Since the premiere of Dr. Sanjay Gupta’s documentary “Weed” back in August, the general public has quickly come to understand the miraculous healing power of cannabidiol, or CBD.

The political perception of medical marijuana changed forever when parents saw little Charlotte Figi, the girl with intractable epilepsy, go from hundreds of seizures a week to just one or two, thanks to CBD treatments.

But that change in perception isn’t a good one.

For now there are two types of medical marijuana – CBD-Only and “euphoric marijuana”, as New Jersey Gov. Chris Christie calls medical marijuana that contains THC.

Just as “We’re Patients, Not Criminals” cast non-patients as criminals, the lobbying for these new CBD-Only laws relies heavily on pointing out that CBD is a “medicine that doesn’t get you high”, which casts THC at best as a medicine with an undesirable side effect and at worst as not a medicine but a drug of abuse.

This is a disaster both politically and medically; let’s begin with the former.

Politically, whole plant medical marijuana (the kind with THC in it) began in 1996 in California and from that point, it took eleven years before there were a dozen whole plant medical marijuana states in America.

CBD-Only medical marijuana began in March in Utah and from that point, it’s taken only four months to put us on the brink of a dozen CBD-Only medical marijuana states.

Also consider that of those first dozen whole plant states, eight of them were passed by citizen ballot initiative.

All twelve of the CBD-Only laws were passed by state legislatures, often by unanimous or near-unanimous votes.

Every legislature that has taken up the issue of CBD-Only medical marijuana has seen the legislation fly through the committees and both chambers (except Georgia, and that state was only derailed by some parliamentary shenanigans by one legislator).

Take North Carolina this week as an example.  On Tuesday, a committee of the North Carolina House of Representatives cancelled a meeting to discuss a CBD-Only bill.  No rescheduled date for the meeting was announced.

Local newspapers on Wednesday posted headlines that the bill’s passage was unlikely.

The Senate wasn’t likely to pass the bill in this short session that ends next week.

There would be no good reason for the House to move forward with the bill.

But on Wednesday afternoon, the meeting was suddenly rescheduled and the CBD-Only bill passed unanimously.  This morning (Thursday) the bill was heard by a second committee and passed immediately.  This afternoon it was heard and amended on the House floor where it passed 111-2.   It now awaits passage by the state Senate.

By the end of this week, it seems North Carolina could become the 12th CBD-Only state, joining Alabama, Florida, Iowa, Kentucky, Mississippi, Missouri (awaiting governor’s signature), New York (governor’s executive order), South Carolina, Tennessee, Utah, and Wisconsin.

Why are legislators so fast to pass these CBD-Only bills?  It’s fair to assume politicians are moved by the plight of epileptic children.

With CBD-Only, there’s no downside of being the guy or gal who voted for legalizing something that “gets you high”.   But even so, how do these bills move so fast and garner little to no opposition?  Because CBD-Only bills are political cover.

Voting for the CBD-Only bill allows the politicians to say they’re sympathetic to the plight of sick people and want to help patients get any medicine that will ease their suffering.

But they can also still play the “tough on drugs” game and maintain their support from law enforcement and prison lobbies.  Their vote garners headlines that a politician formerly considered “anti-medical marijuana” has “changed his mind” or “altered her stance” on medical marijuana.

Best of all, it gets the sick kids and their parents out of the legislative galleries and off the evening news.  For the politicians in these conservative states, it makes the medical marijuana issue go away, or at least puts the remaining advocates in the “we want the marijuana that gets you high” frame where they are more easily dismissed.

Medically, the CBD-Only laws are also a disaster.

Cannabidiol is just one constituent of cannabis and by itself, it doesn’t work as well as it does with the rest of the plant.   Dr. Raphael Machoulem, the Israeli researcher who discovered THC (the cannabinoid that “gets you high”), called it “the entourage effect”, the concept of many cannabinoids and other constituents working in concert, synergistically.

To make an overly-simple analogy, it’s as if we discovered oranges have vitamin C in them, but banned oranges completely and only allowed people with scurvy to eat vitamin C pills.    Yes, those pills can help you if you’re vitamin deficient, but any nutritionist will tell you eating the whole orange will not only allow your body to absorb the vitamin C better, the fiber from the orange is also good for your body, and oranges taste delicious, which makes you a little happier.  Plus, if oranges are in your diet, you’re not going to get scurvy in the first place.

The authors of these CBD-Only bills aren’t writing them for optimal medical efficacy, however, they’re writing them for political cover.

The parents treating their children in Colorado with CBD oil will tell you that it takes quite a bit of tinkering with the ratio of CBD to THC in the oil to find what works best for their child’s type of seizures.   Some of these kids need a higher dose of THC.

But the legislators write the laws mostly to ensure that the THC “that gets you high” is nearly non-existent.  The North Carolina law, for instance, mandates that the oil contains at least 10 percent CBD and less than 0.3 percent THC.

That’s a CBD:THC ratio of at least 34:1.

For comparison, an article by Pure Analytics, a California cannabis testing lab, discusses the high-CBD varietals most in demand by patients are “strains with CBD:THC ratios of 1:1, 2:1, and 20:1.”   The article explains how a breeding experiment with males and females with 2:1 ratios produced 20:1 ratio plants about one-fourth of the time.

It also describes a strain called “ACDC” that “consistently exhibited 16-20% CBD and 0.5-1% THC by weight.”

That’s one variety with a range of 16:1 to 40:1.  But you must only use the ones that are 34:1 or higher.

In another indicator that politicians are more interested in political cover than helping sick kids, many of these laws are written with no mechanism for in-state production and distribution of the CBD oil.  Some expressly protect the parent who goes out of state to acquire the oil (likely from Colorado) and brings it back home.

So parents are given hope for their kids, but they have to go to Colorado, establish three months residency to qualify for a medical marijuana card, clear the hurdles necessary to get their child signed up for the card, purchase the high-CBD oil, break Colorado law by taking it out of state, and break federal law by being an interstate drug trafficker.

Then back home, the parents are safe, assuming the oil they purchased in Colorado meets the CBD:THC ratio mandated by law.  The ratio listed on the label or mentioned by the provider is no guarantee.

At The Werc Shop, a cannabis testing lab in Los Angeles, an intern writes about how she was sold a strain promised to be 15 percent CBD and 0.6 percent THC, a 25:1 ratio that would be illegal in North Carolina if processed into oil.

When she ran liquid chromatography tests on the sample, it turned out to be 9.63 percent CBD to 6.11 percent THC, a 1.6:1 ratio.  CBD-Only isn’t just a political and medical disaster in the states that adopt it.

These laws also have a detrimental effect on the process of passing whole plant medical marijuana in other states.   Every medical marijuana state since California has enacted increasing restrictions on its access based on the need to keep out the illegitimate marijuana users – the ones who just want to get high.

First, qualifying conditions were restricted.  Then, home cultivation of marijuana was eliminated.

Now, medical marijuana laws are being debated and passed that ban all marijuana smoking and allow no access to the plant itself, just pills, oils, and tinctures.

Thus, it is no surprise that as Wisconsin, New York, and Florida are hotly debating and likely to pass whole plant medical marijuana laws, the legislatures and governors of those two states rushed to pass CBD-Only laws first.

It’s reminiscent of then Governor Arnold Schwarzenegger rushing to sign a marijuana decriminalization bill in summer of 2010 to take the talking point of California arrests for personal possession away from Prop 19′s campaign to legalize marijuana.

Every press conference and public debate about the CBD-Only bills will emphasize “it doesn’t have the THC that gets you high”, forcing whole plant advocates into a defense of THC’s medical efficacy in spite of the “high” even more than they’re already forced to.

This is why any fight to allow patients to grow whole plant medical marijuana with the high-inducing THC in it must now pivot to the support of all adults’ right to grow marijuana if they want to get high.

Every new restriction on medical marijuana, whole plant or CBD-Only, arises from the perceived need to keep the healthy high-seekers out of the medical marijuana.

Eventually, pharmaceutical companies will perfect the CBD:THC ratios and dosages in sprays, tinctures, and inhalers that will surpass the consistency and efficacy of the plant with its natural variety.

Those companies will be glad to supply the 34:1 CBD oil North Carolina requires and whatever ratio any other state requires, for a hefty profit, of course.

Source: Russ Belville  June 23, 2014  

The following two articles come from Australia.  The co-author of the first, Alex Wodak is a world renowned activist in the movement to legalise drugs – in particular cannabis.  The carefully referenced response in the second article was written by Professor Dr. Stuart Reece.

Some frequently asked Q’s and A’s about medicinal cannabis

Prepared by Laurie Mather, PhD, FANZCA, FRCA, Emeritus Professor of Anaesthesia, The University of Sydney (lmather@med.usyd.edu.au) and Alex Wodak, AM, FRACP, FAChAM, FAFPHM Emeritus Consultant, Alcohol and Drug Service, St Vincent’s Hospital, Sydney, NSW, Australia (alex.wodak@gmail.com), 18 June, 2014

A History:

Q: What is cannabis?

A: Some people call it by its American name, marijuana. The name ‘cannabis’ describes its botanical origins and comes from the Latin word for hemp. The name ‘marijuana’ (or sometimes ‘marihuana’) is a contrived name given to associate it with African and Hispanic Americans who used it as a recreational drug in the United States during the 1930s.

Q: What has the cannabis plant been used for?

A: Cannabis is an ancient herb-like plant that has been used for thousands of years for fibre-making for products such as clothing and rope, for dietary ingredients, as an element of folk medicine, and as an agent to promote spiritual transcendence, particularly in the religions of South Asia. ‘Recreational’ cannabis use was uncommon in the West before the 1960s. A League of Nations meeting in Geneva in 1925 decided to ban cannabis internationally. Cannabis first started to come to the attention of law makers and enforcers in the USA in the 1930s. The Congressional Record from that time includes comments about perceived depravity attributed to cannabis use along with racial slurs. Progressively it became an illegal substance in many countries, including Australia.

Q: When did cannabis come into Western civilisations?

A: European venturers over many centuries, as judged by their writings, certainly encountered cannabis in their travels to exotic Eastern and Far Eastern lands. By the mid 19th century, cannabis, in one form or another, had become part of the medical-societal-experimental experience of many European societies.

Q: When did cannabis come into Western-style medicine?

A: Cannabis was adopted into British medicine from India in the mid-19th century having been observed there to relieve pain, muscle spasm, convulsions of tetanus, rabies, rheumatism and epilepsy.

B Cannabis as a medicine:

Q: How does cannabis work?

A: As a plant preparation, cannabis ordinarily contains many hundreds of chemical substances commonly found in plants (‘phytochemicals’), and a hundred or so unique substances commonly referred to as ‘phytocannabinoids’. A small number of phytocannabinoids are believed to cause the main pharmacological effects of cannabis in humans. Cannabis attaches to special receptors in the brain and some other organs in the body. This releases a special chemical that the body produces. The chemical acts as a transmitter.

Q: What is ‘medicinal cannabis’? Some people also refer to this as ‘medical marijuana’.

A: The ‘medicinal’ tag recognizes that cannabis, among many other uses, has the properties of a medicine.

C Benefits of medicinal cannabis:

Q: Why do some argue that medicinal cannabis be legalised?

A: It helps some people with distressing symptoms from serious medical conditions when they have not been sufficiently helped by the standard medicines. Cannabis is considered a ‘second line’ drug to be used when the first line drugs have been tried and have either not worked or had unacceptable side effects.

Q: What kind of evidence is there that cannabis can help some people?

A: The evidence is basically of three kinds. First, there is anecdotal evidence, usually provided by people who have experienced in themselves or observed in others some effect. Most information like this is hard to assess because it lacks corroborative documentation – and this is the kind of evidence that tends to appear in the lay press and on internet blog sites. This is not to say that the evidence is invalid – but only to say that the much of the vital information underpinning the claims is not available in a way that permits scientific scrutiny. The second type of evidence is papers published in reputable medical and scientific journals after peer-review. A third type of evidence is careful reviews of papers reporting the results of cannabis research.

Q: How good is the evidence that cannabis can help some people?

A: Randomised controlled trials (RCTs) are usually regarded as the best way of telling whether a medication is effective. In one recent review, for example, 82 RCTs showed that medicinal cannabis is effective in relieving distressing symptoms in about half a dozen conditions. 9 RCTs found that medicinal cannabis was not effective. This is quite an impressive result. There are at least half a dozen favourable reviews by prestigious organisations.

Q: What are the main medical conditions that might be helped by medicinal cannabis?

A: Severe nausea and vomiting after cancer chemotherapy, especially if no standard treatment has worked; severe chronic non cancer pain, especially if the pain is due to nerve damage; severe wasting in cancer or AIDS (though this is less common these days); stiffness due to multiple sclerosis. There are also some other conditions.

Q: Is cannabis a cure for any conditions or diseases?

A: Not as far as we know so far from scientifically assessed evidence.

Q: Can cannabis help young children with severe epilepsy resistant to all known treatments?

A: A number of people have claimed this. But this possible benefit has not yet been tested in scientifically assessable research.

D Potential risks:

Q: Are there any bad side effects from medicinal cannabis? People talk a lot about psychosis and marijuana: should we be worried about using a medicine that could cause schizophrenia?

A: Most of the assessment of side effects has been based on what is known from studying recreational cannabis. That’s like studying the safety of bootleg alcohol to estimate the safety of regulated alcohol. Used medically, cannabis can cause some mental disorientation, sleepiness, and dry mouth but these are typically less severe and troublesome than many of the medications that might be used to treat the same conditions. Besides, the effects of not treating the conditions also has to be considered. It has also been said that some of these side effects counteract the worse side effects of the other medications such as chemotherapy agents that cause serious side effects themselves. People distressed by severe symptoms unrelieved by conventional medications are unlikely to be concerned by the small risk of serious mental illness in a couple of decades time.

Q: Is there a risk that legal medicinal cannabis would increase the use of recreational cannabis.

A: Recreational cannabis use in those US states which allow medicinal cannabis is not greater than those states where medicinal cannabis is not permitted.

Q: Can’t people taking cannabis become addicted to it?

A: Dependence is a small risk with cannabis in the sense that it is not as severe as the dependence that occurs with tobacco, heroin or cocaine. What matters is not just the risks of cannabis but also its possible benefits and the benefits and risks of using other medicines or no medicines.

Q: Aren’t there more modern and more effective drugs than cannabis?

A: Yes there are. But these don’t work in every case and sometimes they too can produce nasty side effects. Many of the more modern drugs are also much more expensive and some require the patient to be kept in hospital while they are being administered.

E Taking medicinal cannabis:

Q: Are there alternatives to taking cannabis by smoking it? How else can medicinal cannabis be taken?

A: Cannabis can also be vaporised and the vapour inhaled. Devices are now available to make inhalation of cannabis vapour convenient and inexpensive. Oral forms of cannabis (dronabinol and nabilone, developed some 30 years ago) used to be available in Australia but are not available any more because they were expensive and not especially reliable, and they have been made obsolete. There is little scientific information available about other forms of medicinal cannabis given by mouth (such as tincture). Cannabis taken by mouth, although perhaps well-enough absorbed, is broken down in the liver before it gets into the main blood stream, making it hard to get the right dose in many people. Also, when cannabis is taken by mouth there seems to be an increased risk of anxiety attacks because there is no way to ‘stop giving it’ once it has been swallowed. Sativex (aka nabiximols) is a form of medicinal cannabis manufactured by a small pharmaceutical company. It is sprayed on the inside of the mouth. There are many attractive aspects of Sativex®, particularly convenience, but it is not readily available in Australia, and is only permitted in cases of stiffness (spasticity) from multiple sclerosis. Tincture of cannabis used to be legally available some 20 years ago. It has been made available by some individuals in Australia but its supply, these days, is not legal. If medicinal cannabis is allowed in Australia, some people with only a short time left to live and others who have been smoking cannabis for a long time are likely to continue to smoke the drug

Q: Aren’t Sativex and dronabinol available on the Pharmaceutical Benefits Scheme?

A: Neither Sativex (nabiximols) nor dronabinol are available on the Pharmaceutical Benefits Scheme.

Q: Is cannabis available medically in any other countries?

A: Medicinal cannabis is now available in about twenty countries including the USA (23 states), Canada, Switzerland, the Netherlands, and Israel.

Q: How is medicinal cannabis controlled in other countries?

A: In some countries medicinal cannabis controlled quite carefully with prescriptions by doctors and pharmacy dispensing. In some other countries, controls are much more relaxed and cannabis can be bought over the counter.

F Political and community factors:

Q: What’s stopping the government from legalising medicinal cannabis in Australia?

A: The main reason cannabis in not available in Australia is because of political impediments. Some Commonwealth and state/territory laws would have to be changed slightly. States make their decisions independently. Medicinal cannabis is allowed, in principle, under Australia’s international treaty obligations.

Q: How can we allow cannabis to be used medicinally while stopping it being used recreationally?

A: Easy. Australia allows morphine, cocaine, amphetamine and ketamine to be used medically while the recreational use of these drugs is prohibited.

Q: Is Australia doing enough research on medicinal cannabis?

A: Very little research on medicinal cannabis is carried out in Australia.

Q: What about people who might take medicinal cannabis and then try to drive a car?

A: There is an increased risk of a car crash if a driver has taken cannabis recently. This risk is much less than with alcohol but the risk if even greater after a combination of alcohol plus cannabis has been taken. A number of medicines which are prescribed today in Australia also increase the risk of a car crash.

Q: What is public opinion in Australia about medicinal cannabis?

A: In a community survey commissioned by the Commonwealth Department of Health in 2010, 69% of Australians supported medicinal cannabis with 75% supporting more research.

Q: Do many Australians take cannabis for medicinal purposes now?

A: Yes, but we don’t know how many.

Q: Will medicinal cannabis be allowed in Australia?

A: Possibly. But it’s very hard to predict this.

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Response to Comments by Wodak and Mather

1.  One notes that Dr Alex Wodak is one of the key authors of this paper.  As the undisputed champion of drug decriminalisation in Australia for the last 30 years one must necessarily wonder what impact his personal views have on the advice he has provided to the parliament on this occasion.

2. The title of the paper uses the phrase “Medical cannabis”.  It is a matter of record that “medical cannabis” has been deliberately used as the “Trojan horse” or thin edge of the wedge which is strategically used to introduce cannabis decriminalization.  This has been true in many instances overseas, and the US states where it is now decriminalized.  Moreover this tactic was made explicit in NSW last year during the unsuccessful attempt to introduce what was popularly thought to be a medical cannabis bill, but it turned out was only for homosexual patients who liked to smoke cannabis.  In the GPSC2 report which was tabled before the parliament at that time, it was acknowledged that only patients who liked to smoke cannabis – and their friends and carers – would be likely to avail themselves of the alleged benefits of the then proposed legislation.  In other words the very use of the term “medical cannabis” is the standard misnomer for cannabis decriminalization 1 which it has been found to be the most successful way to introduce it in virtually every jurisdiction around the world, and has been repeatedly used in NSW.

3. As was noted recently by Dr Nora Volkow the Director of the NIH Institute concerned with drug addiction 2, cannabis has a well recognized withdrawal syndrome associated with it, which can be experienced by up to 50% of people who are exposed to it on a daily basis, particularly when that exposure occurs in adolescence 1.  In the fourth answer on page 1, the authors list a series of symptoms including pain, muscle spasm, agitation, fits, convulsions and rheumatics all of which are recognized presentations of cannabis withdrawal 3.  Since the pro-pot group acknowledged that only pot-smokers will want to smoke pot if it is legalized, what they are really saying is that they will be able to treat their cannabis dependence syndrome more easily if it is made more readily available.  Even the cannabis advocates acknowledge that more efficacious and safer treatments exist for every purported indication for which they suggest its use.

4. The first answer on page 2 is completely incorrect.  In this response Wodak et. al. appear to claim that smoked cannabis is a medicine.  As noted by Dr Volkow raw cannabis contains hundreds of chemicals and is an impure substance.  After burning as in smoking the products of full and partial oxidation form thousands of chemicals many of them highly toxic and frankly carcinogenic including similar tars, polycyclic hydrocarbons and aromatic amines as those found in tobacco smoke.  No regulatory authority in the world (e.g. FDA 4 in USA or TGA 5 in Australia) acknowledges any smoked preparation as a valid form of dosing of any medicine.  The term “medical cannabis” is therefore in strictly medical terms a misnomer which has been

strategically designed to confuse and mislead people as part of the clever public relations marketing campaign of the big cannabis industrial developers (by analogy with big tobacco interests), as have now developed in California, Colorado, Oregon, Washington state and elsewhere.

