As social acceptance and public policy around marijuana shift, and especially if legalized recreational use becomes more widespread, we will need to consider the influence and potential regulation of its marketing.  For this, we should use what we already know from the science to guide our decisions and policies to minimize harm, because inevitably, advertising is going to reach children and adolescents, people who are addicted to marijuana, and those of all ages who are on their way to becoming addicted.

Ads for addictive substances—including tobacco and alcohol and fattening foods—have the obvious intent of generating new customers as well as enticing current users to use more, but that’s not all they do. Marketers know that by associating such products with other pleasurable stimuli and situations, ads contribute to reinforcing those positive associations in the brains of users, and thus contribute to the process of developing an addiction. 

Drug addiction is a disease of learning—learning to associate drugs with positive feelings and to associate cues that signal drug availability with similar feelings, ultimately leading to craving for the drug.  This part of the addictive progression is known as conditioning, discovered in the 1890s by Pavlov. Today we also understand the brain mechanisms that underlie the phenomenon: Once a person becomes conditioned to drug-related stimuli, those stimuli independently become associated with increases in dopamine in the brain’s reward pathway (i.e., without the drug even being present). These dopamine bursts fuel drug-seeking and craving. The same process can cause such stimuli to act as triggers contributing to relapse in those who are already addicted and are struggling to recover.

When there are salient advertisements for a product, it’s very hard to contain them, because images don’t even need to reach the level of conscious awareness to stimulate the urge to use that product. Recent neuroimaging research has confirmed the brain’s extraordinary sensitivity to “unseen” rewarding stimuli: A 2008 fMRI study by Anna Rose Childress and colleagues confirmed that limbic circuitry respond to drug (as well as sexual) reward cues that are too fleeting to be consciously registered. Also, because of the reach of the Internet, it will be hard to restrict exposure to marijuana advertising just to people in states where it is legal, or just to people old enough to purchase it.

For decades we have seen the harmful effects that alcohol and tobacco ads can have, especially those that target young people; similar associations have been found between exposure to food advertising and obesity. The relative harm of marijuana compared to other legal drugs remains hotly contested, but its potential addictiveness—especially to young people—is undisputed. Thus, it is crucial that states consider the lessons learned from tobacco and alcohol policy research and restrict (or preclude) marijuana advertising to reduce as much as possible the development of newly addicted individuals and avoid inducing relapse in people who are already addicted.

Source: www.drugabuse.gov October 23, 2014

The 50 states are sometimes called “laboratories of democracy”. Although the expression is intended to highlight in flattering terms how innovative they can be, it also suggests that the states’ political experiments can and do fail. In the event of failure, the hope must be that damage can be stopped at the state line. Today, the experiment of state-by-state marijuana legalization is failing before our eyes—and failing most signally where the experiment has been tried most boldly. The failure is accelerating even as the forces pushing legalization are on what appears to be an inexorable march.

In November 2012, the states of Colorado and Washington voted to legalize the sale of marijuana to any adult consumer. Advocates of legalization carried the vote with a substantial campaign budget, a few million dollars, and a brilliant slogan: “Drug dealers don’t ask for ID.” The implied promise: Marijuana legalization would be joined to tough enforcement to keep marijuana away from minors. After all, persistent and heavy marijuana use among adolescents has been shown to reduce their IQ as adults by 6 to 8 points. An Australian study of identical twins found that a twin who started using cannabis before age 17 was 3 times more likely to attempt suicide than the twin who did not. People in Colorado had good reason to worry about teen drug use. Colorado voters had approved a limited experiment with medical marijuana in 2000. A complex series of judicial and administrative decisions in the mid-2000s overthrew most restrictions on the dispensing of marijuana. Between 2009 and 2012, the number of dispensaries jumped past 500, and the number of medical cardholders multiplied from roughly 1,000 to more than 108,000. 

With so many medical-marijuana card-holders walking about, it was simply inevitable that some would re-sell their marijuana to underage users. A 2013 study of Colorado teens in drug treatment found that 74 percent had shared somebody else’s medical marijuana. The number of occasions on which they had shared averaged over 50 times. According to a report by the Rocky Mountain High-Intense Drug Trafficking Area, Colorado teens, by 2012, were 50 percent more likely to use marijuana than their peers in the rest of the country.

Debates about marijuana tend to travel pretty fast into the domain of libertarian ideology: I’m a consenting adult, why can’t I do what I want? Yet the best customers for the marijuana industry are not adults at all. The majority of people who try marijuana quit by age 30. Adults in their twenties are significantly less likely than high school students to smoke; 14 percent of twenty-somethings say they smoke marijuana, while 22.7 percent of 12th-graders smoke at least once a month, and 6.5 percent say they smoke every day. 

Why do people quit using marijuana as they mature? Your guess is as good as anybody else’s, but whatever the reason, the trend presents marijuana sellers with a marketing problem. Yet there is promising news from the emerging marijuana industry’s point of view: People who start smoking in their teens are significantly more likely to become dependent than people who start smoking later: about 1 in 6, as opposed to 1 in 10. Start them young; keep them longer. Very rationally, then, the marijuana industry is rolling out products designed to appeal to the youngest consumers: cannabis-infused soda, cannabis-infused chocolate taffy, cannabis-infused jujubes.

The promise that legalization will actually protect teenagers from marijuana is false. So, too, are the other promises of the legalizers. It is false to claim that marijuana legalization will break drug cartels. Those cartels will continue to traffic in harder and more lucrative drugs, such as heroin, cocaine, and methamphetamine. Criminal cartels may well stay in the marijuana business, too, marketing directly to underage users. Public policy is about trade-offs, and marijuana users need to face up to the trade-off they are urging on American society. Legal marijuana use means more marijuana use, and more marijuana use means above all more teen marijuana use.

Proponents of marijuana legalization often question why the law bans marijuana but not alcohol or tobacco. One important difference is that alcohol and tobacco are drugs on the decline. Since 1980, per capita consumption of alcohol has dropped almost 20 percent. One-third of Americans smoked tobacco in 1980; fewer than one-fifth smoke today. The progress against drunk driving is even more remarkable: Fatalities caused by drunk drivers have decreased by more than half since 1982.

The reduction in tobacco and alcohol use has been hastened by increasingly restrictive laws that govern where and how these products may be consumed. Tobacco-smoking has been banned on planes, in restaurants, and in almost all public places. The drinking age, reduced in the 1970s from 21 to 18 in most states, was restored to 21 by federal action in the 1980s. Tobacco taxes have been steeply hiked. Bars that served intoxicated patrons face rising tort risk.

With marijuana, however, the law is heading in the opposite direction, and has been for some time. Since 1996, 20 states and the District of Columbiahave approved “medical marijuana” laws, whereby people who obtain a prescription from a doctor can legally use or purchase marijuana. As in Colorado, many of these supposed medical regimes are degenerating into legalization by another name. Oregon, for example: At the end of 2012, it was home to 56,531 medical-marijuana patients. The majority of these 56,000-plus permissions were approved by only nine doctors. One doctor—an 80-year-old retired heart surgeon in Yakima—approved 4,180 medical-marijuana applications in a span of 12 months. Only 4 percent of Oregon’s medical-marijuana patients, as of the end of 2012, suffered from cancer. Only 1 percent were diagnosed with HIV/AIDS. The large majority, 57 percent, cited unspecified “pain” as the ailment for which treatment was sought. Yet none of the nine doctors who wrote the majority of the marijuana prescriptions was a pain specialist.

Fewer than 2 percent of California card holders have HIV, glaucoma, multiple sclerosis, or cancer: One survey found that the typical California medical-marijuana patient was a healthy 32-year-old man with a history of drug and alcohol abuse. Here, too, some doctors are signing thousands of recommendations after only the scantiest examination—or none at all. An NBC news investigator in Los Angeles visited one dispensary, was examined by a man who later proved to be an acupuncturist and massage therapist, and then received a prescription signed by a doctor who lived 67 miles away.

In the words of Los Angeles police chief Charlie Beck, most dispensaries are “for-profit businesses engaged in the sale of recreational marijuana to healthy young adults.” By early 2012, Los Angeles contained almost eight times as many dispensaries as Starbucks coffee shops. The city became alarmed that the customers who congregated at these dispensaries were active in crimes from robbery to murder. By July, the City Council voted unanimously to shut down all of the nearly 800 known dispensaries in the city. The marijuana lobby succeeded in preventing that ban from going into effect, so the next year, the city government tried a different approach: a local referendum called Proposition D to cap the number of dispensaries at 135, raise taxes on marijuana sales, and forbid dispensaries to locate near primary, middle, and high schools. 

The proposition was approved, but this approach also proved ineffective. In the words of Medical Marijuana Business Daily (yes, it exists): 

Officials have actually only forced about 70 dispensaries to close so far. While some other dispensaries shut down on their own to avoid legal troubles, most did not. That means at least 700—possibly more—illegal shops are still open.

“What happened is that we’re really trying to put a Band-Aid on some crazy open wound, and it’s not big enough to stop the bleeding,” said Adam Bierman, who runs the consultancy MedMen. “Prop D as a concept is half decent, but there’s really no way to enforce it.”

Marijuana does possess certain medicinal properties. So does opium. But we don’t allow unscrupulous quacks to write raw opium prescriptions for anyone willing to pay $65. And if we did, would anybody be surprised that the vast majority of opium buyers were not recovering from surgery—and that many of them shared or resold some of their opium to underage users?

Some older adults have a hard time crediting the dangers of marijuana use because they imagine the marijuana on sale today is the same low-grade stuff they smoked in college. The marijuana sold in the 1980s averaged between 3 and 4 percent THC, the psychoactive ingredient. Today’s selectively bred marijuana averages over 12 percent THC, with some strains reaching 30 percent. Hundreds of YouTube videos will show you how to combust a marijuana wax with butane, to boost the THC content to 90 percent. As marijuana consumers shift from smoking to ingesting marijuana, they can ingest larger and larger doses of THC at a time. Since 2006, Colorado emergency rooms have seen a steep rise in the number of patients arriving panicked and disoriented from excess THC, including a near doubling of patients ages 13 and 14.  

It’s said that nobody ever died from a marijuana overdose. Nobody ever died from a tobacco overdose either, but that doesn’t prove tobacco safe. Of all the dangers connected to marijuana, the most lethal is the risk of automobile accident. Marijuana-related fatal car crashes have nearly tripled across the United States in the past decade.Marijuana legalizers may counter: Can’t we just extend laws against drunk driving to stoned driving?

Unfortunately, it’s not so easy. What exactly defines marijuana impairment remains fiercely contested by an increasingly assertive marijuana industry. It took Colorado four tries to enact a legal definition of marijuana impairment: five nanograms of THC per milliliter of blood. Yet even once enacted, the standard remains very difficult to enforce. Alcohol impairment can be detected with a Breathalyzer. Marijuana impairment is revealed only by a blood test, and long-established law requires police to obtain a search warrant before a blood test is administered.

More important than catching impaired drivers after the fact is deterring them before they get behind the wheel. In the absence of a blood-testing kit, marijuana users themselves will find it difficult to know how much is too much. Time recently quoted a spokesperson for the Colorado Department of Transportation: “It’s not like alcohol. People metabolize it differently. There are different potencies,” the official said. “So there’s really no solution in terms of saying ‘you’re now at the limit.’ I just don’t think there’s enough research that we can say, ‘Wait x amount of hours before getting on the road.’ I don’t know whether it’s five hours or 10 hours or the next day. We just don’t know.” Back in 2007, a survey by the National Highway Traffic Safety Administration found that on any given Saturday night, about 12 percent of drivers tested positive for alcohol; about 6 percent for marijuana. Since then, 10 more states and the District of Columbia have adopted medical-marijuana regimes, which surely means even more buzzed drivers on the roads. 

Yet the most pervasive harm of marijuana may be psychic rather than physical. A battery of studies have found regular marijuana use to be associated with worse outcomes at school, social life, and work. I use the cautious phrase “associated with,” because it’s far from clear whether marijuana use is a cause or an effect of other problems—or (most likely) both cause and effect. An isolated, underachieving kid starts smoking marijuana. That kid then descends deeper into isolation and underachievement. Marijuana may not have been the “cause” of the kid’s malaise, but it intensifies the malaise and may inhibit or even prevent his emergence from it.

The negative spiral of despondency leading to marijuana use, leading to deeper and more protracted despondency, makes the present moment a particularly unpropitious one for marijuana legalization. The United States is currently recovering feebly from the gravest economic crisis since the Great Depression. Prospects for young people especially have narrowed. Are we really going to say to them: “Look, we haven’t got jobs for you, your chances at marriage are dwindling, you may be 30 before you can move out of your parents’ place into a home of your own, but we’ll make it up to you with pot, video games, and online porn”? They want to start life, but they are being offered instead only narcotic dreams.

