijuana) is totally safe, a miracle drug, Not true,” he says.

Source:  http://www.ctvnews.ca/health/pot-pains-why-marijuana-can-become-toxic-for-some-1.2984756     13th July 2016

 

Abstract

The recent demonstration that massive scale chromosomal shattering or pulverization can occur abruptly due to errors induced by interference with the microtubule machinery of the mitotic spindle followed by haphazard chromosomal annealing, together with sophisticated insights from epigenetics, provide profound mechanistic insights into some of the most perplexing classical observations of addiction medicine, including cancerogenesis, the younger and aggressive onset of addiction-related carcinogenesis, the heritability of addictive neurocircuitry and cancers, and foetal malformations.

Tetrahydrocannabinol (THC) and other addictive agents have been shown to inhibit tubulin polymerization which perturbs the formation and function of the microtubules of the mitotic spindle. This disruption of the mitotic machinery perturbs proper chromosomal segregation during anaphase and causes micronucleus formation which is the primary locus and cause of the chromosomal pulverization of chromothripsis and downstream genotoxic events including oncogene induction and tumour suppressor silencing.

Moreover the complementation of multiple positive cannabis-cancer epidemiological studies, and replicated dose-response relationships with established mechanisms fulfils causal criteria. This information is also consistent with data showing acceleration of the aging process by drugs of addiction including alcohol, tobacco, cannabis, stimulants and opioids. THC shows a non-linear sigmoidal dose-response relationship in multiple pertinent in vitro and preclinical genotoxicity assays, and in this respect is similar to the serious major human mutagen thalidomide.

Rising community exposure, tissue storage of cannabinoids, and increasingly potent phytocannabinoid sources, suggests that the threshold mutagenic dose for cancerogenesis will increasingly be crossed beyond the developing world, and raise transgenerational transmission of teratogenicity as an increasing concern.

Copyright © 2016 Elsevier B.V. All rights reserved.

KEYWORDS:

Cannabis; Chromothripsis; Dose-response relationship; Epigenetics; Foetal malformations; Heritable; Interdisciplinary; Microtubules; Oncogenesis; Population effects; Threshold dose; Transgenerational; Tubulin

Source:      Reece AS1, Hulse GK2.   Mutat Res. 2016 Jul;789:15-25. doi: 10.1016/j.mrfmmm.2016.05.002. Epub 2016 May 4.PMID: 27208973    10.1016/j.mrfmmm.2016.05.002   DOI: [PubMed – in process] 

Filed under: Cannabis/Marijuana,Health :

Some cannabis users have developed an “inverted expertise” on the drug – often equipped with more up-to-date knowledge than the people trying to help them, a conference being held at the University of York was told today.

A group of national experts gathered at the University’s King’s Manor to exchange ideas on effective treatment for cannabis users.

There has been a dramatic increase in the number of people seeking treatment for problems related to cannabis use over the last decade. Research has revealed there was a 64% increase in the number of people seeking treatment between 2005 through to 2015 in England. Cannabis has also now overtaken heroin as the drug most likely to prompt calls for help.

The increase in requests for treatment is in contrast with the steady decline in the population’s use of cannabis, delegates were told.

Researchers at the University of York – including Ian Hamilton, Lecturer in Mental Health and Charlie Lloyd, Senior Lecturer in Health Sciences – and the University of Leeds are investigating why so many cannabis users are seeking treatment and how services are responding.

Initial findings suggest that individuals seek help with problems which are not usually associated with cannabis, such as irritability and poor impulse control.

Also, that treatment services are not sufficiently prepared to offer effective interventions, as cannabis is still seen as a benign drug.

Dr Mark Monaghan, a lecturer in Criminology and Social Policy at Loughborough University, told the delegates: “There is this ‘inverted expertise’ around cannabis in which the users have all the up-to-date knowledge of the local markets and the service providers are lagging behind.

“This can have a significant knock-on effect for the kind of services they are providing. Cannabis users are quite knowledgeable in what is going on in terms of the market.

“The providers are slightly lagging behind in terms of their knowledge base. Because they are lagging behind they don’t have intelligence on what the consumers are using; it creates this situation where they don’t really know what to do.”

He added: “We need to know what people are using and we need to offer them evidence-based treatments.

“Treatment across the sector is really variable. We do need more research on the changing nature of the cannabis market. We need to explore the reason why more people are presenting to treatment centres.”

Ian Hamilton, Department of Health Sciences’ Lecturer in Mental Health, who organised the event, said: “This is the first research that has looked at both the demand for cannabis treatment and the reasons why there’s been a significant rise in it. The outcome of the conference today was agreement amongst commissioners, providers and researchers that there is a problem we need to explore, around why people are presenting to treatment services, and how we can offer effective interventions once they are in treatment.”

Source:  https://www.york.ac.uk/news-and-events   7th June 2016

A new study, published in Archives of Sexual Behavior by researchers affiliated with New York University’s Center for Drug Use and HIV Research (CDUHR), compared self-reported sexual experiences related to use of alcohol and marijuana. Since marijuana has increased in popularity in the U.S., the researchers examined if and how marijuana use may influence risk for unsafe sexual behavior.

“With marijuana becoming more accepted in the U.S. along with more liberal state-level policies,” notes Joseph J. Palamar, PhD, MPH, an affiliate of CDUHR and an assistant professor of Population Health at NYU Langone Medical Center (NYULMC), “it is important to examine users’ sexual experiences and sexual risk behavior associated with use to inform prevention and harm reduction.”

In this study, the researchers interviewed 24 adults (12 males and 12 females, all self-identified as heterosexual and HIV-negative) who recently used marijuana before sex. Compared to marijuana, alcohol use was more commonly associated with social outgoingness and use often facilitated connections with potential sexual partners; however, alcohol was more likely than marijuana to lead to atypical partner choice or post-sex regret.

Alcohol was commonly used as a social lubricant to meet sexual partners, and this was related, in part, to alcohol being readily available in social gatherings.

“Interestingly, some users reported that the illegality of marijuana actually facilitated sexual interactions,” notes Dr. Palamar. “Since smoking marijuana recreationally is illegal in most states and smoking it tends to produce a strong odor, it usually has to be used in a private setting. Some individuals utilize such private or intimate situations to facilitate sexual encounters.”

While users often described favorable sexual effects of each drug, both alcohol and marijuana were reportedly associated with a variety of negative sexual effects including sexual dysfunction. For example, marijuana use was linked to vaginal dryness and alcohol was commonly described as increasing the likelihood of impotence among males.

The researchers noted that the sexual effects tended to be similar across males and females, and both alcohol and marijuana were generally associated with loss of inhibitions. Both drugs appear to be potentially associated with increased feelings of self-attractiveness, but possibly more so for alcohol, and participants reported feelings of increased sociability and boldness while consuming alcohol.

While some participants reported that marijuana use made them more selective in choosing a partner, many participants— both male and female—felt that their “standards” for choosing a partner were lowered while under the influence of alcohol.

“It wasn’t surprising that alcohol use reportedly led to less post-sex satisfaction than marijuana,” said Dr. Palamar. “Participants reported feelings of regret more frequently after sex on alcohol, but compared to alcohol they generally didn’t report poor judgment after using marijuana.”

When smoking marijuana, participants tended to reported increased feelings of anxiety or a sense of wariness in unfamiliar situations that they did not generally seem to experience after using alcohol. Therefore, these drugs appear to have different effects with regard to socialization that may precede a sexual encounter.

“Sexual encounters on marijuana tended to be with someone the individual knew,” comments Dr. Palamar. “Sex on alcohol was often with a stranger so the situation before sex may be much more important than the drug used.” Marijuana and alcohol are associated with unique sexual effects, with alcohol use reportedly leading to riskier sexual behavior. Both drugs appear to potentially increase risk for unsafe sex.

“Research is needed continue to study sexual effects of recreational drugs to inform prevention to ensure that users and potential users of these drugs are aware of sexual effects associated with use,” emphasizes Dr. Palamar. “Our results can inform prevention and harm reduction education especially with regard to marijuana, since people who smoke marijuana generally don’t receive any harm reduction information at all. They’re pretty much just told not to use it.”

More information: Joseph J. Palamar et al. A Qualitative Investigation Comparing Psychosocial and Physical Sexual Experiences Related to Alcohol and Marijuana Use among Adults, Archives of Sexual Behavior (2016). DOI: 10.1007/s10508-016-0782-

Source:  http://medicalxpress.com/news/2016-08-drunk-stonedcomparing-sexual-alcohol-marijuana.html   4th Aug.2016

Newswise — New research from the University of British Columbia suggests there may be some truth to the belief that marijuana use causes laziness– at least in rats.

The study, published today in the Journal of Psychiatry and Neuroscience, found that tetrahydrocannabinol (THC), the main psychoactive ingredient in marijuana, makes rats less willing to try a cognitively demanding task.

“Perhaps unsurprisingly, we found that when we gave THC to these rats, they basically became cognitively lazy,” said Mason Silveira, the study’s lead author and a PhD candidate in UBC’s department of psychology. “What’s interesting, however, is that their ability to do the difficult challenge was unaffected by THC. The rats could still do the task– they just didn’t want to.”

For the study, researchers looked at the effects of both THC and cannabidiol (CBD) on rats’ willingness to exert cognitive effort.  They trained 29 rats to perform a behavioural experiment in which the animals had to choose whether they wanted an easy or difficult challenge to earn sugary treats.  Under normal circumstances, most rats preferred the harder challenge to earn a bigger reward. But when the rats were given THC, the animals switched to the easier option, despite earning a smaller reward.

When they looked at the effect of CBD, an ingredient in marijuana that does not result in a high, researchers found the chemical did not have any effect on rats’ decision-making or attention. CBD, which is believed to be beneficial in treating pain, epilepsy and even cancer, also didn’t block the negative effects of THC.

“This was surprising, as it had been suggested that high concentrations of CBD could modulate or reduce the negative effects of THC,” said Catharine Winstanley, senior author of the study and an associate professor in UBC’s department of psychology. “Unfortunately, that did not appear to be the case.”  Given how essential willingness to exert cognitive effort is for people to achieve success, Winstanley said the findings underscore the importance of realizing the possible effect of cannabis use on impairing willingness to engage in harder tasks.

While some people view marijuana as a panacea that can cure all ailments, the findings also highlight a need for more research to determine what THC does to the human brain to alter decision-making. That could eventually allow scientists to block these effects of THC, allowing those who use medical marijuana to enjoy the possible benefits of cannabis without the less desirable cognitive effects.

Method

At the beginning of each behavioural experiment, rats chose between two levers to signal whether they wanted an easy or hard challenge.

Choosing the easy challenge resulted in a light turning on for one second, which the rats could easily detect and respond to by poking it with their nose, receiving one sugar pellet as a reward. In the more difficult challenge, the light turned on for only 0.2 seconds, rewarding the rat with two sugar pellets if they responded with a nose poke.

Source:  http://www.newswise.com/articles/view/659725/?sc=dwtn  24th Aug.2016

Even in a culture that puts safety above all else, pilots aren’t properly educated about the potential dangers of common drugs such as antihistamines and sleeping pills. That’s the conclusion from a new National Transportation Safety Board report on rising drug use among aviators, which largely mirrors trends of greater use of prescription, over-the-counter, and illicit drugs by Americans in general.

About 40 percent of the 6,667 pilots killed in accidents since 1990 had prescription, over-the-counter, or illicit drugs in their bodies, according to a study of nearly 6,600 accidents from 1990 to 2012. Over-the-counter antihistamines such as Benadryl and Claritin were the most common. Antihistamine use rose to almost 10 percent between 2008 and 2012, up from 5.6 percent in the 1990s.

The vast majority of those killed in the period of the study—96 percent—were general aviation pilots typically flying small, one-engine planes; less than 1 percent of incidents involved major airlines. The study focused on evidence of drug use, not on whether the effects of the drug led to impairment while flying. Alcohol was not included in the study because toxicology screenings often detect ethanol the body creates naturally after death.

Use of illicit drugs such as marijuana and cocaine increased to almost 4 percent in the 2008-12 span, up from 2.3 percent in the 1990s. Most of the illicit drugs in the study resulted from greater use of marijuana among the pilots who died, the agency said.

The NTSB, which recommends safety improvements, called on the Federal Aviation Administration to better educate pilots about the potential dangers of some common drugs and develop a policy on marijuana use by pilots. Colorado and Washington have legalized marijuana for adult use, and almost two dozen other states allow marijuana for medical uses. More states are also likely to vote on legalizing recreational and medical marijuana use.

Dr. Mary Pat McKay, the NTSB’s chief medical officer, said more research is needed to determine how drugs can interact with each other and lead to pilot impairment. Sleep aids and pain medications, for example, can hurt pilot performance and yet there aren’t guidelines on how pilots might safely use those drugs.

Source: www.businessweek.com  10th Sept. 2014

The public is lately inundated with stories about “non-violent” drug offenders who have been sent to prison. One case-in-point is the story of Larry Duke, allegedly a fine upstanding citizen and “non-violent drug offender” who received two life sentences for a 1989 conviction involving 14,000 pounds of marijuana.

Please read the original story at the link below and then read the additional facts not contained in the first article. As you will see, the pro-pot people are happy to lie to the American public to gain sympathy for “non-violent” drug offenders who are anything but.

http://blogs.ajc.com/news-to-me/2013/11/14/non-violent-life-sentences/

Here’s the rest of the story.

