At a lively debate last week on the proposed legalization of marijuana, an attorney who supports the 2016 ballot initiative told the audience the measure is the “first step” toward full legalization of drugs in Arizona.

Local criminal defense attorney Marc Victor, arguing in favor of legalization, debated Seth Leibsohn, chairman of Arizonans for Responsible Drug Policy. Victor said he wished some of the initiative’s language was different, but said “it’s better than being the world’s leader in incarceration rates.”

His comments were met with applause and whistles. “So … this is just the first step towards full legalization, not just of marijuana, but based on everything you said, also heroin, cocaine and meth,” Leibsohn said.

Victor stood up, took the mic and responded, “Yeah, it’s a first step: I wanna see freedom! I wanna see people decide for themselves what to put in their own bodies, and that includes everything that one can put in his or her own body for competent adults.”

Sheila Polk, who is part of a group opposed to legalization, said later that she was shocked by that comment. “I always heard that out there, kind of as a rumour, that marijuana was the first step,” she told Insider. But, she said, this was the first time she’d heard supporters “openly admit that this is what this initiative is about.” Talk about a talking point. Carlos Alfaro, Arizona political director of the Marijuana Policy Project, disputed that the marijuana effort is a step toward legalizing other drugs, saying it doesn’t “help our efforts to include other drugs in the conversation.”

Source:  AZCentral.com | May 2, 2015

Legalization keeps rolling ahead. But because of years of government roadblocks on research, we don’t know nearly enough about the dangers of marijuana—or the benefits

Yasmin Hurd raises rats on the Upper East Side of Manhattan that will blow your mind.

Though they look normal, their lives are anything but, and not just because of the pricey real estate they call home on the 10th floor of a research building near Mount Sinai Hospital. For skeptics of the movement to legalize marijuana, the rodents are canaries in the drug-policy coal mine. For defenders of legalization, they are curiosities. But no one doubts that something is happening in the creatures’ trippy little brains.

In one experiment, Hurd’s rats spent their adolescence getting high, on regular doses of tetrahydrocannabinol (THC), the psychoactive compound in marijuana. In the past, scientists have found that rats exposed to THC in their youth will show changes in their brain in adulthood. But Hurd asked a different question: Could parental marijuana exposure pass on changes to the next generation, even to offspring who had never been exposed to the drug?

So she mated her rats, but only after she had waited a month to make sure the drug was no longer in their system. She raised the offspring, along with another group of rats that shared the same life experiences except for the THC. She then trained the children to play a game alone in a box. The prize: heroin.

Press one lever to get a shot of saline into the jugular vein. Press the other to get a rush of opiates. Initially, the rats with THC-exposed parents performed about the same as the rats with sober parents. But when Hurd’s team changed the rules, requiring the rats to work harder for the drug, differences emerged. The rats with drug-using parents pushed the lever more than twice as much. They wanted the heroin more.

When she analyzed the brains of the rats, she also found differences in the neural circuitry of the ones with drug-using parents. Even the grandkids have begun to show behavioral differences in how they seek out rewards. “This data tells us we are passing on more things that happen during our lifetimes to our kids and grandkids,” Hurd explains, though it remains unclear how those changes manifest in humans. “I wasn’t expecting these results, and it’s fascinating.”

Welcome to the encouraging, troubling and strangely divided frontier of marijuana science. The most common illicit drug on the planet and one of the fastest-growing industries in America, pot remains–surprisingly–something of a medical mystery, thanks in part to decades of obstruction and misinformation by the federal government. Potentially ground breaking studies on the drug’s healing powers are being done to find treatments for conditions like epilepsy, posttraumatic stress disorder (PTSD), Alzheimer’s disease, Parkinson’s disease, sickle-cell disease and multiple sclerosis. But there are also new discoveries about the drug’s impact on recreational users.

The effects are generally less severe than those of tobacco and alcohol, which together cause more than 560,000 American deaths annually. Unlike booze, marijuana isn’t a neurotoxin, and unlike cigarettes, it has an uncertain connection to lung cancer. Unlike heroin, pot brings almost no risk of sudden death without a secondary factor like a car

crash. But science has also found clear indications that in addition to short-term effects on cognition, pot can change developing brains, possibly affecting mental abilities and dispositions, especially for certain populations. The same drug that seems relatively harmless in moderation for adults appears to be risky for people under age 21, whose brains are still developing. “It has a whole host of effects on learning and cognition that other drugs don’t have,” says Jodi Gilman, a Harvard Medical School researcher who has been studying the brains of human marijuana users. “It looks like the earlier you start, the bigger the effects.”

Beyond Reefer Madness

That relatively measured tone is a far cry from the shrill warnings of Harry J. Anslinger, the first commissioner of the Federal Bureau of Narcotics, who in the 1930s set the standard for America’s fraught debate over marijuana with wild exaggerations. “How many murders, suicides, robberies, criminal assaults, holdups, burglaries and deeds of maniacal insanity it causes each year, especially among the young, can only be conjectured,” he wrote as part of a campaign to terrify the country. As recently as the 1970s, President Richard Nixon talked about the drug as a weapon of the nation’s enemies. “That’s why the communists and the left-wingers are pushing the stuff,” he was recorded saying in private. “They’re trying to destroy us.”

The official line today is better grounded in data and research. And the new focus is squarely on brain development. “I am most concerned about possibly harming the potential of our young people,” says Dr. Nora Volkow, the head of the National Institute for Drug Abuse (NIDA), which funds Hurd’s and Gilman’s work. “That could be disastrous for our country.”

But decades of prohibition and official misinformation continue to shape public views. “The government did not spend as much effort in finding out the facts about marijuana,” says Hurd. “That strategy of scaring people rather than provide knowledge has made people sceptical now when they hear anything negative.”

As states now rush to legalize pot and unwind a massive criminalization effort, the federal government is trying to play catch-up on the science, with mixed success. The only federal marijuana farm, at the University of Mississippi, has recently expanded production with a $69 million grant in March, and Volkow has expressed a new openness to studies of marijuana’s healing potential. In the coming months, Uncle Sam will begin a 10-year, $300 million study with thousands of adolescents to track the harm that marijuana, alcohol and other drugs do to the developing brain. High-tech imaging will allow researchers for the first time to map the effects of marijuana on the brain as humans age.

But scientists and others point out that a shift to fund the real science of pot still has a long way to go. The legacy of the war on drugs haunts the medical establishment, and federal rules still put onerous restrictions on the labs around the country that seek to work with marijuana, which remains classified among the most dangerous and least valuable drugs. “We can do studies on cocaine and morphine without a problem, because they are Schedule II,” explains Fair Vassoler, a researcher at Tufts University who has replicated Hurd’s rat experiment with synthetic pot. “But marijuana is Schedule I.”

That means that under the law, marijuana has “no medical benefit,” even though 23 states have legalized pot as medicine and NIDA acknowledges that “recent animal studies have shown that marijuana can kill certain cancer cells and reduce the size of others.” And marijuana researchers face barriers even higher than those faced by

scientists studying other Schedule I drugs, like heroin and LSD. Pot studies must pass intensive review by the U.S. Public Health Service, a process that has delayed and thwarted much research for more than 15 years. The result is sometimes a catch-22 for scientists seeking to understand the drug. “The government’s research restrictions are so severe that it’s difficult to find and show the medical benefit,” says neurobiologist R. Douglas Fields, the chief of the nervous-system-development section at the National Institutes of Health (NIH).

That all may change soon. On Capitol Hill, a left-right coalition of Senators Kirsten Gillibrand of New York, Rand Paul of Kentucky and Cory Booker of New Jersey introduced a bill in March to federally legalize medical marijuana in states that have already approved it. “For far too long,” said Paul, a Republican candidate for President, “the government has enforced unnecessary laws that have restricted the ability of the medical community to determine the medicinal value of marijuana.”

The Cannabinoid System

Harm researchers and neuroscientists aren’t completely deadlocked. They agree on at least one thing. Marijuana’s positive and negative effects both spring from the same source: the body’s endocannabinoid system. First discovered in the late 1990s, it’s a complex neural system that researchers are only beginning to fully comprehend.

A little Brain Science 101: Human grey matter contains around 86 billion neurons, a type of cell that essentially talks to other cells in the brain through electrochemical processes. Neurons talk to each other through chemical messengers known as neurotransmitters–including dopamine, serotonin, glutamate and compounds called endocannabinoids–which in turn send instructions to your body about what to do.

Researchers now know the body produces endocannabinoids, which activate cannabinoid receptors in the brain. Interestingly, one plant on earth produces a similar compound that hits those same receptors: marijuana. Just as poppy-derived morphine mimics endorphins, marijuana-derived cannabinoids like THC and cannabidiol (CBD) mimic endocannabinoids, which impact feelings of hunger and pleasure. Cannabinoid receptors are especially widespread in the brain, where they play a key role in regulating the actions of other neurotransmitters.

“The more we investigate the hidden recesses of the brain, the more it seems like practically every neuron either releases endocannabinoids or can sense them using cannabinoid receptors,” explains Gregory Gerdeman, a neuroscientist and endocannabinoid researcher at Florida’s Eckerd College. Neurotransmitters carry out brain communication through synapses. “But too much synaptic excitation is poisonous–it damages cells,” says Gerdeman. “Endocannabinoids are a mechanism for putting on the brakes when that toxic level of excitation is approached.”