As human beings, our judgment is not only imperfect, but is prone to fail in highly predictable ways. Insert a recurring charge onto our phone bill, and we will soon cease to notice it. We evolved under conditions where sugars and salt were scarce, and so we will eat far more than we need if given the chance. We overestimate our luck and will gamble our money in ways that make no mathematical sense. Our brains are wired for addictions. If a substance can trigger that addiction, it can overthrow all the reasoning and moral faculties of the mind. 

Lucrative industries have arisen to exploit these weaknesses in ways highly harmful to their customers. And the bold irony is that when their practices are challenged, they’ll invoke the very principles of individual choice and self-mastery that their industry is based on negating and defeating. So it was with tobacco. So it is with casino gambling. So it will be with marijuana. 

Proponents of marijuana legalization do make a valid point when they worry that marijuana laws are enforced too punitively—and that this too punitive approach inflicts disparate punishment on minority users as compared with white users. Ordinary marijuana users should receive civil penalties; repeat users belong in treatment, not prison; communities should experience law enforcement as an ally and supporter of local norms, not an outside force stamping young people with indelible criminal records for mistakes that carry fewer consequences for the more affluent and the better connected. It’s also true, however, that these alternative methods can succeed only if the background rule is that marijuana is illegal. It’s very often the threat of criminal sanction that impels users to seek the treatment they need, while still young enough to turn their lives around. 

The illegal U.S. market for marijuana is already twice as big as the market for coffee. As that market is legalized, it will expand, and the industry that serves the market will be emboldened to hire lobbyists to promote its continued expansion. The vision offered by some academics of a legal but non-commercial marijuana market shows little realism about American government. American legislatures exhibit notoriously poor resistance against check-book-wielding special interests. 

The resistance will be all the weaker since the costs of marijuana legalization will be borne by people to whom American legislatures pay scant attention anyway. Marijuana retailers will be located most densely in America’s poorest neighbourhoods, just as liquor and cigarette retailing is now. Out of whose pockets will the marijuana taxes of the future be paid? Whose addiction and recovery services will be least well funded? In a society in which it is already sufficiently difficult for people to rise from the bottom, who’ll find that their rise has become harder still?

David Frum is the author, most recently, of the novel Patriots (2012) and is a commentator for CNN and the Daily Beast.

Source: http://www.commentarymagazine.com/article/dont-go-to-pot/

Because when it comes to weed, our vision may have gotten more than a little cloudy.

The author, Patrick J. Kennedy, is a former United States congressman from the state of Rhode Island.

There has been a lot of talk recently about marijuana legalization — increasing tax revenue for states, getting nonviolent offenders out of the prison system, protecting personal liberty, and the benefits for those with severe illnesses. These are good and important conversations to have, and smart people from across the ideological spectrum are sharing their perspectives. But one key dimension of the issue has been left out of the discussion until now: the marketing machine that will spring up to support these now-legal businesses, and the detrimental effect this will have on our kids.

Curious how this might work? Look no further than Big Tobacco. In 1999, the year after a massive legal settlement that restricted certain forms of advertising, the major cigarette companies spent a record $8.4 billion on marketing. In 2011, that number reached $8.8 billion, according to the Campaign for Tobacco-Free Kids. To put it into context, the auto industry spent less than half of that on advertising in 2011, and car ads are everywhere.

Why do we think the legal marijuana industry will behave differently from Big Tobacco?

At the same time, despite advertising bans, these notoriously sneaky tobacco companies continue to find creative ways to target kids. Data from the 2011 National Survey on Drug Use and Health found that the most heavily marketed brands of cigarettes were also the most popular among people under 18. This is not a coincidence, and gets to the very core of Big Tobacco’s approach: Hook them young, and they have a customer for life.

Why do we think the legal marijuana industry will behave differently from Big Tobacco? When the goal is addiction, all bets are off. In Colorado, where there are new rules governing how legal marijuana is advertised in traditional media, there are still many opportunities to market online and at concerts, festivals and other venues where kids will be present. Joe Camel might be retired, but he’s been replaced by other gimmicks to get kids hooked — like snus and flavored cigarettes. The marijuana industry is following suit by manufacturing THC candies, cookies, lollipops and other edibles that look harmless but aren’t. Making marijuana mainstream will also make it more available, more acceptable and more dangerous to our kids.

A billboard touts the supposed relative “safety” of marijuana alongside Route 495 in Secaucus, N.J.

SOURCE Carlo Allegri/Corbis

Addiction is big business, and with legal marijuana it’s only getting bigger.

Not surprisingly, Big Tobacco is also getting on the marijuana bandwagon. Manufacturers Altria and Brown & Williamson have registered domain names that include the words marijuana and cannabis. Imagine how much they will spend peddling their new brand of addiction to our kids. We cannot sit by while these companies open a new front in their battle against our children’s health.

Can we really afford to ignore its consequences in the name of legalization?

Why is this an issue? There is a mistaken assumption that marijuana is harmless. It is not. Marijuana use is linked with mental illness, depression, anxiety and psychosis. It affects parts of the brain responsible for memory, learning, attention and reaction time. Developing brains are especially susceptible to all of the negative effects of marijuana and other drug use. In fact, poison control centers in Colorado and Washington state have seen an increase in the number of calls regarding marijuana poisoning. This isn’t a surprise — with legal marijuana comes a host of unintended consequences.

I’ve spent the last several years after leaving Congress advocating for a health care system that treats the brain like it does any other organ in the body. Effective mental health care, especially when it comes to children, is critically important. Knowing what we now know about the effects of marijuana on the brain, can we really afford to ignore its consequences in the name of legalization? Our No. 1 priority needs to be protecting our kids from this emerging public health crisis. The rights of pot smokers and the marijuana industry end where our children’s health begins.

I’m not alone in my concerns about this trend toward legalization. Even Colorado Gov. John Hickenlooper has said that marijuana legalization in his state was “reckless,” and reaffirmed his opposition to it during his campaign for re-election. He also said he will “regulate the heck” out of it. For that, I applaud his leadership and courage. Five more states have legalization ballot measures up for a vote this fall. I hope common sense will prevail, and they choose a better path than making addiction the law of the land. 

At the end of the day, legalizing and marketing marijuana is making drug use acceptable and mainstream. Just as Big Tobacco lied to Americans for decades about the deadly consequences of smoking, we can’t let “big marijuana” follow in its footsteps, target our kids and profit from addiction.

Source: www.OZY.com Nov. 27, 2014.

This article originally appeared on VICE Romania

Ana Iorga is a Romanian neuromarketing pioneer, who specialises in market research using EEG sensors, biometric measures and implicit-association tests. Attending an advertising conference in Amsterdam last month, Ana staged an impromptu experiment to measure the effect that weed has on the brain using the EEG helmet she tends to carry around in her bag.

“I noticed how quite a few of the attendees grabbed a joint between breaks, and I kept wondering what goes on in their brains during those moments. Because I don’t possess any mind-reading techniques, I thought about comparing their brain activity before and after smoking,” she told me when she got back.

Two of her colleagues were kind enough to sacrifice themselves to the shrine of science; One evening, after dinner, one of them lit a spliff and the other got to munching on a space cookie.

The first participant – EEG trajectory before smoking

“Before consuming the products, we went to the hotel bar and I recorded their brain activity. After 15 minutes, I repeated the measures. I was convinced that I’d see a decrease in brain activity, because they said they felt slower, more absent and more relaxed. I was very surprised by the result.”

The first participant – EEG trajectory after smoking

Your brain contains billions of cells called neurons, which communicate with each other through electricity. The simultaneous communication between billions of neurons produces a large quantity of electric brain activity, which can be detected and measured through EEG technology. Because these electric impulses are triggered periodically as waves, they’re called “brain waves”.

EEG sensors measure the activity of neurons located on the surface of the cerebral cortex, and in the case of the two subjects, they showed a very high frequency and amplitude after smoking – the cerebral rhythm being visibly changed compared to the initial situation. This translates into a brain activity contrasting heavily with the participants’ mood (in stand-by mode and relaxed mode).

The second participant – EEG trajectory before eating the space cookie

Often, studies claim that THC has the effect of slowing down the cerebral rhythm when it is associated with a state of relaxation, and of speeding up when it is associated with visual hallucinations or tripping. With Ana’s two subjects, “it was clear that the cerebral rhythm was faster after smoking and that wave amplitude was larger – which doesn’t mean that things function chaotically, but that the brain is in a higher alert state. Maybe the guy was tripping or had some sort of bizarre feelings,” explains Laura Crăciun – a neurologist.

Crăciun emphasises that in the case of the first subject there is an imbalance standing out between the left hemisphere’s cerebral electricity [which deals with logic, language and math processes] and the right [where creativity, intuition, art and music processes take place] and along the sequence from the wave recording taken before smoking. That means that the imbalance is not exclusively determined by cannabis smoking.

Both subjects had consumed moderate quantities of alcohol at dinner, which didn’t interfere with the process very much. During the experiment, the two weren’t asked to perform any tasks, as their brain activity was measured in stand-by and relaxation mode.

The second participant – EEG trajectory after eating the space cookie.

“With the subject who ate a space cookie, the effect was both a slowing down [the basic wave frequency rhythm of both hemispheres went down] and speeding up of the amplitude, which is associated with a state of sleep-like, profound relaxation.”

“On the first recording, the cerebral rhythm is visibly faster – in the right hemisphere, because I can’t see a big difference in the left one – as well as less symmetrical and steady, but I wouldn’t say the effect is a “disturbance” over the brain waves, but more likely a state of awareness,” Crăciun added.

Source: http://www.vice.com/en_uk/ 15^th Feb 2015

Super-strength strains of cannabis are responsible for up to a quarter of new cases of psychotic mental illness, scientists will warn this week.

The potent form of the drug, known as ‘skunk’, is so powerful that users are three times more likely to suffer a psychotic episode than those who have never tried it.

The study, leaked to The Mail on Sunday ahead of its publication, is set to reignite the debate around Britain’s drug laws, and will add weight to calls for a tougher stance towards those caught dealing or in possession of cannabis.

According to Crime Survey figures for England and Wales, over a million youngsters aged 16 to 24 smoke cannabis. Regular users are most at risk, prompting experts to warn that youngsters need to be aware of the dangers of skunk, which has been specially cultivated to be four times as strong as the cannabis smoked by previous generations.

The researchers, led by a team at the Institute of Psychiatry at King’s College in London, conclude there is an ‘urgent need… to inform young people about the risks of high-potency cannabis’ amid a worldwide trend towards relaxing drug laws.

They will reveal there is a key difference between potent skunk strains and ‘hash’. Those who used these ‘weaker’ forms did not seem to suffer the same increase in risks.

Psychosis is defined as a form of mental illness where people experience delusions, hallucinations, or both at the same time. Associated with conditions such as schizophrenia and bipolar disorder, some people are so badly affected that they end up committing suicide or seriously harming others because they believe they are being ordered to do so by voices in their heads.

The findings will add substance to a 2012 report by the Schizophrenia Commission, which recommended the need for ‘warnings about the risks of cannabis’ to mental health.

That report was chaired by schizophrenia expert Professor Sir Robin Murray, who also played a key part in the new study. It looked at cannabis use in two groups, each containing about 400 people, from 2005 to 2011. Those in the first group had all suffered ‘first-episode psychosis’– a diagnosed first occurrence of the disorder.

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The research appears to show a striking difference between the effects of skunk and the weaker form of cannabis, hash resin, revealing that hash seemed not to add to a person’s risk of psychosis – even if smoked daily

The second group were volunteers who agreed to answer questions about themselves – including on cannabis use and mental health history – for a study. Some had suffered psychosis, others not. They were not told the nature of the project.

The academics found those in the first group were more likely to smoke cannabis daily – and to smoke skunk – than those in the second. The researchers say: ‘Skunk use alone was responsible for 24 per cent of adults presenting with first-episode psychosis to the psychiatric services in South London.’

This was almost double the previous highest estimate of psychiatric cases linked to the drug – 13 per cent – from a 2002 Dutch study.

The latest research, to be published in The Lancet, concludes: ‘People who used cannabis or skunk every day were roughly three times more likely to have a diagnosis of a psychotic disorder than were those who never used cannabis.’

But the research appears to show a striking difference between the effects of skunk and the weaker form of cannabis, hash resin.