Duke originally wanted 18,000 pounds but settled on 16,000 (8 tons) at a wholesale price of over $7 million.

During the undercover operation, Duke was described as the “largest marijuana dealer on the eastern seaboard.” In recorded conversations, Duke admitted that he had marijuana warehouses across the country and boasted that he recently moved 70,000 pounds (35 tons) in four days. Duke stressed that the money and the dope should never be in the same place.

After being convicted at trial, the court determined that Duke was a habitual offender since this was Duke’s third felony drug conviction. One of those convictions involved 18 tons of pot (36,000 pounds) which was smuggled into Canada in 1983.

The bottom line is this:

Multiple tons of pot do not get manufactured, harvested,  imported, transported, packaged and sold unless there are a lot of guns around to protect the dope and the money.

The pro-pot lobbyists lie about the statistics because it furthers their claim that a lot of non-violent drug users are going to prison. Besides being untrue, they couldn’t have picked a worse person to highlight than Mr. Duke.

Source: email to DrugWatch International from  Monte Stiles   2014

When The Baltimore Sun ran an editorial about the Maryland mall shooter, who killed two people and then himself, the newspaper said that mental health problems need to be identified sooner. But it failed to breathe a word about killer Darion Aguilar’s admitted marijuana use. Dr. Christine Miller, a semi-retired molecular neuroscientist living in Maryland, was not too surprised by the omission. She says the liberal media tend to ignore the relationship between marijuana and mental illness.

 

“I know that the editors are aware of the marijuana-psychosis connection because I have corresponded in the past with one of their journalists who was unable to get them interested in a story on the topic,” she told Accuracy in Media. “They did publish one letter I wrote to their local Towson Times affiliate.”

Miller has researched the cause of schizophrenia for many years, and is working to stave off marijuana legalization in Maryland. “Though none of my work involved the study of marijuana use, I became aware of the growing body of literature showing its association with the onset of schizophrenia, and I now regard those numerous reports as the most well-replicated finding in schizophrenia research,” she says.

In a case in Colorado, where marijuana has been legalized, the national news media recently aired a video of a man stealing an SUV with a 4-year-old boy inside, but did not emphasize his history of drug abuse, including marijuana. The Denver Post reported that a pickup truck he had stolen earlier was found with drug paraphernalia, including empty syringes, five pipes containing residues believed to be of methamphetamine and marijuana, as well as 2.1 grams of pot.

 

In another sensational case, in Tennessee, a woman who said she smoked marijuana all day and all night drove her car into a church and stabbed her husband. Church Hill Police Department Chief Mark Johnson told The Kingsport Times News that the woman stated that God had told her to stab her husband for “worshipping” NASCAR. The woman said, “I smoke a bunch of weed. I love to smoke it. Sometimes when I do, I start seeing things that others don’t. Isn’t God good? He told me that this would happen, and just look, I am okay.”

 

In the Washington, D.C. area, The Baltimore Sun isn’t the only paper reluctant to examine the marijuana link to mental illnesses, including schizophrenia and psychosis. After Dr. Miller testified to the Maryland House Judiciary Committee about the marijuana-psychosis connection, she was contacted by Frederick Krunkel of The Washington Post, asking for a phone interview. She said, “I replied, along with my phone number and a time to call, but they never called.”

“It turns out that 15 percent of marijuana users experience psychosis, half of whom will go on to become schizophrenic if they don’t stop using,” she told AIM. “Fortunately, many do stop if they aren’t addicted already, because paranoia is no fun.” She says some people are under the misimpression that if someone is psychotic due to marijuana, it comes from what the marijuana is laced with. “In fact,” she says, “the converse is true—a large study out of Finland last year shows that in acute substance-induced psychosis cases, the cannabis users convert to schizophrenia spectrum disorder at the highest rate.”

Incredibly, however, the Maryland House of Delegates passed Del. Cheryl Glenn and Del. Dan Morhaim’s medical marijuana bill in a 127-9 vote. The dope lobby, known as the Marijuana Policy Project, is saying, “Maryland may finally become the 21st state with an effective medical marijuana law!”   In attempting to explain the media’s failure to cover both sides of this debate, Miller said, “I think we are losing our journalistic standards.” She believes that papers like the Post no longer have the “depth of talent” from reporters who understand how to cover scientific evidence in controversies like this.

 

Another factor, she said, is that there’s a “giddy rush” by the media to jump on the “progressive bandwagon,” which views the marijuana movement as fashionable. In this regard, she singled out CNN’s Dr. Sanjay Gupta, who has been promoting “medical marijuana” without taking into account the serious mental health problems associated with its use. She said liberal reporters are also influenced by the perception that too many members of minority groups are being punished for drug use.

 

Despite the rush to legalize marijuana for various purposes, Miller said the media will eventually be forced to cover the link between marijuana use and mental illness because of the growing number and severity of violent incidents involving schizophrenic individuals using the drug. Those whose schizophrenia manifests in the context of drug use are much more likely to be violent. She also says that in the wake of its legalization in Colorado, data is coming out of that state about impaired driving associated with the increasing use of marijuana.

Source:   http://www.aim.org/aim-column/media-continue-cover-up-of-marijuana-induced-mental-illness/   27th March 2014

How goes Colorado’s experience with legal marijuana? Spend some time on social media or on numerous blogs and you’ll read headlines like “Revenue Up, Crime Down!” or “Youth Use Declining After Legalization.” In this short blog series, I will tackle different topics that have been the subject of myth and misinformation. 

First up: crime.

Lately legalization advocates have been cheering numbers that show a decline in crime. There are literally hundreds of articles that have been written with this narrative. But an honest look at the statistics shows an increase — not decrease — in Denver crime rates.

Crime is tracked through two reporting mechanisms: the National Incident Based Reporting System (NIBRS), which examines about 35 types of crime, and the FBI Uniform Crime Reports (UCR). The FBI UCR only captures about 50 percent of all crimes in Denver, so the NIBRS is generally regarded as more credible. The Denver Police Department (DPD) uses NIBRS categories to examine an array of crime statistics, since it is the more detailed and comprehensive source of numbers.

The Denver Police statistics show that summing across all crime types — about 35 in all — the crime rate is up almost 7 percent compared with the same period last year. Interestingly, crimes such as public drunkenness are up 237 percent, and drug violations are up 20 percent.

So why are advocates claiming a crime drop? Easy: They blended part of the FBI data with part of the DPD/NIBRS data to cook up numbers they wished to see. When one picks the Part I data from UCR and uses DPD/NIBRS property-crime numbers only while studiously avoiding the DPD/NIBRS data on all other crimes, one can indeed manufacture the appearance of a decline. As one can see here, even when using the FBI UCR numbers — in their entirety — crime has risen.

A report commissioned by the National Association of Drug Court Professionals puts it nicely:

When a closer look at the data is undertaken, a different picture — something other than “crime is down” — appears to emerge. …

Legalization proponents should not infer causality regarding the downward trend observable when isolating just the UCR’s Part I crime index.

When I asked the president of the Colorado Drug Investigators Association, Ernie Martinez, about these statistics, he urged me to look at the crimes that have been happening in connection to marijuana — even after legalization:

Across the Front Range, we are experiencing more and more butane explosions due to hash extraction methods, calls for service on strong smells, and calls to ER’s on adverse effects after either ingestion or smoked use. Black-market continues to exist unabated, availability of black market marijuana is ever present and cheaper than legalized MJ. Medical marijuana registrants continue to rise due to many factors such as more quantity allowed and more plants allowed, all due to Physician recommendations.

So if crime is up, can we blame legal pot? We do not know whether legalization has anything to do with it. But we do know that reputable news organizations should stop relying on the Big Marijuana lobby for statistics. They wouldn’t blindly trust coal-industry statistics on the environmental effects of strip mining, and they should bring similar skepticism to propaganda claims disseminated by this new industry.

Source:  www.twitter.com/kevinsabet   8th November 2014

 

If medical marijuana is a step toward legalization, just make it legal — or at least decriminalize it — and don’t dump it all on doctors. Making physicians the gatekeepers of legal marijuana is not fair to doctors and is not conducive to public health.

The problem is that marijuana has been prescribed by the courts, not by health-care professionals.

“Dried marijuana is not an approved drug or medicine in Canada,” says the Health Canada website. “The Government of Canada does not endorse the use of marijuana, but the courts have required reasonable access to a legal source of marijuana when authorized by a physician.” Many physicians are reluctant to take on that responsibility.

“We have Health Canada telling us that marijuana is not a medicine, we have our malpractice insurance company telling us to be very cautious because nobody is taking responsibility for the safety of it,” says Dr. Chris Simpson, a Queen’s University cardiologist and incoming president of the Canadian Medical Association.

Simpson doesn’t dismiss marijuana — he says “many compelling anecdotes” indicate that marijuana can help patients with HIV, hard-to-treat seizures and other conditions. But, he adds, “we have people out there saying marijuana can cure cancer, which seems quite improbable.”

“Somewhere in between those two extremes is the truth, and I think we need to find the truth, and the way to do that is with the appropriate research.” Testifying before a parliamentary health committee in May, Dr. Meldon Kahan, medical director of the substance-use service at Women’s College Hospital in Toronto, detailed a long list of harmful effects from cannabis use. They included impairments in attention, increased anxieties, psychosis and cancer.

“Widespread cannabis prescribing by physicians will increase the social and psychiatric harms of cannabis,” Kahan said, calling for the development of evidence-based guidelines for prescribing smoked marijuana.

“Guidelines will give physicians solid grounds on which to make prescribing decisions. Physicians are facing a deluge of requests to prescribe cannabis, and guidelines will give them the support they need to refuse to prescribe cannabis when medically unnecessary or unsafe.”

Because Health Canada allows marijuana to be prescribed by physicians, that enhances the public perception that marijuana is not only harmless, but therapeutic.

“The evidence suggests otherwise,” Kahan said. “Smoked cannabis has negligible therapeutic benefits.” Would marijuana pass the scrutiny of the University of B.C.’s Therapeutics Initiative, established to examine the effectiveness of prescription drugs? It uses solid evidence and rigorous scientific research, and it has saved lives. Marijuana should undergo the same scrutiny as to its potential benefits and harms.

But medical marijuana is not treated the same as other drugs. Science has little to do with it.

“The current means of ‘prescribing’ violates all of the usual practices of medicine,” wrote Maryland psychiatrists Dinah Miller and Anette Hanson in a 2012 Baltimore Sun commentary. “What other medication do we authorize for a year, with no stipulation as to frequency, dose or certainty that there has been a positive response without side effects?”

If marijuana can relieve the agony of someone with severe chronic pain or terminal cancer, who would withhold it? But let’s face it, the biggest demand for pot is as a recreational drug, like alcohol and tobacco. It should be handled the same, with regulations as to its production and distribution. We should not clog our courts and jails with pot-smokers.

By all means, investigate its potential for good, but let’s not pretend it does no harm.

Source: http://www.timescolonist.com/opinion/editorials/editorial-don-t-pretend-pot-is-harmless-1.1304417#sthash.8ubjqn0w.dpuf 9th August 2014

Daily marijuana use among college students is the highest it’s been in more than three decades, and 51 percent of all full-time college students have admitted to smoking pot at some point in their lives.

The group of University of Michigan scientists who conduct the nationwide Monitoring the Future study says illicit drug use has been rising gradually among American college students since 2006, when 34 percent indicated that they used some illicit drug in the prior year.  By 2013, that rate was up to 39 percent, meaning that 429 of the 1,100 students surveyed said they had used one or more drugs in the 12 months preceding the survey.

The study pointed out that daily or near-daily use of marijuana – defined as 20 or more occasions of use in the prior 30 days – has been on the rise. The recent low was 3.5 percent in 2007, but the rate had risen to 5.1 percent by 2013.  “This is the highest rate of daily use observed among college students since 1981 – a third of a century ago,” Lloyd Johnston, the principal investigator of the MTF study, said in a statement.

“In other words, one in every 20 college students was smoking pot on a daily or near-daily basis in 2013, including one in every 11 males and one in every 34 females. To put this into a longer-term perspective, from 1990 to 1994, fewer than one in 50 college students used marijuana that frequently.”

The survey is part of the long-term MTF study, which also tracks substance use among the nation’s secondary students and older adults under research grants from the National Institute on Drug Abuse.

Marijuana has remained the most widely used illicit drug over the 34 years that MTF has tracked substance use by college students, but the level of use has varied considerably over time.  In 2006, 30 percent of the nation’s college students said they used marijuana in the prior 12 months, whereas in 2013 nearly 36 percent indicated doing so.

Nonmedical use of the amphetamine Adderall, used by some students to stay awake and concentrate when preparing for tests or trying to finish homework, ranks second among the illicit drugs being used in college.  According to the study, 11 percent of college students in 2013 indicated some Adderall use without medical supervision in the prior 12 months.

The use of psycho-stimulants, including Adderall and Ritalin, has nearly doubled since the low point in 2008, but their illegal use remained steady between 2012 and 2013.

The next most frequently used illegal drugs by college students are ecstasy, hallucinogens and narcotic drugs other than heroin. About 5 percent of college students reported they had used one of these in the prior 12 months.

Ecstasy use, after declining considerably between 2002 and 2007, from 9.2 percent annual prevalence to 2.2 percent, has made somewhat of a comeback on campus, the study showed.