Cannabinoids like CBD may be thought of as neuro-protectants–that is, brain protectors. In fact, the NIH actually owns a patent (No. 6630507) on cannabinoids as neuro-protectants, based on the work of researcher Aiden Hampson and his mentor, Nobel Prize–winning neuroscientist Julius Axelrod. They found that CBD showed particular promise in limiting neurological damage in patients with Alzheimer’s disease and Parkinson’s disease and in those who have suffered a stroke or head trauma.

Endocannabinoids also play a role in the regulation of pain, mood, appetite, memory and even the life and death of individual cells. Curiously, cannabinoid receptors aren’t

densely packed in the medulla (within the brain stem), which controls breathing and the cardiovascular system. That’s why a heroin overdose can be fatal–the drug shuts down the respiratory control center – but a marijuana overdose generally can’t. PTSD researchers are keen to crack the cannabinoid code because the compounds appear to play a role in extinguishing unpleasant memories. “Part of what happens with PTSD is that the brain’s stress buffers have been blown out by trauma,” says Gerdeman. “Endocannabinoids within the amygdala”–the brain region important for emotional learning and memory–“act as a key mechanism for what we call memory extinction.”

But what accounts for the potentially healing effects of pot in some can cause harm in others. That’s because endocannabinoids appear to play a critical role in the development of the adolescent brain. If the brain were a house, the childhood years would be spent pouring the foundation and framing up the walls. Adolescence is when the wiring and plumbing get finished. Neural networks are refined and strengthened through pruning. The strong synapses, axons and dendrites are preserved, the weak culled.

Researchers now believe the cannabinoid system plays a critical role in this neural fine-tuning. This is where the worries about teenage pot use come to the fore. At the precise moment when the brain relies on a finely calibrated dose of endocannabinoids, the adolescent weed smoker floods the system. “If you actively and repeatedly overload the endogenous cannabinoid system,” says Volkow, “you are going to disrupt that very well-orchestrated system.”

That disruption may lie at the heart of still inconclusive science about marijuana’s impact on human behavior, especially among younger users. Early studies suggest that there may be long-lasting impacts on mental acuity, higher brain function and impulse control for younger users. There is also a well-documented connection between pot smoking and schizophrenia, a condition that affects about 1% of the U.S. population. Scientists have been aware of the link since the 1970s. Among those with a family history of mental illness, marijuana can hasten the emergence of schizophrenia.

Researchers are trying to identify the mechanisms in play. “Many genes are undoubtedly involved in risk for schizophrenia,” says Dr.Michael Compton, a professor at Hofstra North Shore–LIJ School of Medicine and the head of psychiatry at New York City’s Lenox Hill Hospital. “But there are also a host of social or environmental influences at work.” For a subset of the population, the earlier the initiation of marijuana use, the earlier the onset of psychosis.

Here’s why that matters: The later schizophrenia emerges, the greater the likelihood of recovery. Schizophrenia onset in a 15-year-old is often permanently life-altering. In a 24-year-old, it can be less damaging, because the person has had the chance to accomplish more psychological and social-developmental milestones. But that doesn’t mean all teenage pot users are smoking themselves into mental illness. Darold Treffert, the Wisconsin psychiatrist who first documented the marijuana-schizophrenia link in the 1970s, puts it this way: “Perhaps some persons can safely use marijuana, but schizophrenics cannot.” A test or a clear genetic marker to identify kids who are vulnerable to schizophrenia is likely years away.

The Healing Possibilities

While American research on the potential harms from marijuana is booming, the U.S. continues to lag in funding investigations into the possible benefits. In the late 1990s, the U.S. and British governments commissioned separate studies of medical marijuana.

The U.K. study was spurred by multiple-sclerosis patients’ using pot to calm spasticity. The U.S. study, done by the Institute of Medicine, was in response to California’s 1996 legalization of medical marijuana.

Both studies reached a similar conclusion: medical pot wasn’t a hippie’s delusion. The research showed that the stuff held real therapeutic potential for specific conditions, including epilepsy, chronic pain and glaucoma. The British responded by treating marijuana as a plant with biotech prospects. U.K. officials licensed GW Pharmaceuticals, a start-up lab in Salisbury, England, to grow weed and develop cannabinoid drugs, some of which U.S. scientists like Hurd use in their research.

The Americans, meanwhile, doubled down on the war on drugs. Barry McCaffrey, Bill Clinton’s drug czar, was outraged at the Institute of Medicine’s results. “I think what the IOM report said is that smoked marijuana is harmful, particularly for those with chronic conditions,” he said–pretty much the opposite of the report’s conclusions. Nonetheless, he and then Attorney General Janet Reno vowed to prosecute medical-marijuana patients and doctors who prescribed the drug. Shortly thereafter, the U.S. Department of Health and Human Services adopted even tougher strictures against the study of marijuana as a medicine.

The federal anti-pot policies resulted in a strange kind of scientific trade deficit. The U.S. leads the world in studies of marijuana’s harm, but we’re net importers of data dealing with its healing potential. THC discoverer Raphael Mechoulam runs the world’s leading cannabinoid lab at the Hebrew University of Jerusalem. Spanish biologist Manuel Guzmán is doing cutting-edge work on the potential of cannabinoids to retard the growth of glioblastoma, one of the deadliest forms of brain cancer. Canada’s health agency may soon approve the world’s first clinical trial to test medical marijuana on military and police veterans with PTSD.

There are signs of change at home, though. This year, the Colorado department of public health awarded $9 million in grants for medical-marijuana research, funded with tax revenue from state-licensed pot stores. They will be among the first U.S. clinical trials to look into the effectiveness of marijuana for childhood epilepsy, irritable-bowel disease, cancer pain, PTSD and Parkinson’s disease. Dr.Kelly Knupp, a paediatric-epilepsy specialist at Children’s Hospital in Denver, will track children using high-CBD marijuana strains to calm seizures. “Some of these children can have 100 to 200 seizures a day,” Knupp says. “We’re hoping we can measure seizure frequency to see if there’s any improvement” among kids trying the cannabinoid medicine.

This Is a Rat on Drugs

Back at Hurd’s Upper East Side lab, the rats have begun to show the way. In a separate experiment, she gave heroin-addicted rats doses of CBD and found that it decreased their willingness to work hard for more heroin, suggesting that parts of marijuana could help human drug addicts stay clean. She is now testing that hypothesis by giving CBD tablets, made in England, to recovering human addicts in New York City.

She is also continuing to study the behavior of rats whose only exposure to marijuana’s active ingredients came through the DNA passed on to them from their parents or grandparents. That research suggests that THC may have epigenetic effects, which have been found in other drugs like cocaine and heroin, changing the way genes express themselves in the brains of offspring. This doesn’t necessarily mean that parents who smoked weed in high school have damaged their kids, because those changes may be

overrun by other behaviors. The science is too new to know for sure. “It’s not a given that this is going to happen,” Hurd explains of her rats. “They tell us the potential.”

That word–potential–still qualifies much of what is known about pot, but it won’t be that way for long. The science of pot is likely to expand in the coming years, and it could boom if federal restrictions are lifted. What the government once dismissed as a communist plot that prompted murderous rages has turned out to be a window into the very workings of the human mind. In the years to come, researchers may yet find genetic markers that predispose people to pot-induced psychotic reactions, map out the specific ways in which THC changes the brain and find new medicines for some of the most intractable illnesses. Until then, the great marijuana experiment will continue in a country where 1 in 10 adults–and 35% of high school seniors–admit to conducting their own, mostly recreational, research.

Barcott is a journalist who has contributed to the New York Times, National Geographic and other publications. Scherer is TIME’s Washington bureau chief. Portions of this article were adapted from Barcott’s new book Weed the People: The Future of Legal Marijuana in America, published by TIME Books.  the Future of Legal Marijuana in America,” is now available wherever books are sold, including Amazon.com, Barnes & Noble and Indiebound.

Source:  May 25, 2015 issue of TIME.

Research Summary

Observational studies suggest that heavy, habitual marijuana use in adolescence may be associated with cognitive decline and adverse educational outcomes. However, conflicting data exists. The authors of this study used data from a large population-based prospective cohort of 1155 individuals from the United Kingdom to investigate the effects of cannabis use by age 15 on subsequent educational outcomes. They also explored the relationship between tobacco use and educational outcomes to assess for possible bias. The primary educational outcomes were performance in standardized English and mathematics assessments at age 16, completion of 5 or more assessments at a grade level C or higher, and leaving school having achieved no qualifications. Exposure was measured by self-report and serum cotinine levels.

* In fully adjusted models both cannabis and tobacco use were associated with adverse educational outcomes.

* A dose response effect was seen with higher frequency of cannabis use associated with worse outcomes.

* Adjustment for other substance use and conduct disorder attenuated these effects and tobacco had a stronger association than cannabis.

