In September, 2012, the University of Southern California discovered a critical link between recreational marijuana use and a high risk of men developing subtypes of testicular cancer. The American Cancer Society has concurred with these findings and a support is effect on testicular cells in young male patients. Additional facts have borne out, that young men who have smoked marijuana before, are twice as likely to develop mixed germ cell tumors.

Subtypes of Testicular Cancer Unfortunately, testicular cancer is a common cancer that occurs in young men between the ages of 15 to 45 years of age. Testicular cancer cases have risen recently in the last few years, with researchers looking at exposures to environmental causes. The subtypes of testicular cancer are known as “non-seminoma” and mixed germ cell tumors. Both of these subtypes have been linked with marijuana use, where seminoma carries a bad prognosis. Continued research and clinical studies are being conducted to determine just how marijuana might cause testicular cancer. Researchers admit that they do not understand how marijuana triggers carcinogenesis in the testis; they just know that cancerous cells act through the cellular networks in the end cannabinoid system, which is a part of making sperm cells.

Marijuana And Developing Testicular Cancer – A link to Get Alert As previously stated, young men are the at risk group that is at risk of developing cancerous tumors. Clinicians are asking recreational users of marijuana to begin paying attention to changes in their testicles. Also, young men should let their personal physicians know that they use marijuana regularly, so that their healthcare providers can help monitor their sexual health. The University of Southern California found that the data they collected reflected that men within their survey and analysis had used recreational marijuana more than once per week. A critical alert is going out to all young men and healthcare providers who live in the 17 states where medicinal marijuana is legal, including California, despite being illegal for medical use at a federal level. Researchers state that this alert is to be seriously considered for both recreational and medicinal use of cannabis.

Future Health Impact for Men Even though researchers have discovered a link between marijuana and testicular cancer, the rate of non-seminoma cancer is low, but the lifetime risk of even a 1% chance is alarming. This broad range alert is being taken seriously and urgently because some men who can develop testicular germ cell tumors can recover, but there are still a small percentage of men who won’t. Also, the treatments in fighting germ cell tumors involve extensive radiation and chemotherapy. Marijuana can have long term impact on poor sexual performance of men and their overall health, like fertility or the removal of the affected testis.

Self-Exams Are Necessary

Yes, some medical professionals in those states that legalized marijuana do not agree with the findings of the University of Southern California, touting the cancer fighting properties of cannabis usage. However, earlier in 2012, a government released study showed that marijuana use has become high among teenagers. According to the National Cancer Institute, there isn’t a routine screening test for detecting testicular cancer. This cancer is generally found due to men examining their own bodies or through a regular physical exam for men. Men should examine their scrotum area and testicles for signs that include:

* Enlargement of a testicle

* Significant loss of size in one of the testicles

* Feeling of heavy feeling in the scrotum

* Dull ache in the lower abdomen or in the groin

* Sudden collection of fluid in the scrotum

* Pain or discomfort in a testicle or in the scrotum

* Enlargement or tenderness of the breasts

Previous Marijuana/Testicular Cancer Study The University of California’s Keck School of Medicine was not the first to realize a link between marijuana and testicular cancer in young men. In 2009 the Fred Hutchinson Cancer Research Center, Seattle, Washington, researchers intimated a link in young men that ingested marijuana almost daily. The Keck researchers discovered low testosterone, low sperm count, and in some cases impotency, as a result of frequent marijuana use.

Conclusion

To smoke or not to smoke, is the question that is being left in the hands of young men. Even though the University’s studies are somewhat limited, researchers state that young men could be taking a chance with their future health if they continue to use marijuana in a recreational setting, with testicular cancer being one of the consequences. The reproductive system of men naturally produces a cannabinoid style chemical that has been shown to protect the body against cancer tumors, but the research also identified

that other marijuana properties interferes with this protective chemical, weakening its actions.

Source:   examiner.com   12th  August 2014

This is a question that was asked on the Illinois Poison Center Facebook page a couple of weeks ago.  Up until a year or two ago, I would have said no.  Now I am not so sure.

Marijuana has changed a lot in the decades since President Obama intercepted and sucked down half a joint at high school parties in Hawaii.  The quality of weed (as measured by THC content) grown in the 1970’s and 80’s does not compare to what is available today.  According to the University of Mississippi Marijuana Potency Monitoring program, the percent of THC in marijuana seized by federal agents increased from 1.37 to 8.49 percent in the 30 year period 1978 to 2008.  For medical marijuana, extracts like BHO and edibles, the THC content can be even higher.

So what does the availability of great weed have to do with poisoning? The mantra of poisoning is that it is the dose that determines a compound’s toxicity.  A little bit of aspirin is good, a lot of aspirin is deadly.  Water is healthy for you, but too much water is deadly.  There is nothing on this earth that is not without poison, it is only a matter of dose.

In the past 8 months, there have been an increasing number of articles on a potential link between marijuana and cardiac effects, especially in young people without other risk factors.

o July, 2014 (hot off the presses) the Journal of Emergency Medicine presented a case of a 21 year old male with clean coronaries who suffered a heart attack after acutely smoking marijuana o April, 2014 in Acta Cardologica, a case series of three individuals who developed heart attacks after smoking marijuana was published o April 2014, in the Journal of the American Heart Association published a study from France that collated 35 cases of cardiovascular effects after smoking marijuana.  These cases had a 25% mortality rate.

o December, 2013 in Forensic Science International is a case report of a 21 year old gentleman who was undergoing continuous heart monitoring and it was noted that his heart would stop beating for up to 5 seconds when smoking weed.  On repeat heart monitoring after he ceased all marijuana smoking, his heart monitor exams returned to normal.  It is proposed that prolonged periods of a non-beating heart can lead to sudden death.

Besides an increase in the reports of cardiac effects attributed to marijuana, there is also a rise in the number of cases of “Cannabinoid Hyperemesis Syndrome” (CHS).  In these cases, people who smoke a lot of marijuana end up in a cycle of prolonged continuous vomiting.  A common trait of the syndrome is that the only relief that affected individuals get is from taking hot showers or hot baths.  However, as painful as vomiting for hours on end sounds, the adverse effects of CHS to other organs can be much worse:

o Patients with Cannabinoid Hyperemesis Syndrome are at risk for acute kidney failure o Takotsubo Cardiomyopathy (literal translation is “broken heart)  in conjunction with CHS was reported in April, 2014 in the Hawaii Journal of Medicine and Public Health.

With the changes in laws and increasing availability around the country, more people are smoking marijuana.  With potent clones being chosen for cultivated marijuana, the quality of weed available has never been higher.  It is not a stretch to say that more people, smoking more potent marijuana in large amounts, will lead to an increasing number of adverse effects being reported.

So is weed bad?  As medical marijuana gains acceptance and there are more controlled trials, my impression is that in controlled, regulated amounts, benefit may be shown for many diseases.  In unregulated or ‘overdose’ amounts, there is a chance that weed will be bad for you.  Kind of like drinking beer, there is a line between moderation and excess.

For the past several years, I had a standard line in a canned illicit drug lecture that “no one ever died acutely from smoking weed.”   Half the audience would high five each other.  Sadly, with the influx of new reports of adverse cardiovascular effects, I won’t be able to use that line any more.

