Effects of Drugs

As part of a ‘painful period’ of cuts, Trump and RFK Jr. plan on dismantling the agency that focuses on substance abuse.

 by Jonathan Cohn – Mar 30, 2025
ONE OF THE BIGGEST ADVANCES in public health from the last few years is one that you’ve probably never heard about—and one that now may be in jeopardy thanks to the Trump administration.

I’m talking about a dramatic turnaround in America’s opioid crisis, the epidemic that began in the late 1990s with an explosion in the use of addictive prescription painkillers, and then got even worse with a surge in the use of heroin and its synthetic alternative, fentanyl. The effects have left families, communities, and in some cases whole regions of the country reeling, and more than 700,000 Americans dead from overdoses.

But recently the death rate from overdoses has started to fall. In the latest twelve-month period that the official data captures, the decline has been particularly steep: 24 percent.

In raw numbers, that’s 27,000 fewer deaths over the course of a year—a figure that, as Johns Hopkins University professor Brendan Saloner told me in an interview, is “astonishing.”

Pinpointing the cause of the drop is, as always, difficult. Researchers like Saloner think it’s most likely a combination of factors—like changes in the purity of fentanyl available from dealers and more effective interdictions of foreign smuggling chains. There’s also the grim possibility of a “burning out” effect, as the people most likely to overdose die off.

But another likely factor, in the view of most experts, has been a surge in federal support for substance abuse programs.

That includes the programs offering prevention, treatment, and recovery services, as well as those focusing on “harm reduction” strategies like the distribution of Naloxone, the fast-acting drug that can keep overdose victims alive long enough to get them emergency medical care.

The surge started with legislation that Barack Obama signed in the final year of his presidency, but in the years that followed the effort was relatively bipartisan. That included support from Donald Trump, who talked frequently about the opioid crisis during the 2016 campaign and then, as president, returned to the subject in a memorable October 2017 speech.

“As Americans, we cannot allow this to continue,” Trump said, citing his late brother’s difficulties with alcoholism as a personal connection to the issue. “It is time to liberate our communities from this scourge of drug addiction.” And although his record didn’t really live up to his rhetoric, his administration did launch several anti-opioid initiatives.

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But just nine days later, Kennedy announced sweeping layoffs designed to slash HHS staff by 25 percent, as part of a broader reorganization that will partly dismantle several of the department’s smaller agencies. One of them is an agency that’s been at the center of the federal opioid effort.

IT’S CALLED the Substance Abuse and Mental Health Services Agency, or SAMHSA. And if you’ve never heard of it, don’t feel bad. Most people haven’t.

But SAMHSA is the agency that awards and manages the big grant program that states use to finance their substance abuse efforts. It’s also the agency that runs the National Survey on Drug Use and Health, the gold-standard assessment that policymakers and researchers rely on to understand trends and shifts in how people are using drugs.

Other SAMHSA duties include establishing best practices for different types of substance abuse initiatives, offering training programs for substance abuse workers, and operating the new 988 hotline for suicide and mental health crises.1 In order to keep close tabs on what’s actually happening in the country—and maintain an ongoing dialogue with local officials—SAMHSA had staff in the ten HHS regional offices.

Now all of that is going to change. The plan Kennedy announced will eliminate SAMHSA as a separate entity, folding it and several other smaller agencies into a new division called the “Administration for a Healthy America.” It will also cut the number of HHS regional offices in half, leaving just five.

And while HHS officials have not specified publicly how many SAMHSA staff will lose their jobs, the New York Times has reported (and a source familiar with discussions has since confirmed to me) that Kennedy and his lieutenants have talked about reducing the agency’s headcount by half, with occasional mention of even bigger cuts.

The official rationale for the cuts and consolidation is that they will make SAMHSA work better: “Transferring SAMHSA to AHA will increase operational efficiency and assure programs are carried out because it will break down artificial divisions between similar programs,” an HHS press release said.

“This will be a painful period for HHS,” Kennedy acknowledged, although he vowed that the public won’t feel much of a pinch: “We’re going to do more with less. No American is going to be left behind.”

There’s absolutely nothing controversial about trying to reorganize the sprawling, frequently byzantine structure of HHS, or hacking away at the internal processes and rules that can impede rather than enable progress. Just three years ago, a blue-ribbon commission convened by the Commonwealth Fund—a well-respected, left-leaning think-tank—issued its own call for substantial changes at the department.

But that document was the result of lengthy, careful discussion of priorities and tradeoffs. There are few visible signs that the Trump administration engaged in such deliberations, and plenty of signs that it didn’t—especially at SAMHSA.

SAMHSA GOT ITS FIRST TASTE of cuts back in February, when the Trump administration ordered government-wide firings of “probationary” workers (which meant anybody, whether newly hired or newly promoted, who’d been in their position for less than a year).

Among those hit hardest were the ten regional offices, according to Scott Gagnon, who ran the New England division. SAMHSA’s staffing at several of them fell from four or three workers to one or none, he told me, undermining capabilities and responsiveness in a way that will only get worse with the new cuts HHS just announced.

“Imagine what that means—they’re still going to cover the whole country, but now every office is going to cover up to twelve states, instead of just five or six,” said Gagnon, who is now on administrative leave because the courts ordered the Trump administration to reinstate the probationary workers but HHS hasn’t put them on the job. “In my state of Maine, they would see me several times a year. Now they might be lucky to get one or two visits. It’s just really going to dilute that responsiveness and that connection,”

The damage to SAMHSA’s data collection work could be even more pernicious, several experts told me, because the data is so essential to public and private-sector leaders trying to craft substance abuse policy—and because projects like the big national survey require so much expertise and institutional knowledge to operate.

“That is the only national survey we have on drug use, and if the staff who does that work is cut, then we’re flying blind,” Regina LaBelle, a Georgetown University professor who served in the Obama and Biden administrations, told me.

“Good data actually takes a lot of manpower,” added Kathryn Poe, a health care researcher at the think tank Policy Matters Ohio. “You have to clean it, you have to evaluate it, you have to organize it. You have to make sure that you’re getting accurate reporting. You have to actually analyze it. And all of that is stuff that’s done by humans.”

THE BEST HOPE for the government’s opioid efforts is that all of the talk about making HHS more effective is genuine, that they will cut smartly and not arbitrarily, and that somewhere in the Trump administration there are officials mindful of recent progress and eager to—as Saloner put it to me—“be heroic and do something big and important to sustain what was already underway.”

But it’s awfully hard to imagine such thoughtful, deliberate reforms coming from leaders who wave around chainsaws while discussing their designs on government, or who say their ultimate goal is turning career civil servants into “villains.” And it’s hard to understand how HHS is going to get more efficient when it is shuttering so many offices—and firing so many people—whose very jobs are to watch over agency programs and make sure they are working properly.

“They have the know-how, in-house, to make decisions about how to steer resources, that institutional judgment . . . that’s intangible but super important,” Saloner said, adding that they are also the ones who handle the tedious, unglamorous and essential work “of making sure that there’s compliance with federal standards, that things are being correctly reported, that there’s no misuse or waste of funds.”

As for Trump, his interest in the opioid project also seems suspect at best. The rhetoric from his first campaign and term, whatever its authenticity, featured a discernible empathy for people with substance abuse problems—and a clear commitment to the proposition that an effective strategy included the kinds of investments SAMHSA has managed.

Now, whenever Trump talks about opioids, it’s to raise the specter of fentanyl as a foreign menace, justifying his border policies and posture towards other countries.

Trump is also behind congressional efforts to enact sweeping spending cuts, in order to offset the cost of his multitrillion-dollar tax cut. And although the Republicans in Congress are still arguing over how to do that, it’s easy to imagine them agreeing to cuts in substance abuse funds given that one element of the current strategy—harm reduction—already has loud critics among conservatives, who think it implicitly condones drug use.

And that’s to say nothing of the possibility, which Republicans in Congress have discussed explicitly, of cuts to Medicaid, the federal-state program that pays medical bills for more than 70 million mostly low-income Americans. It is the nation’s single biggest financier of mental health and substance abuse treatment.

If Medicaid shrinks and fewer people have coverage, either states will have to make up for the lost substance abuse funding by pulling funds from elsewhere, or they’ll just let the shortfalls stand. Either way, the result will likely be fewer people getting the help they need and, ultimately, more people dying from overdoses.

It doesn’t have to be that way, as the last two years have shown. But it’s not at all clear the Trump administration knows this—or that it cares.

Source: https://www.thebulwark.com/p/when-make-america-healthy-again-actually-means-opposite-rfk-trump-opioid-overdose-hhs-samhsa-painful

Filed under: Addiction,Drug Specifics,Effects of Drugs,Latest News,Opioids,Political Sector,Prevalence,Prevention and Intervention,USA :
COMMENTARY:  Public Health  – Feb 14, 2025

by Paul J. Larkin – Rumpel Senior Legal Research Fellow and Bertha K. Madras, PhD – Professor of psychobiology at Harvard Medical School, based at McLean Hospital and cross appointed at the Massachusetts General

Key Takeaways

Today, some members of America’s political class are desensitized to the drug crisis. They tolerate normalizing psychoactive substance use.

The relentless movement to legalize drug use has succeeded, largely by appealing to the goodwill and sympathies of the American public.

For supply reduction, the U.S. must send a clear message to the world that we are not an open market for drugs.

The federal government has long sought to prevent the horrors of drug addiction by interdicting the supply of dangerous psychoactive drugs—and reducing demand for them.

One step was the Anti-Drug Abuse Act of 1988. It established the Office of National Drug Control Policy (ONDCP) within the Executive Office of the President. Headed by a director colloquially known as “drug czar,” ONDCP had the task of developing a national drug-control strategy to reduce drug use. Its creation symbolized a strong bipartisan effort to prevent illicit drugs from destroying lives and weakening the nation.

Sadly, we have lost that shared mission. No president since George W. Bush has publicly demonstrated a deep and firm support for ONDCP and its mission.

The agency does not reside in the White House office building, let alone the West Wing. The federal government has largely been a bystander despite the unraveling of restrictive opioid prescribing, state implementation of medical/recreational marijuana programs in violation of federal laws, and the incipient movement by states to legalize psychedelics. Most presidents have largely ignored these trends.

The first Trump administration assembled a commission to combat drug addiction and the opioid crisis. The current one should support a comprehensive effort led by ONDCP to overhaul drug policies and strengthen America’s commitment to reducing and delegitimizing drug use. We need a revitalized ONDCP equipped with innovative goals and measurable outcomes to disrupt the pipeline to addiction and to cease preventable, premature deaths and mental health decline. A single centralized agency ensures coordination across federal agencies, state, and local levels to maximize efficiency and accountability.

Today, some members of America’s political class are desensitized to the drug crisis. They tolerate normalizing psychoactive substance use and the addiction, health crises, deaths, and collateral damage to families that follow.

Reformers advocate destigmatizing regular use of hazardous psychoactive drugs. “Harm reduction” practices, initially framed as temporary measures, now are uncritically promoted in some quarters without clear boundaries or outcome goals.

This “Meet drug users where they are” approach has regressed to a “Leave them where they are” one. The grim realities of “tranq”-induced catatonia on the streets of Philadelphia’s Kensington neighborhood, San Francisco’s Tenderloin district, Boston’s Mass and Cass intersection, and other drug-ridden homeless encampments lay bare the stark failure of America’s waning resolve to minimize drug use.

Among other nations, we are an outlier. America’s drug crisis has escalated dramatically since ONDCP was born. Overdose deaths surged from 3,907 (1.6 per 100,000) in 1987 to a record 107,543 (32.2 per 100,000) in 2023, with teen rates doubling recently. Among twelfth-graders, 13 percent use marijuana daily, despite heightened risks for addiction and psychosis. In 2023, daily use of marijuana and regular use of hallucinogens among 19- to 30-year-olds reached record levels, fueled by pervasive myths about “safety” or “medical” efficacy

Whether used for medical or recreational purposes, or both, 25 percent of cannabis users have a cannabis-use disorder; among twelve- to 24-year-olds, such a disorder is more prevalent than alcohol-use disorder. Over 90 percent of individuals with substance-use disorders (48.7 million people) neither recognize their need for help nor seek treatment.

Topping it off, seizures of fentanyl-laced pills exploded from 49,000 in 2017 to a staggering 115 million in 2023. Reversing this runaway train demands a transformative political and cultural shift led by the president, ONDCP, and Congress.

How?

Start by learning from past mistakes. The relentless movement to legalize drug use has succeeded, largely by appealing to the goodwill and sympathies of the American public. In 1996, activists persuaded California’s voters to adopt marijuana as a medicine by labelling it as “compassionate use” for end-stage cancer and HIV-AIDS wasting.

That success gave legalizers a foothold. Slowly, the movement persuaded other states to adopt medical-use marijuana for myriad purposes without a shred of evidence; this later morphed into recreational-use programs. Dual-purpose “dispensaries” now sell marijuana for any reason. Activists persuaded the medical profession that pain was the “fifth vital sign” and pressured caregivers to prescribe highly addictive opioids liberally for any type of pain. We know where that went.

Finally, recent campaigns to use political means to normalize hallucinogens for medical use bear a striking resemblance to the two campaigns noted above, including media hype and their tendency to lampoon cautious Cassandras. Compassion is a virtue, except when it leads to long-term harm.

Those who are driving the normalization of substance use as a chemical shortcut for pleasure or relief are willing to sacrifice long-term well-being for short-term escapism. Without prevention strategies to disrupt this pathway of use, addiction, and death, no amount of treatment or law enforcement will resolve the crisis.

We should oppose efforts to destigmatize drug use but support destigmatization of individuals with substance-use disorders to ease their entry into treatment and recovery. To end the frequently heard lament of parents—“If only I knew”—we need a national educational campaign that counters the myths promulgated by proponents.

We need more research to understand why substance-use disorders are resistant to treatment- and recovery. Harm-reduction strategies that don’t show objective reductions in disordered use should be challenged. And we must recognize that minorities are hurt, not helped, by liberalizing drug use because it can worsen the conditions in already suffering neighborhoods.

Finally, we should strengthen ONDCP by returning it to cabinet-level status and empowering it to adopt a results-driven business model. Steps would include, on the demand side, ensuring that federal funding is allocated to prevention and treatment programs that prioritize objective, evidence-based positive outcomes.

For supply reduction, the U.S. must send a clear message to the world that we are not an open market for drugs. This will involve stopping the smuggling of fentanyl, dismantling illegal markets, and seizing traffickers’ ill-gotten gains. Incentives and penalties can persuade nations that produce drugs and their precursor chemicals to curb their export of substances poisoning Americans.

President Trump has a unique opportunity to pivot and reform America’s recurring drug crises. A bold approach will signal America’s commitment to reversing our damaging trajectory.

This piece originally appeared in the National Review

Source:  https://www.heritage.org/public-health/commentary/the-drug-crisis-hasnt-gone-away-the-trump-administration-should-confront

Filed under: Culture,Drug Specifics,Drug use-various effects,Effects of Drugs,Mental Health,Political Sector,Prevalence,Prevention and Intervention,Treatment and Addiction,USA,Youth :

by Nora Volkow, Director, NIDA – January 14, 2025

Dr. Nora Volkow outlines a new roadmap for cannabis and cannabis policy research. In this uncertain and rapidly changing landscape, Dr. Volkow emphasizes that research on cannabis and cannabis policy is badly needed to guide individual and public health decision-making.

The greatly increased availability of cannabis over the last two decades has outpaced our understanding of the public-health impacts of the drug. It is now available for medical purposes in most states, and adults may now purchase it for recreational use in nearly half the states. With greater availability has come decreased public perception of harm, as well as increased use.

In this uncertain and rapidly changing landscape, research on cannabis and cannabis policy is badly needed to guide individual and public health decision-making.

The National Survey on Drug Use and Health reported that between 2012 and 2019, past-year use of cannabis among people 12 and older rose from 11 percent to over 17 percent, and although trend comparisons aren’t possible because of changes in the survey’s methodology, in 2022, nearly 22 percent of people had used the drug in the past year. Very steep increases are also being seen in the number of people 65 and older who use cannabis.

At the same time, the cannabis industry is producing an ever-wider array of products with varying and sometimes very high concentrations of delta-9-tetrahydrocannabinol (THC) Greater harms from cannabis use are associated with regular consumption of high-THC doses. And there is a cornucopia of other intoxicating products available to the public, some containing other cannabinoids about which we still know very little.

To create a roadmap for research in this space, NIDA along with the National Center for Complementary and Integrative Health (NCCIH), the National Cancer Institute (NCI), and the Centers for Disease Control and Prevention (CDC), sponsored an independent consensus study by the National Academies of Sciences, Engineering, and Medicine (NASEM). The study resulted in a comprehensive report, Public Health Consequences of Changes in the Cannabis Policy Landscape, that was published in September.

The report describes in detail the different regulatory frameworks that exist in different states, and it draws on prior research to identify policies that are likeliest to have the greatest impact protecting public health. Those include approaches like restrictions on retail sales, pricing, and marketing; putting limits or caps on THC content in products; and laws about cannabis-impaired driving. They also could include different forms of taxation and even state monopolies. While state monopolies have not yet been tried with cannabis, they have proven effective at reducing the public health impacts of alcohol.

But the report also underscores that few conclusions can yet be drawn about the impacts of legalization or the different ways it been implemented. It is clear that people are consuming cannabis more and in a wider variety of ways, and there is some evidence of increases in emergency department visits due to accidental ingestion, car accidents, psychotic reactions, and a condition of repeated and severe vomiting (hyperemesis syndrome). But we are hindered in our further understanding because policy details vary so much between states and because data are collected and reported in so many different ways, making interpretation difficult.

Consequently, the report enumerates recommendations for research that should be conducted by federal, state, and tribal agencies to provide greater clarity and inform policy, including several domains within the purview of the NIH.

The report underscores the need for more detailed information on health and safety outcomes associated with specific policy frameworks. This includes more data on outcomes associated with different regulations for how cannabis products are sold and marketed, whether they can be used in public spaces, and whether more restrictive rules about how cannabis can be sold, such as those existing in other countries like Uruguay, are associated with improved health and safety outcomes. Many states have developed approaches to promote health and social equity, including programs to expunge or seal records of cannabis offenses and preferential licensing for individuals or groups most adversely impacted by the disparities in criminal penalties, but whether these programs will achieve their intended goals also requires careful evaluation.

Finally, more research is needed on the health effects of cannabis use by specific groups like youth, pregnant women, older adults, and veterans, and on its effects in individuals with various medical conditions for which medicinal cannabis might be used. Studies are also needed on health effects of the high-potency and synthetic or semi-synthetic cannabinoid products that are emerging. But the authors underscore that the focus cannot solely be that of risks—it must also include research on potential benefits of cannabis in managing some chronic mental or physical health conditions as well as interactions with prescription drugs that patients may already be taking to manage their health issues.

Much of this research will require or benefit from better surveillance of cannabis cultivation, product sales, and patterns of use. Existing surveillance, as the report points out, has suffered from a lack of funding and coordination, producing gaps in our knowledge. There is also a need for better tests for detecting cannabis impairment. Unlike alcohol, THC remains in the body long after its psychoactive effects have worn off. So, unlike commonly used alcohol sobriety tests, blood tests for cannabis that are currently widely used in law enforcement and employment screening cannot distinguish between recent or past use. Better surveillance and improved tests can inform research on interventions to mitigate risks to health and safety associated with cannabis use. They can also help inform the development of cannabis product safety and quality standards.

Some of the pressing questions identified by the NASEM report are already research priority areas for NIDA. For instance, our medicinal cannabis registry, which was funded starting in 2023, will be able to inform research, policy, and practice by gathering longitudinal data about cannabis use and outcomes from a cohort of people using the drug medicinally. The project will include a program to test the composition and potency of cannabis products used and will integrate registry data with other data sources.

The NIDA-funded Monitoring the Future survey has tracked nationwide cannabis use trends in adolescents and young adults for decades. The survey has recently recorded reduction in teenage use of substances in general, including cannabis, and recent surveys have also shown increases in disapproval of cannabis use and perception of its harms in this age group. However, it continues to show that cannabis is one of the most-used drugs by teenagers, with a quarter of 12th graders reporting use in the past year.

Since its launch nearly a decade ago, the trans-NIH Adolescent Brain Cognitive Development (ABCD) study has been collecting longitudinal data on drug use and its developmental impacts in a large national cohort from late childhood through early adulthood. More recently, ABCD has been complemented by a similar study on the first decade of life, the multi-Institute Healthy Brain and Child Development (HBCD) study. HBCD is recruiting a cohort of pregnant participants across the country and will use neuroimaging and other tools to track the impacts of prenatal exposure to cannabis and other environmental influences on the developing brain. By identifying risk and resilience factors for cannabis use in youth, the data from ABCD and HBCD will be extremely valuable in informing prevention programs in these age groups.

Advances in cannabis and cannabis policy research could be aided by wider adoption of the standard 5mg unit of THC required in research studies funded by NIDA and other NIH Institutes. Adoption of this standard was based on the need for consistency across research studies, which will facilitate more real-world-relevant research and translation of findings into policy and clinical practice. Research using this standard could also provide better insights into the effects of cumulative exposure and long-term developmental and cognitive effects of prenatal exposure.

Scientific research should always drive best practices in public health. To that end, NIDA and other NIH institutes will continue to support essential research on cannabis, the health effects of new products, and the effects of policy changes around this drug. It is essential to ensure that, where they are legal, product contents are accurately represented to the consumer in an environment where public health takes precedence over profits.

Source:  https://nida.nih.gov/about-nida/noras-blog/2025/01/new-roadmap-cannabis-cannabis-policy-research

Filed under: Cannabis/Marijuana,Drug use-various effects,Effects of Drugs,USA :

Sima Patra • Sayantan Patra • Reetoja Das • Soumya Suvra Patra

Published: December 31, 2024

DOI: 10.7759/cureus.76659

Cite this article as: Patra S, Patra S, Das R, et al. (December 31, 2024) Rising Trend of Substance Abuse Among Older Adults: A Review Focusing on Screening and Management. Cureus 16(12): e76659. doi:10.7759/cureus.76659

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Abstract

There is undoubtedly an alarmingly rising trend of substance use among older adults. This has necessitated a paradigm shift in healthcare and propelled strategies aimed at effective prevention and screening. Age-related physiological changes, such as diminished metabolism and increased substance sensitivity, make older adults particularly vulnerable to adverse effects of substances. This not only has adverse psychological consequences but also physical consequences like complicating chronic illnesses and harmful interactions with medications, which lead to increased hospitalization.

Standard screening tools can identify substance use disorders (SUDs) in older adults. Tools like the Cut-down, Annoyed, Guilty, and Eye-opener (CAGE) questionnaire and Michigan Alcohol Screening Test-Geriatric (MAST-G) are tailored to detect alcoholism, while the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) and Alcohol Use Disorders Identification Test (AUDIT) assess abuse of illicit and prescription drugs. Since older adults are more socially integrated, screening should be done using non-stigmatizing and non-judgmental language.

Prevention strategies include educational programs, safe prescribing practices, and prescription drug monitoring. Detection of substance abuse should be followed by brief interventions and specialized referrals. In conclusion, heightened awareness, improved screening, and preventive measures can mitigate substance abuse risks in this demographic. Prioritizing future research on non-addictive pain medications and the long-term effects of substances like marijuana seems justified.

 

Source: https://www.cureus.com/articles/322781-rising-trend-of-substance-abuse-among-older-adults-a-review-focusing-on-screening-and-management?score_article=true#!/

Filed under: Addiction,Drug use-various effects,Education,Effects of Drugs,Mental Health,Prevention and Intervention,Social Affairs,Treatment and Addiction,USA :

By Ian Webster  Oct 28, 2024

Ian W Webster AO is Emeritus Professor of Public Health and Community Medicine of the University of New South Wales. He has worked as a physician in public and regional hospitals in Australia and UK and in NGOs dealing with homelessness, alcohol and drug problems and mental illness.

Please review Ian Webster’s paper which clearly shows that we need to learn from our success in the past that Prevention is the best way forward.

The second New South Wales Drug Summit will be held in regional centres for two days in October and the final two days will be in Sydney on the 4th and 5th December to be co-chaired by Carmel Tebbutt and John Brogden – a balance of politics.

Do summits achieve worthwhile outcomes?

The first Drug Summit in 1985 was national. It worked. It established the enduring principle of harm minimisation. It brought police, health, and education together, canvassed all drugs – including alcohol and tobacco, and it started funding for practicable and policy-based research.

It worked because Prime Minister Hawke needed it to, for family reasons. It worked because the Health Minister, Neal Blewett, needed it to work as he had carriage of its outcomes and the national response to burgeoning HIV/AIDS epidemic.

The 1999 NSW Drug Summit was in response to the rising prevalence of heroin use and opiate deaths. It worked because there was a political will to succeed. It included measures to deal with blood borne infections of HIV, hepatitis B and C; it expanded the state’s opioid treatment programs; expanded needle-syringe programs; introduced the antidote naloxone; and three seminal firsts – the first medically supervised injecting centre, drug courts, and court referral into treatment.

It worked because the Premier Bob Carr wanted it to. Which meant that the summit’s recommendations were managed through the Cabinet Office, supported by a ministerial expert advisory group. The ‘piper called the tune’ for all the state government departments; and they were made to work together.

The Alcohol Summit of 2003 was not as effective. Politicians were too close to the alcohol problem and implementation was handed to the Department of Health which meant other departments washed their hands of involvement. Police, on the other hand, carried the day with counterattacks on alcohol violence and behaviours at liquor outlets.

Contemporary drug problems

Now other substances must be dealt with – amphetamine type stimulants, especially crystalline methamphetamine, cocaine, hallucinogens, MDMA, pharmaceutical stimulants, the potent drug fentanyl, the even more potent nitrazenes, ketamine and unsanctioned use of psychiatric/neurological drugs. Cocaine is flooding the drug markets.

Heroin and alcohol remain as major problems. The Pennington Institute estimated there were 2,356 overdose deaths in 2022, 80% of which were unintended. And alcohol, not only damages the drinker, and the bystander, but creates extensive social harms in the lives of others.

NSW Ice Inquiry

Four and half years ago Commissioner, Dan Howard, reported on his Inquiry into the Drug Ice; he had started the Inquiry six years previously. His recommendations provide a scaffold for the upcoming Summit. The earlier NSW Drug Summit (1999) was followed by a strong impetus to implement its recommendations, but the Government dropped the ball 20 years ago. The last formal drug and alcohol plan was 10 years before the Ice Inquiry.

Fundamental to drug law reform is the decriminalisation of personal use and possession of drugs. This recommendation stands above all others in Dan Howard’s Report.

The thrust of the Inquiry’s recommendations centre on harm minimisation:

  • drug problems are health problems,
  • government departments across the board have responsibilities,
  • treatment, diversion, workforce initiatives, education and prevention programs must be adequately resourced,
  • accessible and timely data are needed,
  • Aboriginal communities, and other vulnerable communities, those in contact with the criminal justice system, all disproportionally affected by alcohol and other drugs, must be high priority population groups.

The NSW Liberal Government pushed back against decriminalising low-level personal drug use, against medically supervised injecting centres, against pill testing, cessation of drug detection dogs at music festivals, and needle and syringe programmes in prisons. Later it gave in-principle support to 86 of the recommendations.

Will the Summit achieve?

The hopes of the drug and alcohol sector are for easy access to naloxone (antidote to opiates), supervised drug-taking services, accessible sites for drug-checking, early surveillance on trends, better access to now available effective treatments, for the treatment of prisoners to equal that for all citizens, and a more equitable distribution of treatment and rehabilitation services across the state, and to ‘at-risk’ population groups.

Success will depend on the practicality of the recommendations and the preparedness of government to act on them in good faith.

It is trite to say, but this depends on political will. The will was strong in the earlier national Drug Summit (1985) and NSW Drug Summit (1999). But so far, Government responses to the Ice Inquiry have been late and weak-willed which does not bode well for the delivery of needed reforms.

There is now a Labor Government, also tardy in its response. It remains to be seen whether NSW Labor has the stomach to overturn past prejudicial stances on drug use and addiction, and whether it will put sufficient funds to this under-funded and stigmatised social and health problem.

What will not be achieved

The Summit and its outcome cannot attack the real drivers of drug problems – the incessant search by humankind for mind altering substances, the mysteries of addiction, and the abysmal treatment of people in unremitting pain.

The root causes of drug problems are socially determined. Action at this level will require an unimaginable upheaval of society and government. In western countries drug overdoses (including alcohol overdoses), suicide, and alcoholic liver disease, are regarded as ‘diseases of despair’. The desperation and despair which pervades vulnerable, and not so vulnerable, population groups, is the underground of drug use problems here and in other countries. Commissioner Howard said, we [society] are given “tacit permission to turn a blind eye on the factors driving the most problematic drug use: trauma, childhood abuse, domestic violence, unemployment, homelessness, dispossession, entrenched social disadvantage, mental illness, loneliness, despair and many other marginalising circumstances that attend the human condition.”

Somehow a better balance must be struck for law enforcement between the war on traffickers and the human rights of users. It is for the rest of us to treat drug using people as our fellow citizens.

Kind Regards

Herschel Baker

 

Source: Drug Free Australia

Filed under: Addiction,Alcohol,Australia,Cannabis/Marijuana,Cocaine,Drug use-various effects,Effects of Drugs,Health,Mental Health,Prevalence,Prevention and Intervention,Social Affairs :

“When President Biden and Vice President Harris took office, the number of drug overdose deaths was increasing 31% year-over-year. They immediately took action: making beating the overdose epidemic a key pillar of their Unity Agenda for the Nation and taking a comprehensive, evidence-based approach to strengthening public health and public safety. As an Administration, we have removed more barriers to treatment for substance use disorder than ever before and invested historic levels of funding to help crack down on illicit drug trafficking at the border. Life-saving opioid overdose reversal medications like naloxone are now available over-the-counter and at lower prices. We are at a critical inflection point. For the sixth month in a row, we are continuing to see a steady decline in drug overdose deaths nationwide. This new data shows there is hope, there is progress, and there is an urgent call to action for us all to continue working together across all of society to reduce drug overdose deaths and save even more lives.”

Filed under: Drug Specifics,Effects of Drugs,Health,Prevalence,Social Affairs,USA :

Vienna, 26 June 2024

The emergence of new synthetic opioids and a record supply and demand of other drugs has compounded the impacts of the world drug problem, leading to a rise in drug use disorders and environmental harms, according to the World Drug Report 2024 launched by the UN Office on Drugs and Crime (UNODC) today.

“Drug production, trafficking, and use continue to exacerbate instability and inequality, while causing untold harm to people’s health, safety and well-being,” said Ghada Waly, Executive Director of UNODC. “We need to provide evidence-based treatment and support to all people affected by drug use, while targeting the illicit drug market and investing much more in prevention.”

The number of people who use drugs has risen to 292 million in 2022, a 20 per cent increase over 10 years. Cannabis remains the most widely used drug worldwide (228 million users), followed by opioids (60 million users), amphetamines (30 million users), cocaine (23 million users), and ecstasy (20 million users).

Nitazenes – a group of synthetic opioids which can be even more potent than fentanyl – have recently emerged in several high-income countries, resulting in an increase in overdose deaths.

Though an estimated 64 million people worldwide suffer from drug use disorders, only one in 11 is in treatment. Women receive less access to treatment than men, with only one in 18 women with drug use disorders in treatment versus one in seven men.

In 2022, an estimated 7 million people were in formal contact with the police (arrests, cautions, warnings) for drug offences, with about two-thirds of this total due to drug use or possession for use. In addition, 2.7 million people were prosecuted for drug offences and over 1.6 million were convicted globally in 2022, though there are significant differences across regions regarding the criminal justice response to drug offences.

The Report includes special chapters on the impact of the opium ban in Afghanistan; synthetic drugs and gender; the impacts of cannabis legalization and the psychedelic “renaissance”; the right to health in relation to drug use; and how drug trafficking in the Golden Triangle is linked with other illicit activities and their impacts.

Drug trafficking is empowering organized crime groups

Drug traffickers in the Golden Triangle are diversifying into other illegal economies, notably wildlife trafficking, financial fraud, and illegal resource extraction. Displaced, poor, and migrant communities are suffering the consequences of this instability, sometimes forced to turn to opium farming or illegal resource extraction to survive, falling into debt entrapment with crime groups, or using drugs themselves.

These illicit activities are also contributing to environmental degradation through deforestation, the dumping of toxic waste, and chemical contamination.

Consequences of cocaine surge

A new record high of 2,757 tons of cocaine was produced in 2022, a 20 per cent increase over 2021. Global cultivation of coca bush, meanwhile, rose 12 per cent between 2021 and 2022 to 355,000 hectares. The prolonged surge in cocaine supply and demand has coincided with a rise in violence in states along the supply chain, notably in Ecuador and Caribbean countries, and an increase in health harms in countries of destination, including in Western and Central Europe.

Impact of cannabis legalization

As of January 2024, Canada, Uruguay, and 27 jurisdictions in the United States had legalized the production and sale of cannabis for non-medical use, while a variety of legislative approaches have emerged elsewhere in the world.

In these jurisdictions in the Americas, the process appears to have accelerated harmful use of the drug and led to a diversification in cannabis products, many with high-THC content. Hospitalizations related to cannabis use disorders and the proportion of people with psychiatric disorders and attempted suicide associated with regular cannabis use have increased in Canada and the United States, especially among young adults.

Psychedelic “renaissance” encourages broad access to psychedelics

Though interest in the therapeutic use of psychedelic substances has continued to grow in the treatment of some mental health disorders, clinical research has not yet resulted in any scientific standard guidelines for medical use.

However, within the broader “psychedelic renaissance”, popular movements are contributing to burgeoning commercial interest and to the creation of an enabling environment that encourages broad access to the unsupervised, “quasi-therapeutic” and non-medical use of psychedelics. Such movements have the potential to outpace the scientific therapeutic evidence and the development of guidelines for medical use of psychedelics, potentially compromising public health goals and increasing the health risks associated with the unsupervised use of psychedelics.

Implications of opium ban in Afghanistan

Following the drastic decrease of Afghanistan’s opium production in 2023 (by 95 per cent from 2022) and an increase in production in Myanmar (by 36 per cent), global opium production fell by 74 per cent in 2023. The dramatic contraction of the Afghan opiate market made Afghan farmers poorer and a few traffickers richer. Long-term implications, including on heroin purity, a switch to other opioids by heroin users, and/or a rise in demand for opiate treatment services may soon be felt in countries of transit and destination of Afghan opiates.

Right to health for people who use drugs

The report outlines how the right to health is an internationally recognized human right that belongs to all human beings, regardless of a person’s drug use status or whether a person is imprisoned, detained or incarcerated. It applies equally to people who use drugs, their children and families, and other people in their communities.

Source: https://www.unodc.org/unodc/en/press/releases/2024/June/unodc-world-drug-report-2024_-harms-of-world-drug-problem-continue-to-mount-amid-expansions-in-drug-use-and-markets.html

Filed under: Addiction,Cannabis/Marijuana,Cocaine,Effects of Drugs,Global Drug Legalisation Efforts,Others (International News) :

By Leah Kuntz

Psychiatric Times Vol 41, Issue 6
Review tapering challenges and strategies for benzodiazepines in this Special Report article.

SPECIAL REPORT: ADVANCES IN PSYCHIATRY

Benzodiazepines, a controversial treatment widely prescribed for patients with anxiety and insomnia, carry a considerable risk of abuse. The poster “Mood Over Matter: Literature Review on Benzodiazepine Tapering, Current Practices and Updates on Adjunct Mood Stabilizers,” which was presented at the 2024 APA Annual Meeting, summarized a literature review of current benzodiazepine tapering practices, outpatient detoxification challenges, and potential barriers to discontinuation. The poster presenters also prioritized reviewing literature that highlighted mood stabilizer adjunct use.

Research demonstrates why clinicians should use caution when prescribing benzodiazepines. Results of a recent study revealed that between 2014 and 2016 an estimated 25.3 million (10.4%) adults in the United States reported using benzodiazepines, and approximately 17.2% of these individuals admitted to misuse.

Similarly, the National Institute on Drug Abuse documented that benzodiazepines were implicated in more than 14% of opioid overdose deaths in 2021. Furthermore, a report from the Centers for Disease Control and Prevention pinpointed benzodiazepines as a factor in nearly 7000 overdose deaths across 23 states from January 2019 to June 2020, constituting 17% of all drug overdose deaths. This time frame saw a staggering 520% surge in deaths related to illicit benzodiazepines, and fatalities from prescribed benzodiazepines rose by 22%.

The poster presenters stated that psychiatric and addiction- focused clinicians play an integral role in preventing benzodiazepine misuse and addiction.

To help patients taper benzodiazepines to discontinuation, clinicians must be up-to-date on practices; if clinicians mismanage tapering, sudden withdrawal can prove fatal. Challenges to tapering patients with chronic benzodiazepine use can be found in the Table.

Table. Challenges to Tapering Chronic Benzodiazepine Use

As for tapering strategies, the presenters suggested adjunct mood stabilizers such as carbamazepine and oxcarbazepine. Carbamazepine, when used as an adjunct or prophylactically, can help reduce intense withdrawal symptoms and thus keep patients on track for discontinuation. However, carbamazepine has received criticism regarding its efficacy, and it is well documented to have a series of concerning adverse effects such as skin reactions, agranulocytosis, leukopenia, and significant drug-drug interactions by nature of its metabolism. This makes some clinicians wonder: Are the risks worth the benefit?

Oxcarbazepine has also been proposed as an alternative. Results of some small-scale clinical trials noted moderate efficacy for oxcarbazepine in helping patients with detoxification, and it has fewer adverse effect concerns. The presenters suggested that other mood stabilizers, particularly those with antiepileptic effects, require further research for their potential help with benzodiazepine addiction.

“Through a more current literature review, we hope to increase the tools available to psychiatrists for more success in discontinuation and maintaining sobriety for patients,” the presenters wrote.

In a previous Psychiatric Times article, Steve Adelman, MD, of the University of Massachusetts Medical School in Boston, suggested 8 universal precautions adapted from Gourlay et al for use by psychiatrists who must decide whether to initiate or continue pharmacotherapy with benzodiazepines. They include making a diagnosis with an appropriate differential and creating and ratifying a treatment agreement. However, other clinicians, such as Daniel Morehead, MD, a Psychiatric Times columnist and featured cover author in this issue, suggest that although benzodiazepines carry risks, those risks are exaggerated by government officials, critics, and the public at large.

Source: https://www.psychiatrictimes.com/view/how-to-safely-and-effectively-taper-benzodiazepines

Filed under: Effects of Drugs,Mental Health,Prescription Drugs,Psychiatric drugs,Treatment and Addiction,USA :

By Priyanjana Pramanik, MSc.Jun 11 2024

Reviewed by Lily Ramsey, LLM

In a recent study published in JAMA Network Open, researchers explored whether cannabis use is linked to mortality from all causes, cancer and cardiovascular disease (CVD).

Their findings indicate that heavy cannabis use is associated with a significantly higher risk of CVD mortality among females. However, they observed no association between cancer and all-cause mortality among the entire sample of males and females.

Background

Cannabis is the most commonly used illegal drug worldwide, and its increasing legalization underscores the need to understand its health impacts.

Previous research has suggested potential cardiovascular risks associated with cannabis use, but these studies often focused on specific populations, limiting the generalizability of their findings.

Furthermore, there has been a lack of research examining the differential effects of cannabis on males and females. Although cannabis use for medical purposes is expanding, its safety and efficacy for various conditions remain unclear.

Some studies have suggested a link between heavy cannabis use and increased all-cause and cardiovascular mortality. Still, others have found no such associations, often constrained by methodological limitations like small sample sizes, short follow-up periods, or limited age ranges of participants.

Only one prior study explored the relationship between cannabis use and cancer mortality, finding no significant link.

About the study

This study addressed existing gaps by examining sex-stratified links of lifetime cannabis use to CVD, cancer, and all-cause mortality in a large general population sample.

The cohort study utilized data from the UK Biobank, a large-scale biomedical database comprising 502,478 individuals aged 40 to 69, recruited from 2006 to 2010 from 22 cities across the UK.

Participants provided detailed health information through questionnaires, interviews, physical assessments, and biological samples, and their data was linked to mortality records up to December 19, 2020.

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Cannabis use was self-reported and categorized into never, low, moderate, and heavy use based on lifetime frequency.

The study assessed the association between cannabis use and mortality using Cox proportional hazards regression models, adjusting for clinical and demographic variables.

Analyses were stratified by sex to address potential differences between males and females. Mortality outcomes were defined using codes from the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, and various covariates such as age, education, income, smoking history, alcohol use, hypertension, diabetes, dyslipidemia, body mass index (BMI), prior CVDs, and antidepressant use were included in the models.

The study employed Kaplan-Meier survival analyses, considering two-sided P values less than 0.05 as significant.

Findings

The study analyzed 121,895 UK Biobank participants, aged 55.15 years on average for females and 56.46 years for males.

Among the participants, 3.88% of males and 1.94% of females were heavy cannabis users. Over a median follow-up of 11.8 years, there were 2,375 deaths, including 440 due to cancer and 1,411 due to CVD.

Heavy cannabis use in males was associated with an increased risk of all-cause mortality, with a hazard ratio (HR) of 1.28, but not significantly with CVD or cancer mortality after adjusting for all factors.

In females, heavy use of cannabis was associated with a higher risk of mortality from CVD (HR 2.67) and a non-significant increase in all-cause and cancer mortality after full adjustment.

Notably, among female tobacco users, heavy cannabis use significantly increased risks for all-cause mortality (HR 2.25), CVD mortality (HR 2.56), and cancer mortality (HR 3.52).

In contrast, male tobacco users saw an increased risk only for cancer mortality (HR 2.44). Excluding participants with comorbidities showed no significant associations between heavy use of cannabis and mortality.

The findings suggest a sex-specific impact of heavy cannabis use on mortality, particularly in females.

Conclusions

This study diverges from previous research that largely examined all-cause mortality among younger populations, showing a heightened risk associated with cannabis use.

Few studies addressed the link between cannabis use and CVD mortality, with mixed findings. Some studies indicated a significant association, while others did not.

The study’s strengths include a large sample size and standardized data collection protocols from the UK Biobank. However, the cross-sectional design limits causal inference, and the low response rate might introduce participant bias.

The study’s focus on middle-aged UK participants limits generalizability to other demographics.

Self-reported data on cannabis use and lack of recent usage patterns, dosage information, and follow-up on cannabis use during the study period are significant limitations.

Future research should involve longitudinal studies to explore the possible causal impact of cannabis use on mortality, with a focus on precise measurements of cannabis use, including frequency, dosage, and methods of consumption.

These studies should also aim to understand the sex-specific impacts and the links between of cannabis use and cancer mortality, given the ambiguous current evidence.

 

Source: https://www.news-medical.net/news/20240611/Heavy-cannabis-use-increases-the-risk-of-cardiovascular-disease-for-women-study-finds.aspx

Filed under: Cannabis/Marijuana,Drug use-various effects,Effects of Drugs :

COVID-19 pandemic and increasingly dangerous drug supply among factors that may have contributed to diminished impact of intervention

A data-driven intervention that engaged communities to rapidly deploy evidence-based practices to reduce opioid-related overdose deaths – such as increasing naloxone distribution and enhancing access to medication for opioid use disorder – did not result in a statistically significant reduction in opioid-related overdose death rates during the evaluation period, according to results from the National Institutes of Health’s HEALing (Helping to End Addiction Long-Term) Communities Study. Researchers identified the COVID-19 pandemic and increased prevalence of fentanyl in the illicit drug market – including in mixtures with cocaine and methamphetamine – as factors that likely weakened the impact of the intervention on reducing opioid-related overdose deaths.

The findings were published in the New England Journal of Medicine and presented at the College on Problems of Drug Dependence (CPDD) meeting on Sunday, June 16, 2024. Launched in 2019, the HEALing Communities Study is the largest addiction prevention and treatment implementation study ever conducted and took place in 67 communities in Kentucky, Massachusetts, New York, and Ohio – four states that have been hard hit by the opioid crisis.

Despite facing unforeseen challenges, the HEALing Communities Study successfully engaged communities to select and implement hundreds of evidence-based strategies over the course of the intervention, demonstrating how leveraging community partnerships and using data to inform public health decisions can effectively support the uptake of evidence-based strategies at the local level.

“This study brought researchers, providers, and communities together to break down barriers and promote the use of evidence-based strategies that we know are effective, including medications for opioid use disorder and naloxone,” said NIDA director, Nora D. Volkow, M.D. “Yet, particularly in the era of fentanyl and its increased mixture with psychostimulant drugs, it’s clear we need to continue developing new tools and approaches for addressing the overdose crisis. Ongoing analyses of the rich data from this study will be critical to guiding our efforts in the future.”

NIH launched the HEALing Communities Study, a four-year, multisite research study to test a set of evidence-based interventions for reducing overdose deaths across health care, justice, and behavioral health settings. Over 100,000 people are now dying annually of a drug overdose, with over 75% of those deaths involving an opioid. Numerous evidence-based practices have been proven to prevent or reverse opioid overdose, but these strategies are gravely underused due to a number of barriers.

As part of the intervention, researchers collaborated with community coalitions to implement evidence-based practices for reducing opioid overdose deaths from the Opioid-Overdose Reduction Continuum of Care Approach. These evidence-based practices focus on increasing opioid education and naloxone distribution, enhancing access to medication for opioid use disorder, and safer opioid prescribing and dispensing. The intervention also included a series of communication campaigns to help reduce stigma and increase the demand for evidence-based practices.

Communities were randomly assigned to either receive the intervention (between January 2020 and June 2022) or to the control group (which received the intervention between July 2022 and December 2023). To test the effectiveness of the intervention on reducing opioid-related overdose deaths, researchers compared the rate of overdose deaths between the communities that received the intervention immediately with those that did not during the period of July 2021 and June 2022.

Between January 2020 and June 2022, intervention communities successfully implemented 615 evidence-based practice strategies (254 related to overdose education and naloxone distribution, 256 related to medications for opioid use disorder, and 105 related to prescription opioid safety).

Despite the success in deploying evidence-based interventions in participating communities, between July 2021 and June 2022, there was not a statistically significant difference in the overall rate of opioid-involved overdose deaths between the communities receiving the intervention and those that did not, (47.2 opioid-related overdose deaths per 100,000 people in the intervention group, versus 51.7 in the control). The study team is also examining data on the impact of the intervention on total overdose deaths and examining specific drug combinations, such as stimulants and opioids, and on non-fatal opioid overdoses, among other study outcomes.

“The implementation of evidence-based interventions is critical to addressing the evolving overdose crisis,” said Miriam E. Delphin-Rittmon, Ph.D., HHS Assistant Secretary for Mental Health and Substance Use and the leader of SAMHSA. “This study recognizes there is no quick fix to reduce opioid overdose deaths. Saving lives requires ongoing commitment to evidence-based strategies. The HEALing Communities Study facilitated the implementation of 615 evidence-based practice strategies, with the potential to yield lifesaving results in coming years.”

