Cannabis/Marijuana

Report by prominent marijuana policy group finds costs would outweigh any tax revenue under legalization; Healthy and Productive Illinois coalition urges rejection of legalization

Today, the day before the unofficial “marijuana holiday,” Healthy and Productive Illinois (HPIL) – a project of Smart Approaches to Marijuana Action (SAM Action) – released a comprehensive working paper on the projected costs of legalization in Illinois, finding that legalization would cost the state $670.5 million, far outweighing estimated tax revenue projections of approximately $566 million. The report will be released today at 9:30 am in Room N505 of the Thompson State Building in Chicago, during a press conference by HPIL to announce opposition to legalization.

This report uses data from states like Colorado that have legalized marijuana to debunk the myth that taxed marijuana sales will be a boon to the state’s well-reported fiscal crisis. A conservative approximation of quantifiable data such as administrative and regulatory enforcement, increased drugged driving fatalities and other vehicle related property damages, short term health costs, and increased workplace absenteeism and accidents would cost the state $670.5 million in 2020.

“This study clearly demonstrates that the only people who will make money from marijuana commercialization are those in the industry that grow and sell it, at the direct expense of public health and safety,” said Dr. Aaron Weiner Director of Addiction Services at Linden Oaks Behavioral Health. “This industry is actively lobbying in Springfield to move their agenda forward, misleading our leaders and the general public. We have to speak up about the truth to protect the health of our State,” continued Dr. Weiner.

Healthy and Productive Illinois is a coalition formed to spread science-based awareness on marijuana harms and push back against the movement to legalize marijuana. The group believes the marijuana industry is mimicking the tactics of the Big Tobacco industry.

“We know that when citizens of Illinois are informed that marijuana is already decriminalized, only 23% want to fully legalize it,” said Andy Duran, Executive Director of Linking Efforts Against Drugs (LEAD). “Lack of knowledge and confusion is the fuel that drives the commercial marijuana market forward, just like tobacco before it. Imagine what would happen if everyone was aware that the State will lose money, too,” continued Duran.

There is sufficient information available to suggest that marijuana legalization could incur additional costly side effects, but at this time data is not robust enough to quantify their long-term impact. One of these additional costs would be controlling an expanded black market.

“In Oregon and Colorado, we are seeing thriving black markets and illegal grow operations hiding amongst legal growers,” said Chief James Black, Vice President of the Illinois Association of Chiefs of Police. “This expanded black market creates a real problem for law enforcement who now have to work even harder and allocate more precious resources to weed out illegal grow ops,” continued Chief Black.

Additional costs include:

* Additional workplace injuries among part-time employees

* Increases in alcohol use and abuse

* Increases in tobacco use

* More opioid abuse

* Increases in short-term/long-term recovery for marijuana use disorders

* Greater marijuana use among underage students

* Property and other economic damage from marijuana extraction lab explosions

* Controlling an expanded black market, sales to minors, and public intoxication

* Other administrative burdens of most state legalization programs, such as:

– money for drugged driving awareness campaigns;

– drug prevention programs; and

– pesticide control and other agricultural oversight mechanisms

* Long-term health impacts of marijuana use

“Cost reports such as this are the dirty truth that the pot industry doesn’t want law makers and the general public to see,” said Dr. Kevin Sabet, Founder and President of SAMA and former senior drug policy advisor to President Obama. “The pot industry is dead set on becoming the next Big Tobacco. The men in suits behind Big Pot will become rich while communities of color continue to suffer with addiction, black markets thrive, and states are left to foot the bill,” continued Dr. Sabet.

Source: Email from SAM (Smart Approaches to Marijuana) <info@learnaboutsam.org>

April 2018

Introduction: This literature survey aims to extend the comprehensive survey performed by Bergamaschi et al. in 2011 on cannabidiol (CBD) safety and side effects. Apart from updating the literature, this article focuses on clinical studies and CBD potential interactions with other drugs.

Results: In general, the often described favorable safety profile of CBD in humans was confirmed and extended by the reviewed research. The majority of studies were performed for treatment of epilepsy and psychotic disorders. Here, the most commonly reported side effects were tiredness, diarrhea, and changes of appetite/weight. In comparison with other drugs, used for the treatment of these medical conditions, CBD has a better side effect profile. This could improve patients’ compliance and adherence to treatment. CBD is often used as adjunct therapy. Therefore, more clinical research is warranted on CBD action on hepatic enzymes, drug transporters, and interactions with other drugs and to see if this mainly leads to positive or negative effects, for example, reducing the needed clobazam doses in epilepsy and therefore clobazam’s side effects.

Conclusion: This review also illustrates that some important toxicological parameters are yet to be studied, for example, if CBD has an effect on hormones. Additionally, more clinical trials with a greater number of participants and longer chronic CBD administration are still lacking.

Keywords: : cannabidiol, cannabinoids, medical uses, safety, side effects, toxicity

Introduction

Since several years, other pharmacologically relevant constituents of the Cannabis plant, apart from Δ9-THC, have come into the focus of research and legislation. The most prominent of those is cannabidiol (CBD). In contrast to Δ9-THC, it is nonintoxicating, but exerts a number of beneficial pharmacological effects. For instance, it is anxiolytic, anti-inflammatory, antiemetic, and antipsychotic. Moreover, neuroprotective properties have been shown.1,2 Consequently, it could be used at high doses for the treatment of a variety of conditions ranging in psychiatric disorders such as schizophrenia and dementia, as well as diabetes and nausea.1,2

At lower doses, it has physiological effects that promote and maintain health, including antioxidative, anti-inflammatory, and neuroprotection effects. For instance, CBD is more effective than vitamin C and E as a neuroprotective antioxidant and can ameliorate skin conditions such as acne.3,4

The comprehensive review of 132 original studies by Bergamaschi et al. describes the safety profile of CBD, mentioning several properties: catalepsy is not induced and physiological parameters are not altered (heart rate, blood pressure, and body temperature). Moreover, psychological and psychomotor functions are not adversely affected. The same holds true for gastrointestinal transit, food intake, and absence of toxicity for nontransformed cells. Chronic use and high doses of up to 1500 mg per day have been repeatedly shown to be well tolerated by humans.1

Nonetheless, some side effects have been reported for CBD, but mainly in vitro or in animal studies. They include alterations of cell viability, reduced fertilization capacity, and inhibition of hepatic drug metabolism and drug transporters (e.g., p-glycoprotein).1Consequently, more human studies have to be conducted to see if these effects also occur in humans. In these studies, a large enough number of subjects have to be enrolled to analyze long-term safety aspects and CBD possible interactions with other substances.

This review will build on the clinical studies mentioned by Bergamaschi et al. and will update their survey with new studies published until September 2016.

Relevant Preclinical Studies

Before we discuss relevant animal research on CBD possible effects on various parameters, several important differences between route of administration and pharmacokinetics between human and animal studies have to be mentioned. First, CBD has been studied in humans using oral administration or inhalation. Administration in rodents often occures either via intraperitoneal injection or via the oral route. Second, the plasma levels reached via oral administration in rodents and humans can differ. Both these observations can lead to differing active blood concentrations of CBD.1,5,6

In addition, it is possible that CBD targets differ between humans and animals. Therefore, the same blood concentration might still lead to different effects. Even if the targets, to which CBD binds, are the same in both studied animals and humans, for example, the affinity or duration of CBD binding to its targets might differ and consequently alter its effects.

The following study, which showed a positive effect of CBD on obsessive compulsive behavior in mice and reported no side effects, exemplifies the existing pharmacokinetic differences.5 When mice and humans are given the same CBD dose, more of the compound becomes available in the mouse organism. This higher bioavailability, in turn, can cause larger CBD effects.

Deiana et al. administered 120 mg/kg CBD either orally or intraperitoneally and measured peak plasma levels.5 The group of mice, which received oral CBD, had plasma levels of 2.2 μg/ml CBD. In contrast, i.p. injections resulted in peak plasma levels of 14.3 μg/ml. Administering 10 mg/kg oral CBD to humans leads to blood levels of 0.01 μg/ml.6 This corresponds to human blood levels of 0.12 μg/ml, when 120 mg/kg CBD was given to humans. This calculation was performed assuming the pharmacokinetics of a hydrophilic compound, for simplicity’s sake. We are aware that the actual levels of the lipophilic CBD will vary.

A second caveat of preclinical studies is that supraphysiological concentrations of compounds are often used. This means that the observed effects, for instance, are not caused by a specific binding of CBD to one of its receptors but are due to unspecific binding following the high compound concentration, which can inactivate the receptor or transporter.

The following example and calculations will demonstrate this. In vitro studies have shown that CBD inhibits the ABC transporters P-gp (P glycoprotein also referred to as ATP-binding cassette subfamily B member 1=ABCB1; 3–100 μM CBD) and Bcrp (Breast Cancer Resistance Protein; also referred to as ABCG2=ATP-binding cassette subfamily G member 2).7 After 3 days, the P-gp protein expression was altered in leukemia cells. This can have several implications because various anticancer drugs also bind to these membrane-bound, energy-dependent efflux transporters.1 The used CBD concentrations are supraphysiological, however, 3 μM CBD approximately corresponds to plasma concentrations of 1 μg/ml. On the contrary, a 700 mg CBD oral dose reached a plasma level of 10 ng/ml.6 This means that to reach a 1 μg/ml plasma concentration, one would need to administer considerably higher doses of oral CBD. The highest ever applied CBD dose was 1500 mg.1Consequently, more research is warranted, where the CBD effect on ABC transporters is analyzed using CBD concentrations of, for example, 0.03–0.06 μM. The rationale behind suggesting these concentrations is that studies summarized by Bih et al. on CBD effect on ABCC1 and ABCG2 in SF9 human cells showed that a CBD concentration of 0.08 μM elicited the first effect.7

Using the pharmacokinetic relationships mentioned above, one would need to administer an oral CBD dose of 2100 mg CBD to affect ABCC1 and ABCG2. We used 10 ng/ml for these calculations and the ones in Table 1,6,8 based on a 6-week trial using a daily oral administration of 700 mg CBD, leading to mean plasma levels of 6–11 ng/ml, which reflects the most realistic scenario of CBD administration in patients.6 That these levels seem to be reproducible, and that chronic CBD administration does not lead to elevated mean blood concentrations, was shown by another study. A single dose of 600 mg led to reduced anxiety and mean CBD blood concentrations of 4.7–17 ng/ml.9

Table 1.

Inhibition of Human Metabolic Enzymes by Exogenous Cannabinoids In Vitro and the Extrapolated Levels of Oral Daily CBD Administration in Humans Needed to Reach These In Vitro Concentrations (Adapted)6,8

CYP-450 isoform 1A1 1A2 1B1 2A6 2B6 2C9 2D6 3A4 3A5 3A7
CBD (in μM) 0.2 2.7 3.6 55.0 0.7 0.9–9.9 1.2–2.7 1.0 0.2 12.3
aExtrapolated oral daily CBD doses to reach the levels above (in mg) 4900 63,000 84,000 1.28 Mio. Ca. 16,000 21,000–231,000 28,000–63,000 Ca. 23,000 4900 0.29 Mio.
aThe calculations made here are based on the assumption that the CBD distribution in the blood follows the pharmacokinetics of a hydrophilic substance such as alcohol. The reality is more complex, because CBD is lipophilic and, for example, will consequently accumulate in fat tissue. These calculations were made with the intention to give the reader an impression and an approximation of the supraphysiological levels used in in vitro studies.

It also seems warranted to assume that the mean plasma concentration exerts the total of observed CBD effects, compared to using peak plasma levels, which only prevail for a short amount of time. This is not withstanding, that a recent study measured Cmax values for CBD of 221 ng/ml, 3 h after administration of 1 mg/kg fentanyl concomitantly with a single oral dose of 800 mg CBD.10

CBD-drug interactions

Cytochrome P450-complex enzymes

This paragraph describes CBD interaction with general (drug)-metabolizing enzymes, such as those belonging to the cytochrome P450 family. This might have an effect for coadministration of CBD with other drugs.7 For instance, CBD is metabolized, among others, via the CYP3A4 enzyme. Various drugs such as ketoconazol, itraconazol, ritonavir, and clarithromycin inhibit this enzyme.11 This leads to slower CBD degradation and can consequently lead to higher CBD doses that are longer pharmaceutically active. In contrast, phenobarbital, rifampicin, carbamazepine, and phenytoin induce CYP3A4, causing reduced CBD bioavailability.11 Approximately 60% of clinically prescribed drugs are metabolized via CYP3A4.1 Table 1 shows an overview of the cytochrome inhibiting potential of CBD. It has to be pointed out though, that the in vitro studies used supraphysiological CBD concentrations.

Studies in mice have shown that CBD inactivates cytochrome P450 isozymes in the short term, but can induce them after repeated administration. This is similar to their induction by phenobarbital, thereby implying the 2b subfamily of isozymes.1 Another study showed this effect to be mediated by upregulation of mRNA for CYP3A, 2C, and 2B10, after repeated CBD administration.1

Hexobarbital is a CYP2C19 substrate, which is an enzyme that can be inhibited by CBD and can consequently increase hexobarbital availability in the organism.12,13 Studies also propose that this effect might be caused in vivo by one of CBD metabolites.14,15Generally, the metabolite 6a-OH-CBD was already demonstrated to be an inducer of CYP2B10. Recorcinol was also found to be involved in CYP450 induction. The enzymes CYP3A and CYP2B10 were induced after prolonged CBD administration in mice livers, as well as for human CYP1A1 in vitro.14,15 On the contrary, CBD induces CYP1A1, which is responsible for degradation of cancerogenic substances such as benzopyrene. CYP1A1 can be found in the intestine and CBD-induced higher activity could therefore prevent absorption of cancerogenic substances into the bloodstream and thereby help to protect DNA.2

Effects on P-glycoprotein activity and other drug transporters

A recent study with P-gp, Bcrp, and P-gp/Bcrp knockout mice, where 10 mg/kg was injected subcutaneously, showed that CBD is not a substrate of these transporters itself. This means that they do not reduce CBD transport to the brain.16 This phenomenon also occurs with paracetamol and haloperidol, which both inhibit P-gp, but are not actively transported substrates. The same goes for gefitinib inhibition of Bcrp.

These proteins are also expressed at the blood–brain barrier, where they can pump out drugs such as risperidone. This is hypothesized to be a cause of treatment resistance.16 In addition, polymorphisms in these genes, making transport more efficient, have been implied in interindividual differences in pharmacoresistance.10 Moreover, the CBD metabolite 7-COOH CBD might be a potent anticonvulsant itself.14 It will be interesting to see whether it is a P-gp substrate and alters pharmacokinetics of coadministered P-gp-substrate drugs.

An in vitro study using three types of trophoblast cell lines and ex vivo placenta, perfused with 15 μM CBD, found BCRP inhibition leading to accumulation of xenobiotics in the fetal compartment.17BCRP is expressed at the apical side of the syncytiotrophoblast and removes a wide variety of compounds forming a part of the placental barrier. Seventy-two hours of chronic incubation with 25 μM CBD also led to morphological changes in the cell lines, but not to a direct cytotoxic effect. In contrast, 1 μM CBD did not affect cell and placenta viability.17 The authors consider this effect cytostatic. Nicardipine was used as the BCRP substrate in the in vitro studies, where the Jar cell line showed the largest increase in BCRP expression correlating with the highest level of transport.17,and references therein

The ex vivo study used the antidiabetic drug and BCRP substrate glyburide.17 After 2 h of CBD perfusion, the largest difference between the CBD and the placebo placentas (n=8 each) was observed. CBD inhibition of the BCRP efflux function in the placental cotyledon warrants further research of coadministration of CBD with known BCRP substrates such as nitrofurantoin, cimetidine, and sulfasalazine. In this study, a dose–response curve should be established in male and female subjects (CBD absorption was shown to be higher in women) because the concentrations used here are usually not reached by oral or inhaled CBD administration. Nonetheless, CBD could accumulate in organs physiologically restricted via a blood barrier.17

Physiological effects

CBD treatment of up to 14 days (3–30 mg/kg b.w. i.p.) did not affect blood pressure, heart rate, body temperature, glucose levels, pH, pCO2, pO2, hematocrit, K+ or Na+ levels, gastrointestinal transit, emesis, or rectal temperature in a study with rodents.1

Mice treated with 60 mg/kg b.w. CBD i.p. for 12 weeks (three times per week) did not show ataxia, kyphosis, generalized tremor, swaying gait, tail stiffness, changes in vocalization behavior or open-field physiological activity (urination, defecation).1

Neurological and neurospychiatric effects

Anxiety and depression

Some studies indicate that under certain circumstances, CBD acute anxiolytic effects in rats were reversed after repeated 14-day administration of CBD.2 However, this finding might depend on the used animal model of anxiety or depression. This is supported by a study, where CBD was administered in an acute and “chronic” (2 weeks) regimen, which measured anxiolytic/antidepressant effects, using behavioral and operative models (OBX=olfactory bulbectomy as model for depression).18 The only observed side effects were reduced sucrose preference, reduced food consumption and body weight in the nonoperated animals treated with CBD (50 mg/kg). Nonetheless, the behavioral tests (for OBX-induced hyperactivity and anhedonia related to depression and open field test for anxiety) in the CBD-treated OBX animals showed an improved emotional response. Using microdialysis, the researchers could also show elevated 5-HT and glutamate levels in the prefrontal cortex of OBX animals only. This area was previously described to be involved in maladaptive behavioral regulation in depressed patients and is a feature of the OBX animal model of depression. The fact that serotonin levels were only elevated in the OBX mice is similar to CBD differential action under physiological and pathological conditions.

A similar effect was previously described in anxiety experiments, where CBD proved to be only anxiolytic in subjects where stress had been induced before CBD administration. Elevated glutamate levels have been proposed to be responsible for ketamine’s fast antidepressant function and its dysregulation has been described in OBX mice and depressed patients. Chronic CBD treatment did not elicit behavioral changes in the nonoperated mice. In contrast, CBD was able to alleviate the affected functionality of 5HT1A receptors in limbic brain areas of OBX mice.18 and references therein

Schiavon et al. cite three studies that used chronic CBD administration to demonstrate its anxiolytic effects in chronically stressed rats, which were mostly mediated via hippocampal neurogenesis.19 and references therein For instance, animals received daily i.p. injections of 5 mg/kg CBD. Applying a 5HT1A receptor antagonist in the DPAG (dorsal periaqueductal gray area), it was implied that CBD exerts its antipanic effects via these serotonin receptors. No adverse effects were reported in this study.

Psychosis and bipolar disorder

Various studies on CBD and psychosis have been conducted.20 For instance, an animal model of psychosis can be created in mice by using the NMDAR antagonist MK-801. The behavioral changes (tested with the prepulse inhibition [PPI] test) were concomitant with decreased mRNA expression of the NMDAR GluN1 subunit gene (GRN1) in the hippocampus, decreased parvalbumin expression (=a calcium-binding protein expressed in a subclass of GABAergic interneurons), and higher FosB/ΔFosB expression (=markers for neuronal activity). After 6 days of MK-801 treatment, various CBD doses were injected intraperitoneally (15, 30, 60 mg/kg) for 22 days. The two higher CBD doses had beneficial effects comparable to the atypical antipsychotic drug clozapine and also attenuated the MK-801 effects on the three markers mentioned above. The publication did not record any side effects.21

One of the theories trying to explain the etiology of bipolar disorder (BD) is that oxidative stress is crucial in its development. Valvassori et al. therefore used an animal model of amphetamine-induced hyperactivity to model one of the symptoms of mania. Rats were treated for 14 days with various CBD concentrations (15, 30, 60 mg/kg daily i.p.). Whereas CBD did not have an effect on locomotion, it did increase brain-derived neurotrophic factor (BDNF) levels and could protect against amphetamine-induced oxidative damage in proteins of the hippocampus and striatum. No adverse effects were recorded in this study.22

Another model for BD and schizophrenia is PPI of the startle reflex both in humans and animals, which is disrupted in these diseases. Peres et al., list five animal studies, where mostly 30 mg/kg CBD was administered and had a positive effect on PPI.20 Nonetheless, some inconsistencies in explaining CBD effects on PPI as model for BD exist. For example, CBD sometimes did not alter MK-801-induced PPI disruption, but disrupted PPI on its own.20 If this effect can be observed in future experiments, it could be considered to be a possible side effect.

Addiction

CBD, which is nonhedonic, can reduce heroin-seeking behavior after, for example, cue-induced reinstatement. This was shown in an animal heroin self-administration study, where mice received 5 mg/kg CBD i.p. injections. The observed effect lasted for 2 weeks after CBD administration and could normalize the changes seen after stimulus cue-induced heroin seeking (expression of AMPA, GluR1, and CB1R). In addition, the described study was able to replicate previous findings showing no CBD side effects on locomotor behavior.23

Neuroprotection and neurogenesis

There are various mechanisms underlying neuroprotection, for example, energy metabolism (whose alteration has been implied in several psychiatric disorders) and proper mitochondrial functioning.24 An early study from 1976 found no side effects and no effect of 0.3–300 μg/mg protein CBD after 1 h of incubation on mitochondrial monoamine oxidase activity in porcine brains.25 In hypoischemic newborn pigs, CBD elicited a neuroprotective effect, caused no side effects, and even led to beneficial effects on ventilatory, cardiac, and hemodynamic functions.26

A study comparing acute and chronic CBD administration in rats suggests an additional mechanism of CBD neuroprotection: Animals received i.p. CBD (15, 30, 60 mg/kg b.w.) or vehicle daily, for 14 days. Mitochondrial activity was measured in the striatum, hippocampus, and the prefrontal cortex.27 Acute and chronic CBD injections led to increased mitochondrial activity (complexes I-V) and creatine kinase, whereas no side effects were documented. Chronic CBD treatment and the higher CBD doses tended to affect more brain regions. The authors hypothesized that CBD changed the intracellular Ca2+ flux to cause these effects. Since the mitochondrial complexes I and II have been implied in various neurodegenerative diseases and also altered ROS (reactive oxygen species) levels, which have also been shown to be altered by CBD, this might be an additional mechanism of CBD-mediated neuroprotection.1,27

Interestingly, it has recently been shown that the higher ROS levels observed after CBD treatment were concomitant with higher mRNA and protein levels of heat shock proteins (HSPs). In healthy cells, this can be interpreted as a way to protect against the higher ROS levels resulting from more mitochondrial activity. In addition, it was shown that HSP inhibitors increase the CBD anticancer effect in vitro.28 This is in line with the studies described by Bergamaschi et al., which also imply ROS in CBD effect on (cancer) cell viability in addition to, for example, proapoptotic pathways such as via caspase-8/9 and inhibition of the procarcinogenic lipoxygenase pathway.1

Another publication studied the difference of acute and chronic administration of two doses of CBD in nonstressed mice on anxiety. Already an acute i.p. administration of 3 mg/kg was anxiolytic to a degree comparable to 20 mg/kg imipramine (an selective serotonin reuptake inhibitor [SSRI] commonly prescribed for anxiety and depression). Fifteen days of repeated i.p. administration of 3 mg/kg CBD also increased cell proliferation and neurogenesis (using three different markers) in the subventricular zone and the hippocampal dentate gyrus. Interestingly, the repeated administration of 30 mg/kg also led to anxiolytic effects. However, the higher dose caused a decrease in neurogenesis and cell proliferation, indicating dissociation of behavioral and proliferative effects of chronic CBD treatment. The study does not mention adverse effects.19

Immune system

Numerous studies show the CBD immunomodulatory role in various diseases such as multiple sclerosis, arthritis, and diabetes. These animal and human ex vivo studies have been reviewed extensively elsewhere, but studies with pure CBD are still lacking. Often combinations of THC and CBD were used. It would be especially interesting to study when CBD is proinflammatory and under which circumstances it is anti-inflammatory and whether this leads to side effects (Burstein, 2015: Table 1 shows a summary of its anti-inflammatory actions; McAllister et al. give an extensive overview in Table 1 of the interplay between CBD anticancer effects and inflammation signaling).29,30

In case of Alzheimer’s disease (AD), studies in mice and rats showed reduced amyloid beta neuroinflammation (linked to reduced interleukin [IL]-6 and microglial activation) after CBD treatment. This led to amelioration of learning effects in a pharmacological model of AD. The chronic study we want to describe in more detail here used a transgenic mouse model of AD, where 2.5-month-old mice were treated with either placebo or daily oral CBD doses of 20 mg/kg for 8 months (mice are relatively old at this point). CBD was able to prevent the development of a social recognition deficit in the AD transgenic mice.

Moreover, the elevated IL-1 beta and TNF alpha levels observed in the transgenic mice could be reduced to WT (wild-type) levels with CBD treatment. Using statistical analysis by analysis of variance, this was shown to be only a trend. This might have been caused by the high variation in the transgenic mouse group, though. Also, CBD increased cholesterol levels in WT mice but not in CBD-treated transgenic mice. This was probably due to already elevated cholesterol in the transgenic mice. The study observed no side effects.31 and references within

In nonobese diabetes-prone female mice (NOD), CBD was administered i.p. for 4 weeks (5 days a week) at a dose of 5 mg/kg per day. After CBD treatment was stopped, observation continued until the mice were 24 weeks old. CBD treatment lead to considerable reduction of diabetes development (32% developed glucosuria in the CBD group compared to 100% in untreated controls) and to more intact islet of Langerhans cells. CBD increased IL-10 levels, which is thought to act as an anti-inflammatory cytokine in this context. The IL-12 production of splenocytes was reduced in the CBD group and no side effects were recorded.32

After inducing arthritis in rats using Freund’s adjuvant, various CBD doses (0.6, 3.1, 6.2, or 62.3 mg/day) were applied daily in a gel for transdermal administration for 4 days. CBD reduced joint swelling, immune cell infiltration. thickening of the synovial membrane, and nociceptive sensitization/spontaneous pain in a dose-dependent manner, after four consecutive days of CBD treatment. Proinflammatory biomarkers were also reduced in a dose-dependent manner in the dorsal root ganglia (TNF alpha) and spinal cord (CGRP, OX42). No side effects were evident and exploratory behavior was not altered (in contrast to Δ9-THC, which caused hypolocomotion).33

Cell migration

Embryogenesis

CBD was shown to be able to influence migratory behavior in cancer, which is also an important aspect of embryogenesis.1 For instance, it was recently shown that CBD inhibits Id-1. Helix-loop-helix Id proteins play a role in embryogenesis and normal development via regulation of cell differentiation. High Id1-levels were also found in breast, prostate, brain, and head and neck tumor cells, which were highly aggressive. In contrast, Id1 expression was low in noninvasive tumor cells. Id1 seems to influence the tumor cell phenotype by regulation of invasion, epithelial to mesenchymal transition, angiogenesis, and cell proliferation.34

There only seems to exist one study that could not show an adverse CBD effect on embryogenesis. An in vitro study could show that the development of two-cell embryos was not arrested at CBD concentrations of 6.4, 32, and 160 nM.35

Cancer

Various studies have been performed to study CBD anticancer effects. CBD anti-invasive actions seem to be mediated by its TRPV1 stimulation and its action on the CB receptors. Intraperitoneal application of 5 mg/kg b.w. CBD every 3 days for a total of 28 weeks, almost completely reduced the development of metastatic nodules caused by injection of human lung carcinoma cells (A549) in nude mice.36 This effect was mediated by upregulation of ICAM1 and TIMP1. This, in turn, was caused by upstream regulation of p38 and p42/44 MAPK pathways. The typical side effects of traditional anticancer medication, emesis, and collateral toxicity were not described in these studies. Consequently, CBD could be an alternative to other MMP1 inhibitors such as marimastat and prinomastat, which have shown disappointing clinical results due to these drugs’ adverse muscoskeletal effects.37,38

Two studies showed in various cell lines and in tumor-bearing mice that CBD was able to reduce tumor metastasis.34,39 Unfortunately, the in vivo study was only described in a conference abstract and no route of administration or CBD doses were mentioned.36 However, an earlier study used 0.1, 1.0, or 1.5 μmol/L CBD for 3 days in the aggressive breast cancer cells MDA-MB231. CBD downregulated Id1 at promoter level and reduced tumor aggressiveness.40

Another study used xenografts to study the proapoptotic effect of CBD, this time in LNCaP prostate carcinoma cells.36 In this 5-week study, 100 mg/kg CBD was administered daily i.p. Tumor volume was reduced by 60% and no adverse effects of treatment were described in the study. The authors assumed that the observed antitumor effects were mediated via TRPM8 together with ROS release and p53 activation.41 It has to be pointed out though, that xenograft studies only have limited predictive validity to results with humans. Moreover, to carry out these experiments, animals are often immunologically compromised, to avoid immunogenic reactions as a result to implantation of human cells into the animals, which in turn can also affect the results.42

Another approach was chosen by Aviello et al.43 They used the carcinogen azoxymethane to induce colon cancer in mice. Treatment occurred using IP injections of 1 or 5 mg/kg CBD, three times a week for 3 weeks (including 1 week before carcinogen administration). After 3 months, the number of aberrant crypt foci, polyps, and tumors was analyzed. The high CBD concentration led to a significant decrease in polyps and a return to near-normal levels of phosphorylated Akt (elevation caused by the carcinogen).42 No adverse effects were mentioned in the described study.43

Food intake and glycemic effects

Animal studies summarized by Bergamaschi et al. showed inconclusive effects of CBD on food intake1: i.p. administration of 3–100 mg/kg b.w. had no effect on food intake in mice and rats. On the contrary, the induction of hyperphagia by CB1 and 5HT1A agonists in rats could be decreased with CBD (20 mg/kg b.w. i.p.). Chronic administration (14 days, 2.5 or 5 mg/kg i.p.) reduced the weight gain in rats. This effect could be inhibited by coadministration of a CB2R antagonist.1

The positive effects of CBD on hyperglycemia seem to be mainly mediated via CBD anti-inflammatory and antioxidant effects. For instance, in ob/ob mice (an animal model of obesity), 4-week treatment with 3 mg/kg (route of administration was not mentioned) increased the HDL-C concentration by 55% and reduced total cholesterol levels by more than 25%. In addition, treatment increased adiponectin and liver glycogen concentrations.44 and references therein

Endocrine effects

High CBD concentrations (1 mM) inhibited progesterone 17-hydroxylase, which creates precursors for sex steroid and glucocorticoid synthesis, whereas 100 μM CBD did not in an in vitro experiment with primary testis microsomes.45 Rats treated with 10 mg/kg i.p. b.w. CBD showed inhibition of testosterone oxidation in the liver.46

Genotoxicity and mutagenicity

Jones et al. mention that 120 mg/kg CBD delivered intraperetonially to Wistar Kyoto rats showed no mutagenicity and genotoxicity based on personal communication with GW Pharmaceuticals47,48These data are yet to be published. The 2012 study with an epilepsy mouse model could also show that CBD did not influence grip strength, which the study describes as a “putative test for functional neurotoxicity.”48

Motor function was also tested on a rotarod, which was also not affected by CBD administration. Static beam performance, as an indicator of sensorimotor coordination, showed more footslips in the CBD group, but CBD treatment did not interfere with the animals’ speed and ability to complete the test. Compared to other anticonvulsant drugs, this effect was minimal.48 Unfortunately, we could not find more studies solely focusing on genotoxicity by other research groups neither in animals nor in humans.

Acute Clinical Data

Bergamaschi et al. list an impressive number of acute and chronic studies in humans, showing CBD safety for a wide array of side effects.1 They also conclude from their survey, that none of the studies reported tolerance to CBD. Already in the 1970s, it was shown that oral CBD (15–160 mg), iv injection (5–30 mg), and inhalation of 0.15 mg/kg b.w. CBD did not lead to adverse effects. In addition, psychomotor function and psychological functions were not disturbed. Treatment with up to 600 mg CBD neither influenced physiological parameters (blood pressure, heart rate) nor performance on a verbal paired-associate learning test.1

Fasinu et al. created a table with an overview of clinical studies currently underway, registered in Clinical Trials. gov.49 In the following chapter, we highlight recent, acute clinical studies with CBD.

CBD-drug interactions

CBD can inhibit CYP2D6, which is also targeted by omeprazole and risperidone.2,14 There are also indications that CBD inhibits the hepatic enzyme CYP2C9, reducing the metabolization of warfarin and diclofenac.2,14 More clinical studies are needed, to check whether this interaction warrants an adaption of the used doses of the coadministered drugs.

The antibiotic rifampicin induces CYP3A4, leading to reduced CBD peak plasma concentrations.14 In contrast, the CYP3A4 inhibitor ketoconazole, an antifungal drug, almost doubles CBD peak plasma concentration. Interestingly, the CYP2C19 inhibitor omeprazole, used to treat gastroesophageal reflux, could not significantly affect the pharmacokinetics of CBD.14

A study, where a regimen of 6×100 mg CBD daily was coadministered with hexobarbital in 10 subjects, found that CBD increased the bioavailability and elimination half-time of the latter. Unfortunately, it was not mentioned whether this effect was mediated via the cytochrome P450 complex.16

Another aspect, which has not been thoroughly looked at, to our knowledge, is that several cytochrome isozymes are not only expressed in the liver but also in the brain. It might be interesting to research organ-specific differences in the level of CBD inhibition of various isozymes. Apart from altering the bioavailability in the overall plasma of the patient, this interaction might alter therapeutic outcomes on another level. Dopamine and tyramine are metabolized by CYP2D6, and neurosteroid metabolism also occurs via the isozymes of the CYP3A subgroup.50,51 Studying CBD interaction with neurovascular cytochrome P450 enzymes might also offer new mechanisms of action. It could be possible that CBD-mediated CYP2D6 inhibition increases dopamine levels in the brain, which could help to explain the positive CBD effects in addiction/withdrawal scenarios and might support its 5HT (=serotonin) elevating effect in depression.

Also, CBD can be a substrate of UDP glucuronosyltransferase.14Whether this enzyme is indeed involved in the glucuronidation of CBD and also causes clinically relevant drug interactions in humans is yet to be determined in clinical studies. Generally, more human studies, which monitor CBD-drug interactions, are needed.

Physiological effects

In a double-blind, placebo-controlled crossover study, CBD was coadministered with intravenous fentanyl to a total of 17 subjects.10Blood samples were obtained before and after 400 mg CBD (previously demonstrated to decrease blood flow to (para)limbic areas related to drug craving) or 800 mg CBD pretreatment. This was followed by a single 0.5 (Session 1) or 1.0μg/kg (Session 2, after 1 week of first administration to allow for sufficient drug washout) intravenous fentanyl dose. Adverse effects and safety were evaluated with both forms of the Systematic Assessment for Treatment Emergent Events (SAFTEE). This extensive tool tests, for example, 78 adverse effects divided into 23 categories corresponding to organ systems or body parts. The SAFTEE outcomes were similar between groups. No respiratory depression or cardiovascular complications were recorded during any test session.

