The risk of developing psychosis is more than tripled for those who abuse cannabis, according to results from a new twin study.

Researchers from the Norwegian Institute of Public Health (NIPH), together with colleagues from Virginia Commonwealth University, examined the relationship between cannabis and psychosis using psychiatric interviews of Norwegian twins. The interviews reveal whether the twins had symptoms of psychosis and cannabis abuse.

“Previous research has shown that patients with psychotic disorders use cannabis more often than the general population. However research has been divided over whether cannabis use was the cause of the psychotic disorders,” says Ragnar Nesvåg, senior researcher at NIPH and the main author of the study.

Genetic factors influence both cannabis abuse and psychosis and the same genes may lead to an increased risk for both problems. “The relative importance of genes in the causes of a disease is known as heritability, and we know from previous studies at the NIPH that cannabis abuse is very heritable, explains Eivind Ystrom, senior researcher at NIPH. “In order to determine whether cannabis abuse can lead to psychosis, it is important to account for genetic risk,” he adds.

The researchers therefore tested both the hypotheses that cannabis use causes psychotic symptoms and that psychotic symptoms lead to cannabis abuse.

Abuse increased the risk by 3.5

The hypothesis best suited to the data was that cannabis abuse caused symptoms of psychosis. Within a twin pair, the twin with symptoms of cannabis abuse had a 3.5 times higher risk of developing symptoms of psychosis compared with the twin who did not have symptoms of cannabis abuse.

“Our analyses showed a significant association between cannabis abuse and symptoms of psychosis in the general population. We also tested the hypothesis that symptoms of psychosis caused cannabis abuse, but the hypothesis was less suited to the data. Therefore, it appears that cannabis abuse can be a cause of psychosis,” says Ystrom.

Confirmed high heritability

Previous studies have shown that cannabis abuse is very heritable, which was also confirmed in this study. As much as 88 per cent of the causes of why some people abused cannabis, yet others did not, could be attributed to some people having risk genes.  Despite this, the researchers found that a common genetic risk could not explain the entire association with symptoms of psychosis. Even after genetic risk and risk of childhood environment were taken into account, people with cannabis abuse still had a multiplied risk of developing symptoms of psychosis. Nesvåg says that psychosis is associated with huge costs to society. These findings should be considered when evaluating the cost of policies for increased cannabis availability, such as decriminalisation or legalisation.

About twin studies

Investigating whether a particular risk factor causes disease requires studies where you look at two people who are otherwise identical, where one is exposed to a risk factor and the other is not. The effects on their health can be investigated. For obvious reasons, these experiments are neither practical, ethical or legally feasible.

Studying twins is a viable option because they have genetic similarity, they have grown up in the same family, and they have the same socioeconomic background.

More information: Ragnar Nesvåg et al. Genetic and Environmental Contributions to the Association Between Cannabis Use and Psychotic-Like Experiences in Young Adult Twins,

Source:  Schizophrenia Bulletin (2016). DOI: 10.1093/schbul/sbw101  Provided by: Norwegian Institute of Public Health

If Marijuana is Medicine, How Come it Makes People So Sick?

There’s a great irony that comes from the pot industry’s claims that marijuana is medical and it’s supposed to help with nausea.   It’s called Cannabis Hyperemesis, and it hits with a vengeance.

This past week a parent wrote to PopPot, saying: “Parents should watch for red flags of pot use in their children including frequent, long hot showers; weight loss; unexplained nausea and vomiting.”

“I took my teen to the doctor assuming the stress of a rigorous course load combined with the demands of an after school sport were taking a physical toll on my child, ” the mom wrote.  “In hindsight, these were the signs of escalating pot use as described in this Pub Med article about cannabinoid hyperemesis. Unfortunately many in the medical community are ignorant of the detrimental effects of pot use on our young people —  ranging from psychotic breaks to debilitating gastrointestinal symptoms.”

From another mother in Pueblo, Colorado who also wrote this past week:  “Last week I met a 14-year-old girl suffering from Cannabis Hyperemesis Syndrome.  When I met her, at first I thought she had an addiction to meth because she was so very thin and malnourished.  She was asking me how can she return to live with her parents who are marijuana users when marijuana is so toxic for her.”

Incidences of this severe illness appear to be on the rise since the rollout of legal weed.  The high THC content of today’s weed — 5x the amount in the 1980s — seems to be involved also.  Because of misdiagnosis or denial of drug use by patients, this syndrome is going undetected.  Furthermore, users self-medicate and exacerbate this severe illness, as a medical marijuana patient was doing for more than eight months.

From veterans hospitals to addiction specialists as well as gastroenterologists, there’s suddenly an increased interest in and diagnoses of this condition.  Further research into this mysterious illness turns up numerous medical journal articles on the link between excessive and/or long-term cannabis use and hyperemesis.

Cannabis Hyperemesis: How to Know if You or Someone You Love is Afflicted

This syndrome is still largely unknown throughout the medical profession and even among cannabis users. The most prominent cases are among long-term users that started using the drug at a very early age and have used daily for over 10 years, according to the MedScape article, Emerging Role of Chronic Cannabis Use and Hyperemesis Syndrome. The article goes on to say that it can also effect newer users and even non-daily users.

In Practical Gastroenterology, there’s a case of a 19 year old Hispanic man who contracted the problem within only two years of marijuana use.  Symptoms reported in a Current Psychiatry article include cyclic vomiting, abdominal pain, nausea, gastric pain and compulsive hot bathing or showers to ease pain.  Frequent bathing and vomiting can also lead to dehydration and excessive thirst. Mild fever, weight loss, and a drop in blood pressure upon standing are other symptoms.

Sufferers find they need to take many showers or baths a day just to get relief from the chronic nausea and vomiting. The bouts of illness are so severe and frightening they lead to frequent trips to the emergency room. And finally, this debilitating illness can be very disruptive to life and relationships. The many absences from work lead to job loss and the inability to hold down a job.

Parents may mistake this situation as bulimia, particularly if the teens hide the vomiting.  Another common way this disease is misdiagnosed as cyclic vomiting syndrome. According to the Current Psychiatry article, 50% of those diagnosed with CVS are daily cannabis users.  Another common misreading by doctors of the compulsive habit of frequent hot baths is as Obsessive Compulsive Disorder.

Further complicating matters, doctors find that even when cannabis use is consistent, the bouts of hyperemesis come and go, which further serves to keep the patient in denial about the connection to their drug use.

In Spite of Cannabis Hyperemesis, Addiction is a Stronghold

Complete cessation of marijuana use is the only known cure for Cannabis Hyperemesis Syndrome.

Sadly, even those who have greatly suffered over a long period of time, still want to be able to consume marijuana. The claim by the industry that marijuana is not addictive is easily disproved when you see the comments to a High Times article, What is Cannabinoid Hyperemesis Syndrome?  Not only do many commenters admit they suffer from this detrimental effect of this drug, they confess they still love marijuana. The commenters lament having to give up their stoner lifestyle even after years of disabling illness! A number of them state that once they are well, they plan to return to the habit, albeit to a lesser degree.

Source:  http://www.poppot.org/2016/11/19/cannabis-hyperemesis-toxic-side-effect-of-dangerous-drug/   19th Nov. 2016

The surgeon general’s recent report is a much-needed call to arms around a public health crisis.

On Nov. 17, Dr. Vivek Murthy, a vice admiral of the U.S. Public Health Service Commissioned Corps and U.S. surgeon general, issued a timely and much-needed report on what has become a public health crisis and menace in this country – namely, misuse and addiction to legal and illegal psychoactive drugs.

In the report preface, Murthy remarks that before starting his current job he stopped by the hospital where he had practiced. It was the nurses who said to him, he writes, “please do something about the addiction crisis in America.” He knew they were right, and he took their wise counsel.

Why are they right? Substance use disorders, where a person is functionally impaired and often physically dependent on a drug, affect nearly 21 million Americans annually – the same number of people who have diabetes and 150 percent of those with a cancer diagnosis, of any type.

In 2015, about 67 million people reported binge drinking in the past month, and 48 million were using illegal drugs or misusing prescribed drugs. In the past year, 12.5 million Americans reported misusing prescription pain relievers. In 2014, 47,055 people died from a drug overdose, with more than half of those using an opioid (like OxyContin, Percodan, Vicodin, methadone and heroin).

The numbers chill the mind, and yet with the widespread use, abuse and potentially deadly consequences, only 1 in 10 of those with a substance use disorder obtain any treatment. The nurses to whom Murthy spoke were surely seeing the consequences of drug misuse in their emergency rooms, clinics and inpatient units. They also were likely seeing the consequences among their family, friends and co-workers. (Health professionals are prone to misuse alcohol and drugs.)

What distinguishes the surgeon general’s report is its call for a long overdue shift in alcohol and drug policy – away from a criminal justice approach to a clinical or public health approach. What also distinguishes every cover note and chapter is a spirit of hope, that substance use can be prevented, detected early, effectively treated and its manifold adverse impacts mitigated.

To start, the surgeon general urges that we begin by “improving public awareness of substance misuse and related problems.” Negative attitudes, critical judgments and moral invective towards people with addiction not only interfere with delivering good care they deter people who need services from getting them.

But the report also makes clear that there is no single solution or path, nor should we expect one with problems this broad and deep. The heart of the report then, chapter by chapter, speaks to comprehensive policy action: prevention, early intervention, ongoing treatment, so-called wellness activities, identifying and reaching out to high-risk populations and supporting research efforts.

Central to the report is that we must integrate health care services with substance use treatment: not by referral from one to the other but by embedding screening and basic forms of treatment into primary care and family practice. We screen for hypertension, lipids, diabetes and much more; why aren’t we screening for problem alcohol and drug use where these problems are most likely to appear? Screening, Brief Intervention and Referral for Treatment, or SBIRT, is perhaps the best-known and most effective means of extending substance screening and management into the general health system.

Of course, all these efforts must be financed. A powerful argument can be made that it costs more to not treat these conditions than to treat them. Substance use disorders cost the U.S. more than $400 billion every year on health care expenses, criminal justice costs, social welfare consequences and lost workplace productivity. However, our health, social welfare and criminal justice systems are simply too siloed, (separated) and we pay the human and financial price of not reaching across the ersatz boundaries of government and community agencies.

Still, some laws are making inroads to improve care. The Affordable Care Act requires treatment for substance use disorders to be an “essential benefit,” no different from any other illness. The 2008 Federal Parity Act, now finally with regulations, also requires insurers to not discriminate against people with addictions. The policy and legislative pillars are there, and we need to keep using them.

The surgeon general ends his report with a vision for the future. He is deeply sanguine that we can disrupt the addiction epidemic that has seized our country. The path is a public health one, as I have illustrated above, but the report talks also of what individuals and families can do: reach out to those we see in trouble, withhold judgment, support those in recovery, and, for parents, talk to your child about alcohol and drugs. “Making [these changes] will require a major cultural shift in the way Americans think about, talk about, look at, and act toward people with substance use disorder,” the report reads. “For example, cancer and HIV used to be surrounded by fear and judgment, but they are now regarded by most Americans as medical conditions like many others.”

We owe a great thanks to the surgeon general and the many experts and advocates who put together this call for how we can respond to what is now a public health crisis. We can do that. It will be hard, but the alternative of not taking collective action will be far harder to bear.

Source: http://www.usnews.com/opinion/policy-dose/articles/2016-11-21/surgeon-general-is-right-to-target-the-public-health-crisis-of-addiction

Nora D. Volkow, Aidan J. Hampson, and Ruben Baler

Abstract:

INTRODUCTION

The search for a state of mental relaxation and well-being is one of the factors driving the widespread consumption of cannabis. The most frequently abused illicit substance worldwide, cannabis is consumed regularly by about 2.4% of the world population (approximately 181 million people in 2013) (1).

The principal psychoactive component of cannabis is_9-tetrahydrocannabinol (THC), which acts as an orthosteric agonist for cannabinoid receptors and mediates both the positive and negative effects of cannabis. The cannabinoid receptors are part of the brain’s endocannabinoid system (ECS), which modulates multiple neurobiological processes including reward and stress, a fact that is relevant for understanding not just the recreational use of cannabis but also its therapeutic potential.

This review focuses on the role of the ECS in the modulation of stress responses, its interaction with the reward system in the brain, and the implications of this emerging understanding for cannabis abuse, mental illnesses, and therapeutics.

CONCLUSIONS

Cannabis has been used for centuries across the globe. However, the recent changes in laws regarding legalization of recreational or medicinal cannabis, along with the availability of cannabis with increasingly higher THC levels (94, 163), are generating a sense of urgency for understanding the potential adverse effects of cannabis exposure as well as its purportedly medicinal actions.

Although many studies have been published on deleterious effects of chronic cannabis vis-´a-vis cognition, emotion, and psychiatric symptoms, the findings are inconsistent, which has made it easier for proponents of cannabis legalization to dismiss them and wrongly claim that cannabis use has no harmful effects. At the same time, major advances in our understanding of ECS neurobiology have opened exciting new opportunities for the development of novel, smarter medications for psychiatric and neurological disorders.

Source:     Annu. Rev. Pharmacol. Toxicol. 2017. 57:2.1–2.23

Repeated binge drinking during adolescence can affect brain functions in future generations, potentially putting offspring at risk for such conditions as depression, anxiety, and metabolic disorders, a Loyola University Chicago Stritch School of Medicine study has found.

“Adolescent binge drinking not only is dangerous to the brain development of teenagers, but also may impact the brains of their children,” said senior author Toni R. Pak, PhD, an associate professor in the Department of Cell and Molecular Physiology of Loyola University Chicago Stritch School of Medicine.

The study by Dr. Pak, first author Anna Dorothea Asimes, a PhD student in Dr. Pak’s lab, and colleagues was presented Nov. 14, 2016 at Neuroscience 2016, the annual meeting of the Society for Neuroscience

The study, which was based on an animal model, found that adolescent binge drinking altered the on-off switches of multiple genes in the brains of offspring. When genes are turned on, they instruct cells to make proteins, which ultimately control physical and behavioral traits. The study found that in offspring, genes that normally are turned on were turned off, and vice versa.

Teenage binge drinking is a major health concern in the United States, with 21 percent of teenagers reporting they have done it during the past 30 days. Among drinkers under age 21, more than 90 percent of the alcohol is consumed during binge drinking episodes. Binge drinking is defined as raising the blood alcohol concentration to 0.08 percent, the legal driving limit, within two hours (generally about five drinks for a male and four drinks for a female).

In the study, one group of adolescent male and female rats was exposed to alcohol in amounts comparable to six binge drinking episodes. The rats mated after becoming sober and the females remained sober during their pregnancies. (Thus, any effects on offspring could not be attributed to fetal alcohol syndrome.) The alcohol-exposed rats were compared to a control group of rats that were not exposed to alcohol.

In the offspring of alcohol-exposed rats, researchers examined genes in the hypothalamus, a region of the brain involved in many functions, including reproduction, response to stress, sleep cycles and food intake. Researchers looked for molecular changes to DNA that would reverse the on-off switches in individual genes. They found 159 such changes in the offspring of binge-drinking mothers, 93 gene changes in the offspring of binge-drinking fathers and 244 gene changes in the offspring of mothers and fathers who both were exposed to binge drinking.

The study is the first to show a molecular pathway that teenage binge drinking by either parent can cause changes in the neurological health of subsequent generations.  While findings from an animal model do not necessarily translate to humans, there are significant similarities between the study’s animal model and humans, including their metabolism of alcohol, the function of the hypothalamus, and the pattern and amount of binge drinking, Pak said.

The study was supported by a grant from the National Institute on Alcohol Abuse and Alcoholism. It is titled “Binge alcohol consumption during puberty causes altered DNA methylation in the brain of alcohol-naive offspring.”

Source: Loyola University Health System Article ID: 664605 http://www.newswise.com/articles/view/664605/?sc=dwtn  10th Nov. 2016

By Dr. Carlton E. Turner

As the former Drug Czar under President Ronald Reagan, with an extensive background in marijuana research, I thought I should share some of my thoughts about ‘medical’ marijuana.