Source:  ipcblog.org   12th August  2014

As part of the big push for drug legalisation in the USA,  it is becoming very clear that this is not only being funded  by organisations and individuals who have been pushing for this for years, but also by those who expect to make a great deal of money out of it.  Parent groups and others in the drug prevention field are horrified that financial gain is being put above the health and welfare of their children – and of society in general.   The following comment was sent to the New York Times following their  editorial agreeing with the legalisation of marijuana.

In, the United Kingdom, we have not legalised marijuana for spurious so-called ‘medical reasons or for ‘recreational use’. Guess what – the findings of a report just released by the Health and Social Care Information Centre shows that drug use amongst secondary school students in England has plummeted by 50% since 2003….  In stark contrast to what is happening to students in the USA.   If you want your young people to continue using marijuana take note that research shows this will reduce their IQ points – and for heavy, regular users they are statistically more likely to move on to using cocaine.

Those standing to make big bucks out of the sale of marijuana will tell you soothingly that the relaxation of your drug laws will only be for adults and that minors will be protected….. yes, like they are not supposed to be able to purchase tobacco and alcohol products ?

The younger a person is when they start to use an addictive substance the more likely they are to become problem drug users.

Brent Lewin | Bloomberg | Getty Images

Big Oil has one. Big Telecom has one. Big Pharma has one. If you’re an industry with a true foothold in Washington—a “Big” lobby, in other words—you’ve got to have a “revolving door.”

And increasingly, it seems like the $2.5 billion-a-year (and growing) American cannabis trade is building its own—let’s call it a “revolving hotbox,” to use the pot smoker’s parlance—attracting a growing number of ex-politicians and former political staffers to the industry’s cause.

Earlier this summer, Jack Lavin, former chief of staff to Illinois Gov. Pat Quinn, resigned to become a lobbyist. One of his first three clients was a marijuana start-up company, which hired Lavin specifically to lobby the governor’s office. Read MoreWARNING!!! Legalizing pot will make income inequality a lot worse

William Delahunt, a former U.S. representative from Massachusetts, started a nonprofit medical marijuana company last year. That outfit became the subject of controversy last month, when the state pulled its three dispensary licenses, after public outcry over its financial ties to a consulting firm Delahunt runs.

Gary Johnson, a former New Mexico governor and Libertarian Party presidential candidate, recently became CEO of Cannabis Sativa, a publicly traded marijuana company whose stock price has been skyrocketing of late.

“Overall, I don’t see a downside to any of this,” Johnson said of the increasing involvement of people like him. “From the standpoint of the legalized environment nationwide, it is all headed that way, and it is headed that way very quickly.”

Steve Katz, an upstate New York Assembly member, has boasted of his intentions to get into the weed business after his term in office expires. Read MoreThe New York Times calls on US to legalize marijuana

And the National Cannabis Industry Association, the nation’s leading marijuana trade group, hired Michael Correia, a former GOP congressional staffer, to be its first full-time lobbyist.

Source:  http://www.cnbc.com/id/101886620  August, 1, 2014.

The United States is on the verge of having powdered alcohol – in packets like Kool-aid but with the punch of a rum or vodka cocktail – on sale across the country. After much confusion, Palcohol, which has seven flavours including Cosmopolitan and “Powderita” is on hold over problems with its labelling.

There is a lot we don’t know about this form of alcohol (although a version was patented as far back as 1964), but we know enough about how many young people might receive it and the troubles that are likely to come from putting this kind of product on the market. The makers of Palcohol have defended claims that their product could be used as a sneaky way of avoiding high drinks prices in venues and that the idea came as a neat way of avoiding carrying booze after a day of physical activities. In reality, it could be used in all sorts of ways.

What we do know is that powdered alcohol will probably be particularly appealing to young people, judging from their demonstrated preference for flavoured alcohol (take alcopops for example), and alcoholic jello. Many adults never imagined that alcoholic jello would take off among youth, but we know from recent research that these are not only popular, but also most popular among the kids who drink the most. Powdered alcohol is also easily concealable, which will make it more feasible for people who are underage to get hold of, travel with and consume, in both liquid and food form. Palcohol’s makers appear to have been caught off guard after the Alcohol Tobacco Tax and Trade Bureau (TTB) announced approval for the product. They hastily changed marketing for their product. Their website had suggested mixing it with guacamole (for “kamikaze guacamole”), salad or other foods as part of their plans to market the product while pointing out that this does not add flavor to the dish, just alcohol.

What’s an average mixed drink?

The producers of Palcohol suggest adding five ounces of liquid to make “one average mixed drink”. It isn’t too big a leap to suggest that drinkers will experiment with adding less liquid and using multiple packets to strengthen the effects – something you can’t do with a regular bottle of drink.

When it comes to alcohol consumption in its traditional liquid form there can be a narrow margin of safety before brain stem functions like breathing, heartbeat rhythm and the gagging reflex begin to shut down when large amounts are consumed over a short space of time, as the fallout from the Neknomination craze has shown. When drinking over a two-hour time period brain stem function may be impaired for average sized men and women respectively at approximately 13 and 10 standard drinkservings of alcohol. The National Institute on Alcohol Abuse and Alcoholism defines the threshold of low risk drinking as no more than four and three drinks in any one day and 14 and seven in any one week period for men and women respectively. The possibility of consuming multiple packets could be dangerous.

Alcohol poisoning is already on the rise: hospitalisations of 18 to 24-year-olds related to alcohol overdoses in the US increased by 67% between 1999 and 2008. The hospitalisation of 26 teens aged 14 to 18 after loading up with drink before a Whiz Khalifa concert in New York shows that alcohol is already too accessible without making it available in packets that are easy to slip into a coat, a classroom or a concert. And of course, what better way to maximise the high than to add Palcohol to beverage alcohol, for at least twice the effect?

Stealth intoxication

The manufacturers have said they only promote responsible drinking, including asking people to make sure they find out whether they can take the product into venues. But we know very little about this new vehicle of alcohol delivery: is it easily detectable when added to other drinks? Could it be used as another form of stealth intoxication in a manner similar to other drugs used to facilitate sexual assaults, for example? If the company suggest adding it to food but say it doesn’t affect taste, does this up the chances of some unsuspecting person consuming it? Experience in multiple countries with alcopops has shown this type of product and marketing attracts young people at earlier ages, putting them at higher risk for addiction and other negative consequences than those who wait until they are older to drink.

In the US, regulation falls between a number of entities but the Treasury Department’s Alcohol Tobacco Tax and Trade Bureau (TTB) has the most power to regulate alcohol and control decisions through labelling and alcohol taxes. It is the agency that recently gave and then within days and without public explanation withdrew labelling approval for Palcohol to go on the market. It is also possible that the Food and Drug Administration could prevent Palcohol from going to market based on claims that it could be considered a food product or food additive. Given that Palcohol has never before been consumed or sold to the US public at large, it is unlikely the FDA would have considered it to be generally regarded as safe, the FDA’s standard for food safety.

The new, the cool, the tongue-in-cheek all appeal to younger people. Alcoholic powder would likely attract a similarly youthful and risk-taking customer base as did alcoholic jello, and the result might just be more drinking, more addiction, injuries and other adverse consequences to the drinkers as well as the people around them.

