National Treatment Agency for Substance Misuse. [UK] National Treatment Agency for Substance Misuse, 2013.

More problem drinkers started specialist treatment in 2010/12 but more successfully completed it, slightly reducing the overall numbers; scope for more to benefit from treatment is indicated by the low levels of referrals from primary medical services. Summary The featured report presents and comments on data from the National Drug Treatment Monitoring System on people who have received specialist treatment for alcohol problems in England between 1 April 2011 and 31 March 2012. This account occasionally draws figures from the data source as well as the featured report.

Main findings

Compared to last year, this year’s statistics show a slight decrease in the number in treatment from 111,025 in 2010/11 to 108,906 in 2011/12, a slight increase in new entrants, and more successfully completing treatment.

The drop in the total is not due to fewer people finding their way to services. New presentations tell a different story, up each year since the statistics were collected from 67,912 in 2008/09 to 74,353 in 2011/12. Instead the drop is due to successful completions rising steadily from 26,270 in 2008/09 to 38,174 in 2011/12 chart. In contrast, the proportion of people dropping out of treatment has fallen to 28% of all those leaving, down from 30% in 2010/11, 33% in 2009/10 and 29% in 2008/09.

In 2011/12, 70% of all people in alcohol treatment were aged 30 to 54 and nearly two-thirds (64%) were men.

People starting specialist treatment came via a number of routes. At 38%, self-referral was most common. Next at 19% was referral from primary care surgeries, but the 14,330 who came this way does not seem an especially high figure given that around one in five people seeing a GP drinks above lower-risk levels. Referrals from hospital accident and emergency departments accounted for just 1% or 872 patients, again seemingly small when an estimated 35% of emergency attendances are alcohol-related. Employment services successfully referred just 177 people.

About half (51%) of all people in treatment in 2011/12 for harmful drinking and alcohol dependency had received a structured psychosocial intervention, normally consisting of

‘talking therapies’ such as cognitive-behavioural therapy, which helps them understand and then change their attitudes and behaviour towards alcohol. Just over 1 in 10 (11%) were prescribed medications to help them detoxify or prevent relapse, 1 in 10 were admitted as inpatients, 9% attended structured day care services, and 4% a residential service.

66,894 people left treatment during 2011/12, 38,174 or 57% because they had successfully completed it. Of these successful completers, 58% were not drinking at all, the remainder drinking in a controlled way. Though 28% of leavers dropped out or left early, some may have done so because they had got all they needed from treatment; others will have failed to make progress. After rising from 2008/09 to 2009/10, numbers dropping out of treatment have since fallen by 10%.

The authors’ conclusions

While long-term trends have yet to emerge, a picture of the alcohol treatment system in England and its performance is beginning to form and will become clearer over the next few years as the bank of data accumulates and the reporting system itself settles further. Latest figures show that while more people came into treatment for alcohol problems during the year, even more got better over the same time, meaning the total number in treatment fell. The declining drop-out rate suggests that services have got better at engaging and holding on to people who need help for an alcohol problem.

Low numbers successfully referred in to specialist treatment by GPs and accident and emergency departments suggest that an aim for the coming years is that these two key routes will become more active in identifying and referring drinkers who need treatment. To meet the challenges ahead we must take every opportunity to identify alcohol misuse and ensure that services are in place in all areas to provide appropriate, evidence-based treatment for those who need it.

Source: editor@findings.org.uk 12.02.13

It is not surprising to see the outrage from the Colorado Pot Cartel and its many customers upon hearing the news that I am again running legislation addressing driving under the influence of drugs per se in our state. What is surprising is the naiveté of the industry thinking that the defeat of my legislation last session would somehow silence the issue. Studies on the effects of THC indicate that if a driver has greater than 1 nanogram/ml, they are impaired. In fact, if a driver has between 2 and 5 nanograms/ml in their system, even if they are a chronic user, they are six to seven times more likely to crash than a sober driver. While chronic users can compensate for some effects, they can never fully compensate for all effects of THC while driving. Marijuana users driving a motor vehicle on the streets and highways of Colorado while under the influence of THC are a clear and present danger to the innocent traveling public. The number of marijuana-impaired drivers who caused fatal crashes more than doubled from 2.9 percent to 7 percent between 2006 and 2010. In 53 percent of fatal crashes caused by an impaired driver, the driver tested positive for cannabis. Steven Ryan was convicted of DUI vehicular homicide for the 2010 deaths of a mother and her 2-week-old child in Aurora. Ryan had 4 nanograms of THC and no other substances in his system. The smoke and mirrors used by the Colorado Pot Cartel to put citizens at risk for another year in 2011 will not stand the focus of the legislature in 2012. There are 14 states that have some form of a per se DUI law for marijuana. Thirteen of those states have a zero-tolerance law. Two of the 14 only have a zero-tolerance law for people under 21. And two of the 14 states have a per se limit of 2 nanograms of THC in whole blood (not plasma). I predict that with the realization of the lives at risk from this true public safety threat, the Colorado Senate will pass this legislation unanimously.

http://www.denverpost.com/opinion/ci_19838120?source=pkg#ixzz2KiE7kAEA 01/30/2012

Abstract

Objectives To determine the prevalence of recent alcohol, nicotine or cannabis use in young persons presenting for mental healthcare.

Design A cross-sectional study of young people seeking mental healthcare completed self-report questionnaires regarding their use of alcohol, nicotine or cannabis.

Setting Data were collected from two sites as part of the national headspace services programme.

Participants 2122 young people aged 12–30 years provided information as part of a patient register; a subset of N=522 participants also provided more detailed information about their patterns of alcohol use.

