Definition of a Nightmare: Trying to Enforce Colorado’s Conflicting Marijuana Regulatory Laws
The Police Foundation and the Colorado Association of Chiefs of Police released the above report this week to guide law enforcement about marijuana in other states. The report points to the Byzantine layers of regulations that evolved from constitutional amendments voters passed to legalize medical marijuana in 2000 (Amendment 20) and recreational marijuana in 2012 (Amendment 64).

From June 1, 2001 to December 21, 2008, Colorado issued medical marijuana cards to 4,819 patients. Each cardholder could designate a caregiver to grow marijuana for up to five patients. In 2009, a court decision overturned the limit of five patients per caregiver. That year, with virtually no limits on the number of patients caregivers could supply, 41,039 citizens obtained medical marijuana cards, an increase of 762 percent.

The legislature responded by passing bills in 2010 and 2011 to create the Colorado Medical Marijuana Code. Among other things, the Code legalized commercial medical marijuana centers to grow and sell medical marijuana, reinstated the five-patient limit for caregivers, set up a business-licensing regimen, and allowed for marijuana-infused products to be sold to patients. In 2012, citizens passed Amendment 64, legalizing recreational marijuana, and new sets or regulations were created for both home growers and commercial growers, processors, and retail sales outlets. This resulted in four models of regulation.

Caregiver/Patient
Caregivers can grow medical marijuana for up to five patients and themselves.
Patients licensed by the Department of Public Health and Environment
Regulatory authorities: Department of Public Health and Environment & local law enforcement

Medical Commercial
Businesses, owners, and employees licensed
Regulatory authority: Department of Revenue, Marijuana Enforcement Division

Recreational Commercial
Businesses, owners, and employees licensed
Regulatory authority: Department of Revenue, Marijuana Enforcement Division

Recreational Home Grows
Anyone age 21 or older can grow up to six plants
Law enforcement seeing “co-op cultivations” where many home growers are growing at one location
No license required
Regulatory authority: local law enforcement

Caregivers must register the location of their cultivation sites, but no punishment is specified for those who do not, and many don’t. Because of privacy laws, patient information cannot be accessed to check for whom caregivers are growing. Caregivers have no cards and no sanctions if they fail to register. Attempting to establish probable cause under conflicting regulatory mechanisms makes it difficult to prosecute those who ignore the regulations.

Data kept by the Denver Police Department and the Department of Revenue show the number of marijuana facilities in Denver and statewide:

Medical Centers–Denver 198, Statewide 501
Infused Medical Product Factories–Denver 78, Statewide 158
Medical Cultivations–Denver 376, Statewide 739

Recreational Stores–Denver 126, Statewide 306
Infused Recreational Factories–Denver 44, Statewide 92
Recreational Cultivations–Denver 190, Statewide 375
Labs Checking Recreational for THC–Denver 9, Statewide 15

Total Marijuana Facilities–Denver 1,021, statewide 2,186

The result of trying to enforce conflicting regulatory laws can be seen in another recently released Colorado report. It estimated that demand for marijuana in Colorado in 2014 was 130 metric tons but legal supplies could only account for 77 metric tons. The rest, according to press reports, came from criminals in the black market or legal cultivators selling under the table in the “grey” market.

“Colorado law enforcement officials . . . are convinced that the black and the grey markets are thriving in Colorado primarily through unregulated grows, large quantities of marijuana stashed in homes, and by undercutting the price of legitimate marijuana sales. In fact, police have stated that legalized marijuana may have increased the illegal drug trade.”

Source: www.The Marijuana Report.Org  February 2015

A new call to action has been released from scientists around the world, reflecting “a growing consensus among experts that frequent cannabis use can increase the risk of psychosis in vulnerable people and lead to a range of other medical and social problems,” according to the The Guardian.

Researchers now believe the evidence for harm is strong enough to issue clear warnings, said the article.  For example, Sir Robin Murray, professor of psychiatric research at King’s College London, stated:

“It’s not sensible to wait for absolute proof that cannabis is a component cause of psychosis. There’s already ample evidence to warrant public education around the risks of heavy use of cannabis, particularly the high-potency varieties. For many reasons, we should have public warnings.”

Estimates suggest that deterring heavy use of cannabis could prevent 8 to 24% of psychosis cases handled by treatment centers, depending on the area. In London alone, where the most common form of cannabis is high-potency marijuana (or “skunk” as it is sometimes called in the United Kingdom), avoiding heavy use could avert many hundreds of cases of psychosis every year.

“It is important to educate the public about this now,” said Nora Volkow, director of the US National Institute on Drug Abuse (NIDA). “Kids who start using drugs in their teen years may never know their full potential. This is also true in relation to the risk for psychosis. The risk is significantly higher for people who begin using marijuana during adolescence. And unfortunately at this point, most people don’t know their genetic risk for psychosis or addiction.”

Ian Hamilton, a mental health lecturer at the University of York, said more detailed monitoring of cannabis use is crucial to ensure that information given out is credible and useful. Most research on cannabis, particularly the major studies that have informed policy, is based on older low-potency cannabis resin, he points out. “In effect, we have a mass population experiment going on where people are exposed to higher potency forms of cannabis, but we don’t fully understand what the short- or long-term risks are,” he said.

Prof Wayne Hall, director of the Centre for Youth Substance Abuse Research at the University of Queensland, said that while most people can use cannabis without putting themselves at risk of psychosis, there is still a need for public education:

“We want public health messages because, for those who develop the illness, it can be devastating. It can transform people’s lives for the worse. People are not going to develop psychosis from having a couple of joints at a party. It’s getting involved in daily use that seems to be the riskiest pattern of behavior: we’re talking about people who smoke every day and throughout the day.”

“When you’re faced with a situation where you cannot determine causality, my personal opinion is why not take the safer route rather than the riskier one, and then figure out ways to minimize harm?” said Amir Englund, a cannabis researcher at King’s College London.

A UK government spokesperson also said its position on cannabis was clear.

“We must prevent drug use in our communities and help people who are dependent to recover, while ensuring our drugs laws are enforced. There is clear scientific and medical evidence that cannabis is a harmful drug which can damage people’s mental and physical health, and harms communities.”

These comments underline the need for a global drug policy that prevents drug use, instead of promoting it. Global drug policy should continue to evolve to match the new scientific evidence available, and that includes taking into account the heavy price that increases in drug use entail, particularly in less-developed countries.

Source:    www.preventdontpromote.org   16^th April  2016

Prevent. Don’t Promote. (http://preventdontpromote.org/) is a global campaign that more than 300 organizations across the world are launching at UNGASS 2016 to support the UN drug conventions.  This consortium of organizations advocates fora global drug policy based on public health and safety through the prevention of drug use and drug problems.

Aligned with the principles of Drug Policy Futures, we believe that drug policies should:

• Prevent initiation of drug use.
• Respect human rights (for users and non-users alike) as well as the principle of proportionality.
• Strike a balance of efforts to reduce the use of drugs and the supply of drugs.
• Protect children from drug use.
• Ensure access to medical help, treatment and recovery services.
• Provide access to controlled drugs for legitimate scientific and medical purposes.

Ensure that medical and judicial responses are coordinated with the goal of reducing drug use and drug-related consequences.

Few states where marijuana use is legal restrict its use around children

A new study to be presented at the Pediatric Academic Societies 2016 Meeting found that one in six infants and toddlers admitted to a Colorado hospital with coughing, wheezing and other symptoms of bronchiolitis tested positive for marijuana exposure.

The study, “Marijuana Exposure in Children Hospitalized for Bronchiolitis,” recruited parents of previously healthy children between one month of age and two years old who were admitted to Children’s Hospital Colorado (CHC) between January 2013 and April 2014 with bronchiolitis, an inflammation of the smallest air passages in the lung. The parents completed a questionnaire about their child’s health, demographics, exposure to tobacco smoke, and as of October 2014, whether anyone in the home used marijuana. Marijuana became legal in Colorado on January 1, 2014.

Of the children who were identified as having been exposed to marijuana smokers, urine samples showed traces of a metabolite of tetrahydrocannabinol (THC), the psychoactive component of marijuana, in 16 percent of them. The results also showed that more of the children were THC positive after legalization (21 percent, compared with 10 percent before), and non-white children were more likely to be exposed than white children.

The findings suggest that secondhand marijuana smoke, which contains carcinogenic and psychoactive chemicals, may be a rising child health concern as marijuana increasingly becomes legal for medical and recreational use in the United States, said lead researcher Karen M. Wilson, MD, MPH, FAAP, an associate professor of pediatrics at the University of Colorado School of Medicine and section head at CHC. Most states with legal marijuana do not restrict its combustion around children, she said.