The results of the evaluation of pharmacokinetics, to see if interaction between the drugs occurred, were as follows. Peak CBD plasma concentrations of the 400 and 800 mg group were measured after 4 h in the first session (CBD administration 2 h after light breakfast). Peak urinary CBD and its metabolite concentrations occurred after 6 h in the low CBD group and after 4 h in the high CBD group. No effect was evident for urinary CBD and metabolite excretion except at the higher fentanyl dose, in which CBD clearance was reduced. Importantly, fentanyl coadministration did not produce respiratory depression or cardiovascular complications during the test sessions and CBD did not potentiate fentanyl’s effects. No correlation was found between CBD dose and plasma cortisol levels.

Various vital signs were also measured (blood pressure, respiratory/heart rate, oxygen saturation, EKG, respiratory function): CBD did not worsen the adverse effects (e.g., cardiovascular compromise, respiratory depression) of iv fentanyl. Coadministration was safe and well tolerated, paving the way to use CBD as a potential treatment for opioid addiction. The validated subjective measures scales Anxiety (visual analog scale [VAS]), PANAS (positive and negative subscores), and OVAS (specific opiate VAS) were administered across eight time points for each session without any significant main effects for CBD for any of the subjective effects on mood.10

A Dutch study compared subjective adverse effects of three different strains of medicinal cannabis, distributed via pharmacies, using VAS. “Visual analog scale is one of the most frequently used psychometric instruments to measure the extent and nature of subjective effects and adverse effects. The 12 adjectives used for this study were as follows: alertness, tranquility, confidence, dejection, dizziness, confusion/disorientation, fatigue, anxiety, irritability, appetite, creative stimulation, and sociability.” The high CBD strain contained the following concentrations: 6% Δ9-THC/7.5% CBD (n=25). This strain showed significantly lower levels of anxiety and dejection. Moreover, appetite increased less in the high CBD strain. The biggest observed adverse effect was “fatigue” with a score of 7 (out of 10), which did not differ between the three strains.52

Neurological and neurospychiatric effects

Anxiety

Forty-eight participants received subanxiolytic levels (32 mg) of CBD, either before or after the extinction phase in a double-blind, placebo-controlled design of a Pavlovian fear-conditioning experiment (recall with conditioned stimulus and context after 48 h and exposure to unconditioned stimulus after reinstatement). Skin conductance (=autonomic response to conditioning) and shock expectancy measures (=explicit aspects) of conditioned responding were recorded throughout. Among other scales, the Mood Rating Scale (MRS) and the Bond and Bodily Symptoms Scale were used to assess anxiety, current mood, and physical symptoms. “CBD given postextinction (active after consolidation phase) enhanced consolidation of extinction learning as assessed by shock expectancy.” Apart from the extinction-enhancing effects of CBD in human aversive conditioned memory, CBD showed a trend toward some protection against reinstatement of contextual memory. No side/adverse effects were reported.53

Psychosis

The review by Bergamaschi et al. mentions three acute human studies that have demonstrated the CBD antipsychotic effect without any adverse effects being observed. This holds especially true for the extrapyramidal motor side effects elicited by classical antipsychotic medication.1

Fifteen male, healthy subjects with minimal prior Δ9-THC exposure (<15 times) were tested for CBD affecting Δ9-THC propsychotic effects using functional magnetic resonance imaging (fMRI) and various questionnaires on three occasions, at 1-month intervals, following administration of 10 mg delta-9-Δ9-THC, 600 mg CBD, or placebo. Order of drug administration was pseudorandomized across subjects, so that an equal number of subjects received any of the drugs during the first, second, or third session in a double-blind, repeated-measures, within-subject design.54 No CBD effect on psychotic symptoms as measured with PANSS positive symptoms subscale, anxiety as indexed by the State Trait Anxiety Inventory (STAI) state, and Visual Analogue Mood Scale (VAMS) tranquilization or calming subscale, compared to the placebo group, was observed. The same is true for a verbal learning task (=behavioral performance of the verbal memory).

Moreover, pretreatment with CBD and subsequent Δ9-THC administration could reduce the latter’s psychotic and anxiety symptoms, as measured using a standardized scale. This effect was caused by opposite neural activation of relevant brain areas. In addition, no effects on peripheral cardiovascular measures such as heart rate and blood pressure were measured.54

A randomized, double-blind, crossover, placebo-controlled trial was conducted in 16 healthy nonanxious subjects using a within-subject design. Oral Δ9-THC=10 mg, CBD=600 mg, or placebo was administered in three consecutive sessions at 1-month intervals. The doses were selected to only evoke neurocognitive effects without causing severe toxic, physical, or psychiatric reactions. The 600 mg CBD corresponded to mean (standard deviation) whole blood levels of 0.36 (0.64), 1.62 (2.98), and 3.4 (6.42) ng/mL, 1, 2, and 3 h after administration, respectively.

Physiological measures and symptomatic effects were assessed before, and at 1, 2, and 3 h postdrug administration using PANSS (a 30-item rating instrument used to assess psychotic symptoms, with ratings based on a semistructured clinical interview yielding subscores for positive, negative, and general psychopathology domains), the self-administered VAMS with 16 items (e.g., mental sedation or intellectual impairment, physical sedation or bodily impairments, anxiety effects and other types of feelings or attitudes), the ARCI (Addiction Research Center Inventory; containing empirically derived drug-induced euphoria; stimulant-like effects; intellectual efficiency and energy; sedation; dysphoria; and somatic effects) to assess drug effects and the STAI-T/S, where subjects were evaluated on their current mood and their feelings in general.

There were no significant differences between the effects of CBD and placebo on positive and negative psychotic symptoms, general psychopathology (PANSS), anxiety (STAI-S), dysphoria (ARCI), sedation (VAMS, ARCI), and the level of subjective intoxication (ASI, ARCI), where Δ9-THC did have a pronounced effect. The physiological parameters, heart rate and blood pressure, were also monitored and no significant difference between the placebo and the CBD group was observed.55

Addiction

A case study describes a patient treated for cannabis withdrawal according to the following CBD regimen: “treated with oral 300 mg on Day 1; CBD 600 mg on Days 2–10 (divided into two doses of 300 mg), and CBD 300 mg on Day 11.” CBD treatment resulted in a fast and progressive reduction in withdrawal, dissociative and anxiety symptoms, as measured with the Withdrawal Discomfort Score, the Marijuana Withdrawal Symptom Checklist, Beck Anxiety Inventory, and Beck Depression Inventory (BDI). Hepatic enzymes were also measured daily, but no effect was reported.56

Naturalistic studies with smokers inhaling cannabis with varying amounts of CBD showed that the CBD levels were not altering psychomimetic symptoms.1 Interestingly, CBD was able to reduce the “wanting/liking”=implicit attentional bias caused by exposure to cannabis and food-related stimuli. CBD might work to alleviate disorders of addiction, by altering the attentive salience of drug cues. The study did not further measure side effects.57

CBD can also reduce heroin-seeking behaviors (e.g., induced by a conditioned cue). This was shown in the preclinical data mentioned earlier and was also replicated in a small double-blind pilot study with individuals addicted to opioids, who have been abstinent for 7 days.52,53 They either received placebo or 400 or 800 mg oral CBD on three consecutive days. Craving was induced with a cue-induced reinstatement paradigm (1 h after CBD administration). One hour after the video session, subjective craving was already reduced after a single CBD administration. The effect persisted for 7 days after the last CBD treatment. Interestingly, anxiety measures were also reduced after treatment, whereas no adverse effects were described.23,58

A pilot study with 24 subjects was conducted in a randomized, double-blind, placebo-controlled design to evaluate the impact of the ad hoc use of CBD in smokers, who wished to stop smoking. Pre- and post-testing for mood and craving of the participants was executed. These tests included the Behaviour Impulsivity Scale, BDI, STAI, and the Severity of Dependence Scale. During the week of CBD inhalator use, subjects used a diary to log their craving (on a scale from 1 to 100=VAS measuring momentary subjective craving), the cigarettes smoked, and the number of times they used the inhaler. Craving was assessed using the Tiffany Craving Questionnaire (11). On day 1 and 7, exhaled CO was measured to test smoking status. Sedation, depression, and anxiety were evaluated with the MRS.

Over the course of 1 week, participants used the inhaler when they felt the urge to smoke and received a dose of 400 μg CBD via the inhaler (leading to >65% bioavailability); this significantly reduced the number of cigarettes smoked by ca. 40%, while craving was not significantly different in the groups post-test. At day 7, the anxiety levels for placebo and CBD group did not differ. CBD did not increase depression (in contract to the selective CB1 antagonist rimonabant). CBD might weaken the attentional bias to smoking cues or could have disrupted reconsolidation, thereby destabilizing drug-related memories.59

Cell migration

According to our literature survey, there currently are no studies about CBD role in embryogenesis/cell migration in humans, even though cell migration does play a role in embryogenesis and CBD was shown to be able to at least influence migratory behavior in cancer.1

Endocrine effects and glycemic (including appetite) effects

To the best of our knowledge, no acute studies were performed that solely concentrated on CBD glycemic effects. Moreover, the only acute study that also measured CBD effect on appetite was the study we described above, comparing different cannabis strains. In this study, the strain high in CBD elicited less appetite increase compared to the THC-only strain.52

Eleven healthy volunteers were treated with 300 mg (seven patients) and 600 mg (four patients) oral CBD in a double-blind, placebo-controlled study. Growth hormone and prolactin levels were unchanged. In contrast, the normal decrease of cortisol levels in the morning (basal measurement=11.0±3.7 μg/dl; 120 min after placebo=7.1±3.9 μg/dl) was inhibited by CBD treatment (basal measurement=10.5±4.9 μg/dl; 120 min after 300 mg CBD=9.9±6.2 μg/dl; 120 min after 600 mg CBD=11.6±11.6 μg/dl).60

A more recent study also used 600 mg oral CBD for a week and compared 24 healthy subjects to people at risk for psychosis (n=32; 16 received placebo and 16 CBD). Serum cortisol levels were taken before the TSST (Trier Social Stress Test), immediately after, as well as 10 and 20 min after the test. Compared to the healthy individuals, the cortisol levels increased less after TSST in the 32 at-risk individuals. The CBD group showed less reduced cortisol levels but differences were not significant.61 It has to be mentioned that these data were presented at a conference and are not yet published (to our knowledge) in a peer-reviewed journal.

Chronic CBD Studies in Humans

Truly chronic studies with CBD are still scarce. One can often argue that what the studies call “chronic” CBD administration only differs to acute treatment, because of repeated administration of CBD. Nonetheless, we also included these studies with repeated CBD treatment, because we think that compared to a one-time dose of CBD, repeated CBD regimens add value and knowledge to the field and therefore should be mentioned here.

CBD-drug interactions

An 8-week-long clinical study, including 13 children who were treated for epilepsy with clobazam (initial average dose of 1 mg/kg b.w.) and CBD (oral; starting dose of 5 mg/kg b.w. raised to maximum of 25 mg/kg b.w.), showed the following. The CBD interaction with isozymes CYP3A4 and CYP2C19 caused increased clobazam bioavailability, making it possible to reduce the dose of the antiepileptic drug, which in turn reduced its side effects.62

These results are supported by another study described in the review by Grotenhermen et al.63 In this study, 33 children were treated with a daily dose of 5 mg/kg CBD, which was increased every week by 5 mg/kg increments, up to a maximum level of 25 mg/kg. CBD was administered on average with three other drugs, including clobazam (54.5%), valproic acid (36.4%), levetiracetam (30.3%), felbamate (21.2%), lamotrigine (18.2%), and zonisamide (18.2%). The coadministration led to an alteration of blood levels of several antiepileptic drugs. In the case of clobazam this led to sedation, and its levels were subsequently lowered in the course of the study.

Physiological effects

A first pilot study in healthy volunteers in 1973 by Mincis et al. administering 10 mg oral CBD for 21 days did not find any neurological and clinical changes (EEG; EKG).64 The same holds true for psychiatry and blood and urine examinations. A similar testing battery was performed in 1980, at weekly intervals for 30 days with daily oral CBD administration of 3 mg/kg b.w., which had the same result.65

Neurological and neuropsychiatric effects

Anxiety

Clinical chronic (lasting longer than a couple of weeks) studies in humans are crucial here but were mostly still lacking at the time of writing this review. They hopefully will shed light on the inconsistencies observerd in animal studies. Chronic studies in humans may, for instance, help to test whether, for example, an anxiolytic effect always prevails after chronic CBD treatment or whether this was an artifact of using different animal models of anxiety or depression.2,18

Psychosis and bipolar disorder

In a 4-week open trial, CBD was tested on Parkinson’s patients with psychotic symptoms. Oral doses of 150–400 mg/day CBD (in the last week) were administered. This led to a reduction of their psychotic symptoms. Moreover, no serious side effects or cognitive and motor symptoms were reported.66

Bergamaschi et al. describe a chronic study, where a teenager with severe side effects of traditional antipsychotics was treated with up to 1500 mg/day of CBD for 4 weeks. No adverse effects were observed and her symptoms improved. The same positive outcome was registered in another study described by Bergamaschi et al., where three patients were treated with a starting dose of CBD of 40 mg, which was ramped up to 1280 mg/day for 4 weeks.1 A double-blind, randomized clinical trial of CBD versus amisulpride, a potent antipsychotic in acute schizophrenia, was performed on a total of 42 subjects, who were treated for 28 days starting with 200 mg CBD per day each.67 The dose was increased stepwise by 200 mg per day to 4×200 mg CBD daily (total 800 mg per day) within the first week. The respective treatment was maintained for three additional weeks. A reduction of each treatment to 600 mg per day was allowed for clinical reasons, such as unwanted side effects after week 2. This was the case for three patients in the CBD group and five patients in the amisulpride group. While both treatments were effective (no significant difference in PANSS total score), CBD showed the better side effect profile. Amisulpride, working as a dopamine D2/D3-receptor antagonist, is one of the most effective treatment options for schizophrenia. CBD treatment was accompanied by a substantial increase in serum anandamide levels, which was significantly associated with clinical improvement, suggesting inhibition of anandamide deactivation via reduced FAAH activity.

In addition, the FAAH substrates palmitoylethanolamide and linoleoyl-ethanolamide (both lipid mediators) were also elevated in the CBD group. CBD showed less serum prolactin increase (predictor of galactorrhoea and sexual dysfunction), fewer extrapyramidal symptoms measured with the Extrapyramidal Symptom Scale, and less weight gain. Moreover, electrocardiograms as well as routine blood parameters were other parameters whose effects were measured but not reported in the study. CBD better safety profile might improve acute compliance and long-term treatment adherence.67,68

A press release by GW Pharmaceuticals of September 15th, 2015, described 88 patients with treatment-resistant schizophrenic psychosis, treated either with CBD (in addition to their regular medication) or placebo. Important clinical parameters improved in the CBD group and the number of mild side effects was comparable to the placebo group.2 Table 2 shows an overview of studies with CBD for the treatment of psychotic symptoms and its positive effect on symptomatology and the absence of side effects.69

Table 2.

Studies with CBD with Patients with Psychotic Symptoms (Adapted)69

Assessment Oral CBD administration Total number of study participants Main findings
BPRS (brief psychiatric rating scale) Up to 1500 mg/day for 26 days 1 Improvement of symptomatology, no side effects
BPRS Up to 1280 mg/day for 4 weeks 3 Mild improvement of symptomatology of 1 patient, no side effects
BPRS, Parkinson Psychosis Questionnaire (PPQ) Up to 600 mg/day for 4 weeks 6 Improvement of symptomatology, no side effects
Stroop Color Word Test, BPRS, PANSS (positive and negative symptom scale) Single doses of 300 or 600 mg 28 Performance after placebo and CBD 300 mg compared to CBD 600 mg; no effects on symptomatology
BPRS, PANSS Up to 800 mg/day for 4 weeks 39 CBD as effective as amisulpride in terms of improvement of symptomatology; CBD displayed superior side effect profile

Treatment of two patients for 24 days with 600–1200 mg/day CBD, who were suffering from BD, did not lead to side effects.70 Apart from the study with two patients mentioned above, CBD has not been tested systematically in acute or chronic administration scenarios in humans for BD according to our own literature search.71

Epilepsy

Epileptic patients were treated for 135 days with 200–300 mg oral CBD daily and evaluated every week for changes in urine and blood. Moreover, neurological and physiological examinations were performed, which neither showed signs of CBD toxicity nor severe side effects. The study also illustrated that CBD was well tolerated.65

A review by Grotenhermen and Müller-Vahl describes several clinical studies with CBD2: 23 patients with therapy-resistant epilepsy (e.g., Dravet syndrome) were treated for 3 months with increasing doses of up to 25 mg/kg b.w. CBD in addition to their regular epilepsy medication. Apart from reducing the seizure frequency in 39% of the patients, the side effects were only mild to moderate and included reduced/increased appetite, weight gain/loss, and tiredness.

Another clinical study lasting at least 3 months with 137 children and young adults with various forms of epilepsy, who were treated with the CBD drug Epidiolex, was presented at the American Academy for Neurology in 2015. The patients were suffering from Dravet syndrome (16%), Lennox–Gastaut syndrome (16%), and 10 other forms of epilepsy (some among them were very rare conditions). In this study, almost 50% of the patients experienced a reduction of seizure frequency. The reported side effects were 21% experienced tiredness, 17% diarrhea, and 16% reduced appetite. In a few cases, severe side effects occurred, but it is not clear, if these were caused by Epidiolex. These were status epilepticus (n=10), diarrhea (n=3), weight loss (n=2), and liver damage in one case.

The largest CBD study conducted thus far was an open-label study with Epidiolex in 261 patients (mainly children, the average age of the participants was 11) suffering from severe epilepsy, who could not be treated sufficiently with standard medication. After 3 months of treatment, where patients received CBD together with their regular medication, a median reduction of seizure frequency of 45% was observed. Ten percent of the patients reported side effects (tiredness, diarrhea, and exhaustion).2

After extensive literature study of the available trials performed until September 2016, CBD side effects were generally mild and infrequent. The only exception seems to be a multicenter open-label study with a total of 162 patients aged 1–30 years, with treatment-resistant epilepsy. Subjects were treated for 1 year with a maximum of 25 mg/kg (in some clinics 50 mg/kg) oral CBD, in addition to their standard medication.

This led to a reduction in seizure frequency. In this study, 79% of the cohort experienced side effects. The three most common adverse effects were somnolence (n=41 [25%]), decreased appetite (n=31 [19%]), and diarrhea (n=31 [19%]).72 It has to be pointed out that no control group existed in this study (e.g., placebo or another drug). It is therefore difficult to put the side effect frequency into perspective. Attributing the side effects to CBD is also not straightforward in severely sick patients. Thus, it is not possible to draw reliable conclusions on the causation of the observed side effects in this study.

Parkinson’s disease

In a study with a total of 21 Parkinson’s patients (without comorbid psychiatric conditions or dementia) who were treated with either placebo, 75 mg/day CBD or 300 mg/day CBD in an exploratory double-blind trial for 6 weeks, the higher CBD dose showed significant improvement of quality of life, as measured with PDQ-39. This rating instrument comprised the following factors: mobility, activities of daily living, emotional well-being, stigma, social support, cognition, communication, and bodily discomfort. For the factor, “activities of daily living,” a possible dose-dependent relationship could exist between the low and high CBD group—the two CBD groups scored significantly different here. Side effects were evaluated with the UKU (Udvalg for Kliniske Undersøgelser). This assessment instrument analyzes adverse medication effects, including psychic, neurologic, autonomic, and other manifestations. Using the UKU and verbal reports, no significant side effects were recognized in any of the CBD groups.73

Huntington’s disease

Fifteen neuroleptic-free patients with Huntington’s disease were treated with either placebo or oral CBD (10 mg/kg b.w. per day) for 6 weeks in a double-blind, randomized, crossover study design. Using various safety outcome variables, clinical tests, and the cannabis side effect inventory, it was shown that there were no differences between the placebo group and the CBD group in the observed side effects.6

Immune system

Forty-eight patients were treated with 300 mg/kg oral CBD, 7 days before and until 30 days after the transplantation of allogeneic hematopoietic cells from an unrelated donor to treat acute leukemia or myelodysplastic syndrome in combination with standard measures to avoid GVHD (graft vs. host disease; cyclosporine and short course of MTX). The occurrence of various degrees of GVHD was compared with historical data from 108 patients, who had only received the standard treatment. Patients treated with CBD did not develop acute GVHD. In the 16 months after transplantation, the incidence of GHVD was significantly reduced in the CBD group. Side effects were graded using the Common Terminology Criteria for Adverse Events (CTCAE v4.0) classification, which did not detect severe adverse effects.74

Endocrine and glycemic (including appetite, weight gain) effects

In a placebo-controlled, randomized, double-blind study with 62 subjects with noninsulin-treated type 2 diabetes, 13 patients were treated with twice-daily oral doses of 100 mg CBD for 13 weeks. This resulted in lower resistin levels compared to baseline. The hormone resistin is associated with obesity and insulin resistance. Compared to baseline, glucose-dependent insulinotropic peptide levels were elevated after CBD treatment. This incretin hormone is produced in the proximal duodenum by K cells and has insulinotropic and pancreatic b cell preserving effects. CBD was well tolerated in the patients. However, with the comparatively low CBD concentrations used in this phase-2-trial, no overall improvement of glycemic control was observed.40

When weight and appetite were measured as part of a measurement battery for side effects, results were inconclusive. For instance, the study mentioned above, where 23 children with Dravet syndrome were treated, increases as well as decreases in appetite and weight were observed as side effects.2 An open-label trial with 214 patients suffering from treatment-resistant epilepsy showed decreased appetite in 32 cases. However, in the safety analysis group, consisting of 162 subjects, 10 showed decreased weight and 12 had gained weight.52 This could be either due to the fact that CBD only has a small effect on these factors, or appetite and weight are complex endpoints influenced by multiple factors such as diet and genetic predisposition. Both these factors were not controlled for in the reviewed studies.

Conclusion

This review could substantiate and expand the findings of Bergamaschi et al. about CBD favorable safety profile.1Nonetheless, various areas of CBD research should be extended. First, more studies researching CBD side effects after real chronic administration need to be conducted. Many so-called chronic administration studies, cited here were only a couple of weeks long. Second, many trials were conducted with a small number of individuals only. To perform a throrough general safety evaluation, more individuals have to be recruited into future clinical trials. Third, several aspects of a toxicological evaluation of a compound such as genotoxicity studies and research evaluating CBD effect on hormones are still scarce. Especially, chronic studies on CBD effect on, for example, genotoxicity and the immune system are still missing. Last, studies that evaluate whether CBD-drug interactions occur in clinical trials have to be performed.

In conclusion, CBD safety profile is already established in a plethora of ways. However, some knowledge gaps detailed above should be closed by additional clinical trials to have a completely well-tested pharmaceutical compound.

Abbreviations Used

AD Alzheimer’s disease
ARCI Addiction Research Center Inventory
BD bipolar disorder
BDI Beck Depression Inventory
CBD cannabidiol
HSP heat shock protein
IL interleukin
MRS Mood Rating Scale
PPI prepulse inhibition
ROS reactive oxygen species
SAFTEE Systematic Assessment for Treatment Emergent Events
STAI State Trait Anxiety Inventory
TSST Trier Social Stress Test
UKU Udvalg for Kliniske Undersøgelser
VAMS Visual Analogue Mood Scale
VAS Visual Analog Scales

Acknowledgments

The study was commissioned by the European Industrial Hemp Association. The authors thank Michal Carus, Executive Director of the EIHA, for making this review possible, for his encouragement, and helpful hints.

Author Disclosure Statement

EIHA paid nova-Institute for the review. F.G. is Executive Director of IACM.#

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44. Jadoon KA, Ratcliffe SH, Barrett DA. Efficacy and safety of cannabidiol and tetrahydrocannabivarin on glycemic and lipid parameters in patients with type 2 diabetes: a randomized, double-blind, placebo-controlled, parallel group pilot studyDiabetes Care. 2016;39:1777–1786 [PubMed]
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50. Persson A, Ingelman-Sundberg M. Pharmacogenomics of cytochrome P450 dependent metabolism of endogenous compounds: implications for behavior, psychopathology and treatmentJ Pharmacogenomics Pharmacoproteomics 2014;5:12–7.
51. Ghosh C, Hossain M, Solanki J, et al. Pathophysiological implications of neurovascular P450 in brain disordersDrug Discov Today. 2016;21:1609–1619 [PMC free article] [PubMed]
52. Brunt TM, van Genugten M, Höner-Snoeken K, et al.Therapeutic satisfaction and subjective effects of different strains of pharmaceutical-grade cannabisJ Clin Psychopharmacol. 2014;34:344–349 [PubMed]
53. Das RK, Kamboj SK, Ramadas M, et al. Cannabidiol enhances consolidation of explicit fear extinction in humansPsychopharmacology. 2013;226:781–792 [PubMed]
54. Bhattacharyya S, Morrison PD, Fusar-Poli P, et al. Opposite effects of Δ-9-tetrahydrocannabinol and cannabidiol on human brain function and psychopathologyNeuropsychopharmacology. 2010;35:764–774 [PMC free article] [PubMed]
55. Martin-Santos R, Crippa J, Batalla A. Acute effects of a single, oral dose of d9-tetrahydrocannabinol (Δ9-THC) and cannabidiol (CBD) administration in healthy volunteersCurr Pharm Des. 2012;18:4966–4979 [PubMed]
56. Crippa JAS, Hallak JEC, Machado-de-Sousa JP, et al.Cannabidiol for the treatment of cannabis withdrawal syndrome: a case reportJ Clin Pharm Ther. 2013;38:162–164 [PubMed]
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61. Appiah-Kusi E, Mondelli V, McGuire P, et al. Effects of cannabidiol treatment on cortisol response to social stress in subjects at high risk of developing psychosisPsychoneuroendocrinology. 2016;7(Supplement):23–24
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68. Leweke F, Koethe D, Gerth C. Cannabidiol as an antipsychotic: a double-blind, controlled clinical trial of cannabidiol versus amisulpiride in acute schizophrenia. In: 15th annual symposium on cannabinoids Cannabinoid Research Society: Clearwater Beach, FL, 2005
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June 2017

There was big news in Congress today that I wanted you to know about. A proposed government spending bill released today eliminated a provision that has protected the marijuana industry from federal prosecution for violating the Controlled Substances Act.

The Rohrabacher-Farr language was eliminated from the Commerce, Justice, Science bill that funds the Department of Justice, even though the language had previously been included in the 2017 base text. In addition, the Financial Services bill retained language preventing Washington, DC from implementing full retail sales and commercialization of recreational marijuana.

Smart Approaches to Marijuana (SAM) submitted testimony to the Appropriations Committee to push back against this provision, which has allowed unsafe and untested products to masquerade as medicine. Rather than submit their products to the FDA for approval as safe and effective medicines, the marijuana industry has instead been using medical marijuana laws as a guise to increase demand for marijuana consumption and service the black market with large amounts of high-potency marijuana.

“If I were an investor, I would sell my marijuana stocks short,” said Kevin Sabet, President of SAM. “The marijuana industry has lost in every state in which they were pushing legislation in 2017, the industry’s largest lobbying group is losing its bank account , and now they are losing protection that has helped them thrive despite marijuana’s illegal status. Although the debate over Rohrbacher-Farr is far from over, the bad news just keeps coming for the pot industry. But it’s great news for parents, prevention groups, law enforcement, medical professionals, victims’ rights advocates and everyone who cares about putting public health before profits.”

Evidence demonstrates that marijuana – which has skyrocketed in average potency over the past decade – 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.

Thank you for the work that you are doing to help with these big wins for public health and safety!  

Source: Email from Smart Approaches to Marijuana (SAM) June 2017

There was big news in Congress yesterday that I wanted you to know about. We are pleased to report that the House has not included any pro-pot riders in its spending bills this year! Thank you for all of your efforts, including calls and emails. Congress has heard your voice and acted to preserve the public health and safety of our kids and communities.

Pro-pot advocates filed more than ten amendments to protect the marijuana industry and increase marijuana investment opportunities, but none of the amendments were allowed to proceed. The lessons of legalization are getting out, and it’s clear the experiment has failed, as our recent Cole Memo Report has shown. The black market is thriving, kids are ending up in emergency rooms, and drugged driving fatalities are soaring .

The fight isn’t over, though. Even though the House bill is clear, the Senate version of the spending bill still contains key marijuana industry protections. Those differences will be resolved in the coming months. We will continue to send out alerts to let you know when it’s time to come together and act.

Thank you again for all your work over the past years. You’ve made a difference, and we are grateful for your partnership. Please consider a donation to help with our efforts as we continue this battle in the coming months.

Source: Email SAM Action <info@samaction.net> from Kevin Sabet September 2017

I was just learning this morning that CBD is well documented to trigger and act via PPAR gamma receptors which are well known to physicians as used in a class of diabetes drugs called the thiazolidinediones (pioglitazone and its congeners).

So I thought I should just check if this was involved in pregnancy and gestation.

Sure enough – BINGO!!!

Another strike of GOLD!!!

So I wrote this to add in the references…

Cannabidiol is known to interact with the (Peroxisome Proliferation Activated Receptor) PPARγ pathway 1-8.

PPARγ is known to be a very important transcription factor in metabolic regulation and is also the master regulator of the adipogenic differentiation pathway.

It also plays a key role in the reproductive tract with actions on the corpus luteum and developing gametes.

It has been documented in a rich literature to have a major effect on developing embryos and the reproductive tract 9-32.

References

1 De Filippis, D. et al. Cannabidiol reduces intestinal inflammation through the control of neuroimmune axis. PLoS One 6, e28159, doi:10.1371/journal.pone.0028159 (2011).
2 Esposito, G. et al. Cannabidiol reduces Abeta-induced neuroinflammation and promotes hippocampal neurogenesis through PPARgamma involvement. PLoS One 6, e28668, doi:10.1371/journal.pone.0028668 (2011).
3 Hegde, V. L., Singh, U. P., Nagarkatti, P. S. & Nagarkatti, M. Critical Role of Mast Cells and Peroxisome Proliferator-Activated Receptor gamma in the Induction of Myeloid-Derived Suppressor Cells by Marijuana Cannabidiol In Vivo. J Immunol 194, 5211-5222, doi:10.4049/jimmunol.1401844 (2015).
4 Hind, W. H., England, T. J. & O’Sullivan, S. E. Cannabidiol protects an in vitro model of the blood-brain barrier from oxygen-glucose deprivation via PPARgamma and 5-HT1A receptors. Br J Pharmacol 173, 815-825, doi:10.1111/bph.13368 (2016).
5 O’Sullivan, S. E. & Kendall, D. A. Cannabinoid activation of peroxisome proliferator-activated receptors: potential for modulation of inflammatory disease. Immunobiology 215, 611-616, doi:10.1016/j.imbio.2009.09.007 (2010).
6 O’Sullivan, S. E., Sun, Y., Bennett, A. J., Randall, M. D. & Kendall, D. A. Time-dependent vascular actions of cannabidiol in the rat aorta. European journal of pharmacology 612, 61-68, doi:10.1016/j.ejphar.2009.03.010 (2009).
7 Ramer, R. et al. COX-2 and PPAR-gamma confer cannabidiol-induced apoptosis of human lung cancer cells. Mol Cancer Ther 12, 69-82, doi:10.1158/1535-7163.MCT-12-0335 (2013).
8 Scuderi, C., Steardo, L. & Esposito, G. Cannabidiol promotes amyloid precursor protein ubiquitination and reduction of beta amyloid expression in SHSY5YAPP+ cells through PPARgamma involvement. Phytother Res 28, 1007-1013, doi:10.1002/ptr.5095 (2014).
9 Adaikalakoteswari, A. et al. Low Vitamin B12 in Pregnancy Is Associated With Adipose-Derived Circulating miRs Targeting PPARgamma and Insulin Resistance. The Journal of clinical endocrinology and metabolism 102, 4200-4209, doi:10.1210/jc.2017-01155 (2017).
10 Anghebem-Oliveira, M. I. et al. Type 2 diabetes-associated genetic variants of FTO, LEPR, PPARg, and TCF7L2 in gestational diabetes in a Brazilian population. Arch Endocrinol Metab 61, 238-248, doi:10.1590/2359-3997000000258 (2017).
11 Casamadrid, V., Amaya, C. A. & Mendieta, Z. H. Body Mass Index in Pregnancy Does Not Affect Peroxisome Proliferator-activated Receptor Gamma Promoter Region (-359 to -260) Methylation in the Neonate. Ann Med Health Sci Res 6, 38-43, doi:10.4103/2141-9248.180272 (2016).
12 Cawyer, C. et al. Attenuation of hyperglycemia-induced apoptotic signaling and anti-angiogenic milieu in cultured cytotrophoblast cells. Hypertens Pregnancy 35, 159-169, doi:10.3109/10641955.2015.1122035 (2016).
13 Drew, P. D. & Kane, C. J. Peroxisome Proliferator-Activated Receptor-gamma Agonists: Potential Therapeutics for Neuropathology Associated with Fetal Alcohol Spectrum Disorders. J Clin Cell Immunol 7, doi:10.4172/2155-9899.1000469 (2016).
14 Gao, F., Hu, W., Li, Y., Shen, H. & Hu, J. Mono-2-ethylhexyl phthalate inhibits human extravillous trophoblast invasion via the PPARgamma pathway. Toxicology and applied pharmacology 327, 23-29, doi:10.1016/j.taap.2017.04.014 (2017).
15 Hasby Saad, M., El-Anwar, N., Lotfy, S., Fouda, M. & Hasby, E. Human placental PPAR-gamma & SOX2 expression in serologically proved toxoplasmosis. Parasite Immunol, e12529, doi:10.1111/pim.12529 (2018).
16 Hu, W. et al. Activation of Peroxisome Proliferator-Activated Receptor Gamma and Disruption of Progesterone Synthesis of 2-Ethylhexyl Diphenyl Phosphate in Human Placental Choriocarcinoma Cells: Comparison with Triphenyl Phosphate. Environ Sci Technol 51, 4061-4068, doi:10.1021/acs.est.7b00872 (2017).
17 Kurzynska, A., Chojnowska, K., Bogacki, M. & Bogacka, I. PPAR ligand association with prostaglandin F2alpha and E2 synthesis in the pig corpus luteum-An in vitro study. Anim Reprod Sci 172, 157-163, doi:10.1016/j.anireprosci.2016.07.014 (2016).
18 Lecoutre, S. et al. Depot- and sex-specific effects of maternal obesity in offspring’s adipose tissue. The Journal of endocrinology 230, 39-53, doi:10.1530/JOE-16-0037 (2016).
19 Lendvai, A., Deutsch, M. J., Plosch, T. & Ensenauer, R. The peroxisome proliferator-activated receptors under epigenetic control in placental metabolism and fetal development. Am J Physiol Endocrinol Metab 310, E797-810, doi:10.1152/ajpendo.00372.2015 (2016).
20 Lin, Y., Bircsak, K. M., Gorczyca, L., Wen, X. & Aleksunes, L. M. Regulation of the placental BCRP transporter by PPAR gamma. J Biochem Mol Toxicol 31, doi:10.1002/jbt.21880 (2017).
21 Maekawa, M. et al. Polyunsaturated fatty acid deficiency during neurodevelopment in mice models the prodromal state of schizophrenia through epigenetic changes in nuclear receptor genes. Transl Psychiatry 7, e1229, doi:10.1038/tp.2017.182 (2017).
22 Mahendra, J. et al. Evidence Linking the Role of Placental Expressions of Peroxisome Proliferator-Activated Receptor-gamma and Nuclear Factor-Kappa B in the Pathogenesis of Preeclampsia Associated With Periodontitis. J Periodontol 87, 962-970, doi:10.1902/jop.2016.150677 (2016).
23 Marginean, C. et al. The role of TGF-beta1 869 T > C and PPAR gamma2 34 C > G polymorphisms, fat mass, and anthropometric characteristics in predicting childhood obesity at birth: A cross-sectional study according the parental characteristics and newborn’s risk for child obesity (the newborns obesity’s risk) NOR study. Medicine (Baltimore) 95, e4265, doi:10.1097/MD.0000000000004265 (2016).
24 Meher, A. P. et al. Placental DHA and mRNA levels of PPARgamma and LXRalpha and their relationship to birth weight. J Clin Lipidol 10, 767-774, doi:10.1016/j.jacl.2016.02.004 (2016).
25 Papamitsou, T., Toskas, A., Papadopoulou, K., Economou, Z. & Sioga, A. Expression of peroxisome proliferator activation receptors (PPARs) and TNFalpha in placenta tissues in unexplained recurrent pregnancy loss: an immunohistochemical study. Histology and histopathology 31, 1029-1036, doi:10.14670/HH-11-734 (2016).
26 Roberti, S. L. et al. Critical role of mTOR, PPARgamma and PPARdelta signaling in regulating early pregnancy decidual function, embryo viability and feto-placental growth. Molecular human reproduction, doi:10.1093/molehr/gay013 (2018).
27 Shapiro, A. L. et al. Nicotinamide Promotes Adipogenesis in Umbilical Cord-Derived Mesenchymal Stem Cells and Is Associated with Neonatal Adiposity: The Healthy Start BabyBUMP Project. PLoS One 11, e0159575, doi:10.1371/journal.pone.0159575 (2016).
28 Singh, S. P. et al. Gestational Exposure to Sidestream (Secondhand) Cigarette Smoke Promotes Transgenerational Epigenetic Transmission of Exacerbated Allergic Asthma and Bronchopulmonary Dysplasia. J Immunol 198, 3815-3822, doi:10.4049/jimmunol.1700014 (2017).
29 Sonanez-Organis, J. G. et al. HIF-1alpha and PPARgamma during physiological cardiac hypertrophy induced by pregnancy: Transcriptional activities and effects on target genes. Gene 591, 376-381, doi:10.1016/j.gene.2016.06.025 (2016).
30 Wang, L. L., Yu, Y., Guan, H. B. & Qiao, C. Effect of Human Umbilical Cord Mesenchymal Stem Cell Transplantation in a Rat Model of Preeclampsia. Reprod Sci 23, 1058-1070, doi:10.1177/1933719116630417 (2016).
31 Wu, Y., Ruan, Y., Shen, L. & Gong, Q. Protective effects of PPAR-gamma against pregnancy-induced hypertension by differential ETR expression in rat models. J Cell Biochem 119, 3118-3128, doi:10.1002/jcb.26454 (2018).
32 Xu, Y. et al. An M1-like Macrophage Polarization in Decidual Tissue during Spontaneous Preterm Labor That Is Attenuated by Rosiglitazone Treatment. J Immunol 196, 2476-2491, doi:10.4049/jimmunol.1502055 (2016).