The authors highlight three specific factors that likely weakened the impact of the intervention on reducing opioid-related overdose deaths. First, the intervention launched two months before the COVID-19 shutdown which severely disrupted the ability to work with health care, behavioral health, and criminal legal systems in implementing evidence-based practices. Indeed, due in large part to the emergence of the COVID-19, only 235 of the 615 strategies (38%) were implemented before the comparison period began in July 2021.

Second, after communities selected which evidence-based practices they wanted to implement, they only had 10 months to implement them before the comparison period began. The authors note that this was not enough time to robustly recruit necessary staff, change clinical practice workflows, or develop new collaborations across agencies and organizations. They note more time to implement these strategies, and more time between implementation and measuring results, may be needed to observe the full impact of the intervention.

Lastly, significant changes in the illicit drug market could have impacted the effectiveness of the intervention. Fentanyl increasingly permeated the illicit drug supply, and was increasingly mixed or used in combination with stimulant drugs like methamphetamine and cocaine, or in counterfeit pills made to look like prescription medications. The increasing use of fentanyl, as well as xylazine, over the study period posed new challenges for treatment of opioid use disorder and opioid-related overdose.

“Even in the face of a global pandemic and worsening overdose crisis, the HEALing Communities Study was able to support the implementation of hundreds of strategies that we know save lives,” said Redonna Chandler, Ph.D., director of the HEALing Communities Study at NIDA. “This is an incredible feat for implementation science, and shows that when we provide communities with an infrastructure to make data-driven decisions, they are able to effectively implement evidence-based practices based on their unique needs.”

The HEALing Communities Study was supported and carried out in partnership between the National Institute of Health’s National Institute on Drug Abuse (NIDA) and the Substance Abuse and Mental Health Services Administration (SAMHSA) through the NIH HEAL Initiative.

Source: https://nida.nih.gov/news-events/news-releases/2024/06/nih-funded-intervention-did-not-impact-opioid-related-overdose-death-rates-over-evaluation-period

Filed under: Effects of Drugs,Prevention and Intervention,Social Affairs,USA :

Associate Professor | Department Chair | Director, Forensic Science Research Center

Department of Criminal Justice, California State University

The opioid epidemic is a public health and safety emergency that is killing thousands and destroying the quality of life for hundreds of thousands of Americans and those who care about them. Fentanyl and other opioids affect all age ranges, ethnicities, and communities, including our most vulnerable population, children. Producing fentanyl is increasingly cheap, costing pennies for a fatal dose, with the opioid intentionally or unintentionally mixed with common illicit street drugs and pressed into counterfeit pills. Fentanyl is odorless and tasteless, making it nearly untraceable when mixed with other drugs. Extremely small doses of fentanyl, roughly equivalent to a few grains of salt, can be fatal, while carfentanil, a large animal tranquilizer, is 100 times more potent than fentanyl and fatal at an even smaller amount.

The Biden-Harris Administration should do even more to fund opioid-related prevention, treatment, eradication, and interdiction efforts to save lives in the United States. The 2022 Executive Order to Address the Opioid Epidemic and Support Recovery awarded $1.5 billion to states and territories to expand treatment access, enhance services in rural communities, and fund law enforcement efforts. In his 2023 State of the Union address, President Biden highlighted reducing opioid overdoses as part of his bipartisan Unity Agenda, pledging to disrupt trafficking and sales of fentanyl and focus on prevention and harm reduction. Despite extensive funding, opioid-related overdoses have not significantly decreased, showing that a different strategy is needed to save lives.

Opioid-related deaths have been estimated cost the U.S. nearly $4 trillion over the past seven years—not including the human aspect of the deaths. The cost of fatal overdoses was determined to be $550 billion in 2017. The cost of the opioid epidemic in 2020 alone was an estimated $1.5 trillion, up 37% from 2017. About two-thirds of the cost was due to the value of lives lost and opioid use disorder, with $35 billion spent on healthcare and opioid-related treatments and about $15 billion spent on criminal justice involvement. In 2017, per capita costs of opioid use disorder and opioid toxicity-related deaths were as high as $7247, with the cost per case of opioid use disorder over $221,000. With inflation in November 2023 at $1.26 compared to $1 in 2017, not including increases in healthcare costs and the significant increase in drug toxicity-related deaths, the total rate of $693 billion is likely significantly understated for fatal overdoses in 2023. Even with extensive funding, opioid-related deaths continue to rise.

With fatal opioid-related deaths being underreported, the Centers for Disease Control and Prevention (CDC) must take a primary role in real-time surveillance of opioid-related fatal and non-fatal overdoses by funding expanded toxicology testing, training first responder and medicolegal professionals, and ensuring compliance with data submission. The Department of Justice (DOJ) should support enforcement efforts to reduce drug toxicity-related morbidity and mortality, with the Department of Homeland Security (DHS) and the Department of the Treasury (TREAS) assisting with enforcement and sanctions, to prevent future overdoses. Key recommendations for reducing opioid-related morbidity and mortality include:

  • Funding research to determine the efficacy of current efforts in opioid misuse reduction and prevention.
  • Modernizing data systems and surveillance to provide real-time information.
  • Increasing overdose awareness, prevention education, and availability of naloxone.
  • Improve training of first responders and medicolegal death investigators.
  • Funding rapid and thorough toxicology testing in emergency departments and coroner/medical examiner agencies.
  • Enhancing prevention and enforcement efforts.

Challenge And Opportunity

Opioids are a class of drugs, including pain relievers that can be illegally prescribed and the illicit drug heroin. There are three defined waves of the opioid crisis, starting in the early 1990s as physicians increasingly prescribed opioids for pain control. The uptick in prescriptions stemmed from pharmaceutical companies promising physicians that these medications had low addiction rates and medical professionals adding pain levels being added to objective vital signs for treatment. From 1999 to 2010, prescription opioid sales quadrupled—and opioid-related deaths doubled. During this time frame when the relationship between drug abuse and misuse was linked to opioids, a significant push was made to limit physicians from prescribing opioids. This contributed to the second wave of the epidemic, when heroin abuse increased as former opioid patients sought relief. Heroin-related deaths increased 286% from 2002 to 2013, with about 80% of heroin users acknowledging that they misused prescription opioids before using heroin.  The third wave of the opioid crisis came in 2013 with an increase in illegally manufactured fentanyl, a synthetic opioid used to treat severe pain that is up to 100 times stronger than morphine, and carfentanil, which is 100 times more potent than fentanyl.

In 2022, nearly 110,000 people in the United States died from drug toxicity, with about 75% of the deaths involving opioids. In 2021, six times as many people died from drug overdoses as in 1999, with a 16% increase from 2020 to 2021 alone. While heroin-related deaths decreased by over 30% from 2020 to 2021, opioid-related deaths increased by 15%, with synthetic opioid-involved deaths like fentanyl increasing by over 22%. Over 700,000 people have died of opioid-related drug toxicity since 1999, and since 2021 45 people have died every day from a prescription opioid overdose. Opioid-related deaths have increased tenfold since 1999, with no signs of slowing down. The District of Columbia declared a public emergency in November 2023 to draw more attention to the opioid crisis.

In 2023, we are at the precipice of the fourth wave of the crisis, as synthetic opioids like fentanyl are combined with a stimulant, commonly methamphetamine. Speedballs have been common for decades, using stimulants to counterbalance the fatigue that occurs with opiates. The fatal combination of fentanyl and a stimulant was responsible for just 0.6% of overdose deaths in 2010 but 32.3% of opioid deaths in 2021, an over fifty-fold increase in 12 years. Fentanyl, originally used in end-of-life and cancer care, is commonly manufactured in Mexico with precursor chemicals from China. Fentanyl is also commonly added to pressed pills made to look like legitimate prescription medications. In the first nine months of 2023, the Drug Enforcement Agency (DEA) seized over 62 million counterfeit pills and nearly five tons of powdered fentanyl, which equates to over 287 million fatal doses. These staggering seizure numbers do not include local law enforcement efforts, with the New York City Police Department recovering 13 kilos of fentanyl in the Bronx, enough powder to kill 6.5 million people. 

The ease of creating and trafficking fentanyl and similar opioids has led to an epidemic in the United States. Currently, fentanyl can be made for pennies and sold for as little as 40 cents in Washington State. The ease of availability has led to deaths in our most vulnerable population—children. Between June and September 2023, there were three fatal overdoses of children five years and younger in Portland, OR. In a high-profile case in New York City, investigators found a kilogram of fentanyl powder in a day care facility after a 1-year-old died and three others became critically ill.

The Biden Administration has responding to the crisis in part by placing sanctions against and indicting executives in Chinese companies for manufacturing and distributing precursor chemicals, which are commonly sold to Mexican drug cartels to create fentanyl. The drug is then trafficked into the United States for sale and use. There are also concerns about fentanyl being used as a weapon of mass destruction, similar to the anthrax concerns in the early 2000s.

The daily concerns of opioid overdoses have plagued public health and law enforcement professionals for years. In Seattle, WA, alone, there are 15 non-fatal overdoses daily, straining the emergency medical systems. There were nearly 5,000 non-fatal overdoses in the first seven months of 2023 in King County, WA, an increase of 70% compared to 2022. In a landmark decision, in March 2023 the Food and Drug Administration (FDA) approved naloxone, a drug to reverse the effects of opioid overdoses, as an over-the-counter nasal spray in an attempt to reduce overdose deaths. Naloxone nasal spray was initially approved for prescription use only in 2015 , significantly limiting access to first responders and available to high-risk patients when prescribed opioids. In New York, physicians have been required to prescribe naloxone to patients at risk of overdose since 2022. Although naloxone is now available without a prescription, access is still limited by price, with one dose costing as much as $65, and some people requiring more than one dose to reverse the overdose. Citing budget concerns, Governor Newsom vetoed California’s proposed AB 1060, which would have limited the cost of naloxone to $10 per dose. Fentanyl testing strips that can be used to test substances for the presence of fentanyl before use show promise in preventing unwanted fentanyl-adulterated overdoses. The Expanding Nationwide Access to Test Strips Act, which was introduced to the Senate in July 2023, would decriminalize the testing strips as an inexpensive way to reduce overdose while following evidence-based harm-reduction theories.

Illicit drugs are also one of the top threats to national security. Law enforcement agencies are dealing with a triple epidemic of gun violence, the opioid crisis, and critical staffing levels. Crime prevention is tied directly to increased police staffing, with lower staffing limiting crime control tactics, such as using interagency task forces, to focus on a specific crime problem. Police are at the forefront of the opioid crisis, expected to provide an emergency response to potential overdoses and ensure public safety while disrupting and investigating drug-related crimes. Phoenix Police Department seized over 500,000 fentanyl pills in June 2023 as part of Operation Summer Shield, showing law enforcement’s central role in fighting the opioid crisis. DHS created a comprehensive interdiction plan to reduce the national and international supply of opioids, working with the private sector to decrease drugs brought into the United States and increasing task forces to focus on drug traffickers.

Prosecutors are starting to charge drug dealers and parents of children exposed to fentanyl in their residences in fatal overdose cases. In an unprecedented action, Attorney General Merrick Garland recently charged Mexican cartel members with trafficking fentanyl and indicting Chinese companies and their executives for creating and selling precursor chemicals. In November 2023, sanctions were placed against the Sinaloa cartel and four firms from Mexico suspected of drug trafficking to the United States, removing their ability to legally access the American banking system. Despite this work, criminal justice-related efforts alone are not reducing overdoses and deaths, showing a need for a multifaceted approach to save lives.

While these numbers of opioid overdoses are appalling, they are likely underreported. Accurate reporting of fatal overdoses varies dramatically across the country, with the lack of training of medicolegal death investigators to recognize potential drug toxicity-related deaths, coupled with the shortage of forensic pathologists and the high costs of toxicology testing, leading to inaccurate cause of death information. The data ecosystem is changing, with agencies and their valuable data remaining disjointed and unable to communicate across systems. A new model could be found in the CDC’s Data Modernization Initiative, which tracked millions of COVID-19 cases across all states and districts, including data from emergency departments and medicolegal offices. This robust initiative to modernize data transfer and accessibility could be transformative for public health. The electronic case reporting system and strong surveillance systems that are now in place can be used for other public health outbreaks, although they have not been institutionalized for the opioid epidemic.

Toxicology testing can take upwards of 8–10 weeks to receive, then weeks more for interpretation and final reporting of the cause of death. The CDC’s State Unintentional Drug Overdose Reporting System receives data from 47 states from death certificates and coroner/medical examiner reports. Even with the CDC’s extensive efforts, the data-sharing is voluntary, and submission is rarely timely enough for tracking real-time outbreaks of overdoses and newly emerging drugs. The increase of novel psychoactive substances, including the addition of the animal tranquilizer xylazineto other drugs, is commonly not included in toxicology panels, leaving early fatal drug interactions undetected and slowing notification of emerging drugs regionally. The data from medicolegal reports is extremely valuable for interdisciplinary overdose fatality review teams at the regional level that bring together healthcare, social services, criminal justice, and medicolegal personnel to review deaths and determine potential intervention points. Overdose fatality review teams can use the data to inform prevention efforts, as has been successful with infant sleeping position recommendations formed through infant mortality review teams.

Plan Of Action

Reducing opioid misuse and saving lives requires a multi-stage, multi-agency approach. This includes expanding real-time opioid surveillance efforts; funding for overdose awareness, prevention, and education; and improved training of first responders and medicolegal personnel on recognizing, responding to, and reporting overdoses. Nationwide, improved toxicology testing and reporting is essential for accurate reporting of overdose-involved drugs and determining the efficacy of efforts to combat the opioid epidemic.

Agency Role
Department of Education (ED) ED creates policies for educational institutions, administers educational programs, promotes equity, and improves the quality of education.

ED should increase resources for creating and implementing evidence-based preventative education for youth and provide resources for drug misuse with access to naloxone.
Department of Justice (DOJ) DOJ is responsible for keeping our country safe by upholding the law and protecting civil rights. The DOJ houses the Office of Justice Programs and the Drug Enforcement Agency (DEA), which are instrumental in the opioid crisis.

DOJ should be the principal enforcement agency, with the DEA leading drug-related enforcement actions. The Attorney General should continue to initiate new sanctions and a wider range of indictments to assist with interdiction and eradication efforts.
Department of Health and Human Services (HHS) HHS houses the Centers for Disease Control and Prevention (CDC), the nation’s health protection and preventative agency, and collects and analyzes vital data to save lives and protect people from health threats.

The CDC should be the primary agency to focus on robust real-time opioid-related overdose surveillance and fund local public health departments to collect and submit data. HHS should fund grants to enhance community efforts to reduce opioid-related overdoses and provide resources and outreach to increase awareness.
Department of Homeland Security (DHS) DHS focuses on crime prevention and safety at our borders, including interdiction and eradication efforts, while monitoring security threats and strengthening preparedness.

DHS should continue leading international investigations of fentanyl production and trafficking. Additional funding should be provided to allow DHS and its investigative agencies to focus more on producers of opioids, sales of precursors, and trafficking to assist with lessening the supply available in the United States.
Department of the Treasury (TREAS) TREAS is responsible for maintaining financial infrastructure systems, collecting revenue and dispersing payments, and creating international economic policies.

TREAS should continue efforts to sanction countries producing precursors to create opioids and trafficking drugs into the U.S. while prohibiting business ties with companies participating in drug trades. Additional funding should be available to support E.O. 14059 to counter transnational organized crime’s relation to illicit drugs.
Bureau of Prisons (BOP) The BOP provides protection for public safety by providing a safe and humane facility for federal offenders to serve their prescribed time while providing appropriate programming for reentry to ease a transition back to communities.

The BOP should provide treatment for opioid use disorders, including the option for medication-assisted treatment, to assist in reducing relapse and overdoses, coupled with intensive case management.
State Department (DOS) The DOS spearheads foreign policy by creating agreements, negotiating treaties, and advocating for the United States internationally.

The DOS should receive additional funding to continue to work with the United Nations to disrupt the trafficking of drugs and limit precursors used to make illicit opioids. The DOS also assists Mexico and other countries fight drug trafficking and production.

Recommendation 1. Fund research to determine the efficacy of current efforts in opioid misuse reduction and prevention.

DOJ should provide grant funding for researchers to outline all known current efforts of opioid misuse reduction and prevention by law enforcement, public health, community programs, and other agencies. The efforts, including the use of suboxone and methadone, should be evaluated to determine if they follow evidence-based practices, how the programs are funded, and their known effect on the community. The findings should be shared widely and without paywalls with practitioners, researchers, and government agencies to hone their future work to known successful efforts and to be used as a foundation for future evidence-based, innovative program implementation.

Recommendation 2. Modernize data systems and surveillance to provide real-time information.

City, county, regional, and state first responder agencies work across different platforms, as do social service agencies, hospitals, private physicians, clinics, and medicolegal offices. A single fatal drug toxicity-related death has associated reports from a law enforcement officer, fire department personnel, emergency medical services, an emergency department, and a medicolegal agency. Additional reports and information are sought from hospitals and clinics, prior treating clinicians, and social service agencies. Even if all of these reports can be obtained, data received and reviewed is not real-time and not accessible across all of the systems.

Medicolegal agencies are arguably the most underprepared for data and surveillance modernization. Only 43% of medicolegal agencies had a computerized case management system in 2018, which was an increase from 31% in 2004. Outside of county or state property, only 75% of medicolegal personnel had internet access from personal devices. The lack of computerized case management systems and limited access to the internet can greatly hinder case reporting and providing timely information to public health and other reporting agencies.

With the availability and use of naloxone by private persons, the Public Naloxone Administration Dashboard from the National EMS Information System (NEMSIS) should be supported and expanded to include community member administration of naloxone. The emergency medical services data can be aligned with the anonymous upload of when, where, and basic demographics for the recipient of naloxone, which can also be made accessible to emergency departments and medicolegal death investigation agencies. While the database likely will not be used for all naloxone administrations, it can provide hot spot information and notify social services of potential areas for intervention and assistance. The database should be tied to the first responder/hospital/medicolegal database to assist in robust surveillance of the opioid epidemic.

Recommendation 3. Increase overdose awareness, prevention education, and availability of naloxone.

Awareness of the likelihood of poisoning and potential death from the use of fentanyl or counterfeit pills is key in prevention. The DEA declared August 21 National Fentanyl Prevention and Awareness Day to increase knowledge of the dangers of fentanyl, with the Senate adopting a resolution to formally recognize the day in 2023. Many states have opioid and fentanyl prevention tactics on their public health websites, and the CDC has educational campaigns designed to reach young adults, though the education needs to be specifically sought out. Funding should be made available to community organizations and city/county governments to create public awareness campaigns about fentanyl and opioid usage, including billboards, television and streaming ads, and highly visible spaces like buses and grocery carts.

ED allows evidence-based prevention programs in school settings to assist in reducing risk factors associated with drug use and misuse. The San Diego Board of Supervisors approved a proposal to add education focused on fentanyl awareness after 12 juveniles died of fentanyl toxicity in 2021. The district attorney supported the education and sought funding to sponsor drug and alcohol training on school campuses. Schools in Arlington, VA, note the rise in overdoses but recognize that preventative education, when present, is insufficient. ED should create prevention programs at grade-appropriate levels that can be adapted for use in classrooms nationwide.

With the legalization of over-the-counter naloxone, funding is needed to provide subsidized or free access to this life-saving medication. Powerful fentanyl analogs require higher doses of naloxone to reverse the toxicity, commonly requiring multiple naloxone administrations, which may not be available to an intervening community member. The State of Washington’s Department of Public Health offers free naloxone kits by mail and at certain pharmacies and community organizations, while Santa Clara University in California has a vending machine that distributes naloxone for free. While naloxone reverses the effects of opioids for a short period, once it wears off, there is a risk of a secondary overdose from the initial ingestion of the opioid, which is why seeking medical attention after an overdose is paramount to survival. Increasing access to naloxone in highly accessible locations—and via mail for more rural locations—can save lives. Naloxone access and basic training on signs of an opioid overdose may increase recognition of opioid misuse and empower the community to provide immediate, lifesaving action.

However, there are concerns that naloxone may end up in a shortage. With its over-the-counter access, naloxone may still be unavailable for those who need it most due to cost (approximately $20 per dose) or access to pharmacies. There is a national push for increasing naloxone distribution, though there are concerns of precursor shortages that will limit or halt production of naloxone. Governmental support of naloxone manufacturing and distribution can assist with meeting demand and ensuring sustainability in the supply chain.

Recommendation 4. Improve training of first responders and medicolegal death investigators.

Most first responders receive training on recognizing signs and symptoms of a potential overdose, and emergency medical and firefighting personnel generally receive additional training for providing medical treatment for those who are under the influence. To avoid exposure to fentanyl, potentially causing a deadly situation for the first responder, additional training is needed about what to do during exposure and how to safely provide naloxone or other medical care. DEA’s safety guide for fentanyl specifically outlines a history of inconsistent and misinformation about fentanyl exposure and treatment. Creating an evidence-based training program that can be distributed virtually and allow first responders to earn continuing education credit can decrease exposure incidents and increase care and responsiveness for those who have overdosed.

While the focus is rightfully placed on first responders as the frontline of the opioid epidemic, medicolegal death investigators also serve a vital function at the intersection of public health and criminal justice. As the professionals who respond to scenes to investigate the circumstances (including cause and manner) surrounding death, medicolegal death investigators must be able to recognize signs of drug toxicity. Training is needed to provide foundational knowledge on deciphering evidence of potential overdose-related deaths, photographing scenes and evidence to share with forensic pathologists, and memorializing the findings to provide an accurate manner of death. Causes of death, as determined by forensic pathologists, need appropriate postmortem examinations and toxicology testing for accuracy, incorporated with standardized wording for death certificates to reflect the drugs contributing to the death. Statistics on drug-related deaths collected by the CDC and public health departments nationwide rely on accurate death certificates to determine trends.

The CDC created the Collaborating Office for Medical Examiners and Coroners (COMEC) in 2022 to provide public health support for medicolegal death investigation professionals. COMEC coordinates health surveillance efforts in the medicolegal community and champions quality investigations and accurate certification of death. The CDC offers free virtual, asynchronous training for investigating and certifying drug toxicity deaths, though the program is not well known or advertised, and there is no ability to ask questions of professionals to aid in understanding the content. Funding is needed to provide no-cost, live instruction, preferably in person, to medicolegal offices, as well as continuing education hours and thorough training on investigating potential drug toxicity-related deaths and accurately certifying death certificates.

Cumulatively, the roughly 2,000 medicolegal death investigation agencies nationwide investigated more than 600,000 deaths in 2018, running on an average budget of $470,000 per agency. Of these agencies, less than 45% had a computerized case management system, which can significantly delay data sharing with public health and allied agencies and reduce reporting accuracy, and only 75% had access to the internet outside of their personally owned devices. Funding is needed to modernize and extend the infrastructure for medicolegal agencies to allow basic functions such as computerized case management systems and internet access, similar to grant funding from the National Network of Public Health Institutes.

Recommendation 5. Fund rapid and thorough toxicology testing in emergency departments and coroner/medical examiner agencies.

Rapid, accurate toxicology testing in an emergency department setting can be the difference between life and death treatment for a patient. Urine toxicology testing is fast, economical, and can be done at the bedside, though it cannot quantify the amount of drug and is not inclusive for emerging drugs. Funding for enhanced accurate toxicology testing in hospitals with emergency departments, including for novel psychoactive substances and opioid analogs, is necessary to provide critical information to attending physicians in a timely manner to allow reversal agents or other vital medical care to be performed.

With the limited resources medicolegal death investigation agencies have nationally and the average cost of $3000 per autopsy performed, administrators need to triage which deaths receive toxicology testing and how in-depth the testing will be. Advanced panels, including ever-changing novel psychoactive substances, are costly and can result in inaccurate cause of death reporting if not performed routinely. Funding should be provided to medicolegal death investigating agencies to subsidize toxicology testing costs to provide the most accurate drugs involved in the death. Accurate cause of death reporting will allow for timely public health surveillance to determine trends and surges of specific drugs. Precise cause of death information and detailed death investigations can significantly contribute to regional multidisciplinary overdose fatality review task forces that can identify potential intervention points to strengthen services and create evidence to build future life-saving action plans.

Recommendation 6. Enhance prevention and enforcement efforts.

DOJ should fund municipal and state law enforcement grants to use evidence-based practices to prevent and enforce drug-related crimes. Grant applications should include a review of the National Institute of Justice’s CrimeSolutions.gov practices in determining potential effectiveness or using foundational knowledge to build innovative, region-specific efforts. The funding should be through competitive grants, requiring an analysis of local trends and efforts and a detailed evaluation and research dissemination plan. Competitive grant funding should also be available for community groups and programs focusing on prevention and access to naloxone.

An often overlooked area of prevention is for justice-involved individuals who enter jail or prison with substance use disorders. Approximately 65% of prisoners in the United States have a substance abuse order, and an additional 20% of prisoners were under the influence of drugs or alcohol when they committed their crime. About 15% of the incarcerated population was formally diagnosed with an opioid use disorder. Medications are available to assist with opioid use disorder treatments that can reduce relapses and post-incarceration toxicity-related deaths, though less than 15% of correctional systems offer medication-assisted opioid use treatments. Extensive case management coupled with trained professionals to prescribe medication-assisted treatment can help reduce opioid-related relapses and overdoses when justice-involved individuals are released to their communities, with the potential to reduce recidivism if treatment is maintained.

DEA should lead local and state law enforcement training on recognizing drug trends, creating regional taskforces for data-sharing and enforcement focus, and organizing drug takeback days. Removing unused prescription medications from homes can reduce overdoses and remove access to unauthorized users, including children and adolescents. Funding to increase collection sites, assist in the expensive process of properly destroying drugs, and advertising takeback days and locations can reduce the amount of available prescription medications that can result in an overdose.

DHS, TREAS, and DOS should expand their current efforts in international trafficking investigations, create additional sanctions against businesses and individuals illegally selling precursor chemicals, and collaborate with countries to universally reduce drug production.

Budget Proposal

A budget of $800 million is proposed to evaluate the current efficacy of drug prevention and enforcement efforts, fund prevention and enforcement efforts, improve training for first responders and medicolegal death investigators, increase rapid and accurate toxicology testing in emergency and medicolegal settings, and enhance collaboration between law enforcement agencies. The foundational research on the efficacy of current enforcement, preventative efforts, and surveillance should receive $25 million, with findings transparently available and shared with practitioners, lawmakers, and community members to hone current practices.

DOJ should receive $375 million to fund grants; collaborative enforcement efforts between local, state, and federal agencies; preventative strategies and programs; training for first responders; and safe drug disposal programs.

CDC should receive $250 million to fund the training of medicolegal death investigators to recognize and appropriately document potential drug toxicity-related deaths, modernize data and reporting systems to assist with accurate surveillance, and provide improved toxicology testing options to emergency departments and medicolegal offices to assist with appropriate diagnoses. Funding should also be used to enhance current data collection efforts with the Overdose to Action program34 by encouraging timely submissions, simplifying the submission process, and helping create or support overdose fatality review teams to determine potential intervention points.

ED should receive $75 million to develop curricula for K-12 and colleges to raise awareness of the dangers of opioids and prevent usage. The curriculum should be made publicly available for access by parents, community groups, and other organizations to increase its usage and reach as many people as possible.

BOP should receive $25 million to provide opioid use disorder medication-assisted treatments by trained clinicians and extensive case management to assist in reducing post-incarceration relapse and drug toxicity-related deaths. The policies, procedures, and steps to create medication-assisted programming should be shared with state corrections departments and county jails to build into their programming to expand use in carceral settings and assist in reducing drug toxicity-related deaths at all incarceration levels.

DOS, DHS, and TREAS should jointly receive $50 million to strengthen their current international investigations and collaborations to stop drug trafficking, the manufacture and sales of precursors, and combating organized crime’s association with the illegal drug markets.

Conclusion

Opioid-related overdoses and deaths continue to needlessly and negatively affect society, with parents burying children, sometimes infants, in an unnatural order. With the low cost of fentanyl production and the high return on investment, fentanyl is commonly added to illicit drugs and counterfeit, real-looking prescription pills. Opioid addiction and fatal overdoses affect all genders, races, ethnicities, and socioeconomic statuses, with no end to this deadly path in sight. Combining public health surveillance with enforcement actions, preventative education, and innovative programming is the most promising framework for saving lives nationally.

 

FEDERATION OF AMERICAN SCIENTISTS © 2024
Source: https://fas.org/publication/underscoring-opioid-epidemic/
Filed under: Drug Specifics,Drug use-various effects,Effects of Drugs,Fentanyl,Heroin/Methadone,USA :

As the workplace evolves, so do the challenges that organizations face in maintaining a safe and productive environment.

 

A Surge in Drug Test Tampering

 

According to Quest Diagnostics’ latest report, the percentage of employees in the general U.S. workforce showing signs of tampered drug tests increased dramatically in 2023. Instances of substituted urine specimens surged by over 600%, while invalid urine specimens rose by 45.2%. These unprecedented numbers indicate a significant increase in efforts to circumvent drug testing protocols.

 

Suhash Harwani, Ph.D., Senior Director of Science for Workforce Health Solutions at Quest Diagnostics, noted, “The increased rate of both substituted and invalid specimens indicates that some American workers are going to great lengths to attempt to subvert the drug testing process.” This trend underscores a growing issue where the normalization of drug use may be influencing employees to believe they can bypass drug tests without considering the consequences for workplace safety.

 

Historic Highs in Drug Positivity Rates

 

The overall drug positivity rate in the general U.S. workforce (those who do not work federally mandated, safety-sensitive positions) remained steady at 5.7% in 2023, maintaining historically high levels. The combined U.S. workforce (general workforce + federal mandated, safety-sensitive positions) also showed a persistent drug positivity rate of 4.6%, the highest in over two decades. Post-accident marijuana positivity has climbed sharply, with an increase of 114.3% between 2015 and 2023.

 

Marijuana Use and Legalization

 

Marijuana positivity tests continued to increase, particularly in states where recreational use is legal. In the general workforce, marijuana positivity increased by 4.7% in 2023, reaching a new peak. Over the past five years, this rate has risen by 45.2%. Despite the decrease in marijuana positivity among federally mandated, safety-sensitive workers, the data suggests that broader legalization might be contributing to increased usage and associated workplace risks.

 

Rising Drug Use in Office-Based Industries

 

Interestingly, the Quest Diagnostics report also highlights a rise in drug positivity rates within traditionally office-based industries. Real estate, lending, professional services, and education sectors all saw significant increases in drug positivity. This trend may reflect the broader impacts of the pandemic, such as increased stress and isolation from work-from-home policies, potentially leading to higher drug use.

 

Sam Sphar, Vice President and General Manager of Workforce Health Solutions at Quest Diagnostics, pointed out the importance of mental health support and drug education programs in these sectors: “The results underscore the growing need for mental health support and drug education programs to ensure employees are safe and productive, whether working at home or in the office.”

 

The Need for Comprehensive Drug Testing Programs

 

The findings from the Quest Diagnostics Drug Testing Index highlight the critical importance of effective drug testing programs. Such programs not only help maintain a safer work environment but also act as a deterrent against drug use. Dr. Harwani noted that the mere expectation of drug testing can dissuade individuals from using drugs or applying for positions where testing is standard practice.

 

In conclusion, as drug use continues to evolve and adapt to societal changes, organizations must remain vigilant. Implementing robust drug testing and support programs is essential to ensure a safe, healthy, and productive workplace.

 

Source: Workforce drug test cheating surged in 2023, finds Quest Diagnostics Drug Testing Index analysis of nearly 10 million drug tests. (2024, May 15). Quest Diagnostics Newsroom. https://newsroom.questdiagnostics.com/2024-05-15-Workforce-Drug-Test-Cheating-Surged-in-2023,-Finds-Quest-Diagnostics-Drug-Testing-Index-Analysis-of-Nearly-10-Million-Drug-Tests

Filed under: Drug use-various effects,Effects of Drugs,USA :

Appointing Jeff Sessions as US Attorney General infused new life into those of us who know that marijuana is destroying our nation from within. But were we premature in believing that Donald Trump would put an end to what Barack Obama and George Soros inflicted on this nation in the last eight years? After eight months, we still don’t have federal drug policy flowing from the President.

The pattern of past presidents is familiar. Bill Clinton moved the Office of National Drug Control Policy (ONDCP) to a backwater, and reduced its size by about 75 per cent. In 1996, with help from Hillary Clinton and investor George Soros, Clinton allowed California to violate federal laws and become the first victim of the ‘medical marijuana’ hoax. Soros, Peter Lewis and John Sperling, all out-of-state billionaires, financed that campaign with close to $7million (£5.3million).

Obama downgraded the position of Drug Czar from cabinet level to reporting to the Vice President. He then allowed, or directed, Attorney General Eric Holder to ignore the inherent responsibility of the Executive Branch to enforce federal law. Drug strategy in ONDCP was changed to focus on ‘harm reduction’, the subversive ploy of Soros to focus on treatment and rehabilitation, at the expense of primary prevention. The President espoused the claim that ‘marijuana is no worse than alcohol’, leaving most people with a flawed impression. Federal agencies such as the Substance Abuse and Mental Health Services Administration (SAMHSA) spent their fortunes on anything other than marijuana. Congress passed the Rohrabacher/Farr Bill which withheld federal dollars from the Drug Enforcement Administration (DEA) so they couldn’t even enforce the law. The result? Twenty-nine states now have some form of legalised pot. Marijuana users had increased from about 15million to 22.3million Americans at the last count.

Now comes President Trump. During the campaign he indicated he felt legalising marijuana should be a state’s right. He is wrong, but could be forgiven if he took the time to learn why. He was building a hotel empire while many of us have been fighting the drug problem for 40 years. The truth about marijuana has been so misrepresented and suppressed for the last 20 years that he, like most people, doesn’t know what to believe. He has the best scientific information in the world available to him, but the question is: who is giving him advice? Anyone? Or drug legalisers such as Rohrabacher, Peter Theil, Trump confidant Roger Stone? Or even George Soros?

The truth is, marijuana was a dangerous drug 50 years ago, when the potency was only 0.5 per cent to 2 per cent. Today’s highly potent pot, with an advertised range of 25 per cent (+/-) of the active ingredient THC, and up to 98 per cent as wax or oils used in edibles, dabbing and vaping, has the potential to destroy the country by ruining our collective health and intellectual capacity.

Experts such as Dr Stuart Reece from Australia or Dr Bertha Madras of Harvard will attest that marijuana use by either parent can cause congenital abnormalities in a foetus. What’s worse, these abnormalities can affect the next four generations.

Psychotic breaks, mental illness and addiction caused by marijuana have led to a substantial increase in crime, homelessness, erosion of the quality of our inner cities, academic failure, traffic fatalities and public health costs. The combined economic impact in the US is well over $1trillion per annum.

Only the federal government has the resources to combat billionaire-backed legalisation campaigns and the illicit drug trade; the enforcement of federal laws is the only thing that will save California and the nation. Hopefully the President will step up and get us back on track without further delay.

Roger Morgan

RogerMorgan is the Chairman of the Take Back America Campaign http://www.tbac.us

Source: https://www.conservativewoman.co.uk/roger-morgan-trump-must-clamp-marijuana-america-doomed/ October 2017

Filed under: Cannabis/Marijuana,Drug use-various effects on foetus, babies, children and youth,Economic,Effects of Drugs,Global Drug Legalisation Efforts,Political Sector,USA :

US DRUG CZAR EXPLAINS CAUSES AND RSDT TOOL TO PREVENT TEEN DRUG USE AND OVERDOSE DEATH INTERVIEW WITH U.S. DRUG CZAR JOHN WALTERS

Introduction:  In response to recent news of a huge increase in drug overdose deaths and arrests for drug trafficking among Fairfax County youths, Fox News TV5 reporter Sherri Ly interviewed U.S. Drug Czar John Walters for his expert views on the cause and potential cure for these horrific family tragedies.  Following is a transcript of that half-hour interview with minor editing for clarity and emphasis added.  The full original interview is available through the 11/26/08 Fox5 News broadcast video available at link:

WALTERS:  Well, as this case shows, while we’ve had overall drug use go down, we still have too many young people losing their lives to drugs, either through overdoses, or addiction getting their lives off track.  So there’s a danger.  We’ve made progress, and we have tools in place that can help us make more progress, but we have to use them. 

Q 1:  You meet with some of these parents whose children have overdosed.  What do they tell you, and what do you tell them?

WALTERS:  It’s the hardest part of my job; meeting with parents who’ve lost a child.  Obviously they would give anything to go back, and have a chance to pull that child back from the dangerous path they were on.  There are no words that can ease their grief.  That’s something you just pray that God can give them comfort.  But the most striking thing they say to me though is they want other parents to know, to act.  And I think this is a common thing that these terrible lessons should teach us.

Many times, unfortunately, parents see signs: a change in friends, sometimes they find drugs; sometimes they see their child must be intoxicated in some way or the other.  Because it’s so frightening, because sometimes they’re ashamed – they hope it’s a phase, they hope it goes away – they try to take some half measures.  Sometimes they confront their child, and their child tells them – as believably as they ever can – that it’s the first time.  I think what we need help with is to tell people; one, it’s never the first time.  The probability is low that parents would actually recognize these signs – even when it gets visible enough to them – because children that get involved in drugs do everything they can to hide it.  It’s never the first time.  It’s never the second time.  Parents need to act, and they need to act quickly.  And the sorrow of these grieving parents is, if anything, most frequently focused on telling other parents, “Don’t wait: do anything to get your child back from the drugs.”

Secondly, I think it’s important to remember that one of the forces that are at play here is that it’s their friends.  It’s not some dark, off-putting stranger – it’s boyfriends, girlfriends.  I think that was probably a factor in this case.  And it’s also the power and addictive properties of the drug.  So your love is now being tested, and the things you’ve given your child to live by are being pulled away from them on the basis of young love and some of the most addictive substances on earth.  That’s why you have to act more strongly.  You can’t count on the old forces to bring them back to safety and health.

Q 2:  When we talk about heroin – which is what we saw in this Fairfax County drug ring, alleged drug ring – what are the risks, as far as heroin’s concerned?  I understand it can be more lethal, because a lot of people don’t know what they’re dealing with?

WALTERS:  Well it’s also more lethal because one, the drug obviously can produce cardiac and respiratory arrest.  It’s a toxic substance that is very dangerous.  It’s also the case that narcotics, like heroin – even painkillers like OxyContin, hydrocodone, which have also been a problem – are something that the human body gets used to.  So what you can frequently get on the street is a purity that is really blended for people who are addicted and have been long time addicted.  So a person who is a new user or a naïve user can more easily be overdosed, because the quantities are made for people whose bodies have adjusted to higher purities, and are seeking that effect that only the higher purity will give them in this circumstance.  So it’s particularly dangerous for new users.  But we also have to remember, it almost never starts with heroin.  Heroin is the culmination here.  I think some of the – and I’ve only seen press stories on this — some of these young people may have gotten involved as early as middle school.

We have tools so that we don’t have to lose another young woman like this– or young men.  We now have the ability to use Random Student Drug Testing (RSDT) because the Supreme Court has, in the last five years, made a decision that says it can’t be used to punish.  It’s used confidentially with parents.  We have thousands of schools now doing it since the president announced the federal government’s willingness to fund these programs in 2004.  And many schools are doing it on their own.  Random testing can do for our children what it’s done in the military, what it’s done in the transportation safety industry– significantly reduce drug use.

First, it is a powerful reason not to start.  “I get tested, I don’t have to start.”  We have to remember, it’s for prevention and not a “gotcha!”  But it’s a powerful reason for kids to say, even when a boyfriend or girlfriend says come and do this with me, “I can’t do it, I get tested.  I still like you, I still want to be your friend; I still want you to like me, but I just can’t do this,” which is very, very powerful and important.  And second, if drug use is detected the child can be referred to treatment if needed.

Q 3:  Is the peer pressure just that much that without having an excuse, that kids are using drugs and getting hooked?

WALTERS:  Well one of the other unpleasant parts of my job is I visit a lot of young people in treatment; teenagers, sometimes as young as 14, 15, but also 16, 17, 18.  It is not uncommon for me to hear from them, “I came from a good family.  My parents and my school made clear what the dangers were of drugs.  I was stupid.  I was with my boyfriend (or girlfriend) and somebody said hey, let’s go do this.  And I started, and before I knew it, I was more susceptible.”

We have to also understand the science, which has told us that adolescents continue to have brain development up through age 20-25.  And their brains are more susceptible to changes that we can now image from these drugs.  So it’s not like they’re mini-adults.  They’re not mini-adults.  They’re the particularly fragile and susceptible age group, because they don’t have either the experience or the mental development of adults.  That’s why they get into trouble, that’s why it happens so fast to them, that’s why it’s so hard for them to see the ramifications.

So what does RSDT do?  It finds kids early–­ if prevention fails.  And it allows us to intervene, and it doesn’t make the parent alone in the process.  Sometimes parents don’t confront kids because kids blackmail them and say “I’m going to do it anyway, I’m going to run away from home.”  The testing brings the community together and says we’re not going to lose another child.  We’re going to do the testing in high school – if necessary, in middle school.  We’re going to wrap our community arms around that family, and get those children help.  We’re going to keep them in school, not wait for them to drop out.  And we’re certainly not going to allow this to progress until they die.

Q 4:  And in a sense, if you catch somebody early, since you’re saying the way teenagers seem to get into drug use is a friend introduces it to a friend, and then next thing you know, you have a whole circle of friends doing it.  Are you essentially drying that up at the beginning, before it gets out of hand?

WALTERS:  That is the very critical point.  It’s not only helping every child that gets tested be safer, it means that the number of young people in the peer group, in the school, in the community that can transfer this dangerous behavior to their friends shrinks.  This is communicated like a disease, except it’s not a germ or a bacillus.  It’s one child who’s doing this giving it behaviorally to their friends, and using their friendship as the poison carrier here.  It’s like they’re the apple and the poison is inside the apple.  And they trade on their friendship to get them to use.  They trade on the fact that people want acceptance, especially at the age of adolescence.  So what you do is you break that down, and you make those relationships less prone to have the poison of drugs or even underage drinking linked to them.  And of course we also lose a lot of kids because of impaired driving.

Q 5:  And how does the drug testing program work, then, in schools– the schools that do have it.  Is it completely confidential?  Are you going to call the police the minute you find a student who’s tested positive for heroin or marijuana or any other illicit drug?

WALTERS:  That’s what is great about having a Supreme Court decision.  It is settled – random testing programs cannot be used to punish, to call law enforcement; they have to be confidential.  So we have a uniform law across the land.  And what the schools that are doing RSDT are seeing is that it’s an enormous benefit to schools for a relatively small cost.  Depending on where you are in the country, the screening test is $10-40.  It’s less than what you’re going to pay for music downloads in one month for most teenage kids in most parents’ lives.  And it protects them from some of the worst things that can happen to them during adolescence.  Not only dying behind the wheel, but overdose death and addiction.

 Schools that have done RSDT have faced some controversy; so you have to sit down and talk to people; parents, the media, young people.  You have to engage the community resources.  You’re going to find some kids and families that do have treatment needs.  But with RSDT you bring the needed treatment to the kids.

I tell, a lot of times, community leaders – mayors and superintendents, school board members – that if you want to send less kids into the criminal justice system and the juvenile justice system, drug test — whether you’re in a suburban area or in an urban area.

What does the testing do?  It takes away what we know is an accelerant to self-destructive behavior: crime, fighting in school, bringing a weapon, joining a gang.  We have all kinds of irrefutable evidence now – multiple studies showing drugs and drinking at a young age accelerate those things, make them worse, make them more violent, as well as increasing their risks of overdose deaths and driving under the influence.  So drug testing makes all those things get better.  And it’s a small investment to make everything else we do work better.

Again, drug testing is not a substitute for drug education or good parenting or paying attention to healthy options for your kid.  It just makes all those things work better.

Q 6:  And I know you’ve heard this argument before, but isn’t that big brother?  Aren’t there parents out there who say to you, “I’m the parent: why are you going to test my child for drugs in school; that’s my job?” 

WALTERS:  I think that is the critical misunderstanding that we are slowly beginning to change by the science that tells us substance abuse is a disease.  It’s a disease that gets started by using the drug, and then it becomes a thing that rewires our brain and makes us dependent.  So instead of thinking of this as something that is a moral failing, we have to understand that this is a disease that we can use the kind of tools for public health – screening and interventions – to help reduce it.

Look, let me give you the counter example.  It’s really not big brother.  It’s more like tuberculosis.  Schools in our area require children to be tested for tuberculosis before they come to school.  Why do they do that?  Because we know one, they will get sicker if they have tuberculosis and it’s not treated.  And we can treat them, and we want to treat them.  And two, they will spread that disease to other children because of the nature of the contact they will have with them and spreading the infectious agent.  The same thing happens with substance abuse.  Young people get sicker if they continue to use.  And they spread this to their peers.  They’re not secretive among their peers about it; they encourage them to use them with them.  Again, it’s not spread by a bacillus, but it’s spread by behavior.

If we take seriously the fact that this is a disease and stop thinking of it as something big brother does because it’s a moral decision that somebody else is making, we can save more lives.  And I think the science is slowly telling us that we need to be able to treat this in our families, for adults and young people.  We have public health tools that we’ve used for other diseases that are very powerful here, like screening – and that’s really what the random testing is.  We’re trying to get more screening in the health care system.  So when you get a check up, when you bring your child to a pediatrician, we screen for substance abuse and underage drinking.  Because we know we can treat this, and we know that we can make the whole problem smaller when we do. 

Q 7:  You have said there were about 4,000 schools across the country now that are doing this random drug testing.  What can we see in the numbers since the Supreme Court ruling in 2002, as far as drug use in those schools, and drug use in the general population?

WALTERS:  Well, what a number of those schools have had is of course a look at the harm from student drug and alcohol use.  Some of them have put screening into place, random testing, because they’ve had a terrible accident; an overdose death; death behind the wheel.  What’s great is when school districts do this, or individual schools do this, without having to have a tragedy that triggers it.  But if you have a tragedy, I like to tell people, you don’t have to have another one.  The horrible thing about a tragic event is that most people realize those are not the only kids that are at risk.

There are more kids at risk, obviously, in our communities in the Washington, DC area where this young woman died.  We know there’s obviously more children who are at risk of using in middle school and high school.  The fact is those children don’t have to die.  We cannot bring this young lady back.  Everybody knows that.  But we can make sure others don’t follow her.  And the way we can do that is to find, through screening, who’s really using.  And then let’s get them to stop – let’s work with their families, and let’s make sure we don’t start another generation of death.  So what you see in these areas is an opportunity to really change the dynamic for the better.

Q 8:  Now, although nationally drug use among our youth is going down – what does it say to you – when I look at the numbers specific to Virginia, the most recent that I could find tells me that 3% of 12th graders, over their lifetime, have used a drug like heroin?  What does it say to you?  To me, that sounds like a lot.