“Our study demonstrates that, as with secondhand tobacco smoke, children can be exposed to the chemicals in marijuana when it is smoked by someone nearby,” Dr. Wilson said. “Especially as marijuana becomes more available and acceptable, we need to learn more about how this may affect children’s health and development.” In the meantime, she said, “marijuana should never be smoked in the presence of children.”

Source:   https://www.sciencedaily.com/releases/2016/04/160430100247.htm

Bertha Madras is a professor of psychobiology at McLean Hospital and Harvard Medical School, with a research focus on how drugs affect the brain. She is former deputy director for demand reduction in the White House Office of National Drug Control Policy. Data from 2015 indicate that 30 percent of current cannabis users harbor a use disorder — more Americans are dependent on cannabis than on any other illicit drug. Yet marijuana advocates have relentlessly pressured the federal government to shift marijuana from Schedule I — the most restrictive category of drug — to another schedule or to de-schedule it completely. Their rationale? “States have already approved medical marijuana”; “rescheduling will open the floodgates for research”; and “many people claim that marijuana alone alleviates their symptoms.”

Yet unlike drugs approved by the Food and Drug Administration, “dispensary marijuana” has no quality control, no standardized composition or dosage for specific medical conditions. It has no prescribing information or no high-quality studies of effectiveness or long-term safety. While the FDA is not averse to approving cannabinoids as medicines and has approved two cannabinoid medications, the decision to keep marijuana in Schedule I was reaffirmed in a 2015 federal court ruling. That ruling was correct. [https://www.washingtonpost.com/news/in-theory/wp/2016/04/29/scientists-want-to-study-marijuana-big-pot-just-wants-to-sell-it/]

To reside in Schedules II-V and be approved for diagnosing, mitigating, treating or curing a specific medical condition, a substance or botanical must proceed through a rigorous FDA scientific process proving safety and efficacy. Not one form of “dispensary marijuana” with a wide range of THC levels — butane hash oil, smokables, vapors, edibles, liquids — has gone through this rigorous process for a single medical condition (let alone 20 to 40 conditions).

To approve a medicine, the FDA requires five criteria to be fulfilled:

1. The drug’s chemistry must be known and reproducible.Evidence of a standardized product, consistency, ultra-high purity, fixed dose and a measured shelf life are required by the FDA. The chemistry of “dispensary marijuana” is not standardized. Smoked, vaporized or ingested marijuana may deliver inconsistent amounts of active chemicals. Levels of the main psychoactive constituent, THC, can vary from 1 to 80 percent. Cannabidiol (known as CBD) produces effects opposite to THC, yet THC-to-CBD ratios are unregulated.

2. There must be adequate safety studies. “Dispensary marijuana” cannot be studied or used safely under medical supervision if the substance is not standardized. And while clinical research on long-term side effects has not been reported, drawing from recreational users we know that marijuana impairs or degrades brain function, and intoxicating levels interfere with learning, memory, cognition and driving. Long-term use is associated with addiction to marijuana or other drugs, loss of motivation, reduced IQ, psychosis, anxiety, excessive vomiting, sleep problems and reduced lifespan. Without a standardized product and long-term studies, the safety of indefinite use of marijuana remains unknown.

3. There must be adequate and well-controlled studies proving efficacy. Twelve meta-analyses of clinical trials scrutinizing smoked marijuana and cannabinoids conclude that there is no or insufficient evidence for the use of smoked marijuana for specific medical conditions. There are no studies of raw marijuana that include high-quality, unbiased, blinded, randomized, placebo-controlled or long-duration trials.

4. The drug must be accepted by well-qualified experts. Medical associations generally call for more cannabinoid research but do not endorse smoked marijuana as a medicine. The American Medical Association: “Cannabis is a dangerous drug and as such is a public health concern”; the American Academy of Child and Adolescent Psychiatry: “Medicalization” of smoked marijuana has distorted the perception of the known risks and purposed benefits of this drug;” the American Psychiatric Association: “No current scientific evidence that marijuana is in any way beneficial for treatment of any psychiatric disorder … the approval process should go through the FDA.”

5. Scientific evidence must be widely available. The evidence for approval of medical conditions in state ballot and legislative initiatives did not conform to rigorous, objective clinical trials nor was it widely available for scrutiny.

Marijuana fails to meet any of these five criteria for accepted medical use in the United States. At present, it belongs in Schedule I.

Is Schedule I drug a roadblock to marijuana research? Not really. The major roadblock to five proposed studies at the California Center for Medicinal Cannabis Research was not the Schedule I label, but the scarcity of patients willing to enrol in five major clinical trials. The process for marijuana research could be streamlined by Drug Enforcement Administration oversight and expansion of marijuana production, and a special sub-category of Schedule I could further reduce paperwork. But moving marijuana to Schedule II “to promote research” is conceivably unethical, as marijuana would then be designated a safe and effective medicine in the absence of high-quality evidence.

Should we dismiss heartfelt appeals from people suffering various diseases, knowing that a host of chronic, debilitating ailments are inadequately managed? Human stories should not be ignored, and rigorous, creative solutions can be formulated in response. However, the “marijuana mess” and its “new realities” were created not by the federal government but by political processes designed to circumvent the FDA, the only federal agency that safeguards our nation’s medicines. If the more than $100 million spent on ballot and legislative initiatives instead had been used for quality clinical trials, our nation would know much more about the therapeutic potential of cannabinoids. Instead, “dispensary marijuana” is evolving into a human experiment without informed consent.

We revere the brain more than other body part because it is the repository of our humanity. When a brain disease strikes, it can fundamentally transform an individual. We schedule and restrict psychoactive drugs because they can negatively affect the human brain and behavior. Of brain diseases, substance use disorders are among the most lamentable forms of human anguish. They are also among the most preventable.

Source:  www.washingtonpost.com/news/in-theory/wp/2016/04/29/5

This new street drug is 10,000 times more potent than morphine, and now it’s showing up in Canada and the U.S.

It was first developed in a Canadian lab more than three decades ago, promising and potent — and intended to relieve pain in a less addictive way. Labeled W-18, the synthetic opioid was the most powerful in a series of about 30 compounds concocted at the University of Alberta and patented in the U.S. and Canada in 1984.

But no pharmaceutical company would pick it up, so on a shelf the recipe sat, the research chronicled in medical journals but never put to use. The compound was largely forgotten.  Then a Chinese chemist found it, and in labs halfway around the world started developing the drug for consumers in search of a cheap and legal high — one experts say is 100 times more potent than fentanyl and 10,000 stronger than morphine. [Deaths from opioid overdoses set a record in 2014]

And now it has come to North America. The substance first surfaced in Canada last fall, when Calgary police seized pills containing traces of the drug,according to the Calgary Herald. Then more than 2.5 pounds of W-18 was discovered in the home of a Florida man, who was sentenced to 10 years in federal prison after he pleaded guilty to smuggling fentanyl from China,reported the Sun Sentinel. He faced no charges for possessing the W-18, however, because it’s not yet illegal in the U.S.

And just last week, Health Canada’s Drug Analysis Service confirmed that four kilograms of a chemical powder seized in a fentanyl investigation in December 2015 was indeed the dangerous W-18 drug. Health officials are concerned for many reasons. There are currently no tests to detect the drug in a person’s blood or urine, according to reports, making it difficult for doctors to help someone who might be overdosing, a risk outlined in the drug’s 1984 patent.  Its effect on humans is largely unknown because W-18 was only ever tested on lab mice.

“Whenever this drug starts circulating on the streets you’re going to have deaths,” Sacramento-based forensic chemist Brian Escamilla told the Calgary Sun. Health Canada is working to have W-18 added to its Controlled Drugs and Substances Act.

The Drug Enforcement Administration has not made a formal statement warning of the hazards of W-18, but a spokesman for the department did tell the Calgary Sun that its unclear how far the drug has infiltrated the U.S. and alluded to reports suggesting W-18 is being cut with heroin and cocaine in Philadelphia.  If that’s true, the new drug could exacerbate the growing heroin epidemic.

The debut of W-18 also draws attention to the growing influence Chinese chemists have on the kinds of drugs entering the U.S. Last fall, China banned 116 different synthetic drugs, according to reports, including fentanyl and the deadly flakka, a drug that put south Florida in crisis mode. Since then, flakka has all but disappeared.

In its absence, however, Chinese drug manufacturers began producing alternatives to sell, including W-18, a DEA spokesman told the Calgary Sun.

“Instead of selling heroin in quarter-ounce, half-ounce quantities, you’re talking about micrograms of these substances that are 100 times more potent than fentanyl,” Baer said.