Source: Email to www.drugwatch.org from Stuart Reece April 2018

The Oregon Health Authority also issued this month a baseline report titled Marijuana Report: Use, Attitudes, and Health Effects in Oregon. This comprehensive report includes several key findings.
 
Pictured above, for example, is a state map showing the 40 cities and 11 counties that have banned marijuana businesses within their boundaries. However, the Oregon Medical Marijuana Dispensary Program shows those numbers to be higher. Some 80 of the state’s 242 cities and 17 of its 36 counties have banned marijuana processing businesses and marijuana dispensaries from conducting business within their boundaries.
 
Oregon legalized marijuana for medical use in 1998 and for recreational use in 2014. Possession of up to eight ounces became legal for those age 21 or older July 1, 2015. Because recreational dispensaries will not open until late this year, the state allowed dispensaries selling pot for medical use to begin selling pot for recreational use as well October 1, 2015.
 
In just three months, however, some changes are already being seen. Marijuana-related calls to the state’s Poison Control Center increased in the last half of 2015, for example, from 105 in 2014 to 158 in 2015.
 
Other data include:

  • One in ten 8th-graders and one in five 11th-graders used marijuana in the past month, about the same as national levels.
  • Approximately 90% of marijuana users smoke the drug.
  • Some 62% of 11th-graders report marijuana is easy to get, some say easier than cigarettes.
  • Nearly half of current marijuana using 11th-graders who drive say they drove within three hours of using the drug.
  • Half (51%) of Oregon adults have seen marijuana store or product advertising, but less than one-third (29%) have seen information about marijuana health effects.
  • Nearly two-thirds (63%) of Oregon adults say they don’t know when it is legal to drive after using marijuana.

Read this report here.

Cannabis oil has come under scrutiny

RUNGROJ YONGRIT/EPA-EFE/REX/Shutterstock

By Alison George

Cannabis is in the headlines for its potential medical benefits after the recent confiscation of cannabis oil medication from the mother of a 12-year-old British boy with severe epilepsy. The furore that ensued is shining a light on campaigns for cannabis oils to be made legal for medical reasons, and the UK government has now announced a review into the use of medicinal cannabis. Here’s what you need to know.

What is cannabis oil?

Cannabis oil is extracted from the cannabis plant Cannabis sativa. The plants medicinal properties have been touted for more than 3,000 years. It was described in the ancient Eygyptian Ebers papyrus around 1550BC, and it was likely used as a medicine in China before that. Some varieties of the plant contain high levels of the psychoactive substance tetrahydrocannabinol (THC), which is responsible for the “high” that comes from smoking or eating cannabis leaves or resin. The plant’s other major chemical component is cannabidiol, which has no psychoactive effect. Both act on the body’s natural cannabinoid receptors which are involved in many processes such as memory, pain and appetite. The cannabis plant also contains more than 100 other different cannabinoid compounds at lower concentrations.

So can cannabis oil make you high?

It depends on the THC content. Some types of Cannabis sativa plant, known as hemp, contain very little THC. The extracts from these plants contain mainly cannabidiol, so will not get anyone stoned.

Is it legal?

That’s a complicated question. In the UK cannabidiol is legal. Cannabis plant extracts (known as hemp or CBD oils) are available in high-street stores but the THC content must be below 0.2 per cent. “THC is not psychoactive at this level,” says David Nutt, a neuropsychopharmacologist at Imperial College London. But cannabidiol is illegal in many other countries.

In the USA for example, cannabidiol is classed as a schedule 1 controlled substance, and can only be sold in states where cannabis use is legal.

However, the tide may turn in favour of cannabidiol after a recent World Health Organisation review. This concluded that cannabidiol “exhibits no effects indicative of any abuse or dependence potential” but “has been demonstrated as an effective treatment of epilepsy … and may be a useful treatment for a number of other medical conditions.”

What is the evidence that cannabis oils can help treat epilepsy?

Although there is some scientific evidence that THC has potential to control convulsions, its mind-altering effects mean that much of the focus has turned to cannabidiol – particularly for childhood epilepsies that conventional drugs fail to control.

Two recent high quality randomised and placebo controlled trials showed that cannabidiol is an effective treatment for Lennox-Gastaut syndrome and Dravet syndrome, severe forms of epilepsy. The mechanism of action is unknown, but it may be due to a combination of effects, such as inhibiting the activity of neurons and dampening inflammation in the brain.

The situation is less clear when it comes to the use of commercial cannabis oils to control seizures, where the evidence is mainly anecdotal, and the oils can contain differing concentrations of cannabidiol and THC.

The UK government announced on 19 June that it would review the use of medical cannabis.

Are there any cannabis-based epilepsy drugs on the market?

Not yet. In April the US Food and Drug Administration recommended the approval of a drug called Epidiolex for Lennox-Gastaut syndrome and Dravet syndrome. Its active ingredient is cannabidiol, and final approval is due at the end of this month.

However, it is possible the drug is not as effective as cannabis oil containing THC, says Nutt. For example, the cannabis oil used to treat Billy Caldwell, the boy at the centre of the recent cannabis oil confiscation furore, contained cannabidiol and a low dose of THC, because cannabidiol alone did not stop all his seizures.

This is one of the big unknowns. “It is important to remember that there is currently very little scientific evidence to support cannabis oil containing both THC and cannabidiol as a treatment for epilepsy,” said the charity Epilepsy Action, in a statement issued this month.

Are cannabis-based medications available for other conditions?

Yes. A synthetic version of THC called Nabilone has been used since the 1980s to treat nausea after chemotherapy and to help people put on weight. A drug called Sativex is also approved for the treatment of pain and spasms associated with multiple sclerosis. It contains an equal mix of THC and cannabidiol, but would not be suitable for the treatment of children with epilepsy such as Billy. “If you used that to treat epilepsy, the kids would be stoned off their heads,” says Nutt.

What is the aim of the UK government’s review of medical cannabis? 

The first part of the review will look at the evidence for the therapeutic value of cannabis-based products. It can recommend any promising ones for the second part of the review. This will be carried out by the government’s Advisory Council for the Misuse of Drugs, which can recommend a change to the legal medical status of cannabis and cannabinoids.

This will hopefully lead to a relaxation of the rules surrounding research into cannabis-based medicines says Tom Freeman, a clinical psychopharmacologist at King’s College London.

In the UK cannabis currently has Schedule 1 status, the most restrictive category, which is for drugs which are not used medicinally such as LSD. “This creates a Catch 22 situation,” says Freeman. “You can’t show that cannabis and cannabis-based products have medicinal value because of restrictions on medical research.”  If cannabis is moved to the Schedule 2 category, it will join substances such as morphine and diamorphine (heroin) which can be prescribed by doctors if there is a clinical need. 

Source: https://www.newscientist.com/article/2172415-cannabis-oil-what-is-it-and-does-it-really-work-as-medicine/  June 2018

Watch Here and Share!

As the legal status of marijuana changes its perceived dangers are lessening while the potency of the drug is increasing.

This video covers marijuana as a psychoactive substance that induces its effects by manipulation of natural brain chemicals known as  the endocannabinoids.The toxic and addictive impact that results from the drug’s disruption of natural endocannibinoids is characterized in this video by the testimony of those impacted by the drug and by the scientists who are studying its effects.

This video is 26 minutes and will help to clarify the many myths and misconceptions regarding the effects of marijuana.

Source: Email from SAM (Smart Approaches to Marijuana) <info@learnaboutsam.org>

March 2018

Submitted by Livia Edegger 

As support for decriminalising and legalising marijuana is growing, several new studies highlight the potentially harmful effects of the drug on its user’s brain and heart. The findings are particularly revealing in the field of recreational cannabis use. While studying the brains of a group of twenty occasional cannabis smokers, researchers from Harvard University found that as few as one or two uses a week can change the brain. Smoking marijuana was found to primarily affect the areas involved in decision making, emotions and motivations. Along the same lines, a group of French researchers found that marijuana use ups the risk of developing heart problems (i.e. strokes, heart attacks and circulation problems). More research is needed to better understand the health risks associated with marijuana.

Links:

Source:

http://preventionhub.org/en/prevention-update/even-casual-cannabis-use-can-affect-health

Submitted by Andy Travis 

Those who first used alcohol at or before the age of 14 were nearly four times more likely to meet the criteria for past year alcohol abuse or dependence than those who started using alcohol between the ages of 18 and 20 (16.5% vs. 4.4%) and more than six times more likely than those who started using alcohol at or after age 21 (16.5% vs. 2.5%).

These findings illustrate the need for alcohol education and prevention efforts as early as middle school.

Percentage of Adults (Ages 21 or Older) Who Abused or Were Dependent on Alcohol in the Past Year, by Age of First Alcohol Use, 2009.

 

Similarly, adults who first started using marijuana at or before the age of 14 are most likely to have abused or been dependent on illicit drugs in the past year. Adults who first used marijuana at age 14 or younger were six times more likely to meet the criteria for past year illicit drug abuse or dependence than those who first used marijuana when they were 18 or older (12.6% vs. 2.1%) and almost twice as likely as those who started between the ages of 15 and 17 (12.6% vs. 6.6%).

Percentage of Adults (Ages 21 or Older) Who Abused or Were Dependent on Illicit Drugs in the Past Year, by Age of First Marijuana Use, 2009.

 

Links:
• Adults Who Initiate Alcohol Use Before Age 21 More Likely to Abuse or Become Dependent on Alcohol(link is external) – CESAR FAX, University of Maryland, USA.
• Early Marijuana Use Related to Later Illicit Drug Abuse and Dependence(link is external) – CESAR FAX, University of Maryland, USA.

Source:

http://preventionhub.org/en/prevention-update/adults-who-initiate-alcohol-and-marijuana-use-age-21-are-much-more-likely-abuse-or-become-d

Submitted by Andy Travis

Much research on normative misconceptions among university students has been published in North America, but much less has surfaced in Europe. This cross-sectional study is based on 12 classes of second-year French college students in sociology, medicine, nursing or foreign language. Rather than focus on one substance the students were asked to estimate the proportion of tobacco, cannabis, alcohol use and heavy episodic drinking among their peers and to report their own use.

Researchers found that that substance use patterns and perceptions of the norms differ significantly across academic disciplines and that substance users are more likely to misjudge real peer use prevalence.

They conclude that social norms of substance use are an important factor among students personal use. Overestimating these norms is associated with increased levels of use. In addition to other strategies, the researchers recommend that prevention programs should consider changing use perception when it is overestimated.

“These results show that there are grounds for university level prevention campaigns based on local survey results.”

read more…

Source:

http://preventionhub.org/en/prevention-update/french-students-found-overestimate-their-peers-consumption-cannabis-tobacco-and-alcohol-pre

An effective drug-free workplace policy is one of the best ways for employers to protect their businesses. An effective program does not end with pre-employment screening, since any drug user can count up to three days before the test and then begin to use again after being hired.

Drug-free workplace policies reduce the amount of sick time, absenteeism, workman’s comp claims, insurance premiums, and protects against civil lawsuits because of an employee who inflicts damage on others because of impairment.

Communities that emphasize and encourage drug-free workplace practices can have an impact on overall drug use in the community. When combined with effective education and prevention, and by increasing the incentive of users to seek treatment, we can promote a drug-free culture and a thriving business environment that protects individuals, families and the community.

While some might think they don’t need a drug-free workplace policy, as we discussed last week, that’s really not true. Small businesses, not just large companies, need firm drug testing policies.

One new form of marijuana that’s growing in popularity nationwide underscores the need for workplace drug testing programs. This dangerous drug, wax marijuana, can easily be used in the workplace because it doesn’t look like regular marijuana — and frighteningly, it’s the most powerful form of the drug.

Here’s what employers need to know about wax marijuana, and why it shows the need to participate in Drug Free Work Week.

The 411 on Wax Marijuana – and What it Means for Drug Free Workplace Programs

With aliases like butter and honeycomb because of its waxy texture, wax is the most powerful form of marijuana.

According to wax marijuana users, a single hit can leave a high lasting all day. One dosage is equal to 20 marijuana cigarettes and can produce powerful hallucinations and psychotic effects. This potency is because wax marijuana is more than 80% pure THC.

Manufacturers produce wax by extracting the main psychoactive compound, Tetrahydrocannabinol (THC), from marijuana. They use flammable substances like butane in the process, which makes it quite dangerous, but renders the wax marijuana very strong.

While wax marijuana is legal in states like Colorado and Washington, it’s illegal under federal law and in most states.

Employers should take note – due to its appearance, wax marijuana can be passed off as lip balm.

This means that your employees could bring the most powerful form of marijuana into the workplace and use it right under your nose.

Remember, any on-the-clock substance abuse has lasting effects on your workplace, particularly when it comes to the safety of your employees. Just one hit of wax marijuana can result in an extremely powerful, daylong high — rendering your worker a serious danger to everyone around them.

Your workplace needs a drug testing policy to combat new trends in substance use, like wax marijuana.

Drug Free Work Week is a great opportunity for you to take stock of your existing drug testing policy or create a new workplace drug testing program. If you don’t take the time now to create or revise a policy, you may pay for it down the line as your employees try new drugs, such as wax marijuana, and end up causing injuries or financial damage to your workplace.

Partner With ARCpoint Labs for Workplace Drug Testing Policies.

Located nationwide, ARCpoint Labs provides workplace drug testing assistance. We can work with you to create and implement a drug testing policy that fits your unique needs, considering desired detection windows, new and emerging drugs, and your community’s particular substance abuse issues. Let us work with you to carry out a custom drug testing program.

Source: http://sober-work-place.com/drug-testing-2/with-wax-marijuana-use-on-the-rise-make-sure-you-celebrate-drug-free-work-week/  Introduction from Monte Stiles from DWI

Psychology of Addictive Behaviors journal makes corrections, SAM calls on media to correct stories

FOR IMMEDIATE RELEASE

January 19, 2015

Contact: Jeffrey Zinsmeister

jeff@learnaboutsam.org

+1 (415) 680-3993

[WASHINGTON, DC] – A prominent journal article about marijuana and health which resulted in media outlets reporting on marijuana’s harmlessness has now been corrected. A recheck of the statistics has now found that the incidence of psychotic disorders trended toward a 2.5-fold increase in marijuana users, a difference that went beyond a trend to reach significance in a one-tailed statistical test. This degree of impact matches very well the results of many prior studies involving marijuana use and psychosis though falls short of the five-fold increase in psychosis risk for marijuana users seen with the high strength strains that are more recently available.

Dr. Christine Miller, a former schizophrenia researcher from Johns Hopkins University and now Director of SAM Maryland, first alerted the journal, Psychology of Addictive Behaviors, last December. Some media outlets have already corrected their original story.

“We commend the Washington Post’s Ariana Cha for now updating her story, and hope many more will follow her lead,” remarked Dr. Miller. “The flaw in the original University of Pittsburgh report were certain correction factors applied to the raw data, factors which are strongly affected by psychosis rather than being causes of such a disorder. These inappropriate corrections overpowered the marijuana effect. We’re glad the corrections have been made.”

SAM urges other media outlets to correct their headlines and stories.

The new data comes on the heels of a major report released by the State of Vermont’s Health Department which found that marijuana worsened conditions ranging from mental illness to motor vehicle accidents to negative pregnancy effects – and almost all of them are found to be worsened by marijuana:

For more information about marijuana use and its effects, see http://www.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 31 states.

www.learnaboutsam.org

Source:

http://psycnet.apa.org/record/2015-58335-001

Submitted by Livia Edegger

Earlier this month Germany celebrated the results of the 2014 drug report which revealed a rapid decline in smoking, drinking and marijuana use among youth over the past ten years. Smoking among German teens aged 12 – 17 has halved in ten years (11.7%). Smoking rates have also dropped among 18 – 25 year olds, not as significantly though. Drinking rates have fallen from 17.9% in 2001 to 13.6% in 2012 among 12 – 17 year olds. In terms of gender differences, teenage boys are twice more likely to consume alcohol than their female counterparts. Little has changed among 18 – 25 year olds, the group that accounts for the highest alcohol consumption rate. Drinking in that age group was reported at 38.4% in 2012 which means it only dropped by a little over 1%. Cannabis ranks first among illicit drugs used with 5.6% of 12 – 17 year old teenagers using it compared to 9.2% in 2001. After years of steady consumption rates, cannabis use among 18 – 25 year olds is on the rise again and at 15.8% resembles figures of 2001.

Source:

http://preventionhub.org/en/prevention-update/germany-releases-drug-report

23rd July 2014

A teenage rugby player cut off his own penis and stabbed his mother while high on skunk, his father has revealed, as he called for the drug to be reclassified.

The father, named only as Nick because he wants to remain anonymous as his son is rebuilding his life, is backing Lord Nicholas Monson’s campaign to have skunk reclassified from a class B to a class A drug and for the traditional weaker form of cannabis to be decriminalised.

Lord Monson launched his call following the suicide of his 21-year-old son Rupert, who was addicted to skunk.

Nick, speaking for the first time in an interview with Radio Five Live, said his son, a county rugby player, started smoking “weed” when he was around sixteen and a half before switching to skunk because of “boredom”.

That was the beginning of what Nick said his son would describe as “two and a half years of hell” which culminated in a psychotic episode.

His son went from a “very bright, bubbly lad” to a “waste of space”. The teenager became delusional and paranoid, including sleeping “with a tennis racket in his bed because he thought people were living in the walls”.

Describing the horrific incident when his son attacked his mother and inflicted “incredibly deep self harm”, Nick said it had been a “perfectly normal day” before his son woke in the middle of the night ranting and raving.

“It was absolutely devastating, you can’t imagine anything of that nature happening…the whole episode was just surreal, I remember looking back its almost as if I’m peering in through a window and it’s happening to someone else.”

Nick’s son was in a mental institute for around 6 months, and in total spent almost two years in prison following the incident.

He has undergone surgery, and will have more operations to repair the damage, though Nick said he couldn’t say whether his son would be able to have children. He is clean of drink and drugs, but Nick cautioned that even being around other people smoking skunk could trigger another psychotic episode. His ex-wife has recovered, and has fully reconciled with her son who, Nick said, is “actually in really good form.”

“We recognise that this was an illness… he was totally oblivious, actually has no real memory of anything that happened, even now,” Nick said. “Maybe that’s for the best.”

Source:

https://www.telegraph.co.uk/news/2017/06/02/teenage-rugby-player-cut-penis-high-onskunk-says-father-wants/

A team of researchers from the UF Drug Policy Institute, Harvard University, and other institutions authored a lengthy response to a recent monograph written by the George Soros-funded ICSDP claiming that cannabis health claims have been overblown.

The team, led by former American Society of Addiction Medicine President Stu Gitlow, and other researchers with leadership ties to groups like the American Academy of Pediatrics, Boston Children’s Hospital, the University of Texas, the University of Pennsylvania, and other institutions found that the ICSDP report is an example of deceptive and biased research and that it contains abundant factual errors and logical flaws.

The report’s introduction reads: “The ICSDP conveniently cites evidence that supports its own predetermined narrative, concluding that only the pro-marijuana lobby has any substantive evidence in its favor-and ignores evidence to the contrary. Its main strategy is to attribute overblown “straw man” arguments to established marijuana researchers, misstating their positions and then claiming to “rebut” these positions with research.

“This response/critique reveals the lack of objectivity present in the report and, point-by-point, shows how the interests of the nascent Big Marijuana industry, private equity firms, and lobbyists lining up to capitalize on a new marijuana industry, are served.”

About the UF Drug Policy Institute

The UF Drug Policy Institute (DPI) serves the state of Florida, the Nation, and the global community in delivering evidence-based, policy-relevant, information to policymakers, practitioners, scholars, and the community to make educated decisions about issues of policy significance in the field of substance use, abuse, and addiction.

Read about our Distinguished Fellows Here

Just finished reading the cannabis section of the world drug report mentioned below and here were of the points that stuck out to me:

  • Cannabis herb (they make a distinction between herb and resin) seizures in North America account for 64% of worldwide seizures.
  • US outdoor eradication rates significantly dropped (6,470 in 2012 from 23, 622 in 2011) but it is unclear if the decrease was due to declining law enforcement activity in that area or to increasing legal grows due to new laws in CO and WA.
  • In 2012 , between 125 million and 227 million people who estimated to have used cannabis, that corresponds to 2.7 and 4.9% of the population aged 15-64 years.

We are changing laws to accommodate this small proportion of the population. These laws will have a deleterious knock on effect for the 95% majority of the population.

  • Over the past 5 years (in N. America, the largest cannabis herb market) prevalence rates in the US have increased but declined in Canada between 2008-2011 and increasing again between 2011-2012.

Cannabis use in the UK is down to the lowest levels since measurements began in 1996….. but the UK Government has not so far relaxed firm drug laws.

  • In the US, between 2006-2010 there was a 59% increase in cannabis-related ER visits and a 14% increase in cannabis-related treatment admissions.

•   Expert analyses predicts that legalization of cannabis will most likely reduce production costs which would in turn be expected decease prices overtime. Since cannabis consumption responds to prices, the lower prices will likely lead to high consumption. It is estimated that for each 10% drop in price there will be an approx. 3% increase in total users and a 3-5%

Source:

World Drug Report 2014

http://www.unodc.org/wdr2014/

 

Submitted by Andy Travis

This study found that youth with more substance users in their networks reported greater alcohol, cigarette, and marijuana consumption regardless of whether these network members provided tangible or emotional support. The homeless setting was more significant in consumption than meeting network members in other contexts. Numbers of adults and school attendees in networks reduced consumption.

Read more

Links:
• One in three parents do not talk to their children about the risks associated with drinking alcohol(link is external) Full statement ,with further links.
• Alcohol. It’s no joke. | Why Let Drink Decide(link is external) The video campaign.

Source:

http://preventionhub.org/en/prevention-update/survey-uk-parents-suggests-parents-more-concerned-about-risks-drugs-alcohol-government-anno

11th January 2011

Henrietta Szutorisza, Yasmin L. Hurda,

A B S T R A C T

Extensive debates continue regarding marijuana (Cannabis spp), the most commonly used illicit substance in many countries worldwide. There has been an exponential increase of cannabis studies over the past two decades but the drug’s long-term effects still lack in-depth scientific data. The epigenome is a critical molecular machinery with the capacity to maintain persistent alterations of gene expression and behaviors induced by cannabinoids that have been observed across the individual’s lifespan and even into the subsequent generation.

Though mechanistic investigations regarding the consequences of developmental cannabis exposure remain sparse, human and animal studies have begun to reveal specific epigenetic disruptions in the brain and the periphery. In this article, we focus attention on long-term disturbances in epigenetic regulation in relation to prenatal, adolescent and parental germline cannabinoid exposure. Expanding knowledge about the protracted molecular memory could help to identify novel targets to develop preventive strategies and treatments for behaviors relevant to neuropsychiatric risks associated with developmental cannabis exposure.

Source: Neuroscience and Biobehavioral Reviews 85 (2018) 93–101

Abstract

Metabolic and behavioural effects of, and interactions between Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD) are influenced by dose and administration route.

Therefore we investigated, in Wistar rats, effects of pulmonary, oral and subcutaneous (sc.) THC, CBD and THC+CBD. Concentrations of THC, its metabolites 11-OH-THC and THC-COOH, and CBD in serum and brain were determined over 24h, locomotor activity (open field) and sensorimotor gating (prepulse inhibition, PPI) were also evaluated.

In line with recent knowledge we expected metabolic and behavioural interactions between THC and CBD. While cannabinoid serum and brain levels rapidly peaked and diminished after pulmonary administration, sc. and oral administration produced long-lasting levels of cannabinoids with oral reaching the highest brain levels.

Except pulmonary administration, CBD inhibited THC metabolism resulting in higher serum/brain levels of THC. Importantly, following sc. and oral CBD alone treatments, THC was also detected in serum and brain. S.c. cannabinoids caused hypolocomotion, oral treatments containing THC almost complete immobility.

In contrast, oral CBD produced mild hyperlocomotion. CBD disrupted, and THC tended to disrupt PPI, however their combination did not.

In conclusion, oral administration yielded the most pronounced behavioural effects which corresponded to the highest brain levels of cannabinoids. Even though CBD potently inhibited THC metabolism after oral and sc. administration, unexpectedly it had minimal impact on THC-induced behaviour.

Of central importance was the novel finding that THC can be detected in serum and brain after administration of CBD alone which, if confirmed in humans and given the increasing medical use of CBD-only products, might have important legal and forensic ramifications.

Source: Eur Neuropsychopharmacol. 2017 Dec;27(12):1223-1237. doi: 10.1016/j.euroneuro.2017.10.037. Epub 2017 Nov 10.

Abstract

Background

Marijuana is a widely used recreational substance. Few cases have been reported of acute myocardial infarction following marijuana use. To our knowledge, this is the first ever study analyzing the lifetime odds of acute myocardial infarction (AMI) with marijuana use and the outcomes in AMI patients with versus without marijuana use.

Methods

We queried the 2010-2014 National Inpatient Sample (NIS) database for 11-70-year-old AMI patients.

Pearson Chi-square test for categorical variables and Student T-test for continuous variables were used to compare the baseline demographic and hospital characteristics between two groups (without vs. with marijuana) of AMI patients. The univariate and multivariate analyses were used to assess and compare the clinical outcomes between two groups. We used Cochran–Armitage test to measure the trends. All statistical analyses were executed by IBM SPSS Statistics 22.0 (IBM Corp., Armonk, NY). We used
weighted data to produce national estimates in our study.

Results

Out of 2,451,933 weighted hospitalized AMI patients, 35,771 patients with a history of marijuana and 2,416,162 patients without a history of marijuana use were identified. The AMI-marijuana group consisted more of younger, male, African American patients. The length of stay and mortality rate were lower in the AMI-marijuana group with more patients being discharged against medical advice.

Multivariable analysis showed that marijuana use was a significant risk factor for AMI development when adjusted for age, sex, race (adjusted OR 1.079, 95% CI 1.065-1.093, p<0.001); adjusted for age, female, race, smoking, cocaine abuse (adjusted OR 1.041, 95% CI 1.027-1.054, p<0.001); and also when adjusted for age, female, race, payer status, smoking, cocaine abuse, amphetamine abuse and alcohol abuse (adjusted OR: 1.031, 95% CI: 1.018-1.045, p<0.001). Complications such as respiratory failure (OR 18.9, CI 15.6-23.0, p<0.001), cerebrovascular disease (OR 9.0, CI 7.0-11.7, p<0.001), cardiogenic shock (OR 6.0, CI 4.9-7.4, p<0.001), septicemia (OR 1.8, CI 1.5–2.2, p<0.001), and dysrhythmia (OR 1.8, CI 1.5-2.1, p<0.001) were independent predictors of mortality in AMI-marijuana group.

Conclusion

The lifetime AMI odds were increased in recreational marijuana users. Overall odds of mortality were not increased significantly in AMI-marijuana group. However, marijuana users showed higher trends of AMI prevalence and related mortality from 2010-2014. It is crucial to assess cardiovascular effects related to marijuana overuse and educate patients for the same.

Source: Desai R, Patel U, Sharma S, et al. (November 03, 2017) Recreational Marijuana Use and Acute Myocardial Infarction: Insights from Nationwide Inpatient Sample in the United States . Cureus 9(11): e1816. DOI 10.7759/cureus.1816

Hamilton County Coroner Dr. Lakshmi Kode Sammarco released 2017 drug statistics Tuesday.

Last fall, the coroner said overdoses in Hamilton County had surpassed the total of last year, with 427 suspected deaths – and three months remaining in 2017, making the toll the worst since the heroin epidemic began. in the Tri-State.

Most overdose deaths have been due to fentanyl or chemically similar drugs, Sammarco said.

The county reported 403 overdose deaths in 2016 – up 30 percent, overdose deaths were totalled at 529 for 2017.

Sammarco described the increasing number of cases as “scary.” She said drug prevention efforts can only do so much without the help of the public.

“We can’t do this alone. Everybody here is busting their butt to try to get a handle on not just the supply, but to get help for the addicts and families. But we need the communities to step up, we need every neighborhood to keep an eye on their neighborhood. To try and help us get the dealers off the street, to try and get help to the addicts. You see something, say something.”

Sammarco noted the death toll was reduced by Narcan.

“The number of lives being saved is huge,” she said. “There’s no doubt they would’ve been double or triple what they were without Narcan.”

The coroner said 30,000 items were turned into the office’s drug section in 2017. Hfour drug analysts each processed well over 7,000 items, which 2.5 times higher than any other lab in Ohio.

Prevention First, a local non-profit aimed at reducing substance abuse released their findings from this year’s student drug-use survey.

They said of the more than 30,000 students grades 7 through 12 surveyed, nearly 14 percent have admitted to using alcohol in the past 30 days.

Tobacco use was only reported in five percent of students. Marijuana usage was slightly higher at more than eight percent.

Prescription drug abuse was reported in only 2.4 percent of students.

Commissioners said aside from marijuana use, the statistics have been trending downward since 2000.

“Hats off to Prevention First for leading the charge on that and for providing all of this really important information when it comes to prevention and what young people are doing in this community because this is the tip of the spear,” Commissioner Denise Driehaus said.

The survey, which is given every two years by Prevention First, was distributed to 80 public and private schools in six southwest Ohio counties.

To try to top overdoses before they happen, the Hamilton County Heroin Coalition is launching a Quick Response Teams early next month, on April 3.

The coalition is uniting with fire departments, law enforcement and social workers to create a team that follows up with overdose victims and offers them same-day addiction treatment. according to a prepared statement.

Modelled on an effort in Colerain Twp., the team will try to find overdose survivors using a database maintained by the Greater Cincinnati Fusion Center, a public safety data collecting agency.

Heroin Coalition commander and Norwood Police Lt. Tom Fallon told Hamilton County commissioners Monday the database would help locate overdose survivors who are otherwise hard to find.

The team will also use “predictive analysis” to track drug activity to target potential overdoses in with the help of University of Cincinnati’s Institute of Crime Science.

The effort is funded by a $400,000 grant from the U.S. Department of Justice funded through the Comprehensive Addiction and Recovery Act.

Source: http://www.fox19.com/story/37764381/hamilton-county-coroner

All creatures great and small are being poisoned by the pesticides and rodenticides in the water they drink, and in the food they eat. This polluted water from northern California marijuana grows eventually flows to much of the State. The lawless pot industry is nothing less than purveyors of poison. The recent scientific study “Cultivating Disaster: The Effect of Cannabis Cultivation on the Environment of Calaveras County,” points out that the cultivation of the drug was allowed by the State without adequate understanding of the impact on the environment and public health, welfare and safety. The chemicals that flow from the grow sites to the watershed had never been approved for these crops.