From 1970 to 1981, I held various positions at the Research Institute of Pharmaceutical Sciences, School of Pharmacy at the University of Mississippi. During this time, I published over 100 original papers, chapters in books, patents, and two large Marijuana Bibliographies covering marijuana research starting in the 1880s. I also served as the Director of the federal government’s Marijuana Project.

That research project was funded by the National Institute of Mental Health and the National Institute on Drug Abuse. The project grew Cannabis sativa L. plants from seeds obtained from over 100 sites worldwide. We processed the plant material into marijuana and supplied this standardized research marijuana to researchers throughout the world. All of the marijuana shipped was analyzed by a procedure developed at the University and recognized as the world standard by the United Nations Narcotic Laboratory.

Now that you know a bit of my background let me give you the facts about marijuana:

Marijuana is a very crudely prepared drug comprised of the dried leaves, small stems, and flowers of the Cannabis plant. Marijuana contains unique chemicals called cannabinoids. Cannabinoids have biological activity and have been the subject of thousands of research studies since the 1970s. Some cannabinoids can be medicinal and have been regulated by the FDA, and prescribed by licensed physicians since 1985.

The synthetic form of the major psychoactive ingredient in marijuana, Delta-9-THC (Delta-9-tetrahydrocannabinol), known as Marinol®, is prescribed daily by physicians for nausea, vomiting, as an appetite stimulant for AIDS patients, and to ease the pain in multiple sclerosis patients. Another drug, which has been approved by the FDA is the Nabilone, a synthetic cannabinoid, which is prescribed for vomiting in patients undergoing cancer treatment.

Pro-drug groups, marijuana users, the media, politicians, and those wanting to profit from marijuana sales distort the truth about FDA-approved cannabinoid drugs and all cannabinoid research findings. They claim that society should not use marijuana derivative drugs approved by the FDA. That only “natural” marijuana should be used as medicine. To further cloud the facts, medical reporters claim marijuana works for many ailments, but in reality, they are referring to cannabinoid drugs.  The marijuana legalization advocates want to confuse the public to accept that ‘natural’ marijuana as a panacea for any human condition, and falsely claim it is safe to use as an unregulated “medicine.” But this so-called “medical marijuana” is a fraud and a con job.

The fact is that marijuana is a dirty drug with so many different side effects that it will never pass the required safety and efficacy testing for medicine. Marijuana can contain over 700 individual chemicals, and when smoked the number of chemicals expand to the thousands. The smoke contains 50 percent to 70 percent more cancer-causing compounds than tobacco. To argue that the “natural” plant form of marijuana should be used over FDA approved marijuana derivatives is like telling a mother whose child is suffering from a bacterial infection that she should offer her child moldy bread instead of penicillin. Think about the life expectancy when people took herbs for medical conditions compared to the life expectancy with modern medicines. Marijuana is not, and will never be medicine. * Carlton E. Turner, Ph.D., served as Deputy Assistant to President Ronald Reagan for Drug Abuse Policy and as Director of the White House Drug Abuse Policy Office. Turner is considered one of the nation’s leading experts on the pharmacology of marijuana.

Source:  : brent@brentbeleskey.com  American Center for Democracy  19th November 2016

ABOUT ACD American Center for Democracy is a New York-based not-for-profit organization, which monitors and exposes the enemies of freedom and their modus operandi, and explores pragmatic ways to counteract them.

The new data confirms mounting body of scientific evidence highlighting problems with rising marijuana use; SAM Honorary Advisor Patrick Kennedy to speak as part of report’s official release

[ALEXANDRIA, VA] – A new report, released today by the office of the U.S. Surgeon General, adds to the mounting body of scientific evidence highlighting the dangers of marijuana use and emphasizing prevention as essential for protecting youth. It also stands as a further warning of the large impending public health costs of marijuana legalization policies, which permit the marijuana industry to profit from the patterns of heavy marijuana use that pose the greatest threat to public health and safety.

Among the report’s findings:

* Long-term health consequences of marijuana use:  mental health problems, chronic cough, frequent respiratory infections, increased risk for cancer, and suppression of the immune system.

* Other serious health-related issues stemming from marijuana use: breathing problems; increased risk of cancer of the head, neck, lungs, and respiratory tract; possible loss of IQ points when repeated use begins in adolescence; babies born with problems with attention, memory, and problem solving (when used by the mother during pregnancy).

* Increased risk for traffic accidents:  Marijuana use “is linked to a roughly two-fold increase in accident risk.”

* Increased risk of schizophrenia:  “[T]he use of marijuana, particularly marijuana with a high THC content, might contribute to schizophrenia in those who have specific genetic vulnerabilities.

* Increased risk of addiction from high-potency marijuana available in legalized states:  “Concern is growing that increasing use of marijuana extracts with extremely high amounts of THC could lead to higher rates of addiction among marijuana users.”

* Permanent Loss of IQ:  “One study followed people from age 13 to 38 and found that those who began marijuana use in their teens and developed a persistent cannabis use disorder had up to an eight point drop in IQ, even if they stopped using in adulthood.”

“Once again, the scientific community has spoken loud and clear on the numerous, and serious health risks of marijuana,” said Kevin Sabet, President of SAM. “The more we know about marijuana, the worse it appears for public health and safety. Policymakers, especially those in the incoming Presidential administration and Congress, should read this report closely and heed the advice of the scientific community.”

“In particular, the Surgeon General’s report underscores the serious problems with patterns of heavy marijuana use — the same patterns that furnish the pot industry with the vast majority of its revenues,” commented Jeffrey Zinsmeister, SAM’s Executive Vice President. “As we seek to avoid the mistakes we made with Big Tobacco, we should be aware that the pot industry profits off of the very types of marijuana use that most harm public health and safety.”

Source:     http://www.learnaboutsam.org.  Press release  17th Nov.2016   Email: austin.galovski@curastrategies.com

Authors: Daniela Vergara1 *, L. Cinnamon Bidwell2 , Reggie Gaudino3 , Anthony Torres3 , Gary Du3 , Travis C. Ruthenburg3 †, Kymron deCesare3 , Donald P. Land3 , Kent E. Hutchison4 and Nolan C. Kane1 * Affiliations: 1 University of Colorado Boulder, Department of Ecology and Evolutionary Biology. 2 University of Colorado Boulder, Institute of Cognitive Science. 3 Steep Hill Labs Inc. 1005 Parker Street, Berkeley, CA 94710. 4 University of Colorado Boulder, Department of Psychology and Neuroscience. *Correspondence to: daniela.vergara@colorado.edu or nolan.kane@colorado.edu University of Colorado Boulder 1900 Pleasant Street Boulder, CO 80309 †Current address: SC Laboratories Inc. 4000 Airport Way South, Seattle, WA 98108.

Abstract: 

As the most widely used illicit drug, the basis of the fastest growing major industry in the US, and as a source of numerous under-studied psychoactive compounds, understanding the psychological and physiological effects of Cannabis is essential. The National Institute on Drug Abuse (NIDA) is designated as the sole legal producer of Cannabis for use in US research studies. We sought to compare the chemical profiles of Cannabis varieties that are available to consumers in states that have state-legalized use versus what is available to researchers interested in studying the plant and its effects.

Our results demonstrate that the federally produced Cannabis has significantly less variety and lower concentrations of cannabinoids. Current research, which has focused on material that is far less diverse and less potent than that used by the public, limits our understanding of the plant’s chemical, biological, psychological, medical, and pharmacological properties. Investigation is urgently needed on the diverse forms of Cannabis used by the public in state-legal markets.

Introduction:

The United States has witnessed enormous changes concerning public acceptance of marijuana. Use has more than doubled since 2002, across all genders, ethnicities and socioeconomic status

Considering changes on the cultural, political, and legal fronts, research on the effects of Cannabis products that are consumed though legal outlets in states that have legalized is urgently needed. The Cannabis plant is unique in producing a diversity of cannabinoids, a terpenoid chemical compound that interacts with the endocannabinoid system in the brain and nervous system

One of the primary cannabinoids produced, Δ-9-tetrahydrocannabinolic acid (THCA), is converted to the neutral form Δ-9-tetrahydrocannabinol (THC) when heated, e.g. by smoking. THC interacts with the endocannabinoid system producing a wide range of physiological and neurological effects. Studies have found that marijuana’s effects on mood, reward, and cognitive dysfunction appear to follow a dose dependent function based on the THC content

Due to this and other purported psychotropic effects, THCA has been actively selected for by the Cannabis industry and varieties containing more than 30% THCA by weight have been cultivated  In addition to THC, marijuana’s effects are likely related to a number of other compounds including nearly 74 different cannabinoids present at varying ratios across strains. For example, another cannabinoid produced by the plant, is converted to cannabidiol (CBD) when heated. CBD may mitigate the effects of THC and may have other beneficial effects

Demand for high CBDA plants has increased, due to potential therapeutic uses for cancer 19 and  epilepsy.    Other important cannabinoids produced by the plant include cannabigerol (CBG cannabichrome (CBC)  and Δ-9-tetrahydocannabivarin (THCV)

Because research universities across the nation have national grants and must verify compliance with federal law, scientists at these institutions are restricted to research with the only federally legal source of Cannabis. Our current understanding of the effects of marijuana in humans (e.g. on mood, cognition, or pain) has therefore relied exclusively on government-grown marijuana, often administered in a laboratory setting,

Thus, nearly all published US laboratory studies have used Cannabis material obtained from the National Institutes of Health/National Institute on Drug Abuse (NIDA) supply, the only federally legal source for Cannabis plant material. At the same time, dispensary-grade Cannabis available to consumers in state-regulated markets is becoming increasingly potent and diverse. Strains differ substantially in potency and cannabinoid content, and hence, are likely to differ in terms of their effects .

Strains bred for high THCA content are thought to result in greater levels of intoxication as well as differing psychological and physiological effects compared to strains bred for high CBDA content. Accordingly, NIDA has recently developed plant material with varying levels of cannabinoids for research purposes, but the extent to which government cannabis is consistent with cannabis produced in the private market is not clear. To address the critical question of whether the potency and variety of NIDA-provided cannabis reflects products available to consumers through state-regulated markets, we compared the cannabinoid variation and potency from plants from four different cities in the US where peer-reviewed cannabis is legal for medical or recreational reasons (Denver, Oakland, Sacramento, and Seattle; cannabinoid data provided by Steep Hill Labs Inc.) to the cannabinoid content of plants supplied for research purposes by NIDA, using the data publicly available on their website 28.

Results 

NIDA differs from all other locations except Seattle in production of CBD (fig. 1A), and differs significantly from all other locations in production of THC. NIDA has the lowest CBD and THC percent with a mean and s.d. of 6.16 ± 2.43%, and 5.15 ± 2.60% respectively.

Sacramento has the highest percent CBD with 12.83 ± 4.73% and Seattle has the highest percent THC with 19.04 ± 4.43%. There are significant differences between the percent of both CBD and THC between US city locations, in addition to differences with NIDA (fig. 1A). CBG production does not differ in any location.

Cannabis plants grown in all locations produce very little CBG, particularly NIDA with only a single sample producing more than 1% CBG (fig. 1B). THC-V is also produced in low quantities in all locations. The only statistically significant difference is between Denver, whose mean and s.d is 1.12 ± 0.13%, and Oakland 2.35 ± 0.68%

Source:  http://biorxiv.org/content/biorxiv/early/2016/10/26/083444.full.pdf

Blames it in part for scores of deaths around the U.S.

The Drug Enforcement Administration placed a synthetic opioid called U-47700 on the most restrictive list of controlled substances, calling the drug a threat to public health and blaming it in part for scores of deaths around the U.S.

The ban, which is scheduled to take effect Monday, is the latest action by the DEA to try to crack down on the growing peril of synthetic narcotics. Unlike opioids such as heroin and the painkiller oxycodone that derive from the opium poppy, synthetic narcotics can be produced more easily and more cheaply in labs. They are worsening the country’s already severe crisis of opioid abuse, which killed more than 28,000 people in the U.S. in 2014, according to the Centers for Disease Control and Prevention. The designer drugs come mostly from Chinese labs, many of which sell them openly online and dub them “research chemicals” to provide a patina of legitimacy, according to the DEA. Many of the substances are variants of fentanyl, a powerful synthetic opioid.

The labs can rely on existing scientific papers and patents to produce new drugs. That was the case with U-47700, a relic of 1970s pharmaceutical research that never made it to market and was the subject of an investigation by The Wall Street Journal published last week. When law enforcement moves to ban one substance, the labs can simply turn to another that hasn’t been restricted yet.

“Because substances like U-47700 are often manufactured in illicit labs overseas, the identity, purity and quantity are unknown, creating a ‘Russian Roulette’ scenario for any user,” the DEA said in a news release announcing the ban. The agency placed the drug on Schedule I, the category for chemicals the DEA says have no medical purpose and present high potential for abuse.

U-47700 was associated with 46 fatalities in 2015 and 2016, according to the DEA. The Journal investigation noted that NMS Labs, a major private lab outside Philadelphia that works with states, tallied 105 overdose deaths related to U-47700 just this year, through September. Axis Forensic Toxicology, a private lab firm in Indianapolis, linked another 20 deaths to the drug. The fatalities occurred in at least 31 states, from Alaska to Florida.

Some users take U-47700 knowingly. They can frequent online drug forums to discuss the drug and its effects. And they can order it online from Chinese labs or intermediaries and have it shipped directly to their homes. In interviews with the Journal, users have said U-47700 provides a euphoric high but is short-lasting and can quickly create intense cravings.

Other users, however, may take U-47700 unknowingly, the DEA said. Dealers sometimes mix it with other opioids and it also has appeared in counterfeit prescription painkillers.

Source:  (Wall Street Journal, 11/12/16)

Note:  Uruguayan legislator Sebastian Sabini, suggests future legalization of all drugs – starting with marijuana, then cocaine, then …??

Diego Prandini is bent over in a small, brightly lit room, watering marijuana plants of all shapes and sizes. He crawls into a corner to reach some smaller specimens, labelled with names like “Ushua” and “RGB1,” all of which will be part of the next two-kilogram harvest.

“I’ve been at this for seven hours today,” he says, standing and smiling. “So my back is starting to get a little tired.”

Until recently, this job would have been illegal, and he might have worked for dangerous narcotraficantes, perhaps in hidden in nearby Paraguay. But Prandini, 37 and sporting a T-shirt and mohawk, tends his plants in a pleasant middle-class neighborhood of Uruguay’s capital, and as a break, he heads downstairs to enjoy a joint with his co-workers and watch YouTube videos.

The copious smoke they blow out is visible from the street, and next door, their shop sells pipes, marijuana seeds and smoking paraphernalia. Some Brazilian tourists wander in, asking if they can buy some finished marijuana. They can’t.

It’s not legal to buy weed on the street in Uruguay — yet — but Prandini and his colleagues are taking advantage of Latin America’s first full pot legalization project, which has been carefully and gradually rolled out as Uruguay hopes to serve as a model for its neighbors and minimize unintended consequences of the effort.

The country now has many legal cannabis clubs, which pool resources to grow copious amounts of marijuana and distribute it to registered, paying members — no doctor’s note required — who can then smoke where they please. Legislation passed in 2013 also allows Uruguayan residents to sign up to grow plants at home for personal use; soon, pharmacies will begin selling small amounts of cannabis to enlisted users across the country.

Some here have criticized the slow, uneven pace of the program, but legislator Sebastian Sabini, one of the main proponents of the law, said that it is far more important to do the program right so that it serves as a model for legalizing other substances and ending the deadly and unproductive war on drugs.

“Latin America is one of the regions which has suffered the most from the politics of prohibition,” said Sabini, sitting in his congressional office in Montevideo decorated with a Che Guevara poster and a flier he picked up while visiting a marijuana shop in Colorado. “We have a low-intensity undeclared war in Mexico, with 25,000 disappeared and 60,000 killed in recent years; we have wide-scale impunity and areas where narco traffickers control daily life. We see drug groups donating to political campaigns, forming alliances with the state and infiltrating our institutions, all of which generates more violence than we already would have as a poor and unequal part of the world.”

