A new potential treatment for marijuana dependence, and the success of network therapy, which engages family and friends in a patient’s substance abuse treatment, were two of the topics discussed at the recent annual meeting of the New York Society of Addiction Medicine. This is the second of a two-part report on the meeting, “Addiction Medicine 2013: Emerging Problems, Current Treatment.”

Researchers at Columbia University in New York are studying a new treatment for marijuana dependence.

Margaret Haney, PhD, led a study of 11 people, which has not yet been published, of a synthetic version of THC—the active ingredient in marijuana—called nabilone. Marijuana-dependent patients received either a placebo or one of two doses of nabilone.

Nabilone decreased marijuana withdrawal symptoms, such as increasing sleep and appetite, and decreased marijuana self-administration, in a laboratory model of relapse. Patients did not experience a “high” from nabilone, indicating it does not have a high abuse potential. The study was funded by the National Institute on Drug Abuse.

Dr. Haney’s colleague, Ziva Cooper, PhD, of Columbia University, Department of Psychiatry, New York State Psychiatric Institute, noted that while many people do not regard marijuana dependence as a major problem, it can lead to significant impairment or distress. “Marijuana dependence is likely to become more common as marijuana becomes legal in more states,” she said at the recent New York Society of Addiction Medicine meeting.

Marijuana potency has been increasing over the last 40 to 50 years, Dr. Cooper said. There is currently no medication approved by the U.S. Food and Drug Administration for treatment of marijuana dependence. Of people who do seek treatment for marijuana dependence, many are unable to stay abstinent, Dr. Cooper observed. In one study, 71 percent returned to marijuana use within six months.

Another treatment that has shown potential for marijuana dependence is a combination of oral THC and lofexidine, a drug used in the United Kingdom for opiate withdrawal, which is not approved in the United States. In a small study, patients who took the combination treatment had decreased cravings for marijuana and cigarettes, decreased relapse rate and improved sleep compared with either THC or lofexidine alone.

Network Therapy: Involving Family and Friends in Substance Abuse Treatment

Engaging close family and friends in substance abuse counseling—a process called network therapy—can help improve abstinence rates while providing much-needed support, according to an expert at New York University School of Medicine.

Marc Galanter, MD, a psychiatrist who originated network therapy, says including family and friends provides a valuable resource for patients if they relapse, while keeping them

accountable. The therapy also provides support to those affected by patients’ substance use disorders. Dr. Galanter conducted a study, published in 2004, that found substance abuse patients who engaged in network therapy were twice as likely to be abstinent compared with those who did not engage in the treatment.

“Participants in network therapy should have a close, ongoing relationship with the patient, and should not have a substance use disorder, so they don’t undermine the course of treatment,” Dr. Galanter said at the recent annual meeting of the New York Society of Addiction Medicine.

He continues treating patients separately in addition to seeing them as part of network therapy. The friends and family members who agree to be part of network therapy must agree to be available if the patient needs help. “They secure compliance—such as making sure the patient doesn’t go to a bar,” says Dr. Galanter. They also can suggest solutions to help the patient achieve and maintain abstinence.

Patients who know their drug test results will be shared with their network will be more motivated to pass the test, because they won’t want to let their family and friends down, Dr. Galanter observed.

Network therapy can help enforce patient agreements for future behavior, he added. “For instance, a patient may agree that if he can’t become abstinent within a few weeks, he will go into residential treatment. If he backs down, it’s harder for him to dismiss what he initially agreed to if he did so in front of his network.” Source: www.drugfree.org March 5th 2013

Source: www.drugfree.org March 5th 2013

I. INTRODUCTION

Recently, the federal government has expanded its enforcement actions against commercialized “medical marijuana” operations. In the wake of those enforcement efforts, the governors of Washington, Rhode Island, and Colorado have petitioned the Drug Enforcement Administration (DEA) to reschedule marijuana.

Specifically, the petition asks the DEA to reclassify marijuana from Schedule I to Schedule II under the Federal Controlled Substances Act (CSA).

The governors contend that such rescheduling will eliminate the conflict between state and federal law and enable states to establish a “regulated and safe system to supply legitimate patients who may need medical cannabis.”

The current petition takes a unique approach. It seeks to move marijuana and also all tetrahydrocannabinols, including delta-9-THC— the primary psychoactive component of marijuana—to Schedule II “for medicinal purposes only.”

In other words, the petition requests that “marijuana and related items [be] removed from Schedule I and rescheduled as ‘medical cannabis in Schedule II.’”

Marijuana advocacy organizations, such as the Marijuana Policy Project (MPP) and Americans for Safe Access (ASA) are urging other governors around the country to join onto the petition. The petition has garnered considerable publicity, but, as MPP acknowledges, “rescheduling is not a cure-all.”

This is an understatement. Indeed, for the reasons described below, it is not even a significant step in the direction that the governors, MPP, and ASA hope to move .This Article begins with a brief background of the Controlled Substances Act and then discusses the process of rescheduling, the meaning of Schedule II drugs (which is the classification called for by the governors), the legal definition of a drug with “medical use,” and Schedule II implications on both research and state and federa lregulations. The conclusion states that despite the vociferous calls for a federal marijuana reclassification, such a move would still not allow marijuana to be legally prescribed and distributed as a drug with medical use and that it is unnecessary for the legitimate claim of the need for more research into the drug. Instead, calling for rescheduling is a misguided effort that will only serve to increase the stridency of the political rhetoric in this debate. The proposal ignores the fact that the current provisions of the CSA and the Food, Drug, and Cosmetic Act(FDCA) together already restrict the availability of controlled substances products to such medical purposes. Moreover, the petition offers no alternate means or criteria for identifying such legitimate medical use.

II BACKGROUND

A. The Controlled Substances Act

Congress enacted the Controlled Substances Act in 1970 as part of the Comprehensive Drug Abuse Prevention and Control Act of 1970,replacing the previous patchwork of federal legislation governing psychoactive and potentially addictive substances.

Congress acted for a dual purpose: (1) to control and regulate the licit and illicit trade in, and use of, such substances; and (2) to implement the U.S. obligations under the Single Convention on Narcotic Drugs 1961, and subsequently, the Convention on Psychotropic Drugs 1971. As a signatory to these treaties, the U.S. is required by federal legislation to establish a range of requirements and prohibitions seeking to ensure that all psychoactive substances are used solely for legitimate medical and scientific purposes.

Therefore, the CSA already requires that controlled substances be used only for such purposes. As discussed more fully below, the CSA and FDCA contain coordinated provisions designed to ensure that properly manufactured, tested, and standardized medications are made available by qualified and licensed practitioners to patients.

The CSA governs all aspects of the handling of covered substances (“controlled substances”), including import/export, manufacturing, distribution, dispensing, individual possession, and research. The CSA divides such substances into five categories or “schedules,” depending on a substance’s usefulness as a modern medication on the one hand, and its potential for abuse/addiction on the other.

The CSA also requires that each person or entity who handles a controlled substance (until it reaches the ultimate consumer) be licensed or registered with the DEA, and each registrant must adhere to specific measures designed to ensure that controlled substances are manufactured, distributed, and dispensed only(1) for legitimate medical or scientific purposes, and (2) to patients legitimately in need of the substance.

B. How Are Drugs Rescheduled?

A substance may be rescheduled in several ways. First, an “interested party” may initiate an administrative action by filing a petition with the DEA, as did the governors of Washington and Rhode Island. Second, the DEA itself can initiate such an action.

Third, a product containing a controlled substance will be scheduled as part of the

Food and Drug Administration (FDA) approval process. Finally, Congress may reschedule or schedule a substance by legislation, although this has very rarely occurred in the past.

The scheduling process examines eight factors:

* (1)The drug’s actual or relative potential for abuse;

* (2) Scientific evidence of its pharmacological effect, if known;

* (3) The state of current scientific knowledge regarding the drug or other substance;

* (4) Its history and current pattern of abuse;

* (5) The scope, duration, and significance of abuse;

* (6) What, if any, risk there is to public health;

* (7) Its psychic or physiological dependence liability; and

* (8) Whether the substance is an immediate precursor of a substance already controlled under [the CSA].

Both the FDA and DEA analyze these factors, although the FDA’s recommendations on any scientific and medical issues are binding on the DEA. When enacting the CSA in 1970, Congress placed marijuana in Schedule I, along with other psychoactive substances of botanical origin ,such as psilocybin, ibogaine, mescaline, and peyote.

Substances in Schedule I have:

* “a high potential for abuse[;]”

* (2) no “currently accepted medical use” in the U.S.; and

* (3) lack “accepted safety for use .. . under medical supervision.”

Schedule I substances may only be used in research studies that are supervised by the FDA and licensed by the DEA. By contrast, Schedule II substances have:

* “a high potential for abuse” (as with Schedule I);

* (2) “a currently accepted medical use” in the U.S. or “a currently accepted medical use with severe restrictions[;]” and

* (3) abuse “may lead to severe psychological or physical dependence.”

Schedule II substances may be prescribed by physicians and dispensed by pharmacists

only when incorporated into specific FDA-approved products. Interpreting this statutory language as meaning “Schedule II substances may be prescribed,” however, is dangerously incomplete and may result in significant confusion. Such confusion underlies the governors’ current petition.

C. Schedule II Substances Are Not Directly Prescribed

Part of the confusion over the actual significance of Schedule II status stems from a misunderstanding of the interrelated, but distinct, functions of the CSA and the FDCA. The CSA and FDCA work together to ensure that medications meet exacting standards of quality, safety, and efficacy and that, when these medications contain controlled substances, they are handled in a manner that will ensure access to legitimate patients while minimizing abuse and diversion.

The CSA classifies substances into categories or schedules, generally by the International Non-proprietary Name (INN) or generic name of the active chemical ingredient (Active Pharmaceutical Ingredient or API). Each substance has a separate drug code. Generally, all such medical products, when approved for marketing by the FDA and scheduled by the DEA, are placed in the same schedule as the substance they contain.

By contrast, under the FDCA, the FDA approves specific medical products

produced by a particular “innovator” (for branded products) or generic manufacturers.

For example, oxycodone, an opioid, is classified as a Schedule II substance.