Source:  https://www.washingtonpost.com/news/morning-mix/wp/2016/04/27

The legalisation of cannabis financed by Soros and encouraged by Obama will lead to social decay

Fresh research has shown once again that cannabis is intensely harmful. A Swedish study of more than 45,000 men, published by The American Journal of Psychiatry, has revealed that those who used marijuana more than 50 times in their late teens were 40 per cent more likely to die by the age of 60 than those who never used it.

Study after study has flagged up the damage cannabis does to users and others in their ambit. Long-term potheads display on average an eight-point decline in IQ over time, a higher risk of psychosis and permanent brain damage.

They display more antisocial behaviour, such as stealing money or lying to get a job. They manifest more depression and demotivation, and conversely also a greater association with aggression and violent death.

Scientists from Britain, the US, Europe and Australia recently warned that the threat to mental health from heavy cannabis use was serious enough to warrant a global public health campaign.

If cannabis were legalised or decriminalised, more would use it. Untold millions more would then be enslaved to this drug. Given its numerous devastating side-effects, not to mention the gateway it provides to other illegal drugs, this would amount to a social catastrophe.

Almost without public comment, however, that is precisely what America is inflicting upon itself. It was President Obama who started this ball rolling. In his 2008 presidential campaign, he said he supported the “basic concept of using medical marijuana”. Subsequently, his administration has winked at serial violations of federal drugs laws.

Twenty-three states and the District of Columbia have legalised cannabis for “medical” purposes. Alaska, Colorado, Oregon and Washington have gone further and made recreational cannabis legal.

In Britain, many have fallen for the legalisers’ seductive siren song

Two years ago, Obama said he was “encouraged” to see states allowing greater access to marijuana. One wonders if he is encouraged by the outcome. The US government’s national survey on drug use and health reported in 2014 that one in ten Americans over the age of 12 had used an illicit drug in the previous 30 days, a higher percentage than in every year from 2002 to 2013.

In part, it said, this reflected the rising use of cannabis which had reached a similar record level. By an amazing coincidence, it turns out this rise was fastest in those states that had legalised the drug. Colorado legalised medical marijuana in 2006 and its recreational use in 2012. Now it leads the country in cannabis use by 12 to 18 year-olds over the past month, with Oregon fifth and Washington in sixth place. Between 2007 and 2009, an average 5.6 per

cent of Colorado’s high school students tested positive for cannabis. By 2012 this had soared to 57 per cent.

Of course it doesn’t stop there. “Soft” drugs open doors to hard drugs. So the US is also buckling under a wave of heroin and opiate addiction, described by a medical witness to the Senate judiciary committee last January as a “public health epidemic”.

While Obama lifted the bar, this epidemic is principally the result of the transnational multi-million dollar campaign to legalise drugs, funded in large measure by the financier George Soros.

He wrote in his autobiography that his remedy for drug abuse would be to establish a “strictly controlled distribution network” that he would run and through which he would make most drugs legally available.

According to Forbes magazine, he has spent some $200 million since 1994 campaigning for drug legalisation in the US and throughout the West. His globally embedded activist groups have distorted the entire drugs debate through their ubiquitous propaganda. Their core mantra is that “the war on drugs has failed”. On the contrary, in stubbornly prohibitionist Britain illegal drug use has been declining.

Legalisation, they claim, will end drug crime. Nonsense. Unless all drugs are distributed free of cost or without restrictions, there will always be a black market. Last year, Colorado’s attorney-general Cynthia Coffman admitted: “We have plenty of cartel activity in Colorado (and) plenty of illegal activity that has not decreased at all.”

In Britain, many whose ignorance is exceeded only by their credulity have fallen for the legalisers’ siren song. The all-party parliamentary group for drug policy reform, which has called for the possession and use of all drugs to be decriminalised and said users have a human right to feed their habit, states on its website that it has “received financial assistance from the Open Society Fund”, which is financed by George Soros.

The legalisers’ goal is overturning the UN drug conventions that underpin the criminalisation of the drugs trade. Recently, a special assembly of the UN General Assembly was convened at their behest to discuss drug policy reform.

Soros spent a reported $48 million on this alone. Soros-funded activists and their supporters claimed that 1,000 world leaders were calling for the decriminalisation and regulation of drugs. These alleged leaders, however, were largely Soros fronts and other legalisers. They failed. The UN and its member states decided to hold the line against illegal narcotics.

The US hasn’t done so. America has now embarked on a process that leads ineluctably to social and cultural decay, nudged into it by none other than the leader of the free world himself.

Source: The Times   MELANIE PHILLIPS April 26 2016

NDPA comment:  This article from Canada suggests that organised crime may well infiltrate a new drug policy regime.  We would suggest that at the street level successful small time dealers will not willingly give up their business either; they will simply undercut the price of legally obtainable marijuana and/or target the under-age customers who will not be allowed to purchase legally.

———————-

OTTAWA – Legalizing marijuana won’t automatically make Canada’s black market for weed go up in smoke or banish organized crime, warns a draft federal discussion paper on regulation of the drug.

Justin Trudeau’s Liberal government says a legal marijuana regime will keep pot out of the hands of children and deny criminals the profits of illicit dealing.

However, the December draft paper, obtained by The Canadian Press through the Access to Information Act, flags the ongoing involvement of organized crime — including possible infiltration of the new system — as a key issue the government must confront.

The Liberals plan to introduce legislation next year to remove marijuana consumption and incidental possession from the Criminal Code, and create new laws to more severely punish those who provide pot to minors or drive while under its influence. In the House of Commons, Public Safety Minister Ralph Goodale recently said the new system would do a far better job of stopping the flow of shady money “to illegal gangs and organized crime.”

The draft discussion paper outlines a more complex scenario.

“As the experiences of other jurisdictions and of the regulation of alcohol and tobacco in Canada have shown, regulating a substance does not automatically remove it from illicit markets as evidenced by importation and sales of contraband tobacco,” the paper says.

“Given the degree to which organized crime is currently involved in the marijuana market, they could continue to produce marijuana illicitly and may attempt to infiltrate a regulated industry.”

Canada’s illegal market for marijuana is estimated to be worth billions of dollars and organized crime is known to play a major role in illicit production, importation and distribution, the paper says. That means those who obtain pot — with the exception of sanctioned medical users — are exposed to criminal elements.

The paper warns of severe risks and consequences:

— Pressure from criminal elements to use more serious and dangerous drugs such as cocaine and crystal meth;

— Enticement of purchasers to become local distributors and therefore embark on a serious criminal path;

— Exposure to extortion, particularly those who do not pay for purchases or, if entangled in dealing, fail to follow orders or meet quotas.

The federal and provincial governments should have the power to levy taxes on marijuana, with Ottawa responsible for taxing manufacturers and importers, and provinces levying taxes at the retail level, the C.D. Howe Institute recommended in a recently published report.

The federal government should discourage black-market activity by defining the legal amount of pot someone can possess, as well as maintaining and building on penalties for illegal production and trafficking, the think tank argued.

“The challenge for policymakers is to set tax rates that do not foster an illicit market alongside legal sales.”

Source:  http://www.montrealgazette.com/health/organized+crime  3rd April 2016

“Between a battle lost and a battle won, the distance is immense and there stand empires” – Napoleon

The emperor Napoleon used two key interchangeable battle plans: manoeuvre and attrition. In the first, Napoleon’s main force held the enemy’s attention to his front, while other forces fell upon one of his flanks. The second poured frontal firepower into those he wished to overthrow in enormous amounts until they appeared to weaken, then great masses of men would be thrown in to smash their way through. Such a battle was costly affair. But it worked until Wellington beat him at Waterloo, in a far-from-guaranteed victory.

This week, history repeated itself. From 19-21 April, for the first time in almost 20 years, the United Nations held a General Assembly Special Session on the world drug problem and policy. This session, in New York, was the grand finale of heavily financed global pro-cannabis, pro-legalisation media manoeuvres. Taking up the rear, personal attacks including internet trolling were used to silence individuals wishing to prevent and reduce drug use worldwide – as my own and this website’s experience can attest. According to the Washington Times, over $48million was poured into this campaign by George Soros alone, a man feted for his philanthropic funding of international-policy and journalism schools and scholarships in strategic areas.

Another $70million of his firepower was directed to pro-legalisation organisations, enabling groups such as the International Drugs Policy Consortium (IDPC, funded also by unwitting taxpayers via the EU Commission) and Stop The Harm, to smash their way via a further 213 organisations into UNGASS debates.

“The pro-legalisation movement hasn’t come from a groundswell of the people. A great deal of its funding and fraud has been perpetrated by George Soros and then promoted by celebrities,” confirmed John Walters, former director of the White House Office of National Drug Control Policy. For example, Soros donated $5million in 2008 and more in 2012 for Barack Obama’s US presidential campaigns and has funded current presidential candidate Hillary Clinton. Soros’ accounts also show that he also donated at least $250,000 to former UN Secretary General Kofi Annan’s foundation with Annan most strongly adding his voice to the ranks of the pro-cannabis campaign.