The Uruguay program comes as states in the U.S. consider legalizing marijuana. On Tuesday, California, Nevada and Massachusetts voted to legalize pot for recreational use and a similar vote in Maine was too close to call.

In contrast with the United States, Uruguay aims to avoid the creation of lucrative marijuana businesses. Profits are tightly controlled, there are no brands and advertising is banned. It’s an approach Sabini would like to see extended to other intoxicating substances. He hopes that by proving careful regulation can prevent increased usage, decriminalization can be extended to cocaine. He also would like to ban all advertising on alcohol.

Uruguay, a quiet nation of just 3.5 million residents, is considered one of the most safe and stable countries in Latin America, and its residents enjoy a quality of life often approaching parts of Europe. It’s also often led other countries in the region in adopting liberal causes. The country legalized divorce and votes for women early in the 20th century, and more recently, popular former president José “Pepe” Mujica — a former left-wing guerrilla who ruled the country while driving around in an old Volkswagen Bug — oversaw the legalization of abortion and same-sex marriage, as well as the cannabis law.

Neighboring Brazil and Argentina have no plans to legalize marijuana, so Uruguay took steps to avoid becoming a marijuana tourist destination.

The cannabis registration program is only open to Uruguayans and long-term residents, which doesn’t stop Brazilians and Argentines from often stumbling into grow shops trying — and failing — to buy a gram of weed. Club members and home growers are technically prohibited from selling their finished product, but authorities admit many probably do so.

Since Uruguay passed its 2013 law, both Colombia and Chile have taken steps to legalize medical marijuana — allowing clubs to grow for personal use — but stopped far short of allowing cultivation and sale for recreational use.

Jorge Suarez, president of Uruguay’s Pharmacy Assn., says he sees no problem with eventually selling the product directly to tourists. “If Uruguayans can buy a little bit of the drug, why can’t they?”

Suarez has agreed to sell the drug when it becomes available, but he admits many of his colleagues have balked at being asked to sell a narcotic at low prices and have yet to sign up for the program.

“Many simple pharmacies say they don’t have much in the terms of security to protect a valuable product like that. But if we are selling it so cheap, and it’s everywhere, why would people rob us for that? I think they’d be more likely to ask for money or take our hair-care products, like they usually do,” he said.

The marijuana supplied to the shops is being mass produced by two companies licensed by the government, and the final launch of the pharmacy program is being held up by a postal service labor dispute.

Even as members of Uruguay’s smoking clubs say they strongly support the broad spirit of the law, some mumble about its specifics, saying they’re worried the pharmacy weed will be low-quality, or complaining that they should be able to use their growing experience to expand their small businesses and sell.

Laura Blanco, president of Uruguay’s Cannabis Studies Assn., admits she has her own small quibbles with the law. But she says it would be an error to go the more North American route and treat marijuana just like any other consumer good.

“We strongly defend a collective system not motivated by profit. Basically, because we believe that this needed to be separated from the market,” says Blanco, surrounded by American books from back to the ’60s and ’70s on marijuana and other drugs. “It’s a substance that changes your mind.”

Source:    http://www.latimes.com/world/mexico-americas/la-fg-uruguay-marijuana-20161109-story.html

Ben Cort, an addiction treatment specialist from Colorado, speaks in opposition to Proposition 64 during a panel about the legalization of marijuana at the Anaheim Convention Center.

An addiction expert from Colorado, where marijuana is legal, Cort is drowning in a sea of concern over Proposition 64, California’s ballot initiative that would allow recreational weed.

Once an addict himself, Cort can’t believe the Golden State appears on the verge of legalizing something that terrifies him. Though he’s no fan of pot, it’s not so much the plant that scares Cort. What worries him is that science allows THC – the active ingredient in marijuana that gets you high – to become nuclear-charged.

A little THC wax or oil, he cautions, can go a very long way, especially when it’s ingested.

“We’re the canary in the coal mine,” says Cort, a manager with the University of Colorado Hospital’s rehab program. “We’re treating more addicts for cannabis than we are for opiates.”

Cort says he’s seen THC levels in so-called gummy bears 20 times higher than levels that are legal in Oregon, another state where recreational marijuana is law but where THC percentages are controlled.

Prop. 64, Cort says, will legalize dangerously high THC. That’s not Snoop Dogg cool. That’s emergency room serious.

The federal National Institute on Drug Abuse reports, “These extracts can deliver extremely large amounts of THC to users, and their use has sent some people to the emergency room.” Such high THC levels, institute officials warn, also can turn what many consider a relatively benign drug into something addictive.

UNICORN PROMISES

While writing about marijuana, I’ve interviewed doctors, lawyers, pot growers, medical marijuana dispensary owners, officials with the National Organization for the Reform of Marijuana Laws and patients in pain.

Until I attended a two-hour informational panel discussion Tuesday sponsored by the Anaheim Police Department, I figured I knew all about pot. Speakers included Cort; Police Chief John Jackson of the Greenwood Village, Colo., Police Department; Chief Justin Nordhorn of the Washington State Liquor and Cannabis Board; Attorney Robert Bovett of Oregon Counties Legal Counsel; Lauren Michaels, legislative affairs manager

for the California Police Chiefs’ Association; and Nate Bradley, executive director of the California Cannabis Industry Association.

When a speaker asked who had read Prop. 64, only one hand went up and it wasn’t mine. So to prepare for this column I also read – OK, I skimmed some chunks – all 62 pages. A lot of Prop. 64 is wonky and details who can do what and where. But some reads more like dreams of fairies and unicorns than reality.

“Incapacitate the black market,” the proposal promises “and move marijuana purchases into a legal structure with strict safeguards against children accessing it.”

Untrue, said Jackson, who stressed that illegal sales continue in Colorado.

“Revenues will,” Prop. 64 predicts, “provide funds to invest in public health programs that educate youth to prevent and treat serious substance abuse.”

Wrong, Jackson said. More teens in Colorado are being sent to emergency rooms because of THC-laced edibles.

Revenues will pay to “train local law enforcement to enforce the new law with a focus on DUI enforcement.”

Incorrect again. Jackson said his department is busier than ever dealing with more drivers high on weed and handling more THC-related traffic fatalities.

Other parts of Prop. 64 are just dumb and dumberer.   Like allowing radio and television advertising.

“Make no mistake,” Jackson said of Prop. 64. “This whole thing is about money.

“A drug dealer in a suit is still a drug dealer.”

‘NECESSARY REFORM’

Once marijuana became legal in Washington in 2012, Nordhorn said, children and teens considered it less harmful, and that had ripple effects.

With the advent of vaping, for example, young people inhale THC without anyone knowing if they are taking in an innocent type of e-juice or marijuana.

“Legal marijuana,” Nordhorn said, “is not a silver bullet to get rid of marijuana problems.”

Bovett echoed other panelists, saying that Oregon also has seen an increase in impaired driving, although he added that has been going up since the state approved medical marijuana.

The Oregon Poison Center also reports increases in marijuana-related calls.

Even Bradley, the lone pro-Prop. 64 voice on the panel, admitted he’s concerned about edibles.

Instead of THC levels, Bradley focused on dollars. He said the initiative will take $100 million out of the hands of criminals and the measure will generate $300 million for law enforcement to focus on such things as protecting children.

Bradley has plenty of backers. Among the most visible are Gavin Newsom, lieutenant governor, and Rep. Dana Rohrabacher, R-Costa Mesa. Our local representative has said, “Current marijuana laws have undermined many of the things conservatives hold dear – individual freedom, limited government and the right to privacy.”

Rohrabacher went on to say, “This measure is a necessary reform which will end the failed system of marijuana prohibition in our state, provide California law enforcement the resources it needs to redouble its focus on serious crimes while providing a policy blueprint for other states to follow.”

‘SEED TO SALE’

The most sobering speaker was Michaels of the chiefs’ association. She simply defended California’s newly revamped medical marijuana policies.

Called “seed to sale,” three new laws inked last year shoot down the need for Prop. 64, Michaels said. She stated California now has an enhanced working system to distribute medicinal marijuana legally.

California, Michaels said, already allows local control, protects current producers and includes checkpoints at distribution.

In contrast, she said, Prop. 64 is vertically integrated, favors big business and independent distribution, appoints the state as sole actor for operating licenses and ensures regulatory confusion. Research, learn, vote. Contact the writer: dwhiting@scng.com

Source:   http://www.ocregister.com/articles/marijuana-731244-thc-prop.html   5th October 2016

Introduction

Within Jamaica there is a cultural belief that cannabis use is associated with enhanced creativity, improved concentration [1] and even improved reflexes [2]. These mythical beliefs have resulted in high rates of cannabis use, particularly among the youth, despite cannabis use being illegal in Jamaica.

A 1987 survey of patterns of substance misuse among post primary Jamaican students identified a 19.8% lifetime prevalence for cannabis use, while a 2000 Jamaican National School’s Survey found the lifetime prevalence to have increased to 26.9% [3]. Research findings have suggested that cannabis use may impair neuro-cognitive functioning [4-6].

However, some researchers have suggested that the residual effects of heavy cannabis use on cognitive functions are reversible, lasting only a few days after cessation [7].

Results from one longitudinal study found that cannabis use does not have a long-term negative impact on intelligence [9], while others have found that heavy cannabis users had memory and  learning impairments even after six weeks of supervised abstention [8].

There is a paucity of research on cannabis and neuro-cognitive performance in the Caribbean Region, including Jamaica.   Given the widespread use of cannabis and its easy availability for Jamaican adolescents, it is important to identify if there are any neuro-cognitive effects  associated  with cannabis use, among the youth population. This study therefore investigates whether cannabis use among Jamaican adolescent males will result in lowered performances on neurocognitive tasks.

Metabolites of cannabis in their urine, were excluded from the study. Cannabis users were required to abstain from using for a period of 24 – 48 hours prior to participating in the testing.

Of the 35 participants initially recruited for the cannabis use group, 3 were expelled from school and 2 chose to withdraw from the study. Of the 35 participants in the non-user control group, 3 were excluded from the study because their urine contained metabolites of cannabis. A total of 30 cannabis users and 32 non-users were inter viewed for the study. version 14 (SPSS v.14) and t-tests were conducted to assess if there were any significant differences between the performances of cannabis users and non-users.

Discussion

The mean age of cannabis initiation in this study was found to be early adolescence as seen in other Caribbean studies [3,11].  As adolescence is the developmental period  for

experimentation and risky behaviours,  along with the cultural acceptability of cannabis use during adolescence is a cause for serious concern as the adolescent brain is still undergoing neural development and may be susceptible to impairments in neuro-cognitive functioning.

Cannabis users exhibited lower scores on all assessed neuropsychological functions as compared to non-users. However, the greatest mean differences were observed  through significantly lowered Verbal Comprehension as well as Digit Span scores.  This finding implicates cannabis use during adolescence with impairing the neurocognitive functions of working memory, attention, concentration, mental manipulation, language  development and verbal intelligence. Cannabis users also had significantly lower visual,  verbal and working memory scores than those of non-cannabis users with the largest differences being seen on the delayed subtests. The observance of significantly lower  scores on the delayed subtests implies that the long term memory of cannabis user  may be more susceptibility to neurocognitive decline.

Cannabis users had lower scores on all tests of learning, attention and memory than non-users. This is consistent with findings from previous research neuropsychological performance [13-18]. A meta-analytic study by Grant, et al. [19] also identified impairment in the ability of chronic users of cannabis to recall new information, though findings by Schwartz [20] and Lyons [21] indicate an absence of long-term residual effects of cannabis use on cognitive abilities. Traditionally, Jamaicans view cannabis use as providing many benefits.  These findings are an important step in providing empirical evidence for possible cognitive impairment from cannabis use, among the adolescent population. Further research is needed to determine dose-related, in addition to long-term residual effects of cannabis use on neuropsychological performance in the Caribbean. Understanding the relationship between the complex factors that influence neurocognitive performance of cannabis users should further help to inform the development of public policy and legislation in Jamaica and the Caribbean.

Limitations

The sample size of 30 for the user group even though deemed sufficient, was still small and the present study consisted of male participants only. It would be of interest to know if there is a gender difference in cannabis users’ in performance on neurocognitive tests of memory.

Conclusion

The findings suggest that there is a significant difference in performance between Jamaican male adolescent cannabis users and non-users on neuro-cognitive tests. Users of cannabis displayed cognitive deficits on all tests of memory, intelligence, language and attention that were conducted. The present findings lend new support to the notion that cannabis use may impair neurocognitive functioning.

There are implications for poor school performance by adolescent users of cannabis in Jamaica. These results support the need for public health policies aimed at targeting early prevention strategies, demand reduction, identification and treatment of adolescent cannabis users in Jamaica.

Source:     Ment Health Addict Res, 2016 doi: 10.15761/MHAR.1000118  

Karyl Powell-Booth1,et al

The marijuana industry would rather you didn’t know this nasty truth about weed use before and during pregnancy.

Nine states are carrying measures to legalize marijuana on the Nov. 8 ballot — California, Nevada, Maine, Arizona, Massachusetts, Florida, Arkansas, Montana, and North Dakota. Pot peddlers claim the industry will boost jobs and grow the economy.

But the marijuana industry isn’t interested in the occasional or casual adult user. Like any drug industry, this group is interested in addicts — people who start using early and make it a lifetime habit. Maybe that’s why they don’t care about how their drugs are affecting babies — and why they occasionally take measures to market their products to pregnant women.

Between 7 and 10 percent of newborns at the [Pueblo] hospital are testing positive for THC, the mind-altering ingredient in cannabis.

The data is only now starting to roll in. Recently, 237 physicians from Pueblo, Colorado, banded together to detail some of the health risks associated with marijuana legalization. In particular, Dr. Steven Simerville, a paediatrician at St. Mary-Corwin Hospital, has found that between 7 and 10 percent of newborns at the hospital are testing positive for THC, the mind-altering ingredient in cannabis.

Researchers have found that THC levels in babies lead to decreased spatial reasoning, I.Q., learning, and memory, as well as an increased risk for suicide and later drug use.

Marijuana use in pregnancy takes a toll, said Pamela McColl of British Columbia. She has eyewitness proof. Her sister, who was married to a longtime marijuana user, had a newborn baby who suffered a cerebral haemorrhage at three weeks old. Her sister’s two other children also experienced complications, including reproductive abnormalities and heart defects.

A 2015 study from the University of Copenhagen confirmed that male use of marijuana damages sperm and can lead to birth defects. “So nobody is going to tell me that this isn’t related to marijuana,” she told LifeZette. McColl has been working for years as national director of Smart Approaches to Marijuana in British Columbia in order to spread awareness of the health risks of marijuana. Related: The Heavy Price of Persistent Pot Smoking

Women have been a target market for marijuana use for a while. Whoopi Goldberg and Maya Elisabeth have been instrumental in pushing marijuana as a solution for menstrual cramps — and many government officials are listening. States such as New Jersey are moving to add menstrual cramps to the list of medically approved maladies that could be addressed with marijuana usage. Dispensaries and midwives have been peddling marijuana as a cure-all for morning sickness.

Warning labels on prescription medications, cigarette boxes, and other hazardous products help women understand the risks of casual usage during pregnancy. Pot products carry no such warning.

But using marijuana during pregnancy can lead to a myriad of health problems, including cerebral haemorrhage, spina bifida, Down syndrome — even babies who are born with only half a brain. Research from the University of Adelaide in South Australia shows that marijuana use even before conception can damage the foetus.

“The risk to the foetus is not only cognitive development damage, which shows up in the early preschool years, but also in DNA studies,” McColl explained. “So we’re seeing preliminary research now that shows that use of marijuana by men or women is detrimental to chromosomal health. You can see generational damage here. This is really quite terrifying. People who use marijuana — it may not just be their own children but their grandchildren. This is a 100-year problem we may now be facing.”