California does not regulate marijuana as a medicine because it is a Schedule 1 Controlled Substance under Federal Law, rather it is classified as an agricultural product. However, pot growers do not have to meet the same stringent requirements for chemicals and fertilizers as do all other farmers. Though there is limited testing being conducted by local water providers to determine if dangerous chemicals are leaching into water supplies or waste treatment systems, independent water experts testing water samples in Calaveras County found two thirds of the samples contained chemicals proven to be deadly poison to humans, fish and animals.

Of particular concern is carbofuron, an extremely toxic, water soluble granular pesticide banned in the U.S. but used among Mexican cartels. It is reported that an eighth of a teaspoon would kill a 300 lb black bear. In 2017, UC Davis researchers found harmful bacteria and deadly mold and Aspergillus fungi on marijuana in grows and dispensaries. This critical threat from marijuana grows to our environment and the human population is just beginning to surface.

The damaging effects of marijuana (cannabis), often considered a hallucinogenic drug, have long been known. High level THC, the mind-altering chemical in marijuana, is being grown and sold today as a “medicine.” It is long acting and addictive, causing brain damage, loss of intellect, psychotic breaks, suicides, mental illness, and birth defects and leads to other social costs from higher crime rates, highway deaths, excessive high school dropouts, and increased ER admissions, among others.

This lawless Big Marijuana Industry follows the playbook of Big Tobacco: GET KIDS HOOKED – ADDICTION OFTEN FOLLOWS. Their advertisements include images of Santa Claus, kids’ movies and cartoons, and they sell “edibles,” pot infused candy, lollipops and gummy bears with THC levels 50-70%. Many products are advertised as being 94-95% THC. Now there is crystalline THC that is 99.99% THC, known as “the strongest weed in the world.” Unfortunately, the public perception of marijuana is based on marijuana of the past – with 1- 5% THC.

The Calaveras Study estimates 1200 grows sites in that county; U.S. Forest Service estimates a tag of 2 billion to reclaim these sites. An estimated 50,000 grow sites in California would cost 50 – 80 billion to reclaim. The California Department of Fish and Wildlife says, “We are aware of the seriousness of the problem, but (we) do not know who is going to help clean it up.”

U.S. Attorney General Sessions has indicated his willingness to enforce our federal food and drug and environment laws when it comes to marijuana. Our California U.S. Attorneys must prosecute those who have broken federal, state, and county ordinances and explore funding to pay for cleanup of the land. This is not just a California issue, the U.S. Supreme Court

has ruled that federal marijuana laws preempt state laws and that marijuana control is a federal matter, not a states’ rights matter. There is no time to waste. Our future is at stake.

Source: Press Release Californians Against Legalisation of Marijuana Feb.6th 2018

Marijuana has always been seen as the laid-back drug. It might make you crave ice cream and chocolate cake or induce you to fall asleep, but it certainly wasn’t dangerous.

Yet, as governments in Britain and Canada consider decriminalizing the drug, medical researchers are warning that smoking cannabis increases the risk of lung disease and, more disturbingly, that its use can exacerbate psychosis and that it is linked with the onset of schizophrenia in adolescents.

“We have the evidence of cannabis and its dangers,” said Dr. Richard Russell, a respiratory specialist and a spokesman for the British Lung Foundation, which published a report this week on the dangers of cannabis.

“What we really want to avoid is the situation we had in the 1930s, ’40s and ’50s with cigarettes, where doctors were recommending tobacco as being good for you.”

In its report, the lung foundation warns that cannabis is more harmful to the lungs than tobacco. It says smoking three joints a day can cause the same damage as 20 cigarettes, and tar from marijuana contains 50 per cent more carcinogens than that from tobacco.

Persistent users are risking lung cancer, emphysema, bronchitis and other respiratory illnesses, it says.

One of the major problems is posed by the way users smoke marijuana and hashish: They take puffs that are almost twice as large as those tobacco smokers take and hold the smoke in four times as long. “This means that there is a greater respiratory burden of carbon monoxide and smoke particulates such as tar than when smoking a similar quantity of tobacco.”

The foundation also noted that in the 1960s, the average marijuana joint contained about 10 milligrams of tetrahydrocannabinol (THC), which accounts for the drug’s psychoactive properties. Because of sophisticated cultivation techniques, the average joint today has 150 mg of THC, a 15-fold increase.

Dr. Russell, the respiratory specialist, worries that young people think cannabis is a “cool drug” that is risk-free. A survey carried out this year showed that 79 per cent of British children believe cannabis is safe.

The Canadian government indicated in its Speech from the Throne last month that it is considering the decriminalization of marijuana possession.

Already, it gives exemptions to drug laws to allow sick people to have marijuana. On the other hand, pot grown for medicinal purposes in an abandoned Manitoba mine with Ottawa’s sanction sits in storage.

In Britain, under a proposal due to become law next year, simple possession of a small amount of cannabis will no longer result in an automatic arrest although police will still be able to go after users in “aggravated” circumstances, such as smoking in the presence of children. Cannabis trafficking will also continue to bring a prison sentence.

Meanwhile, clinical studies on the use of marijuana for medicinal purposes are under way with HIV patients in Canada and with people suffering from multiple sclerosis in Britain.

The British Lung Foundation says it is not trying to get involved in the debate over whether cannabis should be legalized, leaving that to politicians. “Our report is not about the moral rights and wrongs of cannabis, but simply making sure everyone is completely clear about the respiratory health risks involved,” said Dr. Mark Britton, chairman of the foundation.

Dr. Russell says he recently saw a 40-year-old patient in his clinic with “severe end-stage emphysema” and has about 18 months to live. The patient has been smoking three joints a day for the past 25 years, the equivalent of smoking 60 cigarettes a day from the age of 15, he says.

Studies of heavy cannabis smoking among Rastafarians in the Caribbean have also pointed to increased danger of early lung cancer, Dr. Russell says.

Les Iversen, a professor of pharmacology at King’s College in London and an expert on cannabis, agrees that smoking marijuana poses dangers, but he says the report’s findings are exaggerated.

There is no specific evidence linking cannabis smoking with lung cancer, Prof. Iversen says.

He says it’s absurd to say smoking three joints is equivalent to smoking 20 cigarettes because joints come in different sizes and strengths as do commercial cigarettes.

Although he adds, “I don’t think any drug is safe.”

Psychiatrists have also linked cannabis use to schizophrenia.

“People with schizophrenia do not take more alcohol, heroin or ecstasy than the rest of us, but they are twice as likely to smoke cannabis regularly,” says Dr. Robin Murray, a professor of psychiatry at the Institute of Psychiatry in London.

Dr. Murray says cannabis, along with cocaine and amphetamines, encourage the release of dopamine in the brain, which in turn leads to increased hallucinations.

He notes that the incidence of schizophrenia in south London has doubled in the past 40 years, and he says increased use of both cannabis and cocaine could be at fault.

Dr. Murray cites a study that interviewed 50,000 conscripts to the Swedish Army about their drug use and followed up later. Heavy users of cannabis at the age of 18 were six times as likely to be diagnosed with schizophrenia by the time they were 33 than those who kept away from the drug.

Another study, this one in the Netherlands, interviewed 7,500 people about their consumption of drugs and looked at their behaviour over the next three years. Regular users of cannabis were more likely to develop psychosis than those who did not use the drug.

“Any public debate on cannabis needs to take account of the risks as well as the pleasure,” Dr. Murray says. “Pro-marijuana campaigners claim, extrapolating from their Saturday-night joint, that cannabis is totally safe. Yet they would be unlikely to claim that a bottle of vodka a day is healthy on the basis of sharing a bottle of Chablis over dinner.

“No drugs that alter brain chemistry are totally safe,” he says. “Just as some who drink heavily become alcoholic, so a minority of those who smoke cannabis daily go psychotic.”

A major study on the links between cannabis and schizophrenia is due to be published in the British Medical Journal next week by Louise Arsenault, a biomedical researcher at the Institute of Psychiatry who was trained at the University of Montreal.

Research made public last year by Dr. Arsenault showed that young men who regularly smoke cannabis are five times more likely to be violent than those who avoid the drug. Using data from a study of 961 young adults in Dunedin, New Zealand, she discovered that one-third of those with a cannabis habit had a court conviction for violence by the time they hit 21 or had displayed violent behaviour. That was three times the level of those who drank excessive amounts of alcohol.

The warnings about marijuana have not deterred members of Britain’s Legalize Cannabis Alliance, who say the report is merely a selective study of existing medical literature, which ignores studies that discount the health threats posed by the drug.

“I’ve used it for 30 years and it doesn’t seem to have affected my health,” says Alun Buffry, the alliance’s national co-ordinator.

“I stopped tobacco three or four years ago and I have noticed that since then my health has improved. My general level of energy has improved and I get more of a high from cannabis than the sleepiness I used to get, which I think had to do with tobacco.”

Mr. Buffry argues that it would be best to legalize cannabis to control the quality of what is sold and eliminate “dirty supplies” that may include potentially harmful glues, fillers and colouring agents.

“I would argue that it would be far more dangerous illegal than it would be legalized,” he says. “Even if cannabis were the most dangerous substance in the world, it is still consumed by millions of people.”

Alan Freeman is The Globe and Mail’s European correspondent.

Source:

https://www.theglobeandmail.com/incoming/theres-a-reason-they-call-it-getting-wasted/article1028091/  Mar. 21 2009

Click on the images to enlarge the detail.

Source:

https://www.intervenenow.com/breaking-the-stigma-of-recovery/

NEW YORK (MainStreet) — Even as a marijuana legalization gains traction around the U.S. and the world, the anti-pot contingent soldiers on to promote its own agenda. These advocates are on a mission to keep marijuana illegal where it is, make it illegal where it is not and to inform the public of the dangers of marijuana legalization as they see it.

So who are these anti-marijuana legalization crusaders?

They come from different backgrounds. Some come from the business world. Two are former White House cabinet members. Another is an academic. Two are former ambassadors. One is the scion of a famous political family. Many are psychiatrists or psychologists. Others are former addicts. Still others are in the field of communications. Oh – one is a Pope.

They have different motivations. Some act because of the people they met who suffered from drug abuse. Others are staunch in their positions for moral reasons and concern for the nation’s future; still others for medical and scientific reasons.

Here is a list of the most significant:

  1. Calvina Fay

Drug Free America Foundation, Inc. and Save Our Society From Drugs (SOS). She is also the founder and director of the International Scientific and Medical Forum on Drug Abuse.

She was a drug policy advisor to President George W. Bush and former Tennessee Governor Lamar Alexander. She has been a U.S. delegate and lecturer at international conferences.

President Bush acknowledged her efforts in drug prevention in 2008, and in 2009 she received the President’s Award from the National Narcotics Officers Associations Coalition.

She related during an interview that she became involved in the world of countering drug abuse as a businessperson. She started a company that wrote drug policy for employers, educated employees on the dangers of drugs and trained supervisors on how to recognize drug abuse. It was from this that she became aware of the gravity of the issue.

“People used to come to me to tell me they had a nephew or niece who had a drug problem,” Fay said. “This was when I realized how broad a problem this is. It became personally relevant at one point.”

President Bush acknowledged her efforts in drug prevention in 2008, and in 2009 she received the President’s Award from the National Narcotics Officers Associations Coalition.

I realized how broad a problem this is. It became personally relevant at one point.”

After she sold her company, she was approached by the DEA and the Houston Chamber of Commerce to improve the way substance abuse in the workplace was addressed. After a while she built a coalition of about 3,000 employers.

During this time she kept meeting more and more people who were addicted or had loved ones who were. So it became important to her to be involved in drug abuse prevention and treatment. She then became aware of the movement to legalize drugs.

“I knew that we had to push back against legalization, because if we did not prevention and treatment would not matter,” Fay asserted.

  1. Kevin Sabet

Sabet is the director of the Drug Policy Institute at the University of Florida, where he is an assistant professor in the psychiatry department at the College of Medicine.

He is a co-founder of Project SAM (Smart Approaches to Marijuana) and has been called the quarterback of the anti-drug movement.

Sabet served in the Obama Administration as a senior advisor for the White House Office of National Drug Control Policy (ONDCP) from 2009-2011. He previously worked on research, policy and speech writing at ONDCP in 2000 and from 2003-2004 in the Clinton and Bush Administrations, respectively. This gives him the distinction of being the only staff member at ONDCP to hold a political appointment in both the Bush and Obama Administrations.

He was one of three main writers of President Obama’s first National Drug Control Strategy, and his tasks included leading the office’s efforts on marijuana policy, legalization issues, international demand reduction,drugged driving and synthetic drug (e.g. “Spice” and “Bath Salts”) policy. Sabet represented ONDCP in numerous meetings and conferences, and played a key role in the Administration’s international drug legislative and diplomatic efforts at the United Nations.

He is also a policy consultant to numerous domestic and international organizations through his company, the Policy Solutions Lab. His current clients include the United Nations, where he holds a senior advisor position at the Italy-based United Nations Interregional Crime and Justice Research Institute (UNICRI) and other governmental and non-governmental organizations.

Sabet is published widely in peer-reviewed journals and books on the topics of legalization, marijuana decriminalization, medical marijuana, addiction treatment, drug prevention, crime and law enforcement.

He is a Marshall Scholar. He received his Ph.D. and M.S. in Social Policy at Oxford University and a B.A. in Political Science from the University of California, Berkeley.

  1. Bill Bennett

Bennett was a former “drug czar” (i.e. director of the Office of National Drug Control Policy) during the administration of President George H.W. Bush. Prior to that he was the Secretary of Education in the Reagan administration. Bennett is a prolific author – including two New York Times Number- One bestsellers; he is the host of the number seven ranked nationally syndicated radio show Morning in America. He studied philosophy at Williams College (B.A.) and the University of Texas (Ph.D.) and earned a law degree from Harvard.

Bennett, along with former prosecutor Robert White, recently penned an op-ed piece for the Wall Street Journal calling marijuana a public health menace. The two are also finishing a book about marijuana legalization which is due out in February 2015.

Bennett frequently features on his radio show guests warning of the dangers of marijuana legalization. He is concerned that while the science shows that legalizing marijuana is not beneficial, public opinion is going in the other direction.

Why is he involved in this? Simply put, he thinks marijuana legalization is bad for America. The author of the acclaimed series of books about American history called America: The Last Best Hope thinks marijuana legalization will have deleterious effect on Americans, especially the youth of America.

“Because as Jim Wilson said, drugs destroy your mind and enslave your soul,” he told MainStreet.

“Medical science now proves it,” he added.

  1. Patrick Kennedy

The other co-founder of Project SAM is former Rhode Island Democrat congressman Patrick Kennedy, son of Ted Kennedy. When he started SAM in Denver in 2013, Kennedy, who has admitted past drug use, was quoted as saying, “I believe that drug use, which is to alter the mind, is injurious to the mind … It’s nothing that society should sanction.”

His organization seeks a third way to address the drug problem, one that “neither legalizes or demonizes marijuana.” Kennedy does not think incarceration is the answer. He wants to make small amounts a civil offense. He emphasizes his belief that public health officials need to be heeded on this issue and they are not. He predicts that, if legalized, marijuana will become another tobacco industry.

“The thought that we will have a new legalized drug does not make sense to me,” Kennedy said during a 2013 MSNBC interview.

  1. Joseph Califano

This former Carter administration U.S. Secretary of Health, Education, and Welfare founded, in 1992, the Center on Addiction and Substance Abuse at Columbia University (since 2013, it has been called CASAColumbia). He is currently the chairman emeritus. The center has been a powerful voice for research, fundraising and outreach on the dangers of addiction. It shines the light, especially on the perils of marijuana for adolescents.

Recently Califano released an updated edition of his book How to Raise a Drug-Free Kid: The Straight Dope for Parents. He believes an update was needed because of the advances in science regarding youth and substance abuse that have occurred during the past five years.

He zeroes in on marijuana in the book, which he says is more potent today than it was 30 or 40 years ago. He points out – during an interview about the book published on the CASAColumbia website – the hazards of “synthetic marijuana” also known as Spice or K2. He says this is available in convenient stores and gas stations but is so lethal it was banned in New Hampshire.

Califano stresses that parents are the bulwark against substance abuse and addiction. He cited data during the interview that “70% of college students say their parents’ concerns or expectations influence whether or how much they drink, smoke or use drugs. Parental disapproval of such conduct is key to kids getting through the college years drug free. This is the time for you to use social media to keep in touch with your kids.”

He makes the analogy that “sending your children to college without coaching them about how to deal with drugs and alcohol is like giving them the keys to the car without teaching them how to drive.”

  1. Stuart Gitlow

Gitlow is the President of the American Society of Addiction Medicine (ASAM), a professional organization representing over 3,000 addiction specialist physicians.

In 2005, he also started the Annenberg Physician Training Program in Addictive Disease at the Mount Sinai School of Medicine in New York, NY. He is currently executive director. He is on the faculty of both the University of Florida and Mount Sinai School of Medicine.

About ASAM’s attitudes toward marijuana, he said:

“Our positions and policies with respect to marijuana have been developed over many decades and have been updated based upon the latest scientific evidence. We are firmly opposed to legalization of marijuana and reject the notion that the plant marijuana has any medical application.”

That said, he believes anecdotal evidence supports that more research should be conducted to deduce which parts of the marijuana plan can havemedical value.

Why did he get involved in this?

“I didn’t get involved in this as a “crusader” or because of a specific interest, but rather because I serve as the spokesperson for ASAM,” he told MainStreet.com. “In fact, though, given that there is so much industry-sourced money financing the marijuana proponents, and that the science-based opposition has little funding at all, I recognize the need for the public to actually hear what the facts are, particularly given the media bias and conflict of interest in terms of being motivated by potential ad revenue.”

  1. David Murray

A senior fellow at the Hudson Institute, Washington D.C., Murray co-directs the Center for Substance Abuse Policy Research. While serving previous posts as chief scientist and associate deputy director for supply reduction in the federal government’s Office of National Drug Control Policy. Before entering government, Murray, who holds an M.A. and Ph.D. in social anthropology from the University of Chicago, was executive director of the Statistical Assessment Service and held academic appointments at Connecticut College, Brown, Brandeis and Georgetown Universities.

What motivated him to get involved in a campaign to oppose marijuana legalization?

“It results from a steady regress from encountering a host of social pathologies (homelessness, failed school performance, domestic violence, child neglect, poverty, early crime, despair and suicide) and then time and again stumbling over a common denominator that either was a trigger or an accelerator of that pathology – substance abuse,” Murray told MainStreet. “Yet one finds as a dispassionate social analyst that the matter is either discounted, or overlooked, or not given sufficient weight, in the efforts to remediate the other surface manifestation pathologies,” he continued. “Moreover, one keeps encountering a sense that there is a closet with a door that is shut and it holds behind the door a host of explanations or guides to understanding of our woes, yet few are willing to open that door and address what lies behind it.”

He notes that even those who acknowledge the impact of substance abuse across so many maladies seem to not approach the problem with an open and searching mind. He said often one finds a ready-made narrative that serves to explain away the impact. The more that narrative is refuted “with counter argument or robust data indicating otherwise” the more social analysts resist or are in denial about the inadequacy of the standard narrative.

Subsequently, people who do criticize this encounter pressure from peers essentially telling to accept the narrative or shut up.

He mentions a good specific example can be found by encountering the reaction to the “gateway hypothesis” regarding early marijuana exposure. The literature in support of the gateway is quite strong he says.

“Yet everywhere the dominant response is to evade the implications,” he points out. “Our analysts pose alternative and unlikely accountings that seem practically Ptolemaic in their complicated denial of the obviously more simple and more real mechanism: exposure to the drug does, in fact, increase the likelihood of developing dependency on other, ‘harder’ drugs in a measurable way.“

  1. John Walters

He was, from December 2001 to January 2009, the director of the White House Office of National Drug Control Policy (ONDCP) and a cabinet member during the Bush Administration. During this time he helped implement policies which decreased teen drug use 25% and increased substance abuse treatment and screening in the healthcare system.

He is a frequent media commentator and has written many articles opposing the legalization of marijuana. He points out many of the fallacies of the pro-legalization movement. His editorials, essays, and media appearances have refuted the claims of the New York Times, pro-legalization libertarians and others.

For example, during a July 2014 appearance on Fox News Walters responded to the editorial boards condoning legalizing pot. Walters said when the science is increasingly revealing the risks of marijuana the “New York Times wants to act like it time to be ruled by Cheech and Chong.”

Walters has taught political science at Michigan State University’s James Madison College and at Boston College. He holds a BA from Michigan State University and an MA from the University of Toronto.

  1. Robert DuPont

DuPont was the founding director of National Institute on Drug Abuse. He has written more than three hundred professional articles and fifteen books including Getting Tough on Gateway Drugs: A Guide for the Family, A Bridge to Recovery: An Introduction to Twelve-Step Programs and The Selfish Brain: Learning from Addiction. Hazelden, the nation’s leading publisher of books on addiction and recovery, published, in 2005, three books on drug testing by DuPont: Drug Testing in Drug Abuse Treatment, Drug Testing in Schools and Drug Testing in the Criminal Justice System.

DuPont is active in the American Society of Addiction Medicine. He continues to practice psychiatry with an emphasis on addiction and anxiety disorders. He has been Clinical Professor of Psychiatry at the Georgetown University School of Medicine since 1980. He is also the vice president of a consulting firm he co-founded in 1982 with former DEA director Peter Bensinger – Bensinger, DuPont and Associates. DuPont also founded, in 1978, the Institute for Behavior and Health a drug abuse prevention organization.

  1. Bertha Madras

A professor of psychobiology for the Department of Psychiatry of Harvard Medical School. She is in a new position at McLean Hospital, a Harvard Medical School hospital affiliate. She was a former deputy director for the White House Office of National Drug Control Policy (ONDCP).

She has done numerous studies about the nature of marijuana. She is the co-editor of The Cell Biology of Addiction, as well as the co-editor of the 2014 books Effects of Drug Abuse in the Human Nervous System andImaging of the Human Brain in Health and Disease.

She rejects the claims of pot proponents. For example, she states that the marijuana chemical content is not known or controlled. She also notes that the “effects of marijuana can vary considerably between plants” and that “no federal agency oversees marijuana, so dose or purity of the plant and the contaminants are not known.”

  1. Carla Lowe

A mother of five grown children, grandmother of nine, graduate of UC Berkeley and former high-school teacher, Lowe got started as a volunteer anti-drug activist in 1977 when her PTA Survey to Parents identified “drugs/alcohol” as their priority concern. She organized one of the nation’s first “Parent/Community” groups in her hometown of Sacramento and co-founded Californians for Drug-Free Youth. She also chaired the Nancy Reagan Speakers’ Bureau of the National Federation of Parents for Drug-Free Youth, co-founded Californians for Drug-Free Schools, and in 2010 founded an all-volunteer Political Action Committee, Citizens Against Legalizing Marijuana (CALM)

She has travelled throughout the U.S. and the world speaking to the issue of illicit drug use, primarily marijuana, and its impact on our young people. As a volunteer consultant for the U.S. State Department and Department of Education, she has addressed parents, students, community groups and heads of state in Brazil, Malaysia, Singapore, Thailand, Pakistan, Germany, Italy, Ireland, and Australia.

CALM, is currently working with parents, law enforcement, and local community elected officials to stop the proliferation of marijuana by banning “medical” marijuana dispensaries and defeating the proposed 2016 ballot measure in California that will legalize recreational use of marijuana.

She wants to go national and is part of an effort to start Citizens Against Legalization of Marijuana-U.S.A. that will also function as a Political Action Committee dedicated to defeating legalization efforts throughout the country.

Lowe is a strong proponent of non-punitive random student drug testing. She believes this is the single most effective tool for preventing illicit drug use by our youth, and will result in billions of dollars in savings to our budget and downstream savings from the wreckage to our society in law enforcement, health and welfare, and education.

 

  1. Christian Thurstone

He is one of a few dozen mental health professionals in America who are board certified in general, child and adolescent, and addictions psychiatry. He is the medical director of one of Colorado’s largest youth substance-abuse treatment clinics and an associate professor of psychiatry at the University of Colorado Denver, where he conducts research on youth substance use and addiction.

According to a May 2013 interview posted on the University of Colorado website, Thurstone was named an Advocate for Action by the White House Office of National Drug Control Policy in October 2012 for his “outstanding leadership in promoting an evidence-based approach to youth substance use and addiction.”

Colorado Gov. John Hickenlooper named Thurstone to a state task force convened to make recommendations about how to implement Amendment 64, a constitutional amendment approved by Colorado voters in November 2012 to legalize the personal use and regulation of marijuana for adults 21 and older.

He became involved in the marijuana issue in 2009 “when a whole confluence of events occurred that led to the commercialization of marijuana….What matters is not so much the decriminalization; it’s the commercialization that affects people, especially kids. …95% of the treatment referrals to Denver Health are for marijuana. Nationwide, it’s two-thirds of the treatment referrals according to the Substance Abuse and Mental Health Services Administration (SAMHSA).”

  1. Peter Bensinger

Bensinger was a former DEA chief during the Ford, Carter and Reagan administrations. He was in the vanguard opposing medical marijuana in Illinois. He acknowledges medical marijuana as a value but he notes that it is available as a pill or spray, so the idea of legalizing smoked marijuana for medicinal purposes is merely a ploy.

  1. David Evans

The executive director of the Drug Free Schools Coalition before becoming a lawyer he was a research scientist, in the Division of Alcoholism and Drug Abuse, New Jersey Department of Health. He was also the manager of the New Jersey intoxicated driving program. He has written numerous articles warning of the dangers of marijuana legalization.

  1. Pope Francis

The new pontiff, while being hailed by many as being a liberal influence in the Catholic Church has taken an intransigent line against marijuana legalization. This past June the new international pop culture icon told the 31st International Drug Enforcement Conference in Rome, “No a ogni tipo di droga (No to every type of drug).”

He was an active opponent of marijuana while a bishop in his native Argentina. He says now that attempts to legalize drugs do not produce the desired results.

He deplores the international drug trade as a scourge on humanity. Pope Francis has said it is a fallacy to say that more drug legalization will lead to less drug use.

  1. Dennis Prager

A nationally syndicated radio talk show host in Los Angeles, Prager has used his microphone to condemn marijuana legalization. He has asked rhetorically, “Would you rather your pilot smoke cigarettes or pot? and “ How would Britain have fared in World War II if Winston Churchill had smoked pot instead of cigars?

  1. Mel and Betty Sembler

The Semblers are longtime soldiers in the war on drugs. They co-founded, in 1976, a nonprofit drug treatment program called Straight, Inc. that successfully treated more than 12,000 young people with drug addiction in eight cities nationally from Dallas to Boston. They also help fund other organizations dedicated to opposing legalizing drugs including marijuana. Betty Sembler is the founder and Board Chair of Save Our Society From Drugs (S.O.S.) and the Drug Free America Foundation, Inc. Both organizations work to educate people about attempts to legalize as “medicine” unsafe, ineffective and unapproved drugs such as marijuana,heroin, PCP and crack as well as to reduce illegal drug use, drug addiction and drug-related illnesses and death.

  1. Seth Leibsohn

Leibsohn is a radio host, writer, editor, policy, political and communications expert. He is a former member of the board of directors of the Partnership for a Drug Free America-Arizona Affiliate.

He told MainStreet that he got involved in the campaign against marijuana after seeing the effects of pot smoking on a college friend.

“One thing I noticed and never left my mind was a friend I had in college who so very clearly, freshman year, was one of the most gifted and intelligent thinkers and writers I had ever met,” he said. ” I predicted to myself and others, he’d be the next big American author, published in The New Yorker, books of short stories galore. But then he picked up a really habitual marijuana smoking practice. He smoked, probably, daily. This was the mid to late ’80s. And to this day, I believe he is still a smoker….and he is a waste-case. Lazy, never had a serious job, never published a serious piece of writing, totally ended up opposite what I had predicted. That story never left my mind.”

Leibsohn also noticed this was happening more and more. But the problem really was driven home while he was the producer and co-host for the Bill Bennett radio show, Morning in America.

“We noticed something very interesting: whenever we dealt with the issues of drug abuse, and particularly marijuana, the phone lines lit up like no other issue,” he said. “We had doctors, we had nurses, we had truckers, we had small businessmen, we had housewives, we had moms, we had brothers, we had teachers, we had sisters, we had aunts, we had uncles telling us story after story of the damage marijuana and other drugs had done to their and their loved ones lives. It amazed me how widespread the issue is. I concluded, to myself, this issue of substance abuse may very well be the most important and damaging health issue in America.”

He also noticed that “there just weren’t that many who seemed to give a serious damn about it.” He said Joe Califano and Bill Bennett were about the only ones he knew with a large microphone or following who would address the issue. The silence in other precincts and from others was astounding to him.

“I still am amazed not more people are taking this as seriously as it should be taken,” he said. “But I know, too, that any family that has been through the substance abuse roller coaster, needs to know they are not alone, and they are the real experts–their stories tell the tale I wish more children and pro-legalizers could hear. Today, I still talk, write, and research on the issue and have joined the board of a non-profit dedicated to helping on it as well,” he explained.

  1. Alexandra Datig

A political advisor and consultant who has experience of more than 13 years on issues of drug policy she was instrumental in the defeat of California Proposition 19, The Regulate Control & Tax Cannabis Act. Datig serves on the Advisory Board for the Coalition for a Drug Free California, the largest drug prevention coalition in California.

She became involved in the anti-marijuana legalization movement because of her own experiences. She was working in politics at the local and state level for over eight years by 2009, but she also reached ten years in sobriety from a 13-year drug addiction that nearly cost her her life. When California Proposition 19 came along, she decided “to jump in and form my own independent campaign committee “Nip It In The Bud.”

“I began reaching out to several other committees, drug prevention groups and law enforcement and together we built a powerful statewide coalition for which I became one of its leading advisors and strategists,” she told MainStreet

“Today, I consider myself a miracle, because I was able to turn my life around,” she told MainStreet. “This is not something I could have done had I not gotten sober. Having rebuilt my life in recovery, I believed that my experience could convince voters that legalizing a drug like marijuana for recreational use would make our roads more dangerous and, much like cigarettes, was targeted at our youth. That legalization would cause harm to first time users, people who suffer from depression and mental disorders and especially people vulnerable to addiction or relapse.”

  1. Monte Stiles

A former state and federal prosecutor, Stiles supervised the Organized Crime/Drug Enforcement Task Force – a group of agents and prosecutors who investigate and prosecute high-level drug trafficking organizations, including Los Angeles street gangs, Mexican cartels and international drug smuggling and money laundering operations.

One of his proudest personal and career achievements was the organization and implementation of the statewide “Enough is Enough” anti-drug campaign which produced community coalitions in every area of Idaho. In addition to the prosecution of drug traffickers, Monte has been a passionate drug educator and motivational speaker for schools, businesses, churches, law enforcement agencies, and other youth and parent organizations. He left government service in April 2011 to devote all of his time to drug education, other motivational speaking and nature photography.

 

I was recently moderating several nights of focus groups in Denver when the subject of marijuana suddenly and unexpectedly broke into the conversation.

At the beginning of each group I asked respondents to introduce themselves, stating their favorite hobbies or leisure time interests, and one thing they would change about Colorado. I’ve been doing this for decades and am used to hearing “the usual suspects” when it comes to what respondents want to change. Fix the traffic. Improve the schools. Stop the influx of new residents, particularly those from California and Texas. I even got a few mentions of the oddly standard, “I wish we had an ocean and a beach.”

But this time, in every group, someone mentioned he or she would go back on the state’s wholesale legalization of marijuana. I probed Coloradans some on the topic this trip, and the buyers’ remorse is palpable. People didn’t really know what they were getting into.I wrote about the possibility of second thoughts on marijuana previously, in early April; ordinarily I wouldn’t circle back so quickly, but I am seeing too much evidence to ignore the growing backlash.

It’s not just ordinary voters who now are second-guessing the move. Leaders are wondering aloud whether they should have done more to fight against approval of the referendum. Colorado’s mainstream civic elite, which ordinarily and routinely organizes large coalitions to fight ballot measures it deems bad for the state, generally chose to stand aside during the two referenda — one on medical marijuana and the other on leisure use — leaving the opposition to movement to conservative groups alone.

The problem with new policies enacted through the referendum process is that there are always unintended consequences. I spotted one on this last trip to Mile High country. Some voters now think that the marijuana trade, and the associated tax revenue, is such a financial bonanza that it should pay for most everything. It’s going to be a lot harder to pass any increases in general sales or property taxes because voters will instead want pot tax dollars to carry the burden.

It may be only a statistical margin of error quirk, but looking at the latest CBS News polling on marijuana legalization, I am wondering if there is a larger doubting of the wisdom of legalization.

For the first time in any time series I’ve monitored, support for legalization actually declined in mid-May’s CBS poll.

CBS found that just 48 percent of Americans believe marijuana should be legal, down from 51 percent in two earlier polls taken by CBS in January and February. Given that each study interviewed samples of approximately 1,000 adults, for a 3 percent margin of error, a 4-point drop in legalization support is just outside the margin — and more importantly, it’s a rare drop of any magnitude in momentum for legalization. For more than a decade, every successive poll saw rising support for marijuana. The latest CBS numbers are a throwback to a poll the organization took in 2012. That’s a serious regression for marijuana advocates.

Pot’s regress since January in the CBS polling is most noteworthy among the middle-aged (45-64) population (-13 percentage points in support for legalization) and by liberals (-9 points in support). Frankly, I am not at all surprised by the latter. Overall, support by liberals still stands at a stout 63 percent, but if I had deeper crosstabs, I’d expect that some green liberals with children under the age of 18 are starting to have some reservations about pot, just as many do about tobacco.

Pollsters will be keeping a close watch on these numbers. Is the trend in rising support for marijuana reaching a ceiling? Could there even be a growing pushback? Could the backlash be more about health and air quality than about conservative ideology? 

Hill is a pollster who has worked for Republican campaigns and causes since 1984.

Source:

http://thehill.com/opinion/david-hill/207342-david-hill-buyers-remorse-on-marijuana

For decades, attorney Richard Blau focused his legal savvy on the high-stakes business of booze. Alcohol-industry law was an attorney’s dream, full of unresolved questions and deep-pocketed players clawing their way to the top.

So when Florida’s talk turned to marijuana, another storied pastime with its own dubious history, Blau’s titan of a law firm, GrayRobinson, jumped at the opportunity. Blau now leads a special practice for clients wanting to capitalize on medical cannabis — and bend the laws to their advantage.

“The playbook is to get in and lend a hand in crafting those rules, so they read the way our clients want them to read,” Blau said. “The powerful people are the ones to get in on the ground floor.”

Months before the state’s November vote to legalize medical marijuana, some of Florida’s biggest law firms are already staking their claims to the lucrative legal minefield of the budding weed industry.

Orlando-based GrayRobinson, which employs 101 attorneys in Tampa Bay and nearly 300 across the state, will devote a core of its “regulated products” group to the nuances of marijuana law.