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1 Lonsberry B “Medical marijuana is a fraud.”  News Radio WHAM 1180.  http://www.wham1180.com/onair/bob-lonsberry-3440/medical-marijuana-is-a-fraud-12428431  Viewed 13th July 2014. 2 The Institute she directs is called the National Institute of Drug Abuse. 3 See Epilepsy Action Australia – http://www.epilepsy.org.au/living-with-epilepsy/lifestyle-issues/alcohol-and-drugs 4 Food and Drug Administration 5 Therapeutic Goods Administration

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5. The answer to the second question on page 2 is also incorrect.  Wodak et. al. claim that cannabis is a second line drug for various – unspecified – medical conditions.  This is erroneous.  As clearly stated on the Epilepsy Action Australia webpage cited 6 it is not indicated at all by reputable authorities in this country as it is not even legal!  The other point is that to achieve the so-called therapeutic effects one frequently has to achieve concentrations into the toxic range.  There are numerous other treatments for glaucoma, asthma, epilepsy, pain and nausea.  Were it legal and therefore ethical to list cannabis for these disorders, cannabis would be about 10th line, 20th line, 60th line, 80th line and 10th line respectively.  This is another way of – politely – saying that there are no valid clinical indications for cannabis at this time.  As Wodak and colleague correctly observe the indication for AIDS wasting has now become obsolete because of the great improvements in the treatments for AIDS.

6. Moreover in addressing this all important issue – the motivation for medical cannabis – Wodak and Mather appear to overlook the role of the pro-cannabis lobby in this campaign.  Indeed one wonders if there would be any campaign to legalize cannabis if those who do not like to use it themselves were excluded from advocacy roles.  One can only surmise at the relationship of the present advocates of the pro-pot position to the pro-pot practice.

7. Wodak and colleague’s answer to Question 3 on page 2 is also erroneous.  Anecdotal evidence is not considered evidence which is even evaluable by reputable medical authorities.  Wodak’s remarks do not state this clearly.  One notes – paradoxically – that Wodak is keen to discount such evidence in the case of implant naltrexone – even in anecdotal cases where implant naltrexone has been obviously enormously successful (such as five years heroin free).  At this point Wodak appears to be applying a double standard.  The third type of evidence cited by Wodak and colleague is vague and unclear.  The authors refer to “careful reviews of papers”.  This is not a medical term.  Modern Science considers “systematic reviews” and “meta-analyses”.  Wodak and Mather do not even use these terms. So their meaning is unclear.  In the context one must be concerned that this obfuscation of meaning may be deliberate.

8. Similar concerns apply to the fourth answer on page 2.  Wodak and Mather refer to “one recent review”.  The source is not even referenced!  There are many reviews in medicine and one needs to consider the whole of the literature.  Apparently this was not a systematic review or a formal meta-analysis as otherwise one would expect the authors of the present work to have cited this.  Moreover the results of meta-analyses are typically reported in very complex form – not the very simplistic format which seems to be indicated by Wodak and Mather.  The question is not  “What were the findings of one particular review?”.  The question in principle is “What does the totality of the literature say?”, or more formally “What were the findings of the largest, most comprehensive and most recent meta-analyses of the topic”.  Moreover one again notes that Wodak and Mather have reported only a fraction of the information required to form an evaluation.  How many of the patients involved in these un-sourced trials had to discontinue their trial medication because of toxicity?  How many were lost to follow up?  And particularly in how many patients who had not been previously exposed to smoked cannabis and who had been provided with access to all the usually recommended treatment options – was cannabis found to be the best therapy?  Wodak and Mather’s un-referenced material does not even consider these pivotal questions, much less provide the parliament with the sorely needed information to address them.

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6 http://www.epilepsy.org.au/living-with-epilepsy/lifestyle-issues/alcohol-and-drugs

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9. The fifth answer on page 2 realting to the alleged medical indications for cannabis is also highly suspect.  Let us review these conditions individually.

1) Nausea and vomiting with cancer chemotherapy can generally be controlled adequately with current methods.  The drugs most commonly used and often effective are prochlorperazine and metaclopramide.  Chief amongst the newer agents is the 5HT3 7 antagonists such as ondansetron, tropisetron and dolasetron, some of which can also be given as a sub-lingual wafer or by subcutaneous, intramuscular, or intravenous injection if needed so that vomiting itself does not preclude their administration.  Similarly prochlorperazine can be given by suppository.  These medications can all be given by many routes of administration.  Other medications can also be used including steroids where required.

2) Pain clinics have numerous ingenious ways to control pain.  Pain can also be induced by cannabis withdrawal, and cannabis use itself has been shown to be linked with chronic back pain, so beware the pain presenting in the cannabis addicted patient / advocate.  Nevertheless Wodak and Mather are correct that many patients are left in difficult situations by their chronic non-cancer pain.  This is an active area of research internationally, and one to which Australian researchers, particularly at the University of Adelaide, are making major contributions.  The recent demonstration that inflammatory activity in the brain and nerves is associated with pain generation and pain perceptual mechanisms has opened major investigative pathways for the development of several exciting new agents.  This is a project upon which some of the top medicinal chemists in the world are actively engaged, some of whom work intramurally at the NIH and NIDA 8 itself.  One notes in passing that Wodak and Mather have neglected to observe that D-naltrexone and D-naloxone show special promise for this application.

3) AIDS wasting – As noted by Wodak and Mather this indication is disappearing due to the efficacy of the newer treatments for AIDS.

4) There are other treatments for MS stiffness.  In particular recent advances in immunology have meant that the treatment of MS itself has dramatically improved in recent times with several newer options including teriflunomide, dimethyl fumarate, fingolomod and dalfampridine.  Benzodiazepines, Lioresal, several anticonvulsants and local Botox can all find application when spasm is a problem.

10. The sixth answer on page 2 is also erroneous.  Wodak and Mather claim that cannabis is not a cure for any described medical condition.  Cannabis dependence and withdrawal is a well described medical condition acknowledged both in DSM-IV and DSM-V 9 of the APA 10.  Administration of cannabis to patients in such states will produce a short term relief of symptoms, albeit with an exacerbation of its many long term toxic effects, oncogenicity, and gateway effects in other drug use, and likely damage to adolescent brain development 1-2.  There is no intention in making this point to be humorous.  This is very important because it is clear that many of the patients who are brought along to parliamentary enquiries, and who offer public testimony of the wonderful effects of cannabis are actually speaking from a background of pre-existing cannabis dependency and addiction.  Lawmakers need to keep this key issue always in the forefront of their minds.  As correctly identified by Dr Volkow, cannabis can cause many illnesses so the claim that cannabis relives a pain in whose aetiology cannabis was implicated, must be viewed with substantial circumspection by those charged with responsible decision making in our community.  Lawmakers should note that these disorders include chronic back pain 2.

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7 5HT is the standard medical abbreviation for serotonin.  This refers to the 5HT-3 ligand – receptor pair. 8 National Institute of Drug Abuse 9 Diagnostic and Statistical Manual IV and V respectively. 10 American Psychiatric Association

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11. The purported answer of Wodak and Mather to the issue of cannabis related toxicity given as answer 1 on page 3 is not only erroneous but dangerous.  It is misleading and confusing.  Of course one can form an impression of the possible early toxicity of high level cannabis exposure by studying low level recreational exposure.

12. In addressing the subject of cannabis toxicity their answer actually acknowledges none of the key salient points made by Dr Nora Volkow in her leading article in the New England Journal of Medicine on June 4th 2014.  The interested reader is referred there for more information, and to Hon. Rev. Fred Nile’s speech introducing the subject to the Legislative Council of NSW. In particular, compared with the eminent work of Volkow and colleagues, Wodak and Mather overlook:

1) Known psychiatric toxicity – schizophrenia, anxiety, depression, bipolar disorder;

2) Effects as a gateway agent to other and hard drug use;

3) Damage to brain development particularly when exposure occurs in key developmental stages such as pregnancy, childhood and adolescence

4) Damage to attention, intellect, cognition, memory

5) Damage to long term lifetime trajectories including ability to form stable relationships and to gain useful employment;

6) Respiratory toxicity including chronic bronchitis and emphysema-like changes;

7) Driving related toxicity including fatal car crash, both alone and in combination with alcohol;

8) Cardiovascular diseases including stroke, and heart attack and transient ischaemic attacks;

9) Immunosuppressive actions particularly when given to AIDS patients, and especially when taken by the smoked route;

10) Real concern in many studies about the connections of cannabis to cancer.

13. Moreover as Dr Volkow astutely observes many of these old cannabis studies were done when the THC concentration of cannabis was 3%.  So the studies which found no ill effects in the 1970’s – 1990’s are likely out of date at this time.  Dr Volkow has noted that THC concentrations of cannabis are now reported in the USA commonly at 12%.  Indeed one cannabis shop is said to be opening in Colorado reporting a choice for patrons from 17% – 20% THC in its product!

14. Wodak’s answer in relation to side effects also reverses the true state of affairs.  Clinical reports of cannabis use cite a very high rate of unacceptable side effects, which frequently precludes is clinical application.  Such very elevated rates of discontinuation (often around 30-50%) of cannabis based treatments are rare with other treatments in the conditions under discussion.

15. The risks of mental side effects from cannabis are not distant and remote as Wodak and Mather claim.  Cannabis intoxication, dependence and tolerance in patients exposed to high levels of it – albeit for therapeutic purposes – are common, and

entail anxiety, paranoia, forgetfulness and depression, and at times psychotic disturbances and hallucinations as being not unusual.

16. The second answer on page 3 is misleading. There is extreme concern in the US now, and numerous on the ground reports that cannabis use in states permitting cannabis use has increased dramatically.  California tabled its first cannabis BILLIONAIRE in 2013.  Does anybody seriously believe that that is because nobody is buying his products??

17. It was estimated recently by official sources that Colorado will consume 130 tonnes of cannabis annually 11.  Selling at $220 per ounce 12 and with 35,274 ounces per tonne, this translates to $7,760,280 / tonne or $1,008,836,400 for the whole crop in that state alone.  Unfortunately, whilst tax revenues were cited as a major reason for legalization in Colorado, the simple expedient of not buying it from one of the state’s three registered recreational cannabis dispensaries which were more expensive than the medical pot shops, allowed taxation to be circumvented 13.  It is important to note that 67% of all the cannabis sold was used by the 22% of heaviest users, further confirming the addictive nature of the legally available weed 14.

18. The trade was also encouraging cannabis tourists to flow into the state, just as had happened in the Netherlands 15.  Indeed one court has ruled that the Dutch coffee shops be compensated for the reduction in their trade consequent upon a tightening of the laws which have now been put in place to restrict such cannabis tourism 16.

19. The US reviews cannabis consumption in numerous states.  The CDC have just published national figures however the data from two key states was not available.  The sample from Colorado was unusable, and Washington state did not participate in the survey at all 17.  In other words if official figures fail to show increased use in the states legalizing cannabis that is likely a direct product of the “Don’t’ ask, Don’t tell”  policy applied to addiction epidemiology by CDC.

20. The third answer on page 3 is also incorrect as judged by Dr Volkow’s article.  Even the baseline risk of cannabis addiction is high at 9%, particularly given that up to 40% of the community have been exposed to cannabis.  As Dr Volkow points out the addiction rate can rise up to as high as 50% in many groups.  If as is widely suggested cannabis is legalized, then heavily cannabis addicted patients will become much more commonplace.

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11 Silva R “Colorado marijuana market consumes estimated 130 tonnes of the drug annually.”  HNGN 12th July 2014.   http://www.hngn.com/articles/35958/20140711/colorado-marijuana-market-consumes-estimated-130-tonnes-of-the-drug-annually.htm  Viewed 13th July 2014. 12 Wyatt C., “Colorado Completed First Legal Pot Study.”  Associated Press.    http://hosted.ap.org/dynamic/stories/U/US_RETHINKING_POT_DEMAND?SITE=AP&SECTION=HOME&TEMPLATE=DEFAULT   Viewed 13th July 2014. 13 Wyatt C., “Colorado Completed First Legal Pot Study.”  Associated Press.    http://hosted.ap.org/dynamic/stories/U/US_RETHINKING_POT_DEMAND?SITE=AP&SECTION=HOME&TEMPLATE=DEFAULT  Viewed 13th July 2014. 14 Light M.L., Orens A.;, Lewandowski B., Pickton T.  “Market size and demand for marijuana in Colorado.” Prepared for Colorado Dept of Revenue.   http://www.colorado.gov/cs/Satellite?blobcol=urldata&blobheadername1=Content-Disposition&blobheadername2=Content-Type&blobheadervalue1=inline;+filename%3D”Market+Size+and+Demand+Study,+July+9,+2014.pdf”&blobheadervalue2=application/pdf&blobkey=id&blobtable=MungoBlobs&blobwhere=1252008574534&ssbinary=true  Viewed 13th July 2014. 15 Rodriguez C., “Marijuana for tourists, discord for the Netherlands.”  Forbes magazine 24th September 2013. http://www.forbes.com/sites/ceciliarodriguez/2013/09/24/weed-ghettos-for-tourists-anger-netherlands-neighbors/   Viewed 13th July 2014. 16 Kooren M, “Dutch Cannabis coffee shops to be compensated over tourist laws.” Reuters.  http://rt.com/business/shops-dutch-coffee-cannabis-303/   Viewed 13th July 2014. 17 CDC MMWR – Youth Risk Behaviour Surveillance – United States , 2013.  http://www.cdc.gov/mmwr/pdf/ss/ss6304.pdf   Viewed 13th July 2014.

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21. The fourth answer on page 3 is also misleading.  If one speaks with unbiased and independent respiratory physicians who treat asthma, ophthalmologists who treat glaucoma, neurologists who treat epilepsy, and pain physicians who treat pain, one hears the same refrain repeated over and over again that cannabis is not required as a treatment.  The treatments of today are in general more than sufficient for the clinical requirements.

22. The fifth answer on page 3 is strangely at variance with every drug regulatory agency in the world.  Oddly, Wodak and Mather seem to recommend the smoked route in direct contrast to every other medicinal chemist and regulatory agency the world over.  One can only wonder if this does not reveal their personal bias.

23. Australia is a signatory to the international narcotic conventions particularly the Single convention 1961.  Legalization would entail a major change in Australian society and Australian Law to allow legal cannabis.  We would be in breach of our international treaty obligations.  Amongst other things, these treaties allow us to participate in international policing operations to help to break up global drug running gangs, and to cooperate with law enforcement across national boundaries on many issues.

24. There is no question that Australia’s use of its presently legal drugs, tobacco and alcohol is responsible for an enormous public health burden.  Adding cannabis to this situation, when – paradoxically – Wodak has been one of the loudest voices opposing alcohol- and tobacco- related harms – would clearly compound this situation.  Moreover because of the well established gateway effect of cannabis, allowing cannabis would increase the use of the other illegal drugs.  Hence this change would signal Australia’s degeneration into an increasingly drug taking-culture.  We would become less employed and less employable; that is our welfare bill will inevitably rise. The rate of congenital abnormalities would rise so children would be borne with lifelong disabilities including mental retardation.  The rate of chronic disease in the community, including chronic back pain, would rise.  In other words legalizing cannabis will increase our physical and mental health bill and our long term welfare dependency bill, at the same time as reducing our taxation base and national income generating capacity.  This is an impossible cost squeeze and social dysfunction squeeze for any Government.

25. The fifth answer on page 3 relating to restricted use of cannabis is invalid.  Wodak and Mather claim that one could nevertheless restrict cannabis use if it was allowed medicinally by analogy with morphine, cocaine, amphetamine and ketamine.  40% of our population has not been exposed to these agents.  Moreover this is not the pattern which has been seen recently as medicinal cannabis is the all too obvious leading edge of cannabis decriminalization around the world.  One notes the very reverse of this in the Dutch experience alluded to above.

26. The sixth answer on Page 3 is also suspect.  Wodak and Mather have neglected to mention that  cannabis is the drug most frequently implicated in car crashes after alcohol, and the most frequently implicated of all the illicit drugs in motor vehicle crashes.  Legalizing it and increasing its use would obviously exacerbate this by an amount at least proportional to the amount of its increased use.

27. Moreover as the authors correctly observe alcohol is already legal, so that legalizing cannabis effectively legalizes the highly dangerous cannabis–alcohol cocktail.  This

has been shown to be very dangerous in many studies, as is acknowledged by the present authors.

28. Wodak claims that many Australians take cannabis medicinally at present.  He has not stated how many of these were previously habituated to cannabis.  He does not say how many of these are taking it for cannabis-induced diseases.  He does not give data on the overall physical or mental health of cannabis smokers, prior to the commencement of their supposed serious illness.

29. The other chestnut which Dr Wodak frequently mentions, although it is absent from the present paper, is that alcohol and tobacco are related to far more ill-health in the Australian community than cannabis.  In a simple quantitative sense it may or may not be correct.  In either event it is an appalling argument in that it fails to correct for the very different exposure patterns of the different agents.  The more frequent use of tobacco and alcohol in our community is directly related to their differing legal status.  Both the numbers consuming tobacco and alcohol and the relative amounts consumed, are greater for the legal drugs than any of the illegal drugs, precisely because of their legal status.  So whilst Wodak and colleagues frequently use this argument to ridicule genuine medical concerns in relation to the illicit drugs, in fact it is a potent argument in favour of retention of the present status quo, and the illicit status of the presently proscribed agents including cannabis.  Given what has now been established by medical researchers in relation to cannabis-induced toxicity it presumes far too much to suppose that cannabis is any less toxic than our presently legal intoxicants.  No reputable scientist who is unbiased and familiar with the published research in this area would support this liberalist position.

30. In fact detailed examination of communities where cannabis consumption is normative, such as the northern rivers district of NSW including the Nimbin-Mullumbimby area, show that the area is shockingly affected by unduly elevated rates of depression, suicide, murder, unemployment, family breakdown rates, poverty and general unhappiness 18, despite its being situated in some of the most fertile and productive rural landscapes in the country.  Given what is now known of the medical effects of cannabis, much of this social disadvantage and community repression which is reflected on every metric, can likely be related directly or indirectly to the known high cannabis consumption rate in the area, and the apparently legally protected status of the region’s not insignificant cannabis crop.

General Remarks

31. Overall one is left with the impression that the work that has been produced by Wodak and Mather is a thoroughly activist piece.  This document distorts and mishandles the truth at most points.  In short it is a document such as might be expected from Australia’s leading drug advocate.  In that sense it is highly predictable.

32. That it purports to be a reputable and scientifically reliable source of information for lawmakers is appalling.  It is neither scientific nor reliable.  In a scientific sense it is nothing less than a national scandal.  It is not so much a scurrilous abuse of scientific process and current evidence in regard to both the basic science of pathophysiology and applied clinical therapeutics, as a mockery, a debasement, and a frank abuse of science and medical data.

33. Given that Dr Alex Wodak appears to position himself as one of Australia’s leading national figures advising the nation on addictive drugs, the conclusion becomes inescapable that Australia has been ill-advised on illicit drug policy by this self-confessed drugs legalization activist, and that our policies in this area are therefore likely misinformed, ill-conceived and / or ill-constructed.

34. Given that the activist position adopted by Dr Wodak, speaking in the name of Science, is clearly at major variance with the contemporaneous pronouncement of acknowledged world leaders, sufficient evidence exists for a formal motion of censure against Dr. Wodak from this house for attempting to mislead the Legislative Council of NSW.

References

1. Volkow ND, Baler RD, Compton WM, Weiss SR. Adverse health effects of marijuana use. N Engl J Med 2014;370(23):2219-27.

2. Reece AS. Chronic toxicology of cannabis. Clin Toxicol (Phila) 2009;47(6):517-24.

California cannabis growers may be making millions, but their thirsty plants are sucking up a priceless resource: water. Now scientists say that if no action is taken in the drought-wracked state, the consequences for fisheries and wildlife will be dire.

“If this activity continues on the trajectory it’s on, we’re looking at potentially streams going dry, streams that harbor endangered fish species like salmon, steelhead,” said Scott Bauer of the California Department of Fish

Studying aerial photographs of four watersheds within northern California’s so-called Emerald Triangle, Bauer found that the area under marijuana cultivationdoubled between 2009 and 2012. It continues to grow, with increasing environmental consequences.

Bauer presented data to CNBC indicating that growers are drawing more than 156,000 gallons of water from a single tributary of the Eel River, in Mendocino County, every day.

The average marijuana plant needs about 6 gallons of water a day, depending on its size and whether it’s grown inside or outside, according to a local report that cited research. Pot growers object to that number, saying that the actual water use of a pot plant is much less.

Although the marijuana business has helped revive the local economy, residents may now be feeling the effects of living alongside growers. And, as growers—some legal, some not—face a severe drought, local law enforcement officers expect the fight over natural resources to intensify.

“I never want to see crime increase, but I have a feeling it will, because of the commodities that are up here,” said Humboldt County Sheriff Mike Downey. “When we get to the end of the grow season, which is August and September, the need for enhanced water availability is gonna be there, and I don’t think the water’s going to be there, so you’re going to see people, I believe, having some conflict over water rights.”