Specific products, such as OxyContin® (an extended release form), are also in Schedule II. Physicians prescribe a specific branded or generic product, in a particular dose and dosage form. In some cases, a more complex or “differential” scheduling occurs. That is, the pure or even “street” version of an API may be scheduled separately from a substance comprised of an FDA-approved formulation containing that active ingredient.

For example, gamma hydroxybutyricacid or sodium oxybate (“GHB”), the “date rape” drug, is a Schedule I substance. However, a separate substance or drug code has been created for all GHB-containing formulations that have passed through the FDA approval process. This separate substance is in Schedule III, as is any product containing it, such as Xyrem® . Similarly, tetrahydrocannabinols are in Schedule I, but a separate substance comprising an FDA-approved formulation of synthetic THC (called dronabinol) is in Schedule III. Specific products containing that substance are Marinol® and its generics.

The DEA has recently proposed to create a separate category or drug code (and hence, substance) for “marihuana extract,” although at present this substance remains in Schedule I. In short, the fact that a substance is in Schedule II (or even III-V)does not mean that the substance itself (as contrasted with specific branded or generic products containing it) can be directly prescribed and dispensed. This is particularly true for botanical raw plant material, for several reasons. First, botanical raw material can vary significantly in its composition. For example, depending on the strain, the opium poppy can produce differing amounts of morphine, codeine, thebaine, or oripavine.

A prescription designating “opium” or even “concentrate of poppy straw”

would not indicate the precise formulation of active ingredients (and, therefore, the dose) that the physician intends the patient to use in treatment.

Second, raw plant material can be contaminated by fungi and other dangerous microbes, depending on the cultivation, harvesting and storage practices employed (including storage by a wholesaler or retailer). These and other contaminants can be more reliably identified and removed during various processes of manufacturing, extraction, and formulation. Third, there is currently no method of administering raw plant material, which ensures that the patient receives a reproducible dose of active ingredients each time, in a manner that does not create any toxic by products. Indeed, no raw plant material has ever been approved by the FDA for sale by prescription, although a number of psychoactive plant and other botanical raw materials are listed in Schedule II of the CSA.

The governors’ petition contends that, “with modern DNA analysis” using polymerase chain reaction (PCR) and gel electrophoresis testing among other validated analytical

techniques, a “compounding pharmacist could easily and inexpensively quantify the levels of cannabinoids.”

Indeed, it avers that “accurate analytical kits are available” to enable “extremely accurate characterization[s] of a plant’s genetic make-up.”

However, the petition provides no evidence (nor even any citations) that such technology exists and that the results of such testing would provide proof of quality and batch-to-batch consistency that would meet the standards of modern medicine and be satisfactory to the FDA.

A recent documentary on the Discovery Channel examined the practices of Harborside Health Center in Oakland, California—by its own admission, the largest marijuana dispensary on the planet—revealed that the buds(which are distributed directly to member-patients) are merely examined visually using a microscope. The documentary noted that Steep Hill Laboratory tests some plant material, but there was no evidence that Steep Hill’s instrumentation and techniques are “validated,” that its operators are properly trained and educated, that its reference standards are accurate, or that its results are replicable by other laboratories. The FDA has established extremely high standards in the area of Chemistry, Manufacturing, and Controls (CMC) to ensure that a medication is consistent in composition, stable over a reasonable period of time, and not contaminated with excessive impurities.

Recently, a company seeking to develop a generic to Marinol® was forced to abandon one of its product development programs because of CMC issues. In light of the challenges faced even by pure synthetic cannabinoids products, it is unlikely that an individual testing raw botanical material would be able to demonstrate this exacting level of consistency. Furthermore, herbal plant materials would likely be administered through smoking or vaporization. The FDA has also established extremely rigorous CMC criteria for inhaled products. Metered dose inhalers must meet demanding standards in order to ensure that they maintain “consistent dosing and particle size distribution. ..throughout the expiration dating period.”

Notably, virtually all inhaled products have been approved only for pulmonary conditions, such as asthma. Vaporized products for non-pulmonary conditions have faced considerable concern from FDA.

It is therefore not surprising that crude botanical opiate or other materials are not prescribed and dispensed .Marketed medications containing pure opiate APIs (morphine, codeine, etc.) were available at the time the CSA was enacted. Therefore, the crude raw botanical materials from whence they were derived—opium (latex), poppy straw, and concentrate of poppy straw— were placed in Schedule II along with those APIs.9

However, their Schedule II status does not allow physicians to prescribe dried opium or poppy straw, or even the pure APIs derived from them, but rather only specific products containing those APIs.

The same would apply to marijuana, even if the plant material were reclassified to Schedule II, along with poppy straw. Imagine for a moment that the “medical marijuana” advocates were instead “medical opium” advocates and that various states passed laws decriminalizing (or affirmatively authorizing and regulating) the cultivation and distribution of opium plant material, i.e., opium latex or poppy straw. Even though opium latex and poppy straw are each in Schedule II, there would still be a conflict between such state laws and both the CSA and the FDCA. As a well-known drug reform advocacy website states, “if poppies are grown as sources for opiates, there is no question that it violates the CSA.” Furthermore, physicians would not be authorized to prescribe, nor pharmacists to dispense, dried opium latex or poppy straw. In order to be prescribed, a specific product containing opiate APIs would have to pass muster in the FDA approval process. Therefore, the mere act of placing herbal marijuana in Schedule II would not make it available to patients nor address the conflict between state and federal law.

D. Pharmacist Compounding

The petition appears to rely heavily on the premise that, if marijuana were moved to Schedule II, pharmacists could blend and dispense raw marijuana plant material upon the prescription of a physician. However, under the FDCA, a pharmacist’s compounding authority is quite limited. The FDA generally permits “traditional” compounding, which involves the preparation of a medication that is tailored to the specific needs of a particular patient, based on an unsolicited physician’s prescription.

It does not include wide scale manufacturing of products by pharmacists; this runs afoul of the FDCA: The drugs that pharmacists compound are not FDA-approved and lack an FDA finding of safety and efficacy. However, FDA has long recognized the important public health function served by traditional pharmacy compounding. FDA regards traditional compounding as the extemporaneous combining, mixing, or altering of ingredients by a pharmacist in response to a physician’s prescription to create a medication tailored to the specialized needs of an individual patient.

Traditional compounding typically is used to prepare medications that are not available commercially, such as a drug for a patient who is allergic to an ingredient in a mass-produced product, or diluted dosages for children. Through the exercise of enforcement discretion, FDA historically has not taken enforcement actions against pharmacies engaged in traditional pharmacy compounding .Rather, FDA has directed its enforcement resources against establishments whose activities raise the kinds of concerns normally associated with a drug manufacturer and whose compounding practices result in significant violations of the new drug, adulteration, or misbranding provisions of the FDCA.

Therefore, it is unlikely that rescheduling would enable pharmacists to prepare marijuana-based products for a significant number of patients. Moreover, pharmacists are only authorized to dispense a controlled substance to a patient based on a legitimate prescription from a physician. Under the CSA, a prescription must contain the drug name, strength, dosage form, quantity prescribed, and directions for use.

Again, there is no evidence that a pharmacist could “easily” prepare a blend of cannabis plant material that would meet these requirements and the standards of FDA-approved modern medications. Presumably, the governors’ petition is referring to the testing technologies currently employed by the panoply of marijuana “testing laboratories” that provide services to some dispensaries. However, in a recent article authored by the Director of the California branch of the National Organization for the Reform of Marijuana Laws (NORML), approximately one third of laboratories examined demonstrated “unacceptable deviations of more than 25% from the mean.”

The remaining laboratories were consistent only to within approximately 20%.

This might meet the standards for testing the potency of seized cannabis (which serve law enforcement and policy development purposes), but it would certainly not meet the standards of pharmaceutical testing for prescription medications administered to patients. Furthermore, other evidence from around the country suggests that laboratory results are even less reliable.

E. Accepted Medical Use

The primary difference between Schedule I and II substances lies in the phrase “currently accepted medical use in treatment in the United States.” This phrase is not defined in the CSA. However, the DEA has developed a five-part test for determining which substances are classified as Schedule II that has been upheld by federal courts:

* The drug’s chemistry must be known and reproducible;(2) There must be adequate safety studies;

* (3) There must be adequate and well-controlled studies proving efficacy;

* (4) The drug must be accepted by qualified experts; and

* (5) The scientific evidence must be widely available.

Mere anecdotal evidence (reports of specific cases), state laws, or even the policy positions of medical organizations, are not sufficient to satisfy these criteria, but rather only data from robust, controlled studies are sufficient to satisfy them.

Not surprisingly, FDA approval of a 1 product is sufficient (although not necessary) to establish that such product has an accepted medical use in the U.S. The governors’ petition asserts that there is a “consensus of medical opinion concerning medical acceptability of cannabis amongst the largest groups of physicians in the United States.”

In support of this statement, the petition states that the American Medical Association (AMA)allegedly reversed its position that marijuana should remain a Schedule I substance.

However, contrary to the governors’ petition, the AMA does not believe that there has been sufficient research to justify making herbal marijuana available as a prescription medication: “Despite more than 30 years of clinical research, only a small number of randomized ,controlled trials have been conducted on smoked cannabis.”

Furthermore, while the AMA’s Report does state that the Schedule I status should be “reviewed,” it limits the purpose of such review to the “goal of facilitating the conduct of clinical research and development of cannabinoid-based medicines, and alternate delivery methods.” The AMA does not recommend that marijuana should be rescheduled in order that it can be directly prescribed and dispensed in its raw form to patients. In fact, the AMA recommendation cautions that, “this should not be viewed as an endorsement of state-based medical cannabis programs, the legalization of marijuana,

or that scientific evidence on the therapeutic use of cannabis meets the current standards for a prescription drug product .”

In the body of its report, the AMA further clarified its position by stating: The AMA supports the concept of drug approval by scientific and regulatory review to establish safety and efficacy, combined with appropriate standards for identity, strength, quality, purity, packaging, and labelling, rather than by ballot initiative or state legislative action.

The future of cannabinoid-based medicine lies in the rapidly evolving field of botanical drug substance development, as well as the design of molecules that target various aspects of the endocannabinoid system. To the extent that rescheduling marijuana out of Schedule I will benefit this effort, such a move can be supported. The term “botanical drug substance” is derived from an FDA guidance document Guidance for Industry: Botanical Drug Products It refers, not to herbal plant material, but to extracts or similar preparations of the active botanical components.