Attorneys with Holland & Knight, a prominent firm in Tampa with more than 1,000 lawyers across the world, last week released an alert for clients on the “legal landscape (and) complex marketplace for marijuana-related businesses.”

And Akerman, the Miami-based corporate-law giant and largest law firm in the state, recently launched a “regulated substances task force” with nearly two dozen senior attorneys and public-policy professionals ready to advise, among others, cultivators, private-equity groups and dispensaries.

“The shifting interplay between state and federal laws presents new challenges and unprecedented opportunities for Akerman clients,” managing partner Richard Spees said in a statement, “and we are positioned to help them capitalize.”

Groups with ostensible legal ties have filed for Florida business licenses with names like Medical Marijuana Business Lawyers and the Cannabis Law Group, joining a wave of “ganjapreneurs” grabbing for a piece of industry profits.

But the introduction of these powerhouse firms ups the ante, helping squash the images of two-bit, Breaking Bad-style “Better Call Saul” legal operations and legitimizing what could be a landslide of million-dollar corporate disputes.

“We’re not the ‘pot lawyers.’ This is not ‘reefer madness.’ It’s 100 percent professional, 100 percent legitimate . . . and we take it 100 percent seriously,” said Troy Kishbaugh, a health care specialist serving on GrayRobinson’s regulated-products group. “We have a large health care base . . . and they want their patients to get the best care possible. And if medical marijuana happens to be part of that medical regimen, they want to make sure they’re doing it right.”

The state’s biggest firms bolstered their practices this spring after Florida lawmakers passed a “Charlotte’s Web” bill legalizing a non-high-producing cannabis strain used to treat cancer and epilepsy.

An even bigger fight comes in November, when voters could pass Amendment 2 and legalize weed for a much broader slate of medical uses. Its prospects seem increasingly upbeat: A Quinnipiac University poll last week found 88 percent of Florida voters support adult medical-cannabis use.

If the vote passes, Florida could follow California in becoming America’s second-biggest medical-weed state, with around 400,000 patients spending an average of $3,000 a year, estimates from state regulators and a national cannabis-industry trade group show.

State regulators have several months to decide on the law’s little details, leaving a huge window for “cannabusiness” interests pushing to find an unserved niche. The state Department of Health’s Office of Compassionate Use, which is drafting the rules, discussed at a public hearing Friday a range of potential enterprises, from medical-cannabis testing to home delivery.

Lawyers wise to food and alcohol regulation are shoo-ins for the firms’ legal-weed practices: Many of the rules facing Big Pot, attorneys argue, could look a lot like those governing Big Tobacco, Big Food and Big Booze.
Joining them are lawyers with a vast range of expertise:

• Health care experts to address hospital and physician groups on how to protect themselves while administering, storing and suggesting the use of a drug still illegal under federal law.
• Banking and financial gurus to advise on securing investment, handling money and saving on taxes in what has long been an all-cash business.
• Land use attorneys who can help resolve zoning and landlord disputes over where growers and distributors can operate from seed to sale.
• Even intellectual-property specialists with knowledge on how to protect and preserve cannabis companies’ strains, brands and reputations, in much the same way consultants have long advised Budweiser or Marlboro.

For precedent, attorneys here are analyzing the legal laboratories of the 23 states, plus Washington D.C., that have legalized medical cannabis, and the two states, Washington and Colorado, that have okayed weed for personal use.

They also are following in the footsteps of nationwide firms versed in guiding the emerging trade. Seattle’s Canna Law Group, launched by international law firm Harris Moure in 2011, proved “profitable almost instantly,” partner Dan Harris told the Puget Sound Business Journal last year, adding, “We were shocked at the demand.” One of the group’s attorneys, a young University of Miami graduate, was voted “Marijuana Industry Attorney of the Year” in 2013 by Dope Magazine.

For the finer details, attorneys said, firms are following their clients’ requests to lobby their way into influence. Litigation seems likely: A proposed rule limiting Florida’s medical weed to five nurseries, chosen by lottery, has already stirred up legal wrath.
Attorneys have likened their legal timing to representing alcohol outfits near the sunset of prohibition, a potentially historical chance to mold law and make nice with the grateful captains of a new industry.

But GrayRobinson’s Blau, whose practice group is taking on three new clients a week, stops short of supporting the “green rush” of small-time entrepreneurs. He compares the early days of legal Florida weed to that of the American gold rush, in which organized business interests, not excited ground troops, ended up with the most to gain.

“All those individual wannabe miners thought (they’d strike it rich) when they pushed forward to mine the Klondike … but very few emerged out of that with anything,” Blau said. “In reality, it was the established gold-mining companies who took the ground, and made it their own.”

Source: www.tampabay.com 1st August 2014

Colorado middle schools reported a 24 percent increase in drug-related incidents last year, according to USA Today. School-based experts tell the newspaper they believe the jump is directly related to marijuana legalization. Recreational sales of marijuana began on January 1, 2014.

Schools do not report which kinds of drugs are involved in the incidents, the article notes. State legislators are now asking school districts to keep track of which drugs they are finding.

John Simmons, the Denver Public Schools’ Executive Director of Student Services, says schools in his city saw a 7 percent increase in drug incidents, from 452 to 482. Almost all of the incidents were related to marijuana, he said.

Middle schools across the state reported a total of 951 drug violations, the highest number in a decade. School officials say while marijuana use has long been a problem, more students are trying it now that it is more easily available and socially accepted.

“We have seen parents come in and say, ‘Oh that’s mine, they just took it out of my room,’ and that sort of thing,” said school resource officer Judy Lutkin of the Aurora Police Department. “Parents have it in their houses more often, and the kids just can take it from home.”

“Middle schoolers are most vulnerable to being confused about marijuana,” said Dr. Christian Thurstone, attending physician for the Denver Health Adolescent Substance Abuse Treatment program. “They think, ‘Well, it’s legal so it must not be a problem.’”

Meg Sanders, owner of MiNDFUL, a marijuana company that operates in Colorado, says her business is very careful not to market to children. “We feel it’s our responsibility as a responsible business to card not just once but twice for any recreational customer, and medical patients have to show several documents before they can purchase marijuana,” she said.

Source: http://www.drugfree.org/join-together/jump-colorado-school-drug-cases  19th Feb.  2015

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.

Authoritative organisations which do not support smoked pot or edibles as a legitimate form of medication:

 

 

 

 

 

 

 

 

 

 

 

 

 

Source: http://www.dbrecoveryresources.com/2015/02/medical-organisations-do-not-support-smoked-pot-or-edibles/

 This excellent interview  by Kevin Sabet was published in a Brazilian newspaper and has been translated.

Legalize the use of marijuana creates another “addiction industry” and also does not help to end trafficking, said Kevin Sabet, 35, an American expert who joined the team of drug control of the government of Barack Obama. For him, the politicization of “fashion theme” masks the impact of drugs on public health, whose consumption is increasing among adolescents. to use the term “medical marijuana” only confuses people. “We do not call the morphine ‘medicinal heroin'”

In an exclusive interview with UOL , Sabet showed data from a recent survey that will present the lecture “Impact of drug legalization”, organized by the SPDM – Paulista Association for the Advancement of Medicine. The event takes place on Saturday (23) in Sao Paulo.

One of the cases analyzed by Sabet is Colorado, which allows both the use of “medical marijuana” (since 2001) and recreational (starting this year). In the state, the sale of the drug is banned for children under 21 years. Even so, seven in ten adolescents in treatment for chemical dependency admitted to have used medical marijuana to another person-and, on average, it occurred 50 times.

Even in Colorado, Sabet says the number of young people between 12 and 17 who used marijuana increased from 8.15% (in 2009) to 10.47% (in 2011), well above the national average, which is 7, 55%.

For adults in the state doubled the number of drivers who, under the influence of marijuana, were involved in car accidents with death. The index rose from 5% in 2009 to 10% in 2011.

In the 19 American states that allow marijuana use for medical treatments, Sabet says three in five students in their final year of high school can drugs with “friends”. Only 25% buy drugs from dealers or strangers. The margin of error was not informed.

Art / UOL

Map of legalizing marijuana in the United States

  • Medicinal and recreational use legalized

Colorado and Washington

  • Legalized medicinal use

Arizona, California, Connecticut, Delaware, District of Columbia, Hawaii, Illinois, Maine, Maryland, Massachusetts, Michigan, Montana, Nevada, New Hampshire, New Jersey, New Mexico, Oregon, Rhode Island, Vermont

  • Legalization analysis

Florida and Alaska

The sociologist who studies politics for 18 years for drugs and is currently a senior advisor to the Institute for Research of Crimes Justice and the UN (United Nations), says the numbers are alarming. “It’s the opening of a new industry that just wants to increase the addiction of the people.”

Even the use of marijuana for medical treatment is frowned upon by Sabet. “We do not call the morphine ‘medicinal heroin.” Using the term’ medical marijuana ‘only confuses people and comes from the belief that you have to smoke to get the benefits, “he criticizes. 

Currently, he is dedicated to Project SAM – Smart Approaches to Marijuana (Intelligent Approaches for Marijuana). The non-profit organization’s mission is to reduce the use of cannabis in the world, “without demonizing or legalize” drugs. 

Check out the full interview:

UOL – Do you agree with the legalization of marijuana for medicinal purposes and for recreation? 

                                                                     Kevin Sabet – Often the debate is painted in white and black, as if you had to be either in favor of higher spending or criminals in favor of legalization. I do not agree with that. I think there are many more intelligent policies that do not fall into this polarization.

 What we’re seeing in states like Colorado and Washington [where the medicinal and recreational use of marijuana is allowed] is the inauguration of a new industry that just wants to increase the addiction of people.

 

It is very curious that we have politicians who do not already hold more executive positions in favor of legalization. It’s the latest fashion, it makes them come back to the news and makes them more relevant. I do not know in Brazil, but in the United States, when you become a former president, you’re no longer relevant Kevin Sabet

The type of legalization that worries me is what is happening in the United States and tends to happen in the rest of the world: industrialization and promotion of other addictive industry.

In terms of effects, we also have to think, whether in relation to marijuana and other drugs like cigarettes and even alcohol in the future of our workforce. What kind of workers and students want? Of course we do not want to promote the use of cigarettes for our students, but if you go to school and smokes, her cognition is not impaired, you can still learn. You will not get lung cancer tomorrow. But if marijuana is different. It impairs the person in terms of learning, memorization, attention, motivation.

We have lived through a disaster compared to the tobacco and alcohol industry, and I do not want to raise the pot at that level.

UOL – There are several studies cited including marijuana help cancer patients, since contain tumor growth, stimulate appetite, reduce nausea and relieve pain. With so many benefits, it is possible to advocate a total ban on drugs? 

Sabet – Tue drugs using substances derived from cannabis is something promising. But we do not smoke opium to have the effects of morphine. We do not call the morphine “medical heroin”. Use the term “medical marijuana” only confuses people and comes from the belief that you have to smoke to get the benefits.

In the United States, the so-called “users” of this medical marijuana are in 98% of cases men between 30 and 40 years without terminal cancer. They are also not seropositive for HIV, do not have multiple sclerosis or amyotrophic lateral sclerosis. Basically, they have pain in the lumbar region. Logical that we should treat their pain, but there are other outputs.

The impression of people is that marijuana is good because there are patients dying of cancer who need it. But frankly, if you’re dying of cancer, with six months to live, I do not care what you’re going to use [for pain].

In addition, laws are being written very broadly and in many American states, legislation is flawed. The Colorado began selling the drug in 2008 All you need is to be 18 years and have headaches to get marijuana.

UOL – What must we do to help patients in need of “medical marijuana?” 

Sabet – We have to do special research programs that give patients access to experimental drugs. We should not sell marijuana on the corner, in a store, and say that is medicine, because this is not the way to act of medicine. I do not like this politicization of medicine, the medicine should be in the scientific field.If scientists in Brazil say tomorrow that we need to smoke pot to get the [beneficial] effects, we need to understand why this is and learn. But do not think that is the current case.

Let us study the components of the plant. I know it can be very good for a politician to say that it is in favor of medical marijuana. But honestly, we should not trust politicians talking about scientific issues [laughs]. Let’s hear scientists. And they are not telling you to smoke pot to get rid of your cancer.  

UOL – Earlier this year, Obama said that smoking marijuana is no more dangerous than drinking alcohol, but stressed that in any case, is “a bad idea.” Do you agree with him? 

Sabet – First, do not think that there is healthy this equivalence to say that one thing is better than another because they are different. Alcohol affects your liver, marijuana affects your lungs. Alcohol affects certain parts of your brain, marijuana, other.

In the case of alcohol, we have a cultural acceptance. Alcohol is not legalized because it is a success for public health. It is legal because it has been used for thousands of years in Western culture, that’s the only reason.

In the case of marijuana, it is not used for thousands of years by the majority of the western population and do not want to repeat the experience [like alcohol] again.

I know far more people who drink a glass of wine with no intention of getting drunk. I know who smoke a joint without the intention to “have a cheap”. The reason for smoking a joint is drugging. I do not drink, so would not explain properly, but I’m not justifying do one thing and not another. There is a cultural difference in relation to alcohol which makes the comparison with the fake marijuana.

UOL – Our former president, Fernando Henrique Cardoso, is one of the advocates of marijuana legalization. What do you think of politicians like him? 

Sabet – It is very curious that we have politicians who no longer occupy the executive positions in favor of legalization. It’s the latest fashion, it makes them come back to the news and makes them more relevant. I do not know in Brazil, but in the United States, when you become a former president, you’re no longer relevant [laughs]. Nobody talks about George W. Bush, even Bill Clinton.

It is a very simplistic approach. Visit the slums. Do you think that more drugs will help these communities? This offers some hope to them? Not a hopeful vision.

Marijuana causes infertility? Partially true: laboratory research showed that marijuana can lead to a drop in the amount of sperm and cause them to move about a bit differently, more slowly. “In real life, however, there is nothing showing that it causes infertility among users,” explains psychiatrist at the Hospital Clinicas in Sao Paulo Mario Ivan Braun, author of “Drugs – questions and answers” Read More Getty Images

UOL – If you were a candidate for president of Brazil and was asked in a debate whether you are for or against the legalization of the drug, which speak? 

Sabet – I advocate a health-related approach to drugs in general. This means increasing access to treatment, early intervention, training of physicians to identify the signs of addiction. Treat all problems early, without waiting for someone to give input in the hospital because it is using crack cocaine or four years ago. I want you to discover the defect in the first month of use to prevent the disease from worsening.

And I certainly would not want to start a new industry like tobacco or alcohol, selling the drug. And I also would look at the key issues. Why are people using crack? What happens in the community where they live? Are much more difficult questions, but they are much more important than say if we legalize a drug or not.

UOL – Data collected by lord over the Colorado show that the legalization of drugs had bad consequences, especially for teenagers. 

                                                                    

Sabet – This happens because legalization would not eliminate the black market trafficking. And this is the promise that we get rid of gangs. Gangs are very happy because they now have lower prices. In Colorado, it costs $ 300 (R $ 684) to buy 35 grams of marijuana legalized. With traffickers, the price is $ 150 (R $ 342) for the same amount of drug. You do not go to recreational marijuana store to pay twice the price? In addition, the sale is prohibited for minors. If you want marijuana, which will buy? With traffickers. All these promises that would end the trafficking and increase tax collection are not being met. The governor of Colorado for the fifth consecutive time, decreased the estimate of tax collection with this trade.

Junior Lake / UOL I will not say a parent of a child suffering hundreds of seizures per day should not use something that will help her. Trafficking or grow marijuana in the backyard does not solve the problem, either. It is necessary to regulate the use of cannabidiol Kevin Sabet

UOL – So, how to stop drug trafficking?

 
Sabet – The only way would be to stop trafficking is sell the drug at cost of production. In other words, it would be like trying to get rid of trafficking in crack cocaine or selling the drug for pennies for each dose. From the standpoint of public health, you do not want that. You just want to raise taxes cigarette, you try to increase costs because the more expensive, fewer people will want it. You may be able to get rid of some of the harms and reduce some traffic, but not eliminate it. The output, once again, is to reduce the number of addicts in treatment and awareness campaigns.

UOL – For adults, shows that you doubled the number of fatal accidents involving drivers under the influence of marijuana in Colorado. 

Sabet – legalization advocates could even argue that drivers “were not under the influence of drugs”, but as they were fatal accidents, tests on the victims showed high levels of substances derived from cannabis in organisms. Of course not every accident caused by a drunk driver occurs due to intake of alcohol. Most likely, it could be because he sent an SMS at the time. But it is a big risk factor.

Many teens think that driving under the influence of marijuana is safe. But I say that it is dangerous to drive on a road where the limit is 70 km / h, so 30 km / h to 100 km / h. Even if marijuana makes you slower, it is also dangerous. It also affects your depth perception and your reaction time.

UOL – There should be stricter laws in Colorado against these drivers? 

Sabet – The issue of legalization is that you create space for a completely new political group that will do anything to make access to drugs as easy as possible. Then, during the campaigns of legalization they say: “do not worry, we will oversee and regulate.”The next minute, they shy away. In power, they hold the money, will influence the advice of the small towns, giving money to politicians to create 20 shops selling marijuana in a local community. Ie, you have these defenders who will try to minimize all the dangers of driving under the influence of drugs. Their message to the children, for example, is that smoking marijuana is safer than drinking alcohol.   

UOL – If legalization is not an option, which would then be proposed to reduce the consumption of drugs? 

Sabet – The question is: what do you think the worst? A legal market to reach 25-50% of the population, because it will increase the use of the drug or an illegal market that reaches 7%? Both are bad, but I would opt for the second scenario and work to reduce this rate.

We need better prevention and awareness, particularly for teenagers campaigns. Over the past decade, scientific research have advanced tremendously with regard to the effects of drugs on the adolescent brain, but at the same time, the perception of these young people from the harmful effects of marijuana is decreasing. This owes much to discussions of legalization.

Many people find that marijuana is not addictive, but rather addictive. And is also associated with severe mental illness. We need more campaigns, more research, more treatment. In the case of trafficking, we need to give more alternatives for youth, for the sale of the drug did not show more profitable than legitimate work. It is necessary to solve social problems.

UOL – Uruguay recently legalized the sale of the drug in the country, which should start in November, but was postponed to 2015 This precisely because the government is still studying efficient methods to identify the buyer.. On occasion, José Mujica criticized how the drug has been legalized in the USA, “anyway” and “irresponsibly that scares”. Do you agree with Mujica? 

Sabet – He is too smart to say it did not want to copy the state of Colorado and Washington, because that would be a total disaster. Would not be surprised if the sale of marijuana in Uruguay even start, or even never happen. It is not a popular measure, the government spent a few million on campaigns trying to convince people that this is something good, and yet 70% are against.

Rational argument is “let’s stop trafficking”, but again, unless you take the drug, give marijuana to children 10 years will still be traffickers. And is not that what you want. The president himself [Mujica] said he does not like marijuana, is not in favor of it, just want to control it. This is a much better approach than the American states. It is much more honest than some guys in the USA. But still do not think Uruguayans have a viable program. They are realizing that it is much more complicated than they thought it would be. So, good luck to them. I am very skeptical.

UOL – For the United States, it is worrying that a Latin American country to legalize marijuana? 

Sabet – I do not know if it would be a problem, but it is strange to the United States. The country does not want legalization, but it is happening at the state level. The American government will simply ignore the issue. To be honest, we only see them [and Uruguay Mujica] mentioned in the paper when the subject is marijuana. They [Obama and Mujica] nor talked about it when they met. So it’s not a concern for the United States.

UOL – recently had here in Brazil the case of a five year old girl with severe epilepsy that caused more than 60 seizures daily. After cannabidiol , she had significant improvement in health status. However, the parents were “smuggling” the substance, and were not satisfied with that. How is this question in the USA? 

Sabet – also have this problem in the United States. More than 400 children are receiving cannabidiol in liquid form legally by the government. However, you do not have data to show the effectiveness of the substance. If a parent is a substance that is experimental, unproven, then fine by me accordingly. I will not say to a parent of a child suffering hundreds of seizures per day not to use something that will help.

But traffic or planting marijuana in the backyard does not solve the problem. It is necessary to regulate the use of cannabidiol by pharmaceutical and health areas.

Source:  http://noticias.uol.com.br/internacional/ultimas-noticias/   23rd August 2014

 

A pair of new studies has revealed that marijuana use could lead to abuse of other drugs and alcohol. Experts said that these risks need to be considered not only by doctors and patients but by policy makers as well particularly in states where marijuana is legalized for recreational or medical use.

For the first study, which was published in the journal Drug and Alcohol Dependence, the results showed that adults who smoke marijuana have five times increased odds of developing alcohol use disorder (AUD) compared with their counterparts who do not smoke.

By looking at the data of more than 27,000 adults, researchers found that the participants who did not have AUD but reported using cannabis during the first survey were 5.4 times more likely to have an AUD three years later.  The participants who already battle with an alcohol use disorder and were using marijuana were also found to aggravate their dependence on alcohol.

“Among adults with no history of AUD, cannabis use at Wave 1 was associated with increased incidence of an AUD three years later relative to no cannabis use,” study researcher Renee Goodwin, from Columbia University, and colleagues wrote. “Among adults with a history of AUD, cannabis use at Wave 1 was associated with increased likelihood of AUD persistence three years later relative to no cannabis use.”

The second study, which was published in JAMA Psychiatry and involved more than 34,000 subjects, revealed that participants who used cannabis during the first survey were about six times as likely to suffer from substance use disorder after three years.

Researchers also found an increased risk for drug use disorders and nicotine dependence among pot smokers.   Although the study authors said that their findings do not establish a cause and effect relationship between pot use and substance abuse, they noted that there may be an overlap in brain circuitry that influence drug use and dependence.

“Our study indicates that cannabis use is associated with increased prevalence and incidence of substance use disorders,” Carlos Blanco, from the National Institute on Drug Abuse, and colleagues wrote. “These adverse psychiatric outcomes should be taken under careful consideration in clinical care and policy planning.”

 Source:  http://www.techtimes.com/articles/135554/20160222   22nd Feb 2016

The Rocky Mountain High Intensity Drug Trafficking Area released its third annual report this week. The organization has been tracking the impact of marijuana legalization in Colorado since the state first legalized the drug for medical use in 2000, passed legislation to allow dispensaries beginning in 2009–which spawned a commercial marijuana industry–and legalized pot for recreational use in 2012. The 2015 report shows that by 2013, Colorado marijuana use was nearly double the national usage rate. The state ranked 3rd in the nation for youth use in 2013, up from 14th in 2006; 2nd in the nation for young adult use in 2013, up from 8th in 2006; and 5th in the nation for adults, up from 8th in 2006.

Drug-related school expulsions, most of which are marijuana-related, far exceed school expulsions for alcohol use. Note the sudden jump in drug expulsions that began in 2009 when Colorado allowed a commercial marijuana industry to emerge. Total school suspensions and expulsions rose from 3,736 by the end of the 2008-2009 school year to 5,249 by the end of the 2013-2014 school year.

Marijuana-related traffic fatalities in Colorado also began rising with the introduction and growth of the commercial marijuana industry in 2009. While total State wide fatalities decreased between 2006 and 2014, marijuana-related fatalities increased over that time.

Colorado marijuana-related emergency room visits increased to 18,255 in in 2014.

Marijuana-related hospitalizations have nearly quintupled since Colorado first legalized marijuana for medical use. Again, note the surge starting in 2009 when growers, processors, and dispensaries were first authorized, and a commercial industry began developing extensive marijuana products such as edibles, vape pens, and butane hash oils (BHO) to attract new customers. BHO has elevated THC levels to the highest seen in the nation; some contain 75 percent to 100 percent THC.

Although there is no data to document whether the increase in homelessness in Denver and other Colorado cities is marijuana-related, those who provide services to the homeless report that many say they relocated to Colorado because of marijuana’s legality.

In Colorado, marijuana is not available in about three-fourths of the state. Of a total 321 local jurisdictions, 228 (71 percent) ban all forms of marijuana businesses; 67 (21 percent) allow both medical and recreational marijuana businesses; and 26 (8 percent) allow only medical or recreational marijuana businesses.

Read report here.
Source: www.themarijuanareport.org  16th September 2015

By Kathy Gyngell Posted 12th September 2014

For years the great and the good of the drug legalising world – including members and former members of the Government’s own Advisory Council on the Misuse of Drugs – have consistently denied that cannabis is a gateway drug or addictive. They have downplayed its devastating consequences for adolescents. They have derided or ignored cannabis prevention campaigners and the evidence presented to them.

It is time for them to recant  – now and publicly – for their misleading and casual advice.

They can no longer remain in denial about the drug they have appeared so keen to defend, to normalise and to claim is less harmful than alcohol.

Irrefutable evidence of its damaging consequences for adolescents was published yesterday, in a new study of adolescent cannabis use , in The Lancet Psychiatry  –  a study in which almost  3,800 people took part.

Its objective was to find out more about the link between the frequency of cannabis use before the age of 17 and seven outcomes up to the age of 30, such as completing high school, obtaining a university degree and cannabis and welfare dependence.

The researchers found that the risks increased relative to dose, with daily cannabis users suffering the greatest harm.

They found that teenagers who smoked cannabis daily were over 60 per cent less likely to complete school or get a degree than those who never had. They were also 60 per cent less likely to graduate college, seven times more likely to attempt suicide, eight times as likely to go on and use other illegal drugs, and 18 times more likely to develop a cannabis dependence.

To its shame, the Washington Post described these findings as ‘startling”.  The fact is that they only reflect numerous previously published studies and surveys.

However, let’s hope that the that self-styled Global Commission on Drugs Policy and its leading light, Sir Richard Branson, will take note that Professor Neil McKeganeyrightly excoriated them on Tuesday   for promoting the legalisation of all currently illegal drugs.

It should be concerned and reflect on its gung-ho recommendations in light of this catalogue of damage; and so should President Obama – who seems to think kids smoking dope is OK.  He should really be worrying for under the lax approach of his administration cannabis use, or marijuana as Americans call it, has risen 29 per cent in six years, that is nearly a 5 per cent increase per year.  It is difficult to detach this rise from the effective decriminalisation of the drug in 23 states under so called medical marijuana legislation.  And the US is yet to see the full effects of the January 2014 initiation of legal marijuana in Colorado and Washington on the rest of the nation.

Thankfully, in the UK the number of 11–15 year olds who say they’d used cannabis in the past month (4 per cent) has been dropping consistently over the last 13 years or so.  The number significantly less than in the US where a worrying 7 per cent of high-school seniors (aged 17-18) are daily or near-daily users.

Richard Mattick, the study author and Professor of Drug and Alcohol Studies at the National Drug and Alcohol Research Centre, University of New South Wales, in Australia, is right to stress: “Our findings are particularly timely given that several US states and countries in Latin America have made moves to decriminalise or legalise cannabis, raising the possibility that the drug might become more accessible to young people.”

The cat is out of the bag in the US. Let’s hope here in the UK, those seeking to normalise cannabis use, including the Lib Dems, several members of the ACMD and a number of Government-funded charities will finally see how irresponsible they have been and are.

Source:  www.conservativewoman   12th Sept. 2013

WASHINGTON — A new report out from the Governors Highway Safety Association finds that driving while on drugs, even marijuana, poses a significant safety risk on our roadways, on par with drunken driving.

Researchers found that the percentage of drivers killed who tested positive for drugs is almost the same as those who tested positive for any alcohol — 40 percent.  More than 5,000 drivers killed each year have drugs in their system at the time of the crash.

“The proportion with drugs in their system has increased over the past several years and now the level is about the same with alcohol in their systems,” says Dr. Jim Hedlund, author of the report.

The report puts a special emphasis on marijuana use and its impact on driving because lawmakers across the country are debating whether to legalize the drug.

“The evidence is very clear that marijuana affects decision times, reaction times and so forth.  If you are using marijuana, you are at an increased risk of being in a crash,” says Hedlund.

He is particularly concerned that lawmakers are not considering the impact of marijuana on deadly crashes when talking about legalizing the drug.  Hedlund also says the laws on the books for drug-impaired driving need to be clearer and more in line with drunken driving laws.

“Every state must take steps to reduce drug-impaired driving, regardless of the legal status of marijuana,” says Jonathan Adkins, executive director of GHSA.

“This is the first report to provide states and other stakeholders with the information that they need.  And we encourage [the National Highway Traffic Safety Administration] to issue guidance on best practices to prevent marijuana-impaired driving.  We look to the federal government to take a leadership role in this issue similar to that of drunk driving and seat belt use,” he adds.

The report calls on states to take several measures to address the issue head-on.  It urges states to assess the data in their region, examine and update drug-impaired driving laws, test all drivers who are killed in a crash for drugs and separate statistics between drunken driving from driving while on drugs.

Source:    Governors Highway Safety Association  Sept.2015

Haven Dubois, 14, died in accidental drowning on May 20, 2015, coroner says

Family members hold a picture of Haven Dubois, 14, who was found in cardiac arrest in a Regina creek on May 20, 2015. (CBC)

Richelle Dubois, the mother of 14-year-old Haven Dubois, says she is determined to learn more about the circumstances surrounding her son’s death. “I’m not done with this until I’m satisfied that they’ve looked into everything,” Dubois said Wednesday following the release of a coroner’s report that looked into the May 20, 2015 death of Haven. “I need to make sure that they’ve done their job properly.”
According to the report, the Regina boy was found drowned. The report said boys who were with Haven on that day told the coroner that he suffered a bad reaction to marijuana.
The boy’s mother Dubois has expressed concerns the death might have been connected to gangs. Police said foul play had been ruled out. Richelle Dubois said last fall she had waited a long time for the coroner to complete her report on her son Haven’s death. (CBC)
Coroner Maureen Stinnen interviewed a number of boys who were with Dubois, who said he was at school in the morning before getting into a car with friends.
“They apparently smoked some marijuana and they indicated that Haven began ‘freaking out,'” Stinnen’s report said. One of the youths Stinnen interviewed said it was Dubois’s first time smoking drugs. After getting out of the car, Dubois continued suffering ill effects and started walking away from the school, F. W. Johnson Collegiate.

Left alone on a bench

“Witnesses indicate he was ‘spinning in circles’ with his arms crossed at his chest,” the report said. One witness said he sat for a while with Dubois on a bench in a park, but left him alone so he could go get a skateboard and backpack. When the boy returned, Dubois wasn’t at the bench.
A friend said he last saw Dubois walking north by the creek in the area where his mother had discovered the body. Over the noon hour, Dubois was found face down in about a metre of water. Efforts to resuscitate him failed.
Dubois had no history or depression or suicidal tendencies, the coroner said. However, a toxicology report indicated he had the active component of cannabis in his blood.

Reactions to marijuana vary, coroner says

“The effect of marijuana on individuals varies considerably, from minor effects such as general feeling of well-being, to agitation and paranoia,” the report said. “These effects are subject to dose, age and experience of the user. Even in low doses, marijuana can precipitate a panic reaction and irrational behaviour.”
Stinnen said the case was thoroughly investigated by the Regina police and while “questions remain,” there were no indications of foul play. She concluded that Dubois’s death was an accidental drowning with drug use a “significant contributing factor.”

Mother seeks more information

Richelle Dubois said Wednesday she feels she did not get enough information from police about their investigation. “It’s so easy for them to brush it aside. It’s just another dead Indian to them,” Dubois said. “That’s how I feel; that we’re just another Indian family.”
According to a spokesperson from the police, officers met with Dubois three times. Dubois said the findings of the coroner, noting how marijuana can lead some people to panic and act irrationally, provide a possible explanation for her son’s death, but she still has questions.
“l know this isn’t the end of it,” she said. “This little two and a quarter page [report] isn’t the end of it.” Dubois added she has made a formal request to view police reports on the case.

Source: http://www.cbc.ca/news/canada/saskatchewan/marijuana-significant-factor-in-haven-dubois-death-1.3392179

Proponents raised $7.6 million to opponents’ $169,000 to legalize marijuana for recreational use, a ratio of 45 to 1. Opponents in Alaska and Oregon could not afford to present other viewpoints in TV commercials. Meanwhile, after just ten months of legal marijuana, five Colorado cities passed amendments to ban the sale of recreational marijuana within their borders. The Republican gubernatorial challenger ran on a platform calling for the repeal of legalization. As citizens’ anger mounts over outsiders sweeping in, getting what they want, and leaving behind a mess for taxpayers to clean up, we are likely to see more of that.

Alaska Legalizes Recreational Marijuana–You might think the 23 states that have legalized marijuana were responding to citizen demand. You would be wrong. The Drug Policy Alliance and the Marijauna Policy Project, their funders George Soros and the late Peter Lewis, a by-now burgeoning marijuana industry, and an estimated $200 million are behind the drive to legalize marijuana. Imagine a Congress where all 435 Representatives and 100 Senators belong to just one party, and you can begin to understand how one-sided marijuana initiatives have been.

Source:  TheMarijuanaReport.org  Nov. 2014

 

Big Business made a lot of money out of selling tobacco products  –  and it took many years before the link between smoking and  cancer were accepted.   Big Pharma make a lot of money from selling pharmaceutical drugs.  Big Business Mark II intends to make a lot of money out of selling marijuana (cannabis) products – regardless of the research that now shows this substance is not harmless.

The graphics above show just how much money was spent by the proponents of drug legalisation compared to the amounts that those who oppose legalisation were able to muster from grass roots supporters.   It is not surprising that so many of the American public were hoodwinked into voting for easier access to drugs – beginning with marijuana but eventually all currently illegal substances.

There was much misinformation, errors of omission and emphasis on ‘ individual freedoms’ – and no information about scientific research showing the dangers – particularly to young people – of using marijuana.

Already there are signs of discontent in many places with legalised marijuana – more driving accidents,  more instances of children being made ill from consuming what appeared to be sweets but was in reality marijuana packaged as a candy or chocolate bar …..how long will it be before the

Pandora’s Box can be tightly closed ?

National Drug Prevention Alliance   November 2014

Xcel Energy utility officials say lighting companies working with cannabis growers are testing LED lamps that require less electricity

DENVER, CO – DECEMBER 02: Denver Fire Department Lieutenant, Tom Pastorius, does an inspection of a Denver marijuana grow operation, December 02, 2014. Local government officials from Denver to smaller cities and rural hamlets say the pivotal first-year rollout went smoothly in most cases. (Photo by RJ Sangosti/The Denver Post)

GOLDEN — Surging electricity consumption by Colorado’s booming marijuana industry is sabotaging Denver’s push to use less energy — just as the White House perfects a Clean Power Plan to cut carbon pollution.

Citywide electricity use has been rising at the rate of 1.2 percent a year, and 45 percent of that increase comes from marijuana-growing facilities, Denver officials said Wednesday.