It will reveal that hash seemed not to add to a person’s risk of psychosis – even if smoked daily.

Skunk is shorthand for around 100 strains of cannabis that contain a high proportion of tetrahydrocannabinol (THC), the drug’s primary psychoactive compound. But the levels of another compound, cannabidiol – which may have anti-psychotic effects – are the reverse, high in hash and virtually zero in skunk.

The researchers speculate this could be due to the differing chemical make-up of the two forms: ‘The presence of cannabidiol [in hash] might explain our results, which showed that hash users do not have any increase in risk of psychotic disorders compared with non-users.’

Michael Ellis, a Tory member of the Home Affairs Select Committee, said: ‘This powerful new study illustrates that those in government and the police must be careful to send out the right message. Cannabis isn’t a harmless drug: it can ruin lives.’

‘I WAS SMOKING EVERY NIGHT AND HAVING CRAZY THOUGHTS’ 

Erica Camus

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Erica Camus (pictured) believes her psychosis was triggered by smoking Skunk

Freelance journalist Erica Camus knows first hands the terrifying experience of psychosis. which she now links to the powerful skunk cannabis she used in her teenage years and 20s. Erica, 34, from Staffordshire says: ‘I started smoking cannabis when I was about 13. It was fine- it gave me the giggles and nothing bad happened.

‘But at 19, after moving to London and getting a stressful job as a fashion journalist, I got my hands on skunk. The paranoia I felt was instant, but I still kept smoking it. I’d have a joint or two every night because I thought it would make me calm down. It didn’t.

‘I was parting a lot, handing out with arty squatters. Then I had a contraceptive coil fitted and kept thinking: ‘The Government has out spy equipment in me. At one stage I was terrified of getting a video out in case it made me fat- I thought they had calories in them. They were crazy thoughts but I couldn’t see them for what they were.

‘Eventually I moved back home with my mother. One night she found me searching for ‘spy equipment; in the spare room. it was the final straw. she took me to the GP, who referred me to a psychiatrist.

‘That was in 2003. I’m still on anti-psychotic medication, Skunk probably isn’t the only reason I’ve development mental health problems, but I’m sure it was the trigger.’

Source:: http://www.dailymail.co.uk/news/article-2953915/Scientists-cannabis-TRIPLES-psychosis-risk-Groundbreaking-research-blames-skunk-1-4-new-mental-disorders.html#ixzz3RoQDIWK9

The Russian government is likely to disband the Federal Drug Control Service, according to an official document obtained by The Moscow Times.

The document, signed on Feb. 10 by Larisa Brychyova, head of the legal directorate of the presidential administration, cites an order by President Vladimir Putin to dissolve the agency from March 1.

The agency’s functions will be redistributed among the Interior and Health ministries, according to the document.

Business daily Vedomosti reported Monday that the agency is being liquidated due to budget considerations.

Putin’s proposal will be considered by the Cabinet before becoming official, a process that is generally no more than a technicality for Kremlin initiatives.

The Federal Drug Control Service was established in 2003 on the foundations of the Federal Tax Police Service and employs about 35,000 people, having been ordered by Putin in 2012 to cut its staff by 5,000 people by 2016, state news agency Interfax reported. The service was allocated more than 29.5 billion rubles ($473 million) from the federal budget last year, according to its website.

According to the Kommersant daily, drugs policy director Viktor Ivanov — the agency’s outspoken head — will likely return to the presidential administration where he served as a presidential aide before joining the agency in 2008.

In an interview with Kommersant last week, Ivanov denied rumors that the agency would be liquidated, saying that in the last five years it had busted almost 350 criminal gangs, “almost 10 times more than all other law enforcement agencies put together.” He also said in the interview that since the agency was created, the drug-related mortality rate in Russia has halved.

Last October, Ivanov said that drugs are to blame for 80 percent of all deaths of Russians aged 18 to 34 in Russia during the past five years. The rate has improved, but the number is still too high, Ivanov said in an interview with the TV Center television channel.

There are 8.5 million drug addicts in Russia — almost 6 percent of the population — a government report said in 2013. Many of them are heroin users, supplied by the steady flow of the opiate into Russian from Afghanistan through neighboring Central Asian countries. The Russian Federation has the highest prevalence of opiate use in eastern and southeastern Europe, according to the UN 2014 World Drug Report.

Ivanov and his agency were often criticized for their opposition to drug substitution therapies. As many as 100 drug users in Crimea have died since the peninsula was annexed from Ukraine by Russia as a direct result of the treatment becoming illegal under Russian law, a UN official said in January.

In recent years, Ivanov’s agency has found it hard to battle the spread of synthetic marijuana and other smoking blends that are known generally as “spice.” Sold widely online, they have caused a spate of recent high-profile deaths.

Longtime anti-drugs crusader Yevgeny Roizman, founder of the City Without Drugs movement in Yekaterinburg, spoke against the decision to disband the agency Monday.

“This agency is much more effective than the police. Moreover, competition between various agencies makes them achieve results,” he wrote in his LiveJournal blog.

“After investing loads of money and creating a powerful professional structure that has proved its effectiveness, to then just disband it all is a chaotic and absurd decision. Drug dealers are dancing with joy. Some people in the Interior Ministry are dancing too,” he wrote.

Source: http://www.themoscowtimes.com/ 16^th Feb.2015

Abstract

Background:

There has been an increase in non-daily smoking, alternative tobacco product and marijuana use among young adults in recent years. Objectives: This study examined perceptions of health risks, addictiveness, and social acceptability of cigarettes, cigar products, smokeless tobacco, hookah, electronic cigarettes, and marijuana among young adults and correlates of such perceptions. Methods: In Spring 2013, 10,000 students at two universities in the Southeastern United States were recruited to complete an online survey (2,002 respondents), assessing personal, parental, and peer use of each product; and perceptions of health risks, addictiveness, and social acceptability of each of these products.

Results:

Marijuana was the most commonly used product in the past month (19.2%), with hookah being the second most commonly used (16.4%). The least commonly used were smokeless tobacco products (2.6%) and electronic cigarettes (4.5%). There were high rates of concurrent product use, particularly among electronic cigarette users. The most positively perceived was marijuana, with hookah and electronic cigarettes being second. While tobacco use and related social factors, related positively, influenced perceptions of marijuana, marijuana use and related social factors were not associated with perceptions of any tobacco product.

Conclusions/Importance:

Marketing efforts to promote electronic cigarettes and hookah to be safe and socially acceptable seem to be effective, while policy changes seem to be altering perceptions of marijuana and related social norms. Research is needed to document the health risks and addictive nature of emerging tobacco products and marijuana and evaluate efforts to communicate such risks to youth.

KEYWORDS:

addiction; health risk; marijuana use; social norms; tobacco use; youth

Source: http://www.ncbi.nlm.nih.gov/pubmed/25268294 14 Sept 2014

Singer’s poignant track pays tribute to the brother who went from David Beckham lookalike to death from alcoholism within 10 years.

Tom Maybury

Henry Maybury and (inset) his brother Tom

Henry Maybury looked up to his handsome big brother.

They loved to banter about football, with Tom teasing Henry about his love of Aston Villa. Last month, Tom would have been celebrating his 31st birthday with his family. If he hadn’t drunk himself to death. At the age of 29.

“To see my brother go from a David Beckham lookalike to someone who shook all the time and could barely recognise his relatives was completely heartbreaking,” says Henry.

But the 22-year-old is determined that some good should come out of the tragedy. He is campaigning to raise awareness of alcohol addiction, telling others about his brother.

He has written and released a song, Lost Days, to raise money for addiction charities. An accompanying video starts with the message: “Alcohol abuse kills about 2.5 million people each year worldwide. “I witnessed it take over someone I loved and then lost.”

It features a man drinking, and the effect it has on his family, who are begging him to stop. Then there’s the line: “It’s just too late, all we can do is pray.”

The video has proved an internet hit with more than a million views. Celebrities including Lorraine Kelly, John Challis, Adam Woodyatt and Abi Phillips have shown their support.

Henry, from Shrewsbury, explains: “When Tom passed away it was a rough couple of months for everyone. “I was sitting in my bedroom when I came across this song, Lost Days, that I’d written about Tom because I saw what alcohol was doing to him.

“I asked people to take part in the video and auditioned 200 of them on Skype. I did it on a tiny budget and recorded it at Chichester University, where I’ve just graduated in musical theatre. “I uploaded the video and it went viral. Within the first hour I had 200 shares on Facebook and in the first couple of weeks there were more than a million hits on YouTube.

“The most touching response was the people who contacted me to say ‘It really makes you think’.

“I would love the video to be used in schools. I remember being at school when we had people in to talk about subjects like this – but I’d just switch off.“I’d hope the video would get the message across better.

“I was asked to speak at a DrugFam conference at the Holiday Inn at Birmingham Airport, to help the families of those with drug and alcohol addiction. They said the video could save lives.”

Tom Maybury died on February 22, 2013 in Royal Shrewsbury Hospital from liver and kidney failure and alcohol poisoning. He was the eldest son of Neil and Sally and brother to Toby, Natasha and Henry.

“My brother had so much going for him. I just don’t want other people to follow in his footsteps,” says Henry. “I’m passionate about spreading the word that it could happen to anyone. “Tom went from being a normal teenager, having a few drinks on a Saturday night, to going to the pub every night and drinking a lot more than two pints.

“He started drinking heavily at the age of 19 but we noticed he had a real problem in his early twenties. You don’t pick up on it at first.

“We don’t know what triggered it, whether he had an addictive gene. He went to agricultural college and had a gardening business, but he lost his licence because of drink-driving and the work dried up. So he just stayed at home, drinking pretty much continuously.  The first thought that went through his head when he woke up was to have a drink – cider and beer, mainly.

“But however much we tried to help, it’s impossible unless they want to be helped. He suffered from epilepsy and would sometimes be hospitalised after a bad fit. His epilepsy medicine would stop working because of the alcohol.

“The ambulance was called on a regular basis. Hospital would dry him out and he would say he wanted to quit, but then the draw was too much and he’d drink again.

“Alcohol is so readily available these days, and cheap. He was dependant on drink for a decade.” Tom was warned by medics that his liver would fail, but the warnings fell on deaf ears. “He was warned that his liver would pack up – and it did,” says Henry.

“It was just so diseased. He had yellow eyes, was shaking continuously and could barely recognise his family. He really suffered at the end. We knew he wasn’t going to get better. He was my big brother. I looked up to him and he always had my back. I want to make sure he’s not been forgotten.

“After I made the video, several people told me ‘Your brother would be so proud of you’. “It’s nerve-racking, telling your story to the world. I wasn’t expecting the support. I’ve always said I want to help people through my music. I have lots more songs in the pipeline, I want to release another video in January and an album called Timeline in 2015.”

Henry and his mother Sally have set up the Lost Days Charitable Aid Trust and a committee to decide where best to send the money raised by downloading the single from iTunes. It includes Professor John Kelly, the first professor for addiction at Harvard University, and Canon Mark Oakley from St Paul’s Cathedral. Henry has done all this despite having his own problems to deal with.

“Music has always been a massive part of my life, but I wanted to be a professional rugby player,” he remembers.

“I was playing 40 hours a week, for Ellesmere School, Shrewsbury Rugby Club and Shropshire. “Then, at the age of 15, I was struck down by arthritis and ended up in a wheelchair. “But I was determined to beat it and within a year I was back on the rugby field. It’s still a problem, one I manage with medication. “It can be painful and make it difficult to walk, but I won’t let it stop me. It has helped me, I think. The music industry is so tough but I am tough too after what I’ve been through.”

For more information and to donate, go to www.henrymaybury.com .

Source: http://www.birminghammail.co.uk/news/health 2^nd November 2014

Binge Drinking

Alcohol-fueled tailgates attract students at colleges around the United States. 

Despite decades of research, hundreds of campus task forces and millions invested in bold experiments, college drinking in the United States remains as much of a problem as ever.

More than 1,800 students die every year of alcohol-related causes. An additional 600,000 are injured while drunk, and nearly 100,000 become victims of alcohol-influenced sexual assaults. One in four say their academic performance has suffered from drinking, all according to the National Institute on Alcohol Abuse and Alcoholism.

The binge-drinking rate among college students has hovered above 40 percent for two decades, and signs are that partying is getting even harder. More students now drink to get drunk, choose hard liquor over beer and drink in advance of social events. For many the goal is to black out.

Drinking is so central to students’ expectations of college that they will fight for what they see as a basic right. After Syracuse University, named the nation’s No.1 party school by The Princeton Review, tried to limit a large outdoor gathering, outraged students labelled the campus a police state.