Source:   www.theconservation.com  April 2014

Smart Approaches to Marijuana (SAM), co-founded by Patrick Kennedy, organizes broad coalition and responds to recent legalization editorial WASHINGTON- Project SAM (Smart Approaches to Marijuana), a nonpartisan alliance of lawmakers, scientists and other concerned citizens, co-founded by former Congressman Patrick J. Kennedy and directed by former White House adviser Kevin A. Sabet, was joined by the American Society of Addiction Medicine and dozens of other groups in launching a new, full-page ad in the New York Times today in response to their recent pro-marijuana editorial. The ad – “Perception/Reality”- depicts a young laid-back man’s face (“perception”) juxtaposed over the body of high-powered business executive’s body (“reality”) implying that if America is not careful, we will soon have a very large, powerful marijuana industry on our hands. It appears on page A5 today. Below the image, the copy reads: “The legalization of marijuana means ushering in an entirely new group of corporations whose primary source of revenue is a highly habit-forming product. Sounds a lot like another industry we just put in its place. Many facts are being ignored by this and other news organizations. Go to GrassIsNotGreener.com to see why so many major medical associations oppose marijuana legalization.” The ad will also be used by local community groups, including SAM’s 27 state affiliates, in order to educate the public on the reality of the marijuana

industry. The ad links to a new online resource of information – www.GrassIsNotGreener.org — which lists medical and other organizational opposition to legalization. The website also contains scientific papers and facts about marijuana, and will remain a resource for information on the emerging marijuana industry. “In the marijuana business, the values of the flower children have been quickly replaced by the values of Wall St. power brokers,” remarked Kevin A. Sabet, President and CEO of SAM. “We’re on the brink of creating the next Big Tobacco. We feel like this is an important message most Americans have not considered.” The advertisement was supported by a diverse coalition, including the American Society of Addiction Medicine (ASAM), National Association of Drug Court Professionals (NADCP), National Families in Action (NFIA), and others.  According to the National Institutes of Health, marijuana is addictive, reduces IQ, and contributes to car crashes. The American Medical Association released a statement recently opposing the legal sales of marijuana and calling the use of the drug “a public health concern.” Smart Approaches to Marijuana (SAM) is supported by a scientific advisory board comprising the heads of major medical associations and widely respected national researchers and scientists. The ad will be displayed in Saturday’s edition of the New York Times and was funded by SAM, ASAM, NADCP, NFIA, and dozens of individual volunteers and community groups. Project SAM, has four main goals: * To inform public policy with the science of today’s potent marijuana. * To prevent the establishment of “Big Marijuana” – and a 21st-Century tobacco industry that would market marijuana to children. * To promote research of marijuana’s medical properties and produce, non-smoked, non-psychoactive pharmacy-attainable medications. * To have an adult conversation about reducing the unintended consequences of current marijuana policies, such as lifelong stigma due to arrest.

About Project SAM Project SAM is a nonpartisan alliance of lawmakers, scientists and other concerned citizens who want to move beyond simplistic discussions of “incarceration versus legalization” when discussing marijuana use and instead focus on practical changes in marijuana policy that neither demonizes users nor legalizes the drug. Project SAM has affiliates in 27 states, including Washington, Oregon, New York, California, Colorado, Vermont, Hawaii, Massachusetts, Missouri, and other jurisdictions.

Source:kevin@learnaboutsam.orgAugust.2014                                                                                              

We’ve all been learning about the cost of not caring about mental illness. The human and financial toll of our nation’s neglect toward the mentally ill is staggering. And directly related to that neglect is the cost of not caring about a growing public health problem: marijuana use.

There has been a lot of talk about pot lately. Discussions of tax revenue, health benefits, violence reduction, and individual liberty. But one issue got completely lost: the developing brains of our children.

It’s about time we start focusing on the rights of our kids, not pot smokers.

As states rush unwisely to legalize marijuana, will this president be remembered for reforming our broken health care system, or for watching the commercialization of a new, legal drug that threatens healthy brain development and the mental health of our children?

That means I don’t want another massive, heavily commercialized drug industry targeting them. Because addiction is a disease that starts in adolescence, industries know they have to focus on young people for profits. After all, if you don’t start using any drug by age 21, you are unlikely ever to do so.

Now we know why Big Tobacco marketers used cartoons and candy to hook kids. We are seeing the same thing play out in places like Colorado and Washington.

Already, candies, cookies, and lollipops high in THC adorn legal marijuana stores in Colorado and Washington. Never mind that the Poison Control Centers in those two states have reported increased calls for marijuana poisonings, and that kids are getting the message that drug use is OK. After all, it’s legal now.

In other areas of life we tend to rightly put an emphasis on children. We demand better education. We ask that our kids make healthier eating choices. We are expanding health care, including mental health care, to our young people. So how can we, in the same breath, be OK with pot legalization? The marijuana of today is nothing like the marijuana most baby boomer’s experimented with. It’s virtually a different drug.

So it is no surprise that the president’s own Department of Health and Human Services reported last year that marijuana is the top reason kids are in treatment. It is why I hear about the stories in my inbox from countless parents who are now penniless because they had to spend their child’s college fund on treatment for a drug they first thought was harmless. It is why I hear even more stories from recovering addicts who say, “It all started with pot.”

Thanks to a massive misinformation campaign funded by greed, the gap is wide and deep between what reputable science knows about marijuana’s harms and what the public believes about this drug.

I applaud the president for leading the effort toward reforming our drug laws and emphasizing public health. I salute Attorney General Eric Holder’s smart on crime initiative, which promotes drug treatment courts and other diversion programs for nonviolent drug crimes. We should indeed reform broken laws that disproportionately harm ethnic and racial minorities and the poor. But let’s not replace one tragedy of over incarceration with another — a public health crisis that will hit the most vulnerable the hardest.

And we must not abandon the interests of our kids.

Our country cannot afford another industry that glamorously commercializes addictive drugs, profits from harming people — especially children — and expects the rest of us to pick up the tab for users’ health care and all of the social problems they cause. For every $1 we collect from state and federal taxes on alcohol and tobacco, we spend $10 to address problems stemming from their use. There is no reason to believe marijuana will pay for itself, either.

And the last time I checked, beer and cigarettes — two legal, highly addictive drugs — were pretty easy for kids to get.

Our nation’s future is in the brains of our youth, and they’re getting the shaft — again. Our marijuana debate has been entirely too focused on accommodating drug-using adults, the vast majority of whom would have to admit they first picked up their substance of choice when they were only kids. Their recreational good times have overshadowed our obligations to protect children from drugs.

This is by careful design because so many of the people eager to profit from addiction know the United States’ sentiments about marijuana would change dramatically if we started policy debates with this question: “What is in the best interests of our children?”

I’ll take the best interest of kids over the pot users’ interests — any day. Patrick Kennedy is a former congressman and an honorary board member of Smart Approaches to Marijuana (Project SAM).

Source:www.usatoday.com  28th July 2014

Omega-3 fish oil might help protect against alcohol-related neurodamage and the risk of eventual dementia, according to a study. Many human studies have shown that long-term alcohol abuse causes brain damage and increases the risk of dementia. The new study found that in brain cells exposed to high levels of alcohol, a fish oil compound protected against inflammation and neuronal cell death.

Omega-3 fish oil might help protect against alcohol-related neurodamage and the risk of eventual dementia, according to a study published in the journal PLOS ONE.

Many human studies have shown that long-term alcohol abuse causes brain damage and increases the risk of dementia. The new study found that in brain cells exposed to high levels of alcohol, a fish oil compound protected against inflammation and neuronal cell death.