Denver has a goal of capping energy use at 2012 levels. Electricity is a big part of that.

The latest Xcel Energy data show cannabis grow facilities statewide, the bulk of which are in Denver, used as much as 200 million kilowatt hours of electricity in 2014, utility officials said. City officials said 354 grow facilities in Denver used about 121 million kwh in 2013, up from 86 million kwh at 351 facilities in 2012.

“Of course we want to grow economically. But as we do that, we’d like to save energy,” city sustainability strategist Sonrisa Lucero said.

She and other Denver officials joined 30 business energy services and efficiency leaders seeking U.S. Department of Energy guidance Wednesday at a forum in Golden. Energy Undersecretary Franklin Orr said feds will promote best practices and provide technical help through an Office of Technology Transitions.

“It’s a big issue for us,” Lucero told Orr. “We really do need some assistance in finding some good technology.”

Orr said he tried to figure out “how we would address that to Congress.”

When the EPA later this summer unveils the Clean Power Plan for state-by-state carbon cuts and installation of energy-saving technology, utilities are expected to accelerate a shift away from coal-generated electricity toward cleaner sources, such as natural gas, wind and solar.

Until they can replace more coal-fired plants, the nation’s utilities increasingly are trying to manage demand by, for example, offering rebates to customers who conserve electricity.

Colorado for years has been encouraging cuts in carbon emissions by requiring utilities to rely more on renewable sources.

Yet electricity use statewide has been increasing by 1 percent to 2 percent a year, due in part to population growth, said Jeffrey Ackermann, director of the Colorado Energy Office.

The rising electricity demand means more opportunities to save money by using energy more efficiently , Ackermann said. “We’re not going to compel people to reduce their usage. … But we’re going to try to bring efficiency into the conversation.”

Colorado’s marijuana sector, in particular, is growing rapidly, relying on electricity to run lights that stimulate plant growth, as well as air-conditioning and dehumidifiers. The lights emit heat, raising demand for air conditioning, which requires more electricity.

“How do you capture their attention long enough to say: Hey, if you make this investment now, it could pay back in the future,” Ackermann said, referring to possibilities for better lights.

Southwest Energy Efficiency Project director Howard Geller said new adjustable light-emitting diode, or LED, lights have emerged that don’t give off heat. Companies installing these wouldn’t require so much air-cooling and could cut electricity use, Geller said.

Lighting companies are working with pot companies to test the potential for LED lamps to reduce electricity use without hurting plants, Xcel spokesman Mark Stutz said. Xcel is advising companies on how much electricity different lights use, he said.

Denver officials currently aren’t considering energy-efficiency rules for the industry, said Elizabeth Babcock, manager of air, water and climate for the city. Marijuana-growing facilities in 2013 used 1.85 percent of total electricity consumed in Denver.

“We see many opportunities in all sectors,” Babcock said. “Energy efficiency lowers the cost of doing business, and there are lots of opportunities to cut energy waste in buildings, transportation and industry.”

Source:    www.denverpost.com   7th January 2015

There has been a lot of talk recently about marijuana legalization — increasing tax revenue for states, getting nonviolent offenders out of the prison system, protecting personal liberty, possible health benefits for those with severe illnesses. These are good and important conversations to have, and smart people from across the ideological spectrum are sharing their perspectives.

But one key dimension of the issue has been left out of the discussion until now: the marketing machine that will spring up to support these now-legal businesses, and the detrimental effect this will have on our kids.

Curious how this might work? Look no further than Big Tobacco. In 1999, the year after a massive legal settlement that restricted certain forms of advertising, the major cigarette companies spent a record $8.4 billion on marketing. In 2011, that number reached $8.8 billion, according to the Campaign for Tobacco-Free Kids. To put it into context, the auto industry spent less than half of that on advertising in 2011, and car ads are everywhere.

At the same time, despite advertising bans, these notoriously sneaky tobacco companies continue to find creative ways to target kids. Data from the 2011 National Survey on Drug Use and Health found that the most heavily marketed brands of cigarettes were also the most popular among people under 18.

This is not a coincidence, and gets to the very core of Big Tobacco’s approach: Hook them young, and they have a customer for life. Why do we think the legal marijuana industry will behave differently from Big Tobacco? When the goal is addiction, all bets are off.

In Colorado, where there are new rules governing how legal marijuana is advertised in traditional media, there are still many opportunities to market online and at concerts, festivals and other venues where kids will be present. Joe Camel might be retired, but he’s been replaced by other gimmicks to get kids hooked — like snus and flavored cigarettes. The marijuana industry is following suit by manufacturing THC candies, cookies, lollipops and other edibles that look harmless but aren’t. Making marijuana mainstream will also make it more available, more acceptable and more dangerous to our kids.

Addiction is big business, and with legal marijuana it’s only getting bigger.

Not surprisingly, Big Tobacco is also getting on the marijuana bandwagon. Manufacturers Altria and Brown & Williamson have registered domain names that include the words “marijuana” and “cannabis.” Imagine how much they will spend peddling their new brand of addiction to our kids. We cannot sit by while these companies open a new front in their battle against our children’s health.

Why is this an issue? There is a mistaken assumption that marijuana is harmless. It is not. Marijuana use is linked with mental illness, depression, anxiety and psychosis. It affects parts of the brain responsible for memory, learning, attention and reaction time. Developing brains are especially susceptible to all of the negative effects of marijuana and other drug use. In fact, poison control centers in Colorado and Washington state have seen an increase in the number of calls regarding marijuana poisoning. This isn’t a surprise — with legal marijuana comes a host of unintended consequences.

I’ve spent the past several years after leaving Congress advocating for a health care system that treats the brain like it does any other organ in the body. Effective mental health care, especially when it comes to children, is critically important.

Knowing what we now know about the effects of marijuana on the brain, can we really afford to ignore its consequences in the name of legalization? Our No. 1 priority needs to be protecting our kids from this emerging public health crisis. The rights of pot smokers and the marijuana industry end where our children’s health begins.

I’m not alone in my concerns about this trend toward legalization. Even Colorado Gov. John Hickenlooper has said that marijuana legalization in his state was “reckless” and reaffirmed his opposition to it during his campaign for re-election. He also said he will “regulate the heck” out of it. For that, I applaud his leadership and courage.

Alaska, Oregon and the District of Columbia have legalization ballot measures up for a vote this fall. I hope common sense will prevail, and they choose a better path than making addiction the law of the land.

At the end of the day, legalizing and marketing marijuana is making drug use acceptable and mainstream. Just as Big Tobacco lied to Americans for decades about the deadly consequences of smoking, we can’t let “big marijuana” follow in its footsteps, target our kids and profit from addiction.

Patrick J. Kennedy is a former United States representative from the state of Rhode Island.

Source: http://www.npr.org/2014/10/30/360217001/kennedy-are-we-ready-for-big-tobacco-style-marketing-for-marijuana

 

AS THE LEGAL AND MEDICAL USE OF MARIJUANA BECOMES MORE COMMONPLACE, OFFICIALS ARE STRUGGLING TO DETERMINE AND ENFORCE SAFE LEVELS OF IMPAIRMENT.

Determining how intoxicated someone is can be quite a difficult task. For alcohol consumption, a substance that the body excretes in a quick, linear fashion, we can measure the amount of metabolic by-products present in the blood using a breathalyzer, or directly measure ethanol levels with a blood test.

Although the issue is somewhat complicated by differing tolerances, research conducted throughout the 20th century showed that nearly everyone loses their ability to drive safely above certain blood alcohol levels.

In the US, medical marijuana is legal in 29 states and adult recreational use is legalized in eight. Widespread popularity of this psychoactive drug seems to necessitate a similar method for measuring whether or not someone is too high to drive.

Actually creating a “weed breathalyzer” or other marijuana field sobriety test, however, is fraught with scientific complications. According to a commentary published in Trends in Molecular Medicine, the main psychoactive compound in marijuana, THC, not only lingers in the body inconsistently, it also has unpredictable cognitive effects between users.

Early medical studies implied that THC could be detected in the blood for approximately six hours after smoking. Yet subsequent work by the article’s co-author, Marilyn Huestis, found that behavioral changes and motor impairments may last 6-8 hours after smoking despite near zero blood levels after just 2.5 hours.

Even if THC blood levels could accurately judge impairment, taking blood samples after a suspicious accident is likely to be fruitless for law enforcement.

“[Blood levels decline by] 74 percent in the first 30 minutes, and 90 percent by 1.4 hours,” said Huestis to Wired. “And the reason that’s important is because in the US, the average time to get blood drawn [after arrest] is between 1.4 and 4 hours.”

So why do people continue to feel stoned long after the drug is gone from the blood? Unlike ethanol, a hydrophilic molecule, THC doesn’t like hanging out in the water-based blood plasma and rapidly distributes into the cells of lipophilic fatty tissues, organs, and the brain.

“In fact, individual experiences reflect two different levels of drug ‘high,’” the article states. “..Namely a low ‘high’ effect in the absorption phase during cannabis inhalation, and a much higher effect later during the distribution phase owing to the lag time for full distribution of the active THC to the site of action – in this case, the brain.”

Furthermore, the body does not metabolize all the THC absorbed by body tissues at the time of smoking, vaping, or eating; the excess is slowly broken down over days to weeks. Heavy cannabis users will develop a THC tolerance due to this chronic, low-level exposure.

Consequently, occasional users and heavy users may feel wildly different effects from consuming the same dose of THC, preventing determination of a universal, safe dosage cut-off for drivers. A national poll from 2017 suggests that half of Americans are unconcerned by the prospect of stoned drivers on the roads, but law enforcement officials in many US states have drug-impaired driving laws that they intend to enforce. So, what tools should they use?

Huestis, who is also a senior investigator at the National Institute on Drug Abuse, does not support a legal driving limit for marijuana. She believes that, currently, well-trained police officers are best-suited for recognizing signs of impairment. Meanwhile, researchers such as herself are working to identify biomarkers that are more representative of the drug’s cognitive effects than blood THC. Ideally, these can then be measured using rapid non-invasive tests.

Another interesting prospect: Researchers at University of California San Diego are recruiting participants for a trial to develop an iPad-based cannabis-specialized field sobriety test. Volunteers will randomly receive marijuana joints at various THC concentrations, then complete driving simulations and undergo experimental impairment assessments.

Source: http://www.iflscience.com/health-and-medicine/why-is-it-so-hard-to-test-for-marijuana-intoxication/ January 2018

One in five Canadians between 15 and 24 years of age reports daily or almost daily use of cannabis prior to legalization. They see it as “much safer than alcohol and tobacco” and “not as dangerous as drunk driving.”

Author 1. Paul W Bennett

Research Associate in Education, Saint Mary’s University

Disclosure statement

Paul W Bennett does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

Partners

The Conversation UK receives funding from Hefce, Hefcw, SAGE, SFC, RCUK, The Nuffield Foundation, The Ogden Trust, The Royal Society, The Wellcome Trust, Esmée Fairbairn Foundation and The Alliance for Useful Evidence, as well as sixty five university members.

One of the enduring myths about marijuana is that it is “harmless” and can be safely used by teens.

Many high school teachers would beg to disagree, and consider the legalization of marijuana to be the biggest upcoming challenge in and around schools. And the evidence is on their side.

As an education researcher, I have visited hundreds of schools over four decades, conducting research into both education policy and teen mental health. I’ve come to recognize when policy changes are going awry and bound to have unintended effects. As Canadian provinces scramble to establish their implementation policies before the promised marijuana legalization date of July 2018, I believe three major education policy concerns remain unaddressed.

These are that marijuana use by children and youth is harmful to brain development, that it impacts negatively upon academic success and that legalization is likely to increase the number of teen users.

‘Much safer than alcohol’

Across Canada, province after province has been announcing its marijuana implementation policy, focusing almost exclusively on the control and regulation of the previously illegal substance. This has provoked fierce debates over who will reap most of the excise tax windfall and whether cannabis will be sold in government stores or delegated to heavily regulated private vendors.

All of the provincial pronouncements claim that their policy will be designed to protect “public health and safety” and safeguard “children and youth” from “harmful effects.”

Still, one in five young people between 15 and 24 years of age, according to a recent national study, report daily or almost daily use of cannabis.

They also see marijuana as “much safer than alcohol and tobacco” and “not as dangerous as drunk driving.”

Few either know about or seem concerned over the clear linkage between heavy use and early-onset psychosis.

Early-onset paranoid psychosis

So what does the evidence say? First, heavy marijuana use can, and does, damage brain development in youth aged 13 to 18. A 2015 Canadian Centre on Substance Abuse study confirmed the direct link between cannabis use and loss of concentration and memory, jumbled thinking and early onset paranoid psychosis.

One of the leaders in the medical field, Dr. Phil Tibbo, initiator of Nova Scotia’s Weed Myths campaign targeting teens, has seen the evidence, first hand, of what heavy use can do as director of Nova Scotia’s Early Psychosis Program. His brain research shows that regular marijuana use leads to an increased risk of developing psychosis and schizophrenia and effectively explodes popular and rather blasé notions that marijuana is “harmless” to teens and “recreational use” is simply “fun” and “healthy.”

Damaging to academic performance Second, marijuana negatively impacts neurocognitive performance in teens and users perform more poorly in quantitative subjects requiring precision — like mathematics and senior science.

In 2017, Dutch researchers Olivier Marie and Ulf Zolitz found that the academic performance of Maastricht University students increased substantially when they were no longer legally permitted to buy cannabis. The effects were stronger for women and low performers and academic gains were larger for courses needing numerical or mathematical skills.

Third, legalization of marijuana is likely to increase the number of teen users. Research from Oregon Research Institute conducted in 2017 showed that teenagers who were already using marijuana prior to legalization increased their frequency of use significantly afterwards. Research from New York University, published in 2014, indicated that many high school students normally at low risk for marijuana use (e.g., non-cigarette-smokers, religious students, those with friends who disapprove of use) reported an intention to use marijuana if it were legal. Medical researchers and practitioners have warned us that legalization carries great dangers, particularly for vulnerable and at-risk youth between 15 and 24 years of age.

Age of restriction

Marijuana legalization policy across Canada is a top-down federal initiative driven largely by changing public attitudes and conditioned by the current realities of the widespread use of marijuana, purchased though illicit means.

Setting the age of restriction, guided by the proposed federal policy framework, has turned out to be an exercise in “compromise” rather than one focused on heeding the advice of leading medical experts and the Canadian Medical Association (CMA). In a 2016 submission to the government, the CMA argued that 25 would be the ideal age for legal access to marijuana, as the brain is still developing until then, but that a lower minimum age of 21 should be considered — to discourage children from purchasing marijuana from organized crime groups.

The report argued that: “Marijuana use is linked to several adverse health outcomes, including addiction, cardiovascular and pulmonary effects (e.g., chronic bronchitis), mental illness, and other problems, including cognitive impairment and reduced educational attainment. There seems to be an increased risk of chronic psychosis disorders, including schizophrenia, in persons with a predisposition to such disorders.” In fact, the minimum age for purchasing and possessing marijuana is going to be age 18 in Alberta and Quebec, and 19 in most other provinces. Getting it “out of high schools” was a critical factor in bumping it up to age 19 in most provinces.

Every Canadian province is complying with the federal legislation, but — in our federal system – it’s “customized” for each jurisdiction.

The Canadian Western provinces — Alberta, British Columbia and Saskatchewan —have opted for regulating private retail stores, while Ontario and the Maritime provinces (Nova Scotia, New Brunswick and P.E.I.) are expanding their liquor control commissions to accommodate retail sales of cannabis. High school teachers, as of September 2018, may be battling a spike in marijuana use and greater peer pressure to smoke pot on the mistaken assumption that it is “harmless” at any age.

Clamping down in schools

For high school principals and staff, this will be a real test.

By September 2018, the old line of defence that using marijuana is illegal will have disappeared. Recreational marijuana will be more socially acceptable. The cannabis industry will be openly marketing its products. High school students who drive to school will likely get caught under new laws prohibiting motor vehicle use while impaired by drugs or alcohol. Fewer students are likely to abstain when it is perfectly legal to smoke pot when you reach university, college or the workplace. We have utterly failed, so far, in getting through to the current generation of teens, so a much more robust approach is in order.

“Be firm at the beginning” is the most common sage advice given to beginner teachers. Clamping down on teen marijuana use during and after school hours will require clarity and firm resolve in the year ahead — and the support of engaged and responsible parents.

Legalization of recreational marijuana is bound to complicate matters for Canadian high schools everywhere. Busting the “Weed Myths” should not be left to doctors and health practitioners. Pursuing research-based, evidence-informed policy and practice means getting behind those on the front lines of high school education.

Source: https://theconversation.com/marijuana-at-school-loss-of-concentration-risk-of-psychosis-90374 January 25th 2018

 

 

 

 

 

 

The percentage of drivers testing positive for marijuana or other illegal drugs is increasing, according to a new report. In 2013 and 2014, 15.1 percent of drivers tested positive for drugs, up from 12.4 percent in 2007.

The findings come from the Governors Highway Safety Association. The group found 38 percent of people who died in auto accidents in 2013 and were tested had detectable levels of potentially impairing drugs – both legal and illegal – in their system. That percentage is almost the same as those testing positive for alcohol, CNN reports.

The most common drugs detected were marijuana (34.7 percent) and amphetamines (9.7 percent), which includes nasal decongestants and drugs to treat attention deficit hyperactivity disorder.

“Alcohol-impaired driving is still a big deal, but we have paid more attention to it than to drug-impaired driving and it’s time to pay more attention to drug-impaired driving,” said report author James Hedlund. He notes drunk driving has been decreasing as drugged driving increases.

He noted one reason for the rise in drugged driving could be that “marijuana use is increasing, driven in parts by the states that legalized marijuana for medicinal and recreational use, and the second is that prescription painkiller use has gone up substantially.”

The report found 6.9 percent of people killed in auto accidents had hydrocodone in their system, while 3.6 percent had detectable levels of oxycodone, 4.5 percent had benzodiazepines (found in anti-anxiety and anti-depression drugs), and 4.5 percent had cocaine.

“Alcohol is the deadliest drug we have by practically any metric…and alcohol in combination with [marijuana] is particularly malignant,” Dr. Gary Reisfield, professor of psychiatry at the University of Florida, told CNN.

The report recommends that states train law enforcement officers to recognize the physical and behavioral signs associated with different substances.

Source:  www.drugfree.org 1st October 2015

The Food and Drug Administration has issued warning letters to “high CBD” hemp oil vendors, stating that their products are unapproved drugs that often don’t contain any active ingredient.

list of firms that were issued warning letters for marketing “unapproved drugs for the diagnosis, cure, mitigation, treatment, or prevention of diseases” was posted on the FDA’s website to warn consumers about these mostly hemp-derived products. Capsules, dog treats, e-liquids and oils all claiming to have CBD tested either negative or very low for cannabinoids.

Many of these companies claim on their websites that their products are completely legal because they are made from hemp and don’t have any psychoactive properties. The truth is they exist in a legal vacuum as long as they don’t market their products as drugs, which is why the FDA has stepped in.

The Industrial Hemp Farming Act of 2013 amended the Controlled Substances Act (CSA) to exclude industrial hemp from the definition of “marijuana,” loosening the restrictions on strains of Cannabis sativa that are very low in THC. This has facilitated cultivation of hemp in the U.S., but a great deal of hemp still gets imported (1,138 metric tons in 2011) everyday from China, Canada and the EU. Before 2013, essentially all the hemp used for its fiber and seed was imported and regulated by the DEA. Since the Marijuana Tax of 1937, it has been legal to cultivate hemp with a DEA license, but the tight restrictions meant almost no one did it.

Cannabis sativa that is low in THC may still contain CBD, so whole-plant extracts of hemp grown for industrial purposes could make a product semi-rich in CBD, if done correctly. A cheap extraction process like steam distillation done on a sample of plant material that is mostly stalks and leaves might extract some CBD, but it can also extract unsafe pesticides and toxins absorbed from the soil.

Cannabis thrives in toxic soils and accumulates heavy metals, so the soils it grows in needs to be carefully selected and tested for pollutants. If grown in another country, especially one with lax environmental regulations, hemp products might be highly contaminated.

Source:  http://www.hightimes.com/  7th March 2015

 

 

 

PHOENIX (December 18) — New state data from the U.S. Substance Abuse and Mental Health Services Administration shows that Colorado now leads the nation in marijuana use across all age levels and, most disturbingly, in the 12-17 and 18-25 age categories. Marijuana legalization advocates have persistently claimed that marijuana use will not rise with legalization, and that legalization will have little bearing on under-age use. This latest data from the U.S. Department of Health and Human Services proves otherwise.

“Sadly for Colorado’s youth, the data now substantiates the theory that increased availability leads to increased use — despite being assured the contrary by legalization advocates. Arizonans should pay close attention,” said Seth Leibsohn, chair of Arizonans for Responsible Drug Policy. “In Colorado, teen marijuana use has not only increased since legalization, it is now the highest in the nation — more than 73 percent higher than the national average. For those who recommended a ‘wait-and-see’ approach based on Colorado’s experience, the results are in and they are not good. It should be crystal clear, in Arizona and any other state considering legalizing marijuana, that going down the same path would be devastating to our youth and our communities.”

“According to this data, Colorado is not only number one for marijuana use but also ranks near the top in the nation in its use of other illicit drugs,” said Sheila Polk, vice chair of Arizonans for Responsible Drug Policy. “Serious peer-reviewed science warns us that marijuana does significant harm to the developing adolescent brain, causes impaired memory and judgment, lowers IQ and increases school drop-out rates. It is unconscionable to unleash this harmful drug on Arizona’s youth.”

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About Arizonans for Responsible Drug Policy

The Arizonans for Responsible Drug Policy PAC was formed to actively oppose any initiative that would legalize the recreational use of the drug marijuana in the state of Arizona. Visit www.arizonansforresponsibledrugpolicy.org for more information.

Source:  Press Release 18th Dec 2015  melissa@axiompublicaffairs.com

A lack of guidance from the U.S. Environmental Protection Agency frustrated Colorado’s efforts to decide how to handle pesticides and pot.

State regulators have known since 2012 that marijuana was grown with potentially dangerous pesticides, but pressure from the industry and lack of guidance from federal authorities delayed their efforts to enact regulations, and they ultimately landed on a less restrictive approach than originally envisioned.

Three years of e-mails and records obtained by The Denver Post and dozens of interviews show state regulators struggled with the issue while the cannabis industry protested that proposed limits on pesticides would leave their valuable crops vulnerable to devastating disease.

Last year, as the state was preparing a list of allowable substances that would have restricted pesticides on marijuana to the least toxic chemicals, Colorado Department of Agriculture officials stopped the process under pressure from the industry, The Post found.

DENVER, CO – AUGUST 19: Lucas Targos the head grower at L’Eagle sprays the marijuana plants in their cultivation room on Wednesday August 19, 2015. They spray with neem oil which helps combat the spider mites and mildew. He sprays the plants every 7-10 days. This was the last spraying before they go into the flowering stage. Targos was an organic food farmer before working with marijuana. (Photo by Cyrus McCrimmon/The Denver Post )

“This list has been circulated among marijuana producers and has been met with considerable opposition because of its restrictive nature,” wrote Mitch Yergert, the CDA’s plant industry director, shortly after the April 2014 decision. “There is an inherent conflict with the marijuana growers’ desire to use pesticides other than those” that are least restrictive.

Another year passed before regulators publicly released a draft list of pesticides allowed on marijuana plants — a broader, less restrictive list than initially proposed. That only occurred after the city of Denver began quarantining plants over concerns that pesticides posed a health hazard.

The marijuana industry “was the biggest obstacle we had” in devising any effective pesticide regulation, said former Colorado agriculture commissioner John Salazar.

“We were caught between a rock and a hard spot,” he said. “Anything we wanted to allow simply was not enough for that industry.”

The U.S. Environmental Protection Agency, which regulates pesticides, offered the state little advice about what to do because marijuana is an illegal crop under federal law.

“We tried to work with the EPA, to figure out what to do, but we got nothing,” Salazar said.

With little federal guidance and no science to know which pesticides might be safe for consumers, the department made pesticide inspections a low priority, records show.

“Our current policy is to investigate complaints related to MJ (marijuana), otherwise focus on higher priorities,” Laura Quakenbush, the CDA’s pesticide registration coordinator, wrote to a colleague in a December 2012 e-mail.

Critics say the state bowed to industry’s influence.

“Colorado has given the marijuana industry way too much power, way too much control over the political process,” said Kevin Sabet, co-founder of Smart Approaches to Marijuana, a group that opposed legalizing marijuana.

“Regulators are trusting the industry and saying, ‘Show us how to regulate you.’ They’re putting their trust in the industry,” said Samantha Walsh, a lobbyist who has represented marijuana-testing labs and the unions representing workers at cannabis cultivation facilities.

“There’s been foot-dragging in much of the industry,” she said. “It’s a failure of the government to step in and institute these practices.”

State officials say it was important to take into account industry concerns.

“CDA felt there was a need to further explore all possibilities of how best to regulate and identify what pesticides could be legally used on marijuana. During this process, we believe we have identified a better way forward than what we originally proposed in April of 2014,” Yergert told The Post.

The agency is just now preparing for regular inspections of marijuana growers using pesticides, Yergert said, something it already does for other commercial users such as crop-dusting businesses. In July, the CDA began visiting marijuana businesses for “compliance assistance” that focuses on education and training.

And last week, Yergert said, the agency began a new rule-making process to formalize the list of pesticides growers can use.

Heavy-hitting pesticides

Marijuana and pesticides hit CDA’s radar in 2012 when a former employee of the Kine Mine, then a medical marijuana dispensary in Idaho Springs, complained to the state of not being given protective clothing to spray growing plants.

CDA inspectors found two heavy-hitting pesticides — Floramite and Avid — were used on dozens of cannabis plants.

The CDA cited the business with violating a pesticide’s label restrictions. The state was unable to do more because it had not yet determined which pesticides could and could not be used on cannabis in Colorado.

As commercial grow operations spread after recreational pot sale became legal in 2014, complaints continued to flow. Sales of recreational and medical marijuana reached nearly $700 million last year and topped $540 million through July. There are 600 pot-growing licenses in Denver alone.

“I think everyone thought marijuana growers were a bunch of organic growers who would never use pesticides on pot, but that’s definitely not the case,” said Mowgli Holmes, a molecular geneticist at Phylos Bioscience and board member of the Cannabis Safety Institute in Oregon. “A lot of this pesticide use is new and driven by commercial pressures.”

When large numbers of cannabis plants are grown indoors and in close proximity, they are vulnerable to mites and powdery mildews, which can destroy a crop quickly.

To date, there have been 24 inquiries into pesticide complaints involving marijuana businesses, CDA officials said.

Another early complaint came in 2012 when a consumer said a popular cannabis leaf wash for killing bugs claimed to be “99.9999%” water that worked because of an ionic charge.

A state lab found it actually contained high levels of “pyrethrin, a plant-based insecticide that requires EPA registration,” wrote Quakenbush, the CDA’s pesticide registration coordinator.

Officials determined that because the product label did not say that it contained a pesticide, they lacked authority over its use, according to e-mails. The state referred the mislabelling problem to the EPA for investigation, and the state did not look further into the issue.

But the case led state inspectors to send several e-mails to the EPA seeking guidance on how to handle the emerging pesticide problem. Officials also asked whether pesticides allowed on tobacco would suffice. The state received no response, according to e-mails the state provided.

The federal agency responded in an e-mail to The Post that “over the past several years, the U.S. EPA has had interactions with representatives from the Colorado Department of Agriculture on this issue” but provided no details.

Health impact

Colorado initially wanted to do as New Hampshire did, allowing only the least harmful pesticides to be used in marijuana cultivation.

Those included neem, cinnamon and peppermint oils — products so nontoxic that federal registration is not required and no tolerance level is necessary for their residues.

By restricting cannabis growers to those products, Colorado could adapt its rules over time as more information became known about the health impact of chemical residues from pesticides.

Before the sale of recreational pot became legal in 2014, “a majority in the industry’s underground didn’t have very sophisticated practices and were using lots of toxic things they shouldn’t have on a regular basis,” said Devin Liles, who runs The Farm cultivation facility in Boulder.

In April 2014, the CDA laid out the issue: “For food crops, a tolerance (of pesticide residues) must be established. No tolerances have been established for marijuana because they are not recognized as a legal ‘agricultural crop.’ “

Put simply, many pesticides that the marijuana industry was already using — some of them allowed by the EPA on food crops — were to be off the table.

Small, informal working group meetings were held in March and April. Liles said other members of a group on which he participated immediately were worried.

“Some operations were really concerned because what they were using was now on the chopping block,” he said, “and they didn’t know if it would become more restrictive later.”

The proposed rule was published, and a meeting during which stakeholders could speak was scheduled for that May.

“The Colorado Department of Agriculture does not recommend the use of any pesticide not specifically tested, labeled and assigned a set tolerance for use on marijuana because the health effects on consumers are unknown,” the proposed rule said.

Then in late April 2014, soon after CDA issued the proposed rule — and following two meetings where officials heard the industry’s reaction — the agency pulled the plug on its rule-making process.

“The termination will allow the agency more time to meet with the representative group of stakeholders and further review the impacts of the proposed rule,” according to the portion of the Colorado secretary of state’s website where the hearings are tracked.

“We continued to have conversations without having any resolution,” Ron Carle ton, CDA’s former deputy commissioner, said in an interview. “The industry was of the opinion they needed the same kind of access to pesticides that other growers were using, that this low-level stuff wouldn’t do it.”

CDA and the marijuana industry continued to wrangle. That June, CDA shared copies of an early, broadened draft list of approved pesticides with at least one industry group.

“The list never meant much because it was always in draft form, never formalized or finalized, and rule-making never occurred,” Michael Elliott, executive director of the Marijuana Industry Group, told The Post in an e-mail.

At a CDA meeting with businesses in December, Elliott said growers were frustrated because they did not believe the state was giving them the tools necessary to fight the problems they faced.

“We need clean product, and we have a huge list of things to test for and failure could literally shut down a business,” he said.

Meanwhile, CDA continued its policy of not checking to see what pesticides marijuana growers were using unless someone complained.

“To date, CDA has not actively sought to inspect and enforce the provisions of the (Colorado) Pesticide Applicator’s Act on marijuana producers,” Yergert, CDA’s plant industry director, wrote in a memo for a meeting in December. The Pesticide Applicator’s Act is the state’s authority to enforce EPA pesticide laws.

The delays had Yergert worried that CDA’s inaction could be problematic.

“The last thing that I want is somebody to get sick and they say it was due to pesticide use” and that the state knew about it, he said at the December meeting with industry representatives. “None of us wants to be in front of that train.”

Turning up the heat

While state regulators and the industry debated how pesticides should be regulated, Denver was about to turn up the heat.

Denver firefighters conducting routine safety inspections of marijuana growhouses in early 2014 discovered some growers were burning sulphur as a fumigant to kill mites. Firefighters say that’s a fire hazard.

Once stopped from using the dangerous substance, the growers turned to pesticides, and firefighters noticed cabinets full of odd-sounding chemicals.

“They will do something to protect these million-dollars worth of plants,” said Lt. Tom Pastorius. “We stopped one issue with the sulphur. But that just led to a whole different issue.”

The city’s environmental health department responded by quarantining about 100,000 plants in March after application logs showed pesticides they knew little about. City health officials met with CDA and learned of the agency’s draft list of pesticides it said were OK to use.

The meeting prompted the state to release the list publicly. It was the first time growers say they were fully aware of what they could and could not use.

“At that time, we didn’t want to put the list out,” said John Scott, CDA’s pesticide program manager. “We were still working on the rule itself.”

But once Denver had quarantined the plants, “we felt like it couldn’t wait,” Scott said.

Pesticides on the list have labels so broadly written that the state determined their use on marijuana is permissible. However, CDA also says it does not recommend their use because no one knows whether the pesticides are safe when used on marijuana.

Three of the growers whose plants were quarantined fought back in court, suing the city for allegedly overextending its authority. Pesticides, the businesses argued, were the purview of CDA, not the city.

The industry also turned to the Colorado legislature and had a last-minute amendment designed to stop Denver’s enforcement added to a bill about marijuana tax revenues, according to documents and interviews.

It’s not the only example of marijuana growers looking toward the Capitol for help. Also during the last session, several legislators tried but failed to pass a law that would have removed pesticides entirely from the list of ingredients on marijuana product packages.

The enforcement amendment, which ensured that pesticide oversight of marijuana growers would stay with the state, was tacked on from the Senate floor on the day before it adjourned.

“The worry was that communities could basically ban the use of some pesticides based on emotional responses rather than factual ones,” said Sen. Jerry Sonnenberg, R-Sterling, the amendment’s sponsor. “It was to codify that the state was in charge, not Denver, not any city.”

The impetus for his amendment, Sonnenberg said, came primarily from conversations with three lobbyists who records show are with the Marijuana Industry Group.

Sonnenberg’s re-election committee had accepted about $1,000 in contributions from the three since 2010, according to state campaign finance records. In that time, he’s accepted about $1,800 from all marijuana-related contributors, records show. All contributions Sonnenberg received since 2010 totaled $49,900, according to state filings.

More broadly, the industry has spent at least $421,000 on lobbying on various cannabis-related issues this year, state reports show. In contrast, utility giant Xcel Energy has spent $230,640, according to the company. The city eventually won in court, but the amendment passed as well. Subsequent enforcement actions by Denver occurred at the retail level, far from where plants are actually covered in pesticides and where CDA’s pesticide authority extended.

The city declined to comment on the legislature’s action.

“What was most frustrating about what happened in Denver is that the city went from not participating in the statewide conversation and doing absolutely nothing to placing holds on businesses,” Elliott at MIG said in an interview. “We would have appreciated having them involved in the state process and perhaps having worked out more local solutions instead of coming down quickly with holds.”

Elliott paused, then offered: “That said, I understand why they reacted the way they did. They identified a safety issue and took action. Very little has been going on on this issue on a statewide level.”

Source: The Denver Post   4th Oct. 2015

Comments below from David Evans Esq., a lawyer and special adviser to the Drug Free America Foundation, re the suggestion that marijuana could assist in treating opiate addiction.

WHAT ARE THE PHYSICAL AND BEHAVIORAL ADVERSE EFFECTS OF USING “MEDICAL” MARIJUANA WHILE IN OPIATE TREATMENT?

Memory defect (short and long term) – how are they to remember compliance issues and new problem solving? Masks other mental health issues – anxiety, PTSD, Bipolar

Marijuana use impacts the brain, creates a delay in learning skills to NOT have substance use in life.

In order for change to occur, person must acknowledge loss of control – how can someone do this when control is still lost with marijuana?

Changes in coordination, mood swings, memory/learning problems

Marijuana use deters the return to normal brain functioning and the continued drive for more substances and stimuli in the pleasure seeking area of the brain.