Outcome measures Prevalence levels of recent alcohol, nicotine or cannabis use within relevant age bands (12–17, 18–19 and 20–30) or primary diagnostic categories.

Results The rates for use at least weekly of alcohol for the three age bands were 12%, 39% and 45%, and for cannabis 7%, 14% and 18%, respectively. The rates of daily nicotine use for the three age bands were 23%, 36% and 41%. The pattern of alcohol use was characterised by few abstainers as well as many risky drinkers. Age of onset across all three substances was approximately 15 years. Individuals who used any of the three substances more frequently were likely to be older, male or have psychotic or bipolar disorders.

Conclusions Frequent use of alcohol, nicotine or cannabis in young people seeking mental healthcare is common. Given the restricted legal access, the patterns of use in those aged 12–17 years are particularly notable. Reductions in substance use needs to be prioritised within services for at-risk young people.

Source: BMJ Open 2013;3:e002229 doi:10.1136/bmjopen-2012-002229

Marijuana is the most commonly used illicit drug in the United States, taken by 7 percent of Americans according to a 2012 government survey.

The drug is illegal in the United States on a federal level, however, Washington and Colorado became the first states to pass laws legalizing recreational pot use last November. Eighteen states plus the District of Columbia also have laws permitting the use of medical marijuana.

In what they call the first case-controlled study to find a link between marijuana use and strokes, researchers enlisted 150 patients who had an ischemic stroke and 10 who had a transient ischemic attack (TIA).

Strokes, or brain attacks, are caused by disruptions of blood flow to the brain. About 85 percent of strokes are ischemic, meaning they are caused by blood clots or plaque deposits in linings of blood vessels that stop blood flow to the brain. That’s different from a less-common hemorrhagic stroke that occurs when a blood vessel in the brain bursts. Symptoms of strokes include severe headache, sudden numbness or weakness of the face or limbs, sudden confusion or trouble speaking, vision problems, dizziness and loss of coordination.

People may also experience a TIA, also called a “mini” or “warning” stroke, a temporary blockage that causes stroke symptoms that go away after a few minutes without causing lasting damage. About one-third of people who have a TIA go on to have a stroke within a year, according to the American Heart Association.

The researchers found 16 percent of the subjects who went to the hospital following a stroke episode had marijuana in their system, compared to 8.1 percent of control subjects who came to the hospital. Barber adds there have been case reports of people with no other vascular risk factors having a stroke or TIA hours after using marijuana.

However, all but one of the stroke patients who had marijuana in their urine also used tobacco. Barber still believes the marijuana was the culprit.

“For starters, this is a young age group to be having strokes, and many didn’t have any of the traditional risk factors. And some patients had a stroke while actually smoking cannabis,” he told EverydayHealth. “We know cannabis can cause changes in blood pressure and heart rate that are associated with increased stroke risk. Importantly, it can also cause heart palpitations, [a sign of atrial fibrillation]. And atrial fibrillation is very strongly associated with stroke,” he added.

Every year more than 795,000 Americans have a stroke, 610,000 who have one for the first time. About 130,000 Americans die from a stroke each year, about one death every four minutes.

Source:The study was presented Feb. 6 at the American Stroke Association’s International Stroke Conference in Honolulu.

The article below mentions cocaine use increasing in the UK and the EU report states the cocaine is the second most popular illicit drug in Europe after cannabis. It has been known since the 1990s that heavy cannabs users are 66% more likely to use cocaine than non-user of cannabis. Contact the NDPA for references to these studies.

IRELAND has one of the highest rates of cocaine use in Europe, a new report shows. The country has also been identified by international law enforcement agencies as a gateway for cannabis smuggled from Morocco into the rest of Europe.

In the first overview of drug trafficking throughout the continent, the report from Europol and the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) also found:

* Ireland is a hotbed for Vietnamese and Chinese organised crime gangs cultivating home-grown cannabis.

* We top the poll for use of new drugs or “head shop” highs.

* Polish and Lithuanian gangsters are increasingly trafficking drugs from the Netherlands into Ireland.

In the study, Ireland is identified as among a “handful” of countries, also including the UK and Spain, where cocaine use remains “relatively high”, particularly among young adults. The EU drugs market survey shows cocaine is the second most popular illicit drug in Europe after cannabis. The reports warns: “Labelled as the ‘champagne of drugs’ because of its high price and associations with the rich and famous, cocaine snorted in powder form has found acceptance among drug users in recreational settings.”

Ireland is also one of a number of countries that has seen a phenomenal rise in home-grown cannabis over the past five years. The study says Vietnamese-organised crime gangs have in recent years become prominent in the indoor cultivation of cannabis in many countries, Ireland among them.

“Chinese nationals have also been reported to grow cannabis commercially in countries including Ireland and the United Kingdom,” the report states. Polish and Lithuanian gangs are also trafficking drugs from the Netherlands into Ireland and the UK. Turning to new psychoactive substances – or “legal highs”, often sold in “head shops” – the study found young people, aged between 15 and 24, in Ireland were three times more likely to have taken them than in most other European countries.

Legacy

Meanwhile, experts say they aren’t surprised by the report’s findings. Dr Chris Luke, a consultant in emergency and preventative medicine at Cork’s University and Mercy hospitals, said: “We’re still seeing plenty of long-term cocaine use. It’s the legacy of the Celtic Tiger.”