By not requiring warning labels on cannabis products, the government is leaving itself open to lawsuits. Warning labels on prescription medications, cigarette boxes, and other hazardous products help women understand the risks of casual usage during pregnancy. Marijuana products carry no such warning.

By not condemning the marijuana movement, the U.S. government violates the United Nations Drug Control Conventions and betrays its allies. “When I was at the U.N. in April, they reamed out the Americans, saying, ‘You cannot do this. We all agreed,’” McColl said. Sweden, Zimbabwe, Nigeria, and numerous other countries are worried that the U.S. drug industry would leak across to their borders and pose public health problems for their rising generations.

Nobody knows what will happen to the babies who are born THC-positive. Previous studies in the 1970s on THC-positive infants had levels around 2.5 percent; many of these infants today are measuring around 15 percent. “We don’t know what it means now,” Dr. Simerville said in a press conference about the marijuana crisis. He explained the brain doesn’t finish developing until the late twenties — and early exposure to cannabis will have devastating neurological effects on the developing brain.

There may not be enough research to document exactly what neurological trauma will occur for some of these babies. But McColl confirmed that the 20,000-plus scientific studies have shown clearly that cannabis is “unsafe for human consumption” and could cost taxpayers billions of dollars down the road in health care costs.

Source:  http://www.lifezette.com/healthzette/littlest-most-vulnerable-going-to-pot/  6th Nov.2016A

Teens who take opioid painkillers without a prescription also often use cannabis, according to a new study.

Researchers analyzed information from more than 11,000 children and teens ages 10 to 18, in 10 U.S. cities. Participants were asked whether they had used prescription opioids in the past 30 days, and whether they had ever used cannabis.

Overall, about 29 percent of the teens said they had used cannabis at some point in their lives. But among the 524 participants who said they had used prescription opioids in the past 30 days, nearly 80 percent had used cannabis. The findings show that among young opioid users, the prevalence of cannabis use is high, said Vicki Osborne, a doctoral student in epidemiology at the University of Florida. Osborne presented the study Oct. 31 at the meeting of the American Public Health Association in Denver.

Among teens who said they used opioids without a prescription (meaning they obtained the drugs through a friend, family member or other avenue), about 88 percent had used cannabis, compared with 61 percent of those who did have a prescription for the opioids they used.

The study also found that the teens who reported having used alcohol or tobacco in addition to opioids were much more likely to use cannabis as well. Of the participants who had used opioids, those who also reported recent alcohol use were nearly 10 times more likely to have used cannabis, compared with those who didn’t use alcohol recently. And those who currently smoked tobacco were 24 times more likely to have used cannabis than those who were not tobacco users, the study found.

Efforts to prevent young people who use opioid painkillers from also using cannabis should target those who use alcohol and tobacco, Osborne said. Efforts should also target males, who were more likely to report using cannabis than females were, she said.

Interventions should also target young people who use opioids without a prescription, Osborne said. Even though such use of opioids among youth is not as high as it is among adults, the proportion of youth using opioids without a prescription is still concerning, she said.

The researchers plan to study the data further, and look at when young people start using cannabis versus when they start using opioids, Osborne said. Previous studies have found that legalizing medical marijuana actually appears to lead to a reduction in opioid use among adults. However, Osborne said the new findings among youth may be different from those in adults, because even in states that have legalized the use of marijuana, the drug is still illegal for teens to use.

Source:  http://www.livescience.com/56784-teen-opioid-cannabis-use.html  7 Nov16

correspondence should be addressed; Norwegian Institute of Public Health, Department of Mental Disorders, PO Box 4404, Nydalen, N-0403 Oslo, Norway; tel: +47-21078373, fax: +47-22118470, e-mail: ragnar.nesvag@fhi.no

Abstract

To investigate contributions of genetic and environmental risk factors and possible direction of causation for the relationship between symptoms of cannabis use disorders (CUD) and psychotic-like experiences (PLEs), a population-based sample of 2793 young adult twins (63.5% female, mean [range] age 28.2 [19–36] y) were assessed for symptoms of CUD and PLEs using the Composite International Diagnostic Interview.

Latent risk of having symptoms of CUD or PLEs was modelled using Item Response Theory. Co-twin control analysis was performed to investigate effect of familiar confounding for the association between symptoms of CUD and PLEs.

Biometric twin models were fitted to estimate the heritability, genetic and environmental correlations, and direction for the association.

Lifetime use of cannabis was reported by 10.4 % of the twins, and prevalence of PLEs ranged from 0.1% to 2.2%. The incidence rate ratio of PLEs due to symptoms of CUD was 6.3 (95% CI, 3.9, 10.2) in the total sample and 3.5 (95% CI, 1.5, 8.2) within twin pairs.

Heritability estimates for symptoms of CUD were 88% in men and women, and for PLEs 77% in men and 43% in women. The genetic and environmental correlations between symptoms of CUD and PLEs were 0.55 and 0.52, respectively. The model allowing symptoms of CUD to cause PLEs had a better fit than models specifying opposite or reciprocal directions of causation. The association between symptoms of CUD and PLEs is explained by shared genetic and environmental factors and direct effects from CUD to risk for PLEs.

Source:  http://schizophreniabulletin.oxfordjournals.org/content/early/2016/07/18/schbul.sbw101

Childhood Emotional Abuse Linked to Adult Migraine

DENVER — There is an association between childhood trauma, especially sexual trauma, and the misuse of prescription pain pills and injectable drugs, according to a large nationwide sample that followed subjects from adolescence into adulthood.

The more types of trauma that subjects experienced during childhood, the greater the odds of pain pill misuse, and those odds increase with increasing age, said Kelly Quinn, PhD, assistant professor of population health at the NYU Langone Medical Center in New York City.

“That speaks to the fact that childhood trauma potentially has down-the-road consequences that may not manifest immediately, but could have implications for the later course of health,” she told Medscape Medical News.

Dr Quinn presented the research here at the American Public Health Association 2016 Annual Meeting.

She and her colleagues analyzed a range of trauma types in a diverse nationwide population using data from the National Longitudinal Study of Adolescent to Adult Health.

Of the 12,288 participants, 54% were female, 66% white, 16% were black, and 12% were Hispanic.

The cohort was stratified into three waves: adolescence, which involved participants 12 to 21 years of age; emerging adulthood, which involved participants 18 to 28 years; and adulthood, which involved participants 24 to 34 years.

The researchers looked at the exposure to trauma before the age of 18, and assessed nine specific traumas: neglect; emotional, physical, and sexual abuse; parental incarceration and binge drinking; and witness to, being threatened with, or experiencing violence.

Overall, 16% of participants experienced emotional abuse during childhood and 5% experienced personal violence. In the cohort, 47% of participants reported no childhood trauma, 28% reported one, 13% reported two, 7% reported three, 3% reported four, and 2% reported at least five.

The risk for injectable drug use in adulthood was highest for people who had experienced sexual abuse (odds ratio [OR], 4.77; 95% confidence interval [CI], 2.44 – 9.34) and for people who had witnessed violence (OR, 2.82; 95% CI, 1.24 – 6.44).

During emerging adulthood, 20.25% of the participants misused pain pills, and during adulthood, 10.46% did. After adjustment for sociodemographic factors, the more traumas experienced, the higher the probability of pain pill misuse during emerging adulthood and adulthood.  The relation between the number of trauma types experienced and injectable drug use during emerging adulthood was particularly striking.

Dr Quinn ascribed the drop-off in risk at five or more traumas to the infrequency of injectable drug use in the population, which was approximately 1%. But “regardless of the drop-off, those are compelling findings,” she said.

These results are similar to those seen in the 2003 Adverse Childhood Experiences (ACE) study of an HMO population in California (Pediatrics. 2003;111:564-572).

Dr Quinn ascribed the drop-off in risk at five or more traumas to the infrequency of injectable drug use in the population, which was approximately 1%. But “regardless of the drop-off, those are compelling findings,” she said.

These results are similar to those seen in the 2003 Adverse Childhood Experiences (ACE) study of an HMO population in California (Pediatrics. 2003;111:564-572).

Dr Quinn ascribed the drop-off in risk at five or more traumas to the infrequency of injectable drug use in the population, which was approximately 1%. But “regardless of the drop-off, those are compelling findings,” she said.

These results are similar to those seen in the 2003 Adverse Childhood Experiences (ACE) study of an HMO population in California (Pediatrics. 2003;111:564-572).

The causative relation remains unclear, according to Laurens Holmes, MD, DrPH, director of health disparity research at the Nemours Alfred I. duPont Hospital for Children in Wilmington, Delaware.

He said he is impressed by the ability of Dr Quinn’s team to control for a wide range of variables, but noted that causal relations are notoriously difficult to confirm. Before being completely convinced, a closer look at the data is required, he explained.

Still, “the fact they were able to control for other traumas that were not central or fundamental to the study makes the study a bit more reasonable and realistic,” Dr Holmes told Medscape Medical News.

If the relation is causative, it could have implications for the treatment and prevention of drug use.

“If you can get a sense of trauma that may have  happened in childhood and address it early on, maybe you can avoid the misuse of drugs altogether,” Dr Quinn said. This has “implications for drug users later down the road. You wouldn’t expect to successfully treat them and prevent relapse if you weren’t addressing the constellation of issues that go on in their life. That’s when trauma-informed treatment comes into play.”

This study could also have implications for the dispensation of pain medication, according to session moderator Judith Weissman, PhD, JD, research manager in the division of general internal medicine and clinical innovation at the NYU Langone Medical Center.

The results could help identify patients who might be at high risk for addiction, she pointed out.

In the United States, the misuse of prescription pain pills quadrupled from 1999 to 2008 (J Safety Res. 2012;43:283-289).

“There has to be much more consideration and discretion in how opioids are passed out by physicians who are not pain experts. A prescription gets a person out of pain, but ultimately it can create a problem down the road,” Dr Weissman said.

Source:  American Public Health Association (APHA) 2016 Annual Meeting: Abstract 354983. Presented November 2, 2016.

VICTORIAN paramedics are being called to an average of almost 60 alcohol-related and 25 drug-affected patients a day.

A surge in ice-related call-outs is a main cause of an increase in attendances of almost 30 per cent on the year before.

Prescription medication — mostly sleeping tablets and anti-anxiety medication benzodiazepines — continue to be involved in more ambulance call-outs than illicit drugs.

But a Turning Point report shows that the proportion of illicit drug misuse has dramatically increased.

Attendances for crystal methamphetamine or “ice” almost doubled in 2014-2015. The 2271 attendances a year, or six a day, is an eightfold increase since 2010-2011.

The Ambo Project, a summary of Victoria’s drug and alcohol related ambulance attendances, shows that alcohol-related harm is the most common problem: there were 21,602 call-outs compared with 9038 for illicit drugs and 9941 for prescription medications.

The number of alcohol-related cases increased almost threefold in the past six years; paramedics now attend 57 cases daily; in 49, it is the only drug involved.

Turning Point lead researcher Belinda Lloyd said ambulance call-outs for prescription medications, including antidepressants, anti-psychotics and painkillers, were higher in regional areas per rate of population.

“This is no longer a problem for major cities and entertainment precincts,” Ms Lloyd.

“We need more awareness about how to minimise the harm from drugs.”

Ambulance Victoria general manager of emergency operations Mick Stephenson, said the increase in drug call-outs, particularly amphetamines, meant paramedics more frequently sedated patients to prevent self-harm and protect health workers.

“They take this stuff at their peril because they don’t know what’s in it and nor do we.”

Minister for Mental Health Martin Foley said training of almost 40,000 frontline health workers in dealing with ice-affected patients started today.

Opposition health spokeswoman Mary Wooldridge said alcohol and drug-fuelled harm continued to put paramedics and others at risk.

Source:  http://www.heraldsun.com.au/news/victoria/ambulance-callouts-soar  7th Nov 2016

In a report aired on Sunday’s 60 Minutes on CBS — and previewed in a piece on Friday’s CBS Evening News — medical correspondent Dr. Jon LaPook highlighted some of the problems seen in Colorado that have increased in the couple of years since the state legalized marijuana use in 2014.

LaPook spoke with a doctor from Pueblo County who recalled a substantial increase in women giving birth whose newborn babies test positive for marijuana, threatening the babies with permanent brain development problems. After also recounting a substantial increase in illegal production forcing many more law enforcement actions, the CBS correspondent also recalled the difficulty in detecting marijuana use in drivers.

LaPook began by forwarding the views of Dr. Steven Simerville of Pueblo’s St. Mary Corwin Medical Center, who supports an effort in his county to ban marijuana use there. LaPook:

He supports the ballot initiative to ban recreational pot — in part because he says he’s noticed more babies being born with marijuana in their system. His observations are anecdotal, but he’s concerned by what he has seen in his own hospital. In the first nine months of this year, 27 babies born at this hospital tested positive for THC — the psychoactive ingredient in marijuana. That’s on track to be about 15 percent higher than last year.

After Dr. Simerville was seen informing LaPook that there are currently newborn babies at the hospital being treated for marijuana exposure, LaPook followed up: “What does the mother say when you say, ‘Your baby just tested positive for marijuana and it can possibly harm the baby’? What does the mother say?”

Dr. Simerville recalled that pot legalization has contributed to the misconception that, because it is legal, it is not harmful for the babies of pregnant women:

SIMERVILLE: They are not surprised that they tested positive. Obviously they know they’ve been smoking marijuana. But they’re in disbelief that it’s harmful. They frequently say, “How can it be harmful? It’s a legal drug.”

LAPOOK: Dr. Simerville says that’s a common misconception, especially because 25 states have approved marijuana for medical use for conditions like epilepsy, pain, and stimulation of appetite. But on the federal level, it’s still illegal. Today’s pot is, on average, four to five times stronger than it was in the 1980s. It can also get passed on to babies in high concentrations in breast milk.

Viewers were then informed of the dangers for babies in brain development:

SIMERVILLE: I try to explain to them that even though you’re not smoking very much, the baby is getting seven time more than you’re taking, and that this drug has been shown to cause harm in developing brains.

LAPOOK: Research suggests babies exposed to marijuana in utero may develop verbal, memory, and behavioral problems during early childhood.

After recalling a 70 percent increase in teenagers visiting the emergency room testing positive for marijuana, LaPook informed viewers of the possible ill effects for teens using marijuana:

That worries Dr. Simerville because evidence is emerging that heavy teenage use — using four to five days a week — may be linked to long-term damage in areas of the brain that help control cognitive functions like attention, memory, and decision-making.

It’s not known if there’s any amount of marijuana that is safe for the developing brain, which may still be maturing during the mid to late 20s.

The piece then moved to dealing with the burdens on law enforcement in having to find increased illegal growing of marijuana, and the difficulty in detecting the substance in the bodies of those illegally driving under the influence.

Source: http://blabber.buzz/index.php?option=com_k2&view=item&id=47494:cbs-highlights-problems-after-marijuana-legalization-in-colorado&Itemid=1005 c

In this new era of legalized marijuana, far too little research has been conducted on the effect of cannabis on the development of human embryos, say researchers at Georgetown University Medical Center who scoured medical literature on the topic and found what they say is worrisome animal research.

Their study, in the journal BioMed Central (BMC) Pharmacology and Toxicology, suggests an urgent need for human epidemiological and basic research that examines the link between maternal cannabinoid use, either smoked or eaten in candy bars, and the health of newborns. Cannabinoids are chemicals like THC, the primary psychoactive compound in marijuana, that act on cannabinoid receptors in neurons, repressing the normal release of neurotransmitters.

“We know from limited human studies that use of marijuana in early pregnancy is associated with many of the same risks as tobacco, including miscarriage, birth defects, developmental delays and learning disabilities, but animal research suggests the potential for many more developmental issues linked with the drug,” says the study’s senior investigator, G. Ian Gallicano, PhD, associate professor of biochemistry and molecular & cellular biology at Georgetown.

Gallicano says one reason for limited research is that the classification of marijuana as a Schedule I drug creates challenges to conducting research.

