Sources: Jon Gettman (2006), US Forest Service (California outdoor grow stats include small portions of Oregon and Nevada), Office of National Drug Control Policy, SF Public Utilities Commission, Evan Mills (2012).

 

Facts and Talking Points

Components of marijuana have medical value, but that does not mean we should smoke or vaporize non standardized products to get that value.

Recently, due to CNN and other media outlets, there has been a flood of interest in CBD a component contained in marijuana.  CBD does not get you high, and as such, it has been generally bred out of modern, smoked marijuana. But it can be grown under special conditions.

There is some limited anecdotal and other evidence showing CBD effectiveness for epilepsy, especially in children.

We should find a way to get CBD to patients who need it, but we owe those who suffer a product with safety assurances. Many products on the current “medical” marijuana market have no such assurances, are never tested in FDA-registered labs, and have no guarantees of quality and content or information on dosing or side effects.

For those who might benefit from CBD, a company in Britain has developed a standardized CBD product which will soon be in clinical trials in the U.S. and which may also be available from physicians through special FDA-approved channels.

What is CBD?

 CBD and THC are the two primary cannabinoids produced by the cannabis (marijuana) plant. CBD does not have THC like psychoactivity. CBD was essentially bred out of high potency modern recreational cannabis, but there has been recent interest in its therapeutic potential. As a result, a number of breeders claim to have “high CBD” strains and numerous purveyors are selling products that they claim are high in CBD. However, many of these products also contain significant levels of THC.

How does CBD work?

CBD works through a number of complex mechanisms. Preclinical studies indicate that

CBD has analgesic (pain relieving), anti-convulsant, anti-psychotic and neuroprotective effects. Unlike THC, it does not bind to the CB1 or CB2 cannabinoids receptors, which is why it does not produce THC-like psychoactivity.

Many groups are trying to sell or give away CBD in different states without going through any FDA or NIH process. However these products have no such safety assurances.

SAM is working on a long-term solution to expand and accelerate the current research so that every patient who might benefit from CBD can obtain it.

Are these CBD products safe? 

“High CBD” plant material usually also contains varying levels of THC, sometimes significant amounts. Most simple extraction processes cannot reliably extract CBD solely or primarily. Indeed, extremely complex and expensive equipment is required to remove the THC from a “high CBD” extract.  The situation is made more hazardous by the fact that existing research demonstrates that, in many cases, large doses of CBD are needed to achieve a specific therapeutic effect. Accordingly, a child taking a therapeutic dose of CBD (100-1000 milligrams per day) would potentially also be exposed to a large amount of THC. For example, using a 10:1 preparation, a child who ingested 300 mg of CBD per day would also be ingesting 30mg of THC. That is the equivalent of three of the highest dose (10mg) Marinol capsules, which would make most adult patients intoxicated.  A 2:1 or 1:1 plant ratio product would contain even higher levels of THC.

What is the legal status of CBD?

Because CBD is a component of the cannabis/marijuana plant, it is a Schedule

I substance under the federal Controlled Substances Act (CSA). The FDA has recently confirmed that CBD is, indeed, a Schedule I substance. Lisa Kubaska, PharmD, who works for the FDA’s Center for Drug Evaluation and Research stated in an email to an inquiry from a journalist:“CBD meets the definition of Schedule 1 under the Controlled Substance Act.”  For example, some companies advertise the following as “high CBD” strains:

Harlequin at 11.6%/6.9% CBD: THC;

Canna Tonic at 8.11%/6.9% CBD: THC;

Sour Tsunami at 7.24%/4.32% CBD: THC (see http://www.synergymmj.com/products.html).

It is also unclear whether their advertised ratios are accurate, i.e., whether the testing results are valid. Recent internet comments by parents complain that batches of “artisanal” CBD products do not have a consistent or anticipated effect and/or they are horrified that their children become “high”. This is a problem because medicines should be standardized and consistent among batches.  Finally, in many cases, the “high CBD” products may be contaminated by pesticides, synthetic fertilizers, and dangerous microbes.  Pesticides are neurotoxic, which could be quite dangerous to children with epilepsy. A number of physicians are reporting instances of bacterial infections, allegedly resulting from the use of these products.

Don’t you need some THC to synergize with CBD?

There is absolutely no reliable scientific evidence that THC is necessary to synergize the effects of CBD. Instead, there is evidence from preclinical research that THC may be pro-convulsant in sensitive brains; other research indicates that chronic use of THC can impair IQ in adolescents. Physicians are beginning to report instances of THC toxicity in children taking “high CBD” preparations, e.g., high anxiety, increased seizures, insomnia, etc. Until more is known, the most conservative course of action would be to remove THC entirely from a CBD product.

Why is there so much interest in CBD now?

 A number  of years ago, Project CBD in California, inspired by research being conducted by GW Pharmaceuticals in the U.K. (see below), began to educate interested patients and others about the therapeutic potential of CBD, which was virtually absent in high-THC marijuana in the U.S. Indeed, before GW embarked on its cannabinoid research and development program, many individuals in the U.S. believed that CBD was an inert compound. There were also anecdotal reports of some adults with epilepsy who discovered that inhaled marijuana seemed to prevent or reduce their seizures. As more and more scientific research demonstrated that CBD had a variety of therapeutic effects, interest in the use of CBD in epilepsy grew.

The CNN program hosted by Dr. Sanjay Gupta in August 2013 portrayed the case of a little girl with horrible, life-threatening intractable epilepsy. According to Dr. Gupta, her condition was greatly improved by a CBD-rich preparation produced by a company in Colorado. Understandably, this program resulted in enormous interest in CBD from families of children with epilepsy. As desperate parents sought “high CBD” products wherever they could purchase them, a number of dispensaries and other opportunistic vendors began to sell these products. However, the labelled potency and composition are often inaccurate and uneven, depending on the marijuana strain from which they come, the methods of manufacture used to prepare them, and the quality of the testing facility/procedures. At many places in the cultivation and manufacturing process, lack of standardization can result in higher levels of THC and lower levels of CBD –as well as the varying levels of dangerous microbes or pesticides -in the final preparation, e.g. growing from seed rather than clones; differences in the cultivation, harvesting, and drying conditions; uneven decarboxylation; and use of toxic extraction chemicals, such as butane or non-pharmaceutical ethanol.

Should the law be changed to allow high CBD, low THC products? 

 A state considering such a change in law should look to the example of other states where “high-CBD” products are legal for medical use, such as California.

In California, various preparations are available, and children can readily be given these products with 1) parental consent and 2) a physician’s recommendation.

Nevertheless, for the reasons stated above, the “legality” of these products has not made properly tested and standardized CBD products available to parents.

Products vary in consistency; testing laboratories do not provide reproducible and reliable results; testing each batch is expensive; most testing CBD laboratories do not test for pesticides or microbes; parents do not know how to prepare extracts from plant materials; the products themselves can be expensive; no dosing information is available; and more. Legislation is a blunt instrument, and any change in state law will, necessarily, be quite broad (e.g. “high CBD, low THC”) to permit various opportunistic growers and vendors to enter the state and prey upon vulnerable parents. Unless an elaborate testing system is established and enforced by the state, this will not ensure the safe, tested, and standardized products that parents seek for their children. Even certain more popular products are of uncertain composition, quality and efficacy. Companies selling these products have not made public the composition/ratio of an adequate number of batches, nor have they provided full battery anonymized case studies showing how many patients benefit and to what extent, how many patients get little or no benefit, what side effects they experience, and what they charge for the product. At most, 11 “selected” case studies have been presented, all of which show

However, these are anecdotal cases reported by parents, and it is unlikely that current CBD preparations work for all seizure conditions.

Source:  www.learnaboutsam.org  2013

Alcohol-related deaths among Welshmen have risen by 15% in the last decade, figures have shown,  A report published yesterday by the Office for National Statistics (ONS) found that between 2002 and 2012, the death rate for men in Wales rose by 15%, while the comparable figure for England was a 2% rise.

By contrast, Scotland saw a 37% fall with Northern Ireland saw figures dropping by 8%.

The report said the harmful effects of drinking have caused more than 5,000 deaths every year in Wales and England for the past decade.  And it warns that the harmful effects of alcohol accounts for 2.5 million deaths worldwide each year.

“Excessive alcohol consumption is a major cause of preventable premature death, accounting for 1.4% of all deaths registered in England and Wales in 2012,” the study said.

Of the UK’s four nations, only Scotland had both male and female alcohol-related death rates that were significantly higher in 2012 than they were in 2002.  Meanwhile, overall death rates were highest among men aged 60 to 64.

The figures published by the ONS showed, that in Wales, 311 men and 193 women died due to alcohol-related reasons in 2012 – an increase of 9.8% on the 459 who died in 2011.  The number of deaths in 2012 is the highest since 2008, when 541 people died, and the second highest since at least 1991.

In Wales and England, accidental alcohol poisoning was the fourth highest alcohol-related cause of death in 2012 (accounting for 396 deaths), with over a third of cases among people in their 40s.   There were 14 deaths from accidental alcohol poisoning among people in their 20s.

Eric Appleby, chief executive of Alcohol Concern, said: “We are facing historically high levels of health harms caused by alcohol misuse, with over a million alcohol-related hospital admissions each year.   “To tackle this, we’re urging the Government to take tougher action including introducing minimum unit pricing.”

A Welsh Government spokesman said: “Each of these deaths is a tragedy for the individuals, their families and friends and society as a whole. These statistics are of course disappointing, and highlight the scale of the challenge we face to change public behaviours in relation to alcohol consumption. Over-consumption of alcohol can be addressed with a strategic approach to changing behaviours.

“Welsh Ministers have been pressing for the devolution of alcohol licensing powers for a number of years.  We want to limit advertising of alcohol products and see the introduction of a minimum unit price for alcohol.”

Source:  www.walesonline.co   20th Feb 2014

Alcohol Concern Cymru says its report highlights the ‘serious public health challenge’ of alcohol-related brain damage .Alcohol Concern Cymru says alcohol -related brain damage can be treated effectively

A new report outlining the “serious public health challenge” of alcohol-related brain damage has been labelled as a “wake-up call” by campaigners. Alcohol Concern Cymru’s ‘All in the Mind’ paper, published today, says alcohol -related brain damage (ARBD) is poorly understood by the public and many healthcare professionals which is leading to under-diagnosis and lack of treatment.  It says there is still “ignorance” and “stereotypes” around the subject, with many seeing its associated conditions, such as Wernicke-Korsakoff’s Syndrome which leads to confusion, memory loss, and difficulty reasoning and understanding, being confined to particular groups of society.

The charity says that the ARBD can be treated effectively, but warns that many health professionals do not know what to look for. The report said: “The long term effects of alcohol on the brain can be both psychological (mental health problems) and physiological (damage to brain tissue). People who drink heavily are particularly vulnerable to developing mental health problems, and alcohol has a role in a number of conditions, including anxiety and depression, psychotic disorders and suicide.

“Over a long period of time, however, heavy drinkers may also develop various types of physical brain damage. These are due in part to the toxic effects of alcohol itself, but long term alcohol misuse can also lead to vitamin deficiencies that exacerbate the damage.

“Although less common than some other alcohol-related conditions, ARBD nevertheless represents a serious public health challenge and remains very much overlooked and misunderstood.   This paper seeks to clear up much of the ignorance around ARBD and to place it firmly in the context of our drinking society, rather than stereotyping it as an extreme affliction of a distinct group of easily identifiable ‘problem drinkers’.  It also makes the case that, unlike some other forms of mental impairment, ARBD is not a progressive condition – it does not inevitably worsen, and can be successfully treated. It makes the case for ensuring that appropriate treatment is provided promptly to all who can benefit from it.”

Alcohol Concern Cymru director, Andrew Misell, said he hoped the report would be seen as a “wake-up call”.  He said: “Most of us know that alcohol can damage our liver, but the fact that it could undermine our long-term brain function is much less well known. And when alcohol-

related brain damage is on the radar, the focus is often on older street drinkers.

“But staff on the front line have been seeing younger people, and other people who don’t fit the stereotype of a homeless dependent drinker, coming in with ARBD.

“Once again, our willingness to see alcohol problems as someone else’s problem, confined to an extreme group of obvious drinkers, is keeping us from seeing the elephant on our doorstep. We hope this paper will be a wake-up call for all of us who drink.

“It’s been excellent to see the stigma around Alzheimer’s Disease gradually disappearing. Unfortunately, the same cannot be said for ARBD. But the prognosis for people with ARBD can be very good – up to three quarters can make some sort of recovery.  That has to spur us on to take concerted action to support people to overcome this condition.  One very simple and relatively cheap treatment that doesn’t seem to be used a much as it could be is injections of Vitamin B1, also known as thiamine.”

The report raised concerns about the level of drinking in younger people but said research found the highest prevalence of ARBD between the ages of 50 and 60, and follows concerns about the rise in older people abusing alcohol.  Recent figures for substance misuse showed the proportion of over 50s in Wales being referred to alcohol treatment centres has increased in the past year from 23.8% of all referrals in July-September 2012 to 25.2% in the same period for 2013.

Today’s report calls for better training for health and social care professionals on how to recognise ARBD and for the Welsh Government to draw up a care pathway for the diagnosis and treatment of the associated conditions.

A Welsh Government spokesman said: “The Substance Misuse Delivery Plan 2013-15 sets out the actions that the Welsh Government is taking to tackle alcohol related brain damage and the recommendations from Alcohol Concern’s report are welcomed and will be considered in conjunction with these actions.”

Source:  www.walesonline.co.uk  Mar 18, 2014 06:00 

LOS ANGELES — Chris Folkerts started selling electronic cigarette-like devices from the trunk of his car two years ago. Now he and two partners own one of the biggest brands in the business, with products in 4,000 stores nationally, an art deco office on the city’s fashionable Miracle Mile and an endorsement deal with rapper Snoop Dogg.

The rapid success of Grenco Science, the privately held company Folkerts founded, mirrors the fast growth of the business it is in — marketing devices that allow marijuana users to vaporize their psychoactive weed rather than smoke it.  “This is a big industry — it is the future,” Folkerts, 31, says. “We’re really on the cusp of exploding.”

With Grenco’s “G Pen” line and a vast marketplace of competitors, marijuana users can avoid the hassles, hazards and telltale smell that goes with lighting up a pot pipe or cigarette, as well as the uncertain dosage and delayed effects that come with ingesting marijuana-infused food and drink.

Just as e-cigarettes have transformed the business and national debate over tobacco smoking, e-cig technology and vaping are bringing major change to cannabis culture and business — even altering the way pot is packaged and sold in states where it is legal for medical or recreational purposes.

Steve DeAngelo, a marijuana entrepreneur and activist who founded the Harborside Health Center medical marijuana dispensary in Oakland, says the arrival of compact, portable, microprocessor-controlled vaporizers and advances in extracting active ingredients from cannabis plants have caused a shift in consumer demand.

Some dispensaries such as his and many in Colorado, where recreational pot is legal, now do roughly 50% of their business in raw marijuana leaf or flowers, and the rest in edibles and concentrates, some prepackaged in cartridges for use in vape pens, he says. “The percentage of raw (pot) flowers we sell has been dropping steadily,” DeAngelo said. “The percent of extracts and concentrates … has been rising steadily.”

Grenco Science is headquartered in the fashionable Deco Building in the Miracle Mile area of Los Angeles. Chris Folkert started selling electronic cigarette-like devices from the trunk of his car two years ago. Now he and two partners own one of the biggest brands in the business, with products in 4,000 stores nationally.(Photo: Dan MacMedan, USA TODAY)

A TRUE GROWTH INDUSTRY

The transformative technology comes at a time when marijuana is gaining in legal and public acceptance.  While marijuana remains illegal under federal law, Colorado and Washington have made it legal to possess and use, and 20 states have made it legal for medical uses. Alaska has scheduled a vote on full legalization in August, and legal changes for pot are afoot in several other states. Recent public opinion polls for the first time show majority support for ending pot prohibition, and President Obama recently said marijuana was no worse than alcohol.

The rise of marijuana e-cigs coincides with the development in recent years of potent new forms of concentrated marijuana extractions in liquid, viscous and waxy forms. Those concentrates lend themselves easily to vaporization and are used to fuel many of the vape pens on the market, though there also are many vaporizers made for consuming marijuana leaves and flowers.  Vaping’s growth, ease of discreet use and high-strength concentrates raise alarms among pot’s opponents.

“This really portends the next generation of marijuana use,” says John Lovell, a Sacramento attorney and lobbyist for the California Narcotics Officers’ Association and California Police Chiefs Association.  Those law enforcement groups remain strongly opposed to marijuana legalization, and Lovell says the rise of high-strength concentrates for vaporizing “gives the lie to the allegation that somehow marijuana use is benign.” Home manufacturing of the concentrates can be dangerous if flammable solvents such as butane are used, he notes, and their potency can deliver a fast and powerful high to the user.

The concentrates can be composed of as much as 80% or even 90% THC (tetrahydrocannabinol), the psychoactive ingredient of the cannabis plant. Advocates such as DeAngelo say the extraction process can be designed to concentrate another ingredient, CBD (cannabidiol), for non-psychoactive medical uses.

A DANGER FOR CHILDREN?

Some parents are alarmed that pot concentrates may be discreetly vaporized by children.”It’s a perfect combination — it’s so easy (and) there’s no odor,” says Marcie Beckett, a San Diego mother of two who is part of a coalition opposing marijuana legalization. “People beware: Kids can now use these vaping devices to use marijuana, and you’ll never know.”

So far there’s been little scientific research on the use of vaporizers, though the federal Food and Drug Administration has announced its intention to examine and regulate e-cigarettes. Many cities, including Los Angeles, have moved to prohibit e-cig use in public.

Some doctors who support marijuana’s medical use recommend vaping with reservations. Bob Blake, a San Diego-area physician, says he advises patients against vaporizing concentrates because of unknown health risks with some types of vape pens. He says the long-term health effects of smoking marijuana are far less than smoking tobacco, but he recommends vaporizing cannabis flowers and leaves to many patients who don’t smoke. He hands out an informational paper on vaporizing to patients, including some in their 80s, and recommends certain vaporizers he thinks are safest.

But the biggest market for vaporizing may be for those who wish to consume marijuana without detection by others.  “People want discretion,” Blake says. “With vaporizers, in a large room a person can be medicating without offending the other person in the room.”  Because of marijuana’s legal status, finding reliable estimates of the size of the marijuana business and pot vaporizers market is difficult. But the money involved speaks volumes.

High Times magazine, which chronicles pot culture, recently expanded to its largest size ever, up 26 pages to 152 pages, to make room for vaporizers ads, Managing Editor Jen Bernstein says.  “These pens are great,” she says. “We definitely increased the book size to accommodate this growing corner of the market.” In Denver, more than 600 people showed up last week for a job fair by a vaping device maker expanding staff.

HIGH-END VAPING

Investors are attracted to the growth potential of vaporization.  Seibo Shen quit his Silicon Valley tech and software work less than two years ago to form a vaporizer start-up, VapeXhale. He raised $143,000 in 40 days through a fundraising campaign on Indiegogo.com, he says, then raised more from private investors. He met his partners through an online forum for vaping enthusiasts.

He said he has been vaporizing pot since the late 1990s, but only in the last few years has the technology become smaller and consumer friendly. He estimates three-quarters of the tech executives he knows in Silicon Valley use marijuana, and that health-conscious white-collar workers who don’t like smoke are his target market.  “People are trying to be healthier in general,” he said. “Why shouldn’t their cannabis consumption follow suit?”

He is working the high end of the market. G Pens have a retail price of around $100, and many cheap imports go for as little as $20, while the first model from Shen’s VapeXhale sells for more than $450. It is a heating unit attached to bong-like liquid-filled glassware, designed to deliver a maximum high without concern for portability or discretion.

At Grenco Science, now housed in a landmark former bank building on Wilshire Boulevard called the Deco Building, Folkert declined to reveal Grenco’s sales or revenue figures. But with an office in what was the bank vault, he says business is booming, even as the company battles cheap knockoffs from China and counterfeit sales.

The company sells its pens through thousands of smoke shops, head shops and other retailers as well as directly online. He is creating fashion, art, music and extreme sports marketing tie-ins to extend the product’s reach into new sales outlets, such as at South By Southwest, the tech and music festival in Austin this month.  Snoop Dogg, the rapper who flaunts marijuana use, has his own line of G Pens sold by Grenco. The rapper stars in an instructional video and is the brand’s public face.

The rise of handy vaporizers has boosted retailers, too. “I’ve been in the business for 20 years, and I’ve never seen anything impact the market like this,” says Tony Van Pelt of Pomona, Calif., who sells vaporizers and related items online and in stores.  “This is the moment I’ve been waiting for,” he says. “This vaporizing thing has changed the whole world.”

WHAT IS VAPING?

*  Vaporizers, often powered by battery or electricity, extract the active ingredients from marijuana by heating it to a temperature lower than required for combustion.

•     Cannabis leaves or concentrates are heated to around 338 to 356 degrees Fahrenheit, less   than the approximately 450 degrees required to burn.

•    When air is drawn through cannabis heated to the proper temperature, it emits a vapor that is inhaled.

•    Because there is no fire or combustion, there is no smoke.

•   They can be as small as a ballpoint pen or as large as a toaster. Some have digital controls for precise temperature controls.