New figures also show that the number of illegal drugs seized here is on the rise. Drugs worth €55.3m were seized in 2011, with cannabis the most commonly found drug. Cocaine worth €7.9m was also found. The total seized was up on 2010, when drugs worth €45m were taken.

www. Independent.ie February 01 2013

Eastern European gangs are becoming “prominent” traffickers of drugs into Ireland, according to a report. It also claims Ireland is a distribution point for the supply of cannabis resin from Morocco to Britain. Research by EU police and drugs agencies confirms that Vietnamese and Chinese organised criminal gangs (OCGs) are heavily involved in cannabis cultivation across the continent, including Ireland. The EU Drug Markets Report said criminal gangs were exploiting the legitimate, commercial transport sector to move drugs and that the internet was emerging as an “online marketplace for drugs”. Action was needed to address this, it said. The report said while heroin was in overall long-term decline and cocaine use was falling in high-prevalence countries including Ireland, the trade in synthetic drugs and domestically produced cannabis was growing. The 158-page report, the first EU market analysis of its kind, said Dutch, British, and Belgian OCGs seemed to control much of the trade in western Europe in amphetamine and MDMA (ecstasy). But it said Eastern European gangs were muscling in on the trade, including to Ireland: “Intelligence suggests the growing prominence of Polish and Lithuanian OCGs in trafficking drugs obtained in the Netherlands to various Nordic and Baltic States, Ireland, and the United Kingdom.” The report, jointly compiled by the European Monitoring Centre for Drugs and Drug Addiction and Europol, said their reach was extending as far as the US and Russia. It said Lithuanian OCGs were brokers for “numerous illicit commodities” and had links with Russian gangs. Last November, Garda Commissioner Martin Callinan warned that Irish gangs were joining forces with Russian outfits in the supply of drugs and cigarettes, while Eastern European networks were involved in supplying firearms and narcotics. The report said Ireland was being used to smuggle cannabis resin from Morocco into the UK. “Average seizure sizes greater than 1kg suggest that Ireland is also an entry point for Morocco resin into Europe,” it said. “Resin seizures represent about 15% of estimated national consumption; it is likely that some of the resin entering Ireland eventually ends up in the United Kingdom.”

Source: Irish Examiner Friday, February 01, 2013

Dust-Off is flying off the shelves in university towns as party-loving Brits find cheap ways to get high. The deadly habit, known as dusting, involves sucking in compressed gas with a straw on the can’s nozzle.

The high is so intense it can paralyse the user for up to ten minutes.

Ryan Linas, 20, from Nottingham Trent University, said: “You take a full can of Dust-Off and inhale as much as you can in one breath. You just feel really high. It’s euphoric. Of course it’s dangerous, all drugs are dangerous but it’s really cheap and you don’t have to worry about getting arrested when you buy it.”

The trend has spread to several unis across the UK after becoming a huge hit in America.

The spray contains freon, which pushes oxygen out of the lungs and can cause a mini stroke or heart attack. Ryan added: “My friend from Leeds introduced me to dusting when he came back from Seattle.

“I’m not boasting or anything but you can get high over and over again for £4.99.”

Tesco supermarkets have barred under-18s from buying Dust-Off.

Source: Daily Star Sunday 3rd Feb.2013

Canada’s ban on marijuana was effectively upheld Friday when Ontario’s top court struck down the country’s laws related to medicinal pot much to the chagrin of activist groups.

In overturning a lower court ruling, the Court of Appeal ruled the trial judge had made numerous errors in striking down the country’s medical pot laws.

Among other things, the Appeal Court found the judge was wrong to interpret an earlier ruling as creating a constitutional right to use medical marijuana.

“Given that marijuana can medically benefit some individuals, a blanket criminal prohibition on its use is unconstitutional,” the Appeal Court said.

“(However), this court did not hold that serious illness gives rise to an automatic right to use marijuana.”

Currently, doctors are allowed to exempt patients from the ban on marijuana, but many physicians have refused to prescribe the drug on the grounds its benefits are not scientifically proven.

The Canadian HIV/AIDS Legal Network called the decision a disappointing missed opportunity.

Source: The Canadian Press – Friday, February 1 2013

The largest effect of marijuana is neurological. The main psychoactive (mind-altering) chemical in marijuana is delta-9-tetrahydrocannabinol, or THC. THC targets the specific brain cells or cannabinoid receptors that are in the highest concentration found in sections of the brain dealing with pleasure, learning, concentration, coordination and memory. These areas show measurably lower functioning when someone smokes not only for that day but also for weeks afterward.

Few drugs have such a long-lasting effect in the brain. This is due to the brain being made up largely of fatty tissue and THC binds and is stored in fat cells. The more someone ingests the more is stored. This is why marijuana is detected in drug tests for much longer than most other drugs.

Anytime you artificially introduce chemicals that create a flood of dopamine in the brain there is a potential for dependence. Dopamine is a neurotransmitter and sends signals from one nerve cell to another. In the case of marijuana, THC targeting these receptors creates the “high” and a feeling of euphoria is created. Anytime you have a drug that creates such pleasure there is a possibility for abuse.

Now I’d like to be clear: not everyone who smokes marijuana will become addicted. Addiction doesn’t work like that. Some people can ingest drugs with relativity little effect on their lives. For some it takes control. Brains respond differently. People have different psychological experiences, different genetics. Some have a glass of wine at dinner and some drink until they lose everything. The line of addiction is crossed when the substance that is abused affects a person’s life in significant ways and they still don’t stop.

Marijuana is no different. It can be used with little effect being shown on a person’s life or it can tear apart a family. Since I work with teens and by extension families, I’ve seen kids choose smoking pot over friends, sports, school, jobs and just about anything worthwhile. It is clear that marijuana use by teens is much higher than in the general adult population. Ask any teenager how hard it is to buy marijuana at school and most will tell you it’s available daily.