Comments:

This data sheds more light on a possible association between early exposure to cannabis and tobacco and subsequent poor educational outcomes. However, given the nature of the analysis, causality cannot be implied. Further research is needed at longer follow-up periods to gain more understanding of the relationship between cannabis use in adolescence and educational outcomes.  Jeanette M. Tetrault, MD

Source: Addiction. 2015;110(4):658–668.

United Nations: The UN advocates a carefully balanced international policy on world drug problem, with increased focus on its prevention, treatment and also relevant economic strategies, said a senior UN official here.

“Through increased focus on public health, prevention, treatment and care as well as on economic, social and cultural effects and strategies — we can build a multi-sector, approach founded on partnership and cooperation,” said UN Deputy Secretary- General Jan Eliasson at a UN General Assembly (GA) debate on world drug problem on Thursday, Xinhua reported.

Drug trafficking was a multibillion-dollar enterprise that has infiltrated societies, governments, and national and international institutions, including those that are responsible for its control. According to President of UNGA Sam Kutesa, annual proceeds from the illicit drug market worldwide are estimated to be around $322.

Kutesa noted the link between illicit trade in drugs and terrorism financing, corruption and trafficking in small arms and light weapons, stressing the urgency of combating drug trafficking across the globe.

“Our collective efforts must focus on prevention, while also rendering treatment and care to persons affected by drug addiction and those needing help to alleviate pain and suffering,” said Kutesa.

“We must also scale up interventions and international cooperation to resist and combat drug-related international organized crime,” he added.

The UNGA high-level debate is one of the preparatory events leading up to the UNGA Special Session on the world drug problem in 2016, aiming to give practical advice on practices in dealing with the world drug problem.

Source:  zeenews.india.com  8th May 2015 

– and “It’s Time to Regulate E-Cigarettes,” by David A. Kessler and Matthew L. Myers (Op-Ed, April 23):

We applaud your editorial and Op-Ed essay for highlighting the rise in electronic cigarette use among high school students and for condemning the tobacco industry for aggressively targeting kids.

Unfortunately, the noxious tactics of Big Tobacco — flavored products, colorful packaging, kid-friendly advertising — are not limited to the marketing of e-cigarettes. They also characterize the commercialization of marijuana in states like Colorado, where pot has been legalized. Attempts to ban edible marijuana products that target youth, such as “Pot Tarts” or “Pot Lollipops,” have been met with fierce opposition from a burgeoning marijuana industry eager to hook kids early, and ensure a steady stream of future profits.

As we condemn the harms of e-cigarettes and their marketing to youth, we should also acknowledge that the legalization and mass commercialization of marijuana means yet another industry that thrives on addiction and recklessly targets the most vulnerable in society. We can reform our drug laws and address the currents pitfalls of prohibition without giving rise to the next Big Tobacco.

PATRICK J. KENNEDY

KEVIN A. SABET

Princeton, N.J.

The writers, a former congressman and a former White House drug policy adviser, respectively, are leaders of Smart Approaches to Marijuana.

Source: Letters to Editor  nytimes.com  5th MY 2015

A new drug prevention initiative has been initiated in Lee County, Va. that will provide youth with another way to resist the peer pressures of experimenting with drugs.

“This new program, ‘Give Me A Reason’, was designed to establish a way for parents to obtain free-of-charge drug testing kits that they can use to test their children for drug use,” said Lee County Sheriff Gary Parsons.

The kit uses a cheek swab saliva-based method that is much less invasive than blood test and less susceptible to tamper with. The press release states the kit will test for cocaine, marijuana, methadone, methamphetamine, hydrocodone, barbiturates, opiates, morphine and oxycodone.

“The best thing about these kits it is that they can be used in the privacy of your own home, and you can have the results in 10 minutes,” said the sheriff. “If parents have a drug test kit at home, their children will hopefully think twice before giving into peer pressure.”

The release states the kit will be one way to be able to help deter children from making a decision that may ruin their life. The department wants to have as many resources available to help parents deter their children form making the decision to try drugs.

“This is a voluntary program to help children make positive choices,” Parsons said. “We want our children in this community to have a successful future and make productive adults.”

Source:  middlesborodailynews.com   4th My 2015

NJ officials are looking to ban the sale of kraton in NJ. (Photo by Paula Bronstein/Getty Images)   It has been around for years and can easily be bought in New Jersey tobacco shops, gas stations and on the internet. Kratom – an organic herb which grows naturally in Southeast Asia – is quickly becoming a “go-to’” drug for young people because of its opioid-like effects

The drug can cause hallucinations, delusions and respiratory problems.

Kratom has been around for centuries and has been used to alleviate pain, boost energy and reduce anxiety, but it is not approved in the United States for any medical use.  Kratom can be bought in leaf form, but is usually purchased as a capsule or chopped up and used for smoking or tea. Studies show it can be addictive and can result in severe withdrawl symptoms. Other side effects include agitation, aggression, tremors, nausea and vomiting.  It is illegal in Tennessee and has been banned in Australia, Malaysia and Thailand.

“Just like most emerging drugs, kratom has the effects that kids are looking for.  In some cases it makes them mellow, in some cases, they think it’s a safe alternative. The depressant and euphoric effects that they get out of kratom are very much like heroin and other opioids,” said Ezra Helfend, acting director of the Middlesex County chapter of the National Council on Alcoholism and Drug Dependence.  “It is a drug that many of us in the drug prevention field are watching, just like synthetic marijuana. There is a concern because there seems to be issues with what is being sold in stores and with the number of kids who are getting their hands on it. Children have access to these products and we would prefer that they didn’t.”

In an effort to prevent another drug crisis like the heroin epidemic in Monmouth and Ocean counties, Assemblyman Ron Dancer, R-Jackson will introduce legislation next month that would make kratom illegal in New Jersey.

“There is no doubt, kratom is a dangerous substance. Like we did with bath salts and spice, we need to crack down on it now before we’re faced with another drug epidemic,” he said.

Dancer’s bill would criminalize the manufacture, possession and sale of products containing kratom. It would amend state law to include kratom as a controlled dangerous substance. Violators would face prison terms ranging from 18 months to 10 years and fines of up to $150,000 depending on the severity of the violation.

Source: Efforts underway in NJ to prevent new drug craze | http://nj1015.com/efforts-underway-in-nj-to-prevent-new-drug-craze/?trackback=tsmclip   April 26, 2015 8:09 AM

– a nationwide longitudinal cohort study

Background

High mortality rates have been reported in people released from prison compared with the general population. However, few studies have investigated potential risk factors associated with these high rates, especially psychiatric determinants. We aimed to investigate the association between psychiatric disorders and mortality in people released from prison in Sweden.

Methods

We studied all people who were imprisoned since Jan 1, 2000, and released before Dec 31, 2009, in Sweden for risks of all-cause and external-cause (accidents, suicide, homicide) mortality after prison release. We obtained data for substance use disorders and other psychiatric disorders, and criminological and sociodemographic factors from population-based registers. We calculated hazard ratios (HRs) by Cox regression, and then used them to calculate population attributable fractions for post-release mortality. To control for potential familial confounding, we compared individuals in the study with siblings who were also released from prison, but without psychiatric disorders. We tested whether any independent risk factors improved the prediction of mortality beyond age, sex, and criminal history.

Findings

We identified 47 326 individuals who were imprisoned. During a median follow-up time of 5·1 years (IQR 2·6–7·5), we recorded 2874 (6%) deaths after release from prison. The overall all-cause mortality rate was 1205 deaths per 100 000 person-years. Substance use disorders significantly increased the rate of all-cause mortality (alcohol use: adjusted HR 1·62, 95% CI 1·48–1·77; drug use: 1·67, 1·53–1·83), and the association was independent of socio-demographic, criminological, and familial factors. We identified no strong evidence that other psychiatric disorders increased mortality after we controlled for potential confounders. In people released from prison, 925 (34%) of all-cause deaths in men and 85 (50%) in women were potentially attributable to substance use disorders. Substance use disorders were also an independent determinant of external-cause mortality, with population attributable fraction estimates at 42% in men and 70% in women. Substance use disorders significantly improved the prediction of external-cause mortality, in addition to sociodemographic and criminological factors.

Interpretation

Interventions to address substance use disorders could substantially decrease the burden of excess mortality in people released from prison, but might need to be provided beyond the immediate period after release.

Funding

Wellcome Trust, Swedish Research Council, and the Swedish Research Council for Health, Working Life and Welfare.

Source:  http://www.thelancet.com/journals/lanpsy/article/   21st April 2015

Prof Philip Murphy

Prof Murphy, who is head of psychology at Edge Hill University, has worked professionally in drug misuse since 1984 and has carried out extensive research into how the misuse of cannabis and ecstasy impairs cognitive performance such as memory and its effect on mood disturbances.

However, although he against the legalisation of cannabis and its use recreationally, he believes there is political confusion which has hampered it being used to produce beneficial medication.

He explains: “I am opposed to the legalisation of cannabis. But I am perfectly happy to see cannabinoids prescribed as medication. I think there is confusion surrounding this at a political level.  There is a fear among politicians that they will be seen to have legalised cannabis.”

Prof Murphy says cannabis is comprised of more than 400 compounds and around 60 of these are regarded as active cannabinoids.