Source: http://www.usatoday.com/story/money/business/2014/03/15/marijuana-vaporizing-gains/6042675/

Even as states legalize marijuana, some U.S. officials are demanding tougher sentences for illegal pot growers if they also invade public lands, kill native vegetation and wildlife, and spread toxic pesticides. The officials’ environmental concerns took center stage at a hearing in Washington, D.C., on Thursday of the U.S. Sentencing Commission, a government body that guides federal judges on penalties for convicted criminals. Illegal marijuana crops often are grown by Mexican drug cartels that find it easier to plant on the U.S. side of the border rather than smuggle in the drugs, say prosecutors and law enforcement officials.   Sometimes armed, the growers plant huge gardens in remote parts of national forests and parks, setting up clandestine camps, diverting streams for irrigation and spreading pesticides, some so poisonous they are banned in the United States, the officials say. Christopher Boehm, assistant director in the U.S. Forest Service’s investigations arm, told the commission that the problem could become worse as marijuana acceptance increases, with growers trying to meet higher demand by expanding crops on public lands.   Marijuana is legal for medical use in 20 states, and Colorado and Washington state have legalized its sale for recreational use. The U.S. Justice Department, joining the call for tougher environmental penalties, proposed increasing prison time by months or even years by treating illegal marijuana growers more like methamphetamine producers, who use toxic chemicals. The proposal’s impact would vary widely depending on the criminal history of each defendant.   In the U.S. House of Representatives, Jared Huffman of California – where the bulk of marijuana is grown – has led a bipartisan drive for sentencing changes to consider environmental harm and has been joined by Utah Republican Orrin Hatch and California Democrat Dianne Feinstein in the Senate. The lawmakers’ call for harsher penalties contrasts with the Obama administration’s move to slash jail time for federal drug defendants to try to cut the ballooning prison population.  “It may seem contradictory that someone in my position would on the one hand be arguing for stronger criminal penalties on this problem and simultaneously arguing for decriminalization as the ultimate solution,” Huffman told

Reuters in a phone interview. “But that is the only responsive approach. It gets at the immediate problem and the longer-term solution.”  Huffman represents Mendocino, Humboldt and Trinity counties in northern California known as “the Emerald Triangle” for their long history as the epicenter of U.S. marijuana cultivation. GROWING PROBLEM In 1996, California passed a law that allows marijuana growth for medical use, but any cultivation on federal land is considered a crime under the Controlled Substances Act. The drug remains illegal under federal law. That leaves state regulators stretched between trying to regulate the environmental practices of legal medical growing operations, while combating the illegal ones in the forests.  In the United States, the problem has grown in recent years. In an informational video, the U.S. Forest Service said that in the 1990s rangers might find patches of a few hundred plants but now regularly discover huge operations with many thousands of plants. A single plant can use up to 15 gallons of water per day, the Forest Service says, and fish populations can be hurt when natural water sources are dammed or drained. In 2012, nearly one million marijuana plants were found and destroyed at 471 sites on National Forest lands in 20 states across the country, lawmakers say.  . State and federal agencies, as well as private land holders, often get stuck with the clean-up bill. “(They) bring clothes and old tents and plastic waste and beer cans, and we have to clean all that crap up so the animals don’t eat it and it doesn’t pollute our rivers and lakes and streams,” said Jay Green, an agent at the U.S. Environmental Protection Agency’s criminal enforcement division in California. “They should be held accountable for that.”  In the past, prosecutors have used different measures to try to win restitution awards when growers are arrested, charging them with depredation of public land or violations of federal pesticide regulations in addition to the drug charges.  Federal environmental regulators are in a bit of a quandary also about policing legal growers. In the “Emerald Triangle,” private land cultivated with marijuana doubled between 2009 and 2012 as growers from around the country flocked to the area in a “green rush” to supply medical marijuana dispensaries, said Scott Bauer from California’s Department of Fish and Wildlife.  Some medical marijuana growers – with outside fields or indoor greenhouses – use a large amount of water and fertilizers but are not subject to the same federal rules as traditional farmers, said the EPA’s Green. He said the chemical run-off from legal plots can flow into storm drains or sewers, which for a conventional farmer would require a permit from the EPA. But because marijuana is illegal under federal law, the EPA is not allowed to permit a pot farm.

Source:   Reuters  March 2014 

Lisbon, 05.03.2014

Europol and the EMCDDA have issued today early-warning notifications about two synthetic drugs that have recently been linked to serious harms in the EU.

The first concerns a new psychoactive substance associated with 18 deaths in the United Kingdom and eight in Hungary in 2013. 4,4′-DMAR — the para-methyl derivative of 4-methylaminorex — is not currently controlled by drug legislation in EU Member States. Also known as  ‘4-methyl-euphoria’, ‘4-methyl-U4Euh’, ‘4-M-4-MAR’, ‘4,4-dimethylaminorex’ or ‘Serotoni’, the substance has been found in Denmark, Finland, Hungary, the Netherlands, Sweden and the United Kingdom since it was first detected in 2012.

The use of other drugs in combination with 4,4’-DMAR appears to have been a factor in most of the fatalities recorded. A range of adverse effects associated with 4,4’-DMAR have been reported, including agitation, hyperthermia, foaming at the mouth, breathing problems and cardiac arrest.

4,4’-DMAR has been found as a powder and in tablet form, with tablets having a variety of logos, colours and shapes, as detailed in the early-warning notification. Concern over this substance has led to the European Union Early-warning system (EWS) on new psychoactive substances — operated by the EMCDDA and Europol — to launch a joint exercise to better understand the harms posed by this substance.

The second warning focuses on ecstasy tablets that have been found with dangerously high levels of MDMA (3,4-methylenedioxymethylamphetamine) in Belgium, the Netherlands, Switzerland and the United Kingdom. The potentially toxic levels of MDMA present in these tablets could lead to serious harm, and there have already been deaths associated with such tablets in the Netherlands and the United Kingdom.

MDMA tablets in the EU typically contain between about 60 and 100 mg of MDMA (2012 figures), however, tablets containing between 150 and 200 mg of MDMA are currently available and some have been found to contain even higher amounts, e.g. 240 mg. It is important to note that no illicit tablets can be considered safe as they can contain unexpected ingredients in unpredictable amounts.

This development is particularly concerning in light of the significant increase in the production and availability of MDMA in the EU. As outlined in Europol’s 2013 Serious and Organised Crime Threat Assessment (SOCTA) and the 2013 EU Drug Markets Report, Belgium and the Netherlands remain centres for synthetic drugs production in the EU and are also among those Member States most affected by the recent resurgence in MDMA availability. Full news release and more information can be found on the Europol website.

Source:  http://www.emcdda.europa.eu/news/2014/europol     5th March 2014

Why are we doing this? It would be a lot easier not to have the headaches and hate-mail that come with fighting legalisation. But we want to safeguard the next generation, to protect our children. We want to stop the creation of the next Big Tobacco.

We don’t have the $100million megaphone of the pro-legalisation lobby figure-headed by Nathan Edelman and George Soros. So not enough people know the truth. Just as the tobacco industry put out false science when it started, so does the marijuana industry. We must bridge the gap between the public misunderstanding of the drug and the scientific understanding. We must give information to decision-makers so that they have the courage to go forward.

We don’t want to replace one public-health tragedy with another one.

Having said that, people are beginning to recognise that Big Marijuana, like Big Tobacco, is an industry that relies on addiction for profits. It is sending people to hospital emergency rooms as you read this. They will profit over people who have no voice, or the budget for a voice.

Our two choices are not “lock ‘em up or legalise”. That is a false dichotomy. We need a real conversation about pot instead. Families deserve that. “Incarceration or legalisation?” “Lock ‘em up, or let ‘em loose?” … These phrases have dominated the discussion about marijuana over the past decade. As a result, marijuana-legalisation advocates — not scientists, doctors, people in recovery, disadvantaged communities or young people affected by marijuana use and its policies — have been at the forefront of changing marijuana laws.

So we founded Project SAM to consist of experts and knowledgeable professionals advocating for a fresh approach that neither legalises, nor demonises, marijuana. We are a nonpartisan alliance of lawmakers, scientists and other concerned citizens who want to move beyond simplistic discussions of “incarceration versus legalisation” when discussing marijuana use, and instead focus on practical changes in marijuana policy. We support a treatment, health-first marijuana policy. CONFRONTING PRESIDENT OBAMA…

In January, the US president commented that marijuana was less dangerous than alcohol, which led to an international media frenzy in support of global legalisation of the drug. On 22 January, we took the decision to release a statement about this, as follows.

“We at Smart Approaches to Marijuana, joined by leaders of major medical associations, recognise that marijuana legalisation goes against the President’s own goals of effective education and health care reform. We have identified many of the same problems with marijuana legalisation that he acknowledged when quizzed about his views of the drug by a reporter for The New Yorker. Chief among them: the legalisation of marijuana leads quickly to a slippery slope that could open the gates to legalisation – and commercialisation – of other addictive substances for recreational use. Clearly, the President knows that, for decades, several of today’s largest pro-marijuana-legalisation groups have been advocating for the full-scale legalisation of all recreational drugs, including psychedelics and cocaine.  As the President noted, the case for marijuana legalisation is overstated. As parts of the US plunge headlong into ill-informed drug policies rooted in opinions, political agendas and corporate greed, the President astutely notes that it is a matter of time before we’re also asked to consider the legalisation of a “negotiated dose of cocaine” or “a finely calibrated dose of meth”. That is the nature of addiction and substance abuse. It leads to the next problem, and the next problem and the next – and many times, the damage is irreversible and irreparable.

“However, we take issue with the President’s comparisons between marijuana and alcohol, and we strongly encourage him – a president who has, on many occasions, championed rigorous science – to work closely with his senior drug policy advisors and scientists, who fully acknowledge the growing world body of science showing the harms of marijuana use to individuals and communities. Today’s marijuana is far more potent than the marijuana the President acknowledged using during his teens and early adulthood. The President must also stop to consider the highly concentrated – and increasingly popular – form of marijuana called “hash oil.” Doses of that oil often exceed 80% THC – which is essentially a different drug than the weed of Woodstock, which ranged around 1-3% THC. “We should know better than to follow the same path by legalising a third, addictive substance that will inevitably be commercialised and marketed to children. Two wrongs don’t make a right: just because our already legal drugs may have very dangerous impacts on society it does not mean that other drugs should follow the same path.”

On 31 January, Obama stated on CNN that “If we start having a situation where big corporations with lots of resources and distribution and marketing arms are suddenly going out there, peddling marijuana, then the levels of abuse that may take place are going to rise further”.

Despite the hate mail we receive, we are doing something right. Perhaps the hate mail is because we are doing something right.

ALCOHOL vs MARIJUANA?

Coming back to the alcohol argument: what is the No 1 most dangerous drug? Alcohol. Why would we want to create another alcohol? This big, legal, ‘regulated’ business knows that 80% of its revenue comes from the 20% of people who abuse substances, the people who are most vulnerable, from people who shouldn’t be drinking any more. That is how they have marketed for decades. The people who will suffer most will be the most vulnerable, those who cause trouble to their communities – and cannot afford rehab when problems worsen. They are the target market for Big Pot.

People raise the issue of alcohol harms ‘versus’ marijuana harms. Yes, alcohol is worse when it comes to violence or liver damage. But marijuana is worse when it comes to IQ and loss of competitiveness and motivation, lung issues, mental health. Both cause traffic fatalities when drivers drug/drink drive. Two wrongs don’t make a right.

Once we have an industry whose business it is to increase addiction, then we will have a public-health problem on our hands.

Legalisers constantly refer to people in prison for marijuana. But there are three times as many alcohol arrests as there are for marijuana; do we want marijuana arrests to soar to that level by legalising it? In the UK, only 0.2% of people in prison are there for marijuana offences alone; in the US it is also less than 1%.  What do we have to say about our legal drugs: alcohol, tobacco and prescription drugs?  “600,000 deaths a year. A trillion dollars in the cost to society. And some of the most effective lobbies accessing governments.”

4TH WAVE OF LEGAL PHARMACEUTICALS

People have not woken up to what legalisation is all about. It would be the fourth wave of legal pharmaceuticals, following alcohol, tobacco, prescription drugs. After the debate about marijuana legalisation, there will be debates about heroin legalisation, cocaine legalisation: in a TV interview, Edelman has publicly expressed his ambition to legalise all drugs.

People are beginning to wake up to the fact that legalising marijuana is not about ‘responsible’ adults using pot in the privacy of their own homes. It is about the pot shop in your neighbourhood, about the advertising being viewed by children – and this is an industry which cannot be tamed once it is unleashed. There is smuggling of drugs across state lines in Washington and Colorado; the black market is alive and well, undiminished by legalisation.

On 17 February, we announced that Conspire, a company that provides drug testing to businesses and schools via Alere Toxicology and others, found that the number of their clientele testing positive for THC, the active ingredient in marijuana, rose 44% since December 2013. The announcement was made as we launched www.legalizationviolations.org to track legalisation’s effect in Colorado and Washington. With new data coming in every week to confirm that negative impact and the fuelling of drug use, it is important to have a central repository for tracking and collecting information.

We hope that other states and countries will pause and take note before they consider change so that we don’t have to relearn damaging lessons over and over again. While it is good to learn from experience, it is better to learn from other people’s experience!

Sadly, the marijuana conversation is mired with myths. Recent surveys show that many people do not think that marijuana can be addictive, despite scientific evidence to the contrary. Many would be surprised to learn that the American Medical Association has come out strongly against the legal sales of marijuana, citing public health concerns. Its opinion is consistent with most major medical associations, including the American Academy of Paediatrics and American Society of Addiction Medicine.

Because today’s marijuana is at least 5-6 times stronger than the marijuana smoked by most of today’s parents, we are often shocked to hear that, according to the National Institutes of Health, one in six 16-year-olds who try marijuana will become addicted to it; marijuana intoxication doubles the risk of a car crash; heavy marijuana use has been significantly linked to an 8-point reduction in IQ; and marijuana use is strongly connected to mental illness.

Constantly downplaying the risks of marijuana, its advocates have promised reductions in crime, flowing tax revenue and little in the way of negative effects on youth. We shouldn’t hold our breath, though.  We can expect criminal organisations to adapt to legal prices, sell to people outside the legal market – children – and continue to profit from larger revenue sources, such as human trafficking and other drugs. If drugs become legal, criminals will not become saintly citizens overnight but merely change commodities, such as profiteering from human trafficking instead of drugs.

We can expect the social costs ensuing from increased marijuana use to greatly outweigh any tax revenue — witness the fact that tobacco and alcohol cost society $£10 for every $£1 gained in taxes. Probably worst of all, we can expect our teens to be bombarded with promotional messages from a new marijuana industry seeking lifelong customers.

In light of the currently skewed discourse on marijuana, these are difficult facts to digest. People have been promised great things with the legalisation experiment. They can expect to be let down.

What makes a person great is the power and ingenuity and imagination of their brain. Their brain is the single most important organ in the body. It is everything to who we are as human beings. Our countries should be doing better to protect our most vital natural resource: our brains. We should not consign the next generation to substandard opportunities, simply because we have not been grown-up enough to know that there are consequences to public policies which we did not consider. Every life is so important that it must be given the best chance.

Legalisation is not inevitable. We must remind people who struggle with addiction that they are not alone: we are with them. The APA, ASAM are with us. On the other side is an alliance of people who want to line their pockets with money from those are addicted. We cannot give up. We are in this for the long haul.

Source:   addictiontoday.org  March 07 2014

On the basis of three innovative US programmes for offenders or doctors with substance use problems, this analysis concludes that many seriously dependent individuals stop using if non-use is enforced through intensive monitoring and swift, certain but not necessarily severe consequences.

Summary Typical US substance use treatment amounts to a few weeks of outpatient counselling. Given that these disorders are characterised by lifelong risk of relapse, it is not surprising that many treatments yield suboptimal outcomes for many patients. Interventions that work:

• last months or years rather than weeks; • carefully monitor use of alcohol or other drugs of abuse; • impose swift, certain, and meaningful consequences for use and non-use of substances.

This article profiles three innovative care management programmes with these characteristics: physician health programmes, and two therapeutic jurisprudence programmes – South Dakota’s 24/7 Sobriety Project and HOPE probation. These actively and intensively manage the environments in which people with substance use disorders make decisions to use or not to use.

Physician health programmes

Physician health programmes offer drug- and alcohol-using physicians the opportunity, motivation, and support to achieve long-term recovery, using all three strategies in the new paradigm: monitoring, treatment, and 12-step programmes. In return, physicians sign contracts, typically for five years, to adhere to the programme, including completing treatment and submitting to frequent random drug testing to ensure abstinence. Each working day physicians phone or log-in to find out if they must report for testing. All are expected to be active in 12-step or similar community support programmes. Substance use or any other evidence of non-compliance typically results in immediate removal from medical practice to arrange extended treatment followed by more intensive monitoring. A chart review study of a single episode of physician health programme care involving 904 physicians showed that only 0.5% of tests on this high risk, substance abusing population were positive for alcohol or other drugs of abuse.

Hawaii Opportunity Probation with Enforcement

The Hawaii Opportunity Probation with Enforcement (HOPE) programme manages convicted offenders, most of whom are identified as likely to violate community supervision requirements. Their most common drug problem is smoked crystal methamphetamine. A judge tells offenders about the rules, including that they are subject to intensive random testing similar to that used by physician health programmes. Violations of probation, including any drug or alcohol use, missed drug tests, or missed appointments, are met with certain, swift but brief imprisonment.

When asked at the start of the programme, only a few HOPE probationers choose treatment to help them meet the abstinence requirement. The remainder are simply monitored unless they violate probation; most are then referred to treatment. About 85% complete the programme (which can last up to six years) without treatment.

In a 12-month period, 61% of HOPE offenders had no positive drug tests and fewer than 5% had four or more. A study compared probationers randomly assigned to HOPE or to standard probation. After a year, HOPE probationers were 55% less likely to be arrested for a new crime, 72% less likely to use drugs, 61% less likely to miss supervisory appointments, 53% less likely to have their probation revoked, and were sentenced to 48% fewer days of prison.

South Dakota’s 24/7 Sobriety project South Dakota’s 24/7 Sobriety programme serves drink-driving offenders, nearly half of whom have three or more drink-driving convictions. Participants must undergo twice-daily alcohol breath tests at a local police station or wear continuous transdermal alcohol monitoring bracelets and are also subject to regular drug urinalyses or must wear drug detection patches. Positive tests result in immediate brief imprisonment and missed appointments in immediate issuance of arrest warrants. Results are impressive: over 90% of all types of tests are negative, for alcohol breath tests, virtually all. Post-programme recidivism among twice-daily tested offenders is considerably lower than among comparison offenders.

Conclusions

A distinctive feature of these three interventions is the strong leverage used to sanction substance use and to reward abstinence: in physician health programmes, removal from practice and ultimately the loss of medical license versus continuing to practice in a prestigious and well paid profession; in HOPE and 24/7 Sobriety, immediate brief imprisonment versus freedom.

Mandatory abstinence in this new paradigm contrasts sharply with programmes which mandate treatment but do not impose meaningful consequences for substance use. The two offender programmes contrast with common approaches where consequences for non-compliance, including substance use, are delayed, uncertain, and, when applied often after many violations, draconian. This new way of managing substance use patients challenges the view that relapse is an essential feature of their disorder, shifts the focus away from finding new biological treatments, and shows that the key to long-term success lies in sustained changes in the environment in which decisions to use and not use are made. If this passively or actively rewards substance use, use is likely to continue, but the drinking and drug use of many – not all – seriously dependent individuals stops if the environment not only prohibits use, but enforces this with intensive monitoring and swift, certain but not necessarily severe consequences.

Source:   Findings.org.uk  March 2014

Regular cannabis use that starts in adolescence strips away IQ, a NIDA-supported 25-year study of 1,000 individuals suggests. Study participants who initiated weekly cannabis use before age 18 dropped IQ points in proportion to how long they persisted in using the drug, while nonusers gained a fraction of a point.

Persistent cannabis users’ cognitive difficulties were evident to friends and family and measurable on psychological tests. Moreover, among adolescent-onset users, quitting or cutting back did not fully eliminate the IQ loss. Drs. Madeline Meier, Terrie Moffitt, Avshalom Caspi, and colleagues at Duke University, King’s College London, and the University of Otago, New Zealand, say their findings accord with other data that have suggested that cannabis use may harm the developing brain.

Cannabis Use Correlates With Cognitive Decline

The study participants were 1,037 people who were born in 1972 and 1973 in Dunedin, New Zealand, and enrolled as infants in the longitudinal Dunedin Multidisciplinary Health and Development Study. Their families represented the range of socioeconomic statuses in that region.

Dr. Meier and her team tested each participant’s IQ four times up to age 13; asked about past-year cannabis use at ages 18, 21, 26, 32, and 38; and assessed IQ again at age 38. The researchers used the Wechsler Intelligence Scale for Children-Revised (WISC-R) and the Wechsler Adult Intelligence Scale-IV (WAIS-IV) to assess IQ in childhood and adulthood, respectively. The team averaged each participant’s four childhood IQ scores and compared that number with his or her score at age 38.

Persistent Cannabis Users Show IQ Decline Individuals who reported regular (more than 4 days a week) cannabis use in more assessments (out of 5, conducted over 20 years) incurred greater average declines in IQ between childhood and age 38.

Age at First Diagnosis Affects Impact on IQ The relationship between IQ decline and cannabis dependence was stronger among individuals who were first diagnosed before age 18 than among those who were first diagnosed after age 18.

Changes in the participants’ IQ scores from childhood to age 38 correlated with the number of assessments at which they reported having used cannabis regularly (at least 4 times weekly). Those who reported regular use at 1 of the 5 drug assessments scored 3 IQ points lower, on average, at age 38 than they had in childhood; the scores of those who reported regular use at 3 or more assessments fell 5 points.   In contrast, the scores of participants who reported no cannabis use throughout the study increased slightly. The researchers found similar correlations between participants’ IQ trajectories and the number of assessments in which they met diagnostic criteria for cannabis dependence.

When researchers matched adolescent-onset and adult-onset cannabis users with equally persistent use, they saw greater IQ declines among the adolescent-onset users. In fact, whereas individuals who were dependent on cannabis before age 18 and in a total of 3 or more assessments lost 8 IQ points, on average, individuals who developed dependence as adults did not exhibit IQ declines in relation to their cannabis dependence.

The 8-point decline observed among the most persistent adolescent-onset users would move an individual who started at the 50th percentile with an IQ of 100 to the 29th percentile, says Dr. Meier. Such a drop could put a person at a disadvantage compared with his or her peers in terms of ability to get an education or find and hold a good job, she says.

Dr. Meier and colleagues also assessed a variety of specific mental functions at age 38, such as memory and processing speed, using a battery of tests. Dr. Moffitt notes that although she and her colleagues had expected to see impairments in memory, “all kinds of functions were impaired, across the board. Virtually every kind of brain function was involved: memory, processing speed, executive functions, verbal skills, attention, and so forth.”

These deficits affected participants’ daily functioning to an extent that was noticeable to people who knew them well. The researchers asked informants chosen by the participants themselves to provide information on the participants’ mental capacities at age 38. The informants reported more memory and attention problems among cannabis users than among non-users who had started out with the same IQs in childhood.

Cannabis May Harm the Developing Brain

Dr. Meier and colleagues’ findings suggest that IQ is particularly vulnerable to cannabis exposure in adolescence:

* Only adolescent-onset users evidenced significant IQ decline.

* Among all the study participants who initiated weekly cannabis use before age 18, there was little difference in average IQ loss between those who had reduced or stopped their use of the drug for a year or more by age 38, versus those who continued to use frequently.

Among 36 individuals who initiated cannabis use as adolescents and reported use in at least 2 of 5 assessments, 17 reported infrequent use of the drug during the year preceding their final assessment at age 38. These individuals still had IQ scores lower than their childhood scores—although the decline was less than was found among those who continued to use the drug frequently.

During puberty, neurons and neurotransmitter systems mature and link up into refined neural networks. “We hypothesize that cannabis use may interrupt these changes. Animal studies also suggest that this is the case,” Dr. Meier says. To strengthen this hypothesis, future imaging studies might look for structural changes or functional connectivity problems in the brains of adolescent cannabis users.