Why has the drumbeat of attention, effort and moneyfailed to influence what experts consider a public-health crisis? It is not for lack of information. Dozens of studies show exactly why, when, where and how students drink. Plenty more identify effective intervention and prevention strategies. A whole industry has sprung up around educating students on the dangers of alcohol abuse.

For the most part, undeterred by evidence that information alone is not enough, colleges continue to treat alcohol abuse as an individual problem, one that can be fixed primarily through education.

“Institutions of higher education are still really committed to the idea that if we just provide the right information or the right message, that will do the trick, despite 30 or 40 years of research that shows that’s not true,” said Robert F. Saltz, a senior research scientist at the Prevention Research Center, part of the Pacific Institute for Research and Evaluation. “The message isn’t what changes behavior. Enforcement changes behavior.”

Yet many colleges still look the other way. Few have gone after environmental factors like cheap and easy access to alcohol or lenient attitudes toward underage drinking.

At some colleges, presidents are reluctant to take on boosters and alumni who fervently defend rituals where drinking can get out of control. Administrators responsible for prevention often are not equipped with the community-organizing skills to get local politicians, bar owners and the police to try new approaches, enforce laws and punish bad actors.

A student’s death or an unwelcome party-school ranking might prompt action, but it is unlikely to be sustained or meaningful. A new prevention program or task force has only so much impact.

Even at colleges that try to confront these issues comprehensively, turnover and limited budgets pose significant obstacles. When administrations change, so do priorities.

In the 1990s college presidents routinely declared alcohol abuse the greatest threat to campus life, and the federal government demanded that they do something.

The first large-scale examination of alcohol use among college students began in 1993. Run by Henry Wechsler, a social psychologist at the Harvard University School of Public Health, the College Alcohol Study surveyed 17,000 students at 140 colleges on why and how they drink.

The following year, Mr. Wechsler pronounced 44 percent of all college students binge drinkers, using that term to mean consuming four or five drinks in a row. The results set off a storm of news coverage and helped shift public understanding of college drinking from a relatively harmless pastime to a public-health concern. The Robert Wood Johnson Foundation, which financed the first survey, invested millions in further surveys and research.

Mr. Wechsler and his team painted a complex portrait of campus culture, one in which the environment fueled excessive drinking. More than half of the bars surrounding campuses, they found, used discounts and other promotions to lure in students. Higher rates of binge drinking were associated with membership in a fraternity or sorority, a belief that most students drink and easy access to alcohol.

At the same time, the studies made clear that much is beyond colleges’ control. Half of students had started binge drinking before they got to campus.

Advocates and policy makers sensed an opportunity. The United States Department of Education established the Higher Education Center for Alcohol, Drug Use and Violence Prevention, which provided research, training and technical assistance. Mr. Wechsler’s findings sparked a 10-campus experiment to try to bring drinking under control. Focusing on colleges with higher-than-average rates of binge drinking, the project aimed to prove that by working with community partners to change the environment, colleges have the power to shift student behavior. The Johnson foundation put more than $17 million into the project, which was conducted with the American Medical Association over a 12-year period.

Binge drinking

But early results showed that in the first few years, half of the colleges involved did not try much of anything. The other half reported “significant although small” improvements in drinking behavior. Meanwhile, a survey of about 750 college presidents found that they were sticking to what they had always done, focusing on arguably effective “social norming” campaigns, which aim to curb students’ drinking with the message that their peers do not drink as much as it seems. Today a number of colleges that participated in the lengthy experiment still struggle with students’ alcohol problems.

Several colleges developed new programs: training servers, notifying parents when underage students were caught drinking and coordinating enforcement with the local police. Setbacks, however, were common. Louisiana State University found local bar owners hostile to the idea of scaling back happy hours or drink specials. At the University of Colorado at Boulder, the campus-community coalition had little authority. To appeal to local businesses, a new mayor in Newark, Del., weakened regulations on selling alcohol near dormitories at the public flagship university.

The following years saw the end of several major projects. Mr. Wechsler’s College Alcohol Study wrapped up in 2006, having surveyed 50,000 students and produced reams of research. The Robert Wood Johnson Foundation shifted its attention elsewhere. The Amethyst Initiative, a campaign by more than 100 college presidents to reconsider the legal drinking age, came and quickly went. And in 2012, funding cuts eliminated the federal center that had guided colleges on preventing alcohol and drug abuse.

Jim Yong Kim, a physician with a public-health background who was president of Dartmouth College, attempted to drag the issue back into the spotlight, announcing an intensive, public-health and data-driven approach to dealing with campus drinking. He used his influence to drum up participation from 32 institutions in the National College Health Improvement Program’s Learning Collaborative on High-Risk Drinking and secured money to keep it going for two years. But when he left Dartmouth to lead the World Bank, in 2012, the leadership and the money dried up. The project issued its first and final report this year.

Educators and researchers who lived through this period say a combination of exhaustion, frustration, inertia, lack of resources and campus and community politics derailed the national conversation about college drinking. Taking on the problem proved tougher than anyone had thought.

“All those efforts caused some issue fatigue,” said John D. Clapp, director of the federal alcohol and drug center when it closed. The feeling, he said, was “Hey, we tried this, and it’s time to move on.”

Today, fewer than half of colleges consistently enforce their alcohol policies at tailgates, in dormitories and at fraternity and sorority houses. Only a third do compliance checks to monitor illegal alcohol sales in nearby neighborhoods. Just 7 percent try to restrict the number of outlets selling alcohol, and 2 percent work to reduce cheap drink specials at local bars, according to the Minnesota researchers.

Philosophically, many educators are resistant to the idea of policing students. They would prefer to treat them as young adults who can make good choices with the right motivation. Traci L. Toomey, who directs the alcohol-epidemiology program at Minnesota’s School of Public Health, recalls visiting a campus that had long prided itself on letting students monitor the flow of alcohol at social events. “As if somehow magically they’d do a great job,” she said.

In the Minnesota surveys, only about 60 percent of campus law-enforcement officials said they almost always proactively enforced alcohol policies. Half cited barriers such as understaffing and students’ easy access to alcohol at private parties and at bars that don’t check IDs. Only 35 percent of colleges’ law-enforcement units almost always issue criminal citations for serious alcohol-related incidents, preferring instead to refer cases to other offices, like judicial or student affairs.

Students themselves say more-aggressive enforcement could change their behavior. One survey of those who had violated their colleges’ alcohol policies found that parental notification, going through the criminal-justice system or being required to enter an alcohol treatment program would be more of a deterrent than fines and warnings.

Duke University was home to an all-day party known as Tailgate, which raged in a parking lot before and after every home football game. Wearing costumes, cranking up the music and funneling beer, students left behind a mess so huge it required front-loaders to clear. Administrators tried all sorts of things — cars versus no cars, kegs versus cans, shorter and longer hours, food and entertainment — in a futile effort to rein in bad behavior. In 2010, a 14-year old sibling of a student was found passed out in a portable toilet. Administrators shut it down.

Fraternities and sororities remain a third rail for many college presidents. “Even though the Greek system was identified as the highest area of risk in terms of harm and rates of drinking, we didn’t have many schools touch that,” said Lisa C. Johnson, a former managing director of the Learning Collaborative on High-Risk Drinking. “It’s fraught with politics. It’s fraught with, Are we going to lose funding from alumni who value the traditions? Also, it’s complex because Greek houses may be owned by the fraternities, not the university.”

Some prevention advocates hope that scrutiny of sexual assault on campuses may result in more attention to alcohol abuse, because the connection has been well documented. It took a series of federal complaints and investigations, supporters say, for colleges to begin revising and better enforcing their sexual-assault policies.

Others are betting that money will talk. Jonathan C. Gibralter, president of Frostburg State University, calculated that alcohol abuse cost $1 million in staff time and lost tuition over a recent four-year period. Putting a price tag on the problem, he said, helped keep people motivated to crack down on off-campus parties, work with local law enforcement and raise expectations among students.

The different forces at play nationally may not be enough to focus attention on dangerous drinking in college, but culture change can happen. It’s just slow, said John Porter, director of the Center for Health and Well Being at the University of Vermont, which has grappled with alcohol abuse for more than two decades. Asked to lead a new campus wide approach to the problem, Mr. Porter remains hopeful. When he was a child, he said, he used to sit on his mother’s lap in the front seat of their Buick. She’d be smoking cigarettes. Nobody was wearing seat belts. “Today we’d be aghast,” he said.

Source: THE CHRONICLE OF HIGHER EDUCATION DEC. 14, 2014

Last month, people voted to legalize recreational use of marijuana in Oregon, Alaska and the District of Columbia. As the movement toward marijuana legalization continues, lawmakers and policy experts are looking to the experiments in Colorado and Washington for guidance. We should not overlook, however, valuable lessons from our experience with another legal drug: tobacco.

In the late 19th century, the landscape of tobacco consumption was very different than it is today. Tobacco use was much less prevalent, and cigarettes accounted for a tiny portion of consumption. Yet by the mid-20th century, almost half of U.S. adults smoked, with major consequences for public health. Despite important health policy achievements since, cigarette smoking remains a major contributor to the top causes of death in the United States, including cardiovascular and lung diseases, as well as cancer.

This drastic rise in the prevalence of smoking can be attributed to a number of successful business strategies. Hand-rolling of cigarettes, a technique that limited production potential, was supplanted by machine manufacturing. Changes in the chemical composition and curing process of cigarettes made them more flavorful as well as more addictive. Aggressive marketing techniques sought to build a larger consumer base. Advertisements often featured doctors in an effort to quell public fear over smoking-related health concerns; other campaigns targeted children or adolescents, who represented potential lifetime customers. Finally, the industry created powerful lobbying groups to protect their profits from regulations aimed at curbing consumption.

Alarmingly, marijuana businesses are now mimicking many of Big Tobacco’s successful strategies. New methods of consuming marijuana (such as vaporization) are said to represent a healthier way to get high — though little research supports this claim — encouraging individuals to consume more marijuana in one sitting. The percentage of tetrahydrocannabinol (the euphoria-inducing compound associated with many adverse health effects) in marijuana is much higher than it was a few decades ago. Just as tobacco companies featured doctors in advertisement campaigns, marijuana advocates have appealed to medical authority by successfully lobbying in many places for the approval of “medical marijuana” for a plethora of conditions, even when little or no scientific evidence supports its use.

Although it is laudable that Colorado has placed restrictions on marijuana advertising, it is also disturbing that the marijuana industry quickly mounted powerful legal efforts to challenge these restrictions in court.

The formula for success in profiting from a legal drug is simple and has been clearly outlined by Big Tobacco: Identify a product with addictive potential, aggressively market it to as large an audience as possible, develop technical innovations to allow for and promote increased consumption, and deny or minimize potential costs to human health. The marijuana industry is poised to copy this formula, with dire consequences.

Important lessons can also be drawn from the Netherlands, where marijuana has been decriminalized since 1976. Following decriminalization, the Dutch government strictly enforced guidelines prohibiting advertising and transactions above a certain quantity (to discourage mass production and distribution). For about a decade, marijuana consumption rates remained stable. However, in the mid-1980s, waning enforcement of these guidelines coincided with a drastic increase in both the commercialization of marijuana and rates of consumption. The overriding lesson from the Netherlands is that it was commercialization, not decriminalization itself, that led to sharp increases in use.

If we are intent on legalizing marijuana for recreational use, lessons from the tobacco industry and the Dutch marijuana experiment suggest that we do so in a way that does not pit corporate incentives against the interests of public health. Similar to efforts in Uruguay, production and distribution should be done solely by the government so as to ensure that there is no corporate incentive to entice more people to consume marijuana in larger quantities. Advertisements in all media venues should be banned, or as stringently regulated as allowed by law.

While the health effects of marijuana are generally not as severe as those of cigarette smoking, the consequences — including addiction, psychosis and impaired cognitive abilities — are nonetheless real. Notably, these effects are most pronounced in children and adolescents. Claims that marijuana legalization will make it easier to prevent use by minors are not backed by scientific or historical evidence. The most prevalent drugs consumed by teenagers are those that are legal: alcohol and tobacco. This should give us pause to consider the optimal way to legalize marijuana — and indeed whether other states should consider legalization at all.

Samuel T. Wilkinson is a resident physician in psychiatry at the Yale School of Medicine. This first appeared in The Washington Post.