Stream water rules in California are the same for growers of marijuana as they are for growers of any crop: Growers should divert no more than 10 percent of a stream’s flow, and they should halt diversion altogether during late summer, when fish are most vulnerable to low water levels. But Bauer pointed out that those rules apply to permit holders, and most marijuana growers haven’t bothered to get permits.

With so much of California’s cannabis business operating in the more lucrative underground market, and with so many growers across the region, the California Department of Fish and Wildlife and the Humboldt County Sheriff’s office say they lack the resources to take action against all offenders. So they target the most egregious.

“We get those calls daily. People are upset. Somebody has dried up a stream, somebody is building a road across sensitive fish and wildlife habitat, so that is happening on a daily basis,” Bauer said. “And we do our best with the personnel we have to respond to those calls.” Sheriff Downey concurred with Bauer about the manpower challenge authorities face.

“We have a very active marijuana unit that is out there, especially during the grow season. But we have so many grows here that we have a hard time keeping up or making a valiant dent in the marijuana growing in the county,” said Downey.

“With the increase in water usage and pressure upon that, that lucrative business becomes even more lucrative because the price of the marijuana, the value of it, goes up even though we’ve had a glut on the market the last few years,” he added.

One increasingly popular solution among some growers is the collection of rain water during the wetter, winter months that they can use to water crops during the dry, summer season.

“As long as cannabis farms remain small and decentralized, there’s no reason why we can’t grow everything we need to meet the state’s demands using all stored rain water,” says Hezekiah Allen, an environmental consultant and director of public affairs for the Emerald Growers Association.

And for some, it’s a business opportunity.   “I’ve heard people shut down their grow operations, bought water trucks and have changed from growing to supplying waters to the other growers,” said Chip Perry, a consultant for MC2, a service that helps people obtain medical marijuana cards.

Source:  nbcnews.com  July 7th 2014

President Obama visited Denver this week, was offered marijuana, and laughed.  His administration made possible the open marketing and use of marijuana in Colorado and Washington state by directing that federal law not be enforced. The president is joined by Hillary Clinton and Rand Paul in supporting marijuana legalization. As Clinton recently told CNN, “On recreational marijuana, states are the laboratories of democracy. We (are) experimenting with that right now. I want to wait and see what the evidence is.”

There is no indication that Obama is really paying attention to what he has done in Colorado. During our recent visit to the state we found no one is measuring this “experiment” at all. Even more troubling, if this were truly an experiment, the impact of this “laboratory” is on human subjects, many of whom—Colorado adolescents, communities in neighboring states—were hardly approached for “informed consent.”  Nor did citizens we talked to vote for what they see happening to them now.

To get the ballot amendment passed, promises were made to the residents of Colorado. The marijuana market would be tightly monitored, and strictly regulated, “from seed to sale.” There were assurances of no underage youth involvement, no blatant advertising to kids, no interstate trafficking, or black-market criminal cartels running operations. All transactions would be regulated, controlled, and assessed.

But none of that “assessing” is actually happening. And as we learned from a first-hand visit to Colorado this month, there is ample, clear, and disturbing evidence that each of those promised conditions is being violated, with impunity.

We learned that legalization has encouraged soaring levels of potency as new forms of the drug have appeared in edible candies, butane-extracted cannabis oils, in vaporizers used at school desks, undetected. The impact on society? Nobody knows, as nobody is measuring.

Are the underage getting the drug in greater numbers? One public school administrator told us that he is attending increasing numbers of private, disciplinary hearings for twelve-year olds who are daily marijuana users. Denver is awash with marijuana that is advertised as having a potency of three times or more the national average—which is already almost three times stronger today than it was in days of Woodstock. Potent, cheap THC gummy bears with hallucinogenic effects are advertised in newspapers, featuring cartoon characters such as Fred Flintstone.

On our visit we met with community leaders, educators, law enforcement personnel, and researchers at the University of Colorado medical center. They are the ones assembling the evidence from the front lines, from schools, hospitals, burn centers, and treatment facilities. A portrait is emerging of considerable, and rising, damage. And yet no comprehensive study is

being undertaken. No surveillance, evaluation, or even plotting a trajectory against a prior baseline.

Governor Hickenlooper’s office intends to conduct a “gap analysis,” trying to determine what information is missing in order to conduct a proper study, and whether there are data sufficient to learn anything. But aren’t these steps one takes before you plunge? As one parent put it, “you don’t want to have the only experiment be your own son.” People said that the state was “hurtling forward, with no one driving.” Meanwhile, legalization advocates are already proclaiming that all is well.

The black market thrives. According to the director of the Rocky Mountain trafficking center, “By legalizing marijuana in Colorado, we have become the black market for about 40 other states that we can document. So instead of eliminating it, we have become it. We are also the black market for those under twenty-one.”

Is any of this really unexpected? Dr. Francis Collins, head of the National Institutes of Health, was recently asked about legalization by USA Today. He warned, “We don’t know a lot about the things we wish we did.” Risks of IQ loss?  “Perhaps it would be better if, before we plunged into (legalization) there was a little bit more recognition of that particular consequence.” Increased cancer risk? “We don’t know. Nobody’s done that study.”

Advocates rushed right over these gaping holes in our knowledge. Profits beckoned, and surely tax revenue. Well, actually, tax revenues are well below those promised, but the profits—and the costs—are real.

What we saw in Colorado has the markings—the steeply rising curve—of a drug use epidemic. Epidemics subside, but after the outbreak, the populace often settles into a new normal, at higher levels of the disease. The damage is difficult to reverse, and of those caught in the outbreak, not all return. Are other states going to follow this leap?

If the president believes that there is some important medical and societal “experiment” going on with legal marijuana, he is simply not paying attention. The evidence to date is stunning. It is time to stop pretending otherwise.

Source:  http://www.weeklystandard.com July 10, 2014

(CNN) — This week, Washington state opened marijuana stores for the first time. And these stores don’t just carry your father’s kind of weed. In addition to highly potent cigarettes — which are much stronger than those some people might remember from Woodstock — stores are also selling super-strength, pot-infused cookies, candies, sodas, vapor and wax concentrates.

Time will tell what the effects will be, but the state is not the first place to implement such a policy. Colorado started to sell marijuana six months ago. When President Barack Obama stopped by a Denver bar on Tuesday night, it comes as no surprise that someone offered him weed.  Colorado’s experience with pot legalization can hardly be called a success. In fact, it should be considered a warning for the residents of Washington.

Special-interest “Big Tobacco”-like groups and businesses have ensured that marijuana is widely promoted, advertised and commercialized in Colorado. As a result, calls to poison centers have skyrocketed, incidents involving kids going to school with marijuana candy and vaporizers seem more common, and explosions involving butane hash oil extraction have risen. Employers are reporting more workplace incidents involving marijuana use, and deaths have been attributed to ingesting marijuana cookies and food items.  So much for the old notion that “pot doesn’t kill.”

Marijuana companies, like their predecessors in the tobacco industry, are determined to keep lining their pockets.

Indeed, legalization has come down to one thing: money. And it’s not money for the government — Colorado has only raised a third of the amount of tax revenue they have projected — it’s money for this new industry and its shareholders.

Open Colorado newspapers and magazines on any given day and you will find pages of marijuana advertisements, coupons and cartoons promoting greater and greater highs. The marijuana industry is making attractive a wide selection of marijuana-related products such as candies, sodas, ice cream and cartoon-themed paraphernalia and vaporizers, which are undoubtedly appealing to children and teens.

As Al Bronstein, medical director of the Rocky Mountain Poison and Drug Center recently said, “We’re seeing hallucinations, they become sick to their stomachs, they throw up, they become dizzy and very anxious.” Bronstein reported that in 2013, there were 126 calls concerning adverse reactions to marijuana. From January to April this year, the center receive 65 calls. And, since Colorado expanded marijuana stores for medical users, peer-reviewed research has found a major upsurge in stoned driving-related deaths (that is not surprising since marijuana intoxication doubles the risk of a car crash).

It is little wonder that every major public health association, including the American Medical Association, the American Academy of Child and Adolescent Psychiatry and the American Society of Addiction Medicine oppose the legalization of marijuana.

The scientific verdict is that marijuana can be addictive and dangerous.

Despite denials by special interest groups and marijuana businesses, the drug’s addictiveness is not debatable: 1 in 6 kids who ever try marijuana will become addicted to the drug, according to the National Institutes of Health. Many baby boomers have a hard time understanding this simply because today’s marijuana can be so much stronger than the marijuana of the past.

In fact, more than 450,000 incidents of emergency room admissions related to marijuana occur every year, and heavy marijuana use in adolescence is connected to an 8-point reduction of IQ later in life, irrespective of alcohol use. As if our national mental illness crisis needed more fuel, marijuana users also have a six times higher risk of schizophrenia and are significantly more likely to development other psychotic illnesses. It is no wonder that health groups such as the National Alliance of Mental Illness are increasingly concerned about marijuana use and legalization. That does not mean we need to arrest our way out of a marijuana problem.

We should reform criminal justice practices and emphasize prevention, early intervention and treatment when necessary. But we do not need to legalize — and thus commercialize and advertise — marijuana to implement these reforms.

The only people better off under legalization are the big companies that stand to profit from sales of marijuana. And we can be sure they will get even richer while public health and safety suffers.

Source: edition.cnn.com  July 10th 2014

Steroid use in Britain’s gyms is growing so fast, dirty needles are being disposed of in fitness centre sharps bins. The explosion in the popularity of potentially lethal muscle-building drugs has led to hundreds of thousands taking jabs. Their numbers now outstrip drug addicts who inject themselves with heroin in the UK, a Sunday Mirror investigation reveals.  Our findings today confirm rising fears among drug charities and health experts that use of anabolic steroids – which mimic the effects of male hormone testosterone – is spiralling out of control. We discovered HIV infection among steroid injectors has risen to the same level found in heroin users – 1.5 per cent.

At one needle exchange in Warrington staff told us 90 PER CENT of the syringes they see have been used for steroids compared to only 10 per cent for heroin. Another exchange said children as young as 15 were using the drugs.

Anabolics can become addictive and lead to heart attacks, strokes and a higher chance of liver and prostate cancer as well as psychological problems. Killer Raoul Moat was on them when he shot three people in two days in 2010.

They are all too easily available online. But it is the tolerance of the growing problem by gyms around the country that is most worrying.

A shocked fitness fan who spotted one of the “sharps” bins containing used needles at a Virgin Active health club in London told us: “I couldn’t believe my eyes. “It’s one of the poshest gyms I’ve been in, £100 a month, and the bins were sitting right there in the toilets. It’s the first time I’ve seen that. I had a look and there were loads of needles and swabs.”

Easygym say they have the bins in their clubs for “safety reasons” and there are plans in place to introduce them in Dragon’s Den star Duncan Bannatyne’s 61 health clubs. Anytime Fitness is considering whether to introduce them.  The clubs are following recommendations from health watchdog NICE – but nowhere near far enough.

NICE is concerned that gym users will share needles and spread HIV and Hepatitis B and C. It asked gyms not just to provide sharps bins but also sterile syringes for its members. None of the gyms we spoke to said they did this.

But the watchdog’s policy of accepting steroid use and the gyms’ adherence to that was yesterday blasted by tragic mum Tina Dear, whose Royal Marine son Matthew, 17, died just weeks after he started using steroids to bulk up. He is throught to have had a severe reaction sending his body into shock.

Tina, of Southend, Essex, said: “Needles bins in gyms normalise steroid use. People will go into changing rooms, see the gym has provided a bin and naturally presume steroids are safe.

“They’ll think it’s OK. But it’s not. It’s Russian Roulette. People don’t know what they’re taking. Gyms should be practising zero tolerance, especially when it comes to youngsters who look up to the older guys. They need positive role models.”

Jim McVeigh is acting director at the Centre for Public Health at Liverpool John Moores University and Britain’s leading expert in the misuse of anabolic steroids.  He said the official figure of 70,000 steroid users in the UK was wrong. He warned: “It’s safe to say there are hundreds of thousands of steroid users in this country, more than heroin injectors.”

Needle exchanges – first set up in the wake of the AIDS crisis – confirm what he believes. One in Yorkshire, run by drug and alcohol charity Crime Reduction Initiatives (CRI), deals with 70 per cent steroid users compared to 30 per cent heroin.

And the problem is affecting younger and younger people.   David Rourke from CRI’s Sheffield needle and syringe programme said he’s heard of children as young as 15 using steroids. He said: “We deal with guys over 18, but elsewhere I know of much younger kids.”

He believes the bins are a good idea. He said: “I have heard of gyms where used needles are shoved up into ceiling tiles. A safe alternative can’t be a bad thing.” Steroids are legal for personal use, but Jim McVeigh warned that is no indication they are safe. He said: “The fact is, users are taking a big risk. Often they don’t have a clue what they’re taking.

“These are people who wouldn’t buy a hotdog off the street, but they’ll take drugs off a stranger on the internet and inject themselves. There have been no long-term clinical tests on these substances, and most users take a cocktail of anything up to 12. They are playing with fire. We have no idea what long term health effects will be.”

Researchers from Public Health England and Liverpool John Moores University last year surveyed 395 men who used steroids and other performance enhancing drugs. As well as the one in 65 found to have HIV, the study also found one in 18 had been exposed to Hepatitis C and one in 11 had been to Hepatitis B.

While dealing steroids person to person is illegal, buying them online is easy. A simple Google search presents dozens of outlets offering the drugs. Gyms who have installed the bins yesterday defended their use.

Virgin Active said: “Sharp boxes are installed for practical and safety purposes for those with medical conditions, or needing to dispose of razors. Their presence in no way condones the use of steroids in our clubs.” Any illegal steroid activity is reported to the police, the spokesman added.

Easygym said: “Steroid use is not something we encourage or promote. For Health and Safety reasons only we provide a sharps bins for needles and razor blades. Bannatyne Health Clubs said: “The 61 health clubs will all have sharps boxes shortly.”

Anytime Fitness added: “We are currently looking at a sharps policy.” Professor Mike Kelly, Director of the NICE Centre for Public Health said: “Research shows people who inject these drugs are at an increased risk of blood-borne viruses including hepatitis.

“Needle and syringe programmes aim to stop people sharing potentially contaminated injecting equipment. Delivering these programmes in gyms is an important way to protect people.”  But mum Tina, still grieving her lost son, said: “Gyms should be pushing education as their first priority instead of putting bins in their toilets.” * For more advice visit cri.org.uk and matthewdearfoundation.co.uk

Drug is a fuel for violent crime

Men on steroids are twice as likely to be involved in violence and carry weapons, say US studies.  Scientists have linked steroid use to mood swings, paranoid jealousy, extreme irritabililty and impaired judgement. Anabolics addict Raoul Moat shot his ex-girlfriend Samantha Stobbart, her new partner Chris Brown and blinded PC David Rathband after blasting him in the face in 2010.  In a letter to police, Moat, 37, described his anger saying: “It’s like the Hulk. It takes over and it’s more than anger and it happens when I’m hurt.”

Ex-US Marine David Bieber, who shot dead PC Ian Broadhurst in Leeds in 2003, was also pumped up on steroids. His father blamed the drugs for his 48-year-old son’s descent into a life of violence and crime.  And 35-year-old Norwegian mass murderer Anders Breivik, who killed 77 people in a bombing and shooting rampage in July 2011, was a heavy steroid user too.

Serious health risks for users Anabolic steroid users take enormous risks to boost the size of their muscles.  But it’s not only serious medical conditions – from high blood pressure to liver, kidney and prostate cancer – they could trigger.

Taking the drugs can also can lead to a reduced sperm count, infertility, shrunken testicles and baldness in men. It can also cause severe acne.  In women, steroid use can increase facial and bodily hair growth, deepen the voice and cause problems with periods.  And some of the darker side effects are psychological, such as aggressive behaviour, mood swings, manic behaviour and even hallucinations.

Source: http://www.mirror.co.uk/news/uk-news/sunday-mirror-investigation-reveals-shocking-3816366#ixzz36tr76b7s 

Our children are surrounded by books, magazines, fashion, television, movies, music and the ever present celebrities who extoll the virtues of pot. These factors, combined with the business of Big Marijuana, and pro-pot lobbying organizations that spend millions to sell the idea of surrendering to the drug culture, are undoing decades of drug education work in America – all while the federal government (and many states) turn a blind eye to the social, economic and legal chaos being inflicted upon us.

In a new study, published in the Journal of Medical Internet Research, new evidence has emerged regarding the prevalence of pro-pot messages through Twitter and other social media outlets.

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Youth regularly receive pro-marijuana tweets

Hundreds of thousands of American youth are following marijuana-related Twitter accounts and getting pro-pot messages several times each day, researchers at Washington University School of Medicine in St. Louis have found.

The tweets are cause for concern, they said, because young people are thought to be especially responsive to social media influences. In addition, patterns of drug use tend to be established in a person’s late teens and early 20s.

In a study published online June 27 in the Journal of Medical Internet Research, the Washington University team analyzed messages tweeted from May 1 through Dec. 31, 2013, by a Twitter account called Weed Tweets@stillblazintho. Among pro-marijuana accounts, this one was selected because it has the most Twitter followers — about 1 million. During the eight-month study period, the account posted an average of 11 tweets per day.

“As people are becoming more accepting of marijuana use and two states have legalized the drug for recreational use, it is important to remember that it remains a dangerous drug of abuse,” said principal investigator Patricia A. Cavazos-Rehg, PhD. “I’ve been studying what is influencing attitudes to change dramatically and where people may be getting messages about marijuana that are leading them to believe the drug is not hazardous.”

Although 19 states now allow marijuana use for medical purposes, much of the evidence for its effectiveness remains anecdotal. Even as Americans are relaxing their attitudes about marijuana, in 2011 marijuana contributed to more than 455,000 emergency room visits in the United States, federal research shows. Some 13 percent of those patients were ages 12 to 17.

A majority of Americans favor legalizing recreational use of the drug, and 60 percent of high school seniors report they don’t believe regular marijuana use is harmful. A recent report from the U.N. Office on Drugs and Crime said that more Americans are using cannabis as their perception of the health risk declines. The report stated that for youth and young adults, “more permissive cannabis regulations correlate with decreases in the perceived risk of use.”

Cavazos-Rehg said Twitter also is influencing young people’s attitudes about the drug. Studying Weed Tweets, the team counted 2,285 tweets during the eight-month study. Of those, 82 percent were positive about the drug, 18 percent were either neutral or did not focus on marijuana, and 0.3 percent expressed negative attitudes about it.

Many of the tweets were meant to be humorous. Others implied that marijuana helps a person feel good or relax, and some mentioned different ways to get high.     With the help of a data analysis firm, the investigators found that of those receiving the tweets, 73 percent were under 19. Fifty-four percent were 17 to 19 years old, and almost 20 percent were 16 or younger. About 22 percent were 20 to 24 years of age. Only 5 percent of the followers were 25 or older.

“These are risky ages when young people often begin experimentation with drugs,” explained Cavazos-Rehg, an assistant professor of psychiatry. “It’s an age when people are impressionable and when substance-use behaviors can transition into addiction. In other words, it’s a very risky time of life for people to be receiving messages like these.”

Cavazos-Rehg said it isn’t possible from this study to “connect the dots” between positive marijuana tweets and actual drug use, but she cites previous research linking substance use to messages from television and billboards. She suggested this also may apply to social media.

“Studies looking at media messages on traditional outlets like television, radio, billboards and magazines have shown that media messages can influence substance use and attitudes about substance use,” she said. “It’s likely a young person’s attitudes and behaviors may be influenced when he or she is receiving daily, ongoing messages of this sort.”

The researchers also learned that the Twitter account they tracked reached a high number of African-Americans and Hispanics compared with Caucasians. Almost 43 percent were African-American, and nearly 12 percent were Hispanic. In fact, among Hispanics, Weed Tweets ranked in the top 30 percent of all Twitter accounts followed.

“It was surprising to see that members of these minority groups were so much more likely than Caucasians to be receiving these messages,” Cavazos-Rehg said, adding that there is particular concern about African-Americans because their rates of marijuana abuse and dependence are about twice as high as the rate in Caucasians and Hispanics. The findings point to the need for a discussion about the pro-drug messages young people receive, Cavazos-Rehg said.

“There are celebrities who tweet to hundreds of thousands of followers, and it turns out a Twitter handle that promotes substance use can be equally popular,” she said. “Because there’s not much regulation of social media platforms, that could lead to potentially harmful messages being distributed. Regulating this sort of thing is going to be challenging, but the more we can provide evidence that harmful messages are being received by vulnerable kids, the more likely it is we can have a discussion about the types of regulation that might be appropriate.”

This study was funded by the National Center for Research Resources (NCRR), the National Institute on Drug Abuse (NIDA) and the NIH Roadmap for Medical Research of the National Institutes of Health (NIH).