He explains that pharmaceutical preparations of cannabinoid medications will have carefully selected the clinically beneficial cannabinoids for a given condition requiring treatment.  As a result, he says clinically prescribed cannabinoid medications bear very little similarity to black market cannabis.

Prof Murphy says: “Such preparations have been designed for administration by routes other than smoking such as tablets and sprays.  When you extract the therapeutic compounds of cannabis – notably one known as CBD which has a number of very powerful medicinal applications – you are talking about something very different from the black market supplies of cannabis bought in pubs or on street corners.

“It is the difference between a properly produced pharmaceutical product and something in its raw form.  I cannot see any logical argument against the use of a pharmaceutical preparation involving cannabinoids.”

Prof Murphy has done a lot of work looking at the negative effects of cannabis when used recreationally and has found it impairs memory performance, makes the brain work harder to maintain the level of performance of non-users and is linked to episodes of psychotic behaviour, especially where a predisposition to psychotic episodes exists.

Prof Murphy says: “There is evidence cannabis can impair memory functioning, can change the levels of activity in the brain which suggest the brain has to work harder to match the performance of a non-user on some laboratory tasks and that some black market preparations very high in concentrations of a cannabinoid known as THC can lead to psychotic episodes in people with a predisposition to such episodes.

“With recreational cannabis users, I have found cannabis to be a very dependance producing drug. The main psycho active compound of cannabis is THC. THC levels in the days of the hippies were one to two per cent.

“However, today, particularly in skunk cannabis, THC levels can be 20 per cent or even more.  People say cannabis is not addictive, but that is now an outdated view as cannabis has changed so much from what it used to be.”

Despite knowing the negative implications of cannabis, Prof Murphy says it is perfectly possible to have a drug made using cannabinoids and available by prescription only.

He explains: “Carefully manufactured pharmaceutical preparations need to be prescribed by qualified clinicians in a context of professional clinical management.

“Cannabis should not be legalised for recreational use and open sale.

“This does not logically contradict its appropriate use in treating illness and curbing suffering.  Sadly, it is likely that political considerations around a fear of having been seen to have legalised cannabis may have retarded the development of cannabinoid based medications.

“This is very unfortunate and likely to have perpetuated suffering for some people unnecessarily. All the work I have done on illegal cannabis affecting memory still holds true.  But as with any other medication, we have to hold potential problems in consideration against the potential benefits.

“That is for the clinician treating the patient to do as they would with any other medication.  There are negative effects to every medication. It is about balancing the benefits against the potential risk.”

Source:  http://www.lep.co.uk/news    17th April 2015

Cigarette warning labels with images depicting diseases caused by smoking help young adults learn about the dangers of lighting up, new research suggests. A study appearing in the Annals of Behavioral Medicine suggests graphic images accompanying written health warnings on cigarette packs may help people better understand and increase their concern about how smoking can harm their health.

“Our outcomes suggest that focusing on enhancing understanding and knowledge from smoking warning labels that convey true consequences of smoking may not only influence motivation directly – both in terms of quitting and prevention of smoking – but may actually drive the emotional experience of the label, which we know is an important predictor of motivation,” Renee Magnan, an assistant professor of psychology at Washington State University, Vancouver, said in a news release.

Magnan added that this was a preliminary study, but it suggested such labels could contribute to larger anti-smoking education campaigns. Researchers took two groups of people between the ages of 18 and 25, which included both smokers and non-smokers, and asked, via an online survey about how much they learned about the harms of smoking from different warning labels.

Participants were shown labels highlighting the negative impacts of lung cancer, heart disease, stroke, impotence, eye disease, neck, throat and mouth cancers and vascular disease, some of which were accompanied by images of the disease. Some labels included pictures that showed the disease, while others were text only.

Young adults in both groups said the labels paired with images did a better job at giving them better understanding, more knowledge, caused more worry and did a better job at discouraging them from smoking than the text alone.

The only exceptions were images of a cigarette held limply in a hand, which was supposed to represent impotence, and an IV in someone’s hand, which was meant to show a long illness, both of which received similar ratings to the corresponding text-only warning.  Magnan said in the news release she wanted to do this study because not much research has been done on whether people learn anything from the labels, although an increasing amount of evidence suggests images on warning labels may help discourage smoking. Magnan’s research was conducted with colleague Linda D. Cameron of the University of California-Merced.

As part of the 2009 Family Smoking Prevention and Tobacco Control Act, the Food and Drug Administration (FDA) published a final rule in 2011 requiring tobacco companies to include color graphics on cigarette packets warning consumers of the negative health implications of smoking. In August 2012, this rule was overturned by the government after it was challenged by several tobacco companies, who claimed such graphic warnings would violate the tobacco industry’s right to free speech. This decision was upturned by the Supreme Court in 2013, giving the FDA permission to enforce graphic warnings on cigarette packets.

Source:   CADCA’s online newsletter, April 9, 2015 

If all new cars had devices that prevent drunk drivers from starting the engine, an estimated 85 percent of alcohol-related deaths could be prevented in the United States, a new study concludes.

The devices, called alcohol ignition interlocks, could prevent more than 59,000 crash fatalities and more than 1.25 million non-fatal injuries, according to the University of Michigan researchers. The findings appear in the American Journal of Public Health.

“Alcohol interlocks are used very effectively in all 50 states as a component of sentencing or as a condition for having a license reinstated after DUIs, but this only works for the drunk drivers caught by police and it doesn’t catch the people who choose to drive without a license to avoid having the interlock installed,” said lead author Dr. Patrick Carter.

He said most drunk drivers make about 80 trips under the influence of alcohol before they are stopped for a DUI. “If we decided that every new car should have an alcohol ignition interlock that’s seamless to use for the driver and doesn’t take any time or effort, we suddenly have a way to significantly reduce fatalities and injuries that doesn’t rely solely on police,” he told Reuters.

The study assumed it would take 15 years for older cars to be replaced with new vehicles that required interlock devices, which detect blood-alcohol levels. The devices prevent drivers above a certain threshold from starting the vehicle.

While all age groups would suffer fewer deaths and injuries if they used the interlock devices, the youngest drivers would benefit the most, the study found. Among drivers ages 21 to 29 years, 481,000 deaths and injuries could be prevented. Among drivers under 21, almost 195,000 deaths and injuries could be avoided.

“It is often difficult to penetrate these age groups with effective public health interventions and policies to prevent drinking and driving,” Carter said.

Source:  http://www.drugfree.org/   4th March 2015

… By: Jodi M. Gilman and Bertha K. Madras

People will tell you that “medical marijuana” is beneficial for a variety of disorders, from anxiety and depression to glaucoma, pain, and nausea. It would certainly be terrific if smoking marijuana could have such widespread therapeutic effects! After all, it would mean that one drug can treat a multitude of different ailments, and is now actually medicine! The fact that medical marijuana is now legal and available in 23 states lends credibility to this idea. Unfortunately, there’s one critical problem with “medical marijuana”; the science to support its effectiveness and safety, the dual standard for an approved medicine, does not yet exist, if it ever will.

To be clear, “medical marijuana” refers mainly to smoked marijuana available in dispensaries, not to the FDA-approved oral medications that contain constituents of marijuana such as the psychoactive THC (tetrahydrocannabinol) or the non-psychoactive CBD (cannabidiol).  There is a THC/CBD based medication that shows benefits for spasticity in multiple sclerosis, and a THC medicine (Marinol) approved for treatment of appetite loss in people with AIDS. The FDA-approved THC-based Marinol is stocked at pharmacies, is in capsule form, and is legal in all 50 states! There is no need to vote on whether Marinol is legal because it has been thoroughly tested by the FDA. Smoked marijuana, on the other hand, has not been tested, and the FDA has not approved its use for any medical condition.

Voting on ballots or having state legislators decide what is and what is not “medicine” is not the same as scientifically testing whether a product meets standards for medicinal use. Real medicines have to go through a rigorous FDA (Food and Drug Administration) process of testing in human subjects for safety, efficacy, long term effects and side effects for a single medical condition, in addition to meeting many other standards, including measuring shelf life, manufacturing practices, labelling practices, and even inspections of the cleanliness of the facilities in which the drug is manufactured.

There are very sound reasons why this process was developed. Before FDA-approval was required for medications in 1938, companies could claim whatever they wanted about their products, and there was no recourse when people were harmed by these false claims. There are examples throughout history of people experiencing harm, going blind, and even dying from products and medicines that were not properly tested and regulated.

Later on, an important layer of regulation was added, after it became clear that certain psychoactive drugs, medical or not, could be misused, produce intoxication, lead to addiction, or cause other harms if misused. Under the Controlled Substances Act of 1970, specific criteria had to be met in order

for a drug to have accepted medical use in the United States. Failure to meet just one of these five criteria disqualifies a drug for medicinal use. These criteria are not unreasonable, and each makes sense from a medical, safety, and personal perspective. Unfortunately, marijuana fails each and every one of these criteria:

1. The chemistry of medical marijuana is not known and not reproducible.

There are lots of variables that influence the composition of marijuana; soil, water, temperature, fertilizer, different breeds of seed, age of harvested plant, and any possible toxic chemicals will affect the plant. Furthermore, the marijuana plant itself contains over 400 chemicals; most are the same chemicals present in tobacco cigarettes, and some toxic ones are present in even higher amounts.  Simply put, marijuana is not a pure compound; there is no way to make sure that ingredients are measured reliably and are consistent from one batch to another. There are no standards for how much smoked or vaporized marijuana gets into the bloodstream or into the brain. THC content and amounts vary, the time course of peak effects varies, and delivery efficiency varies.  In other words, there is absolutely no standardization of the chemical nature of medicinal marijuana. This lack of standardization wouldn’t be acceptable with any other medicine.