Dr. Meier and Dr. Moffitt and colleagues ruled out several potential alternative explanations for the observed correlations between cannabis and IQ decline. In a series of analyses, they showed that the correlation still remained after adjusting for participants’ cannabis use in the last week before IQ testing, tobacco use, and dependence on alcohol and other drugs.

Fewer cannabis users than non-users in the study were educated beyond high school, and studies have correlated education with improvements in IQ. However, looking only at the study participants who had a high school diploma or less, the persistent cannabis users still showed greater IQ declines. Dr. Meier and Dr. Moffitt and colleagues suggest that cannabis use and fewer years of school could be reciprocally related. Effects of cannabis on the brain could result in poor academic performance and school dropout, which might produce further declines in brain functioning.

Addiction makes it difficult for people to look beyond immediate gratification to the longer term consequences of their actions. Accordingly, patients in drug abuse treatment are often coached to make and rehearse mental associations between situations that trigger drug cravings and the problems that are likely to ensue from succumbing to them. The cognitive behavioral programs that incorporate this strategy generally are effective, but researchers have shed little light on the neurological basis for their efficacy—until now.

In a study led by Dr. Kevin N. Ochsner of the Social Cognitive Neuroscience Laboratory at Columbia University, smokers reported milder cigarette cravings when they thought about smoking’s harmful effects while viewing smoking cues than when they focused on its pleasures. Brain imaging correlated the reductions in craving with altered activity levels in regions associated with emotional regulation and reward.

Mental Adjustment Alters Brain Activity

Dr. Ochsner and colleagues recruited smokers as study subjects because smoking accounts for more illness and death than any other addiction. To gain insight on the smokers’ ability to regulate cravings in general, the team also investigated their responses to cues for high-fat food.

The participants were 21 men and women who had smoked for 10 years, on average, and were not trying to quit. In preparation for the study, the participants practiced turning their thoughts to rewarding effects of cigarettes or high-fat food consumption when given the instruction “NOW” and to negative effects when given the instruction “LATER.” In the study itself, the researchers gave each participant 100 such instructions, in random order, each followed by a 6-second exposure to a screen image of either cigarettes or food. Then, after a 3-second delay with the screen blank, the participant reported how much he or she desired to smoke or eat, on a scale of 1 (not at all) to 5 (very much).

The power of thinking about negative effects proved to be considerable. The participants reported 34 percent less intense urges to smoke and 30 percent less intense food cravings after the LATER instruction compared with the NOW instruction.

Brain scans taken during the experiment showed how concentrating on long-term negative consequences alters brain activity to reduce craving. Functional magnetic resonance imaging (fMRI) of the participants’ whole brain revealed increased activity levels in areas—the dorsomedial, dorsolateral, and ventrolateral regions of the prefrontal cortex (PFC)—that support cognitive control functions, such as focusing, shifting attention, and controlling emotions. Activity decreased in regions that previous studies have linked with craving; these areas include the ventral striatum and ventral tegmental area, which are parts of the reward circuit; the amygdala; and the subgenual cingulate. Individual participants who reported larger reductions in craving exhibited these changes to a more marked degree. A specialized mediation analysis of the images found that the increase in PFC activity drove the decrease in ventral striatum activity, which, in turn, fully accounted for the reduction in craving.

“These results show that a craving-control technique from behavioral treatment influences a particular brain circuit, just as medications affect other pathways,” says Dr. Steven Grant of NIDA’s Division of Clinical Neuroscience and Behavioral Research.

The researchers noted that the study participants reduced their smoking and food cravings to the same extent, even though smoking cravings were initially more intense. This finding suggests that calling undesirable consequences to mind has potential to help people overcome a variety of unhealthy urges.

Scans Show Effects of Craving Regulation in the Brain When study participants thought of the long-term negative consequences of cigarette consumption (after receiving the instruction “LATER”), rather than short-term pleasures (“NOW”), they reduced their craving. Brain scans showed increased activity in the dorsolateral prefrontal cortex—a region critical to setting goals, planning, and controlling behavior—which, in turn, inhibited the ventral striatum, part of the reward pathway that generates craving. Text Description of Scans Show Effects of Craving Regulation in the Brain Graphic

Healing Perspectives

“Cognitive reappraisal—mentally changing the meaning of an event or object to lessen its emotional impact and therefore alter the behaviors it triggers—is a strategy that helps a variety of problems,” says Dr. Ochsner. Cognitive-behavioral therapists train patients to use this approach, among others, to cope with negative emotions, stress, and substance cravings. Dr. Ochsner says, “People may not realize that they can control cravings or emotions using cognitive strategies—for example, thinking of negative consequences and distracting and distancing oneself—but patients can learn these techniques and then must continue to apply them over time.”

Dr. Ochsner says there is broad scientific interest in the neurobiological mechanisms underlying cognitive control over thoughts and emotions that promote unhealthy behaviors. Such studies generally find that although there is some overlap in the regions of the PFC engaged when people exert cognitive control, different areas seem to support different strategies for the regulation of emotional responses.

“The mediation analysis that Dr. Ochsner and colleagues conducted is unique among imaging studies and is a particular strength of this research,” says Dr. Grant. “Because the researchers examined the interaction of brain regions, the results provide a perspective on the neural circuits involved in cognitive control of craving.”

Dr. Grant suggests two important next steps in this area of research: identifying why some people have more problems than others in controlling the desire for cigarettes and determining whether brain activity predicts the ability to quit smoking.

Sources

Kober, H., et al. Prefrontal-striatal pathway underlies cognitive regulation of craving. Proceedings of the National Academy of Sciences 107(33):14811–14816, 2010. Kober, H., et al. Regulation of craving by cognitive strategies in cigarette smokers. Drug and Alcohol Dependence 106(1):52–55, 2010.  NIDA Notes April 19, 2012

A recent large-scale epidemiological study sheds light on the relationship between cannabis use disorder (CUD) and social anxiety disorder (SAD). The findings affirmed that a significant portion of individuals with CUD also have SAD, and showed that comorbid SAD is associated with greater severity of cannabis-related problems. Moreover, almost all individuals with both CUD and SAD had at least one additional clinically significant psychiatric disturbance.

The researchers say that their findings highlight the importance of assessing CUD patients for SAD. Their evidence suggests that SAD can be both a contributing cause and a consequence of CUD, and that treating both disorders may be a key to helping patients recover from each.

A Common Comorbidity

Dr. Julia D. Buckner at Louisiana State University, Dr. Richard G. Heimberg at Temple University, Dr. Franklin Schneier at Columbia University, and Dr. Carlos Blanco’s team at the New York State Psychiatric Institute analyzed data from the 2001‒2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Their results confirmed previous observations that patients with CUD experience high rates of SAD.

Of the 43,093 respondents to the survey, 3,297 (7.6 percent) reported having had drug problems consistent with CUD at some time in their lives. Of those with CUD, 340 (10.3 percent) also reported having had, at some time in their lives, social anxiety that was severe enough to warrant a clinical diagnosis of SAD.

Given these numbers, Dr. Buckner says, assessing CUD patients for SAD can facilitate treatment for many. Identifying and treating comorbid SAD can remove an obstacle to recovery from substance abuse. “For example, research suggests that socially anxious people may be less likely to participate in group therapy or seek a sponsor. Also, higher levels of anxiety at the end of CUD treatment have been shown to lead to a higher rate of relapse into cannabis use and related problems,” she says.

The Order of Maladies

Over 80 percent of the NESARC respondents with CUD‒SAD comorbidity reported that their SAD preceded their CUD, and 15 percent reported CUD onset before SAD onset. Based on this observation, Dr. Buckner and colleagues suggest that two alternative pathways can lead to CUD‒SAD comorbidity.

In both pathways, CUD and SAD promote and exacerbate each other. In the more common one, individuals develop CUD as an adverse consequence of self-medicating to ease their social anxiety. In the alternative pathway, uncontrolled cannabis use generates social difficulties and anxiety that develop into SAD.

From a clinical perspective, the researchers say, it will be important to determine whether different pathways indeed exist, because the two groups may respond differently to treatment. For example, those who develop CUD as a result of relying on cannabis to manage their anxiety may benefit from skills to help them better manage their anxiety. In contrast, those who develop SAD as a result of CUD-related impairment may benefit first from strategies to help them better manage their social difficulties and other cannabis-related problems.

SAD and Cannabis Use Severity

Further analysis suggested that people with CUD and SAD experience more cannabis-related problems than those with only CUD. Among NESARC respondents with CUD, 21 percent of those who met the diagnostic criteria for cannabis dependence—which requires compulsive use of the drug and drug-related psychological or physiological problems—also had SAD. In contrast, the rate of SAD among those who met the criteria for cannabis abuse—which specifies only periodic cannabis use and does not require physiological problems—was 8.5 percent.

After controlling statistically for the effects of gender, race, and other psychiatric comorbidities, the researchers estimated that an individual with cannabis dependence had 1.6 times higher odds of comorbid SAD, compared to an individual with cannabis abuse.

Compounded Comorbidities

The patient with CUD and SAD probably has other psychiatric problems as well, the NESARC data suggest. More than 99 percent of the respondents who reported CUD‒SAD also reported symptoms meeting the diagnostic criteria for at least one additional psychiatric disorder .  More than 98 percent had experienced another Axis I disorder (e.g., other substance use disorder, mood disorder, or anxiety disorder), and about 73 percent had experienced an Axis II personality disorder (e.g., obsessive-compulsive, paranoid, avoidant, antisocial, schizoid). The CUD‒SAD group’s odds for reporting a third comorbidity were over 7 times higher than those of respondents who had CUD without SAD.

Not surprisingly, individuals with CUD‒SAD reported poorer overall health than those with CUD alone. Just over half rated their health status as excellent or very good, compared to 60 percent of those with CUD alone.

Clinical Implications

“In drug treatment settings, anxiety in general, but SAD in particular, can often be overlooked because providers are focused on substance use,” says Dr. Buckner. However, addressing patients’ social anxiety in treatment can enhance their chances for successful recovery from substance abuse, as well as improve their general quality of life. A finding that a patient with CUD has comorbid SAD can also alert clinicians to a high likelihood of other comorbid problems.

“The relationships among anxiety disorders and substance use disorders are complex and merit this kind of attention, given how commonly they co-occur,” says Dr. Naimah Weinberg from NIDA’s Division of Epidemiology, Services, and Prevention Research. “This type of study, with the power to focus on a particular anxiety disorder and type of substance dependence, helps refine our understanding of these complex relationships. If the results can be replicated, particularly by prospective studies, this may offer an opportunity for intervention with high-risk youth to prevent the development of substance use disorders.”

Source: National Epidemiological Study of Alcohol and Related Conditions (NESARC). Drug and Alcohol Dependence 124(1–2):128–134, 2012   Oct. 2013

SMOKED MARIJUANA IS NOT MEDICINE

In 1970, Congress enacted laws against marijuana based in part on its conclusion that marijuana has no scientifically proven medical value. Likewise, the Food and Drug Administration (FDA), which is responsible for approving drugs as safe and effective medicine, has thus far declined to approve smoked marijuana for any condition or disease. Indeed, the FDA has noted that “there is currently sound evidence that smoked marijuana is harmful,” and “that no sound scientific studies support medical use of marijuana for treatment in the United States, and no animal or human data support the safety or efficacy of marijuana for general medical use.”1

Voices in the medical community likewise do not accept smoked marijuana as medicine:

· The American Medical Association (AMA) in November 2013, amended their position on cannabis, stating that “(1) cannabis is a dangerous drug and as such is a public health concern; (2) sale of cannabis should not be legalized; (3) public health based strategies, rather than incarceration should be utilized in the handling of individuals possessing cannabis for personal use; and (4) that additional research should be encouraged.”2

· The American Society of Addiction Medicine’s (ASAM) public policy statement on “Medical Marijuana,” clearly rejects smoking as a means of drug delivery. ASAM further recommends that “all cannabis, cannabis-based products and cannabis delivery devices should be subject to the same standards applicable to all other prescription medication and medical devices, and should not be distributed or otherwise provided to patients …” without FDA approval. ASAM also “discourages state interference in the federal medication approval process.”3 ASAM continues to support these policies, and has also stated that they do not “support proposals to legalize marijuana anywhere in the United States.”4

· The American Cancer Society (ACS) “is supportive of more research into the benefits of cannabinoids. Better and more effective treatments are needed to overcome the side effects of cancer and its treatment. However, the ACS does not advocate the use of inhaled marijuana or the legalization of marijuana.”5

· The American Glaucoma Society (AGS) has stated that “although marijuana can lower the intraocular pressure, the side effects and short duration of action, coupled with the lack of evidence that its use alters the course of glaucoma, preclude recommending this drug in any form for the treatment of glaucoma at the present time.”6

· The Glaucoma Research Foundation (GRF) states that “the high dose of marijuana necessary to produce a clinically relevant effect on intraocular pressure in people with glaucoma in the short term requires constant inhalation, as much as every three hours. The number of significant side effects generated by long-term use of marijuana or long-term inhalation of marijuana smoke make marijuana a poor choice in the treatment of glaucoma. To date, no studies have shown that marijuana – or any of its approximately 400 chemical components – can safely and effectively lower intraocular pressure better than the variety of drugs currently on the market.”7 2

· The American Academy of Pediatrics (AAP) believes that “[a]ny change in the legal status of marijuana, even if limited to adults, could affect the prevalence of use among adolescents.” While it supports scientific research on the possible medical use of cannabinoids as opposed to smoked marijuana, it opposes the legalization of marijuana.8

· The American Academy of Child and Adolescent Psychiatry (AACAP) “is concerned about the negative impact of medical marijuana on youth. Adolescents are especially vulnerable to the many adverse development, cognitive, medical, psychiatric, and addictive effects of marijuana.” Of greater concern to the AACAP is that “adolescent marijuana users are more likely than adult users to develop marijuana dependence, and their heavy use is associated with increased incidence and worsened course of psychotic, mood, and anxiety disorders.” “The “medicalization” of smoked marijuana has distorted the perception of the known risks and purposed benefits of this drug.” Based upon these concerns, the “AACAP opposes medical marijuana dispensing to adolescents.”9

· The National Multiple Sclerosis Society (NMSS) has stated that “based on studies to date – and the fact that long-term use of marijuana may be associated with significant, serious side effects – it is the opinion of the National Multiple Sclerosis Society’s Medical Advisory Board that there are currently insufficient data to recommend marijuana or its derivatives as a treatment for MS symptoms. Research is continuing to determine if there is a possible role for marijuana or its derivatives in the treatment of MS. In the meantime, other well tested, FDAapproved drugs are available to reduce spasticity.”10

· The National Association of School Nurses (NASN) consensus it that marijuana is properly categorized as a Schedule I substance under the Controlled Substances Act and concurs with DEA that “the clear weight of the currently available evidence supports this classification, including evidence that smoked marijuana has a high potential for abuse, has no accepted medicinal value in treatment in the United States, and evidence that there is a general lack of accepted safety for its use even under medical supervision.”11 NASN also supports of the position of the AAP that “any change in the legal status of marijuana, even if limited to adults, could affect the prevalence of use among adolescents.”12

· The American Psychiatric Association (APA) states that there is no current scientific evidence that marijuana is in any way beneficial for treatment of any psychiatric disorder. Current evidence supports, at minimum, a strong association of cannabis use with the onset of psychiatric disorders. Adolescents are particularly vulnerable to harm due to the effects of cannabis on neurological development. The APA does support further research of cannabisderived substances as medicine, facilitated by the federal government, and if scientific evidence supports the use for treatment of specific conditions, the approval process should go through the FDA and in no way be authorized by ballot initiatives.13  3

DANGERS OF MARIJUANA

MARIJUANA IS DANGEROUS TO THE USER AND OTHERS

Without a clear understanding of the mental and physical effects of marijuana, its use on our youth, our families, and our society, we will never understand the ramifications it will have on the lives of our younger generation, the impact on their future, and its costs to our society. Legalization of marijuana, no matter how it begins, will come at the expense of our children and public safety. It will create dependency and treatment issues, and open the door to use of other drugs, impaired health, delinquent behavior, and drugged drivers. This is not the marijuana of the 1970s; today’s marijuana is far more powerful. On May 14, 2009, analysis from the National Institute on Drug Abuse (NIDA)-funded University of Mississippi’s Potency Monitoring Project revealed that marijuana potency levels in the U.S. are the highest ever reported since the scientific analysis of the drug began.14   This trend continues.

· According to the latest data, the average amount of THC in seized samples has reached 12.98 percent. This compares to an average of just under four percent reported in 1983 and represents more than a tripling of the potency of the drug since that time.15

· “We are increasingly concerned that regular or daily use of marijuana is robbing many young people of their potential to achieve and excel in school or other aspects of life,” said NIDA Director Nora D. Volkow, MD. “THC, a key ingredient in marijuana, alters the ability of the hippocampus, a brain area related to learning and memory, to communicate effectively with other brain regions. In addition, we know from recent research that marijuana use that begins during adolescence can lower IQ and impair other measures of mental function in adulthood.”16

· “We should also point out that marijuana use that begins in adolescence increases the risk they will become addicted to the drug,” said Volkow. “The risk of addiction goes from about 1 in 11 overall to 1 in 6 for those who start using in their teens, and even higher among daily smokers.”17 The most recent statistics on the use of marijuana in the United States shows that marijuana use continues to rise.

· In 2012, an estimated 23.9 million American’s aged 12 and older were current (past month) illicit drug users. This represents 9.2 percent of the population 12 and older. Marijuana was the most commonly used illicit drug with 18.9 million past month users.18

· The use of illicit drug use among young adults aged 18 to 25 increased from 19.7 percent in 2008 to 21.3 percent in 2012, driven largely by an increase in marijuana use (from 16.6 percent in 2008 to 18.7 percent in 2012). 19

· In 2012, an estimated 2.9 million persons aged 12 and older used an illicit drug for the first time within the past 12 months. That equals about 7,900 initiates per day. The largest number of new initiates used marijuana (2.4 million).20  4

· Among 12 and 13 year olds, 1.2 percent used marijuana; for 14 and 15 year olds, it was 6.1 percent; and for 16 and 17 year olds, it climbed to 14 percent.21

· An estimated 17 percent of past year marijuana users aged 12 and older used marijuana on 300 or more days within the past 12 months. This means that almost 5.4 million persons used marijuana on a daily or almost daily basis over a 12 month period.22

· An estimated 40.3 percent (7.6 million) of current marijuana users aged 12 and older used marijuana on 20 or more days in the past month.23

· Among persons 12 or older, of the estimated 1.4 million first-time past year marijuana users initiated use prior to age 18.24

· On an average day 646,707 adolescents aged 12-17 years of age smoked marijuana, and 4,000 adolescents used marijuana for the first time.25

· According to the 2013 Monitoring the Future Survey, one in every 15 high school seniors (6.5 percent) is a daily or near-daily marijuana user.26

· Nearly 23 percent of high school seniors say they smoked marijuana in the month prior to the survey, and just over 36 percent say they smoked within the previous year. More than 12 percent of eight graders said they used marijuana during the past year.27

· The 2011 Partnership Attitude Tracking Study found that nine percent of teens (nearly 1.5 million) smoked marijuana heavily (at least 20 times) in the past month. Overall, past-month teen use was up 80 percent from 2008.28

§ Nearly half of teens (47 percent) have ever used marijuana – a 21 percent increase from2008.29

 

§ Two out of every five teens (39 percent) have tried marijuana during the past year, an increase from 31 percent in 2008.30

 

§ Past-month use increased 42 percent, from 19 percent in 2008 to 27 percent in 2011 (an increase of 4 million teens).31

 

§ Past-year use is up 26 percent from 31 percent in 2008 to 39 percent in 2011 (an increase of 6 million teens).32

 

§ Lifetime use is up 21 percent, from 39 percent in 2008 to 47 percent in 2011 (an increase of 8 million teens).33  Increasingly, the international community is joining the United States in recognizing the fallacy of arguments claiming marijuana use is a harmless activity with no consequences to others.

 

· Antonio Maria Costa, then Executive Director of the United Nations Office on Drugs and Crime, noted in an article published in The Independent on Sunday “The debate over the drug is no longer about liberty; it’s about health.” He continued, “Evidence of the damage to mental 5 health caused by cannabis use–from loss of concentration to paranoia, aggressiveness and outright psychosis–is mounting and cannot be ignored. Emergency-room admissions involving cannabis is rising, as is demand for rehabilitation treatment. …It is time to explode the myth of cannabis as a ‘soft’ drug.”34

 

· The President of the International Narcotics Control Board (INCB), Raymond Yans, voiced grave concern about the recent referenda in the United States that would allow the recreational use of cannabis by adults. “Legalization of cannabis within these states would send wrong and confusing signals to youth and society in general, giving the false impression that drug abuse might be considered normal and even, most disturbingly, safe. Such a development could result in the expansion of drug abuse, especially among young people, and we must remember that all young people have a right to be protected from drug abuse and drug dependency.”35 “The concern with marijuana is not born out of any culture war mentality, but out of what science tells us about the drug’s effects.”36

 

MENTAL HEALTH ISSUES RELATED TO MARIJUANA

There is mounting evidence that use of marijuana, particularly by adolescents, can lead to serious mental health problems.

 

· According to Nora Volkow, the Director of the National Institute of Drug Abuse, “Regular marijuana use in adolescence is known to be a part of a cluster of behaviors that can produce enduring detrimental effects and alter the trajectory of a young person’s life – thwarting his or her potential. Beyond potentially lower IQ, teen marijuana use is linked to school dropout, other drug use, mental health problems, etc. Given the current number of regular marijuana users (1 in 15 high school seniors) and the possibility of this increasing with marijuana legalization, we cannot afford to divert our focus from the central point: regular marijuana use stands to jeopardize a young person’s chances of success – in school and in life.”37

 

· A major study published in the Proceedings of the National Academy of Sciences in August 2012 provides finding that long-term marijuana use started in teen years does have a negative effect on intellectual function. The more dependent the person becomes

on marijuana, the more significant the impairment. The impairment was significant in five different cognitive areas, especially executive function and processing speed. Participants who used cannabis heavily in their teens and continued through adulthood showed a significant drop in their intelligence quotient (IQ) – an average of eight points. Those who started using marijuana regularly after age 18 showed minor declines. Those who never used marijuana showed no decline. Even after stopping cannabis use, neuropsychological deficits were never recovered among those who started smoking during their teen years.38

 

· “Nearly one in ten first-year college students at a mid-Atlantic university have a cannabis use disorder (CUD) according to a NIDA-funded study of drug use conducted by investigators from the Center for Substance Abuse Research at the University of Maryland.” “Students who had used cannabis five or more times in the past year – regardless of whether or not they met the criteria for CUD – reported problems related to their cannabis use, such as concentration problems (40.1 percent), regularly putting themselves in physical danger (24.3 percent), and driving after using marijuana (18.6 percent).”39   6

 

· According to a report by the Office of National Drug Control Policy on teens, depression and marijuana use: 40

 

§ Depressed teens are twice as likely as non-depressed teens to use marijuana and other illicit drugs.