As the AMA Report states:

The crude botanical substance can become a “botanical drug substance” through processes of extraction, blending, addition of excipients, formulation, and packaging in a defined manner. Particular attention is devoted to product composition because botanicals are complex mixtures of chemical/structural components. Similar to conventional products, a botanical drug substance must undergo animal toxicity studies, and demonstrate its safety and efficacy in randomized, double-blind, placebo-controlled trials. Additional pharmacologic and toxicologic studies are required if a non-oral route (e.g., inhalation) of administration is contemplated. If the substance is intended to treat chronic conditions, 6 to 12 months in long-term safety extension studies is considered sufficient.

Therefore, rather than accepting that marijuana meets the accepted standards for modern medicine, the AMA is essentially stating that research into crude marijuana plant material is a dead end.

ANALYSIS

A. Application of the FDCA and CSA to Intrastate Manufacturing/Cultivation and Distribution Under the Federal Constitution, Congress has specific enumerated powers and can only pass legislation pursuant to one of those powers. Under the Commerce Clause, Congress has the power to regulate commerce amongst the states.

The U.S. Supreme Court has expansively defined the scope of activity that involves or affects interstate commerce. With regard to the CSA, the Court has ruled that, under the Commerce Clause, the CSA is valid as applied to “the intrastate ,non-commercial cultivation and possession of cannabis for personal medical purposes” on the advice of a physician. Similarly, the FDA broadly interprets the reach of the FDCA, which applies to products in, or that are introduced or delivered for introduction into, or received in, interstate commerce. A product is a “drug,” subject to the quality, safety, and efficacy requirements of the FDCA if it is “intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease” or is “intended to affect the structure or any function of the body. A “new drug” cannot be introduced or delivered for introduction into interstate commerce unless approved by the FDA.

In light of the interconnectedness of many aspects of the national economy, it is highly likely that any marijuana medical product would be deemed to affect interstate commerce, particularly if the transaction has a commercial aspect.

The use of the internet or other publication method to advertise a product creates an additional connection to the channels of interstate commerce. Therefore, intrastate manufacture and distribution of marijuana products would not avoid the requirements and restrictions of the CSA and FDCA. Accordingly, a physician would not be able to prescribe, or a pharmacist to dispense, a marijuana medical product unless that product had secured FDA marketing approval

B. Rescheduling Is Not Necessary To Make Marijuana Products Available For Research

A committee of the California Medical Association recently called for the rescheduling of marijuana “so it can be tested and regulated.” However, it is not necessary for marijuana to be rescheduled in order for legitimate research to proceed. Schedule I status does not prevent a product from being tested and researched for potential medical use.

The FDA (and its Controlled Substances Staff) will allow an investigational product containing a controlled substance (including Schedule I substances) to be tested in a clinical (human) trial if there is adequate evidence of safety from non-human studies.

The CSA imposes stringent security, record keeping, and other requirements, but these apply equally to Schedule I and Schedule II substances. Under the CSA, the only differences between Schedule I and II are rather technical.

Before granting a Schedule I research registration, the DEA will separately inquire whether the FDA believes that the researcher is qualified and competent and the trial design will elicit scientifically valid data. A Schedule I research registration must be renewed each year, whereas research registrations for other controlled substances are valid for three years.

Schedule I research registrations are protocol, as well as substance, specific.

By contrast, a Schedule II registration is valid for research into all Schedule II substances and protocols. Physicians, if they possess registrations to prescribe and administer products containing controlled substances, may conduct research (if permitted by the FDA and the relevant ethics committee) on any Schedule II substance as a “coincident” or adjunct activity to that registration; they need not obtain a separate research registration from DEA.

These additional Schedule I restrictions can delay a research program but are not insurmountable. Furthermore, it may be possible to make minor amendments to the CSA to “equalize” Schedule I and Schedule II research requirements without necessitating a rescheduling of marijuana. Even in the absence of such a statutory amendment, Schedule I research certainly does go forward. In a recent pharmaceutical company-sponsored human clinical study investigating a product derived from marijuana extracts,

the DEA registered approximately thirty research sites in the U.S. and also registered an importer to bring the product into the U.S. from the U.K., where it was manufactured.

C. Obtaining Raw Plant Material for Research

Schedule II status would not make it easier for medical researchers to obtain marijuana plant material for purposes of research. The U.S.’s obligations under the Single Convention on Narcotic Drugs require that a national agency have exclusive control over the domestic cultivation of marijuana, as well as its importation and exportation.

The National Institute on Drug Abuse (NIDA) primarily implements the responsibilities outlined in the treaty. The NIDA contracts with the University of Mississippi’s National Center for Natural Products Research (NCNPR) to cultivate marijuana for research purposes.

Researchers who obtain grant funding from an institute of the National Institutes of Health (NIH), such as NIDA, can obtain marijuana for their studies, while researchers who are externally funded must undergo the equivalent of a grant review process (a review of their study design by an expert committee of the Public Health Service) in order to obtain such marijuana at cost from NIDA. NCNPR has the ability to produce

standardized marijuana of varying THC potencies. Its cultivation area of five acres has been adequate to supply all marijuana-related studies to date.

Even if marijuana were placed in Schedule II, these treaty obligations would remain in force. This does not, however, mean that it would never be possible to conduct large scale cultivation of marijuana for purposes of commercial medication development, although such cultivation would have to be closely supervised by the NIDA or the DEA, in a manner similar to NCNPR’s “farm.” Furthermore, it is also possible that cultivation would take place in another country (under the auspices of that country’s national agency), and extracts of the active ingredients would be imported into this country for research, just as concentrate of poppy straw is now imported into the U.S. for the development of modern opioid products. Under 100-year old international policies,

most countries, including the U.S., do not cultivate psychoactive plant material for purposes of commercial medication development, but rather import such narcotic raw material(NRM) from a short list of authorized manufacturing/cultivating countries.

Importantly, such extracts are exempt from the Single/Convention’s national agency mandate. As indicated above, this is precisely how marijuana extract-derived medications are currently made available for research in the U.S.

D. State Regulation of Marijuana

Would Schedule II status permit states to regulate the cultivation, sale, and distribution of marijuana for either medical or recreational use? As noted above, the CSA was enacted in part to implement the U.S.’s international obligation to restrict the use of psychoactive substances to legitimate medical and scientific purposes.

Schedule II substances are subject to very strict controls, given that almost all the security and other controls that govern Schedule I substances apply equally to Schedule II substances. Additionally, unlike Schedule I substances, Schedule II substances can be developed into commercialized products, and are therefore subject to production and procurement quotas determined by the DEA. Accordingly, a state could not attempt to establish a regulatory system that undermined or otherwise conflicted with these CSA restrictions. Again, poppy straw is a Schedule II substance, as is morphine, but a state could not create a regulatory structure that was more lenient than that established by the CSA.

E. Marijuana as a Federally-Illegal Substance

Placing marijuana in Schedule II would not eliminate its status as an illegal substance under the CSA. While the severity of many of the CSA’s criminal penalties are keyed to the schedule of the substance in question, this is not entirely true for marijuana.

There are statutes under the CSA that prescribe specific penalties for manufacturing, distributing or dispensing (or possessing with intent to do the same) of certain quantities of marijuana. Furthermore, even considering those statutes that are keyed to a substance’s schedule, the same criminal penalties apply equally to Schedule I and II substances.

Thus, none of these statutes would be directly affected by a change in marijuana’s schedule. Finally, the CSA provides that it is illegal to possess any controlled substance without a valid prescription from a physician. Again, under the FDCA, a medical product cannot be manufactured and sold (a precursor for it to be prescribed) unless the product has been approved by the FDA.

Hence, transferring crude herbal marijuana to Schedule II would have no impact on these statutes

CONCLUSION

By contrast to the careful and detailed structure of the CSA, the governors’ petition offers no criteria or guidelines that would clearly identify the scope of legitimate “medical use.” At present in California, and in several other states, it is widely recognized that the concept of “medical use” of marijuana is highly questionable. For payment of a small cash sum, almost anyone can obtain a physician’s “recommendation” to purchase, possess, and use marijuana for alleged medical purposes. Indeed, numerous studies have shown that the most customers of these dispensaries do not suffer from chronic, debilitating conditions such as HIV, AIDS, or cancer.

Parties on both sides of the argument agree that this system has essentially legalized marijuana for recreational use—at least amongst those individuals able and willing to buy a recommendation. The petition would potentially expand that system on a national scale, permitting any physician in any state to prescribe any form of marijuana for any medical condition. This has nothing to do with its Schedule, because placing marijuana in Schedule II would do nothing to change the fact that it could still not be prescribed— the FDA would first have to approve a specific product. Rather, vociferous calls for rescheduling like these simply muddle and confuse an already highly charged debate.

Source: Dr. Kevin Sabet Wayne Law Review April 1, 2012 Volume 58 No. 1

A new study found that middle school students in small towns and rural areas who received brief interventions had lower rates of prescription drug abuse into late adolescence and young adulthood.

Prescription drug abuse is taking a medication without a prescription, or in ways or for reasons not prescribed. Abuse of prescription drugs can have serious and harmful consequences, including addiction, poisoning and even death from overdose. Surveys have found that prescription and over-the-counter medications are among the top substances abused by young people. Developing successful community-based interventions to prevent this abuse is an important public health goal.

A team led by Dr. Richard L. Spoth at Iowa State University conducted 3 studies to assess the effectiveness of brief community-based interventions among rural or small-town students in grades 6 or 7. The studies didn’t target prescription drug abuse specifically. Rather, all 3 studies used universal preventive interventions, which address general risk and protective factors for substance abuse. The work was funded by NIH’s National Institute on Drug Abuse (NIDA), National Institute on Alcohol Abuse and Alcoholism (NIAAA) and National Institute of Mental Health (NIMH).

Study 1 (conducted from 1993 to 2008) tested an intervention focused on families of 6th graders. Study 2(1998-2011) tested a combined family-focused intervention and a school-based life skills training program in 7th graders from 24 schools. Study 3(2002-2009) tested a family-focused intervention and school-based interventions in 6th graders from 28 school districts. Students were randomly assigned to an intervention or control group.

Students completed written questionnaires or phone interviews through ages 17 to 25. They were asked about lifetime use of drugs such as barbiturates, tranquilizers, amphetamines, narcotics, opioids and pain relievers not prescribed by a doctor for their use. The results appeared online on February 14, 2013, in the American Journal of Public Health.