The study was conducted by Michael A. Collins, PhD, Edward J. Neafsey, PhD, and colleagues at Loyola University Chicago Stritch School of Medicine, and collaborators at the University of Kentucky and the National Institute of Alcohol Abuse and Alcoholism (NIAAA). Collins and colleagues exposed cultures of adult rat brain cells over several days to concentrations of alcohol equivalent to about four times the legal limit for driving — a concentration seen in chronic alcoholics. These brain cultures were compared with cultures exposed to the same high levels of alcohol, plus a compound found in fish oil called omega-3 docosahexaenoic acid (DHA).

Researchers found there was up to 90 percent less neuroinflammation and neuronal death in the brain cells exposed to alcohol plus DHA than in the cells exposed to alcohol alone. An earlier meta-analysis by Collins and Neafsey, which pooled the results of about 75 studies, found that moderate social drinking may have the opposite effect of reducing the risk of dementia and/or cognitive impairment during aging. (Moderate drinking is defined as a maximum of two drinks per day for men and 1 drink per day for women.)

It appears that limited amounts of alcohol might, in effect, tend to make brain cells more fit. Alcohol in moderate amounts stresses cells and thus toughens them up to cope with major stresses and insults down the road that could cause dementia. But too much alcohol overwhelms the cells, leading to neuroinflammation and cell death.

Further studies are needed to confirm whether fish oil protects against alcohol-related cognitive injury and dementia in adult rodent models. “Fish oil has the potential of helping preserve brain integrity in chronic alcohol abusers,” Collins said. “At the very least, it is unlikely that it would hurt them.”

But Collins added that the best way for an alcohol abuser to protect the brain is to cut back to low or moderate amounts or quit entirely. “We don’t want people to think it is okay to take a few fish oil capsules and then continue to go on abusing alcohol,” he said. PLOS ONE is an international, peer-reviewed, open-access online journal. Collins earlier reported findings at the 14th Congress of the European Society for Biomedical Research on Alcoholism in Warsaw.

Source: Neuroinflammation and Neurodegeneration in Adult Rat Brain from Binge Ethanol Exposure: Abrogation by Docosahexaenoic Acid. PLoS ONE, 2014; 9 (7): e101223 DOI:10.1371/journal.pone.0101223

Some US states have recently passed, or are considering the passage of legislation that provides access to marijuana for paediatric epileptic disorders. Oftentimes, this is in the form of a CBD-only bill and is limited to paediatric victims. In other cases, medical marijuana legislation attempts to cover a wide range of conditions that is not limited to CBD oil for children.

The tragedy of paediatric epilepsy victims is troubling and important, and every caring person will look for a way to help these children even if there is only a small chance of success.

On the other hand, some unscrupulous people cynically use these children to further their goal of legalization by opening up a Pandora’s box of maladies that must be remedied (in their opinion) by providing access to a crude street drug. This often produces legislation that promotes widespread fraud and abuse, and is often a stepping stone to efforts to legalize for recreational use.

In making these decisions, it is critical that we consult experts, and not popular opinion or anecdotal evidence, to inform our choices about these matters. It is not compassionate to give false hope to those in desperate need of relief, or provide a remedy that ultimately may do more harm than good. These children deserve better.

While we are in the process of looking for solutions, please be mindful of the following opinion given recently by the President of the American Epilepsy Society. I highly recommend it. Monte Stiles

Epilepsy experts call for more research into medical marijuana

As the Florida Legislature and citizens debate the issues of medical marijuana, our hearts are with the families struggling to find answers for their children who live with severe forms of epilepsy like Dravet Syndrome. Yet, as physicians and researchers specializing in the treatment of this challenging spectrum of disorders we must ensure that our professional and lay community does not make treatment decisions that are not based in sound research and science.

While there are a number of anecdotal reports of positive outcomes from a particular strain of marijuana used for treating patients with epilepsy, robust scientific evidence for the use of marijuana for treatment of epilepsy is lacking. The lack of information does not mean that marijuana is ineffective for epilepsy. It merely means that we do not know if marijuana is a safe and efficacious treatment for epilepsy.

In addition, little is known about the long term effects of using marijuana in infants and children on memory, learning and behavior. This is of particular concern because of both clinical data in adolescents and adults and laboratory data in animals demonstrating potential negative effects of marijuana and its derivatives on their critical neurological functions.

Such safety concerns coupled with a lack of evidence of efficacy in controlled studies result in a risk/benefit ratio that does not yet support use of marijuana for treatment of seizures.

The form of marijuana in the spotlight is known as Charlotte’s Web from a plant that is thought to contain relatively little tetrahydrocannabinol, or THC, the primary component that produces a high. Instead, the strain has high amounts of another compound — cannabidiol, or CBD. This is not smoked but used in an oil form.

Several members of the American Epilepsy Society are now conducting clinical trials of CBD including one developed by a British drug company. There are several steps in a clinical trial and we need to wait to draw conclusions until there has been a trial with a control group or a placebo-controlled trial.

The preliminary steps underway now will not have a placebo group and will be used for dose finding, tolerability and to establish an understanding of how human bodies absorb and process the drug. If these initial safety studies are encouraging then further controlled studies will be needed to determine if CBD is effective in the treatment of seizures and in which patient populations (ie., what ages and types of epilepsy). These studies are critical, as the pathway to finding new drugs and treatments is full of treatments once thought to be the “miracle cure” that were rejected after the rigors of a clinical trial.

These studies are especially important in a condition like epilepsy that has a very variable course, and sometimes significant improvement can actually be a result of unpredictable ebb and flow of the disease.

Treatments cannot advance without clinical trials. Clinical trials are necessary to test the safety and effectiveness of new therapies and to develop better ways of using known treatments. The American Epilepsy Society is supportive of well-designed clinical research to determine the safety and efficacy of marijuana in the treatment of epilepsy. We urge the entire community of medical professionals, patients, families and regulators to focus their efforts on getting accurate information and allowing proper research to be done.

Healthcare professionals, patients, and caregivers are reminded that use of marijuana for epilepsy may not be advisable due to lack of information on safety and efficacy, and that despite 20 states legalizing the use of medical marijuana, it has not been reviewed and approved by the Food and Drug Administration for use in the treatment of any form of seizures or epilepsy.

Under federal law, every new therapy and device must go through carefully monitored studies in human volunteers before it can be marketed for regular use in patients. The studies with CBD and many other clinical studies need people with epilepsy to volunteer. To this end, those with epilepsy are in a special position to help themselves and others through participation in medical research that can lead to effective treatments.

The recent discussions surrounding medical marijuana highlight the fact that the epilepsy community desperately needs new therapies and approaches for patients with resistant or refractory seizures. We need to know more about the basic mechanisms and causes of epilepsy so that we can better match therapies to patients, and someday soon find targets for cures.   But none of these giant steps forward will be possible without robust, careful research that safeguards the health of study participants while uncovering important new findings

The actions of the people of Florida will be watched closely by the entire nation. We hope the needs of people living with epilepsy and their families will be a strong voice in this debate. However we also urge that the eagerness to find treatments will not overshadow the need to conduct rigorous research and testing. Together as an epilepsy community we must take this step to find the answers for people living with these severe forms of epilepsy.

Dr. Elson So,  President of the American Epilepsy Society.

Source: http://www.miamiherald.com/2014/01/22/3886526/epilepsy-experts-call-for-more.html

Level of drinking among teens is just a third of a decade ago

* Number of schoolchildren who have done drugs has halved over a decade

* Figures suggest the young are abandoning ‘sex, drugs and rock and roll’

* Opponents of drug liberalisation hail the findings as a vindication of bans

A generation of youngsters have turned their back on drink, drugs and smoking, according to a state-backed survey.