Source: http://www.sciencedaily.com/releases/2014/06/140627133057.htm?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+sciencedaily%2Fmind_brain%2Fmarijuana+%28Marijuana+News+–+ScienceDaily%29

The most recent version of this article was published on 2014-02-22

Cannabis use is associated with working memory (WM) impairments; however, the relationship between cannabis use and WM neural circuitry is unclear. We examined whether a cannabis use disorder (CUD) was associated with differences in brain morphology between control subjects with and without a CUD and between schizophrenia subjects with and without a CUD, and whether these differences related to WM and CUD history. Subjects group-matched on demographics included 44 healthy controls, 10 subjects with a CUD history, 28 schizophrenia subjects with no history of substance use disorders, and 15 schizophrenia subjects with a CUD history. Large-deformation high-dimensional brain mapping with magnetic resonance imaging was used to obtain surface-based representations of the striatum, globus pallidus, and thalamus, compared across groups, and correlated with WM and CUD history. Surface maps were generated to visualize morphological differences. There were significant cannabis-related parametric decreases in WM across groups. Similar cannabis-related shape differences were observed in the striatum, globus pallidus, and thalamus in controls and schizophrenia subjects. Cannabis-related striatal and thalamic shape differences correlated with poorer WM and younger age of CUD onset in both groups. Schizophrenia subjects demonstrated cannabis-related neuroanatomical differences that were consistent and exaggerated compared with cannabis-related differences found in controls. The cross-sectional results suggest that both CUD groups were characterized by WM deficits and subcortical neuroanatomical differences. Future longitudinal studies could help determine whether cannabis use contributes to these observed shape differences or whether they are biomarkers of a vulnerability to the effects of cannabis that predate its misuse.

Source:   http://schizophreniabulletin.oxfordjournals.org/content/early/2013/12/10/schbul.sbt176.

LAS VEGAS — Explosions caused by methamphetamine labs are all but gone from southern Nevada neighborhoods, but a new and similar threat is popping up with greater frequency in homes and apartments all over the Las Vegas valley.  Changing attitudes and laws about marijuana have given rise to homemade labs designed to create highly concentrated forms of pot, but making it is dangerous, and not only for the participants.   The end product takes several forms and is known by many names: oil, honey, and wax are a few.

These concentrated forms of marijuana can contain five times as much THC, the active ingredient, as regular weed.  As more people obtain marijuana cards and public attitudes change, more of these bathtub scientists are making their own oil, with disastrous results.  Across social media, kitchen magicians brag about their prowess in turning marijuana into something else, but too often, their experiments end with a bang.   A security camera in Portland watches as people across the street scramble and a home bursts into flames.

Authorities in Colorado report more than 30 oil-related explosions this year, with dozens of injuries, four times as many as all of last year.

Fires and explosions are popping up all over the West as weed warriors experiment with assorted techniques for creating hash oil, honey or the more concentrated bubbling goo known as wax.

“If you can imagine what a bomb would do in your home is exactly what we’re seeing.  It’s complete devastation. The houses in some cases are condemned,” Metro Narcotics Unit Lieutenant Laz Chavez said.

In late May, Lt. Chavez and his team responded to an explosion and fire at an upscale apartment complex on Horizon Ridge Parkway. The sticker on the door indicates it is still sealed off.  Blown-out windows only hint of what the interior is like. The resident was severely burned because of a butane explosion that demolished the apartment.

This middle-class home in Henderson is likewise boarded up and sealed shut. It will likely have to be torn down. The dumpster in front is partly filled with debris that used to be inside; that is until a would-be cook put his batch of wax into the refrigerator to cool.

The already-compressed butane found an electrical spark, and kaboom!  “The next thing you know, it was detonated. It turned the refrigerator into a bomb. The whole house was destroyed,” Lt. Chavez said.

“By the time we get there, it’s a house fire,” Henderson Fire Department Deputy Chief Shawn White said.  Local fire departments, including Henderson, have responded to four hash oil fires so far but expect to see a lot more. Deputy Chief White says the methods used pretty much guarantee that problems will erupt, especially when cooks pump compressed butane into tubes packed with marijuana.

“It’s not safe. If you build up that much vapor in a confined area that finds an ignition source, you’re going to have an explosion,” White said. “When you cook it, you have to do it in a very well ventilated area. I mean, these fumes are pure. I usually do it out in my backyard,” one cook explained in his YouTube video.

Earlier this year, the I-Team observed as two local chefs made a batch of pot oil to help a young girl with cancer. The oil has reportedly held her cancer at bay.

In this exercise, the cooks used alcohol as a stripping agent and were careful about having good ventilation, but as numerous online videos demonstrate, oil makers aren’t exactly meticulous, and more than a few of them do their work while sampling their own product.

“That is the scary part. You have people who believe they are scientists, who believe they can experiment and at the same time, they’re high. They’re under the influence of the drug they are trying to extract, and that’s a recipe for disaster,” Chavez said.  Those who get caught making this stuff can be charged with various crimes, Metro says, including arson or child endangerment, if children are anywhere near it, even those who have medical marijuana cards.  “I don’t think there is anything medicinal about this. We’re going after them,” Chavez said.  Most of the explosions seem to happen in rental properties, meaning, it is tenants not homeowners who are taking these risks.

Metro is considering whether to ask for tweaks to Nevada statutes to specifically exclude the oil or wax process from the medical marijuana exemption.

Source: http://www.8newsnow.com/story/25939339/i-team-pot-oil-explosions-growing-problem-in-las-vegas-valley  July  3rd  2014   By George Knapp, Chief Investigative Reporter 

A new survey finds an estimated 17 percent of American high school students say they drink, smoke or use drugs during the school day. The National Center on Addiction and Substance Abuse (CASA) at Columbia University found 86 percent of teens say they know which of their peers are abusing substances at school, CNN reports.

The findings come from an annual telephone survey of about 1,000 students ages 12 to 17. According to the survey, 60 percent of high school students say drugs are available on school grounds, and 44 percent know a classmate who sells drugs at school. Marijuana is the most commonly sold drug at school. Prescription drugs, cocaine and Ecstasy are also available.

Social media plays a role in peer pressure to use drugs and alcohol, the study found. Three-quarters of students said they are encouraged to use marijuana or alcohol when they see images of their peers doing so. The survey found 45 percent said they have seen photos online of their classmates drinking, using drugs or passing out, up 5 percent since last year.

For the first time in the history of the survey, a majority of private school students—54 percent—said their school was “drug-infected.” In 2011, that figure was 36 percent.

Teens are more likely to use drugs or alcohol if they have been left alone overnight, and are less likely to do so if they regularly attend religious services, the survey found.

“The take away from this survey for parents is to talk to their children and get engaged in their children’s lives,” Emily Feinstein, project director of the teen survey, said in a news release. “They should ask their children what they’re seeing at school and online. It takes a teen to know what’s going on in the teen world, but it takes parents to help their children navigate that world.”

Source:  www.partnership@drugfree.org.  5^th Sept. 2012

Drug decriminalization in Portugal is a failure, despite various reports published recently all over the world saying the opposite.

There is a complete and absurd campaign of manipulation of Portuguese drug policy facts and figures, which some authors appear to have fallen for.

The number of new cases of HIV / AIDS and Hepatitis C in Portugal recorded among drug users is eight times the average found in other member states of the European Union.

“Portugal keeps on being the country with the most cases of injected drug related AIDS (85 new cases per one million of citizens in 2005, while the majority of other EU countries do not exceed 5 cases per

million) and the only one registering a recent increase. 36 more cases per one million of citizens were estimated in 2005 comparatively to 2004, when only 30 were referred ” (EMCDDA – November 2007).

– Since the implementation of decriminalization in Portugal, the number of homicides related to drug use has increased 40%. “Portugal was the only European country to show a significant increase in homicides between 2001 and 2006.” (WDR – World Drug Report, 2009)

“With 219 deaths by drug ‘overdose’ a year, Portugal has one of the worst records, reporting more than one death every two days. Along with Greece, Austria and Finland, Portugal is one of the countries that recorded an increase in drug overdose by over 30% in 2005”. (EMCDDA – November 2007)

The number of deceased individuals that tested positive results for drugs (314) at the Portuguese Institute of Forensic Medicine in 2007 registered a 45% raise climbing fiercely after 2006 (216). This represents the highest numbers since 2001 – roughly one death per day – therefore reinforcing the growth of the drug trend since 2005.

(Portuguese IDT – November 2008)

– “Behind Luxembourg, Portugal is the European country with the highest rate of consistent drug users and IV heroin dependents”. (Portuguese Drug Situation Annual Report, 2006)

– Between 2001 and 2007, drug use increased 4.2%, while the percentage of people who have used drugs (at least once) in life, multiplied from 7.8% to 12%. The following statistics are reported:

• Cannabis:       from 12.4% to 17%
• Cocaine:        from 1.3% to 2.8%
• Heroin:          from 0.7% to 1.1%
• Ecstasy:        from 0.7% to 1.3%.

(Report of Portuguese IDT 2008)

– “There remains a notorious growing consumption of cocaine in Portugal, although not as severe as that which is verifiable in Spain. The increase in consumption of cocaine is extremely problematic.” (Wolfgang Gotz, EMCDDA Director – Lisbon, May 2009)

– “While amphetamines and cocaine consumption rates have doubled in Portugal, cocaine drug seizures have increased sevenfold between 2001 and 2006, the sixth highest in the world”. (WDR – World Drug Report, June 2009)

– “It is difficult to assess trends in intensive cannabis use in Europe, but among the countries that participated in both field trials between 2004 and 2007 (France, Spain, Ireland, Greece, Italy, Netherlands and Portugal), there was an average increase of approximately 20%”. (EMCDDA – November 2008)

The reality of Portuguese drug addiction seems to have been tampered with. The statistical results seem to have been manipulated by institutions controlled by the government.

The problem is serious and deserves consistent answers. The banner of “harm reduction” cannot be an ideology and an end in itself. It is extremely disturbing to promote the correct use of drugs “safely” (sic) integrating consumption into the habits (about 70% of Portuguese addicts scrutinized in the country are not in drug-free programs but in programs that, while called treatments, are actually “replacements” because these “treatments” substitute one drug for another) that is being made possible by public institutions (such as the Portuguese IDT), who submits with the support (sic) from the State, countless numbers of addicts to a life of dependency.

“Resounding success”? Glance at the results!

If facts are important, the Portuguese model is a mistake.

The example of CzechRepublic, Mexico and Argentina that adopted the sadly famous Portuguese drug decriminalization model should not be followed by anyone.

Manuel Pinto Coelho

(Chairman of APLD – Association for a Drug Free Portugal and member of International Task Force on Strategic Drug Policy)

Source: DrugWatchInternational.  31^st October, 2011

“Medical” marijuana is approved in 21 states and the District of Columbia for numerous conditions, including glaucoma, Crohn disease, posttraumatic stress disorder, epilepsy, Alzheimer disease, and chemotherapy-induced nausea and vomiting. Both the number of states and the number of approved indications for medical marijuana are expected to increase. Physicians will bear the responsibility of prescribing marijuana and thus have an obligation to understand the issues involved in its “medicalization.”

Medical marijuana differs significantly from other prescription medications. Evidence supporting its efficacy varies substantially and in general falls short of the standards required for approval of other drugs by the US Food and Drug Administration (FDA). Some evidence suggests that marijuana may have efficacy in chemotherapy-induced vomiting, cachexia in HIV/AIDS patients, spasticity associated with multiple sclerosis, and neuropathic pain. However, the evidence for use in other conditions—including posttraumatic stress disorder, glaucoma, Crohn disease, and Alzheimer disease—relies largely on testimonials instead of adequately powered, double-blind, placebo-controlled randomized clinical trials. For most of these conditions, medications that have been subjected to the rigorous approval process of the FDA already exist. Furthermore, the many conditions for which medical marijuana is approved have no common etiology, pathophysiology, or phenomenology, raising skepticism about a common mechanism of action.

There is no clear optimal dose of marijuana for its various approved conditions. The concentration of Δ⁹-tetrahydrocannabinol (THC) and other cannabinoids in each marijuana cigarette, the size of cigarettes, and the quantity of smoke inhaled by users can vary considerably. The relative lack of controlled clinical trial data makes finding the appropriate dose even more challenging. Furthermore, given that medical marijuana is approved for mostly chronic conditions that require long-term dosing, physicians must be aware of the development of tolerance and dependence (as evidenced by downregulation of the brain cannabinoid receptors), as well as withdrawal on discontinuation.

Prescription drugs are produced according to exacting standards to ensure uniformity and purity of active constituents and excipients. Because regulatory standards of the production process vary by state, the composition, purity, and concentration of the active constituents of marijuana are also likely to vary. This is especially problematic because unlike most other prescription medications that are single active compounds, marijuana contains more than 100 cannabinoids, terpenoids, and flavonoids that produce individual, interactive, and entourage effects. Although THC is believed to be the principal psychoactive constituent of marijuana, other cannabinoids present in marijuana may have important effects that may offset THC’s negative effects. For instance, cannabidiol has been shown to have anxiolytic and antipsychotic effects that might offset the anxiogenic and psychotogenic potential of THC. Yet cannabidiol is sometimes bred out to increase the THC potency of some medical marijuana strains.

Benefits notwithstanding, the potential harms associated with medical marijuana need to be carefully considered. No other prescription medication is smoked; concerns remain about the long-term risks of respiratory problems associated with smoking marijuana, which are a subject of active investigation. THC is already available in a pill approved by the FDA, yet this form seems to be less desirable to those seeking medical marijuana; this may in part be because its euphoric effects are not immediate and cannot be reliably controlled, unlike smoked marijuana. Furthermore, there is evidence that marijuana exposure is associated with an increased risk of psychotic disorders in vulnerable individuals. Clearly, some but not all individuals are at risk of psychosis with exposure to marijuana, but it is not possible to identify at-risk individuals. In individuals with established psychotic disorders, marijuana use has a negative effect on the course and expression of the illness. Furthermore, recent findings suggest that long-term marijuana exposure is associated with structural brain changes as well as a decline in IQ.

The current system of dispensing marijuana does not safeguard adequately against the potential for diversion and abuse. Many states, for instance, allow patients to grow their own marijuana. Furthermore, marijuana may be contaminated with pesticides, herbicides, or fungi, the latter being especially dangerous to immunocompromised individuals such as patients with HIV/AIDS or cancer. Central regulatory oversight by the FDA makes possible the recall of harmful drugs or contaminated batches and the dissemination of new information about drug safety. Is there sufficient oversight to monitor potential contamination of marijuana, especially when patients are permitted to grow it themselves?

A significant but largely overlooked problem with the medical marijuana movement is the message the public infers from its legalization and increasing prevalence. There is an increasing perception, paralleling trends in legalization, that marijuana is not associated with significant or lasting harm; data from 3 decades indicate that among adolescents, risk perception is inversely proportional to prevalence of cannabis use. As legalization has spread for medical or recreational purposes, it is possible that the perception of risk by adolescents will continue to decrease, with a subsequent increase in use. This is especially problematic given that many of the negative effects of marijuana are most pronounced in adolescents.

Projections of substantial revenue rather than evidence-based medicine may explain the eagerness of many states to legalize medical marijuana. Physicians have been invited to participate in the development of medical marijuana programs late in the process. In some instances (eg, Connecticut), legislators approved medical marijuana but consulted physicians with relevant expertise only afterward.

An unmet need remains for treatments of a number of debilitating medical conditions. Specific constituents of marijuana may have therapeutic promise for specific symptoms associated with these disorders. However, if marijuana is to be used for medical purposes, it should be subjected to the same evidence-based review and regulatory oversight as other medications prescribed by physicians. Potentially therapeutic compounds of marijuana should be purified and tested in randomized, double-blind, placebo- and active-controlled clinical trials. Toward this end, the federal government should actively support research examining marijuana’s potentially therapeutic compounds. These compounds should be approved by the FDA (not by popular vote or state legislature), produced according to good manufacturing practice standards, distributed by regulated pharmacies, and dispensed via a conventional and safe route of administration (such as oral pills or inhaled vaporization). Otherwise, states are essentially legalizing recreational marijuana but forcing physicians to act as gatekeepers for those who wish to obtain it.

An inquiry on Foetal Alcohol Spectrum Disorder (FASD) has been told men could be just as responsible for causing the condition as women.

A Northern Territory select committee inquiry into action to prevent FASD held public hearings in Alice Springs after visiting Katherine and Tennant Creek.

Criminal lawyer Russell Goldflam presented the People’s Alcohol Action Coalition’s submission and told the inquiry stopping men and women drinking alcohol is the only real solution to prevent damage to the foetus.

Outside the hearing he told reporters new research from South Korea shows an embryo can be affected at the time of conception by compromised semen from men who drink excessively.

“This is very early days. The research has only been done on animals at this stage and it was only published a few months ago,” he said.

What is FASD?

Foetal Alcohol Spectrum Disorder is an umbrella term given to a range of conditions caused by alcohol exposure during pregnancy. There is no agreed way of screening, diagnosing or even defining the condition.

Signs and symptoms of FASD:

• Low birth weight
• Small head circumference
• Failure to thrive
• Feeding problems
• Sensitivity to noise, touch and/or light
• Developmental delay.

In an older child:

• Learning difficulties
• Developmental delays
• Attention deficit/hyperactivity/ADHD
• Memory problems
• Difficulties with social relationships
• Impulsiveness
• Inappropriate behaviour
• Poor understanding of consequences
• Major organ damage.

Source: NT Centre for Disease Control, April 2014

“But it may well be that in some cases FASD is nothing to do with the drinking of the mother but may be from the drinking of the father who helped conceive that child.”

He said the research could have profound implications on policy responses to FASD.

“Instead of focussing on ‘irresponsible women who drink’ we need to cast our net more broadly and develop policies in the population overall, including men,” he said.

Push for a floor price on alcohol

The group has lobbied for years for the Northern Territory Government to introduce a floor price to control alcohol sales.

It has also urged the NT not to impose policies that criminalise the behaviour of women who drink when they’re pregnant.

“We’re now beginning to realise the enormity of the problem of children not even being born with a real chance in life because they’re afflicted with this inherited condition which stunts their growth, stunts their development as individuals, stunts their potential,” Mr Goldflam said.

“It may turn out that there are so many people in this category that it stunts our community as a whole.”

The Public Health Association’s Dr Rosalie Schultz told the inquiry by the time most women realise they are pregnant the baby is already affected by FASD.

She said this meant efforts to reduce the prevalence of the disorder needed to apply to the entire population, not just women who drink when they are pregnant.

Source: abc.net.au 1^st Aug.2014

 The Center for Disease Control and Prevention recently reported that excessive alcohol drinking accounts for one in 10 deaths among working-age adults in the U.S.

This is a horrible waste of lives and the CDC is working with partners to support the implementation of strategies for preventing excessive alcohol use as recommended by the Community Preventive Services Task Force.

The CDC says excessive drinking includes binge drinking (four or more drinks on an occasion for women, five or more drinks on an occasion for men); heavy drinking (eight or more drinks a week for women, 15 or more drinks a week for men); and drinking while underage or pregnant.

 Annually from 2006 to 2010, excessive alcohol use led to an average of 87,798 deaths and 2.5 million years of potential life lost. Excessive drinking shortened the lives of those who died by about 30 years.

 Most of the deaths (69 percent) involved adults 20 to 64 years old. About 5 percent of the deaths involved people younger than 21.

These deaths were due to health effects from drinking too much over time, such as breast cancer, liver disease and heart disease, as well as health effects from drinking too much in a short period, such as violence, alcohol poisoning and motor vehicle crashes.

The findings were based on an analysis of data from the Alcohol-Related Disease Impact application for 2006-2010.

 The ARDI provides national and state-specific estimates of alcohol-attributable deaths and years of potential life lost. It currently includes 54 causes of death for which estimates of alcohol involvement were either directly available or could be calculated on the basis of existing scientific information.

The national annual average death rate due to excessive alcohol use was 28 deaths per 100,000. State-specific estimates of deaths and years of potential life lost because of excessive drinking by condition are available at apps.nccd.cdc.gov/DACH_ARDI/default/default.aspx

 Unfortunately, the estimates for 2006 through 2010 are similar to the 2001 estimates, which emphasize the substantial and ongoing public health impact of excessive drinking.

According to the CDC, excessive drinking cost the U.S. about $224 billion, or $1.90 per drink, in 2006. Most of these costs were due to lost productivity, including reduced earnings among excessive drinkers as well as deaths due to excessive drinking among working-age adults.

 The real question is how to manage this problem. Prohibition has already been tried and was a dismal failure. Laws are already on the books to regulate the sale and use of alcohol. Yet it continues to injure and/or kill too many of those who use it.

Now, many states have chosen to disregard the lessons offered by alcohol and are choosing to allow recreational marijuana use in addition to alcohol, in spite of the fact that there is nothing in place to reliably measure the level of intoxication from marijuana.