In study 1, the intervention reduced the rate of prescription drug abuse by 65%. Of the youth who participated in the intervention, 5% reported lifetime prescription drug abuse at age 25, compared with 16% of those in the control group. In study 2, rates for prescription drug abuse were reduced 33-62% at different ages. In study 3, 23% of youth who participated in the intervention reported lifetime prescription drug abuse in the 12th grade, compared with 29% of those in the control group.

These findings show that brief interventions among 6th and 7th graders in small towns and rural areas can bring long-term reductions in prescription drug abuse.

“The intervention effects were comparable or even stronger for participants who had started misusing substances prior to the middle school interventions, suggesting that these programs also can be successful in higher risk groups,” Spoth says.

This study adds to growing evidence that brief intervention programs can have lasting effects on risky behaviors like drug abuse. Further research will be needed to better understand how best to design programs that target different high-risk populations.

Source: www.nih.gov/researchmatters/march2013/interventions.htm March 4th 2013

Denver television station CBS4 reports that Colorado has seen a sharp spike in marijuana use among teenagers since voters passed Amendment 64 last November, legalizing recreational use of the drug. As described in The Economist, along with a Washington State measure also legalizing marijuana, Amendment 64 is “an electoral first not only for America but for the world.”

That means two American states are to the left of the Scandinavian countries, Holland, and every other liberal country regarding marijuana.

CBS4 quotes a number of local high-school students: “I’ve seen a lot more people just walking down the street smoking (joints),” high-school student Irie Johnson said. “In high school it has kind of gotten out of hand,” student Alaina Tanenbaum said.

According to the CBS4 report, based in part on data from a local drug-testing lab: “Experts say the test results show that children are getting higher than ever with alarming levels of THC, marijuana’s active ingredient, in their bodies.”

The massive increase in both the number of users and the amount of marijuana used by young people is precisely what I and many others predicted. It was easy to foresee.

When something desirable is made easier to obtain, more people will obtain it. It is difficult to imagine an exception to this commonsense observation.

So legalizing marijuana is foolish because it leads to far more use of the drug and the availability of ever more potent forms. But the foolishness doesn’t end there. Equally foolish is that as a society we have made peace with marijuana while making war on tobacco. This has been a classic example of upside-down thinking; and we are reaping exactly what we have sown. We have produced a generation of young Americans who would never put a cigarette or cigar near their lips, but who increasingly get high on pot.

Yes, tobacco — specifically cigarettes — kills and marijuana doesn’t. But, if you’ll forgive the ultimate political incorrectness, young people would do much better in life if they smoked tobacco rather than weed. First, tobacco doesn’t kill young people. When it kills, it generally kills much older adult people. Moreover, according to a recent issue of the New England Journal of Medicine, if you stop smoking cigarettes by age 44, you will lose only one more year of life than a person who has never smoked.

Second, regular pot smokers increasingly tune out of life, becoming what are known as potheads, or, to put it bluntly, losers.

Third, as noted in the CBS4 report, “new studies that have been published say the risk of a car accident increases two-fold after someone consumes pot.” In other words, innocent human beings — sometimes whole families — are more likely to be maimed, paralyzed, and killed by pot smokers than by cigarette smokers.

For myriad reasons, then, I would far prefer my teenager indulge in cigarettes — not to mention cigars — than pot. Anyone who thinks that pot is less harmful to a teenager than tobacco is fooling himself — and his teenager.

If this is not obvious, ponder these questions: Would you rather your airplane pilot smoke pot or tobacco while flying? How would Britain have fared in World War II if Winston Churchill had smoked pot instead of cigars?

In terms of the effects of tobacco and pot on the smoker while smoking, there is simply no comparison between pot and tobacco.

What the Left has done to America’s youth in the last 40 or so years is so damaging as to be unforgiveable. They have ruined public-school education; left them with so much debt that they will likely be the first American generation to live in a fashion materially inferior to that of their parents; and robbed their innocence with sex-education classes, now beginning in kindergarten in Chicago and elsewhere. Now they are making marijuana available to more kids and in greater potency than ever before.

But they have left them with higher self-esteem.

Dennis Prager is a nationally syndicated radio talk-show host and columnist. His most recent book is Still the Best Hope: Why the World Needs American Values to Triumph. He is the founder of Prager University and may be contacted at dennisprager.com.

Source: www.nationalreview.com 12th March 2013

The NDPA notes that there is more drug use in USA schools since the legalisation of marijuana in two states. This item from Australia on drug use amongst students is shocking; in the UK we need to continue to keep firm drug laws and to promote drug prevention to our youth in order that the same situation does not occur in our schools.

THE Gold Coast region is the booming drug school capital of Queensland, according to confidential data. Exclusive statistics provided to the Bulletin show the number of students excluded from southeast district schools have more than doubled in the past three years. Those figures threaten to triple this year as the region — from the tourist strip, west to Beaudesert and north to Beenleigh and Logan — overtakes Brisbane’s combined northside and southside suburbs for young “stoners”. Police and welfare workers are convinced the Coast’s alarming youth drug trend is fuelled by the economic downturn. Unable to get work in the construction or hospitality industries, former students who began their dope habit back in the early years of secondary school are now returning to their old campuses to deal drugs. “They have fallen back on the only commerce they know — the drug trade,” a police source said. Welfare workers are aware of principals in the Beenleigh region who are banning ex-students from returning to the grounds in a bid to stop school-gate drug deals.. Documents obtained by Right To Information laws reveal many of the offenders are in Year 8, and more than 250 pages of “suspension” reports show increasing numbers of them are bullying females. They use either their mobile phones or Facebook to obtain “the happy drug” from dealers in houses near their schools. In a shocking incident, a student sold 160 tablets, suspected to be speed. Another student who took the tablets overdosed and was taken to hospital, authorities writing that his life was placed at risk. Other reports show students obtain drugs from dealers at Pacific Fair and other shopping centres, skate parks and train stations. However, most students are aware of the CCTV cameras at major business centres, and prefer carparks, skateparks, drains, hidden areas under bridges or bushland near schools to set up their bongs. The young dealers boast about selling weed for as little as $5. A bag of pot is worth $60. Police keeping watch on hotspot schools have found female students smoking an hour before classes. When a female student refused to get inside the police car, an officer was forced to “put her in a wrist lock” as they struggled to get to the deputy principal’s office. Student intelligence being fed to welfare workers suggests criminals are buying or renting homes near schools so “stoners” can gain easy access during lunch breaks. School suspension reports show students arriving at school preparing to party. They bring water-pipe bongs, grinders, clip-seal bags, scissors, pliers and garden hoses. Boys are hiding “the happy drug” in their shoes and toothpick holders, while girls place lighters down their bras. Glassy-eyed, barely able to stand, sometimes with their heads resting on their desks, they are nonchalant about their drug habit interfering with their education.
Asked why she squatted on a netball court to smoke weed, a female student told her deputy principal: “I’ve had a bad week.” A student who arrived at a new school after being excluded from another for drug-related activities brought “weed” on his second day. Before excluding him, his new principal told him: “You admitted to bringing a lunch box-size container of marijuana to school on the second day of attendance at our high school and daily thereafter. “You admitted to supply marijuana … you admitted to asking a student to hide your stash. The behaviour is so serious that suspension would be inadequate to deal with this behaviour.”

Source: www.goldcoast.com.au 13th March 2013

 

Fans enjoy Madeon’s set at last year’s Ultra Music Festival. Starting Friday, Ultra Music Festival is expected to attract more than 160,000 young people from across the world to party with hundreds of international DJs and music artists. This year, it’s attracting something else: Molly.

Molly is a party drug that is a derivative of Ecstasy, which has fuelled dance parties for decades. It appeared on the dance-music and hip-hop scenes around early 2011 — billed as pure MDMA, the amphetamine that is the prime ingredient of Ecstasy. It comes as crystals or as a white powder inside a capsule and can cause high blood pressure, a rapid heart rate, possible brain injury and even heart attacks, depression and suicidal thoughts after the drug is out of the body, especially if the user has an underlying mental illness.

“They tend to have a psychiatric phenomenon,” Bernstein said. “That seems to be a phenomenon that we are seeing with the bath salts that we don’t see as much with amphetamines or methamphetamines.” Mick Elle, 37, a musician and former DJ raised in Miami, had a three-month depression that he blames on Molly. “What I hate about Molly is I had a hangover of two or three weeks. Took me three months to recover,” Elle said. “It’s such a blowup. But when you go up, eventually you will have to go down.”

The Florida Poison Information Center at Jackson Memorial Hospital received its first calls related to Molly in 2011. From 2011 to 2012, the number of calls more than doubled, from eight to 20 calls. Katie Victoria, 27, a student at Broward College, first heard about Molly when she moved to Miami four years ago from Maryland. “Before I moved to Miami, I never had heard of such a term,” Victoria said. “I don’t think anywhere else in the United States it’s as popular as here.” But as popular as it may be, Molly is not a high law enforcement priority because it is not nearly as prevalent as cocaine and marijuana and leads to far less street violence, said Lt. Dan Kerr, commander of the Crime Suppression Unit of the Miami Police Department.

That changes during Ultra. “Ultra is really when we work the buys,” Kerr said. “That’s when big shipments come in.” Victoria went to Ultra in 2010 and doesn’t plan to go again. “A lot of the 18-year-old kids cannot even buy alcohol, so obviously what they are doing is Molly,” said Victoria. She reported seeing partiers take 10 pills in one Ultra night. “You really think they’re gonna do one Molly and that’s it? No, because kids are not that responsible,” she said. “They don’t think about their health that way.”

A spokesman for Ultra said no one was available to comment, as they were too busy preparing for the event. The festival’s policy, listed on its website, says the possession of any illegal substance is not tolerated. Security is extremely tight and all bags are searched at the gate. Jose Gutierrez, 24, an events promoter in Miami who has been going to Ultra for five years, said everyone is on drugs. “If they are not on drugs, they are not having fun,” said Gutierrez, who says he has taken Molly at Ultra since 2010. “You feel the music in your body. It’s like tickling in the inside and that’s what makes you smile,” he said. “You smile and you don’t stop dancing.”