2. There is a lack of evidence of safety for the use of marijuana under medical supervision.  Studies have shown that long-term use of marijuana can affect memory, attention, decision-making, IQ, even brain structure and connectivity. Most, if not all, of these effects have been shown to be worse in adolescents. Clinical trials have not reported whether marijuana can be used safely long term for chronic conditions, whether it interferes with daily functioning, whether its use extends to family members or children, or what proportion of daily marijuana users become addicted to the drug, if they use it to relieve symptoms.  Trials have also not shown what range of doses is safe. Possible risks of intoxication (e.g. changed perceptions, impaired thinking, memory, judgment, driving, psychosis, risks for accidents, injuries, and falls), psychological effects (e.g. anxiety, panic, increased appetite), cardiovascular effects (e.g. increased heart rate, blood pressure), and pulmonary effects (e.g. may worsen symptoms of asthma) have not been adequately studied. Long-term effects of marijuana use (e.g. addiction, withdrawal symptoms, impaired learning and memory) have not been adequately quantified. There is virtually no research on long-term effects of marijuana used for chronic medical conditions.

3. There is a lack of evidence of efficacy of medical marijuana.

This may be the biggest problem of all! Simply, we do not know whether or not it actually works. While some people believe that marijuana makes them feel better, belief is not the same as objective proof, and the scientific evidence is largely absent. While marijuana has been approved under state laws for dozens of chronic diseases and conditions (in fact, some state laws have added the words “any other medical condition that may benefit from marijuana” to its list of conditions for which marijuana can be recommended), the evidence for efficacy for most of these targeted uses does not exist. Clinical trials of smoked marijuana (i.e., medical marijuana as it is purported to be used to confer therapeutic benefits) suffer from issues such as small sample sizes, the use of subjects who are experienced marijuana users, lack of control groups, inconsistent dosing, modest/not clinically meaningful effects, and difficulty with blinding (i.e., people can soon figure out that they are either are or are not smoking real marijuana, which “unblinds” the study). There is

evidence also that some psychiatric disorders, such as psychosis, anxiety and depression, may actually get worse when patients use marijuana. There is insufficient evidence that the benefits outweigh the risks of marijuana.

4. Qualified experts do not accept the drug.

The American Medical Association, the largest national organization representing physicians in the United States, is opposed to legalization of marijuana for medicinal purposes, calling for further study.  So is the American Society of Addiction Medicine, American Cancer Society, and a whole host of other key medical associations.  An Institute of Medicine report, from an esteemed body of physicians and scientists agreed that there is no future in smoked marijuana as a medicine, but there may be some isolated cannabinoids from the plant that have therapeutic potential.

5. Scientific evidence is not widely available.

Data from clinical trials is not available for smoked marijuana. Again, clinical trials are small and limited, and physicians, scientists, and statisticians do not have access to raw data from these trials.

Because smoked marijuana fails in all five of these categories, it should not be considered medicine. While scientists may someday discover that individual constituents of the marijuana plant at specified doses may be useful in relieving symptoms or treating certain medical conditions, proof of this medicinal effect remains elusive. This is not to deny that marijuana may actually confer therapeutic benefit; only that we don’t know currently whether smoking marijuana has clinically significant medical benefits, whether these benefits outweigh any potential risks, and whether it is possible to isolate the potential therapeutic chemicals in marijuana from the intoxicating chemicals. If you have a medical problem, chances are, there are far more effective treatments than smoked marijuana; prescribed treatments have undergone meticulous testing procedures to minimize risk. Though some may be disappointed, today’s smoked marijuana should not be confused with real medicine. Smoking and inhaling a large array of chemicals in order to deliver a drug is a backward step in medicine and a risky step for a patient.

Source:  http://www.recoveryanswers.org/   1st April 2015

A major challenge in neuroscience is to determine the nanoscale position and quantity of signalling molecules in a cell type– and subcellular compartment–specific manner.

We developed a new approach to this problem by combining cell-specific physiological and anatomical characterization with super-resolution imaging and studied the molecular and structural parameters shaping the physiological properties of synaptic endocannabinoid signalling in the mouse hippocampus. We found that axon terminals of perisomatically projecting GABAergic interneurons possessed increased CB1 receptor number, active-zone complexity and receptor/effector ratio compared with dendritically projecting interneurons, consistent with higher efficiency of cannabinoid signalling at somatic versus dendritic synapses.

Furthermore, chronic Δ9-tetrahydrocannabinol administration, which reduces cannabinoid efficacy on GABA release, evoked marked CB1 down regulation in a dose-dependent manner. Full receptor recovery required several weeks after the cessation of Δ9-tetrahydrocannabinol treatment.

These findings indicate that cell type–specific nanoscale analysis of endogenous protein distribution is possible in brain circuits and identify previously unknown molecular properties controlling endocannabinoid signalling and cannabis-induced cognitive dysfunction.

Source:Nature Neuroscience18,75–86(2015) doi:10.1038/nn.3892 Pub. online 08/12/14 

The number of babies born in Florida with neonatal abstinence syndrome (NAS) soared more than 10-fold in the past 20 years, according to a new report by the Centers for Disease Control and Prevention (CDC). During the same period, these births increased three-fold nationally.  Babies born with NAS undergo withdrawal from the addictive drugs their mothers took during pregnancy, such as oxycodone, morphine or hydrocodone, HealthDay reports.  Almost all of the babies identified in the Florida study required admission to the neonatal intensive care unit, where they stayed an average of 26 days.

“These infants can experience severe symptoms that usually appear within the first two weeks of life,” said lead researcher Jennifer Lind. Symptoms can include seizures, fever, excessive crying, tremors, vomiting and diarrhoea, she said. Withdrawal can take several weeks to a month.

A majority of babies with NAS need treatment with morphine or the anticonvulsant phenobarbital to reduce seizures and other symptoms of withdrawal, the article notes.

Only about 10 percent of the babies’ mothers were referred for drug counselling or rehabilitation during pregnancy, even though urine drug tests were performed on 87 percent of the mothers, and 90 percent of those tests came back positive. In 2013, Florida launched an initiative to tackle the growing problem of NAS. A task force of doctors, public health experts and social workers in Florida made recommendations in the areas of prevention, intervention and best practices, and treatment. It recommended that hospitals be required to report babies born with symptoms of NAS, as they do with babies born with infectious diseases such as measles and tuberculosis. The group recommended considering new laws to offer pregnant women immunity for seeking substance abuse treatment. According to the CDC report, NAS is now a mandatory reportable condition in Florida.

Source:  http://www.drugfree.org/join-together     10th March 2015

On the heels of the Federal Drug Administration’s (FDA) second public workshop to explore the public health considerations associated with e-cigarettes, nonprofit research organization RTI International released a new research paper “Exhaled Electronic Cigarette Emissions: What’s Your Secondhand Exposure?,” which explores the composition of e-cigarette vapor and the potential health impacts of secondhand exposure.

“As proliferation of e-cigarettes surges, understanding the health effects of e-cigarette use and exposure to vapors is essential,” said Jonathan Thornburg, Ph.D., author of the study published by RTI Press, and director of Exposure and Aerosol Technology at RTI. “We need to be aggressively investing in and conducting research that answers lingering questions about the potential health impacts of secondhand exposure to e-cigarettes, while taking the necessary action to protect public health now.”

The study finds e-cigarette emissions contain enough nicotine, and numerous other chemicals to cause concern. A non-user may be exposed to secondhand aerosol particles similar in size to tobacco smoke and diesel engine smoke. Meanwhile, e-cigarettes are a rapidly growing business with annual sales doubling yearly to $1 billion in 2013, and a current lack of regulation that has allowed for a surge in marketing.

Because e-cigarette products are not yet regulated, the chemicals and devices involved vary widely, as may the potential health impacts. Many factors — including the specific device used — influence the chemical makeup and toxicity of e-cigarette emissions. The full scope of health impacts of e-cigarette smoke, as well as secondhand exposure’s impacts on children, is still unknown.

“Secondhand exposure to e-cigarettes is just one aspect of the research that must be considered as we make decisions about appropriate use of these products,” said Annice Kim, Ph.D., senior social scientist at RTI. “It is critical that we explore the role of e-cigarette marketing — especially to children and youth — so that we can better understand motivators for use and put public health safeguards in place.”

RTI hosted a press briefing today to answer questions about public health concerns associated with secondhand exposure to e-cigarette emissions and product marketing.