The largest single recipient of Soros’s $200million largesse in this area since 1994, according to Forbes magazine is the Drug Policy Alliance headed by Ethan Nadelmann.

The outcome of all this investment has been, as no doubt planned, a constant salvo of headlines. “The war on drugs is dead,” wrote IDPC. “The best reasons why we must reform our drug laws,” blasted Richard Branson via the Virgin website, referring to and praising a pro-legalisation letter “brilliantly collated by the Drug Policy Alliance”.

And who else but the DPA called the press conference proclaiming that: “World leaders call for decriminalisation and regulation of drugs,” ironically referring to many of those it had itself been involved in funding. Dutifully and obediently, the Washington Post wrote that “More than 1,000 world leaders say the drug war has been a disaster” while the Huffington Post wrote of “Censorship and exclusion on Day One of UNGASS” (HuffPo and WP links to Soros). Abroad, Kerry Cullinan, director of South Africa Health News Service funded by – well you probably guessed – fired a broadside with “How to get rid of a ‘delusional, dangerous’ policy on drugs”. In the UK, Nick Clegg speaking on behalf of the Global Commission on Drugs Policy (GCDP) funded by – yes, you’ve guessed again –charged in, accusing Home Secretary Theresa May of tampering with a Coalition pro-legalisation report he’d engineered when deputy PM. Ironically, his attack merely succeeded in showing the ‘Portuguese Model’ of decriminalisation hadn’t emerged  so bright and shiny under scrutiny. The Lancet was also on hand to publish its sympathetic ‘scientific’ evidence for the legalisation cause. But then its editor chief editor, Sir Richard Horton, is a key adviser to the International Centre for Science in Drug Policy which in turn is funded by… do I need to repeat it again? Hence its promotion by Soros-funded Transform Drugs Policy Foundation. The British Medical Journal and the BMA have long given platforms to Transform to spin pro-drugs propaganda dressed up as science, as The Conservative Woman revealed in another blog.

All these roads, so to speak, trace back back to one source – to one man.

Given his massive investment and global campaign, many feared that this month’s United Nations’ session would mark the beginning of the end of drugs control. But to the surprise of many, the UNGASS battle didn’t play out as the legalising lobby hoped. “UN drugs summit opens with worldwide divisions laid bare,” came the BBC headline.

Yes, Jamaica defended its decriminalisation of possession of small amounts of marijuana; Canada stated its intention to liberalise drugs; and Switzerland argued for a four-pronged approach: prevention, therapy, damage limitation and repression.

But Iran stated it had seized 620 tons of drugs last year and was helping protect the world from “the evils of addiction”. Singapore, too, slammed calls for a soft approach. Indonesia called for a zero-tolerance approach.Cuba (please note) also opposed the legalisation of drugs and condemned any declaration suggesting them to be harmless: “It will be really difficult to solve the problems of mass production of and trafficking in drugs from the South, if the majority demand from the North [ie, US] is not eliminated”. Did Obama take this on board on his recent Cuban sojourn, I wonder?

But while US drug czar Michael Botticelli wobbled on the political tightrope, it was Russia and Putin who provided the most powerful resistance to the pro-legalisation campaign.

So, despite the barrage, on 19 April the United Nations, led by UNODC head Yury Fedotov of Russia, opted for a ‘new’ framework that wasn’t new at all. It reaffirmed the cornerstone principles of the global drug control system, emphasising “the health and welfare of humankind that is the founding purpose of the international drug conventions”.  Who won the UNGASS battle then? Not George Soros and his liberal American political allies, but the Russians filling the leadership void that the US under Obama has abandoned – with the backing of the majority of the world’s leaders (press: please note).

There was a Parthian shot. On the last day of the week, hors de combat, The Guardian proclaimed: “Legalise all drugs,’ business and world leaders tell UN”. Actually, the world leaders had agreed and signed the UN document. The Guardian referred merely to former leaders, members of the Soros-funded GCDP.

“You must not fight too often with one enemy, or you will teach him all your art of war,” Bonaparte advised. We have been taught much.

Source:  http://www.conservativewoman.co.uk/deirdre-boyd-strip-away-the-spin-and-the-world-has-again-trashed-drugs-thanks-russia-and-iran/   April 2016

* Marijuana Use Impairs Verbal Memory

Researchers at the National Institute on Drug Abuse (NIDA) are sounding the alarm over a possible increase in unknown cognitive and behavioral harms that widespread cannabis use may unmask.

A clinical review conducted by NIDA director Nora Volkow, MD, points out that as legalization of the drug for recreational and medical use spreads, vulnerable populations, especially adolescents, are exposed to toxic effects of the drug.

“This is not a problem that is specific to marijuana,” Dr Volkow told Medscape Medical News. “Young brains and drugs shouldn’t mix. Period.” The study was published in the March issue of JAMA Psychiatry.

Powerful Disruptors

Dr Volkow explained that young brains are engaged in a protracted period of “brain programming,” in which everything an adolescent does or is exposed to can affect the final architecture and network connectivity of the brain.

“Drugs are powerful disruptors of brain programming because they can directly interfere with the process of neural pruning and interregional brain connectivity,” she added.

In the short term, she said, this kind of interference can negatively affect academic performance. However, long-term use can impair behavioral adaptability, mental health, and life trajectories.

Currently, four states ― Colorado, Washington, Oregon, and Alaska ― as well as the District of Columbia have legalized cannabis for recreational use among adults. Twenty-three other states, plus the District of Columbia, also regulate cannabis use for medical purposes.

As a result of this rising tide of legalized marijuana, Dr Volkow and colleagues believed a more focused and in-depth study of its use and consequences was urgently needed.

Neuropsychological Decline

“Emerging evidence suggests that adolescents may be particularly vulnerable to the adverse effects of cannabis use,” the investigators write.

Several studies, for example, have shown that individuals who use cannabis at an earlier age have greater neuropsychological impairment and that persistent use of cannabis from adolescence was associated with neuropsychological decline from the age of 13 to 38 years. This was not found to be the case when cannabis was first used in adulthood.

There is also “fairly clear evidence” of structural alterations in a number of areas in the brain associated with exposure to cannabis, although some evidence suggests that concomitant drinking may explain some of the structural alterations attributed solely to cannabis use.

fMRI studies have also pointed to changes in neural activity among cannabis users, including inefficient processing during a working memory task.

Differences in neuropsychological test performance as well as in brain structures and function in cannabis users vs nonusers may well have been there before users took up the drug, the investigators note.

Evidence suggesting alterations in brain structure and function in cannabis users is inconsistent, and both areas evidently require further research.

“There is both preclinical and clinical evidence supporting the view that cannabis use is associated with an ‘amotivational’ state,” said Dr Volkow. The term “cannabis amotivational syndrome” is distinguished by apathy and difficulty with concentration.

She also notes that long-term, heavy cannabis use has been associated with underachievement in terms of educational pursuits.

On the other hand, it is also likely that diminished motivation could impair learning as well, she adds, inasmuch as tetrahydrocannabinol (THC), the active ingredient in cannabis, has been shown to disrupt reward-based learning.

“Amotivation in chronic heavy users may also reflect the fact that cannabis itself has become a major motivator,” Dr Volkow writes, “so other activities (eg, schoolwork) become demoted in the individual’s reward hierarchy.”

What now needs to be established is whether higher concentrations of THC might make the risk of developing amotivation or even addiction more likely, investigators add.

Cannabis and Psychosis

There is also a lingering controversy over whether cannabis can trigger psychiatric disorders, notably, psychotic disorders and schizophrenia.

“It is recognized that cannabis with a high THC can trigger an acute psychotic episode,” Dr Volkow writes.

However, she cautions that the extent to which cannabis can result in schizophrenia is still being debated, although the consensus is that cannabis use in those at risk for schizophrenia can trigger the disease and exacerbate its course.

Particularly at high doses, THC has been known to trigger schizophrenialike positive and negative symptoms.

Studies have also consistently shown an association between the use of cannabis and schizophrenia in cases in which cannabis use precedes psychosis.

“The association between cannabis use and chronic psychosis (including a schizophrenia diagnosis) is stronger in those individuals who have had heavy or frequent cannabis use

during adolescence, earlier use, or use of cannabis with high THC potency,” Dr Volkow and colleagues observe.

“From these studies, ever use of cannabis is estimated to increase the risk of schizophrenia by approximately 2-fold, accounting for 8% to 14% of cases, with frequent use or use of cannabis with high THC potency increasing the risk of schizophrenia 6-fold.”

Dr Volkow cautions that legitimate controversy remains as to how much cannabis use contributes to psychosis and the degree to which cannabis can precipitate psychosis in patients who have no genetic predisposition for the illness.