In a few years, I hope that we are not going to look back on the injury and fatality statistics for marijuana and wonder why we let yet another dangerous drug out into our world, and especially the world of our children. Dr. Terry Gaff is a physician in northeast Indiana

 Source: kpcnews.com 2^nd August 2014

To the Editor, New York Times:

Much of the country — with The New York Times regrettably in the vanguard — is advocating the reckless addition of a third drug, marijuana, to two drugs currently legal for adults: alcohol and tobacco. These two legal drugs are the leading causes of preventable illness.

The legal status of a drug has dramatic impact on its use. In the last 30 days, 52 percent of Americans 12 and older used alcohol, 27 percent used tobacco and only 7 percent used marijuana. The dramatically lower level of marijuana use reflects its illegal status, not its appeal. Why is it in our nation’s interest to see marijuana use climb? Since when is smoking a program that we promote?

The best policy to protect public health is one that reduces, not increases, marijuana use. There are plenty of ways to achieve this goal, including a strong public education effort focused on the negative health effects of marijuana.

There are reasons why employers, including the United States government, prohibit marijuana use in the workplace. There are reasons why marijuana emergency room admissions are reported at the rate of 1,250 a day and 455,000 a year, and why highway crashes double for marijuana users.

We cannot ignore the negative effects that legalization would have on under-age use and addiction, highway safety, treatment costs, mental health problems, emergency room admissions, workplace accidents and productivity, and personal health.

PETER BENSINGER
ROBERT L. DuPONT
Chicago, July 30, 2014

 Mr. Bensinger was administrator of the Drug Enforcement Administration from 1976 to 1981. Mr. DuPont, president of the Institute for Behavior and Health, was director of the National Institute on Drug Abuse from 1973 to 1978. They are co-founders of Bensinger, DuPont & Associates, which provides employee assistance program, gambling helpline and drug-testing services.

NHS figures show increase of 22% in number of cases over last 10 years, from 1,192 in 2004-5 to 1,536 in past 12 months

More than 7,800 babies have been born with ‘neonatal withdrawal symptons’ in the past five years, after becoming dependent on drugs their mothers took during pregnancy. Photograph: Alamy

More than 1,500 babies a year are born addicted to drugs, NHS figures show. They include cases where doctors have been forced to give opiates to babies in order to wean them off heroin.

More than 7,800 newborns have been recorded with “neonatal withdrawal symptoms” in the last five years, effectively putting them into cold turkey after becoming dependent on drugs their mothers took during pregnancy.

They include 6,599 cases in England, 738 in Scotland and 464 cases in Wales, according to data obtained by the Mirror.

The figures show a 22% increase in cases over the last 10 years, from 1,192 in 2004-5 to 1,536 in the past 12 months.

Christian Guy, director of the Centre for Social Justice thinktank, said: “The 1,500 innocent babies born into the trauma of addiction each year are being given a tragic start in life. It demonstrates that addiction is not just about individual choice – it affects children, families, communities and public services.”

Vivienne Evans, chief executive of the family support charity Adfam, said: “If pregnant women think they will be mistreated, stigmatised or have their children taken away, they will be scared to access the health services that they and their babies need. We need specialist doctors, midwives and social workers to work with them.”

A study published this year found that more than half of women drink more than the recommended amount of alcohol during the first three months of pregnancy. Women who had more than two units a week were twice as likely to give birth to unexpectedly small or premature babies as women who did not drink at all.

Source: theguardian.com, Saturday 2 August 2014

Abstract

Cannabis is a common drug of abuse that is associated with various long-term and short-term adverse effects. The nature of its association with vomiting after chronic abuse is obscure and is under recognised by clinicians. In some patients this vomiting can take on a pattern similar to cyclic vomiting syndrome with a peculiar compulsive hot bathing pattern, which relieves intense feelings of nausea and accompanying symptoms. In this case report, we describe a twenty-two year-old-male with a history of chronic cannabis abuse presenting with recurrent vomiting, intense nausea and abdominal pain. In addition, the patient reported that the hot baths improved his symptoms during these episodes. Abstinence from cannabis led to resolution of the vomiting symptoms and abdominal pain. We conclude that in the setting of chronic cannabis abuse, patients presenting with chronic severe nausea and vomiting that can sometimes be accompanied by abdominal pain and compulsive hot bathing behaviour, in the absence of other obvious causes, a diagnosis of cannabinoid hyperemesis syndrome should be considered.

INTRODUCTION
Cannabis has been used recreationally for millennia and is the third most commonly used drug after tobacco and alcohol[1,2]. Research into the neurobiology of the compound has led to the discovery of an endogenous cannabinoid system. The therapeutic potential of cannabinoids has been recognized and these compounds are utilized as anti-emetics[3–5]. Recently, a distinct syndrome in chronic cannabis abusers characterized by recurrent vomiting associated with abdominal pain and a tendency to take hot showers has been increasingly recognised. This clinical manifestation is paradoxical to the previously identified therapeutic role of cannabinoids as anti-emetics. We describe the case of a young male seeking repeated emergency room care with recurrent nausea and vomiting.

CASE REPORT
A 22-year male presented with recurrent episodes of nausea, refractory vomiting, and colicky epigastric pain for one week. The symptoms were characterized by treatment-resistant nausea in the morning, continuous vomiting, and colicky epigastric abdominal pain. Each episode lasted 2 to 3 h and increased with food intake. He often had two or more episodes a day during the symptomatic period. He had been treated for the severe nausea and vomiting in the emergency room on two occasions in the preceding two months. He also reported having learned to help himself by taking a hot bath each time the symptoms appeared, which dramatically improved his symptoms. This habit had become a compulsion for him for symptom relief with each episode of hyperemesis. On physical examination his mucous membranes were dry, his pulse rate was 102/min and blood pressure was 140/100 with positive orthostasis. The remainder of the physical examination was unremarkable. His complete blood count and comprehensive metabolic panel were unremarkable. In addition, serum amylase and lipase levels were within the normal range. His urine drug screen was positive for tetrahydrocannabinol (THC). Abdominal X-ray series and ultrasonography were within normal limits.

Oesophagogastroduodenoscopy revealed Grade 2 distal oesophagitis and hiatal hernia. On further interviewing, he admitted to consistent marijuana abuse for the past 6 years, often smoking cannabis every hour or two on a daily basis. The patient and his mother did not recall any significant past illnesses or recurrent vomiting when he was a child. He was treated with intravenous fluids with steady improvement in symptoms, and metoclopramide, pantoprazole and morphine for the abdominal pain. It was explained that marijuana was the cause of his symptoms and he was advised not to resume marijuana abuse. On subsequent follow-up, he had abstained from cannabis and remained symptom-free.

DISCUSSION
Cannabis is one of the most commonly abused drugs worldwide. Over the past decade, marijuana has remained the most commonly used illicit substance with close to 50% of high school seniors admitting use at some time[1]. It is estimated that each year 2.6 million individuals in the USA become new users and most are younger than 19 years of age[6].
The long-term and short-term toxicity of cannabis abuse is associated with pathological and behavioural effects. However, cannabis has also been suggested to have therapeutic properties with anticonvulsive, analgesic, anti-anxiety and anti-emetic activities. Cannabis has also been used to treat anorexia in patients with acquired immunodeficiency syndrome[3–5]. The actions of cannabis are mediated by specific cannabinoid receptors. The first of the cannabinoid receptors-CB-1-was identified in 1990 and this finding revolutionized the study of cannabinoid biology. Since then, a multitude of roles for the endogenous cannabinoid system has been proposed. A large number of endogenous cannabinoid neurotransmitters or endocannabinoids have been identified, and the CB-1 and CB-2 cannabinoid receptors have been characterized[7]. The CB-1 receptors exert a neuromodulatory role in the central nervous system and enteric plexus[8]. Cannabinoid type 2 receptors have an immunomodulatory effect and are located on tissues such as microglia[5]. The presence of other receptors, transporters, and enzymes responsible for the synthesis or metabolism of endocannabinoids are being recognised at an extraordinary pace. Cannabinoids have a wide variety of effects on the body systems and physiologic states (Table ​(Table1)1) due to their actions on the receptors as well as direct toxic effects.
The anti-emetic effect of cannabinoids is largely mediated by CB-1 receptors in the brain and the intestinal tract, although some of their effect may also be receptor-independent. However, in this report, we were presented with the paradoxical effect of hyperemesis in a susceptible chronic cannabis abuser. Such a paradoxical response has previously only been demonstrated following acute toxicity to an intravenous injection of crude marijuana extract[9]. Proposed mechanisms of cannabinoid hyperemesis include toxicity due to marijuana’s long half-life, fat solubility, delayed gastric emptying, and thermoregulatory and autonomic disequilibrium via the limbic system[10]. Cannabinoids are known to impair peristalsis in a dose-dependent manner[11,12], which can theoretically override the centrally mediated anti-emetic effects, thus leading to hyperemesis. It is not known why the hyperemesis syndrome surfaces after several years of cannabis abuse. The effects of cannabinoids on the functions of the thermoregulatory and autonomic mechanisms of the brain can lead to behavioural changes[10]. Such effects might be the underlying mechanism for the compulsive hot bathing behaviour. There is also a supposition that the syndrome could represent a type of cyclic vomiting. Cyclic vomiting syndrome (CVS) in adults is now very well recognized, and it has been proposed that marijuana contributes to CVS[13]. However, unlike the other forms of CVS, patients with cannabinoid hyperemesis are not likely to have a history of migraine or other psychosocial stressors and the peculiar behaviour of hot showers is unique to this syndrome.

Based on the published research and case reports[10,14–16], we propose the set of clinical characteristics for the diagnosis of cannabinoid hyperemesis syndrome shown in Table ​Table2.2. Allen et al[10] first noted this condition in a group of nineteen patients from Australia with chronic cannabis abuse and cyclical vomiting illness. An earlier case report by de Moore et al[17] described a chronic cannabis abuser with psychogenic vomiting, which was complicated by spontaneous pneumomediastinum. Subsequent reports have identified similar clinical presentations[7–9,18]. Given the high prevalence of chronic cannabis abuse worldwide and the paucity of reports in the literature, clinicians need to be more attentive to the clinical features of this underrecognised condition.
Source: Cyclic vomiting and compulsive bathing with chronic cannabis abuse.
Clin Gastroenterol Hepatol. 2008 Jun; 6(6):710-2
ReviewThe therapeutic potential of cannabis. Lancet Neurol.
2003 May; 2(5):291-8.

A stern warning to those arguing for the legalisation of cannabis.

New Zealand Drug Detection Agency CEO Kirk Hardy has just returned from a trip to Colorado, one of the American States to have legalised marijuana.

He says it’s in a real mess, with children dealing the drug in schools and authorities struggling to keep up.

“Fatalities and driving accidents have increased drastically, we’re having young children admitted to hospital through inhalation of cannabis products, such as edibles.”

Source: http://www.newstalkzb.co.nz/auckland/news 17^th July 2014

‘Go on, have a chooff, it’s harmless!’ Well so has been the mantra of the pro-drug lobby. However, can one play Russian Roulette ‘safely? The answer is NO you can’t! The mounting and irrefutable scientific evidence against Cannabis remains conclusive – This illicit drug will damage you!

Researchers from the UK’s Bristol University have broken new ground in tracking THC (the psychoactive compound in Cannabis) impact in the brain of laboratory rats, by using electrodes connected directly into ‘the grey matter’ – not something that can be done on humans.

The results were not only disturbing, but reinforced many other studies, including one major break-through study carried out in Australian earlier this year; that is that Cannabis and the potential for mental illness are inseparable.

Two parts of their brain were shown to be affected – the hippocampus which is essential for forming new memories and prefrontal cortex which integrates those memories and uses them for future behaviour and decision-making…Disruption of the brain waves which allow these two areas to communicate is what happens in schizophrenia, a mental disorder.

The lead author of the study, Dr Matt Jones stated: ‘Cannabis is making normal people behave more like schizophrenia patients when they take it and that’s something they should bear in mind…Previous studies have shown a link but we didn’t have this level of detail.’

The Dutch Professor van Os and his team in conjunction with the Institute of Psychiatry in London and other researchers in Germany, conducting follow-up studies have verified that cannabis users are potentially doubling their risk of developing schizo-affective states or other psychotic manifestations such as paranoia and audio-hallucinations.3 The Dalgarno Institute continues to advocate for…

•  Continued illicit status of cannabis
•  Compulsory seizure of all assets of Drug traffickers and tougher sentences for same.
•  More thorough Demand Reduction strategies for young people
•  Recovery focused rehabilitation for drug

References:

1 www.dailymail.co.uk/health/article-2053486/One-cannabis-joint-bring-schizophrenia.html

2 Ibid

3 http://www.bmj.com/content/342/bmj.d738

Source: Press Release from dalgarnoinstitute.org.au October 2011

This letter was published by the NY Times on 7/30/14:

 “To the Editor:

 Your opinion, in “Repeal Prohibition, Again,” that marijuana should be legalized is based in part on an assumption that during Prohibition “people kept drinking.” Prohibition reduced the public’s alcohol intake considerably. The rate of alcohol-associated illness dropped in similar fashion. Prohibition was perhaps a political failure, but an impressive success from a public health standpoint.

 Both alcohol and marijuana can lead to the chronic disease of addiction, directly affect the brain and negatively affect function. As more than 10 percent of our population has addictive disease, your statement that marijuana is “far less dangerous than alcohol” doesn’t reflect decades of research demonstrating risks associated with both of these drugs.

 Why would we possibly wish to add to the alcohol- and tobacco-driven personal and public health catastrophe with yet another substance to which some people will become addicted?

 Some people use marijuana currently. Legalize it, and more people will use more marijuana, leading to more addiction, lower productivity and higher societal costs.

 STUART GITLOW

President, American Society

of Addiction Medicine

New York, July 27, 2014”

 Stuart Gitlow, MD, MPH, MBA, is a psychiatrist and Executive Director of the Annenberg Physician Training Program in Addictive Diseases at Mount Sinai School of Medicine. He is also President of the American Society of Addiction Medicine, and the author of Practical Guides in Psychiatry: Substance Use Disorders (2006, Lippincott Williams & Wilkins).

Overall crime in the City and County of Denver has increased nearly 7 percent in the first six months of 2014 compared to the same period last year, according to new analyses of Colorado crime data.

 The numbers, released by the Rocky Mountain High Intensity Drug Trafficking Area (HIDTA), differ markedly from widely published reports claiming crime in the Mile High City has dropped since the state opened its first recreational marijuana shops Jan. 1. (This April 7 report in the Washington Post is a great example of how journalists have jumped the gun — so to speak — on declarations that “crime is down across the board.”)

 Before unpacking the numbers, HIDTA officials said they do “not infer causality” between the increased crime rates they found and the opening of Colorado’s recreational pot shops, most of which are concentrated in Denver. Similarly, marijuana proponents should not claim the drug’s legalization has caused crime to drop.

 OK, so why such sharp discrepancy between the numbers reported by marijuana-interest groups, marijuana-cheerleading reporters and the HIDTA analyses, which are based on data collected by the National Incident Based Reporting System (NIBRS) and prepared to Denver Department of Safety Public Information Standards?

Rocky Mountain HIDTA Director Tom Gorman explains:

“The marijuana advocates’ claims boil down to old-fashioned cherry picking. What they are not telling everybody is that they are not looking at all reported crime categories in Denver, or even at all the crimes that fall under those categories. They are taking the numbers that favor their position — and in their case, those numbers are some of the crimes included in the FBI Uniform Crime Report, Part I.

 “If you want a true and complete picture of all crime in Denver, you have to look at the Denver report that uses the National Incident Based Reporting System (NIRBS) because the FBI Uniform Crime Report (UCR) captures only about 50 percent of all crimes reported — and tracked — in Denver.”

 To illustrate how much more thoroughly NIRBS data are tracked than the UCR data, Mr. Gorman’s office provided this quick chart listing only two categories of crime. The numbers in parenthesis refer to the number of subcategories of crime tracked under that larger category. (Note: For example, the FBI report looks at four subcategories of “violent crime,” while the Denver Police Department tracks those four subcategories and three others under the heading “crimes against persons.”)

 The NIRBS data show overall crime in Denver is up 6.7% when comparing the first six months of 2014 to the first six months of 2013.

We encourage you to review all of the numbers for yourself, but here are some highlights:

Crimes against people in Denver County increased more than 18 percent. Under this category:

There were 21 murders in the first six months of 2013 and 13 in the same period of this year. That’s a drop of 38 percent.

Aggravated assault was up 2.2 percent, from 1,167 reports to 1,193.

Simple assault increased 35 percent, from 1,634 reports to 2,207.

Reports of intimidation jumped 45 percent, from 370 reports to 537.

Forcible sex offenses dropped from 419 reports to 340 reports, or 18.9 percent.

Non-forcible sex offenses declined from 12 to 7, or 41.7 percent.

Reports falling under the category of crimes against property fell 8 percent. However, subcategories of crime often involving marijuana were on the rise, Mr. Gorman noted. Among them were reports of stolen property, which increased 16.4 percent.

Criminal offences reported under the category of crimes against society increased 22.8 percent. Under this category:

Drug/Narcotics Violations increased 20.6 percent, from 1,069 reports to 1,289 reports.

Weapon law violations jumped 43 percent from 209 reports to 299 reports.

Criminal offences falling under the category titled “all other offenses,” nearly doubled with an increase of 96.2 percent. Under this category:

Reports of disorderly conduct and disturbing the peace skyrocketed 214 percent from 234 reports in the first six months of 2013 to 735 reports in the same period of this year.

Family offences considered nonviolent jumped 30 percent from 174 to 227 reports.

Criminal trespassing also rocketed up 162.4 percent from from 274 reports to 719.

Liquor law and drunkenness violations were up 237 percent from 27 reported offenses to 64.

Like the Rocky Mountain HIDTA, the National Association of Drug Court Professionals has examined the NIRBS data. Researchers affiliated with that organization compared the first six months of each of the last five years and found that reports of simple assault and domestic violence have risen steadily.

“We are not inferring causality between these increases … just like legalization proponents should not infer causality regarding the downward trend observable when isolating just the UCR’s Part One Crime Index,” NADCP Chief Executive Officer West Huddleston recently wrote. “However, we are promoting the position that the question remains open, and at best we can say there is contradictory evidence when trying to draw conclusions about the effect marijuana legalization has had on crime.”

It’s past time for news organizations to report this more accurate picture of crime in Denver — and not just the numbers handed to them by marijuana proponents or the numbers they select to build their preferred narratives.

 Source:drthurstone.com 23rd July 2014

Two of the larger social trends of our time — the growth of payday gambling and the legalization of marijuana — have two things in common: They are justified as the expansion of personal liberty, and they serve the interests of an expanding government.

The ideological alliance behind these changes is among the strangest in U.S. politics. Libertarians seek to lift governmental restraints on consensual acts. State governments seek sources of revenue without the political inconvenience of requesting broad tax increases. Both find common ground in encouraging and exploiting the weaknesses and addictions of citizens. (And business interests and their lobbyists, of course, find new ways to profit from reliable vices.)

The financial appeal is forthright. Maryland did not legalize gambling to expand the realm of personal autonomy. It collects a 61 percent tax on slot machine revenue. Colorado expects about $114 million in taxes and fees during its first year of marijuana legalization. “If Colorado is able to rake in substantial amounts of tax revenue,” according to one news account, “legalization advocates’ pitches to legislatures in Oregon, Massachusetts and Alaska become that much easier.”

Consider the perspective of a state legislator. Your state has incurred a variety of unfunded obligations. Voting to raise taxes might cost you your job. Legalizing gambling or pot, in contrast, will bring in new revenue and perhaps new campaign donations. And some people will call it the advance of freedom!

This is a tribute to a hardy weed — in this case, the hardy weed of government, which can grow in any political environment. If you are a progressive who wants universal health coverage, government expands. If you are a libertarian who wants people to be able to waste their money at casinos, or smoke and ingest whatever they damn well please, government expands as well.

But this particular enlargement depends on minimizing and dismissing the consequences for individuals and communities.

Gambling is described as entertainment, though modern slot machines are really sophisticated computer programs designed to elicit Pavlovian responses until victims “play to extinction.” An estimated 40 percent to 60 percent of slot revenue comes from problem gamblers. And casinos are often sited to attract working-class people.

Pot is called harmless, though we really have little information on the health and cultural effects of the widespread legal distribution of modern, potent methods of consuming THC (the chemical name). We do know that the substance is addictive in about one of nine cases (more like one in six when use starts in the teens); that it can make structural changes in portions of the brain controlling emotion and motivation; and that regular use undermines memory, attention span, problem-solving skills and the ability to complete complex tasks. What possible use could these attributes be in a modern economy?