 

§ Depressed teens are more than twice as likely as their peers to abuse or become

dependent on marijuana.

 

§ Marijuana use can worsen depression and lead to more serious mental illness such as

schizophrenia, anxiety, and even suicide.

 

§ Teens who smoke marijuana at least once a month are three times more likely to have suicidal thoughts than non-users.

 

§ The percentage of depressed teens is equal to the percentage of depressed adults, but depressed teens are more likely than depressed adults to use marijuana than other drugs.

 

· Researchers from the University of Oulu in Finland interviewed over 6,000 youth ages 15 and 16 and found that “teenage cannabis users are more likely to suffer psychotic symptoms and have a greater risk of developing schizophrenia in later life.”41

 

· John Walters, then the Director of the Office of National Drug Control Policy, Charles G. Curie, then the Administrator of the Substance Abuse and Mental Health Services

Administration, and experts and scientists from leading mental health organizations joined together in May 2005 to warn parents about the mental health dangers marijuana poses to teens. According to several recent studies, marijuana use has been linked with depression and suicidal thoughts, in addition to schizophrenia. These studies report that weekly marijuana use among teens doubles the risk of developing depression and triples the incidence of suicidal thoughts.42

 

· Dr. Andrew Campbell, a member of the New South Wales (Australia) Mental Health Review Tribunal, published a study in 2005 which revealed that four out of five individuals with schizophrenia were regular cannabis users when they were teenagers. Between 75-80 percent of the patients involved in the study used cannabis habitually between the ages of 12 and 21.43 In addition, a laboratory-controlled study by Yale scientists, published in 2004, found that THC “transiently induced a range of schizophrenia-like effects in healthy people.”44

· In a presentation on “Neuroimaging Marijuana Use and Effects on Cognitive Function”

Professor Krista Lisdahl Medina suggests that chronic heavy marijuana use during adolescence is associated with poorer performance on thinking tasks, including slower psychomotor speed and poorer complex attention, verbal memory and planning ability. “While recent findings suggest partial recovery of verbal memory functioning within the first three weeks of adolescent abstinence from marijuana, complex attention skills continue to be affected. Not only are their thinking abilities worse, their brain activation to cognitive task is abnormal.”45  7 Many of these effects of using marijuana affect all ages, not just youth.

 

· Memory, speed of thinking, and other cognitive abilities get worse over time with marijuana use, according to a study published in the March 14, 2006 issue of Neurology, the scientific journal of the American Academy of Neurology. The study found that frequent marijuana users performed worse than non-users on tests of cognitive abilities, including divided attention and verbal fluency. Those who had used marijuana for 10 years or more had more problems with their thinking abilities than those who had used marijuana for 5-to-10 years. All of the marijuana users were heavy users, which was defined as smoking four or more joints per week.46

 

· Australian researchers report that long-term, heavy cannabis use may be associated with structural abnormalities in areas of the brain which govern memory, emotion, and aggression. Brain scans showed that the hippocampus was 12 percent smaller and the amygdale 7 percent smaller in men who smoked at least 5 cigarettes daily for almost 10 years. Dr. Mura Yucel, the lead researcher stated that “this new evidence plays an important role in further understanding the effects of marijuana and its impact on brain functions. The study is the first to show that long-term cannabis use can adversely affect all users, not just those in the high-risk categories such as the young, or those susceptible to mental illness, as previously thought.”47

 

· A two-year study by the National Cannabis Prevention and Information Centre, at the

University of New South Wales in Sydney, Australia found that cannabis users can be as

aggressive as crystal methamphetamine users, with almost one in four men and one in three women being violent toward hospital staff or injuring themselves after acting aggressively. Almost 12 percent were considered a suicide risk. The head of the Emergency Department at St. Vincent’s Hospital, Gordian Fulde, said “that most people still believed marijuana was a soft drug, but the old image of feeling sleepy and having the munchies after you’ve smoked is entirely inappropriate for modern-day marijuana. With hydroponic cannabis, the levels of THC can be tenfold what they are in normal cannabis so we are seeing some very, very serious fallout.”48

 

· Carleton University researchers published a study in 2005 showing that current marijuana users who smoke at least five “joints” per week did significantly worse than non-users when tested on neurocognition tests such as processing speed, memory, and overall IQ.49

 

· U.S. scientists have discovered that the active ingredient in marijuana interferes with

synchronized activity between neurons in the hippocampus of rats. The authors of this

November 2006 study suggest that action of tetrahydrocannabinol, or THC, might explain why marijuana impairs memory.50

 

· According to an Australian study, there is now conclusive evidence that smoking cannabis hastens the appearance of psychotic illnesses by up to three years. Dr. Mathew Large from the University of New South Wales reports that “…in addition to early cannabis smoking bringing on schizophrenia it brings it on early by an average of 2.7 years early – earlier than you would have otherwise developed it had you not been a cannabis smoker. The risks for older people is about a doubling of the risk.” “For young people who smoke cannabis regularly, instead of having around a one percent chance of developing schizophrenia during their life they will end up with something like a five percent chance of developing schizophrenia.” Philip Mitchell, 8 head of Psychiatry at the University stated that while “this research can’t distinguish about whether cannabis causes schizophrenia or brings it out in vulnerable people…it makes it very clear that cannabis is playing a significant role in psychosis.”51

 

· Doctors at Yale University documented marijuana’s damaging effect on the brain after nearly half of 150 healthy volunteers experienced psychotic symptoms, including hallucinations and paranoid delusions, when given THC, the drug’s primary active ingredient. The findings were released during a May 2007 international health conference in London. 52

 

· According to Margaret Trudeau, “Marijuana can trigger psychosis.” “Quitting cannabis has been an important part of my recovery from mental illness,” Margaret Trudeau, ex-wife of former Canadian prime Minister Pierre Trudeau, reported at a press conference at the Canadian Mental Health Conference in Vancouver on February 15, 2007. “Every time I was hospitalized it was preceded by heavy marijuana use.”53

 

· A pair of articles in the Canadian Journal of Psychiatry reflects that cannabis use can trigger schizophrenia in people already vulnerable to the mental illness and assert that this fact should shape marijuana policy.54

 

· Robin Murray, a professor of psychiatry at London’s Institute of Psychiatry and consultant at the Maudsley Hospital in London, wrote an editorial which appeared in The Independence on Sunday, on March 18, 2007, in which he states that the British Government’s “mistake was rather to give the impression that cannabis was harmless and that there was no link to psychosis.” Based on the fact that “…in the late 1980s and 1990s psychiatrists like me began to see growing numbers of young people with schizophrenia who were taking large amounts of cannabis.” Murray claims that “…at least 10 percent of all people with schizophrenia in the UK would not have developed the illness if they had not smoked cannabis.” By his estimates, 25,000 individuals have ruined their lives because they smoked cannabis. He also points out that the “skunk” variety of cannabis, which is very popular among young people in Great Britain, contains “15 to 20 percent THC, and new resin preparations have up to 30 percent.”55

 

· Dr. John MacLeod, a prominent British psychiatrist states: “If you assume such a link (to schizophrenia with cannabis) then the number of cases of schizophrenia will increase

significantly in line with increased use of the drug.” He predicts that cannabis use may account for a quarter of all new cases of schizophrenia in three years’ time.56

 

· A study by scientists at the Queensland Brain Institute in Australia on long-term marijuana use and the increased risk of psychosis confirms earlier findings. “Compared with those who had never used cannabis, young adults who had six or more years since first use of cannabis were twice as likely to develop a non-affective psychosis (such as schizophrenia), “ McGrath wrote in a study published in the Archives of General Psychiatry Journal. “They were also four times as likely to have high scores in clinical tests of delusion.”57

 

· A study published in the March 2008 Journal of the American Academy of Child and

Adolescent Psychiatry cited the harm of smoking marijuana during pregnancy. The study

found a significant relationship between marijuana exposure and child intelligence.

Researchers concluded that “prenatal marijuana exposure has a significant effect on school-age intellectual development.”58 9

 

· A study by doctors from the National Institute of Drug Abuse found that people who smoked marijuana had changes in the blood flow in their brains even after a month of not smoking. The marijuana users had PI (pulsatility index) values somewhat higher

than people with chronic high blood pressure and diabetes, which suggests that marijuana use leads to abnormalities in the small blood vessels in the brain. These findings could explain in part the problems with thinking and remembering found in other studies of marijuana users.59

 

PHYSICAL HEALTH ISSUES RELATED TO MARIJUANA

Marijuana use also affects the physical health of users, both short and long term.

 

· In 2011, according to the Drug Abuse Warning Network (DAWN), there were 1,252,000 emergency department (ED) visits involving an illicit drug. Marijuana was involved in 455,668 of these visits, second only to cocaine.60

 

· ED visits for marijuana increased 19 percent between 2009 and 2011.61

 

· Among ED visits made by patients aged 20 or younger resulting in drug misuse or abuse, marijuana was the most commonly involved illicit drug (143.9 visits per 100,000).62

 

· In 2012, an estimated 22.2 million persons aged 12 or older were classified with substance dependence and abuse in the past year (8.5 percent of the population 12 or older). Marijuana was the illicit drug with the largest number of persons (4.3 million) with past year dependence or abuse.63

 

· On an average day in 2010 there were 266 drug related ED visits for youth 12 to17 years of age that involved marijuana.64

 

· Under the Safe Drinking Water and Toxic Enforcement Act of 1986, the Governor of

California is required to revise and republish at least once a year the list of chemicals known to the state to cause cancer or reproductive toxicity. On September 11, 2009, the California Environmental Protection Agency, Office of Environmental Health Hazard Assessment, published the latest list. The list included a chemical added in June, marijuana smoke, and lists cancer as the type of toxicity.65

 

· A study by researchers at the Erasmus University Medical Center in Rotterdam, Netherlands found women who smoked pot during pregnancy may impair their baby’s growth and development in the womb. The babies born to marijuana users tended to weigh less and have smaller heads than other infants, both of which are linked to increased risk of problems with thinking, memory, and behavioral problems in childhood.66

 

· A long-term study of over 900 New Zealanders by the University of Otago, New Zealand School of Dentistry has found that “heavy marijuana use has been found to contribute to gum disease, apart from the known effects that tobacco smoke was already known to have.”67  10

 

· A study from Monash University and the Alfred Hospital in Australia has found that “bullous lung disease occurs in marijuana smokers 20 years earlier than tobacco smokers. Often caused by exposure to toxic chemicals or long-term exposure to tobacco smoke, bullae is a condition where air trapped in the lungs causes obstruction to breathing and eventual destruction of the lungs.” Dr. Matthew Naughton explains that  the peak inspiration and held for as long as possible before slow exhalation. This predisposes to greater damage to the lungs and makes marijuana smokers more prone to bullous disease as compared to cigarette smokers.”68

 

· In December 2007 researchers in Canada reported that “marijuana smoke contains significantly higher levels of toxic compounds — including ammonia and hydrogen cyanide — than tobacco smoke and may therefore pose similar health risks.” “Ammonia

levels were 20 times higher in the marijuana smoke than in the tobacco smoke, while hydrogen cyanide, nitric oxide and certain aromatic amines occurred at levels 3-5 times higher in the marijuana smoke.”69

 

· Marijuana worsens breathing problems in current smokers with chronic obstructive pulmonary disease (COPD), according to a study released by the American Thoracic Society in May 2007. Among people age 40 and older, smoking cigarettes and marijuana together boosted the odds of developing COPD to 3.5 times the risk of someone who smoked neither.70

 

· Scientists at Sweden’s Karolinska Institute, a medical university, have advanced their

understanding of how smoking marijuana during pregnancy may damage the fetal brain.

Findings from their study, released in May 2007, explain how endogenous cannabinoids exert adverse effects on nerve cells, potentially imposing life-long cognitive and motor deficits in afflicted new born babies.71

 

· A study from New Zealand reports that cannabis smoking may cause five percent of lung cancer cases in that country. Dr. Sarah Aldington of the Medical Research Institute in Wellington presented her study results at the Thoracic Society conference in Auckland on March 26, 2007.72

 

· Researchers at the Fred Hutchinson Cancer Research Center in Seattle found that frequent or long-term marijuana use may significantly increase a man’s risk of developing the most aggressive type of testicular cancer, nonseminoma. Nonseminoma is a fast-growing testicular malignancy that tends to strike early, between the ages of 20 and 35, and accounts for about 40 percent of all testicular cancer cases. Dr. Stephen Schwartz stated that researchers are still studying the long-term health consequences of marijuana smoking, especially heavy marijuana smoking and “in the absence of more certain information, a decision to smoke marijuana recreationally means that one is taking a chance on one’s future health.”73

 

· According to researchers at the Yale School of Medicine, long-term exposure to marijuana smoke is linked to many of the same kinds of health problems as those experienced by long term cigarette smokers. “…[C]linicians should advise their patients of the potential negative impact of marijuana smoking on overall lung health.”74

 

· While smoking cigarettes is known to be a major risk factor for the bladder cancer most common among people age 60 and older, researchers are now finding a correlation between smoking marijuana and bladder cancer. In a study of younger patients with transitional cell 11 bladder cancer, Dr. Martha Terriss found that 88.5 percent had a history of smoking marijuana.

 

Marijuana smoke has many of the same carcinogen-containing tars as cigarettes and may get even more into the body because marijuana cigarettes are unfiltered and users tend to hold the smoke in their lungs for prolonged periods. Dr. Terriss notes that more research is needed, but does recommend that when doctors find blood in a young patient’s urine sample, they may want to include questions about marijuana use in their follow-up.75

 

· Smoking marijuana can cause changes in lung tissue that may promote cancer growth, according to a review of decades of research on marijuana smoking and lung cancer. However, it is not possible to directly link pot use to lung cancer based on existing evidence. Nevertheless, researchers indicate that the precancerous changes seen in studies included in their analysis, as well as the fact that marijuana smokers generally inhale more deeply and hold smoke in their lungs longer than cigarette smokers, and that marijuana is smoked without a filter, do suggest that smoking pot

could indeed boost lung cancer risk. It is known, they add, that marijuana smoking deposits more tar in the lungs than cigarette smoking does.76

 

· Smoking three cannabis joints will cause one to inhale the same amount of toxic chemicals as a whole pack of cigarettes according to researchers from the French National Consumers’ Institute. Cannabis smoke contains seven times more tar and carbon monoxide than cigarette smoke. Someone smoking a joint of cannabis resin rolled with tobacco will inhale twice the amount of benzene and three times as much toluene as if they were smoking a regular cigarette.77

 

· According to research, the use of marijuana by women trying to conceive or those recently becoming pregnant is not recommended, as it endangers the passage of the embryo from the ovary to the uterus and can result in a failed pregnancy. Researchers from Vanderbilt University say a study with mice has shown that marijuana exposure may compromise the pregnancy outcome because an active ingredient in marijuana, tetrahydrocannabinol (THC), interferes with a fertilized egg’s ability to implant in the lining of the uterus.78

 

· Infants exposed to marijuana in the womb show subtle behavioral changes in their first days of life, according to researchers in Brazil. The newborns were more irritable than non-exposed infants, less responsive, and more difficult to calm. They also cried more, startled more easily, and were jitterier. Such changes have the potential to interfere with the mother-child bonding process. “It is necessary to counter the misconception that marijuana is a ‘benign drug’ and to educate women regarding the risks and possible consequences related to its use during pregnancy,” Dr. Marina Carvahlo de Moraes Barros and her colleagues concluded.79

 

· Marijuana smoking has been implicated as a causative factor in tumors of the head and neck and of the lung. The marijuana smokers in whom these tumors occur are usually much younger than the tobacco smokers who are the usual victims of these malignancies. Although a recent study published by the Medical College of Georgia and Stanford University suggests a causal relationship between marijuana exposure and bladder cancer, larger scale epidemiologic and basic science studies are needed to confirm the role of marijuana smoking as an etiologic agent in the development of transitional cell carcinoma.80

 

· According to a 2005 study of marijuana’s long-term pulmonary effects by Dr. Donald Tashkin at the University of California, Los Angeles, marijuana smoking deposits significantly more tar 12 and known carcinogens within the tar, such a polycyclic aromatic hydrocarbons, into the airways. In addition to precancerous changes, marijuana smoking is associated with impaired function of the immune system components in the lungs.81

 

· Smoked marijuana has also been associated with an increased risk of the same respiratory symptoms as tobacco, including coughing, phlegm production, chronic bronchitis, shortness of breath and wheezing. Because cannabis plants are contaminated with a range of fungal spores, smoking marijuana may also increase the risk of respiratory exposure by infectious organisms (i.e., molds and fungi).82

 

· Marijuana takes the risks of tobacco and raises them. Marijuana smoke contains more than 400 chemicals and increases the risk of serious health consequences, including lung damage.83

 

· An April 2007 article published by the Harm Reduction Journal, and funded by the prolegalization Marijuana Policy Project, argues that the use of a vaporizer has the potential to reduce the danger of cannabis as far as respiratory symptoms are concerned. While these claims remain scientifically unproven, serious negative

consequences still remain. For example, driving skills are still impaired, heavy adolescent use may create deviant brain structure, and 9-12 percent of cannabis users develop symptoms of dependence. A vaporizer offers no protection against these  consequences.84

 

· According to two studies, marijuana use narrows arteries in the brain, “similar to patients with high blood pressure and dementia,” and may explain why memory tests are difficult for marijuana users. In addition, “chronic consumers of cannabis lose molecules called CB1 receptors in the brain’s arteries,” leading to blood flow problems in the brain which can cause memory loss, attention deficits, and impaired learning ability.85

 

· A small study (50 patients) was conducted by the University of California San Francisco, from 2003 to 2005, leading researchers to find that smoked marijuana eased HIV-related foot pain. This pain, known as peripheral neuropathy, was relieved for 52 percent of the patients in the controlled experiment. Dr. Donald Abrams, director of the study said that while subjects’ pain was reduced he and his colleagues “found that adverse events, such as sedation, dizziness and confusion were significantly higher among the cannabis smokers.”86

 

· In response to this study, critics of smoked marijuana were quick to point out that while THC does have some medicinal benefits, smoked marijuana is a poor delivery mechanism. Citing evidence that marijuana smoke is harmful, Dr. David Murray, then chief scientist at the Office of National Drug Control Policy, noted that “People who smoke marijuana are subject to bacterial infections in the lungs…Is this really what a physician who is treating someone with a compromised immune system wants to prescribe?”87

 

§ Dr. Murray also said that the findings are “not particularly persuasive” because of the small number of subjects and the possibility that subjects knew they were smoking marijuana and had an increased expectation of efficacy. He expressed the government’s support for pain relief for HIV-affected individuals and said that while “We’re very much supportive of any effort to ameliorate the suffering of AIDS patients,the delivery mechanism for THC should be pills, and not smoked marijuana, which can cause lung damage and deliver varying dosages of THC.”88  13

 

§ Researchers involved with the University of California, San Francisco, project admitted that there may be a problem with efforts to gauge the effects of marijuana vs. the effects of a placebo. Some users were immediately able to acknowledge that their sample was indeed cannabis because of the effects of that substance. One participant, Diana Dodson said, “I knew immediately [that I received cannabis] because I could feel the effects.”89

 

· Pro-marijuana advocates were encouraged by a medical study published in Cancer

Epidemiology, Biomarkers & Prevention. The study, published in October 2006, was based on interviews with people in Los Angeles (611 who developed lung cancer, 601 who developed cancer of the head or neck regions, and 1,040 people without cancer who were matched [to other subjects] on age, gender, and neighborhoods). The study found that people who smoke marijuana do not appear to be at increased risk of developing lung cancer.90 While this study’s findings differed from previous studies and researchers’ expectations, “[o]ther experts are warning that the study should not be viewed as a green light to smoke pot, as smoking marijuana has been associated with problems such as cognitive impairment and chronic bronchitis.”91 The National Institute on Drug Abuse (NIDA) continues to maintain that smoking marijuana is detrimental to pulmonary functions.

 

§ In its October, 2006, issue of NIDA Notes, mention is made of the most recent Tashkin study. “Biopsies of bronchial tissue provide evidence that regular marijuana smoking injures airway epithelial cells, leading to dysregulation of bronchial epithelial cell growth and eventually to possible malignant changes.” Moreover, he adds, because marijuana smokers typically hold their breath four times as long as tobacco smokers after inhaling, marijuana smoking deposits significantly more tar and known carcinogens within the tar, such as polycyclic aromatic hydrocarbons, in the airways. In addition to precancerous changes, Dr. Tashkin found that marijuana smoking is associated with a range of damaging pulmonary effects, including inhibition of the tumor-killing and bactericidal activity of alveolar macrophages, the primary immune cells within the lung.”