“All of the model systems point to the notion that cannabinoids affects many aspects of human development because THC and other chemicals alter molecular pathways that shouldn’t be disrupted during development of a fetus,” he says. “We also know that THC is a promising agent for treating cancer, because it negatively affects tumor growth and can cause the death of cancer cells. Embryo development has similarities to tumor formation – it turns on growth pathways that are necessary for development,” Gallicano says. “The fact that THC seems to stop cancer growth suggests how damaging the chemical could be for a fetus.”

The study grew from a project of four current Georgetown medical students (Joseph Friedrich, Dara Khatib, Keon Parsa, and Ariana Santopietro) for a course, Sexual Development and Reproduction, taught by Gallicano. They undertook the analysis given that although four states have legal recreational marijuana use and 24 allow use of medical marijuana, little research has been conducted on outcomes from use of the drug in pregnancy and biological mechanisms that cause these issues.

The students reviewed the scientific literature for studies on cannabinoids and embryonic development published between 1975 and 2015. They cite the following findings:

* THC lasts in the body for weeks, especially in maternal tissues that act as reservoirs for THC and other cannabinoids, according to studies of pregnant dogs. Human cells studies have shown that THC has a half-life of eight days in fat deposits and can be detected in blood for up to 30 days;

* THC readily crosses the human placenta, which can slow clearance of the drugs while prolonging fetal exposure;

* THC levels in smoked marijuana have increased nearly 25-fold since 1970, and can be substantially stronger in edible preparations of cannabis; * THC and other cannabinoids interfere with use of folic acid (vitamin B9), which has long been known to be essential for normal development and growth of the human

placenta and embryo. Deficiencies in folic acid are linked to low human birth weight, increased risk of spontaneous abortion, and neural tube defects such as spina bifida.

* Cannabinoid signaling plays important roles in development of a mouse embryo. It is required for proper pre-implantation development, embryo transport to the uterus, and implantation.

* In post-implantation development, cannabinoid signaling functions in a multitude of pathways, including, but not limited to blood vessel growth, fate of embryonic stem cells, and normal cognitive development. For example, disruption of one key neural pathway, BDNF, has been linked to increased risk of congenital malformations and impaired cognition, including autism and low IQ in humans.

The authors also say the harms found in animal studies cited in this study do not include the damaged induced from the act of smoking marijuana.

No funding for the study was provided or sought. Article: The grass isn’t always greener: The effects of cannabis on embryological development, Joseph Friedrich, Dara Khatib, Keon Parsa, Ariana Santopietro and G. Ian Gallicano, BMC Pharmacology and Toxicology, doi: 10.1186/s40360-016-0085-6, published 29 September 2016.

(Photo: Frank Eltman, AP)

The percentage of traffic deaths in which at least one driver tested positive for drugs has nearly doubled over a decade, raising alarms as five states are set to vote on legalization of marijuana.

Amid a disquieting increase in overall U.S. traffic fatalities, the National Highway Traffic Safety Administration has tracked an upswing in the percentage of drivers testing positive for illegal drugs and prescription medications, according to federal data released to USA TODAY and interviews with leaders in the field.

The increase corresponds with a movement to legalize marijuana, troubling experts who readily acknowledge that the effects of pot use on drivers remain poorly understood. Recreational marijuana use is now legal in Colorado, Washington state, Oregon, Alaska and the District of Columbia, even as it remains outlawed on a federal level. Five states — Arizona, California, Maine, Massachusetts and Nevada — are set to vote on legalization.

It’s “very probable” that Colorado’s move to legalize recreational marijuana has caused an increase in fatal crashes, said Glenn Davis, the state’s highway safety manager.

In 2015, 21% of the 31,166 fatal crashes in the U.S. involved at least one driver who tested positive for drugs after the incident — up from 12% in 2005, according to NHTSA. The rate rose in 14 of the last 15 years, falling for the first time last year. It was down less than one percentage point compared with 2014.

Drugs are emerging as a more significant factor as a cause of crashes, says Mark Rosekind, administrator of the National Highway Traffic Safety Administration. A separate federal study of 11,000 weekend, night time drivers found  15.1% tested positive for illegal drugs in 2013 and 2014, up from 12.4% in 2007. Marijuana represented the largest increase, as 12.6% tested positive in 2013 and 2014, up from 8.6% in 2007.

Researchers caution that the connection between drugs and deadly crashes is not as significant as the effect of drunken driving, which is responsible for more than 30% of road fatalities. Experts also note that available data is not comprehensive — and some drugs, including certain over-the-counter medications, have no effect at all on the driver. Many drivers who get high and then get behind the wheel are subject to arrest for driving under the influence just as those who drink and drive.

One victim, according to prosecutors, was David Aggio of California. He was killed March 8, 2014, when Rodolfo Alberto Contreras, who was high on marijuana, ran a red light at nearly 80 mph, crossed the center divider and demolished Aggio’s Ford Explorer, prosecutors said.

Contreras in June became the first drugged driver in California to be convicted of second-degree murder. According to California prosecutors, his response at the scene of the crime, when confronted about the incident, was: “I want my weed.”

He was sentenced to 20 years to life in prison.

Auto-safety experts are particularly concerned about a spike in drugged driving in states that have legalized recreational marijuana, such as Colorado, where voters approved it in 2012. The nation’s opioid epidemic could also be a contributing factor.

In 2015, 12.4% of fatal crashes in Colorado involved a driver who tested positive for cannabis alone, up from 8.1% in 2013, according to the Colorado Department of Transportation. The number of drivers involved in fatal crashes who tested positive for any drug hit a record 18.6% in Colorado in 2015, up from a low of 12.3% in 2012.

Marijuana proponents dispute the suggestion that pot use is killing more people on the road.

Jolene Forman, staff attorney at the Drug Policy Alliance, which supports marijuana legalization, cautioned against drawing conclusions on the effect of marijuana legalization on drivers.

“We’re interested in pursuing policies that advance what is empirically shown, rather than knee-jerk, fear-based policies,” Forman said. “It’s too soon to say that it’s had a positive or negative effect but preliminary data look very promising. It looks like marijuana legalization has not led to road safety concerns.”

Complicating matters is that research on the effects of drugged driving is scarce, leaving road-safety experts with little understanding of the full ramifications.

For starters, many drivers involved in fatal crashes aren’t tested for drugs. What’s more, just because drivers have drugs in their system doesn’t mean they are impaired. Marijuana is noticeable in the bloodstream for weeks, but its strongest effects dissipate after a few hours.

In addition, there’s no generally accepted field sobriety test for officers to conduct and there’s no standard level of impairment for marijuana. In contrast, all states punish drivers for blood-alcohol concentration at or above 0.08%, according to the Governors Highway Safety Association. But a study released in June by the University of Iowa’s National Advanced Driving Simulator (NADS) concluded that drivers with blood concentration of 13.1 ug/L of the main active ingredient in marijuana, THC, “showed increased weaving that was similar to those with” with 0.08 blood-alcohol level.

“As we see more people drive on the road with different controlled substances, whether they be illicit or prescription drugs, the risk is increasing,” said Tim Brown, associate research scientist at NADS and co-author of the study, in an interview.

Anyone who’s driving dangerously because they’re high can be flagged by officers who are looking for drunken drivers, said J.T. Griffin, chief government affairs officer for Mothers Against Drunk Driving. MADD last year updated its mission statement to target drugged driving.

“The best way to deal with drugged driving is really to do more work on drunk driving,” Griffin said.

As societal acceptance of recreational marijuana grows, educational efforts are needed to help people understand the potential risks of drugged driving, safety advocates say. Yet while marijuana may be less harmful than other drugs, experts say more research is desperately needed to understand its effect on motorists.

“Any impaired driving is a very serious crime,” Colorado’s Davis said. “Sometimes when we interview focus groups, they’re unaware that they can even get a DUI for marijuana, and some people even feel that they can drive better.”

Source:  Partnership News Service thepartnership@drugfree.org  3rd Nov.16

A new study finds the number of young children and teens hospitalized for opioid painkiller overdoses has almost tripled in recent years.

Opioid overdoses increased 205 percent from 1997 to 2012 among children ages 1 to 4, HealthDay reports. Among teens ages 15 to 19, overdoses increased 176 percent.

Most poisonings due to opioid painkillers among children under 10 were accidental. Lead researcher Julie Gaither of the Yale School of Medicine says young children are “eating them like candy.” Most overdoses among teens were accidental, although some were suicide attempts, Dr. Gaither noted.

Source: The study appears in JAMA Pediatrics. Partnership News Service thepartnership@drugfree.org  3rd Nov.2016

A synthetic opioid known as “pink” is legal in most states, even though it is almost eight times stronger than morphine, CNN reports.

The drug, also known as U-47700, is responsible for dozens of deaths nationwide, the article notes. Adam Kline, Police Chief of White Lake, Michigan, told CNN the drug can be legally purchased on the “dark web” in the form of a powder, pill or nasal spray. Last month, the Drug Enforcement Administration told NBC News it is aware of confirmed deaths associated with the drug in New Hampshire, North Carolina, Ohio, Texas and Wisconsin. The drug, along with other synthetic opioids, is being shipped into the United States from China and other countries.

Source:  thepartnership@drugfree.org  2nd Nov.  2016

Thanks to advances in science, we have never known so much about the effects marijuana use has on the human body, particularly, the fragile brain. Yet, in a political era when scientific research is regularly marshalled to end public policy debates, the powerful, growing scholarship on marijuana has largely been ignored or dismissed. Indeed, marijuana use seems to be one of the glaring areas in modern life where wishful thinking reigns over rationality.

Yet, as the lesson of tobacco demonstrates, when Americans are given the scientific facts about serious threats to their health, they adjust their behavior and insist on measures to safeguard their communities. In the instance of marijuana, the public can be forgiven for not knowing the true threat. With the assistance of a sympathetic media, marijuana legalization advocates, many seeking to profit off the drug, continue to sell romantic falsehoods and outright lies. They casually dismiss the growing list of serious concerns about marijuana emerging from scientific scholarship and survey research, or just cry “reefer madness” without examining the evidence.

Amidst the current marijuana public policy discussion, more than ever, concerned citizens, community leaders, lawmakers, educators, and parents need to better understand the growing body of research about this drug. What follows is a compilation and discussion of the latest research, including reports that are beginning to come in on the effects legalization has had in Colorado and neighbouring states—including increased criminal activity even with legalization. While all research has limitations, what we do know is becoming clearer by the day, and it will make many question what they thought they knew about this drug of abuse.

Key Recent Findings:

Journal of the American Medical Association: “There is little doubt about the existence of an association between substance use and psychotic illness…studies suggest that the association between cannabis use and later psychosis might be causal, a conclusion supported by studies showing that cannabis use is associated with an earlier age at onset of psychotic disorders, particularly schizophrenia.”

Society for the Study of Addiction: “Regular cannabis use in adolescence approximately doubles the risks of early school-leaving and of cognitive impairment and psychoses in adulthood. Regular cannabis use in adolescence is also associated strongly with the use of other illicit drugs

World Psychiatric Association: “Evidence that is a component cause of psychosis is now sufficient for public health messages outlining the risk, especially of regular use of high-potency cannabis and synthetic cannabinoids.”

American Academy of Paediatrics: “The adverse effects of marijuana have been well documented” and include “impaired short-term memory, decreased concentration, attention span, and problem solving” which “interfere[s] with learning.”

American Psychological Association: “Heavy marijuana use in adolescence or early adulthood has been associated with a dismal set of life outcomes including poor school performance, higher dropout rates, increased welfare dependence, greater unemployment and lower life satisfaction.”

Proceedings of the National Academy of Sciences: “Persistent adolescent-onset cannabis users” showed “an average 8-point IQ decline from childhood to adulthood.”

Clinical Psychological Science Journal: Duke University and UC Davis researchers “found that those dependent on cannabis experienced more financial difficulties, such as paying for basic living expenses and food, than those who were alcohol dependent.”

Journal of Drug and Alcohol Dependence: States that have legalized “medical” marijuana find an association with higher 12th grade drop-out rates, lessened college attainment, and increases in daily smoking. Further, there is a dose/response relationship between adverse impact and years of increased exposure under legalization.

U.S. Department of Health and Human Services, SAMHSA: Since legalizing marijuana, Colorado climbed to number one among states for both youth (12-17) and college age adults (18-25) marijuana use.

Discussion:

The further acceptance of marijuana legalization and commercialization in some states will lead to a greater availability of the drug. Greater availability and acceptance will lead to greater use of marijuana, both in the sense of more users, and likely further in the sense of more frequent and greater consumption.

In states that have legalized already there is strong evidence that adult use has surged upward. There is further evidence that use by youth will also increase.

Youth use of marijuana in states that have now commercialized sales was already more extensive than national norms, however, reports since the first commercialization began in January, 2014, indicate growing use amongst all age groups.

As marijuana use intensifies, the consequences of such use and abuse accelerates. These consequences are considerable, and will impose significant costs, both personal and economic, on health and social well-being.

Finally, and perversely, evidence is strong that the consequences will include not only continued, but intensified and entrenched criminal activity associated with drug use. Indications are clear that the criminal and violent black market capitalizes on increased marijuana availability and use. Marijuana commercialization/legalization is advancing both a public health and a public safety disaster.

We shall review recent evidence of the health-related consequences in this document. In a later accompanying document we will assess the impact on use of drugs beyond marijuana, as well as the impact on further criminal drug markets.

Though comparisons between marijuana and other substances of abuse are frequently made to the effect that marijuana is not proportionally lethal, there are nevertheless other measures of the drug’s dangers. Former National Institute on Drug Abuse Director Dr. Bob DuPont has termed marijuana “the most dangerous drug,” in part because of the sheer prevalence of what is the most widely used illegal substance in the world, and in part because the effects are not always felt or experienced by those affected. They can nevertheless be measured and are real. In some instances, research shows that they appear irreversible, even after abstinence.

Among the more troubling findings are those showing a relationship between marijuana use and psychotic episodes, diminished memory, verbal skill, and other cognitive performance, lowered life achievements, criminal and anti-social behavior, school leaving and academic failure, and even lowered life satisfaction.

Most concerning, perhaps, are the findings that heavy, early marijuana use is associated with a loss of intelligence over the life course. Specific supporting citations for other statements will be found below.

Further, Dr. Wayne Hall’s twenty-year review of the literature in the journal Addiction, as we will present in greater detail in the review, showed a clear relationship between youth marijuana use and subsequent use of other drugs. As Hall has argued:

The relationships between regular cannabis use and other illicit drug use have persisted after statistical adjustment for the effects of confounding variables in both longitudinal studies and discordant twin studies… The order of involvement with cannabis and other illicit drugs, and the increased likelihood of using other illicit drugs, are the most consistent findings in epidemiological studies of drug use in young adults.

In general, the health risks of marijuana use are reasonably well known, and based on long-standing research that now consists in multiple studies across many nations, exploring many dimensions of what is a very complex drug.

The last decade has witnessed an intensification of concern and stimulated even more studies of marijuana’s manifold impact, involving several areas of the body and the mind. The comprehensive nature of the physiological impact mirrors, to some extent, the widespread dispersal of the body’s naturally-occurring endocannabinoid receptor system.

There are additional physiological concerns, many based on smoking as the manner of consumption, focused on its effects on the cardiac and respiratory systems. These threats are real and mounting.

But the most compelling investigations regarding risk are emerging from studies of the brain, however the drug is consumed. These include both the structure and the functioning of the neurophysiology of the brain, and they further extend into discoveries regarding the consequences of brain activity, as we have mentioned, such as cognition, memory, learning, executive performance, and general behavior. Moreover, they also include examinations of drug dependency and what is termed “marijuana use disorder.”

That is, both the brain as an organ as well as “the mind,” the very personhood, of the individual are affected by the chemistry of the drug. Most concern is focused on the principle intoxicating element, THC , which shows signs of being actively toxic to the nervous system, the potency of which in modern forms is escalating dramatically under marijuana commercialization.