Source: http://www.courant.com/opinion/op-ed/hc-op-marijuana-mimics-big-tobacco-1214-20141212-story.html

By John P. Walters and David W. Murray

Mayor de Blasio seems to believe that law enforcement doesn’t so much protect minority communities as harm them. His administration’s latest effort will have the NYPD reduce enforcement of marijuana laws — a move toward legalization under the banner of social justice. The push for marijuana legalization begins with the claim that the drug is essentially benign or even beneficial.

It follows that arresting people for using marijuana is unjust, with possession arrests damaging lives, filling prisons and wasting police resources. Worse, the enforcement of marijuana laws causes the disproportionate arrest and incarceration of African-American males and represents an assault on civil rights, if not a “war” on communities of color.

The claims are wrong:

Actual risk of arrest while using marijuana is stunningly low. Roughly 5 percent of US arrests in a given year are for marijuana possession. We calculate about one arrest for marijuana possession for every 34,000 joints smoked.

Drug arrests simply aren’t a significant portion of law-enforcement activity, and possession arrests for marijuana certainly don’t fill our prisons. A 2008 study by the Bureau of Justice Statistics found that fewer than 0.3 percent of those incarcerated in state prison (which is where most US inmates are incarcerated) are there for simple marijuana-possession offenses — and many of those have just “pled down” from more serious offenses.

Are African-Americans targeted victims of the drug laws? No — race is not the driver of “disparate impact.”

First, African-American drug-use rates are likely higher than most studies assume: Researchers usually rely on surveys of drug use, but such surveys undercount dropouts, the homeless and the imprisoned — populations in which African-Americans are disproportionately represented and drug use is high.

Second, African-Americans are arrested for drug trafficking more often than whites — crimes that more commonly lead to prison time.

Third, African-American drug use often occurs in areas with intensive policing, such as urban street corners, which means that the risk of arrest for African-Americans is higher than for whites, whose use of drugs is typically less conspicuous.

Fourth, it’s not just drug-related crime where we see racial disproportions in arrests and incarcerations: The same is true for almost all crimes. Eliminating drug-law enforcement would change little.

In short, Vanita Gupta, the acting assistant attorney general for the Justice Department’s Civil Rights Division, is simply wrong to say that the “war on drugs has been a war on communities of color” — unless she’s willing to argue that virtually all efforts to combat crime are wars on communities of color.

That is, the disproportions of arrests, incarcerations and victimization that afflict many African-American communities are a direct consequence of the disproportionate crime (and devastating suffering from crime) that plagues those communities.

Responding to this reality in the 1980s, then-Sen. Joe Biden led the bipartisan effort to pass tough new laws against cocaine and crack. Lawmakers have since made efforts to ensure the laws are more fair, but we shouldn’t forget how bad the epidemic was, and how law enforcement worked to protect victimized communities.

The problem isn’t the presence of the laws against drugs. Rather, the problem is the presence and use of illegal drugs.

Drug use is strongly associated with failure to finish high school. It has crippling effects on securing employment or joining the military — critical pathways out of poverty.

Poor cognitive performance linked to drug use most affects those who already struggle to succeed because of family disruption, poverty, disabilities and discrimination.

Does any serious person believe young men and women of all races and backgrounds will be better off with more drug use? Where we find racial injustice or failed policies, we should correct them. But abandoning law enforcement through drug legalization presents a grave danger to all young Americans.

 John P. Walters and David W. Murray direct Hudson Institute’s Center for Substance Abuse Policy Research. Both served in the Office of National Drug Control Policy.

Source: http://nypost.com/2014/12/16/drug-enforcement-is-not-racist/

Although a growing number of states have approved post traumatic stress disorder (PTSD) as a qualifying condition for medical marijuana use, new research shows that the drug may actually worsen symptoms and increase violent behavior.

A large observational study of more 2000 participants who were admitted to specialized Veterans Administration treatment programs for PTSD showed that those who never used marijuana had significantly lower symptom severity 4 months later than those who continued or started use after treatment. Veterans who were using marijuana at treatment admission but quit after discharge (“stoppers”) also had significantly lower levels of PTSD symptoms at follow-up.

On the other hand, the highest levels of violent behavior were found in the so-called “starters,” those who were not using the substance at admission but who started use after discharge.

At the American Academy of Addiction Psychiatry (AAAP) 25th Annual Meeting, lead author Samuel T. Wilkinson, MD, from the Yale University School of Medicine, in New Haven, Connecticut, told conference delegates that the findings suggest marijuana nullifies the benefits of intensive PTSD treatment.

“This wasn’t a randomized controlled trial. But at least in this study, we found that marijuana is not associated with improvement in PTSD and that initiating marijuana was associated with worsening outcomes in a number of measures,” said Dr Wilkinson.

Little Substantive Evidence

Despite the fact that a number of states have approved the use of medical marijuana for PTSD, there’s little evidence to support its use for treatment of the disorder.

“There have been a few longitudinal assessments, but no randomized controlled trials showing efficacy and safety,” added Dr Wilkinson.

The investigators evaluated data from the Northeast Program Evaluation Center for veterans who were admitted across the United States between 1991 and 2011 into specialized intensive PTSD treatment programs lasting a mean of 42.5 days.

A total of 2276 representative veterans were included in this analysis. They were split into four groups: in addition to the marijuana starters (n = 831), those with no use at treatment admission or after discharge were placed in the “never used” group (n = 850); those using at admission and after discharge were placed in the “continuing use” group (n = 296); and those who quit using after treatment were in the “stoppers” group (n = 299).

All were evaluated at admission and at a follow-up 4 months after discharge. Measures used included the short version of the Mississippi Scale (MISS) to assess PTSD symptom severity, the drug and alcohol subscales of the Addiction Severity Index (ASI), and reports of violent behavior.

Results showed that use of marijuana was significantly associated with higher PTSD symptom severity, as well as higher levels of violent behavior and alcohol and drug use.

Scores on the MISS showed that all groups except the starters had at least some improvement. However, the lowest levels of PTSD symptoms at the 4-month follow-up were in the marijuana stoppers, with a score decrease of 7.9% (P < .0001 vs the continuing users and the starters), and in the never users, with a score decrease of 5.5% (P < .0001 vs the starters).

Surprise Finding

Although there were changes in violence scores in all three groups, improvement was significantly less in the starters than in the other 3 groups (P < .0001 for all three comparisons). “This was a surprise because generally, marijuana is not thought to be associated with violence. There’s been a little bit of literature investigating this, but this was interesting,” said Dr Wilkinson.

The starters also had greater severity in scores on both the ASI drug use and alcohol use subscales vs the other three groups (P < .0001 for all).

On the other hand, the stoppers had significantly lower severity scores on the drug use subscale (P < .0001 vs the other 3 groups) and lower alcohol subscale scores (P < .0001 vs continuing users; P < .001 vs never users).

“This showed that those who started marijuana did turn to other drugs to cope with residual PTSD symptoms, which is to be expected,” Dr Wilkinson said. “However, there was no evidence that those who stop cannabis use turn to other drugs or alcohol.”

During the Q&A session after his presentation, an audience member pointed out that there was no implication that cannabis drove PTSD severity and asked whether it could just be that the patients with more severe symptoms use more cannabis.“There wasn’t a sense of that from these data,” replied Dr Wilkinson. However, he added that they found only an association and not causation, because the study was not prospective or randomized.

“When we looked at a different analysis, there was a dose response. Those who used more marijuana or who had greater change in marijuana use had worse PTSD symptoms,” he said.

When another attendee mentioned that she had seen violent behavior in some veterans who use marijuana and have traumatic brain injuries (TBIs), Dr Wilkinson noted that the investigators did not evaluate whether any of the study participants specifically had a TBI.

A Band-Aid Solution?

Session moderator Carla Marienfeld, MD, told Medscape Medical News that public perception has been that marijuana soothes those with PTSD.

“Addiction psychiatrists struggle a lot with how to communicate with our patients about this. People assume that there aren’t a lot of risks, but there are some papers starting to show that there really are,” she said.“Most people assume things based on their own experience. So when you talk to patients, they often say, ‘it’s the only thing that helps me sleep’ or ‘it’s the only thing that calms me down.’ But when you actually start looking into the symptoms of whether or not they get better with marijuana use, I don’t think studies, at least with these initial data, are going to bear that out.”

Although Dr Marienfeld, like Dr Wilkinson, is from the Yale University School of Medicine, she was not involved with this research. She noted that it could be that cannabis is acting as a Band-Aid instead of being a long-term solution.“Marijuana use may make patients feel better for the short term, and we need to look at that. Does it make things better for a few hours and then it gets worse the next day? That would be an important study to understand,” she said.

She added that because Dr Wilkinson presented an association study, “there’s not really a take-away for clinicians yet. But I think it’s important for them to bear this in mind and watch for this kind of data.”Dr Wilkinson reports having received a past grant from the American Psychiatric Foundation/Janssen through Yale University for a project involving electroconvulsive and cognitive-behavioral therapies.

American Academy of Addiction Psychiatry (AAAP) 25th Annual Meeting: Paper presentation 5, presented December 6, 2014.

Source: http://www.medscape.com/viewarticle/836588#vp_1

Health minister seeks court ban amid fears new cannabis-laced electronic cigarettes could incite further use of drug

Cannabis-laced electronic cigarette

Recreational use of cannabis is illegal in France.

France has sought to stamp out a new electronic cigarette containing cannabis, launched on Tuesday with the claim that it provides all of the relaxation but none of the mind-altering effects of the drug.

The health minister, Marisol Touraine, said the product would incite the consumption of cannabis and she intended to approach the courts to ban it. “I am opposed to such a product being commercialised in France,” she told RTL radio.

The product was launched by a French-Czech company called Kanavape which said it hoped to offer millions of people a legal and flavourful way to consume cannabis.

Smoking e-cigarettes, or vaping, is fashionable in France, and while people have long since figured out how to doctor them to smoke marijuana – as evidenced by hundreds of YouTube tutorials on the subject – Kanavape claims its product is legal.

The company extracts Cannabidiol – a compound in cannabis that does not contain the mind-altering THC ingredient – from hemp, a variety of cannabis grown for fibre and seeds.

The hemp is grown on farms in France, Spain and the Czech Republic without chemicals or fertiliser, the company claims on its website. “Kanavape provides you with a unique experience. Cannabidiol is a non-psychotic component of hemp. It does not have euphoric effects but helps you feel more relaxed,” it says.

Recreational use of marijuana is illegal in France, but the country allows the drug’s active ingredients to be used for medical purposes.

Source: The Guardian, Tuesday 16 December 2014 13.02 GMT

Two dozen doctors in Arizona are responsible for making medical marijuana available to more than 34,000 patients according to a new report, with several writing recommendations at the rate of one an hour for every business hour of the day.

The study being released today by the Arizona Department of Health Services finds these 24 doctors, most of them naturopaths, wrote close to two-thirds of all the recommendations in the most recent fiscal year.

State Health Director Will Humble said his agency has reported 30 of these doctors to their state licensing boards. But Humble said these were doctors where there was clear evidence that they were not following laws which require them to check a website run by the Arizona Board of Pharmacy to see whether their patients had prescriptions for other drugs. He does not know whether the boards ever followed up.

“One physician, a naturopath, over that last fiscal year, did almost 3,000 certifications,’’ Humble said. `It does make you raise an eyebrow.”

Humble said he has no independent authority to investigate whether the doctors that are writing out the lion’s share of the recommendations are in fact complying with requirements that they adequately examine patients to ensure that marijuana is appropriate.

The new report also finds that the highest concentration of medical marijuana users is in Yavapai County, with close to 1.5 percent of the total population there having a state-issued card entitling them to obtain up to 2.5 ounces of marijuana every two weeks. Gila County was a close second. At the other extreme, 0.3 percent of Yuma County residents are medical marijuana users.

Source:http://www.eastvalleytribune.com/arizona/politics/article_9140c3c3-34b7-5ac7-a46f-969eb5569091.html 13^th Nov.2014

Here is a challenge for President Obama’s recently confirmed Surgeon General, Dr. Vivek Murthy—will he confront what is becoming the largest immediate health risk to American youth: brain damage resulting from increased use of high-potency marijuana, which follows prominent drug legalization efforts in states and communities nationwide?

Murthy acquired some political notoriety by casting guns as a public health issue, but when it comes to marijuana, he has been, at best, reticent. Asked during Senate confirmation hearings about marijuana legalization, Murthy said more research needs to be done about the drug’s impact before conclusions are drawn. But all available evidence points in one, disturbing direction: frequent and early-onset marijuana use does major damage to IQ, memory, learning, and emotion. It’s hard to find a more perfect summons for a Surgeon General doing his public health duty.