 

§ NIDA also comments on the Tashkin study in the Director’s Notes from February 2007. While acknowledging that the study concluded “that the association of these cancers with marijuana, even long-term or heavy use, is not strong and may be below practically detectable limits…these results may have been affected by selection bias or error in measuring lifetime exposure and confounder histories.”92

 

§ In October 2006, one of the study’s authors, Dr. Hal Morgenstern, Chair of Epidemiology at the University of Michigan School of Public Health, said although the risk of cancer did not prove to be large in the recent study, “I wouldn’t go so far as to say there is no increased cancer risk from smoking marijuana.”93

 

· The British Lung Foundation‘s 2012 survey of 1,000 adults found that a third wrongly believed that cannabis did not harm one’s health. The survey also revealed that 88 percent thought tobacco cigarettes were more harmful than cannabis ones, although the risk of lung cancer is actually 20 times higher from a cannabis cigarette than a tobacco cigarette. Part of the reason for this is that people smoking cannabis take deeper puffs and hold them for longer than tobacco smokers. This means that a person smoking a cannabis cigarette inhales four times as 14 much tar and five times as much carbon monoxide as someone smoking a tobacco cigarette. The Foundation warned that smoking one cannabis cigarette increase the chances of developing lung cancer by as much as an entire packet of 20 cigarettes. “It is alarming that, while new research continues to reveal the multiple health consequences of smoking cannabis, there is still a dangerous lack of public awareness of quite how harmful this drug can be,” said Dame Helena Shovelton, Chief Executive of the British Lung Foundation. “We therefore need a serious public health campaign – of the kind that helped raise awareness of the dangers of eating fatty food or smoking tobacco – to finally dispel the myth that smoking cannabis is somehow a safe pastime.”94

 

· A large international study by researchers from the University of Adelaide found that women who use marijuana during pregnancy double the risk of giving birth prematurely. Preterm or premature births, which is at least three weeks prior to the due date, can result in serious and life-threating health problems for the baby, and increased health problems in later life, such as heart disease and diabetes.95

 

MARIJUANA AS A PRECURSOR TO ABUSE OF OTHER DRUGS

 

· Teens who experiment with marijuana may be making themselves more vulnerable to heroin addiction later in life, if the findings from experiments with rats are any indication. “Cannabis has very long-term, enduring effects on the brain,” according to Dr. Yamin Hurd of the Mount Sinai School of Medicine in New York, the study’s lead author.96

 

· Marijuana is a frequent precursor to the use of more dangerous drugs and signals a significantly enhanced likelihood of drug problems in adult life. The Journal of the American  Medical Association reported, based on a study of 300 sets of twins, “that marijuana-using twins were four times more likely than their siblings to use cocaine and crack cocaine, and five times more likely to use hallucinogens such as LSD.”97

 

· Long-term studies on patterns of drug usage among young people show that very few of them use other drugs without first starting with marijuana. For example, one study found that among adults (age 26 and older) who had used cocaine, 62 percent had initiated marijuana use before age 15. By contrast, less than one percent of adults who never tried marijuana went on to use cocaine.98

 

· Columbia University’s National Center on Addiction and Substance Abuse (CASA) reports that teens who used marijuana at least once in the last month are 13 times likelier than other teens to use another drug like cocaine, heroin, or methamphetamine and almost 26 times likelier than those teens who have never used marijuana to use another drug.99

 

· Marijuana use in early adolescence is particularly ominous. Adults who were early marijuana users were found to be five times more likely to become dependent on any drug, eight times more likely to use cocaine in the future, and fifteen times more likely to use heroin later in life.100

 

· Healthcare workers, legal counsel, police and judges indicate that marijuana is a typical precursor to methamphetamine. For instance, Nancy Kneeland, a substance abuse counselor in Idaho, pointed out that “in almost all cases meth users began with alcohol and pot.”101  15

 

· An estimated 2.9 million persons aged 12 or older – an average of approximately 7,900 per day  used a drug other than alcohol for the first time in the past year according to the 2012 National Survey on Drug Use and Health. Almost two-thirds (65.6 percent) of these new users reported that marijuana was the first drug they tried.102

 

· Nearly one in ten high school students (9 percent) report using marijuana 20 times or more in the past month according to the findings of the 2011 Partnership Attitude Tracking Survey.103

 

· Teens past month heavy marijuana users are significantly more likely than teens that have not used marijuana in the past to: use cocaine/crack (30 times more likely); use Ecstasy (20 times more likely); abuse prescription pain relievers (15 times more likely): and abuse over the counter medications (14 times more likely). This clearly denotes that teens that use marijuana regularly are using other substances at a much higher rate than teens who do not smoke marijuana, or smoke less often.104

 

DEPENDENCY AND TREATMENT

 

· “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.”105

 

· A study of substance abuse treatment admissions in the United States between 1998 and 2008 found that although admission rates for alcohol treatment were declining, admission rates per 100,000 population for illicit drug use were increasing. One consistent pattern in every region was the increase in the admission rate for marijuana use which rose 30 percent nationally.106

 

· California, a national leader in ‘medical’ marijuana use, saw admission for treatment for marijuana dependence more than double over the past decade. Admissions grew from 52 admissions per 100,000 population in 1998 to 113 per 100,000 in 2008, an increase of 117 percent.107

 

· “Research shows that use of [marijuana] can lead to dependence. Some heavy users of marijuana develop withdrawal symptoms when they have not used the drug for a period of time. Marijuana use, in fact, is often associated with behavior that meets the criteria for substance dependence established by the American Psychiatric Association.”108

 

· Marijuana was the illicit drug with the highest rate of past year dependence or abuse in 2012; of the 7.3 million persons age 12 or older classified with illicit drug dependence or abuse, 4.3 million had marijuana dependence or abuse (representing 1.7 percent of the total population aged 12 or older and 58.9 percent of all those classified with illicit drug dependence or abuse).109  16

 

· Among all ages, marijuana was the second most common illicit drug responsible for treatment admissions in 2011 after opioids, accounting for 18 percent of all admissions—outdistancing cocaine, the next most prevalent cause.110

 

· The proportion of admissions for marijuana as the primary substance of abuse for persons aged 12 or older increased from 15 percent in 2001 to 18 percent in 2011.111

 

· Forty percent of primary marijuana admissions were under age 20 (versus 11 percent of all admissions).112

 

· Twenty-five percent of primary admissions had first used marijuana by age 12 and another 32 percent by age 14.113

 

DANGERS TO NON USERS

DELINQUENT BEHAVIORS

 

Marijuana use is strongly associated with juvenile crime:

 

 

· In a 2008 paper entitled Non-Medical Marijuana III: Rite of Passage or Russian Roulette, CASA reported that in 2006 youth who had been arrested and booked for breaking the law were four times likelier than those who were never arrested to have used marijuana in the past year.114

 

· According to CASA in their report on Criminal Neglect: Substance Abuse, Juvenile Justice and the Children Left Behind, youth who use marijuana are likelier than those who do not to be arrested and arrested repeatedly. The earlier an individual begins to use marijuana, the likelier he or she is to be arrested.

 

· Marijuana is known to contribute to delinquent and aggressive behavior. A June 2007 report released by the White House Office of National Drug Control Policy (ONDCP) reveals that teenagers who use drugs are more likely to engage in violent and delinquent behavior. Moreover, early use of marijuana, the most commonly used drug among teens, is a warning sign for later criminal behavior. Specifically, research shows that the instances of physically attacking people, stealing property, and destroying property increase in direct proportion to the frequency with which teens smoke marijuana.115

In a report titled The Relationship between Alcohol, Drug Use, and Violence among Students, the Community Anti-Drug Coalitions of America (CADCA) reported that according to the 2006 Pride Surveys, during the 2005-2006 school year:

 

· Of those students who report carrying a gun to school during the 2005-2006 year, 63.9 percent report also using marijuana.

· Of those students who reported hurting others with a weapon at school, 68.4 percent had used marijuana. 17

 

· Of those students who reported being hurt by a weapon at school, 60.3 percent reported using marijuana.

 

· Of those students who reported threatening someone with a gun, knife, or club or threatening to hit, slap, or kick someone, 27 percent reported using marijuana.

 

· Of those students who reported any trouble with the police, 39 percent also reported using marijuana.116

 

· According to ONDCP, the incidence of youth physically attacking others, stealing, and destroying property increased in proportion to the number of days marijuana was smoked in the past year.117

 

· ONDCP reports that marijuana users were twice as likely as non-users to report they disobeyed school rules.118

 

· Youths aged 12 to 17 who had engaged in fighting or other delinquent behaviors were more likely than other youths to have used illicit drugs in the past month. In 2011 past month illicit drug use was reported by 18.5 percent of youths who had gotten into a serious fight at school or work compared with 8 percent of those who had not engaged in fighting at school or work, and by 45.1 percent of those who had stolen or tried to steal something worth over $50 in the past year compared with 8.7 percent who had not attempted or engaged in such theft.119

 

DRUGGED DRIVERS

 

Drugged driving, also referred to as impaired driving, is driving under the influence of alcohol, over-the-counter-medications, prescription drugs, or illegal drugs.

 

· The principal concern regarding drugged driving is that driving under the influence of any drug that acts on the brain could impair one’s motor skills, reaction time, and judgment. Drugged driving is a public health concern because it puts not only the driver at risk, but also passengers and others who share the road.120

 

· In Montana, where there has been an enormous increase in “medical” marijuana cardholders, Narcotics Chief Mark Long told a legislative committee in April 2010 that “DUI arrests involving marijuana have skyrocketed, as have traffic fatalities where marijuana was found in the system of one of the drivers.”121

 

· In 2011 there were 9.4 million persons aged 12 and older who reported driving under the influence of illicit drugs during the past year. The rate was highest among young adults aged 18 to 25.122

 

· Drugs that may affect driving were detected in one of every seven weekend nighttime drivers in California during the summer of 2012. In the first California statewide roadside survey of alcohol and drug use by drivers, 14 percent of drivers tested positive for drugs and 7.4 percent of drivers tested positive for alcohol, and just as many as tested positive for marijuana as alcohol. 123 18

 

· Since 2000, Liberty Mutual Insurance and Students Against Destructive Decisions (SADD) have been conducting a study of teens driving under the influence. Their most recent report, released in February 2012, found that nearly one in five teens have gotten behind the wheel after smoking marijuana.

§ They also found that driving under the influence of marijuana (19 percent) is a greater threat than driving under the influence of alcohol (13 percent). What greatly concerned the researchers is that many teens don’t even consider marijuana use a distraction to their driving. 124

 

§ “Marijuana affects memory, judgment, and perception and can lead to poor decisions when a teen under the influence of this or other drugs gets behind the wheel of a car,” said Stephen Wallace, Senior Advisor for Policy, Research and Education at SADD. “What keeps me up at night is that this data reflects the dangerous trend toward acceptance of marijuana and other substances compared to our study of teens conducted just two years ago.”125

 

§ The study also found that most teen drivers would not drive while under the influence if asked by their passengers not to. However, even more alarming is that teen passengers are less concerned about riding in a car with a driver who has smoked marijuana than one who has used alcohol.126

 

· A study in the British Medical Journal on the consequences of cannabis impaired driving found that drivers who consume cannabis within three hours of driving are nearly twice as likely to cause a vehicle collision as those who are not under the influence of drugs or alcohol.127

 

· A study in the Epidemiologic Reviews by researchers from Columbia University found that drivers who get behind the wheel after smoking pot run more than twice the risk of getting into an accident. This risk is even greater if the driver had also been drinking alcohol. “As more states consider medical use of marijuana, there could be health implications,” said senior author Gouhua Li. 128

 

· Researchers at the Pacific Institute for Research and Evaluation in Maryland studied a government data base on traffic fatalities and examined the data from 44,000 drivers involved in single-vehicle crashes who died between 1999 and 2009. They found that 24.9 percent of the drivers tested positive for drugs and 37 percent had blood-alcohol levels in excess of .08, the legal limit. The study is one of the first to show the prevalence of drug use among fatally injured drivers. Among the drivers who tested positive for drugs, 22 percent were positive for marijuana, 22 percent for stimulants, and 9 percent for narcotics.129

 

· In a study of seriously injured drivers admitted to a Maryland Level-1 shock-trauma center, 65.7 percent were found to have positive toxicology results for alcohol and/or drugs. Almost 51 percent of the total tested positive for illegal drugs. A total of 26.9 percent of the drivers tested positive for marijuana.130 19

 

· The percentage of fatally injured drivers testing positive for drugs increased over the last five years according to data from the National Highway Traffic Safety Administration (NHTSA). In 2009, 33 percent of the 12,055 drivers fatally injured in motor vehicle crashes with known test results tested positive for at least one drug compared to 28 percent in 2005. In 2009, marijuana was the most prevalent drug found in this population – approximately 28 percent of fatally injured drivers who tested positive tested positive for marijuana.131

 

· Recognizing that drugged driving is a serious health and safety issue, the National Organization for the Reform of Marijuana Laws (NORML) has called for a science-based educational campaign targeting drugged driving behavior. In January of 2008, Deputy Director Paul Armentano released a report titled, Cannabis and Driving, noting that motorists should be discouraged from driving if they have recently smoked cannabis and should never operate a motor vehicle after having consumed both marijuana and alcohol. The report also calls for the development of roadside, cannabis-sensitive technology to better assist law enforcement in identifying drivers who may be under the influence of pot.132

· In a 2007 National Roadside Survey of alcohol and drug use by drivers, a random sample of weekend night time drivers across the United States found that 16.3 percent of the drivers tested positive for drugs, compared to 2.2 percent of drivers with blood alcohol concentrations at or above the legal limit. Drugs were present more than 7 times as frequently as alcohol.133

 

· According to a National Institute of Drug Abuse (NIDA) funded study, a large number of American adolescents are putting themselves and others at great risk by driving under the influence of illicit drugs or alcohol. In 2006, 30 percent of high school seniors reported driving after drinking heavily or using drugs, or riding in a car whose driver had been drinking heavily or using drugs, as least once in the prior two weeks. Dr. Patrick O’Malley, lead author of the study, observed that “Driving under the influence is not an alcohol-only problem. In 2006, 13 percent of seniors said they drove after using marijuana while ten percent drove after having five or more drinks.” “Vehicle accidents are the leading cause of death among those aged 15 to 20,” added Dr. Nora Volkow, Director of NIDA. “Combining the lack of driving experience among teens with the use of marijuana and/or other substances that impair cognitive and motor abilities can be a deadly combination.” 134

 

· A June 2007 toxicology study conducted at the University of Maryland’s Shock-Trauma Unit in Baltimore found that over 26 percent of injured drivers tested positive for marijuana. In an earlier study, the U.S. National Survey on Drug Use and Health estimated that 10.6 million Americans had driven a motor vehicle under the influence of drugs during the previous year. 135

 

· A study of over 3000 fatally-injured drivers in Australia showed that when marijuana was present in the blood of the driver they were much more likely to be at fault for the accident. And the higher the THC concentration, the more likely they were to be culpable.136

 

· The National Highway Traffic Safety Administration (NHTSA) has found that marijuana significantly impairs one’s ability to safely operate a motor vehicle. According to its report, “epidemiology data from road traffic arrests and fatalities indicate that after alcohol, marijuana is the most frequently detected psychoactive substance among driving populations.” Problems reported include: decreased car handling performance, inability to maintain headway, 20 impaired time and distance estimation, increased reaction times, sleepiness, lack of motor coordination, and impaired sustained vigilance.137

 

OTHER CONSEQUENCES OF MARIJUANA USE

· In Massachusetts in 2009 the possession of one ounce of marijuana went from a criminal charge to a civil fine. Police and District Attorneys want residents to know that smoking marijuana is not a victimless crime. Middlesex District Attorney Gerard T. Leone Jr. says that he fears that “decriminalization has created a booming ‘cottage industry’ for dope dealers to target youths no longer fearing the stigma of arrest or how getting high could affect their already dicey driving. What we’re seeing now is an unfortunate and predictable outcome. It’s a cash and carry business. With more small-time dealers operating turf encroachment is inevitable. This tends to make drug dealers angry.” Wellesley Deputy Police Chief William Brooks III, speaking on behalf of the Massachusetts Chiefs of Police Association said “the whole thing is a mess. The perception out there among a lot of people is it’s ok to do it now, so there’s an uptick in the number of people wanting to do it…Most of the drug-related violence you see now – the shootings, murders – is about weed.” Several 2010 high-profile killings have been linked by law enforcement to the increased market:

§ The May fatal shooting of a 21-year-old inside a Harvard University dorm, allegedly in a bid to rob him of his pot and cash.

 

§ The June murder of a 17-year-old in Callahan State Park, where he was lured by two men seeking revenge in a fight over marijuana.

 

§ The September massacre of four people in Mattapan, including a 21-year-old woman and her 2-year-old son, over an alleged pot-dealing turf dispute.

 

§ The September fatal shooting of a 29-year-old man, by four men, one a high school senior, in connection with robbery and murder of a drug dealer.138

 

· Children often bear the consequences of actions engaged in by parents or guardians involved with marijuana:

§ In Bradenton, Florida a Highway Patrol officer tried to stop a man speeding on  I-75. The driver did not stop until he ran up on the median and crashed into a construction barrel. In the car the troopers found three small children, forty pounds of marijuana and several thousand dollars in cash.139

 

§ A Hamilton, Montana man put his three toddlers in the back seat of his one ton Chevy pickup and then partied with a friend as he drove along the highway. At 50 miles an hour he swerved into another car killing the owner. While partying with his friend in the vehicle he had smoked two bowls of pot.140

 

§ An Ohio mother is accused of teaching her two-year-old daughter smoke pot and recording the incident on her cell phone.141  21

 

§ A Virginia mother and her roommate were charged with reckless child endangerment after her two-year-old daughter ingested an unknown amount of marijuana in a motel room.142

 

§ A California couple was arrested after a video surfaced of them allowing their 23- month-old son to use a marijuana pipe. The video showed the child smoking the pipe. The pipe was tested and found to have marijuana residue in it. Both parents said they had medical marijuana cards, but could not explain why they would give it to their child and then videotape the incident.143

 

§ Cincinnati, Ohio police arrested a woman for allegedly giving her three children, ages seven, four, and one, marijuana. The seven-year-old told the school counselor that she had been forced to smoke marijuana. All three children tested positive for marijuana..144

 

§ In Stockton, California a two-year-old girl was in critical condition after ingesting marijuana resin. Although four adults were home at the time, none were supervising the child when she found a jar lid containing resin.145

 

§ Two toddlers in Louisiana were hospitalized after ingesting marijuana and amphetamines. A search warrant of the home found several unsecured bottles of prescription medication and a hand-rolled cigar containing marijuana.146

 

· In Santa Clara, California, in one week in December, four dispensaries and one marijuana grower were hit by vandals, burglars, or armed robbers. At one location four suspects robbed the victim by throwing him to the floor, holding a piece of metal to his throat, and demanding marijuana and money. At one dispensary, the owner, who is paralyzed and in a wheelchair, was closing up the shop when armed robbers knocked him over and barged in. The robbers tied him up and took marijuana and cash.147

 

· The Los Angeles Police Department investigated a series of robberies and shootings at marijuana dispensaries. Over a one week period in June 2010 a Northridge dispensary robbery left one employee in critical condition after being shot in the face; the shooting was the second at that business that year and the third dispensary to be targeted in three days. Two people were fatally shot in a pot shop robberies in Echo Park and Hollywood, and a third person was wounded.148

 

· On March 4, 2010, a California man was killed after opening fire on two Pentagon Police Officers. In a story on MSNBC, the Friday before the incident, John Patrick Bedell’s parents had warned local authorities that his behavior had become erratic and that he was unstable and had a gun. Bedell was diagnosed as bipolar and had been in and out of treatment programs for years. His psychiatrist, J. Michael Nelson, said “Bedell tried to self-medicate with marijuana, inadvertently making his symptoms more pronounced.”149   Bedell had been given a recommendation for medical use of marijuana in 2006 for chronic insomnia. According to long-time friend Reb Monaco “he was not a person who should have been issued a medical clearance to use marijuana, but he was.”150  22

 

· A marijuana dealer kidnapped and murdered a 15 year-old boy after he got angry at the teen’s half-brother for owing him a $2,500 drug debt.151

 

· Grant Everson and three friends armed with box cutters and a shot-gun slipped into Everson’s parents’ Chaska, Minnesota home demanding money to open a coffee house in the marijuana friendly City of Amsterdam, Netherlands. Although Grant lost his nerve, his friends proceeded to shoot and kill his mother. All four were arrested. Their alibi was that they had been sleeping in the same Burnsville apartment after a night of smoking marijuana and playing video games.152 The National Transportation Safety Board investigation of a small plane crash near Walnut Ridge, Arkansas, killing a passenger and the pilot, was a result of pilot error. Pilot Jason Heard failed to fly high enough and maintain enough airspeed to avoid a stall. The report notes that Pilot Jason Heard had enough marijuana in his system to have contributed to the accident.153

 

MARIJUANA AND INCARCERATION

Federal marijuana investigations and prosecutions usually involve hundreds of pounds of marijuana. Few defendants are incarcerated in federal prison for simple possession of marijuana.

 

· In 2008, according to the United States Sentencing Commission (USSC), 25,337 people were sentenced in federal court for drug crimes under six offense categories. Marijuana accounted for 6,337 (25 percent). Looking even further, of the 6,337 people sentenced, only 99 people or 1.6 percent, were sentenced for “simple possession” of marijuana.154

 

· According to a Bureau of Justice Statistics survey of state and federal prisoners published in October 2006, approximately 12.7 percent of state prisoners and 12.4 percent of federal prisoners were serving time for a marijuana-related offense. This is a decrease from 1997 when these figures were 12.9 percent and 18.9 percent respectively.155

 

· Between October 1, 2005 and September 30, 2006, there were 6,423 federal offenders sentenced for marijuana-related charges in the U.S. Courts. Approximately 95.9 percent of the cases involved trafficking.156

 

· In Fiscal Year 2006, there were 25,814 offenders sentenced in federal court on drug charges. Of those, only 1.6 percent (406 people) were sentenced for simple possession.157

· According to the White House Office of National Drug Control Policy, “Many inmates ultimately sentenced for marijuana and possession were initially charged with more serious crimes but were able to negotiate reduced charges or lighter sentences through plea agreements with prosecutors. Therefore the …figure for simple possession defendants may give an inflated impression of the true numbers, since it also includes these inmates who pled down from more serious charges.” 158

 

· While illicit drugs are implicated in three-quarters of incarcerations (75.9 percent), few inmates are incarcerated for marijuana possession as their controlling or only offense. 23 Inmates incarcerated in federal and state prisons and local jails for marijuana possession as the controlling offenses accounted for 1.1 percent of all inmates and 4.4 percent of those only offense accounted for .9 percent of all inmates and 2.9 percent those incarcerated for drug law violations.159

 

· Findings from the 2008 Arrestee Drug Abuse Monitoring System (ADAM II), which surveys drug use among booked male arrestees in ten major metropolitan areas across the country, shows the majority of arrestees in each city test positive for illicit drug use, with as many as 87 percent of arrestees testing positive for an illegal drug. Marijuana is the most commonly detected drug at the time of the arrest. In seven of the ten sites arrestees who are using marijuana are using it on the average of every other day for the past 30 days.160

 

OTHER CONSIDERATIONS

MARIJUANA USE AMONG YOUTH IS RISING AS PERCEPTION OF RISK DECREASES

 

· Historical drug trends from the national Monitoring the Future Survey show that when anti drug attitudes soften there is a corresponding increase in drug use in the coming years. An adolescent’s perception of risks associated with substance use is an important determinant of whether he or she engages in substance abuse. Youths who perceive high risk of harm are less likely to use drugs than youths who perceive low risk of harm.