We must acknowledge that many studies demonstrate a risk that is emergent, and not fully known; multiple factors and confounders do coincide and must be accounted for before we argue “causation” for the effects that have been shown. Nevertheless, a substantial and repeated body of research that, taken piece by piece, showing “associations” or “correlations” or “predispositions,” must now be seen as sufficient, when taken together, to establish a clear and present danger.

In some measure, the worst effects are contingent, in the sense that not all forms of use by all individuals will produce the direst impact. But by now the evidence is compelling that certain forms of use, under certain circumstances, is deeply damaging.

Simply put, any honest observers must accept that the preponderance of evidence, as suggested by our review of recent literature which follows, demonstrates a high risk from marijuana use that is now overwhelming.

What we find is research from several related lines of inquiry, all pointing in the same direction. The risks are only worsening with time, in each line of inquiry, serving to confirm a congruence with the findings from other arena.

Studies of various marijuana disorders of behavior are being underpinned and given a basis by studies of the brain and its performance; showing consistent patterns from several interrelated domains of impact. Moreover, as over time the tools brought to bear have become more sophisticated and able to measure subtle and consequential effects, the sense of concern over what we are doing to youth is only mounting.

Though all users, even adult non-frequent users, have been shown to suffer some deficits through marijuana intoxication, and though there are further indications that even young adult casual users undergo structural brain changes, the evidence is far more robust and more worrying in other circumstances.

Danger increases, that is, when any of the following conditions are co-present with marijuana use: the existence of co-morbidities (or even predispositions), especially collateral substance dependencies or psychological deficits; certain genetic profiles that confer greater susceptibility; heavy, frequent use (daily use being the most threatening), especially of high-potency varieties; and especially exposure at a developmentally young age, during periods of highly consequential brain formation and calibration, generally ranging from prenatal or paediatric exposure up to young adulthood.

Where more than one of these factors is present, the risks escalate; where the developmentally young smoke high-potency cannabis frequently for an extended period – most markedly those with predisposing psychological deficits – the effects can be catastrophic in their lives, including dramatic “psychotic breaks.” These effects appear to be, in some cases, largely irreversible.

And it is this “worst-case scenario” that, perversely, is being fostered by state legalization and commercialization measures, thereby ensuring the greatest magnitude of damage.

A further implication of these facts concerns our emerging knowledge of the risks, given that most longitudinal studies showing long-term adult impacts were carried out without an appreciation of how the various factors above conferred greater vulnerability.

Often, studies that failed to find major impact were based on samples of adults, not adolescents, who were not exposed to heavy, frequent, newly-potent doses. Yet the commercialization of marijuana has resulted in marijuana potency that eclipses anything we have ever previously seen, in some cases by orders of magnitude. Highly potent “edibles” and concentrated cannabis extractions, like “shatter” are taking potency levels once common in the two- to three-percent range up to 80 percent. The consequence is that most everything we thought we knew about marijuana’s risks needs to be re-assessed under contemporary conditions, and most every danger, as we progressively uncover them, turns out to be heightened.

These finding are warnings of grave danger, with the promise of yet more to be discovered. Not all is “proven,” and not all establishes independent causation, but the evidence is strong enough, and growing daily, to activate in public policy a “precautionary principle.” That is, the evidence is strong enough to warrant a clear directive not to proceed further. Simply put, the pathway of legalization must not be pursued.

Recent Research and Findings: An Annotated Review

What has research over the past two decades revealed about the adverse health effects of recreational cannabis use? (full article), Addiction, (2014).

“Regular cannabis use in adolescence approximately doubles the risks of early school-leaving and of cognitive impairment and psychoses in adulthood. Regular cannabis use in adolescence is also associated strongly with the use of other illicit drugs.”

Unintentional Pediatric Exposures to Marijuana in Colorado: 2009-2015, Pediatrics, (2016).

“Annual pediatric marijuana cases increased more than 5-fold from 2009 (9) to 2015 (47). Colorado had an average increase in cases of 34% (P < .001) per year while the remainder of the United States had an increase of 19% (P < .001).”

Wants Marijuana Products to Have Warnings Against Use in Pregnancy, National Council on Alcoholism and Drug Dependence, (2015).

The American Medical Association seeks warnings against marijuana use in pregnancy.

Cannabis Use and Earlier Onset of Psychosis, Psychiatry, (2011).

“There is little doubt about the existence of an association between substance use and psychotic illness. National mental health surveys have repeatedly found more substance use, especially cannabis use, among people with a diagnosis of a psychotic disorder. There is a high prevalence of substance use among individuals treated in mental health settings,6 and patients with schizophrenia are more likely to use substances than members of the wider community. Prospective birth cohort and population studies suggest that the association between cannabis use and later psychosis might be causal, a conclusion supported by studies showing that cannabis use is associated with an earlier age at onset of psychotic disorders, particularly schizophrenia.”

The Impact of Marijuana Policies on Youth: Clinical, Research, and Legal Update, American Academy of Pediatrics, (2015).

“The adverse effects of marijuana have been well documented, and studies have demonstrated the potential negative consequences of short- and long-term recreational use of marijuana in adolescents. These consequences include impaired short- term memory and decreased concentration, attention span, and problem solving, which clearly interfere with learning. Alterations in motor control, coordination, judgment, reaction time, and tracking ability have also been documented; these may contribute to unintentional deaths and injuries among adolescents (especially those associated with motor vehicles if adolescents drive while intoxicated by marijuana).

Negative health effects on lung function associated with smoking marijuana have also been documented, and studies linking marijuana use with higher rates of psychosis in patients with a predisposition to schizophrenia have recently been published, raising concerns about longer-term psychiatric effects. New research has also demonstrated that the adolescent brain, particularly the prefrontal cortex areas controlling judgment and decision-making, is not fully developed until the mid-20s, raising questions about how any substance use may affect the developing brain. Research has shown that the younger an adolescent begins using drugs, including marijuana, the more likely it is that drug dependence or addiction will develop in adulthood. A recent analysis of 4 large epidemiologic trials found that marijuana use during adolescence is associated with reductions in the odds of high school completion and degree attainment and increases in the use of other illicit drugs and suicide attempts in a dose-dependent fashion that suggests that marijuana use is causative.”

American Academy of Pediatrics Reaffirms Opposition to Legalizing Marijuana for Recreational or Medical Use, American Academy of Pediatrics, (2015).

The American Academy of Pediatrics () reaffirms its opposition to legalizing marijuana, citing the potential harms to children and adolescents.

Half-Baked — The Retail Promotion of Marijuana Edibles, New England Journal of Medicine, (2015).

“Edibles that resemble sugary snacks pose several clear risks. One is over-intoxication….At high doses, can produce serious anxiety attacks and psychotic-like symptoms. This problem is augmented by differences in the pharmacokinetic and metabolic effects of marijuana when it is ingested rather than smoked. In addition, case reports document respiratory insufficiency in young children who have ingested marijuana.”

Adverse Health Effects of Marijuana Use, New England Journal of Medicine, (2014).

A review of the current state of the science related to the adverse health effects of the recreational use of marijuana, focusing on those areas for which the evidence is strongest.

A New England Journal of Medicine Article about Marijuana, Psychology Today, (2014) summarizes the adverse health effects as published in the New England Journal of Medicine.

UN: cannabis law changes pose ‘very grave danger to public health’, The Guardian, (2014).

United Nations International Narcotics Control Board warns of “very grave danger” from legalizing marijuana.

Damaging Effects of Cannabis Use on the Lungs, Advances in Experimental Medicine and Biology, (2016).

“Cannabis smoke affects the lungs similarly to tobacco smoke, causing symptoms such as increased cough, sputum, and hyperinflation. It can also cause serious lung diseases with increasing years of use. Cannabis can weaken the immune system, leading to pneumonia. Smoking cannabis has been further linked with symptoms of chronic bronchitis. Heavy use of cannabis on its own can cause airway obstruction. Based on immuno-histopathological and epidemiological evidence, smoking cannabis poses a potential risk for developing lung cancer.”

Marijuana use in adolescence may increase risk for psychotic symptoms, American Journal of Psychiatry, (2016).

Regular marijuana use significantly increased risk for subclinical psychotic symptoms, particularly paranoia and hallucinations, among adolescent males.

Heavy, persistent pot use linked to economic, social problems at midlife: Study finds marijuana not ‘safer’ than alcohol, Clinical Psychological Science, (2016).

Science Daily’s review of a research study that followed children from birth up to age 38 has found that people who smoked cannabis four or more days of the week over many years ended up in a lower social class than their parents, with lower-paying, less skilled and less prestigious jobs than those who were not regular cannabis smokers. These regular and persistent users also experienced more financial, work-related and relationship difficulties, which worsened as the number of years of regular cannabis use progressed.

The impact of adolescent exposure to medical marijuana laws on high school completion, college enrolment and college degree completion, Drug & Alcohol Dependence, (2016).

States that have legalized marijuana find an association with higher 12th grade drop out rates, lessened college attainment, and increases in daily smoking. Further, there is a dose/response relationship between adverse impact and years of increased exposure under legalization.

Early marijuana use associated with abnormal brain function, lower IQ, Lawson Health Research Institute, (2016).

“Previous studies have suggested that frequent marijuana users, especially those who begin at a young age, are at a higher risk for cognitive dysfunction and psychiatric illness, including depression, bipolar disorder and schizophrenia.”

Marijuana Users Have Abnormal Brain Structure and Poor Memory, Northwestern Medicine, (2013).

“Teens who were heavy marijuana users — smoking it daily for about three years — had abnormal changes in their brain structures related to working memory and performed poorly on memory tasks, reports a new Northwestern Medicine® study. A poor working memory predicts poor academic performance and everyday functioning. The brain abnormalities and memory problems were observed during the individuals’ early twenties, two years after they stopped smoking marijuana, which could indicate the long-term effects of chronic use. Memory-related structures in their brains appeared to shrink and collapse inward, possibly reflecting a decrease in neurons.”

Young adult sequelae of adolescent cannabis use: an integrative analysis, Lancet Psychiatry, (2014).

Adolescent cannabis use has adverse consequences in young adulthood:

“We recorded clear and consistent associations and dose-response relations between the frequency of adolescent cannabis use and all adverse young adult outcomes. After covariate adjustment, compared with individuals who had never used cannabis, those who were daily users before age 17 years had clear reductions in the odds of high-school completion…and degree attainment…, and substantially increased odds of later cannabis dependence…, use of other illicit drugs…, and suicide attempt.”

Traditional marijuana, high-potency cannabis and synthetic cannabinoids: increasing risk for psychosis, World Psychiatry, (2016).

“Evidence that [THC] is a component cause of psychosis is now sufficient for public health messages outlining the risk, especially of regular use of high-potency cannabis and synthetic cannabinoids.”

Monitoring Marijuana Use in the United States; Challenges in an Evolving Environment, (2016).

“Use of marijuana or any of its components, especially in younger populations, is associated with an increased risk of certain adverse health effects, such as problems with memory, attention, and learning, that can lead to poor school performance and reduced educational and career attainment, early-onset psychotic symptoms in those at elevated risk, addiction in some users, and altered brain development.”

Marijuana use and use disorders in adults in the , 2002–14: analysis of annual cross-sectional surveys, Lancet Psychiatry, (2016).

Commenting on this study to the Associated Press, Dr. Wilson Compton, Deputy Director of said, “if anything, science has shown an increasing risk that we weren’t as aware of years ago.” He added that other research has increasingly linked marijuana use to mental impairment, and early, heavy use by people with certain genes to increased risk of developing

psychosis.

Prenatal marijuana exposure, age of marijuana initiation, and the development of psychotic symptoms in young adults, Psychological Medicine, (2015).

Prenatal marijuana exposure linked to bad childhood outcomes; if effect is further “mediated” through early onset marijuana use, strong association with negative adult outcomes, such as arrest, low educational performance, unemployment.

One in six children hospitalized for lung inflammation positive for marijuana exposure, American Academy of Pediatrics, (2016).

Colorado: 16% of exposed children admitted to hospital for lung inflammation tested positive for MJ metabolite.

Cannabis use increases risk of premature death, American Journal of Psychiatry, (2016).

Cannabis use in youth increases the risk of early death.

Scientists Call for Action Amidst Mental Health Concerns, The Guardian, (2016).

“Most research on cannabis, particularly the major studies that have informed policy, are based on older low-potency cannabis resin.” According to Sir Robin Murray, professor of psychiatric research at King’s College London: “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.””

Marijuana use in adolescence may increase risk for psychotic symptoms, American Journal of Psychiatry, (2016).

Chronic marijuana use in adolescent boys increases risk of developing persistent subclinical psychotic symptoms (hallucinations, paranoia). “For each year adolescent boys engaged in regular marijuana use … subsequent symptoms increased by 21% and… paranoia or hallucinations increased by 133% and 92%, respectively. This effect persisted even when [study] participants stopped using marijuana for 1 year.”

Heavy, persistent pot use linked to economic, social problems at midlife, Clinical Psychological Science, (2016).

“Regular long-term [marijuana] users also had more antisocial behaviors at work, such as stealing money or lying to get a job, and experienced more relationship problems, such as intimate partner violence and controlling abuse.”

Effects of Cannabis Use on Human Behavior, Including Cognition, Motivation, and Psychosis: A Review, Psychiatry, (2016).

This longitudinal study documented adolescent-onset (but not adult-onset) persistent cannabis users showed neuropsychological decline ages 13 to 38 years. “Longitudinal investigations show a consistent association between adolescent cannabis use and psychosis. Cannabis use is considered a preventable risk factor for psychosis… strong

physiological and epidemiological evidence supporting a mechanistic link between cannabis use and schizophrenia… raise[s] the possibility that our current, limited knowledge may only apply to the ways in which the drug was used in the past.”

Marijuana use disorder is common and often untreated, National Institute of Health/NESARC, (2016).

“People with marijuana use disorder are vulnerable to other mental health disorders … onset of the disorder was found to peak during late adolescence. …People with marijuana use disorder…experience considerable mental disability. …Previous studies have found that such disabilities persist even after remission of marijuana use disorder.”

The health and social effects of nonmedical cannabis use, World Health Organization, (2016).

“There is a worrying increasing demand for treatment for cannabis use disorders and associated health conditions in high- and middle-income countries, and there has been increased attention to the public health impacts of cannabis use and related disorders in international policy dialogues.”

AKT1 genotype moderates the acute psychotomimetic effects of naturalistically smoked cannabis in young cannabis smokers, Translational Psychiatry, (2016).

“Smoking cannabis daily doubles an individual’s risk of developing a psychotic disorder, yet indicators of specific vulnerability have proved largely elusive. Genetic variation is one potential risk modifier.”

What’s That Word? Marijuana May Affect Verbal Memory, Internal Medicine, (2016).

Researchers found a “dose-dependent independent association between cumulative lifetime exposure to marijuana and worsening verbal memory in middle age.”

Adolescent Cannabinoid Exposure Induces a Persistent Sub-Cortical Hyper-Dopaminergic State and Associated Molecular Adaptations in the Prefrontal Cortex., Cerebral Cortex, (2016).

“We report that adolescent, but not adult, exposure induces long-term neuropsychiatric-like phenotypes similar to those observed in clinical populations…. findings demonstrate a profound dissociation in relative risk profiles for adolescent versus adulthood exposure to in terms of neuronal, behavioral, and molecular markers resembling neuropsychiatric pathology.”

Cannabis increases the noise in your brain, Biological Psychiatry, (2015).

“At doses roughly equivalent to half or a single joint, ∆9- produced psychosis-like effects and increased neural noise in humans. The dose-dependent and strong positive relationship between these two findings suggest that the psychosis-like effects of cannabis may be related to neural noise which disrupts the brain’s normal information processing activity.”

Marijuana Use: Detrimental to Youth, American College of Pediatricians, (2016).

“Marijuana is the leading illicit substance mentioned in adolescent emergency department admissions and autopsy reports, and is considered one of the major contributing factors leading to violent deaths and accidents among adolescents.”