There is also little doubt that an expanded legal market in pot also expands the illegal market for reselling (or giving) to children and teens. And the product — especially Colorado’s ingestible pot lollipops and gummy bears — is particularly suitable. The social message of normalization, of banalization, is intended — and received by young people. The first $40 million of Colorado’s pot revenue is slated for public school construction. What were once “drug-free school zones” are becoming drug-funded schools. Will there be a celebratory plaque in seventh-grade classrooms: “Brought to you by the potheads of the Centennial State”?

Parents no longer expect much help from government in reinforcing the cultural and moral norms necessary to the raising of responsible, successful children. But now some states are profiting from actively undermining those norms. Apparently, only consenting adults matter. Libertarian utopias are always childless.

For the strongest ideological advocates of this approach, the outcomes are largely irrelevant. It ultimately doesn’t matter if teen drug use increases by X percent or gambling addiction rises Y percent. Ending “consensual crimes” is a matter of principle — not just on pot and slots but on heroin and meth. The idea of a political community upholding standards, in order to help other institutions (such as families) pass healthy cultural norms between generations, is anathema.

But libertarians are now, paradoxically, providing ideological cover for irresponsible government. State officials just want the money, however it is blessed, without requesting it through the normal democratic process. Rather than building social competence and capital, politicians increasingly benefit when citizens are addicted, exploited, impoverished and stoned. And that deserves contempt, not applause.

Source:http://www.washingtonpost.com/opinions/michael-gerson-corrupting-citizens-for-fun-and-profit/2014/07/14/da321826-0b87-11e4-b8e5-d0de80767fc2_story.html

When Edward Madewell’s mother asked him to come home after five years of homelessness and drift, he bought a Greyhound bus ticket and headed for Missouri.

Halfway there, his mother told him he would have to give up the marijuana he uses to control seizures and switch to prescribed medicine. Madewell changed his plans and headed for Colorado, where recreational weed has been sold legally since Jan. 1. “I’m not going to stop using something organic,” he said. “I don’t like the pills.”

Madewell is among the homeless lured to Colorado by legal marijuana who are showing up at shelters and other facilities, stressing a system that has seen an unusually high number of people needing help this summer.Of the new kids we’re seeing, the majority are saying they’re here because of the weed. They’re traveling through. It is very unfortunate,” said Kendall Rames, deputy director of Urban Peak, a nonprofit that provides food, shelter and other services to young people in Denver and Colorado Springs.

Younger visitors to Father Woody’s Haven of Hope, which serves people age 18 and older, typically are more demanding and difficult than their elders, director Melinda Paterson said. “Typically, they have an attitude. But we are really strict here. We treat you with respect, … and if they are not respectful, we ask them to leave,” she said.

Combined with an increase in those who arrive penniless and seeking jobs in the state’s strengthening employment market, the homeless influx is straining a service network already under stress, said Murray Flagg, divisional social services secretary for the Salvation Army’s Intermountain Division. Not everyone who works with the homeless singles out marijuana as a contributing factor to their arrival here. “We have had an influx, and the majority of them have been from out of town. I have no idea if the marijuana law has had an impact,” Paterson said.

But homeless advocates agree that numbers have swollen, sometimes dramatically, over the past year.

The number of those who go to Father Woody’s normally rises by about 50 people per month during the summer, Paterson said. This year, she said, “we have gotten 923 new homeless over the last three months,” more than 300 a month.

About two months ago, she added, the shelter began bringing those who eat breakfast and lunch there to the table in shifts to accommodate the increase. “It is worrisome in the sense that how are we going to clothe and feed and find shelter for them?” she said.

Between May 1 and July 15, Urban Peak’s drop-in center, where homeless people 15 through 24 can get a meal, do laundry, shower or take GED and other classes, saw the number of new visitors jump by 5 percent over the same period last year, Rames said. Last summer, the Salvation Army’s single men’s Crossroads Shelter in Denver housed an average of 225 men each night.

This summer’s average is about 300 per night, and when other shelters are full, the organization provides a bed for as many as 350, Flagg said. In the past, the shelter’s residents averaged between 35 and 60 years old. “Now we are seeing a much larger number of 18- to 25-year- olds.”

An informal survey performed at the shelter suggested that about 25 percent of the increase in population was related to marijuana, Flagg said.

While many come to smoke without worrying about the law, others “are folks looking to work in the industry, a lot of them have an agricultural background,” or other experience they expect will be in demand, he said. They may also have a felony on their record that automatically disqualifies them from getting a job in the highly regulated business.

Those who do find jobs in pot shops and grow houses often don’t earn enough to pay rent or buy a home in Denver’s expensive housing market, Flagg said. They, too, can end up homeless. The shelters don’t require anyone to explain why they came to Colorado, but some do volunteer their reasons. On the list of reasons given at St. Francis Center, a daytime shelter, marijuana trails only looking for work, said Tom Leuhrs, the executive director.

While marijuana use contributes to the number of homeless, the growth in their numbers indicates that people are having difficulty moving into the workforce from high school and college, Leuhrs said. “The economy is not supporting them. There are not enough jobs,” Leuhrs said. He sees an almost even split between those, like Madewell, who say they use pot for medical reasons, and others who crave easy access to a legal high.

Dusty Taylor, 20, who was standing in line for breakfast at Urban Peak this week, said he came back to Colorado, where he grew up and had been homeless in the past, after hearing weed had been legalized. “I said, I should go back. It was, like, I don’t want to catch a felony for smoking.”

Source: http://www.denverpost.com/News/ci_26216037/Legal-pot-blamed-for-some-of-influx-of-homeless-in-Denver-this-summer :   07/25/2014 

If I had a world of my own, everything would be nonsense. Nothing would be what it is, because everything would be what it isn’t.”

-Alice In Wonderland

Why is it that all of the conversation nowadays on the subject of medical marijuana leaves me feeling like we have all fallen down the proverbial rabbit hole? Voices in the discussion, who would normally have been considered sensible and sane, are now being made to seem provincial, prudish, callous and even crazy. All the while, those who once were considered “a little crazy” in their views are being held up as open-minded, wise, sensible and compassionate. How have we, in so short a time, come to a point where the whole debate seems to be turned upside-down?

It seems to me this curious turn has come about by blowing a lot of smoke at the State Legislature and among Nevada voters. Unfortunately after tumbling down that rabbit hole, we have come to this strange place where nothing can be seen as what it is, and everything seems to be nonsense.

Here are just a few of the strange myths and misperceptions which have actually gotten traction on the subject of medical marijuana.

It’s Just a Harmless Little Vice

The advocates of medical marijuana often are the same folks who downplay the effects of cannabis products; both on public health and on society as a whole. They would say, “Lighten up, man! It’s not a big deal. It’s just a modest vice, no different from alcohol or tobacco.” They would argue that marijuana’s mild consequences affect only the person who takes it. Overall societal consequences are minimal.

Of course, the more savvy advocates among them would quickly change the subject and say that this really isn’t about the free recreational use of marijuana. All that is irrelevant. Rather, it is about the rights of a small group of seriously ill people to derive some comfort or benefit from using marijuana as a medicine. No doubt, they would produce studies showing that marijuana has helped people through terminal illnesses or severe pain. They will cite other studies that show children prone to seizures deriving benefits from marijuana products. Some studies might even claim that the substance has curative powers against cancer or other terminal diseases.

Of course, it’s hard to argue with this. Medical studies are a dime a dozen nowadays; and it seems you can find a study to prove any point you want to make. Still, I, for one, won’t reject the idea that the marijuana plant may have important and valid medicinal uses. I believe that every plant is here on earth for an intended good purpose. So there may indeed be severe cases where marijuana is helpful in managing pain or bringing comfort to a suffering patient. I doubt anyone would deny such a person the one treatment that might help, just because it happens to be marijuana.

On the other hand, I also know human nature all too well. Common sense dictates that there are always a lot of people out there trying to game the system. And I’d predict that a majority of medical marijuana cardholders will not be those extreme cases we are talking about. Rather they will be people willing to say whatever is necessary to have access to the substance. Let’s face it, the use of medical marijuana will become much more widespread than just those few extreme and justifiable cases. It will undoubtedly have a way of spilling over its bounds onto people who have no medical need for it whatsoever.

And that kind of marijuana use is just what bothers most of the medical marijuana naysayers. That’s because it comes at a huge cost to society.Marijuana has been shown to dull the senses, slow down productivity, degrade intelligence and disable employees in the workforce. It has also been shown to cause an increase in certain types of crimes in the neighborhoods and communities where it is present; including violent crimes. Marijuana does NOT only affect the one who takes it. It affects homes, families and schools. It affects children, spouses, neighbors and other innocent bystanders.

So don’t let the proponents of medical marijuana downplay the real effects of this substance on the community.Make no mistake. This is not just a harmless little vice we are talking about. Marijuana use is a bad thing for communities, for the nation and for society as a whole.

 The Myth Of Regulation

Of course, there is the argument that the full regulation of marijuana would be far better than the black market model of distribution we have now. This concept may have merit. But numerous problems with the state law, and careful observation of other states where marijuana has been legalized, seem to indicate that marijuana can’t really be regulated in a meaningful way at this point by the states.

The fact that federal law prohibits the use of marijuana; medical or not; makes regulation by the states problematic to say the least. In the case of medical use, it requires the establishment of an alternative state distribution system outside of the standard FDA-regulated pharmacy distribution.

Coming up with a problem-free system for that is a tall order. Recently passed Nevada state law has tried to tackle it; but there are still a multitude of unintended loopholes and catch-22s that have come up.

Meanwhile, it comes as no surprise that medical marijuana has become an emerging big business opportunity in Nevada.And wherever there is a lot of money involved, there will also be those who will exploit the loopholes and catch-22s. That leads to plenty of unintended consequences.

Moapa Valley is on track to become a victim to at least one of these unintended consequences. One provision in the law allows registered marijuana cardholders to grow their own medical supply if there is not a registered dispensary within 25 miles of their home. Of course, the local town advisory boards have wisely stood firm in saying ‘No!’ to marijuana dispensaries in these communities. Even if their answer had been ‘yes,’ it is doubtful whether a dispensary operator would choose to locate here due to such low demand and minimal profit potential.

So what does that mean? Well, without a licensed dispensary around, anyone with a doctor’s note can obtain a medical marijuana card allowing them to legally grow far more marijuana here in their local basement than they would ever use for medical purposes. And “Dr. Reefer” (of Las Vegas billboard fame) is reportedly giving those cards out to anyone who claims to have a headache.

So what happens when some of these urban cardholders find out (as they inevitably will) that there is a quiet little town nearby where they could legally cultivate an ongoing crop of marijuana with minimal regulation? What’s more, by selling the excess of said crop on the black market, they could easily add $1,000 a month or more to their household income! Well, as Mesquite Mayor Al Litman said last week in a city council meeting, we are “bound to see some budding entrepreneurs moving into the community.” And they probably won’t be the type to join the Chamber of Commerce or flip pancakes at Rotary Club Breakfasts.

As the state law is now, this will change things for Moapa Valley, beginning early next year. The home-growers will move in and set up shop. And eventually all of those adverse effects of marijuana at-large in the community will begin to be felt here in these little towns.

The state law, as currently written, leaves no good option for towns like Moapa Valley and Moapa in combatting this catch-22. It is not a matter of choice whether we want marijuana in our community or not. We will have it.

Fortunately, there have been some recent efforts begun by local leaders to appeal to our State Legislators asking for changes to be enacted in the law at next year’s session. A few small revisions in the wording of the law could provide better options for small outlying communities in this matter. We applaud these efforts by town board members and other leaders; and we hope they will be successful.

 The Elephant In The Room

Finally, we must address the concept that everyone sees, but no one wants to admit is there. Whether it’s advocates confess it or not, medical marijuana is just a brief sleight of hand to divert public attention away from the real goal which is the enactment of full recreational use.

With that being so obviously the case; and the whole medical marijuana discussion being a flim-flam sham leading up to it; the whole thing feels even more like we are falling down Alice’s rabbit hole into a strange world of nonsense.

Honestly! How is a sensible person supposed to engage in an intelligent conversation about the medical benefits of marijuana; and talk about how we will all be better off if it is regulated by government agencies; when we all know that we aren’t just talking about medical use at all. It’s obvious that once a medical use distribution system is established, well regulated or not, it will be just one more little nibble of the mushroom before the conversation will have suddenly expanded into full recreational use right before our eyes. And that would be truly nothing short of madness.

At that point, the once sensible voices in the debate will exclaim, like Alice did in Lewis Carroll’s classic story book, “But we don’t want to go among mad people!”To which marijuana proponents will respond as did the famous Hatter, “Oh, you can’t help that, my dear. We’re all mad here!”

Source: http://mvprogress.com/ 16 July 2014

FROM THE EDITOR’S DESK: Down The Rabbit Hole

It may well be that health care providers in Springfield are mum on medical marijuana because of the potential liability associated with it.  Just last week a Florida jury awarded Cynthia Robinson, whose husband died of lung cancer, $23.6 billion in punitive damages from R.J.  Reynolds.

Paving the way for the verdict was the state’s Supreme Court’s ruling making it easier to prove that Big Tobacco knowingly sold dangerous products and hid the hazards of cigarette smoking.  The Court said that smokers and their families needed only to prove addiction and illnesses or death.

The dangers of marijuana are well documented.  Based upon years of research the Food and Drug Administration has concluded that “marijuana has a high potential for abuse, has no accepted medical use in the United States, and lacks an acceptable level of safety for use even under medical supervision.”

Physicians who are considering recommending marijuana should be checking their medical malpractice insurance.  They may find that recommending the use of a non-FDA approved medication is excluded from coverage.
Source: State Journal-Register (IL) Copyright: 2014 The State Journal-Register

Source:  Judy Kreamer Educating Voices, Inc.  Naperville August 2014

How goes Colorado’s experience with legal marijuana? Spend some time on social media or on numerous blogs and you’ll read headlines like “Revenue Up, Crime Down!” or “Youth Use Declining After Legalisation.”

Lately legalization advocates have been cheering numbers that show a decline in crime. There are literally hundreds of articles that have been written with this narrative. But an honest look at the statistics shows an increase — not decrease — in Denver crime rates.

Crime is tracked through two reporting mechanisms: the National Incident Based Reporting System (NIBRS), which examines about 35 types of crime, and the FBI Uniform Crime Reports (UCR). The FBI UCR only captures about 50 percent of all crimes in Denver, so the NIBRS is generally regarded as more credible. The Denver Police Department (DPD) uses NIBRS categories to examine an array of crime statistics, since it is the more detailed and comprehensive source of numbers.

The Denver Police statistics show that summing across all crime types — about 35 in all — the crime rate is up almost 7 percent compared with the same period last year. Interestingly, crimes such as public drunkenness are up 237 percent, and drug violations are up 20 percent.

So why are advocates claiming a crime drop? Easy: They blended part of the FBI data with part of the DPD/NIBRS data to cook up numbers they wished to see. When one picks the Part I data from UCR and uses DPD/NIBRS property-crime numbers only while studiously avoiding the DPD/NIBRS data on all other crimes, one can indeed manufacture the appearance of a decline. As one can see here, even when using the FBI UCR numbers — in their entirety — crime has risen.

A report commissioned by the National Association of Drug Court Professionals puts it nicely: When a closer look at the data is undertaken, a different picture — something other than “crime is down” — appears to emerge. …

Legalization proponents should not infer causality regarding the downward trend observable when isolating just the UCR’s Part I crime index.

When I asked the president of the Colorado Drug Investigators Association, Ernie Martinez, about these statistics, he urged me to look at the crimes that have been happening in connection to marijuana — even after legalization:

Across the Front Range, we are experiencing more and more butane explosions due to hash extraction methods, calls for service on strong smells, and calls to ER’s on adverse effects after either ingestion or smoked use. Black-market continues to exist unabated, availability of black market marijuana is ever present and cheaper than legalized MJ. Medical marijuana registrants continue to rise due to many factors such as more quantity allowed and more plants allowed, all due to Physician recommendations.

So if crime is up, can we blame legal pot? We do not know whether legalization has anything to do with it. But we do know that reputable news organizations should stop relying on the Big Marijuana lobby for statistics. They wouldn’t blindly trust coal-industry statistics on the environmental effects of strip mining, and they should bring similar scepticism to propaganda claims disseminated by this new industry.

Source: www.conservativewoman.co.uk 13th August 2014

Colorado’s tax collections from recreational marijuana sales in the past fiscal year came in more than 60 percent below early predictions, and now a state lawmaker says it may be time to reconsider the tax formula.
State Rep. Dan Pabon, who is leading a special legislative committee on marijuana revenue, said the medical-marijuana system also may come under scrutiny.
“There’s some real impact that the medical marijuana market is having on the recreational marijuana market,” said Pabon, D-Denver. “I think it’s worth looking at the taxation on the recreational side but also looking at the rules and regulations on the medical side.” Tuesday marked the first meeting of the committee, which is studying how Colorado spends its marijuana tax money.

The first item of business: Why is there so much less of it than predicted?

When Colorado voters approved special taxes on recreational marijuana in November, the official fiscal analysis estimated the taxes would bring in a combined $33.5 million through that fiscal year, which ended this summer. Budgeters for Gov. John Hickenlooper had similarly optimistic projections.  But the actual number came in at just more than $12 million.  A market study for the Colorado Department of Revenue says the lower-taxed medical-marijuana market, which continues to outpace the recreational market in sales, is to blame.  Rather than pulling consumers out of the medical-marijuana market, the recreational market largely has feasted on tourists and people who previously bought pot on the black market.  “I think our original assumption about the cannibalization was wrong,” Colorado Legislative Council economist Larson Silbaugh said at Tuesday’s committee meeting.  The result, suggested David Blake of the Colorado attorney general’s office, is that the resilience of the medical-marijuana market “is being driven by avoidance of that tax.”

Dorinda Floyd, the chief financial officer for the Department of Revenue, said recreational sales continue to rise and eventually are expected to surpass medical sales “in the out years.” Meanwhile, state economists have adjusted their predictions. A forecast in June significantly dialed back expectations for the current fiscal year — $30.6 million in special recreational marijuana taxes, compared with the roughly $100 million that Hickenlooper’s office had predicted this year. A new forecast is due in September.  “While I think our forecasts are getting better,” Silbaugh said, “they’re still based on just six months of data.”

Source: denverpost.com 12th August 2014

Two new drugs are detected each week across Europe with researchers trying to alert the public to the dangers of new chemicals. Young people have died “horrific deaths” from taking multiple drugs, a senior member of the Forensic Science service in Northern Ireland has said. Twenty people have died in the last year from drugs known as “speckled cherries”. Many more have died from taking a cocktail of other substances.

Forensic expert Peter Barker said it was time for an anti-drugs campaign along the lines of road safety adverts. “We’ve seen some really horrific deaths where people have killed themselves after taking multiple drugs,” he said. “I think we need to be much more stark in the message we send to the public – adverts similar to those we’ve seen in road safety campaigns.” The forensic labs are based in Carrickfergus and they use state of the art equipment to carry out toxicology reports after someone has died.

‘Bucket chemistry’

Mr Barker said so-called legal highs are presenting significant challenges. “We call it bucket chemistry – these drugs are developed in back alley garages,” he added. “They haven’t had clinical trials and no one knows what is in them. They are not safe for people to take, even if they have taken a similar compound before.”

About two new drugs are detected each week across Europe and that means researchers are always trying to stay ahead of the game to alert the public to the dangers of new chemicals. They have the same machines used by the Olympics dope-testers – cutting edge technology that can detect tiny amounts of different substances.

At a recent inquest, Coroner John Leckey described the recent drugs deaths as being similar to having a serial killer on the loose. Mr Barker said the deaths were extremely unpleasant: “They can cause convulsions, palpitations and heart attacks.

“Children do need to be educated about the dangers.”

Source: http://www.bbc.co.uk/news/uk-northern-ireland 21st August 2014

It was reported today that Ian Duncan Smith is threatening to stop heroin addicts from being able to claim incapacity benefits.  About a hundred of my patients are heroin users and they are all signed off work. IDS pointed out that it was unfair that hardworking tax payers were paying for the addictions of others. This may well be true but is an attempt to force heroin users in to gainful employment really a viable option?

We recently advertised for an admin assistant at our surgery. It is a low paid, unskilled, part time position that required no previous experience and no great physical exertion. Such is the nature of the times; we had over 60 applicants, most of whom were greatly over qualified for the post. None of the applicants were intravenous heroin users, but if they were we wouldn’t have short listed them. If we wouldn’t consider employing a heroin user, who does Mr. Smith think will? With the exception of the odd ailing rock star, I am yet to hear of a gainfully employed injecting heroin addict.

Heroin is an awful all-consuming drug that destroys the personality of the person behind the habit. The next fix becomes more important to the user than food, shelter and most sadly the people who care about them most. It is not a lifestyle that can easily coexist with a 9-5 job. IDS is very welcome to switch all of my heroin addicts from incapacity benefit to job seekers allowance, but it would simply be an expensive and time consuming PR exercise that led people from one handout to another.