WALTERS:  Yeah, and it’s absolutely true.  I think the problem here is that when you tell people we are taking efforts that are making progress nationwide, they jump to the conclusion that that means that we don’t have a problem anymore.  We need to continue to make this disease smaller.  It afflicts our young people.  It obviously also afflicts adults, but this is a problem that starts during adolescence — and pre-adolescence in some cases — in the United States.  We can make this smaller.  We not only have the tools of better prevention but also better awareness and more recognition of addiction as a disease.  We need to make that still broader.  We need to use random testing.  If we want to continue to make this smaller, and make it smaller in a permanent way, random testing is the most powerful tool we can use in schools.

We want screening in the health care system.  We have more of that going on through both insurance company reimbursement and public reimbursement through Medicare and Medicaid for those who come into the public pay system.  That needs to grow.  It needs to grow into Virginia, it’s already being looked at in DC; it needs to grow into Maryland and the other states that don’t have it.  We are pushing that, and it’s relatively new, but it’s consistent with what we’re seeing – the science and the power of screening across the board.

We need to continue to look at this problem in terms of also continuing to push on supply.  We’re working to reduce the poisons coming into our communities, which is not the opposite of demand; that we have to choose one or the other.  They work together.  Keeping kids away from drugs and keeping drugs away from kids work together.  And where we see that working more effectively, we’ll save more lives.  So again, we’ve seen that a balanced approached works, real efforts work, but we need to follow through.  And the fact that you still have too many kids at risk is an urgent need.  Today, you have kids that could be, again, victims that you have to unfortunately tell about on tonight’s news, that we can save.  It’s not a matter we don’t know how to do this.  It’s a matter of we need to take what we know and make it reality as rapidly as possible.

Q 9:  Where are these drugs coming from?  Where’s the heroin that these kids allegedly got coming from?

WALTERS:  We do testing about the drugs to figure out sources for drugs like heroin.  Principally, the heroin in the United States today has come from two sources.  Less of it’s coming out of Colombia.  Colombia used to be a source of supply on the East Coast, but the Colombian government, as a part of our engagement with them on drugs, has radically reduced the cultivation of poppy and the output of heroin.  There still is some, but it’s dramatically down from what it was even about five years ago.  Most of the rest of the heroin in the United States comes from Mexico.  And the Mexican government, of course, is engaged in a historic effort to attack the cartels.  You see this in the violence the cartels have had as a reaction.  So we have promising signs.  There are dangerous and difficult tasks ahead, but we can follow through on that as well.

Most of the heroin in the world comes from Afghanistan; 90% of it.  And we are working there, of course, as a part of our effort against the Taliban and the forces of terror and Al Qaeda, to shrink that.  The good news is that last year we had a 20% decline in cultivation and a 30% decline in output there.  Most of that does not come here, fortunately.  But it has been funding the terrorists.  It’s been drained out of most of the north and the east of the country.  It’s focused on the area where we have the greatest violence today, in the southwest.  We’re working now – you see Secretary Gates talking to the NATO allies about bringing the counter-insurgency effort together with the counter-narcotics effort to attack both of these cancers in Afghanistan.  We have a chance to change heroin availability in the world in a durable way by being successful in Afghanistan.  We’ve started that path in a positive way.  Again, it’s a matter of following through as rapidly as possible.

Q 10:  Greg Lannes, the father of the girl in Fairfax County who died, told me that one of his main efforts, as you imagined, was to let people know that those drugs, they’re coming from where it is produced, outside our country; that they’re getting all the way down to the street level and into our neighborhoods– something that people don’t realize.  So when you hear that they busted a ring of essentially teenagers who have been dealing, using and buying heroin, what does that say to you as the man in charge of combating drugs in our country?

WALTERS:  Well again, we have tools that can make this smaller.  But we have to use those tools.  And we have multiple participants here.  Yes we need to educate.  And we need to make sure that parents know they need to talk to their children, even when their children look healthy and have come from a great home.  Drugs – we’ve learned, I think, over the last 25 years or more, drugs affect everybody; rich or poor, middle class, lower class or upper class.  Every family’s been touched by this, in my experience, by alcohol or drugs.  They know that reality– we don’t need to teach them that.

What we need to teach them is the tools that we have that they can help accelerate use of.  Again, I think – there is no question in my mind that had this young woman been in a school, middle school or high school that had random testing – since that’s where this apparently started, based on the information I’ve seen in the press – she would not be dead today.  So again, we can’t go back and bring her to life.  But we can put into place the kind of screening that makes the good will and obvious love that she got from her parents, the obvious good intentions that I can’t help but believe were a part of what happened in the school, the opportunities that the community has to have a lot of resources that she didn’t get when she needed them.  And now she’s dead.  Again, we can stop this: we just have to make sure we implement that knowledge in the reality of more of our kids as fast as possible.

Q 11:  Should anyone be surprised by this case?  And that such a hardcore drug like heroin is being used by young people?

WALTERS:  We should never stop being surprised when a young person dies.  They shouldn’t die.  They shouldn’t die at that young age, and we should always demand of ourselves, even while we know that’s sometimes going to happen today, that every death is a death too many.  I think that it is very important not to say we’re going to accept a certain level.  Never accept this.  Never!  That’s my attitude, and I know that’s the president’s  attitude as well here.  Never accept that heroin’s going to get into the lives of our teenagers.  Never accept that our children are going to be able to use and not be protected.  It’s our job to protect them.  They have a role, also, obviously in helping to protect themselves.  But we need to give them the tools that will help protect them.

When I talk to children and young adults in high school or college, they know what’s going on among their peers.  And in some ways, when you get them alone and they feel they can talk candidly, they tell us they don’t understand why we, as adults who say this is serious, don’t act.  They know that we see children who are intoxicated; they know that we must see signs of this, because as kid’s lives get more out of control, they show signs of it.  They want to know why we don’t act.

We can use the tools of screening, and we can use the occasion of a horrible event like this to bring the community together and say it’s time for us to use the shock and the sorrow for something positive in the future.  I haven’t met a parent of a child who’s been lost who doesn’t say I just want to use this now for something positive.  And that’s understandable, and I think we ought to honor that wish.

Q 12:  Well, I guess I’m not asking should we accept that this is in our schools, but is it naïve for people not to understand or realize that these hardcore drugs are in our schools, and in our communities, and in our neighborhoods. 

WALTERS:  Yeah.  Where it is naïve, I think, is to not recognize the extent and access that young people have to drugs and alcohol.  I think we sometimes think that because they come from a home where this isn’t a part of their lives now, that it’s not ever going to be part of their lives.  Look, your viewers should go on the computer.  Type marijuana into the Google search engine and see how many sites encourage them to use marijuana, how to get marijuana, how to grow marijuana, the great fun of marijuana.  Go on YouTube and type in marijuana, and see how many videos come up using marijuana, joking around about marijuana.  And then when you start showing one, of course the system is designed to show you similar things.  Type in heroin.  See what kind of sites come up, and see what kind of videos come up on these sites.  Young people spend more time on these sites than they do, frequently, watching television.  Remember, there is somebody telling your children things about drugs.  And if it’s not you, the chances are they’re telling them things that are false and dangerous.  So there is a kind of naiveté about what the young peoples’ world, as it presents itself to them, tells them about these substances.  It minimizes the danger, it suggests that it’s something that you can do to be more independent, not be a kid anymore. 

We, from my generation — because I’m a baby boomer — unfortunately have had an association of growing up in America with the rebellion that’s been associated with drug use.  That’s been very dangerous, and we’ve lost a lot of lives.  We have to remember that it’s alive and well, and has become part of the technological sources of information that young people have.  I also see young people in treatment centers who got in a chat room and somebody offered them drugs or offered them to come and buy them alcohol and flattered them, and got them involved in incredibly self-destructive behavior.  The computer brings every predator and every dangerous influence into your own child’s home – into their bedroom in some cases, if that’s where that computer exists.  You wouldn’t let your kids go out and play in the park with drug dealers.  If you have a computer and it’s not supervised, those drug dealers are in that computer.  Remember that.  And they’re only a couple of keystrokes away from your child.

Q 13:  And you talk about the YouTube and the computers and all those things.  What about just the overall societal image?  Because we have this whole image with heroin, of heroin chic.  How much does that contribute to the drug use, and how difficult does it make your job, when a drug is being made out to be cool in society by famous people?

WALTERS:  There are still some elements of that.  It was more prominent a number of years ago.  I would say you see less of that now glamorized in the entertainment industry, or among people who are celebrities in and out of entertainment.  You see more cases of real harm.  But it’s still out there.  The one place that I think is replacing that, just to get people ahead of the game here, is prescription pharmaceuticals.  Those have been marketed to kids on the internet as a safe high.  They falsely suggest that you can overcome the danger of an overdose because you can predict precisely the dosage of OxyContin, hydrocodone, Vicodin.  And there are sites that suggest what combination of drugs to use.  We’ve seen prescription drug use as the one counter example of a category of drug use going up among teens.  We’re trying to work on that as well, but that’s something that’s in your own home, because many people get these substances for legitimate medical care.  Young people are going to the medicine cabinet of family or friends, taking a few pills out and using those.  And those are as powerful as heroin, they’re synthetic opioids, and they have been a source of overdose deaths. 

So let’s not forget – while this Fairfax example reminds us of the issues of heroin chic and of the heroin that’s in our communities, the new large problem today is a similar dangerous substance in pill form in our own medicine cabinets.  Barrier to access is zero.  They don’t have to find a drug dealer; they just go find the medicine cabinet.  They don’t have to pay a dime for it because they just take it and they share that with their friends.  We need to remember, that’s another dimension here.  Keep these substances out of reach – under our control when we have them in our home.  Throw them away when we’re done with them.  Make sure we talk to kids about pills.  Because people, again, are telling them that’s the place to go to avoid overdose death, is to take a pill.

Q 14:  When you see a lot of these celebrities checking in and out of rehab, does it sort of glamorize it for kids?  And teach them hey, you can use, you can check into rehab, you can come back, you can – you know.  Is there a mixed message there?

WALTERS:  There is.  Some young people interpret it the way you describe; of it’s something you do and you can get away with it by going into rehab.  We do a lot of research on young people’s attitudes for purposes of helping shape prevention programs in the media, as well as in schools and for parents.  We do a lot with providing material to parents.  I would say that compared to where we’ve been in the last 15 or 20 years, there’s less glamorization today.

I think we should also remember the positive, because we reinforce that.  A lot of young people – obviously not all or we wouldn’t have this death – believe that taking drugs makes you a loser.  They’ve seen that a lot of those celebrities are showing their careers going down the toilet because they can’t get away from the pills and the drugs and the alcohol.  And I think they see that even among some of their peers.  That’s a good thing.  We should reinforce that as parents: teaching our kids that drug and alcohol use may be falsely presented to you as something you do that would make you popular, make you seem like you should have more status in society generally.  But actually, look at a lot of these people; they’ve had enormous opportunities, enormous gifts, and they can’t stop themselves from throwing them away.  And they may not stop themselves from throwing away their lives. 

I think you could use these events as a teachable moment.  It can go two ways.  Help your child understand what the truth is here.  And I tell young people – and I think parents have to start this more directly – this is the way this is going to come to you:  Somebody you really, really want to like you; somebody you really, really like; someone you may even love — or think you love — they’re going to say come and do this with me.  If you can’t find any other reason to not do this with them, say, “Before we do this, let’s go to a treatment center.  Let’s go talk to people who stood where we stood and said it’s not going to happen to me.”  If everybody, when they got the chance to start, thought of an addict or somebody who was dead, they wouldn’t start.  The fact is that does not enter their mind. 

Many people in treatment centers understand that part of the task of recovery is helping other people avoid this.  So they’re willing to talk about it.  In fact, that’s part of their path of staying clean and sober, which not many kids are going to be able to do on their own.  But it makes them think that what presents itself as something overwhelmingly attractive has behind it a horrible dimension, for their friends as well as for themselves.  And more and more, I think kids understand this.

We can use the science of this as a disease, and the experience of many families.  Remember, uncle Joe didn’t used to be like this.  Especially Thanksgiving, when we have families getting together and all of a sudden mom’s going to get loaded and become ugly in the corner.  We also have to remember we have an obligation to reach out to those people, and to get them help.  We can treat them.  Nobody gets sober, in my experience, by themselves.  They have to take responsibility.  But you have to overcome the pushback, and addiction and alcoholism have, as a part of the disease, denial.  When you tell somebody they have a problem, they get angry with you.  They don’t say hey thanks, I want your help.  They don’t hit bottom and become nice.  That’s a myth.  They need to be grabbed and encouraged and pushed.  Almost everybody in treatment is coerced – by a family member, by an employer, sometimes by the criminal justice system.

So remember that, when you find your child using and they want to lie to you up down and sideways saying, “It’s the first time I’ve ever done it.”  No, no, no, no, no, that’s the drugs talking.  That shows you, if anything, you have a bigger problem than you realized and you need to reach out, get some professional help.  But don’t wait!

Source:    National Institute of Citizen Anti-drug Policy (NICAP)

DeForest Rathbone, Chairman, Great Falls, Virginia, 703-759-2215, DZR@prodigy.net

Filed under: Alcohol,Brain and Behaviour,Cannabis/Marijuana,Crime/Violence/Prison,Drug use-various effects,Education,Education Sector,Effects of Drugs,Heroin/Methadone,Internet,Political Sector,Prescription Drugs,Prevention and Intervention,Social Affairs,Synthetics,Treatment and Addiction,USA,Youth :

Vienna (Austria), 22 March 2024 — The 67th session of the Commission on Narcotic Drugs (CND) concluded today, after a two-day high-level segment focusing on the Midterm Review of the 2019 Ministerial Declaration and five days of discussions focused on the implementation of international drug control treaties and drug policy commitments.

In his closing remarks, H.E. Philbert Johnson of Ghana, Chair of the CND at its 67th session, thanked all delegations for contributing to the biggest gathering of the Commission ever, with 140 Member States of the United Nations represented as well as representatives of 18 intergovernmental organizations, 141 non-governmental organizations, and nine UN entities. More than 2500 participants attended in total.

Ghada Waly, Executive Director of the United Nations Office on Drugs and Crime (UNODC), in her closing remarks acknowledged that a fundamental truth had emerged from this year’s high-level segment – that even in times of division and fractures, common ground can be found, as embodied in the High-Level Declaration adopted at the opening session.

The Executive Director made the following pledge on behalf of UNODC as part of the Chair’s Pledge4Action initiative: “UNODC pledges to support a paradigm shift towards much stronger frameworks for prevention in Member States, whether to prevent drug use and harmful behaviours, to prevent illicit economies from exploiting and expanding, or to prevent violence associated with the illicit drug trade, with a focus on children and adolescents, as well as those who are in settings of vulnerability.”

She continued: “We will strive to provide and improve low-cost and accessible tools that build prevention skills, identify and share best practices for prevention in different contexts, and encourage and support far greater investment in prevention nationally and globally, to build the resilience of individuals and communities.”

During the regular segment of the 67th session, Member States exchanged views on, inter alia, a) the implementation of the international drug control treaties and drug policy commitments; b) the inter-agency cooperation and coordination of efforts in addressing and countering the world drug problem; c) the recommendations of the subsidiary bodies of the Commission; and d) the Commission’s contributions to the review and implementation of the 2030 Agenda for Sustainable Development.

The Commission decided to place one benzodiazepine, one synthetic opioid, two stimulants, one dissociative-type substance, sixteen precursors of amphetamine-type stimulants and two fentanyl precursors under international control. The scheduling of the two series of amphetamine-type stimulant precursors is part of – for the first time – the taking of a pre-emptive measure to address the proliferation of closely related designer precursors with no known legitimate use.

During the 67th  session of the CND, four resolutions were also adopted, covering topics including: alternative development; rehabilitation and recovery management programmes; improving access to and availability of controlled substances for medical purposes; and preventing and responding to drug overdose.

2024 Midterm Review

In accordance with the 2019 Ministerial Declaration, Commission conducted a midterm review of progress made in the implementation of all international drug policy commitments during the two-day High-Level Segment, consisting of a General Debate and two multi-stakeholder round-table discussions on the topics “Taking stock: work undertaken since 2019” and “The way forward: the road to 2029”. The final review is planned for 2029.

As part of the General Debate, 66 countries pledged concrete actions towards addressing and countering the world drug problem as part of the Chair’s Pledge4Action initiative.

FURTHER INFORMATION

The CND is the policymaking body of the United Nations with prime responsibility for drug control and other drug-related matters. The Commission is the forum for Member States to exchange knowledge and good practices in addressing and countering the world drug problem.

 

Source: https://www.unodc.org/unodc/en/frontpage/2024/March/twenty-three-new-substances-precursors-placed-under-international-control-four-resolutions-passed-at-67th-session-of-the-commission-on-narcotic-drugs.html

Filed under: Effects of Drugs,Health,Others (International News),Prevention and Intervention :

A meta-analysis of all studies worldwide showing association between marijuana use and schizophrenia:

Moore TH, Zammit S, Lingford-Hughes A, et al. Cannabis use and risk of psychotic or affective mental health outcomes: a systematic review. Lancet. 2007;370:319–328.
http://dirwww.colorado.edu/alcohol/downloads/Cannabis_and_behavior.pdf

“There was an increased risk of any psychotic outcome in individuals who had ever used cannabis…with greater risk in people who used cannabis most frequently. There is now sufficient evidence to warn young people that using cannabis could increase their risk of
developing a psychotic illness later in life.”

The most recent study conducted in the United States (Columbia University, New York), showing a high risk (odds ratio, “OR”) for schizophrenia spectrum disorders, particularly in those who become cannabis-dependent:

Davis GP, Compton MT, Wang S, Levin FR, Blanco C. Association between cannabis use, psychosis, and schizotypal personality disorder: findings from the National Epidemiologic Survey on Alcohol and Related Conditions. Schizophr Res. 2013 Dec;151(1-3):197-202.
“There was a similar dose-response relationship between the extent of cannabis use and schizotypal personality disorder (OR=2.02 for lifetime cannabis use, 95% CI 1.69-2.42; OR=2.83 for lifetime cannabis abuse, 95% CI 2.33-2.43; OR=7.32 for lifetime cannabis dependence, 95% CI 5.51-9.72). Likelihood of individual schizotypal features increased significantly with increased extent of cannabis use in a dose-dependent manner.”

Studies that corrected for general genetic background effects and many non-cannabis environmental variables by comparing siblings. The risk ratios are somewhat lower than general population studies, because genetic predisposition is more or less controlled for:

McGrath J, Welham J, Scott J, Varghese D, Degenhardt L, Hayatbakhsh MR, Alati R, Williams GM, Bor W, Najman JM. Association between cannabis use and psychosis-related outcomes using sibling pair analysis in a cohort of young adults. Arch Gen Psychiatry. 2010; 67(5):440-7.
“Longer duration since first cannabis use was associated with multiple psychosis-related outcomes in young adults… the longer the duration since first cannabis use, the higher the risk of psychosis-related outcomes…
Compared with those who had never used cannabis, young adults who had 6 or more years since first use of cannabis (i.e., who commenced use when around 15 years or younger) were twice as likely to develop a nonaffective psychosis…
This study provides further support for the hypothesis that early cannabis use is a risk-modifying factor for psychosis-related outcomes in young adults.”

Giordano GN, Ohlsson H, Sundquist K, Sundquist J, Kendler KS. The association between cannabis abuse and subsequent schizophrenia: a Swedish national co-relative control study.
Psychol Med. 2014 Jul 3:1-8. [Epub ahead of print]
http://journals.cambridge.org/download.php?file=%2FPSM%2FS0033291714001524a.pdf&code=79f795824a92c8eead870197ef071dd8

“Allowing 7 years from initial CA registration to later diagnosis, the risk for schizophrenia in discordant full sibling pairs remained almost twofold….The results of this study therefore lend support to the etiologic hypothesis, that CA is one direct cause of later schizophrenia.”

Those diagnosed with schizophrenia who also use recreational drugs are much more likely to be violent, including those who use cannabis:

Fazel S, Långström N, Hjern A, Grann M, Lichtenstein P. Schizophrenia, substance abuse, and violent crime. JAMA. 2009 May 20;301(19):2016-23.
“The risk was mostly confined to patients with substance abuse comorbidity (of whom 27.6% committed an offense), yielding an increased risk of violent crime among such patients (adjusted OR, 4.4; 95% CI,3.9-5.0), whereas the risk increase was small in schizophrenia patients without substance abuse comorbidity (8.5% of whom had at least 1 violent offense; adjusted OR,1.2; 95% CI, 1.1-1.4; P<0.001 for interaction).”

Fazel S, Gulati G, Linsell L, Geddes JR, Grann M. Schizophrenia and violence: systematic review and meta-analysis. PLoS Med. 2009 Aug;6(8):e1000120. doi: 10.1371/journal.pmed.1000120. Epub 2009 Aug 11.
“The effect of comorbid substance abuse was marked with….. an OR of 8.9” (as compared to the general population)

Arseneault L, Moffitt TE, Caspi A, Taylor PJ, Silva PA. Mental disorders and violence in a total birth cohort: results from the Dunedin Study. Arch Gen Psychiatry. 2000;57(10):979-86.
“for having more than two of these disorders at once…..the OR (odds ratio for violence) was, …..for marijuana dependence plus schizophrenia spectrum disorder, 18.4”

Harris AW, Large MM, Redoblado-Hodge A, Nielssen O, Anderson J, Brennan J. Clinical and cognitive associations with aggression in the first episode of psychosis. Aust N Z J Psychiatry. 2010 Jan;44(1):85-93.
‘The use of cannabis with a frequency of more than fourfold in the previous month was the only factor that was found to be associated with serious aggression’

Self-report of psychotic symptoms by otherwise healthy users (12% to 15%):

Thomas H. A community survey of adverse effects of cannabis use. Drug Alcohol Depend. 1996 Nov;42(3):201-7.
“This survey estimates the frequency of various adverse effects of the use of the drug cannabis. A sample of 1000 New Zealanders aged 18-35 years were asked to complete a self-administered questionnaire on cannabis use and associated problems. The questionnaire was derived from criteria for the identification of cannabis abuse which are analagous to criteria commonly used to diagnose alcoholism. Of those who responded 38% admitted to having used cannabis. The most common physical or mental health problems, experienced by 22% of users were acute anxiety or panic attacks following cannabis use. Fifteen percent reported psychotic symptoms following use.”

Smith MJ, Thirthalli J, Abdallah AB, Murray RM, Cottler LB. Prevalence of psychotic symptoms in substance users: a comparison across substances. Compr Psychiatry. 2009 May-Jun;50(3):245-50. doi: 10.1016/j.comppsych.2008.07.009. Epub 2008 Sep 23.
“Among all users of substances without a diagnosis of abuse or dependence, cannabis users reported the highest prevalence of psychotic symptoms (12.4%).”

Barkus EJ, Stirling J, Hopkins RS, Lewis S.. Cannabis-induced psychosis-like experiences are associated with high schizotypy Psychopathology 2006;39(4):175-8.
“In the sample who reported ever using cannabis (72%) the means for the subscales from the CEQ were as follows: ……Psychotic-Like Experiences (12.98%).”

Rates of psychotic symptoms in those with cannabis dependence as compared to non-dependent users and nonusers:

Fergusson DM, Horwood LJ, Swain-Campbell NR. Cannabis dependence and psychotic symptoms in young people. Psychol Med. 2003 Jan;33(1):15-21.
“Young people meeting DSM-IV criteria for cannabis dependence had elevated rates of psychotic symptoms at ages 18 (rate ratio = 3.7; 95% CI 2.8-5.0; P < 0.0001) and 21 (rate ratio = 2.3; 95% CI 1.7-3.2; P < 0.0001).”

Smith MJ, Thirthalli J, Abdallah AB, Murray RM, Cottler LB. Prevalence of psychotic symptoms in substance users: a comparison across substances. Compr Psychiatry. 2009 May-Jun;50(3):245-50. doi: 10.1016/j.comppsych.2008.07.009. Epub 2008 Sep 23.
“more than half of the respondents who were dependent on cocaine (80%), cannabis (63.5%), amphetamines (56.1%), and opiates (53.1%) reported psychotic symptoms. Among all users of substances without a diagnosis of abuse or dependence, cannabis users reported the highest prevalence of psychotic symptoms (12.4%)……. There was also a marked increase in the risk for psychotic symptoms when dependence became moderate or severe for cannabis (OR=25.1, OR=26.8; respectively).”

Studies on the psychotomimetic properties of THC administered to healthy individuals in the clinic:

D’Souza DC, Perry E, MacDougall L, Ammerman Y, Cooper T, Wu YT, Braley G, Gueorguieva R, Krystal JH. The psychotomimetic effects of intravenous delta-9-tetrahydrocannabinol in healthy individuals: implications for psychosis. Neuropsychopharmacology. 2004 Aug;29(8):1558-72.
“∆-9-THC (1) produced schizophrenia-like positive and negative symptoms; (2) altered perception;(3) increased anxiety; (4) produced euphoria; (5) disrupted immediate and delayed word recall, sparing recognition recall; (6) impaired performance on tests of distractibility, verbal fluency, and working memory (7) did not impair orientation; (8) increased plasma cortisol. These data indicate that D-9-THC produces a broad range of transient symptoms, behaviors, and cognitive deficits in healthy individuals that resemble some aspects of endogenous psychoses.”

Morrison PD, Nottage J, Stone JM, Bhattacharyya S, Tunstall N, Brenneisen R, Holt D, Wilson D, Sumich A, McGuire P, Murray RM, Kapur S, Ffytche DH. Disruption of frontal θ coherence by ∆9-tetrahydrocannabinol is associated with positive psychotic symptoms. Neuropsychopharmacology. 2011;;36(4):827-36.
“Compared with placebo, THC evoked positive and negative psychotic symptoms, as measured by the positive and negative syndrome scale (p<0.001)…… The results reveal that the pro-psychotic effects of THC might be related to impaired network dynamics with impaired communication between the right and left frontal lobes.”

Bhattacharyya S, Crippa JA, Allen P, Martin-Santos R, Borgwardt S, Fusar-Poli P, Rubia K, Kambeitz J, O’Carroll C, Seal ML, Giampietro V, Brammer M, Zuardi AW, Atakan Z, McGuire PK. Induction of psychosis by ∆9-tetrahydrocannabinol reflects modulation of prefrontal and striatal function during attentional salience processing. Arch Gen Psychiatry. 2012 Jan;69(1):27-36. doi: 10.1001/archgenpsychiatry.2011.161.
“Pairwise comparisons revealed that 9-THC significantly increased the severity of psychotic symptoms compared with placebo (P<.001) and CBD (P<.001).”,

Freeman D, Dunn G, Murray RM, Evans N, Lister R, Antley A, Slater M, Godlewska B, Cornish R, Williams J, Di Simplicio M, Igoumenou A, Brenneisen R, Tunbridge EM, Harrison PJ, Harmer CJ, Cowen P, Morrison PD. How Cannabis Causes Paranoia: Using the Intravenous Administration of ∆9-Tetrahydrocannabinol (THC) to Identify Key Cognitive Mechanisms Leading to Paranoia. Schizophr Bull. 2014 Jul 15. pii: sbu098. [Epub ahead of print]
“THC significantly increased paranoia, negative affect (anxiety, worry, depression, negative thoughts about the self), and a range of anomalous experiences, and reduced working memory capacity.”

For data on dose-response (a very large study by Zammit et al., and another by van Os et al.) and the greater risk for psychosis posed by high strength marijuana (DiForti et al.):

Zammit S, Allebeck P, Andreasson S, Lundberg I, Lewis G, 2002, Self reported cannabis use as a risk factor for schizophrenia in Swedish conscripts of 1969: historical cohort study. BMJ. 2002 Nov 23;325(7374):1199. http://www.bmj.com/content/325/7374/1199.full.pdf
“We found a dose dependent relation between frequency of cannabis use and risk of schizophrenia, with an adjusted odds ratio for linear trend across the categories of frequency of cannabis use used in this study of 1.2 (1.1 to 1.4, P < 0.001). The adjusted odds ratio for subjects with a history of heaviest use of cannabis ( > 50 occasions) was 3.1 (1.7 to 5.5)………………Cannabis use is associated with an increased risk of
developing schizophrenia, consistent with a causal relation. This association is not explained by use of other psychoactive drugs or personality traits relating to social integration.”

van Os J, Bak M, Hanssen M, Bijl RV, de Graaf R, Verdoux H. Cannabis use and psychosis: a longitudinal population-based study. Am J Epidemiol. 2002 Aug 15;156(4):319-27.
“…..further evidence supporting the hypothesis of a causal relation is demonstrated by the existence of a dose-response relation.. between cumulative exposure to cannabis use and the psychosis outcome……. About 80 percent of the psychosis outcome associated with exposure to both cannabis and an established vulnerability to psychosis was attributable to the synergistic action of these two factors. This finding indicates that, of the subjects exposed to both a vulnerability to psychosis and cannabis use, approximately 80 percent had the psychosis outcome because of the combined action of the two risk factors and only about 20 percent because of the action of either factor alone.”

DiForti M, Morgan C, Dazzan P, Pariante C, Mondelli V, Marques TR, Handley R, Luzi S, Russo M, Paparelli A, Butt A, Stilo SA, Wiffen B, Powell J, Murray RM. High-potency cannabis and the risk of psychosis. Br J Psychiatry. 2009,195(6):488-91.
“78% (n = 125) of the cases group preferentially used sinsemilla (skunk) compared with only 31% (n = 41) of the control group (unadjusted OR= 8.1, 95% CI 4.6–13.5). This association was only slightly attenuated after controlling for potential confounders (adjusted OR= 6.8, 95% CI 2.6–25.4)………. Our most striking finding is that patients with a first episode of psychosis preferentially used high-potency cannabis preparations of the sinsemilla (skunk) variety…… our results suggest that the potency and frequency of cannabis use may interact in further increasing the risk of psychosis.”

DiForti M, Marconi A, Carra E, Fraietta S, Trotta A, Bonomo M, Bianconi F, Gardner-Sood P, O’Connor J, Russo M, Stilo SA, Marques TR, Mondelli V, Dazzan P, Pariante C, David AS, Gaughran F, Atakan Z, Iyegbe C, Powell J, Morgan C, Lynskey M, Murray RM. Proportion of
patients in south London with first-episode psychosis attributable to use of high potency cannabis: a case-control study. Lancet Psychiatry, online February 18, 2015, http://dx.doi.org/10.1016/S2215-0366(14)00117-5.
“In the present larger sample analysis, we replicated our previous report and showed that the highest probability to suffer a psychotic disorder is in those who are daily users of high potency cannabis. Indeed, skunk use appears to contribute to 24% of cases of first episode psychosis in south London. Our findings show the importance of raising awareness among young people of the risks associated with the use of high-potency cannabis. The need for such public education is emphasised by the worldwide trend of liberalisation of the legal constraints on cannabis and the fact that high potency varieties are becoming much more widely available.”

For data on percent of those with marijuana-induced psychosis who go on to receive a diagnosis of a schizophrenia spectrum disorder:

Arendt M, Mortensen PB, Rosenberg R, Pedersen CB, Waltoft BL. Familial predisposition for psychiatric disorder: comparison of subjects treated for cannabis-induced psychosis and schizophrenia. Arch Gen Psychiatry. 2008;65(11):1269-74. http://archpsyc.ama-assn.org/cgi/reprint/65/11/1269
“Approximately half of the subjects who received treatment of a cannabis induced psychosis developed a schizophrenia spectrum disorder within 9 years after treatment…… The risk of schizophrenia after a cannabis-induced psychosis is independent of familial predisposition……. cannabis-induced psychosis may not be a valid diagnosis but an early marker of schizophrenia……. Psychotic symptoms after cannabis
use should be taken extremely seriously.”

Niemi-Pynttäri JA, Sund R, Putkonen H, Vorma H, Wahlbeck K, Pirkola SP. Substance-induced psychoses converting into schizophrenia: a register-based study of 18,478 Finnish inpatient cases. J Clin Psychiatry. 2013 74(1):e94-9.
“Eight-year cumulative risk to receive a schizophrenia spectrum diagnosis was 46% for persons with a diagnosis of cannabis-induced psychosis ….. chances for amphetamine-, hallucinogen-, opioid-, sedative- and alcohol-induced (schizophrenia spectrum diagnoses) were 30%, 24%, 21%, and 5% respectively.”

For cause and effect (which comes first: psychosis or marijuana use):
Arseneault L, Cannon M, Poulton R, Murray R, Caspi A, Moffitt TE, 2002, Cannabis use in
adolescence and risk for adult psychosis: longitudinal prospective study.BMJ. 2002 Nov 23;325(7374):1212-3.
“Firstly, cannabis use is associated with an increased risk of experiencing schizophrenia symptoms, even after psychotic symptoms preceding the onset of cannabis use are controlled for, indicating that cannabis use is not secondary to a pre-existing psychosis. Secondly, early cannabis use (by age 15) confers greater risk for schizophrenia outcomes than later cannabis use (by age 18). Thirdly, risk was specific to cannabis use, as opposed to use of other drugs….”

Henquet C, Krabbendam L, Spauwen J, et al. Prospective cohort study of cannabis use, predisposition for psychosis, and psychotic symptoms in young people. BMJ. 2005;330:11–15. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC539839/pdf/bmj33000011.pdf
“Exposure to cannabis during adolescence and young adulthood increases the risk of psychotic symptoms later in life. Cannabis use at baseline increased the cumulative incidence of psychotic symptoms at follow up four years later…but has a much stronger effect in those with evidence of predisposition for psychosis……….Predisposition for psychosis at baseline did not significantly predict cannabis use four years later..”

and also:

Kuepper R, van Os J, Lieb R, Wittchen HU, Höfler M, Henquet C. Continued cannabis use and risk of incidence and persistence of psychotic symptoms: 10 year follow-up cohort study.BMJ. 2011 Mar 1;342: d738 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3047001/pdf/bmj.d738.pdf
“In individuals who had no reported lifetime psychotic symptoms and no reported lifetime cannabis use at baseline, incident cannabis use over the period from baseline to T2 increased the risk of later incident psychotic symptoms over the period from T2 to T3 (adjusted odds ratio 1.9, 95% confidence interval 1.1 to 3.1; P=0.021)…………There was no evidence for self medication effects, as psychotic experiences at T2 did not predict incident cannabis use between T2 and T3 (0.8, 0.6 to 1.2; P=0.3).”

For data on those who quit using when psychotic symptoms develop (further evidence against self-medication):

Fergusson DM, Horwood LJ, Ridder EM. Tests of causal linkages between cannabis use and psychotic symptoms. Addiction. 2005;100(3):354-66.

For degree of risk relative to other drugs:

Niemi-Pynttäri JA, Sund R, Putkonen H, Vorma H, Wahlbeck K, Pirkola SP. Substance-induced psychoses converting into schizophrenia: a register-based study of 18,478 Finnish inpatient cases. J Clin Psychiatry. 2013 74(1):e94-9.
“Eight-year cumulative risk to receive a schizophrenia spectrum diagnosis was 46% for persons with a diagnosis of cannabis-induced psychosis ….. chances for amphetamine-, hallucinogen-, opioid-, sedative- and alcohol-induced (schizophrenia spectrum diagnoses) were 30%, 24%, 21%, and 5% respectively.”

Smith MJ, Thirthalli J, Abdallah AB, Murray RM, Cottler LB. Prevalence of psychotic symptoms in substance users: a comparison across substances. Compr Psychiatry. 2009 May-Jun;50(3):245-50. doi: 10.1016/j.comppsych.2008.07.009. Epub 2008 Sep 23.
“more than half of the respondents who were dependent on cocaine (80%), cannabis (63.5%), amphetamines (56.1%), and opiates (53.1%) reported psychotic symptoms. Among all users of substances without a diagnosis of abuse or dependence, cannabis users reported the highest prevalence of psychotic symptoms (12.4%)……. There was also a marked increase in the risk for psychotic symptoms when dependence became moderate or severe for cannabis (OR=25.1, OR=26.8; respectively).”

Another angle on the potential confound of self-medication: genetic predisposition for schizophrenia does not predict cannabis use:

Veling W, Mackenbach JP, van Os J, Hoek HW. Cannabis use and genetic predisposition for schizophrenia: a case-control study. Psychol Med. 2008 Sep;38(9):1251-6. Epub 2008 May 19.
“BACKGROUND: Cannabis use may be a risk factor for schizophrenia. RESULTS: Cannabis use predicted schizophrenia [adjusted odds ratio (OR) cases compared to general hospital controls 7.8, 95% confidence interval (CI) 2.7-22.6; adjusted OR cases compared to siblings 15.9 (95% CI 1.5-167.1)], but genetic predisposition for schizophrenia did not predict cannabis use [adjusted OR intermediate predisposition
compared to lowest predisposition 1.2 (95% CI 0.4-3.8)].”

For data on potential benefits of cessation:

González-Pinto A, Alberich S, Barbeito S, Gutierrez M, Vega P, Ibáñez B, Haidar MK, Vieta E, Arango C. Cannabis and first-episode psychosis: different long-term outcomes depending on continued or discontinued use. Schizophr Bull. 2011 May;37(3):631-9. Epub 2009 Nov 13. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3080669/pdf/sbp126.pdf
“OBJECTIVE: To examine the influence of cannabis use on long-term outcome in patients with a first psychotic episode, comparing patients who have never used cannabis with (a) those who used cannabis before the first episode but stopped using it during follow-up and (b) those who used cannabis both before the first episode and during follow-up….. CONCLUSION: Cannabis has a deleterious effect, but stopping use after the first psychotic episode contributes to a clear improvement in outcome. The positive effects of stopping cannabis use can be seen more clearly in the long term.”

Kuepper R, van Os J, Lieb R, Wittchen HU, Höfler M, Henquet C. Continued cannabis use and risk of incidence and persistence of psychotic symptoms: 10 year follow-up cohort study.BMJ. 2011 Mar 1;342: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3047001/pdf/bmj.d738.pdf
“The finding that longer exposure to cannabis was associated with greater risk for persistence of psychotic experiences is in line with an earlier study showing that continued cannabis use over time increases the risk for psychosis in a dose-response fashion. This is also in agreement with the hypothesis that a process of sensitisation might underlie emergence and persistence of psychotic experiences as an indicator of liability to psychotic disorder.”

For data on marijuana use resulting in an earlier age of onset of schizophrenia (suggestive of causality), see Dragt et al. and a meta-analysis (see Large et al.,); also: a very extensive (676 schizophrena patients) and therefore more statistically powered analysis (see DeHert paper); two papers showing that the age-of-onset effect may be specific to those without a family history (see Scherr et al. and Leeson et al., papers); two studies that evaluate the age of onset specific to gender (Veen et al. and Compton et al. ) which is important because comparing across genders can be confounded by the greater tendency of males to engage in risky behavior (the conclusions are not the same in terms of gender; the gender distribution was slightly better in the Veen et al. study) and finally, two papers of relevance to specificity of age of onset effect to cannabis, a meta-analysis of published studies on age of onset that shows another drug of abuse (tobacco) is not associated with
a decreased age of onset (Myles et al.) and a study showing that ecstasy, LSD, stimulants, or sedatives did not have an effect to lower age of onset whereas cannabis use did (Barnes et al.) :

Large M, Sharma S, Compton MT, Slade T, Nielssen O. Cannabis Use and Earlier Onset of Psychosis: A Systematic Meta-analysis. Arch Gen Psychiatry. 2011 68(6):555-61. http://www.ncbi.nlm.nih.gov/pubmed/21300939
“The results of meta-analysis provide evidence for a relationship between cannabis use and earlier onset of psychotic illness, and they support the hypothesis that cannabis use plays a causal role in the development of psychosis in some patients. The results suggest the need for renewed warnings about the potentially harmful effects of cannabis.”

Dragt S, Nieman DH, Schultze-Lutter F, van der Meer F, Becker H, de Haan L, Dingemans PM, Birchwood M, Patterson P, Salokangas RK, Heinimaa M, Heinz A, Juckel G, Graf von Reventlow H, French P, Stevens H, Ruhrmann S, Klosterkötter J, Linszen DH; on behalf of the EPOS group.Cannabis use and age at onset of symptoms in subjects at clinical high risk for psychosis. Acta Psychiatr Scand. 2011 Aug 29. doi: 10.1111/j.1600-0447.2011.01763.x. [Epub ahead of print]
“Cannabis use and age at onset of symptoms in subjects at clinical high risk for psychosis. Objective: Numerous studies have found a robust association between cannabis use and the onset of psychosis. Nevertheless, the relationship between cannabis use and the onset of early (or, in retrospect, prodromal) symptoms of psychosis remains unclear. The study focused on investigating the relationship between cannabis
use and early and high-risk symptoms in subjects at clinical high risk for psychosis. Results: Younger age at onset of cannabis use or a cannabis use disorder was significantly related to younger age at onset of six symptoms (0.33 < r(s) < 0.83, 0.004 < P < 0.001). Onset of cannabis use preceded symptoms in most participants. Conclusion: Our results provide support that cannabis use plays an important role in the development of psychosis in vulnerable individuals.”

De Hert M, Wampers M, Jendricko T, Franic T, Vidovic D, De Vriendt N, Sweers K, Peuskens J, van Winkel R.Effects of cannabis use on age at onset in schizophrenia and bipolar disorder. Schizophr Res. 2011 Mar;126(1-3):270-6.

“BACKGROUND: Cannabis use may decrease age at onset in both schizophrenia and bipolar disorder, given the evidence for substantial phenotypic and genetic overlap between both disorders….RESULTS:… Both cannabis use and a schizophrenia diagnosis predicted earlier age at onset. There was a significant interaction between cannabis use and diagnosis, cannabis having a greater effect in bipolar patients….DISCUSSION:…. Our results suggest that cannabis use is associated with a reduction in age at onset in both schizophrenic and bipolar patients. This reduction seems more pronounced in the bipolar group than in the schizophrenia group: the use of cannabis reduced age at onset by on average 8.9 years in the bipolar group, as compared to an average predicted reduction of 1.5 years in the schizophrenia group.”

Scherr M, Hamann M, Schwerthöffer D, Froböse T, Vukovich R, Pit schel-Walz G, Bäuml J.. Environmental risk factors and their impact on the age of onset of schizophrenia: Comparing familial to non-familial schizophrenia. Nord J Psychiatry. 2011 Aug 31. [Epub ahead of print]
“Background and aims: Several risk factors for schizophrenia have yet been identified. The aim of our study was to investigate how certain childhood and adolescent risk factors predict the age of onset of psychosis in patients with and without a familial component (i.e. a relative with schizophrenia or schizoaffective disorder). Results: Birth complications and cannabis abuse are predictors for an earlier onset of schizophrenia in patients with non-familial schizophrenia. No environmental risk factors for an earlier age of onset in familial schizophrenia have been identified.”

Leeson VC, Harrison I, Ron MA, Barnes TR, Joyce EM. The Effect of Cannabis Use and Cognitive Reserve on Age at Onset and Psychosis Outcomes in First-Episode Schizophrenia. Schizophr Bull. 2011 Mar 9. [Epub ahead of print] http://schizophreniabulletin.oxfordjournals.org/content/early/2011/03/09/schbul.sbq153.full.pdf+html
“Objective: Cannabis use is associated with a younger age at onset of psychosis, an indicator of poor prognosis, but better cognitive function, a positive prognostic indicator. We aimed to clarify the role of age at onset and cognition on outcomes in cannabis users with first-episode schizophrenia as well as the effect of cannabis dose and cessation of use……Conclusions: Cannabis use brings forward the onset of psychosis in people who otherwise have good prognostic features indicating that an early age at onset can be due to a toxic action of cannabis rather than an intrinsically more severe illness. Many patients abstain over time, but in those who persist, psychosis is more difficult to treat.”

Veen ND, Selten JP, van der Tweel I, Feller WG, Hoek HW, Kahn RS. Cannabis use and age at onset of schizophrenia. Am J Psychiatry. 2004 Mar;161(3):501-6. http://ajp.psychiatryonline.org/cgi/reprint/161/3/501
“The results indicate a strong association between use of cannabis and earlier age at first psychotic episode in male schizophrenia patients.”

Compton MT, Kelley ME, Ramsay CE, Pringle M, Goulding SM, Esterberg ML, Stewart T, Walker EF. Association of pre-onset cannabis, alcohol, and tobacco use with age at onset of prodrome and age at onset of psychosis in first-episode patients. Am J Psychiatry. 2009 Nov;166(11):1251-7. Epub 2009 Oct 1. http://ajp.psychiatryonlie.org/cgi/reprint/166/11/1251
“Whereas classifying participants according to maximum frequency of use prior to onset (none, ever, weekly, or daily) revealed no significant effects of cannabis or tobacco use on risk of (editor’s note: “timing of”) onset, analysis of change in frequency of use prior to
onset indicated that progression to daily cannabis and tobacco use was associated with an increased risk of onset of psychotic symptoms. Similar or even stronger effects were observed when onset of illness or prodromal symptoms was the outcome. A gender-by-daily-cannabis use interaction was observed; progression to daily use resulted in a much larger increased relative risk of onset of psychosis in females than in males.”

Myles N, Newall H, Compton MT, Curtis J, Nielssen O, Large M. The age at onset of psychosis and tobacco use: a systematic meta-analysis. Soc Psychiatry Psychiatr Epidemiol. 2011 Sep 8. [Epub ahead of print]
“Unlike cannabis use, tobacco use is not associated with an earlier onset of psychosis.”

Barnes TR, Mutsatsa SH, Hutton SB, Watt HC, Joyce EM. Comorbid substance use and age at onset of schizophrenia. Br J Psychiatry. 2006 Mar;188:237-42. http://bjp.rcpsych.org/content/188/3/237.full.pdf+html
“Alcohol misuse and any substance use (other than cannabis use) were not significant in relation to age at onset….. those patients in the sample who reported that they had used cannabis had an earlier age at onset of psychosis than other patients who did not report cannabis use but who shared the same profile with regard to the other variables (e.g. comparing men who reported alcohol misuse and use of both cannabis and other drugs with men who had the same characteristics apart from the fact that they had not used cannabis).”

Data from other cultures

Sarkar J, Murthy P, Singh SP. Psychiatric morbidity of cannabis abuse. Indian J Psychiatry. 2003 Jul;45(3):182-8. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2952166/pdf/IJPsy-45-182.pdf
“The paper evaluates the hypothesis that cannabis abuse is associated with a broad range of psychiatric disorders in India, an area with relatively high prevalence of cannabis use. Retrospective case-note review of all cases with cannabis related diagnosis over a 11 -year period, for subjects presenting to a tertiary psychiatric hospital in southern India was carried out. Information pertaining to sociodemographic, personal, social, substance-use related, psychiatric and treatment histories, was gathered. Standardized diagnoses were made according to Diagnostic Criteria for Research of the World Health Organization, on the basis of information available.Cannabis abuse is associated with
widespread psychiatric morbidity that spans the major categories of mental disorders under the ICD-10 system, although proportion of patients with psychotic disorders far outweighed those with non-psychotic disorders. Whilst paranoid psychoses were more prevalent, a significant number of patients with affective psychoses, particularly mania, was also noted.”