And the link between legalization and increased use is becoming clearer by the day. The point was hammered home by the results of the 2014 Monitoring the Future study released yesterday by the National Institute on Drug Abuse (NIDA). The survey is school-based, reporting on the drug use of 8th, 10th, and 12th graders by type of drug used and by the frequency of use (lifetime, past year, and past month, as well as daily cigarette and marijuana use).

Researchers know that youth marijuana use is strongly related to perceptions of risk and norms of social disapproval. When marijuana use is perceived as a high risk and socially disapproved, marijuana use is low. When perceived risk or social disapproval decline, increased marijuana use will likely follow. Advocates for marijuana legalization ignore this basic point—it is their claims that marijuana is a “medicine,” and their support for marijuana’s legal, recreational status, that lead children and young adults to discount the very serious risks they face in using this drug. One can tell people that rattlesnakes make good pets. But don’t be surprised when tragedy ensues.

While this year’s Monitoring the Future study shows marijuana use relatively flat since 2013, the worrisome news lies in the results for youth attitudes and perceptions. NIDA notes a stunning five-year decline of fully 31 percent among 12th graders in perceived risks of smoking marijuana “regularly” (from 52.4 percent in 2009 to 36.1 percent in 2014).

Percent Perceiving Great Risk of Smoking Marijuana Regularly

The study also shows a sharp decline in the perceived risks of using marijuana “occasionally”—16.4 percent of surveyed 12th graders thought such use would cause harm, compared with 19.5 percent last year, a 16 percent decline in but a single year. The decline in perceptions of risk may be accelerating.

As norms of disapproval and perceptions of risk for tobacco use are thankfully rising, tobacco use has declined. Perversely, the societal message concerning marijuana is leading us in exactly the wrong direction, and more youth now use marijuana than tobacco.

Cigarettes and Marijuana use

Further, the use of marijuana by youth is in fact steadily up, if you analyze these data over a longer time period than, for example, the Denver Post‘s headlines would have you do. Since 2007, lifetime, past year, past month, and daily use of marijuana among 8th, 10th, and 12th graders combined have all increased (by 13, 9, 16, and 22 percent in the respective categories). Surely the declining perceived risk of marijuana’s harmfulness augers a worsening of these trends, which should deeply worry leaders and concerned citizens.

Equally troubling, consumption of marijuana “edibles” by youth is also strikingly up, and all the more so in states that have approved so-called “medical” marijuana. About 26 percent of 12th graders who reported using marijuana in the past year have consumed edibles laced with the marijuana intoxicant, THC. But in states with medical marijuana laws, the rate is 40 percent of 12th graders, a statistically significant difference. Again, it should not surprise us to find increased drug use in states that put the force of law behind a “medicine” that has not been approved by the Food & Drug Administration—these actions directly alter public perceptions of harm and do so with demonstrable effect: last year’s Monitoring the Future study showed in states with medical marijuana laws that a staggering 40.4 percent of high school seniors reported using marijuana in the past year. In states that do not allow medical marijuana, 29.7 percent of 12th graders reported marijuana use (though the difference between the categories did not attain statistical significance in this year’s study).

Though the results of Monitoring the Future are based on self-reports and hence subject to some misreporting, the study samples used are fairly robust, with more than 40,000 students participating (representing the approximately 18 million public and private high school students in the country). And generally speaking, the studies remain valuable in determining the impact of societal trends regarding drugs—indeed “predicting” the future, which is done in at least two important ways.

First, adolescent drug use presages subsequent drug use all throughout life, as drug use is largely an adolescent-onset behavioral disorder. Therefore, when youth use rates rise, we can expect the impact of that use to cascade through subsequent years. Conversely, the protective effect of shielding children from experimenting with drugs during adolescent years can literally last a lifetime.

Second, as we have seen, steep declines in norms and attitudes among youth regarding marijuana use and its dangers portend greater use in the future. This relationship of attitudes and values to subsequent drug use has been well documented in the Netherlands, a country notorious for its liberalized drug use policies (though policies that have been recently retrenched).

When cannabis coffee shops opened in Amsterdam, researchers did not find the expected surge in Dutch youth marijuana use—lifetime use among Dutch 18- to 20-year-olds was 15 percent in 1984. But as a new generation of Dutch youth came of age under the liberalized regime with commercialized cannabis and shifting social norms, marijuana use rose dramatically, with 44 percent of 18- to 20-year-olds reporting lifetime use in 1996—a threefold increase in just over a decade. 

We can similarly expect a looming social disaster if we do not take action to reverse course in our own country. “A mind is a terrible thing to waste,” a famous ad campaign once stressed in support of minority college education. Monitoring the Future showed us yesterday that the minds and well-being of all children and young adults remain at risk. How long must we wait before the Surgeon General casts politics aside and does his duty to the nation? How long before the Obama Administration confronts and rejects the travesty of legal, recreational marijuana?

Source:  http://www.hudson.org/research/10877-the-future-of-teen-drug-use-

Largest paediatric medical group in the US takes firm stance against legalization. It joins the American Medical Association, American Psychiatric Association, American Medical Association, American Society of Addiction Medicine, and other major medical groups who have already voiced opposition to legalization. 

WASHINGTON, DC – The American Academy of Paediatrics, an organization of 62,000 paediatricians committed to the optimal physical, mental, and social health and well-being for all infants, children, adolescents, and young adults, today came out firmly against marijuana legalization and wide-scale medical marijuana. The group also urged research into marijuana’s medical components and the use of treatment instead of criminalization for users.

 “The AAP today reiterated the widely held scientific view that marijuana is dangerous and should not be legalized,” commented Dr. Sharon Levy, member of the AAP group that organized the position and SAM Science Advisory Board Member.

Dr. Seth Ammerman, MD, lead author of the statement and clinical professor of paediatrics at Stanford University’s School of Medicine, remarked, “If you look at the history of the tobacco industry, we have lots of rules and regulations to try to prevent youth use, but tobacco companies ignore these or have loopholes to get around them. Rather than going the route of tobacco, let’s be more proactive and take a public health-oriented approach.”

Additionally, the report called for several provisions consistent with Project SAM’s policy pillars, including efforts to research the non-smoked components of marijuana for the potential treatment of epilepsy and other conditions.

“Americans now have a choice: they can believe the scientific evidence presented by America’s paediatricians, or the pseudoscience peddled by Big Tobacco 2.0,” remarked SAM President Kevin Sabet.  “The AAP should be commended for making their position so publicly known. They have proven that we can oppose legalization but also be in favour of a sensible, treatment-based approach that encourages science and research.”

The AAP report follows an American Psychiatric Association position paper released last year, which concluded: “There is no current scientific evidence that marijuana is in any way beneficial for the treatment of any psychiatric disorder. In contrast, current evidence supports, at minimum, a strong association of cannabis use with the onset of psychiatric disorders. Adolescents are particularly vulnerable to harm, given the effects of cannabis on neurological development.”

Source: KEVIN@LEARNABOUTSAM.ORG 26^th Jan. 2015

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 Legalization.” In this short blog series, I will tackle different topics that have been the subject of myth and misinformation.

First up: crime.

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 skepticism to propaganda claims disseminated by this new industry.

 Follow Kevin A. Sabet, Ph.D. on Twitter: www.twitter.com/kevinsabet

 Source: http://m.huffpost.com/us/entry/5663046 2^nd January 2015

Smoking cannabis is linked to more respiratory problems than smoking tobacco, according to a UK study in general practice.

The study, published in the British Journal of General Practice, included 500 smokers, of whom 248 were long-term users of tobacco only and 252 were users of both cannabis and tobacco.

The cannabis smokers generally reported more respiratory symptoms, in particular bringing up phlegm, and suffering from wheezing or whistling, and were slightly more likely to have COPD – as indicated by an FEV1/FVC lower than 70% on spirometry.

Even after taking into account the risk from the tobacco they smoked in joints and from also smoking cigarettes, the cannabis users still had a significantly higher rate of symptoms such as bringing up phlegm – the rate of which was increased by 0.4% with each additional joint-year of cannabis use.

Similarly, after accounting for the tobacco-related risk, each additional joint-year of cannabis use was associated with a 0.3% greater prevalence of COPD.

Dr Roy Robertson, from the University of Edinburgh, and colleagues concluded: ‘In a general practice-based sample of established adult tobacco and cannabis users, cannabis use… was associated with greater reporting of respiratory symptoms. In particular, the slightly increased presence of cough, wheeze, and sputum production are more likely in cannabis smokers.

‘In addition, it was also associated with objective evidence of COPD.’

They added: ‘Part of the adverse effect of cannabis is likely attributable to the tobacco included in the cannabis joint; however even after this additional tobacco smoked with cannabis was taken into account, the effects of cannabis on increased respiratory symptoms and increased prevalence of spirometric COPD were still apparent.’

Source: Br J Gen Pr 2014; available online 26 January

Cocaine addicts can’t recognise loss – such as the consequences of a break-up or being sent to jail – because the drug changes their brain, according to a new study.

Researchers found cocaine addicts may continue their destructive drug habit despite such huge personal setbacks because their brain circuits responsible for predicting emotional loss are impaired. They say the find could be used to develop new treatments, and spot those most at risk of relapsing. 

Cocaine

The new study recorded the brain activity of 75 people – 50 cocaine users and 25 healthy controls – using EEG, a test that detects electrical activity in the brain, while subjects played a gambling game.  Each person had to predict whether or not they would win or lose money on each trial. 

The study, published in The Journal of Neuroscience, focuses on the difference between a likely reward, or loss, related to a given behaviour and a person’s ability to predict that outcome – a measurement known as Reward Prediction Error, or RPE.Such RPE signalling is believed to drive learning in humans, which guides future behaviour. After learning from an experience, we can, in the best case, change our behaviour without having to go through it again.

Previous research determined that predictions of actual reward or loss are managed by shifting levels of the nerve signaling chemical dopamine produced by nerve cells in the brain, where changes in dopamine levels accompany unexpected gains and losses.The new study recorded the brain activity of 75 people – 50 cocaine users and 25 healthy controls – using EEG, a test that detects electrical activity in the brain, while subjects played a gambling game. Each person had to predict whether or not they would win or lose money on each trial.

Results showed that the group of cocaine users had impaired loss prediction signaling, meaning they failed to trigger RPE signals in response to worse-than-expected outcomes compared to the 25 healthy people.

Researchers say their findings offer insights into the compromised ability of addicts to learn from unfavourable outcomes, potentially resulting in continued drug use and relapse, even after suffering major losses.

Study lead author Doctor Muhammad Parvaz, Assistant Professor of Psychiatry at the Icahn School of Medicine in the US, said: ‘We found that people who were addicted to cocaine have impaired loss prediction signalling in the brain.

‘This study shows that individuals with substance use disorder have difficulty computing the difference between expected versus unexpected outcomes, which is critical for learning and future decision making.

‘This impairment might underlie disadvantageous decision making in these individuals.’

Half had used cocaine within 72 hours of the study and the other half had abstained for at least 72 hours. 

The cocaine addicts with the more recent use had higher electrical activity associated with the brain’s reward circuit when they had an unpredicted compared to a predicted win, a pattern that was similar to the 25 healthy controls. The cocaine users who had abstained for at least 72 hours did not show the higher activity in response to an unpredicted win.

The researchers said these findings are consistent with the hypothesis that in addiction the drug is taken to normalise a certain brain function, which in this case is RPE signalling of better-than-expected outcomes. Principal investigator Doctor Rita Goldstein said: ‘This is the first time a study has targeted the prediction of both gains and losses in drug addiction, showing that deficits in prediction error signalling in cocaine addicted individuals are modulated by recent cocaine use.

‘The reductions in prediction of loss across all cocaine addicted individuals included in this study are also of great interest; they could become important markers that can be used to predict susceptibility for addiction or relapse or to develop targeted interventions to improve outcome in this devastating, chronically relapsing disorder.’ 

Source: http://www.dailymail.co.uk/sciencetech/article-2938830/Cocaine-changes-addict-s-brains-t-recognise-loss-partner-leaves-sent-jail.html#ixzz3QuR3dTvL 

4^th Feb.2015

 Colorado released a sweeping report Monday about marijuana and health — everything from pot’s effect on drivers, asthma, cancer rates and birth defects.

The 188-page report doesn’t include new research on marijuana. Instead, it’s a review of what its authors call limited existing studies.

The report looks at studies showing that risk of a motor vehicle crash doubles among drivers with recent marijuana use, and that heavy use of marijuana is associated with impaired memory.

Other highlights from the report:

— In adults, heavy use of marijuana is associated with impaired memory, persisting a week or more after quitting.