If he chose to take it one step further and remove all their benefits, the result would be an almighty Hurrah from some, but would simply mean a large number of the most vulnerable members of our society being made homeless and being pushed further in to crime, prostitution and begging as they looked for alternative ways to feed their habits. The extra burden placed on to the criminal justice system would almost certainly end up costing far more than the relatively meager handouts that heroin users currently receive in the form of incapacity benefits.

Our local drug and rehab services are quite good but although most of my patients who use heroin are actively enrolled within substance misuse services, very few will successfully turn their lives around. Treating heroin addicts punitively with prison sentences doesn’t seem to work either, so it would appear to me better to try and work out why people fall in to heroin addiction in the first place. Most of us experiment with drugs to some level or another in our youth, but even during my own sustained and enthusiastic period of adolescent experimentation, I never got anywhere near a place where injecting a syringe full of heroin in to my arm jumped out as being a good idea.

Most, although by no means all of my patients who use heroin seem to take those extra few steps in to harder drugs and full scale addiction after fairly miserable starts in life. Heroin is often an escape from the grim realities of life and amongst my patients, child abuse and growing up in care seem to pop up time and time again as the most damaging experiences addicts are trying to escape from.

As a doctor I try not to get carried away with the emotion and morality of what I see as it interferes with the practical aspect of the job. Many of my patients have self inflicted injuries and illnesses and whether they are due to heroin, alcohol, smoking, or falling off horses, me offering extra indignation benefits no one. In my eyes politicians have no option but to take the same approach. I am dealing with addiction on an individual basis whilst they have to consider it on a more national scale, but ultimately the realities are the same.

Heroin dependence exists and is hugely detrimental to everyone. Vitriolic sound bites about the cost to taxpayers might make favorable headlines in the right wing media, but it doesn’t make the problem go away. There will always be victims who fall prey to heroin, but how about trying to prevent young vulnerable people from plunging in to addiction, rather than simply vilifying them once they have.

Source: www.blogs.independent.co.uk   23^rd May 2012

A Liverpool coroner has warned drug users that a batch of tablets containing the ecstasy-like drug PMA (paramethoxyamphetamine) may be circulating in the area. Douglas Fraser issued the warning after recording a verdict of death due to non-dependent use of drugs at the inquest of a 29-yearold Toxteth man, Lee Monaghan, who was found dead at his home on June 8. The investigating pathologist, Dr Jonathan Medcalf, said that Mr Monaghan had a fatal concentration of PMA in his system when he died, as well as traces of alcohol and cocaine. Paramethoxyamphetamine has been used as a recreational drug since the 1970s and has had short periods of popularity in Australia, Canada and Scandinavia.

The substance is a Class A drug under the Misuse of Drugs Act. The drug may be sold as ecstasy or it may be referred to by street names such as ‘cloverleaf’ or ‘Positive Mental Attitude (PMA)’. The drug is chemically similar to MDMA and effects include an increase in energy, visual distortions, a general feeling of changes to consciousness and hallucinations. Reactions after ingestion can include pupil dilation, erratic eye movements, muscle spasms, sharp increases in body temperature, nausea and vomiting. In some cases the drug can lead to convulsions, coma and death.

Anecdotal reports suggest that people who may be used to taking MDMA may find that PMA does not act as quickly as they would normally expect. Users should be warned not to redoes too quickly as increasing the concentration of PMA in the body increases the risk of adverse effects, including fatalities. According to the US Drug Enforcement Agency, doses of less than 50 milligrams (usually one pill) cause symptoms like MDMA, while dosages over 60-80 mg (lower than those used regularly for MDMA) are considered potentially lethal. DrugScope has ascertained that press reports suggesting that Mr Monaghan’s death was the first in the UK to be attributed to the drug are inaccurate. The National Programme on Substance Abuse Deaths confirmed that PMA toxicity was implicated in the death of a 21-year-old Cornish man who died in August 2001.

Source:  Drugscope Sept.2011

Excessive alcohol use is usually associated with damage to the liver. While that is a common side effect, researchers are now warning that heavy drinking can also take a toll on the lungs.

Alcohol can break down the immune system in the lungs, making them more vulnerable to infection, and the damage it causes. It’s why alcoholics are at increased risk of developing pneumonia and life-threatening acute respiratory distress syndrome (ARDS), for which there is no treatment.

Researchers at Thomas Jefferson University say they have discovered that one of the keys to immune system failure in the lung is a build-up of fat. It’s significant, they say, because it not only explains why alcohol is linked to lung disease but offers the possibility of a new treatment.

Alcoholic fatty lung

“We call it the alcoholic fatty lung,” said lead researcher Ross Summer, M.D. “The fat accumulation in the lungs mimics the process that causes fat to build up and destroy the liver of alcoholics.”

When you over-consume alcohol your liver cells begin to produce fat – most likely a defense against the toxic effects of alcohol. Over time that fat accumulates to the point that heavy drinkers develop so called “fatty liver disease.”

The fat build-up at first impairs liver function but can also cause scarring that eventually leads to liver failure. So, what does this have to do with the lungs?

The lungs also contain cells that produce fat. These cells expel a fatty secretion onto the inner lining of the lung to keep the airways properly lubricated during breathing. Summer and his teams speculated that these cells might act the same way liver cells do after extended alcohol exposure.

The study

Laboratory rats were enlisted for experiments and the researchers noted the lung cells increased production of triglycerides by 100% and free fatty acids by 300%. The researchers also noticed that immune cells in the lungs were less effective against infection.

From this, the researchers conclude that lipid lowering drugs might be an effective tool for doctors treating alcohol-related pneumonia. They think it might also head off development of ARDS.

Increased scrutiny

Alcohol only recently has received new scrutiny as a serious health threat. The Centers for Disease Control and Prevention (CDC) says there are approximately 88,000 deaths in the U.S. each year that can be attributed to excessive alcohol use, making it the third leading lifestyle cause of death in the nation.

“Excessive alcohol use is responsible for 2.5 million years of potential life lost (YPLL) annually, or an average of about 30 years of potential life lost for each death,” the CDC said in a report.

In 2006, there were more than 1.2 million emergency room visits and 2.7 million physician office visits due to excessive drinking, the agency said. The economic costs of excessive alcohol consumption in 2006 were estimated at $223.5 billion.

Then there is the whole category of deaths and injuries due to accidents caused by excessive alcohol consumption. And there is some evidence that the current statistics understate the problem.

In March researchers writing in the Journal of Studies on Alcohol and Drugs suggested a lot of highway deaths – and other accidents in which alcohol was a factor – might not make it into the alcohol-related statistics.

Between 1999 and 2009, more than 450,000 Americans were killed in a traffic crashes. The researchers maintain that in cases where alcohol was involved, death certificates very often failed to list alcohol as a cause of death.

Defining problem drinking

What constitutes excessive drinking? Heavy drinking is defined as 8 or more drinks per week for women and 15 or more drinks for men.

But don’t think only drinking on Saturday night – but polishing off 12 beers – will qualify you as a moderate drinker. Binge drinking, according to the CDC, is the worst kind.

Binge drinking is defined as 4 or more drinks on a single occasion for women and 5 drinks for men.

Source:  www.consumeraffairs.com  7^th July 2014

At a time, as now, when the interests of big business coincide with those of major media outlets and the known preferences of ensconced liberal academics, it behoves us to consider seriously the debate on the legal status of cannabis.  There comes a time in the life of democracies where the voice of the masses, the “vox populi” driven by the herd instinct can endanger or at least drown out the voice of Science and Reason.

It is therefore very refreshing, and in terms of its pertinence to the current debate, of great importance, that a confluence has been struck between the world’s top addiction researcher, Dr Nora Volkow, the Director of the Nationals Institutes of Health Institute devoted to the research and care into drug addiction, with the world’s undisputed leading medical a journal, the New England Journal of Medicine.  Dr Volkow overseas the distribution of around USD$1 Billion in research funds to addiction researchers globally, and funds an estimated 85% of addiction research around the world.  She is an eminent and well published researcher in her own right, with a recent search of the National Library of Medicine Catalogue, known as PubMed showing 603 peer reviewed papers published in her name, along with doubtless countless monographs and book chapters which are not listed on this famous international database.

Dr Volkow’s recent piece in the New England Journal of Medicine was entitled “Adverse Effects of Marijuana Use”, and may be found in volume 370, No. 23, pages 2219-2227, and was published on 5th June 2014.

It cannot be stressed to members enough that her piece was written specifically to counterbalance the implicit presumption which underlies much of the liberalist position that marijuana is essentially harmless, and that all those who seek to restrict its use are nothing more than kill-joys and party poopers.  Dr Volkow’s paper makes the point successfully that the reason the legal drugs alcoh9ol and tobacco are associated with more disease and death than the illicit drugs, lies not in their intrinsic toxicity, but in the wider availability of the legal drugs.  Since the pro-cannabis lobby seek to increase the availability of cannabis, its measured toxicities will inevitably increase.  This is the inevitable conclusion presented by the thoughtful authors of this paper.  Indeed the documented trend in cannabis potency in the US from 1975-2013 has been an strictly inverse relationship between perceived harm and teenage smoking trends now for forty years.  This is in the context of a four-fold monotonic rise in cannabinoid content from 3% in the 19080’s to 12% in 2012.

To the liberalist perspective the findings in the paper are devastating.  The researchers document that cannabis is addictive.  Whilst rates of cannabis addiction in the general community are reported at 9%, it rises to around 16% when use commences in adolescence, and up to 50% in those who smoke daily.  Cannabis addiction can cause a recognized withdrawal state.  Because the brain develops and matures until the end of the third decade of life, there are grave concerns related to the exposure of young people to it.  It has been shown to interfere with the circuits and wiring of the prefrontal executive centres, and in the critical hippocampal formation which is pivotally involved in the formation of new memories, attention, and emotionality. It damages the precuneus which is a key integrative area.  Moreover these effects last not only during cannabis intoxication, but also, because it is fat soluble, for days afterwards.  Because of its effect on the brain’s dopamine-dependent reward pathways, it increases the use of other drugs in later life.  Cannabis damages memory, cognitive function and attention systems.  Cannabis, tobacco and alcohol all act as gateway drugs and prime the brain to the use of harder drugs in later life.

Cannabis therefore has the not surprising effect of reducing:

* school performance,

* school grades achieved,

* school retention rates,

* IQ,

* income attained,

* employment rates, and

* life satisfaction and

* increasing criminality rates.

Mental illness is also elevated by cannabis.  Increased rates of anxiety, depression, psychosis, inlcuding schizophrenia, have all been observed across the board, not just in those who may be considered to be predisposed.  Moreover known schizophrenia is exacerbated by cannabis exposure.  Car crashes including fatal car crashes are elevated.  Cannabis-related emergency room visits have risen.  Drivers can be intoxicated with both cannabis and alcohol which are cumulatively toxic, dangerous and lethal.

Since cannabis is immunosuppressive real concerns exist about its use in HIV/AIDS patients,  or its administration to patients with respiratory conditions.

Cannabis smoking has been shown to increase lung secretions and suppress respiratory immunity.  It is associated with chronic bronchitis, lung hyperinflation, and increased airways resistance.  Whilst its affect on lung cancer is uncertain at this time, a negative result was reported in a single US study examining only very low level cannabis exposure – a mere 30 joint years (one joint daily for 30 years).  However serious cause for concern has been raised by studies of its cardiovascular effects, showing associations with stroke, heart attack, and transient ischemic episodes.

There are real concerns about the use of cannabis in pregnancy which require further study. The authors also note that because of the dramatic rise in potency in cannabis, older studies showing a lack of effect may be falsely reporting negative results, given the increased potency of the preparation available in modern times.  The effect of second-hand smoke and passive smoking also needs careful research.

In conclusion this lengthy and exhaustive report from the world’s leading researchers in addiction medicine strikes a very sombre and sobering warning note to any sane parent, and any members of this Honourable House who are contemplating having grandchildren.  Devastating effects on maturating brain function, mental illness, gateway effects for other drugs, lifetime educational achievement, poverty, employment rates, driving, respiratory and cardiovascular effects have all been demonstrated beyond reasonable doubt in a context where the potency of the available preparations has risen by four-fold.  Passive smoking effects and effects on pregnancy are likely but as yet not proven.  Increased availability is necessarily associated with increased morbidity and mortality.

There is enough material here to give serious pause to any members tempted by alleged tax revenue streams to succumb to the siren song of the seduction of “the weed.”

We have been warned most soberly and most sombrely.  It will be up to us to heed this eminent warning and to act accordingly and appropriately.

Source:  : Speech for NSW Parliament on Cannabis legalization Based on Dr Volkow’s Paper in NEJM July 2014

More mothers are now drinking heavily in pregnancy, leading to birth defects The number of diagnosed cases of foetal alcohol syndrome in those born to women who drink during pregnancy has tripled since records of the debilitating condition were first kept 16 years ago.

In 2012-2013 there were 252 diagnoses of the syndrome, which can leave victims severely mentally and physically impaired, compared with 89 in 1997-98. Cases are up 37% since 2009-2010.

Experts say the figures, for England only, suggest an improved ability to diagnose the condition but also a continued failure to deal with alcohol abuse.   It is feared that those so far diagnosed are the tip of the iceberg. There is often no physical sign of the condition, but victims are left with learning difficulties and an inability to connect emotionally with their peers. Without diagnosis, they are often not helped during their time at school and become isolated as adults.

Susan Fleisher, chief executive of the National Organisation for Foetal Alcohol Syndrome, whose adopted daughter suffers from the condition, said: “The World Health Organisation says that one in 100 people has foetal alcohol spectrum disorder, which is the umbrella term used to describe the conditions that occur in people who have been diagnosed with some, but not all, of the symptoms of foetal alcohol syndrome. But there have been studies in Italy and the US that say that between 2% and 5% of the population is affected by this.

“And, remember, Britain is the number one binge-drinking country in Europe. The chances are we are closer to 5%, although we can’t say that for sure because it is under-diagnosed and difficult to diagnose. Only 20% have the physical signs of this condition such as small, wide-set eye openings, flattened filtrum, thin upper lip, lower ears, different creases in the hands and there can be skeletal damage. Those are the physical things, but if you don’t see them, then perhaps you don’t ask the question.”

Alcohol kills brain cells in developing foetuses by reducing their oxygen and nutrient intake. More than half of women drink more than the recommended daily amounts, and a quarter of those drink more than twice the recommended amounts. In 2002 some 200,000 women were admitted to NHS hospitals because of alcohol abuse. By 2010 the figure was 437,000. Luciana Berger, the shadow public health minister, said the government should do more to highlight the consequences of heavy drinking and, in particular, during pregnancy. The Department of Health advises that alcohol is to be avoided in pregnancy, while the independent National Institute for Health and Clinical Excellence advises women to avoid alcohol in the first three months of pregnancy because of the risk of a miscarriage.

In 2007 Lord Mitchell introduced an alcohol labelling bill into the House of Lords. The bill was passed, but it failed to gain a sponsor in the Commons. The bill sought to make it mandatory for all containers of alcoholic products to have a government warning telling purchasers: “Drinking alcoholic beverages during pregnancy, even in small quantities, can have serious consequences for the health of the baby.”

In the United States and Canada all containers have similar wording and all pubs, bars and clubs are obliged to display a warning statement.

Berger, who uncovered the new figures, said: “The government must ensure that expectant mums have the information they need to make informed choices during their pregnancy. Instead, ministers have relied too heavily on the drinks industry to do it for them.

“Government must stop putting the interests of business before the health of mums and babies and take a bolder approach.”

Source:  theguardian.com 21st June 2014

Jokes aside about tuned-out stoners who can’t find their car, some experts are asking, what if marijuana actually makes kids dumb?

Earlier this month, three researchers at the National Institute of Drug Abuse published an article in the New England Journal of Medicine surveying the current state of the evidence.   According to their report, marijuana use in adolescence and early adulthood may measurably lower users’ IQ decades later down the road.  They conclude there is reason to believe marijuana may permanently harm the adolescent brain.

Until the age of 21, the piece notes, the brain “is intrinsically more vulnerable than a mature brain to the adverse long-term effects of environmental insults.” Given the rapid pace of marijuana legalization, researchers are noting an increased urgency to do research on the developing brains of teen users.

Washington and Colorado have both legalized recreational marijuana use, and legalization is actively being considered in 14 additional states.   While none of these states propose making pot legal for minors, destigmatization and greater ease of access have already resulted in heavier use among youths in Colorado.

As marijuana is increasingly normalized and seen as relatively harmless, some experts doubt whether we know enough to justify rapid shifts in policy and behavior in pot usage.

“There is a lot we know and a lot we don’t,” said Wilson Compton, deputy director of the National Institute of Drug Abuse and a co-author of the NEJM paper, in an interview.  “We think it’s very important to understand risk and protective factors and to understand how significant any one of them is.”

 Mile high

Public opinion, for the moment, may be racing faster than science can keep up. Last fall, Gallup reported that a solid 58 percent of Americans favored legalizing pot.   And an NBC-Wall Street Journal poll this spring found that 49 percent saw tobacco as harmful, while 24 percent said the same of alcohol, 15 percent of sugar, and just 8 percent of marijuana.

Shifting perception is quickly translating to youth drug usage in Colorado, which became ground zero for pot legalization in 2012 when the state voters chose to legalize and tax the drug.

The Office of National Drug Control Policy reported last year that one in four Boulder County high school students now use pot — more than three times the national average.   And the numbers are shifting fast.  In Adams County, a Denver suburb, high school marijuana use jumped from 21 percent in 2008 to 29 percent in 2012.   Middle school pot use in Adams County jumped 50 percent during that period — from 5.7 to 8.5 percent.

Down under

No one is certain what all of these behavior changes mean for the long-term health of kids who become heavy pot users in adolescence, but some researchers think they have a good hunch.

One of the most critical insights comes from a 40-year, ongoing study in Dunedin, New Zealand, where researchers have for years followed the lives of 1,037 children born there during a one-year span in 1972 and 1973.The kids, now adults, were tested at two-year intervals throughout their childhood and subsequently at ages 21, 26, 32 and now 38.

Retention at each stage of the study has been remarkable: At the last interval, they got to 95 percent of the original group.  Every angle of physical, mental and social health is examined, and researchers also interview friends and relatives.

The result is an unprecedented data trove.

Arizona State University psychology professor Madeline Meier and several co-authors at Duke University used Dunedin’s data to check the effect of adolescent marijuana use, publishing their findings in 2012 in the Proceedings of the National Academy of Sciences.

Those who regularly used marijuana as teens, the study found, lost significant IQ points between their 13th and 38th years.

Friends and associates also reported more cognitive problems among regular pot users, and even those who quit did not entirely regain all the ground they had lost in their youth.

Deflecting challenges

The data is so rich that Meier and her colleagues were able to deflect two challenges to their conclusions, and so far no more have surfaced. One critic from Norway published a critique suggesting that socioeconomic differences may have been the real culprit.   Perhaps, he posited, people with duller careers and less stimulating associates had their IQs artificially boosted during their schooling years, and then failed to maintain mental growth as they aged.

Meier and her colleagues went back to the original data and broke it down again, this time focusing strictly on middle class kids, and found that the results held firm.

Another challenger suggested that kids who used pot were naturally lacking in self-control, and thus likely to see their IQ slip as they aged.  Again re-analyzing the Dunedin data, the researchers demonstrated that marijuana’s impact on IQ took place regardless of how much self-control the subject had in childhood.

Meier readily admits the limits of this kind of observational study, which — unlike controlled, clinical studies — cannot determine causation and is often confounded by unseen variables. “With observational data there could always be an alternative explanation,” Meier said.  “However, we did rule out some of the best and most plausible explanations.”

One of the key findings was that the IQ reduction does not occur if the user began smoking marijuana after adulthood.   This, Meier says, has led some to see validation in the study for legalization among adults.

Moving forward

“The association seems clear but causal mechanisms not fully understood,” Wilson Compton said.  “What we need is additional work.”

The NEJM article by Volkow, Compton and their co-authors cites research showing “impaired neural connectivity” among users who began smoking pot in their teens — including areas of the brain that affect alertness, learning and memory.   They also cite studies showing reduced function in the prefrontal networks, which manage conscience and self-control.

All of this is not really surprising, they argue, since the developing brain is peculiarly vulnerable to damage in adolescence and early adulthood.  The NIDA team is currently planning (and arranging funding for) a study that will follow 10,000 children from age 10 through adulthood, looking at the impact of numerous substances and behaviors on the brain.

The team will do biological tests and interviews, as well as functional magnetic resonance imaging to see what the brain is doing in real time. The key to such an ambitious study, Compton said, will be follow-up rates.