Rodrigo C, Welgama S, Gunawardana A, Maithripala C, Jayananda G, Rajapakse S. A retrospective analysis of cannabis use in a cohort of mentally ill patients in Sri Lanka and its implications on policy development. Subst Abuse Treat Prev Policy. 2010 Jul 8;5:16. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2910013/pdf/1747-597X-5-16.pdf
”BACKGROUND: Several epidemiological studies have shown that cannabis; the most widely used illegal drug in the world, is associated with schizophrenia spectrum disorders (SSD)……. CONCLUSIONS: Self reported LTC (editor’s note: life time cannabis) use was strongly associated with being diagnosed with SSD (editor’s note: schizophrenia spectrum disorders”.

Population study showing change in incidence rate in young when drug laws are eased

Ajdacic-Gross V, Lauber C, Warnke I, Haker H, Murray RM, Rössler W. Changing incidence of psychotic disorders among the young in Zurich. Schizophr Res. 2007 Sep;95(1-3):9-18. Epub 2007 Jul 16.
“There is controversy over whether the incidence rates of schizophrenia and psychotic disorders have changed in recent decades. To detect deviations from trends in incidence, we analysed admission data of patients with an ICD-8/9/10 diagnosis of psychotic disorders in the Canton Zurich / Switzerland, for the period 1977-2005. The data was derived from the central psychiatric register of the Canton Zurich. Ex-post forecasting with ARIMA (Autoregressive Integrated Moving Average) models was used to assess departures from existing trends. In addition, age-period-cohort analysis was applied to determine hidden birth cohort effects. First admission rates of patients with psychotic
disorders were constant in men and showed a downward trend in women. However, the rates in the youngest age groups showed a strong increase in the second half of the 1990’s. The trend reversal among the youngest age groups coincides with the increased
use of cannabis among young Swiss in the 1990’s.”

Estimates of how many men aged 20-40 would have to avoid regular marijuana use for one year in order to prevent one case of schizophrenia in that same year (but for number relevant to a 20 year avoidance of schizophrenia by avoiding regular marijuana use during
20 years, divide by 20):

Hickman M, Vickerman P, Macleod J, Lewis G, Zammit S, Kirkbride J, Jones P. If cannabis caused schizophrenia–how many cannabis users may need to be prevented in order to prevent one case of schizophrenia? England and Wales calculations. Addiction. 2009;104(11):1856-61.

“In men the annual mean NNP (number needed to prevent) for heavy cannabis and schizophrenia ranged from 2800 [90% confidence interval (CI) 2018–4530] in those aged 20–24 years to 4700 (90% CI 3114–8416) in those aged 35–39”.

Key studies interpreted to diminish the connection between marijuana and schizophrenia:

Proal AC, Fleming J, Galvez-Buccollini JA, Delisi LE. A controlled family study of cannabis users with and without psychosis. Schizophr Res. 2014 Jan;152(1):283-8.
“The results of the current study, both when analyzed using morbid risk and family frequency calculations, suggest that having an increased familial risk for schizophrenia is the underlying basis for schizophrenia in these samples and not the cannabis use. While cannabismay have an effect on theage of onset of schizophrenia it is unlikely to be the cause of illness.”

Rebuttal: Miller CL. Caution urged in interpreting a negative study of cannabis use and schizophrenia. Schizophr Res. 2014 Apr;154(1-3):119-20.
“The morbid risk reported for the relatives of the non-cannabis-using patients (Sample 3) was actually 1.4-fold higher than the cannabis using patients (Sample 4), but the study did not have enough power to statistically confirm or refute a less than 2-fold difference. An increase in sample size would be required to do so, and if the observed difference were to be confirmed, it would explain not only why the Sample 4 data fits poorly with a multigene/small environmental impact model but also would give weight to the premise that cannabis use significantly contributes to the development of this disease.”

Power RA, Verweij KJ, Zuhair M, Montgomery GW, Henders AK, Heath AC, Madden PA, Medland SE, Wray NR, Martin NG. Genetic predisposition to schizophrenia associated with increased use of cannabis. Mol Psychiatry. 2014 Jun 24. doi: 10.1038/mp.2014.51. [Epub ahead of print] http://emilkirkegaard.dk/en/wp-content/uploads/Genetic%20predisposition%20to%20schizophrenia%20associated%20with%20increased%20use%20of%20cannabis.pdf
“Our results show that to some extent the association between cannabis and schizophrenia is due to a shared genetic aetiology across common variants. They suggest that individuals with an increased genetic predisposition to schizophrenia are
both more likely to use cannabis and to use it in greater quantities.”

Rebuttal: Had this paper been titled “The causal genes for schizophrenia have been discovered” it would never have been published. In the absence of a consistent finding of genes of major effect size for schizophrenia, this study of inconsistently associated genes of low effect size is meaningless.

Buchy L, Perkins D, Woods SW, Liu L, Addington J. Impact of substance use on conversion to psychosis in youth at clinical high risk of psychosis. Schizophrenia Res 156 (2-3): 277–280.
“Results revealed that low use of alcohol, but neither cannabis use nor tobacco use at baseline, contributed to the prediction of psychosis in the CHR sample”.
Rebuttal: The study was small in size and the age range of their subjects at study onset was large (12 to 31) which included both subjects that had not reached the peak age of risk for schizophrenia even by the end of the study as well as subjects who were well past the peak age of onset of schizophrenia. The fact that the study screened out psychotic individuals was problematic for the latter group, in that those who were most vulnerable to the psychosis inducing effects of cannabis would already have converted to psychosis by that age.

Overview of Key Public Health Issues Regarding the Mental Health Effects of Marijuana

For the monetary cost of schizophrenia to the U.S. annually ($63 billion in 2002 dollars):

Wu EQ, Birnbaum HG, Shi L, Ball DE, Kessler RC, Moulis M, Aggarwal J. The economic burden of schizophrenia in the United States in 2002. J Clin Psychiatry. 2005 Sep;66(9):1122-9.

For the trends in adolescent drug, alcohol and cigarette use, showing an upward tick in marijuana use as medical marijuana has become more prevalent, and that the mind-altering drug legal for adults (alcohol) is still more commonly used by teens than is marijuana:

Johnston, L. D., O’Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2012). Monitoring the Future national results on adolescent drug use: Overview of key findings, 2011. Ann Arbor, MI: Institute for Social Research, The University of Michigan.

For a summary of Sweden’s drug law experience:
Hallam C., 2010, Briefing paper 20, The Beckley Foundation: What Can We Learn from Sweden’s Drug Policy Experience? www.beckleyfoundation.org/pdf/BriefingPaper_20.pdf
“in the case of Sweden, the clear association between a restrictive drug policy and low levels of drug use is striking. In his foreword to the article on Sweden’s Successful Drug Policy, Antonio Maria Costa is frank enough to confess that, “It is my firm belief that the generally positive situation of Sweden is a result of the policy that has been applied to address the problem”.

For data showing the relationship between drug enforcement policies in Europe and drug use, such that Sweden has a zero tolerance policy on drugs and has one of the lowest rates of “last month use” in Europe (1%), 4-fold lower than the Netherlands and 7-fold lower than Spain and Italy, two countries that have liberalized their enforcement policies so that marijuana possession carries no substantive penalty.

European Monitoring Centre for Drugs and Addiction, 2012 Annual report
http://www.emcdda.europa.eu/attachements.cfm/att_190854_EN_TDAC12001ENC_.pdf

Source: Microsoft Word – 2015- Summary of literature on marijuana and psychosis.doc (momsstrong.org) January 2016

Filed under: Alcohol,Brain and Behaviour,Cannabis/Marijuana,Crime/Violence/Prison,Drug use-various effects,Effects of Drugs,Nicotine,Political Sector,Social Affairs :

Background. Chronic cannabis use has become prevalent with decriminalization, medical prescription, and recreational legalization in numerous US states. With this increasing incidence of chronic cannabis use a new clinical syndrome has become apparent in emergency departments and hospitals across the country, termed Cannabinoid Hyperemesis (CH). CH has been described as cyclical vomiting and abdominal pain in the setting of chronic cannabis use, which is often temporarily relieved by hot showers.

CH presents a diagnostic challenge to clinicians who do not have a high clinical suspicion for the syndrome and can result in high costs and resource utilization for hospitals and patients. Tis study investigates the expenditures associated with delayed CH evaluation and delayed diagnosis.

Methods.

This is a retrospective observational study of 17 patients diagnosed with CH at three medical centers in the United States from 2010 to 2015, consisting of two academic centers and a community hospital. Emergency department (ED) costs were calculated and analyzed for patients eventually diagnosed with CH. Results. For the 17 patients treated, the total cost for combined ED visits and radiologic evaluations was an average of $76,920.92 per patient.

On average these patients had 17.9 ED visits before the diagnosis of CH was made. Conclusion. CH provides a diagnostic challenge to clinicians without a high suspicion of the syndrome and may become increasingly prevalent with current trends toward cannabis legalization. The diagnosis of CH can be made primarily through a thorough history and physical examination. Awareness of this syndrome can save institutions money, prevent inappropriate utilization of healthcare resources, and save patients from unnecessary diagnostic tests.

Source: Copyright © 2019 David I. Zimmer et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Filed under: Effects of Drugs :

Abstract

The recent demonstration that massive scale chromosomal shattering or pulverization can occur abruptly due to errors induced by interference with the microtubule machinery of the mitotic spindle followed by haphazard chromosomal annealing, together with sophisticated insights from epigenetics, provide profound mechanistic insights into some of the most perplexing classical observations of addiction medicine, including cancerogenesis, the younger and aggressive onset of addiction-related carcinogenesis, the heritability of addictive neurocircuitry and cancers, and foetal malformations. Tetrahydrocannabinol (THC) and other addictive agents have been shown to inhibit tubulin polymerization which perturbs the formation and function of the microtubules of the mitotic spindle. This disruption of the mitotic machinery perturbs proper chromosomal segregation during anaphase and causes micronucleus formation which is the primary locus and cause of the chromosomal pulverization of chromothripsis and downstream genotoxic events including oncogene induction and tumour suppressor silencing. Moreover the complementation of multiple positive cannabis-cancer epidemiological studies, and replicated dose-response relationships with established mechanisms fulfils causal criteria. This information is also consistent with data showing acceleration of the aging process by drugs of addiction including alcohol, tobacco, cannabis, stimulants and opioids. THC shows a non-linear sigmoidal dose-response relationship in multiple pertinent in vitro and preclinical genotoxicity assays, and in this respect is similar to the serious major human mutagen thalidomide. Rising community exposure, tissue storage of cannabinoids, and increasingly potent phytocannabinoid sources, suggests that the threshold mutagenic dose for cancerogenesis will increasingly be crossed beyond the developing world, and raise transgenerational transmission of teratogenicity as an increasing concern.

Keywords: Cannabis; Chromothripsis; Dose-response relationship; Epigenetics; Foetal malformations; Heritable; Interdisciplinary; Microtubules; Oncogenesis; Population effects; Threshold dose; Transgenerational; Tubulin.

Filed under: Cannabis/Marijuana,Drug Specifics,Drug use-various effects on foetus, babies, children and youth,Effects of Drugs :

Source:  Drugwatch International 2018

Filed under: Cannabis/Marijuana,Drug Specifics,Effects of Drugs,Health :

 

(February 22, 2018 – Denver, CO) – The Marijuana Accountability Coalition (MAC), along with Smart Approaches to Marijuana (SAM), launched a new report today examining marijuana legalization in Colorado, joining Colorado Christian University and the Centennial Institute in an open press event. SAM honorary advisor, former Congressman Patrick Kennedy, also delivered the report to Colorado House Speaker Crisanta Duran earlier today. MAC is an affiliate of SAM Action, SAM’s 501 c-4 organization, started by former Obama and Bush Administration advisors.

“We will continue to investigate, expose, challenge, and hold the marijuana industry accountable,” said Justin Luke Riley, founder of MAC. “We will not remain silent anymore as we see our state overtaken by special marijuana interests.”

 

The report also comes with a two-page report card synopsis giving Colorado an “F” on many key public health and safety indicators.

Future MAC initiatives include an effort to expose politicians taking marijuana industry money, and exposing the harms of 4/20 celebrations.

“I am increasingly concerned that legalized marijuana is wrecking our state. Communities across Colorado are suffering because of it, and it is absolutely necessary to continue to give voice to the people, families and communities being harmed. I’m glad MAC has stepped up to be that voice,”  said Frank McNulty, former Speaker of the House of Representatives in the U.S. State of Colorado.

The new report card discussed the following impacts in the state:

  • Colorado currently holds the top ranking for first-time marijuana use among youth, representing a 65% increase in the years since legalization (NSDUH, 2006-2016). Young adult use (youth aged 18-25) in Colorado is rapidly increasing (NSDUH, 2006-2016).
  • Colorado toxicology reports show the percentage of adolescent suicide victims testing positive for marijuana has increased (Colorado Department of Public Health & Environment [CDPHE], 2017).
  • Colorado marijuana arrests for young African-American and Hispanic youth have increased since legalization (Colorado Department of Public Safety [CDPS], 2016).
  • The gallons of alcohol consumed in Colorado since marijuana legalization has increased by 8% (Colorado Department of Revenue [CDR], Colorado Liquor Excise Tax, 2017).
  • In Colorado, calls to poison control centers have risen 210% between the four-year averages before and after recreational legalization (Rocky Mountain Poison and Drug Center [RMPCD], 2017 and Wang, et al., 2017).

“As a university we are entrusted to help shape and guide the minds of younger generations. Marijuana has been proven to be harmful to the developing brains of young people. We should not live in a state where marijuana companies have a financial interest in hooking as many people as they can on this dangerous drug,” said Jeff Hunt, Vice President of Public Policy, Colorado Christian University
Director, Centennial Institute.

“The promotion of marijuana use may be part of the driving force behind the negative societal effects Colorado has been seeing for the past several years which annually continues to worsen and include increased prevalence in overall and teen suicides,” said Dr. Kenneth Finn, a physician Board Certified in Pain Medicine, Physical Medicine and Rehabilitation, Pain Management in Colorado.

“Isn’t it sad to think about how we are more concerned with how many plants we are legally entitled to grow, rather than how this drug is devastating the growth and potential of MY generation, and generations to come? We are growing plants, yet stunting growth. And I’m sick of it. I am craving cultural redemption and a redefined identity,” said Courtney Reiner, Student at Colorado Christian University.

“My family, my community, and my state have not benefited from the legalization of marijuana. The costs and harms outweigh any tax revenue. Our state has developed a deep drug bias where the negative effects of marijuana are minimized,” said Aubree Adams, who is also part of a group of mothers called Moms Strong.

Other data highlighted in the report include:

  • In Colorado, the annual rate of marijuana-related emergency room visits increased 35% between the years 2011 and 2015 (CDPHE, 2017).
  • Narcotics officers in Colorado have been busy responding to the 50% increase in illegal grow operations across rural areas in the state (Stewart, 2017).
    • In 2016 alone, Colorado law enforcement confiscated 7,116 pounds of marijuana, carried out 252 felony arrests, and made 346 highway interdictions of marijuana headed to 36 different U.S. states (RMHIDTA, 2017).
  • The U.S. mail system has also been affected by the black market, seeing an 844% increase in marijuana seizures (RMHIDTA, 2017).
  • The crime rate in Colorado has increased 11 times faster than the rest of the nation since legalization (Mitchell, 2017), with the Colorado Bureau of Investigation reporting an 8.3% increase in property crimes and an 18.6% increase in violent crimes (Colorado Bureau of Investigation [CBI], 2017).
    • The Boulder Police Department reported a 54% increase in public consumption of marijuana citations since legalization (Boulder Police Department [BPD], 2017).
  • Marijuana urine test results in Colorado are now double the national average (Quest Diagnostics, 2016).
  • Insurance claims have become a growing concern among companies in legalized states (Hlavac & Easterly, 2016).
  • The number of drivers in Colorado intoxicated with marijuana and involved in fatal traffic crashes increased 88% from 2013 to 2015 (Migoya, 2017). Marijuana-related traffic deaths increased 66% between the four-year averages before and after legalization (National Highway Traffic Safety Administration [NHTSA], 2017).
    • Driving under the influence of drugs (DUIDs) have also risen in Colorado, with 76% of statewide DUIDs involving marijuana (Colorado State Patrol [CSP], 2017).
 

www.MarijuanaAccountability.CO

__________________________________________________________________

About SAM Action

SAM Action is a non-profit, 501(c)(4) social welfare organization dedicated to promoting healthy marijuana policies that do not involve legalizing drugs. Learn more about SAM Action and its work at visit www.samaction.net.

www.samaction.net

Filed under: Cannabis/Marijuana,Drug use-various effects,Economic,Effects of Drugs,Environment,Legal Sector,Political Sector,Social Affairs,USA :

 

Outbreak Alert Update: Potential Life-Threatening Vitamin K-Dependent Antagonist Coagulopathy Associated With Synthetic Cannabinoids Use

Summary

 

Since the index case was identified on March 8, 2018 in Illinois, at least 160 people have presented to Healthcare facilities with serious unexplained bleeding. The preponderant number of patient presentations were in Illinois with other cases being reported from Florida, Indiana, Kentucky, Maryland, Missouri, Pennsylvania, Virginia, and Wisconsin. Laboratory investigation confirms brodifacoum exposure in at least 60 patients. There are at least 3 fatalities. At least 7 synthetic cannabinoids product samples related to this outbreak have tested positive for brodifacoum. At least one synthetic cannabinoids product has tested positive for both synthetic cannabinoid AB-FUBINACA and brodifacoum.

 

Lessons Learned:

Patients with a history of synthetic cannabinoids (e.g., K2, Spice, and AK47) use may:

  • Present with complaints unrelated to bleeding (e.g., appendicitis) and have numerical coagulopathy.
  • Be asymptomatic and ignorant of their numerical coagulopathy.

The issue with vitamin K treatment is cost, not availability. The cost of oral vitamin K for two weeks treatment can be $8,000 and treatment may be for months. Options are being explored to address these issues.

What are the Clinical Signs of Coagulopathy?

 

Clinical signs of coagulopathy include bruising, nosebleeds, bleeding gums, bleeding disproportionate to injury, vomiting blood, coughing up blood, blood in urine or stool, excessively heavy menstrual bleeding, back or flank pain, altered mental status, feeling faint or fainting, loss of consciousness, and collapse.

 

 

What Do Health Care Providers Need To Do?

 

Healthcare providers should maintain a high index of suspicion for vitamin K-dependent antagonist coagulopathy in patients with a history of synthetic cannabinoids (e.g., K2, Spice, and AK47) use:

 

  • Presenting with clinical signs of coagulopathy, bleeding unrelated to an injury, or bleeding without another explanation; some patients may not divulge use of synthetic cannabinoids.
  • Presenting with complaints unrelated to bleeding (e.g., appendicitis).

 

Healthcare providers should be aware that patients with vitamin K-dependent antagonist coagulopathy associated with synthetic cannabinoids use may have friends or associates who have used the same synthetic cannabinoids product but are asymptomatic and ignorant of their numerical coagulopathy.

 

All patients should be asked about history of illicit drug use. All “high-risk” patients (e.g., synthetic cannabinoids users), regardless of their presentation, should be screened for vitamin K-dependent antagonist coagulopathy by checking their coagulation profile (e.g., international normalized ratio (INR) and prothrombin time (PT)).

 

  • Proceduralists (e.g., trauma/general/orthopedic/oral/OB-GYN/cosmetic surgeons, dentists, interventional cardiologists/radiologists, and nephrologists) should be aware that patients with a history of synthetic cannabinoids (e.g., K2, Spice, and AK47) use may be anti-coagulated without clinical signs of coagulopathy. These patients should be screened for vitamin K-dependent anti-coagulant coagulopathy prior to their procedure.

 

  • Contact your local Poison Information Center (1-800-222-1222) for questions on diagnostic testing and management of these patients.
  • Promptly report suspected cases to your local health department or your state health department, if your local health department is unavailable. In addition, report any similar cases encountered since 01 February 2018 to your local health department.

 

In an effort to better understand the scope of this outbreak, ask your Medical Examiners’ office to report suspected cases, especially those without an alternative diagnosis. If individuals are identified after death or at autopsy showing signs of suspicious bleeding as described above, coroners are encouraged to report the cases to their local health department.

 

For updated information about the Illinois outbreak—connect with the Illinois Department of Health http://www.dph.illinois.gov/topics-services/prevention-wellness/medical-cannabis/synthetic-cannabinoids

 

 
Source:  Coca @ CDC

 

 
 

 

 

 

Filed under: Drug Specifics,Effects of Drugs,Social Affairs,USA :

There exists sufficient empirical data from cellular to epidemiological studies to warrant caution in the use cannabinoids including cannabidiol as recreational and therapeutic agents.

 

Cannabinoids bind to CB1R receptors on neuronal mitochondrial membranes where they can directly disrupt key functions including cellular energy generation, DNA maintenance and repair, memory and learning.

 

Empirical literature associates cannabinoid use with CB1R-mediated vasospastic and vasothrombotic strokes, myocardial infarcts and arrhythmias.  Cannabis has been associated with increased cardiovascular stiffness and vascular aging, a major surrogate for organismal aging.  In the pediatric-congenital context CB1R-mediated cannabis vasculopathy forms a major pathway to teratogenesis including VSD, ASD, endocardial cushion defects, several other cardiovascular anomalies  and, via the omphalo-vitelline arterial CB1R’s, gastroschisis.  Cannabis has been linked with several other malformations including hydrocephaly.  Cannabinoids also induce epigenetic perturbations; and, like thalidomide, interfere with tubulin polymerization and the stability of the mitotic spindle providing further major pathways to genotoxicity.

 

Assuming validity of the above data, increased levels of both adult and neonatal morbidity should accompany increased cannabis use. The “Colorado Responds to Children with Special Needs” program tracked congenital anomalies 2000-2013.  Importantly this data monitors the teratological history of Colorado since 2001 when the state was first advised that intrastate cannabis would not be prosecuted by the Federal Government.

 

Over the period 2000-2013 Colorado almost doubled its already high congenital anomaly rate rising from 4,830 anomalies / 65,429 births (7.4%) to 8,165 / 65,004 (12.6%); the US mean is 3.1%.  Major cardiovascular defects rose 61% (number and rate); microcephaly rose 96% (from 30 to 60 cases peaking at 72 in 2009); and chromosomal anomalies rose 28% (from 175 to 225, peaking at 264 in 2010).  Over the whole period this totals to 87,772 major congenital anomalies from 949,317 live births (9.25%).

 

The use of cannabis in Colorado can be determined from the SAMHSA National Survey on Drug Use and Health.  A close correlation is noted between major congenital anomaly rates and rates of cannabis use in Coloradans >12 years (R=0.8825; P=0.000029;).  Although data is not strictly comparable across U.S. registries, the Colorado registry is a passive rather than active case-finding registry and so might be expected to underestimate anomaly rates.  Given the Colorado birth rate remained almost constant over the period 2000-2013, rising only 3.6%, a simple way to quantitate historical trends is to simply project forwards the historical anomaly rate and compare it to the rise in birth numbers.  However rather than remaining relatively stable in line with population births, selected defects have risen several times more than the birth rate.

 

Colorado had an average of 67,808 births over the period 2000-2013 and experienced a total of 87,772 birth defects, 20,152 more than would have been predicted using 2000 rates.  Given the association between cannabis use and birth defects and the plausible biological mechanisms, cannabis may be a major factor contributing to birth congenital morbidity in Colorado. If we accept this and apply the “Colorado effect” to the over 3,945,875 births in USA in 2016 we calculate an excess of 83,762 major congenital anomalies annually nationwide if cannabis use rises in the US to the level that it was in Colorado in 2013.

 

In reality both cannabis use and cannabis concentration is rising across USA following legalization which further implies that the above calculations represent significant underestimations.  This data series terminates in 2013 prior to full legalization in 2014.  Moreover, parents of children harbouring severe anomalies may frequently elect for termination, which will again underestimate numbers of abnormal live births.

 

In California 7% of all pregnant mothers were recently shown to test positive for cannabis exposure, including almost 25% of teenage mothers in 2015  so cannabinoids clearly constitute a significant population-wide teratological exposure.  This is particularly relevant to cannabis genotoxicity as many studies show a dramatic up-tick in genotoxic effect in the dose-response curve for both tetrahydrocannabinol and cannabidiol above a certain threshold dose as higher, sedating levels are reached.  Cannabis is usually used amongst humans for its sedative effects.

 

Other examples of high congenital anomaly rates accompanying increased cannabis use include North Carolina, Mexico, Northern Canada, New Zealand and the Nimbin area in Australia.

 

The above data leave open the distinct possibility that the rate of congenital anomalies from significant prenatal paternal or maternal cannabis exposure may become substantial.

 

With over 1,000 trials listed on clincaltrials.gov the chance of a type I experimental error for cannabinoid therapeutics and a falsely positive trial finding is at least 25/1,000 trials at the 5% level.

 

The major anomaly rate is just the “tip of the iceberg” of the often subtle neurobehavioral teratology of Foetal Cannabinoid Syndrome (FCS) following antenatal cannabinoid exposure characterized by attention, learning, behavioral and social deficits which in the longer term impose significant educational, other addiction and welfare costs – and is clearly more common.  Foetal Alcohol Syndrome (FAS) is known to be epigenetically mediated and foetal alcohol is known to act via CB1R’s . Cannabis has significant and heritable epigenetic imprints in neural, immune and germ cell (sperm) tissues, and epigenomic disruption has been implicated in FCS.  CB1R-mediated disruption by disinhibition of the normal gamma and theta oscillatory rhythms of the forebrain which underpin thinking, learning and sanity have been implicated both in adult psychiatric disease and the neurodevelopmental aspects of FCS.

 

All of this implies that in addition to usually short-term therapy-oriented clinical trials, longer term studies and careful twenty-first century next generation studies will be required to carefully review inter-related genotoxic, teratologic, epigenetic, transcriptomic, metabolomic, epitranscriptomic and long term cardiovascular outcomes which appears to have been largely overlooked in extant studies – effects which would appear rather to have taken Coloradans by surprise.  Congenital registry data also needs to be open and transparent which it presently is not.  We note that cannabidiol is now solidly implicated in genotoxicity.  Governments are duty-bound to carefully weigh and balance the implications of their social policies; lest like Colorado, we too unwittingly create a “Children with Special Needs Program”.

 

Authors:

Albert Stuart Reece,  Moira Sim,  Gary Kenneth Hulse

 

 

 

 

Filed under: Cannabis/Marijuana,Effects of Drugs,Health :

Case for Caution with Cannabis

There exists sufficient empirical data from cellular to epidemiological studies to warrant caution in the use cannabinoids including cannabidiol as recreational and therapeutic agents.

 

Cannabinoids bind to CB1R receptors on neuronal mitochondrial membranes where they can directly disrupt key functions including cellular energy generation, DNA maintenance and repair, memory and learning .

 

Empirical literature associates cannabinoid use with CB1R-mediated vasospastic and vasothrombotic strokes, myocardial infarcts and arrhythmias .  Cannabis has been associated with increased cardiovascular stiffness and vascular aging, a major surrogate for organismal aging.  In the pediatric-congenital context CB1R-mediated cannabis vasculopathy forms a major pathway to teratogenesis including VSD, ASD, endocardial cushion defects, several other cardiovascular anomalies  and, via the omphalo-vitelline arterial CB1R’s  gastroschisis.  Cannabis has been linked with several other malformations including hydrocephaly.  Cannabinoids also induce epigenetic perturbations; and, like thalidomide, interfere with tubulin polymerization and the stability of the mitotic spindle providing further major pathways to genotoxicity.

 

Assuming validity of the above data, increased levels of both adult and neonatal morbidity should accompany increased cannabis use. The “Colorado Responds to Children with Special Needs” program tracked congenital anomalies 2000-2013.  Importantly this data monitors the teratological history of Colorado since 2001 when the state was first advised that intrastate cannabis would not be prosecuted by the Federal Government.

 

Over the period 2000-2013 Colorado almost doubled its already high congenital anomaly rate rising from 4,830 anomalies / 65,429 births (7.4%) to 8,165 / 65,004 (12.6%); the US mean is 3.1%.  Major cardiovascular defects rose 61% (number and rate); microcephaly rose 96% (from 30 to 60 cases peaking at 72 in 2009); and chromosomal anomalies rose 28% (from 175 to 225, peaking at 264 in 2010).  Over the whole period this totals to 87,772 major congenital anomalies from 949,317 live births (9.25%).

 

The use of cannabis in Colorado can be determined from the SAMHSA National Survey on Drug Use and Health.  A close correlation is noted between major congenital anomaly rates and rates of cannabis use in Coloradans.  Although data is not strictly comparable across U.S. registries, the Colorado registry is a passive rather than active case-finding registry and so might be expected to underestimate anomaly rates.  Given the Colorado birth rate remained almost constant over the period 2000-2013, rising only 3.6%, a simple way to quantitate historical trends is to simply project forwards the historical anomaly rate and compare it to the rise in birth numbers.  However rather than remaining relatively stable in line with population births, selected defects have risen several times more than the birth rate.

 

Colorado had an average of 67,808 births over the period 2000-2013 and experienced a total of 87,772 birth defects, 20,152 more than would have been predicted using 2000 rates.  Given the association between cannabis use and birth defects and the plausible biological mechanisms, cannabis may be a major factor contributing to birth congenital morbidity in Colorado. If we accept this and apply the “Colorado effect” to the over 3,945,875 births in USA in 2016 we calculate an excess of 83,762 major congenital anomalies annually nationwide if cannabis use rises in the US to the level that it was in Colorado in 2013.

 

In reality both cannabis use and cannabis concentration is rising across USA following legalization which further implies that the above calculations represent significant underestimations.  This data series terminates in 2013 prior to full legalization in 2014.  Moreover parents of children harbouring severe anomalies may frequently elect for termination, which will again underestimate numbers of abnormal live births.

 

In California 7% of all pregnant mothers were recently shown to test positive for cannabis exposure, including almost 25% of teenage mothers in 2015  so cannabinoids clearly constitute a significant population-wide teratological exposure .  This is particularly relevant to cannabis genotoxicity as many studies show a dramatic up-tick in genotoxic effect in the dose-response curve for both tetrahydrocannabinol and cannabidiol above a certain threshold dose as higher, sedating levels are reached.  Cannabis is usually used amongst humans for its sedative effects.

 

Other examples of high congenital anomaly rates accompanying increased cannabis use include North Carolina, Mexico, Northern Canada, New Zealand and the Nimbin area in Australia.

 

The above data leave open the distinct possibility that the rate of congenital anomalies from significant prenatal paternal or maternal cannabis exposure may become substantial.

 

With over 1,000 trials listed on clincaltrials.gov the chance of a type I experimental error for cannabinoid therapeutics and a falsely positive trial finding is at least 25/1,000 trials at the 5% level.

 

The major anomaly rate is just the “tip of the iceberg” of the often subtle neurobehavioral teratology of Foetal Cannabinoid Syndrome (FCS) following antenatal cannabinoid exposure characterized by attention, learning, behavioral and social deficits which in the longer term impose significant educational, other addiction and welfare costs – and is clearly more common .  Foetal Alcohol Syndrome (FAS) is known to be epigenetically mediated and foetal alcohol is known to act via CB1R’s .  Cannabis has significant and heritable epigenetic imprints in neural, immune and germ cell (sperm) tissues, and epigenomic disruption has been implicated in FCS.  CB1R-mediated disruption by disinhibition of the normal gamma and theta oscillatory rhythms of the forebrain which underpin thinking, learning and sanity have been implicated both in adult psychiatric disease and the neurodevelopmental aspects of FCS .

 

All of this implies that in addition to usually short-term therapy-oriented clinical trials, longer term studies and careful twenty-first century next generation studies will be required to carefully review inter-related genotoxic, teratologic, epigenetic, transcriptomic, metabolomic, epitranscriptomic and long term cardiovascular outcomes which appears to have been largely overlooked in extant studies – effects which would appear rather to have taken Coloradans by surprise.  Congenital registry data also needs to be open and transparent which it presently is not.  We note that cannabidiol is now solidly implicated in genotoxicity.  Governments are duty-bound to carefully weigh and balance the implications of their social policies; lest like Colorado, we too unwittingly create a “Children with Special Needs Program”.

 

Source: Email: sreece@bigpond.net.au

Filed under: Drug use-various effects on foetus, babies, children and youth,Effects of Drugs,Health :

Source:   e-mail from FamilyFirst.org.nz / March 2019

 

Filed under: Cannabis/Marijuana,Effects of Drugs,Social Affairs :

As marijuana use becomes increasingly normalized and liberalized, more and more adolescents are initiated into using the drug with serious implications for the healthcare system and public health.   Confirming what those of us in the prevention community have long known, a systematic review and meta-analysis published in JAMA Psychiatry found that marijuana use in adolescence was associated with increased risk of depression and suicide in young adulthood (18-32 years of age). After pooling data from 11 studies of over 23,300 individuals, researchers found that compared to non-users, adolescents who used marijuana were 40% more likely to suffer from depression, 50% more likely to experience suicidal ideation, and 250% more likely to attempt suicide in young adulthood.

Proponents of legalization often argue that alcohol and tobacco are legal even though they are responsible for far more deaths than marijuana. That is true. However, it is precisely because they are legal and widely accessible that they are so deadly. Do we want to add yet another legal intoxicant that has been linked to a number of negative health and social consequences at the individual and population levels? Two wrongs never make a right. Adolescent use of marijuana increases risk of suicidality by 250%. If the nation’s entire population of approximately 25,000,000 adolescents had access to recreational marijuana in the context of legalization, we could expect to see big increases in future suicides among young adults that are directly attributable to marijuana use. That is far too high a price to pay.

 

Source: https://www.dfaf.org/research/

 

Filed under: Drug use-various effects on foetus, babies, children and youth,Effects of Drugs,Health,Youth :

Researchers report 63 percent of breast milk samples from mothers using marijuana contained traces of the drug

With the legalization of marijuana in several states, increased use for both medicinal and recreational purposes has been documented in pregnant and breastfeeding women. Although national organizations like the American Academy of Pediatrics recommend that breastfeeding mothers do not use marijuana, there has been a lack of specific data to support health or neurodevelopmental concerns in infants as a result of exposure to tetrahydrocannabinol (THC) or other components of marijuana via breast milk.

To better understand how much marijuana or constituent compounds actually get into breast milk and how long it remains, researchers at University of California San Diego School of Medicine conducted a study, publishing online August 27 in Pediatrics.

Fifty-four samples from 50 women who used marijuana either daily, weekly or sporadically — with inhalation being the primary method of intake — were examined. Researchers detected THC, the primary psychoactive component of marijuana, in 63 percent of the breast milk samples for up to six days after the mother’s last reported use.

“Pediatricians are often put into a challenging situation when a breastfeeding mother asks about the safety of marijuana use. We don’t have strong, published data to support advising against use of marijuana while breastfeeding, and if women feel they have to choose, we run the risk of them deciding to stop breastfeeding — something we know is hugely beneficial for both mom and baby,” said Christina Chambers, PhD, MPH, principal investigator of the study, professor in the Department of Pediatrics at UC San Diego School of Medicine and director of clinical research at Rady Children’s Hospital-San Diego.

The World Health Organization recommends exclusive breastfeeding for up to six months. Early breastfeeding is associated with a reduced risk of obesity, asthma and sudden infant death syndrome and with improved immune health and performance on intelligence tests. In mothers, breastfeeding has been associated with lower risks for breast and uterine cancer and type 2 diabetes.

Cannabinoids — marijuana’s active compounds, such as THC — like to bind to fat molecules, which are abundant in breast milk. This stickiness has suggested that, in women who use marijuana, these compounds can end up in breast milk, raising concerns about their potential effects on nursing babies.

“We found that the amount of THC that the infant could potentially ingest from breast milk was relatively low, but we still don’t know enough about the drug to say whether or not there is a concern for the infant at any dose, or if there is a safe dosing level,” said Chambers, co-director of the Center for Better Beginnings at UC San Diego. “The ingredients in marijuana products that are available today are thought to be much more potent than products available 20 or 30 years ago.”

The samples of breast milk used for the study were obtained from mothers who joined the Mommy’s Milk Human Milk Research Biorepository at UC San Diego, a program that focuses on looking at the numerous benefits of breast milk at the molecular level. Chambers and her research team collaborated with Skaggs School of Pharmacy and Pharmaceutical Sciences at UC San Diego to measure the levels of marijuana in the samples.

Chambers said the results are a stepping stone for future research. More studies need to be done, not only to determine the long-term impact of marijuana in breast milk for children, but more specifically: “Are there any differences in effects of marijuana in breast milk for a two-month-old versus a 12-month-old, and is it different if the mother smokes versus eats the cannabis? These are critical areas where we need answers as we continue to promote breast milk as the premium in nutrition for infants.

Source: https://www.sciencedaily.com/releases/2018/08/180827080911.htm

 

Filed under: Drug use-various effects on foetus, babies, children and youth,Effects of Drugs,Health,USA :

 

One in six cases of psychosis are linked to cannabis use, claims psychiatric expert

  • Professor Robin Murray said that smoking cannabis is linked to psychosis
  • He said 50,000 people have the condition due to smoking cannabis as teenagers  
  • His comments follow a renewed debate over the legalisation of the drug

 

A psychiatric expert has claimed one in six people with psychosis in Britain would never have developed it if they had not smoked cannabis.

Professor Robin Murray, an authority on schizophrenia at King’s College London, said about 50,000 people were now diagnosed as psychotic solely because they used the drug while teenagers.

Many had no family history of psychosis and would have had no risk of developing the disease if they had not smoked high-strength cannabis, he claimed.

The academic’s comments follow a renewed debate over the legalisation of the drug, following the first ever NHS prescription for cannabis oil being given to 12-year-old Billy Caldwell to treat his epilepsy last week.

The Royal College of Psychiatrists has also spoken out to warn that cannabis use doubles the risk of someone becoming psychotic, after former Tory leader William Hague suggested it should be decriminalised for recreational use.

Professor Murray said: ‘If you smoke heavy, high-potency cannabis, your risk of psychosis increases about five times.

‘A quarter of cases of psychosis we see in south London would not have happened without use of high-potency cannabis. It is more prevalent in that area, but the figure for Britain would be one in six – or approximately 50,000 people.’

Cannabis can make users feel paranoid, experience panic attacks and hallucinations, and it is also linked to depression and anxiety. Many experts claim it is only people who are predisposed to psychosis who develop it after smoking cannabis. However, Professor Murray added: ‘It is true there are some people with a family history of it who are pushed into psychosis more easily by smoking cannabis. But most have no family history, there is no evidence they are predisposed to schizophrenia or psychosis. The problems start only when they are 14 or 15 and start using cannabis.’

It is believed the drug disrupts dopamine, a brain chemical which helps people predict what is going to happen and respond rationally. In developing brains, cannabis can skew this so that people become paranoid and deluded.

Dr Adrian James, registrar at the Royal College of Psychiatrists, said: ‘As mental health doctors, we can say with absolute certainty that cannabis carries severe risks. The average cannabis user is around twice as likely as a non-user to develop a psychotic disorder.’

 

  • Source:  https://www.dailymail.co.uk/sciencetech/article-5881123/Psychiatric-expert-claims-one-six-people-psychosis-linked-cannabis-use.html
Filed under: Cannabis/Marijuana,Effects of Drugs :

 

NEARLY 800 babies were born suffering the effects of their mother’s drug addiction in the past three years in Scotland – with experts warning the true toll is likely to be higher.

 

New figures show 774 babies were recorded as affected by addiction or suffering withdrawal symptoms from drugs between 2014 and 2017.

The drugs pass from mother to foetus through the bloodstream, resulting in babies suffering a range of withdrawal symptoms after birth and developmental delays in childhood.

Consultant neonatologist Dr Helen Mactier, honorary secretary of the British Association of Perinatal Medicine, said there was a “hidden” number of women who took drugs in pregnancy and varying definitions of drug misuse in pregnancy which meant figures were likely to be an underestimate.

She said: “The problem largely in Scotland is opioid withdrawal – heroin and methadone.

“The baby withdraws from these substances and they are very irritable, cross, unhappy children who can be quite difficult to feed until they finally get over the withdrawal.”

Dr Mactier said at birth the babies were usually small, and had small heads and visual problems. She added there is evidence they suffer developmental delays in early childhood.

The figures, revealed in a written parliamentary answer, show an increase of 80% in cases from the three-year period from 2006-9, when 427 babies were born with the condition.

However, it said the data over time should be treated with caution as there has been an improvement in recording drug misuse.

The highest numbers over the past three years were recorded in Grampian, which had 169 cases. Glasgow had 137 cases, while Tayside recorded 90, Lanarkshire 78 and Lothian 72.

Numbers have been dropping since 2011-14, when a peak of 1,073 cases were recorded.

Dr Mactier, who works at Glasgow’s Princess Royal Maternity Hospital, said having to treat babies born addicted to drugs was becoming less common in recent years.

She said: “The numbers are coming down, but we are not sure why. It is partly because women who use drugs intravenously tend to be older, so are becoming too old to have children.”

However, she pointed out one controversial area was stabilising pregnant addicts on heroin substitutes such as methadone.

She added: “That may be good for the mum, to keep her more stable and out of criminality. It is not entirely clear if that is safe for the babies, so we need more research.”

Scottish Conservative health spokesman Miles Briggs, who obtained the figures, said: “It’s a national tragedy that we see such numbers of babies being born requiring drug dependency support – we need to see action to help prevent this harm occurring.”

Martin Crewe, director of Barnardo’s Scotland, said: “We know how important it is for children to get a good start in life. We would like to see no babies born requiring drug dependency support.”

Source:   Sunday Post  15th October 2018

Filed under: Effects of Drugs,Social Affairs :

 

Fentanyl overdoses share many characteristics with heroin overdoses – with some important differences, according to an addiction specialist at Boston Medical Center’s Grayken Center for Addiction.

“Fentanyl is faster acting and more potent than heroin, so overdoses evolve in seconds to minutes, instead of minutes to hours, as we see with heroin overdoses,” says Alexander Walley, M.D., Director of the Boston University Addiction Medicine Fellowship Program and the Inpatient Addiction Medicine Consult Service at Boston Medical Center. “The window during which a bystander can respond shrinks substantially with fentanyl,” said Dr. Walley, who spoke about fentanyl overdoses at the recent annual meeting of the College on Problems of Drug Dependence. He noted that people may not know they are using fentanyl. In addition to being mixed into heroin, fentanyl can be sold as cocaine or counterfeit prescription opioids.

Dr. Walley was the principal investigator of a study published last year by the Centers for Disease Control and Prevention that included interviews with 64 people who survived or witnessed an opioid overdose, as well as a review of medical examiner records of 196 people who died of an opioid overdose.

He found 75 percent of people who witnessed a suspected fentanyl overdose described symptoms as occurring within seconds to minutes. Among people who witnessed the opioid overdose antidote naloxone being administered, 83 percent said that two or more naloxone doses were used before the person responded.

When Dr. Walley and colleagues analyzed death records for people who died of an opioid overdose, they found 76 percent tested positive for fentanyl in March 2015 – up from 44 percent in October 2014. They found 36 percent of fentanyl deaths had evidence of an overdose occurring within seconds to minutes after drug use, and 90 percent of people who died from a fentanyl overdose had no pulse by the time emergency medical services arrived.

Only 6 percent of fentanyl overdose deaths had evidence of lay bystander-administered naloxone. “Although bystanders were frequently present in the general location of overdose death, timely bystander naloxone administration did not occur because bystanders did not have naloxone, were spatially separated or impaired by substance use, or failed to recognize overdose symptoms,” the researchers concluded. “Findings indicate that persons using fentanyl have an increased chance of surviving an overdose if directly observed by someone trained and equipped with sufficient doses of naloxone.”

Dealing With the Fentanyl Crisis

The approach to fentanyl overdoses should be similar to heroin overdoses – except that time is especially of the essence, Dr. Walley noted. “The best way to reduce overdose risk is to not use opioids in the first place,” he said. “But if a person is using opioids, he or she should make sure someone else is observing and is prepared to use naloxone quickly.”

He stressed that for people who use fentanyl or heroin and stop because of treatment or incarceration, and then start taking the drug again upon release, the risk of an overdose is especially high because their tolerance for the drug has decreased.

Early treatment for addiction is especially important in the age of fentanyl, Dr. Walley said. “We need to make a better effort to reach people sooner,” he said. “Fentanyl is so deadly we can’t afford to wait.”

As with other types of opioid use disorders, the recommended treatment for fentanyl addiction is medication – methadone, buprenorphine (Suboxone) or naltrexone (Vivitrol).

“We need to figure out ways to make effective treatments work for patients, rather than make the patients work for the treatment,” Dr. Walley said. “That means making treatment more convenient and patient-centered. We also need to start treatment in in-patient detox programs. We know these people are more vulnerable to overdose when they are discharged, so we should start treatment before then. We also need to engage people who seek help in the emergency room in overdose prevention, harm reduction and treatment.”

 

Source:  https://drugfree.org/drug-and-alcohol-news/featured-news-rapid-response-fentanyl-overdose-critical/?utm_source=pns&utm_medium=email&utm_campaign=featured-news-rapid-response-fentanyl-overdose-critical

Filed under: Drug Specifics,Effects of Drugs,Social Affairs :

A new study finds the rise in drug overdose deaths in the United States has contributed to an increase in organ transplants, CNN reports.

Overdose death donors accounted for 1.1 percent of donors in 2000 and 13.4 percent in 2017, representing a 24-fold rise, the researchers report in the Annals of Internal Medicine.

The study also found many organs from overdose-death donors were not used to save lives when they could have been.

“The current epidemic of deaths from overdose is a tragedy. It would also be tragic to continue to underutilize life-saving transplants from donors,” said lead researcher Dr. Christine Durand of Johns Hopkins University. “We have an obligation to optimize the use of all organs donated. The donors, families and patients waiting deserve our best effort to use every gift of life we can.”

 

Source:   https://drugfree.org/drug-and-alcohol-news/rise-drug-overdose-deaths-contributes-increase-organ-transplants/?utm_source=pns&utm_medium=email&utm_campaign=rise-drug-overdose-deaths-contributes-increase-organ-transplants

Filed under: Effects of Drugs,Social Affairs :

Filed under: Effects of Drugs,Social Affairs :

This collection of articles has been collated to show how the use of cannabis has been involved in many murders and attacks of violence.

Attacker Smoked Cannabis: suicide and psychopathic violence in the UK and Ireland
“Those whose minds are steeped in cannabis are capable of quite extraordinary criminality.”

What do we want?

Our demands are simple:

· acknowledge that cannabis is a dangerous drug and a prime factor in countless acts of suicide and psychopathic violence, and that no amount of ‘regulation’ will eliminate this danger;
· acknowledge that the alleged medicinal benefits of certain aspects of cannabis are a red herring to soften attitudes to the pleasure drug and ensure that certain corporations are well placed if and when the pleasure drug is legalised;
· admit that since around 1973 cannabis has been decriminalised in all but name, and that this has been a grave mistake;
· begin punishing possession: a caution for a first offence, a mandatory six-month prison sentence and £1000 fine thereafter.