Nearly 6 percent of students – 5.8 percent – said they had used ecstasy in the prior 12 months in 2012, and was at 5.3 percent in 2013. Hallucinogen use among college students has remained at about 5 percent since 2007, following an earlier period of decline.

The use of narcotic drugs other than heroin, like Vicodin and OxyContin, peaked in 2006, with 8.8 percent of college students indicating any past-year use without medical supervision. Past-year use of these dangerous drugs by college students has since declined to 5.4 percent in 2012, where it remained in 2013.

Use of synthetic marijuana – which used to be legally available and was sold over the counter in convenience stores and other shops – ranked fairly high in 2011 with past-year use at more than 7 percent of college students that year. Just over 2 percent admitted use in 2013.

Fewer than 1 percent of college students in 2013 admitted to using inhalants, crack cocaine, heroin, methamphetamine, “bath salts,” GHB and ketamine in the previous 12 months.

Conversely, alcohol use has declined some on campuses in recent years. In 2008, 69 percent of students said they had at least one drink in the prior 30 days, whereas in 2013 that number had dropped to 63 percent.

Similarly, the percent indicating that they got drunk during that period fell from a recent high of 48 percent in 2006 to 40 percent by 2011, where it then remained through 2013.

Overall, about three quarters – 76 percent – of college students indicated drinking at least once in the past 12 months, and 58 percent sad they had gotten drunk at least once in that period.

Source:  http://www.mlive.com/    8th Sept. 2014

In recent years, the use of cannabis in medical treatment has sparked a heated debate between state and federal governments. Although the federal government has banned marijuana — it is classified as a Schedule I Drug and a license is needed to possess it — some individual states have decriminalized it for medical use. A Schedule I Drug is defined as one with no currently accepted medical use and a high potential for abuse. As of July 2014, 23 states and Washington, D.C., have legalized medical marijuana and have set laws, fees and possession limits. 

What if there were an alternative?  In time, there could be. 

Researchers such as Aron Lichtman, Ph.D., professor of pharmacology and toxicology in the Virginia Commonwealth University School of Medicine, are studying cannabis-like chemicals called endogenous cannabinoids that are made by the human body and brain.

For more than 25 years, Lichtman has studied the effects of marijuana and THC on the brain, and the long-term consequences of exposure.

Below, Lichtman discusses misconceptions about marijuana, defines cannabinoids and delves into his field of research. Ultimately, he hopes his work will lead to the development of a medication that shares the medical benefits of cannabis, but has been scientifically proven to be safe and effective to reduce pain and suffering in patients.

One of the main reasons patients may obtain a prescription for medicinal cannabis is to manage pain due to headaches or diseases such as cancer or chronic conditions such as nerve pain. What are the issues with medical marijuana as it stands now? 

The problem with cannabis is that where it has been made legal, state medical dispensaries can prescribe it for any medical condition. Unfortunately, there are few studies that prove that cannabis is actually effective at treating a particular medical issue, although there are many claims about it.

Further, cannabis is not regulated by the Food and Drug Administration, or any other federal agency. There are no standardized guidelines in place for its use, and there is a lack of scientific evidence to support its use and long-term effects.

The science that we have about marijuana should help guide those who are experts in public health policy. Delivering medication as a raw material that has to be smoked and contains a lot of toxins is not safe.

Health care professionals do not give patients opium to smoke — there are better ways of administering it. As scientists, we know its active ingredients, we’re working on codeine and we have other opiates that chemists have synthesized.  I believe we can do the same thing for cannabis. We can do far better than cannabis.

What is the public perception of marijuana? 

Many in the general public believe that marijuana is safe — and that’s a problem. Cannabis is a drug, it contains THC, and yes, THC does have beneficial medical effects. But there is little known about the implications of long-term use of cannabis, and we’re just starting to investigate this. It could produce problems in terms of learning and memory. We do not know how it effects the brains and bodies of juveniles.

While it is helpful for some people, there are others who can get into trouble with it in terms of dependency. A small percentage of people can have acute panic attacks with it — have a psychotic episode. This can land people in the ER/hospital.

What are cannabinoids? 

Cannabinoids represent a class of drugs that are different in structure, but are most often thought about as being present in cannabis or marijuana.

There are three groups of cannabinoids: phytocannabinoids, synthetic or man-made cannabinoids and endogenous cannabinoids.

The most well-known cannabinoid is delta-9-tetrahydrocannabinol, or THC, which is the main constituent of cannabis responsible for most of the effects associated with marijuana. In addition to THC, there are more than 100 similarly structured chemicals. Some of them have THC effects, and some have effects of their own. These are called phytocannabinoids, which are plant-derived cannabis-like chemicals.

How did synthetic/man-made cannabinoids come to be? How potent are they? 

Through the years, chemists have been involved with this research and once the structures of these naturally-occurring plant materials were elucidated, the chemists made modifications to these structures so they could add different chemical constituents to THC or change it around – and these are considered synthetic or man-made cannabinoids.

There are thousands of synthetic cannabinoids that have been developed. Some of these are equally as potent as THC, others are inactive. But there are some that are up to 100 times more potent than THC. Potency refers to the dose that delivers a given effect. When there is an increase in potency of these chemicals, there can be a lot of side effects.

THC is approved by the FDA in a capsule to be taken orally to treat nausea and vomiting associated with cancer chemotherapy and to stimulate appetite in AIDS patients. The dose range is between 5 and 90 milligrams. A synthetic cannabinoid in pill form called cesamet is also approved by the FDA which delivers a similar effect as marinol, but at a fraction of that dose. It can be done at 2-4 milligrams per day.

Your main area of research focus is the third type of cannabinoid — endocannabinoids. What is known about this group?

Endogenous cannabinoids are chemicals that naturally occur in our bodies and brains. They are lipids, so they are greasy and stick to cell membranes very well. When compared with THC and synthetic cannabinoids, endogenous cannabinoids differ in chemical structure – but they produce very similar effects. Much in the way endorphins (which occur in the body) mimic morphine and heroine, which are both opiates derived from plant matter, the endocannabinoids mimic THC.

Anandamide and 2-arachidonoylglycerol, or 2-AG, are examples of endocannabinoids. 2-AG can be found in the central nervous system at a high concentration. These endocannabinoids work dramatically differently to the chemicals in marijuana. The body produces enzymes that very quickly break down these endocannabinoids. We and others have developed drugs that inhibit these enzymes, which when administered in preclinical models result in elevated levels of endocannabinoids and reductions in pain and anxiety, but without THC-like effects. Our bodies also have marijuana-like receptors called cannabinoid receptors. We have studied these, too.

Through your research, what are you hoping to learn? How could this research one day impact patients? 

Our goal is to see if we can produce a medication that is targeted toward this naturally occurring marijuana-like system. To get there, we need to understand how the endogenous cannabinoid system works on the basic science level.

From there, we can eventually develop a medication that has decreased dependence liability and decreased addiction liability (so people are not going to crave it and become dependent on it), but it would reduce pain and make people more functional.

This work could possibly impact treatment for different disease states — from post-traumatic stress disorder to neurodegenerative diseases such as Alzheimer’s disease and Parkinson’s disease. The medications that may be developed could help reduce some of the symptoms of disease and improve a patient’s quality of life.

There’s not going to be a cure-all, but I think the potential is there to help with public health by understanding how the system works and developing target drugs and therapies. This is not developing another anti-inflammatory drug that works like all the rest but in a new flavor. This is searching out brand new targets, finding different enzymes that regulate endocannabinoids that can produce a wide range of effects.

Source:  http://www.healthcanal.com/   8th Sept 2014 

Others see a regulated, licensed dispensary model, perhaps with medical supervision. But misuse of opiate pharmaceuticals already represents the second-largest illicit drug threat in America. Would there be political corruption in the quest for those dispensary licenses? Perhaps, as with marijuana in Colorado, the state itself will run the show. What are the political implications of a state-regulated market for drugs? I have witnessed one such scheme, in Amsterdam, with the state-controlled distribution of heroin. The physician in charge presided over a clean, well-lit facility, clinical and efficient, where every morning that day’s clients entered her facility for their supervised heroin injections. The Dutch called their scheme “daycare.” 

Come evening, the clients were discharged back into the streets. What if these drug users decided to continue their career of crime and seek illicit heroin to supplement their state-supported allotment? “Oh, that doesn’t happen,” the doctor assured me with a chilling smile. “If so, we simply withhold their heroin.” This state has a nanny, indeed, and I fear that her clients are no longer free. They are wards of the state, and they are kept on a tight leash. 

Controlled addiction happens elsewhere in the world, too. There is evidence that, in some places, suicide bombers, youth warriors, child sex slaves and even manual laborers are given drugs to keep them captive. Criminal drug dealers have long used such leverage to “own” their clientele. 

For the addicted, the price exacted to maintain their dose may be bottomless, and can entail betrayals of self and others. The “clients” of Amsterdam are no longer active citizens, nor are they even willing actors, for they have contracted a disease that threatens their self-governance and gives whoever controls their drug of choice undue power over them. Do we want to hand the government that leash? 

To be sure, some libertarians would stop at legalizing marijuana. But it’s hard to see how that will last. Marijuana is addictive (responsible for three-fifths of illicit drug abuse according to a 2012 National Survey on Drug Use and Health), and is a gateway to other drugs. Already, in parts of Europe and even Canada, cocaine, meth and opiates are legally used, with heroin distribution state-sponsored. This is not a conjectural debate.

And the political risks are already evident. All these marijuana users that are reliable supporters of pro-legalization candidates in their state campaigns—that donate their money and pledge their votes—how would we feel if they were all heroin users, compelled by their disease to support a particular political candidate? The fact that the United States is currently experiencing a surge in heroin makes this a question worth asking. Even President Obama, whose administration has facilitated marijuana legalization, himself asked the logical follow-up question: “[What if] we’ve got a finely calibrated dose of meth, it isn’t going to kill you or rot your teeth, are we OK with that?”  

Are we? 

How does a libertarian abide the threat that today’s congressman might become tomorrow’s party functionary in charge of dispensing or withholding the desperately needed dose? If an essential predicate of libertarian society is the willing, rational actor, capable of weighing and understanding consequences, what’s left when this condition is absent?  Such a state is not the attainment of liberty, but rather its end. 

John P. Walters, director of drug control policy for President George W. Bush, is chief operating officer of the Hudson Institute.  

Source: http://www.politico.com/magazine/story/2014/06/why-libertarians-are-wrong-about-drugs-107896_Page2.html#ixzz3D2I5DxCy   16th June 2014

Filed under: Cannabis/Marijuana,USA :

I live in Denver, where marijuana dispensaries outnumber pharmacies, liquor stores, McDonald’s and Starbucks. When I walk and drive the streets of this beautiful Rocky Mountain city, I often encounter the smell of marijuana smoke. Marijuana users are not allowed to smoke openly and publicly, but a bench in the front yard is considered private property, allowing the smell to pollute the clean mountain air. 

The problems in Colorado began 14 years ago with the passage of Amendment 20 legalizing medical marijuana. Abuse and fraud flourished under its provisions because medical marijuana became easily available for recreational use.

In November, Florida voters will be faced with the choice to legalize marijuana for “medical use.” Voters should instead ask themselves whether they want marijuana legalized in Florida for recreational use. That’s essentially what Amendment 2 will do. The amendment is so flawed that if it passes, medical marijuana will be readily available for anyone who wants to obtain it.

Like Colorado, Florida’s Amendment 2 allows “Medical Marijuana Treatment Centers” to develop edibles. These food products have been developed intentionally to allow discreet consumption of marijuana in public places, at schools and in the workplace, and to introduce the product to a larger – younger – consumer base.

In Colorado, marijuana is sold in soda, salty snacks like nuts, granola bars, breakfast cereals, cookies, rice cereal treats, cooking oil and even salad dressing. Some companies buy commercially available children’s candies like Swedish fish, Sour Patch Kids, lollipops or lemon drops and infuse them with marijuana. Others make chocolate bars, Tootsie Rolls and truffles.   So now in Colorado, parents who once taught their children not to take candy from a stranger must tell their children not to take candy from a friend because it could very well contain marijuana. Our emergency rooms report a striking increase in children who have unintentionally ingested marijuana edibles and require medical treatment.

Florida’s Amendment 2 allows for any medical condition, not just terminal, chronic or debilitating conditions, to qualify for marijuana treatment, as long as “a physician believes that the medical use of marijuana would likely outweigh the potential health risks for a patient.” This exception will result in patients who use marijuana to get high, despite the stated intention of the amendment to prohibit such conduct.

Colorado’s marijuana patient registry statistics show that only 1 percent of patients list HIV/AIDS; 2 percent, seizures; and 3 percent, cancer. A whopping 94 percent of those using “medical marijuana” claim to have “severe pain,” a subjective and unverifiable condition.

Sixty-six percent of users are male with an average age of 41, despite severe pain being a condition more closely associated with older, female patients. In Denver, it is common to see young, 20-something able-bodied men flocking to medical marijuana centers Friday and Saturday nights to get their “medicine.”  Since outright legalization in 2012 for all persons 21 or older, Colorado has seen an explosion of medical marijuana patients between 18-20 years old.

Moreover, the long-term health implications from youth marijuana use are troubling. A longitudinal study found an association between weekly marijuana use by persons under the age of 18 and permanent decline in IQ.

You might think Florida won’t go as far as Colorado and Washington, but it will be one step closer. Every state that passes medical marijuana laws believes they will be able to correct the errors of those who have paved the way. This has yet to be accomplished.