By the end of an Ultra weekend as many as 50 people might overdose and need medical treatment after taking Molly and other drugs, Kerr said. The Miami Police Department’s Special Events unit, which will coordinate the officers that will staff the event, have met with local merchants and residents about possible route changes during the event.

Documented health effects aside, Molly is popular in the music world. Kanye West, Lil’ Wayne and 2 Chainz have referenced the drug in their lyrics. Madonna used her Molly remark to release MDNA, her 12th studio album, at last year’s Ultra — wearing its controversial title emblazoned on a T-shirt at the festival. And Miami-based international DJ Cedric Gervais, 33, released a single in April 2012 called Molly. “It’s about a girl because I was looking for this girl called Molly,” said Gervais, a resident at the Fontainebleau Hotel club LIV. “The crowd is thinking MDMA, that’s the controversy of it.”

Read more here: http://www.miamiherald.com/2013/03/12/v-print/3281778/police-expect-club-drug-molly.html#storylink=cpy

—

Source: Posted on Tue, Mar. 12, 2013 South Florida News Service

 

 

WHITE MOUNTAINS – Experts in Colorado are starting to study the impact medical marijuana has had on teen drug use in their state. Medical marijuana sales are scheduled to begin in April in Arizona. Fifteen states and the District of Columbia now have medical-marijuana programs.

Two recently released national surveys, the National Survey on Drug Use and Health conducted by the Substance Abuse and Mental Health Services Administration and the University of Michigan’s Monitoring the Future data have shown increases in teen marijuana use, marked by a decreased perception of harm in the drug.

“The basic rule with any drug is if the drug becomes more available in the society, there will be more use of the drug,” said Thomas Crowley, a University of Colorado psychiatry professor and director of the university’s Division of Substance Dependence. “And as use expands, there will be more people who have problems with the drug.”

In Colorado treatment centers, clinicians are treating more and more teens for marijuana

addiction since the state legalized marijuana for medicinal use. At the Denver Health Medical

Center, treatment referrals have tripled with 83 percent of the teens that smoke pot daily saying they obtained it from a medical marijuana patient. Navajo County Drug Project (NCDP) tracks youth drug use through the biannual Arizona Youth Survey, conducted by the Arizona Criminal Justice Commission. In the 210 survey, 29.2 percent of participating Navajo County youth, in eighth to 12th grade reported having used marijuana in their lifetime. This was down from 42.1 percent in 2008 and 29.3 percent in 2006. “These statistics show a steady decline of marijuana use among Navajo County youth,” said NCDP Director Debe Campbell. “We won’t have parallel data until 2012, when we expect to see escalation of use,” she added.

The National Institute on Drug Abuse (NIDA) allocated money for health advocates to study the effects of medical-marijuana policies on broader drug use and public health. NIDA officials decided to offer the funding after seeing a rapid change in marijuana policies across the country.

Source: http://www.wmicentral.com/news/latest_news/medical-potlaws Jan. 17. 2011

In the past decade or so, research with MRI and functional MRI has revolutionised what we know about how the human brain develops. We now understand that the brain undergoes protracted development, continuing throughout adolescence and beyond.

1.Adolescence is defined as the period starting with the physical and hormonal changes associated with puberty and ending when an individual attains a stable, independent role in society.2 Although the point marking the end of adolescence varies with culture, the end of the teenage years represents a working consensus in developed countries. One brain region that develops substantially during the teenage years is the prefrontal cortex, which is involved in executive functions, such as decision making, inhibitory control, and planning,3,4 and in social understanding and self-awareness.5 A key finding from structural MRI studies is that the volume of grey matter, which contains brain cell bodies and synapses, changes between childhood and adulthood. In the prefrontal cortex, grey matter increases in volume during childhood, peaks in early adolescence, and then declines in adolescence and throughout the 20s.1 The loss of grey matter during adolescence is thought to be due, at least partly, to synaptic pruning—the process by which excess synapses are eliminated. Supporting this notion, findings from studies of post-mortem human brain tissue have shown a decline in the number of synapses in the prefrontal cortex during adolescence.6 Synaptic pruning is partly dependent on environmental input: synapses that are used are strengthened; synapses that are not used are pruned away.7 In this way, synaptic pruning sculpts neuronal circuitry according to the environment during sensitive periods of brain development. Although a great deal of evidence supports early periods of sensitivity to sensory information,7 less is known about the existence of later sensitive periods. Meier and colleagues’ study8 provides some evidence that adolescence might represent a period of brain development that is particularly sensitive to environmental input. The researchers investigated the association between self-reported persistent cannabis use and changes in cognitive ability in 1037 participants of the Dunedin longitudinal study, which has followed this cohort in Dunedin, New Zealand, from birth to their current age of 38 years. Cognitive ability was assessed from IQ and various neuropsychological measures, including working memory, processing speed, perceptual reasoning, and verbal comprehension.

Cannabis use over the past year was reported at five time points between 18 and 38 years. A major strength of this study was that cognitive ability had already been tested at the age of 13 years, before first cannabis use, so the researchers had a baseline measure with which to compare the results of a second test in the same individuals 25 years later. The findings showed that persistent cannabis use is associated with a statistically significant decline in cognitive ability. That is, the more persistent the cannabis use, the greater the cognitive decline. Second, the association between persistent cannabis use and cognitive decline was significantly greater for people who began using cannabis before, compared with after, 18 years. Third, if cannabis use started in adolescence (before 18 years), the cognitive deficit remained significant when people had stopped using for at least 1 year before testing.

These findings provide prospective evidence from a large cohort that adolescent cannabis use is more damaging to cognitive abilities during adulthood than is adult use. The results remained significant after adjustment for other possible confounding factors, including alcohol and so-called hard-drug dependence (eg, heroin, cocaine, or amphetamines), years of education, and diagnosis of schizophrenia. But we still have to be cautious about interpreting the correlation between cannabis use and reduced cognitive ability as a direct causal relation. Perhaps a third factor— for example, decreased motivation or a psychiatric disorder developed in adolescence, such as anxiety or depression—leads people to smoke cannabis and perform poorly on IQ and neuropsychological tests.

Nevertheless, this study is important because it suggests that adolescence is a period of brain development that is sensitive to environmental factors. Cannabis seems to have long lasting negative consequences on a broad spectrum of cognitive abilities, perhaps because persistent cannabis use during adolescence affects how brain circuitry develops.9 Could training and rehabilitation programmes reverse the decline in cognitive ability associated with cannabis use in people younger than 18 years? This is a question for future research. People can relearn sensory information that has been lost because of lack of sensory input in early sensitive periods of brain development, but only via fairly intensive training and under certain conditions.10 The implications of this study are far reaching. Other environmental influences—for example, alcohol, tobacco, and drug treatments—might also negatively affect the developing brain in the long term. Conversely, if the adolescent brain is particularly malleable, this might be a key time for positive effects of the environment, such as teaching, rehabilitation, and training. As highlighted in a recent Series in The Lancet,11 global health and education policy should include a greater focus on adolescence, when the brain is still highly adaptable and can be shaped by the environment

Source: www.thelancet.com Published online October 30, 2012

 

Not many of us are chemists. Yet by removing one oxygen atom average people here in Missouri regularly are turning common decongestants like Sudafed and Claritin-D into the illicit drug methamphetamine. Nationwide those explosive mom and pop meth labs were estimated by a Rand study to cost taxpayers more than $23 billion a year in health care costs, child endangerment and clean-up. But as St. Louis Public Radio’s Maria Altman reports a local pharmaceutical company may have the answer.

In a non-descript office building in suburban St. Louis a little company was busy developing big technology; a binding agent to make a tamper-resistant drug. They weren’t yet sure exactly what drug Westport Pharmaceuticals they would tackle. Paul Hemings is the General Manager and Vice President of the Highland Pharmaceuticals subsidiary. He says looking back, it was staring them in the face.

“It started with our patent attorney who also has a chemistry background and lives out in Pacific where this meth problem is huge and one day she just mentioned ‘have you thought about this?” That is how to prevent pseudoephedrine, a common ingredient in nasal decongestants, from being turned into methamphetamine. Zephrex-D was the result.

How It Works

Hemings points out the pills’ waxy white coating. He says the new drug works just as well as other pseudoephedrine products, but meth cooks can’t extract the key ingredient. That means they can’t make meth. “We can end meth labs in the U.S. starting right here in our backyard where the problem is the biggest,” Hemings said. Last year alone law enforcement seized more than 1,800 clandestine labs in Missouri, the most of any state in the country. Detective Sgt. Jason Grellner is with the Franklin County Narcotics Enforcement Unit and is considered the expert on Missouri’s meth lab epidemic.Grellner says he was skeptical of Zephrex-D after years of being told by large pharmaceutical companies that a tamper-resistant drug couldn’t be made.

Now he says he’s a believer. “I’ve seen the testing by independent laboratories; I’ve personally tested the product in a one-pot meth lab setting; and I know of other testing that has been done,” he said. “They have manufactured a product that is meth lab resistant.”

Requiring A Prescription?

Grellner doesn’t expect “big pharma,” as he calls it, to change their pseudoephedrine products, at least not yet. He says for now the best way to keep the pills that still can be converted into meth away from criminals is to require prescriptions. “They have manufactured a product that is meth lab resistant.” – Detective Sgt. Jason Grellner

That faces strong opposition, including from the St. Louis Chapter of the Asthma and Allergy Foundation. “We do know that meth is a terrible problem in Missouri, we just disagree on how to take care of this,” said Joy Krieger, the foundation’s executive director and a registered nurse. Krieger says they support a proposed law to further limit the amount of pseudoephedrine people can buy each month, but she says getting a prescription is an expensive hassle. “Pseudoephedrine is safe for those purchasing it for proper reasons, so penalizing

residents and citizens who have done nothing wrong we think is not a fair way to look for a solution,” she said.

The Legal Perspective

State Representative Jeff Roorda has sponsored legislation for the state-wide prescription law every year since 2005. The Democrat from Jefferson County, the heart of Missouri’s meth country, says with Zephrex-D, there is a good alternative available for cold and allergy sufferers, so there can be no more excuses. “Now we have a pseudoephedrine that’s incapable of being converted into methamphetamine, I mean arguments against this just hold absolutely no water anymore,” Roorda said. The impact of Zephrex-D remains to be seen.