Woman killed by taxi driver ‘might be alive if he had been properly managed’
Shropshire Star | 19 Mar 2018 |

“From the limited evidence which was available to the independent investigation team, it appears possible that, if MB had been fully compliant with anti-psychotic medication and had refrained from misuse of cannabis, then he may not have suffered from a relapse of his psychotic illness.”
Martin Bell had been sectioned for about nine months in August 1999 and was released around six weeks before he killed Gemma Simpson.
The family of a woman who was killed and partially dismembered by a taxi driver who was suffering from a psychotic illness have said she “might still be alive today” if he had been managed properly.
Gemma Simpson’s family were responding to the publication of a report into the treatment of Martin Bell, who killed 23-year-old Miss Simpson in 2000 with a hammer and a knife before sawing her legs off and burying her at a beauty spot near Harrogate, in North Yorkshire.
Bell admitted manslaughter on the grounds of diminished responsibility after leading police to her body 14 years later, and was told he must serve a minimum of 12 years in prison.
Bell had been sectioned in a hospital for about nine months in August 1999 and was released around six weeks before he killed Miss Simpson.
On Monday, NHS England published an independent report into his care and treatment.
The report, which said its authors were severely hampered by a lack of medical records, concluded: “From the limited evidence which was available to the independent investigation team, it appears possible that, if MB had been fully compliant with anti-psychotic medication and had refrained from misuse of cannabis, then he may not have suffered from a relapse of his psychotic illness.
“In these circumstances, the death of Gemma Simpson might have been prevented.”
The new report confirmed that doctors had considered Bell’s cannabis use may have contributed to or exacerbated Bell’s illness and he had smoked the drug on the day he killed Miss Simpson in his Harrogate flat.
But it said that “notwithstanding the failures in service provision outlined in this report, there were no actions that clinicians could have specifically taken to enforce the continuation of medication given MB’s presentation in May 2000, nor to enforce his abstinence from cannabis.”
In a statement issued by the campaign group Hundred Families, Miss Simpson’s family said they broadly welcomed the findings of the report but added: “In 2000 Martin Bell was known to carry a knife, was delusional, and recognised as a real risk to others, yet he was able to be released without any effective package of care, monitoring, or even a proper assessment of how the risks he posed to others would be managed.
“There appear to have been lots of red flags, just weeks and days before Gemma’s death, that should have raised professional concerns.
“We believe that if he had been managed properly, Gemma might still be alive today.”
The family said they understood the pressures on mental health services but said: “We keep hearing that lessons have been learned, but we want to make sure they are truly learned in this case.”
In court in 2013, prosecutors said Bell struck Miss Simpson, who was from Leeds, an “uncountable” number of times with the knife and hammer in a “frenzied” attack before leaving her body for four days in a bath.
He then sawed off the bottom of her legs so she would fit in the boot of a hire car before burying her at Brimham Rocks, near Harrogate.
Bell, who was 30 at the time of the attack, handed himself in at Scarborough police station in 2013 and later took police to where she was buried.

Source: https://www.shropshirestar.com/news/uk-news/2018/03/19/woman-killed-by-taxi-driver-might-be-alive-if-he-had-been-properly-managed/ NHS England report: https://www.england.nhs.uk/north/wp-content/uploads/sites/5/2018/03/independent-investigation-mb-march-18.pdf

On 14 May 2017, Akshar Ali, acting with his friend Yasmin Ahmed, murdered his wife and mother-of-four Sinead Wooding, stabbing her with a knife six times and bludgeoning her with a hammer before dumping her body in a woodland and setting it alight. On 17 January 2018, he and his accomplice were sentenced to 22 years in prison.
One might think the fact that the guilty pair smoked and grew cannabis together would be of interest to reporters, and worthy of at least a fleeting sentence or two, but I have found it mentioned in only two news reports, one in the Yorkshire Evening Post, the other in South African news site IOL.
Of far more interest to some British media, sadly, is the fact that Ali was an ostensible Muslim and Ms Wooding a Muslim convert who had, in the weeks before she was murdered, defied her husband by wearing western clothing and seeing a friend he did not approve of. Some media, including the BBC, the Guardian and, curiously, British media abnormally incurious about the role of cannabis in a gruesome act of uxoricide the Sun managed to avoid mentioning either the matter of Islam or the smoking of cannabis.
Is it, I wonder, an abnormal lack of curiosity that prevents reporters from mentioning the smoking of a powerful psychoactive drug that is a prime factor in countless thousands of similar cases? Or is it a deliberate omission?

An extraordinary murder in Ireland

The following story from Ireland, which occurred ten years ago, is extraordinary for two reasons. First, the 143 injuries the attacker inflicted is, as far as I’m aware, a record. As I have noted many times, a frenzy of violence involving multiple stab wounds is nearly always a sign of a mind unhinged by drugs. 143, though, points to a frightening level of madness, and, as such, the verdict of not guilty by reason of insanity is unsurprising.
But then there is this:
The jury had deliberated for under one hour and had returned during that hour to ask if the fact that Mr Connors had smoked cannabis before the killing was relevant to his culpability.
Mr Justice Birmingham told the jury that consultant psychiatrist, Dr Damien Mohan, had considered whether Mr Connors’ behaviour was attributable to drugs or mental illness and was of the “firm and clear” view that the accused’s mental disorder was the causative factor.
In other words, the fact that the defendant had smoked cannabis before the killing, which occurred around six o’clock in the morning, was not deemed relevant, and the link between his mental disorder and his consumption of cannabis appears to have gone unexplored.

Man found not guilty of murder by reason of insanity
Irish Examiner 4 Feb 2009

A jury has found a Dublin man who killed a stranger with garden shears not guilty of murder by reason of insanity at the Central Criminal Court.
Thomas Connors (aged 25) thought Michael Hughes (aged 30), from Banagher in Offaly, was the embodiment of the devil when he found him sleeping in the stairwell of an apartment block.
Mr Justice George Birmingham told the jury that it had reached “absolutely the right verdict in accordance with the expert evidence”. He thanked it for its careful attention to the case and exempted its members from jury service for seven years.
Mr Connors, of Manor Court, Mount Argos, Harold’s Cross, killed Mr Hughes in a savage attack in the stairwell of an adjacent apartment block, Manor Villa, on the morning of December 15, 2007.
Mr Justice Birmingham said this was a case of “mind boggling sadness” and, were it not for the issue of insanity, would have been a perfectly clear and appalling case of murder.
He said: “Consequent on the special verdict of not guilty by reason of insanity I direct that Mr Connors be committed to a specially designated centre, the Central Mental Hospital, until further order.”
Prosecuting counsel, Paul O’Higgins SC, said Mr Hughes’ family were aware that victim impact evidence would not be heard because the case did not involve the imposition of a sentence.
Mr Justice Birmingham said to the family: “You truly have been through the most appalling experience. Words can’t and don’t describe it and all I can do is express my sympathy.”
The jury had deliberated for under one hour and had returned during that hour to ask if the fact that Mr Connors had smoked cannabis before the killing was relevant to his culpability.
Mr Justice Birmingham told the jury that consultant psychiatrist, Dr Damien Mohan, had considered whether Mr Connors’ behaviour was attributable to drugs or mental illness and was of the “firm and clear” view that the accused’s mental disorder was the causative factor.
Yesterday, the jury heard that Mr Hughes had gone out for a night in Dublin with his cousin and friends. He was to stay at his cousin’s flat in Harold’s Cross but the cousin had gone home early and Mr Hughes was unable to get into the flat when he returned after 4am.
Mr Hughes decided to sleep in the stairwell and sometime after 6am Mr Connors came crashing through the glass doors of the apartment block with garden shears and savagely attacked him, inflicting 143 injuries.
Residents heard screaming and rang gardaí who found Mr Connors walking away from the scene with the shears. He told gardaí that he had fought with the devil and the devil was gone now.
In the days leading up to the killing Mr Connors, a married man with one child, had gone to hospital three times seeking help. He was hearing voices and suffering delusions that his wife was the daughter of the devil. On the second visit he was given tablets. His wife was so frightened by his behaviour that she took their child to a women’s shelter.
On the third occasion, the day before the killing, doctors at Saint Vincent’s Hospital decided Mr Connors should be admitted to Saint James’ but he absconded during the four-hour wait for an ambulance.
In the hours before he killed Mr Hughes, Mr Connors thought the devil was in his apartment and had taken a duvet outside and stabbed it, believing the devil had been hiding in it.
Dr Mohan told the jury that Mr Connors suffered from schizophrenia, as did his father. He had been hospitalised with psychosis in 2004 and 2005 and believed that his father-in-law was the devil.
The victim’s father, Liam Hughes, made a statement outside the Four Courts on behalf of the Hughes family. He said that the family’s thoughts, as always but especially today, were on the 30 years of “love, kindness and generosity of spirit they enjoyed with the deceased”.
Mr Hughes said his son would be remembered by his friends as “a respectful and decent person”. He said a former teacher had contacted the family to pay tribute to Michael as “an honest, kind, sincere, popular and respected person who was a credit to his family and school”.
Mr Hughes said Michael had been a hard-working young man who commuted from Offaly to Dublin each day to work and had recently entered into further education. Mr Hughes said his son had coped admirably with the demands of full-time work and part-time study.
On October 27, 2007, he had become engaged to Deborah Lynch, who was with the family in court. Mr Hughes said his family had shared in their joy at setting up a home together and planning for their future.
He said: “Only seven short weeks later Deborah’s hopes and dreams were shattered.”
He said the Hughes family earnestly hoped that she would find happiness in the future.
Mr Hughes thanked UCD, which had honoured Michael recently on what would have been his conferring day, and his employer, Dublin Bus. He also thanked the team who investigated his son’s death, the Garda family liaison officer and the many friends who had offered comforting words.
He said it had been 13 months since the killing but the pain and horror of it had “scarcely lessened”. He said the natural “role reversal” in the cycle of life could not now happen as he had lost his son.
He said the family was disturbed and saddened by the evidence given in court, but there relieved that the process was over. He asked that the family’s privacy be respected at this time.

Source: https://www.irishexaminer.com/breakingnews/ireland/man-found-not-guilty-of-murder-by-reason-of-insanity-397642.html Posted on May 6, 2019 Leave a comment on An extraordinary murder in Ireland

Jail for man who shot girlfriend 13 times with airgun – before trying to strangle and suffocate her
Leicester Mercury | 27 July 2017 |

Kristian Pole had been smoking cannabis when he ‘flipped out’ and attacked his partner at his home in Leicester
A man who failed to take a chance given by a judge, following an airgun attack on a girlfriend, has been jailed for two years.
Kristian Pole repeatedly fired pellets at close range into his then girlfriend’s face, limbs and body. Then he tried to strangle her and suffocate her with a pillow, Leicester Crown Court was told.
The frightened woman managed to run from Pole’s home in Leicester and alert the police, having suffered bruising and red marks from 13 plastic pellets and being gripped around her neck, in August last year.
Judge Robert Brown gave Pole a chance, in June, by imposing a two-year community order, with rehabilitation requirements, because he had already served several months on remand in custody.
Pole later failed to inform the probation service he had moved address – a condition of the order. He also refused to tell them where he was living with a new partner. This resulted in him being brought back to court, where Judge Brown re-sentenced him on Tuesday.
The judge told 24-year-old Pole, of no known address: “I’ve no choice but to revoke the order and impose custody. You’ve thrown away the chance of a community order by your own actions. When I sentenced you in June, for possessing a BB gun with intent to cause fear of violence and causing actual bodily harm, you’d already served eight or nine months in custody.”
He told Pole, who admitted the offences: “You’d done well on remand and changed your attitude. I was invited to take a chance on you and put you on a community order.
“You’ve failed to engage with the probation service and moved out of your mother’s address, without notifying those concerned about where you were living. This was a serious example of an assault.”
Lynsey Knott, prosecuting, said the assault with the BB gun happened when Pole’s then girlfriend visited his home, where he was smoking cannabis with a male friend.
When the cannabis ran out he erupted in violence, attacking her and shooting “at close range” her face and limbs.
James Varley, mitigating, said: “He’d smoked too much cannabis and flipped out.
“Your Honour will have told many defendants it’s not the harmless drug that many young people think it is.
“It has deleterious effects … what else could explain his conduct other than he was completely out of it when his cannabis supply was cut off.”

Source:https://www.leicestermercury.co.uk/news/leicester-news/jail-man-who-shot-girlfriend-243489

Couple killed friend, set him on fire and then had sex to celebrate, court told
ITV News | 16 Feb 2019 |

Cold-hearted killers who brutally murdered a vulnerable friend before setting him on fire and then having sex will spend at least 28 years in jail.

Evil William Vaill and Deborah Andrews were handed life sentences for killing Skelmersdale dad Eamon Brady in a “brutal and sustained” attack.
Mr Brady was hit in the head with a hammer at least 17 times and repeatedly stabbed and slashed in the neck and body in the early hours of July 21.
Vaill, 37, and Andrews, 44, then wrapped his body in bedding and set it on fire before stealing a PlayStation 4, sound bar, DVD player and bank card belonging to their victim.
Andrews later described the couple as “the new Bonnie and Clyde”.
After the callous killing, the pair went to Beacon Country Park where they burned clothing and hid the weapons. They are also believed to have had sex in a nearby park hours after the attack, the court heard.
They also went on to attempt to sell his PlayStation 4 and use the stolen bank card in a local shop.
The evil couple, who had been friends with Mr Brady for several years, bumped into him by chance after Vaill had attended a funeral. They went back to his flat in Elmridge, Skelmersdale, where they drank and smoked cannabis.
By the time of the murder, Vaill, whose previous convictions include arson and criminal damage, had been drinking for 40 straight hours.
The pair left the flat at around around 4:50am and later told police that Mr Brady was alive and well when they left. But recordings in the police van heard that Andrews was ‘buzzing’ about the murder and describing the pair as the new Bonnie and Clyde.
Vaill, of Evington, Skelmersdale, pleaded guilty to murder and arson last month and was today given a life sentence with a minimum of 28-and-a-half years in prison.
Andrews, of Elmstead, Skelmersdale, was found guilty after a trial and given a life sentence with a minimum of 28 years in prison.
Both appeared emotionless throughout the sentencing at Preston Crown Court while Andrews sat with her hands in her pockets throughout.
Prosecuting, Francis McEntree said Mr Brady was a vulnerable man who was regularly taken advantage of by those around him. He had earlier told family that he wanted to move out of Skelmersdale to escape from people who were ‘leeching off him’.
He knew both of the victims well, having been friends for several years and they had all spent the together socially in a “happy, if noisy” manner.
Mr Brady had been friends with Vaill since their teenage years and an earlier incident in which Vaill stabbed him in the foot with a penknife was considered no more than horseplay after Mr Brady had laughed at him getting hurt when he kicked a lamppost.
An emotional victim statement read on behalf of Mr Brady’s daughter Amy Brady told of the devastating effects she has suffered since the murder of her best friend.
Her father’s death came 17 days short of the second anniversary of her brother Ryan’s death and that after seeing his battered and burnt body, Ms Brady now regularly suffers nightmare and is left “angry with the world”.
“There was a hole in my heart when my brother died that has been made bigger and will never be filled,” it stated.
“My dad was not only my dad, he was my entire being.”
Defending Vaill, Stuart Denney said he had begun cannabis and alcohol use since before he was a teenager and that Skelmersdale was “the worst place in the world for him”.
Michael Lavery, defending Andrews, said she had “limited capabilities and intelligence” and was previously of good character.
Sentencing the pair, Judge Mark Brown said: “Having killed him you set fire to his body to destroy evidence of what had happened and in doing so you committed arson with reckless disregard for the lives of the other residents in the building who were asleep at the time.
“It’s another matter of this case that having just murdered this a man in extremely violent and brutal circumstances that you had sex with each other soon after.”

Source: https://www.itv.com/news/granada/2019-02-16/couple-killed-friend-set-him-on-fire-and-then-had-sex-to-celebrate-court-told/

Teenager found guilty of fatal stabbing of Luke Howard
Liverpool Echo | 22 Jan 2009 |

A LIVERPOOL teenager has been found guilty of killing a friend he stabbed 12 times in a drunk and drug-fuelled rage.

A jury at Liverpool Crown Court found Charlijo Calvert, 15, not guilty of the murder of 16-year-old Luke Howard but unanimously convicted him of manslaughter.
Calvert, of Ronald Street, Old Swan, stabbed Luke, from Dovecot, in the early hours of August 30 at the house of a friend in Ashcombe Road, Knotty Ash.
During the week-long trial, the court heard a group of teenage boys, including the victim and defendant, had gone to the house and drank alcohol, smoked cannabis and snorted cocaine.
Throughout the night, and into the early hours, witnesses said they saw Luke prodding Calvert with a screwdriver and the pair “winding each other up”. At one point, the court heard, they threatened to stab each other but the fatal attack at around 7am.

Source: https://www.liverpoolecho.co.uk/news/liverpool-news/teenager-found-guilty-fatal-stabbing-3462600

Four ‘racist’ killings, two years apart, with one important commonality
1. Skunk addicted schizophrenic fulfils sick fantasy by killing a black woman: ‘Psychiatric reports stated that Maxwell was suffering from paranoid schizophrenia, and his abnormality was so great that it affected his judgment [sic].The reports also said his condition was exacerbated by the heavy use of skunk.’ (3 Apr 2007)
2. Drive caught in gang’s ‘revenge’: ‘The 41-year-old minibus taxi driver was dragged screaming from his cab and beaten to death in July by several white teenagers in Huddersfield… Some of the teenagers had been drinking and smoking cannabis with some girls, who they then persuaded to call up and order the minibus – with fatal consequences.’ (26 Jan 2007)
3. Racist thugs face 30 years in prison for axe murder: ‘The two men who murdered black teenager Anthony Walker were last night each facing up to 30 years in jail after the trial judge ruled the killing was racially motivated, effectively doubling the time they will serve… Anthony Walker wanted to be a lawyer, maybe a judge. He loved God, worked hard at his studies, practised his basketball skills whenever he could, though not on a Sunday if it clashed with church.
Paul Taylor and Michael Barton revelled in the nicknames Chomper and Ozzy. One wanted to be a burglar, the other wanted to join the army, but was too stupid to pass the exams. They spent their time hanging around, smoking cannabis and, in the words of one, “going out robbing”.’ (1 Dec 2005)
4. Asian gang kicked man to death: ‘Three Asian men who kicked a white computer expert to death and bragged: “That will teach an Englishman to interfere in Paki business” were found guilty of murder at the Old Bailey yesterday… The court heard that the three had been drinking all evening in the West End before returning to east London to drink vodka and smoke cannabis.’ (23 Nov 2005)
You know, of course, what the important commonality is, a much more important factor than apparent ‘racism’. I will note here only, as the article does not, that the ‘skunk addicted schizophrenic’ who deliberately targeted a black woman is himself black.

In defence of Peter Hitchens (@ClarkeMicah) and the theory of mental illness

Mail on Sunday columnist Peter Hitchens, author of The War We Never Fought, has received a lot of abuse recently for pointing out in his MoS column of 7 April that the killer of Jo Cox, Thomas Mair, was mentally ill, not a ‘political actor’, and that his mental state was not discussed at his trial (at which Mair himself did not speak).
This matters a great deal, because those who cannot accept that, far from being part of a ‘far-right terrorist plot’, Mair was simply mentally unhinged, and that this mental illness was likely the result of or exacerbated by psychoactive medication, often equally refuse to believe that the prime factor in a particular act of suicide or psychopathic violence isn’t terrorism, Islam, immigration, austerity, video games, gangs, gun laws, ‘depression’, or racism, but cannabis.
Many have cited the following sentencing remarks of the judge in the Mair case, Mr Justice Wilkie, as evidence that Mr Hitchens is barking up the wrong tree:
There is no doubt that this murder was done for the purpose of advancing a political, racial and ideological cause namely that of violent white supremacism and exclusive nationalism most associated with Nazism and its modern forms.
Those who believe that Mair was a ‘terrorist’ are not open to the possibility that the judge is mistaken, nor aware that his remarks are, as Mr Hitchens points out, unusually political in tone. I wonder, then, what such people would make of these sentencing remarks of Judge Findlay Baker, QC, to a man who stabbed his friend’s father to death with a pair of garden shears: “This was an attack of extreme and persistent violence. And I have no doubt it would not have happened if you had not consumed cannabis.”
Or these, of Judge Anthony Niblett, to a man who punched his girlfriend and burnt down her house: “Those whose minds are steeped in cannabis are capable of quite extraordinary criminality. Your mind has been steeped in cannabis for much of your adult life.”
Or these, of Judge Rosalind Coe, QC, to a young man who attempted to murder his infant son: “If any case demonstrates the dangers and potentially tragic consequences of cannabis abuse, such as you had taken part in for many years, this is such a case.”
I could go on.
By contrast, some judges all but shrug and hold up their hands when trying to make sense of a heinous crime. The judge who sentenced 16-year-old Aaron Campbell, for example, said he had “no idea” why Campbell abducted, raped and murdered six-year-old Alesha MacPhail, even though it was noted during the trial that he was high on cannabis when he committed the crime, and knew the MacPhail family from having bought the drug from Alesha’s father. Some judges, like some people, can see the wood amid the trees. Some cannot.

Violence and legalised cannabis in Uruguay: a clarification

I would like to clarify the meaning of a tweet I sent yesterday of a link to an article on violence and homicide in Uruguay, ‘Uruguay gets tough on crime after posting record homicide rate’.
The article reports that in 2018, a year after cannabis went on sale, following legalisation in 2013, there were a record 414 homicides in Uruguay, a small nation of 3.5 million people once famed for its peace and tranquillity. So alarming was this figure (up from 284 in 2017) that 400,000 voters signed a petition calling for exceptional measures against violent crime.
I must stress first that, while it is likely that at least some of these acts of homicide were committed by people whose minds have been damaged by cannabis, I do not say that cannabis legalisation was the cause. I tweeted the article whilst arguing about correlation and causation with a dim-witted young drugs enthusiast who had claimed that an apparent decrease in rates of cannabis consumption amongst teenagers in Washington state was caused by cannabis being legalised there. I have written before that dope heads parrot the phrase ‘correlation does not equal causation’ only when the correlation upsets them. When they find a correlation they like they immediately claim cannabis legalisation as the cause.
Again, I do not say that homicide rate in Uruguay is exceptionally high because cannabis has been legalised. As Peter Hitchens points out in an article on Portugal, ‘The Alleged Portuguese Drug Paradise Examined’, legalisation or decriminalisation nearly always follows years of lax enforcement, making any before-and-after comparison meaningless. By contrast, in his largely excellent book Tell Your Children, Alex Berenson spends too much time, as I write in my review, trying to prove that violent crime has risen in those American states that have legalised cannabis, when he would have done better to expand his section on the alleged ‘war’ on drugs in America and the fact that, contrary to popular opinion, rates of incarceration solely for drugs possession in the USA have been quite low for many years.
I would further add that suggestions that ‘gang warfare’ is involved in Uruguay’s high homicide rate seem similarly erroneous. Drug rivals killing each other makes a good subject for a film or TV series,
but the reality is often a much blander case of a paranoid young man in possession of a weapon killing somebody (often not his ostensible target) out of fear or delusion.

Xixi Bi Llandaff murder: Jordan Matthews jailed for life

He accepted he was smoking “quite a lot” of cannabis at the time and the court heard he felt “insecure” when his girlfriend visited her family in China.

Source: https://www.bbc.co.uk/news/uk-wales-south-east-wales-39026270

‘Cannabis made my boy a killer’

THE mother of a violent schizophrenic who stabbed his best friend to death last night described how her son’s long-term cannabis habit turned him into a monster.
Julie Morgan, formerly from Cardiff, claimed her 20-year-old son Richard Harris’ ‘kind and gentle’ side disappeared not long after he started smoking cannabis from the age of 14.
“Cannabis took my son from me, I have no problem saying that,” said the 45-year-old.

Carl Madigan knifed Sam Cook in heart two weeks after friend slashed man’s stomach open

Facebook accounts show Carl Madigan, 23, and Shaun Bethell, 19, hanging around together and smoking cannabis before the shocking offences which will now define their young lives.
In a dreadful two week period last October, Madigan killed tragic Sam Cook while Bethell, a teenager with a record to rival any career criminal’s, left a man’s bowel hanging out of his body.

Man found guilty of murdering girlfriend’s toddler before claiming he slipped underwater in bath in 999 call

Smith was also found to have a high reading of cannabis in his bloodstream almost six hours after the 999 call – while a makeshift Ribena bottle ‘bong’ and the remains of six cannabis joints were found in a rear annex.
Despite Willett claiming she “always put the kids first,” text messages showed a woman desperate to buy cannabis, even on the night before Teddy’s death.

Cork man, 26, who shattered skull of girlfriend’s infant daughter jailed for eight years
Brendan Kelly, defence barrister, said[…] that the accused appeared to be detached from what was going on and that the defendant had been a long-time cannabis user.

Dad shook baby daughter to death as he was agitated at running out of cannabis
Daily Mirror

A dad who shook his baby daughter to death because he was agitated at running out of cannabis was today jailed for six years.
William Stephens, aged 25, shook daughter Paris so violently she suffered catastrophic head injuries and was bleeding in the eyes.
The thug attacked 16-week-old Paris for crying after he was left to look after her while mum Danah Vince, 19, went to see a doctor.
The little girl died two days later in hospital and one shocked expert said he had never before seen such a severe case of bleeding in the eyes.
Stephens had a history of violence and social services were called in because of his volatile relationship with mum Vince.
A serious case review is being carried out into the way public bodies handled the case.
Stephens – who had serious learning difficulties – was convicted of manslaughter after a seven-week trial.
Vince was cleared of causing or allowing the baby’s death in January.
Passing sentence, the judge Mr Justice Teare told Stephens: “This is a case where a loss of temper and control has resulted in fatal violence to a defenceless baby.
“You will have to live with the fact that you killed your daughter.”
Defence lawyer Ignatious Hughes QC, told the jury: “There is plenty of evidence that he and Danah Vince are likely to have been in a state of agitation due to lack of cannabis.”
Bristol crown court heard Stephens and Vince often fought and argued and social services stepped in to get the pair to sign agreements against domestic violence.
Stephens, from Southmead, Bristol, was given a restraining order to stay away from Vince but defied the ban and continued living with her and their daughter.
He appeared in juvenile court in 2006 for three assaults on a previous girlfriend and received a community order.
Five months later he appeared in front of magistrates for battery and was given the same punishment.
A year later he was given a caution for repeatedly punching a pregnant woman and in November 2008 got another caution for common assault.
In April 2010, he was hauled before magistrates for assaulting a police officer.
The local council is conducting a serious case review which will be published next year.
A spokesman said: “This is an extremely sad case where there has been the tragic loss of a young life.
“If nothing else I hope that today’s verdict offers some small measure of closure.
“An independent Serious Case Review by the Bristol Safeguarding Children Board is being completed, carefully examining the role of public bodies involved in the case to see if there are any lessons to be learnt.
“The complexity of this case will become apparent once that review is published early next year following the conclusion of all relevant legal processes.”
A year later, Danah Vince, the mother of the baby, committed suicide.

Source: https://www.mirror.co.uk/news/uk-news/william-stephens-shook-baby-paris-2923262

Teen faces one year for vicious attack on man outside takeaway

A 17-year-old boy has been warned he faces a one-year sentence for leading a vicious gang attack on a young man who was repeatedly punched and kicked outside a takeaway in Dublin.
The boy, who cannot be named because he is a minor, has pleaded guilty at the Dublin Children’s Court to assault causing harm and violent disorder in connection with the incident on the night of November 14, 2015.
Judge John O’Connor adjourned sentencing to see if the boy’s solicitor can organise a psychological assessment of the teenager whose behaviour, he said, has become more violent and aggressive.
The judge also noted the boy had tragic personal circumstances.
He said it was unacceptable that the boy had started smoking cannabis at the age of 12, and anyone who says it is not addictive “is not living in the real world”.
Garda Dave Jennings had told Judge O’Connor that the victim, a foreign national who is also aged in his late teens, had been at a Chinese takeaway at Kiltalown Way, Tallaght. A group of youths shouted in to him that they were going to rob him when he came out.
When he walked out one of them grabbed the handlebars of his bicycle and the youth then punched him in the side of his face.
The rest of the youths then joined in, grabbing the man, who was repeatedly punched and kicked before his bike was stolen.
The defendant struck the first blow but was not involved in the rest of the attack.
The victim fled back into the takeaway but was followed and had to run into the kitchen area for his safety. Garda Jennings agreed with Damian McKeone, defending, that the attack was not racially motivated.
CCTV footage was shown to Judge O’Connor, who described it as a “vicious assault”.

Source: https://www.irishexaminer.com/ireland/teen-faces-one-year-for-vicious-attack-on-man-outside-takeaway-399847.html

Robbers who held knife to man’s neck before stealing his phone and laptop jailed

Two males who robbed a man at knifepoint at his home in north Belfast have been jailed.
Bennet Donaghy and his accomplice, who at the time of the offence was 16, targeted their victim in the early hours of September 13, 2015.
He managed to escape and ran down the Shore Road in the middle of the night shouting for help.
Donaghy (20), a father-of-one from Cheston Close in Carrickfergus, was handed a 30-month sentence at Belfast Crown Court yesterday. His accomplice, who cannot be named, was given 15 months’ jail.
Both men were informed they would spend half their sentences in custody, with the remainder on licence.
The pair admitted a charge of assault with intent to rob, while the youth also admitted stealing the man’s laptop and mobile phone.
Prior to sentencing, Judge Gordon Kerr QC was informed that the victim was asleep on his sofa at around 4am when he heard persistent knocking at his front door.
He recognised the youth, who he knew from the area, with another young man.
The younger man asked the victim to lend him money, but when he handed them £5 the pair told him: “That’s not enough.”
Crown prosecutor Robin Steer said Donaghy then produced a knife and held it against the occupant’s neck.
The youth, who the man said looked like he was under the influence of drugs, punched the victim a number of times while Donaghy told him he was from the UDA and ordered him to hand over drugs and money.
The man’s home was ransacked, but he escaped and ran down the Shore Road barefoot and with a bruised face, only to be stopped by police.
Officers subsequently called at a house in the area, where they arrested Donaghy and the youth. Also located was a four-inch knife, along with the man’s laptop and mobile phone.
During police interviews, the youth admitted he knew the occupant, but claimed he was unable to remember what had happened because he had smoked a cannabis cigarette.
Like his accomplice, Donaghy claimed to have no recollection of the incident because he too had been smoking drugs.
Mr Steer told Belfast Crown Court there were a number of aggravating factors.
These included the use of violence and threats during the robbery, the presence of a weapon and the fact the victim was targeted in his home in the middle of the night.
Defence barrister Jon Paul Shields, representing the youth, confirmed that his client was under the influence of drugs on the night in question.
He also added that he had since “recognised the seriousness of the offences.”
Telling the court his client knew his behaviour had been unacceptable, Mr Shields said: “At the time, he simply did not give any thought to what he was doing.”
The barrister also told how the young man, who has been working with the Youth Justice Agency, had expressed shame over the incident.
The lawyer said that at the time of the offence, his client had just lost a child, which led to him self-medicating.
Barrister Chris Holmes, acting on behalf of Donaghy, said that his client “apologises profusely to the victim”.
He added that on the night of the robbery, Donaghy was “very, very much under the influence” of drugs.
Mr Holmes also spoke of the defendant’s troubled background, telling the judge his client “didn’t have his sorrows to seek when he was being brought up”, which in turn contributed to poor mental health.

Source: https://www.belfasttelegraph.co.uk/news/northern-ireland/robbers-who-held-knife-to-mans-neck-before-stealing-his-phone-and-laptop-jailed-35560290.html

Sally Hodkin murder: Killer ‘had miscarriage’ prior to fatal stabbing

A patient who murdered a grandmother believed she had suffered a miscarriage and was smoking cannabis in the lead up to the killing, an inquest has heard.
Nicola Edgington virtually decapitated Sally Hodkin with a stolen butcher’s knife in Bexleyheath, in 2011, six years after killing her own mother.
Edgington told hospital staff she needed to be sectioned and felt like killing someone.
A recent report found NHS and police failings led to Mrs Hodkin’s murder.
Edgington, a diagnosed schizophrenic, was discharged from the Bracton Centre mental health facility in 2009 despite an order she be detained indefinitely following the killing of her mother Marion in Forest Row, Sussex, in 2005.
Around two weeks before the killing on 10 October, 2011, Edgington made a number of emergency calls to police about “crackheads” stealing from her flat in early October. She had also been using skunk cannabis, the inquest heard.
On 29 September, she sent a message to her brother telling him about the miscarriage, saying she wanted to reconnect.
The message also mentioned their mother, with Edgington saying: “No-one’s taking care of me like she would.”
Her brother replied on the same day: “You stabbed her to death and left me to find the body. Good news about your miscarriage … do us a favour and slit your wrists.”
On the day of Mrs Hodkin’s murder, Edgington was taken to Oxleas House mental health unit, but was later allowed to walk out of the building.
She got a bus to Bexleyheath, bought a large knife from Asda and stole a steak knife from a butcher’s shop.
Edgington then stabbed Mrs Hodkin and another woman in the street.
Elizabeth Lloyd-Folkard, a forensic social worker who was looking after Edgington, told the inquest that around a week before the killing, she had “no cause of concern about her state of mind”.
Contact with family members, substance misuse, and any issues around pregnancy were noted in reports as high-risk factors that could affect Edgington’s mental health, the inquest heard.
Mrs Hodkin’s son Len Hodkin told the inquest: “All of those risk factors were present in the two to three weeks leading up to October 10.
“It’s not coming with the benefit of hindsight, this information was available to you and other members of the multi-disciplinary team at the time.”
The inquest continues.

Source: https://www.bbc.co.uk/news/uk-england-london-46022330

Filed under: Brain and Behaviour,Cannabis/Marijuana,Crime/Violence/Prison,Drug use-various effects,Effects of Drugs,Health :

Two major public health issues are colliding,’ CDC official warns

Public health officials grappling with record-high syphilis rates around the nation have pinpointed what appears to be a major risk factor: drug use.

“Two major public health issues are colliding,” said Dr. Sarah Kidd, a medical officer at the Centers for Disease Control and Prevention and lead author of a new report issued Thursday on the link between drugs and syphilis.
The report shows a large intersection between drug use and syphilis among women and heterosexual men. In those groups, reported use of methamphetamine, heroin and other injection drugs more than doubled from 2013 to 2017.
The data did not reveal the same increases in drug use among gay men with syphilis, the group with the highest rates of the disease.

Researchers said the results suggest that drug use — and the risky sexual behaviors associated with it — may be driving some of the increase in syphilis transmission among heterosexuals.
People who use drugs are more likely to engage in unsafe sexual behaviors, which put them at higher risk for sexually transmitted diseases, experts said. The CDC also saw increases in syphilis among heterosexuals during the crack cocaine epidemic of the 1980s and 1990s, and use of the drug was associated with higher syphilis transmission.
“The addiction takes over,” said Patricia Kissinger, an epidemiology professor at Tulane University School of Public Health and Tropical Medicine.

For example, people using drugs may avoid condoms, have multiple sex partners or exchange sex for drugs or money — all significant risk factors for sexually transmitted diseases, said Dr. Sara Kennedy, medical director of Planned Parenthood Northern California.
“I think it’s impossible to eradicate syphilis and congenital syphilis unless we are simultaneously addressing the meth-use and IV-use epidemic,” Kennedy said.
Syphilis rates are setting records nationally. They jumped by 73 percent overall and 156 percent for women from 2013 to 2017. The highest rates were reported in Nevada, California and Louisiana.
Syphilis — which had been nearly eradicated before its resurgence in recent years — is treatable with antibiotics, but if left untreated it can lead to organ damage and even death. Congenital syphilis, which occurs when a mother passes the disease to her unborn baby, can lead to premature birth and newborn deaths.

The study’s authors analyzed syphilis cases from 2013 to 2017 and determined which patients had also reported using drugs. They discovered methamphetamine was the biggest problem: More than one-third of women and one-quarter of heterosexual men with syphilis reported using methamphetamine within the previous year.
Substance use among both populations was highest in 13 Western states and lowest in the Northeast. In California, methamphetamine use by people with syphilis nearly doubled for women and heterosexual men from 2013 to 2017, according to the California Department of Public Health.

‘OPPORTUNITY LOST’

The intersecting epidemics of sexually transmitted infections and substance abuse make it harder to identify and treat people with syphilis because drug use makes people less likely to go to the doctor and to report their sexual partners, Kidd said.
Pregnant women also may be reluctant to seek prenatal care and get syphilis testing and treatment because of concerns their doctor will report the drug use.
To stem the transmission of syphilis, the CDC urges more collaboration between programs that address STDs and programs that treat substances abuse.

Drug use is an “incredibly huge contributing factor” to somebody getting an STD and transmitting it, said Jennifer Howell, sexual health program coordinator for the health district in Washoe County, Nev.
“Everybody needs to see that we are dealing with a lot of the same clients,” she said.
Fresno County has the highest rate of congenital syphilis in California. Its health department analyzed 25 cases of congenital syphilis in 2017 and determined that more than two-thirds of the mothers were using drugs, said Joe Prado, the county’s community health division manager.
The county has started offering STD testing for people entering inpatient drug treatment facilities, Prado said. “That’s our opportunity to get them screened,” he said.
Those who return for the results are offered incentives such as gift cards. The county also gives people in drug treatment a care package that contains condoms and education materials about sexually transmitted infections, Prado said.

The city of Long Beach sends a mobile clinic to drug treatment facilities, where it provides HIV testing, said Dr. Anissa Davis, the city’s health officer. She said Long Beach hopes to expand services to include screening for other sexually transmitted infections.
Although increased collaboration between drug treatment providers and STD clinics is essential, it’s not always easy because they traditionally have not worked together, said Kissinger of Tulane.
“The STI people are hyper-focused on STIs and the substance abuse people are focused on substance abuse,” she said. It is an “opportunity lost” if people in drug treatment aren’t screened for syphilis and other sexually transmitted infections, she added.

Fighting the rising rates of syphilis will also require more resources, said Dr. Jeffrey Klausner, a professor of medicine and public health at UCLA.
“The STD workforce has almost entirely disappeared,” he said. “While policies could be put in place that require syphilis testing, those policies also have to come with resources.”

SOURCE: ANNA GORMAN, KAISER HEALTH NEWS 15TH FEB2019

Filed under: Drug use-various effects,Effects of Drugs,Health,Social Affairs,USA :

With no age restrictions on its use, some people – even children – are likely consuming CBD on a very frequent basis.

While a growing chorus of voices recommend CBD oil for all manner of ailments with glowing reviews and assurances of its safety, consumers would be wise to think very carefully before jumping on the bandwagon.

This article seeks to pull back the curtain on the CBD story and reveal the very real potential dangers of use by otherwise healthy people so that you can make a truly informed decision for your family.

Please note that I am not disputing the benefits of cannabis in this article. I know it helps a lot of very sick people manage their illness in a comfortable way without the need for pharmaceuticals. What I am presenting is the other side of the story that is usually not discussed – even glossed over in favor of aggressive marketing to otherwise healthy people.

What is CBD Oil?

CBD oil is an alternative remedy for inflammation, pain, seizures and many other conditions. It is gaining widespread popularity over pharmaceutical drugs to treat the same ailments.

Manufacturers make CBD oil by diluting the active ingredient cannabidiol with a carrier fat such as coconut oil. Depending on what carrier oil is used (i.e., saturated fats or vegetable oils), the remedy then appeals to a wider variety of people. In other words, CBD fans can find an oil that fits their particular food philosophy on fats.

Cannabidiol

You might be surprised to learn that cannabidiol is one of over a hundred compounds known as cannabinoids. The buds, flowers, leaves and stalks (not seeds) of the hemp plant contain them. Other common names for this plant are marijuana or cannabis.

Tetrahydrocannabinol, better known as THC, is another well known cannabinoid in hemp plant matter. It is best known for its mind altering effects, which pot smokers experience firsthand. (1)

Fans of CBD oil claim that cannabidiol is safe because it has zero inherent psychoactive properties like THC. However, this is disputable, if not downright false, in light of research on both animals and humans. More on this later.

Hash (Cannabis) Oil vs CBD Oil vs Hemp Seed Oil

It is important to understand the key differences between the three primary oils derived from the hemp or marijuana plant. These characteristics determine whether the oil is used as food or medicine and, in turn, whether it is even legal or not.

CBD oil falls in the gray area, which is why it is so confusing and potentially dangerous for anyone except those who are gravely ill with few other treatment options. Hopefully, the discussion below will help clear things up for you!

Cannabidiol (CBD) Oil

As described above, manufacturers create medicinal CBD oil by blending cannabidiol with a carrier oil. This active ingredient is either isolated or alcohol extracted from whole cannabis plant matter.

CBD was legalized in all 50 states by the 2014 Farm Bill, which served as the springboard for its explosive growth. However, this approval came with an important caveat. The legislation required extraction of CBD for academic research or under a state pilot program. Since then, a number of states broadened this narrow definition, which legalized other CBD manufacturing processes. (2)

Hemp Seed Oil

CBD oil is vastly different from hemp seed oil, which is a food and not medicine. It is made by cold pressing the seeds on the cannabis plant. The resulting oil is high in inflammatory omega-6 fats. Hemp seeds contain no THC and hence the oil should technically not contain any either.

Some countries require testing for THC in hemp seed oil to verify purity. Typical requirements are that there are no more than 5-10 or even zero parts per million (ppm) detected in the final product.

Hemp Oil (Hash or Cannabis Oil)

In comparison, hash or cannabis oil does contain high inducing THC. It is also misleadingly known as honey oil.

It comes from aerial parts of the marijuana plant except the seeds. This medicinal or recreational oil can be made from any of the three sub-species of the cannabis plant – Cannabis sativa, Cannabis indica, and more rarely Cannabis ruderalis.

Hash oil is illegal for recreational use in most states but is approved for medicinal use by a growing list of others. It is usually consumed by eating or smoking. It is also sold in cartridges for use in vaping pens.

In summary, while hemp seed oil is widely recognized as safe and available on healthfood store shelves all across the country, hemp oil is still regulated as as a medicinal only drug in some states and completely outlawed in others. CBD oil falls in the gray area somewhere between the two.

The question that remains to be answered is its safety. Does the narrow legalization of CBD in the 2014 Farm Bill guarantee its safety? Or is it actually more risky than consumers have been led to believe?

CBD Oil Risks

The side effects of consuming cannabidiol are very real though commonly glossed over by those selling it.

Drug Contraindications

CBD oil may potentially interact in a negative way with anti-epilepsy drugs. As of now, only in vitro (test tube) observations exist with no living organism testing proving safety. Drugs that may interact include: (3)
•carbamazepine (Tegretol)
•phenytoin (Dilantin)
•phenobarbital (Luminal, Solfoton, Tedral)
•primidone (anti-seizure)

Side Effects

According to a review of existing research by the journal Cannabis and Cannabinoid Research, the most common side effects of consuming CBD or CBD oil include:
•fatigue
•nausea or vomiting
•diarrhea
•dizziness
•anxiety or depression
•changes in appetite/weight
•Psychosis

While there is a well known link between psychotic disorders and pot, CBD is generally regarded as anti-psychotic. (4)

How can this be if a CBD side effect is psychosis? (5)

Perhaps this common belief is simply not true!

Psychoactive Effects of Cannabinoids

Perhaps cannabinoid oil purveyors tend to ignore the well established reactions because the side effect profile of CBD is better than pharmaceutical drugs used to treat similar conditions.

In addition, proponents of CBD oil use insist on its safety because cannabidiol is not mind altering like its cousin cannabinoid THC.

Research from the 1970s seems to confirm that CBD is well tolerated up to 600 mg without psychotic episodes. (6)

However, more recent research disputes this assumption.

Conversion of CBD to THC

Researcher Kazuhito Watanabe, PhD and his team at Daiichi College of Pharmaceuticals, Japan discovered a disturbing problem with cannabidiol. (7)

They found that CBD converts into THC, the same psychosis inducing substance found in weed. In addition, CBD converted into two other THC-like cannabinoids known as HHCs (hexahydroxycannabinols). All three produced high inducing symptoms in mice.

This research indicates that THC is not the only mind altering cannabinoid in hemp. It also suggests the possibility that a person can be exposed to brain altering, high inducing substances by simply consuming CBD.

Getting High on CBD?

Acidity is necessary for the conversion of CBD to THC and the two psychoactive HHCs. Researchers performed this conversion using artificial digestive juices. The change accelerated in the presence of some kind of sugar (or alcohol).

In people consuming CBD oil, this would parallel as acidity in the stomach. Since people commonly consume CBD oil in sugary lattes, candy, goodies, smoothies or alcoholic beverages, this situation mimics the reality of many people who use it.

Effects of THC Derived from CBD

To test the effects of these components, the researchers then injected mice with small quantities of the THC and HHCs converted from CBD. The researchers tested for the four most common symptoms of THC exposure including:
•Catalepsy – loss of sensation or consciousness
•Hypothermia – drop in body temperature
•Prolonged sleep
•Reduced pain perception

Mice injected with small amounts of THC and HHCs converted in artificial gastric juices from CBD tested positively for all 4 pot exposure symptoms.

Human Studies

Follow-up research in 2016 published in the journal Cannabis and Cannabinoid Research gives additional pause.

More than 40% of epileptic children orally administered CBD exhibited adverse events, with THC like symptoms the most common. In their conclusion, researchers challenged the accepted premise that CBD is not high-inducing.

Gastric fluid without enzymes converts CBD into the psychoactive components Δ9-THC and Δ8-THC, which suggests that the oral route of administration may increase the potential for psychomimetic adverse effects from CBD. (8)

Is CBD Oil Safe for Children?

The takeaway of existing research as of this writing seems to indicate extreme caution when it comes to ingestion of CBD oil especially by children.

Research definitively shows that THC exposure affects their developing brains in a negative way – perhaps permanently. The important point here is that consuming CBD or CBD infused oil can initiate this THC exposure – not just smoking or vaping pot. The Journal of Current Pharmaceutical Design warns:

The literature not only suggests neurocognitive disadvantages to using marijuana in the domains of attention and memory that persist beyond abstinence, but suggest possible macrostructural brain alterations (e.g., morphometry changes in gray matter tissue), changes in white matter tract integrity (e.g., poorer coherence in white matter fibers), and abnormalities of neural functioning (e.g., increased brain activation, changes in neurovascular functioning). (9)

CBD During Pregnancy

The Journal Future Neurology warns that cannabis exposure crosses the placenta. “Human epidemiological and animal studies have found that prenatal cannabis exposure influences brain development and can have long-lasting impacts on cognitive functions.” (10)

Since CBD partially converts to THC under acidic conditions, women who consume CBD oil for morning sickness or other discomforts of pregnancy should understand that use may mimic using pot directly. Just because CBD oil is natural and works effectively to alleviate symptoms does not mean it is safe for your baby.

Always discuss any supplemental foods with a practitioner before use!