Many studies struggle to keep track of people over many years, he said, but there are models for what works.  Persistence is critical, he said, because tracking down people who move is tough. “The science and the art is to not make it too burdensome,” he says.  “You have to make it interesting and important enough for them that they will be willing to continue.”

By the time the new study is funded, launched and completed 20 years later, an entire generation will have grown up under shifting attitudes toward and usage of marijuana. And, if Meier and her colleagues are right, many of these newly minted adults will be carrying permanent mental handicaps acquired in the experiment.

Source:   http://www.sjr.com/article/ZZ/20140620/NEWS/306209982/2002/LIFESTYLE

June 20, 2014

A discovery of Colorado students as young as 12 with “substantial amounts of marijuana” in their possession has anti-drug organizations sounding alarm bells and calling it “a canary in a coal mine” for Florida.  Cpl. Mike Dillon of the Mesa County (Colorado) sheriff’s department confirmed statements he made to Drug Free America Foundation.

In a telephone interview Wednesday he told Sunshine State News he caught children not yet in their teens bringing as much as three-quarters of an ounce of marijuana to school, “which is quite a bit of marijuana, especially for a 12-year-old.”   Dillon said he was working as a middle school resource officer when he discovered the uptick in student marijuana possession.

“Kids were stealing medical marijuana from their parents. I was finding … more often than not, they had taken it from somebody in their residence and those people didn’t even know their kids were taking it.” Colorado voters approved the regulation of medical marijuana in 2000 and limited recreational marijuana — up to 1 ounce in adults age 21 and over — effective last Jan. 1.   Asked how certain he was that the “uptick” came from medical and not the newer recreational marijuana, Dillon said in all cases in which he was involved, “parents had a medical prescription for the drug.” Hard numbers as proof aren’t easy to come by because generally speaking, school disciplinary statistics don’t isolate marijuana from general drug violations. But school resource officers, counselors, nurses, staff and officials with Colorado school safety and disciplinary programs are anecdotally reporting an increase in marijuana-related incidents in middle and high schools. The best quantifiable evidence in Colorado to date that indicates marijuana is a significantly growing problem in schools comes from a 2012-13 report that documents why 720 students were expelled from public schools across the state.

For the first time, marijuana was separated from other drugs when school officials were asked to identify the reason for students’ expulsions.   Marijuana came in first. It was listed as being a reason for 32 percent of expulsions. In an interview with the Denver Post, Janelle Krueger, longtime adviser to the Colorado Association of School Resource Officers, said, “We have seen a sharp rise in drug-related disciplinary actions which, anecdotally, from credible sources, is being attributed to the changing social norms surrounding marijuana.”   Krueger is the program manager for Expelled and At-Risk Student Services for the Colorado Department of Education. She said school officials believe the jump — or uptick — is linked to marijuana’s availability and the message legalization sends to kids — even though 21 is the legal age in the Rocky Mountain State — that marijuana is a medicine and a safe and accepted recreational activity.  Christine Harms, director of the Colorado School Safety Resource Center, backs up Krueger’s observations.

She said school psychologists “are seeing more incidents of kids smoking and thinking it is the safe thing to do.”   One doctor who works with adolescents with drug problems reported to Harms that 74 percent of the youth in his marijuana addictions group said they got their marijuana from someone who has a medical marijuana card. According to the Post, school and law enforcement officials claim “marijuana that parents or other adults might have kept hidden in the past may now be left in the open, where it is easier for  kids to dip into it to sell, use or, in some cases, simply to show off.”

Grand Junction, Colo., school resource officer Jeff Grady, who has spent 25 years working in schools, told the Post a story about sitting in his car at a park near Grand Junction High School one day watching groups of kids through binoculars because they come to the park to smoke on lunch breaks. “Kids are smoking before school and during lunch breaks.   They come into school reeking of pot,” he told the newspaper.  “They are being much more brazen.”

He said they’re harder to cite for any offense because now they can say they were around an adult medical marijuana user and weren’t smoking themselves. Calvina Fay, director of the Drug Free America Foundation, sees Colorado’s dramatic increase in pre-teen schoolchildren possessing marijuana as a warning to Floridians who will vote on approving medical marijuana in November. “This is the sad reality that we are seeing in all states that have passed these measures,” said Fay in a written statement.

“They use people who suffer with debilitating cancer or other conditions as a Trojan horse to pass these broad measures, and inevitably these powerful pot products end up in kids’ hands.”  It troubles Polk County Sheriff Grady Judd, president of the Florida Sheriff’s Association, and other public safety officials that the ballot language Floridians will vote on does not address age in any way.

“Amendment 2 is full of loopholes, including no age restrictions, which may allow youth to easily obtain marijuana without parental consent,” Judd has said. Fay also points to weak state oversight of pot shops, which she believes invites problems.   A Florida Department of Health fiscal analysis predicts there will be more than 1,800 pot shops allowed to sell marijuana, but anticipates the hiring of only 13 inspectors to provide oversight statewide.

“We are unleashing the Wild West of incredibly potent marijuana and not providing the sheriffs to oversee it,” said Fay.   “This is a canary in a coal mine for Florida’s parents and school officials; they need to heed these warnings from Colorado.”  National policy organization Drug Free America Foundation said in its press release it is working with the Don’t Let Florida Go to Pot coalition to educate Floridians on the dangers of marijuana so they can cast an informed vote on Amendment 2 in November.

Source: http://www.sunshinestatenews.com/story/colorado-deputy-school-resource-officers-will-be-busier-if-medical-marijuana-passes-florida June 19, 2014

Yesterday, the checkout line at my favorite Lowe’s Home Improvement store was so long that I watched an obviously frustrated man walk away from a shopping cart that easily contained what would have been a $250 purchase. The people in front of me and behind me were steamed, too. “The problem isn’t just here in the garden center,” one woman said. “The whole store is understaffed.”

She was right — but I wasn’t going to give up my spot in that line to wander inside the main store building to find a manager to address the situation. So, I held my ground, whipped out my mobile phone and called Lowe’s toll-free, customer-service number (thanks, Lowe’s, for posting that right over the register) to relay the problem — and what I’d just witnessed in terms of lost business.

What I ultimately learned from that conversation is that Lowe’s corporate executives should have a hard discussion with Colorado Gov. John Hickenlooper and economic-development offices in the cities where their stores operate in this state. Why? Because Lowe’s doesn’t want to hire people who can’t pass drug tests — and here in Cannabis, er, Colorful Colorado, the company is greeted with too many job applicants who test positive for THC, the active ingredient in marijuana.

Wonder of wonders, Lowe’s doesn’t want people acutely or sub-acutely under the influence of marijuana operating forklifts, using circular saws, cutting ceramic tiles, driving company trucks — or cleaning its toilets. And no, the company isn’t interested in lowering its hiring standards, either, said Amy, the friendly and always-approachable manager at my favorite Lowe’s store.

Within minutes of the customer-service center alerting her of my call, Amy was on the line with me to apologize. I assured her that I wasn’t at all angry. Instead, my call was motivated by a love of the place. It was by working for Lowe’s that my younger brother picked up a lot of the skills that eventually helped him open his own residential remodeling company. I have dear friends who work for Lowe’s. All my son wanted to do for his 4th birthday was invite a dozen of his best buddies to Lowe’s to build wooden race cars during one of the company’s Saturday build-it workshops for kids. It’s a longstanding joke in my family that we should own shares of the company given how many times my father visits his favorite Lowe’s store every week. Dr. T, who serves in the U.S. Army, really appreciates Lowe’s stated appreciation — and discounts — for those in the armed services.

So, call me crazy, but I’m actually protective of the company and its brand.

“We’re trying to find the best people to hire, and it’s really hard these days,” Amy the manager told me.

“Why do you think it’s so difficult?” I asked.

“Because hardly anybody passes a drug test,” she quickly replied. “It’s a real problem.”

When I probed a little more, I learned that marijuana use is the chief reason for the applicants’ failed test results — and by a long shot.

Perhaps Lowe’s is painfully aware that marijuana isn’t like alcohol in all sorts of ways vital to workforce readiness. Maybe its executive ranks know how tough it is to pinpoint a marijuana user’s level of impairment. Maybe the company is also versed in studies the world over showing the risk of a traffic accident significantly increases when a person has even 1 ng/ml THC in his or her system.

However, one thing is certain: Lowe’s isn’t the only Colorado employer struggling to find drug-free workers to fill decent jobs. Conspire!, a drug-testing company based in Colorado Springs, reports that THC-positive, workplace drug tests it has administered in that city have increased 30 percent since the start of 2013.

So, I get it: Lowe’s, which stands by the slogan “Never stop improving,” faces a dilemma — and one that IS affecting its shoppers. I’m willing to wait a little longer in line because I like the company so much — but I suspect I’m an exception, not the rule.

And as a longstanding and loyal customer, I certainly don’t want Lowe’s to lower its hiring standards — or even feel pressured to do so.

Source:   dthurstone.com  14th May 2014

Marijuana use, cultivation and black market trafficking remain “pervasive” in Oregon, a trend fostered by Mexican drug cartels, Asian gangs and the state’s own medical marijuana program, a new law enforcement report concludes.

The findings were part of a “threat assessment” by Oregon HIDTA, a federally funded agency that manages law enforcement resources in high-intensity drug trafficking areas of the state. The report paints a grim portrait of drug trafficking and abuse in Oregon, particularly when it comes to heroin.   On marijuana, the conclusions echo complaints law enforcement officials have raised over the prevalence and black market availability of the drug, particularly cannabis grown under Oregon’s medical marijuana program.

Law enforcement officials have long argued that the drug’s increased potency and widespread cultivation by organized crime and medical marijuana cardholders lead to abuse and illicit trafficking.  The report comes as marijuana legalization advocates in the state and nationally push to get an initiative on the fall ballot.

Nearly all police surveyed this year reported a “high level of marijuana” available in their area “with more than one-third” reporting that the drug was more available this year compared to 2013.  Use of marijuana by Oregon residents is greater when compared with other states; the latest national survey found that in 2011 and 2012, Oregon ranked fourth in the country for cannabis use by people 12 and older, with most consumers between 18 and 25. (The top three: Rhode Island, Alaska and Vermont.)

Among the report’s findings:

The popularity of hash oil is on the rise. Butane, a flammable solvent, is often used to make the potent marijuana concentrate. The report cites a recent investigation by The Oregonian into butane hash oil, which identified nine major BHO-related explosions since 2011, including one that killed a Portland man.

“Liquid THC production – – and incidence of butane hash oil lab explosions — is expected to rise as the market expands for marijuana edibles and demand increases for product that has a strong psychoactive effect,” the report notes.

Oregon State Police data shows that between 2008 and 2013, toxicology tests detected marijuana more than any other drug, not including alcohol, in impaired driving investigations. The rate of detection increased 16 percent between 2010 and 2013, the report found.

The report also notes that “accidental exposure” to marijuana is an ongoing concern. An analysis of U.S. poison center data shows the rate of “unintentional marijuana exposure” in children younger than 9 more than tripled between 2005 and 2011 in states that passed marijuana decriminalization legislation before 2005.  The director of the Oregon Poison Center told The Oregonian on Monday that the center receives between two and 15 calls a year related to children accidentally ingesting marijuana. Sandy Giffin, the director, said it’s hard to determine whether there’s been an increase in marijuana-related calls since the numbers are small.  While Mexico remains a chief foreign source of heroin, meth and marijuana, Oregon’s medical marijuana program’s generous plant and possession limits make it a source for black market marijuana. People designated as caregivers are allowed to care for an unlimited number of medical marijuana patients, each allowed up to 11/2 pounds of marijuana. Caregivers with many patients may “exploit the program by claiming they are growing for legitimate OMMP patients,” according to the report. The Oregon Medical Marijuana Program includes nearly 60,000 patients; 30,000 people hold caregiver cards as well.  “The large number of cardholders, coupled with the high volume of plants cultivated, the difficulties associated with investigating compliance, and the attraction of selling surplus amounts on the black market for substantial profit and little risk has resulted in incidents of non-compliance in the HIDTA region and statewide,” the report states.

— Grow sites also remain potential targets for theft and violence, the report says, relying on anecdotal evidence including a 2012 fatal shooting during a Cottage Grove home invasion robbery. In 2010, detectives executive a search warrant on a Douglas County grow site encountered booby traps that entailed shotgun shells “rigged to explode at chest level if a trip line was triggered.”

— Marijuana’s potency also is on the rise, HIDTA reports. The U.S. Drug Enforcement Administration analysis found the average THC in seized samples reached 15.1 percent – the highest level recorded since the agency began testing in 1976.

— Though the state seized fewer outdoor marijuana plants in 2012 and 2012, Mexican cartel operations “remain Oregon’s primary production and trafficking threat.” Law enforcement officials suspect cartel-operated outdoor marijuana production will shift to areas of the state with fewer police resources.  “Budgetary shortfalls will continue to impact the ability of law enforcement officers to effectively locate and eradicate outdoor grow sites due to prioritization of resources, displacement of staff, and diminished provision of flight time,” the authors note.

— When it comes to indoor marijuana cultivation, Oregon continues to be one of the top 10 states for indoor seizures, ranking fourth in the nation in 2012. About half of the total indoor plants seized last year in Oregon were linked to non-compliant medical marijuana grow sites.

The authors speculate that the medical marijuana program will be exploited to “encourage larger indoor marijuana grow operations,” which will “contribute to the volume of marijuana trafficking through and out of the state.”

Source:  http://www.oregonlive.com/marijuana/index.ssf/2014/06/16 medical_marijuana

A charity has called for action to tackle the “growing and serious” problem of excessive drinking in older age after official figures revealed the number of alcohol-related deaths among people aged 75 and over has increased to their highest level since records began in 1991.

The rise in alcohol-related deaths in the UK among the elderly in 2012, up 18% for men and 12% for women, came despite an overall drop in the number of such deaths across all age groups to 8,367, down 361 on the previous year, Office for National Statistics (ONS) data shows.

The death rates per 100,000 also reached their highest level since records began, at 28.5 for men and 13.5 for women – illustrating that the rise is not just a result of an aging population.  Caroline Abrahams, charity director at Age UK said excessive drinking was often linked with issues such as bereavement, loneliness and isolation.

“Whilst the spotlight on excessive drinking generally falls on younger people, the most significant increases in alcohol related harm are actually in older age groups, with people aged 65 and over also reporting the highest rates of drinking on five or more days a week,” she said. “The numbers of alcohol-related hospital admissions, illnesses and mental health disorders among older people are also sadly on the rise.  “It’s time that excessive drinking in older age is recognised as a growing and serious problem and that appropriate and effective preventative and treatment services are made available.”

There were 580 alcohol-related deaths among men aged 75 and over in 2012 and 385 among women aged 75 and over.  When the data series began in 1991 there were 18.1 deaths per 100,000 men aged 75 and over (equivalent to 257 in absolute terms) and 10.5 deaths per 100,000 women aged 75 and over (equivalent to 271 deaths).  The only other group which saw a rise in deaths in 2012 over the previous year was women aged between 55-74, with a 3% increase to 1,318 deaths in 2012 and a rise in the rate per 100,000 from 19.5 to 19.8.

The overall number of alcohol-related deaths per 100,000, adjusted for age, fell to 11.8 in 2012, its lowest level since 2000, when it stood at 11.2. But the ONS said Scotland was the only country in the UK in which male and female death rates were significantly lower in 2012 than 2002.

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 and we’re one of the few European countries where liver disease is on the increase.”

Alcoholic liver disease was responsible for 63% (4,425) of alcohol-related deaths in 2012. The fourth highest alcohol-related cause of death was accidental alcohol poisoning (396 deaths), including 14 deaths of people in their 20s. The ONS said: “There has been speculation that the influence of social media drinking games may drive these figures up in the future particularly among younger people.”

Professor Kevin Fenton, director of health and wellbeing at Public Health England, said it was working in partnership with the NHS, other agencies and local authorities to tackle

harmful use of alcohol. “Key priorities are implementing measures which make drinking at lower risk levels the easier choice; early identification and advice targeted at those who are most at risk; and the right treatment and support for people who are dependent on alcohol,” he said.

Source:  http://www.theguardian.com/society/2014/feb/19/alcohol-deaths-elderly-rise-ons

A daily dose of powerful anti-HIV medicine helped cut the risk of infection with the AIDS virus by 49 percent in intravenous drug users in a Bangkok study that showed for the first time such a preventive step can work in this high-risk population.

“This is a significant step forward for HIV prevention,” said Dr. Jonathan Mermin, director of the U.S. Centers for Disease Control and Prevention, which helped conduct the clinical trial along with the Thailand Ministry of Health.

The study, published on Wednesday in the journal Lancet, looked at the treatment approach known as pre-exposure prophylaxis, or PrEP, in which HIV treatments are given to uninfected people who are at high-risk for HIV infection.

The drug used in the study was Gilead’s older and relatively cheap generic HIV drug tenofovir. The study was launched in 2005.

Prior studies of this approach showed it cut infection rates by 44 percent in men who have sex with men, by 62 percent in heterosexual men and women and by 75 percent in couples in which one partner is infected with HIV and the other is not. The new results showed that it also protects intravenous drug users.

“We now know that PrEP can work for all populations at increased risk for HIV,” Mermin said in a statement.  Based on the results, the CDC plans to recommend that U.S. doctors who wish to prescribe this treatment for their patients follow the same interim guidelines issued last year to prevent sexual transmission among other high-risk individuals.

Intravenous use of drugs like heroin accounts for about 8 percent of all new HIV infections in the United States and about 10 percent of new HIV infections worldwide. In some regions, such as Eastern Europe and Central Asia, injection drug abuse accounts for about 80 percent of all new infections.

The new findings involved more than 2,400 intravenous drug users in Bangkok who were not infected with the human immunodeficiency virus, which causes AIDS, and were being treated at the city’s drug treatment clinics.  Half took tenofovir and half took a placebo. All participants were given HIV prevention counseling, risk-reduction strategies such as condoms and methadone treatment, and monthly HIV testing.

At the end of the study, there were 17 HIV infections among people taking the HIV medication, compared with 33 infections among those not taking the drugs, the researchers found.  The researchers also looked to see what factors influenced infection rates among those taking the HIV medication. They found that people who took their medication at least 71 percent of the time had a 74 percent lower risk of becoming infected with HIV.

Although it was not clear how the preventive drug treatment worked – by stopping infections caused by sharing dirty needles or by unprotected sex among drug users – the study produced a reduction in infection rates, said Dr. Salim Abdook Karim of the University of KwaZulu-Natal in Durban, South Africa and of Columbia University in New York.

“The introduction of PrEP for HIV prevention in injecting drug users should be considered as an additional component to accompany other proven prevention strategies like needle exchange programs, methadone programs, promotion of safer sex and injecting practices, condoms, and HIV counseling and testing,” Karim, who was not involved in the study, wrote in a commentary accompanying the study in the Lancet.

“PrEP as part of combination prevention in injecting drug users could make a useful contribution to the quest for an AIDS-free generation,” Karim added.
Source: http://www.foxnews.com/health/   13^th June 2013

Ask Dr. K: Some who use drugs ‘almost addicted’ –

Q) I think I may have a drug problem. But how can I tell if I’m truly addicted?

A) The world is not divided neatly into those who are “addicts” and those who are not. More and more, doctors are viewing substance use as a spectrum.

Imagine that spectrum as a straight, horizontal line. At the left end are people who do not use potentially addicting substances.

Just in from the left end is a group that uses a potentially addicting substance regularly but only in small amounts — and never feels pressure to use that substance.

At the extreme right end are people who need to use a potentially addicting substance every day, and do. They do whatever it takes to get that substance. They are addicted to it, and they:

– Need ever-increasing amounts of the drug in order to get high.

– Experience unpleasant physical and emotional symptoms when the drug is leaving the body.

– Use more of a drug or use it for a longer period of time than intended.

– Are unable to stop using the drug, having repeated, failed attempts to stop or cut down.

– Spend a lot of time obtaining, thinking about or using the drug.

Just in from the right end are those with substance abuse. This is milder than addiction; it describes those who have experienced significant impairment or distress because of their need to use a potentially addicting substance. One or more of the following is also true:

– They are failing to fulfill major obligations at home, school or work.

– They have repeatedly used substances when doing so may be physically dangerous.

– They have recurrent legal problems as a result of substance use.

– They just can’t stop using the substance despite the problems it is causing them.

There’s also the “almost addicted.” They’re to the right of those who regularly use addicting substances without a problem. And they’re to the left of those with substance abuse. For the almost addicted, substance use:

– Falls outside normal behavior, but is short of meeting the criteria for addiction or abuse.

– Causes problems for the person using drugs or for loved ones or other bystanders.

If you think you might have a problem, one place to start is with your doctor. He or she can help you find the resources you need to help you quit.

Source: ERIE TIMES-NEWS, –  NOVEMBER 06. 2012