The research, published yesterday, showed that the proportion of schoolchildren who have tried cannabis or other illegal drugs has almost halved over the past ten years, and is continuing to drop year by year.

Alongside the unprecedented decline in drug taking, the results showed the level of drinking among schoolboys and schoolgirls is just a third of the rate a decade ago, and cigarette smoking has hit a 30-year low.

The spectacular drop in numbers of pupils both trying and regularly using drugs, alcohol and tobacco could herald a historic turnaround.

The figures follow evidence of a drop in numbers of teenage pregnancies, thanks in part to the availability of long-term contraceptive implants and injections.

Some analysts believe teen pregnancies are becoming less common because more girls want to complete their education and work on their careers.

Others have speculated that thanks to the rise of social media, millions of teenagers are spending their time at home in their rooms rather than out on the streets.

The study’s findings are based on questionnaires filled in during school lessons by more than 5,000 pupils aged between 11 and 15.

The survey was designed to minimise the impact of any boasting or misleading replies. For example, a dummy question was inserted asking pupils if they had taken a made-up drug, called Semeron, to try and decide which pupils were answering the questions honestly.

The results, published by the Government’s Health and Social Care Information Centre, showed that the proportion who have tried illegal drugs dropped from 30 per cent in 2003 to 16 per cent last year, with a fall of 1 percentage point between 2012 and 2013.

Regular drug takers – those aged between 11 and 15 who used drugs in the past month – went down from 12 per cent to 6 per cent over the decade. Cannabis use was recorded by 13.3 per cent of pupils in 2003 but only 7 per cent last year.

A decade ago, 9 per cent of pupils smoked once a week. However in 2013, 3 per cent of pupils reported smoking a weekly cigarette, the lowest level recorded in 30 years.

And a similar pattern applied to drinking habits. A quarter of pupils had drunk alcohol in the past week when the questionnaire was answered in 2003 – last year it was fewer than one in ten, 9 per cent.

Turning their backs on sex, drugs and rock and roll: A quarter of pupils had drunk alcohol in the past week when asked in 2003 – but last year it was fewer than one in ten, 9 per cent. (Stock image)

The figures suggest that today’s young people are abandoning the ‘sex, drugs and rock and roll’ ethos of the baby boom generation.

The rapid and sustained drop in drug abuse is a major blow to liberal reform lobbyists – who have claimed that cannabis and other substances must be decriminalised because the war on drugs is lost.

In fact, the study could be seen to suggest that the illegal status of cannabis, ecstasy, amphetamine and cocaine is helping persuade young people to reject drugs.

Among those pressing the Government for decriminalisation have been Sir Richard Branson, Sting and comedian Russell Brand, who have argued that laws against drugs create ‘many unintended and negative consequences’.

Deputy Prime Minister Nick Clegg has even put his name to a call for a programme of ‘rigorously monitored’ cannabis legalisation.

However yesterday opponents of drug law liberalisation said the legalisers are out of date. Kathy Gyngell, from think-tank Centre for Policy Studies, said: ‘It is Sting and Richard Branson who are out of line and old fashioned.

‘The war on drugs is being won, thanks to ministers who have stuck to their guns. We are seeing the eclipse of the post-Woodstock, selfish, baby boom generation.

‘Young people are becoming more sober in every respect. They have seen what has happened and they know they can’t behave like that.’

While noting the decline of drug taking among children, the report warned that drugs still pose a risk to vulnerable young people. It said: ‘Young people who use drugs run the risk of damage to mental health including suicide, depression, psychotic symptoms and disruptive behaviour disorders.’

Source: http://www.dailymail.co.uk/news/article-2704957/Youth-turning-backs-alcohol-drugs-smoking-Level-drinking-teens-just-decade-ago.html#ixzz38SzdR2M2 

 PUBLISHED: 00:47, 25 July 2014 | UPDATED: 07:13, 25 July 2014

A close look at the under-25 age group shows cognitive decline, poor attention and memory and decreased IQ among those who regularly smoke pot — defined as at least once a week.

Teenagers and young adults who frequently use marijuana may be hurting their brainpower, according to studies about pot and adolescence presented today at the American Psychological Association’s annual convention. A close look at the under-25 age group shows cognitive decline, poor attention and memory and decreased IQ among those who regularly smoke pot, defined as at least once a week, says Krista Lisdahl, director of the brain-imaging and neuropsychology lab at the University of Wisconsin-Milwaukee.

“It needs to be emphasized that regular cannabis use, defined here as once a week, is not safe and may result in addiction and neurocognitive damage, especially in youth,” says a study she co-wrote in the June issue of the journal Current Addiction Reports.

Lisdahl says recent moves toward legalization and decriminalization of marijuana as well as increases in youth use have focused new attention on studies such as hers and others seeking to know more about the impact on youth and their developing brains.  “The adolescent period is a sensitive period of neurodevelopment,” she says.

Overall, marijuana use begins in the later teens, around age 16 or 17, peaks in the early 20s and drops off between ages 23 and 25, says Lisdahl.  “Is it a coincidence that use significantly goes down at 25 when the brain is at its full maturation? I don’t think so,” she says.

Lisdahl says recent studies show increases in marijuana use among high school seniors and young adults. And brain-imaging studies of these regular marijuana users have shown significant changes in brain structure, especially among teens. Brain imaging shows abnormalities in the brain’s gray matter — which is associated with intelligence — have been found in 16- to 19-year-olds whose pot smoking increased in the previous year, she says.

A study co-written by Bettina Friese, a research scientist at the Pacific Institute for Research and Evaluation in California, analyzed data from 17,482 teenagers in Montana and found that pot smoking was higher in counties where larger numbers of people voted to legalize medical marijuana in 2004.

“People don’t perceive it as a very harmful substance, and these community norms translate to teens,” she says. “From the teen study, they do reference legalization:   ‘If it was that bad a drug, they wouldn’t be trying to legalize it.’ “

But psychologist Alan Budney, of Dartmouth College, (who works in treatment) says marijuana now is likely a more dangerous product and may mean greater chances for addiction since some legalized forms have higher levels of tetrahydrocannabinol, or THC, the major psychoactive chemical.

“Unfortunately, much of what we know from earlier research is based on smoking marijuana with much lower doses of THC than are commonly used today,” he says. “All we know so far is that more people are showing up in the ERs with adverse effects. We’ve only seen a little bit of it with marijuana, but now we’re seeing more of it.”

Budney worries that teen pot use is “much, more troublesome” because teens are more vulnerable to the negative consequences of overuse.  “It is just as hard to treat cannabis addiction as it is to treat alcohol addiction,” he says.

Source: www.usatoday.com 9th August 2014

Prescription Drugs ‘Orphan’ Children In Eastern Kentucky

Orphaned by prescription drug overdoses .   Story highlights

• Many children and teens in eastern Kentucky have lost a parent to drug overdose
• “Without a normal mom and dad, you feel different,” one teen says
• Kentucky is the fourth most medicated state in the nation and sixth for overdoses
• A drug task force aims to help children left behind by parents’ addictions

This area of eastern Kentucky is known for lush, green hillsides and white picket fences. It is a place where bluegrass music may be heard trailing off when a car passes by, where “downtown” is a two-block stretch of quaint shops. Life here may seem simple, but a darkness has been quietly nestling itself into the community.