CBD from Hops and Other Non-Cannabis Plants

Some CBD products and oil come from plants other than cannabis. Hops is one that is popular currently. (11)

People that use non-cannabis CBD mistakenly believe that they are safe from THC. False marketing of these products encourages this line of thinking.

Be warned that no matter where CBD comes from, the potential for conversion of CBD to THC in the digestive tract exists. CBD is ultimately a cannabinoid no matter what plant it comes from. Thus, unless the CBD is applied transdermally or intravenously to avoid the acidic conditions within the digestive tract, the risk for THC exposure and brain-altering effects still exists.

To give you a example of how this works, consider how beta carotene converts to Vitamin A in the digestive tract. It doesn’t matter if the beta carotene comes from carrots, peppers or squash. This nutrient will still potentially convert to Vitamin A. The same principle applies to CBD that is consumed orally. The digestive process can result in conversion to THC no matter what plant is the source of the CBD.

Is CBD Safe for Anyone?

Consumers desperately need more research about the high-inducing effects of CBD-to-THC that could manifest as a result of the digestive process.

The half life of oral CBD in the body is about 2 days. Thus, depending on how much a person consumes and how often, the potential risk of psychosis could increase over time depending on individual metabolism.

It seems that, as of this writing, the prudent course of action for the cautious consumer is to adopt a wait and see attitude toward CBD and CBD oil products pending further research on the very real potential for mind altering, pot-like effects.

Some companies are already working to develop synthetic transdermal CBD. Such a drug would bypass the gastrointestinal tract and avoid bioconversion to psychoactive THC and/or HHCs. Of course, this treatment likely has its own set of yet unknown dangers!

While the risks of THC exposure from CBD oil and other products are likely of little concern for gravely ill people who desperately need it, for otherwise healthy people and children, beware! It seems wise until further research is concluded to treat CBD oil, candy, and other products just like any other high inducing drug. Just. Say. No.

Sarah Pope MGA

Since 2002, Sarah has been a Health and Nutrition Educator dedicated to helping families effectively incorporate the principles of ancestral diets within the modern household.

Sarah was awarded Activist of the Year at the International Wise Traditions Conference in 2010.

Sarah received a Bachelor of Arts (summa cum laude, Phi Beta Kappa) in Economics from Furman University and a Master’s degree in Government (Financial Management) from the University of Pennsylvania.

Mother to three healthy children, blogger, and best-selling author, her work has been covered by USA Today, The New York Times, National Review, ABC, NBC, and many others.

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Comments (115)

Anna

Well, by now Healthline has corrected the article you reference as evidence for CBD causing psychosis, after I (and maybe others, who knows) pointed out to them that they had mistakenly put the side effects of THC for those of CBD. Now it lists only diarrhoea, changes in appetite and fatigue. Time for you to follow suit? You both reference the same scientific article, and now that this is the only remaining reference to back up your claim, I think it is time you actually looked at it and realised that it does not support your claim either. Could you then still go on and claim to have truth on your side, knowing that your claim is based on nothing at all? And keep on calling people who disagree with you biased? It’s pretty clear to me who is the biased one here, and probably to most others as well.
Sarah, you may have good intentions but you are not making the world a better place by publishing misinformation. Maybe a few people will be kept from trying CBD due to reading it, but most people will realise right away how ridiculous it is. It will just contribute to their mistrust of official information and authority figures on the subject of drugs. Because fact is that a lot of fairly harmless drugs have been needlessly demonised along with the genuinely dangerous ones since Nixon started his war on drugs. You might believe otherwise, but people who try them know better. And the more misinformation they see around them, the more they will be inclined to disbelieve also the genuine warnings about those drugs which can actually be really harmful. Especially now in this age of ‘fake news’ where people are more and more unsure of what information they can trust. People actually end up harming themselves much more due to ignorance than they would if they had full knowledge of the whole subject in advance! Proper education is the way to reduce the harm from drugs the most, not waging a war against them with misinformation – isn’t it obvious by now that this war has totally failed, because it is unwinnable?

April 20th, 2019 2:14 pm Reply

Sarah Pope MGA

I actually cited a scientific study about CBD converting to THC in the gut! You are welcome to believe anything you like, but the fact is that some people do experience psychosis from CBD. Read through the comments and read the referenced research study.

April 22nd, 2019 7:39 am Reply

rooislangwtf

The effort the Japanese study went to, to convert cbd to thc makes me wonder what the likelihood is of it actually happening in the human body (ph of 1.2 that’s lower than normal gastric acid and then a heck of a lot of purification). The epilepsy study didn’t go past observation to indicate thc effects (urine tests would’ve helped).

So the real conclusion to draw is until more tests are done:
Dont take cbd with alcohol or a lot of sugars or get a way to take cbd non orally (a patch or a suppository maybe).

April 10th, 2019 7:34 pm Reply

PATRICIA DONOVAN

I believe you picked and chose your so-called info from a multitude of sources without validating ANY of it. You are doing an extreme dis-service to those who use CBD effectively. People have to do their own research and find what works for them. Not all brands are created equal. I could write a book, with VALID sources, disputing virtually every point you made.

February 13th, 2019 1:06 pm Reply

Sarah Pope MGA

I find it amusing that people who disagree with an article frequently get in a huff and claim that “all” the sources/references are invalid and that they could “write a book” disputing every point. LOL Go read a site then that confirms all your biases. You don’t want the truth .. you want an article validating your belief system.

February 13th, 2019 1:37 pm Reply

Tim Wolford

I believe failed to include that the types of CBD oils in question are the Full Spectrum which has THC properties. The two other types will NOT produce THC and they are Broad Spectrum and Isolate Spectrum. The majority of CBD oils on the market today are Full Spectrum with THC compounds, however when the THC is extracted from the CBD Oils you have a Broad Spectrum product which may cost more, but will NOT have THC period! Do your homework and don’t always believe everything you read, especially when the Spectrums were never discussed

February 12th, 2019 11:23 am Reply

Sarah Pope MGA

Please read the article. You have apparently missed the point completely as have several other commenters. There is NO BRAND of CBD oil that is safe. ANY cannabidiol even if from another plant (like hops) will potentially trigger a conversion to THC in the gut. When NYC just banned CBD from edibles sold at restaurants, healthfood stores etc, there was NO distinction between “full spectrum” and isolate spectrum.

February 13th, 2019 8:56 am Reply

Dela Baldwin

Not all CBDs are created equal. Not all CBD has THC. A lot have trace amounts however not all. My company is 100% 0.00000 % THC free.

February 5th, 2019 9:52 am Reply

Sarah Pope MGA

I don’t think you understood the article! I am not suggesting that any CBD oil has THC in it … it DOESN’T MATTER how your CBD oil is produced … some CAN AND DOES CONVERT to small amounts of THC in the acidity of the digestive tract when consumed. Some people have a HUGE negative reaction to this.

Beta carotene partially converts to Vitamin A in the digestive tract too as do many other substances.

February 5th, 2019 10:26 am Reply

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Filed under: Brain and Behaviour,Cannabis/Marijuana,Drug use-various effects,Effects of Drugs :

Tens of thousands of people are ending up in hospital with cannabis-related health problems, official figures have revealed.

There were 27,501 admissions linked to cannabis in England in 2016/17, a 15 per cent rise in just two years from 23,866 in 2014/15.

Labour MP Jeff Smith, who requested the figures on cannabis-related hospitalisations, said the large increase was ‘a concern’.

The influential medical journal The Lancet has just taken the unprecedented step of branding cannabis a ‘huge risk to health’.

Mr Smith, an ex-DJ who has admitted taking drugs, said: ‘It could be that the rise in hospital admissions is associated with rises in particular types of cannabis being used – street cannabis now tends to be more “skunk”.’

‘Skunk’ has a high concentration of the main psychoactive compound THC, which is strongly linked to increased risk of psychosis.

A recent study based on drugs seized by police found that 94 per cent of cannabis now sold on UK streets is ‘skunk’. Academics say this super-strength cannabis could be behind the rise in mental health problems linked to the drug.

Now,The Lancet has warned in a hard-hitting editorial that with the ‘increasing liberalisation of laws’, users need to be made ‘aware of risks to their health and wellbeing.

The journal was reflecting on results from the 2018 Global Drug Survey, which asked 130,000 people in 44 nations about their use of drugs. The Lancet said: ‘Globally, cannabis is still the top illicit drug used and, with the concurrent use of tobacco, remains a huge health risk.’

Its position is in marked contrast to 1995 when it stated: ‘The smoking of cannabis, even long-term, is not harmful to health.’

Mr Smith claimed: ‘Legalisation and regulation is a better way of reducing harm than leaving the trade in the hands of criminals.’

Source: Mail Online July 11th 2018

Filed under: Cannabis/Marijuana,Drug use-various effects,Effects of Drugs,Health,Social Affairs :

Mass Illness from Marijuana Edibles in San Francisco There’s more potential for overdose from edibles than smoked marijuana, although the teen in Seattle who jumped to his death last December did it after smoking pot for the first time.  Two shocking incidents in California suggest that overdose emergencies will increase if that states vote to legalize marijuana in November.  Here’s a summary of recent cases of toxicity from edibles:

· 19 people were hospitalized in San Francisco on August 7 from THC, after attending a quinceañera party.  The source is believed be marijuana-infused candies, perhaps gummy bears. Several children were among those poisoned, one as young as six.  A 9-year-old had severe difficulty breathing.

· Pot brownies sent a bachelorette party to the emergency room in South Lake Tahoe over the weekend of July 30-31. Eight of the 10 women were admitted to the hospital according to the City of South Lake Tahoe’s website.

· A JAMA Paediatrics article explains the dramatic rise in children’s hospitalizations related to marijuana in Colorado since legalization.  In 10 cases, the product was not in a child-resistant container; in 40 scenarios (34%) there was poor child supervision or product storage.  Edible products were responsible for 51 (52% ) of exposures.  The report claimed that child-resistant packaging has not been as effective in reducing kids’ unintended exposure to pot as hoped.

· The report mentions the death of one child, an 11-month-old baby.  Nine of the children had symptoms so serious that they ended up in the intensive care unit of Colorado Children’s Hospital.  Two children needed breathing tubes.

· The state of Washington has a similar problem with edibles, as reported on the King County Health Department’s website.  From 2013 to May 2015, there were 46 cases of children’s intoxications related to marijuana edibles reported in Washington.  However, reporting is voluntary and the state estimates that number could be much higher.

·  In May, a father plead guilty to deliberately giving his 4-year-old daughter marijuana-laced cake in Vancouver, Washington.  He was sentenced to two years in prison.

Intoxication from marijuana edibles has risen steadily since legalization. Source: King County Department of Health. Top photo: AP

· In Hingham, MA, there was a 911 related to teen girl who ingested marijuana edibles.  The candies were in a package labelled Conscious Creations, which didn’t disclose ingredients.   Massachusetts has a medical marijuana program, but it is not clear how or to whom they were sold or dispensed.

 

· July, 2016: Two California teens were hospitalized after eating a marijuana-laced cookie. The teens reported purchasing the cookie from a third teenager who was subsequently arrested.

· July, 2016: A California man was arrested for giving candy laced with marijuana to a 6-year-old boy and an 8-year-old boy; the 6-year-old was hospitalized for marijuana poisoning.

· July, 2016: Police in Arizona arrested a mother for allegedly giving her 11- and 12-year-old children gummy candy infused with marijuana. Police say the marijuana-infused candy was originally purchased by an Arizona medical marijuana user, but was illegally transferred to the mother in question.  (State medical marijuana programs have poor track records of assuring the “medicine” goes to whom it is intended.)

· On April 27, a Georgia woman was arrested after a 5- year-old said he ate a marijuana cake for breakfast.  The child was taken to the hospital for treatment following the incident; according to officials, his pulse was measured at over 200 beats per minute.

· Last year there were more than 4,000 treatments at hospitals and poison center treatments in the US related to marijuana toxicity in children and teens.

Growth of marijuana edibles intoxication by age. Source: King County, Washington

Edible marijuana poses a “unique problem,” because “no other drug is infused into a palatable and appetizing form” – such as cookies, brownies and candy.    Many household items cause poisonings, but marijuana edibles are different because they’re made to look appealing and they appeal to children.

 

Source:  http://www.poppot.org/2016/08/08/latest-child-dangers-marijuana-e

Filed under: Cannabis/Marijuana,Drug use-various effects on foetus, babies, children and youth,Effects of Drugs,Global Drug Legalisation Efforts,Social Affairs,USA :

Patterns of illicit drug use in each UK country analysed in annual report

An overview of illicit drug use across the whole of the UK in 2016 has been published by the Home Office.

The ‘United Kingdom Drug Situation: Focal Point Annual Report 2016’ has collated data across all four home nations and includes specific analysis of policy, prevention, treatment, drug-related deaths, infectious diseases and drug markets.

Key points relating to the UK as a whole:

· Prevalence in the general population is lower now than ten years ago, with cannabis being the main driver of that reduction. However, there has been little change in recent years.

· Seizures data suggests that herbal cannabis has come to dominate the market. While resin was involved in around two-thirds of cannabis seizures in 2000, it was involved in only five per cent in 2015/16.

· Using the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) definition, which refers to deaths caused directly by the consumption of at least one illicit drug, the total number of drug-related deaths in the UK during 2014 was 2,655; a five per cent increase from 2013 and the highest number reported to date.

· Over the last decade the average age of death has increased from 37.6 years in 2004 to 41.6 in 2014, with males being younger than females (40.3 years and 44.6 years respectively). The largest proportion of deaths in the UK in 2014 was in the 40–44 years age group.

· There were 124,234 treatment presentations in the UK in 2015. This total includes for the first time, data from individuals presenting to treatment services in prisons in England.

· Benzodiazepines were cited as a primary problem substance in far greater proportion of cases in Scotland and Northern Ireland than in England or Wales, whereas Wales had a far higher proportion of clients citing amphetamines/methamphetamines than in any of the other countries.

· National Take-Home Naloxone programmes continue to supply naloxone to those exiting prison in Scotland and Wales: there were 932 kits issued by NHS staff in prisons in Scotland, and 146 in Wales, in 2015/16.

· There were 50 new diagnoses of HIV among people who inject drugs reported from Scotland, compared with 17 in 2014. This increase was due to an outbreak of HIV in people who inject drugs in Glasgow.

Source:  http://www.sdf.org.uk/patterns-illicit-drug-use-uk-country-analysed-annual-report/

Filed under: Effects of Drugs,Social Affairs (Papers) :

HUNTINGTON, W.Va. — Officer Sean Brinegar arrived at the house first — “People are coming here and dying,” the 911 caller had said — and found a man and a woman panicking. Two people were dead inside, they told him.

Brinegar, 25, has been on the force in this Appalachian city for less than three years, but as heroin use has surged, he has seen more than his fair share of overdoses. So last Monday, he grabbed a double pack of naloxone from his gear bag and headed inside.

A man was on the dining room floor, his thin body bluish-purple and skin abscesses betraying a history of drug use. He was dead, Brinegar thought, so the officer turned his attention to the woman on a bed. He could see her chest rising but didn’t get a response when he dug his knuckle into her sternum.

Brinegar gave the woman a dose of injected naloxone, the antidote that can jumpstart the breathing of someone who has overdosed on opioids, and returned to the man. The man sat up in response to Brinegar’s knuckle in his sternum — he was alive after all — but started to pass out again. Brinegar gave him the second dose of naloxone.

Maybe on an average day, when this Ohio River city of about 50,000 people sees two or three overdoses, that would have been it. But on this day, the calls kept coming.

Two more heroin overdoses at that house, three people found in surrounding yards. Three overdoses at the nearby public housing complex, another two up the hill from the complex.

From about 3:30 p.m. to 7 p.m., 26 people overdosed in Huntington, half of them in and around the Marcum Terrace apartment complex. The barrage occupied all the ambulances in the city and more than a shift’s worth of police officers.

By the end of it, though, all 26 people were alive. Authorities attributed that success to the cooperation among local agencies and the sad reality that they are well-practiced at responding to overdoses. Many officials did not seem surprised by the concentrated spike.

“It was kind of like any other day, just more of it,” said Dr. Clay Young, an emergency medicine doctor at Cabell Huntington Hospital.

But tragic news was coming. Around 8 p.m., paramedics responded to a report of cardiac arrest. The man later died at the hospital, and only then were officials told he had overdosed. On Wednesday, authorities found a person dead of an overdose elsewhere in Cabell County and think the death could have happened Monday. They are investigating whether those overdoses are tied to the others, potentially making them Nos. 27 and 28.

It’s possible that the rash of overdoses was caused by a particularly powerful batch of heroin or that a dearth of the drug in the days beforehand weakened people’s tolerance. But police suspect the heroin here was mixed with fentanyl, a synthetic opioid that is many times more potent than heroin. A wave of fatal overdoses signaled fentanyl’s arrival in Huntington in early 2015, and now some stashes aren’t heroin laced with fentanyl, but “fentanyl laced with heroin,” said Police Chief Joe Ciccarelli. Another possibility is carfentanil, another synthetic opioid, this one used to sedate elephants. Police didn’t recover drugs from any of the overdoses, but toxicology tests from the deaths could provide answers.

A battle-scarred city

In some ways, what happened in Huntington was as unremarkable as the spurts in overdoses that have occurred in other cities. This year, fentanyl or carfentanil killed a dozen people in Sacramento, nine people in Florida, and 23 people in about a month in Akron, Ohio. The list of cities goes on: New Haven, Conn.; Columbus, Ohio; Barre, Vt.

But what happened in Huntington stands out in other ways. It underlines the potential of a mysterious substance to unleash wide-scale trauma and overwhelm a city’s emergency response. And it suggests that a community that is doing all the right things to combat a worsening scourge can still get knocked back by it.

“From a policy perspective, we’re throwing everything we know at the problem,” said Dr. James Becker, the vice dean for governmental affairs and health care policy at the medical school at Marshall University here. “And yet the problem is one of those that takes a long time to change, and probably isn’t going to change for quite a while.”

Surrounded by rolling hills packed with lush trees, Huntington is one of the many fronts in the fight against an opioid epidemic that is killing almost 30,000 Americans a year. But this city, state, and region are among the most battle-scarred. West Virginia has the highest rate of fatal drug overdoses of any state and the highest rate of babies born dependent on opioids among the 28 states that report data. But even compared with other communities in West Virginia, Huntington sees above-average rates of heroin use, overdose deaths, and drug-dependent newborns. Local officials estimate up to 10 percent of residents use opioids improperly.

The heroin problem emerged about five years ago when authorities around the country cracked down on “pill mills” that sent pain medications into communities; officials here specifically point to a 2011 Florida law that arrested the flow of pills into the Huntington area.

As the pills became harder to obtain and harder to abuse, people turned to heroin. It has devoured many communities in Appalachia and beyond.

In Huntington, law enforcement initially took the lead, with police arresting hundreds of people. They seized thousands of grams of heroin. But it wasn’t making a dent. So in November 2014, local leaders established an office of drug control policy.

“As far as numbers of arrests and seizures, we were ahead of the game, but our problem was getting worse,” said Jim Johnson, director of the office and a former Huntington police officer. “It became very obvious that if we did not work on the demand side just as hard as the supply side, we were never going to see any success.”

The office brought together law enforcement, health officials, community and faith leaders, and experts from Marshall to try to tackle the problem together.

Changes in state law have opened naloxone dissemination to the public and protected people who report overdoses. But the city and its partners have gone further, rolling out programs through the municipal court system to encourage people to seek treatment. One program is designed to help women who work as prostitutes to feed their addiction. Huntington has eight of the state’s 28 medically assisted detox beds, and they’re always full.

Also, in 2014, a center called Lily’s Place opened in Huntington to wean babies from drugs. Last year, the local health department launched this conservative state’s first syringe exchange. The county, health officials know, is at risk for outbreaks of HIV and hepatitis C because of shared needles, so they are trying to get ahead of crises seen in other communities afflicted by addiction.

“Huntington just happens to have taken ownership of the problem, and very courageously started some programs … that have been models for the rest of the state,” said Kenneth Burner, the West Virginia coordinator for the Appalachia High Intensity Drug Trafficking Areas program.

‘A revolving door’

While paramedics in the area have carried naloxone for years, it was this spring that Huntington police officers were equipped with it. Just a few officers have administered it, but Monday was Brinegar’s third time reviving overdose victims with naloxone.

Paramedics, who first try reviving victims by pumping air with a bag through a mask, had to administer another 10 doses of naloxone Monday. Three doses went to one person, said Gordon Merry, the director of Cabell County Emergency Services. During the response, ambulances from stations outside Huntington were called into the city to assist the eight or so response teams already deployed.

Merry was clearly proud of the response, but also frustrated. He was tired, he said, of people whom emergency crews revived going back to drugs. Because of the power of their disease, saving their lives didn’t get at the root of their addiction.

“It’s a revolving door. We’re not solving the problem past reviving them,” he said. “We gave 26 people another chance on life, and hopefully one of those 26 will seek help.”

In the part of town where half the overdoses happened, some homes are well-kept, with gardens, bird feeders, and American flags billowing. “Home Sweet Home,” read an engraved piece of wood above one front door; in another front yard, a wooden sculpture presented a bear holding a fish with “WELCOME” written across its body.

But many structures are decrepit and have their windows blacked out with cardboard and sheets. At one boarded-up house, the metal slats that once made up an overhang for the front porch split apart and warped as they collapsed, like gnarled teeth. On the plywood that covered a window frame was a message spelled out in green dots: GIRL SCOUTS RULE.

In and around the public housing complex, which is made up of squat two-story brick buildings sloping up a hill, people either said they did not know what had happened Monday, or that “lowlifes” in another part of the complex sparked the problem. Even as paramedics were responding to the overdoses, police started raiding residences as part of their investigation, including apartments at the complex, the chief said.

Just up the hill, a man named Bill was sitting on a recliner on his front porch with his cat. He said he saw the police out in the area Monday, but doesn’t pay much attention to overdoses anymore. They are so frequent.

Bill, who is retired, asked to be identified only by his first name because he said he has a son in law enforcement. He has lived in that house for five decades and started locking his door only in recent years. His neighbors’ house had been broken into, and he had seen people using drugs in cars across the street from his house. He called the police sometimes, he said, but the users were always gone by the time the police arrived.

“I hate to say this, but you know, I’d let them die,” Bill said. “If they knew that no one was going to revive them, maybe they wouldn’t overdose.”

Even here, where addiction had touched so many lives, it’s not an uncommon sentiment. Addiction is still viewed by some as a bad personal choice made by bad people.

“Some folks in the community just didn’t care” that 26 of their fellow residents almost died, said Matt Boggs, the executive director of Recovery Point.  Recovery Point is a long-term recovery program that teaches “clients” to live a life without drugs or alcohol. Boggs himself is a graduate of the program, funded by the state and donations and grants.

The clients live in bunk rooms at the facility for an average of more than seven months before graduating. The program says that about two-thirds of graduates stay sober in the first year after graduation, and about 85 percent of those people are sober after two years.

Local officials praise Recovery Point, but like many other recovery programs, it is limited in what it can do. It has 100 beds for men at its location in Huntington, and is expanding at other sites in the state, but Boggs said there’s a waiting list of a couple hundred people.

Mike Thomas, 30, graduated from the main part of the program a month ago and is working as a peer mentor there as he transitions out of the facility. Thomas has been clean since Oct. 15, 2015, but has dreams about getting high or catches himself thinking he could spare $100 from his bank account for drugs.

Thomas hopes to find a full-time job helping addicts. His own recovery will be a lifelong process, one that can be torn apart by a single bad decision, he said. He will always be in recovery, never recovered.    “I’m not cured,” he said.

 

A killer that doesn’t discriminate

As heroin has bled into communities across the country, it has spread beyond the regular drug hotbeds in cities. On a 2004 map of drug use in Huntington — back then, mostly crack cocaine — a few blocks of the city glow red. Almost the entire city glows in yellows and reds on the 2014 map.

In 2015, there were more than 700 drug overdose calls in Huntington, ranging from kids in their early teens to seniors in their late 70s. In 2014, it was 272 calls; in 2012, 146. One bright spot: fatal overdoses, which stood at 58 in 2015, have ticked down so far this year.

“I used to be able to say, ‘We need to focus here,’” said Scott Lemley, a criminal intelligence analyst at the police department. “I can’t do that anymore.”

Heroin hasn’t just dismantled geographic barriers. It has infiltrated every demographic “It doesn’t discriminate.   Prominent businessmen, their child. Police officers, their child. Doctors, their child,” Merry said. “The businessman and police officer do not have their child anymore.”

The businessman is Teddy Johnson. His son, Adam, died in 2007 when he was 22, one of a dozen people who died in a five-month period because of an influx of black-tar heroin. The drug hadn’t made its full resurgence into the region yet, but now, Johnson sees the drug that killed his son everywhere.

 

Teddy Johnson lost his son, Adam, in 2007 to a heroin overdose. He has several tattoos dedicated to Adam’s memory.  He runs a plumbing, heating, and kitchen fixture and remodelling business. From his storefront, he has witnessed deals across the street.

Adam, who was a student at Marshall, was a musician and artist who hosted radio shows. He was the life of any party, his dad said.

Johnson was describing Adam as he sat at the marble countertop of a model kitchen in his business last week. With the photos of his kids on the counter, it felt like a family’s home. Johnson explained how he still kept Adam’s bed made, how he kept his son’s room the same, and then he began to cry.

“The biggest star in the sky we say is Adam’s star,” he said. “When we’re in the car — and it can’t be this way — but it always seems to be in front of us, guiding us.”

Adam’s grave is at the top of a hill near the memorial to the 75 people — Marshall football players, staff, and fans — who died in a 1970 plane crash. It’s a beautiful spot that Johnson visits a few times each week, bringing flowers and cutting the grass around his son’s grave himself. Recently a note was left there from a couple Johnson knows who

just lost their son to an overdose; they were asking Adam to look out for their son in heaven.

But even here, at what should be a respite, Johnson can’t escape what took his son. He said he has seen deals happen in the cemetery, and he recently found a burnt spoon not more than 20 feet from his son’s grave.

Johnson keeps fresh flowers on his son’s grave and cuts the grass around the grave himself.

“I’ve just seen too much of it,” he said.

If Huntington doesn’t have a handle on heroin, at least the initiatives are helping officials understand the scale of the problem. More than 1,700 people have come through the syringe exchange since it opened, where they receive a medical assessment and learn about recovery options. The exchange is open one day a week, and in less than a year, it has distributed 150,000 clean syringes and received 125,000 used syringes.

But to grow and sustain its programs, Huntington needs money, officials say. The community has received federal grants, and state officials know they have a problem. But economic losses and the collapse of the coal industry that fueled the drug epidemic have also depleted state coffers.

“We have programs ready to launch, and we have no resources to launch them with,” said Dr. Michael Kilkenny, the physician director of the Cabell-Huntington Health Department. “We’re launching them without resources, because our people are dying, and we can’t tolerate that.”

In some ways, Huntington is fortunate. It has a university with medical and pharmacy schools enlisted to help, and a mayor’s office and police department collaborating with public health officials. But what does that herald then for other communities?

“If I feel anxious about what happens in Huntington and in Cabell County, I cannot imagine what it must be like to live in one of these other at-risk counties in the United States, where they don’t have all those resources, they don’t have people thinking about it,” said Dr. Kevin Yingling, the dean of the Marshall University School of Pharmacy.

Yingling, Kilkenny, and others were gathered on Friday afternoon to talk about the situation in Huntington, including the rash of overdoses. But by then, there was already a different incident to discuss.

A car had crashed into a tree earlier that afternoon in Huntington. A man in the driver seat and a woman in the passenger seat had both overdosed and needed naloxone to be revived. A preschool-age girl was in the back seat.

Source:    https://www.statnews.com/2016/08/22/heroin-huntington-west-virginia-overdoses/ 22.08.16

Filed under: Addiction (Papers),Effects of Drugs,Effects of Drugs (Papers),Political Sector,USA :

In Southern Ohio, the number of drug-exposed babies in child protection custody has jumped over 200%.  The problem is so dire that workers agreed to break protocol to invite a reporter to hear their stories.  Foster care placements are at record levels, and the number of drug-exposed newborns in their custody has jumped over 200% in the past decade

Inside the Clinton County child protection office, the week has been tougher than most.

Caseworkers in this thinly populated region of southern Ohio, east of Cincinnati, have grown battle-weary from an opioid epidemic that’s leaving behind a generation of traumatized children. Drugs now account for nearly 80% of their cases. Foster-care placements are at record levels, and the number of drug-exposed newborns in their custody has jumped over 200% in the past decade. Funding, meanwhile, hasn’t budged in years.

“Many of our children have experienced such high levels of trauma that they can’t go into traditional foster homes,” said Kathi Spirk, director of Clinton County job and family services. “They need more specialized care, which is very expensive.”

The problem is so dire that workers agreed to break protocol and invite a reporter to camp out in a conference room and hear their stories. For three days, they relived their worst cases and unloaded their frustrations, in scenes that played out like marathon group therapy, for which they have no time. Many agreed that talking about it only made them feel worse, yet still they continued, one after another.

Hence the bad week.

Given the small size of their community, they asked that their names be changed out of concern for their own safety and the privacy of the children.

The caseworkers, like most, are seasoned in despair. Many worked in the 1990s when crack cocaine first arrived, followed by crystal meth in the early 2000s. In 2008, after the shipping giant DHL shuttered its domestic hub here in Wilmington and shed more than 7,000 jobs, prescription pill mills flourished while the economy staggered. Back then, a typical month saw 30 open cases, only a few of them drug-related. But the flood of cheap heroin and fentanyl, now at its highest point yet, has changed everything. A typical month now brings four times as many cases, while institutional knowledge has been flipped on its head.

“At least with meth and cocaine, there was a fight,” said Laura, a supervisor with over 20 years of experience. “Parents used to challenge you to not take their kids. And now you have them say: ‘Here’s their stuff. Here’s their formula and clothes.’ They’re just done. They’re not going to fight you any more.”

Heroin has changed how they approach every step of their jobs, they said, from the first intake calls to that painstaking decision to place a child into temporary foster care or permanent custody. Intake workers now fear what used to be routine.

“Occasionally, we’d get thrown a dirty house, something easy to close and with little trauma to the child,” said Leslie, another worker. “We’re not getting those any more.

Now they’re all serious, and most of them have a drug component. So you may get a dirty house, but it’s never just a dirty house.”

‘I had a four-year old whose mom had died in front of her and she described it like it was nothing’ Children come into the system in two ways. The first is through a court order after caseworkers deem their environment unsafe, and if no friends or family can be found.

Because of the added trauma, removing a child is always the last option, caseworkers said. But in a county with only 42,000 people spread out over 400 square miles, the magnitude of the epidemic has compromised an already delicate safety net. Relatives are overwhelmed financially. Multiple generations are now addicted, along with cousins, uncles, and neighbors. In many cases, a safe house with a grandparent or other relative will eventually attract drug activity.

Law enforcement will also bring children in, usually after parents overdose. These cases often reveal the most horrendous neglect: a three-year old who needed every tooth pulled because he’d never been made to brush them, or kids found sleeping on bug-infested mattresses, going to the toilet in buckets because the water had been shut off. Children are coming in more hardened, they said, older than their years.

“I had a four-year-old whose mom had died in front of her and she described it like it was nothing,” said Bridgette, another caseworker. “She knew how to roll up a dollar bill and snort white powder off the counter. That’s what she thought dollar bills were for.” She added that many of the children could detail how to cook heroin. One foster family had a five-year-old boy who put his medicine dropper in his shoe. “Because that’s where daddy hid his needles,” she said.

“The kids are used to surviving in that mess,” added Carole, another veteran. “Now all the sudden the system is going in and saying it’s not safe. All their survival instincts are taken away and they go ballistic. They don’t know what to do.”

During the first weeks of foster care, meltdowns, tantrums, and violence are common as children navigate new landscapes and begin to process what they’ve experienced.

One afternoon, the caseworkers brought in a foster couple who’d taken in two sisters, an infant born drug-exposed, and her four-year old sister. The baby had to be weaned off opioids and now suffered chronic respiratory problems. Part of her withdrawal had included non-stop hiccups. The older girl had lived with her parents in a drug house and displayed clear signs of post-traumatic stress. Once, a family friend sitting next to her in a car had overdosed and turned purple. She’d witnessed domestic abuse, and one day a neighbor shot and killed her dog while she watched (she’d let the dog out). After a meltdown at a classmate’s pool party, over a year after entering foster care, she revealed having seen a toddler drown in a pond while adults got high. Through therapy, she’d also revealed sexual assault. The foster mother described how the girl suffered flashbacks, triggered by stress and certain anniversaries, like the day of her removal, and other seemingly random events. When this happened, she slipped into catatonic seizures.

“Her eyes are closed and you can’t wake her,” she said. “It’s like narcolepsy, a deep, unconscious sleep. We later discovered it was a coping mechanism she’d developed in order to survive.”

Despite what they’ve endured, most children wish desperately to return to their parents. Many come to see themselves as their parents’ caretakers and feel guilty for being taken away, especially if they were the ones to report an overdose, as in the case of a four-year-old girl who climbed out of a window to alert a neighbor. “She asked me: if I took her away, who was going to take care of mommy?” Bridgette remembered.

For caseworkers, reunification is the endgame. After children enter temporary foster care, the agency spends up to two years working closely with the family while the parents try to stay sober. The only contact with their children comes in the form of twice-weekly visits held in designated rooms here at the office. Each contains a tattered sofa and some second-hand toys. Currently, the agency runs about 200 visits each week. The encounters are monitored through closed-circuit cameras. For everyone involved, it can be the most trying period.

Many parents use the time to build trust and re-establish bonds. “During those first four years, a child gets such good stuff from their parents,” said Sherry, the caseworker who monitors the visits. “The kids are just trying to get that back.” Some parents bring doughnuts and pictures, while others need more guidance. Caseworkers hold parenting classes. Some moms lost newborns at the hospital after they tested positive for drugs; workers teach them how to feed and hold the child, and encourage them to bring outfits to dress their babies.

For other children, the visits trigger a storm of emotion that churns up the trauma of removal. “We had one girl who’d scream and wail at the end of every visit,” Laura, the supervisor, remembered. “Each time she thought she’d never see her mother again. We’d have to pry her out of mom’s arms and carry her down the hallway.”

“We’d sit in our offices and just sob,” added another worker. “But that girl’s cries weren’t enough to keep Mom off heroin.”

The number of available foster families is dwindling, while the cost of supporting them has never been higher

Perhaps the greatest difference with heroin and opioids, caseworkers said, is their iron grasp. Staying sober is a herculean task, especially in this rural community short on resources, where the nearest treatment facilities are over 30 miles away in Dayton, Cincinnati, or Columbus. At some point, nearly every parent falls off the wagon. They disappear and miss visits, leaving children to wait. One of the hardest parts of the job is telling a child that mom or dad isn’t coming, or that they can’t even be found.

“You see the hurt in their eyes,” Sherry said. “It’s a look of defeat, and it just breaks your heart.” She remembered a mother who’d failed to show up for months, then made it for her twin boys’ birthday. “The next day she overdosed and died.”

A tally sheet is used to track how many times prospective clients waiting to enter the program call a detox center, in Huntington, West Virginia. Photograph: Brendan Smialowski/AFP/Getty Images

When parents fail drug screenings during the 18-month period, caseworkers use discretion. Parents might be doing better in other areas like landing a job, or finding secure housing, so workers help them to get back on the wagon. “It’s all about showing progress,” Laura said. Some parents make it 16, 17 months sober and fully engaged. “And they’re the toughest cases, because we’ve been rooting for them this whole time and helping them. We’re giving kids pep talks, saying: ‘Mom’s doing great, she’s getting it together!’ They’re so happy to be going home. And then it all falls apart.”

With heroin, defeat is something the workers have learned to reckon with. Lately they’ve started snapping photos of parents and children during their first visit together, getting medical histories and other vital information – something they used to do much later. “Because we know the parents probably aren’t going to make it,” Laura admitted. “And if we never see them again, this is the info we need.” When asked how many opioid cases had ended in reunification, only two workers raised their hands.

The repeated disappointments come as resources and morale have reached their tipping point. The number of available foster families is dwindling, they said, while the cost of supporting them – over $1.5m a year – has never been higher.

Spirk, the agency’s director, said that all the agency’s budget was paid for with federal dollars and a county tax levy, although they’ve been flat-funded for nearly 10 years. The state contributes just 10%. When it comes to investing in child protection, Ohio ranks last in the country – despite having spent nearly $1bn fighting its opioid problem in 2016 alone.

The Ohio house of representatives recently passed a new state budget with an additional $15m for child protective services, but the state senate has yet to pass its own version. The only bit of hope came in March, when the Ohio attorney general’s office announced a pilot program that will give Clinton County, along with others, additional resources to help treat children for trauma, and to assist with drug treatment. It starts in October.

The epidemic’s unrelenting barrage has also taken a toll on mental health. “Our caseworkers are experiencing secondary trauma and frustration at not being able to reunify children with their parents because of relapses,” Spirk said.

Almost every caseworker said they had experienced depression or some form of PTSD, although no one had sought professional help. The privacy of their cases also means that few can speak openly with friends or family members. Some chose to drink, while others leaned on their faiths. But most said coping mechanisms they once relied on had failed.

“I used to have a routine on my drive home,” Laura said. “I’d stop in front of a church, roll down my window, and throw out all the day’s problems. The next morning I’d pick them back up. These days, I can’t do that anymore.”

“There’s no more outlet,” added Shelly, another supervisor. “You think you’re able to separate but you can’t let it go anymore. You try to eat healthy, do yoga, whatever they tell you to do. But it’s just so horrific now, and it keeps getting worse.”

At some point, the inevitable happens. When a parent can’t stay sober, or stops showing progress, the decision is made to place the child into permanent custody and put them up for adoption. For everyone, including caseworkers, it’s the most wrenching day.

The final act of every case is the “goodbye visit”, held in one of the nicer conference rooms. It’s a chance for parents to let their children know they love them and will miss them, and that it’s time to move on. Adoptive parents can choose to stay in contact, but it isn’t mandatory.

To make the time less stressful, Sherry, the worker who monitors the visits, has them draw pictures together, which she scans and gives to them as mementoes. She also tapes the meetings for them to keep. Watching from her tiny room full of TV screens, she can’t help but cry. “What people don’t realize is that when a baby comes into our custody, they’re still in a carrier seat. By the time the case is over, we’ve helped to potty train them. Two years is a very long time with a child. So in a way, it’s like my goodbye visit, too.”

Caseworkers have started making “life books” for kids once they come into the system. It’s where they put the photos they’ve taken, plus any pictures of birth parents or relatives they can find, report cards, ribbons and medals – the souvenirs of any childhood.  “It’s their history,” Sherry said, “so that one day they can make sense of their lives.”   She noted that one kid, after turning 18, tore his to pieces, taking with him only the good memories.

Source:  https://www.theguardian.com/us-news/2017/may/17/ohio-drugs-child-protection-workers

Filed under: Addiction,Addiction (Papers),Drug use-various effects on foetus, babies, children and youth,Effects of Drugs,Effects of Drugs (Papers),Social Affairs,Social Affairs (Papers),USA :

The Centers for Disease Control and Prevention (CDC) stated that 33,091 people died from opioid overdoses in 2015, which accounts for 63 percent of all drug overdose deaths in the same year. A recent report from the CDC found that drug deaths from fentanyl and other synthetic opioids, other than methadone, rose 72 percent in just one year, from 2014 to 2015. Last year, the death of music icon Prince was linked to fentanyl and the prescription drug has become a source of concern for government agencies and law enforcement officials alike, as death rates from fentanyl-related overdoses and seizures have risen across the country.

What exactly is fentanyl?

According to the National Institute on Drug Abuse, fentanyl is a powerful synthetic opioid analgesic that is similar to morphine – but is 50 to 100 times more potent. It is a schedule II prescription drug, and it is typically used to treat patients with severe pain or to manage pain after surgery. It is also sometimes used to treat patients with chronic pain who are physically tolerant to other opioids. In its prescription form, fentanyl is known by such names as Actiq®, Duragesic® and Sublimaze®. Like heroin, morphine and other opioid drugs, fentanyl works by binding to the body’s opioid receptors, which are found in areas of the brain that control pain and emotions.

When opioid drugs bind to these receptors, they can drive up dopamine levels in the brain’s reward areas, producing a state of euphoria and relaxation. But fentanyl’s effects resemble those of heroin and include drowsiness, nausea, confusion, constipation, sedation, tolerance, addiction, respiratory depression and arrest, unconsciousness, coma and death.

So why is abuse and misuse of fentanyl so dangerous?

When prescribed by a physician, fentanyl is often administered via injection, transdermal patch or in lozenges. However, the fentanyl and fentanyl analogs associated with recent overdoses are produced in clandestine laboratories.

This non-pharmaceutical fentanyl is sold in the following forms: as a powder; spiked on blotter paper; mixed with or substituted for heroin; or as tablets that mimic other, less potent opioids. Fentanyl sold on the street can be mixed with heroin or cocaine, which markedly amplifies its potency and potential dangers.

Users of this form of fentanyl can swallow, snort or inject it, or they can put blotter paper in their mouths so that the synthetic opioid is absorbed through the mucous membrane. Street names for fentanyl or for fentanyl-laced heroin include Apache, China Girl, China White, Dance Fever, Friend, Goodfella, Jackpot, Murder 8, TNT, and Tango and Cash.

Can misuse of fentanyl lead to death?

Opioid receptors are also found in the areas of the brain that control breathing rate. High doses of opioids, especially potent opioids such as fentanyl, can cause breathing to stop completely, which can lead to death. The high potency of fentanyl greatly increases risk of overdose, especially if a person who uses drugs is unaware that a powder or pill contains fentanyl.

The United States Drug Enforcement Administration issued a nationwide alert in 2015 about the dangers of fentanyl and fentanyl analogues/compounds. Fentanyl-laced heroin is causing significant problems across the country, particularly as heroin use has increased in recent years.

Source: http://drugfree.org/newsroom/news-item/overdose-deaths-fentanyl-rise-know/   Jan 18th 2017

Filed under: Drug Specifics,Drug use-various effects,Effects of Drugs,Health,Prescription Drugs,Synthetics :

I totally agree that we all need to let Attorney General Jeff Sessions know that the majority of Americans suffer because of marijuana …. whether they choose to use it or not.  It is a factor in crime, physical and mental health, academic failure, lost productivity, et al.  American cannot be great again if we continue to allow poison to be grown and distributed to the masses.

The President has taken a position that “medical marijuana” should be a State’s right, because he is not yet enlightened on the reality of what that means.  If asked to define “medical marijuana” that has helped his friends, I doubt that he would say gummy bears, Heavenly brownies and other edibles with 60 to 80% potency, sold in quantities that are potentially lethal; smoked pot at 25% THC content; or waxes and oils used for dabbing and vaping that are as high as 98% potency that cause psychotic breaks, mental illness, suicides, traffic deaths and more.

Further, if states are to have a right to offer “medical marijuana”, it has to be done under tightly controlled conditions and the profit motive eliminated.  Privately owned cultivation and dispensaries must be banned … including one’s ability to grow 6 plants at home.  6 plants grown hydroponically with 4 harvests a year could generate 24 lbs of pot, the equivalent of about 24,000 joints. That obviously would not be for personal use.  We would just have thousands of new drug dealers, with more crime, more child endangerment, more BHO labs blowing up, more traffic deaths, et al.

Source:   Letter from Roger Morgan to DrugWatch International  Feb. 2017

Filed under: Economic,Effects of Drugs,Global Drug Legalisation Efforts,Medicine and Marijuana,Social Affairs,USA,Youth :

FRAMINHAM, Mass. – A Framingham middle school student was hospitalized Monday after he and another student ate a marijuana edible on the school bus, according to a letter released by Fuller Middle School.   School officials are trying to find out who brought the edibles on the bus and how to make sure it doesn’t happen again.

Stacy Velasquez says her 12-year-old son was riding the bus to school Monday morning when he found a container of gummy bears that got him very sick.   He called her crying.

“He said, ‘I ate something.’ I said, ‘what did you eat?’ He said candy. Where did you get it? He said he found it on the bus,” Velasquez explained.   When she arrived at Fuller Middle School, she says he was in a trance-like state, barely able to speak. She rushed him to the emergency room, snapping a video of his behavior.

“Once the tox screen came back, they said they’d never seen this before in a child so small, like an overdose so to speak of marijuana, but basically it would run its course and he would sleep it off.  And that’s what he did last night,” said Velasquez.

The district superintendent says they have no comment in regards to what happened, just that the police are now investigating.   Though marijuana is now legal in the state of Massachusetts, it’s not legal for anyone under the age of 21 to handle or ingest the drug.

“I would just like someone to make sure the school is doing their part and the bus drivers are doing their part to make sure the children get to and from school safely and that something like this doesn’t happen to someone else’s child,” Velasquez said. “I think the teenager involved [should be charged], because right now, it’s expected to be one of the high schoolers.”

Velasquez said her son is doing fine, he’s just embarrassed about what happened.   As for possible charges, police are looking through video taken on the bus to see who the edibles link back to.

Source:  http://www.fox25boston.com/news/framingham-middle-schooler-hospitalized-after-eating-marijuana-edible-on-school-bus/483211673?utm_source=January 11th 2017

Filed under: Cannabis/Marijuana,Drug use-various effects on foetus, babies, children and youth,Effects of Drugs,Global Drug Legalisation Efforts,Health,Social Affairs,USA,Youth :

Fentanyl is a painkiller that is 50 times stronger than heroin. It has already killed thousands, including Prince. Chris McGreal reveals why so many are playing Russian roulette with this lethal drug Natasha Butler had never heard of fentanyl until a doctor told her that a single pill had pushed her eldest son to the brink of death – and he wasn’t coming back. “The doctor said fentanyl is 100 times more potent than morphine and 50 times more potent than heroin. I know morphine is really, really powerful. I’m trying to understand. All that in one pill? How did Jerome get that pill?” she asked, her voice dropping to a whisper as the tears came. “Jerome was on a respirator and he was pretty much unresponsive. The doctor told me all his organs had shut down. His brain was swelling, putting pressure on to the spine. They said if he makes it he’ll be a vegetable.”

Painkiller addiction claims more lives in the US than guns, cutting across class, race and region

The last picture of Jerome shows him propped immobile in a hospital bed, eyes closed, sustained only by a clutch of tubes and wires. Natasha took the near impossible decision to let him die.  “I had to remove him from life support. That’s the hardest thing to ever do. I had him at 15 so we grew together. He was 28 when he died,” she said. “I had to let him die but after that I needed some answers. What is fentanyl and how did he get it?” That was a question asked across Sacramento after Jerome and 52 other people in and around California’s capital overdosed on the extremely powerful synthetic opioid, usually only used by hospitals to treat patients in the later stages of cancer, over a few days in late March and early April 2016. Twelve died.