The Colorado experiment is failing our children, and so will Florida’s. Coloradans may not be able to go back in time, but you can stop yours before it starts.

Rachel O’Bryan is a Colorado resident and an attorney who spent 18 months serving at the request of Governor John Hickenlooper and the Colorado Department of Revenue to aid in the development of recreational marijuana legislation and regulation. She is a founding member of SMART Colorado, a citizen-led nonprofit that protects Colorado kids from the unintended negative consequences of legalizing marijuana for recreational use.

Source:  http://www.pnj.com/story/opinion/2014/09/13/viewpoint-colorado-going-pot-let-florida/15534781/

The proportion of marijuana-positive drivers involved in fatal motor vehicle crashes in Colorado has increased dramatically since the commercialization of medical marijuana in the middle of 2009, according to a study. The study raises important concerns about the increase in the proportion of drivers in a fatal motor vehicle crash who were marijuana-positive since the commercialization of medical marijuana in Colorado, particularly in comparison to the 34 non-medical marijuana states. 

ShapeThe proportion of marijuana-positive drivers involved in fatal motor vehicle crashes in Colorado has increased dramatically since the commercialization of medical marijuana in the middle of 2009, according to a study by University of Colorado School of Medicine researchers.

With data from the National Highway Traffic Safety Administration’s Fatality Analysis Reporting System covering 1994 to 2011, the researchers analyzed fatal motor vehicle crashes in Colorado and in the 34 states that did not have medical marijuana laws, comparing changes over time in the proportion of drivers who were marijuana-positive and alcohol-impaired.

 The researchers found that fatal motor vehicle crashes in Colorado involving at least one driver who tested positive for marijuana accounted for 4.5 percent in the first six months of 1994; this percentage increased to 10 percent in the last six months of 2011. They reported that Colorado underwent a significant increase in the proportion of drivers in a fatal motor vehicle crash who were marijuana-positive after the commercialization of medical marijuana in the middle of 2009. The increase in Colorado was significantly greater compared to the 34 non-medical marijuana states from mid-2009 to 2011. The researchers also reported no significant changes over time in the proportion of drivers in a fatal motor vehicle crash who were alcohol-impaired within Colorado and comparing Colorado to the 34 non-medical marijuana states.

Stacy Salomonsen-Sautel, Ph.D, who was a postdoctoral fellow in the Department of Pharmacology, is the lead author of the study, which is available online in the journal Drug and Alcohol Dependence. Christian Hopfer, MD, associate professor of psychiatry, is the senior author. 

Salomonsen-Sautel said the study raises important concerns about the increase in the proportion of drivers in a fatal motor vehicle crash who were marijuana-positive since the commercialization of medical marijuana in Colorado, particularly in comparison to the 34 non-medical marijuana states. While the study does not determine cause and effect relationships, such as whether marijuana-positive drivers caused or contributed to the fatal crashes, it indicates a need for better education and prevention programs to curb impaired driving.

Source:. Trends in fatal motor vehicle crashes before and after marijuana commercialization in Colorado. Drug and Alcohol Dependence, 2014; DOI: 10.1016/j.drugalcdep.2014.04.008

Many of the Op-Eds on the subject of the legalisation or otherwise of cannabis are written by journalists or protagonists of one or other point of view. The following links give scientific evidence from scientist and medics in the USA, and do not support the use of cannabis.

 

Medical organisations in the USA do not support smoked pot or edibles

   
   

Authoritative organisations which do not support smoked pot or edibles as a legitimate form of medication, listed by:

Rethinkpot.org:

American Medical Association,

American Cancer Society,

National Multiple Sclerosis Society, 

American Glaucoma Society,

American Academy of Pediatrics, 

National Institute of Drug Abuse (NIDA),

Substance Abuse and Mental Health Service Association (SAMHSA),

Food and Drug Association  (FDA),

American Academy of Ophthalmology,

Drug Enforcement Agency (DEA),

American Society of Addiction Medicine,

Epilepsy Foundation.

 

News coverage about marijuana legalization is fairly predictable. If there’s even a toehold to support driving this addictive substance into the country, count on splashy headlines. Today’s breathless summaries of President Barack Obama’s remarks on the subject to The New Yorker were no exception.

The chief narrative spinning out at this hour boils down to this one quote from the President: “I don’t think it (marijuana) is more dangerous than alcohol.”

Cue the sampling of headlines appearing this evening on a Google search:

Fox News: “Marijuana no more dangerous than alcohol”
USA Today: “Obama: Pot no more dangerous than alcohol”
CNN: Obama says marijuana ‘no more dangerous than alcohol’
Huffington Post: “Obama: Marijuana no more dangerous than alcohol’
Time’s Swampland: “Obama says marijuana can be less dangerous than alcohol”
The (U.K.) Telegraph: “Barack Obama says smoking marijuana less dangerous than alcohol”
NPR: Marijuana is ‘not more dangerous than alcohol’

(Check out how this article conveniently lops off the President’s most critical remarks about marijuana — and asks readers to click over to The New Yorker to see those.)

Then there’s this from Time: “Obama on Marijuana Legalization: ‘It’s important for it to go forward.’”

Now, take a look at the full passage to which these news organizations — and many others — were reacting. It appears at the bottom of this post. The President expresses a fair amount of skepticism about marijuana legalization — but you wouldn’t know that if you’re just skimming the headlines and stories rocketing around the world at this hour.

Why no headlines screaming that the President called the case for marijuana legalization “overstated?” Why aren’t news organizations trumpeting that he called marijuana use a “bad idea, a waste of time, not very healthy.” Where are the headlines about the President’s acknowledgement that marijuana legalization could lead to a slippery slope of negotiated doses of cocaine and finely calibrated doses of meth?

After all, the President has to know the nation’s largest marijuana-advocacy groups already are laying the groundwork for full-scale recreational drug legalization that includes psychedelics, meth and cocaine. This is no secret. They’ve been at it for decades. Just a few months ago, Ethan Nadelmann, executive director of the Drug Policy Alliance, led what amounted to a pep rally for recreational drug lovers. Among his rah rah sis boom bah:

What is it we’re fighting for? Is it simply to legalize it all … some of us, yes, some of us, yes. Some of us believe deeply in our hearts that the best way to treat every drug is the way we treat alcohol and cigarettes today. And we may in fact be right. But what I also know is that to make that argument to the broader public, the public who has engaged and accepted that marijuana should be legally regulated, that we need to hold their hands and engage them into a different basis.”

Nadelmann followed up with this: “We’re not just a movement or people who like marijuana and relish our psychedelics … all the other drugs we enjoy, and we do so responsibly.”

Let’s ask President Obama what he thinks about all of that — and let’s demand the clear and straight answers we’re not getting from him.

While reporters eager to make the case that using weed is much like having a glass of wine or craft beer with a meal spin like tops, far more astute observers see very clearly what’s going on here: the President is playing both sides of a fence. Even some staunch legalization advocates bemoaned his waffling remarks, calling his position on marijuana “incoherent.” Again, judging from today’s giddy and incredibly myopic news coverage, you’d think he was crystalline.

Similarly, smart and responsible journalists will stop the cheerleading for weed — and the stenography — and doggedly question the President’s easy-breezy comparisons of marijuana and alcohol. He’s got opinions, but does current, reputable science support them? Not really, especially if we’re talking child health. Today’s marijuana is at least 10 times more potent than the strains the President recalls using when he was a teenager and young adult. The President — and everyone else basing their opinions on their experiences in the 1960s, ’70s, ’80s and ’90s — must also stop to consider highly concentrated and increasingly popular forms of marijuana called “hash oil.” Doses of that oil often exceed 80 percent THC. That’s a far cry from the weed of Woodstock, which contained 1-3 percent THC, and the marijuana of around 8 percent THC the President used in the 1980s. This is obvious, and it’s worth mentioning.

Also worth mentioning? Kids take their cues from adults — especially adults they admire, like President Obama. So, when he says he doesn’t think marijuana is more dangerous than alcohol, is he stopping to consider what our nation’s health — specifically our nation’s child health — would look like if adolescent marijuana use rates caught up with youths’ use rates of alcohol? The rest of us should certainly stop to think about that — and let’s not wait for news organizations to get around to the reporting. Review the University of Michigan’s Monitoring the Future study for yourself. In 2013, 22.7 percent of high school seniors reported past-month use of marijuana compared to 39.2 percent of seniors who said they used alcohol in the previous 30 days.

Another elephant in this room? The President’s senior drug policy advisors at the White House Office of National Drug Control Policy and the National Institute on Drug Abuse are not on board with marijuana legalization — and it sure would be interesting to know what they make of the President’s comparison of marijuana and alcohol. Similarly, it would be great to know what they think of the President’s remark that it’s “important” for efforts to legalize recreational marijuana in Colorado and Washington — which he also said would be “a challenge” — to move forward. When is it also going to be just as important for these states to pull the plugs on their grand experiments? How much death and destruction must be recorded to make those determinations? Whatever those limits are, it’s probably safe to say the President will be out of office when our country faces them.

At least President Obama makes clear he wants to reform laws that perpetuate racial and ethnic disparities and punish addiction more than treat it. That, too, is a case wildly overstated by marijuana supporters — and the President, having very easy access to public records and advisors who routinely present this information to communities across the country, probably knows this, too. But good for him. Many drug-prevention groups — such as Smart Approaches to Marijuana, or Project SAM — stand with him there. I strongly suspect the President knows marijuana legalization is not at all necessary to make those reforms — so it’s worth asking him what he’s waiting for. Why not champion reform now? We can certainly make changes without compromising the interests of public health and safety.

On the issue of marijuana legalization, President Obama needs to get serious because, whether he likes it or not, pot — especially as the drug harms American youth in greater numbers — is fast becoming a very big part of his legacy and grossly undermining his stated goals for reforming healthcare and education. He needs to lead — and that guidance for our nation must be rooted in much, much more than his opinions and personal experience.

Christine Tatum is a former staff writer for The Denver Post, Chicago Tribune, (Arlington Heights, Ill.) Daily Herald and (Greensboro, N.C.) News & Record. She was elected to serve as 2006-07 national president of the Society of Professional Journalists.

Global reaction:

The United States has staggering problems with alcohol and is failing to control its use and harm — which is all the more reason marijuana legalization is a bad idea for the U.S. and the world, writes Sven-Olov Carlsson, intentional president of IOGT International, in this open letter to President Obama. The IOGT is the world’s largest body of drug-prevention-and-policy advocates.

The President’s remarks on marijuana legalization as reported by The New Yorker:

When I asked Obama about another area of shifting public opinion—the legalization of marijuana—he seemed even less eager to evolve with any dispatch and get in front of the issue. “As has been well documented, I smoked pot as a kid, and I view it as a bad habit and a vice, not very different from the cigarettes that I smoked as a young person up through a big chunk of my adult life. I don’t think it is more dangerous than alcohol.”

Is it less dangerous? I asked.

Obama leaned back and let a moment go by. That’s one of his moves. When he is interviewed, particularly for print, he has the habit of slowing himself down, and the result is a spool of cautious lucidity. He speaks in paragraphs and with moments of revision. Sometimes he will stop in the middle of a sentence and say, ‘Scratch that,’ or, ‘I think the grammar was all screwed up in that sentence, so let me start again.’

Less dangerous, he said, ‘in terms of its impact on the individual consumer. It’s not something I encourage, and I’ve told my daughters I think it’s a bad idea, a waste of time, not very healthy.’ What clearly does trouble him is the radically disproportionate arrests and incarcerations for marijuana among minorities. ‘Middle-class kids don’t get locked up for smoking pot, and poor kids do,’ he said. ‘And African-American kids and Latino kids are more likely to be poor and less likely to have the resources and the support to avoid unduly harsh penalties.’ But, he said, ‘we should not be locking up kids or individual users for long stretches of jail time when some of the folks who are writing those laws have probably done the same thing.’ Accordingly, he said of the legalization of marijuana in Colorado and Washington that ‘it’s important for it to go forward because it’s important for society not to have a situation in which a large portion of people have at one time or another broken the law and only a select few get punished.’

As is his habit, he nimbly argued the other side. ‘Having said all that, those who argue that legalizing marijuana is a panacea and it solves all these social problems I think are probably overstating the case. There is a lot of hair on that policy. And the experiment that’s going to be taking place in Colorado and Washington is going to be, I think, a challenge.’ He noted the slippery-slope arguments that might arise. ‘I also think that, when it comes to harder drugs, the harm done to the user is profound and the social costs are profound. And you do start getting into some difficult line-drawing issues. If marijuana is fully legalized and at some point folks say, Well, we can come up with a negotiated dose of cocaine that we can show is not any more harmful than vodka, are we open to that? If somebody says, We’ve got a finely calibrated dose of meth, it isn’t going to kill you or rot your teeth, are we O.K. with that?’”

Source: Dr.Thurstone.com Jan.19th 2014

For decades, the Netherlands has been known for its tolerant cannabis laws – the poster nation for pro-pot advocates. Cannabis users from across the world have flocked to Amsterdam to patronize its many cannabis-selling “coffee shops.” Throughout this time cannabis has remained illegal in the Netherlands; although, the Dutch have not prosecuted anyone in possession of less than five grams of cannabis for personal use. This distinctive drug policy of tolerance toward cannabis is called gedoogbeleid, and known as the “Dutch model.”