Downplaying the damage that smoking marijuana can do only hurts kids. Teenage brains are still developing into the early 20s. An area of the teenager’s brain that is fairly well developed early on is the area that seeks pleasure and reward. This means that early on we know what feels good and how to seek it out. We know to smoke marijuana feels good and that the more we do it the better we feel. The section that takes the longest to develop is a section of the brain that thinks about outcomes, forms judgment. Also longest to develop are sections that regulate and control impulses or emotions. So what we have is a brain that knows what feels good yet doesn’t have the maturity to think through or control emotional decisions. As with anything developing, adding chemicals to a brain has a cost.

Teens are more likely to have addiction issues the younger that they use as a kid. Marijuana stunts progression of brain development thereby creating psychosocial changes in perception of the world around them. If you alter someone’s ability to make good choices throughout life you can bet the lasting effect will hurt us all when they are adults.

We all base our reactions and thoughts mostly on personal first-hand experience. Many of us in this country have smoked marijuana. Many of us know people who do it in a seemingly harmless way. In thinking about the idea of legalization I hope we can all dig

deeper. Our own arrogance that because we did or do it and are fine doesn’t mean that it’s that way for everyone. The message that our teens are hearing is that it’s safe to use. Factual-based conversations will be needed, but saying marijuana is natural or hurting our economy by having it illegal or that it’s safe is all just untrue.

Will Wooton is director of Pacific Treatment Services and co-author of “Bring Your Teen Back From The Brink”. PTS is a substance abuse company working with teens and young adults. Website: www.PacificTreatmentServices.com.
Source: http://www.pomeradonews.com/2013/01/30/wooton-downplaying-marijuana-damage-only-hurts-kids/

January 31, 2013

Reacting to a federal appellate court decision upholding the U.S. Drug Enforcement Administration’s denial of reclassification of marijuana, The Times states in its Jan. 25 editorial that whether marijuana should be reclassified under federal law to permit its prescription as a medicine should be based on science and an evaluation of the facts, rather than on myths. I fully agree.

And yet the editorial is based on the myth that the DEA has made it “nearly impossible” for researchers to obtain marijuana for such scientific studies. To the contrary, not a single scientifically valid study by a qualified researcher has ever been denied by the DEA or, for that matter, by the National Institute of Drug Abuse. And there is ample government-grown marijuana, specifically for research, available at the marijuana farm run by the University of Mississippi. More surprising, as your editorial points out, is that there is still no scientifically valid study that proves that marijuana is effective, much less safe, as a medicine.

As the DEA administrator 20 years ago, I denied the reclassification of marijuana from a Schedule I controlled drug because there were no valid scientific studies showing that smoking marijuana was an effective medicine. In my decision, published in the Federal Register, I interpreted federal law and set forth a five-part test that included whether there were valid scientific studies demonstrating that marijuana was safe and effective for treating any medical condition. I noted that at that time there were none of the kind of controlled, double-blind studies that the Food and Drug Administration would require before approving a new drug application, and I clearly spelled out that this would be necessary before marijuana would be reclassified to a lower schedule that would permit its use as a physician-prescribed medicine.

Essentially, I invited those who advocate marijuana use as a medicine to conduct research and then present it to the DEA. I laid out a road map for what they needed to do. If scientifically valid studies demonstrated that marijuana was “effective” and “safe,” as the FDA defines those terms, the agency would reclassify marijuana into one of the other schedules. It is amazing that 20 years later there is still no such scientific study establishing that marijuana is effective as a medicine. And yet in the interim, the well-funded marijuana lobby, including the National Assn. for the Reform of Marijuana Laws and others, have spent tens of millions of dollars on convincing voters to pass medical marijuana initiatives based on anecdotes but not science.

The reason the FDA and the DEA have scientific standards is because snake-oil salesmen are able to sell just about anything to sick people without any scientific proof that it has a truly helpful therapeutic effect. If proponents of medical marijuana had invested even a small fragment of their money in scientifically valid studies, we would know one way or the other whether it works.

One can only conclude the marijuana proponents did not go this route because doing so would have shown that cannabis is not an effective and safe medicine. Alternatively, we are left to conclude that their agenda was not about marijuana to help sick people, but rather was getting voters to pass medical marijuana initiatives as a wedge to legalize the drug for “recreational” use.

Source: http://www.latimes.com/news/opinion/opinion-la/la-ol-dea-marijuana-blowbac-20130201,0,5287678.story?track=rss By Robert Bonner – February 1, 2013

It seems like everyone — informed by the science or not — has an opinion on marijuana research these days. And while I may disagree with their conclusions, many editors’ pro-legalization opinion columns are smartly formulated and backed by some credible research. But this past week’s opinion article by a member of the Chicago Tribune’s editorial board, Steven Chapman, was neither. Mr. Chapman makes eight particularly incorrect and misleading assertions that deserve a correction:

1.”Existing laws aren’t keeping kids away from pot.”

Fact: It’s true that many kids smoke marijuana. About half of high school seniors have done so at least once. But many more kids drink alcohol — a legal, addictive, commercialized drug. And while tobacco has been decreasing among kids and is now used slightly less than pot among high schoolers, we can thank a societal shift on attitudes and also 80 years of learning the hard way for that. Overall, still, alcohol and cigarettes are used far greater than marijuana.

We also have had a relatively recent societal shift in attitudes about marijuana. As our country increasingly shuns tobacco, it also has made marijuana more accessible and socially acceptable — and youth are reporting easier access to weed at the same time.

But are they really getting marijuana more easily than beer? The 2009 survey Mr. Chapman referenced has been debunked. A recent by the University of Maryland showed that kids alcohol and cigarettes were the most readily accessible substances, with 50% and 44% respectively, of youth reporting that they could obtain them within a day. Youth were least likely to report that they could get marijuana within a day (31%); 45% report that they would be unable to get marijuana at all.