 

· The 2013 Monitoring the Future Survey, five-year trends are showing significant increase in past-year and past-month (current) marijuana use across all three grades as well as increase in lifetime and daily marijuana use among 10th graders. From 2008 to 2013, past month use increased from 5.8 percent to 7 percent among 8th graders, 13.8 percent to 18 percent among 10th graders and 19.4 percent to 22.7 percent among 12th graders.161

 

· Nearly 23 percent of seniors say they smoked marijuana in the past month, and just over 36 percent smoked it in the past year.162 This means that one in every 15 high school seniors is a daily or near daily user of marijuana.163

 

· For 10th graders, 4 percent say they use marijuana daily, with 18 percent using in the past month, and 29.8 percent using in the past year. More than 12 percent of 8th graders (13 and 14 year olds) say they used marijuana in the past year.164

· This increase in use by teens reiterates the link between use and the perception of risk. Lloyd Johnston, principal investigator of the Monitoring the Future Survey, once again raises this concern as a result of the findings of the survey. “Most noteworthy is the fact that the proportion of adolescents seeing marijuana use as risk declined again sharply in all three grades. Perceived risk- namely the risk to the user that teenagers associate with a drug- has been a lead indicator of use, both for marijuana and other drugs, and it has continued its sharp decline in 2013 among teens. This could foretell further increases in use in the future.”165  24

 

· From 2005 to 2013, the percent of teens seeing great risk from being a regular marijuana user has fallen among 8th graders from 74 percent to 61 percent; among 10th graders, from 66 percent to 47 percent; and among 12th graders, from 58 percent to 40 percent.166

 

· This means that among high school seniors, sixty percent do not view regular marijuana use as harmful.167

 

· Survey results from the past two years also revealed that 34 percent of marijuana-using 12thgraders living in states with medical marijuana laws say that one of the ways the obtain the drug is through someone else’s medical marijuana “prescription.” In addition, more than 6 percent say they get it with their own “prescription.” Thus states with medical marijuana laws do seem to provide another avenue of accessibility to the drug. This link between state laws and marijuana’s accessibility to teens will continue to be explored.168

 

· According to the Partnership Attitude Tracking Survey, 2011 Parents and Teens, nine percent of teens (1.5 million) smoked marijuana heavily (at least 20 times in the past month). Between 2008 and 2011, past month use is up 42 percent, past year use is up 26 percent and lifetime use is up 21 percent among teens.169

 

· Teens report seeing more of their peers smoking marijuana; only 26 percent say that in their school most teens don’t smoke marijuana. Also, 71 percent of teens say they have friends that smoke marijuana regularly, up from 64 percent in 2008.170

 

· A continuing erosion of anti-marijuana attitudes was also noted; only about half of teens (51 percent) say the see great risk in using marijuana, down from 61 percent in 2005.171

 

· Media also plays a role in changing the perception of marijuana use. Nearly half (45 percent) of teens say that the music they listen to makes marijuana seem cool and almost half (47 percent) agree that movies and television shows make drugs seem like the thing to do.172

 

A final note: DEA’s responsibility as it pertains to marijuana is clearly delineated in federal law. But our responsibility to the public goes further – to educate about the fallacy of smoked marijuana as medicine with fact and scientific evidence. DEA supports research into the use of marijuana as a medicine, to be approved through the FDA process, the same as with all other medicines in the U.S.

 

We also want the public to understand the ramifications of the use of this drug and the consequences it will have on our youth and our society as a whole.

 

For more information about marijuana and other drugs of abuse, please visit our websites:

www.DEA.gov; our teen website, written for teens and educators: www.justthinktwice.com; and our parent website, written for parents, caregivers, and educators: www.GetSmartAboutDrugs.com.  25

 

Endnotes

1 “Inter-Agency Advisory Regarding Claims That Smoked Marijuana Is a Medicine.” U.S. Food and Drug

Administration, April 20, 2006.

<http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/2006/ucm/108643.htm>.

2 “AMA Policy Statement on Cannabis, H-95.998.” American Medical Association House of Delegates (1-13), Council

on Science and Public Health Report 2. November 19, 2013. P. 6

3 ASAM Public Policy on “Medical Marijuana.” (April 23, 2010) http://www.wfad.se/latest-news/1-articles/213-asampublic-

policy-statement-on-qmedical-marijuanaq.

4 “American Society of Addiction Medicine Reiterates ASAM Marijuana Policy Positions.” October 27, 2011,

http://www.asam.org/1MARIJUANA%205-062.pdf. “White Paper on State-Level Proposals to Legalize Marijuana.”

Adopted by the ASAM Board of Directors July 25, 2012. www.asam.org/policies/state–level-proposals-to-legalizemarijuana.

5 “Medical Use of Marijuana: ACS Position.” American Cancer Society. April 14, 2010.

Documents.cancer.org/acs/groups/cid/documents/webcontent/001976-pdf.pdf.

6 “American Glaucoma Society Position Statement: Marijuana and the Treatment of Glaucoma.” Jampel, Henry MD.

MHS, Journal of Glaucoma: February 2010- Volume 19-Issue 2 –pp.75-76 doi:10.1097/IJG.obo13e3181d12e39. also

www.glaucomaweb.org .

7 “Medical Marijuana.” Glaucoma Research Foundation, April 24, 2012, www.glaucoma.org/treatment/medicalmarijuana.

php.

8 Committee on Substance Abuse and Committee on Adolescence. “Legalization of Marijuana: Potential Impact on

Youth.” Pediatrics Vol. 113, No. 6 (June 6, 2004): 1825-1826. See also, Joffe, Alain, MD, MPH, and Yancy,

Samuel, MD. “Legalization of Marijuana: Potential Impact on Youth.” Pediatrics Vol. 113, No. 6 (June 6, 2004):

e632-e638h.

9 “AACAP Medical Marijuana Policy Statement.” Approved by Council, June 11, 2012,

http://www.aacap.org/cs/root/policy_statements/aacap_medical_marijuana_policy_statement.

10 “Complementary and Alternative Medicine, Marijuana” National Multiple Sclerosis Society,

www.nationalmssociety.org/about-multiple-sclerosis/what-we-know-about-ms/treatments/complementary–

alternative-medicine/index.aspx. January 30, 2013.

11 “Legalization of Marijuana, Consensus Statement.” National Association of School Nurses. March 2013. p. 1

12 Ibid. p.2

13 “Position Statement on Marijuana as Medicine.” American Psychiatric Association. November 10, 2013. P.1

14 “New Report Finds Highest Levels of THC in U.S. Marijuana to Date.” Office of National Drug Control Policy Press

Release. May 14, 2009.

15 “Potency Monitoring Program Quarterly Report Number 123, Reporting Period September 16, 2013 – December 15,

2013.” Mahmoud ElSohly, Director, NIDA Marijuana Project. p.7.

16 “Regular marijuana use by teens continues to be a concern.” National Institute of Drug Abuse, Press Release,

December 19, 2012. P.2

17 Ibid.

18 “Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings.” U.S. Department

of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Behavioral Health

Statistics and Quality. September 2013. p.1

19 Ibid. p.2

20 Ibid. p.4

21 Ibid. p.19

22 Ibid. p.28

23 Ibid. p.28

24 Ibid. p.56

25 “Substance use by adolescents on an average day is alarming.” SAMHSA News Release, September 29, 2013.

www.samhsa.gov/newsroom/advisories/1308285320.

26 “American teens are more cautious about synthetic drugs.” University of Michigan Press Release, December 18, 2013.

P. 3 www.umich.edu/news.

27 “Sixty percent of 12th graders do not view regular marijuana use as harmful.” National Institutes of Health, National

Institute of Drug Abuse, Press Release, December 18, 2013. p. 1.

28 “The Partnership Attitude Tracking Study: 2011 Parents and Teens Full Report.” METLIFE Foundation and the

Partnership at drufree.org. May 2, 2012.

29 Ibid.

26

30 Ibid.

31 Ibid.

32 Ibid.

33 Ibid.

34 “The Debate Over the Drug is No Longer about Liberty. It’s about Health.” Antonio Maria Costa. March 27, 2007.

Independent on Sunday, United Kingdom.

35 “INCB President voices concern about the outcome of recent referenda about non-medical use of cannabis in the

United States in a number of states.” United Nations Information Service. Press Release. November 15, 2012.

36 “Why Marijuana Legalization Would Compromise Public Health and Safety.” ONDCP Director Gil Kerlikowske,

Speech Delivered at the California Police Chiefs Association Conference. March 4, 2010.

37 “Marijuana’s Lasting Effects on the Brain.” Messages from the Director, Nora Volkow, Director, National Institute of

Drug Abuse. January 2013. www.drugabuse.gov/about-nida-/directors+page/messages-director/2013/01/marijuanaslasting-

effects-brain.

38 “Marijuana Can Lower IQ in Teens.” Sarah Glynn. Medical News Today. September 19, 2012.

http://www.medicalnewstoday.com/articles/250404.php; “Teen Cannabis Use Linked to Lower IQ.” Christian Nordqvist.

Medical News Today. August 28, 2012. http://www.medicalnewstoday.com/articles/249508.php.

39 “Nearly One in Ten First-Year College Students at One University Have a Cannabis Use Disorder; At-Risk Users

Report Potentially Serious Cannabis-Related Problems.” CESAR FAX, Vol. 17, Issue 3, January 21, 2008.

www.cesar.umd.edu.

40 “Teen Marijuana Use Worsens Depression: An Analysis of Recent Data Shows “Self Medication” Could Actually

Make Things Worse.” Office of National Drug Control Policy May 2008.

http://www.whitehousedrugpolicy.gov/news/press08/marij_mental_health.pdf.

41 “Cannabis increases risk of psychosis in teens.” Telegraph News, June 2, 2008.

http://www.telegraph.co.uk/news/uknews/2063199/Cannabis-increases-risk-of-psychosis-in-teens.html.

42 “Drug Abuse; Drug Czar, Others Warn Parents that Teen Marijuana Use Can Lead to Depression.” Life Science

Weekly. May 31, 2005.

43 Kearney, Simon. “Cannabis is Worst Drug for Psychosis.” The Australian. November 21, 2005.

44 Curtis, John. “Study Suggests Marijuana Induces Temporary Schizophrenia-Like Effects.” Yale Medicine.

Fall/Winter 2004.

45 “Marijuana Use Takes Toll on Adolescent Brain Function, Research Finds.” Science Daily, October 15, 2008.

http://www.scienedaily.com/releases/2008/10/081014111156.htm.

46 “Memory, Speed of Thinking and Other Cognitive Abilities Get Worse Over Time With Marijuana Use” March 15,

2006. http://www.news-medical.net

47 “Marijuana May Shrink Parts of the Brain.” Steven Reinberg. U.S. News and World Report – Online. June 2, 2008.

http://health.usnews.com/articles/healthday/2008/06/02/marijuana_may_shrink_parts_of_the_brain.html. “Long-term

Cannabis Users May Have Structural Brain Abnormalities.” Science Daily. June 3, 2008.

http://www.sciencedaily.com/releases/2008/06/080602160845.htm.

48 Kate Benson, “Dope smokers not so mellow.” The Sydney Morning Herald, July 30, 2009.

http://www.smh.com/au/news/health/dope-smokers-not-so-mellow-20090407-9yOi.html.

49 “Neurotoxicology; Neurocognitive Effects of Chronic Marijuana Use Characterized.” Health & Medicine Week. 16

May 2005.

50 “Study: Marijuana may Affect Neuron Firing.” November 29, 2006. UPI.

51 “Marijuana Links with Psychosis.” AM with Tony Eastley. February 8, 2011.

http://www.abc.nte.au/am/content/2011/s3132596.htm.

52 “A Functional MRI Study of the Effects of Cannabis on the Brain.” Prof. Phillip McGuire, UK, May 1, 2007. 2nd

International Cannabis and Mental Health Conference, London, UK.

53 “Quitting Pot Important Part of Trudeau’s Recovery.” Denise Ryan, Vancouver Sun, February 12, 2007.

54 Laucius, Joanne. “Journal Articles Link Marijuana to Schizophrenia” August 28, 2006 www.Canada.com

55 “Teenage Schizophrenia is the Issue, Not Legality.” Robin Murray. Independent on Sunday. March 18, 2007.

www.independent.co.uk.

56 “UN Warns of Cannabis Dangers as it Backs ‘IoS’ Drugs ‘Apology’.” Jonathan Owen. Independent on Sunday.

March 25, 2007. www.independent.co.uk. and “Cannabis-related Schizophrenia Set to Rise, Say Researchers.”

Science Daily. March 26, 2007. www.sciencedaily.com/releases/2007/03/070324132832.htm.

57 “Long-term pot use can double risk of psychosis.” March 1, 2010. http://www.msnbc.com/id/35642202/ns/healthaddictions/?

ns=health-addictions. Also McGrath J, et al “Association between cannabis use and psychosis-related

outcomes using sibling pair analysis in a cohort of young adults” Arch Gen Psych 2010; DOI:

10.1001/archgenspychiatry.2010.6.

27

58 “Prenatal Marijuana Exposure and Intelligence Test Performance at Age 6.” Abstract, Journal of the American

Academy of Child & Adolescent Psychiatry. 47(3):254-263, March 2008. Goldschmidt, Lidush Ph.D. et al.

59 “Marijuana Use Affects Blood Flow in Brain Even After Abstinence.” Science Daily, February 12, 2005.

www.sciencedaily.com/releases/2005/02/050211084701.htm; Neurology, February 8, 2005, 64.488-493.

60 “Highlights of the 2011 Drug Abuse Warning Network (DAWN) Findings on Drug-Related Emergency Department

Visits.” The DAWN Report, Department of Health and Human Services, Substance Abuse and Mental Health

Services Administration, Center for Behavioral Health Statistics and Quality February 22, 2013.p.3

61 Ibid. p.4.

62 “Highlights of the 2010 Drug Abuse Warning Network (DAWN) Findings on Drug-Related Emergency Department

Visits.” The DAWN Report, Department of Health and Human Services, Substance Abuse and Mental Health

Services Administration, Center for Behavioral Health Statistics and Quality July 2, 2012. P.4.

63 “Results from the 2012 National Survey on Drug Use and Health: Summary of Findings.” U.S. Department of Health

and Human Services, Substance Abuse and Mental Health Services Administration, Center for Behavioral Health and

Quality Statistics, September 2013. p. 77

64 “A Day in the Life of American Adolescents: Substance Use Facts Update.” The CBHSQ Report, Center for

Behavioral Health Statistics and Quality, August 29, 2013. http://www.samhsa.gov/data .

65 State of California, Environmental Protection Agency, Office of Environmental Health Hazard Assessment, Safe

Drinking Water and Toxic Enforcement Act of 1986, “Chemicals Known to the State to Cause Cancer or

Reproductive Toxicity, September 11, 2009. http://www.oehha.ca.gov/prop65_list/files/P65single091001.pdf.

66 “Pot smoking during pregnancy may stunt fetal growth.” January 22, 2010.

http://www.reuters.com/article/id=Ustre60L55L20100122.

67 “Heavy Marijuana Use Linked to Gum Disease, Study Shows.” Science Daily, February 6, 2008.

http://www.sciencedaily.com/releases/2008/02/080205161239.htm. “Cannabis Smoking and Periodontal Disease

Among Young Adults.” The Journal of the American Medical Association, Vol. 299, No. 5, February 6, 2008.

http://www.jama.ama-assn.org/cgi/content/full/299/5/25.

68 “Marijuana Smokers Face Rapid Lung Destruction – As Much As 20 Years Ahead of Tobacco Smokers.” Science

Daily, January 27, 2008. http://www.sciencedaily.com/releases/2008/01/080123104017.htm. “Bullous Lung Disease

Due to Marijuana.” Respirology (2008) 13, 122-127.

69 Marijuana Smoke Contains Higher Levels of Certain Toxins Than Tobacco Smoke.” Science Daily, December 18,

2007. http://sciencedaily.com/releases/2007/12/071217110328.htm. “A Comparison of Mainstream and Sidestream

Marijuana and Tobacco Smoke Produced Under Two Machine Smoking Conditions.” American Chemical Society,

Chemical Research in Toxicology, December 17, 2008.

70 “Marijuana Worsens COPD Symptoms in Current Cigarette Smokers.” American Thoracic Society. Science Daily,

May 23, 2007.

71 “How Smoking Marijuana Damages the Fetal Brain.” Karolinska Institute. Science Daily, May 29, 2007.

72 “Cannabis Linked to Lung Cancer Risk.” Martin Johnston. New Zealand Herald, March 27, 2007.

73 “Marijuana Use Linked to Increased Risk of Testicular Cancer.” Science Daily, February 9, 2009.

http://www.scienedaily.com/releases/2009/02/090209075631.htm. “Marijuana Use Linked to Testicular Cancer.

Kelly Fitzgerald. Medical News Today. September 10, 2012.

http://www.medicalnewstoday.com/articles/250050.php.

74 Tertrault, Jeannette M. MD, et. al., “Effects of Marijuana Smoking on Pulmonary Function Respiratory

Complications: A Systematic Review” Arch. Intern. Med. 2007:167:221-228; Science Daily, “Long-term Marijuana

Smoking Leads to Respiratory Complaints,” www.sciencedaily.com/releases/2007/02/070212184119.htm.

75 “Marijuana Use Linked to Early Bladder Cancer.” http://www.medicalnewstoday.com/articlces/36695.php. January

26, 2006.

76 “Marijuana Tied to Precancerous Lung Changes” Reuters. July 13, 2006. http://today.reuters.com/misc See also:

“The Association Between Marijuana Smoking and Lung Cancer” Archives of Internal Medicine.

http://archinte.ama.assn.org/cgi/content/full/166/12/1359?maxtoshow July 10, 2006.

77 “Cannabis More Toxic than Cigarettes: Study,” French National Consumers’ Institute, 60 Million Consumers

(magazine) April 2006, www.theage.com.au.

78 “Conception and Pregnancy Put at risk by Marijuana Use” News-Medical.Net August 2, 2006 See also: “Fatty Acid

Amide Hydrolase Deficiency Limits Earl Pregnancy Events” Research Article. Journal of Clinical Investigation.

Published March 22, 2006, revised May 23, 2006 http://www.jci.org/cgi/content/full/116/8/2122

79 In utero Marijuana Exposure Alters Infant Behavior. Reuters, January 17, 2007.

80 Metro, Michael J., MD. “Association Between Marijuana Use and the Incidence of Transitional Cell Carcinoma

Suggested” http://www.news.medical.net June 28, 2006.

28

81 Tashkent, D.P., “Smoked Marijuana is a Cause of Lung Injury.” Monaldi Archives for Chest Disease 63(2):93-100,

2005.

82 “Marijuana Associated with Same Respiratory Symptoms as Tobacco,” YALE News Release. January 13, 2005.

<http://www.yale.edu/opa/newsr/05-01-13-01.all.htm> (14 January 2005). See also, “Marijuana Causes Same

Respiratory Symptoms as Tobacco,” January 13, 2005, 14WFIE.com.

83 “What Americans Need to Know about Marijuana,” page 9, ONDCP.

84 “Decreased Respiratory Symptoms in Cannabis Users Who Vaporize,” Harm Reduction Journal 4:11, April 16,

2007.

85 “Marijuana Affects Brain Long-Term, Study Finds.” Reuters. February 8, 2005. See also: “Marijuana Affects

Blood Vessels.” BBC News. 8 February 2005; “Marijuana Affects Blood Flow to Brain.” The Chicago Sun-Times.

February 8, 2005; Querna, Elizabeth. “Pot Head.” US News & World Report. February 8, 2005.

86 Smith, Michael. Medpage Today. February 12, 2007.

http://www.medpagetoday.com/Neurology.GeneralNeurology/tb/5048.

87 “HIV Patients: Marijuana Eases Foot Pain.” Associated Press. February 13, 2007.

88 Weiss, Rick. “Research Supports Medicinal Marijuana.” Washington Post. February 13, 2007.

89 Dahlbert, Carrie Peyton. “Marijuana Can Ease HIV-related Nerve Pain.” McClatchy Newspapers. Feb. 13, 2007.

90 Hashibe M, Morgenstem H, Cui Y, et al. Marijuana use and the risk of lung and upper aerodigestive tract cancers:

results of a population-based case-control study. Cancer Epidemiol Biomarkers Prev 2006; 15:1829-1834.

91 “Heavy marijuana use not linked to lung cancer,” News-Medical.Net, Wednesday, May 24, 2006.

92 http://www.nida.nih.gov/DirReports/DirRep207/DirectorReport8.html.

93 http://www.umich.edu/news/index.html?Releases/2006/Oct06/r101006a.

94 “Health risks of cannabis ‘underestimated,’ experts warn.” BBC News. June 5, 2012.

http://www/bbc.co.uk/news/health-18283689. “The impact of cannabis on your lungs.” British Lung Foundation 2012.

www.wkcia.org/research/blf_cannabis_lungs.pdf.

95 “Risk of Premature Birth Doubled By Marijuana Use.” University of Adelaide. Medical News Today. July 19, 2012.

http://www.medicalnewstoday.com/releases/247945.php.

96 Harding, Anne. “Pot May Indeed Lead to Heroin Use, Rat Study Shows” Reuters. July 12, 2006. See also: “Why

Teenagers Should Steer Clear of Cannabis” Vine, Gaia. www.NewScientist.com

97 “What Americans Need to Know about Marijuana.” Office of National Drug Control Policy. October 2003.

98 Gfroerer, Joseph C., et al. “Initiation of Marijuana Use: Trends, Patterns and Implications.” Department of Health

and Human Services, Substance Abuse and Mental Health Services Administration, Office of Applied Studies. July

2002. Page 71.

99 “Non-Medical Marijuana II: Rite of Passage or Russian Roulette?” CASA Reports. April 2004. Chapter V, Page 15.

100 “What Americans Need to Know about Marijuana,” page 9, ONDCP.

101 Furber, Matt. “Threat of Meth—‘the Devil’s Drug’—increases.” Idaho Mountain Express and Guide. December

28, 2005.

102 “Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings.” U.S. Department

of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Behavioral Health

Statistics and Quality. September 2013. p.52

103 “Nearly One in Ten U.S High School Students Report Heavy Marijuana Use in the Past Month: One Third or More of

Heavy Users Also Used Cocaine, Ecstasy, or Other Drugs.” CESARFAX, Vol 21. Issue 21. May 29, 2012.

104 The Partnership Attitude Tracking Study: 2011 Parents and Teens Full Report.” MetLife and the Partnership At

Drugfree.org. May 2, 2012. P7.

105 “Medical pot laws result in increased teen drug use. “White Mountain Independent. January 13, 2011.

http://www.wmicentral.com/news/atests_news/medical-pot-laws-result-in-increased-teen-drug-use/article_a6622a0c-

1f42-11e0-a38e-001cc4c002e0.html.

106 “New Study shows dramatic shifts in substance abuse treatment admissions among states between 1998 and 2008.”

Department of Health and Human Services, Substance Abuse and Mental Health Administration, Office of Applied

Studies. Press Release. December 22, 2010. http://www.samhsa.gov.

107 California No. 1 in marijuana admissions.” Cheryl Wetzstein. The Washington Times. December 30, 2010.

http://www.washingtontimes.com/news/2010/dec/30/

108 “Marijuana Myths & Facts: The Truth Behind 10 Popular Misperceptions.” Office of National Drug Control Policy.