“Rockcastle County is averaging one drug-related death per week,” said Nancy Hale, an anti-drug activist and educator. “When your county is a little over 16,000 people and you’re losing a person a week … you’re losing a whole generation.”

The generation being lost, Hale said, is parents. An inordinate number of children in Rockcastle County — and in neighboring areas in eastern Kentucky — are living without them.

According to 2010 census data, more than 86,000 children in Kentucky are being raised by someone who is not their biological parent — mostly grandparents — and many here blame those fractured families on prescription drugs.

Prescription drugs can be dangerous 

“I know a little girl who found her father dead of a drug overdose, found her uncle dead of a drug overdose, and now she’s living with her aunt,” said Karen Kelly, executive director of Operation UNITE, a community coalition devoted to preventing overdose deaths in Kentucky.

“The kids really are the ones paying the biggest price.”

‘You’re always worried’

“It’s a terrible thing,” said Sean Watkins, 17, a junior at Rockcastle County High. “Especially in our community, it’s really bad.”

When he was 10, Watkins and his family were expecting his mother for dinner, but she never showed up. He and a family friend went looking for her at her home.

They walked into her bedroom and saw her face down, motionless. The friend quickly whisked Watkins out of the room. “I don’t know what was going on, but I knew something was wrong,” said Watkins.

His mother was dead after overdosing on Oxycontin.

At the time, Watkins says that he and his mother had been estranged for years because of her prescription-drug addiction. His father had not been in his life since shortly after his birth.

“Growing up without parents, without a normal mom and dad, you feel different,” said Watkins. “You go to your friend’s house and they have a happy family … you’re jealous. You want that.”

Shortly after his mother’s death, Watkins says his grandmother also became addicted to prescription drugs, and eventually vanished. Now he lives with his grandfather.  “I’m grateful that I have my grandfather who stepped in and takes care of me now,” said Watkins. Still, he calls growing up without parents “horrible.”

Gupta: Let’s end the prescription drug death epidemic

It sometimes feels is as if every student at his school has been touched by the epidemic, he said. “The hardest part of growing up without a dad would be not having that model family that you always see,” said Avery Bradshaw, 16, also a student at Rockcastle County High School.

Bradshaw’s father overdosed on Oxycontin when he was 7. His mother, he said, is in and out of his life, so he is being raised by his great-grandparents.

Avery knows many children at school who are not so lucky. After their parents overdose or abscond because of prescription drugs, the kids go from couch to couch and from home to home — living in a constant state of transience.

For those children whose parents have not overdosed but are deep in their addiction, there is a sense of perpetual wariness about what they might find when they get home from school.

“You’re always worried … if your parents are even going to be there, you know, what’s going on in your house?” said Bradshaw. “A lot of kids have to go through that every day and it definitely wears them down, you know.”

Guardians’ Day

The prescription drug overdose epidemic just recently began appearing on the national radar, so figures concerning the number of children orphaned after a parent overdoses are difficult to assess.

What is known is the high number of overdoses, broadly: In the United States, someone dies of a prescription drug-related overdose about every 19 minutes. The epidemic affects every state in the nation, and has hit hardest in places like Washington, Utah, Florida, Louisiana, Nevada and New Mexico.

Kentucky — and the Appalachian ridge, generally — is one of the regions hit hardest. Kentucky is the fourth most medicated state in the nation and it has the sixth highest rate of overdose deaths, according to the state’s Attorney General.

In Knott County, adjacent to Rockcastle, Kelly said more than half of the children have lost their parents due to death, abandonment or legal removal. Anecdotally, she says, the numbers in other areas could be even higher.

And in nearby Johnson County, so many children have lost parents that school administrators there changed “Parents’ Day” to “Guardians’ Day.”

Addiction and death are common concerns for families here, according to Kelly — too common.

Her voice wavering, Kelly recalled the story of a young girl who realized her mother was overdosing on prescription drugs right in front of her.

“She wanted to call the police and the other adults in the home were so high they wouldn’t allow her to call,” said Kelly. “So she crawled up into her mother’s arms while her mother died. Now she’s just living with a lady she met at the local Boys and Girls Club.

“Those are the situations we’re dealing with in eastern Kentucky.”

Prescription drug deaths: Two stories

“Someone has to take care of these kids, and we simply do not have the facilities to do that,” said U.S. Rep. Hal Rogers, whose district in Kentucky is mired in prescription drug abuse. “So it’s neighbors, it’s churches, other civic groups that are trying to be parents to these kids who are orphaned by drug-abusing parents.

“That’s a huge undertaking, because there’s literally tens of thousands of these young children,” he added.

Rogers started the Operation UNITE drug task force in 2003 as a response to the broader prescription drug abuse epidemic in his state. Initially, he thought, “If we could get the pushers off the streets, that the problem would be solved.”

But years after he launched the task force, groups of children were showing up at community meetings to speak of their struggles after one parent — or both — overdosed.

“That hit me like a ton of bricks in the head,” said Rogers. “These are young people who are now thrown into the streets. So there are some real side effects to these parents using drugs.”

Now, the UNITE program is channeling energy toward the children floundering socially, emotionally and academically after losing parents. They have programs set up at schools across Kentucky.

‘It’s time for it to stop’

Hale, who worked in the local school system for 34 years, started a UNITE chapter at Rockcastle County High.

“It really got to the point where we were sick and tired of going to funerals,” Hale said. “We were tired of having kids come in and not being able to sit through physics class because they were worried about Mom who had overdosed. So we were like, ‘What can we do? How can we help these families?'”

One way UNITE helps is by educating and counseling children who are having problems at home related to addiction. The group also empowers children like Bradshaw to speak out about their own loss.

“I know that a lot of kids deal with drug abuse from their parents,” said Bradshaw. “I don’t know how many have lost parents, but I know a lot of kids definitely deal with that going home every day. I think right now we’re definitely at a point where everybody needs to know about it and how it affects everybody.”

“It’s time for it to stop,” said Kelly. “It’s leaving our communities in shreds and we’re left behind to pick up the pieces from that.”

Advocates such as Hale and Kelly are desperate for an intervention to reach the thousands of children who are not being helped by programs like UNITE.  Watkins said that the pain of having no parents is something that he will deal with for the rest of his life.

“People have to understand that this is a problem,” he said. “It doesn’t affect just the person that uses, it affects the entire family.”

Source:  http://edition.cnn.com/2012/12/14/health/kentucky-overdoses/index.html

Pot plants grow at a medical marijuana dispensary in San Jose Photograph by David Paul Morris/Bloomberg

Months after her biotechnology company sold for $40 million, Jessica Tonani is on Seattle’s Highway 99, where Kurt Cobain in his final days shot heroin in cheap motels. She’s scoring a gram of Blueberry Kush.

Tonani doesn’t plan to smoke the pot. Her typical procedure is to isolate some of its DNA and bank it, sequence its genetic profile, and test it for bacteria. After her stop at Choice Wellness, a medical marijuana store in one of the states where pot is newly legal, she buys the same strain in three more places (often collecting a “new-patient gift” of pot-infused gummi bears or goldfish). The goal for her new company, Verda Bio, is to build a database bringing order to billions of potential DNA combinations and, eventually, create stable strains that people can grow like a Red Delicious apple. Right now, Tonani says, people using pot for health conditions—legal in 23 U.S. states—are doing the equivalent of rummaging through their medicine cabinet blindfolded. One day they might get Tylenol; another, mouthwash. Even when they buy the same strain from the same place, it might not have the same effect because of differences in how each plant is grown. The variety Harlequin, for example, is sometimes recommended for children with epilepsy because it’s high in cannabidiol, or CBD, a non-psychedelic pot compound that appears to limit seizures.