Less than a month later, this mysterious drug – largely unheard of by most Americans – killed the musician Prince and burst on to the national consciousness. Fentanyl, it turned out, was the latest and most disturbing twist in the epidemic of opioid addiction that has crept across the United States over the past two decades, claiming close to 200,000 lives. But Prince, like almost all fentanyl’s victims, probably never even knew he was taking the drug.

“The number of people overdosing is staggering,” said Lieutenant Tracy Morris, commander of special investigations who manages the narcotics task force in Orange County, which has seen a flood of the drug across the Mexican border. “It is truly scary. They don’t even know what they’re taking.” The epidemic of addiction to prescription opioid painkillers, a largely American crisis, sprung from the power of big pharmaceutical companies to influence medical policy. Two decades ago, a small family-owned drug manufacturer, Purdue Pharma, unleashed the most powerful prescription painkiller yet sold over the pharmacist’s counter. Even though it was several times stronger than anything else on the market, and bore a close relation to heroin, Purdue claimed that OxyContin was not addictive and was safe to treat even relatively minor pain. That turned out not to be true.

It spawned an epidemic that in the US claims more lives than guns, cutting across class, race and geographic lines as it ravages communities from white rural Appalachia and Mormon Utah to black and Latino neighbourhoods of southern California. The prescription of OxyContin and other painkillers with the same active drug, oxycodone, became so widespread that entire families were hooked. Labourers who wrenched a back at work, teenagers with a sports injury, just about anyone who said they were in pain

was put on oxycodone. The famous names who ended up as addicts show how indiscriminate the drug’s reach was; everyone from politician John McCain’s wife Cindy to Eminem became addicted.

Clinics staffed by unscrupulous doctors, known as “pill mills”, sprung up churning out prescriptions for cash payments. They made millions of dollars a year. By the time the epidemic finally started to get public and political attention, more than two million Americans were addicted to opioid painkillers. Those who finally managed to shake off the drug often did so only at the cost of jobs, relationships and homes.

After the government finally began to curb painkiller prescriptions, making it more difficult for addicts to find the pills and forcing up black market prices, Mexican drug cartels stepped in to flood the US with the real thing – heroin – in quantities not seen since the 1970s. But, as profitable as the resurgence of heroin is to the cartels, it is labour intensive and time-consuming to grow and harvest poppies. Then there are the risks of smuggling bulky quantities of the drug into the US.

The ingredients for fentanyl, on the other hand, are openly available in China and easily imported ready for manufacture. The drug was originally concocted in Belgium in 1960, developed as an anaesthetic. It is so much more powerful than heroin that only small quantities are needed to reach the same high. That has meant easy profits for the cartels. The Drug Enforcement Administration (DEA) has said that 1kg of heroin earns a return of around $50,000. A kilo of fentanyl brings in $1m.

At first the cartels laced the fentanyl into heroin to increase the potency of low-quality supplies. But prescription opioid painkillers command a premium because they are trusted and have become increasingly difficult to find on the black market. So cartels moved into pressing counterfeit tablets.  But making pills with a drug like fentanyl is a fairly exact science. A few grammes too much can kill. “It’s very lethal in very small doses,” said Morris. “Even as little as 0.25mg can be fatal. One of our labs had a dime next to 0.25mg and you could barely see it. It’s about the size of the head of a pin. Potentially that could kill you.”

The authorities liken buying black market pills to playing Russian roulette. “These pills sold on the street, nobody knows what’s in them and nobody knows how strong they are,” said Barbara Carreno of the DEA.

After Prince died, investigators found pills labelled as prescription hydrocodone, but made of fentanyl, in his home, suggesting he bought them on the black market. The police concluded he died from a fatal mix of the opioid and benzodiazepine pills, a particularly dangerous combination. It is likely Prince did not even know he was taking fentanyl.  Others knowingly take the risk. In his long battle with addiction, Michael Jackson, used a prescription patch releasing fentanyl into his skin among the arsenal of drugs he was fed by compliant doctors. Although it was two non-opioids that killed him, adding fentanyl into the mix was hazardous.

Jerome Butler, a former driver for Budweiser beer who was training to be a security guard, thought he was taking a prescription pill called Norco. His mother’s voice breaks as she recounts what she knows of her son’s last hours. Natasha said she was aware he used cannabis, but had no idea he was hooked on opioid painkillers. She said her son at one time had a legitimate prescription and may have become addicted that way. She has since discovered he was paying a doctor, well known for freely prescribing opioids, to provide pills.  “I didn’t even know,” she said. “You find stuff out after. It’s killing me because they’re saying, ‘Well, yeah, Jerome was taking them pills all the time.’ And I’m like, ‘He was doing what?’”

Jerome may have had a prescription, but like many addicts he will have needed more and more. The pill that killed him was stamped M367, a marking used on Norco pills made of an opioid, hydrocodone. It was a fake with a high dosage of fentanyl.   This is fentanyl. The first time you take it you’re not coming back. You’re gone

“If Jerome had known it was fentanyl he would never have took that,” said Natasha. “This ain’t like crack or a recreational drug that people been doing for so many years and survived it but at 60 or 70 die from a drug overdose because their heart can’t take it no more. This is fentanyl. The first time you take it you’re not coming back. You’re gone.”

That wasn’t strictly true of the batch that hit Sacramento. It claimed 11 other lives. The youngest victim was 18-year-old George Berry from El Dorado Hills, a mostly white upscale neighbourhood. The eldest was 59. But others survived. Some were saved by quick reactions; doctors were able to hit them with an antidote before lasting damage was done. Others swallowed only enough fentanyl to leave them seriously ill but short of death.

It was a matter of luck. When investigators sent counterfeit pills seized after the Sacramento poisonings for testing at the University of California, they found a wide disparity in the amount of fentanyl each contained. Some pills had as little as 0.6mg. Others were stuffed with 6.9mg of the drug, which would almost certainly be fatal. The DEA thinks the difference was probably the result of failing to mix the ingredients properly with other powders, which resulted in the fentanyl being distributed unevenly within a single batch of counterfeit pills.

That probably explains the unpredictable mass overdosing popping up in cities across the US. In August, 174 people overdosed on heroin in six days in Cincinnati, which has one of the fastest-growing economies in the Midwest. Investigators suspect fentanyl because the victims needed several doses of an antidote, Naloxone, where one or two will usually suffice with heroin. The same month, 26 people overdosed on fentanyl-laced heroin in a four-hour period in Huntington, a mostly white city in one of the poorest areas of West Virginia. In September seven people died from fentanyl or heroin overdoses in a single day in Cuyahoga County, Ohio.

The US authorities don’t know for sure how many people fentanyl kills because of the frequency with which it is mixed with heroin, which is then registered as the cause of death. The DEA reported 700 fatalities from fentanyl in 2014 but said it is an underestimate, and rising. In 2012, the agency’s laboratory carried out 644 tests confirming the presence of fentanyl in drug seizures. By 2015, the number of positive tests escalated to 13,002.

The police did not have to look far for the source of the drug that killed Jerome. He and his girlfriend were staying at the house of her aunt, Mildred Dossman, while they waited for their own place to live. Jerome was smoking cannabis and drinking beer with Dossman’s son, William. Shortly before 1am, William went to his mother’s bedroom and came back with the fake Norco pill. Jerome took it and said he was going to bed.  Jerome’s girlfriend was in jail after being arrested for an unpaid traffic fine and so he was alone with their 18 month-old daughter, Success, lying next to him.

“The doctors explained to me that within a matter of minutes he went into cardiac arrest,” said his mother. “Then as he lay there that’s when time progressed for the organs to be poisoned by fentanyl. He was dying with his daughter next to him.” Natasha said other people in the house heard her son in distress, complaining his heart was hurting. But they did nothing because they were afraid that calling an ambulance would also bring the police.

It was not until 10 hours later that the Dossmans finally sought help from a neighbour who knew Jerome. He tried CPR and then called the medics. The police came, too, and in time Mildred Dossman, 50, was charged with distributing fentanyl and black market opioid painkillers. She was the local dealer.

The DEA is tightlipped about the investigation into the Sacramento deaths as its agents work on persuading Dossman to lead them to her suppliers. But it is likely she was getting the pills from Mexican cartels using ingredients from labs in China where production of fentanyl’s ingredients is legal.  Carreno said some Mexican cartels have long relationships with legitimate Chinese firms which for years supplied precursor chemicals to make meth amphetamine.

Packages of fentanyl are often moved between multiple freight handlers so their origins are hard to trace. Larger shipments are smuggled in shipping containers. Last year, six Chinese customs officials fell ill, one of them into a coma, after seizing 72kg of various types of fentanyl from a container destined for Mexico. American police officers have faced similar dangers. In June, the DEA put out a video warning law enforcement officers across the US that fentanyl was different to anything they have previously encountered and they should refrain from carting seizures back to the office.   “A very small amount ingested, or absorbed through the skin, can kill you,” it said.   A New Jersey detective appears in the video after accidentally inhaling “just a little bit of fentanyl puffed into the air” during an arrest: “It felt like my body was shutting down… I thought that was it. I thought I was dying.”

Along with the Mexican connection, a home-grown manufacturing industry has sprung up in the US. Weeks after Jerome died, agents arrested a married couple pressing fentanyl tablets in their San Francisco flat.

Candelaria Vazquez and Kia Zolfaghari made the drug to look like oxycodone pills. They sold them across the country via the darknet using Bitcoin for payment – on one occasion Zolfaghari cashed in $230,000. The couple shipped the drugs through the local post office. Customers traced by the DEA thought they were buying real painkiller pills. The couple ran the pill press in their kitchen. According to a DEA warrant, a dealer said Zolfaghari made large numbers of tablets: “He could press 100 out fast as fuck.”

The pair made so much money that agents searching their flat found luxury watches worth $70,000, more than $44,000 in cash and hundreds of “customer order slips” which included names, amounts and tracking numbers. The flat was stuffed with designer goods. The seizure warrant described Vazquez’s shoe collection as “stacked virtually from floor to ceiling”. Some still had the $1,000 price tags on them. Zolfaghari was arrested carrying a 9mm semi-automatic gun and about 500 pills he was preparing to post. The dealers made so much money that their flat was stuffed with luxury goods and cash.

Even as Americans are getting their heads around fentanyl, it is being eclipsed. In September, the DEA issued a warning about the rise of a fentanyl variant that is 100 times more powerful – carfentanil, a drug used to tranquilise elephants.

“Carfentanil is surfacing in more and more communities,” said the DEA’s acting administrator, Chuck Rosenberg. “We see it on the streets, often disguised as heroin. It is crazy dangerous.”

The drug has already been linked to 19 deaths in Michigan. Investigators say that with its use spreading, it is almost certainly claiming other lives. Dealers are also getting it from China, where carfentanil is not a controlled drug and can be sold to anyone.

Natasha Butler is still trying to understand the drug that killed her son. She wants to know why it is that it took Jerome’s death for her to even hear of it. She accuses the authorities of failing to warn people of the danger, and politicians of shirking their responsibilities.   A bill working its way through California’s legislature stiffening sentences for fentanyl dealing died in the face of opposition from the state’s governor, Jerry Brown, because it would put pressure on the already badly crowded prisons.

“I’m so dumbfounded. How does that happen?” says Natasha. Her tears come frequently as she sits at a tiny black table barely big enough to seat three people. She talks about Jerome and the tragedy for his three children, including Success, who she is now raising.

But some of the tears are to mourn the devastating impact on her own life. “Look where I’m at. I was in Louisiana. I had a house. I had a job. I had a car. I had a life. I worked every day. I was a manager for a major company. I came here, I became homeless. I had to move into this apartment to help out my granddaughter,” she said. “You see me. This is what my kitchen table is. My son is dead. He had three kids and those two mothers of those kids are depending on me to be strong. I want answers and help. I say, you got the little fish. Where did they get it from? How did they get it here? You are my government. You are supposed to protect us.”

Source:  https://www.theguardian.com/global/2016/dec/11/pills-that-kill-why-are-thousands-dying-from-fentanyl-abuse–

Filed under: Effects of Drugs,Health,Methamphetamine/GHB/Hallucinogens/Oxycodone,Prescription Drugs,Social Affairs,Synthetics,USA :

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

Filed under: Addiction,Drug use-various effects,Effects of Drugs,Health :

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

Filed under: Australia,Effects of Drugs,Social Affairs :

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

Filed under: Cannabis/Marijuana,Drug use-various effects,Effects of Drugs,Legal Sector,Marijuana and Medicine :

As a parent and grandparent, I believe legalizing recreational marijuana would result in serious harm to public health and safety, and urge my fellow Californians to vote “No” on Proposition 64 on Nov. 8.

Marijuana is a complicated issue. I support its medicinal use and have introduced federal legislation to make it easier to research and potentially bring marijuana-derived medicines to the market with FDA approval.

I also recognize that our nation’s failure to treat drug addiction as a public health issue has resulted in broken families and overcrowded prisons. That’s why I support the sentencing reform that would reduce the use of mandatory minimum sentences in certain drug crimes, give judges more flexibility to set sentences and promote treatment programs to address the underlying addiction.

But Proposition 64 would allow marijuana of any strength to be sold. It could make it easier for children to access marijuana and marijuana-infused foods. It could add to the already exorbitant costs of treating addiction. And it does not do enough to keep stoned drivers, including minors, off the roads.

With 25 million drivers in our state, that should set off alarm bells. While we do not fully understand how marijuana affects an individual’s driving ability, we do know that it significantly impacts judgment, motor coordination and reaction time.

In Washington, deaths in marijuana-related car crashes have more than doubled since legalization. In Colorado, 21 percent of 2015 traffic deaths were marijuana-related, double the rate five years earlier – before marijuana was legalized.

In California, even without recreational legalization, fatalities caused by drivers testing positive for marijuana increased by nearly 17 percent from 2005 to 2014. While the presence of marijuana does not prove causation, these numbers are concerning. A study on drugged driving and roadside tests to detect impairment required by Proposition 64 should be completed before, not after, legalization goes into effect.

Proposition 64 does not limit the strength of marijuana that could be sold. Since 1995, levels of THC – the psychoactive component of marijuana – have tripled. Increased strength can increase the risk of adverse health effects, ranging from hallucinations to uncontrollable vomiting.

We’ve already seen examples of harm. This summer in San Francisco, 13 children, one only 6 years old, were taken to hospitals after ingesting marijuana-infused candy – a product permitted under Proposition 64.

The combination of unlimited strength and the ability to sell marijuana-edibles should concern all parents. So should the risk of increased youth access. Age restrictions don’t prevent youths from using alcohol; marijuana will not be any different.

Nearly 10 million Californians are under age 18. Studies show that marijuana may cause damage to developing brains, and one in six adolescents who uses marijuana becomes addicted.

While more research on prolonged use is needed, a large-scale study found that people who began using heavily as teens and developed an addiction lost up to eight IQ points, which were not recoverable.

This means that a child of average intelligence could end up a child of below-average intelligence, a lifelong consequence.

The proposition could also allow children to see marijuana advertisements, making it more enticing for them to experiment.

In fact, Superior Court Judge Shelleyanne Chang ruled that Proposition 64 “could roll back” the prohibition of smoking ads on television. Even though it is against federal law, the proposition explicitly permits television and other advertisements, provided that three in four audience members are “reasonably expected” to be adults.

We need criminal justice reform and a renewed focus on treatment. But legalizing marijuana is not the answer, particularly in the nation’s largest state. Proposition 64 fails to adequately address the public health and safety consequences associated with recreational marijuana use.

Sen. Dianne Feinstein is the senior senator from California.

Source:  http://www.sacbee.com/opinion/op-ed/article104501076.html#storylink=cpy

Filed under: Effects of Drugs,Global Drug Legalisation Efforts,Parents,Social Affairs,USA :

Born in Massachusetts, our son started out life with a very bright future.  As a toddler he was interested in things with wheels, and anything his big sister was doing. As he got older, Lego was his obsession. In his early school days he tended to get really into a subject, even those of his own choosing. For a while it was Russian language and then it was the Periodic Table.  He begged me to buy him a 2½-inch thick used Chemistry textbook before he was a pre-teen. I did.

I was able to be a stay-at-home parent until our son was 8. I tried to do all the right things. We played outside, limited screen time, and got together with other little ones and their moms for play groups. I read to him and his sister every night until they both reached middle school and wouldn’t let me anymore. Our son routinely tested in the 99th percentile on standardized tests and at least 3 grade levels above. Now, at age 17, he has dropped out of high school.

My husband and I both have Master’s degrees, and my husband is a public school administrator. His father is a retired architect. My mother is a retired elementary school teacher. Our family believes in education, we believe in learning and growing.     When asked why he continues to use drugs, mostly marijuana, my son said, “I think it’s because of the people we’re around.”

In reflecting back on “What happened?”   I blame marijuana. We now live in Colorado, where marijuana is legal and widely available to everyone.  What if we had never moved here?

How it All Began

My son’s first time using was in 7th grade when marijuana was legal only if used medicinally with a “Red Card,” if recommended by a physician.   Coloradans voted on legalization in November 2012 and marijuana stores opened in January, 2014. But back in 2012, he and some buddies got it from a friend’s older brother who had a Red Card.  From what I can tell, the use just kept escalating until his junior year in high school when he was using at least once a day…and when he attempted suicide.

Between that first incident in 2012 and the suicide attempt in 2015, his father and I waged an all-out battle on the drug that was invading our home. We grounded him; I took to sleeping on the couch outside his bedroom because he was sneaking out in the middle of the night; we yelled and screamed; I cried, we cajoled and tried to reason with him: ”You have a beautiful brain! Why are you doing things that will hurt your brain?”

We did weekly drug tests, we enlisted the school’s support, we enlisted our family’s support and we even tried talking to his friends.

But nothing worked. Our son was in love with marijuana. Our sweet, smart, funny, sarcastic, irreverent, adorable boy was so enamoured with this drug that nothing we did — NOTHING — made any difference. And we slowly lost him.

At the same time I was battling marijuana at home, I was also leading a group in our community to vote against legalizing it in our small town.  I had teamed with a local business-owner and a physician and the three of us got the support of many prominent community members, including the school superintendent, the police chief, and the fire chief. We ran a full campaign, complete with a website where you could donate money, a Facebook page, and yard signs.

Why does he continue to use marijuana? “I think it’s because of the people we’re around.”

My son’s use isn’t the reason I got involved. I had started advocating against marijuana legalization long before I even realized he had a problem. My background is in health communication and I work in the hospital industry.  I sit on our local Board of Health, so allowing retail stores to sell an addictive drug just doesn’t make any sense. I did think about my children; what I was modeling for them; what kind of community we were raising them in, and the kind of world I envisioned for their future. Those are the reasons I got involved. My son’s use is actually the reason that I’ve pulled away from any sort of campaigning.

Unfortunately, we lost our fight. So in 2014, it became legal in our small town to purchase pot without a Red Card. And the following year, his junior year, he almost slipped away from us forever.

It Got Scarier and Scarier

His use by then had escalated to daily (and I suspect often more than once a day). Pot seemed to be everywhere! We found it hidden all over the house — in the bathroom, on top of the china cabinet, in his closet, outside, even in his sister’s bedroom. It’s a hard substance to hide because of the strong smell. Even in the “pharmacy” bottles and wrapped in plastic bags, the skunk stench still manages to seep out. But it sure seemed easy for a young boy to get!

He started leaving school in the middle of the day, or skipping school altogether, and his grades plummeted. Where he was once an A/B student and on the varsity cross-country team, he was now failing classes and not involved in anything. This boy who had tested in the 99th percentile was failing high school. And this boy who had once been the levity in our home, who used to make me laugh like no one else could or has since, this boy became a stranger.

Our son withdrew from everything except his beloved drug. His circle of friends (never big in the first place), was reduced to only those who could supply him with marijuana.

His relationship with his older sister all but disappeared. And his relationship with his father has been strained beyond almost all hope of repair.

Then in late 2015 our son attempted suicide. He was hospitalized, first overnight at the very hospital where I work, and then for a 3-day locked psychiatric unit stay. I remember very little from this difficult (and surreal) time except learning that it wasn’t his first attempt, and that he blamed us for how awful he felt. He started taking an antidepressant and after he was released we took him to a drug counselor for a total of three visits but after that he refused to go — he threatened to jump out of the car if we tried to take him. We tried a different counselor and that only lasted for one visit.

Changing Strategies and a Truce

At this point I convinced my husband that we had to approach things differently, because obviously what we were doing wasn’t working. We stopped the weekly drug tests (we knew he was using so there seemed to be no point anyway). We stopped yelling and punishing. And basically my husband stopped talking to our son altogether — they are both so angry and hurt that any communication turns toxic very quickly. He refused to go back to school so we agreed that he could do online classes.

More and more, our son is feeling isolated from the rest of his family.

There is an uneasy truce in our home right now. Now it just feels like waiting. Waiting for what will happen next. Waiting for the other shoe to drop.

Our son, 17, still lives with us.  His sister left for college this past summer. I acknowledge that he uses pot and doesn’t want to quit, but I continue sending the message that it’s not good for his brain. The one thing my husband and I won’t bend on is no drugs on our property. He has started five different online classes, but has so far finished only one. He doesn’t feel any pressure to finish school — he says he’ll get a GED, but hasn’t made any effort towards that end. He doesn’t drive and doesn’t express any desire to learn, which is probably good because I doubt he could be trusted to drive sober. He started working at a local restaurant recently and has been getting good feedback from his managers, which I take to be a positive sign.   (I’ll take any positive signs at this point!)

Trying Something Else and Blacking Out

I don’t know if the suicide attempt and hospitalization were rock bottom for our family, but I suspect not. Just this past weekend our son came home and I could tell he was on something — and it wasn’t marijuana or alcohol. I checked him periodically throughout the night and in the early morning he was awake and asked me how much trouble he was in. I replied that it depended on what he had taken. He said Xanax. He also said that he had blacked out and couldn’t remember anything that had happened from about an hour after he took it.

Later in the morning, when we were both more awake, I asked him about the Xanax (he got it from someone at the restaurant) and the pot use and what he saw for his future. He has no plans to stop using, but said that he probably wouldn’t take Xanax again (he didn’t like blacking out). He said that he’s very happy with his life right now, that he knows a lot of people who didn’t go to college who work two or three jobs and live in little apartments, and that he’s happy with that kind of future for himself.

I tried not to cry.  Imagine that as the goal for a boy who started life with so much curiosity and such a desire to learn.

It’s not that I don’t think he can have a good and decent life without a college education. But I know that he’ll have a much harder life. Statistically, Americans with fewer years of education have poorer health and shorter lives (partly due to lack of adequate health insurance), and Americans without a high school diploma are at greatest risk.   It’s not just life without a college education, but it is life with a brain that has been changed by marijuana.  Will he be able to give up pot?  If he does give up pot, will he recover the brain he had at one time?  Will he lose motivation?

I asked him why he used pot when he knew how his father and I felt about it and when we had tried so hard to steer him in a different direction.

He said: “I think it’s because of the people we’re around. And all the drugs that are around.”

I’ve finally accepted that his use is not in the range of normal teenage experimentation, and I’m barely surviving on the hope that he’ll eventually grow out of it…and that he doesn’t do any permanent damage.  In the meantime, I’m sorry that we ever moved here.

Parents Opposed to Pot is totally funded by private donations, rather than industry or government. If you have an article to submit, or want to support us, please go to Contact or Donate page.

Source:  http://www.poppot.org/2016/09/19/colorado-move-larger-forces-she-cant-control/#comments

Filed under: Effects of Drugs,Global Drug Legalisation Efforts,Social Affairs,USA :

BY JOIN TOGETHER STAFF

September 25th, 2013

The club drug “Molly” is often laced with other synthetic drugs such as bath salts, making it more dangerous, according to law enforcement officials.

Molly, a club drug blamed for several recent deaths among young people attending music festivals, is sold as a pure form of Ecstasy, or MDMA. Drug dealers are now selling a variety of potentially more dangerous drugs under the name Molly, according to The Wall Street Journal.

Jeff Lapoint, an attending physician at Kaiser Permanente in San Diego, says while Molly generally leads to feelings of empathy, bath salts “are potent stimulants and tend to induce paranoia and hallucinations. It’s like the worst combination: While they’re agitated, now they’re seeing things, too.”

“Molly is just a marketing tool,” said Rusty Payne, a spokesman for the Drug Enforcement Administration, told the newspaper. “It could be a whole variety of things.”

MDMA is difficult to manufacture, so some drug makers get bath salts ingredients and repackage them as Molly, explained James Hall, an epidemiologist at the Center for Applied Research on Substance Use and Health Disparities in Miami. Payne noted bath salts ingredients, such as methylone, are much less expensive than MDMA. Molly is suspected of causing two deaths at a recent New York City music festival. A19-year-old girl in Boston died of a suspected overdose of Molly following a concert, and a man in Washington state died after taking the drug, with dozens more treated for Molly overdoses.

Source:  http://www.drugfree.org/news-service/bath-salts-often-added-to-molly-making-the-drug-more-dangerous-officials/  25th Sept. 2013

Filed under: Drug use-various effects,Effects of Drugs,Synthetics :

Industry Taking Advantage of Opiate Problem to Entrap More People

Medical marijuana proponents have a nationwide effort to add opiate addiction to the list of conditions for medical marijuana.  They aren’t just saying medical marijuana is a replacement for opiates; they are now pitching it as a medical treatment for opiate addiction.  The marijuana industry’s savvy marketing campaign is bigger, trickier and even more devious than Big Tobacco and Big Pharma ever dreamed.   Yet people who get addicted to opiates were already addicted to drugs via marijuana. Mixing marijuana with other drugs is becoming so routine that “drugged and stoned” is a new normal.  When Pennsylvania college student Garet Schenker of Bloomsburg University recently died, it was the combination of marijuana wax and Xanax that killed him.   References to  his death and the toxicology report have been removed from the Internet.  Just because another person didn’t die  from doing  “dabs” and mixing it with Xanax doesn’t mean we shouldn’t warn our children of this dangerous practice. Justin Bondi, one of the young men who died in Colorado last year, was a hiker and adventurer who also mixed marijuana with Xanax and other drugs.   In fact, marijuana users have such an affinity for Xanax that doctors should be questioning patients about marijuana use  and wonder if marijuana is the primary cause of the anxiety. The addiction-for-profit industry, i.e., the marijuana industry, is trying every tactic imaginable to promote drug usage.  The current propaganda that pretends marijuana is treatment to opiate abuse is EVIL.  We condemn those shameless promoters who encourage people to use marijuana based on the theory that it doesn’t cause toxic overdose deaths.   Recent deaths have put a dent into that theory, however.   In Seattle, Hamza Warsame jumped six stories to his death, after he the first time he tried marijuana in December, 2015. Drugged and Stoned Many marijuana driving fatalities are caused by drivers on a cocktail of drugs in addition to pot.  The driver that killed two and injured several others in Santa Cruz had marijuana and an unnamed prescription drug.  The driver responsible for a 3-car crash in Indiana had marijuana, Xanax and drug paraphernalia on him.

Demolished building in Philadelphia, July, 2013. A crane operator was impaired from mixing marijuana with codeine. Six died and 13 were injured in the accident. Photo: AP  A crane operator in Philadelphia killed 6 people while high on marijuana and a codeine painkiller pill, in July 2013.  This accident highlights the inability to see accurate perception of depth when stoned.  The crane operator hit the wall of the Salvation Army thrift store next to the  building he was demolishing. He had no intention to harm people.  Operating any type of heavy machinery under the influence of drugs puts all of us in danger. Diane Schuler  The worst car accident by a driver in recent memory was caused by a driver who used both marijuana and alcohol.  Driver Diane Schuler killed 8, including 5 children, in the Taconic State Parkway crash in New York on July 26, 2009.   It appears that the driver was in pain.  Schuler, three of her nieces, her 2-year old daughter and three men in the oncoming minivan died.   Schuler used marijuana regularly to deal with insomnia.  (Insomnia is a condition promoted by medi-pot advocates.)  Marijuana lobbyists try to portray marijuana customers as single drug users.  This is an entirely false characterization.   Multi-substance addiction is the norm today.   STOP THE LIES! Parents Opposed to Pot is totally funded by private donations, rather than industry or government. If you have an article to submit, or want to support us, please go to Contact or Donate page.

Source:  http://www.poppot.org/2016/05/23/drugged-stoned-deadly-combination/

Filed under: Drugs and Accidents,Economic,Effects of Drugs,Social Affairs :

A drug so powerful that it is normally used to tranquillize large animals like elephants has turned up in the streets of Ohio, West Virginia, Indiana, Kentucky, and Florida.

The drug, carfentanil, is thought to be the cause for a record spike in drug overdoses there. It can be manufactured inexpensively and easily laced with other drugs such as heroin. Officials in Ohio have declared this a public health emergency, and the U.S. Drug Enforcement Administration (DEA) warns that communities everywhere should be on alert about this dangerous drug.

Carfentanil is a synthetic opioid in the same drug class as heroin, fentanyl, and prescription drugs like Oxycodone. The drug is so strong that just a few granules the size of grains of table salt can be lethal. It is 100 times more potent than fentanyl, the prescription painkiller which led to the recent death of the pop star, Prince.

In the past few years, drug traffickers increasingly substituted fentanyl for heroin and other opioids. But now carfentanil, which the DEA says is most probably imported illicitly from China, is being sold on American streets, either mixed with heroin or pressed into pills that look like prescription drugs. Many users don’t realize that they are buying carfentanil, and this has led to deadly consequences.

“Instead of having four or five overdoses in a day, we’re seeing 20, 30, 40, maybe even 50,” said Tom Synan, Chief of Police in Newtown, Ohio, and who also directs the Hamilton County Heroin Coalition Task Force in Southwest Ohio.  Synan said in a NPR article that carfentanil turned up in Cincinnati in July, and that the number of overdoses has overwhelmed first responders.

Hamilton County Health Commissioner Tim Ingram further explained in the same article that, “It can take hours for the body to metabolize carfentanil, far longer than for other opioids. That means a longer-lasting high. But it also means that when someone overdoses, it is more difficult to revive them with naloxone, the emergency medication used to block the effects of opioids.” Ingram has received reports that emergency rooms are using two or three doses to bring people back, and therefore are trying to distribute a more concentrated version of naloxone.

There is no approved human use for carfentanil, and in fact, it is highly restricted even for veterinarians, who can use it legally only to sedate large animals. First responders and emergency room workers are being told to wear protective gloves and masks because carfentanil is so potent, that it can be dangerous to someone who simply touches or inhales it.

Learn more about the abuse of this drug: CBS News’ Dozens of Ohio Overdoses blamed on heroin mixed with elephant tranquilizer

Source:   Newsletter CADCA September 2016

Filed under: Effects of Drugs,Social Affairs :

These are some of the voices (videos) from attendees at a conference in Colorado

who are speaking about legalization of marijuana in Colorado and what it is doing to their youth.  The negative impact has been appalling for many neighbourhoods – children are hospitalized from using edibles,  youth in schools are using in classrooms and their grades are dropping dramatically.   Big money has commercialized this substance to the detriment of the local population and in particular the children and youth.

http://smartcolorado.org/community-voices/ Sept 2016

 

Filed under: Effects of Drugs,Global Drug Legalisation Efforts,USA :

By Christopher Ingraham

Source: Washington Post

USA — An appeals court ruled last week that a federal law prohibiting medical marijuana cardholders from purchasing guns does not violate their Second Amendment rights, because marijuana has been linked to “irrational or unpredictable behavior.”

The ruling came in the case of a Nevada woman who attempted to purchase a handgun in 2011, but was denied when the gun store owner recognized her as a medical marijuana cardholder, according to court documents. S. Rowan Wilson maintained that she didn’t actually use marijuana, but obtained a card to make a political statement in support of liberalizing marijuana law.

Federal law prohibits gun purchases by an “unlawful user and/or an addict of any controlled substance.” In 2011, the Bureau of Alcohol, Tobacco and Firearms clarified in a letter that the law applies to marijuana users “regardless of whether [their] State has passed legislation authorizing marijuana use for medicinal purposes.” Though a growing number of states are legalizing it for medical or recreational use, marijuana remains illegal for any purpose under federal law, which considers the drug to have a high potential for abuse and no accepted medical use.

The U.S. Circuit Court of Appeals for the 9th Circuit ruled that the federal law passes muster with the Constitution, as “it is beyond dispute that illegal drug users, including marijuana users, are likely as a consequence of that use to experience altered or impaired mental states that affect their judgment and that can lead to irrational or unpredictable behavior.”

The court then concluded that it is reasonable to assume that a medical marijuana cardholder is a marijuana user, and hence reasonable to deny their gun purchase on those grounds.

From a legal standpoint, the nexus between marijuana use and violence was established by the U.S. Court of Appeals for the 4th Circuit in Virginia, in the 2014 case of United States v. Carter. That case cited a number of studies suggesting “a significant link between drug use, including marijuana use, and violence,” according to the 9th Circuit’s summary.

In the words of the 4th Circuit, those studies found that: “Probationers who had perpetrated violence in the past were significantly more likely to have used a host of drugs — marijuana, hallucinogens, sedatives, and heroin — than probationers who had never been involved in a violent episode.”

“Almost 50% of all state and federal prisoners who had committed violent felonies were drug abusers or addicts in the year before their arrest, as compared to only 2% of the general population.”

“Individuals who used marijuana or marijuana and cocaine, in addition to alcohol, were significantly more likely to engage in violent crime than individuals who only used alcohol.”

Among adolescent males, “marijuana use in one year frequently predicted violence in the subsequent year.” The 4th Circuit argued that, on the link between drug use and violence, the question of correlation vs. causation doesn’t matter: “Government need not prove a causal link between drug use and violence” to block firearms purchases by drug users. A simple link between drug use and violence, regardless of which way the causality runs, is grounds enough. Still, the 9th Circuit did suggest causation was part of its decision, saying that irrational behavior can be “a consequence” of marijuana use.

This argument — that substance use increases risky behavior — applies to plenty of other drugs, too, and not just illegal ones. For instance, drug policy researchers Mark Kleiman, Jonathan Caulkins and Angela Hawken have pointed out that tobacco users also are more likely to engage in crime relative to the general population. “Compared with nonsmokers, cigarette smokers have a higher rate of criminality,” they wrote in their 2011 book Drugs and Drug Policy: What Everyone Needs to Know. “Smoking in and of itself does not lead to crime, but within the population of smokers we are more likely to find individuals engaged in illicit behavior.”

The authors also point out that there’s a much stronger link between violent behavior and alcohol than there is for many illegal drugs: “There is a good deal of evidence showing an association between alcohol intoxication and pharmacologically induced violent crime,” they write. They added: “There is little direct association between marijuana or opiate use and violent crime. … it is also possible that for some would-be offenders, the pharmacological effect of certain drugs (marijuana and heroin are often given as examples) may actually reduce violent tendencies.”

Christopher Ingraham writes about politics, drug policy and all things data. He previously worked at the Brookings Institution and the Pew Research Center.

Source: Washington Post (DC) September 7, 2016: 

Filed under: Effects of Drugs,Legal Sector,Social Affairs,USA :

Latest statistics show 305 admissions were diagnosed as drugs misuse in the year 2011/12 — compared to 97 in 2007/08.

Across NHS Tayside as a whole the number has more than doubled, with an increase from 244 five years ago to 512 last year.  Doctors have warned there is now a “constant background level of recreational drug use” in the region’s Accident and Emergency departments.

A&E consultant Dr Julie Ronald said people come in with drugs-related problems most weekends.  She said: “We deal with a lot of drugs-related admissions. It can be very time consuming — especially if patients cause disruption to the rest of the department.

“It’s something we see most weekends of some variety. The vast majority are brought in by ambulance.  Usually someone has been with the patient or found them and decided they require medical attention.”

Across Tayside, opioids — such as heroin — were the cause for more than 80% of admissions over the period.  Of these, 60 were categorised as resulting from multiple drugs or other less common drugs.

And 468 — more than 90% — were classed as emergency admissions. Also last year, 28 of the admissions were for cannabis-type drugs, nine were for cocaine, eight for sedatives or hypnotics and seven were for other sedatives.

Dr Ronald, who works in the A&E departments at Ninewells Hospital and Perth Royal Infirmary, said there has been a noticeable increase in younger patients for drugs misuse .She said: “There is a constant background level of recreational drug use. We’re always coming into contact with it. We do see heroin misuse. What we have certainly seen is more recreational legal high-type drugs.   A lot of teens and people in the younger age groups are coming in who have taken party drugs, such as bubbles or MCAT.”

Some 89 of the admissions for 2011/12 had to stay in hospital for a week or longer. Dr Ronald said: “A&E look after the vast majority of people coming in with recreational drug misuse. We tend to keep them in for a few hours for observation, or overnight if they need to be monitored for longer.”

Source:  www.eveningtelegraph.co.uk   15th June 2013

Filed under: Effects of Drugs,Europe,Health,Heroin/Methadone :

Two groups of legal highs that imitate the hallucinogenic effects of LSD and of heroin are to be banned as class A drugs on the recommendation of the government’s drug advisers.

The home secretary, Theresa May, is expected to confirm that AMT, which acts in a similar way to LSD, should be banned along with other chemicals known as tryptamines that have been sold at festivals and in head shops with names including “rockstar” and “green beans”.

The Advisory Council on the Misuse of Drugs (ACMD) said the tryptamine group of chemicals had become widely available in Britain. The experts said four deaths in 2012 and three deaths in 2013 in Britain were attributed to tryptamines. The ACMD also said a synthetic opiate known as AH-7921, sometimes sold as “legal heroin”, should be class A. It follows the death last August of Jason Nock, 41, who overdosed on AH-7921 after buying the “research chemical” on the internet for £25 to help him sleep.

Professor Les Iversen, the ACMD chair, said the substances marketed as legal highs could cause serious damage to health and, in some cases, even death.

He said the ACMD would continue to review new substances as they were picked up by the forensic early warning system in Britain.

“The UK is leading the way by using generic definitions to ban groups of similar compounds to ensure we keep pace within the fast moving marketplace for these drugs,” said Iversen.

 

Source:   theguardian.com 10th June 2014

Filed under: Effects of Drugs,Europe,Global Drug Legalisation Efforts,Legal Highs :

The foremost authority on drugs in the US just smashed a huge misconception about addiction.    If drug addiction is a disease like cancer or Alzheimer’s, how do you explain the seemingly amoral behaviour — the lying, cheating, and hiding — that has come to be linked with so many addicts?

The answer has less to do with morality and much more to do with physical changes in the brains of those who become addicted, as National Institute on Drug Abuse director Dr. Nora Volkow perfectly explains in a recent PBS episode of “The Open Mind,” on addiction.

It makes a lot of sense — especially when explained with chocolate.  Volkow is a chocolate lover, you see. She has a special weakness for dark varieties. Most of the time, she can control her cravings. But occasionally — usually when she’s frustrated or tired or bored — she gives in. Then she’ll overdo it, eating too much of the stuff.

Sound familiar?

If so, that’s because it’s a fairly common type of experience. Most of us can abstain some of the time and give in occasionally, but more often than not, most of us easily follow the rule of moderation. But in people who are vulnerable to addiction (via a mesh of factors including genetics, environment, behaviour, and exposure), this is where things start to look different, Volkow explains. And it’s at this point where the long-held notion that addiction is merely a problem of a lack of self-control begins to crumble.

“When you transition from that stage where most of the time you are able to self-regulate the desires and control and manage your behaviour even though you want to do it, you say it’s not a good idea — when you lose that capacity consistently, that’s when you start to get into the transition of addiction,” she says.

But, as she continues to explain, the problem is not simply a behavioural one. It’s also influenced by physical changes that happen in the brain — changes that produce marked differences between the brains of people who are addicted and those who are not.

One of those differences, Volkow says, is a dysfunction in areas of the frontal cortex, a part of the brain that plays a key role in helping us analyse situations and make decisions. “But if these areas of the brain are not functioning properly, which is what repeated drug use [can do] to your brain, it [can erode] the capacity of frontal cortical areas.”

When that happens, your ability to say no to that chocolate bar gets diminished, or in Volkow’s words, “your ability to make optimal decisions gets dysfunctional.”

Volkow’s ideas are bolstered by decades of research, including a 2011 review of studies that she co-authored for the journal Nature. The authors of a 2004 paper built upon similar research, concluding that addiction is a learned behaviour linked with fundamental changes to the brains of addicts.

For this reason, it’s not as simple as just choosing to use drugs — or, in Volkow’s example, overdo it on the chocolate. And the more we know about the neurological basis of addiction, the better we will be able to treat it.   See  the full “Open Mind” episode on PBS:

Source:    

http://uk.businessinsider.com/watch-nora-volkow-explain-addiction-with-chocolate-2016-6

Filed under: Addiction,Brain and Behaviour,Effects of Drugs :

Dublin city coroner Dr Brian Farrell is to write to the Department of Health to highlight a link between methadone use and heart failure following an inquest into the death of a 30-year-old man.   Philip Wright of Celbridge, Co Kildare, died on December 13th, 2011, having collapsed after taking heroin.

He had discharged himself on December 12th from Connolly Hospital Blanchardstown where he had been taken off methadone, a heroin replacement drug, because of the dangerous effect it was having on his heart. Mr Wright had attended the hospital on December 9th after collapsing at home. He was also on antibiotics for a chest infection.

Dr Joseph Galvin, consultant cardiologist at the hospital, told the coroner an electrocardiogram (ECG) carried out on Mr Wright picked up a problem with his heart and his methadone was stopped on December 11th. He said the drug could put the heart out of rhythm by changing its electrical properties “in a dangerous way”.

Mr Wright’s heart returned to normal after he was taken off methadone, he said. Recent studies had shown up to 18 per cent of people on methadone had experienced the same heart problems, he said.   The doctor recommended that anyone who collapsed while using methadone should have an ECG carried out. “It is not as benign a drug as was first thought,” Dr Galvin said.

He also said he had recommended an alternative drug for Mr Wright to replace the methadone: buprenorphine.  By lunchtime on Monday, December 12th, Mr Wright had not received the drug. His father, James Wright, told the coroner his son feared he would go into severe withdrawal without it.  He discharged himself from hospital against medical advice and obtained heroin. He died of respiratory failure in the bathroom of his parents’ home the following day having injected the heroin.

Evidence was also given that the pharmacy in the hospital did not receive a request for buprenorphine for Mr Wright and there were issues around access to the drug.

There was also a recommendation that there should be an interval between the time methadone is stopped and buprenorphine is given.  Returning a verdict of death by misadventure, Dr Farrell said he would write to the department and to methadone maintenance authorities and clinics about the potential cardiac effects of methadone.

He would also raise the issue of availability of buprenorphine.

Source: www.irishtimes.com Sat. 5th Jan

Filed under: Effects of Drugs,Europe,Health,Heroin/Methadone :

Imagine for a minute a world in which marijuana is available in a vending machine or corner grocery store near you — like any other snack machine — pot-infused lollipops, gummy candies, baked goods and beverages available at the push of a button.

As futuristic as this farfetched tale sounds, this is Colorado’s reality, a state with the dubious distinction of becoming the first to legalize marijuana, which has helped spawn legalization efforts across the U.S., including in New Jersey.   And while Colorado’s experiment has sparked heated debate over drug legalization, a critical and unbiased look at the data clearly shows that marijuana legalization has serious and far-reaching consequences that far outweigh any of its alleged benefits.

Strong emotions on both sides of this issue should not obscure the facts. Marijuana is an addictive substance that is harmful to users, especially to its younger users. As a teen’s brain development is disturbed by chronic marijuana use, the risk for physical and psychological dependency grows exponentially.

In addition to permanently affecting brain functioning, marijuana use can lead to a wide array of negative consequences, ranging from lower grades and isolation from family to an increased risk of psychotic symptoms, depression and suicide.

According to the Office of National Drug Control Policy, legalization will cause a substantial increase in economic and social costs.  The expansion of drug use will increase crime committed under the influence of drugs, as well as family violence, vehicular crashes, work-related injuries and a variety of health-related problems. These new costs will far outweigh any income from taxes on drugs.

Few would argue that a drug that can cause such destruction is something that we should counsel people to avoid. However, legalization efforts do just the opposite. In fact, experience has shown that when drugs are legalized, drug use increases because the perception of harm is reduced.

Moreover, the Drug Enforcement Agency has estimated that legalization could double or even triple the amount of marijuana users.

While it is hard to fathom the societal impact of an additional 17 million to 34 million marijuana users, it is safe to assume that those who profit from legalization have calculated the impact on their bottom line.

Those in favor of legalization often fail to tell you that levels of drug use have gone down substantially since the 1970s when the “war” on drugs began. This is not to say that our drug laws, including those governing marijuana, are not in need of reform.

For instance, the effort to place more drug users into treatment instead of prison is a positive development, both for those struggling with addiction and for taxpayers.

However, reforming and improving our drug laws does not mean we should abandon our fight against the use of illegal drugs like marijuana.

On the contrary, the more we learn about effective methods of combating drug use, the more we learn that legalization is not the answer, and is, in fact, very much part of the problem.

Source:  Source:  www.njassemblyrepublicans.com  Daily Record 13 Apr 2014

 

Filed under: Cannabis/Marijuana,Effects of Drugs,Social Affairs (Papers),USA :

More than 200 people in Colorado who smoked synthetic marijuana during a 1-month period last summer developed altered mental status severe enough to require emergency care, according to a state public health investigation.

 

The investigation was prompted by several hospitals that contacted the Colorado Department of Public Health and Environment (CDPHE). Increasing numbers of patients had come to their emergency departments with aggression, agitation, confusion, and other symptoms after smoking the synthetic drug. The CDPHE asked all Colorado emergency departments to report through a Web-based system any patients treated with altered mental status who used synthetic marijuana between August 21 and September 18.

Source:   JAMA. 2014;311(5):457. doi:10.1001/jama.2014.47.

Filed under: Cannabis/Marijuana,Effects of Drugs,Health,USA :

Seven years ago, Barbara Theodosiou, then a successful entrepreneur building a women’s business mentoring group, stopped going to meetings, leaving the house and taking care of herself. She grew increasingly distraught.

“You almost wake up and get this haunting feeling, this horrible feeling that my God, I just wish I wasn’t going to live today,” said Theodosiou, a mother of four from Davie, Florida. “Not that you would take your life but you’re so scared.” Petrified, really, but not for herself. For her children.  Theodosiou learned two of her four kids were addicted to drugs.

“I found out within six months that both my sons were addicts and like every other mother, I just wanted to go into bed and never get out.”  Her older son, Peter, now 25, took prescription drugs and then escalated to heroin. Her younger son, Daniel, now 22, started what’s called robotripping, where he would take large quantities of cough medicine to get high.

Barbara Theodosiou first noticed her son Daniel might have a problem with drugs when he was 16.  She says she first noticed signs of problems when her younger son was 16.  “I was taking Daniel to school one day and he was just like almost choking. I thought he was having a panic attack,” she said. A short time later, the school called and said staff members thought Daniel was on drugs.  “I was like, ‘There’s no way.’ … I have talked to my children my whole life about drugs.” 

Within just months, after a call from her son Peter’s roommate, her husband went to his house and found needles all over the place.  “If you know about addiction then when you find this out, you realize not only are you in for the fight of your life, but this is not something that gets fixed in six months. This could go on,” she said.