Chronic Adolescent Marijuana Use as a Risk Factor for Physical and Mental Health Problems in Young Adult Men, Psychology of Addictive Behaviors, (2015).

Evidence suggests that youth who use marijuana heavily during adolescence may be particularly prone to health problems in later adulthood (e.g., respiratory illnesses, psychotic symptoms).

Developmental Trajectories of Marijuana Use among Men, Journal of Research in Crime and Delinquency, (2015).

“Young men who engage in chronic marijuana use from adolescence into their 20s are at increased risk for exhibiting psychopathic features, dealing drugs, and enduring drug-related legal problems in their mid-30s.”

Appraising the Risks of Reefer Madness, Cerebrum, (2015).

“Cannabis is generally accepted as a cause of schizophrenia (though less so in North America, where this topic has received little attention),” notes Dr. R. Murray, an Oxford University Professor of Psychiatry.

Prenatal exposure to cannabinoids evokes long-lasting functional alterations by targeting CB1 receptors on developing cortical neurons, Adán de Salas-Quiroga, (2015).

“Prenatal exposure to cannabinoids evokes long-lasting functional alterations by targeting CB1 receptors on developing cortical neurons.” “This study demonstrates that remarkable detrimental consequences of embryonic exposure on adult-brain function, which are evident long after withdrawal, are solely due to the impact of on CB1 receptors located on developing cortical neurons.” Embryonic exposure increased seizures in adulthood and the consequences of prenatal were lifelong; even though the cannabinoid receptors after withdrawal appear normal, there is an apparent impact on connectivity.

Association Between Use of Marijuana and Male Reproductive Hormones and Semen Quality: A Study Among 1,215 Healthy Young Men, American Journal of Epidemiology, (2015).

“Regular marijuana smoking more than once per week was associated with a 28% … lower sperm concentration and a 29% … lower total sperm count after adjustment for confounders.”

Is Marijuana Use Associated With Health Promotion Behaviors Among College Students? Health-Promoting and Health-Risk Behaviors Among Students Identified Through Screening in a University Student Health Services Center, Journal of Drug Issues, (2015).

“Results showed marijuana users were more likely to use a variety of substances and engage in hazardous drinking than non-users.”

Psychosocial sequelae of cannabis use and implications for policy: findings from the Christchurch Health and Development Study, Social Psychiatry and Psychiatric Epidemiology, (2015).

“Findings…suggest that individuals who use cannabis regularly, or who begin using cannabis at earlier ages, are at increased risk of a range of adverse outcomes, including: lower levels of educational attainment; welfare dependence and unemployment; using other, more dangerous illicit drugs; and psychotic symptomatology.”

Young brains on cannabis: It’s time to clear the smoke, Clinical Pharmacology and Therapeutics, (2015).

“There is certainly cause for concern about the amount and frequency of cannabis use among youth….Recent evidence shows that early and frequent use of cannabis has been linked with deficits in short-term cognitive functioning, reduced IQ, impaired school performance, and increased risk of leaving school early – all of which can have significant consequences on a young person’s life trajectory….Heavy cannabis use in adolescence is also a risk factor for psychosis….Youth aged 15-24 spent the largest number of days in a hospital for a primary diagnosis of mental and behavioral disorders due to the use of cannabinoids.”

Association Between Lifetime Marijuana Use and Cognitive Function in Middle Age and Long-term Marijuana Use and Cognitive Impairment in Middle Age, Internal Medicine, (2016).

“These studies have generally shown reduced activity in those with long-term marijuana use in brain regions involved in memory and attention, as well as structural changes in the hippocampus, prefrontal cortex, and cerebellum.”

Denial of Petition To Initiate Proceedings To Reschedule Marijuana, Federal Register/DEA Review of “Scientific Evidence of [Marijuana’s] Pharmacological Effects, If Known”, (2016).

“Individuals with a diagnosis of marijuana misuse or dependence who…initiated marijuana use before the age of 15 years, showed deficits in performance on tasks assessing sustained attention, impulse control, and general executive functioning compared to non-using controls. These deficits were not seen in individuals who initiated marijuana use after the age of 15 years…. Additionally, in a prospective longitudinal birth cohort study of 1,037 individuals, marijuana dependence or chronic marijuana use was associated with a decrease in IQ and general neuropsychological performance compared to pre-marijuana exposure levels in adolescent onset users.

The decline in adolescent-onset users’ IQ persisted even after reduction or abstinence of marijuana use for at least 1 year…. The deficits in IQ seen in adolescent-onset users increased with the amount of marijuana used. Moreover, when comparing scores for measures of IQ, immediate memory, delayed memory, and information-processing speeds to pre-drug-use levels, the current, heavy, chronic marijuana users showed deficits in all three measures.”

The health and social effects of nonmedical cannabis use, World Health Organization, (2016).

“Cannabis is globally the most commonly used psychoactive substance under international control. In 2013, an estimated 181.8 million people aged 15−64 years used cannabis for nonmedical purposes globally (uncertainty estimates 128.5–232.1 million) (UNODC, 2015). There is a worrying increasing demand for treatment for cannabis use disorders and associated health conditions in high- and middle-income countries, and there has been increased attention to the public health impacts of cannabis use and related disorders in international policy dialogues.[…] This publication builds on contributions from a broad range of experts and researchers from different parts of the world. It aims to present the current knowledge on the impact of nonmedical cannabis use on health.”

Source:  https://hudson.org/research/12975-marijuana-threat-assessment-part-one-recent-evidence-for-health-risks-of-marijuana-use

In  2014, an estimated 22.2 million Americans aged 12 years or older had used marijuana in the past month.1

Under federal law, marijuana is considered an illegal Schedule I drug. However, over the last 2 decades, more than half of the states have allowed limited access to marijuana or its components, Δ9-tetrahydrocannabinol (THC) and cannabidiol, for medical reasons.2 More recently, 4 states and the District of Columbia have legalized marijuana for recreational purposes.

Currently, evidence for the therapeutic benefits of marijuana are limited to treatment and improvements to certain health conditions (eg, chronic pain, spasticity, nausea).3 Recreational use of marijuana is established by patterns of individual behaviors and lifestyle choices. In either case, use of marijuana or any of its components, especially in younger populations, is associated with an increased risk of certain adverse health effects, such as problems with memory, attention, and learning, that can lead to poor school performance and reduced educational and career attainment, early-onset psychotic symptoms in those at elevated risk, addiction in some users, and altered brain development.4- 7

In September 2016, the Substance Abuse and Mental Health Services Administration and the Centers for Disease and Control and Prevention (CDC) released an issue of the CDC’s Morbidity and Mortality Weekly Report—Surveillance Summary describing historical trends in marijuana use and related indicators among the non-institutionalized civilian population aged 12 years or older using 2002-2014 data from the National Survey on Drug Use and Health (NSDUH).8

During the last 13 years, marijuana access (ie, perceived availability) and use (ie, past-month marijuana use) have steadily increased in the United States, particularly among people aged 26 years or older, increasing from 54.9% in 2002 to 59.2% in 2014 and from 4.0% in 2002 to 6.6% in 2014, respectively. The factors associated with the national behavior patterns of marijuana use cannot be attributed solely to the heterogeneous body of state laws and policies that vary considerably with respect to year of enactment, implementation lag time, and access stipulations.

However, as state laws and policies continue to evolve, these data will be useful as a baseline to monitor changes in patterns of use and associated variables. Monitoring behavioral patterns is important given the possible increased risk of adverse health consequences due to potency changes—higher concentrations of THC (the psychoactive compound)—of the cannabis plant in the United States in the last 2 decades.9

Estimates from NSDUH data suggest that in 2014, 2.5 million persons aged 12 years or older had used marijuana for the first time within the past 12 months; this projected estimate suggests that there is an average of about 7000 new users each day (approximately 1000 more new users each day in 2014 compared with in 2002). In 2014, mean age at first use of marijuana was 19 years among persons aged 12 years or older and was 15 years among persons aged 12 to 17 years.8

During 2002-2014, the estimated prevalence of marijuana use in the past month, in the past year, and daily or almost daily increased among persons aged 18 years or older but

not among those aged 12 to 17 years, while the perceived risk from smoking marijuana decreased across all age groups. Conversely, the estimated prevalence of past-year marijuana dependence decreased from 1.8% in 2002 to 1.6% in 2014 among all persons aged 12 years or older and from 16.7% in 2002 to 11.9% in 2014 among past-year marijuana users.

Overall, the perceived availability to obtain marijuana among persons aged 12 years or older increased, and acquiring marijuana by buying the drug and growing it increased vs obtaining marijuana for free and sharing the drug. The percentage of persons aged 12 years or older perceiving that the maximum legal penalty for the possession of 1 oz or less of marijuana in their state of residence is a fine and no penalty increased vs perceptions that penalties included probation, community service, possible prison sentence, and mandatory prison sentence.8

These findings on perceived availability to obtain marijuana and fewer punitive legal penalties (eg, no penalty) for the possession of marijuana for personal use may play a role in the observed increased prevalence in use among adults in the United States. However, surveillance data do not reveal causal relationships; therefore, more granular research is needed.

As states adopt policies that increase legal access to marijuana, new indicators will be needed to understand trends in marijuana use and the risk of health effects. Questions regarding mode of use (eg, smoked, vaped, dabbed, eaten, drunk), frequency of use, potency of marijuana consumed, and reasons for use (ie, medical use, recreational use, or both) could be added to existing surveillance systems or launched in new systems.

Traditionally, understanding factors underlying the trends in marijuana use have been assessed by looking at 1 or 2 indicators (eg, perception of harm risk or dependence or abuse). A multivariable approach that includes environmental (eg, law enforcement, laws/policies) and cultural (eg, religion, individual choice) factors might be required to understand the relationship between the perceptions and attitudes toward marijuana and use behavior.

The health effects associated with marijuana use are still widely debated. Nonetheless, marijuana use during early stages of life, when the brain is developing, poses potential public health concerns, including reduced educational attainment, addiction in some users, poor education outcomes, altered brain structure and function, and cognitive impairment.4- 7

Given these potential health and social consequences of marijuana use, additional data sources at the federal and state levels may be required to assess the public health effects of marijuana use. These sources may include data from sectors such as health care (eg, emergency department data), criminal justice (eg, law enforcement data), education (eg, school attendance and performance data), and transportation (eg, motor vehicle injury data).

Assessing the prevalence and public health effects of marijuana use in the United States remains important given the evolving policies for marijuana for medical or recreational use at the state level. Therefore, it is vital to continue to monitor key traditional marijuana indicators but also to enhance public health surveillance to include monitoring of indicators that assess emerging issues so that public health actions could prevent adverse health consequences.

Given that legislation, types of products, use patterns, and evidence for potential harms and benefits of marijuana and its compounds are all evolving, clinicians need to understand the magnitude of marijuana use and associated behaviors so they can provide informed answers to patient questions, screen, counsel, treat, and refer patients to community treatment or counseling centers if abuse or adverse effects are identified.

Source: JAMA. 2016;316(17):1765-1766. doi:10.1001/jama.2016.13696

.1) Here is link to today’s Denver Post article highlighting proposed budget cuts by Colorado’s Governor.  http://www.denverpost.com/2016/11/01/2018-colorado-budget-john-hickenlooper-cuts/

While many representing Colorado along with media often portray the roll out of marijuana legalization/commercialization as going  “fairly well” or not  “as bad as we thought”,  the actual budget numbers paint a very concerning picture.

The Governor is now proposing new and significant budget cuts for this upcoming legislation session in the following areas:  capital construction for our schools, health and human services,  public safety/courts, healthcare including Colorado hospitals, and education including K-12 and higher education.  Areas that have experienced and reported increased negative impacts and/or costs associated with increased marijuana availability/commercialization.

Areas mentioned where marijuana tax revenues will be spent highlight some of the negative impacts from increased marijuana availability/commercialization, and include:

“Hiring of more mental health professionals in schools and child welfare caseworkers“

$18 million program to create affordable housing for the homeless” (Denver has reported dramatic increases in student homelessness as has other areas in Colorado)

“$16 million in marijuana taxes for forthcoming initiative to control the illegal pot trade operating in the shadows of the state’s legal industry” (Attached below is recent state report highlighting growth of illegal grey and black markets in Colorado to include new criminal and cartel activities and involvement)

Colorado’s Governor Hickenlooper says the budget plan’s priority is “to minimize the pain”

Yet, Coloradans were promised that marijuana tax revenues would be a boon to our state and schools.  And sadly and most disappointedly, many of the cuts being proposed are in the precise areas that funds are now needed more than ever because of the negative impacts from marijuana legalization/commercialization.

Article also highlights the possible elimination of marijuana coordination staff/office (Andrew Freedman and his staff) . Which may potentially make it even more difficult to ensure that the special interests and powerful commercial marijuana interests guiding much of Colorado’s policy making to date along with key leaders,  may never be held accountable for the costs and or negative impacts/burdens to the public of its troublesome implementation.   Further, it may make capturing data and impacts from marijuana legalization/commercialization, even more difficult than it already has been.  Which is deeply troubling as capturing such data and reporting impacts has been something few state leaders have wanted to be held responsible for doing.  With few having the courage or wherewithall, including media,  to ask:  “Why?”  Even though marijuana has been legalized/commercialized in Colorado for years now.

2) Below is recent editorial of Pueblo Chieftain, Pueblo’s main newspaper, in support of the citizen effort to reverse decision by Pueblo City Council members opting for marijuana commercialization.  Which was an important provision in Colorado’s Constitution legalizing marijuana with approximately 70% of Colorado’s cities and

counties wisely opting out in order to better protect kids, schools and communities in their municipalities.  This is very significant as the Pueblo Chieftain, like other newspapers in Colorado including Colorado’s main newspaper, The Denver Post,  have benefited tremendously from increased advertising revenues from commercial marijuana businesses/interests.  And due to the fact the Pueblo Chieftain was initially very supportive of marijuana commercialization, and now feels differently due to negative impacts as described in their editorial, which is attached below.

3) Regarding messaging around Colorado’s Healthy Kid Survey which in 2015   “randomly” selected youth surveys to use (i.e didn’t use all surveys collected)  in its final data analysis versus national health surveys that use different and more weighted approaches that show Colorado now ranks number one for youth marijuana use ages 12 and up.  With Colorado educators as reported in both Colorado’s main newspapers (The Denver Post and Colorado Gazette) reporting that marijuana has become number one issue Colorado public schools are facing.

As Colorado’s 2015 statewide Healthy Kid Survey shows, reported marijuana use in our state varies dramatically by region for several reasons. Here is link to infographic by Colorado State Health Department.  https://www.colorado.gov/pacific/sites/default/files/PF_Youth_HKCS_MJ-Infographic-Digital.pdf.

Please note that in areas where there has been tremendous marijuana availability/commercialization (with Denver and Pueblo being the two municipalities that have become epicenters of commercialized marijuana businesses and special interests)  youth use is very high and reaches up to 30.1% of  high schoolers reporting using once or more in last month (which prevention world defines as “regular”  use).

This is very high and far exceeds levels that led to national youth tobacco campaigns and public outcry around youth tobacco use years ago.  It’s even more concerning when one considers that the average THC levels of Colorado marijuana today far exceeds levels what health experts in the Netherland concluded in 2014 report, should be considered a hard drug.   Also, note that in 2015 Healthy Kid Survey while 91% of surveyed high schoolers reporting regular marijuana use say they are smoking it, 28% say they are dabbing it, 28% say they are eating it, and 21% say they are vaping it, which is deeply troubling as is the lowering perception of harm of our youth throughout the state (an evidence based predictor of future increased use based on what we’ve learned from studying other substances) as  highlighted in the infographic provided by Colorado’s Public Health Department.