Tonani analyzed more than 20 samples of Harlequin along with Analytical 360, a Seattle testing lab, and found that 22 percent were high in the psychedelic tetrahydrocannabinol, or THC, and had almost no CBD. Any kids taking it were likely just getting stoned.

Tonani is also looking at contaminants to determine where they’re introduced and how to control for them. The first two samples turned up a long list of nastiness, including the fecal bacteria Enterobacter asburiae and the vaginal bacteria Gardnerella vaginalis. What this means, politely, is that many people handling pot don’t wash their hands.

The irony of legalization in the U.S. is that recreational users often now have more certainty of their weed’s safety than people with legitimate conditions whose suffering was part of the original justification. Washington State, for example, requires its few dozen recreational stores to test pot for contaminants and to display THC and CBD content. There’s no such rule for the far more numerous medical pot stores—as many as 300 in the Seattle area alone—which are still in a legal gray area after the state legislature failed to pass a bill regulating them this year.

“It’s exactly the opposite of the way it should be,” says Randy Oliver, chief science officer at Analytical 360. Oliver says his lab gives failing grades to about 15 percent of the recreational samples it tests for mold, potentially dangerous to sick people with compromised immune systems. Medical pot stores rarely seek tests of mold and other contaminants, he says.

Some of the latest states permitting medical marijuana, including Florida and Utah, have done so by allowing only a type that’s verified as low in THC and high in CBD. Colorado, the other state to permit recreational use, doesn’t require contaminant testing for medical marijuana centers, though most test on their own, says Natriece Bryant, a spokeswoman for the state’s Marijuana Enforcement Division. Colorado also has rules on hand-washing and sanitation for those locations.

In the dispensaries Tonani visits, there’s little consistency. The waiting room in one place is like a doctor’s office, with plush leather chairs and stacks of manila folders. At another, lit with a harsh bulb over a marijuana plant growing in a converted shower, the guy at the counter says he’s never found that certain strains work any better for ailments. Just find one that gets you really high and numbs the pain, he says. Tonani, 38, who co-founded GnuBIO, a DNA sequencing company sold (PDF) in April to Bio-Rad Laboratories (BIO), has a personal as well as financial interest in pot’s future. She turned to the drug a decade ago for a gastrointestinal condition that led to the removal of part of her stomach, multiple surgeries, and twice-weekly intravenous infusions. Her doctor has since asked her to counsel other patients who think pot might help, and she’s frustrated not to have better answers.

While Colorado is spending $9 million on research into marijuana’s potential medical benefits, there’s little federal funding because of pot’s classification as a Schedule I dangerous drug. Many of the cannabis breakthroughs—like Sativex, a mouth spray for multiple sclerosis sufferers developed by the U.K.’s GW Pharmaceuticals (GWPH)—have occurred overseas. Verda Bio, which may raise money from investors later this year, hopes to eventually generate revenue from licensing or sales of stable plant varieties and cannabis-based treatments, Tonani says.

“I honestly believe it saved my life,” she says of pot. “But it’s just not a medical system right now. Some people get lucky, and some people don’t.” Source: http://www.businessweek.com/ 8th August 2014

Researchers link a gene already tied to alcohol dependence with a neurotransmitter involved in anxiety and relaxation.

The neurofibromatosis type 1 (Nf1) gene, which has been previously linked to alcohol dependence, may exert its influence on alcohol intake through the regulation of gamma-aminobutyric acid (GABA), a neurotransmitter known to decrease anxiety and boost feelings of relaxation, according to a mouse study published this month (August 18) in Biological Psychiatry. The research, led by scientists at The Scripps Research Institute (TSRI), also links variations in the human Nf1 with the risk and severity of alcohol dependence.

“Despite a significant genetic contribution to alcohol dependence, few risk genes have been identified to date, and their mechanisms of action are generally poorly understood,” co-author Vez Repunte-Canonigo said in a press release.

The team decided to look for a connection with the neurotransmitter GABA as a result of previous work that has shown GABA release in the central amygdala, a brain area involved in decision making, stress, and addiction, is “critical in the transition from recreational drinking to alcohol dependence,” said co-author Melissa Herman. Examining mouse models of alcohol dependence, the team found that mice with functional Nf1 genes started to increase their alcohol intake after a single period of withdrawal, while those with one copy of the gene knocked out did not increase their ethanol consumption. Moreover, in heterozygous Nf1 mice, intake of alcohol did not result in higher GABA release in the central amygdala, which was observed in mice with two functional copies of the Nf1 gene.

The researchers also explored variation in human Nf1 using data from some 9,000 people and found the gene correlated alcohol-dependence risk and severity. “A better understanding of the molecular processes involved in the transition to alcohol dependence will foster novel strategies for prevention and therapy,” co-author Pietro Paolo Sanna said in the release.

Source: the-scientist.com August 27, 2014

It’s common knowledge that teenage boys seem predisposed to risky behaviors. Now, a series of new studies is shedding light on specific brain mechanisms that help to explain what might be going on inside juvenile male brains.

Florida State University College of Medicine Neuroscientist Pradeep Bhide brought together some of the world’s foremost researchers in a quest to explain why teenagers — boys, in particular — often behave erratically. The result is a series of 19 studies that approached the question from multiple scientific domains, including psychology, neurochemistry, brain imaging, clinical neuroscience and neurobiology. The studies are published in a special volume of Developmental Neuroscience, “Teenage Brains: Think Different?”

“Psychologists, psychiatrists, educators, neuroscientists, criminal justice professionals and parents are engaged in a daily struggle to understand and solve the enigma of teenage risky behaviors,” Bhide said. “Such behaviors impact not only the teenagers who obviously put themselves at serious and lasting risk but also families and societies in general.

“The emotional and economic burdens of such behaviors are quite huge. The research described in this book offers clues to what may cause such maladaptive behaviors and how one may be able to devise methods of countering, avoiding or modifying these behaviors.” An example of findings published in the book that provide new insights about the inner workings of a teenage boy’s brain:

• Unlike children or adults, teenage boys show enhanced activity in the part of the brain that controls emotions when confronted with a threat. Magnetic resonance scanner readings in one study revealed that the level of activity in the limbic brain of adolescent males reacting to threat, even when they’ve been told not to respond to it, was strikingly different from that in adult men.

• Using brain activity measurements, another team of researchers found that teenage boys were mostly immune to the threat of punishment but hypersensitive to the possibility of large gains from gambling. The results question the effectiveness of punishment as a deterrent for risky or deviant behavior in adolescent boys.

• Another study demonstrated that a molecule known to be vital in developing fear of dangerous situations is less active in adolescent male brains. These findings point towards neurochemical differences between teenage and adult brains, which may underlie the complex behaviors exhibited by teenagers. “The new studies illustrate the neurobiological basis of some of the more unusual but well-known behaviors exhibited by our teenagers,” Bhide said. “Stress, hormonal changes, complexities of psycho-social environment and peer-pressure all contribute to the challenges of assimilation faced by teenagers.