Now, the U.S. now is the first, and so far the only, nation in the world to have fully legal production, sale, promotion, and use of cannabis for people 21 an older. In stark contrast, the Dutch are moving in the opposite direction, limiting the growth, distribution, and use of cannabis and showing no interest in “medical marijuana.” Cannabis with a THC level of more than 15 percent is now under consideration to be reclassified as a “hard drug.” In the Netherlands, that designation comes with stiff criminal penalties. Furthermore, the nation once had more than 1,000 coffee shops, 300 in Amsterdam alone. Now, there are fewer than 200 in the city and 617 nationwide. This is the result of the government’s actions to force coffee shops to choose either to sell alcohol or marijuana. Notably, many are choosing to sell alcohol.

While it has always been illegal to grow cannabis in the Netherlands, for years police acted as if they didn’t know where the shops were getting the drug. This is no longer the case. Now, new laws target even the smallest cannabis growers. In the past, anyone could grow up to five plants without fear of penalty. In 2011, the government issued new police guidelines declaring that anyone who grew cannabis with electric lights, prepared soil, “selected” seeds or ventilation would be considered a “professional” grower. This is a significant change because professional growers risk major criminal penalties, including eviction and blacklisting from the government-provided housing in which more than half of the country’s citizens reside.

What made the Netherlands make such a strong shift in its cannabis policy? The overall drug policy of the Netherlands – not just for cannabis but including cannabis – has four major objectives:

1. To prevent recreational drug use and to treat and rehabilitate recreational drug users.

2. To reduce harm to users.

3. To diminish public nuisance by drug users (the disturbance of public order and safety in the neighborhoods).

4. To combat the production and trafficking of recreational drugs.

The Netherlands has determined that its relaxed cannabis laws were a threat to these expressed public health objectives. The nation’s new, more restrictive laws on cannabis, including the banning of cannabis with THC levels of 15 percent or more, demonstrate that the government wants to reduce cannabis sale and use for reasons of public health.

As the legalization of medical and recreational marijuana spreads to more states in the U.S., we need to look anew to the Netherlands. The U.S. can benefit from what the lessons the Netherlands has learned about cannabis over the past four decades. How surprising is it that the American media frequently praised the Dutch cannabis policy when it seemed permissive but now that Dutch have become more restrictive their new cannabis policy is ignored?

Robert L. DuPont, M.D.

President, Institute for Behavior and Health, Inc.

Former Director, National Institute on Drug Abuse (1973-1978) Former White House Drug Chief (1973-1977)

Source: www.ibhinc.org 15th March 2015

However the following information shows this substance is far from harmless and more and more users are seeking treatment to help them give up.     NDPA  March  2015

The emerging cannabis treatment population:

http://www.emeraldinsight.com/doi/abs/10.1108/DAT-01-2014-0005?journalCode=dat 

Shootings in New York City have gone up nearly 20 percent in the past year, NYPD Commissioner Bill Bratton announced on March 3, saying that marijuana legalization and the loosening of restrictions across the United States are partly to blame.

Bratton referred to marijuana as “the seemingly innocent drug that’s been legalized around the country,” and says that yes, it’s connected to a rise in shootings. He’s not off the mark. In Colorado, Pueblo County Sheriff Kirk Taylor in Colorado noticed an uptick in crimes, and he’s now tracking the link between crimes and marijuana.

In New York City, marijuana is not legalized, but it has been decriminalized to some degree and the NYPD has stopped arresting people with small amounts of marijuana on their person.

It is ironic that in a city which is a transfer point for huge amounts of drugs . . . heroin, cocaine, hallucinogens, that one drug [that] is actually the causal factor in so much of our shootings and murder is marijuana,” Bratton said. “We just see marijuana everywhere when we make these arrests, and get the guns off the street.”

Watch WABC’s report, along with Bratton’s remarks, in the video.

Murders revolving around marijuana occur in Washington and Colorado. A week ago in Steamboat Springs, a man with an indoor marijuana grow was robbed and murdered. Two have been charged. The black markets are also alive and well in both Washington and Colorado, as a New York Times article explains.

Please share this post with every concerned parent you know! Spread the Word about Pop Pot! Parents Opposed to Pot is a non-partisan grassroots campaign started by parents concerned about the commercial pot industry and its devastating impact on youth and communities. We write anonymously to explore these important issues and protect the privacy of our bloggers. We are totally funded by private donations, rather than industry or government. If you have an article to submit, or want to support us, please go to Contact or Donate page

Source: http://www.poppot.org/2015/03/09 9th March 2015

Among the 137 people who completed the study, the number of seizures fell by an average of 54 percent, according to a team led by Dr. Orrin Devinsky, of New York University Langone Comprehensive Epilepsy Center in New York City.

Keep in mind that Epidiolex is VERY different than the so-called low THC strains of marijuana (also known as Charlotte’s Web) that are being grown and sold in several states. Unlike Epidiolex, the strains of marijuana are not cloned and the end products vary widely. Most importantly, these strains contain varying levels of THC whereas Epidiolex is virtually pure CBD.

Liquid Medical Marijuana Shows Promise for Epilepsy


A liquid form of medical marijuana may help people with severe epilepsy that does not respond to other treatments, according to a new report.

The study included 213 child and adult patients with 12 different types of severe epilepsy. Some of them had Dravet syndrome and Lennox-Gastaut syndrome, which are types of epilepsy that can cause intellectual disability and lifelong seizures.

The patients took a liquid form of medical marijuana, called cannabidiol, daily for 12 weeks.

Among the 137 people who completed the study, the number of seizures fell by an average of 54 percent, according to a team led by Dr. Orrin Devinsky, of New York University Langone Comprehensive Epilepsy Center in New York City.

Among the 23 patients with Dravet syndrome who completed the study, the number of convulsive seizures fell by 53 percent, the investigators found. The 11 patients with Lennox-Gastaut syndrome who finished the study also had a 55 percent decline in the number of attacks called “atonic” seizures, which cause a sudden loss of muscle tone.

The drug wasn’t always easy to take, however, and 12 patients stopped taking it due to side effects, the researchers said. The types of side effects seen in more than 10 percent of the patients included drowsiness (21 percent), diarrhea (17 percent), tiredness (17 percent) and decreased appetite (16 percent).

The study was supported by drug maker GW Pharmaceuticals. The findings are scheduled to be presented next week at the annual meeting of the American Academy of Neurology (AAN) in Washington, D.C. Experts note that findings presented at medical meetings are typically considered preliminary until published in a peer-reviewed journal

Devinsky agreed that larger, placebo-controlled studies are needed to assess the effectiveness of the drug.

“So far there have been few formal studies on this marijuana extract,” he said in an AAN news release. “These results are of great interest, especially for the children and their parents who have been searching for an answer for these debilitating seizures.”

One expert unconnected to the study called the findings “very exciting.”

“Prior to this study, there were mainly anecdotal reports and very few formal studies evaluating cannabidiol, a component of cannabis, in treating seizures,” explained Dr. Scott Stevens, director of Advanced Clinical Experience in Neurology at North-Shore-LIJ Health System in Manhasset, N.Y.

Stevens believes that “these results stand as a stepping stone toward further studies evaluating the use of marijuana in the treatment of epilepsy.”

Source:http://www.webmd.com/epilepsy/news 13/04/2015 (HealthDay News

Hendriks V., van der Schee E., Blanken P.
Drug and Alcohol Dependence: 2011, 119, p. 64–71.

US research led by the programme’s developers has found that a family therapy which intervenes across a child’s social environment is more effective than alternatives for problem substance using teenagers, but this independent European study found individually-focused cognitive-behavioural therapy overall just as effective.

SUMMARY Cognitive-behavioural therapy is a mainstay of addiction treatment, but young problem substance users might benefit more from approaches which intervene with their families and wider environments. The featured study tested this proposition among cannabis users in The Netherlands, pitting multidimensional family therapy against a more conventional, individually-focused cognitive-behavioural therapy.

Key points

  • Multidimensional family therapy is one of a family of approaches which intervene not just with the individual young problem substance user but with their family and other important influences in their lives.

  • US research led by the programme’s developers has found this approach more effective than alternatives or usual treatment or criminal justice procedures.

  • The featured study offers a test of the approach on a non-US caseload and in a study by independent researchers not involved in the programme’s development.

  • As with another independent study, the approach was not found preferable overall to a well-structured alternative, but – again as in other studies – it might have been more effective with the more multiply and severely problematic youngsters.

  • Extra cost and the relative scarcity of qualified practitioners are an obstacle to implementation.

Multidimensional family therapy addresses problem drug use and related problems among adolescents not through a set regimen, but by applying principles and a therapeutic framework to the individual seen as situated within a particular set of environmental influences and constraints. What distinguishes it from some other family therapies is that therapists see substance use as potentially a problem in its own right, and that the intervention extends beyond the child and family to all the social systems (school, juvenile justice, etc) in which the child may be involved.

US studies involving young cannabis users have shown promising results, but almost all these were obtained by one research group. Independent replication studies are needed, and it is unclear whether the impacts of multidimensional family therapy observed in the United States can be generalised to a country such as The Netherlands, where attitudes to cannabis use are more permissive.

To answer these questions the featured study compared the effectiveness of multidimensional family therapy and cognitive-behavioural therapy among adolescent cannabis users in The Netherlands. Between 2006 and 2009 it recruited 109 children aged from 13 to 18 diagnosed as experiencing cannabis abuse or dependence within the past year. They were among the intake at two treatment centres for adolescents in The Hague, one specialising in substance use problems, the other in mental and behavioural health. Patients in the study had to have regularly used cannabis in the past three months and have at least one parent figure who agreed to participate in treatment and in study assessments.

Participants averaged just under 17 years of age and 80% were male. According to their own accounts, they had on average been using cannabis for two years and at study entry had averaged 162 ‘joints’ in the past 90 days – equivalent to nearly two a day. Other substances were used relatively little. They reported an average of about six violent or property crimes in the past three months and a substantial minority were diagnosed with a conduct disorder or oppositional defiant disorder. Four in 10 lived in single-parent households and the same proportion had been imprisoned.

They were allocated at random to multidimensional family therapy or cognitive-behavioural therapy, each planned to last five to six months and delivered on an outpatient basis. In weekly one-hour sessions, the cognitive-behavioural option focused on enhancing patients’ motivation to change their addictive behaviour, and then on changing problem behaviours by means of training in self-control, social and coping skills, and relapse prevention. Monthly sessions were also scheduled for the parents to provide information and support, but not to intervene in family dynamics or parenting.

Multidimensional family therapy was more intensive, scheduled to occupy two one-hour sessions a week with the adolescent, parent(s) and/or family, plus contacts with schools and court staff and other people. It was delivered by trained and supervised therapists who followed a manual by the approach’s developers and were trained by the developers, whose unit in the USA was contacted monthly for feedback and consultation.

An attempt was made to reassess patients to track their progress, the final assessment being 12 months after the baseline assessment conducted just before patients were allocated to the treatments. At the final follow-up, just over 94% of patients were reassessed.

Main findings

Though continued cannabis use was the norm, the general picture was of improvements between the 90 days before starting treatment and the 90 days before the final 12-month assessment. However, these improvements were not significantly greater depending on the treatment to which patients had been allocated. This was the case despite multidimensional family therapy being far better attended; 8 in 10 children completed this treatment compared under 3 in 10 allocated to the cognitive-behavioural option, and they attended sessions totalling 35 hours compared to 10. Significant others in the child’s life also spent much more time engaged in the multidimensional than in the cognitive-behavioural programme.

The number of days in which the children had used cannabis fell from 62–63 days out of 90 to 43 with multidimensional family therapy and 47 with cognitive-behavioural therapy, and the number of joints smoked fell respectively by 38% and 46%. In both options a good treatment response – at least 30% fewer cannabis-using days without substantial increases in use of other substances – was recorded by 42–44% of patients. In both options the number of crimes the children said they had committed fell by over a third.

Despite overall near equivalence, there were indications that children with the severest problems reduced their cannabis use more when allocated to multidimensional family therapy. This was the case whether severity was assessed in terms of intensity of cannabis use or substance use in general, criminality, presence of conduct and/or oppositional defiant disorders (among whom the extra reduction in days of cannabis use peaked at 42 days), and whether the child’s family was assessed as dysfunctional. Differential impacts among children with severe substance use or exhibiting conduct and/or oppositional defiant disorders reached statistical significance.

The authors’ conclusions

The study indicates that multidimensional family therapy and cognitive-behavioural therapy are equally effective in reducing cannabis use and delinquency among adolescents with a cannabis use disorder in The Netherlands, though neither was sufficient to eliminate problem substance use altogether among most of the children. Despite some limitations, the results are robust and applicable to most treatment-seeking adolescents with problem cannabis use in The Netherlands. The results are notable given the much higher treatment ‘dose’ – and consequently, higher costs – of multidimensional family therapy. As others have done, the study also found indications that multidimensional family therapy is differentially effective with adolescents and families with more severe problems.

It should be acknowledged that without a no-treatment control group, it cannot be said for certain that the treatments caused the observed improvements. Also the results derived from youngsters who frequently used cannabis, but not other substances, and who often had a history of delinquency and psychiatric treatment, and from a country with a relatively permissive attitude to cannabis.