The briefing featured RTI experts Thornburg and Kim as well as Stanton Glantz, Ph.D., professor of medicine, University of California, San Francisco (UCSF) and director, UCSF Center for Tobacco Control Research and Education.  E-cigarettes are nicotine-delivering consumer products designed to closely mimic the experience of smoking conventional cigarettes. The courts have already determined e-cigarettes to be tobacco products, and the FDA has proposed following the same classification.

According to the Centers for Disease Control and Prevention, secondhand smoke from traditional cigarettes has killed 2.5 million adults who were non-smokers, in the past 50 years. Secondhand smoke from traditional cigarettes is associated with the top four causes of death in America.

To read the study “Exhaled Electronic Cigarette Emissions: What’s Your Secondhand Exposure?,” which is the 100th publication of RTI Press, and to access more research about e-cigarettes, visit http://www.rti.org/e-cigarettes and follow RTI on Twitter @RTI_Intl.

Source: RTI Press, March 2015  http://www.newswise.com/articles/view/631070/?sc=dwtn   12th March 2015

…Than Students Not Subject to Testing in Same Schools

A study conducted by the Institute for Behavior and Health, Inc., funded by the U.S. Department of Education,a and published in the Journal of Child and Adolescent Substance Abuse shows students in schools with random student drug testing (RSDT) programs who knew they were subject to random testing and expected to be tested in the coming school year reported significantly less marijuana and other illegal drug use than students who knew they were not subject to testing.1

Anonymous self-report student surveys were conducted bi-annually over a three year period among eight high schools with well-established RSDT programs. In all schools, athletes and in five schools, students in extracurricular activities, were subject to RSDT; however, based on student surveys it was clear that many students did not know of their status in these programs. Based on student survey responses, researchers identified two subsets of students: those who knew they were in their schools drug testing pool and aware they could be randomly drug tested (Tested) and students who knew they were not in the testing pool and not subject to random testing (Not Tested).

Significantly fewer students in the Tested group reported past month use of marijuana and other illicit drugs (cocaine, opiates and amphetamine/methamphetamine)b than students in the Not Tested group: 26.3% of Not Tested students reported past month marijuana use and 12.6% of Tested students used marijuana in this time. Similarly, 14.0% of Not Tested students used any of the other three illicit drugs while 8.5% of Tested students reported use of these drugs. Similar differences were found among groups for past year use of drugs, with Tested students reporting significantly less drug use than Not Tested students.

Differences in self-reported rates of past month and past year drug use among Tested and Not Tested students were consistent within each grade, with significantly fewer Tested students in 9th, 10th, 11th and 12th grades reporting drug use than their Not Tested peers.

Groups did not differ in reported rates of past month alcohol use: 38.5% of all Not Tested students reported past month alcohol use compared to 37.1% of Tested students. No differences were found among groups for past year alcohol use. Only one school tested students for alcohol and thus, was excluded from these analyses. 2

Because many opponents of RSDT programs suggest that students subject to testing are typically less likely to use drugs because of school involvement (i.e. participation in athletics or extracurricular activities acts as a preventive measure), researchers examined differences between Tested and Not Tested students engaged in extracurricular activities. Tested/Extracurricular students reported significantly less past month marijuana use (11.9%) than Not Tested/Extracurricular students (19.1%). No differences were found for past month alcohol or other illegal drug use. No differences were found for past year alcohol or other illegal drug use.

This study provides evidence for the efficacy of RSDT in reducing rates of drug use when students are aware that they are subject to random testing and believe they are likely to be tested. It is worthy of note that the differences in past month and past year drug use among Tested and Not Tested students were not found for alcohol use, quite possibly because schools did not include alcohol on testing panels. The study also provides evidence that students subject to testing have more positive attitudes towards testing and their school’s drug and alcohol policies than students not subject to testing. More than half (54.5%) of Tested students reported that drug testing made them want to avoid drugs compared to 26.7% of Not Tested students. The significant difference between Tested/Extracurricular and Not Tested/Extracurricular students in past marijuana use suggests that random student drug testing may further reduce marijuana use among this population.

RSDT is not a stand-alone prevention program but rather one part of a school’s comprehensive prevention program.2 Because so few students actually are tested due to cost and administrative constraints, the study suggests that to ensure maximum effectiveness, existent and future RSDT programs should be aware that it is important for students to know that they are participants in school random drug testing pools.

* This study was part of a demonstration project funded from 2003-2007 by the U.S. Department of Education.

* Random drug test panels for all schools included marijuana, cocaine, opiates and amphetamine/methamphetamine.

For more information on the Institute for Behavior and Health, Inc. visit www.IBHinc.org.

For information about random student drug testing visit www.PreventionNotPunishment.org.

For information about the harmful effects of drug use by teens visit

www.PreventTeenDrugUse.org.   Robert L. DuPont, M.D.President, Institute for Behavior and Health, Inc.  First Director, National Institute on Drug Abuse (NIDA) 1973 to 1978

Source:  Institute for Behaviour and Health.    Revised April 22nd 2013

The hippocampus is important to long-term memory (also known as episodic memory), which is the ability to remember autobiographical or life events.  The brain abnormalities and memory problems were observed during the individuals’ early twenties, two years after they stopped smoking marijuana.

Young adults who abused cannabis as teens performed about 18 percent worse on long-term memory tests than young adults who never abused cannabis.

“The memory processes that appear to be affected by cannabis are ones that we use every day to solve common problems and to sustain our relationships with friends and family,” said senior author Dr. John Csernansky, the Lizzie Gilman professor and chair of psychiatry and behavioral sciences at Northwestern University Feinberg School of Medicine and Northwestern Memorial Hospital.

The study will be published March 12 in the journal Hippocampus.

The study is among the first to say the hippocampus is shaped differently in heavy marijuana smokers and the different looking shape is directly related to poor long-term memory performance. Previous studies of cannabis users have shown either the oddly shaped hippocampus or poor long-term memory but none have linked them.

Previous research by the same Northwestern team showed poor short-term and working memory performance and abnormal shapes of brain structures in the sub-cortex including the striatum, globus pallidus and thalamus.

“Both our recent studies link the chronic use of marijuana during adolescence to these differences in the shape of brain regions that are critical to memory and that appear to last for at least a few years after people stop using it,” said lead study author Matthew Smith, assistant professor of psychiatry and behavioral sciences at the Feinberg School of Medicine.

The longer the individuals were chronically using marijuana, the more abnormal the shape of their hippocampus, the study reports. The findings suggest that these regions related to memory may be more susceptible to the effects of the drug the longer the abuse occurs.

The abnormal shape likely reflects damage to the hippocampus and could include the structure’s neurons, axons or their supportive environments.

“Advanced brain mapping tools allowed us to examine detailed and sometimes subtle changes in small brain structures, including the hippocampus,” said Lei Wang, also a senior study author and an assistant professor of psychiatry and behavioral sciences at Feinberg. The scientists used computerized programs they developed with collaborators that performed fine mappings between structural MRIs of different individuals’ brains.

Subjects took a narrative memory test in which they listened to a series of stories for about one minute, then were asked to recall as much content as possible 20 to 30 minutes later. The test assessed their ability to encode, store, and recall details from the stories.

The groups in the study started using marijuana daily between 16 to 17 years of age for about three years. At the time of the study, they had been marijuana free for about two years. A total of 97 subjects participated, including matched groups of healthy controls, subjects with a marijuana use disorder, schizophrenia subjects with no history of substance use disorders, and schizophrenia subjects with a marijuana use disorder. The subjects who used marijuana did not abuse other drugs.

The study also found that young adults with schizophrenia who abused cannabis as teens performed about 26 percent more poorly on memory tests than young adults with schizophrenia who never abused cannabis.

In the U.S., marijuana is the most commonly used illicit drug, and young adults have the highest — and growing — prevalence of use. Decriminalization of the drug may lead to greater use. Four states have legalized marijuana for recreational use, and 23 states plus Washington D.C. have legalized it for medical use.

Because the study results examined one point in time, a longitudinal study is needed to definitively show if marijuana is responsible for the observed differences in the brain and memory impairment, Smith said.

“It is possible that the abnormal brain structures reveal a pre-existing vulnerability to marijuana abuse,” Smith said. “But evidence that the longer the participants were abusing marijuana, the greater the differences in hippocampus shape suggests marijuana may be the cause.”

The study was funded by the National Institute of Mental Health of the National Institutes of Health, grants R01 MH056584 and P50 MH071616.

Source:  Info.from Drugwatch International abut a study tobe published on 12th March 2015 in the journal Hippocampus.

A study identified 242 infants with neonatal abstinence syndrome (NAS) in three Florida hospitals during a 2-year period. Most of the infants were admitted to the NICU, and the mean length of stay was 26 days. A total of 99.6% of the infants with NAS were exposed to opioids in utero.