Westport Pharmaceuticals officials say they’re open to selling their binding technology to other drug-makers. Right now Zephrex-D is only available in Missouri and the Metro East. Officials say they plan a national roll-out this summer.

Source: http://www.news.stlpublicradio.org 13th March

 

 

Author: Mr. S.W.Varcoe May 2012 www.dalgarnoinstitute.org.au

drug in the past 30 days has decreased 38% from its peak in 1979 (14.1%) to 2009 (8.7%). Equally impressive are statistics from the United Nations Office on Drugs and Crime (UNODC), which has documented a greater than 80% reduction in annual opioid use over the past century!”8,9,10

Yet, there is more to professional health management strategies than economic rationalism. Disease control is a primary goal of good health management policy/strategies. Eradication of any disease is the ultimate goal, but in the interim, management practices can be used with an attempt to alleviate symptoms and to improve health status, enabling best opportunities to work toward recovery and wellness. When there is any option for recovery/wholeness then that becomes the goal.

No good health professional will refuse or omit such options when they are available.

For instance, when it comes to the epidemiology of a disease, treating physicians look to a number of factors, including the agent of contagion. They look to manage, negate and prevent these agents from spreading.

Illicit drug use dependency has now been widely touted as a ‘disease’ and as such the term ‘disease’ has an ever morphing definition in various diagnostic manuals. Regardless of the definition, treatment principles still remain the same – the containment, cessation and future prevention of this disease. Two key factors must be addressed if any sort of positive health outcome is going to be achieved…

a) Susceptibility factors of the patient

b) Exposure factors to the patient

So in treating the disease of drug dependency/addiction one must address both of these factors to have best hope of the drug user becoming healthy again – The health that a) saves money b) keeps you from harm c) enables your full productive potential d) adds to your and the communities general well-being.

The question we now have to ask of any measure that will increase accessibility, permissibility and availability of illicit drugs is, will it exacerbate or alleviate a) susceptibility factors and b) exposure factors? If it does the former, then we have breached good, professional and fiscally responsible health care practice. Any action/method/process that enables the increase or worsening of these two factors is at best reprehensible and at worse culpable and worthy of malpractice suites and license revocation.

When it comes to the mental, physical and emotional health of society’s citizens and particularly its children, any measure that increases the exposure or susceptibility to a disease must be, if not eradicated, utterly contained. To do less is to collapse the very core of what good governance and good health care strategy is for a nation.

When the already available, well managed and effectively deployed ‘exposure’ preventing tool of criminality is employed, we are half way to achieving best potential for full recovery. Removing this proactively used mechanism will only see the opposite be true in a community.

Recent figures show the libertarian claim that the ‘war on drugs is being lost’ is becoming less and less credible Guy Bentley recently argued on this site that “Theresa May has shown a lack of courage and integrity by denying the British people the chance to have an open debate on drugs based on evidence”, because she has dismissed the suggestion of a royal commission to consider the legalisation of drugs. This was followed by the familiar claim that the Government is ‘losing the war on drugs’, although I doubt very much that Theresa May or any other government minister does describe government policy as a ‘war’.

Bentley argues that “36 percent of adults had used an illegal drug in their lifetime; and nine percent of adults used illegal drugs in the last year. Hardly a success.” But look at these figures the other way round: 64 per cent of adults have never used an illegal drug in their lifetime. 91 per cent of adults have not used an illegal drug in the last year. Hardly a failure.

As Bentley himself recognises, heroin and crack cocaine addiction is at a record low, with the number of heroin and crack cocaine users in England below 300,000 for the first time since these records began. Part of the reason for this is that UK drug policy is not simply criminalisation without anything else, or a ‘war’, but has included a major expansion of treatment for drug addiction. Bentley described this progress as a ‘modest fall’, but if you look at the younger generation, the improvements are even more striking. According to recent Home Office analysis, the proportion of those aged 16 to 24 that have ever taken illicit drugs has fallen from 54 percent in 1998 to 38 percent in 2012. Among those aged 11 to 15, the figure has fallen from 29 percent to 17 percent. Those aged 16 to 24 who have taken any illegal drug in the last year has fallen from 30 percent in 1996 to 19 percent in 2012. For the use of Class A drugs in the last year, the proportion has fallen from 9 percent to 6 percent.

So much for the argument that prohibition is doomed to fail and that the ‘war on drugs’ is ‘plainly being lost’. These figures are rather inconvenient for the legalisation lobby.

And so much for the argument that ‘everybody tries drugs’ when they are young. Instead, it seems that a combination of education, treatment, deterrence and socioeconomic factors is driving drug use down.

What those who advocate the legalisation of drugs need to explain is how they think legalisation would make the situation any better. They like to use figures to suggest that the ‘war on drugs’ is failing (although the figures no longer fit the argument), but in doing so they seem to implicitly recognise that drug use is a problem.

Advocates need to explain therefore how legalising drugs is the answer. Does anyone honestly think that legalisation would lead to less, rather than more, drug use?

Bentley argues that these reductions in illegal drug use are balanced out by an increase in the use of ‘legal highs’. But legalisation would make all drugs ‘legal highs’, and would be most likely to lead to a substantial increase in their use. Bemoaning the increasing use of legal highs – which are so easily available because they are legal – hardly seems to support the argument that all other drugs should be made legal too.

As mentioned above, treatment for drug addicts has been expanded in recent years, and often works in conjunction with the criminal justice system. If drugs were not illegal, and no one was ever arrested for possession or for drug-dealing, how many fewer of these addicts would be given treatment at all?

Similarly, advocates of legalisation seem to imagine that if drugs were legalised, all the problems associated with their use would magically disappear. And as the author of ConservativeHome’s ‘Deep End’ column recently put it:

“Liberals seem to imagine that, upon a change in the law, thousands of decent, upright citizens will suddenly come forward to serve the community as caring, responsible pimps and drug dealers who pay their taxes, recognise unions and recycle their rubbish. After all, why become a teacher or a doctor when you could be persuading vulnerable young people to sell their bodies or buy your crystal meth?”

Bentley eventually comes on to the libertarian argument for legalisation, which seems to be the real reason he is advocating it, rather than any conviction that the ‘war on drugs’ is failing and that legalisation is somehow a better approach to dealing with drug use as a problem.

But if drugs were made legal as a matter of principle, then would prescription drugs also be made freely available for people to privately buy? Presumably lots of health and safety and consumer protection laws would also have to be scrapped, along with all laws against selling poisons and toxic and dangerous substances. It would now be legal to sell people toxic substances for the purpose of poisoning themselves.

Libertarians who argue that drugs should be legal as a matter of principle should stop hiding behind the claim that they somehow have a better solution to dealing with drugs as a problem, as though their case is based on pragmatism and experience rather than ideology.

The obvious reality is that they would believe drugs should be legalised whether drug use was getting better or worse. And as recent figures show, their claim that the ‘war on drugs is being lost’ is becoming less and less credible.

Peter Cannon is a Conservative councillor in Dartford, Kent

Tuesday 19 March 2013

New figures reveal a huge increase in the number of hospital admissions for people under 30 with alcohol-related liver disease.

The research carried out by Balance, the North East Alcohol Office, looks at the number of alcohol-related liver disease hospital admissions in England between 2002 and 2012.

As well as a full England summary, the data is broken down by region, gender and age .

Key findings:

* 117% increase in alcohol-related liver disease hospital admissions for under 30’s in England since 2002. This figure is worse in certain areas, the north east has seen a 400% increase.

* 91% increase in alcohol-related liver disease hospital admissions for women in England since 2002. It’s a 114% increase in the Yorkshire and the Humber.

* 93% increase in alcohol-related liver disease hospital admissions for men in England since 2002. It’s a 152% increase in the East of England.

Responding to the research, Eric Appleby, Chief Executive of Alcohol Concern said:

“These figures are terrifying, we’re seeing an increase in alcohol-related liver disease across both sexes, in every age group, in every region of the country. It’s particularly sad to see the number of young people with this awful disease more than doubling.

“We have to start taking this seriously, if this was any other illness immediate action would be taken to halt this so we call on the Department of Health to outline what action it intends to take.”

“We have to get the message across that drinking too much, too often can cause huge health problems and we need to create an environment where alcohol isn’t cheaper than water and available on every corner.”

Source: AlcoholConcern.org.uk 19th March 2013

Teen-age college students are significantly more likely to abstain from drinking or to drink only minimally when their parents talk to them before they start college, using suggestions in a parent handbook developed by Robert Turrisi, professor of biobehavioral health, Penn State.

“Over 90 percent of teens try alcohol outside the home before they graduate from high school,” said Turrisi. “It is well known that fewer problems develop for every year that heavy drinking is delayed. Our research over the past decade shows that parents can play a powerful role in minimizing their teens’ drinking during college when they talk to their teens about alcohol before they enter college.”

The researchers recruited 1,900 study participants by randomly selecting incoming freshmen to a large, public northeastern university. Each of the individuals was identified as belonging to one of four groups: nondrinkers, weekend light drinkers, weekend heavy drinkers and heavy drinkers.

The team mailed Turrisi’s handbook to the parents of the student participants. The 22-page handbook contained information that included an overview of college student drinking, strategies and techniques for communicating effectively, ways to help teens develop assertiveness and resist peer pressure and in-depth information on how alcohol affects the body. The parents were asked to read the handbook and then talk to their teens about the content of the handbook at one of three times to which they were randomly assigned: (1) during the summer before college, (2) during the summer before college and again during the fall semester of the first year of college and (3) during the fall semester of the first year of college.

“We were trying to determine the best timing and dosage for delivering the parent intervention,” Turrisi said. “For timing, we compared pre-college matriculation to after-college matriculation. For dosage, we compared one conversation about alcohol to two conversations about alcohol.” The results appeared in a recent issue of the Journal of Studies on Alcohol and Drugs.

“We know that without an intervention there is movement from each drinking level into higher drinking levels,” Turrisi said. “For example, non-drinkers tend to become light drinkers, light drinkers will become medium drinkers and medium drinkers will become heavy drinkers. Our results show that if parents follow the recommendations suggested in the handbook and talk to their teens before they enter college, their teens are more likely to remain in the non-drinking or light-drinking groups or to transition out of a heavy-drinking group if they were already heavy drinkers.”