COMMENTARY This well designed study has considerable clinical relevance since participants were seeking treatment in the normal way and were clearly using cannabis excessively as well as having other serious problems in their lives – the kind of caseload one would expect at substance use and mental health treatment services for young people, and the kind seen in the UK, where among under-18s cannabis is now by far the most common primary drug in relation to which treatment is provided. Numbers in England in 2013/14 continued to increase to a record 13,659, 71% of all young patients in specialist treatment. Forms of cognitive-behavioural therapy are a common component of treatment in Britain, but family-based therapeutic work is surprisingly rare, given that for example in England, over 80% of young patients were living with their families. Based on the evidence, British practice standardsfrom the Royal College of Psychiatrists on the care of young people with substance misuse problems commend family work, but say it is not standard in British services.

The featured study offers some guidance on whether for young, frequent cannabis users, UK services would do better to replace cognitive-behavioural therapies with family work in the form of multidimensional family therapy. Overall the answer is no; this would cost more without substantially improving outcomes. The finding is particularly important since it derives from a rare test conducted with a European caseload and by a research team independent of the developers of the programme. Independence is important because in several social research areas (1 2 3), programme developers and other researchers with an interest in the programme’s success have been found to record more positive findings than fully independent researchers.

Promising as US studies led by the developers of the programme have been (for example, 1 2), an independent US study found multidimensional family therapy slightly (but not significantly) less effective at promoting recovery from substance use problems than two other therapies, and substantially less cost-effective. Like the featured study, the focus was on young problem cannabis users, and cognitive-behavioural therapy featured among the alternatives.

Multidimensional family therapy is one of a similar set of programmes which integrate intervention in to several domains of a child’s life. Such approaches can improve on typically less well organised and less extensive usual practices (1 2), but this is not always the case, and performance against stronger alternative approaches focused on the individual young cannabis user has been equivalent. Evaluations conducted independently of programme developers have usually been unconvincing, and results overall have not been as impressive as investment in these programmes might be seen to require, especially if they supplement rather than replace legally or socially required procedures. A major obstacle to their use is the expensive training and supervision and considerable skills required to implement them in ways which have been associated with good outcomes.

Best for the hardest cases?

Britain’s National Institute for Health and Clinical Excellence (NICE) has recommended the types of programmes exemplified by multidimensional family therapy for problem-drinking children who also have other major problems and/or limited social support, signalling their particular suitability for the most severely affected and multiply problematic youngsters. In line with this recommendation, the featured study and others suggest that investment in multidimensional family therapy might be warranted for more problematic youngsters – particularly in the featured study, those so at odds with families and society that they can be diagnosed as exhibiting these traits to a pathological degree. That suggestion is tentative, however, primarily because these analyses were not planned in advance so may have capitalised on chance variations in outcomes.

The same limitation applies to the US trials which found multidimensional family therapy particularly suitable for high-severity youngsters. Other limitations too make the US findings an unreliable guide to whether multidimensional family therapy really is best for the most severely affected youngsters (details below), though the plausibility of the findings and the similar findings in The Netherlands mean this contention cannot be dismissed.

One of the US studies compared multidimensional family therapy with cognitive-behavioural therapy. In this study the researchers identified a set of youngsters (about 4 in 10 of the sample) initially more strongly engaged with and affected by substance use, and among whom this engagement weakened less over the course of treatment and a 12-month post-treatment follow-up. They also had more psychological problems. Among this sub-sample, engagement with substance use weakened significantly more when they had been allocated to multidimensional family therapy. Less engaged youngsters were affected about equally by both treatments. But these results were extracted only by a complex analysis which divided the sample up based not just on initial severity, but on their progress in and after treatment. The formation of these categories itself partly depended on the effects of the treatments, then the analysis tested whether the treatments affected each class differently – a circularity which complicates assessment of just what the results mean in practice. This analysis also had to contend with the fact that at each follow-up around 40% or more of the sample could not be reassessed, presumably meaning it had to estimate how they would have scored based on the available data. Such estimates can only be relied on if the data is randomly missing – in this case, if the reasons why a young person did not attend for reassessment had nothing to do with the factors which affected their response to treatment, an unlikely assumption.

Less affected by these complications, a simpler analysis of whether youngsters who started treatment with a deeper engagement with substance use became more disengaged when allocated to multidimensional family therapy was negative, as was one which tested initial psychological problems as a predictor of differential response to treatment. Nor were any relationships found between frequency of substance use and differentially benefiting from multidimensional family therapy. In a similar analysis of a second study comparing multidimensional family therapy to usual criminal justice procedures, the reverse was the case; here it was not the more deeply engaged youngsters who benefited more from multidimensional family therapy, but those who used substances most often. Such inconsistency heightens concerns over cherry-picking of results to demonstrate that multidimensional family therapy is best for most severely affected youngsters.

Last First uploaded 18 April 2015

Source:http://findings.org.uk/PHP/dl.php?file=Hendriks_V_2.tx

Revised 27th April 2015

Those who despise Big Tobacco’s notorious electioneering ain’t seen nothing yet. Big Tobacco 2.0, aka Big Marijuana, can negate Colorado’s grassroots petition process — which helped establish the industry.

When Colorado voters legalized marijuana, they meant well. They wanted a safe trade, regulated like alcohol.

They ended up with a system of, by and for Big Marijuana. It is a racket in which the will of voters gets quashed before votes are cast.

Any doubt about Big Marijuana’s disregard for Colorado’s desire for good regulation will disappear with a new revelation: the industry bought away the public’s chance to vote.

That’s right. Big Marijuana bought away a proposed vote on regulations in Colorado, where we vote on fixing potholes.

At issue is proposed ballot initiative 139, written to give voters a few reasonable options to improve regulation of recreational pot sales. The measure proposed no changes for medical marijuana. On recreational sales, it would have:

* Required child-resistant packaging, as we have for aspirin and ibuprofen.

* Put health warnings on marijuana labels.

* Restricted product THC potency to 16 percent, even though THC occurs naturally at only .2 to .5 percent in cannabis.

Initiative 139 was so reasonable, so in line with the intentions of voters who legalized pot, recent polling showed 80 percent support among registered voters.

Big Marijuana opposes 139 because the industry wants to do as it pleases. It views potency restrictions, which would keep Colorado’s pot products among the more potent in the world, as a sales barrier. Big Marijuana doesn’t want the nuisance of labelling requirements and child-resistant packaging.

Knowing 139 was likely to pass, Big Marijuana sued to keep it off the ballot. The suit stalled efforts to raise money and recruit voluntary signature gatherers. When the Colorado Supreme Court ruled in defense of letting voters decide, Big Marijuana’s anti-139 campaign paid Colorado’s major signature firms to avoid gathering signatures for the pro-139 campaign.

“They were offering $75,000 to $200,0000, depending on size of each company, to get contracts that say they will not gather signatures for this ballot measure,” said attorney and former Colorado House Speaker Frank McNulty, passing along information an anti-139 consultant shared with him.

As Big Marijuana paid for anti-petition contracts, the price of collecting signatures rose. Advocates of 139 responded by raising more money. Former lawmaker Patrick Kennedy, son of former Sen. Ted Kennedy, swooped in to help with a last-ditch fundraising effort this week that boosted the 139 war chest to nearly $800,000.

Just when the campaign planned to hire an Arizona-based firm to gather signatures, Big Marijuana paid the company off.

“The narrative of the marijuana industry has been ‘don’t meddle with our business, because the voters have spoken and the will of the voters is sacred. This is a democracy.’ Then we have a genuine democratic effort to improve recreational marijuana regulation, and the industry shuts down democracy with big money and a bag of dirty tricks,” said Ben Cort, a member of the board of directors of Smart Approaches to Marijuana. “It became clear. No matter how much money we raised, and who we tried to hire, they were going to prevent voters from having any say.”

It is a sad day when an industry’s lawyers can buy away the people’s opportunity to petition for a vote, even after the state’s highest court defended the process. Big Marijuana stopped 139 by stomping on Colorado voters — the people who legalized their industry — as if their will should no longer count. Big Marijuana is officially corrupt.

Source: www.gazette.com  Editorial.  8th July 2016

The seizure of a massive cartel marijuana operation in the mountains of Oregon this week reveals the absurdity of one of the primary arguments used to dupe the general public and politicians. Consider the following:

The pro-pot crowd claims that legalization will eliminate the black market. This is a lie.

The legalization of marijuana allows the pot industry to aggressively advertise and market a crude street drug and 100s of additional products containing extremely high levels of THC. The marketing of these products, and easy access to unlimited supplies, expands the customer base for marijuana and normalizes its use. As a result, the pot industry is free to openly advertise, manufacture, process, transport, and distribute massive quantities of drugs. This gives other “unlicensed” drug dealers the ability to blend in – to literally “hide in plain sight.”

Because the black market exists to avoid taxes, regulations, and make money, cartels can easily undercut the price of “legal” sources and provide a “best price guarantee.”

The demand for high-grade pot from Colorado, California, Washington, Oregon and other legalized states means that massive quantities are exported to every other state in the country. None of this happens legally.

Because of massive fraud and abuse, California has effectively been a recreational use state since 1996, and yet their hills and mountains are full of cartel grows. Despite all of their claims of regulation and enforcement, Colorado has become a source nation for the rest of the country. And in Oregon, where over $9 million in pro-pot spending caused the people of Oregon to legalize “personal use” possession of one half pound quantities of pot, the black market continues to thrive.

Just like the other big pro-pot lie, that regulation keeps marijuana out of the hands of children, we have never had better evidence to reveal the absurd and fraudulent nature of their half-baked claims.

As a federal drug prosecutor who has interviewed 1000s of drug traffickers for over two decades, I can say the following with absolute certainty:

Drug cartels and other criminal drug trafficking organizations are not intimidated by legalization, they are emboldened by it.

Here is the latest evidence of that. A  massive marijuana grow connected to a Mexican drug trafficking organization was raided early Tuesday morning, resulting in one arrest and the seizure of more than 6,500 plants.

A two-month long investigation in rural Dayton led the Yamhill County Interagency Narcotics Team to the illegal marijuana grow in the wetlands near the Willamette River, according to the Yamhill County Sheriff’s Office.

In the early morning darkness, the team, with tactical help from the Oregon State Police SWAT, raided the production site. They discovered thousands of plants valued at more than $9 million.

Officials found an elaborate living area and kitchen hidden underneath a tarp within the marijuana gardens. They discovered 42-year-old Manuel Madrigal hiding in the secret living area. Deputies detained Madrigal, a resident of San Antonio, Texas, who had previous drug arrests.

Madrigal was arrested on federal charges of drug trafficking and transferred into U.S. Marshal custody in Portland.

Yamhill County Sheriff Tim Svenson said the raid was a good example of the dangers Oregon faces from marijuana, even though it is now legal in certain quantities.

“There is still a profit to be made in marijuana by these illegal organizations,” Svenson said. “As long as this continues, we will need to remain diligent in our investigations to keep this money from being routed to other areas of criminal activity.”

The grow was the first-large scale drug trafficking organization operation Yamhill County has seen in several years.

“Historically, these grows have been located on public lands in the mountains of western Yamhill County, and were difficult to access due to steep, dangerous terrain,” a sheriff’s official said in a statement. “This shows a shift in tactics by the drug trafficking organizations.”

The sheriff’s office said the investigation remained ongoing and encouraged anyone with information about the operation to contact the narcotics team at 503-472-6565.

Source:  monte@montestiles.com    July  2016

Tamara D. Warner, PhD1, Dikea Roussos-Ross, MD2, and Marylou Behnke, MD1

Tamara D. Warner: warnertd@peds.ufl.edu; Dikea Roussos-Ross: kroussos@ufl.edu; Marylou Behnke: behnkem@peds.ufl.edu

1University of Florida, Department of Pediatrics, P.O. Box 100296, Gainesville, FL 32610-0296, (352) 273-8985

2University of Florida, Department of Obstetrics and Gynecology, P.O. Box 100294, Gainesville, FL 32610-0294, (352) 273-7660

SYNOPSIS

Pro-marijuana advocacy efforts exemplified by the “medical” marijuana movement, coupled with the absence of conspicuous public health messages about the potential dangers of marijuana use during pregnancy, could lead to greater use of today’s more potent marijuana, which could have significant short- and long-term consequences. This article will review the current literature regarding the effects of prenatal marijuana use on the pregnant woman and her offspring.

INTRODUCTION

Societal attitudes towards marijuana use in the United States are undergoing an historical shift. In the 1960s, a generation of young people embraced marijuana for personal recreational use. Today, “medical” marijuana (cannabis sativa) has been approved for use in 22 states and the District of Columbia either by legislation or by popular vote in statewide referenda or ballot initiatives; 15 of the 22 legal actions were passed in the last decade (since 2004).1 As of May, 2014, another seven states have pending legislation or ballot measures to legalize medical marijuana.2 In addition, two states, Colorado and Washington state, have legalized marijuana for recreational use. The attitudinal shift is apparent not just among adults but among teens as well. The most recent annual survey of adolescent drug use indicates that the annual prevalence of marijuana use has been trending upward since 2008 for 8th, 10th, and 12th graders; perhaps more importantly, the perceived risk of regular marijuana use has declined sharply in recent years, a trend that started in 2005.3

Source:  Clin Perinatal 2014 December 41(4):  877-894  doi 10.1016/j.clp  2014.0.009

PSA Warning Issued in 2005 was Ignored

Eleven years ago the ONDCP and SAMHSA held a press conference to inform of research that confirms what many families already knew–that marijuana use was a trigger for psychosis and mental illness.