Marijuana use is A-motivational – knocks out drive and ambition

Continued use maintains Arrested Development – low emotional maturity – the maturity level is stumped when start using substances

Recovery – means not using drugs

THC suppresses neurons in information processing system of the hippocampus, the part of the brain that is crucial for learning memory and integration of sensory experiences with emotions and motivations. Learned behaviors, which depend on the hippocampus, deteriorate after chronic exposure

· Because marijuana use impacts learning a person falls behind in accumulating intellectual, job, or social skills. This can directly translate to need for more treatment both with intensity and length

Users have trouble sustaining and shifting their attention in and registering, organizing and using information.

Increase risk of motor vehicle/work accidents

For more detailed information log on to a paper in Support of the UN Drug Conventions: The Arguments Against Illicit Drug Legalisation and Harm Reduction also by David Evans.

Source: https://nationalallianceformarijuanaprevention.files.wordpress.com/2011/12/2009-un-drug-conventions-the-argument-against-legaliztion.pdf

Public Health and Safety Communities Applaud Move

DOJ Decision Will Dry Up Money To Marijuana Industry

(January 4, 2018 – Alexandria, VA) – The Department of Justice will announce today it will rescind lax marijuana policy guidance to US Attorneys (the so-called “Cole Memo”) and instead allow US Attorneys to exercise discretion in going after marijuana cases. The new memo will not call for arresting users or others with low-level involvement in marijuana, but instead makes investing in the marijuana industry a risky move.

“This is a good day for public health. The days of safe harbor for multi-million dollar pot investments are over,” said Kevin A. Sabet, a former Obama Administration drug policy adviser who is now head of the anti-legalization group Smart Approaches to Marijuana (SAM). “DOJ’s move will slow down the rise of Big Marijuana and stop the massive infusion of money going to fund pot candies, cookies, ice creams, and other kid-friendly pot edibles. Investor, banker, funder beware.”

The Cole Memo and its compliance was blasted by the nonpartisan Government Accountability Office (GAO) in a 2016 report. The lead GAO author stated that DOJ “has not documented its plan for monitoring the effects of the state marijuana legalization.” A recent poll also found that when voters had more choices than just legalization or prohibition, support for legalization fell by 30%. Most voters were comfortable with laws removing criminal penalties for use but not legalizing sales, which the Cole Memo permitted.

“The Cole Memo had been waived around by money-hungry pot executives for years, searching for legitimacy among investors and banks,” remarked former Congressman Patrick J. Kennedy, a SAM Honorary Advisor. “It’s time we put public health over profits. This is a sensible move that now must be followed up with action so we can avoid a repeat of the nightmare of Big Tobacco.”

“Marijuana, along with alcohol and tobacco, are the three drugs we need to stop our youth from trying,” said Dr. Robert DuPont, the first Director of the National Institute on Drug Abuse and second White House drug czar. “DOJ is doing the right thing by putting a stop to this wink and nod policy of allowing marijuana legalization.”

Corinne Gasper, who lost her daughter Jennifer to a driver high on marijuana, stated, “All too often, marijuana has been seen as benign. An industry not unlike Big Tobacco has downplayed its harms, aided by laws allowing officials to look the other way. For the sake of so many families, I hope those days are now over.”

SAM, a non-profit organization founded by a former member of Congress and a former Obama Administration drug policy advisor, applauded the news. SAM’s Science Advisory board consists of more than a dozen top researchers in the field of marijuana policy ranging from institutions such as Harvard and Johns Hopkins.

Dr. Stuart Gitlow, the former President of the American Society of Addiction Medicine, stated, “This is the right move by DOJ. To protect public health, we must choke the large amounts of funding spent by Big Marijuana to hook kids on highly potent THC products.”

Justin Luke Riley, the Denver-based leader of the Marijuana Accountability Coalition stated, “Recovery from addiction is so much harder when you are bombarded with the kind of pot commercialization we see here in Colorado. DOJ should be applauded for trying to put a stop to the shameless promotion and advertising that is killing our community.”

Ron Brooks, the former head of the National Narcotics Officers Association Coalition, stated, “This is the kind of leadership that will save lives. For too long law enforcement has been handcuffed by vague and unenforced policy guidance.”

Will Jones, a DC-resident who is fighting for social justice in minority communities commented, “Since the Cole Memo was released, the pot industry has relentlessly opened more pot shops in poorer, communities of color. Arrests are even higher now in many jurisdictions than before legalization.”

“Focusing enforcement resources on incarcerating low-level, nonviolent offenders will always be wrong and counterproductive,” said Kevin Sabet, President of SAM. “But there is an urgent need for Federal officials to reassert targeted control over an exploding industry that is undermining public health and safety in our communities.

This is a major blow to an industry that is corrupting our politics and lying to voters in a steadfast pursuit to put profit over public health and safety. Today’s policy change will undoubtedly extend a chilling effect we have seen on marijuana legalization initiatives across the nation this year, and – hopefully – encourage lawmakers to stop and look at what science tells us about the unintended consequences of legal marijuana.

Like the tobacco industry before it, well-heeled lobbyists from the marijuana industry have been touting marijuana commercialization as the panacea for every contemporary challenge we face in America, but the truth is, the health and safety costs caused by the commercialization of cannabis are outweighing any tax revenues collected.”

Source: Press Release from SAM: info@learnaboutsam.org. 4th January 2018

There’s no future for salmon in Northern California’s Emerald Triangle.

On California’s northern coast are three counties that marijuana aficionados call the Emerald Triangle. In their view, the growers there have perfected a strain of cannabis that has high potency and consistently high quality. Result: There are many growers, most tending their crops in remote corners of these mountainous, heavily wooded counties.

This produces serious environmental damage. In Humboldt County where the largest amount of Emerald Triangle marijuana is grown, the sheriff’s office conducted an aerial survey and counted 4,000 visible outdoor grows, nearly all of them illegal. (California was the first of 22 states to permit medical use of marijuana, so some grows were established to serve users who have permit cards.)

The illegal grows are usually carved out of forest land (often national forests or acreage owned by timber companies). Typically, the growers clear-cut the trees on the land they want to use, then bulldoze it to their specifications. Next, they divert a nearby stream to provide the one to six gallons required daily by each plant. They then fertilize the plants, causing runoff. This is followed by a generous dose of rat poison.

The upshot: The U.S. Fish and Wildlife Service a week ago declared that stream diversion by marijuana plantations was robbing the rivers that the streams feed of enough cool water for Coho salmon to breed, thus threatening their survival. California’s north coast is big salmon country, for both sport and commercial fishing. The declaration earned banner headlines in the local press.

This week the USFWS said that it was considering seeking a “Threatened” status for the fisher, a native cousin to the weasel. Many fishers have been dying after ingesting the rat poison put out by marijuana planters.

Disruption of the soil for planting the crop and for cutting roads to some of the remote locations causes runoff that silts the area’s rivers—another preventable threat to the already endangered native salmon and steelhead.

In the area, a multi-agency task force has raided, on average, one marijuana plantation a week since January 2013. The biggest one, in August this year, yielded 10,000 plants; most have had several hundred. The plants are destroyed. The “harvest” often yields cash, weapons, and, sometimes other drugs (although multi-drug hauls tend to found in in-town dealer houses).

In addition to the cost of the raids, “grows” on public land require public resources to clean up and restore the affected area.

Environmentalists in the three counties are quick to run to the battlements and declare all-out war any time the state Transportation Department sets out to widen a highway. With the regular pot plantation raids, however, they are as silent as mice. Occasionally, one will opine in an interview that the problem would go away if marijuana were made legal. This outcome seems unlikely. Large companies might buy up some tracts for growing (along with getting the necessary permits and paying taxes); however, not every small grower will be able to compete; hence, the likelihood they would feed a black market, selling to heavy users at below-market prices. Thus, one problem would yield to another.

Source:  American spectator 9th October 2014
www.drugwatch.org

Summary:

Several studies have demonstrated that the primary active constituent of cannabis, delta-9-tetrahydrocannabinol, induces transient psychosis-like effects in healthy subjects similar to those observed in schizophrenia. However, the mechanisms underlying these effects are not clear. A new study shows that this active ingredient increases random neural activity, termed neural noise, in the brains of healthy human subjects. The findings suggest that increased neural noise may play a role in the psychosis-like effects of cannabis.

Cannabis. Credit: © olyas8 / Fotolia

Several studies have demonstrated that the primary active constituent of cannabis, delta-9-tetrahydrocannabinol (∆9-THC), induces transient psychosis-like effects in healthy subjects similar to those observed in schizophrenia. However, the mechanisms underlying these effects are not clear.

A new study, published in the journal Biological Psychiatry, reports that ∆9-THC increases random neural activity, termed neural noise, in the brains of healthy human subjects. The findings suggest that increased neural noise may play a role in the psychosis-like effects of cannabis.

“At doses roughly equivalent to half or a single joint, ∆9-THC produced psychosis-like effects and increased neural noise in humans,” explained senior author Dr. Deepak Cyril D’Souza, a Professor of Psychiatry at Yale School of Medicine.

“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,” added first author Dr. Jose Cortes-Briones, a Postdoctoral Associate in Psychiatry at Yale School of Medicine.

The investigators studied the effects of ∆9-THC on electrical brain activity in 24 human subjects who participated in a three-day study during which they received two doses of intravenous ∆9-THC or placebo in a double-blind, randomized, cross-over, and counterbalanced design.

If confirmed, the link between neural noise and psychosis could shed light on the biology of some of the symptoms associated with schizophrenia.

“This interesting study suggests a commonality between the effects on the brain of the major active ingredient in marijuana and symptoms of schizophrenia,” stated Dr. John Krystal, Editor of Biological Psychiatry. “The impairment of cortical function by ∆9-THC could underlie some of the cognitive effects of marijuana. Not only does this finding aid our understanding of the processes underlying psychosis, it underscores an important concern in the debate surrounding medical and legalized access to marijuana.”

Source:   http://www.sciencedaily.com/releases/2015  3 Dec.2015

Abstract


To present a summary of current scientific evidence about the cannabinoid, cannabidiol (CBD) with regard to its relevance to epilepsy and other selected neuropsychiatric disorders. We summarize the presentations from a conference in which invited participants reviewed relevant aspects of the physiology, mechanisms of action, pharmacology, and data from studies with animal models and human subjects. Cannabis has been used to treat disease since ancient times. Δ9-Tetrahydrocannabinol (Δ9-THC) is the major psychoactive ingredient and CBD is the major non-psychoactive ingredient in cannabis. Cannabis and Δ9-THC are anticonvulsant in most animal models but can be proconvulsant in some healthy animals.

The psychotropic effects of Δ9-THC limit tolerability. CBD is anticonvulsant in many acute animal models, but there are limited data in chronic models. The antiepileptic mechanisms of CBD are not known, but may include effects on the equilibrative nucleoside transporter; the orphan G-protein-coupled receptor GPR55; the transient receptor potential of vanilloid type-1 channel; the 5-HT1a receptor; and the α3 and α1 glycine receptors. CBD has neuroprotective and anti-inflammatory effects, and it appears to be well tolerated in humans, but small and methodologically limited studies of CBD in human epilepsy have been inconclusive.

More recent anecdotal reports of high-ratio CBD:Δ9-THC medical marijuana have claimed efficacy, but studies were not controlled. CBD bears investigation in epilepsy and other neuropsychiatric disorders, including anxiety, schizophrenia, addiction, and neonatal hypoxic-ischemic encephalopathy. However, we lack data from well-powered double-blind randomized, controlled studies on the efficacy of pure CBD for any disorder. Initial dose-tolerability and double-blind randomized, controlled studies focusing on target intractable epilepsy populations such as patients with Dravet and Lennox-Gastaut syndromes are being planned. Trials in other treatment-resistant epilepsies may also be warranted.

Source:   Epilepsia  Volume 55Issue 6pages 791–802June 2014

 

The truth is it can indeed mean trouble, especially for young people.

These days, it’s become fairly square to criticize marijuana and its rush toward legalization. Twenty-three states have condoned the drug in some form, with four permitting recreational use, and Massachusetts is set to vote on permitting it next year. The proposed federal CARERS Act of 2015 would let states legalize medical marijuana without federal interference and demote pot from a Schedule I drug — one with high abuse potential — to Schedule II. The path toward nationwide decriminalization is looking unobstructed.

But underscoring the incredible momentum to legalize marijuana is the misconception that the drug can’t hurt anybody. It can, especially young people.

The myth that marijuana is not habit-forming is constantly challenged by physicians. “There’s no question at all that marijuana is addictive,” Dr. Sharon Levy tells me. She is the director of the Adolescent Substance Abuse Program at Boston Children’s Hospital, one of a few programs designed to pre-emptively identify substance use problems in teens. At least 1 in 11 young adults who begin smoking will develop an addiction to marijuana, even more among those who use the more potent products that are entering the market.

Levy speaks of an 18-year-old patient who had started smoking marijuana several times a day in 10th grade, dropped out of high school, and been stealing money from her parents. “She and her family were at their wits’ end trying to find appropriate treatment in a health care system that doesn’t consider addiction to marijuana a serious problem,” Levy says. “We are simply not prepared for the fallout of marijuana legalization.”

Such perspectives have been obfuscated by those who might gain from legalization. “People strongly defend marijuana because they don’t want legalization to be derailed,” says Jodi Gilman, an assistant professor at Harvard Medical School with the Center for Addiction Medicine.

An insistence on the banality of the drug is especially dangerous among younger smokers, a population with an epidemic level of pot use. According to the most recent National Survey on Drug Use and Health, the use of tobacco and alcohol among 12-to-17-year-olds has fallen in the past year, but habitual use of marijuana among those 12 and up is increasing.   “If you go into a high school and ask the classroom, ‘Are cigarettes harmful? Is alcohol harmful?’ every kid raises their hands,” Gilman says. “But if I ask, ‘Is marijuana harmful?’ not a hand goes up.”

To bring balance to a narrative driven by pro-legalization campaigns, Gilman and others are interested in leveraging data to show pot’s real effects. Last year, Gilman published research on 18-to-25-year-olds that showed differences in the brain’s reward system between users and non-users. (“I got a lot of hate mail after that,” Gilman says.) And data supporting the hazards keep accumulating. Recently Gilman found that in a group of college students, smokers had impaired working memory even when not acutely high.

Physician concern for marijuana’s acceptance isn’t because doctors are a stodgy bunch — their scepticism is rooted in science and in history. In the 1950s, nearly half of Americans smoked tobacco, a level of adoption that rendered its health hazards invisible. Meanwhile, the corporate forces that drove cigarette smoking to its ascendancy actively subverted those that governed public health.

While marijuana has not been definitively shown to cause cancer or heart disease, its harmful cognitive and psychological effects will take time to capture in studies. The underlying biochemistry at work suggests deeply pathologic consequences. Tetrahydrocannabinol (THC) in marijuana attaches to receptors in the brain that subtly modulate systems ordinarily involved in healthy behaviors like eating, learning, and forming relationships. But THC — which has been increasing in potency in legal products being sold in places like Colorado — throws the finely tuned system off balance.

“Smoking pot turns the volume on this system way, way up,” says Jonathan Long, a research fellow at the Dana-Farber Cancer Institute.

Each hit of THC rewires the function of this critical cognitive system: Early evidence in mice has shown that repeated exposure to THC causes these receptors to disappear altogether, blunting the natural response to positive behaviors and requiring higher doses to achieve the same effect. Marijuana exploits essential pathways we’ve evolved to retrieve a memory, to delicately regulate our metabolism, and to derive happiness from everyday life.

Medical science at its best operates independently of forces that drive the market and its associated politics. It was science that eventually curtailed the power of Big Tobacco and prevented nearly 800,000 cancer deaths in the United States between 1975 and 2000. As marijuana marches toward the same legal status as cigarettes, its potential hazards will require equal attention by science.    The argument here isn’t whether marijuana should be legal. There are champions on either side of that debate. Instead, should the drug become widely available, it’s to our detriment to blindly consider marijuana’s legalization a victory worthy of celebration. We must be cautious when societal shifts can affect health, especially among our most vulnerable populations.

Source: http://www.bostonglobe.com/magazine/2015/10/08/can-please-stop-pretending-marijuana-harmless/MneQebFPWg79ifTAXc1PkM/story.html

 

The only thing green about that bud is its chlorophyll.

—By Josh HarkinsonBrett Brownell, and Julia Lurie

March/April 2014 Issue of Mother Jones

You thought your pot came from environmentally conscious hippies? Think again. The way marijuana is grown in America, it turns out, is anything but sustainable and organic. Check out these mind-blowing stats, and while you’re at it, read Josh Harkinson’s feature story, “The Landscape-Scarring, Energy-Sucking, Wildlife-Killing Reality of Pot Farming.”

 

Sources: Jon Gettman (2006), US Forest Service (California outdoor grow stats include small portions of Oregon and Nevada), Office of National Drug Control Policy, SF Public Utilities Commission, Evan Mills (2012).

UPDATE: Beau Kilmer of the RAND Drug Policy Research Center argues that the government estimates of domestic marijuana production used in this piece and many others are in fact too high. Kilmer’s research, published last week, suggests that total US marijuana consumption in 2010 (including pot from Mexico) was somewhere between 9.2 and 18.5 million pounds.

Source:  https://www.motherjones.com/environment/2014/03/marijuana-pot-weed-statistics-climate-change/

For more than four decades, marijuana has been synonymous with Jamaica. It was traditionally associated with the Rastafarian community in Jamaica and is regarded as a herb of religious significance by the Rastafarians and is widely used as a sacrament in their religious ceremonies.

However, the use of marijuana has transcended its traditional use from that of a sacrament for Rastafarians and it is now being used as a recreational drug in mainstream society. It has assumed both cultural and religious significance and is regarded as a harmless “holy herb” that bestows wisdom on its users.

Marijuana has permeated the society to such an extent that the taboo once associated with its use has her diminished, and this has led to it being more available. As a result of such availability, the “weed” is easily accessible and can be found in the palms of many of the countries’ youth (12 to 19 years old), especially those in the lower socioeconomic communities.

With the amendments to the Dangerous Drugs Act decriminalising the use and possession of small quantities of marijuana, it is projected that more youth will be using the drug.

Given Jamaica’s history with marijuana use and it’s so, called powers of wisdom, persons are unwilling to accept the fact that this herb can have any ill affect on one’s mental health, and persons who admit to suffering ill effects from its use are seen as weak.

This policy seeks to address the effect marijuana usage has on the mental health of adolescents and outlines options for preventing marijuana usage and reducing ganja- related harms.

THE PROBLEM FACING JAMAICA

1) Smoking marijuana increases the risk of mental disorders such as depression and schizophrenia in adolescents.

2) The decriminalising of small quantities of marijuana will only serve to increase the availability and usage of marijuana among the nation’s youth, resulting in increased ganja-related mental illnesses.

3) The focus on marijuana is largely on the criminal justice perspective. However, there is insufficient attention being placed on the issue of health, especially the mental health of young persons who consume the drug.

4) Marijuana is the most commonly used drug in Jamaica. Some of the active ingredients in marijuana have been shown to be harmful to the user. they can induce hallucinations, change thinking, and cause delusions.

5) The United Nations Office on Drugs and Crime (UNDOC) reports that the majority of marijuana users in Jamaica are between the ages of 13-25 years, implying that marijuana use is occurring in the most productive years of individuals’ lives.

6) The World Health Organisation (WHO) and (others) have reported that the most prevalent disorder in Jamaica is schizophrenia, which has been increasing yearly between 2009 and 2013. These studies have also highlighted the connection with early usage of marijuana and the increase in mental illness.

7) The National Secondary Schools Survey (2013) conducted islandwide from a sample of 3,365 grades 8, 10, 11, and 12 students, revealed the following:

a) 43.2% reported that marijuana was the easiest illicit drug to access.

b) One in five students who were current marijuana users were at high risk for marijuana misuse

c) Age of first use of marijuana was 12.9 years

d) 30.8% reported that drugs(including marijuana) were available at their school

e) 50.4% believed that drugs, including marijuana were available near school. Students who believed that drugs were available reported significantly higher use than those who did not believe drugs were available in and around school.

The American Psychiatric Association (APA) is opposed to the use of marijuana. Its position is based the following on:

i. There is no current scientific evidence that marijuana is in any way beneficial for the treatment of any psychiatric disorder. In contrast, current evidence supports, at minimum, 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.

ii. The use of marijuana/ganja in young people has been examined in many major studies worldwide. Results on the findings of these studies have differed. Some have found little or no association between marijuana use and mental disorders. Others have found deleterious effects of marijuana usage on mental health.

iii. Longitudinal studies conducted in New Zealand and Denmark suggest that the effects on the brain caused by marijuana probably explains higher rates of psychose.

The findings highlighted above suggest that the effects on the brain caused by marijuana usage can lead to mental disorders.

OPTIONS

a) A public education/media campaign (digital, print, radio, and TV) to develop and disseminate effective drug information for youth, parents, and caregivers. At the core of the strategy is essential information about the harmful effects of marijuana use.

i. To bring awareness to the fact that the teen brain continues to develop to age 25, therefore, it is vitally important that teens refrain from marijuana use as this use will affect brain development.

ii. Once youth perceive that marijuana use is harmful and risky, marijuana use dramatically declines.

iii. The longer a child delays drug use, addiction and substance abuse disorders are significantly reduced.

b) Teach life skills and drug-refusal skills focusing on critical thinking, communication, and social competency. This strategy will take on the following options:

i. Engaging families to strengthen these skills by setting rules, clarifying expectations, monitoring behaviour, communicating regularly, providing social support, and modelling positive behaviours.

ii. Encouraging social bonding and caring relationships, with people holding strong standards against substance abuse in families, schools, peer groups, mentoring programmes, religious and spiritual contexts, and structured recreational activities.

The campaign will have an enhanced focus on marijuana use and abuse. In addition to new national-level prevention and demand reduction messaging, the education-media campaign will work directly with communities to amplify the effects of the campaign and to encourage youth participation in the initiative through the help of on-the-ground partner organisations such as uniform groups, youth clubs, and national non-profit organisation devoted solely to the education and development of young people through policy and programme creation.

Since marijuana use has become ingrained in Jamaica’s social and cultural psyche, then any policy directed at marijuana reduction must be geared at behaviour modification.

Public education campaigns, whether they are used as a drug-prevention or health-promotion tool, tend to be based on their ability to affect behavioural change.

They have been successfully applied to the reduction of tobacco use and the promotion of road safety and have shown moderately positive results in a number of areas, including the promotion of healthier nutrition, physical activity, participation in screening for breast and cervical cancer, disease prevention, and other health related concerns.

EXPECTED OUTCOMES

i. First 12 months – 42 per cent improvement in perception of risks of marijuana use by both youth and adults; 50 per cent improvement in the disapproval rates of marijuana use by 12 to 19 year-olds;

ii.Year 3-4 – 70 per cent decrease in marijuana use by youth ages 12 to 19 years; 30 per cent decline in ganja-related mental illnesses.

iii. Year 5-7 – 91 per cent reduction in marijuana use by youth ages 12-19 years old; 75 per cent decline in ganja-related mental illnesses.

Despite the best efforts, some teens will use drugs invariably. Legislative and law enforcement methods offer an alternative to prevent and/or reduce adolescent marijuana usage. At the core of this option are the following strategies:

i. Mandatory counselling and treatment for adolescent found using marijuana.

ii. Mandated community service if adolescent continues to offend.

iii. Mandated prison sentence after the offender has done community service on two previous occasions.

Marijuana is the most widely consumed illicit (pre-decriminalisation in some nation states) drug. It is targeted in one way or another by most prevention interventions. However, few interventions have targeted marijuana specifically. Prevention is typically delivered in the context of wider informational activities and shares a platform with prevention for other substances such as other illicit drugs, alcohol, and tobacco. This policy will be geared specifically at marijuana.

The recommended option of a public education campaign marijuana prevention and reduction programme offers the best alternatives for achieving the stated objectives of the policy.

– This is a heavily edited presentation by Sophia Simpson-Wickham who recently completed an MSc in International Public and Development Management in the Department of Government, UWI, Mona. Feedback: mozzass@hotmail.com or editorial

Source: http://jamaica-gleaner.com/article/news/20171210/target-ganja-babies-urgent-focu

As part of the U.S. Food and Drug Administration’s ongoing efforts to protect consumers from health fraud, the agency today issued warning letters to four companies illegally selling products online that claim to prevent, diagnose, treat, or cure cancer without evidence to support these outcomes. Selling these unapproved products with unsubstantiated therapeutic claims is not only a violation of the Federal Food, Drug and Cosmetic Act, but also can put patients at risk as these products have not been proven to be safe or effective. The deceptive marketing of unproven treatments may keep some patients from accessing appropriate, recognized therapies to treat serious and even fatal diseases.

The FDA has grown increasingly concerned at the proliferation of products claiming to treat or cure serious diseases like cancer. In this case, the illegally sold products allegedly contain cannabidiol (CBD), a component of the marijuana plant that is not FDA approved in any drug product for any indication. CBD is marketed in a variety of product types, such as oil drops, capsules, syrups, teas, and topical lotions and creams. The companies receiving warning letters distributed the products with unsubstantiated claims regarding preventing, reversing or curing cancer; killing/inhibiting cancer cells or tumours; or other similar anti-cancer claims. Some of the products were also marketed as an alternative or additional treatment for Alzheimer’s and other serious diseases.

“Substances that contain components of marijuana will be treated like any other products that make unproven claims to shrink cancer tumours. We don’t let companies market products that deliberately prey on sick people with baseless claims that their substance can shrink or cure cancer and we’re not going to look the other way on enforcing these principles when it comes to marijuana-containing products,” said FDA Commissioner Scott Gottlieb, M.D. “There are a growing number of effective therapies for many cancers. When people are allowed to illegally market agents that deliver no established benefit they may steer patients away from products that have proven, anti-tumour effects that could extend lives.” The FDA issued warning letters to four companies – Greenroads Health, Natural Alchemist, That’s Natural! Marketing and Consulting, and Stanley Brothers Social Enterprises LLC – citing unsubstantiated claims related to more than 25 different products spanning multiple product webpages, online stores and social media websites. The companies used these online platforms to make unfounded claims about their products’ ability to limit, treat or cure cancer and other serious diseases. Examples of claims made by these companies include:

· “Combats tumour and cancer cells;”

· “CBD makes cancer cells commit ‘suicide’ without killing other cells;”

· “CBD … [has] anti-proliferative properties that inhibit cell division and growth in certain types of cancer, not allowing the tumour to grow;” and

· “Non-psychoactive cannabinoids like CBD (cannabidiol) may be effective in treating tumours from cancer – including breast cancer.”

Unlike drugs approved by the FDA, the manufacture of these products has not been subject to FDA review as part of the drug approval process and there has been no FDA evaluation of whether they work, what the proper dosage is, how they could interact with other drugs, or whether they have dangerous side effects or other safety concerns. The FDA has requested responses from the companies stating how the violations will be corrected. Failure to correct the violations promptly may result in legal action, including product seizure and injunction.

“We have an obligation to provide caregivers and patients with the confidence that drugs making cancer treatment claims have been carefully evaluated for safety, efficacy, and quality, and are monitored by the FDA once they’re on the market,” Commissioner Gottlieb added. “We recognize that there’s interest in developing therapies from marijuana and its components, but the safest way for this to occur is through the drug approval process – not through unsubstantiated claims made on a website. We support sound, scientifically-based research using components derived from marijuana, and we’ll continue to work with product developers who are interested in bringing safe, effective, and quality products to market.”

This latest action builds on the more than 90 warning letters issued in the past 10 years, including more than a dozen this year, to companies marketing hundreds of fraudulent products making cancer claims on websites, social media and in stores. Additionally, the FDA recently took decisive action to prevent the use of a potentially dangerous and unproven treatment used in ‘stem cell’ centers targeting vulnerable cancer patients. The FDA encourages health care professionals and consumers to report adverse reactions associated with these or similar products to the agency’s MedWatch program.

The FDA, an agency within the U.S. Department of Health and Human Services, promotes and protects the public health by, among other things, assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices. The agency also is responsible for the safety and security of our nation’s food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products.

Source: https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm583295.htm

Millions of people use cannabis as a medicine. That’s not based on clinical evidence, nor do we know which of the hundreds of compounds in the plant is responsible for its supposed effects. Elizabeth Finkel reports.

LAST YEAR DEDI MEIRI, A CANNABIS RESEARCHER AT THE TECHNION, ISRAEL’S OLDEST UNIVERSITY, RECEIVED A “BEFORE AND AFTER” VIDEO OF AN AUTISTIC BOY.

The before showed the boy helmeted, hands tied behind his back, butting his head against a wall. The after showed him calmly sitting at a table, sketching. The difference: two drops of cannabis oil administered below the tongue. The video had been sent to Meiri by Abigail Dar, an Israeli champion for the use of cannabis in children with autism.

Early this year it was a different story. Over the course of a day, Meiri’s lab received a stream of phone calls from Dar: a few autistic children had gone berserk after receiving their two drops of oil.

Meiri, who is primarily a cancer researcher, received the video and the calls because he has, reluctantly, become one of Israel’s cannabis experts. “Even now I am reluctant to tell people I work on medical cannabis,” he says. “I am not pro-cannabis; I think 90% is placebo.”

But Israel is in the grip of a vast medical experiment. Cannabis has taken hold here to treat a startling range of medical conditions. Not just familiar things like anorexia and pain in cancer patients but autism, Crohn’s disease, Tourette’s syndrome, epileptic seizures, multiple sclerosis, arthritis, diabetes and more. With close to 30,000 users in a population of eight million, Meiri says “everyone knows someone who is being treated with cannabis”. While there is a semblance of orderly medicine, with doctors prescribing cannabis oil from eight registered growers, no one can say just what, exactly, is responsible for the apparent responses.

A cannabis plant is a pot-pourri of more than 500 chemicals whose abundance varies greatly across different genetic strains and according to growth conditions – they’re not cultivars so much as chemovars. The medicinal effect may depend on tetrahydrocannabinol (THC), the chemical that gives you the high, or cannabidiol (CBD), which is thought to reduce inflammation and pain, or a hundred other “cannabinoids” unique to the plant with their own medicinal profile.

Bottom line: with dozens of varieties grown under different conditions, Israeli patients are receiving quite different medicinal concoctions.

Israel’s predicament is tame by comparison to the United States. Here it is the Wild West. Federal sheriffs outlaw medical research on the plant while cannabis cowboys peddle chemovars (varying in their content of THC and CBD) for cures and profit. In the 29 US states that have legalised medical cannabis, dispensaries that resemble something out of a Harry Potter tale sell candies, cookies, oils, ointments and joints to an estimated 2.3 million Americans. As to their exact medical benefits and risks, no one knows. This is medieval medicine – akin to boiling willow bark to treat headache. It is also great business – the North American market for legal cannabis products grew 30% in 2016, with sales topping $US6.7 billion.

Israel’s medical cannabis mess is a lot easier to deal with. To help address it, Meiri’s laboratory of Cancer Biology and Cannabinoid Research is conducting a reverse clinical trial. While patients using medical cannabis fill in a monthly questionnaire, the ranks of analytical machines bursting out of Meiri’s lab create chemical fingerprints of the cannabis extracts patients are using. The idea is to try to link individual cannabis compounds to the patient response.

It is an approach that’s “two or three rungs down” from the ideal of randomised placebo-controlled clinical trials (RCTs), says Donald Abrams, an oncologist at the University of California, San Francisco, who prescribes cannabis as a palliative for patients with cancer. “But, if well done and there’s a strong effect, observational studies like these are invaluable.”

Israel is also one of the few places in the world pushing forward with gold-standard RCTs. But given that dozens of cannabis strains are already being used for a ballooning number of conditions, RCTs seem like a finger in the dyke.

Countries like Australia, where the federal government legalised medical cannabis in October 2016, are entering this brave new world with trepidation. “Because there has been no proper research, we’re now at a difficult crossroads,” says University of Melbourne pharmacologist James Angus, who chairs the federal government’s advisory council on the medical use of cannabis. “Our health workforce has no guidelines or experience in prescribing, and patients are demanding it. We’ve run out of time.”

The Promised Land may well be the world’s best bet for deliverance from the medical cannabis mess.

Anecdotes on the medical use of cannabis go back to mythical Chinese emperor Shen Neng in 2700 BCE. More piquant references can be found in ancient Roman, Greek and Indian texts. Or just google.

Thousands of years on from Shen Neng, it seems we still don’t have a great deal more than anecdotes to go on. As a report from the US National Academies of Science in January 2017 states: “Despite increased cannabis use and a changing state-level policy landscape, conclusive evidence regarding the short- and long-term health effects – both harms and benefits – of cannabis use remains elusive.”

While the medical uses of the opium poppy, a vastly more dangerous plant, are well understood, cannabis has remained stuck in a no man’s land. It had been part of the US pharmacopeia till the 1930s, as an alcohol-based tincture, until the federal government effectively outlawed its possession and sale through the Marijuana Tax Act. More draconian penalties followed. It is still demonised by federal law as a ‘Schedule 1’ drug with no medical use, lumped in the same category as heroin, LSD and ecstasy. Yet as a quick online search will show, the plant is lauded for a seemingly inexhaustible list of curative properties.

In the past two decades the disparity between evidence and anecdotes has grown extreme. Despite a majority of states (beginning with California in 1996) having legalised cannabis to treat medical conditions, federal restrictions on research remained ironclad. So researchers have great difficulty studying whether such medical uses have any basis in science. “What we have is a perfect storm,” says Daniele Piomelli, a neurobiologist at the University of California, Irvine.

Piomelli has been researching cannabis as best as he can. To comply with the mandates of the federal Drug Enforcement Agency (DEA), his precious store of 50 milligrams of THC must be kept in a locked safe, in a locked cool room, in a locked lab. “Any person on the street can go to a dispensary and for $10 obtain cannabis,” he says. “But if we bring it into the university we risk being raided by the FBI and DEA. We live in a schizophrenic state.”

Even when researchers have gained permission to do research, the cannabis can only be supplied by one authorised lab, at the University of Mississippi. The lab has been growing the same variety for decades, one that bears little resemblance to the chemovars now available through dispensaries.

In San Francisco, Abrams tried valiantly in the 1990s to set up a clinical trial to test the claims of dying AIDS patients that smoking weed outperformed their anti-nausea drugs. After more than a year trying to get permission from the National Institute on Drug Abuse, the penny finally dropped; the agency, as he often tells journalists, sees itself as the National Institute “on” Drug Abuse, not “for” Drug Abuse. So the January report of the National Academies of Science was hardly a surprise. The document, based on reviewing 10,000 publications, found “modest” evidence for the effectiveness of cannabis to treat nausea and vomiting in adults undergoing chemotherapy, for chronic pain, and to alleviate spasms in multiple sclerosis. It did not, however, deliver a verdict for a long list of illnesses including epilepsy, inflammatory bowel disease, Parkinson’s Disease, post-traumatic stress, anxiety, insomnia and cancer. “For these conditions, the report states, “there is inadequate information to assess their effects.”