<http://www.whitehousedrugpolicy.gov/publications/marijuana_myths_facts/index.html> (January 12, 2006).

109 Ibid. p. 77

110 Treatment Episode Data Sets (TEDS) 2001-2011: National Admissions to Substance Abuse Treatment Services.”

Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for

Behavioral Health Statistics and Quality. July 2012. p.1

29

111 Ibid. P.2

112 Ibid. p19.

113 Ibid. 19.

114 “Non-Medical Marijuana III: Rite of Passage or Russian Roulette?” A CASA White Paper, June 2008.

http://www.casacolumbia.org.

115 “Early Marijuana Use a Warning Sign For Later Gang Involvement,” ONDCP press release, June 19, 2007.

116 “The Relationship Between Alcohol, Drug Use and Violence Among Students.” Community Anti-Drug Coalitions of

American (CADCA). www.cadca.org. Pride Surveys, (2006) Questionnaire report for grades 6-12: 2006 National

Summary. Page 184. http://www.pridesurveys.com/customercetner/us05ns.pdf.

117 Office of National Drug Control Policy. (2006) “Marijuana Myths and Facts: The Truth Behind 10 Popular

Misperceptions. “Page 10. http://www.whitehousedrugpolicy.gov/publications/marijuana_mythis_facts.

118 Ibid.

119 “Results from the 2011 National Survey on Drug Use and Health: Summary of National Findings.” U.S. Department

of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Behavioral Health

Statistics and Quality. September 2012.

120 NIDA Info Facts: Drugged Driving, September 10, 2009, page 1. http://drugabuse.gov/Infofacts/driving.html.

121 Volz, Matt. “Drug overdose: Medical marijuana facing a backlash.” http://www.msnbc.msn.com/id/37282436.

122 Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Office of

Applied Studies. Results from the 2011 National Survey on Drug Use and Health: Summary of National Findings.

September 2012. P.2.

123 “California Roadside Survey Finds Twice as Many Weekend Nighttime Drivers Test Positive for Other Drugs as for

Alcohol: Marijuana as Likely as Alcohol.” CESARFAX, Col. 21, Issue 48, December 3, 2012.

www.cesar.umd.edu/cesar/vol21/21-48.pdf.

124 “Hazy Logic: Liberty Mutual Insurance/SADD Study Finds Driving Under the Influence of Marijuana a Greater

Threat to Teen Drivers than Alcohol.” Liberty Mutual Press Release. February 22, 2012.

http://www.sadd.org/press/presspdfs/marijuana%20Teen%20Release.pdf.

125 Ibid.

126 Ibid.

127 “Cannabis Use Doubles Chances of Vehicle Crash, Review Finds.” Sciencedaily. February 9, 2012.

http://www.sciencedaily.com/releases/2012/02/120210111254.htm.

128 Marijuana and Crash Risk Linked. Caitlin Bronson. ThirdAge. October 13, 2011.

http://www.thirdage.com/news/marijuna-and-crash-risk-linked_10-13-2011.

129 “Drug use involved in 25% of fatal crashes, study finds.” Jonathan Shorman. USA Today. July 23, 2011.

http://www.yourlife.usatoday.com/yhealth/story/2011/06/Drug-use-involved-in-25-of-fatal-chrashes-studyfinds/

48740704/1. “Drugs and Alcohol Involvement in Four Types of Fatal Crashes.” Eduardo Romano and Robert Voas.

Journal of Studies on Alcohol and Drugs. July 2011.

130 DuPont, Robert. “National Survey Confirms that Drugged Driving is Significantly More Widespread than Drunk

Driving.” Commentary, Institute for Behavior and Health, July 17, 2009. page 1. http://www..ibhinc.org.

131 “One-third of Fatally Injured Drivers with Known Test Results Tested Positive for at Least one Drug in 2009.

CESARFAX. Vol. 19, Issue 49. December 20, 2010. www.cesar.umd.edu.

132 “Cannabis and Driving: A Scientific and Rational Review.” Armentano, Paul. NORML/NORML Foundation. January

10, 2008. http://normal.org/index.cfm?Group_ID=7475 for article and http://normal.org/index.cfm?Group_ID=7459

for the full report.

133 DuPont, Robert. “National Survey Confirms that Drugged Driving is Significantly More Widespread than Drunk

Driving.” Commentary, Institute for Behavior and Health, July 17, 2009. page 1. http://www.ibhinc.org.

134 “Drug-Impaired Driving by Youth Remains Serious Problem.” NIDA News Release, October 29, 2007.

http://www.drugabuse.gov/newsroom/07/NR10-29.html.

135 “The Drugged Driving Epidemic,” The Washington Post, June 17, 2007.

136 Drummer, OH, Gerostamoulos J, Batziris H, Chu M, Caplehorn J, Robertson MD, Swann P. “The Involvement of

drugs in drivers of motor vehicles killed in Australian road traffic crashes..” Accid Anal Prev 36(2):229-48, 2004.

137 Couper, Fiona, J, and Logan, Barry Drugs and Human Performance Fact Sheets National Highway Traffic Safety

Administration., page 11. April 2004.

138 “New pot law blamed as violence escalates.” Laurel J. Sweet and O’Ryan Johnson. Boston Herald. November 15,

2010. http://www.bostonherald.com/news/politics/view.bg?articleid=1296392.

139 “FHP: Man led trooper on chase with kids-and pot – in car.” Bay News 9. February 3, 2011.

http://www.baynews9.com/article/news/2011/february/204034/FHP:-Man-led-trooper-on-chase-with-kids-in-car-

?cid=rss.

30

140 “Driving under influence of marijuana a growing problem.” Gwen Florio. Missoulian.com January 16, 2011.

http://missoulian.com/news/local/article_1d9f6f8a-2137-11e0-a0be-001cc4c002e0.html.

141 “Jessica Gamble, Ohio Mom, Charged for Teaching 2-Year-Old Daughter to Smoke Marijuana.” Caroline Black.

CBS WKRC. September 16, 2010. http://www.cbsnews.com/8301-504083_162-20016662-504083.html.

142 “Va. Pair Charged After Toddler Eats Marijuana.” Whz.com. October 8, 2010.

http://wjz.com/wireapnewsva/Manassas.pair.charged.2.1953794.html.

143 “Video shows parents giving pot pipe to toddler.” Beatriz Valenzuela. Daily Press. January 17, 2011.

http://www.vvdailypress.com/articles/parents-25426-pipe.pot.html.

144 “Police: Mom gave pot to her 3 kids.” Lance Berry. October 28, 2010.

http://www.wcpo.com/dpp/news/region/_east_cincinnati/madisonville/police%3A-mom-gave-pot-to-3-kids.

145 “Toddler in Critical Condition After Ingesting Marijuana.” February 2, 2011.

http://losangeles.cbslocal.com/2011/02/02/toddler-in-critical-condition-after-ingesting-marijuana.

146 “Mother charged after toddler hospitalized for eating marijuana, pills.” Michelle Hunter. The Times-Picayune.

October 13, 2008. http://www.nola.com/news/index.ssf/2008/10children_3_and_4_hospitalized. html.

147 “Police: Criminal targeting San Jose’s medicinal marijuana clubs.” Sean Webby. The Mercury News. December 16,

2010. http://www.mercurynews.com/fdcp?1293042861859.

148 “LAPD investigates third shooting at a medical marijuana dispensary.” Andrew Blackstein, Los Angeles Times, July

1, 2010. http://www.latimes.com/news/local/la-me-pot-shooting-201000701,0,4009176.story.

149 “Pentagon shooter had a history of mental illness.” March 5, 2010.

http://www.msnbc.com/id/35716821/ns/us_news_crime_and_courts/

150 Parents warned police of Pentagon shooter’s bizarre mental state.” Washington Post. March 5, 2010.

http://www.washingtonpost.com/wp-dyn/cotnent/article/2010/03/05/AR2010030500957_2.html?hpid=dynamiclead.

151 “Calif. Drug dealer guilty of murdering 15-year-old.” San Diego Union Tribune, July 9, 2008. www.sandiego.com.

152 “4 charged in Chaska Slaying.” David Hanners. Pioneer Press. January 13, 2006. http://www.twincities.com.

153 “NTSB: Pilot Had Marijuana In His System.” KTHV Little Rock. February 6, 2006. www.todaysthv.com.

154 U.S. Sentencing Commission, “2008 Sourcebook of Federal Sentencing Statistics, see:

http://www.ussc.gov/ANNRPT/2008/SBTOC08.htm, Table 33.

155 Bureau of Justice Statistics, “Drug Use and Dependence”, State and Federal Prisoners, 2004, October 2006.

156 United States Sentencing Commission, “2006 Sourcebook of Federal Sentencing Statistics,” June 2007.

157 Ibid.

158 Office of National Drug Control Policy. “Who’s Really in Prison for Marijuana?” May 2005 Page 22.

159 “Behind Bars II: Substance Abuse and America’s Prison Population.” The National Center on Addiction and

Substance Abuse, Columbia University. February 2010. P. 2.

160 “New study Reveals Scope of Drug and Crime Connection: As Many as 87 Percent of People Arrested for Any Crime

Test Positive for Drug Use.” Office of National Drug Control Policy Press Release, May 28, 2009 and Fact Sheet

2008 ADAM II Report, www.whitehousedrugpolicy.gov.

161 “Monitoring the Future Survey, Overview of Findings.” National Institute of Drug Abuse, December 2013. P.2.

www.drugabuse.gov/mointoring-the-future-survey-overview-findings-2013.

162 “Sixty percent of 12 graders do not view regular marijuana use as harmful.” NIDA Press Release, National Institutes

of Health, National Institute on Drug Abuse, December 18, 2013. P. 1

Although choosing to do something because the perceived benefit outweighs the financial cost is something people do daily, little is known about what happens in the brain when a person makes these kinds of decisions. Studying how these cost-benefit decisions are made when choosing to consume alcohol, University of Georgia associate professor of psychology James MacKillop identified distinct profiles of brain activity that are present when making these decisions.

“We were interested in understanding how the brain makes decisions about drinking alcohol. Particularly, we wanted to clarify how the brain weighs the pros and cons of drinking,” said MacKillop, who directs the Experimental and Clinical Psychopharmacology Laboratory in the UGA Franklin College of Arts and Sciences.

The study combined functional magnetic resonance imaging and a bar laboratory alcohol procedure to see how the cost of alcohol affected people’s preferences. The study group included 24 men, age 21-31, who were heavy drinkers. Participants were given a $15 bar tab and then were asked to make decisions in the fMRI scanner about how many drinks they would choose at varying prices, from very low to very high. Their choices translated into real drinks, at most eight that they received in the bar immediately after the scan. Any money not spent on drinks was theirs to keep.

The study applied a neuro-economic approach, which integrates concepts and methods from psychology, economics and cognitive neuroscience to understand how the brain makes decisions. In this study, participants’ cost-benefit decisions were categorized into those in which drinking was perceived to have all benefit and no cost, to have both benefits and costs, and to have all costs and no benefits. In doing so, MacKillop could dissect the neural mechanisms responsible for different types of cost-benefit decision-making.

“We tried to span several levels of analysis, to think about clinical questions, like why do people choose to drink or not drink alcohol, and then unpack those choices into the underlying units of the brain that are involved,” he said.

When participants decided to drink in general, activation was seen in several areas of the cerebral cortex, such as the prefrontal and parietal cortices. However, when the decision to drink was affected by the cost of alcohol, activation involved frontostriatal regions, which are important for the interplay between deliberation and reward value, suggesting suppression resulting from greater cognitive load. This is the first study of its kind to examine cost-benefit decision-making for alcohol and was the first to apply a framework from economics, called demand curve analysis, to understanding cost-benefit decision making.

“The brain activity was most differentially active during the suppressed consumption choices, suggesting that participants were experiencing the most conflict,” MacKillop said. “We had speculated during the design of the study that the choices not to drink at all might require the most cognitive effort, but that didn’t seem to be the case. Once people decided that the cost of drinking was too high, they didn’t appear to experience a great deal of conflict in terms of the associated brain activity.”

These conflicted decisions appeared to be represented by activity in the anterior insula, which has been linked in previous addiction studies to the motivational circuitry of the brain. Not only encoding how much people crave or value drugs, this portion of the brain is believed to be responsible for processing interceptive experiences, a person’s visceral physiological responses.

“It was interesting that the insula was sensitive to escalating alcohol costs especially when the costs of drinking outweighed the benefits,” MacKillop said. “That means this could be the region of the brain at the intersection of how our rational and irrational systems work with one another. In general, we saw the choices associated with differential brain activity were those choices in the middle, where people were making choices that reflect the ambivalence between cost and benefits. Where we saw that tension, we saw the most brain activity.”

While MacKillop acknowledges the impact this research could have on neuromarketing — or understanding how the brain makes decisions about what to buy — he is more interested in how this research can help people with alcohol addictions.

“These findings reveal the distinct neural signatures associated with different kinds of consumption preferences. Now that we have established a way of studying these choices, we can apply this approach to better understanding substance use disorders and improving treatment,” he said, adding that comparing fMRI scans from alcoholics with those of people with normal drinking habits could potentially tease out brain patterns that show what is different between healthy and unhealthy drinkers. “In the past, we have found that behavioral indices of alcohol value predict poor treatment prognosis, but this would permit us to understand the neural basis for negative outcomes.”

Source: Neuropsychopharmacology, 2014; DOI: 10.1038/npp.2014.47  March 2014

The Neuroeconomics of Alcohol Demand: An Initial Investigation of the Neural Correlates of Alcohol Cost-Benefit Decision Making in Heavy Drinking Men.

When President Obama made his “Pot is no worse than alcohol” comments, he revealed one of the main underlying problems with the arguments posed by marijuana advocates  Said the president: “We should not be locking up kids or individual users for long stretches of jail time when some of the folks who are writing those laws have probably done the same thing.” President Obama is likely referring to congressmen like Trey Radel, a Republican from Florida who recently resigned due to his arrest for cocaine possession. On the surface, the president seems to be making a valid point.

But is this the standard we should be using to make our laws?

Should we legalize domestic abuse, prostitution, or DUI, since some of our lawmakers and government officials have committed those crimes as well?

We all make our mistakes.  But, should we admit out faults, and work to improve our own personal behavior so that it conforms with societal standards?  Or should we rewrite our laws in order to justify our own personal mistakes?  By choosing the latter option, we are simply redefining and weakening the standards of our society so that marijuana users can justify their habit.

A Culture of Tolerance

The underlying problem is that we have become a society so accepting of addiction. Think of the endless list of celebrities with addiction problems — Whitney Houston, Charlie Sheen, Lindsay Lohan, and the list goes on. There is the never-ending list of athletes with addiction problems. Even the U.S. military is not immune to drug addiction. Recently, Houston Astros player, Jon Singleton, publicly admitted to his major marijuana addiction. Most notably, Singleton blamed the start of his marijuana use on “the culture growing up in Long Beach, CA”.

There is a notion that a treatment program will solve everyone’s addiction problem.  But over 2/3 of states report that their treatment centers are “at or approaching 100% capacity” while at the same time only about 10% of people with drug and alcohol problems receive treatment. In other words, 90% of people with an addiction don’t seek treatment nor do we have a system that can accommodate them.  So why are we encouraging more use of an addictive substance instead of discouraging it?  More importantly, before we worry about building more treatment centers why don’t we first take a look at the “culture” that promotes drug use?

The Fallacies of the “marijuana is harmless” Argument

It seems that many people have adopted the mindset of:  “Well, when I was in high school/college I smoked a little pot, but I turned out alright, so I guess if we make small amounts of pot legal, then what harm is there in that?”

When it comes to marijuana, we seem to drift into this sympathetic mindset, and then think we should apply that mindset to making public policy. In no other policy area do we develop policies to conform with our own past personal mistakes. So why do we do it with marijuana?  There are certainly many people who adhere to the findings of researchers like CNN’s Dr. Sonjay Gupta who supports legalized marijuana.   But there is much this research does not address. For example, in 2009 marijuana use was reported to be the contributing factor in over 376,000 Emergency Room visits. One study reported “the toxic effects of cannabis on the brain may result in impaired neuropsychological functioning, poor academic performance, and subsequent school dropout, which then results in further neuropsychological decline.”

Drugs and Crime

Pro-marijuana research also doesn’t address the issue of K2, which is synthetic marijuana.  K2 is an emerging new drug that has killed people in Colorado, Iowa, and Nebraska.   This is a perfect example of people who first started using marijuana but then needed a more intense high so they developed another way to achieve that.  Legalizing marijuana encourages more of this cycle. Pro-marijuana research also does not address marijuana use and crime.  In a 2012 study, 37%-58% of people arrested tested positive for marijuana at the time of their arrest. Two cities reported a significant increase in the percentage of arrestees who tested positive for marijuana.

The most revealing findings were:

1. “From 62-87% of male booked arrestees…tested positive for some drug in their system at the time of arrest, but fewer than a third…had ever been in outpatient or inpatient drug or alcohol treatment.”

2. 19-38% were arrested on drug crimes.

This reveals that most people who are being arrested are engaged in other criminal behavior — not just drug use. Moreover, there is only a small percentage of those people who seek treatment.

But let’s also analyze this issue on a personal level.  One recovering marijuana addict offered this: “…it is alarmingly clear to me that the issue of molestation  and the disease of addiction were born dangerously close to each other.” The author went onto describe how she had been groomed by her molester through the use of marijuana: “No like this” John said, showing me how to inhale the smoke that would alter my consciousness, my life, and my brain development for years to come. Marijuana is a gateway drug.” The author then goes on to describe how her life spiraled out of control due to her addiction.

As a law enforcement officer, I have been involved in many investigations of child abuse and sexual assault, and in nearly every case there exists a past history of drug abuse.  It is also very common to find that a person being investigated today for child abuse, has a history of drug use and was also previously abused by their parent(s), who also had a history of drug abuse.

Regardless of where you live, hardly a day passes where you cannot read about a drug-related crime. One good example comes from Lincoln, NE.  As one of the teenagers was sentenced in a drug-related shooting, his life was described as follows: He started smoking marijuana and stealing to eat at age 5.  His mother was an alcoholic and worked as a prostitute.”

These examples show the impact that addiction can have on our society over the course of two, or more, generations. And this type of impact is very hard to put into statistical perspective. But due to this ‘generational impact’, legalizing marijuana does not bode well for the future of the U.S. It has simply become too easy for politicians to state that the solution is increased funding for drug-rehab programs. We’ve heard this argument for decades. While I would always support an addict entering treatment, the reality is that only a small percentage seek treatment. But, before we develop more rehab programs why don’t we first develop a society that says drug use is wrong and a crime?  As Dr. Samuel Wilkinson from The Yale School of Medicine wrote: “If legalization is certain to decrease the power of the drug lords in Mexico and other countries, then this is certainly a favorable outcome. However, if the trade-off is that more people suffer from schizophrenia — and thus more Americans are homeless and debilitated — then this must be recognized and discussed by the public.”

Matt Ernst is a law enforcement officer and also a national security and criminal justice analyst.  Matt can be reached at ernst1997@hotmail.com

Source:  By Matthew Ernst   AMERICAN THINKER   March 2014

The legalization of marijuana in Colorado and Washington and President Barack Obama’s recent remarks again headline the marijuana issue.

In spite of the widespread effort to normalize it, Montana knows firsthand the societal problems marijuana can cause. Colorado and Washington are headed for big problems.

Obama, a former pot smoker himself, recently stated that smoking marijuana was no worse than drinking and his soft approach to enforcing federal law all but endorses the use of it. There seems to be a new — if you like your joint, you can keep it — policy in America. In effect, he has undone years of “zero tolerance” and the “drug free” crusade in our schools and communities.

The legalizers agree that marijuana is dangerous for adolescents and argue that it will still be illegal for them. But it’s those under the age of 21 the industry targets. They are the primary users, consuming the majority of illegal drugs and suffering the most from its long-term consequences. As it becomes more socially accepted, usage increases. That was the case in Montana.

By 2011, Montana had the sixth-highest rate of youth marijuana use in the country and the fourth-highest rate of youth addiction.

After U.S. Attorney General Eric Holder announced that those in compliance with their state’s medical marijuana laws would not be prosecuted, the industry in Montana exploded and became a billion-dollar operation. Montana’s chief of the narcotics bureau, Mark Long, testified, “The current situation is a public health and safety disaster as well as a law enforcement nightmare … and an embarrassment to Montana on a national level.” He said Montana was growing so much marijuana it had become a “source country” for illegal export of the drug. Organized crime moved in and one of the world’s largest outlaw motorcycle gangs was involved in running drugs to their East Coast counterparts. Our surrounding states did not consider us good neighbors as can be anticipated by the neighbors of Colorado and Washington.

As a legislator I was inundated with complaints from cities, towns, communities, law enforcement officials, treatment centers and schools about disruption, safety, crime, dropout rates, students stoned and apathetic toward school and life in general. This new enterprise was making drugs so familiar and acceptable that it was changing Montana’s culture.

I heard of growers destroying neighborhoods, reducing the values of homes and of the language, harassment and stench of crowds at the dispensaries. Parents complained that kids could not play in their own yards. Multiple dispensaries set up near schools, targeting our youth.

Students wrote asking who was defending their rights to a safe, drug-free school. They wanted their friends back. Major industries in Montana reported the inability to find job applicants who didn’t test positive for drugs.

The 2011 Montana Legislature reined in the exploding marijuana industry. They passed the repeal of the medical marijuana initiative, which the governor vetoed in a showy display with a branding iron on the front steps of the capitol. Subsequent legislation took out the profit, curbing commercial growing. Those who had moved to Montana to capitalize on the cannabis industry moved on and those who railed against us for ruining cannabis tourism went elsewhere.

The arguments behind legalization are similar to those used to promote “medical marijuana.”

The illogical deluge of propaganda leaves one to wonder if we are not only losing the war on drugs, but the war on common sense as well.

Source:  www.greatfallstribune.com  2nd March

————————————————————-

MONTANA SOAP BOX: MARIJUANA CAUSES BIG PROBLEMS

 

The legalization of marijuana in Colorado and Washington and President Barack Obama’s recent remarks again headline the marijuana issue.

In spite of the widespread effort to normalize it, Montana knows first hand the societal problems marijuana can cause. Colorado and Washington are headed for big problems.

Obama, a former pot smoker himself, recently stated that smoking marijuana was no worse than drinking and his soft approach to enforcing federal law all but endorses the use of it. There seems to be a new — if you like your joint, you can keep it — policy in America. In effect, he has undone years of “zero tolerance” and the “drug free” crusade in our schools and communities.