— Maternal use of marijuana during pregnancy is associated with negative effects on exposed offspring, including decreased academic ability, cognitive function and attention.

— Regular marijuana use by adolescents and young adults is strongly associated with developing psychotic symptoms and disorders such as schizophrenia in adulthood.

The Colorado Department of Public Health and Environment review was ordered by state lawmakers. A panel of doctors met for several months to compile the survey, which was delivered to lawmakers last week.

The report also lays out areas where there is limited evidence, or where research is lacking.

For example, the report found insufficient evidence to say how long after smoking pot a person is impaired. Other areas of scanty research:

— Doctors noted there is little available research on the health effects of edible or concentrated marijuana.

— Marijuana smoke contains “many of the same cancer-causing chemicals as tobacco smoke.” But doctors noted there is “limited” or “mixed” evidence to suggest pot-smoking is associated with greater risk of lung cancer or other respiratory health effects.

The doctors suggested additional education about the health effects of marijuana and asked for increased public-health surveys about how people use pot.

Researchers noted that because marijuana use was illegal nationwide until 1996 — when California voters approved the first medical uses for pot — research is extremely limited. Marijuana research has historically looked for adverse effects, not possible health benefits.

“This legal fact introduces both funding bias and publication bias into the body of literature related to marijuana use,” authors noted.

Colorado last year funded eight studies to examine possible health benefits of marijuana, including treatment for seizures, Parkinson’s disease and post-traumatic stress disorder. Those studies, totalling about $8 million, may not have results for several years.

Source: CBS  Feb.02 2015   http://denver.cbslocal.com/2015/02/02/colorado-publishes-review-of-marijuana-health-research/

More people have been calling poison control centers in Colorado and Washington state since recreational marijuana became legal for adults 21 and older in those states, the Associated Press reports.

Colorado’s Rocky Mountain Poison and Drug Center received 151 calls for marijuana exposure in 2014, up from 88 calls in 2013 and 61 in 2012. Calls about exposure to marijuana combined with other drugs rose to 70, from 39 the previous year. The Washington Poison Center received 246 calls for marijuana exposure last year, compared with 158 in 2013, the AP noted.

Calls regarding young children accidentally eating marijuana edibles nearly doubled in both states. In 2014, Washington poison centers received 48 calls involving children 12 and under, while Colorado received 45 calls involving children 8 and under.

Public health officials say it is not clear whether the increase in calls is largely due to more people using marijuana, or whether people feel more comfortable reporting problems related to the drug now that it is legal for adults 21 and older. The popularity of potent products such as hash oil may also be a factor in the increased calls.

“There’s a bit of a relaxed attitude that this is safe because it’s a natural plant, or derived from a natural plant,” Dr. Alex Garrard, Clinical Managing Director of the Washington Poison Center. “But this is still a drug. You wouldn’t leave OxyContin lying around on a countertop with kids around, or at least you shouldn’t.”

Dr. Leslie Walker, Chief of Adolescent Medicine at Seattle Children’s Hospital, said in some cases young children who have consumed marijuana have to be intubated because they are having trouble breathing.

Source:  http://www.drugfree.org/join-together/marijuana-related-calls-poison-control-centers-colorado-washington-rise/  28th Jan 2015

Teens can’t control impulses and make rapid, smart decisions like adults can — but why?

Research into how the human brain develops helps explain. In a teenager, the frontal lobe of the brain, which controls decision-making, is built but not fully insulated — so signals move slowly.  “Teenagers are not as readily able to access their frontal lobe to say, ‘Oh, I better not do this,’ ” Dr. Frances Jensen tells Fresh Air’s Terry Gross.

Jensen, who’s a neuroscientist and was a single mother of two boys who are now in their 20s, wrote The Teenage Brain to explore the science of how the brain grows — and why teenagers can be especially impulsive, moody and not very good at responsible decision-making. “We have a natural insulation … called myelin,” she says. “It’s a fat, and it takes time. Cells have to build myelin, and they grow it around the outside of these tracks, and that takes years.”  This insulation process starts in the back of the brain and heads toward the front. Brains aren’t fully mature until people are in their early 20s, possibly late 20s and maybe even beyond, Jensen says.

“The last place to be connected — to be fully myelinated — is the front of your brain,” Jensen says. “And what’s in the front? Your prefrontal cortex and your frontal cortex. These are areas where we have insight, empathy, these executive functions such as impulse control, risk-taking behavior.”   This research also explains why teenagers can be especially susceptible to addictions — including drugs, alcohol, smoking and digital devices.

Interview Highlights

On why teenagers are more prone to addiction

Addiction is actually a form of learning. … What happens in addiction is there’s also repeated exposure, except it’s to a substance and it’s not in the part of the brain we use for learning — it’s in the reward-seeking area of your brain. … It’s happening in the same way that learning stimulates and enhances a synapse. Substances do the same thing. They build a reward circuit around that substance to a much stronger, harder, longer addiction.

Just like learning a fact is more efficient, sadly, addiction is more efficient in the adolescent brain. That is an important fact for an adolescent to know about themselves — that they can get addicted faster.

It also is a way to debunk the myth, by the way, that, “Oh, teens are resilient, they’ll be fine. He can just go off and drink or do this or that. They’ll bounce back.” Actually, it’s quite the contrary. The effects of substances are more permanent on the teen brain. They have more deleterious effects and can be more toxic to the teen than the adult.

On the effects of binge drinking and marijuana on the teenage brain

Binge drinking can actually kill brain cells in the adolescent brain where it does not to the same extent in the adult brain. So for the same amount of alcohol, you can actually have brain damage — permanent brain damage — in an adolescent for the same blood alcohol level that may cause bad sedation in the adult, but not actual brain damage. …

Because they have more plasticity, more substrate, a lot of these drugs of abuse are going to lock onto more targets in [adolescents’] brains than in an adult, for instance.

We have natural cannabinoids, they’re called, in the brain. We have kind of a natural substance that actually locks onto receptors on brain cells. It has, for the most part, a more dampening sedative effect. So when you actually ingest or smoke or get cannabis into your bloodstream, it does get into the brain and it goes to these same targets.

It turns out that these targets actually block the process of learning and memory so that you have an impairment of being able to lay down new memories. What’s interesting is not only does the teen brain have more space for the cannabis to actually land, if you will, it actually stays there longer. It locks on longer than in the adult brain. … For instance, if they were to get high over a weekend, the effects may be still there on Thursday and Friday later that week. An adult wouldn’t have that same long-term effect.

On marijuana’s effect on IQ

People who are chronic marijuana users between 13 and 17, people who [use daily or frequently] for a period of time, like a year plus, have shown to have decreased verbal IQ, and their functional MRIs look different when they’re imaged during a task. There’s been a permanent change in their brains as a result of this that they may not ever be able to recover.

It is a fascinating fact that I uncovered going through the literature around adolescence is our IQs are still malleable into the teen years. I know that I remember thinking and being brought up with, “Well, you have that IQ test that was done in grade school with some standardized process, and that’s your number, you’ve got it for life — whatever that number is, that’s who you are.”

It turns out that’s not true at all. During the teen years, approximately a third of the people stayed the same, a third actually increased their IQ, and a third decreased their IQ. We don’t know a lot about exactly what makes your IQ go up and down — the study is still ongoing — but we do know some things that make your IQ go down, and that is chronic pot-smoking.

On teenagers’ access to constant stimuli

We, as humans, are very novelty-seeking. We are built to seek novelty and want to acquire new stimuli. So, when you think about it, our social media is just a wealth of new stimuli that you can access at all times. The problem with the adolescent is that they may not have the insider judgment, because their frontal lobes aren’t completely online yet, to know when to stop. To know when to say, “This is not a safe piece of information for me to look at. If I go and look at this atrocious violent video, it may stick with me for the rest of my life — this image — and this may not be a good thing to be carrying with me.” They are unaware of when to gate themselves.

On not allowing teenagers to have their cellphones at night

It may or may not be enforceable. I think the point is that when they’re trying to go to sleep — to have this incredibly alluring opportunity to network socially or be stimulated by a computer or a cellphone really disrupts sleep patterns. Again, it’s also not great to have multiple channels of stimulation while you’re trying to memorize for a test the next day, for instance.

So I think I would restate that and say, especially when they’re trying to go to sleep, to really try to suggest that they don’t go under the sheets and have their cellphone on and be tweeting people.  First of all, the artificial light can affect your brain; it decreases some chemicals in your brain that help promote sleep, such as melatonin, so we know that artificial light is not good for the brain. That’s why I think there have been studies that show that reading books with a regular warm light doesn’t disrupt sleep to the extent that using a Kindle does.

Source:   http://www.mprnews.org/story/2015/01/28/npr-teen-brains

Durand D1, Delgado LL1, Parra-Pellot DM1, Nichols-Vinueza D2.

Abstract

BACKGROUND:

Synthetic cannabinoid (SC) or “spice” refers to a variety of herbal/chemical mixtures, which mimic the effects of marijuana. They are generally marked as “herbal incense” and best known by the brand names of “K2,” “spice,” “aroma,” “Mr. Nice Guy” and “dream.” Little data are available on the psychopathological and physical effects of SC.

CASE DESCRIPTION:

We reported on a 23-year-old man without prior psychiatric history who developed acute psychosis and severe rhabdomyolysis (creatine phosphokinase [CPK]: 44,300 UI/L) associated with “Mr. Nice Guy” consumption. To our knowledge, this is the first case report of severe rhabdomyolysis associated with SC use in the U.S.

CONCLUSIONS:

Physicians should be aware of the possibility of new-onset psychotic symptoms and rhabdomyolysis in patients that use SC.

Source: Clin Schizophr Relat Psychoses. 2015 Jan 1;8(4):205-8. doi: 10.3371/CSRP.DUDE.031513.

Hall W1.

Abstract

AIMS:

To examine changes in the evidence on the adverse health effects of cannabis since 1993.

METHODS:

A comparison of the evidence in 1993 with the evidence and interpretation of the same health outcomes in 2013.

RESULTS:

Research in the past 20 years has shown that driving while cannabis-impaired approximately doubles car crash risk and that around one in 10 regular cannabis users develop dependence. Regular cannabis use in adolescence approximately doubles the risks of early school-leaving and of cognitive impairment and psychoses in adulthood.

Regular cannabis use in adolescence is also associated strongly with the use of other illicit drugs. These associations persist after controlling for plausible confounding variables in longitudinal studies. This suggests that cannabis use is a contributory cause of these outcomes but some researchers still argue that these relationships are explained by shared causes or risk factors. Cannabis smoking probably increases cardiovascular disease risk in middle-aged adults but its effects on respiratory function and respiratory cancer remain unclear, because most cannabis smokers have smoked or still smoke tobacco.

CONCLUSIONS:

The epidemiological literature in the past 20 years shows that cannabis use increases the risk of accidents and can produce dependence, and that there are consistent associations between regular cannabis use and poor psychosocial outcomes and mental health in adulthood.

Source: Addiction. 2015 Jan;110(1):19-35. doi: 10.1111/add.12703. Epub 2014 Oct 7.

Grant JD1, Scherrer JF, Neuman RJ, Todorov AA, Price RK, Bucholz KK.

Abstract

BACKGROUND:

Little empirical evidence exists to determine if there are alternative classification schemes for cannabis abuse and dependence beyond the definitions provided by Diagnostic and Statistical Manual (DSM) criteria. Current evidence is not conclusive regarding gender differences for cannabis use, abuse and dependence. It is not known if symptom profiles differ by gender.

METHODS:

Latent class analysis (LCA) was used to assess whether cannabis abuse and dependence symptom patterns suggest a severity spectrum or distinct subtypes and to test whether symptom patterns differ by gender. Data from 3312 men and 2509 women in the National Longitudinal Alcohol Epidemiologic Survey (NLAES) who had used cannabis 12 + times life-time were included in the present analyses. The comparability of the solutions for men and women was examined through likelihood ratio chi(2) tests.

RESULTS:

Based on the Bayesian information criterion and interpretability, a four-class solution was selected, and the classes were labeled as ‘unaffected/mild hazardous use’, ‘hazardous use/abuse’, ‘abuse/moderate dependence’ and ‘severe abuse/dependence’. The solutions were generally suggestive of a severity spectrum. Compared to men, women were more likely to be in the ‘unaffected/mild hazardous use’ class and less likely to be in the ‘abuse/moderate dependence’ or ‘severe abuse/dependence’ classes. The results were generally similar for men and women. However, men had consistently and substantially higher endorsements of hazardous use than women, women in the ‘abuse/moderate dependence’ class had moderately higher rates for four dependence symptoms, and women in two of the classes were more likely to endorse withdrawal.