2. “The sale and use of a substance does not necessarily mean more people will use it.”

Fact: Of course it does. Tobacco and alcohol are legal and readily accessible — and our nation’s use of those substances reflect this. According to the National Survey on Drug Use and Health, past-month use of tobacco stands at about 27%t, and past-month use of alcohol is about 52%. Meanwhile, past-month use of marijuana stands at about 8%of Americans. When RAND researchers analyzed California’s 2010 effort to legalize marijuana, they concluded that the price of the drug could plummet and therefore marijuana consumption could increase. When something is legal, it is very likely that more people use it.

3. “No one, after all, is talking about putting pot in vending machines.” Fact: Yes, as a matter of fact, they are. And it’s not just vending machines. It’s the “Starbucks of marijuana,” too. American society loves commercialization and Big Business has proven time and time again that they just can’t control themselves. A volunteer ban on liquor ads is completely ignored, as are bans on gambling advertising.

And remember what we have learned about Big Tobacco? Here’s evidence presented during the 1990s tobacco settlements to jog your memory:

The Liggett Group: “If you are really and truly not going to sell [cigarettes] to children, you are going to be out of business in 30 years.”

R. J. Reynolds: “Realistically, if our company is to survive and prosper over the long-term, we must get our share of the youth market.”

Lorillard: “The base of our business is the high school student.”

Phillip Morris: “Today’s teenager is tomorrow’s potential regular customer… Because of our high share of the market among the youngest smokers, Philip Morris will suffer more than the other companies from the decline in the number of teenage smokers.” Philip Morris (now Altria) just bought the domain names “altriacannabis.com” and “altriamarijuana.com.”

We are incredibly naive to think a commercial marijuana industry wouldn’t employ all of the same strategies to convince people — especially young people — to use marijuana.

4. “The tolerance-fuels-use theory is thunderously lacking in real-world support. In the Netherlands, where ‘coffee shops’ are allowed to sell pot, teenagers are far less likely to use it than their American peers.”

Fact: The Netherlands experience is far more complicated than Mr. Chapman would care to discuss. Yes, the Netherlands has always had drug use rates below or at around the same rate as the U.S. Frankly, American drug use rates have far exceeded most of the world’s for a few hundred years now. But when the Netherlands started advertising pot – something we in America would be extremely susceptible to — they witnessed a tripling in youth use marijuana use rates, according to independent researchers. Their citizens now have a higher likelihood of needing treatment for marijuana than most of Europe. And they are closing many of their “coffee shops” after years of tolerance because of very potent pot that is saturating the market.

5. “‘In the states that have passed medical-marijuana laws, youth marijuana use has decreased,’

Amanda Reiman, policy manager for the Drug Policy Alliance, told me. In California, “the number of seventh, ninth and 11th graders reporting marijuana use in the last six months and in their lifetimes all declined” after 1996, when the state passed its medical marijuana law.”

Fact: Rule number one in journalism: Check your facts. Informal rule #2: Make sure the facts you do use come from scientists, not advocates. There are two major problems with this statement:

(a) First, it does not come from a respected source, peer-reviewed journal, or anything of the like. The truth is that we are only beginning to learn about what happens to youth marijuana use when marijuana is “medicalized.” The only two peer-reviewed studies that I’ve seen on this shows that marijuana use is higher in medical marijuana states than non-medical marijuana states. And we have seen rapid increases in marijuana use since medical marijuana has been more widely accepted, since about 2007 or so. But we’re still learning. At the very least, the jury is out. But ask kids what they think about marijuana and you’ll probably get the answer that “if it’s medicine, it must be okay.” We know, for example, that the diversion of medical marijuana is common among adolescents in substance treatment. (b) Second, even if we were to look at the overall use statistics and make a wide generalization about the link between medical marijuana and youth use, we would not look at 1996 as a starting point. Medical marijuana outlets were not implemented en masse until about 2006 or so. So while the law passed in 1996, it’s fair to say it was not fully implemented until 10 years later. And what has happened since 2006 in California and nationwide? Use rates have rapidly increased. But as I said before, we still need more research on the topic.

6. “The alleged harms of cannabis on the teen mind and body are exaggerated.”

Fact: By whom? The producers of the 1936 film Reefer Madness? Maybe so. But today’s science has moved beyond scare tactics and there are some general beliefs scientists hold about marijuana and its effect on teens: Addiction: 1 in 6 kids who ever smoke marijuana will become addicted, according to independent research. Mental Health: Marijuana use is significantly linked with mental illness, especially schizophrenia and psychosis, but also depression and anxiety. Learning: Heavy, persistent marijuana use in adolescence is linked to a strong decline in IQ. A new analysis of this study has raised doubts among some, but the original study authors redid their analysis and are sticking to their findings. Also researchers unconnected to both studies have concluded that the new analysis does not overturn the original study. The Director of the National Institute on Drug Abuse summed it up nicely:

…observational studies in humans cannot account for all potentially confounding variables. In contrast, animal studies — though limited in their application to the complex human brain — can more definitively assess the relationship between drug exposure and various outcomes. They have shown that exposure to cannabinoids during adolescent development can cause long-lasting changes in the brain’s reward system as well as the hippocampus, a brain area critical for learning and memory. The message inherent in these and in multiple supporting studies is clear. Regular marijuana use in adolescence is known to be part of a cluster of behaviors that can produce enduring detrimental effects and alter the trajectory of a young person’s life — thwarting his or her potential. Beyond potentially lowering IQ, teen marijuana use is linked to school dropout, other drug use, mental health problems, etc. Given the current number of regular marijuana users (about 1 in 15 high school seniors) and the possibility of this number increasing with marijuana legalization, we cannot afford to divert our focus from the central point: regular marijuana use stands to jeopardize a young person’s chances of success–in school and in life.