“These studies attempt to isolate, examine and understand some of these potential causes of a teenager’s complex conundrum. The research sheds light on how we may be able to better interact with teenagers at home or outside the home, how to design educational strategies and how best to treat or modify a teenager’s maladaptive behavior.”

Bhide conceived and edited “Teenage Brains: Think Different?” His co-editors were Barry Kasofsky and B.J. Casey, both of Weill Medical College at Cornell University. The book was published by Karger Medical and Scientific Publisher of Basel, Switzerland. More information on the book can be found at:http://www.karger.com/Book/Home/261996

The table of contents to the special journal volume can be found at:http://www.karger.com/Journal/Issue/261977

—

Source: Sciencedaily.com Florida State University. “Inside the Teenage Brain: New Studies Explain Risky Behavior.” ScienceDaily. ScienceDaily, 27 August 2014. <www.sciencedaily.com/releases/2014/08/140827203544.htm>.

CORRESPONDENCE FROM TEN DOCTORS

To the Editor: In their article, Volkow et al. (June 5 issue)1 state that marijuana may have adverse health effects, particularly on the vulnerable brains of young people. Potential mechanisms underlying the effect of marijuana on the cerebrovascular system are indeed complex, although a temporal relationship between the use of marijuana (natural or synthetic) and stroke in young people has recently been described.2,3 Simultaneously, the presence of multifocal intracranial arterial vasoconstriction was observed, which was reversible in some cases after cessation of cannabis exposure.3 Thus, stroke, which is still underdiagnosed, may potentially play a role in neuronal damage related to marijuana use, even in young people without cardiovascular risk factors. Furthermore, tetrahydrocannabinol (THC), a major component of cannabis, has been shown experimentally to impair the function of the mitochondrial respiratory chain and to increase the production of reactive oxygen species in the brain.4 Both of these processes are key events during stroke,5 suggesting that THC may also increase a patient’s vulnerability to stroke. In the ongoing shift toward marijuana legalization, physicians should probably inform marijuana users, whether they are using it for recreational purposes or therapeutic indications, about the risk of stroke with potential severe disability.

Valérie Wolff, M.D. Olivier Rouyer, M.D., Ph.D. Bernard Geny, M.D., Ph.D. Fédération de Médecine Translationnelle de Strasbourg, Strasburg, France bernard.geny@chru-strasbourg.fr

To the Editor:

Volkow et al. focus primarily on the neurocognitive and societal effects of marijuana use. We wish to note the known and potentially unknown infectious risks of marijuana, which were not discussed.

Recreational use of marijuana has been associated with a multistate outbreak of salmonellosis, illustrating the potential for widespread exposure through either inadvertent contamination during growing and storage or purposeful adulteration.1 More worrisome are the risks of marijuana use for medical purposes, particularly by the population of immunocompromised patients. Prior reports have documented the frequent contamination of marijuana with fungal organisms and the potential for severe complications, including death.2-4 These risks are not well studied and thus are poorly defined.

To date, 23 states allow the medical use of marijuana; however, dispensaries are currently not subject to regulation or quality control. We believe that the infectious risks need to be better defined, which would allow for appropriate regulatory oversight. The current approach places patients (unknowingly) at undue risk for acquisition of severe, and often lethal, infections.

George R. Thompson, III, M.D. Joseph M. Tuscano, M.D. University of California, Davis, Medical Center, Sacramento, CA grthompson@ucdavis.edu

To the Editor:

One safety aspect that is not discussed by Volkow et al. is the potential for interactions between marijuana and medications. Cannabis sativa Linnaeus products contain more than 700 distinct chemical entities. The relative abundance of these chemical entities in marijuana products and in human plasma can vary considerably depending on numerous factors, including the geographic location of cultivation, the method of preparation or administration, and the cultivar administered.

In vitro studies have shown that constituents of cannabis are potent and broad-spectrum inhibitors of key drug-metabolizing enzymes and transporters, including CYP2C9, CYP2C19, CYP2D6, CYP2E1, CYP3A4, and P-glycoprotein.1-4 Other data from in vitro studies suggest the potential for enzyme induction, especially of CYP1A2.

Case reports support the risk of pharmacokinetic interactions; however, clinical studies have been equivocal. Notably, these studies have not replicated the long-term high potency and high dose achieved by some marijuana users (e.g., hashish users). Health care providers need to maintain a high level of suspicion for drug interactions in their patients who use marijuana products.

Carol Collins, M.D. University of Washington, Seattle, WA carolc3@u.washington.edu

The authors reply: We thank Wolff et al., Thompson and Tuscano, and Collins for their correspondence regarding potential adverse consequences of marijuana use that were not explicitly highlighted in our recent review. Given the shifting landscape of marijuana use, it is critically important that we be on the lookout for the emergence of predictable or unexpected health effects. This is particularly important when it comes to the potential of marijuana to negatively affect persons with various medical conditions, to interact with specific medications, or to influence the course of heretofore unstudied conditions. It will also be important to support the targeted research needed to understand the effects, both positive and negative, that may result from patients experimenting with marijuana in an attempt to relieve their specific symptoms. These studies should also focus on the possibility that such patients may forego evidence-based treatments while chasing after the purported therapeutic benefits of marijuana. Finally, we encourage particular attention to research targeting the effects of marijuana and other substances on adolescents, whose actively developing brains make them a particularly vulnerable population.1,2

Nora D. Volkow, M.D. Wilson M. Compton, M.D. Susan R.B. Weiss, Ph.D. National Institutes of Health, Bethesda, MD nvolkow@nida.nih.gov

Since publication of their article, the authors report no further potential conflict of interest.

Source:  Adverse Health Effects of Marijuana Use N Engl J Med 2014; 371:878-879 August 28, 2014 DOI: 10.1056/NEJMc1407928

An Arbroath dad has told how he fears for his son’s life after the teen was hospitalised three times through using legal highs. Derek Taylor, 51, is scared to let son Andrew, 19, out of the house because the youngster keeps buying legal highs and has collapsed on three occasions.

Each time, Derek has received the nightmare call from medics telling him his son has been rushed to Ninewells Hospital to help him recover. Derek says Andrew used to socialise with Michael McKay, 33, who died earlier this month following a five-month addiction to new psychoactive substances (NPS).

Now Derek is worried that his son will end up having a similar fate.

He said: “It’s three times that he has had to be taken to Ninewells. “It happened twice in about a week and then about six months later it happened again.

“I can’t stop him using legal highs, but you can always tell when he has been, as his nose is red and he’s sniffing a lot. I’m worried he is going to die. It’s on my mind all the time when he goes out with his pals. He’s 19 and if he keeps using them we’re going to put him out.

“We’ve got to the stage now where he has to be home at a certain time otherwise the door will be locked and he won’t get in, because we know what he’s doing. Don’t get me wrong, I love him — but I think it’s a total waste that they have to use an ambulance for him when there’s people out there with serious medical problems.”

Derek, who owns breakdown and recovery service Phone a Tow, says his son buys legal highs from an Angus shop. Now Derek insists action must be taken to shut similar retailers down before it’s too late.

He said: “I’m totally against the shop and the drugs themselves.I think the use of drugs is always wrong unless it’s for genuine medical reasons. The shop needs to be shut down as soon as possible.

And it’s not being used by just a few people. I drive past the shop a lot and there are people going in and out all the time. It’s people of all ages that use it. It’s not just youngsters.”

Source: eveningtelegraph.co.uk 30th August 2014