The ONDCP is the White House Office of National Drug Control Policy; SAMHSA is the Substance Abuse and Mental Health Services Administration.  Each agency has a crucial role in trying to ascertain usage and reduce demand for drugs. Specifically, Dr. Neil McKehaney from the University of Glasgow came to the US and spoke at the national Press Club on May 5, 2005. The agencies went to great effort to share important information.  A video was recently found online.

Cover up of the Marijuana – Mental Illness  Risk

At this same Press Conference, a couple who had lost their 15-year-old son to suicide due to the mental health problems arising from marijuana use, spoke.  The Press covered the story, but did not use their considerable investigative skills to probe into what those parents and Dr. McKenagey were describing.  It is true that about one quarter of American high school students are depressed, which points to multiple problems of American culture, not just drugs. However, knowing how vulnerable teens are, and then not exposing the factors that could make their outcomes worse, is lamentable.

In addition to depression, anxiety and suicide, there are the risks of psychosis, bipolar disorder and schizophrenia that arise from marijuana use.  Pot proponents love to state that anyone who has a psychotic reaction to pot already had the problem before they used it.  They tend to blame family members for not  wanting to admit  mental health problems, and argue that pot is used as a scapegoat.

Several studies have shown a link between marijuana and schizophrenia.  Explains pharmacologist Christine Miller, Ph.D:  “No one is destined to develop schizophrenia. With identical twins, one can develop the disease and the other one will do so only 50% of the time, illustrating the importance of environmental factors in the expression of the disease.  Marijuana is one of those environmental factors and it is one we can do something about.”

A Missed Opportunity

One person who worked in the office of ONDCP Director John Walters told Parents Opposed to Pot, “They accused us of being pot-crazy during a time when there was a methamphetamine crisis going on.  Marijuana is almost always the first drug introduced to young people and the evidence for the mental health risks were very strong by 2005.  Although pot was getting stronger as it is today, the warning was falling on deaf ears.  Members of Congress wanted us to focus on the meth crisis, but marijuana was a growing issue and we had a myriad of issues.”

This Public Service Announcement reached audiences in the Press, and some newspapers and magazines reported about it.  Since the Internet and search engines were not as they are  today,  few parents, children,  schools and mental health professionals took notice.   (Did the marijuana lobbying groups bully and try squelch the information?)

Lori Robinson, whose son suffered the mental health consequences of marijuana said:  “I will always deeply regret Shane not hearing this PSA .  Shane was a smart, gregarious and fun-loving young man who naively began using pot never knowing he was playing Russian roulette with his brain in ’05-’06 at the age of 19.   Dr McKeganey so clearly stated that the public views marijuana as harmless, not realizing the potency of THC was rising while the “antipsychotic” property of CBD was being bred out.  Sadly, despite both parents never used an illegal drug in our lives, our son assumed that since a few of his friend had smoked in high school, it was just a “harmless herb.”   Shane’s story is on the Moms Strong website.

Robinson added, “This video is absolutely current TODAY.  Let’s keep this video circulating & it WILL save young brains & families the destruction that lies ahead when marijuana hijacks your kid’s brain.

The research has expanded since that time and scientific evidence on each of the following outcomes from marijuana use is voluminous: marijuana & psychosis, marijuana & violence and marijuana & psychiatric disorders.

Lessons to be Learned

Lives could have been saved, and so many cases of depression, psychotic breakdowns and crimes could have been prevented – if the public had become more aware back in 2005.   Congress, the Press and most of all, the American psychiatric community was wrong to ignore the warnings that were issued with this PSA. Let’s not continue to ignore  the evidence. Today in the US, mental health is worse than it’s ever been, and the promotion of drug usage may be a huge factor in this problem.  Harm reduction in preference to primary prevention strategies is practiced in many jurisdictions.  Drug overdose deaths have overtaken gun violence deaths and traffic fatalities in the USA — by far — under this strategy. Today Dr. McKeganey is the Director of the Center for Substance Use Research in Glasgow.

Parents Opposed to Pot is totally funded by private donations, rather than industry or government. If you have an article to submit, or want to support us, please go to Contact or Donate page.

Source:  http://www.poppot.org/2016/07/06/warning-pot-causes-mental-illness

For most people, the idea of winning some money will ignite a rush of emotions – joy, anticipation, excitement.

If you were to scan their brains at that very moment, you would see a surge of activity in the part of the brain that responds to rewards.

But, for people who’ve been smoking cannabis, that rush is not as big – and gets smaller and smaller over time, new research suggests.

And that dampened, blunted response may actually increase the risk that marijuana users are more likely to become addicted to pot and other drugs.

Dr Mary Heitzeg, senior author of the new study, a neuroscientist from the University of Michigan Medical School, said: ‘What we saw was that over time, marijuana use was associated with a lower response to a monetary reward.

‘This means that something that would be rewarding to most people was no longer rewarding to them, suggesting but not proving that their reward system has been “hijacked” by the drug, and that they need the drug to feel reward – or that their emotional response has been dampened.’

The findings come from the first long-term study of young marijuana users, that tracked brain responses to rewards over time, and is published in the JAMA Psychiatry.

They reveal measurable changes in the brain’s reward system with cannabis use – even when other factors like alcohol use and cigarette smoking were taken into account.

The study involved 108 people in their early 20s – the prime age for cannabis use.

All were taking part in a larger study of substance abuse, and all had brain scans at three points over a four-year period.

Three-quarters were men, and nearly all were white.

While MRI scans were performed, participants were invited to play a game.

People who smoke cannabis regularly show less activity in the area of the brain that releases the ‘pleasure’ hormone, dopamine

They were required to click a button when they saw a target on a screen in front of them.

Before each round, they were told they could win 20 cents, or $5 – or that they might lose that amount, have no reward or loss.

The researchers were most interested in assessing what happened to the volunteers’ brains – specifically activity in the reward center – the area called the nucleus accumbens.

And the moment that was deemed most important, was the moment of anticipation – when the volunteers knew they might win some money, and were anticipating what it would take to win the simple task.

In that moment of anticipating reward, that area of the brain should spark into action, pumping out the ‘pleasure’ hormone, dopamine.

The greater a person’s response, the more pleasure or thrill a person feels – and the more likely they will be to repeat the behavior later.

The researchers found that the more marijuana use a volunteer reported, the smaller the response in this part of the brain over time.

Past research has shown the brains of people who use a high-inducing drug repeatedly respond more prominently when they are shown cues related to that drug.

That increased response means the drug has been associated in their brains with positive, rewarding feelings.

And, that can make it harder for users to stop seeking out the drug and using it.

First author, Meghan Martz, doctoral student in developmental psychology, said: ‘It may be that the brain can drive marijuana use, and that the use of marijuana can also affect the brain.

‘We’re still unable to disentangle the cause and effect in the brain’s reward system, but studies like this can help that understanding.’

Regardless of that fact, the new findings show there is a change in the reward system over time, when a person regularly uses cannabis, the researchers noted.

Dr Heitzeg and her colleagues also showed recently in a paper in Developmental Cognitive Neuroscience that marijuana use impacts emotional functioning.

The new data on response to potentially winning money may also be further evidence that long-term marijuana use dampens a person’s emotional response – something scientists call anhedonia.

‘We are all born with an innate drive to engage in behaviors that feel rewarding and give us pleasure,’ said co-author Dr Elisa Trucco, a psychologist at the Center for Children and Families at Florida International University.

‘We now have convincing evidence that regular marijuana use impacts the brain’s natural response to these rewards.

‘In the long run, this is likely to put these individuals at risk for addiction.’

Marijuana’s reputation as a ‘safe’ drug, and one that an increasing number of states are legalizing for small-scale recreational use, means that many young people are trying it – as many as a third of college-age people report using it in the past year.

But Dr Heitzeg said that her team’s findings, and work by other addiction researchers, has shown that it can cause effects including problems with emotional functioning, academic problems, and even structural brain changes.

And, the earlier in life someone tries marijuana, the faster their transition to becoming dependent on the drug, or other substances.

‘Some people may believe that marijuana is not addictive or that it’s ‘better’ than other drugs that can cause dependence,’ said Dr Heitzeg.

‘But this study provides evidence that it’s affecting the brain in a way that may make it more difficult to stop using it.

‘It changes your brain in a way that may change your behavior, and where you get your sense of reward from.’

Source: http://www.dailymail.co.uk/health/article    6th July  2016

A new coalition funded by the cannabis industry has formed in Colorado to fight a ballot measure that some say would crush the state’s billion-dollar marijuana industry.

The Colorado Health Research Council (CHRC) announced its formation Thursday to oppose Amendment 139, a constitutional amendment that would limit the THC-potency of marijuana and pot products at 16 percent. The average potency of Colorado pot products is already higher — 17.1 percent for cannabis flower and 62.1 percent for marijuana extracts, according to a state study.

The amendment also would mandate warnings printed on pot packaging that say marijuana’s health risks include “permanent loss of brain abilities” and “birth defects and reduced brain development.”

If passed by voters, the amendment “would have devastating unintended consequences to the citizens and economy of Colorado,” according to CHRC media materials, which add that 80 percent of the pot products on shelves now would be considered illegal under the measure.

Source:  http://www.denverpost.com/2016/06/30/pot-potency-campaign

An analysis has found moderate-quality evidence supporting the use of cannabinoids for certain types of pain, but not for other conditions such as nausea and sleep disorders. This review of nearly 80 randomized controlled trials has been published in JAMA.

Penny F. Whiting, PhD, of the University of Bristol, Bristol, United Kingdom, and colleagues collected data from 79 randomized controlled clinical trials with 6,462 patients on the use of cannabinoids for nausea and vomiting due to chemotherapy, appetite stimulation in HIV/AIDS, chronic pain, spasticity due to multiple sclerosis or paraplegia, depression, anxiety disorder,sleep disorder, psychosis, glaucoma, or Tourette syndrome. Study quality was determined using the Cochrane risk of bias tool.

Improvements in symptoms with use of cannabinoids were not statistically significant in most studies. Only two trials evaluated cannabis and there was no evidence of differential effects between cannabis and other cannabinoids. There was moderate-quality evidence suggesting that cannabinoids could be beneficial for the treatment of chronic neuropathic or cancer pain, along with spasticity due to multiple sclerosis but low-quality evidence for nausea and vomiting due to chemotherapy, weight gain in HIV, sleep disorders, and Tourette’s syndrome. For cannabinoids in the treatment of anxiety, there was very low-quality evidence; in addition, there was low-quality evidence for no effect on psychosis and very low-level evidence for no effect on depression. No clear evidence for benefits or risks with specific types of cannabinoids or modes of administration was noted. An increased risk of short-term adverse events including dizziness, dry mouth, nausea, fatigue, somnolence, euphoria, vomiting, disorientation, drowsiness, confusion, loss of balance, and hallucination was also found.

In an accompanying editorial, Deepak Cyril D’Souza, MBBS, MD, and Mohini Ranganathan, MD, of the Yale University School of Medicine noted that large double-blind randomized clinical trials are needed to test the short- and long-term safety and efficacy of medical marijuana for various medical conditions. They also added that “since medical marijuana is not a life-saving intervention, it may be prudent to wait before widely adopting its use until high-quality evidence is available to guide the development of a rational approval process.” Currently 23 states and the District of Columbia have introduced laws permitting the use of medical marijuana. For more information visit JAMANetwork.c

Source:  http://www.empr.com/   3rd June 2016

Children born to mothers who use cannabis during pregnancy are more likely to have an abnormal brain structure, which may have long-term consequences for mental health.  This is the conclusion of a new study published in the journal Biological Psychiatry,led by Dr. Hanan El Marroun, of Erasmus University Medical Center in the Netherlands.

According to the researchers, around 2-13 percent of women worldwide use cannabis during pregnancy.  Previous research has suggested that expectant mothers who use the drug are more likely to have children with behavioral and mental health problems.

Exactly how cannabis use affects the brain structure of offspring, however, has been unclear, and this is what Dr. El Marroun and colleagues set out to investigate.

“This study is important because cannabis use during pregnancy is relatively common and we know very little about the potential consequences of cannabis exposure during pregnancy and brain development later in life,” says Dr. El Marroun.  “Understanding what happens in the brain may give us insights in how children develop after being exposed to cannabis.”

Thicker prefrontal cortex for children prenatally exposed to cannabis

The team analyzed the data of 263 children aged 6-8 years who were part of the Generation R Study – a population-based study in the Netherlands, in which they were followed from birth.

Of these children, 96 were born to mothers who used cannabis during pregnancy, and most of these mothers were also smokers. A total of 54 children were prenatally exposed to tobacco only, while 113 were not prenatally exposed to either substance. All of the children underwent magnetic resonance imaging (MRI) scans, which allowed the researchers to assess their brain volume and cortical thickness.

Overall, the researchers found no difference in total brain volume, gray matter volume, or white matter volume between the three groups.

However, compared with children who were prenatally exposed to tobacco only, the researchers found those who were prenatally exposed to both cannabis and tobacco had a thicker prefrontal cortex.

The prefrontal cortex is a brain region that plays a role in complex cognitive behavior, planning, decision-making, working memory, and social behavior.