7. “A kid who gets his hands on beer doesn’t have to worry about getting toxic chemicals or nasty fillers. Buying pot in illicit markets may also expose users of all ages to violence, robbery or extortion. But you don’t see innocent bystanders getting killed in shootouts among liquor store owners.”

Fact: Marijuana legalization would do little to curb the black market, especially because that market could easily undercut the new, taxed price of legal marijuana . And let’s be clear: Most kids get their pot from a friend or family member indoors, not from some shady character on a street corner. Don’t believe everything you see in the movies.

8. “The alternative to legalization is sticking with a policy that has produced millions of arrests, squandered hundreds of billions of dollars and turned many harmless people into criminals in the eyes of the law — all while failing to stem the popularity of pot. For kids or adults, there is nothing healthy in that.”

Fact: This is probably my biggest beef with this piece. And it is not because the facts about marijuana use trends over the past 30 years are dead wrong (in fact, marijuana use is much lower than it was in the late 1970s).

To say that the only alternative to current policy is legalization is like saying the only alternative to current gun policy is the repeal of the Second Amendment. Actually, there are myriad of things short of legalization we can do to lessen the harms of current policy while improving upon it. That is why I launched Project: SAM (Smart Approaches to Marijuana) with Patrick Kennedy last week. And many public health professionals have joined us already, including Harvard’s Sharon Levy; University of Kansas’ famed tobacco treatment pioneer, Kim Richter; Denver’s Paula Riggs, a leader in drug treatment in the US, and many others.

So if neither legalization nor prohibition, then what?

Science-based drug education for parents and kids needs to become a top national priority. Community coalitions that engage in multiple community sectors, and drug courts that leverage the criminal justice system with treatment must be brought to scale. Strategies that implement job and stable housing programs should also be more widespread. We do not need to stigmatize people whose only crime is smoking marijuana, of course. But while “lock ’em up” or “legalize” may both fit neatly on a bumper sticker, they are not thoughtful ways to implement drug policy. There exists an approach that neither legalizes, nor demonizes, marijuana. We reject dichotomies — such as “incarceration versus legalization” — that offer only simplistic solutions to the highly complex problems stemming from marijuana use and the policies surrounding it. We champion smart policies that decrease marijuana use — and do not harm marijuana users and low-level dealers with arrest records that stigmatize them for life and in ways that make it even harder for them to break free from cycles of addiction.

People can disagree about whether or not legalization would result in a net benefit or net harm to society. But making up facts or revealing only half-truths gets us nowhere near the reasoned debate on this issue that we all crave.

Source: http://www.huffingtonpost.com/kevin-a-sabet-phd/a-response-to-stevenchap_b_2530530.html 24th January 2013

Research commissioned by Action on Addiction suggests mental health approach to teenage drinking is successful Targeted psychological interventions aimed at teenagers at risk of emotional and behavioural problems significantly reduce their drinking behaviour, and that of their schoolmates, according to the results from a large randomised controlled trial published today in JAMA Psychiatry. The authors argue that the intervention could be administered in schools throughout the UK to help prevent teenage alcohol abuse. The ‘Adventure Trial’ is led by Dr Patricia Conrod, King’s College London’s Institute of Psychiatry, in collaboration with the University of Montreal and Sainte-Justine University Hospital Center (Canada) and was commissioned by Action on Addiction. The trial involved 21 schools in London that were randomly allocated to either receive the intervention, or the UK statutory drug and alcohol education curriculum. A total of 2,548 year-10 students (average age 13.8 years) were classed as high or low-risk of developing future alcohol dependency. Those classed as high-risk fit one of four personality risk profiles: anxiety, hopelessness, impulsivity or sensation seeking. All students were monitored for their drinking behaviour over two years. Four members of staff in each intervention school were trained to deliver group workshops targeting the different personality profiles. 11 schools received the intervention where 709 high-risk teenagers were invited to attend two workshops that guided them in learning cognitive-behavioural strategies for coping with their particular personality profiles. Dr Patricia Conrod, from King’s Institute of Psychiatry and lead author of the paper, says: “Through the workshops, the teenagers learn to better manage their personality traits and individual tendencies, helping them to make good decisions for themselves. Depending on their personality profiles, they might learn cognitive-behavioural strategies to better manage high levels of anxiety, to manage their tendency to have pessimistic reactions to certain situations or to control their tendency to react impulsively or aggressively. Our study shows that this mental health approach to alcohol prevention is much more successful in reducing drinking behaviour than giving teenagers general information on the dangers of alcohol.” After two years, high-risk students in intervention schools were at a 29% reduced risk of drinking, 43% reduced risk of binge drinking and 29% reduced risk of problem drinking compared to high-risk students in control schools. The intervention also significantly delayed the natural progression to more risky drinking behaviour (such as frequent binge drinking, greater quantity of drinking, and severity of problem drinking) in the high-risk students over the two years. Additionally, over the two year period, low-risk teenagers in the intervention schools, who did not receive the intervention, were at a 29% reduced risk of taking up drinking and 35% reduced risk of binge drinking compared to the low-risk group in the non-intervention schools, indicating a possible ‘herd effect’ in this population. Dr Conrod adds: “Not only does the intervention have a significant effect on the teenagers most at risk of developing problematic drinking behaviour, there was also a significant positive effect on those who did not receive the intervention, but who