According to Turrisi, talking to teens in the fall of the first year of college may not work as well; for many families it had no effect on students’ drinking behaviors. Likewise, adding extra parent materials in the fall seemed to have no additional benefit.

Source: eurekalert.org 19th March 2013

College students who use marijuana and other illegal substances, even occasionally, are more likely to leave school than students who don’t dabble in drugs, new research finds.

There’s a strong link between marijuana use and “discontinuous enrollment,” said study author Dr. Amelia Arria, director of the Center on Young Adult Health and Development at the University of Maryland School of Public Health. The same goes for other illicit drugs, she added.

In a recent issue of the Journal of Studies on Alcohol and Drugs, Arria and her colleagues reported that students with high levels of marijuana use (more than 17 days a month) were twice as likely as those with minimal use (less than a day a month) to have an enrollment gap while in college. But even students who used pot less often, in the range of three to 12 days a month, were more likely to experience enrollment gaps.

Arria said, “We wanted to look at whether or not drug use interferes with goals students had set for themselves. Our results show that marijuana use is not a benign thing.”

For their research, the authors used data from the College Life Study, ongoing research on health-related behaviors among college students. They tracked 1,133 participants (47 percent male) over four years. All of the students began their freshman year between the ages of 17 and 19, and they all attended the same university located in the mid-Atlantic region of the United States.

During each school year, they participated in questionnaires and interviews, even if they had decided not to return to classes at the university (a financial incentive was offered). Their enrollment and graduation data were obtained from university records that the students consented to share.

“Continuous enrollment” was defined as being enrolled at the university for at least one credit during each fall and spring semester for the first four years of the study, Arria said. By the study’s end, 71 percent of the students had remained continuously enrolled over four years, and 29 percent had not.

Reasons that students left college varied. While some transferred to another university, others exited college life altogether, so the authors opted to use the term “discontinued enrollment” instead “dropout.”

Aria said it’s key to point out that their results were independent of other factors such as demographics, high school GPA, fraternity or sorority enrollment, personality type, risk-taking behaviors, and a student’s use of tobacco and alcohol.

“Marijuana use was still a predictor of discontinuous enrollment,” Arria said.

A second study, published in the journal Psychiatric Services and funded by the U.S. National Institute on Drug Abuse, looked at drug use and mental health problems and the risk of leaving college prematurely. Arria and her colleagues report that students who experience symptoms of depression and seek treatment for depression during college might be at risk for an enrollment gap, too, especially if they use pot or other illicit drugs.

However, students whose depression was identified and treated before heading to college were not at risk for enrollment problems once at the university level.

Dr. Marc Galanter, director of the division of alcoholism and drug abuse at NYU Langone Medical Center and a professor at the NYU School of Medicine, said the studies are interesting, especially when reviewed together.

“When they say there’s a need for early intervention for illicit drug users, there may be other issues that cast the die for drug use, namely depression,” Galanter said. “The question is, do drugs cause the problem or are they a consequence of some other problem? Could it be depression that leads people to use drugs secondarily? It’s not clear what’s causal.”

Study author Arria said that although marijuana tends to be viewed as a more benign drug, that is a fallacy. “The perceived risk of marijuana is declining because people think it’s more benign than it is, and its use is going up among college students. But we’ve known for a long time that marijuana affects cognition and memory.”

Nonmedical use of prescription drugs is also a concern among college students.

Galanter said, “The real serious drug problem is the painkillers — Percocet, Vicodin, OxyContin. There are a notable number of young people getting seriously addicted. It’s a noticeable statistic. Some of these drugs come from the family medicine cabinet but there are also people who get illicit prescriptions and then sell the drugs as dealers.”

Arria said that school administrators and parents can help by communicating with kids early in adolescence about the risks of drugs, and intervening when a child needs help and support. Armed with that support, students are more likely to stay in college once they get there.

Source: Health Day News 22nd March 2013

Substance-abuse experts, alarmed by the rapid growth of Colorado’s medical-marijuana industry, are intensifying their efforts to study the industry’s impact on drug use. The experts say they especially worry that increasingly permissive attitudes surrounding marijuana use might be leading to higher teenage drug use and addiction rates.

That has been an often-voiced concern during debates over medical marijuana in Colorado. But substance-abuse-prevention workers say evidence from their clinics seems to bear it out. And they point to a recent study showing an increase in teenage marijuana use nationwide and a decrease in perceptions of its risk as further evidence of a need to examine the issue.

“The basic rule with any drug is if the drug becomes more available in the society, there will be more use of the drug,” said Thomas Crowley, a University of Colorado psychiatry professor and director of the university’s Division of Substance Dependence. “And as use expands, there will be more people who have problems with the drug.”

At his substance-abuse-treatment clinic for adolescents at Denver Health Medical Center, Christian Thurstone said he has seen hard evidence of the trend. Since the summer of 2009, roughly when Colorado’s medical-marijuana boom began, Thurstone said he has seen treatment referrals triple, from five to 15 per month. The large majority of those teens are referred — either by the criminal justice system, social services or other means – because of marijuana, he said.

Worried by the increase, Thurstone conducted a survey of 76 kids in his program. Of those, 60 said they knew someone with a medical-marijuana card, and 37 said they have obtained pot from a medical-marijuana patient, though none were patients themselves.

What’s more, Thurstone said teens who got marijuana from a patient were more likely to report smoking pot daily than those who didn’t. About 83 percent of the teens who scored pot from a patient reported daily use, compared with about 56 percent of those who didn’t get marijuana from a patient.

“It looks like it’s increasing access,” Thurstone said of the state’s medical-marijuana program.

“It looks like it’s making social norms more positive for marijuana. And it looks like it’s increasing frequency of use.” Thurstone said he intends to apply for federal grant funding to more fully examine the subject.

Source: The Denver Post www.denverpost.com 01/01/2011

Colorado’s public policies regarding the use of medical marijuana are a complete mess — and as the medical director of a busy adolescent substance abuse treatment program in Denver, I get to contend with this mess every day.

Take, for example, the 19-year-old whom I have treated for severe addiction for several months. He recently showed up in my clinic with a medical marijuana license. How did he get it? Easy, he said. He paid $300 for a brief visit with another doctor to discuss his “depression.” The doctor took a cursory medical history that certainly didn’t involve contacting me.

The teenager walked out with the paperwork needed not only for a license to smoke, but also for a license permitting a “caregiver” to grow up to six marijuana plants for him. My patient, who had quit using addictive substances after a near-death experience, is back to smoking marijuana daily, along with his caregiver.

So, that’s just one young person who managed to game the system, right? Not by a long shot.

In the last three months, I have seen more than a dozen young people — all between the ages of 18 and 25 and with histories of substance abuse — who received from other doctors what are essentially permission slips to smoke pot. Some of my colleagues recently reported seeing a young, pregnant woman who was granted a license to smoke marijuana because of her nausea. (Yes, you read that right.) Kids without licenses tell me about the potent pot they buy from caregivers whose plants yield enough supply to support sales on the side.

Colorado schools are also scrambling to make sense of our muddled public policies. Educators ask me how to deal with students who have marijuana prescriptions for their attention-deficit/hyperactivity disorder and with the “medical marijuana specialists” seen passing out business cards in student parking lots. Here’s what I tell them: Good research shows that using marijuana makes anxiety, depression and ADHD worse, so let’s stop prescribing marijuana to our youth.

Colorado is just beginning to see much bigger and more costly problems associated with teen marijuana smoking. That’s particularly unfortunate because our state already ranks among the top five for adolescent marijuana use and among states providing the least access to adolescent substance abuse treatment.

For teenagers, marijuana is an especially addictive drug. Nationally, almost 5.5 percent of high school seniors smoke marijuana daily, according to researchers at the University of Michigan. About 95 percent of the hundreds of young people referred to my clinic each year have problems with marijuana. I see teenagers who choose pot over family, school, friends and health every day. When they’re high, these young people make poor choices that lead to unplanned pregnancies, sexually transmitted diseases, school dropouts and car accidents that harm innocent people. When teenagers are withdrawing from marijuana, they can be aggressive and get into fights or instigate conflicts that lead to more trouble.

Now, almost every day, a kid asks me, “Doc, how can marijuana be bad? It’s a medicine.”

I recently reviewed medical marijuana licenses in Colorado and found that only 3 percent belong to people with cancer and 1 percent to people with HIV. Those illnesses are not open to much interpretation; you’ve either got them or you don’t. However, a whopping 90 percent of Colorado’s medical marijuana licenses have been awarded for “pain,” which is a highly subjective qualifying condition that makes it easy to abuse the system. Also interesting is that 70 percent of Colorado’s medical marijuana prescriptions are for men, and the biggest age group of licensees is 25- to 34-year-olds.

Medical marijuana in this state is not being prescribed for end-stage illnesses. Instead, it is being handed to the demographic most likely to have addictions.

The medicinal value of smoked tetrahydrocannabinol — marijuana’s active ingredient — has hardly been studied in controlled trials, which is why the American Medical Association recently called for more research. In the absence of credible data, we’re allowing this public debate to be bombarded by junk science and blatant lies championed by people more interested in getting high than in alleviating the pain of end-stage illness.

Medically speaking, there’s probably little need for smoked marijuana. Tetrahydrocannabinol has been available as a pill for years. For patients too nauseous to take a pill, a tetrahydrocannabinol patch has been produced and studied but is not yet available for prescription. The pill and patch have been deemed effective, produce less intoxication and are far less addictive than smoked marijuana.

With such limited data, it’s incredible that marijuana bypassed FDA approval and the way medications are normally dispensed in pharmacies. It is ridiculous that this “medicine” can be sold in an array of flavors alongside pot brownies and candies. Also stunning is that marijuana has bypassed the Colorado Prescription Drug Monitoring Program, which enables me to look up all of my patients’ prescriptions. Now, I can see all of their meds — except for their marijuana.

What Colorado has created is a backdoor way to legalize marijuana, and it has done so in a manner that makes a mockery of responsible medicine.

Let’s stop talking in terms of smoked marijuana’s medicinal value because we’re not even close to knowing what that is. Let’s instead answer the question that’s truly at the heart of all of this political wrangling: Is smoking marijuana a civil right?

Before answering that question, Colorado should carefully study the social costs of accidents, aggression, school dropouts, STDs and teen pregnancy that will inevitably be the result of increased marijuana use. No medication — not even marijuana — is without side effects.