Key Questions

A number of key questions need to be adequately researched before a clearer picture emerges about the potential harms of cannabis use.

The first is, how much cannabis use is too much? Dr Volkow noted that it is not clear whether the effects of cannabis among heavy users apply equally to those who use cannabis much more casually.

The second is, at what age is cannabis use most harmful?

It is fairly clear that cannabis does have negative effects among adolescent users, the researchers note, but it may also have negative effects in older adults who undergo changes in brain plasticity and age-related cognitive decline, both of which could make them more susceptible to toxic effects of the drug.

“Physicians are in a key position to help prevent cannabis use disorder,” said Dr Volkow. “This will require that they screen adolescents and young adults for cannabis consumption and that they intervene to prevent further use,” she added.

In cases in which the adolescent or young person already suffers from the disorder, physicians need to tailor their intervention on the basis of the severity of the disorder and the presence of comorbidities, such as anxiety or depression.

“Science has shown us that marijuana is not a benign drug. The morbidity and mortality from legal drugs is much greater than that for illegal drugs, not because the drugs are more dangerous but because their legal status makes them more accessible and a larger percentage of the population is exposed to them on a regular basis,” she said.

“The current ‘normalization’ movement presses on with complete disregard for the evidence of marijuana’s negative health consequences, and this bias is likely to erode our prevention efforts by decreasing the perception of harm and increasing use among young people, which is the population most vulnerable to the deleterious effects of regular marijuana use.”

Contributor to Mental Illness

Commenting on the article for Medscape Medical News, Oliver Howes, MD, PhD, Institute of Psychiatry, King’s College London, United Kingdom, said he endorses the NIDA’s position on cannabis use.

“I agree that there are potential issues around the use of cannabis, especially if you start it early, in adolescence,” Dr Howes said.

“Early use seems to be what increases your risk of psychosis in particular, but it also seems to be associated with more marked effects generally, and we’ve certainly seen the effects of long- term, early cannabis use on the brain’s dopamine systems that are linked to effects on motivation, or rather the lack of motivation, that you commonly see in heavy cannabis users,” he added.

Dr Howes also shared the NIDA’s viewpoint that there is much that is not known about the long-term effects of cannabis use, especially heavy cannabis use.

He also noted that “as a physician, I quite commonly see young adults who started using cannabis at the age of 12, 13, and 14 and who have come to see me in early adulthood with mental health problems.

“And yes, I do think early cannabis use contributes to the mental health problems that we see later

Source:   Medscape Medical News  17th March 2016

Most of us who drink alcohol won’t die from liver disease – but it still kills more of us than diabetes and road deaths combined The recent report into life on the liver ward makes sobering reading. John has alcohol-induced dementia (Korsakoff’s syndrome) and doesn’t know where he is. Rita has cirrhosis of the liver and is homeless. Her life has spiralled downwards as a wine habit segued into damaging dependence. It’s easy to feel sorry for the Johns and Ritas, though most of us think it’ll never happen to us. But will it? Are we becoming a nation of drinkers and drunks? The UK death rate from liver disease has increased fourfold in the past 30 years as cheap alcohol has flooded our shores and our gullets. Alcohol-related emergencies resulted in over a quarter of a million admissions in 2013/14, most of whom were 45-64-year-olds, who see themselves as regular rather than binge drinkers. Jackie Ballard, the chief executive of Alcohol Concern, says “Alcohol is linked to over 60 medical conditions including cancer, diabetes and high blood pressure.” And the chief medical officer, Sally Davies is so concerned that she has published new and controversial guidelines on safe drinking. The good news is that the tide seems to be turning against alcohol use in the UK. The percentage of men drinking alcohol in a typical week fell from 72% in 2005 to 64% in 2012 (in women the fall was from 57% to 52%). Frequent drinking has also been reported to be in decline.  Most of us who drink alcohol won’t die of liver disease, just as many smokers don’t die of lung cancer. It’s a question of weighing the risks against the benefit that alcohol gives us. It’s my drug of choice but I wouldn’t pretend that it’s harmless.   The great British booze problem: how a few glasses a day has led to an epidemic for the NHS

How much alcohol is too much? Some can probably safely drink more than others; your size, genetics, lifestyle and state of your liver make a difference. But in general, less than 14 units, spread over at least three days a week should be OK. That’s just under a bottle-and-a-half of wine (ABV 13.5%), or an average of one 175ml glass per day. For beer drinkers, that’s less than five pints of higher strength beer (ABV 5.2%) a week.

The liver is a resilient and vital organ. With the kidneys, it acts as a waste-disposal system, filtering our blood of toxins. The liver plays a key role in digestion and also produces hormones, bile to digest fats and proteins for blood clotting. We have two kidneys, which is handy if one fails, but only one liver. Luckily, it can withstand a tremendous battering and still recover. We can survive on a liver that is only 30% operational; after that it gets critical.

Viruses, drugs, chemicals, toxins and some genetic conditions can take their toll on even the youngest and meatiest of livers. At first, these irritants cause inflammation, which is reversible. But long-standing damage causes cirrhosis, which is irreversible thickening (fibrosis) that stops the liver from functioning. We can’t live without a liver, so a transplant becomes the only option. Liver disease kills more of us than diabetes and road deaths combined and is the fifth-biggest killer now after heart attacks, cancer, strokes and lung diseases. It is the only major cause of death in the UK that is still increasing year on year. The hope is that as awareness rises and alcohol intake falls, the crowded NHS liver wards will become a thing of the past.

Source:  http://www.theguardian.com/society/shortcuts/2016/jan/25

DENVER — The family of a Tulsa man who shot himself Saturday night in Keystone, Colorado is blaming his suicide on his ingestion of edible marijuana candies, CBS Denver reports.

“It was completely a reaction to the drugs,” Kim Goodman said about her son Luke’s Saturday night suicide. Luke Goodman’s death is now the third death in Colorado linked to marijuana edibles.

The 23-year-old college graduate was in the midst of a two-week ski and snowboard vacation with family members. Saturday afternoon he and his cousin, Caleb Fowler, took a bus from Keystone to Silverthorne where Fowler says they bought $78 worth of edibles and marijuana.

“He was excited to do them,” Fowler told CBS4.

When the young men got back to Keystone, Fowler said they began ingesting the edible pot. He said his cousin favored some peach tart candies, each piece of candy containing 10 mg of the active ingredient in marijuana, the recommended dose for an adult consuming an edible.

But when Goodman consumed several and experienced no immediate effects he kept gobbling them up.  “Luke popped two simultaneously” after the first two didn’t seem to do anything, said Fowler.

Then he said Goodman took a fifth candy, five times the recommended dose. His mother says her son likely didn’t see the warning on the back of the container which says, “The intoxicating effects of this product may be delayed by two or more hours … the standardized serving size for this product includes no more than 10 mg.”

Several hours later Fowler said his cousin became “jittery” then incoherent and talking nonsensically.  “He would make eye contact with us but didn’t see us, didn’t recognize our presence almost. He had never got close to this point, I had never seen him like this,” Fowler said.

Fowler says Goodman became “pretty weird and relatively incoherent. It was almost like something else was speaking through him.”

When family members left the condo Goodman refused to join them. After they left he got a handgun that he typically traveled with for protection, and turned it on himself.

Summit County Coroner Regan Wood says the preliminary cause of death is a self-inflicted gunshot wound. As for the impact of the marijuana edibles, she said, “That’s what we’ve heard consistently.”

She said the impact the edibles had on Goodman will be more clear when toxicology results come back in a few weeks.   “It’s still under investigation,” said Wood.

While definitive answers may be weeks away, Kim Goodman, Luke Goodman’s mother, told CBS4 she knows why her son took his own life.

“It was 100 percent the drugs,” she said. “It was completely because of the drugs — he had consumed so much of it.”   She said her son was well adapted, well-adjusted and had no signs of depression or suicidal thoughts.

“It was completely out of character for Luke … there was no depression or anything that would leave us being concerned, nothing like that.”

Caleb Fowler echoed the feeling saying he fully believed the ingestion of so much marijuana laced candy triggered the suicide.  “He was the happiest guy in the world. He had everything going for him.”

A year ago a Wyoming college student jumped to his death from a Denver hotel balcony after eating a marijuana cookie. Witnesses said Levy Thamba Pongi was rambling incoherently after eating the cookie. The Denver coroner ruled “marijuana intoxication” was a significant factor in Pongi’s death.

Luke Goodman’s family is now planning a memorial service for Friday in Tulsa. His mother says she remembers her last interaction with her son.

“We both said ‘I love you’ and I said ‘Have a great week.'”