Given the increase in legalization of cannabis across the United States, Dr. John Krystal, editor of Biological Psychiatry, believes expectant mothers should take note of these findings. “The growing legalization, decriminalization, and medical prescription of cannabis increases the potential risk of prenatal exposure. This important study suggests that prenatal exposure to cannabis could have important effects on brain development.” Dr. John Krystal

Additionally, the researchers found that children who were prenatally exposed to tobacco only had a thinner prefrontal cortex than those who were not prenatally exposed to tobacco or cannabis.

Dr. El Marroun says the study results should be interpreted with caution, noting that further studies are needed to determine the underlying mechanisms that link prenatal cannabis exposure to changes in brain structure.

“Nevertheless,” she adds, “the current study combined with existing literature does support the importance of preventing smoking cannabis and cigarettes during pregnancy.”

Source:   www.medicalnewstoday.com   21st  June 2016

Marijuana remains the most commonly used illicit drug in the United States, and its use is particularly widespread among adolescents. Now, a new study has identified the ages at which adolescents are most likely to try the drug, which may have implications for current marijuana intervention programs.

According to the National Institute on Drug Abuse (NIDA), last year, around 6.5 percent of eighth-grade students, 14.8 percent of 10th-graders, and 21.3 percent of 12th-graders reported current marijuana use. Among 12th-graders, 6 percent reported using the drug daily. Marijuana use can pose a number of risks to physical and mental health, including mood changes, altered senses, impaired movement and breathing problems.

Additionally, use of the drug in adolescence may raise the risk of long-term problems, such as poor cognitive functioning; studies have shown that teenagers who use marijuana have a lower IQ and poorer academic outcomes.

Previous research has also indicated that teenagers who use marijuana are more likely to engage in the use of other illicit drugs.  However, NIDA report that adolescent awareness of these risks is gradually decreasing, likely due to increased legalization of marijuana for medical or recreational use across the U.S.

For this latest study, published in the American Journal of Drug and Alcohol Abuse, researchers from the University of Florida (UF) set out to determine the ages at which adolescents are most likely to try marijuana – information that they say could help guide drug prevention programs.

‘Drug education needs to start earlier’

Lead author Dr. Xinguang Chen, a professor in the Department of Epidemiology at UF, and colleagues analyzed data from the 2013 National Survey on Drug Use and Health, which included 26,659 participants aged 12-21 years.

The researchers used the data to estimate the risk of marijuana use initiation among the participants from birth.   Overall, the team found that 54 percent of adolescents had started using marijuana by the age of 21. They found that adolescents are at risk of trying marijuana from the age of 11. This risk steadily increases until the age of 16, at which point it hits a peak, the researchers report.

The authors note that current marijuana intervention programs focus on adolescents aged 15 and older. Based on their results, the authors suggest such programs should be initiated earlier. “Our findings demonstrate the need to start drug education much earlier, in the fourth or fifth grade. This gives us an opportunity to make a preemptive strike before they actually start using marijuana.”

Dr. Xinguang Chen

Marijuana use risk drop at age 17

At the age of 17, the team found that the risk of first-time marijuana use drops. The authors say this could be because teenagers are more focused on their studies and college entrance exams at this age, rather than drug use.

At the age of 18, however, the researchers found the risk of marijuana use initiation hits another peak – a finding they say might be explained by the life changes that occur at this age.  “At 18, many adolescents leave their parents’ homes to start college or enter the workforce,” says study co-author Dr. Bin Yu, also of UF’s Department of Epidemiology. “They may be more susceptible to influence from peers and they have less monitoring by their parents and the community.”

On analyzing the risk of marijuana use by race/ethnicity, the researchers were surprised to find it varied; adolescents from a multiracial background were significantly more likely to use the drug than those from other backgrounds.

The authors say future research should investigate why people from multicultural backgrounds may be at greater risk for marijuana use, as well as why certain age groups are at heightened risk.

They believe such information could aid the development of more targeted marijuana prevention programs.  “This study finding supports the idea of precision intervention. Intervention programs should be developed for both parents and adolescents, and delivered to the right target population at the right time for the best prevention effect.”    Dr. Xinguang Chen

Source:  http://www.medicalnewstoday.com/articles/311391.php  3rd July 2016  Alcohol / Addiction / Illegal Drugs Pediatrics / Children’s HealthNeurology / NeurosciencePublic Health

Marijuana use remains stubbornly high, survey of high school students shows Fewer Colorado high school students view regular marijuana use as risky behavior, according the Healthy Kids Colorado Survey (HKCS), which was released today. Only 48 percent of high school students surveyed saw marijuana use as risky in 2015, compared to 54 percent of those surveyed in the HKCS survey two years earlier. While youth tobacco use has declined, high school marijuana use inched up, the HKCS data shows. Twenty one percent of Colorado high school students used marijuana at least once in the last month, the HKCS shows. Even more troubling, high school use is reported as high as 30.1 percent in some parts of Colorado, according to the HKCS. Meanwhile, only 9 percent of Colorado high schools students reported smoking a cigarette at least once in the last 30 days.   The HKCS collects health information every odd year from Colorado public school students. The data released today was collected in 2015. While the HKCS says Colorado high school youth marijuana use is in line with national data, Colorado ranks first in the nation for past month marijuana usage by those 12-17 years old, according to National Surveys on Drug Use and Health data released in December by the federal Substance Abuse and Mental Health Services Administration. “Colorado voters were promised marijuana would be kept out of the hands of Colorado kids.  And yet, after  three and half years of commercialized recreational marijuana and after over six years of commercialized medical marijuana, that has yet to happen,” said Diane Carlson, a co-founder of Smart Colorado. “Meanwhile, the perception of harm from consuming marijuana for high school students is on the decline according to the Healthy Kids Colorado Survey, which is deeply concerning as much of  Colorado’s marijuana has become an increasingly different, harder, stronger drug,” Carlson added. “Youth marijuana use can have lifelong implications.  The risks, which include psychosis, suicide, drug addiction and lower IQs, have been reported based on research on much lower THC potencies than are typically sold on Colorado’s commercial market. That means the risks and harms for Colorado kids using today’s pot are far more serious and potentially long lasting. And yet too few Colorado kids are aware of just how harmful and risky today’s high-potency pot can be.”

Source:    www.smartcolorado.com  June 2016

Researchers argue that the lack of available treatment and understanding around cannabis dependency is a major public health concern, with users often being ignored

Health experts have warned that the public health care system is unprepared and ill-equipped to provide help for cannabis users, despite a rapid increase in the number of people seeking treatment for problems relating to the drug.

Researchers gathering at a conference at the University of York highlighted the discovery of “concerning, unexpected” new symptoms reported by intensive users of cannabis and synthetic alternatives, including agitation and impulse control problems, contradicting the perception of cannabis as a suppressive drug.

One new study presented to the group demonstrated that while the use of cannabis has fallen in recent years, those smaller numbers of people are using the drug more intensively, with 73 per cent of all cannabis consumed by 9 per cent of users.

We’re effectively seeing a surge of people presenting for treatment but centres are not sure what to do with them,” explained Ian Hamilton, a lecturer in mental health in the Department of Health Sciences at York University, a member of the research group. “It’s like going in for heart surgery but finding the doctors don’t have the necessary equipment to do it.”

While previous studies show that one in 10 dependent cannabis users now seek treatment, researchers at the Cannabis Matters meeting said access and routes into treatment remain unclear and even when they could be traced they were varied.

“We noticed something strange going on with the drug statistics,” said Mark Monaghan, a Social Sciences researcher at Loughborough University. “While fewer people were seemingly using cannabis, more people were lamenting to treatment services to cannabis related problems, but when we started to explore the literature around this, it was pretty unclear as to why this was happening – and what was happening to users once they were getting into treatment.”

Another pattern acknowledged by the researchers was that an increasing number of people seeking help for drug use are citing cannabis as their primary problem, yet the drug is still not taken seriously by many healthcare professionals.

“At a time when cannabis treatment demand is rising there is also increasingly competitive tendering between treatment providers for these contracts,” said Mr Hamilton. “This has created a disincentive for services to share intelligence with each other about good practice and potential solutions with their competitors.”

“Once in treatment it was clear that the response users had was variable in terms of interventions, in particular how seriously cannabis problems were viewed by treatment staff, with the consistent view being that cannabis was a benign drug.”

“It was people using cannabis who had the knowledge and expertise of the drug and its effects, rather that the treatment staff.”

The group of researchers argue that the lack of available treatment and understanding around cannabis dependency is a major public health concern, and should be treated on the same level as alcohol or smoking addiction. The health risks for cannabis

are exacerbated by the fact it is often used in conjunction with tobacco, putting users at increased risk of nicotine addiction and other associated health problems.

“Despite the success of initiatives to reduce tobacco use in the general population, cannabis users have largely been ignored,” The researchers said. “Treatment may offer an opportunity to intervene on both tobacco and cannabis use.”

Of those seeking treatment for drug use in 2014, 43 per cent of the 18-24 age group named cannabis as their primary drug, compared to just 16 per cent for opiates including heroin.

Synthetic cannabinoids such as ‘spice’ have also been named as a potential factor for the suggested increase in dependency among intensive users. According to Professor Harry Sumnall from the Centre for Public Health, SCRAs – which are now banned under the psychoactive substances act – work differently to organic cannabis, their chemicals acting on different neuro-receptors to produce distinct physical and psychological effects.

Over half of those using SCRAs more than 50 times in last year who tried to stop reported withdrawal symptoms, according to the most recent Global Drug Survey.

Synthetic cannabinoids are more likely to lead to emergency medical treatment than any other drug, with one in eight weekly users seeking emergency medical treatment.

In a statement, Rosanna O’Connor, Director of Alcohol, Drugs and Tobacco at Public Health England said: “It is clear that while substance misuse treatment is working well for many, there is a need for increasingly specialist approaches to support a range of complex needs, especially among the more vulnerable in our communities.”

“It’s vital that local authorities continue to invest so those in need of help are supported on the road to recovery, giving them the best possible chance of living a better, healthier life. Public Health England continues to support local areas in delivering effective tailored services, which increasingly need to meet the needs of older drug users and younger people for whom drug use is just one of many problems.”

Source:  http://www.independent.co.uk/life-style/health-and-families   25th June 2016

Regular marijuana use significantly increased risk for subclinical psychotic symptoms, particularly paranoia and hallucinations, among adolescent males.

“Nearly all prior longitudinal studies examining the association between marijuana use and future psychotic symptoms have not controlled for recent patterns of use, have not repeatedly assessed marijuana use across adolescence, or have combined prior and recent use. Therefore, it is impossible to delineate the enduring effect that regular use has on emergent psychotic symptoms and whether this effect is sustained when individuals remain abstinent for several months,”Jordan Bechtold, PhD, of University of Pittsburgh Medical Center, and colleagues wrote.

To determine associations between regular marijuana use in adolescence and subclinical psychotic symptoms, researchers evaluated 1,009 males from as early as first grade through age 18 years. Study participants were recruited in first and seventh grades. Marijuana use, subclinical psychotic symptoms, and time-varying covariates such as other substance use and internalizing/externalizing problems were determined via self-reports from ages 13 to 18 years.

Analysis indicated that for each year adolescent boys engaged in regular marijuana use, their projected level of subsequent subclinical psychotic symptoms increased by 21% and projected risk for subclinical paranoia or hallucinations increased by 133% and 92%, respectively.

This effect persisted even when participants stopped using marijuana for 1 year.

Further, these associations remained after controlling for all time-stable and several time-varying covariates.

Researchers did not find evidence for reverse causation.

“This study demonstrates that adolescents are more likely to experience subclinical psychotic symptoms (particularly paranoia) during and after years of regular marijuana use. Perhaps the most concerning finding is that the effect of prior weekly marijuana use persists even after adolescents have stopped using for 1 year,” the researchers wrote. “Given the recent proliferation of marijuana legalization across the country, it will be important to enact preventive policies and programs to keep adolescents from engaging in regular marijuana use, as chronic use seems to increase their risk of developing persistent subclinical psychotic symptoms.” – by Amanda Oldt

Disclosure: Bechtold reports no relevant financial disclosures. Please see the full study for a list of all authors’ relevant financial disclosures.

Source: Bechtold J, et al. Am J Psychiatry. 2016;doi:10.1176/appi.ajp.2016.15070878.   June 15, 2016

VANCOUVER, BRITISH COLUMBIA–(Marketwired – May 31, 2016)

Researchers at the University of Western Australia have identified the causal links between marijuana use and the development of serious diseases, cancers, birth defects, and the inheritance of traits that can cause such problems in children and grandchildren including the development of Down’s Syndrome. Parental use of marijuana is a children’s rights issue.

Associate Professor Stuart Reece and Professor Gary Hulse from UWA’s School of Psychiatry and Clinical Sciences found illnesses are likely caused by cell mutations resulting from cannabis properties having a chemical interaction with a person’s DNA. Even if a mother has never used cannabis, the mutations passed on by a father’s sperm can cause serious and fatal illnesses in offspring. The parents DNA carrying these mutations can lie dormant and may only affect generations down the road. The study was published in the Mutation Research — Fundamental and Molecular Mechanisms of Mutagenesis.

Source: http://www.sciencedirect.com/science/article/pii/S0027510716300574

bud-busters

Amy Reid followed three Surrey teens as they took a stand against pot and bumped heads with the Prince of Pot

From left, Surrey teens Jordan Smith with twins Connor and Duncan Fesenmaier at the Vancouver Art Gallery on April 20. The high school students were protesting the use and legalization or marijuana. (Photos: AMY REID)