A study identified 242 infants with neonatal abstinence syndrome (NAS) in three Florida hospitals during a 2-year period. Most of the infants were admitted to the NICU, and the mean length of stay was 26 days. A total of 99.6% of the infants with NAS were exposed to opioids in utero. Four out of five of the mothers were reported as using one or more opioids such as oxycodone, morphine, hydrocodone, hydromorphone, tramadol, or meperidine, while about three in five were reported as using methadone. However, only about 10% of mothers with NAS received or were referred for drug addiction rehabilitation or counseling during their baby’s birth hospitalization. The standard of care for pregnant women with opioid addiction is medication assisted treatment (MAT) — comprehensive MAT combined with prenatal care has been shown to reduce complications linked to untreated opioid use disorder. Measures that should be considered when addressing NAS prevention and management include encouraging mothers in supervised drug treatment programs to breastfeed, unless otherwise indicated; boosting the number of community resources available to women of reproductive age for substance abuse and smoking cessation, and improving drug addiction counseling and rehabilitation referral and documentation policies.

Morbidity and Mortality Weekly Report (03/06/15) Vol. 64, No. 8, P. 213 Lind, Jennifer N.; Petersen, Emily E.; Lederer, Philip A.; et al.

Source:     http://www.cdc.gov/mmwr/preview/           6th  March 2015  

With the medical marijuana law cutting profits for street dealers, police believe that drug-trafficking organizations are turning to far more dangerous drugs, flooding the streets with cocaine, heroin and methamphetamine. Tempe Police, the DEA and the Arizona Attorney General’s Office attacked that trend in Operation Terminus, a 30-month investigation that resulted in the dismantling of what investigators described as an extensive drug trafficking network that stretched from Sinoloa, Mexico, to Phoenix, Los Angeles and Indianapolis. Tempe Police Chief Tom Ryff pointed out that the one missing item in this case is marijuana. During the investigation, there were 77 indictments, with authorities seizing $7.5 million cash, 485 pounds of methamphetamine, 50 Kilograms of cocaine, 4.5 pounds of heroin and 37 firearms. “Here, in Arizona alone, you can go to a strip mall and purchase marijuana,” Ryff said. “Drug cartels are sophisticated, they are a criminal enterprise. If the money is not there, they are going to change their tactics.” Ryff praised the Cronkite School at ASU for their work in evaluating the impact of drugs in Arizona as seen in their recent semester long project: Hooked, Tracking Heroin’s hold on Arizona. “They are plowing marijuana fields and planting opiates. It’s killing our youths. It’s an epidemic,” said Lt. Mike Pooley, a Tempe police spokesman. Police believe that drug addiction is the root cause of many property crimes, including burglary and shoplifting. Mesa police arrested a suspect last week who told them he used an air gun resembling a pistol to rob a bank in order to pay his heroin dealer. Operation Terminus started in 2012 with the arrest of an individual named Jesus who was picked up from a different criminal investigation,Tempe police Commander Kim Hale said. The drug-trafficking organizations are based in the Sinoloa state in Mexico, but the drugs are distributed by local syndicates throughout the Valley and as far away as Los Angeles and Indianapolis, he said. “Arizona is ground zero for for drugs and our border states have been impacted just as is the borders in California, Texas and News Mexico,” Hale said. Tempe police released a list of 70 defendants who were charged with a variety of drug trafficking crimes as the result of Operation Terminus.

Source:  www.azcentral.com   6th March 2015

Sanjay Gupta, MD, has gone off the rails and taken CNN with him. To promote his third documentary on the subject, Weed 3, he wrote an article titled “Dr. Sanjay Gupta: It’s time for a medical marijuana revolution” on CNN’s website datelined April 20. Yes, that 4/20, the day marijuana smokers nationwide gather outside to flout federal and state law by openly smoking pot. (Even the four states and DC that have legalized recreational marijuana prohibit smoking in public.)

In his call for a medical marijuana revolution, he morphs from less-than-objective reporter to shameless huckster, concluding, “We should legalize medical marijuana. We should do it nationally. And, we should do it now.”

As CNN’s chief medical correspondent, a practicing neurosurgeon, assistant professor of neurosurgery at Emory University School of Medicine, and associate chief of the neurosurgery service at Atlanta’s Grady Memorial Hospital, he understands how medicine works.

In covering the admission of the nation’s first Ebola patient, American Dr. Kent Brantley who fell ill while caring for Liberians stricken with the disease and was flown to Emory University Hospital for treatment, Dr. Gupta noted how unusual it would be to administer an experimental drug that hadn’t gone through the rigorous FDA process, even to patients with an incurable disease.

But his infatuation with marijuana somehow enables him to suspend the tools of modern medicine that protect people from unsafe, ineffective drugs. Anderson Cooper interviewed Dr. Gupta to promote Weed 2 shortly before it aired last year.

“It’s really fascinating, Anderson,” Dr. Gupta said, “because we’re used to an FDA process where you have the trials that take place and then you’re given a certain dosage and all that stuff. That hasn’t happened with cannabis. What happens is you have these different strains [of marijuana] and they [the producers] will create these hybrids . . . and then, you know, the people who are the dispensers will often times be talking to the patients who come in, finding out what works for them . . . . But, you know, the trial and error of this just feels so nascent and new in what they’re trying to do and really something like this hasn’t been done before, at least not for a long time, in this country.”

Dr. Gupta fails to mention that the dispensers, called “budtenders” – the marijuana equivalent of bartenders – have no medical training whatsoever. Welcome to the brave new world of word-of-mouth medicine: tell me which marijuana strain relieves your (name any of the 50 illnesses legislators have approved marijuana to treat despite lack of FDA approval) and I’ll pass it on to the next person with a similar complaint.

It is the responsibility of all medicine makers, whether pharmaceutical companies or “medical” marijuana growers, to submit their medicines to FDA for approval before marketing them to the public. What Dr. Gupta fails to see is that if a government legalizes “medical” pot, marijuana growers are free to promote and sell their “medicines” without bothering to prove they are safe or effective. But then, when you are so enamored with “medical” weed that you call for it to be legalized, you can forget that love is blind.

Source: The MarijuanaReport.org 22^nd April 2015

Wouldn’t it be simpler for the USA to not legalise so-called medical marijuana and so-called recreational pot ? (drug taking is not recreational !). Freely available marijuana will lead to more use by youth, and research has shown that 10% of users will need treatment for addiction and mental health issues. 10% of a larger number of users will result in a larger number requiring treatment – with the inevitable increase in financial costs of treatment.

ACLU Calls Legislature’s Plans to Raid Pot Taxes “Dangerously Shortsighted and Unwise”

In 2012, voters approved spending marijuana taxes on public health. Now, Republicans and Democrats want to grab that cash for other needs.

Budget negotiations in the state legislature are not going well. House Democrats want taxes; Senate Republicans don’t.

Now, Republicans are telling Democrats to hand their tax proposals over to the Republican-controlled senate (where leaders promise no new taxes) before the two sides start negotiating. As the Seattle Times reports, the Democrats are like, uh, no thanks.

So negotiations are stalled and a special session seems likely.

One of the many efforts that hangs in the balance is the Republican-controlled senate’s plan to raid almost $300 million in expected marijuana tax revenue to pay for K-12 education. (House Democrats also want that money. Their budget keeps most of the 2012 initiative’s earmarks, but redirects some of them to non-marijuana-related needs like life skills training in schools and home visitation programs for new parents.) As I’ve explained before, marijuana tax dollars are—according to the initiative 56 percent of Washington voters supported in 2012—supposed to pay for public health efforts, like drug use prevention, treatment, research, public education campaigns about using marijuana safely, and healthcare. Not only does diverting those funds run counter to the vision of public-health-focused legalization that was sold to the voters. It also has some experts worried about negative impacts on public health.

In its second letter to lawmakers this month, the ACLU of Washington is joined by a long list of substance abuse prevention advocates in pleading with legislators to stop trying to snatch marijuana tax revenues to balance their budgets.

“Using I-502-earmarked funds to fill a budget hole now is dangerously shortsighted and unwise from both a public health and a cost-benefit perspective,” the group writes. “Reduced funding for prevention and drug education programs today means increased substance abuse tomorrow, which translates directly to lost productivity and more health care costs down the line. The increased costs of these outcomes in the years to come will make today’s supposed savings pale by comparison.”

The letter also points out a recent University of Washington survey of 115 low-income families of teens attending Tacoma middle schools, in which only 57 percent of parents knew the legal age for consumption and 63 percent knew home grows are illegal.

“To combat this misinformation,” the letter reads, “the legislature must invest in prevention and drug education, which is known to work—for example, youth initiation of tobacco use was cut in half when tobacco litigation settlement dollars went to prevention programs.Now is not the time to cut funding for programs that prevent marijuana use and abuse by youth.”

Here are the guys who wrote the senate budget plan, which redirects almost all of the tax revenue: Republican Andy Hill (andy.hill@leg.wa.gov) and Democrat Jim Hargrove (jim.hargrove@leg.wa.gov).

And here are those who sponsored the house proposal, which is less dramatic in its redirecting, but still opposed by the ACLU: Ross Hunter (ross.hunter@leg.wa.gov), Timm Ormsby (timm.ormsby@leg.wa.gov), Pat Sullivan (pat.sullivan@leg.wa.gov), Mia Gregerson (mia.gregerson@leg.wa.gov), Chris Reykdal (chris.reykdal@leg.wa.gov).