Kim Goodman told CBS4 she believes marijuana edibles should be removed from store shelves.  “I would love to see edibles taken off the market … I think edibles are so much more dangerous,” she said

Source:  cbs.news.com  26th March 2015

When the Reagans moved into the White House on Jan. 20, 1981, drug use, particularly among teenagers, was hovering near the highest rates ever measured. Of that year’s graduating class, 65 percent had used drugs in their lifetimes, and a remarkable 37 percent were regular drug users.

After the upheaval of the 1970s, Americans had chosen in Reagan a strong, optimistic leader to guide them to a more hopeful future. But there could be little real hope while one of the ’70s’ more damaging legacies—astronomic drug use—was consuming the rising generation.

Fortunately for that generation of young people, Ronald and Nancy Reagan were stronger than the threat.

Eight years later, when the Reagans left Washington, only 19.7 percent of 1989’s graduating class were regular drug users, a 47-percent reduction.

Eight years later, when the Reagans left Washington, only 19.7 percent of 1989’s graduating class were regular drug users, a 47-percent reduction. And the trend that began under their leadership persisted until it reached an all-time low of 14.4 percent in 1992, 61 percent lower than 1981.

While it is simplistic to credit Nancy Reagan alone with this downturn, it is impossible to ignore her leadership and the massive shift she led against the drug culture. Her off-the-cuff response to a young Oakland girl who asked her what to do if confronted with drugs became a clarion call: “Just say no.”

This clear, unequivocal stand against drugs galvanized the nation by placing a moral stake in the ground: Illicit drug use is wrong, harmful, and not compatible with a free society. It provided an example parents, teachers, community leaders, and especially young people could follow when confronting drugs.

Nancy Reagan succeeded in changing the culture. By the spring of 1989, illegal drugs were Americans’ number-one concern. Reagan’s call “to be unyielding and inflexible in your opposition to drugs” was even taken up by Hollywood. The dangers of drugs became a common theme on television programs, particularly those with family audiences, spurring discussions between parent and child.

In the days since Nancy Reagan’s passing, those who seek to normalize drug use have been working to obfuscate the clear evidence of success of the Reagan-era anti-drug efforts. “Just say no” was futile, they claim, ignoring the clear downturns in drug use that occurred when Americans united against drugs. For those who think drug use should be accepted and even encouraged, the clear and simple truth must be suppressed. The reality of drug use that every family member of an addict knows must be ignored.

But Nancy Reagan achieved her goal. She sought to change the nation’s ambivalence about drugs, and attitudes clearly changed.

Since 1975, the Monitoring the Future study has tracked both teen drug usage rates and how teen attitudes about drugs have changed over time. Understanding attitudes is

critical to drug prevention, because it is a foundation of behavior change, for good and ill.

It is exceedingly difficult to look at the major changes in youth attitudes toward drugs, as measured through “perceived harmfulness,” and not see the fruits of the cultural shift Nancy Reagan led. To take one example, in 1980, only 50 percent of high school seniors thought using marijuana “regularly” was harmful. By 1988, it was 77 percent, where it remained until 1993 (not coincidentally, during the Clinton administration, when drug use started creeping up again).

This leads us to where we are today. Not surprisingly, after eight years of an administration that downplays the dangers of drugs, refuses to enforce federal drug laws, and tacitly endorses drug legalization “experiments” in a few states, America’s

young people see drugs in a much more positive light. Only 32 percent now perceive using marijuana “regularly” as harmful, a number even lower than the drug-soaked 1970s. As would be expected, teen usage rates have begun to increase, as shown in The Heritage Foundation’s Index of Culture and Opportunity, with marijuana leading the way. This is happening at the same time that “commercialized” marijuana is breaking records for potency, and scientists are sounding the alarm about marijuana’s link to permanent neurological damage. Most concerning, heroin overdose deaths have increased a catastrophic 440 percent in the past eight years—and heroin use still, all too often, begins with marijuana use.

The “Just Say No” generation to whom Nancy Reagan dedicated herself can rightfully look back with gratitude for the protection she marshalled on their behalf.

In a 1987 letter to the actor Paul Newman, President Reagan extolled the first lady’s work on drugs: “I believe [Nancy] has done more and continues doing more than any other single individual, particularly with regard to young people to whom she is totally dedicated.” Her efforts resulted in millions of young people avoiding the lost opportunity, addiction, and even death that comes with drug use. In the face of today’s rising drug use and the accompanying increases in addiction and overdose deaths, political leaders and our cultural elites should revisit Nancy Reagan’s anti-drug legacy, for it offers a clear example of how powerful moral leadership can alter the fortunes of a generation. We would best remember her by following her example, right now.

Source: www.dailysignal.com 11th March 2016

Cannabis in First-Episode Psychosis Linked to Poor Outcomes * Early, Intensive Treatment for Psychosis Justifies Cost * High-Potency Cannabis Linked to Brain Damage, Experts Warn * Teen Marijuana Use Linked to Earlier Psychosis Onset

Cannabis use by patients with first-episode psychosis (FEP) is associated with significantly worse clinical outcomes over time, a large, retrospective study shows.

Investigators from King’s College London, in the United Kingdom, found that cannabis users were 50% more likely to be admitted to hospital in the 5 years after initial FEP treatment and that length of stays in hospital were longer for these patients.

“We also found that the poor outcomes associated with cannabis use may be linked to antipsychotic treatment failure,” study investigator Rashmi Patel, BMBCh, told Medscape Medical News.

“The findings of this study are important, as they highlight a need for greater emphasis to reduce the risks of cannabis use among people with FEP and to determine how to optimize treatment in this group of patients,” Dr Patel said.

Contributor to Treatment Failure?

Previous research has suggested that cannabis use is associated with an increased risk of developing a psychotic disorder, but until now, little was known about the effects of cannabis on individuals with an established psychotic disorder, said Dr Patel.

The researchers analyzed de-identified electronic health records for 2026 adults treated for FEP at a large mental health care service provider in Europe between 2006 and 2013. Patients were followed for up to 5 years.

At presentation for FEP, cannabis use was noted in the records of 939 individuals (46.3%), consistent with the high levels of lifetime cannabis use seen in other FEP studies, the authors note. In this sample, cannabis use was particularly common in young, single men.

Cannabis use was associated with increased frequency of hospital admission (incidence rate ratio, 1.50; 95% confidence interval [CI], 1.25 – 1.80) and increased odds of a compulsory admission (odds ratio, 1.55; 95% CI, 1.16 – 2.08). Cannabis use was also associated with a greater number of days spent in the hospital. During follow-up, length of stay progressively increased for cannabis users, from an average of 21 extra days within 3 years to 35 additional days within 5 years.

The records also showed that at initial presentation for FEP, cannabis users were more apt to be treated with clozapine (multiple brands), an antipsychotic used for difficult-to-treat schizophrenia, and to receive a higher number of individual antipsychotics (up to 11), which is a proxy marker for treatment failure, the investigators note.

To their knowledge, this is the first published study to “demonstrate the potential mediation of cannabis use with poorer outcomes by a failure of antipsychotic treatment,” they write.

Owing to the observational nature of the study, no firm conclusions can be drawn about cause and effect, they point out. However, they say their findings “highlight the importance of ascertaining cannabis use in people receiving care for psychotic disorders.” The findings should also “prompt further study to investigate the mechanisms underlying poor clinical outcomes in people who use cannabis and strategies to reduce associated harms.”

Teasing Out Confounders

Commenting on the findings for Medscape Medical News, Subroto Ghose, MD, PhD, University of Texas Southwestern Medical Center, in Dallas, said the study is interesting and demonstrates associations between initial cannabis use and poorer outcomes.

“There are, however, certain potential confounders that need to be teased out. The major ones are whether the subjects continued to use cannabis after the index admission. Are there differences between those who stopped using compared to those who continue to use cannabis? Many subjects who use cannabis also use other illicit drugs. How did other substance use impact the results of the study?” he asked.

Dr Ghose also noted that although the greater number of medications prescribed to cannabis users “could reflect non-responsiveness, there are several other reasons why a person could have been prescribed different medications. These include medication tolerability, side effects (as mentioned by the authors), and compliance. These data suggest the need for carefully designed prospective studies in this population,” Dr Ghose concluded.

The study received no specific funding. Several investigators have received funding from pharmaceutical companies, which are listed in the original article.

Source:  BMJ Open. Published online March 3, 2016. 

Survey shows marijuana use disorder linked to substance use/mental disorders and disability.

Marijuana use disorder is common in the United States, is often associated with other substance use disorders, behavioral problems, and disability, and goes largely untreated, according to a new study conducted by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health. The analysis found that 2.5 percent of adults — nearly 6 million people — experienced marijuana use disorder in the past year, while 6.3 percent had met the diagnostic criteria for the disorder at some point in their lives. A report of the study, led by Bridget Grant, Ph.D., of the NIAAA Laboratory of Epidemiology and Biometry, appears online today in the American Journal of Psychiatry.