CONCLUSION:

Our findings generally support the severity dimension for DSM-IV cannabis abuse and dependence symptomatology for both men and women. While our results indicate that public health messages may have generic and not gender-specific content, treatment providers should focus more effort on reducing hazardous use in men and alleviating withdrawal in women.

Source: Addiction. 2006 Aug;101(8):1133-42.

Anderson KG1, Sitney M, White HR.

Abstract

Background. Motivational models for marijuana use have focused on reasons to use marijuana, but rarely consider motives to abstain.

OBJECTIVES:

We examined how both adolescent marijuana abstinence motives and use motives contribute to marijuana use and problems at the end of emerging adulthood. Methods. 434 community recruited youth who had not initiated marijuana use at baseline were followed from adolescence (at ages 12, 15, and 18 years) into emerging adulthood (age 25 years).  Motives to abstain and to use marijuana, marijuana consumption, and marijuana-related problems were assessed across time.

Results. Endorsing more motives to abstain from marijuana across adolescence predicted less marijuana use in emerging adulthood and fewer marijuana-related problems when controlling for past motives to abstain and marijuana-related behavior. Positive reinforcement use motives related to increased marijuana consumption and problems, and negative reinforcement motives predicted problems when controlling for past marijuana use motives and behaviors. Expansion motives during adolescence related to lower marijuana use in emerging adulthood. When considered together, motives to abstain buffered the effect of negative reinforcement motives on outcomes at age 25 for youth endorsing a greater number of abstinence motives.

Conclusions/ Implications. Given these findings, inclusion of both motives to use and abstain is warranted within comprehensive models of marijuana use decision making and may provide important markers for prevention and intervention specialists.

Source: Subst Use Misuse. 2015;50(3):292-301. doi: 10.3109/10826084.2014.977396. Epub 2014 Nov 14.

Jehle CC Jr1, Nazir N, Bhavsar D.

Abstract

The use of cannabis is currently increasing according to U.S. Department of Health and Human Services (HHS). Surprisingly, cannabis use among burn patients is poorly reported in literature. In this study, rates of cannabis use in burn patients are compared with general population.

Data from the National Burn Repository (NBR) were used to investigate incidence, demographics, and outcomes in relation to use of cannabis as evidenced by urine drug screen (UDS). Thousands of patients from the NBR from 2002 to 2011 were included in this retrospective study.

Inclusion criteria were patients older than 12 years of age who received a drug screen. Data points analyzed were patients’ age, sex, UDS status, mechanism of burn injury, total body surface area, length of stay, ICU days, and insurance characteristics. Incidence of cannabis use in burn patients from the NBR was compared against national general population rates (gathered by Health and Human Services) using chi-square tests. Additionally, the burn patient population was analyzed using bivariate analysis and t-tests to find differences in the characteristics of these patients as well as differences in outcomes. Seventeen thousand eighty out of over 112,000 patients from NBR had information available for UDS.

The incidence of cannabis use is increasing among the general population, but the rate is increasing more quickly among patients in the burn patient population (P = .0022). In 2002, 6.0% of patients in burn units had cannabis+ UDS, which was comparable with national incidence of 6.2%. By 2011, 27.0% of burn patients tested cannabis+ while national incidence of cannabis use was 7.0%. Patients who test cannabis+ are generally men (80.1%, P < .0001) and are younger on average (35 years old vs 42, P < .0001). The most common mechanisms of injury among patients who test cannabis+ or cannabis- are similar. Flame injury makes up >60% of injuries, followed by scalds that are >15%. In comparing cannabis+/- patients, cannabis+ patients are more likely to be uninsured (25.2% vs 17.26%, P < .0001). Finally, patients who test cannabis+ have larger burns (TBSA% of 12.94 vs 10.98, P < .0001), have a longer length of stay (13.31 days vs 12.6, P = .16), spend more days in the ICU (7.84 vs 6.39, P = .0006), and have more operations (2.78 vs 2.05, P < .0001).

The rate patients testing positive for cannabis in burn units is growing quickly. These patients are younger and are less likely to be insured. These patients also have larger burns, spend more time in ICUs, and have a greater number of operations. The increasing use of cannabis, as expected from legalization of cannabis in multiple states, among burn patient population may lead to increased burden on already tenuous health care resources.

Source: J Burn Care Res. 2015 Jan-Feb;36(1):e12-7. doi: 10.1097/BCR.0000000000000192.

Day NL1, Goldschmidt L, Thomas CA.

Abstract

AIM:

To evaluate the effects of prenatal marijuana exposure (PME) on the age of onset and frequency of marijuana use while controlling for identified confounds of early marijuana use among 14-year-olds.

DESIGN:

In this longitudinal cohort study, women were recruited in their fourth prenatal month. Women and children were followed throughout pregnancy and at multiple time-points into adolescence.

SETTING AND PARTICIPANTS:

Recruitment was from a hospital-based prenatal clinic. The women ranged in age from 18 to 42, half were African American and half Caucasian, and most were of lower socio-economic status. The women were generally light to moderate substance users during pregnancy and subsequently. At 14 years, 580 of the 763 offspring-mother pairs (76%) were assessed. A total of 563 pairs (74%) was included in this analysis.

MEASUREMENTS:

Socio-demographic, environmental, psychological, behavioral, biological and developmental factors were assessed. Outcomes were age of onset and frequency of marijuana use at age 14. PME predicted age of onset and frequency of marijuana use among the 14-year-old offspring. This finding was significant after controlling for other variables including the child’s current alcohol and tobacco use, pubertal stage, sexual activity, delinquency, peer drug use, family history of drug abuse and characteristics of the home environment including parental depression, current drug use and strictness/supervision.

CONCLUSIONS:

Prenatal exposure to marijuana, in addition to other factors, is a significant predictor of marijuana use at age 14.

Source:   Addiction. 2006 Sep;101(9):1313-22.

A case report of the synthetic amphetamine 2,5-dimethoxy-4-chloroamphetamine. Burish MJ1, Thoren KL2, Madou M1, Toossi S1, Shah M1.

Abstract

Although traditional hallucinogenic drugs such as marijuana and lysergic acid diethylamide (LSD) are not typically associated with seizures, newer synthetic hallucinogenic drugs can provoke seizures. Here, we report the unexpected consequences of taking a street-bought hallucinogenic drug thought to be LSD. Our patient presented with hallucinations and agitation progressing to status epilepticus with a urine toxicology screen positive only for cannabinoids and opioids. Using liquid chromatography high-resolution mass spectrometry, an additional drug was found: an amphetamine-derived phenylethylamine called 2,5-dimethoxy-4-chloroamphetamine. We bring this to the attention of the neurologic community as there are a growing number of hallucinogenic street drugs that are negative on standard urine toxicology and cause effects that are unexpected for both the patient and the neurologist, including seizures.

Source:  Neurohospitalist. 2015 Jan;5(1):32-4. doi: 10.1177/1941874414528939.

van Amsterdam J1, Brunt T2, van den Brink W3. Author information

* 1Amsterdam Institute for Addiction Research, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands jan.van.amsterdam@amc.uva.nl.

* 2Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Utrecht, The Netherlands.

* 3Amsterdam Institute for Addiction Research, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.

Abstract

Cannabis use is associated with an increased risk of psychosis in vulnerable individuals. Cannabis containing high levels of the partial cannabinoid receptor subtype 1 (CB1) agonist tetrahydrocannabinol (THC) is associated with the induction of psychosis in susceptible subjects and with the development of schizophrenia, whereas the use of cannabis variants with relatively high levels of cannabidiol (CBD) is associated with fewer psychotic experiences. Synthetic cannabinoid receptor agonists (SCRAs) are full agonists and often more potent than THC. Moreover, in contrast to natural cannabis, SCRAs preparations contain no CBD so that these drugs may have a higher psychosis-inducing potential than cannabis. This paper reviews the general toxicity profile and the adverse effects of SCRAs with special emphasis on their psychosis-inducing risk.

The review shows that, compared with the use of natural cannabis, the use of SCRAs may cause more frequent and more severe unwanted negative effects, especially in younger, inexperienced users. Psychosis and psychosis-like conditions seem to occur relatively often following the use of SCRAs, presumably due to their high potency and the absence of CBD in the preparations. Studies on the relative risk of SCRAs compared with natural cannabis to induce or evoke psychosis are urgently needed.

Source:  J Psychopharmacol. 2015 Jan 13. pii: 0269881114565142. [Epub ahead of print]

A Harvard scientist wanted to see exactly how easy it is to get medical research published. In some cases, $500 is pretty much all it takes.  As a medical researcher at Harvard, Mark Shrime gets a very special kind of spam in his inbox: every day, he receives at least one request from an open-access medical journal promising to publish his research if he would only pay $500.  “You block one of them with your spam filter and immediately another one pops up,” Shrime, an MD who is pursuing a PhD in health policy, tells me.

These emails are annoying, for sure, but Shrime was worried that there might be bigger issues at stake: What exactly are these journals publishing and who is taking these journals to be credible sources of medical information?

Shrime decided to see how easy it would be to publish an article. So he made one up. Like, he literally made one up. He did it usingwww.randomtextgenerator.com. The article is entitled “Cuckoo for Cocoa Puffs?” and its authors are the venerable Pinkerton A. LeBrain and Orson Welles. The subtitle reads: “The surgical and neoplastic role of cacao extract in breakfast cereals.” Shrime submitted it to 37 journals over two weeks and, so far, 17 of them have accepted it. (They have not “published” it, but say they will as soon as Shrime pays the $500. This is often referred to as a “processing fee.” Shrime has no plans to pay them.) Several have already typeset it and given him reviews, as you can see at the end of this article. One publication says his methods are “novel and innovative”!. But when Shrime looked up the physical locations of these publications, he discovered that many had very suspicious addresses; one was actually inside a strip club.

When Shrime looked up the physical locations of these publications, he discovered that many had very suspicious addresses; one was actually inside a strip club.

Many of these publications sound legitimate. To someone who is not well-versed in a particular subfield of medicine—a journalist, for instance—it would be easy to mistake them for valid sources. “As scientists, we’re aware of the top-tier journals in our specific sub-field, but even we cannot always pinpoint if a journal in another field is real or not,” Shrime says. “For instance, the International Journal of Pediatric Otorhinolaryngology is the very first journal I was ever published in and it’s legitimate. But the Global Journal of Pediatric Otorhinolaryngology is fake. Only someone in my field would know that.”

What angers Shrime more than anything is that fake journals seem to target doctors and researchers in developing countries for whom $500 is an enormous sum of money. “When you dig into these publications, it’s clear that the vast majority of authors on their table of contents come from lower-income countries,” he says. “They’re preying on people who aren’t able to get into the mainstream medical journals because they come from a university that nobody recognizes or they have some other scientific disadvantage.” There is a government agency, the National Library of Medicine, that creates an official list of approved medical journals called PubMed. However, Shrime says, it can sometimes take a while for publications to be indexed. Eighteen months ago, The Lancet, one of the most respected medical journals in the world, launched several new publications like The Lancet Respiratory Medicine and The Lancet Global Health; they have only just been included in PubMed.

“If you want to find a reputable journal, you’d turn to PubMed, but the problem is that there are also many reputable journals that are not on PubMed,” Shrime says. He often turns to Google Scholar in his research because it includes a wider range of publications, but he’s found the service also indexes many of the same bogus journals that accepted his Cocoa Puffs paper. (I made several attempts to reach the journals that accepted Shrime’s fake article, but none replied to my queries.)

If Harvard-trained researchers are sometimes not able to spot a real journal from a fake, what chance do the rest of us have? Journalists, for instance, often cite medical research in their articles without the expertise to know whether their source is credible or not. The good news is that there are tools available to navigate the process. Jeffrey Beall, an academic librarian, has compiled a list of predatory publishers that he updates every year. Shrime recommends that people who cite medical research cross-reference journals with this list, but keep in mind that brand-new predatory journals pop up every day and Beall may not have found them yet.

So, the next time you read an article that references a new weight loss study or cutting-edge research about dieting, it’s worth taking it with a grain of salt. It may very well be legitimate, but it might also be quack science. Or entirely made up.

“If the source is not on PubMed or on Beall’s list, the only real way to tell would be to speak to the leading scholar in that field,” says Shrime. “And who has the time to do that?”

Source: http://www.fastcompany.com/3041493/body-week/why-a-fake-article-cuckoo-for-cocoa-puffs-was-accepted-by-17-medical-journals  28th Jan. 2015