The legalizers agree that marijuana is dangerous for adolescents and argue that it will still be illegal for them. But it’s those under the age of 21 the industry targets. They are the primary users, consuming the majority of illegal drugs and suffering the most from its long-term consequences. As it becomes more socially accepted, usage increases. That was the case in Montana.

By 2011, Montana had the sixth-highest rate of youth marijuana use in the country and the fourth-highest rate of youth addiction.

After U.S. Attorney General Eric Holder announced that those in compliance with their state’s medical marijuana laws would not be prosecuted, the industry in Montana exploded and became a billion-dollar operation. Montana’s chief of the narcotics bureau, Mark Long, testified, “The current situation is a public health and safety disaster as well as a law enforcement nightmare … and an embarrassment to Montana on a national level.” He said Montana was growing so much marijuana it had become a “source country” for illegal export of the drug. Organized crime moved in and one of the world’s largest outlaw motorcycle gangs was involved in running drugs to their East Coast counterparts. Our surrounding states did not consider us good neighbors as can be anticipated by the neighbors of Colorado and Washington.

Source: www.greatfallstribune  3rd March 2014

 

This excerpt from the book Keep Off The Grass gives an interesting background to current situation of the push to legalize cannabis – early last century the majority of delegates to the conventions were aware of both mental and physical harm produced by the drug; and in the international community, at least, there was no doubt of the dangers to health inherent in marijuana.

KEEP OFF THE GRASS   by Gabriel G. Nahas, M.D., Ph.D., D.Sc.

Foreword by Jacques Yves Cousteau

PAUL S. ERIKSSON, PUBliSHER Middlebury, Vermont 05753

IV.              An International Problem (Pages 33-37)

Americans think that anti-marijuana laws were created in recent years just to thwart use of the drug by younger people.  Not true! They are actually the result of international agreements signed by the United States a half century ago in order to halt traffic in what was then considered to be a dangerous substance.

Aware of this fact, on my return to the United States in the autumn of 1970, I decided that the logical place for my own detailed research into that aspect of marijuana would be the Dag Hammarskjold Library for International Scholars at the United Nations in New York. If the nations of the world had seen fit to meet on several occasions in order to control the Distribution of cannabis derivatives, then they must have suspected or known of specific health hazards. The examination of these international documents might lead to some clues that would aid me in the direction of my own laboratory work.

My study soon revealed that at the turn of the century, with the development of intercontinental communications, it became apparent to the nations of the world that the control of substances dangerous to man’s health and to society-mainly opium at that time-had to be controlled on a global basis.  Representatives of sovereign nations held conferences to formulate regulations for the international control of opium and other dangerous drugs. The first such gathering was held in Shanghai in 1904 at the instigation of President Theodore Roosevelt. This preliminary meeting set the stage First Opium Conference at The Hague in 1912. The preamble to the text of this conference spells out its general goals:

“The Emperor of all Russias, the King of England’/ Emperor of India, the Kaiser of Germany , the President of the  French Republic, the President of the United States of America. . . desirous of advancing a step further on the road opened by the International Commission of Shanghai of 1909; determined to bring about the gradual suppression’ the abuse of opium, morphine and cocaine and also of the drugs prepared or derived from these substances which might give rise to similar abuses; taking into consideration the necessity and the mutual advantage of an international agreement on this point; convinced that in this humanitarian endeavor they will meet with the unanimous adherence of all States concerned: have decided to conclude a convention with this object.”

Almost as an afterthought, an “Indian Hemp Re801 was tacked on, calling for the “study [of] the question of Indian Hemp from the statistical and scientific point of with the object of regulating its abuses, should the necessity  be felt, by internal regulation or by international agreement.”

By the time of the Second Opium Conference, her Geneva in 1924, some scientists had agreed that the time for cannabis control was at hand. While opium was still major consideration, Egypt’s delegate, Dr. El Guindy, said, “There is, however, another product, which is at least as harmful as opium, if not more so, and which my government would be glad to see in the same category as the other narcotics already mentioned. I refer to hashish, the product of Cannabis sativa. This substance and its derivatives work such havoc that the Egyptian government has for a long time past prohibited their introduction into the country. I cannot emphasize sufficiently the importance of including this product in the list of narcotics, the use of which is to be regulated by this Conference.”

In answer to questions from other delegates, Dr. EI Guindy claimed that although the Egyptian government had banned the growing of cannabis, large amounts were still smuggled in from neighboring countries. “This illicit use of hashish,” he told the Conference, “is the principal cause of insanity in Egypt, varying from thirty to sixty percent of the total number of cases reported. Taken occasionally and in small doses, hashish perhaps does not offer much danger, but there is always the risk that once a person begins to take it, he will continue. He acquires the habit and becomes addicted to the drug and once this happens it is very difficult to escape.”

The greatest hazards of cannabis intoxication mentioned by Dr. EI Guindy were “acute hashishism,” marked by crises of delirium and insanity, and “chronic hashishism;” marked by visible mental and physical deterioration. Because of pressure from the Egyptian and Turkish delegates, who would not sign a ban on opium unless cannabis was also included, after some debate all the delegates voted in favor of controlling “Indian Hemp” as defined by the “dried flowering or fruiting tops of the pistillate plant Cannabis sativa from which the resin has not been extracted, under whatever name they may be designated in commerce.”  Thus, cannabis was put on the forbidden list, not because of medical reasons, but for social ones.

After World War II, the United Nations inherited the duty of enforcing the highly complex international agreements on control of dangerous drugs, including the above cannabis control resolution. When the World Health Organization came into being in 1948, this responsibility was shifted to them in the form of an: expert Committee on Drug Depen-dence that served as an advisory group to the United Nations Commission on Narcotics. The committee, made up of physicians and scientists, reviewed the cannabis situation and quickly came to the conclusion “that use of the drug was dangerous from every point of view, whether physical, mental or social. The ultimate result of this review was the 1961 Single Convention on Narcotic Drugs in which 500 delegates from seventy-four nations, including some of the best toxicologists and pharmacologists in the world, recommended that cannabis, in all its forms, be limited exclusively to medical and scientific purposes.” The primary reason for this strict regulation was that all the available expert advice from the World Health Organization indicated that cannabis did constitute a danger to health and a hazard to society although, admittedly, not well-documented.

While the United States was a signatory member of both the Second Opium Conference and the United Nations agreements, the signing was done with the attitude that the inclusion of cannabis in an international drug ban was “more important to them than to us.”  Marijuana was not’ problem in America, and there were only a farsighted few like the head of the American delegation, career diplomat, Harry Anslinger, who recognized its dangers.

The Single Convention was hailed by most countries as a landmark for the control of dangerous drugs throughout the world. It was also hailed as a model of the kind of international cooperation the United Nations can achieve.  The agreements reached by the Convention were unanimously ratified by the participating nations.

Ten years later, however, in the United States the climate of opinion had changed as the use of marijuana had become widespread. Now there were dissenters who objected to the inclusion of cannabis in the Single Convention. Thus, Harry Anslinger became the focal point of the attack of the new proponents of pot. One critic said, “The inclusion of cannabis into an international agreement mainly concerned with opiates and cocaine was due to the efforts of one determined man, Harry Anslinger.” But anyone who has read the documents would realize that the agreement was the result of a historical movement to control or eliminate dangerous psychotropic drugs, including cannabis-as are virtually all the United States federal and state anti marijuana laws.

In any event, the United Nations Single convention of 1961 was not the last one to be held on this subject.  A new conference in Vienna in 1971 produced an international agreement to control many of the newer psychotropic drugs such as hallucinogens, barbiturates, and stimulants.

‘While my research at the Dag Hammarskjold Library did not produce any major revelations, it did clarify certain points that I considered to be important to the evolution of my own work. Essentially, I became convinced that the present legal strictures against marijuana in the United States were not based on one man’s perversity but were the result of international agreements that went back to the beginning of this century; cannabis was included in these international agreements because the majority of delegates to the conventions were aware of both mental and physical harm produced by the drug; and in the international community, at least, there was no doubt of the dangers to health inherent in marijuana.

Source:  Book,  Keep Off The Grass by Gabriel Nahas

Almost twice as many people were admitted to hospital for cannabis use than cocaine last year, according to figures obtained by the Scottish Conservatives.

The statistics show there were 608 admissions for cannabis in 2012/13, up from 492 in 2008/09. Cocaine accounted for 316 people being hospitalised across Scotland during the same period.

The Tories are now warning the police and NHS not to “ease off” on the class B drug amid attempts to tackle higher profile illegal substances such as heroin. Scottish Conservative health spokesman Jackson Carlaw MSP said: “Cannabis enjoys a reputation in some quarters as essentially being a safe drug. But we can see from these figures that clearly isn’t the case.

“Allowing the illegal substance that reputation can breed complacency among not only users, but authorities too.  It accounts for almost double the hospital admissions as cocaine, and the five-year trend is certainly moving in the wrong direction. We have to break this relaxed attitude, and ensure that the hundreds who are hospitalised as a result of cannabis don’t fall into a trap of believing what they are doing is a risk-free activity.”

In total, 5693 people were admitted to Scottish hospitals in 2012/13 for drug-related issues, almost 600 fewer than the previous year.

Heroin and other opiates were still the most prevalent reason for drug-related admissions with 3825 people seeking medical attention after using the substance.

Health boards in Dumfries and Galloway, Lothian, Fife and Lanarkshire recorded the most incidents of cannabis-related admissions while NHS Grampian, Forth Valley and Ayrshire and Arran had the fewest. No figures were provided for Orkney, Shetland or the Western Isles.

Community Safety Minister Roseanna Cunningham said: “We have maintained record amounts of money in frontline drug services and support, with drug treatment waiting times dramatically reduced. We have an ambitious programme for education about the dangers of drugs, including cannabis, through Know the Score and Choices for Life.

“Drug taking in the general adult population has fallen since 2006 and drug use among young people is at its lowest levels since 2002. Hospital discharges for drug use have also fallen among younger age groups.”

Source:  http://news.stv.tv/scotland/265829   1st March 2014

In the last several months, my colleagues and I have noticed rising levels of THC in the urine of our young patients but the average increase I present here surprised even us.

THC, which is short for tetrahydrocannabinol, is the active ingredient in marijuana that gives users a high and is chiefly responsible for making the drug addictive (yes, it’s addictive; responsible and respected scientists no longer debate this). In the last 40 years, growers have worked steadily to spike THC levels in marijuana — taking a page from the playbook of Big Tobacco, which was caught spiking nicotine and adding chemicals to make cigarettes more addictive.

Marijuana’s THC levels have increased substantially in the last 40 years. In the 1960s and ’70s, marijuana’s THC levels averaged around 2 percent. Today, they easily exceed 10 percent. In medical marijuana states, including Colorado, where I live, potent strains frequently falling into adolescents’ hands top 40 percent THC. Then there’s the concentrated form of THC, commonly called hash oil, that is extracted from the plant and added to foods and drinks and inhaled through smokeless vaporizers. THC concentrate can exceed 90 percent. At the same time THC has risen, so has adolescent marijuana use. Consider this from the University of Michigan’s Monitoring the Future Survey:

* In 1991, 8 percent of the nation’s high school students reported past-month marijuana use. The past-month use rate reported last year was 15.5 percent.

* In 1991, 0.9 percent of the nation’s high school students reported daily use. Last year it was 3.5 percent.

With all of this top of mind, my colleagues and I examined the results of approximately 5,000 urinalyses of adolescents treated in a downtown Denver clinic where I practice. The patients were ages 13 to 19.

As you’ll see in the chart below, from 2007 through 2009, the average rate was 358 nanograms per milliliter of urine. This time period immediately preceded the opening of hundreds of marijuana dispensaries in Colorado.

From 2010 through February 2013, the average THC rate registered at 536 nanograms per milliliter of urine. This time period coincides with a boom in access to, and social acceptance of, marijuana in Colorado, where voters in November 2012 approved a constitutional amendment legalizing the drug for recreational use.

Why should we care about this rise in THC rates? What do they mean? Here are some preliminary thoughts as I continue my research:

* Young people are using marijuana more frequently, or they’re using more potent marijuana, or they’re using more potent marijuana more frequently. I suspect the third option is most likely.

* When young people report for treatment, their marijuana addiction is more serious. It takes longer to treat them and requires more resources to do so — which means their treatment is more costly.

* Typically, the more severe the addiction, the poorer the prognosis for recovery.

* I am increasingly concerned about concentrated THC, which is infused into an ever-growing number of edible products and pushed to users in other smokeless forms that are billed as safer and healthier to use because they don’t involve smoking. My colleagues and I also have found that these smokeless forms of ingesting THC are increasingly popular with young people who are eager to hide their drug use.

It is reasonable now to question how much longer it will be before we see injection use of THC — especially as marijuana is legalized.

 

1.

Bahahaha  injection! Really?!?!    “Dr. Fool” needs a proper education!  Kim

Reply

Thanks for writing, Kim. Your response is typical of those I have received, so I’m posting it. THC injections have happened in laboratory settings where researchers are examining the links between marijuana use and psychosis. For example, this video, produced by the BBC, shows a woman receiving injections of pure THC and a mixture of THC and cannabinoid. It was posted in 2011 and has received more than 106,000 views.

So, THC injections aren’t implausible. Similarly, synthetic cannabinoid was developed in a laboratory for research purposes. Only a few short years later, “entrepreneurs” who studied published papers, were marketing the substance as a substitute for marijuana that would allow users to get high and also evade drug tests and, possibly, avoid arrest.

Even if THC injections are plausible that doesn’t mean that they will be widespread or even a minor trend. there are many ways to ingest marijuana most of them more comfortable than injection. why would anybody want to inject something that even you say could be smoked or eaten –  Alexander

Reply

Thanks for writing, Alexander. Yes, there are many ways to ingest drugs that are more comfortable than injection — and yet people inject drugs. Heroin can be taken orally, snorted and smoked, but many people who use it inject it. Injection delivers a faster, more intense high, which is why it’s a preferred delivery method for some drug users. Perhaps you also should contact researchers whose studies have included injected THC. Their thoughts are bound to be interesting.

Dr. Thurstone merely has reported that injection use of THC is plausible. As noted, it has certainly happened in clinical research settings. Two YouTube videos showing a woman receiving THC injections (one is posted here) have received nearly a half million views at this writing. Responsible healthcare providers should be aware of the possibility of injection THC. Communities should be aware of it, especially in Colorado, where THC injectables (meaning needles filled with THC) will be legal for sale to people 21 and older on Jan. 1, 2014. People should discuss the matter now — and not wait until it shows up in their homes, neighborhoods, schools and medical clinics.

 

I’m a youth who goes to school in Lakewood. I find it to be a joke how many other kids i see at my middle school are smoking pot. Sadly, so many of these kids are addicted. They often are told that it is not bad and that it will not hurt them, then they become addicted and fall into the vicious cycle due to the harmful effects of the drug. For all of the pro-marijuana people i would like to thank you for 1.) For screwing the youth 2.) For creating lies that deceive kids into doing this drug. If you pro-marijuana people don’t think that pot is bad then you must be high. – Harrison

Reply

Thanks for writing, Harrison. I’m especially interested in hearing from young people on this subject.

 

Hmm. So, when you say “At the same time THC has risen, so has adolescent marijuana use,” that makes me wonder, because you also say “In the 1960s and ’70s, marijuana’s THC levels averaged around 2 percent.”

So, if the hypothesis is that rising THC levels lead to rising use and you lament the 2% THC of the Woodstock Era, why are you only going back to 1991 to set your baseline? Isn’t that a little intellectually dishonest?

Because when we look back at the data from NSDUH, we see this:

1979: 16.8% age 12-17 use of marijuana in past month (that would be your 2% THC, right?)

1985: 11.9% monthly use (with THC between 3.44% – 7.95%, according to the Potency Monitoring Project in the ONDCP’s 2011 Data Supplement.)

1991: 4.3% monthly use, 3.18% – 11.20% THC

1997: 9.4% monthly use, 4.92% – 11.62% THC

2003: 8.0% monthly use, 5.63% – 14.00% THC

2009: 7.2% monthly use, 6.89% – 12.86% THC

Let’s see, given six data points each six years apart, we have learned:

The most kids smoked pot back in 1979 when it was the weakest pot. Then in 1985, fewer kids smoked pot even as it got more than twice as potent. Then in 1991, almost 1/3 as many kids smoked pot, even though it got still more potent. By 1997, twice as many kids were using even as the potency stayed relatively stable. In 2003, fewer kids smoked pot even though it got more potent, and in 2009 fewer kids smoked as the potency dropped.

Pretty much everything happened except your hypothesis according to this data set. even the latest data from 2011 show 8.0% monthly use and the dabs/hash phenomenon was well underway by then.

The reason we’re unfazed by your scaremongering of the urine metabolite levels of your paying clients is that all you’re finding is that the people forced into your business for violating prohibition are getting higher, not that getting higher forces people into your business. You know as well as I do (SAMSHA TEDS-A) that for every one person who self-admits to rehab solely for marijuana, another four are forced there by the criminal justice system. Colorado went and added language to the constitution that is really bad for your bottom line.  – Russ

Reply

Hi, Russ. Thanks for writing. I’ll take it from the top:

“So, if the hypothesis is …” That’s not the hypothesis, and I have not offered one.

Why did I mention Monitoring the Future data going back to 1991? This long-running survey has monitored 12th graders since 1975. However, I’m not interested only in high school seniors. I want to know about students in grades 8-12. The survey started to include 8th and 10th graders in 1991.I’m simply reporting here that kids are showing up in my clinic with more THC in their urine. The higher their THC levels, the more severe their addiction. Their THC levels have risen substantially since 2007. I’m unfazed that you express no concern about the significance of this.

“You know as well as I do …” No, I don’t. What I do know is that marijuana abuse is the No. 1 reason adolescents are admitted for substance abuse treatment in the United States. I also know that most of my patients come to my clinic voluntarily. Few are referred there through the courts. I’m glad you mentioned the TEDS data (that stands for Treatment Episodes Data Set). I encourage people to review it. From the most recent data set, which can be found online here:   http://wwwdasis.samhsa.gov/teds07/tedshigh2k7.pdf:

“The proportion of admissions for primary marijuana abuse increased from 12 percent in 1997 to 16 percent in 2003 through 2007. • Nearly three-quarters (74 percent) of primary marijuana admissions were male. • Over half (51 percent) of primary marijuana admissions were non-Hispanic White, followed by 29 percent who were non-Hispanic Black and 15 percent who were of Hispanic origin. • For primary marijuana admissions, the average age at admission was 24 years.”

That profile is consistent with Colorado’s medical marijuana registry.  It’s also important for people to understand that private treatment centers don’t often participate in TEDS. As the study states: “In general, facilities reporting TEDS data are those that receive State alcohol and/or drug agency funds (including Federal Block Grant funds) for the provision of alcohol and/or drug treatment services.” People who are court-referred are more likely to go to publicly funded treatment programs, Russ.  Another important thing to know about TEDS is that it tracks admissions, or patient visits, not individuals.

By “added language to the constitution,” I suppose you mean Colorado’s Amendment 64. If by “bottom line” you mean the number of patients I see, you’re right. I find it very sad that my patient referrals have tripled since 2009, the start of the boom in marijuana dispensaries in Colorado and the continued era of decriminalization (public records show few people are jailed only for marijuana use in Colorado and across the nation). I am also sad that there’s so much demand for marijuana-addiction treatment now that our clinical program is having to hire another therapist, and at least one other adolescent treatment program serving metro Denver is expanding, too.

 

I’d be interested to know whether those urinalysis results were for actual THC or for THC metabolites like 11-hydroxy-THC.

Reply

Thanks for writing. Good question. We were measuring THC.

 

(yes, it’s addictive; responsible and respected scientists no longer debate this). Please list your source for this statement. Reply

Thanks for asking. There are several studies to review, but a great place to start is the work of Alan J. Budney, a professor of psychiatry at Dartmouth’s Geisel School of Medicine. His research and reviews of the literature have focused on physical withdrawals from cannabis.

Youngsters are at greatest chance of addiction and psychosis as organ is still developing

Younger people, especially teenagers, have the greatest chance of developing addiction and psychosis from smoking cannabis than adults, scientists have revealed.

A study shows that cannabis is particularly damaging to young people as their brains are still developing.

Researchers from the University of Montreal and New York’s Icahn School of Medicine at Mount Sinai reviewed more than 120 genetic studies that looked at cannabis and the adolescent brain, measuring the influence of genetics, environmental factors and previous studies to the idea of a ‘gateway drug’.

Professor Didier Jutras-Aswad, co author of the study said: ‘Of the illicit drugs, cannabis is most used by teenagers since it is perceived by many to be of little harm. ‘Most of the debates and ensuing policies regarding cannabis were done without consideration of its impact on one of the most vulnerable population, namely teens.

‘Data from epidemiological studies have repeatedly shown an association between cannabis use and subsequent addiction to heavy drugs and psychosis.

‘Interestingly, the risk to develop such disorders after cannabis exposure is not the same for all individuals and is correlated with genetic factors, the intensity of cannabis use and the age at which it occurs.

‘When the first exposure occurs in younger versus older adolescents, the impact of cannabis seems to be worse in regard to many outcomes such as mental health, education attainment, delinquency and ability to conform to adult role.’

Cannabis effects our brain by interacting with it’s chemical receptors, situated in the part of our brain that manages decision-making, learning and management, habit formation, management of rewards, motivation and motor function.   Because the brain rapidly changes structure during adolescence, scientists believe usage of cannabis at this time greatly influences the way these parts of the user’s personality develop.

The international cannabis trade has long been a draw for criminal gangs who stand to make a lot of money from the growth and distribution of the drug

The scientists have developed this theory using adolescent rats, observing the differences in the chemical pathways of the brain that govern addiction and vulnerability.  A quarter of teen users of cannabis will develop problems with abusive or dependent relationships with the drug, but there are suggestions that genetic and behavioral factors also have an effect.

Prof Jutras-Aswad added: ‘Individuals who will develop cannabis dependence generally report a temperament characterised by negative affect, aggressivity and impulsivity, from an early age.  ‘Some of these traits are often exacerbated with years of cannabis use, which suggests that users become trapped in a vicious cycle of self-medication, which in turn becomes a dependence.

‘While it is clear that more systematic scientific studies are needed to understand the long-term impact of adolescent cannabis exposure on brain and behaviour, the current evidence suggests that it has a far-reaching influence on adult addictive behaviours particularly for certain subsets of vulnerable individuals.’

Writing in the journal Neuropharmacology, he concluded: ‘It is now clear from the scientific data that cannabis is not harmless to the adolescent brain, specifically those who are most vulnerable from a genetic or psychological standpoint.

‘Identifying these vulnerable adolescents may be critical for prevention and early intervention of addiction and psychiatric disorders related to cannabis use.’

Source: http://www.dailymail.co.uk/news/article  20th February 2014