“…Marijuana use can lead to harmful consequences for individuals and society.”

—George F. Koob, Ph.D., Director, NIAAA

“The new analysis complements previous population-level studies by Dr. Grant’s group that show that marijuana use can lead to harmful consequences for individuals and society,” said George F. Koob, Ph.D., director of NIAAA. In a recent report, Dr. Grant and her team found that the percentage of Americans who reported using marijuana in the past year more than doubled between 2001-2002 and 2012-2013, and the increase in marijuana use disorders during that time was nearly as large. The new study analyzed data about marijuana use that were collected in the 2012-2013 wave of NIAAA’s National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), the largest study ever conducted on the co-occurrence of alcohol use, drug use, and related psychiatric conditions.

The researchers interviewed more than 36,000 U.S. adults about alcohol use, drug use, and related psychiatric conditions. Notably, the current study applies diagnostic criteria for marijuana use disorder from Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to the NESARC data. In DSM-5, marijuana dependence and abuse are combined into a single disorder. To be diagnosed with the disorder, individuals must meet at least two of 11 symptoms that assess craving, withdrawal, lack of control, and negative effects on personal and professional responsibilities. Severity of the disorder is rated as mild, moderate, or severe depending on the number of symptoms met.

Consistent with previous findings, the new data showed that marijuana use disorder is about twice as common among men than women, and that younger age groups are much more likely to experience the disorder than people age 45 and over. The risk for onset of the disorder was found to peak during late adolescence and among people in their early 20s, with remission occurring within 3 to 4 years. Also in keeping with previous findings, the new study found that past-year and lifetime marijuana use disorders were strongly and consistently associated with other substance use and mental health disorders.

Dr. Grant and her colleagues also reported that people with marijuana use disorder, particularly those with severe forms of the disorder, experience considerable mental disability. They note that previous studies have found that such disabilities persist even after remission of marijuana use disorder. The researchers also report that only about 7 percent of people with past-year marijuana use disorder receive any marijuana-specific treatment, compared with slightly less than 14 percent of people with lifetime marijuana use disorder.

“These findings demonstrate that people with marijuana use disorder are vulnerable to other mental health disorders,” said Nora D. Volkow, M.D., director of NIDA, which contributed funding to the study. “The study emphasizes the need for such individuals to receive help through evidence-based treatments that address these co-occurring conditions.”

The study authors note the urgency of identifying and implementing effective prevention and treatment for marijuana use disorder. And with ongoing changes in the drug’s legal status at the state level and a shift in beliefs about the risks associated with its use, they also note that public education about the dangers associated with marijuana use will be increasingly important to address public beliefs that marijuana use is harmless.

As marijuana and alcohol are frequently used together, more research is also needed to understand the effects of combined use. Studies suggest that using marijuana and alcohol together impairs driving more than either substance alone and that alcohol use may increase the absorption of THC, the psychoactive chemical found in marijuana.

In June 2015, NIAAA published a study based on NESARC data showing that alcohol use disorder (AUD) was on the rise in the U.S. over the last decade. The results showed that nearly one-third of adults in the United States have an AUD at some time in their lives, but only about 20 percent seek AUD treatment.

About the National Institute on Alcohol Abuse and Alcoholism (NIAAA): The National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health, is the primary U.S. agency for conducting and supporting research on the causes, consequences, prevention, and treatment of alcohol abuse, alcoholism, and alcohol problems. NIAAA funds the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA) to determine the effects of problematic alcohol use on the developing adolescent brain and examine brain characteristics that predict alcohol use disorder. NIAAA also disseminates research findings to general, professional, and academic audiences. Additional alcohol research information and publications are available at

 Source: www.niaaa.nih.gov. March 2016

The well-funded movement to medicalize marijuana spreading across our nation calls out for caution and restraint. Activists claim that marijuana is a safe medicine but de facto, it is evolving into a gateway for marijuana legalization. The claim conflicts with current science, with intelligent public health policy, with rigorous standards of the drug approval process, and with best practices of medicine.

In 2014, Floridians wisely rejected legalization of marijuana as a medicine by their votes on a ballot initiative. This sensible outcome was shaped by enough funds to educate the public on the realities of this critical issue and to counter misinformation circulating in Florida. But once again, the persistent marijuana industry is knocking on the gates of Florida, this time through legislative action in the Florida state House. Florida Senator Rob Bradley, R-Orange Park, recently introduced an amendment to Florida Bill SB 460. In its original form, the bill limits the potency THC, of the main psychoactive, intoxicating, and addictive substance in marijuana, to 0.8%. The spirit of the bill was to provide access to cannabidiol, a candidate anti-seizure medication that has been essentially bred out of most of the marijuana sold in dispensaries nation-wide. Cannabidiol is not intoxicating, is not addictive, does not interfere with learning and memory, and may even oppose the psychosis induced by THC in susceptible people. In its original language, the bill allows for “low-THC cannabis”, the dried flowers of which contain 0.8 percent or less of tetrahydrocannabinol (THC), the main psychoactive and addictive component of marijuana and more than 10 percent of cannabidiol (CBD). The Bradley amendment is a “Hail Mary pass” or a “cloaking device” or a “stealth bomber” –choose your metaphor. It is a furtive attempt to circumvent the decision of sage Florida voters who turned down the medical marijuana ballot initiative in 2014. The original bill wisely set THC levels at 0.8%, which are not generally intoxicating. Instead of referring to low-THC-cannabis, the amendment (line 35 onwards) now refers to low-THC cannabis and/or medical cannabis. By not defining medical cannabis, nor stating limits on THC doses, it opens the floodgates to “anything goes” – unspecified THC levels in marijuana that may range from 0.8 percent to 80 percent. In its current amended form, SB 460 creates a marijuana industry, allowing high potency marijuana and marijuana edibles (cookies, sodas, candy), which are inherently hazardous and without any scientific evidence of medical safety or effectiveness. To circumvent FDA experts and the process, the marijuana industry and their advocates devised ballot or legislative initiatives, flooded public media, engaged in extensive lobbying of legislative bodies, with scientifically barren emotional claims. Whole plant marijuana as a medicine is not approved by the Food and Drug Administration (FDA), as the evidence is insufficient to fulfill rigorous criteria for approval. To weigh the scientific evidence within the legitimate drug approval process, the FDA convenes an expert team of chemists, pharmacologists, physicians, other scientists, statisticians who study thousands of pages of scientific data, before a decision is made to approve a drug and provide surveillance after approval. This effective and rigorous scientific process is reflected in physician and patient packet inserts of prescription drugs – they include the precise chemical composition of a drug that a patient will introduce into their body, how

often to use it, evidence-based safe doses, how frequently it should be taken, what types of studies were used to show the drug’s effectiveness for a specific condition, how long it takes to have an effect and stay in the body, how the body metabolizes the drug, drug interactions, who should/should not use the drug, a list of unwanted side effects and what proportion of people manifest them, adverse events, and precautions, and other information. This type of document does not exist in marijuana dispensaries. If a false claim is made or an adverse effect sets in, who will protect the public? If a pharmaceutical company makes a false claim for an approved drug, the FDA sweeps in and fines them. It has extracted over $10 billion from drug companies in the past few years for unapproved claims. If adverse events rise to unacceptable levels, the FDA can restrict use of the drug, or label the drug with a severe “Black Box” warning, or withdraw the drug. These protections don’t exist for marijuana; there is no recourse for patients. Why is whole plant marijuana not approved? Concerns focus on abuse liability, safety and effectiveness.

Abuse liability. Marijuana has high abuse potential, no currently approved medical use and is considered unsafe. At least 4.2 million Americans have a cannabis (marijuana) use disorder, with about 30.5 percent of current marijuana users harboring this problem. Long-time heavy users can experience a robust withdrawal, reflecting adaptive changes in the brain and body caused by the drug. Shortly after use, marijuana intoxicates and impairs higher brain functions, learning, memory, planning, and decision-making. Driving skills are reduced and the risk for injuries increases. Functioning at school or at work is compromised, especially because marijuana takes so long to clear from the body, days to weeks, and much longer compared with an alcohol binge. Complex human performance can be impaired as long as 24 hours after smoking a moderate dose of marijuana and the user may be unaware of the drug’s influence. For 7 to 20 days, abstinent marijuana users may have impaired attention, concentration and impulse control. The most robust, durable deficits are documented in heavy, steady marijuana users. Even after one month of withdrawal, daily, heavy marijuana smokers can manifest impaired higher brain functions. Yet the indications for marijuana are for chronic medical conditions, requiring daily or more frequent use.