But bits of information are trickling through. In May, a report in the New England Journal of Medicine offered evidence that an oily, strawberry-flavoured formulation of pure cannabidiol (made by British company GW Pharmaceuticals) could reduce the severity of seizures in children with a rare form of epilepsy known as Dravet’s syndrome. Of the 120 youngsters recruited, 60 received cannabidiol and 60 received only a strawberry-flavoured oil, the placebo. Three of the treated group achieved complete remission from their seizures while in 40% of those treated, the frequency of seizures was reduced by half. But 27% of the placebo group also saw a halving in their seizure rate and there were significant side effects amongst the treated group. “It’s not a magical drug”, explains Ingrid Scheffer, a paediatric neurologist at the University of Melbourne and co-author of the study. But she points out the sometimes exasperated parents of her patients have a different view. “The attitude is, ‘it’s obvious you fuddy duddy, just give it to us’.”

Most of the 400 pages in the hefty NAS tome report on the adverse effects of cannabis, like a raised risk of schizophrenia or road accidents or chronic cough. This, says Piomelli, reflects what researchers obtained funding for: “There is a bias towards the null hypothesis – that cannabis causes harm.” Those harms exist, he agrees. “But society is asking for answers about its benefits, and that’s not a question that researchers have been able to answer.”

Israel staked its claim in the field of cannabis research back in the 1960s. It was the beginning of the pot-smoking hippy revolution. But no one actually knew what the psychoactive ingredient of pot was.

Raphael Mechoulam, a chemist at the Hebrew University of Jerusalem, saw an opportunity. In 1964 he was the first to link pot’s mind-altering effects to THC. His research flourished in a regulated but permissive environment: his chief source of cannabis was the local police station. His group also isolated the natural equivalents of cannabis made by the brain, using pigs (with great difficulty, given the researchers were in Jerusalem). In 1992 they identified anandamide, the so-called bliss molecule, and in 1995 its more prosaically named partner, 2-arachidonoyl glycerol or 2 AG. These brain-made counterparts of THC are known as endocannabinoids.

Meanwhile the Israeli public began to clamour for medical cannabis. Just as in San Francisco, the AIDS epidemic had put medical cannabis on the radar. Mirroring the experience of Donald Abrams, immunologist Zvi Bentwich also witnessed the anti-nausea and pain-relieving effects that smoking cannabis had on his AIDS patients. While anti-retroviral drugs would mercifully bring the raging AIDS epidemic in both countries under control, the clamour for the palliative use of cannabis by cancer patients grew, aided by the internet.

Israel’s government obliged but with strict regulation. Patients, supported by a letter from a physician, could obtain a medical cannabis permit from the ministry of health. Growers needed a licence. One of the first companies to gain one, in 2007, was Tikun Olam. As patient numbers grew, it began to collect information about their responses. In 2015 Bentwich, who also heads the Centre for Emerging Tropical Diseases and AIDS at Ben Gurion University, joined Tikun Olam to lead a formal clinical trials program. “If the medical community is to accept cannabis, that depends on carrying out large reliable clinical trials,” he says. “In the US, as well as in most European countries, that is still extremely difficult.”

So far Israel is leading the pack. It is the only country, for instance, to have published the results of a randomised double blind study on the use of cannabis by Crohn’s disease patients. Timna Naftali, a gastroenterologist at Meir Medical Centre, carried out the trial after discovering several patients were self-medicating with cannabis. “They had reduced their medication and not suffered flare ups,” she says. “It was very intriguing.”

In her trial, 21 patients were assigned randomly to a group that smoked THC-rich cannabis cigarettes twice a day for eight weeks or to a group that smoked cannabis free of THC and other cannabinoids. The results, published in Clinical Gastroenterology and Hepatology, showed that in 10 of 11 patients with Crohn’s disease who smoked the THC-rich cigarettes, there were “significant clinical benefits”. One criticism was that perhaps patients merely felt better due to the euphoric effects of cannabis, so Naftali is repeating the trial, leaving it to an endoscopist to decide. This time 50 patients are receiving an oil, containing a 4:1 ratio of cannabidiol to THC. “As a doctor, I’m not happy about telling patients to smoke,” Naftali says. Another trial that tested a pure extract of cannabidiol was ineffective. “Perhaps it was the low dose,” Naftali muses. “There’s also a claim you have to have it in combination.” Perhaps it is a case of what Mechoulam has dubbed the “entourage effect” – the consequence of a mysterious biological synergy between cannabis compounds.

Another world-first trial under way in Israel is testing the effects of cannabis on youngsters with autism. Given cannabis can trigger psychotic behaviour, it is surprising to think it would be a candidate for a condition where psychotic behaviour is often part of the problem. But a third of autistic children also suffer from seizures.

When paediatric neurologist Adi Aran, at Jerusalem’s Shaare Zedek Medical Centre, prescribed cannabis for the seizures of autistic children, their parents reported dramatic results. Children who never spoke began speaking, and writing for the first time. To verify these anecdotal results, he is running a trial on 120 youngsters, aged 5 to 21 years. Some receive whole cannabis oil containing, amongst other things, a 20:1 ratio of cannabidiol to THC; others receive a purified extract containing only cannabidiol and THC; a final group receive a placebo, an identically flavoured oil. All will undergo a ‘washout’ period, where they are gradually weaned off their oil.

In principle, most doctors would like to see the results of numerous such trials before prescribing cannabis. However, parents like Abigail Dar disagree with this approach. “A parent like me with a complicated child doesn’t have the luxury of principles,” she says. Her son, Yuval, now in his early twenties, is severely autistic, and was once so prone to violent outbreaks she could not be alone with him. “Yuval tried over a dozen anti-psychotic medications since he was 12 years old to treat symptoms

like endless anxiety, restlessness, violent outbreaks or, as we call it, ‘life in the shadow of hell’. They only made him more agitated and aggressive.”

Dar managed to get a medical cannabis prescription for Yuval in 2015. Though autism did not count as one of Israel’s qualifying conditions, the health ministry finally granted permission as a ‘mercy treatment’. “It was a life-changer from the very first day,” according to Dar. “He hasn’t exhibited a single self-injurious behaviour or outburst in the last 14 months. He is calmer, more attentive and communicative. He smiles more.”

Dar has carried out her own careful experimentation for what works for her son, using chemovars that vary in their CBD-to-THC ratio. As far as she is concerned, placing Yuval in a randomised, placebo-controlled, washout trial would be immoral. “With suffering kids you don’t take it away,” she says. “I tell parents to stay away; it’s not in favour of kids.”

Instead, through a collaboration with Meiri’s lab, she is pushing to gather the data already being generated. “We have 200 kids and adults with severe autism we are guiding through strains and dosages to find out what works. We track them with questionnaires: we look at things like violent outbreaks, sleep and appetite. The idea eventually is to go global. It will give us some small amount of knowledge on how to treat autism.”

It’s not just desperate cases like Dar that make cannabis a poor fit for the box of a RCT. Abrams sees no need for more trials when it comes to treating pain or nausea in patients with cancer. Nor is he alarmed by the range of products sold in dispensaries. “I don’t consider it to be that dangerous, compared to the pharmaceutical agents we already prescribe,” he says. “I have many patients that were weaned off opiates thanks to cannabis.” He points out that in the US, 90 people die each day from overdoses of opiates, in many cases prescribed to treat chronic pain [LINK: https://www.cdc.gov/drugoverdose/epidemic/index.html].

Mieri never imagined his CV would one day include heading a laboratory for cannabis research. In early 2015, after four years at the Ontario Cancer Institute, he was all set to return to cancer research.

Then he noticed a curious publication from a Japanese research group that reported a cannabis extract blocked the ability of human breast cancer cells to spread in a culture dish. What pricked Meiri’s interest was that the extracts appeared to be scrambling the cell’s internal scaffolding – his particular area of expertise.

Meiri repeated the experiment on different types of cancer cells. He found the cannabis extract was just as potent as some chemotherapy drugs. But it was another finding that really captured his interest: the effectiveness of the extract depended on the cannabis variety and the grower.

As the son of a strawberry farmer, he understood exactly what he was seeing. “Strawberries taste different in the morning and afternoon,” he explains. He was seeing the effects of a cocktail of different chemicals.

Which of these chemicals were responsible for the anti-cancer effect? To find out, Meiri bought a machine for high-performance liquid chromatography, a technique to separate and identify parts of a mixture. Soon he was a de facto guru. A grant from a philanthropist in 2016 marked a point of no return.

‘The plural of anecdote is not data’ is an oft-quoted medical aphorism. But anecdotes can’t be ignored either. Meiri is acquiring quite a collection. On one occasion, he was contacted by the father of a seven-year-old whose seizures had returned after being free of them for nearly a year. The father, wanting to know why the oil had stopped working, sent samples to Meiri. When the scientist analysed them, he found they were just olive oil. “It was a data point,” he says, “showing that the effects of cannabis extract were real.”

Then there was the disastrous day he learned that several autistic kids taking cannabis oil had gone berserk. “Tali, we have a situation,” he recalls telling the head of the project. All the extracts the children were taking had the same 20:1 ratio of CBD to THC. But looking at the chemical profiles, it was clear the offending medication carried at least five different compounds. “It doesn’t provide the answers,” he says. “It shows where to begin searching.”

There is no simple way out of the cannabis mess. With much of the world clamouring to use cannabis as a cure for all manner of ailments, and an exploding cannabis industry that is happy to push that demand along, it is crucial to establish just how real its clinical benefits and harms are – especially for children.

The medical establishment ideally needs randomised clinical trials, such as those Israel is admirably pushing ahead with. “I would say the Israelis have taken the lead,” Abrams says.

But 30,000 users in Israel and millions in the US aren’t waiting for such results. Some, like Abigail Dar, are too desperate. Others are wedded to their own trial-and-error experiments with different chemovars.

Another complicating factor is that the diabolically complex chemistry of the cannabis plant is too overwhelming to sort out through individual RCTs. Researchers are still scratching at the surface of a potential treasure trove of medicines that appear to act synergistically. The list of conditions to try them against appears never-ending. The number of trials needed to test each combination against each condition seems mindboggling.

The database collated by Meiri and his clinical collaborators is now being prepared for publication. It should help link the pot-pourri of chemicals inside cannabis to its clinical effects. It may be second-tier science, but it appears to be one of the best strategies for navigating a path out of the haze that still envelops medical cannabis.

Conflict of interest statement. Elizabeth Finkel is a member of the scientific advisory board of AUSiMED, which raises funds to support scientific collaborations between Australia and Israel.

Source: Cosmos 76 – Spring 2017

“No One Has Died of an Overdose”

This remains the most outrageous claim of the pro-legalization movement. It is not only dangerously misleading, it is a slap in the face to the families who have lost children, spouses and parents. Everyone admits that people are dying in traffic crashes because of stoned drivers, and that some people have died in butane hash oil explosions, but too many people are turning a blind eye to the other deaths caused by what can only be called an overdose. Tachycardia – a racing heart – is a common, well-known side effect of using marijuana. So is increased blood pressure. A growing body of evidence, here and in other countries, is revealing that marijuana has caused previously overlooked deaths through heart attack and stroke. In Colorado last fall, an 11-month-old infant brought to the ER after being exposed to marijuana died from an inflamed heart muscle (myocarditis) caused by the exposure.

Marijuana can also overwhelm the emotional centers of the brain causing paranoia, delusions, and acute psychosis. The National Academy of Sciences (NAS) report released last January states, “There is substantial evidence of a statistical association between cannabis use and the development of schizophrenia or other psychoses, with the highest risk among the most frequent users.” (The Health Effects of Cannabis and Cannabinoids, Chapter Highlights NAS 2017)

Emergency rooms in Colorado reported a 44 percent increase in marijuana-related visits between 2012 and 2014. Many of these were cases of acute psychosis, particularly in young men, who had to be restrained to keep from harming themselves or others.

Other evidence of marijuana overdose

A growing body of evidence indicates that marijuana is not just associated with suicide but can be a causative factor. The NAS report cited above found an “Increased incidence of suicidal ideation and suicide attempts with a higher incidence among heavier users” and an “Increased incidence of suicide completion.” One of the studies they listed found a seven-fold increase in risk for suicide even after controlling for a prior history of mood disorders.

In 2014, a young man in Colorado either jumped or unwittingly tumbled to his death from a fourth-floor balcony during a psychotic outburst. In July this year, a Vermont father clutching his son to his chest jumped out of a fourth-floor window shortly after smoking marijuana. He said it was God who made him jump.

When a drug drives all sense of reality from your brain, it’s an overdose. In marijuana’s case, these overdoses can and do lead to death.

Dean Whitlock is a freelance writer whose book, Finn’s Clock, a historical fantasy will be coming this fall in paperback. www.deanwhitlock.com.Read the full article in Vermont Digger. Also read why Vermont physicians propose caution with legalization.

Source: http://www.poppot.org/2017/10/18/truth-deaths-by-marijuana-overdose/

Washington’s pot is a bit more potent than the national average. And the state’s teens are more likely to smoke marijuana than young people nationwide.

Although we have the same problems with marijuana as we do with liquor abuse, no blockbuster conclusions came from a recent report on Washington’s marijuana universe.

But a couple of somewhat unexpected environmental wrinkles from Washington’s marijuana industry — both legal and illegal — also emerge in the second annual look at the state’s experience since passage of a 2012 initiative allowing recreational pot sales.

Marijuana growers and processors use 1.63 percent of the state’s electricity, which is a lot, according to the report by the Northwest High Intensity Drug Trafficking Area — a combined effort by several federal, state and local government agencies. By way of comparison, all forms of lighting — in homes, commercial buildings and manufacturing — account for just 7 to 11 percent of electrical consumption nationally. Or, as the report puts it, the power is enough for 2 million homes.

The high power consumption stems from the heat lamps and the accompanying air conditioning for indoor marijuana growing operations. “They are exceedingly energy-consumptive,” said Steven Freng, manager for prevention and treatment for the High Intensity Drug Trafficking Area.

The carbon footprint, according to the report, equals that of about 3 million cars.

And illegal pot growers siphoned off 43.2 million gallons of water from streams and aquifers during the 2016 growing season — water that tribes, farmers and cities would otherwise use as carefully as possible, in part to protect salmon.

Sixty percent of Washington’s illegal pot was grown on state-owned land in 2016. That’s because black-market growers tend to worry about gun-toting owners on private lands, according to Freng and Luci McKean, the organization’s deputy director. The black-market operations use the water during a roughly 120-day growing season.

Marijuana purchases have boomed in Washington. Legal marijuana sales were almost $1 billion in fiscal year 2016 and were on track to be about $1.5 billion in fiscal 2017, which ended June 30. As of February, the state had 1,121 licensed producers, 1,106 licensed processors and 470 licensed retailers.

What Washington’s marijuana users are getting is above average in potency. According to the report, nationwide marijuana products average a THC percentage of 13.2 percent, while Washington state’s THC average percentage was 21.6 percent.

Teen use of marijuana has grown slightly. Depending on how the numbers are crunched, marijuana use among Washington’s young adults and teens ranges from 2 to 5 percent above the national average. Five percent of Washingtonians age 18-to-25 use pot daily, slightly above the national average, the report said.

According to a survey cited in the report, 17 percent of high school seniors and 9 percent of high school sophomores have driven within three hours after smoking pot.

Adult use before driving is still a fuzzy picture. A third of Washingtonians arrested for driving under the influence had THC, the active ingredient in marijuana, in their bloodstreams. One study found an increase in dead drivers with THC above the legal limit in their blood from 7.8 percent in 2013 to 12.8 percent in 2014.

“Adults still don’t understand the effects of impairment behind the wheel of a car,” Freng said.

McKean said that one major unknown is marijuana-laced edibles, which authorities believe have become a significant factor in THC-impaired drivers, but has not been studied enough to provide solid numbers.

Another major unknown, McKean and Freng said, is how marijuana consumption contributes to emergency room and hospital cases because the state hospitals have not agreed to release that data to government officials.

Source: http://crosscut.com/2017/10/washingtons-pot-industry-not-environmentally-friendly-marijuana/

Legalising marijuana can lead to increased use of the drug, according to a French study that looked at consumption levels in two US states and Uruguay in the midst of a debate over France’s narcotics laws.

The study conducted by France’s National Institute of Higher Security and Justice Studies and the French Observatory for Drugs and Drug Addiction examined data from Washington and Colorado, which in 2012 became the first two US states to legalise marijuana for recreational use.

Like several US studies on the subject it noted that legalisation in the states had not increased marijuana use among teenagers, “which nonetheless remains at a high level.”

Among adults, however, marijuana use had increased, particularly among over-25s, the French researchers found.

But in Uruguay, which in July became the first country to legalise marijuana nationwide, “all the indicators of use have risen”, including among teens, the study showed.

In the two American states, the legalisation had led to a “significant” increase in the number of people admitted to hospital with suspected cannabis poisoning, particularly tourists, it added.

On the economic front, it found that sales of recreational marijuana in Colorado and Washington had steadily increased, reaching $1 billion a year in each case.

State tax receipts from the sales had surpassed taxes on cigarettes, the report said, while noting that legalisation had not stamped out marijuana trafficking.

In Uruguay, trafficking was driven by the huge gap between demand and legal production, which accounted for just 10 to 20 percent of marijuana use.

In the American states, by contrast, the black market was being fuelled by the higher cost of over-the-counter marijuana, the report concluded.

The researchers acknowledged, however, that legalisation of marijuana had eased the caseload of the police and judiciary.

In France, marijuana use is a crime punishable by up to a year in prison and a fine of 3,750 euros ($4,400). President Emmanuel Macron has proposed easing the penalty to an on-the-spot fine.

Source: https://medicalxpress.com/news/2017-10-legalising-marijuana-french.html

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 Jun 1;74(6):579-588. doi: 10.1001/jamapsychiatry.2017.0724.

For a long time, those in medicine and the law have been concerned about a link between cannabis and violence.

This has been largely dismissed by the pro-drugs lobby as an association, not proof of a cause. The difference is important to scientific enquiry, as revealed by a telling example given recently by Professor Robert Pickard, a former government advisor.

He says the rise in deaths of hedgehogs on the roads since the end of World War II mirrors the rise in television sales, but it would be daft to suggest that TVs are killing hedgehogs: it’s an association, not a cause.

The evidence linking cannabis and violent crime is compelling: regular use of the drug doubles the risk of a psychotic episode or schizophrenia. And time and again, courts hear how people have become psychotic after smoking cannabis and, in the grips of paranoia and delusions, have murdered someone. The gallery of victims should shame those in the liberal elite who insist there’s no definitive evidence of cause and effect.

But a new study has now provided just this. Researchers followed 1,100 patients for a year after discharge from a psychiatric hospital and those who used cannabis were two-and-a-half times more likely to be violent.

So now there’s clear proof of a causative link, have we witnessed a volte-face from the pro-cannabis lobby? Of course we haven’t, because it was never really about the science.

They want to smoke cannabis, and as soon as science brings doing this into question, they simply brush it aside. Particularly frustrating are the smug, ageing hippies who claim that because they’re still here, it must be fine. They look back on a youth spent smoking spliffs with pathetic, misplaced nostalgia, and fail to realise that, not only did plenty of people not make it through the Sixties and Seventies unscathed, but the super-strong cannabis of today is almost an entirely different product.

How many more lives must be ruined before the pro-drugs lobby admit they got it wrong?

Source: http://www.dailymail.co.uk/health/article-4957554/An-uncomfortable-truth-not-life-worth-living.html#ixzz4uppapuW9

Objective:

The authors sought to determine whether cannabis use is associated with a change in the risk of incident nonmedical prescription opioid use and opioid use disorder at 3-year follow-up.

Method:

The authors used logistic regression models to assess prospective associations between cannabis use at wave 1 (2001–2002) and nonmedical prescription opioid use and prescription opioid use disorder at wave 2 (2004–2005) of the National Epidemiologic Survey on Alcohol and Related Conditions. Corresponding analyses were performed among adults with moderate or more severe pain and with nonmedical opioid use at wave 1. Cannabis and prescription opioid use were measured with a structured interview (the Alcohol Use Disorder and Associated Disabilities Interview Schedule–DSM-IV version). Other covariates included age, sex, race/ethnicity, anxiety or mood disorders, family history of drug, alcohol, and behavioral problems, and, in opioid use disorder analyses, nonmedical opioid use.

Results:

In logistic regression models, cannabis use at wave 1 was associated with increased incident nonmedical prescription opioid use (odds ratio=5.78, 95% CI=4.23–7.90) and opioid use disorder (odds ratio=7.76, 95% CI=4.95–12.16) at wave 2. These associations remained significant after adjustment for background characteristics (nonmedical opioid use: adjusted odds ratio=2.62, 95% CI=1.86–3.69; opioid use disorder: adjusted odds ratio=2.18, 95% CI=1.14–4.14). Among adults with pain at wave 1, cannabis use was also associated with increased incident nonmedical opioid use (adjusted odds ratio=2.99, 95% CI=1.63–5.47) at wave 2; it was also associated with increased incident prescription opioid use disorder, although the association fell short of significance (adjusted odds ratio=2.14, 95% CI=0.95–4.83). Among adults with nonmedical opioid use at wave 1, cannabis use was also associated with an increase in nonmedical opioid use (adjusted odds ratio=3.13, 95% CI=1.19–8.23).

Conclusions:

Cannabis use appears to increase rather than decrease the risk of developing nonmedical prescription opioid use and opioid use disorder.

Source: http://ajp.psychiatryonline.org/doi/abs/10.1176/appi.ajp.2017.17040413

NEW REPORT BY NATIONAL FAMILIES IN ACTION RIPS THE VEIL OFF THE MEDICAL MARIJUANA INDUSTRY

Research Traces the Money Trail and Reveals the Motivation Behind Marijuana as Medicine

  • Tracking the Money That’s Legalizing Marijuana and Why It Matters documents state-by-state financial data, exposing the groups and the amount of money used either to fund or oppose ballot initiatives legalizing medical or recreational marijuana in 16 U.S. states.
  •  NFIA report reveals three billionaires—George Soros, Peter Lewis and John Sperling—who contributed 80 percent of the money to medicalize marijuana through state ballot initiatives during a 13-year period, with the strategy to use medical marijuana as a runway to legalized recreational pot.
  •  Report shows how billionaires and marijuana legalizers manipulated the ballot initiative process, outspent the people who opposed marijuana and convinced voters that marijuana is medicine, even while most of the scientific and medical communities say marijuana is not medicine and should not be legal.
  •  Children in Colorado treated with unregulated cannabis oil have had severe dystonic reactions, other movement disorders, developmental regression, intractable vomiting and worsening seizures.
  •  A medical marijuana industry has emerged to join the billionaires in financing initiatives to legalize recreational pot.

Atlanta, Ga. (March 14, 2017)—A new report by National Families in Action (NFIA) uncovers and documents how three billionaires, who favour legal recreational marijuana, manipulated the ballot initiative process in 16 U.S. states for more than a decade, convincing voters to legalize medical marijuana. NFIA is an Atlanta-based nonprofit organization, founded in 1977, that has been helping parents prevent children from using alcohol, tobacco, and other drugs. NFIA researched and issued the paper to mark its 40th anniversary.

The NFIA study, Tracking the Money That’s Legalizing Marijuana and Why It Matters, exposes, for the first time, the money trail behind the marijuana legalization effort during a 13-year period. The report lays bare the strategy to use medical marijuana as a runway to legalized recreational pot, describing how financier George Soros, insurance magnate Peter Lewis, and for-profit education baron John Sperling (and groups they and their families fund) systematically chipped away at resistance to marijuana while denying that full legalization was their goal.

The report documents state-by-state financial data, identifying the groups and the amount of money used either to fund or oppose ballot initiatives legalizing medical or recreational marijuana in 16 states. The paper unearths how legalizers fleeced voters and outspent—sometimes by hundreds of times—the people who opposed marijuana.

Tracking the Money That’s Legalizing Marijuana and Why It Matters illustrates that legalizers lied about the health benefits of marijuana, preyed on the hopes of sick people, flouted scientific evidence and advice from the medical community and gutted consumer protections against unsafe, ineffective drugs. And, it proves that once the billionaires achieved their goal of legalizing recreational marijuana (in Colorado and Washington in 2012), they virtually stopped financing medical pot ballot initiatives and switched to financing recreational pot. In 2014 and 2016, they donated $44 million to legalize recreational pot in Alaska, Oregon, California, Arizona, Nevada, Massachusetts and Maine. Only Arizona defeated the onslaught (for recreational marijuana).

Unravelling the Legalization Strategy: Behind the Curtain In 1992, financier George Soros contributed an estimated $15 million to several groups he advised to stop advocating for outright legalization and start working toward what he called more winnable issues such as medical marijuana.

At a press conference in 1993, Richard Cowen, then-director of the National Organization for the Reform of Marijuana Laws, said, “The key to it [full legalization] is medical access. Because, once you have hundreds of thousands of people using marijuana medically, under medical supervision, the whole scam is going to be blown. The consensus here is that medical marijuana is our strongest suit. It is our point of leverage which will move us toward the legalization of marijuana for personal use.”

Between 1996 and 2009, Soros, Lewis and Sperling contributed 80 percent of the money to medicalize marijuana through state ballot initiatives. Their financial contributions, exceeding $15.7 million (of the $19.5 million total funding), enabled their groups to lie to voters in advertising campaigns, cover up marijuana’s harmful effects, and portray pot as medicine—leading people to believe that the drug is safe and should be legal for any use.

Today, polls show how successful the billionaires and their money have been. In 28 U.S. states and the District of Columbia, voters and, later, legislators have shown they believe marijuana is medicine, even though most of the scientific and medical communities say marijuana is not medicine and should not be legal. While the most recent report, issued by the National Academies of Sciences (NAS), finds that marijuana may alleviate certain kinds of pain, it also finds there is no rigorous, medically acceptable documentation that marijuana is effective in treating any other illness. At the same time, science offers irrefutable evidence that marijuana is addictive, harmful and can hinder brain development in adolescents. At the distribution level, there are no controls on the people who sell to consumers. Budtenders (marijuana bartenders) have no medical or pharmaceutical training or qualifications.

One tactic used by legalizers was taking advantage of voter empathy for sick people, along with the confusion about science and how the FDA approves drugs. A positive finding in a test tube or petri dish is merely a first step in a long, rigorous process leading to scientific consensus about the efficacy of a drug. Scientific proof comes after randomized, controlled clinical trials, and many drugs with promising early stage results never make it through the complex sets of hurdles that prove efficacy and safety. But marijuana legalizers use early promise and thin science to persuade and manipulate empathetic legislators and voters into buying the spin that marijuana is a cure-all.

People who are sick already have access to two FDA-approved drugs, Dronabinol and Nabilone, that are not marijuana, but contain identical copies of some of the components of marijuana. These drugs, available as pills, effectively treat chemotherapy-induced nausea and vomiting and AIDS wasting. The NAS reviewed 10,700 abstracts of marijuana studies conducted since 1999, finding that these two oral drugs are effective in adults for the conditions described above. An extract containing two marijuana chemicals that is approved in other countries, reduces spasticity caused by multiple sclerosis. But there is no evidence that marijuana treats other diseases, including epilepsy and most of the other medical conditions the states have legalized marijuana to treat. These conditions range from Amyotrophic lateral sclerosis (ALS) and Crohn’s disease to Hepatitis-C, post-traumatic stress disorder (PTSD) and even sickle cell disease.

Not So Fast – What about the Regulations?

Legalizers also have convinced Americans that unregulated cannabidiol, a marijuana component branded as cannabis oil, CBD, or Charlotte’s Web, cures intractable seizures in children with epilepsy, and polls show some 90 percent of Americans want medical marijuana legalized, particularly for these sick children. In Colorado, the American Epilepsy Society reports that children with epilepsy are receiving unregulated, highly variable artisanal preparations of cannabis oil recommended, in most cases, by doctors with no training in paediatrics, neurology or epilepsy. Young patients have had severe dystonic reactions and other movement disorders, developmental regression, intractable vomiting and worsening seizures that can be so severe that their physicians have to put the child into a coma to get the seizures to stop. Because of these dangerous side effects, not one paediatric neurologist in Colorado, where unregulated cannabidiol is legal, recommends it for these children.

Dr. Sanjay Gupta further clouded the issue when he produced Weed in 2013, a three-part documentary series for CNN on marijuana as medicine. In all three programs, Dr. Gupta promoted CBD oil, the kind the American Epilepsy Society calls artisanal. This is because not one CBD product sold in legal states has been purified to Food and Drug Administration (FDA) standards, tested, or proven safe and effective. The U.S. Congress and the FDA developed rigid processes to review drugs and prevent medical tragedies such as birth defects caused by thalidomide. These processes have facilitated the greatest advances in medicine in history.

“By end-running the FDA, three billionaires have been willing to wreck the drug approval process that has protected Americans from unsafe, ineffective drugs for more than a century,” said Sue Rusche, president and CEO of National Families in Action and author of the report. “Unsubstantiated claims for the curative powers of marijuana abound.” No one can be sure of the purity, content, side effects or potential of medical marijuana to cause cancer or any other disease. When people get sick from medical marijuana, there are no uniform mechanisms to recall products causing the harm. Some pot medicines contain no active ingredients. Others contain contaminants. “Sick people, especially children, suffer while marijuana medicine men make money at their expense,” added Ms. Rusche.

Marijuana Industry – Taking a Page from the Tobacco Industry The paper draws a parallel between the marijuana and tobacco industries, both built with the knowledge that a certain percentage of users will become addicted and guaranteed lifetime customers. Like tobacco, legalized marijuana will produce an unprecedented array of new health, safety and financial consequences to Americans and their children.

“Americans learned the hard way about the tragic effects of tobacco and the deceptive practices of the tobacco industry. Making another addictive drug legal unleashes a commercial business that is unable to resist the opportunity to make billions of dollars on the back of human suffering, unattained life goals, disease, and death,” said Ms. Rusche. “If people genuinely understood that marijuana can cause cognitive, safety and mental health problems, is addictive, and that addiction rates may be three times higher than reported, neither voters nor legislators would legalize pot.” NDPA recommends readers to read the whole report Tracking the Money That’s Legalizing Marijuana and Why It Matters

Source: www.nationalfamilies.org. 2017

· Trials on mice found THC – which causes the ‘high’ in weed, can induce seizures

· The same was shown for JWH-018 – the main part of the synthetic cannabis spice

· Japanese researchers have described their findings are being ‘quite important’

· Skunk, made mostly of THC, dominates the illegal British market of marijuana

Smoking super-strength cannabis or spice may trigger life-threatening seizures, researchers have warned.

Trials on mice showed seizures can be induced by both THC – which causes the ‘high’ in marijuana, and JWH-018 – the main component of spice. The rodents also suffered from a shortness of breath and impaired walking after being given both compounds, the scientists discovered.

Japanese researchers warned the results should act as a wake-up call, given how widely high-potency and synthetic weed is used.

The findings contradicts pro-cannabis campaigners who have long argued that cannabis can help to tackle seizures and highlighted research which shows weed can prevent and control seizures in epileptic patients.

However, lead researcher Dr Olga Malyshevskaya, based at the University of Tsukuba, said the latest findings show cannabis is not a soft drug and warned of its dangers.

She said: ‘Our study is quite important. Unaware of the particularly severe effect by those cannabinoids, people see marijuana as a soft drug, without dangerous health effects.’

She added: ‘It is critically important for health-care professionals and policy makers to be aware of the serious adverse effects, as shown in this report. Clinicians in the emergency departments should always suspect seizure activity in patients who have a history of cannabinoid intoxication.

WHAT IS THC?

THC is found in all forms of cannabis, but is abundant in skunk – a super-strength form of the drug that dominates Britain’s illegal market.

Some 80 per cent of what is available on the streets is believed to be skunk, which is created by growers aiming to make the most potent strain of the drug possible in order to maximise their profits.

They remove high amounts of CBD from the plant, allowing the modified herb to contain only THC. It is unsure how much THC was in the strain of cannabis used in the new study.

Over the years, a host of previous research has pointed to a link between the popular recreational drug and mental health conditions. Last October, University College London researchers found that skunk may be twice as addictive as normal strains of cannabis.

Similar health concerns have been raised about synthetic cannabis spice, which can slump users and turn them into ‘zombies’.

It was previously known as a legal high before it was banned last year following a surge in its use. Now it has reached epidemic levels in prison.

‘The number of clinical cases involving marijuana intoxication has been steadily increasing due to increase in cannabis potency over the last two decades.’

What do other experts think?

Ian Hamilton, a cannabis researcher at York University, cautioned the results, which are published in Scientific Reports.

He told MailOnline: ‘We don’t know if people who use cannabis are using something as potent as this.’ For the study, researchers measured the brain activity of the mice after giving them both compounds and recorded them.

Research that claims to show cannabis can control seizures

The findings contradict a body of research which shows weed can prevent and control seizures in epileptic patients. Campaigners have long argued that cannabis has the opposite effect to the new findings and can help to tackle seizures.

Researchers have previously suggested that CBD – the other compound in cannabis which produces no ‘high’, binds to a receptor in the brain that calms down the electrical activity in the brain which causes a seizure.

First Briton to be prescribed liquid cannabis oil on the NHS

Their case was strengthened when an 11-year-old on the brink of death from a severe form of epilepsy made an ‘incredible’ recovery from taking marijuana.

Billy Caldwell, from Castlederg, Northern Ireland, made headlines in April when he became the first Briton to be prescribed such a drug on the NHS.

And 10 months since he was first given the liquid cannabis oil, he hasn’t had any seizures. He used to suffer up to 100 a day.

THE MAN WHO SUFFERS SEIZURES FROM SYNTHETIC CANNABIS

The news comes just a week after DailyMail.com reported on a disturbing video which shows a man from Des Moines, Iowa, having a seizure as an effect of years smoking synthetic marijuana.

Coby O’Brien-Emerick, 27, has experienced chronic seizures every three months for the past five years, putting him in the hospital for weeks on end.

In the video uploaded in December, Coby is seen on the floor convulsing for about nine minutes while paramedics are being called.

The father-of-two told Dailymail.com he asked for his seizure to be recorded in order to understand the severity of it.

The video was posted to YouTube by his mother-in-law to warn others about the dangerous effects of smoking synthetic marijuana .

Source: http://www.dailymail.co.uk/health/article-4917100/Smoking-super-strength-cannabis-trigger-seizures.html 26 Sept. 2017

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 Maryl