4) Additional information.  Attached is link to recent article published in Denver Post highlighting that Colorado adults now rank as top consumers of not only marijuana, but also alcohol, cocaine, and non prescription opioids. http://www.denverpost.com/2016/05/23/colorado-first-in-drugs-survey/

Links to PBS segment covering deaths associated to Colorado’s high THC marijuana can be found in recent press release and action alert, attached below.  Here is link to pdf of October 10th presentation that can be downloaded http://smartcolorado.org/resources/ from our website and contains additional information, and a link to brief policy brief of what we at Smart Colorado have learned from Colorado’s marijuana commercialization experiment  smartcolorado.org/lessons-learned.  Of course, the recent 60 minute news segment was powerful and gave only small a window into the heart wrenching impacts marijuana commercialization is having on Pueblo citizens.  I have also included recent report presented to state legislators from Pueblo’s largest human service agency, Posada, regarding impacts.

http://www.chieftain.com/mobile/msearch/5258397-123/marijuana-pueblo-retail-community

EDITORIAL

Retail marijuana: Yes or no?

CHIEFTAIN EDITORIAL

Published: October 29, 2016; Last modified: October 29, 2016 04:16PM

The legalization of retail marijuana stores two years ago has had profound impacts on the city and county of Pueblo. Some good. Some bad.

Now, the time has come for Pueblo voters to decide whether the benefits outweigh the negatives.

For months, The Pueblo Chieftain has been intensely studying this issue, both with special and ongoing news reporting, and also with private editorial board discussions with those for and against retail marijuana stores and grow operations.   It is an understatement to say the issue is complicated. So bear with us as we try today to discuss the essential concerns.

On the positive side, retail marijuana in Pueblo County — not in the city, where a moratorium on retail sales has been in place since legalization in 2014 — has meant jobs. The figure of 1,300 new jobs has been tossed about, but frankly, we’ve been unable to pin down the exact number.

The jobs range from cultivation workers to retail management. Some of the jobs pay fairly well, but others pay relatively low wages. There are many part-time workers in the field.

Tax revenues have benefited the county, with the total for 2016 expected to be somewhere in the $2.5 million range. Those proceeds have been used for a variety of purposes such as road paving in Pueblo West and scholarships for local students. And the revenues have risen in each of the years retail marijuana has been sold here.

There have been secondary benefits such as to the construction industry, which has remodeled buildings and built new stores, greenhouses and other structures. A number of vacant warehouse-type buildings have been purchased and put to use by marijuana retailers and related businesses.

That all adds up to a significant impact in terms of primary and secondary jobs, and increased revenue for local county government.

The City Council, on the other hand, put a moratorium on retail stores, but is asking voters this year to approve Ballot Question 2B to allow retail operations within the city limits.

If that were to pass, there is no doubt that the city would see benefits similar to what the county has experienced.  There also are the arguments that center around health, with proponents praising marijuana for helping treat all sorts of conditions, perhaps most visibly post-traumatic stress disorder, especially among military veterans.

Opponents argue that more testing is needed before such claims can be verified, and they point to medical studies that clearly establish the negative effects of marijuana on adolescents and young adults as their brains still are developing. They say it’s indisputable that marijuana impedes brain development.

The arguments over health claims cannot be resolved here, or anywhere for that matter. Passion runs high on both sides and there are conflicting test results.  Besides, we feel the time to make those arguments should have been in 2014.

No, we feel we must put the focus today on the benefits and negatives to the community, not the individuals. Sure, the latter is a valid debate topic, but for the sake of today’s conversation, let’s set that one aside for a different time.  So far, we’ve discussed the benefits, and there is no doubt that they are significant.

The negative impacts likewise are significant.

Local experts in law enforcement and nonprofits, particularly those who work with the homeless such as Posada, estimate that some 2,500 additional homeless people — added to an estimated 1,700 homeless here before retail marijuana was legalized — have come to Pueblo to buy and use marijuana. Maybe they came here with a dream to work in the industry, but that hasn’t materialized for most of them.

You see them everywhere, young people on street corners with their backpacks and their dogs, holding signs asking people for money. “Need money for gas,” “Need money for food” the signs read, but the reality is that they want money so they can go into a retail marijuana store, buy product and get stoned.  It is almost impossible to go into a grocery store or big box store parking lot and not be confronted by these individuals. And many are aggressive.

Where do they live? In tents along the Fountain Creek and Arkansas River, in cars parked on the edges of big parking lots, camping out wherever they can find shelter.  Emergency rooms at our local hospitals are beset by these individuals. Doctors and staff tell of heartbreaking stories of young families with malnourished children who are putting those youths through hell so the parents can smoke marijuana.

Ominously, doctors also tell about other individuals they see in the ERs, people who suffer from brain disorders such as schizophrenia who have stopped taking their medications and have come to Pueblo for marijuana. Never mind that marijuana doesn’t successfully treat schizophrenia, a potentially dangerous disorder if, for example, it manifests itself as paranoid schizophrenia. No, these ill people have come to Pueblo for marijuana, thinking incorrectly that they can substitute their pharmaceuticals for pot, and our local ERs and their staffs have to deal with this every day.

These homeless who have come into our community have brought nothing but trouble with them. Yet our community is straining to provide them resources, resources that had been dedicated to Puebloans in need.  But of all of the negative impacts on our community, the worst is the impact of image.  One county commissioner predicted early on — and astoundingly, he thought this was a good thing — that Pueblo is on the way to becoming the “Napa Valley of marijuana.”  That may be the case if the retail industry — especially grow operations — continues to expand at the exponential rate we’ve seen since 2014.

However, we think it’s a negative for our community to be regarded as a center for a drug culture. There’s no doubt, local economic development people say, that our community already is known nationwide for marijuana. And that means, they continue, that many businesses considering relocating to Pueblo or opening a new business here want no part of a community that worships marijuana.

Likewise, existing businesses have struggled to hire employees who can pass drug tests. And those who are required by law to maintain a drug-free work environment have struggled to meet that standard because of drug or alcohol use. Business leaders note

they have seen a dramatic worsening of these issues since recreational marijuana was legalized in 2014.

There have been crime issues. Sophisticated drug operations based in Florida, with Cuban ties, have set up marijuana grow operations, most notably in Pueblo West. And there has been an increase in thefts since marijuana has been available in stores, with opponents of marijuana saying the explanation for the increase is simple: Users, especially those not working and homeless, need money for marijuana.

A group of citizens calling themselves Citizens for a Healthy Pueblo circulated petitions and have placed two issues on this fall’s election ballot. Issues 300 and 200 would ban retail marijuana establishments in the city and county, respectively, and existing stores would have until Oct. 31, 2017, to close.  The group acknowledges that there have been financial benefits and some jobs created. But they argue that Pueblo has made a deal with the devil and they ask a simple question, “Is this really what we want, for Pueblo to be synonymous with marijuana?”

We have the same concern. Has Pueblo sold its soul for a few million dollars in revenue and jobs, the majority of which are relatively low-paying? Do we want our warehouses full of marijuana grows and/or related products?  Do we want to be hassled by someone on every major street corner, or when we go to restaurants and go shopping? Do we want our community overrun by outsiders who offer us nothing except grief and who deplete the resources of our nonprofits, which struggle just to meet Puebloans’ many needs?

In short, while some benefits are real, the costs have been too high.  It’s time to say we have tried this social experiment, tried allowing retail marijuana stores in Pueblo, and we don’t want it anymore.

We urge you to vote yes on County Ballot Question 200 and City Ballot Question 300, and vote no on City Ballot Question 2B (which would allow retail stores within the city limits, as there are none currently).

We know this won’t get rid of marijuana in Pueblo, as medical marijuana was approved years ago by state voters. However, the process to get a medical marijuana card has become significantly more difficult in recent years, and we encourage the state Legislature to make it even tougher.

And while lawmakers are at it, raise the age to 21 from 18 for those eligible for a medical marijuana card. Also, eliminate the entire caregivers system. If marijuana is really a medication, then grow it in a controlled, government-regulated and government-tested facility, with complete product standards — as opposed to being grown in someone’s garage.

The notion of a person growing a drug for another is ludicrous. We demand that the Legislature put an end to this nonsense.

Those who truly need marijuana will still be able to get it. And, we realize, those who want it for recreational use can drive elsewhere in the state to purchase it.

But we are convinced that this is not the image of Pueblo that our community wants to project. We are better than this.   We made a mistake in even going this far, but frankly, that was in large part thanks to our county commissioners, who shoved retail marijuana operations down the throats of communities such as Pueblo West and the St. Charles Mesa, where there was and is significant opposition.  Then the commissioners set up a buffer, a bogus marijuana licensing board made up of the usual suspects to rubber-stamp applications and protect the commissioners from those objecting.

Very well. We have the opportunity now to admit our mistake.

Vote yes on 200 and 300; and no on City Ballot Question 2B.

Source:  : Diane Carlson <diane@smartcolorado.org> Sent: Wed, Nov 2, 2016 3:27 pm Subject: Information from CO for states considering marijuana ballot initiatives

Abstract

BACKGROUND:

There is concern that medical marijuana laws (MMLs) could negatively affect adolescents. To better understand these policies, we assess how adolescent exposure to MMLs is related to educational attainment.

METHODS:

Data from the 2000 Census and 2001-2014 American Community Surveys were restricted to individuals who were of high school age (14-18) between 1990 and 2012 (n=5,483,715). MML exposure was coded as: (i) a dichotomous “any MML” indicator, and (ii) number of years of high school age exposure. We used logistic regression to model whether MMLs affected: (a) completing high school by age 19; (b) beginning college, irrespective of completion; and (c) obtaining any degree after beginning college. A similar dataset based on the Youth Risk Behavior Survey (YRBS) was also constructed for confirmatory analyses assessing marijuana use.

RESULTS:

MMLs were associated with a 0.40 percentage point increase in the probability of not earning a high school diploma or GED after completing the 12th grade (from 3.99% to 4.39%). High school MML exposure was also associated with a 1.84 and 0.85 percentage point increase in the probability of college non-enrollment and degree non-completion, respectively (from 31.12% to 32.96% and 45.30% to 46.15%, respectively). Years of MML exposure exhibited a consistent dose response relationship for all outcomes. MMLs were also associated with 0.85 percentage point increase in daily marijuana use among 12th graders (up from 1.26%).

CONCLUSIONS:

Medical marijuana law exposure between age 14 to 18 likely has a delayed effect on use and education that persists over time.

Source:  https://www.ncbi.nlm.nih.gov/pubmed/27742490 Drug Alcohol Depend. 2016 Nov 1;168:320-327. doi: 10.1016/j.drugalcdep.2016.09.002. Epub 2016 Oct 11.

Wall Street Journal Editorial Board

Marijuana is now legal in 25 states for medicinal purposes and in four for recreational use. Voters in another five have a chance on Nov. 8 to legalize the retail consumption of pot, but the evidence rolling in from these real-time experiments should give voters pause to consider the consequences.

In 2012 Colorado and Washington voters legalized recreational pot, followed by Alaska and Oregon two years later. Initiatives this year in California, Arizona, Nevada, Maine and Massachusetts would allow businesses to sell and market pot to adults age 21 and older.

Adults could possess up to one ounce (more in Maine) and grow six marijuana plants. Public consumption would remain prohibited, as would driving under the influence. Marijuana would be taxed at rates from 3.75% in Massachusetts to 15% in the western states, which would license and regulate retailers.

Marijuana is a Schedule I drug under the federal Controlled Substances Act of 1970, which prohibits states from regulating possession, use, distribution and sale of narcotics. However, the Justice Department in 2013 announced it wouldn’t enforce the law in states that legalize pot. Justice also promised to monitor and document the outcomes, which it hasn’t done. But someone should, because evidence from Colorado and Washington compiled by the nonprofit Smart Approaches to Marijuana suggests that legalization isn’t achieving what supporters promised.

One problem is that legalization and celebrity glamorization have removed any social stigma from pot and it is now ubiquitous. Minors can get pot as easily a six pack. Since 2011 marijuana consumption among youth rose by 9.5% in Colorado and 3.2% in Washington even as it dropped 2.2% nationwide. The Denver Post reports that a “disproportionate share” of marijuana businesses are in low-income and minority communities. Many resemble candy stores with lollipops, gummy bears and brownies loaded with marijuana’s active ingredient known as THC.

The science of how THC affects young minds is still evolving. However, studies have shown that pot use during adolescence can shave off several IQ points and increase the risk for schizophrenic breaks. One in six kids who try the drug will become addicted, a higher rate than for alcohol. Pot today is six times more potent than 30 years ago, so it’s easier to get hooked and high.

Employers have also reported having a harder time finding workers who pass drug tests. Positive workplace drug tests for marijuana have increased 178% nationwide since 2012. The construction company GE Johnson says it is recruiting construction workers from other states because it can’t find enough in Colorado to pass a drug test.

Honest legalizers admitted that these social costs might increase but said they’d be offset by fewer arrests and lower law enforcement costs. Yet arrests of black and Hispanic youth in Colorado for pot-related offenses have soared 58% and 29%, respectively, while falling 8% for whites.

The share of pot-related traffic deaths has roughly doubled in Washington and increased by a third in Colorado since legalization, and in the Centennial State pot is now involved in more than one of five traffic fatalities. Calls to poison control for overdoses have jumped 108% in Colorado and 68% in Washington since 2012.

Colorado Attorney General Cynthia Coffman has said that “criminals are still selling on the black market,” in part because state taxes make legal marijuana pricier than on the street. Drug cartels have moved to grow marijuana in the states or have switched to trafficking in more profitable drugs like heroin.

One irony is that a Big Pot industry is developing even as tobacco smokers are increasingly ostracized. The Arcview Group projects that the pot market could triple over four years to $22 billion. Pot retailers aren’t supposed to market specifically to kids, though they can still advertise on the radio or TV during, say, a college football game. Tobacco companies have been prohibited from advertising on TV since 1971.

The legalization movement is backed by the likes of George Soros and Napster co-founder Sean Parker, and this year they are vastly outspending opponents. No wonder U.S. support for legalizing marijuana has increased to 57% from 32% a decade ago, according to the Pew Research Center.

We realize it’s déclassé to resist this cultural imperative, and maybe voters think the right to get high when you want is worth the social and health costs of millions of more stoners. Then again, since four states have volunteered to be guinea pigs, maybe other states should wait and see if these negative trends continue.

Source:  Release from SAM  October 2016

* Cannabis impairs cognitive and psychomotor performances.

* An 8-h delay after maximal effects is recommended for cannabis self-treatment.

* Blood THCCOOH level >40 μg/l suggests regular cannabis use and long-term impairment.

* No correlation was found between psychomotor task performance and THC blood levels.

* Acute cannabis consumption nearly doubles the risk of a collision.

Abstract

Traffic policies show growing concerns about driving under the influence of cannabis, since cannabinoids are one of the most frequently encountered psychoactive substances in the blood of drivers who are drug-impaired and/or involved in accidents, and in the context of a legalization of medical marijuana and of recreational use.

The neurobiological mechanisms underlying the effects of cannabis on safe driving remain poorly understood. In order to better understand its acute and long-term effects on psychomotor functions involved in the short term ability and long-term fitness to drive, experimental research has been conducted based on laboratory, simulator or on-road studies, as well as on structural and functional brain imaging.

Results presented in this review show a cannabis-induced impairment of actual driving performance by increasing lane weaving and mean distance headway to the preceding vehicle. Acute and long-term dose-dependent impairments of specific cognitive functions and psychomotor abilities were also noted, extending beyond a few weeks after the cessation of use.

Some discrepancies found between these studies could be explained by factors such as history of cannabis use, routes of administration, dose ranges, or study designs (e.g. treatment blinding). Moreover, use of both alcohol and cannabis has been shown to lead to greater odds of making an error than use of either alcohol or cannabis alone. Although the correlation between blood or oral fluid concentrations and psychoactive effects of THC needs a better understanding, blood sampling has been shown to be the most effective way to evaluate the level of impairment of drivers under the influence of cannabis. The blood tests have also shown to be useful to highlight a chronic use of cannabis that suggests an addiction and therefore a long-term unfitness to drive. Besides blood, hair and repeated urine analyses are useful to confirm abstinence

Source:  Elsevier Journal Alerts Volume 268, Pages 92–102  November 2016