Safety. There is a strong association between marijuana use and psychosis or schizophrenia, in at least four ways: (1) marijuana can produce transient schizophrenia-like symptoms in some healthy individuals; (2) in those harboring a psychotic disorder, marijuana may worsen the symptoms, trigger relapse, and negatively affect the course of the illness; (3) susceptible individuals in the general population develop a psychotic illness with heavy marijuana use, which is associated with age of onset of use, strength of THC in marijuana, frequency and duration of use; (4) marijuana use is associated with lowering the age of onset of schizophrenia. Among youth, marijuana use is associated with poor grades and with high school drop-out rates, with those dropping out of school engaging in high rates of frequent marijuana use. Early use of heavy marijuana is associated with lower income, lower college degree completion, greater need for economic assistance, and higher unemployment. In sum, marijuana use is associated with an increased risk of degraded brain function, increased motor vehicle crashes, emergency department visits, psychiatric symptoms, reduced educational and employment achievement, reduced motivation, increased use of, and addiction to other drugs, and adverse health effects on the developing fetus. Effectiveness. The FDA is not the only body that has questioned the effectiveness of marijuana. Non-government academic physicians and scientists have extensively scrutinized biomedical research (meta-analyses) on the use of whole plant marijuana for medical indications. Independently, they have concluded that there is scant, inadequate or no evidence that whole plant medicine is valuable as a first line treatment for a myriad of medical conditions claimed by the marijuana lobby. For edibles, rigorous evidence is at zero or near-zero levels. Indeed, many specialty medical associations

(Neurology, Psychiatry, Ophthalmology, Pediatrics) do not endorse marijuana as a medicine. Clearly, this collective information impacts the amended Florida bill! First, the amendment places no limits on THC concentration, and does not address marijuana potency to be used for a single medical condition. No potency limits for chronic conditions are incompatible with growing evidence that the stronger the marijuana and the more frequently it is used, the more likely (1) for symptoms of psychosis to appear, (2) for reduced age of onset of schizophrenia, (3) for increased impairment of driving and brain function. Second, in chronic medical conditions, daily and more frequent use of marijuana is likely and this will increase the many risks outlined above. Third, the amendment is vague on who can use, at what dose and for which specific diseases or symptoms. Yet, the more frequently marijuana is used and the longer the period of use, the more likely (1) for susceptible persons to become addicted to marijuana; (2) to become addicted to other drugs; (3) to sustain a reduction in I.Q.; (4) to be on welfare and unemployed; (5) to have psychotic episodes; and (6) to be less likely to complete high school or college. The Bradley amendment, whether intended or not, is likely to set Florida on a well-trodden path to legalization of marijuana. Its current objective is to normalize and legalize distribution of potent, intoxicating marijuana as a medicine, in the absence of solid medical evidence. If it passes, the safeguards in the amended bill will not protect the public from an inevitable march towards unfettered access to, and de facto legalization of marijuana. The bill has little to do with compassionate use of marijuana for health, as open-ended THC doses have no scientific basis in medicine. But it will ensure that high potency marijuana becomes available to the public at large, inevitably spreading to youth, the real target of the marijuana industry. Early onset of marijuana use greatly increases the risk of becoming addicted to marijuana and to other drugs. Efforts to shield youth from marijuana have failed in states with “medical marijuana” laws as in these states, youth use marijuana more than in nonmedical marijuana states. This amendment ignores the FDA, ignores meta-analyses completed by independent biomedical researchers, ignores the policy statements of reputable medical associations, and ignores current marijuana science. In 2014, Floridians wisely voted not to accept THC-laden marijuana as a “medical option”. Senator Bradley’s current amendment maneuvers the bill around the will of the people. Above all, this bill ignores the voters of Florida and the democratic process. Floridians should protest this amendment, a blunt force to suppress their opposition to marijuana. Bertha K. Madras is a professor at Harvard Medical School.

Source: http://www.sunshinestatenews.com 2nd March 2016

The lobby calling to decriminalise drugs focuses too much on gang violence. This overlooks death and health destruction among drug users. Photograph: Lawrence Lawry/Science Photo Library
The real horror of drugs stems not from gangs selling them, but from their effects on users, writes Chris Luke.

The wonderfully mischievous Mae West memorably skewered the perennial dilemma surrounding illicit intoxication when she quipped, “To err is human, but it feels divine!” And of course, it is a truth – almost universally acknowledged – that humans love to self-medicate, to seek oblivion and respite from the “grim predicament of existence”, with whatever mind-altering substance they can get hold of, be it 21st century psychotropic or ancient herbal concoction.
It seems equally likely that a debate has raged for ever between those who fret about the effects of such intoxicants on humanity, and those who see them as divine anaesthetics, soporifics and tonics.

The problem with contemporary substance misuse is mainly to do with its sheer scale and unnatural geography. These can be attributed to the global trading which took off in the 17th century, and to modern chemistry which led in the mid-19th century to the refining of organic produce into powders and liquids. These could be conveniently consumed by wealthy Europeans and Americans in a variety of oral, smoke-able and injectable formulations.

The acceleration, since Victorian times, of mechanised global trading and the dissemination of simplified chemistry kits now means that all sorts of chemical contraband are routinely transported thousands of miles from their source, and are easily and universally available for a small sum.

The illicit drug trade is arguably the most successfully globalised of all. Unfortunately, this enormous commercial success for “drug barons” (and sometimes the difference between life and death for dirt-poor drug-cultivators) has created a global pandemic of substance misuse with immensely problematic consequences.

For the most part, these tend to be viewed through the prisms of crime control and drug addiction treatment, and a remarkable number of commentators are now arguing – as did Dr Paul O’Mahony recently in these pages – for “decriminalisation” as the solution. Their central thesis is that it is the violent drug gangs which cause the main problems associated with substance misuse, and that legalisation would squeeze these menacing middlemen out of the equation.

Sadly, I think that this is extraordinarily naive and completely misses the point.
As a doctor who has been on the “receiving end” of industrial levels of substance misuse for many years (in inner-city hospital emergency departments in Dublin, Edinburgh, Liverpool, and now Cork), I am convinced that the question of “legality” of drugs is largely irrelevant in terms of the hazards of drugs to society in general and people’s health in particular.

Putting it very simply, the criminality of users is almost never an issue. It is the deaths, destruction of health and communities and the distraction from the primary function of the emergency department, due to substance misuse, that are of interest to me.

And as for Fintan O’Toole’s recent assertion, in The Irish Times, that “there is no great evidence that the demand is actually higher now . . . than it was a century ago”, I would point out that there is no funding for research into the healthcare frontline workload. So he will have to take my word that, while the appetite for them may not vary much over time, the intoxicants du jour in Ireland are much more worrisome than they were, say, in the post-war period, adding incalculably as they do, in terms of complexity and labour-intensity, to the existing tobacco and alcohol burdens.

The notions of “legalising”, “purifying” and “controlling” once-illegal drugs are frankly laughable in today’s risk-averse society. But drug users (including those who consume alcohol and tobacco) are prone to utter hypocrisy and self-delusion when it comes to their own prescriptions.

The fact is that people are no longer prepared to accept even minimal levels of risk when it comes to existing, legal and fastidiously purified pharmaceuticals (thalidomide is notorious but all medicines carry a risk of occasionally tragic adverse effects) and patients eagerly litigate, even after rare and unpredictable complications from the medications they have been prescribed.

The same would immediately apply to consumers of (hypothetically) legalised “hard drugs” like cocaine and heroin – and even cannabis – whose natural (ie “pure”) effects will always be unpredictably catastrophic for some individuals and inevitably disastrous for society, as dysphoric or delirious people interact with their hazard-ridden environment, as well as with other individuals who may often be less than sympathetic to their drug-addled fellow citizens. In addition, just because a commodity is legal doesn’t mean that it won’t be of interest to criminal gangs: think petrol, tobacco and alcohol and simply look North, after all.

Setting aside such specious reasons for “decriminalising” drugs, it is vital that people grasp the pivotal reality about drug misuse: the hideous and worsening global epidemic of violence – be it in British and Irish cities or Caribbean hotel rooms – is primarily fuelled by the effects of alcohol, cannabis and cocaine on the human psyche, and not by the illegality of the drugs. Drugs (including drink) derange. That is the whole point of taking them, and those who are easily or already deranged will do terrible things to the people around them as a direct result.

Sadly, “anti-prohibitionists” continue wilfully to forget that before drugs (like cocaine, cannabis or opium) were illegal, they were legal – with violent, woeful consequences. My greatest fear is that the ignorance of this seems invincible.

Chris Luke is consultant in emergency medicine in Cork University Hospital and Mercy University Hospital, Cork.

Source 2008 The Irish Times Monday, August 4, 2008