Here’s the full letter:

April 15, 2015
Re: Reallocation of Initiative-502 tax revenue in SSB 6062/SSB 5077 and 2SHB 2136/SHB 1106

Dear Lawmakers,

The undersigned organizations and individuals, representing Washington State’s substance abuse prevention, treatment, and public health communities, along with the ACLU of Washington, are greatly concerned about legislation currently under consideration that seeks to reallocate earmarked tax revenue in Initiative 502 (I-502). Diverting these funds would directly contradict the will of Washington voters, who made it clear in passing I-502 that they wanted a well-regulated and public health-oriented approach to marijuana policy rather than just legalization without more. And these funds provide resources for substance abuse prevention and treatment programming, drug education for youth and adults, community health care services, academic research, and evaluation, all of which are currently grossly underfunded.

Reallocating money from I-502’s original earmarks defies the will of Washington’s voters. By eliminating the Dedicated Marijuana Fund, the relevant Senate proposals, SSB 6062 and SSB 5077, would effectively eliminate I-502’s earmarks, ignoring the Initiative’s intent to “[g]enerate[] new … tax revenue for … health care, research, and substance abuse prevention.” Initiative 502 (2012), Part I – Intent – available athttp://www.newapproachwa.org/sites/newapproachwa.org/files/I-502%20bookmarked.pdf. The House proposals, 2SHB 2136 and SHB 1106, are not as sweeping as the Senate’s, but would still redirect money away from prevention programs to other non-marijuana-related programs. In moving forward with this cash grab, the legislature would be risking the interests and health of both Washington’s youth and its adults—the former would not get the benefit of participating in evidence-based prevention programs, and the latter will not get sufficient education about risky marijuana use. Neither is a good outcome for Washington. I-502 won by a large margin, receiving almost 56% support, and won in 20 of Washington’s 39 counties (including 5 east of the Cascades)—the legislature should respect the clearly expressed will of Washington’s voters.

Using I-502-earmarked funds to fill a budget hole now is dangerously shortsighted and unwise from both a public health and a cost-benefit perspective. Reduced funding for prevention and drug education programs today means increased substance abuse tomorrow, which translates directly to lost productivity and more health care costs down the line. The increased costs of these outcomes in the years to come will make today’s supposed savings pale by comparison.

As the Washington State Institute for Public Policy has shown repeatedly, the benefits from evidence-based public health/prevention and substance programs far outweigh the costs. WSIPP – Benefit-Cost Results – available athttp://www.wsipp.wa.gov/BenefitCost
Washington voters also enacted a measure that was to have been robustly evaluated by the Washington State Institute for Public Policy. RCW 69.50.550 Independent, reliable cost-benefit evaluation of the impacts of I-502 is critical to ensuring the legislature has solid data to inform future decisions about funding priorities that protect and promote public health and safety. SSB 6062 repeals the provisions mandating and funding these evaluations, which is unwise from a policy and public health perspective. Under the Senate proposal, funding for marijuana related research at the University of Washington and Washington State University would also be cut.

I-502 is still a new law and the general public is unfamiliar with its features—making this a crucial time for public education about the law. According to research from the University of Washington, “only 57 percent of Washington parents surveyed knew the legal age for recreational marijuana use.” UW Today, Deborah Bach, Study Shows Teens and Adults Hazy on Washington Marijuana Law, March 9, 2015, available athttp://www.washington.edu/news/2015/03/09/study-shows-teens-and-adults-hazy-on-washington-marijuana-law/. One of the study’s authors indicated it “convincingly points out that people don’t have good information about the new law.” Id. To combat this misinformation, the legislature must invest in prevention and drug education, which is known to work—for example, youth initiation of tobacco use was cut in half when tobacco litigation settlement dollars went to prevention programs. Now is not the time to cut funding for programs that prevent marijuana use and abuse by youth.

Lawmakers should not defy the will of the voters by reallocating I-502 tax revenue away from substance abuse prevention and treatment programming, drug education for youth and adults, community health care services, academic research, and evaluation. Please leave I-502’s critical earmarks intact.

Sincerely,

Carolyn Bernhard, Co-Chair, Prevention Works in Seattle Coalition
Kimberlee R. Brackett, President and CEO Science and Management of Addictions (SAMA)
Julie Campbell, Director, Ballard Coalition
Mark Cooke, Campaign Policy Director, ACLU of Washington
Brittany Rhoades Cooper, PhD Assistant Professor, Human Development, Graduate Faculty in Prevention Science, Extension Specialist, Washington State University
Shelley Cooper-Ashford, Executive Director, Center for MultiCultural Health
Josh Daniel, Content Inventions
Norilyn de la Pena, concerned parent, Federal Way
Aileen De Leon, Executive Director, WAPI Community Services
Rep. Mary Lou Dickerson (ret.), Initiative 502 Co-Sponsor
Dennis M. Donovan, Ph.D., Member, Board of Directors, Science and Management of Addictions (SAMA) Foundation
Sinivia Driggers, President, Samoan Nurses of Washington
Derek Franklin, Washington Association for Abuse & Violence Prevention (WASAVP)
Tracie Friedman, Youth Program Volunteer, Lau Khmu Association of Seattle
John Gahagan, Vice Chair, Science and Management of Addictions (SAMA) Foundation
Mike Graham-Squire, Washington Association for Abuse & Violence Prevention (WASAVP)
Gary Goldbaum, MD, MPH, Snohomish County Health Officer & Director
Kevin Haggerty, MSW, Ph.D., Director, Social Development Research Group
Mona T. Han, Executive Director, Coalition for Refugees from Burma
Patty Hayes, Interim Director, Public Health-Seattle & King County
Laura G. Hill, Professor and Chair, Department of Human Development, Interim Director of the Prevention Science PhD program, Washington State University
Alison Holcomb, National Director, Campaign to End Mass Incarceration at ACLU
Renee Hunter, Executive Director, Chelan-Douglas TOGETHER for Youth
Elaine Ishihara, Director, APICAT for Healthy Communities
Mark Johnson, Johnson Flora, Initiative 502 Co-Sponsor
Ramona Leber, Washington Association for Abuse & Violence Prevention (WASAVP)
Priscilla Lisicich, Executive Director, Safe Streets Campaign – Pierce County
Inga Manskopf, Prevention WINS coalition member
Marcos Martinez, Executive Director, Entre Hermanos
John L. McKay, Visiting Professor of Law Seattle University, Initiative 502 Co-Sponsor
Michael McKee, Health Services & Community Partnership Director,
International Community Health Services
Delton Mosby, Mental Health and Chemical Dependency Professional, Therapeutic Health Services
Sal Mungia, Gordon Thomas Honeywell, Initiative 502 Co-Sponsor
Adrienne Quinn, Director, Department of Community and Human Services, King County
Roger Roffman, Ph.D., Professor Emeritus, School of Social Work, University of Washington
Andrew J. Saxon, MD, Science and Management of Addictions (SAMA) Board Chair, Professor Department of Psychiatry & Behavioral Sciences, University of Washington
Lorena Silva, community member, Yakima Valley
Rick Steves, Guidebook author and travel TV host, Rick Steves’ Europe, Initiative 502 Co-Sponsor
Jennifer Stuber, Associate Professor, University of Washington
Val Thomas-Matson, Program Manager, Health King County Coalition
Linda J. Thompson, Executive Director, Greater Spokane Substance Abuse Council (GSSAC)
Leslie R. Walker, MD, Chief, Division of Adolescent Medicine, University of Washington Department of Pediatrics & Seattle Children’s Hospital
Paul Weatherly, Bellevue College Alcohol/Drug Counseling Program
Leondra Weiss, Nurse Manager, Harborview Women’s Clinic
Robert W. Wood, M.D., Clinical Professor of Medicine, University of Washington, Initiative 502 Co-Sponsor
The Washington State Psychiatric Association

Source: http://www.thestranger.com

Hospitals across the country have been reporting hundreds of cases of seriously ill people coming to the emergency room after using synthetic marijuana. In New York City, more than 120 cases were reported in a single week, according to NPR.

Many cases have also been seen in Alabama and Mississippi. Several people have died, the article notes.

Synthetic marijuana is often sold under the name “K2” or “Spice.” According to the American Association of Poison Control Centers, these drugs can be extremely dangerous. Health effects can include severe agitation and anxiety; fast, racing heartbeat and high blood pressure; nausea and vomiting; muscle spasms, seizures, and tremors; intense hallucinations and psychotic episodes; and suicidal and other harmful thoughts and/or actions.

“We have to chemically restrain and physically restrain them because they become violent and very strong. It takes four to five personnel to restrain them on a gurney,” Dr. Robert Glatter, an emergency physician at Lenox Hill Hospital in New York City, told NPR. One patient last week ended up in the ICU. “He was combative and required sedation in the ER,” Dr. Glatter said.

There is likely something unusual about the K2 that is causing the recent rash of ER visits, Dr. Glatter notes. Makers of synthetic drugs frequently change their molecular structure, to evade laws that outlaw the drugs. The changing structure also makes the drugs more difficult to detect on drug tests. These changes make the effects of the drugs more unpredictable.

“Chemists are getting more and more creative in designing these structures,” said Marilyn Huestis of the National Institute on Drug Abuse. She added, “What’s in it today isn’t going to be what’s in it tomorrow.”

Source:  www.drugfree.org 28th April 2015