Christian Thurstone is a board-certified child/adolescent and addictions psychiatrist who conducts federally funded research on marijuana addiction in teenagers.

Source: http://www.denverpost.com/commented/ci_14289807 1.3.2010

We investigated the existence of a temporal association between age at initiation of cannabis use and age at onset of psychotic illness in 997 participants from the 2010 Survey of High Impact Psychosis (SHIP) in Australia. We tested for group differences in age at onset of psychotic illness and in the duration of premorbid exposure to cannabis (DPEC). Analyses were repeated in subgroups of participants with a schizophrenia-spectrum disorder (SSD), a diagnosis of lifetime cannabis dependence (LCD), and a comorbid SSD/ LCD diagnosis. The association between age at initiation of cannabis use and age at onset of psychotic illness was linear and significant, F(11, 984) = 13.77, P < .001, even after adjusting for confounders. The effect of age at initiation of cannabis use on DPEC was not significant (mean duration of 7.8 years), and this effect was similar in participants with a SSD, LCD, and comorbid SSD/ LCD diagnosis although a shift toward shorter premorbid exposure to cannabis was noted in the SSD/LCD subgroup (mean duration of 7.19 years for SSD/LCD). A temporal direct relationship between age at initiation of cannabis use and age at onset of psychotic illness was detected with a premorbid exposure to cannabis trend of 7–8 years, modi"able by higher severity of premorbid cannabis use and a diagnosis of SSD. Cannabis may exert a cumulative toxic effect on individuals on the pathway to developing psychosis, the manifestation of which is delayed for approximately 7–8 years, regardless of age at which cannabis use was initiated. Introduction There is ongoing debate regarding the association between cannabis use and age at onset of psychosis (AOP). A recent meta-analysis by Large et al. (2011) reported an earlier mean AOP in samples with cannabis use and made a strong argument for causality, although increased use of cannabis by those approaching the onset of psychosis, ie, “self-medication” was considered a reasonable interpretation of the association. If cannabis use brings forward the AOP, then one may anticipate that a temporal relationship between age at initiation of cannabis use (AIC) and AOP might be observed after adjustment for confounder effects. However, few studies have specifically addressed this question within sufficiently large samples of participants with psychosis. Several small studies have demonstrated that AIC is significantly associated with AOP. In 123 consecutive referrals with first-episode psychosis to an early intervention service, Barnett et al. (2007) reported that AIC, cocaine, ecstasy, and amphetamine use was significantly associated with age at first-psychotic symptoms. In a sample of 99 participants with a first psychotic episode, Leeson et al. (2012)3 reported a linear relationship between AIC and age at onset of psychotic symptoms. The average duration of premorbid exposure to cannabis (DPEC) was reported as 6 years and 33 days. In a sample of 57 participants with a non-affective psychotic disorder who gave a history of heavy cannabis use, Galvez-Buccollini et al. (2012) also reported a significant association between AIC and AOP after adjusting for cofounding variables; the DPEC was reported as 7 ± 4.3 years. In a sample of 80 young participants with early onset schizophrenia spectrum disorders (mean AOP was 16.6 years), Estrada et al. (2011) reported that AIC correlated significantly with AOP. Taken together, these small studies suggest a temporal relationship between AIC and AOP in non-affective psychotic disorders. Discussion These findings, derived retrospectively from a large population of representatively ascertained participants with psychosis in Australia, extend previous reports on the association between cannabis and onset of psychosis by demonstrating that AIC is directly and linearly associated with AOP and that an average delay of 7–8 years (mean 7.85, SD = 6.2) is observed from the first exposure to cannabis to the onset of psychotic disorders. Our study can be seen as complementary to previous work in the general population that has established a temporal association between early cannabis use and risk for psychotic disorders and with McGrath et al. (2010) who demonstrated in a prospective birth cohort that significant risk for non affective psychosis increases after 6 years of exposure to cannabis. We also confirm previously reported linear association between AIC and AOP and offer validation to previous work reporting similar mean DPEC (approximately 6–8 years). Notwithstanding some of the inherent limitations to our study imposed by acquiring retrospective information from the DIP (ie, possible recall bias, lack of data on the premorbid pattern of use of other illicit substances until the year prior to onset of psychosis) and the limitation of excluding from analysis illicit substances other than cannabis that may further modulate AOP, this is the largest study examining the effects of AIC use in psychotic disorders. Much research has focused on adolescence as a particularly vulnerable period of brain maturation for those exposed to cannabis. This neurodevelopmental “window of vulnerability” is supported by findings that demonstrate that early cannabis exposure is a risk factor for psychosis related outcomes in young adults. Despite the fact that we also demonstrate a linear trend between early AIC and AOP, our findings do not support a neurodevelopmental “window of vulnerability” hypothesis because those participants who first used cannabis at 12 years of age, for instance, had on average a similar temporal trajectory to illness to those who were first exposed to cannabis at 19 years of age. As noted by Moore et al. (2007), arguments for why earlier use of cannabis might have more harmful effects are intuitively compelling, but no robust evidence supports this view. The increased risk of psychosis in people using cannabis from a younger age observed in the Dunedin cohort could indicate, for instance, a greater cumulative exposure to cannabis rather than a sensitive period of exposure. We can only speculate on the reasons behind the apparent 7–8-year consistent trend of cannabis exposure in people who develop psychosis. It could be argued that both AIC and AOP tend to cluster independently of each other in particular periods in the life-span (AIC in adolescence, AOP in early adulthood); therefore, collinearity resulting in a relatively constant DPEC might be expected even if no causal link between cannabis and psychosis existed. However, this is unlikely to explain why mean DPEC is relatively constant across a wide range of AIC groups extending from 12 to over 21 years of age. Furthermore, if the observed temporal association between AIC and AOP was entirely unrelated to causal effects of cannabis exposure on psychosis onset, we would not observe a shift toward a shorter mean DPEC (7.19 years) in participants with SSD and comorbid LCD. Our findings would be consistent with the notion that cannabis exposure exerts a cumulative toxic effect, particularly in people on the pathway to developing SSD, the manifestation of which is delayed for approximately 7–8 years, regardless of the AIC. While the mechanisms by which cannabis may exert such delayed effects are unclear, several authors have suggested a mechanism involving sensitization of the mesolimbic dopaminergic system, triggered by repeated stimulation with cannabis, to which susceptible individuals may be especially vulnerable, possibly due to a heightened, genetically determined sensitivity to the psychotomimetic effects of cannabis. Source: Schizophrenia Bulletin vol. 39 no. 2 pp. 251–254, Jan 2013

New data shows that teen’s perception of the harmfulness of marijuana is at its lowest levels since the data began being tracked in the late 1970s.

Due to the drug not carrying much of a perceived risk, data is also showing a steady increase in the use of marijuana among teens and first time use is being reported at earlier ages than ever seen before.

Marijuana use among children escalates after eighth grade and a study done by the University of Michigan found that more than 11 percent of 13-14 year olds surveyed report they used marijuana in the past year.

The same study showed that by the time these young teenagers become high school seniors, those numbers increased drastically, with more than one in five saying they smoked marijuana in the past month and more than one-third of them reporting they smoked it within the previous year.

Marijuana has long been seen as the gateway drug to other drugs and alcohol and that suggestion is still relevant today. Chronic drug users often report that marijuana was the first drug that they experimented with before moving on to other harmful drugs, such as cocaine, heroin and methamphetamines.

Teen’s low perception of risk with marijuana use is especially alarming due to National Survey on Drug Use and Health, reporting that 90 percent of addictions have roots in the teenage years. If teens continue to view marijuana use as non-risky, it’s like we are going to continue seeing use among teens, at even earlier ages, become more prevalent.

So why the increase in marijuana use among youth?

One possible thought is that the perception of risk has gone down since states have started legalizing the use of marijuana. This not only sends a message to teens that the drug isn’t as dangerous as it was once seen, but it also increases the availability and access that teens have to marijuana.

Dealers decrease in perceived dangers associated with the sale and possession of marijuana has allowed the drug to be moved more freely across state lines and into our cities.

We want to be clear that just because some states may be changing their laws to legalize the use of marijuana it does not change the detrimental effects drug use can have on a teen’s brain development.

Parents, you need to be informed that marijuana is slowly becoming a norm among teens. Even if your teen may not be using the drug themselves, the likelihood that they have been exposed to it in some form or another is highly likely.

Talk with your teen about marijuana as early as 12 years old to ensure they get the facts from a credible source, you.

Source: http://www.wahpetondailynews.com Thursday, February 7, 2013

New research appearing online today in Clinical Chemistry, the journal of AACC, shows that cannabis can be detected in the blood of daily smokers for a month after last intake. The scientific data in this paper by Bergamaschi et al. can provide real help in the public safety need for a drugged driving policy that reduces the number of drugged driving accidents on the road.

Cannabis is second only to alcohol for causing impaired driving and motor vehicle accidents. In 2009, 12.8% of young adults reported driving under the influence of illicit drugs and in the 2007 National Roadside Survey, more drivers tested positive for drugs than for alcohol. These cannabis smokers had a 10-fold increase in car crash injury compared with infrequent or nonusers after adjustment for blood alcohol concentration.

In this paper, 30 male chronic daily cannabis smokers resided on a secure research unit for up to 33 days, with daily blood collection. Twenty-seven of 30 participants were THC-positive on admission, with a median (range) concentration of 1.4 µg/L (0.3–6.3). THC decreased gradually with only 1 of 11 participants negative at 26 days; 2 of 5 remained THC-positive (0.3 µg/L) for 30 days.

These results demonstrate, for the first time, that cannabinoids can be detected in blood of chronic daily cannabis smokers during a month of sustained abstinence. This is consistent with the time course of persisting neurocognitive impairment reported in recent studies and suggests that establishment of ‘per se’ THC legislation might achieve a reduction in motor vehicle injuries and deaths. This same type of ‘per se’ alcohol legislation improved prosecution of drunk drivers and dramatically reduced alcohol-related deaths.

“These data have never been obtained previously due to the cost and difficulty of studying chronic daily cannabis smoking over an extended period,” said Dr. Marylin Huestis of the National Institutes of Health and author on the paper. “These data add critical information to the debate about the toxicity of chronic daily cannabis smoking.”

Source: American Association for Clinical Chemistry (AACC) : 1st March 2013