attended schools where interventions were delivered to high-risk students. This ‘herd effect’ is very important from a public health perspective as it suggests that the benefits of mental health interventions on drinking behaviour also extend to the general population, possibly by reducing the number of drinking occasions young people are exposed to in early adolescence.” Dr Conrod concludes: “This intervention could be widely administered to schools: it is successful from a public health perspective, appreciated by students and staff, and because we train school staff rather than professional psychologists, the intervention remains relatively inexpensive to roll out.” Approximately 6 out of 10 people aged 11-15 in England report drinking, and in the UK approximately 5,000 teenagers are admitted to hospital every year for alcohol related reasons. Across the developed world, alcohol accounts for approximately 9% of all deaths of people aged 15-29, and so far, universal community or school-based interventions have proven difficult to implement and shown limited success. Nick Barton, Chief Executive of Action on Addiction says: “Dr Conrod’s study, which helps young people reduce their chances of developing an addiction to alcohol and/or drugs in the future, is an exciting development for prevention work in the UK. This is generally recognised as inadequate, and as we see regularly in the media, currently fails to address binge drinking and drug taking among young people. “We know that problematic relationships with alcohol often start at a young age, so if it is possible to reduce the chances of harmful drinking and dependency in later life through school-based interventions we would welcome seeing this programme rolled out across UK schools. “We hope that the publication of this paper will create discussion and debate about the nature of addiction; to help shed light on the complex causes of addictive behaviour, unravel some of the stigma associated with it, help young people understand the triggers for dependency and, ultimately, bring us closer to our goal of disarming addiction.” Action on Addiction also works with children and young people suffering from the effects of addiction via its Families Plus programme, which offers support groups for families, partners and friends of substance misusers. Families Plus is rolling out M-PACT (Moving Parents and Children Together), a programme that takes a ‘whole family’ approach to tackling addiction, involving parents and children together in the treatment process.

Source: Conrod, P. et al. “A cluster randomized trial evaluating a selective, personality-targeted prevention program for adolescent alcohol misuse: Primary two-year outcomes and possible secondary herd effects” JAMA Psychiatry

Cannabis-related stroke is not a myth, and cannabis use should be considered a risk factor for inducing ischemic stroke, a new literature review concludes [1]. The review, published online in Stroke, was conducted by a team led by Dr Valérie Wolff (University Hospital of Strasbourg, France). Other recent research has linked marijuana use to risk of angina and ACS, and to an increased risk of MI in younger adults. Wolff commented that as most cannabis smokers are young, patients under 45 years of age presenting with symptoms of stroke should be asked about cannabis use and their urine tested for cannabinoids. “It is important to establish if cannabis has been the cause, as they can reduce their risk of a subsequent stroke if they stop using the drug,” she said. The tip of the iceberg The authors note that 59 case reports of cannabis-related stroke (mean age 33 years) have been described. The majority were men, with a male-to-female ratio of 4.9:1. Of the 59 cases, 49 were classed as ischemic strokes, five were transient ischemic attacks, one was a hemorrhagic stroke, and, in four patients, a diagnosis of stroke was suspected but not confirmed because there was no neuroimaging. They add that in many cases the strokes appeared to have occurred while the drug was actually being smoked or within half an hour of smoking, which is in accordance with another study showing that cannabis increases MI 4.8-fold during the hour following intake. Wolff said that although there are only these few cases of documented stroke associated with cannabis use, this is probably just the tip of the iceberg. “Nobody is looking for it, and if you don’t look you won’t find it. Neurologists are not thinking about cannabis as a possible cause of stroke, so they don’t ask patients about it.” The authors caution that the reality of the relationship between cannabis and stroke is, however, complex because other confounding factors have to be considered. These include potential triggering factors of sexual activity or concomitant alcohol consumption. There may also be genetic predisposition to susceptibility to stroke from cannabis use, but this needs more study. Wolff estimates that less than 10% of strokes occur in patients under 45 years of age. These strokes are generally caused by cardioembolism or cervical arterial dissection. Around 30% to 60% of strokes in this age group are considered cryptogenic, with no established cause. But in many of these cases, the best diagnostic procedures may not have been performed, she said. In a previous study conducted by Wolff and colleagues, in which they examined vessels in the brain very closely, they found that just 12% of strokes could be classed as cryptogenic. Of these, about 30% may have been caused by cannabis use. “So it is not an insignificant number,” she noted. Mechanism: Multifocal intracerebral stenosis

In terms of mechanism, Wolff said cannabis appears to be associated with multifocal intracerebral stenosis, which can cause a stroke. “We have seen these stenoses in people who are regular cannabis smokers, and when they stop smoking the stenoses disappear. How cannabis causes the stenosis, we do not know. This needs to be studied,” she said. “The stenoses are caused by shrinkage of the blood vessels and can occur in several different areas of the brain. It appears that cannabis may cause the arteries to constrict. These stenoses can be difficult to see. They can be detected with magnetic resonance angiography, but careful scrutiny of the vessels is required. Many are missed,” Wolff added. “In light of this review, cannabis has to be considered as harmful and the cerebrovascular risk when cannabis is consumed is probably underestimated,” the authors conclude. To confirm the link, they call for an epidemiological study to determine the incidence of multifocal intracerebral stenosis, complicated or not by stroke, in the general population and cannabis users. To confirm the diagnosis, it is necessary to perform magnetic resonance angiography in the acute stage of stroke to search for intracranial stenosis, explained the authors. Thereafter, control vascular imaging is important to evaluate the reversibility of vascular abnormalities. However, when there is doubt between stenosis and arterial artifacts, conventional angiography with three-dimensional reconstructed images is needed to confirm diagnosis of stenosis, they added. The authors declared no conflicts of interest.

Source: Cannabis-related stroke: Myth or reality? Stroke 2013; 44:558-563

Wednesday, 23 January 2013 Anna Salleh ABC

Scientists have defended their study linking cannabis and a drop in IQ against claims that socio-economic factors are to blame. The study, published in the Proceedings of the National Academy of Sciences (PNAS), in August last year, by Dr Madeline Meier of Duke University, and colleagues, was the strongest evidence yet that teen use of cannabis could cause a drop in IQ.

Around 1000 people all born in the same year in the New Zealand city of Dunedin were interviewed at 18, 21, 26, 32 and 38 about their cannabis use. The participants were also tested for their cognitive abilities at age 13 before starting to use cannabis, and at age 38.

The study found persistent cannabis use during teenage years was associated with a drop in IQ of eight points by the age of 38. But last week, PNAS published a paper by Norwegian economist, Dr Ole Rogeberg of the Ragnar Frisch Centre for Economic Research, criticising Meier and team for failing to control for socio-economic status.

Rogeberg argued the IQ differences could be explained by socioeconomic status. His hypothesis was that poorer kids were getting an initial boost in IQ when they first went to school but that this fell off rapidly to its base level once they left school.

Rogeberg’s criticisms were widely reported in the media, but now Meier has defended the original findings in The Conversation, co-authored with drug epidemiology expert Professor Wayne Hall of the University of Queensland.

Further analysis

Meier says a further analysis of the original data found no evidence for Rogeberg’s hypothesis and that the same drop in IQ occurred when only middle-class cannabis users were analysed.

“By restricting our analysis to only include children from middle-class homes, our findings of IQ decline in adolescent-onset cannabis users remain unaltered, thereby suggesting the decline in IQ cannot be attributed to socio-economic factors alone,” she says.

Hall says he was “astonished” PNAS did not offer Meier and colleagues the chance to respond in the same issue to Rogeberg’s criticisms and his “dopes smoke dope” hypothesis. “Rogeberg study has been presented as though it was a fairly definitive refutation of the Dunedin study [but] his hypothesis has not been confirmed and that’s been lost in the media coverage,” says Hall.

Medical statistician Dr Thomas Lumley of the University of Auckland says Meier and colleagues should have dealt with socioeconomic factors in their original study.

He says the Dunedin study provides the best evidence to date linking heavy cannabis use during teenage years with a drop in IQ, but even if Rogeberg was wrong, the

findings could still be explained by factors other than the toxic effects of cannabis on the brain.

“Suppose people who enjoy being stoned also tend to select for jobs and recreational activities that involve less mental effort,” says Lumley. “They wouldn’t get practice in using their brain in that particular way and therefore they would do worse in cognitive function tests.”

Hall says neuroimaging studies suggest heavy users have smaller parts of the brain involved in memory and cognitive performance which would suggest cannabis is having some sort of toxic effect. But, he says, even if Lumley was right, cannabis would still be a contributing factor.

“The detailed mechanisms are not clear, but a causal connection between very heavy sustained cannabis use and low intellectual achievement is clear,” he says.

Hall says, apart from effects on cognition, heavy and persistent cannabis use has been linked to dependence, and negative impacts on mental health, relationships, life satisfaction, education and employment. “There are a whole stack of things that are correlated with this heavy pattern of use and it’s unlikely that they’re all artefacts of something else that is unconnected to cannabis use,” he says.

Source: www.abc.net.au 23rd Jan. 2013

If you have kids, you most likely prayed hard that they would avoid drugs and alcohol. Once a child becomes intoxicated, childhood is over. The young person will never be the same again.

Thus, a sane society discourages substance abuse if only to protect children. A sane society does not put a happy face on inebriation.

We are not a sane society.

With almost 30 million Americans currently categorized as “substance abusers,” you would think that Nancy Reagan’s “Just Say No” campaign, which launched in 1983, would be resurrected. But saying no is not what America in 2013 is all about.

Saying yes to whatever you want to do is the rule of the day.

Washington State and Colorado have legalized the use of marijuana, and many Americans are celebrating.

As Bob Dylan once sang: “Everybody must get stoned!” The usual excuses are put forth: It’s a freedom issue. We can tax the drug to generate revenue. It will get the criminal element out of it.

But the truth is that legalized pot (or drugs of any kind) creates massive unintended consequences.

–In Holland, so many problems arose from pot being sold in “coffee shops” that a law banning the sale of cannabis to “foreigners” was passed. It seems the streets of Amsterdam, in particular, have become saturated with stoned people doing things outside that should be done inside.

–The Netherlands recently passed a new law, forbidding children from smoking pot in school. That’s right, some of the urchins were getting high between classes. One teacher told the press it’s hard to stop that when pot is being sold legally across the street where hard-core drug addicts buy it and then sell it to the kids in order to get heroin money.

–In Portugal, they have legalized all drugs. The result: Drug-related homicides have increased by 40 percent. Drug overdoses are up by 30 percent.

–In Switzerland, drug-related deaths doubled and the health care system was overwhelmed after heroin was made legal in Zurich. The law was rescinded.

But here in the USA, we are now bullish on pot. Willie Nelson wrote a book glorifying the drug. Snoop Dogg says he wants to teach his kids how to smoke reefer. And the media in general see marijuana as a harmless diversion. If you are down on pot, you are decidedly uncool.

Fine with me. I’ll risk the stigma. According to the federal government, 8,400 Americans begin using drugs every day, half of them under the age of 18. And 68 percent of folks who become addicted to drugs begin with marijuana. Get the picture?

Celebrate the pot culture if you want. But know that you are not helping kids by taking the high road.

Source: http://townhall.com/columnists/billoreilly/2013/01/19