Barbara Theodosiou’s son Peter was addicted to heroin. He has been in recovery for 3½ years. “It’s like having someone punch you in the stomach. … You’re never the same from the second you find out.”

How does the mother of an addict cope? How does she juggle the incomprehensible challenge between supporting a loved one and not enabling their habit? And how does she deal with the stigma of having a child who is an addict?

In my in-depth interviews with Theodosiou and other mothers of addicts across the country, they made it very clear that being the mother of an addict is an incredibly lonely and isolating place, and that often the only people who understand what they’re going through are other mothers who are going through it themselves.

The fear of getting the call  

Theodosiou’s son Daniel overdosed three times that first year she realized he was using and nearly died each time.  One day, she returned to her house and saw police officers out front. “I remember pulling up and my heart was beating … I was just going to faint right there.”The police officer asked if she was Daniel’s mother. “For sure, I thought he was going to tell me Daniel was dead, and it ended up Daniel overdosed again, and again he was in the hospital.”

Melva Sherwood’s son Andrew died from a heroin overdose in October 2012. He was 27. 

Melva Sherwood of Vermilion, Ohio, got that unimaginable call on October 3, 2012. Her son Andrew, 27 at the time, died of an overdose of heroin. It was his son’s fifth birthday. “It was 11:30 at night. I was sound asleep and it was October. All the windows were open, and the entire neighborhood knew what had happened,” said Sherwood, who says she screamed “at the reality of it, that it was over, that it was done.”  “I have a friend who lives down the street, and she said it was horrifying to hear.”

The blame game 

Many mothers immediately beat up on themselves when they learn their children are battling addiction.  Brenda Stewart with her sons Richard and Jeremy, who both battled addiction and are now doing well.

Brenda Stewart of Worthington, Ohio, says it was heartbreaking realizing two of her three kids were addicts. Her son Jeremy, now 29, used prescription drugs and then heroin, and the drug of choice for Richard, now 31, was crystal meth, she said.

“I’ve been going to counseling for years to figure out what I did wrong. It’s just like, ‘What did I do?'” said Stewart, who has adopted Jeremy’s two children, ages 5 and 7. “And then you come to find out through tons of counseling and parents’ groups and everything else that this is something you didn’t do to your children. And that’s the hardest thing to get away from because you always feel responsible.”

 

Debbie Gross Longo’s son started taking prescription drugs at 15.  Debbie Gross Longo, whose son started using drugs at 13 and taking prescription drugs at 15, says the powerlessness of being an addict’s mom is worse than people might imagine. “As a mother, it’s been hell,” said the mom of four in Stony Brook, New York. “It’s like having a child that you cannot help and sitting on the edge of your seat all at the time because you know something might happen.” 

Viewing addiction as a disease was instrumental, many mothers say, in helping understand they didn’t cause their child’s addiction and couldn’t fix it either.  “When you really start to understand that it is a disease … you can start looking at your child in a different way, loving them for who they are and hating the disease,” said Stewart.

Sadly, the stigma of having a child with addiction is all too real and incredibly painful. Announce to your community your child has a disease like cancer and people will jump to help, said mothers I interviewed. Not so when you tell them your child is an addict.”There are no little girls selling cookies for addiction. Nobody has bumper stickers on their car,” said Theodosiou.  Her son Daniel was in the church group. “When they found out he was an addict, the entire church shunned him. He was completely not invited anywhere.”

‘The hardest thing in the entire world’ 

Every mom I spoke with talked about the intense struggle between supporting their addicted child or children and not enabling their destructive habit.   It is “the hardest thing in the entire world,” said Theodosiou, who said it was only after seven years and 30-plus stints in rehab that she knew she had to make a drastic change.  “All of these people were telling me you have to stop enabling Daniel. You need to let Daniel go. You need to just stop. … I had to actually face leaving Daniel on the street,” she said.  “I finally spoke to a pastor and an addiction specialist who told me that … the last person in the world who could ever help Daniel is me.”

 

Melva Sherwood’s son Aaron works full-time in marketing and sales and may pursue a career in nutrition.  Sherwood, who lost one son to a drug overdose and has another son who battled drug addiction, said she was never able to cut off her children completely, but she set limits.

“As far as enabling, I think you need to lay it on the table for them. This is what you can do. Here are your options but I’m not going to sit here and let you take advantage of me and lie to me,” said Sherwood, who is a registered nurse and the owner of a business providing caregivers for in-home assisted living.

Stewart, whose two sons were addicts, said she eventually realized the longer she enabled her children, the longer they weren’t going to face the consequences.  “It took the line in the sand, telling them I love them and if they were ever ready to get the help and really wanted it that I’m here for them … but I’m not going to set up another appointment,” she said.   But the enabling isn’t just about the addicts, said Stewart. Parents need to realize they are enabling themselves and are risking losing everything by thinking they can save their children.

“There are moms losing their lives to save their children. … They’re spending their whole paycheck trying to take care of their child. They’re not taking care of themselves. That’s just a ripple effect.”

Finding support from other moms 

Theodosiou went through the range of emotions that most mothers of addicts experience: the guilt followed by the intense sadness and then the anger.

“It’s just a very, very sad and a very lonely place,” she said.

Then, one day about a year and a half into her new kind of normal with two sons who were addicted, she had a conversation with God.  “I said, you know, God, if my sons are going to be living this life and be destroyed by this, I’m going to tell every mother and help every mother I can think of. I’m not going to keep it a secret.”

She headed to Facebook and started a group called The Addict’s Mom in 2008.

Her friend thought she was insane.  “She was like, ‘Are you crazy? You are going to go on Facebook and say that you are an addict’s mom?’ And I said, ‘You know what, I am and I know there have to be a million mothers just like me who are addicts’ moms.'”

CNN”s Kelly Wallace did lengthy interviews with mothers across the country whose children battled addiction.

Six years later, The Addict’s Mom, with its Facebook group, its fan page and its online community, has more than 20,000 members, with chapters in every state. Stewart is the state coordinator in Ohio for The Addict’s Mom.

“It’s given me a place that I feel at home, a place that I feel I can give back,” she said. “I also understand the parent’s pain and for me if I can help one parent ease that pain, then I’ve done something.”  Sherwood, who’s an administrator for the Facebook group, said the online community was an “unbelievable eye opener.”

“It was just like somebody turned on the light in the closet,” she said. “It gave me such comfort to … be able to put something out there online at any time during the day and have 20 people respond back with, ‘Hey, we know. We’ve been where you’re at. We feel for you. We’re praying for you.’ ”  “It definitely was a life-changing experience.”

‘If you can’t afford it, jail is your treatment’ 

Besides providing invaluable comfort and support, The Addict’s Mom is a resource center with information on low and no-cost rehabs, psychologists and sober living environments. This month, the group is launching weekly online video meetings where mothers can call in from all over the country and talk with experts on addiction.

The group has also launched offshoots, including The Addict’s Mom Healthy Moms, where the focus is solely on helping the mom live a healthy life (“We don’t even talk about the addict there,” said Theodosiou) and The Addict’s Mom Grieving Moms for mothers who lost children to addiction. It’s also started The Addict’s Dad for fathers and a group called The Addict for the addicts to talk directly with each other.

A big focus now, the moms I interviewed said, is raising awareness about the problem of drug addiction and finding affordable solutions.

“There is treatment if you’re rich and if you can afford it,” said Theodosiou. “If you can’t afford it, jail is your treatment.”  The Addict’s Mom is starting programs in states including New York, Kentucky and Ohio, where moms go into schools and educate students about addiction. The member moms are also flexing their lobbying muscles, advocating for laws such as legislation that allows a judge to order a person into treatment if a family member feels that person is a danger to himself or others.

“Our children are dying and at such an alarming rate,” said Theodosiou, noting how the day before our conversation there were two posts on The Addict’s Mom with reports that two children died.  “We are seeing an alarming rate of death in our society. We have to break the stigma. It’s a disease,'” said Theodosiou. “They are not bad people. We have to get the word out.”

Looking forward  

Raising awareness and helping other mothers drives members of The Addict’s Mom, but they are also always mindful of the lifelong battle their children are facing.  Sherwood’s surviving son is doing well, she said, working full-time in marketing and sales, and planning to take a nutritional coaching course for a possible career in nutrition.

“Today, I have my son back as he learns and implements the plan he has put into place with nutrition, exercise and being with those that truly love him and support his journey toward a better life,” said Sherwood. “What more could a parent ask for!”

Stewart’s son Jeremy has been in recovery for over two years. He’s engaged, is getting ready to buy a house and is very active with his two children. “Our hope is that in the very near future they are back with their father,” said Stewart, who currently cares for her son’s kids. Her older son, Richard, is also doing well, and has been in treatment since the end of June.

Gross Longo’s son, now 25, had been in recovery for six months and just recently relapsed. He entered a detox program and is starting again on the road to recovery, his mother said. “I am once again heartbroken,” she said. “(My son) is doing what he needs to do to get well, but do you understand how this is a day-to-day, year-to-year fight?”  Before her son’s relapse, Gross Longo told me she was so pleased about his recovery but also very cautious.

“They could change on a dime,” she said. “They could be doing wonderful for five years … and then one evening it’s gone.”  Theodosiou’s older son, Peter, has been in recovery for 3½ years and is a recent college graduate. He will soon begin a master’s program in speech pathology.  Her younger son, Daniel, had been in rehab for five weeks — his longest time ever in treatment — but recently relapsed, breaking the condition of his release from jail so he is back behind bars.   “I am really sad about Daniel,” said Theodosiou.

Despite her son’s setback, she continues to advocate for other moms of addicts, but also gets some much needed help for herself.   A few days before our conversation, a member of The Addict’s Mom called her and expressed concern.

“She said, ‘Barbara, we’re worried about you.’ And I said, ‘Why?’ And she said, ‘Because you have to take care of yourself. You help so many other people.  I still struggle with being OK and with my own issues and they help by reminding me, by being there, by being able to talk to them, by sharing resources and supporting me.”

Source:   http://edition.cnn.com/2014/08/26/living/addiction-parents/  26th August 2014

Filed under: Effects of Drugs,Parents,Social Affairs,USA,Youth :

I continue to be puzzled by an attitude that if something is difficult to enforce then we should abandon attempts and just legalize it. That is apparently the attitude of Oregon’s politicians (Republican and Democrat alike) and is reflected in the comments of the official spokesman for the government elites – The Oregonian – in its August 23 edition:

“Oregon has had a wink-wink, nudge-nudge relationship with recreational marijuana use since 1998, when legalization for medical purposes created a wide, open system that distributes pot cards to just about anyone with a vague medical claim and the signature of a compliant physician. We’re not suggesting that marijuana has no palliative value to those with genuine medical problems. But let’s be honest: Recreational marijuana is all but legal in Oregon now and has been for years. Measure 91, which deserves Oregonians’ support, would eliminate the charade and give adults freer access to an intoxicant that should not have been prohibited in the first place.”

There it is. The marijuana advocates foisted a canard on Oregonians by exploiting the plight of those benefiting from the use of medical marijuana. Having convinced Oregonians that those is need should not be denied, they set up a system that guaranteed abuses and then urged others to look the other way when the abuses became obvious and widespread. Wink, wink, nod, nod. There’s a solid foundation for change. (For those of you forced to endure a teachers union led education in Portland public schools, that is what is meant by “sarcasm”.)

And now the second canard is upon us with the assertion that “everyone is already doing it” and that recreational marijuana is not harmful. When the push began, those supporting it chanted “nobody has ever died from marijuana.” And that folks, is just plain bulls—t.

A New York Times article on May 31, 2014, noted:

“Five months after Colorado became the first state to allow recreational marijuana sales, the battle over legalization is still raging.

“Law enforcement officers in Colorado and neighboring states, emergency room doctors and legalization opponents increasingly are highlighting a series of recent problems as cautionary lessons for other states flirting with loosening marijuana laws.

“There is the Denver man who, hours after buying a package of marijuana-infused Karma Kandy from one of Colorado’s new recreational marijuana shops, began raving about the end of the world and then pulled a handgun from the family safe and killed his wife, the authorities say. Some hospital officials say they are treating growing numbers of children and adults sickened by potent doses of edible marijuana. Sheriffs in neighboring states complain about stoned drivers streaming out of Colorado and through their towns.”

On May 24, 2014, Newsweek reported:

“Wednesday’s move in Colorado to tighten rules on edible goods made with pot comes after two adult deaths possibly linked to such products. Meanwhile, a Colorado children’s hospital said it has seen an uptick in the number of admissions of children who ingested marijuana-laced foods since the start of the year.

“’Since the … legalization of recreational marijuana sales, Children’s Colorado has treated nine children, six of whom became critically ill from edible marijuana,’ the statement from Colorado Children’s Hospital said.”

And The Raw Story reported on April 2, 2014:

“A Wyoming college student visiting Colorado on spring break is the first reported death related to the legal sale of recreational marijuana.

“Levy Thamba, a student at Northwest College, fell to his death last month from the balcony of a Holiday Inn in Denver.

“Autopsy results released Monday showed the 19-year-old Thamba, who was also known as Levi Thamba Pongi, died from multiple injuries caused by the fall. But the coroner also listed ‘marijuana intoxication’ from a pot-infused cookie as a significant contributor to the student’s death.”

And finally, CBS reported from Seattle on February 4, 2014:

“According to a recent study, fatal car crashes involving pot use have tripled in the U.S.

‘Currently, one of nine drivers involved in fatal crashes would test positive for marijuana,’ Dr. Guohua Li, director of the Center for Injury Epidemiology and Prevention at Columbia, and co-author of the study told HealthDay News.”

But the Oregonian is undeterred by the mounting evidence of harm:

“Opponents of the measure are right about a couple of things. Allowing retail sales of recreational marijuana inevitably will make it easier for kids to get their hands on the stuff, as will Measure 91′s provision allowing Oregonians to grow their own. It’s also true that outright legalization will increase the number of people driving under the influence, which is particularly problematic given the absence of a simple and reliable test for intoxication. There is no bong Breathalyzer.

“As real as these consequences are, Oregonians should support outright legalization. . .”

We have imposed safety requirements on a whole host of things including guns, automobiles, golf carts, children’s toys and food products that have a lower incident rate of death and injury than is being currently compiled by the unrestricted use of marijuana. Oregon is now tying itself in knots trying to eliminate the use of genetically modified organisms (GMO) with no scientific evidence of harm and only a speculation as to what might become. But there is no apparent concern about the modification of marijuana to increase its potency which has resulted in numerous adverse health issues with children and adults alike.

And while the Oregonian acknowledges that there is no “simple and reliable test for marijuana intoxication” it fails to note that there is similarly no simple and reliable test for testing potency. There are no labeling requirements and no guidelines as to the limits of consumption and impairment. Contrast that with the liquor industry that has defined limits and labeling on the alcohol content of various beers, wine and liquors. There are exacting studies that demonstrate the effects of alcohol on a person given weight variations.

And yet the Oregonian ignores that in favor of addressing it sometime in the future – maybe.

And Oregon’s politicians are even less helpful because they are fixated on tax revenue opportunities from the unrestricted use of marijuana. Little thought is

being given to the problems that will be caused. Their sole focus is upon using regression analysis to determine how high the tax can be without seriously reducing the volume of consumption – it is the same myopic view used when determining the tax on tobacco. That amount of tax will increase over time as the use becomes more widespread and the dependency becomes more pronounced and as state government becomes more dependent on the revenue generated, the ability to correct the abuses of marijuana will be marginalized – just like tobacco.

In the end, this is all about the “me generation” and that pervasive attitude that “if it feels good, do it.” It furthers the myth of life without consequences. The only upside is for those who eschew getting high in favor of getting hired – your prospects for getting a good job and routine promotion are greatly enhanced.

Source: www.oregoncatalyst.com 27th August 2014

Filed under: Effects of Drugs,Global Drug Legalisation Efforts,Legal Sector,USA :

Shootings in New York City have gone up nearly 20 percent in the past year, NYPD Commissioner Bill Bratton announced on March 3, saying that marijuana legalization and the loosening of restrictions across the United States are partly to blame.

Bratton referred to marijuana as “the seemingly innocent drug that’s been legalized around the country,” and says that yes, it’s connected to a rise in shootings. He’s not off the mark. In Colorado, Pueblo County Sheriff Kirk Taylor in Colorado noticed an uptick in crimes, and he’s now tracking the link between crimes and marijuana.

In New York City, marijuana is not legalized, but it has been decriminalized to some degree and the NYPD has stopped arresting people with small amounts of marijuana on their person.

“It is ironic that in a city which is a transfer point for huge amounts of drugs . . . heroin, cocaine, hallucinogens, that one drug [that] is actually the causal factor in so much of our shootings and murder is marijuana,” Bratton said. “We just see marijuana everywhere when we make these arrests, and get the guns off the street.”

Watch WABC’s report, along with Bratton’s remarks, in the video.

Murders revolving around marijuana occur in Washington and Colorado. A week ago in Steamboat Springs, a man with an indoor marijuana grow was robbed and murdered. Two have been charged. The black markets are also alive and well in both Washington and Colorado, as a New York Times article explains.

Please share this post with every concerned parent you know! Spread the Word about Pop Pot! Parents Opposed to Pot is a non-partisan grassroots campaign started by parents concerned about the commercial pot industry and its devastating impact on youth and communities. We write anonymously to explore these important issues and protect the privacy of our bloggers. We are totally funded by private donations, rather than industry or government. If you have an article to submit, or want to support us, please go to Contact or Donate page

Source: http://www.poppot.org/2015/03/09 9th March 2015

Filed under: Cannabis/Marijuana,Crime/Violence/Prison,Effects of Drugs,USA :

Among the 137 people who completed the study, the number of seizures fell by an average of 54 percent, according to a team led by Dr. Orrin Devinsky, of New York University Langone Comprehensive Epilepsy Center in New York City.

Keep in mind that Epidiolex is VERY different than the so-called low THC strains of marijuana (also known as Charlotte’s Web) that are being grown and sold in several states. Unlike Epidiolex, the strains of marijuana are not cloned and the end products vary widely. Most importantly, these strains contain varying levels of THC whereas Epidiolex is virtually pure CBD.

Liquid Medical Marijuana Shows Promise for Epilepsy


A liquid form of medical marijuana may help people with severe epilepsy that does not respond to other treatments, according to a new report.

The study included 213 child and adult patients with 12 different types of severe epilepsy. Some of them had Dravet syndrome and Lennox-Gastaut syndrome, which are types of epilepsy that can cause intellectual disability and lifelong seizures.

The patients took a liquid form of medical marijuana, called cannabidiol, daily for 12 weeks.

Among the 137 people who completed the study, the number of seizures fell by an average of 54 percent, according to a team led by Dr. Orrin Devinsky, of New York University Langone Comprehensive Epilepsy Center in New York City.

Among the 23 patients with Dravet syndrome who completed the study, the number of convulsive seizures fell by 53 percent, the investigators found. The 11 patients with Lennox-Gastaut syndrome who finished the study also had a 55 percent decline in the number of attacks called “atonic” seizures, which cause a sudden loss of muscle tone.

The drug wasn’t always easy to take, however, and 12 patients stopped taking it due to side effects, the researchers said. The types of side effects seen in more than 10 percent of the patients included drowsiness (21 percent), diarrhea (17 percent), tiredness (17 percent) and decreased appetite (16 percent).

The study was supported by drug maker GW Pharmaceuticals. The findings are scheduled to be presented next week at the annual meeting of the American Academy of Neurology (AAN) in Washington, D.C. Experts note that findings presented at medical meetings are typically considered preliminary until published in a peer-reviewed journal

Devinsky agreed that larger, placebo-controlled studies are needed to assess the effectiveness of the drug.

“So far there have been few formal studies on this marijuana extract,” he said in an AAN news release. “These results are of great interest, especially for the children and their parents who have been searching for an answer for these debilitating seizures.”

One expert unconnected to the study called the findings “very exciting.”

“Prior to this study, there were mainly anecdotal reports and very few formal studies evaluating cannabidiol, a component of cannabis, in treating seizures,” explained Dr. Scott Stevens, director of Advanced Clinical Experience in Neurology at North-Shore-LIJ Health System in Manhasset, N.Y.

Stevens believes that “these results stand as a stepping stone toward further studies evaluating the use of marijuana in the treatment of epilepsy.”

Source:http://www.webmd.com/epilepsy/news 13/04/2015 (HealthDay News

Filed under: Cannabis/Marijuana,Effects of Drugs,Marijuana and Medicine :

Funded by a five-year, $7 million federal grant, the University of Illinois at Chicago College of Medicine will create a new center, the first of its kind, to study the effect of long-term alcohol exposure on genes.

The National Institute on Alcohol Abuse and Alcoholism, one of the National Institutes of Health, awarded the funding to establish a Center for Alcohol Research in Epigenetics (CARE). Subhash Pandey, UIC professor of psychiatry, will direct the center.

“Epigenetics” refers to chemical changes to DNA, RNA, or specific proteins, that change the activity of genes without changing the genes themselves. Epigenetic changes can occur in response to environmental or even social factors, such as alcohol and stress — and these changes have been linked to changes in behavior and disease.  Epigenetics plays a role in the development and persistence of neurological changes associated with alcoholism, says Pandey, who is director of neuroscience alcoholism research at UIC and research career scientist at the Jesse Brown VA Medical Center.

 

The CARE researchers will investigate how alcohol-related epigenetic changes influence gene expression and “synaptic remodelling” — the networking of nerve cells to each other. They will also look closely at how these changes correlate with behavior, such as anxiety and depression, and whether epigenetics may play a role in the withdrawal symptoms that make abstinence difficult.

“This award will allow the College of Medicine to build on Professor Pandey’s exemplary research on chronic alcohol use and alcoholism in addition to bolstering our leadership in understanding the causes of alcoholism as well as finding new ways to treat this devastating disease,” said Dr. Dimitri Azar, dean of the University of Illinois College of Medicine.

In a recent study using an animal model, Pandey and colleagues at UIC found that epigenetic changes resulting from exposure to alcohol during adolescence were associated with abnormal brain development and anxiety and alcohol preference in adulthood. In earlier work, the researchers were able to show that reshaping of the DNA scaffolding that supports and controls the expression of genes in the brain may play a major role in alcohol withdrawal symptoms, particularly anxiety.

Several brain regions play a crucial role in regulating both the positive and negative emotional states associated with alcohol addiction. Pandey said the center will look at the circuitry involved in reward and pleasure, depression, cognition, and anxiety.  CARE researchers will study disease using preclinical animal models and post-mortem examination of human brain. Investigators will also do neuroimaging of patients diagnosed with alcohol abuse and dependence and search for “biomarkers” of alcoholism — measurable indicators in blood that correlate with alcohol addiction.

There are two causes of dependence on alcohol, said Pandey — people may drink to get pleasure, or to self-medicate to relieve depression or anxiety. But alcohol addiction may itself cause depression and anxiety, feeding into a cycle.

“Ultimately, we hope these studies may lead to the identification of molecular cellular targets and gene networks which can be used to develop new pharmacotherapies to treat or prevent alcoholism,” Pandey said.

UIC’s CARE is the only NIH-funded alcohol research center in Illinois, said Dr. Anand Kumar, Lizzie Gilman Professor and head of psychiatry, and is “well positioned to perform state-of-the-art basic translational and clinical research in alcoholism.”

In addition to its research projects, CARE will provide resources for training and community outreach. Based in the UIC psychiatry department, it includes collaborators from biophysics and physiology, anaesthesiology, the Jesse Brown VA Medical Center, and the University of Illinois Urbana-Champaign campus.

Source: http://www.newswise.com/articles/view/632573/?sc=dwtn   13th April 2015

Filed under: Alcohol,Effects of Drugs :

Those using strong strains of illegal drugs such as cannabis skunk, or the illegal use of prescription drugs are risking their mental health and the lives of others. Suicidal thoughts are not unknown and this letter from a doctor discusses the problems of confidentiality versus life saving – of the patient or others.

To the Clinicians of the Co-Pilot of Germanwings Flight 9525

Dear German Medical Colleagues,

Please bear with me through this rather long letter. There is so much that I have been wondering and worrying about—including you.

I may never know who you are, but if you provided medical or psychiatric care for Andreas Lubitz, co-pilot of Germanwings Flight 9525, we are colleagues. Whether you saw Mr Lubitz years ago or more recently, or whether you saw him privately or as an airline-appointed medical examiner, you had some responsibility for his care.

And you too are his victims, of sorts. I hope your reputation does not suffer unduly. I hope PTSD does not develop as a result of his apparent suicide. If you provided ethical care (ie, competent care), I hope you are not scapegoated. “Monday morning quarterbacking”—an American football saying about reviewing a game the day after it is played—is always so much easier than preventing problems in real time.

After all, if reports of Mr Lubitz taking an injectable antipsychotic during training in 2009 are true, that doesn’t for sure mean that he had an ongoing or intermittent psychosis. Maybe, just maybe, it could have been a short-acting injection for acute agitation due to extreme stress and/or drug abuse. Similarly, treatment back then for an “episode” of “severe” depression could have seemed to be a one-time episode.

On the other hand, there are reports that Lubitz saw psychotherapists “over a long period of time.” Those psychotherapists probably knew the patient best, especially if he had a particular personality disorder or significant traits of concern (eg, undue narcissism, paranoia).

We have not yet heard anything about whether Lubitz had PTSD, but people with this disorder can appear normal. Perhaps the co-pilot dissociated as he crashed the airplane, which would have allowed him to ignore for minutes the passengers’ screams and the banging on the door of the cockpit. That could account for the fact that voice recording picked up no triumphal shouts, only his steady breathing.

This analysis is all speculation, of course. Maybe it’s the kind of “wild analysis” that Freud so deplored.

I do not know how prominent so-called “anti-psychiatrists” are in Germany, but if they are anything like they are here in the US, they are likely to blame psychiatric medication for the co-pilot’s bizarre and tragic behavior. Of course, they could well have a point. Some antidepressants, which can cause visual side effects, were prescribed for Mr Lubitz, agents perhaps, that we don’t in the US.

We know he was concerned about his vision, but speculation so far is that this complaint was psychosomatic. In addition, sudden withdrawal from some antidepressants can lead to increased agitation. Moreover, antidepressants can trigger a (hypo)manic episode, although of course a manic episode can occur that leads to grandiosity and agitation. On the other hand, no one seems to have described such changes in Mr Lubitz before the crash.

Therefore, I hope your medical documentation was good—better than mine usually was. I hope you documented your risk assessment adequately. If you were unsure of what to do, I hope you obtained consultation and/or supervision. If you worked in a system of care, I hope they adequately monitored the quality of care you provided.

I understand that your medical privacy laws are much more stringent than our patchwork of state and national privacy laws are here in the US, both in life and in death. I heard that you can be imprisoned for up to 5 years for not following strict standards of patient confidentiality. Perhaps that prevented you from contacting Lufthansa instead of just giving the patient an unfit-for-work note, which he subsequently tore up. That, and other reasons, may be causing you to bite your tongue to offer further explanation.

I wonder if your stringent privacy laws are a reaction to the breaches of physicians when the Nazis ruled, as well as the subsequent invasion of privacy in East Germany. Are they an overreaction that needs some degree of correction? After all, airline safety is good, and this may have been a perfect confluence of various factors. Further, to exacerbate our existential anxiety, we have the unexplained disappearance of the Malaysian airliner from just about 2 years ago. Was there a copycat aspect to the Germanwings crash?

All medical colleagues must weigh risk to others against the need for patient confidentiality. This can include whether to divulge patient information such as highly contagious diseases like AIDS or Ebola; abuse of a minor or domestic violence; driving while impaired; carrying a gun; running a nuclear power plant; and being responsible for all kinds of public transportation and safety.

Maybe you wish you could talk and give condolences to those who lost family and friends on the doomed airliner. That would be the human thing to do, but perhaps you can’t?

As psychiatrists, suicide and homicide are essentially our only life and death challenges. So when a patient commits suicide and kills 149 others at the same time, what could feel professionally worse?

Yet we all know that we are not particularly successful at predicting actual suicide or homicide. Complicating that, someone troubled who decides that his or her solution is suicide and/or homicide often seems surprisingly well right before the act. He or she is relieved, having decided on the solution to his problems. We must appreciate our limitations.

Everyone wants to know the co-pilot’s motivation. So do I. But nothing is convincing yet about why he would make sure to kill everyone on board. Way back when, I was taught that in general, suicide was motivated by a desire to die, to kill, and/or be killed. This is a rare example of all—a triple play.

We may need system and cultural changes to how we approach some aspects of mental illness, such as the Air Force Suicide Prevention Program in the US. This program has significantly reduced suicide attempts as well as violence to others.

We and our psychiatric patients are stigmatized in many countries. If such stigma can cause inadequate attention to mental health in routine annual check-ups, no wonder mental health examinations are inadequate for airline pilots.

Complicating our work is the denial, lack of insight, and/or loss of memory among some of our patients. The people that we (clinicians and the public) need to fear most (ie, sociopaths) can be the best at hiding the risk they pose. Periodic research about faking psychiatric symptoms in the emergency department indicates how easily we, in our quest to be helpful, can be fooled. We don’t have corroborating lab tests to fall back on, unlike in other areas of medicine.

During my career, I evaluated and treated a fair number of pilots. Almost always, we grappled with the implications of getting treatment and taking medication. What might help their mental problems might, at the same time, cost them their job, and thereby worsen their mental health. No wonder so many pilots hide psychiatric treatment from their employers.

Who knows? Maybe some of you who treated him didn’t even know that Andreas Lubitz was a pilot. We often know little about the real day to day lives of our patients. Maybe we need to know more.

About a century ago, Freud concluded that his was “an impossible profession.” This may well still be so. The burnout rate of physicians and psychiatrists in the US is over 50%. Know that.

I appreciate why we may never hear your side of the story. That may be a shame, for you probably have much to teach us and can transform some of our fantasies into reality.

In terms of our ethical responsibilities to each other, we are indeed our brothers’—and sisters’—keepers. In that regard, let me know if there is anything more I should know or do.

Your colleague,
H. Steven Moffic, MD (Steve)

Source: Psychiatric Times psychiatrictimes@email.cmpmedica-usa.com 16th April 2015

Filed under: Drug use-various effects,Effects of Drugs,Prescription Drugs,Psychiatric drugs :

Almost one in 500 babies in hospitals in England is born dependent on substances their mother took while pregnant, a BBC investigation has found.

Of 72 NHS hospital trusts who responded to a Freedom of Information request, the average rate for babies born with neonatal abstinence syndrome was 0.2%.

It is caused by women taking legal and illegal drugs while pregnant.  Health experts say it is a declining trend.

BBC’s Look North and the English regions data unit asked NHS hospital trusts to provide details about the number of babies born who were addicted to drugs between 2011 and 2015.  The figures show a wide geographical variation in the number of newborns who were dependent on harmful substances.

One in 100 babies born at Bedford Hospital in 2015 displayed signs of neonatal abstinence syndrome. In contrast, Leicester General had one of the lowest rates with one in every 5,000 babies born addicted to a harmful substance.  In Leeds, around one in 250 babies was born with the condition.

Lisa Batty, 37, from Bradford, gave birth to four children who were addicted to heroin.

“I didn’t care that my kids were addicted to drugs, I was more concerned about where I was getting my next fix from. I know it’s selfish but that’s how it felt at the time,” she said.

“I remember visiting my children in hospital as they suffered withdrawal symptoms from the methadone they were being given as part of their treatment. I remember seeing them trembling and shaking in their cots. I admit I was a bad mum but I’ve turned my life around now”.

Lisa has now recovered from drug addiction and has become involved with the charity Narcotics Anonymous to help others.

The data for England also shows that over the past four years there has been general decline in the number of babies being diagnosed with neonatal abstinence syndrome.   Those working to treat mothers and babies with a drug addiction say the majority of parents they deal with come from a disadvantaged socio-economic background, with most cases involving an abuse of drugs like heroin, cocaine or alcohol.

Susan Flynn is a specialist midwife in Leeds who helps treat mothers who have a drug addiction.   “I have seen the numbers begin to fall slightly in the past three years,” she said. “I don’t think we can say there is one single reason for the decline but maybe the message is getting out there that it’s not right to take drugs or alcohol whilst you’re pregnant.

“There are of course people who say that women who take drugs whilst they’re pregnant should have their children removed from them, but for me I believe everyone should have the chance to turn their life around.”

Liz Butcher, from Public Health England in Yorkshire and the Humber, said: ‘It is particularly important pregnant women who use drugs get supportive, collaborative care

to reduce the risks to the health of their babies.      Many places in the region have specialist staff and well-established training to make sure that happens.”

 Source:  http://www.bbc.co.uk/news/uk-england-36703939    5th July 2016

Filed under: Drug use-various effects on foetus, babies, children and youth,Effects of Drugs :

Tamara D. Warner, PhD1, Dikea Roussos-Ross, MD2, and Marylou Behnke, MD1

Tamara D. Warner: warnertd@peds.ufl.edu; Dikea Roussos-Ross: kroussos@ufl.edu; Marylou Behnke: behnkem@peds.ufl.edu

1University of Florida, Department of Pediatrics, P.O. Box 100296, Gainesville, FL 32610-0296, (352) 273-8985

2University of Florida, Department of Obstetrics and Gynecology, P.O. Box 100294, Gainesville, FL 32610-0294, (352) 273-7660

SYNOPSIS

Pro-marijuana advocacy efforts exemplified by the “medical” marijuana movement, coupled with the absence of conspicuous public health messages about the potential dangers of marijuana use during pregnancy, could lead to greater use of today’s more potent marijuana, which could have significant short- and long-term consequences. This article will review the current literature regarding the effects of prenatal marijuana use on the pregnant woman and her offspring.

INTRODUCTION

Societal attitudes towards marijuana use in the United States are undergoing an historical shift. In the 1960s, a generation of young people embraced marijuana for personal recreational use. Today, “medical” marijuana (cannabis sativa) has been approved for use in 22 states and the District of Columbia either by legislation or by popular vote in statewide referenda or ballot initiatives; 15 of the 22 legal actions were passed in the last decade (since 2004).1 As of May, 2014, another seven states have pending legislation or ballot measures to legalize medical marijuana.2 In addition, two states, Colorado and Washington state, have legalized marijuana for recreational use. The attitudinal shift is apparent not just among adults but among teens as well. The most recent annual survey of adolescent drug use indicates that the annual prevalence of marijuana use has been trending upward since 2008 for 8th, 10th, and 12th graders; perhaps more importantly, the perceived risk of regular marijuana use has declined sharply in recent years, a trend that started in 2005.3

Source:  Clin Perinatal 2014 December 41(4):  877-894  doi 10.1016/j.clp  2014.0.009

Filed under: Cannabis/Marijuana,Drug use-various effects on foetus, babies, children and youth,Effects of Drugs :

Roll Call Video Advises Law Enforcement to Exercise Extreme Caution

DEA has released a Roll Call video to all law enforcement nationwide about the dangers of improperly handling fentanyl and its deadly consequences.  Acting Deputy Administrator Jack Riley and two local police detectives from New Jersey appear on the video to urge any law enforcement personnel who come in contact with fentanyl or fentanyl compounds to take the drugs directly to a lab.

“Fentanyl can kill you,” Riley said. “Fentanyl is being sold as heroin in virtually every corner of our country. It’s produced clandestinely in Mexico, and (also) comes directly from China. It is 40 to 50 times stronger than street-level heroin. A very small amount ingested, or absorbed through your skin, can kill you.”

Two Atlantic County, NJ detectives were recently exposed to a very small amount of fentanyl, and appeared on the video.

Said one detective: “I thought that was it. I thought I was dying. It felt like my body was shutting down.”

Riley also admonished police to skip testing on the scene, and encouraged them to also remember potential harm to police canines during the course of duties.

“Don’t field test it in your car, or on the street, or take if back to the office. Transport it directly to a laboratory, where it can be safely handled and tested.”

The video can be accessed at: http://go.usa.gov/chBWW

More on Fentanyl:

On March 18, 2015, DEA issued a nationwide alert on fentanyl as a threat to health and public safety.

Fentanyl is a dangerous, powerful Schedule II narcotic responsible for an epidemic of overdose deaths within the United States. During the last two years, the distribution of clandestinely manufactured fentanyl has been linked to an unprecedented outbreak of thousands of overdoses and deaths. The overdoses are occurring at an alarming rate and are the basis for this officer safety alert.

Fentanyl, up to 50 times more potent than heroin, is extremely dangerous to law enforcement and anyone else who may come into contact with it. As a result, it represents an unusual hazard for law enforcement.

Fentanyl, a synthetic opiate painkiller, is being mixed with heroin to increase its potency, but dealers and buyers may not know exactly what they are selling or ingesting. Many users underestimate the potency of fentanyl.

The dosage of fentanyl is a microgram, one millionth of a gram – similar to just a few granules of table salt. Fentanyl can be lethal and is deadly at very low doses.

Fentanyl and its analogues come in several forms including powder, blotter paper, tablets, and spray.

Risks to Law Enforcement

Fentanyl is not only dangerous for the drug’s users, but for law enforcement, public health workers and first responders who could unknowingly come into contact with it in

its different forms. Fentanyl can be absorbed through the skin or accidental inhalation of airborne powder can also occur. DEA is concerned about law enforcement coming in contact with fentanyl on the streets during the course of enforcement, such as a buy-walk, or buy-bust operation.

Just touching fentanyl or accidentally inhaling the substance during enforcement activity or field testing the substance can result in absorption through the skin and that is one of the biggest dangers with fentanyl. The onset of adverse health effects, such as disorientation, coughing, sedation, respiratory distress or cardiac arrest is very rapid and profound, usually occurring within minutes of exposure.

Canine units are particularly at risk of immediate death from inhaling fentanyl.

In August 2015, law enforcement officers in New Jersey doing a narcotics field test on a substance that later turned out to be a mix of heroin, cocaine and fentanyl, were exposed to the mixture and experienced dizziness, shortness of breath and respiratory problems.

If inhaled, move to fresh air, if ingested, wash out mouth with water provided the person is conscious and seek immediate medical attention.

Narcan (Naloxone), an overdose-reversing drug, is an antidote for opiate overdose and may be administered intravenously, intramuscularly, or subcutaneously. Immediately administering Narcan can reverse an accidental overdose of fentanyl exposure to officers. Continue to administer multiple doses of Narcan until the exposed person or overdose victim responds favorably.

Field Testing / Safety Precautions

Law enforcement officers should be aware that fentanyl and its compounds resemble powered cocaine or heroin, however, should not be treated as such.

If at all possible do not take samples if fentanyl is suspected. Taking samples or opening a package could stir up the powder. If you must take a sample, use gloves (no bare skin contact) and a dust mask or air purifying respirator (APR) if handling a sample, or a self-contained breathing apparatus (SCBA) for a suspected lab.

If you have reason to believe an exhibit contains fentanyl, it is prudent to not field test it. Submit the material directly to the laboratory for analysis and clearly indicate on the submission paperwork that the item is suspected of containing fentanyl. This will alert laboratory personnel to take the necessary safety precautions during the handling, processing, analysis, and storage of the evidence. Officers should be aware that while unadulterated fentanyl may resemble cocaine or heroin powder, it can be mixed with other substances which can alter its appearance. As such, officers should be aware that fentanyl may be smuggled, transported, and/or used as part of a mixture.

Universal precautions must be applied when conducting field testing on drugs that are not suspected of containing fentanyl. Despite color and appearance, you can never be certain what you are testing. In general, field testing of drugs should be conducted as appropriate, in a well ventilated area according to commercial test kit instructions and training received. Sampling of evidence should be performed very carefully to avoid spillage and release of powder into the air. At a minimum, gloves should be worn and the use of masks is recommended. After conducting the test, hands should be washed with copious amounts of soap and water. Never attempt to identify a substance by taste or odor.

Historically, this is not the first time fentanyl has posed such a threat to public health and safety. Between 2005 and 2007, over 1,000 U.S. deaths were attributed to fentanyl – many of which occurred in Chicago, Detroit, and Philadelphia.

The current outbreak involves not just fentanyl, but also fentanyl compounds. The current outbreak, resulting in thousands of deaths, is wider geographically and involves a wide array of individuals including new and experiences abusers.

In the last three years, DEA has seen a significant resurgence in fentanyl-related seizures. In addition, DEA has identified at least 15 other deadly, fentanyl-related compounds. Some fentanyl cases have been significant, particularly in the northeast and in California, including one 12 kilogram seizure. During May 2016, a traffic stop in the greater Atlanta, GA area resulted in the seizure of 40 kilograms of fentanyl – initially believed to be bricks of cocaine – wrapped into blocks hidden in buckets and immersed in a thick fluid. The fentanyl from these seizures originated from Mexican drug trafficking organizations.

Recent seizures of counterfeit or look-a-like hydrocodone or oxycodone tablets have occurred, wherein the tablets actually contain fentanyl. These fentanyl tablets are marked to mimic the authentic narcotic prescription medications and have led to multiple overdoses and deaths.

According to DEA’s National Forensic Lab Information System, 13,002 forensic exhibits of fentanyl were tested by labs nationwide in 2015, up 65 percent from the 2014 number of 7,864.  The 2015 number is also about 8 times as many fentanyl exhibits than in 2006, when a single lab in Mexico caused a temporary spike in U.S. fentanyl availability.  This is an unprecedented threat

Source:  U.S. Drug Enforcement Administration dea@public.govdelivery.com  11th June 2016

Filed under: Effects of Drugs,Legal Sector,Synthetics,USA :

Guilt-stricken drug dealer pictured in tearful mug shot after handing himself into police because he’d ‘had enough’

Manchester Crown Court heard Heath’s extraordinary confession came after his own addiction brought him to the point where he was living in a drug den with only a coat to his name

Sean Heath

With tears in his eyes guilt-stricken drug dealer Sean Heath poses for his mugshot moments after handing himself into police because he’d ‘had enough’.

The addict stunned officers, who didn’t even know he was dealing drugs, when he turned up at Little Hulton police station, placed 36 wraps of heroin on the counter and told the custody sergeant: ““I’m dealing drugs and I don’t want to do it anymore.”

Manchester Crown Court heard Heath’s extraordinary confession came after his own addiction brought him to the point where he was living in a drug den with only a coat to his name.

Over an eight month period he had been buying crack and heroin and selling to other users to feed his long-term, £200 a day habit.

Now Heath, of no fixed abode, has been jailed for two years and four months, after pleading guilty to possessing class A drugs with intent to supply, reports the Manchester Evening News .

As he was sentenced he said: “Half my life’s gone on drugs – I have just had enough.”

Prosecutor Neil Beckwith told court that Heath handed himself in to police after midnight on May 3, giving officers 36 wraps of a greyish powder which he revealed was heroin.

Interviewed, he said on a typical day he sold 36 wraps of heroin and 56 wraps of cocaine. During Heath’s sentencing hearing, Alistair Reid, defending, said: “This is the first time in my professional career I have had a defendant who has knocked on the door of police, surrendered himself and handed over a class A drug worth over £700 in street value. That goes to show his mindset. He tells me he’s been using illicit drugs since the age of 14, and prior to his remand in custody, would describe himself as an alcoholic.”

Mr Reid said Heath’s drug and drink problems had begun and escalated against a backdrop of family and relationship difficulties, leaving him penniless.

The defence lawyer added: “He has no assets whatsoever to his name – he informs me the only item he has is a coat. He has nothing else in the world in terms of material goods.

“He is, tragically, an indication of the harm illicit drugs cause in society. He sees this as an opportunity he needs to put drug misuse and alcohol misuse behind and move forward – he is determined to completely abstain from drugs.”

Sentencing, Recorder Andrew Jefferies QC said of Heath: “I don’t think you can get any clearer indication of remorse than going to the police station and handing yourself in.”

Source: http://www.mirror.co.uk/news/uk-news/guilt-stricken-drug-dealer-pictured-8113171

Filed under: Effects of Drugs :

 

Addiction Science & Clinical Practice

Katherine A Belendiuk1, Lisa L Baldini2 and Marcel O Bonn-Miller345*

Author Affiliations

1Institute of Human Development, University of California, 1121 Tolman Hall #1690, Berkeley 94720, CA, USA

2Palo Alto University, 1791 Arastradero Road, Palo Alto 94304, CA, USA

3Center of Excellence in Substance Abuse Treatment and Education, Philadelphia VA Medical Center, 3900 Woodland Avenue, Philadelphia 19104, PA, USA

4Center for Innovation to Implementation and National Center for PTSD, VA Palo Alto Health Care System, 795 Willow Road (152-MPD), Menlo Park 94025, CA, USA

5Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3440 Market Street, Philadelphia 19104, PA, USA

For all author emails, please log on.

Addiction Science & Clinical Practice 2015, 10:10 doi:10.1186/s13722-015-0032-7

The electronic version of this article is the complete one and can be found online at:http://www.ascpjournal.org/content/10/1/10

Received:

29 August 2014

Accepted:

15 April 2015

Published:

21 April 2015

© 2015 Belendiuk et al.; licensee BioMed Central.

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Abstract

The present investigation aimed to provide an objective narrative review of the existing literature pertaining to the benefits and harms of marijuana use for the treatment of the most common medical and psychological conditions for which it has been allowed at the state level. Common medical conditions for which marijuana is allowed (i.e., those conditions shared by at least 80 percent of medical marijuana states) were identified as: Alzheimer’s disease, amyotrophic lateral sclerosis, cachexia/wasting syndrome, cancer, Crohn’s disease, epilepsy and seizures, glaucoma, hepatitis C virus, human immunodeficiency virus/acquired immunodeficiency syndrome, multiple sclerosis and muscle spasticity, severe and chronic pain, and severe nausea. Post-traumatic stress disorder was also included in the review, as it is the sole psychological disorder for which medical marijuana has been allowed. Studies for this narrative review were included based on a literature search in PsycINFO, MEDLINE, and Google Scholar. Findings indicate that, for the majority of these conditions, there is insufficient evidence to support the recommendation of medical marijuana at this time. A significant amount of rigorous research is needed to definitively ascertain the potential implications of marijuana for these conditions. It is important for such work to not only examine the effects of smoked marijuana preparations, but also to compare its safety, tolerability, and efficacy in relation to existing pharmacological treatments.

Keywords:

Cannabis; Medical marijuana; Marijuana; Medicine; Treatment; Alzheimer’s disease; ALS; Cachexia; Cancer, Crohn’s disease; Epilepsy; Seizures; Glaucoma; Hepatitis C virus; HCV; HIV; AIDS; Multiple sclerosis; MS; Pain; Nausea; Vomiting; Post-traumatic stress disorder; PTSD

Introduction

National estimates suggest that 5.4 million people in the United States above the age of 12 have used marijuana daily or regularly within the past year [1]. This represents an increase of approximately 74.2 percent since 2006 [1]. Similar increases have also been noted among vulnerable populations in the U.S. (e.g., veterans and adolescents) [2],[3].

Marijuana is currently illegal in every country in the world. In 2012, Uruguay voted to legalize state-controlled marijuana sales but implementation of the law has been postponed until 2015. The policy in the Netherlands is mixed, with permissible retail sale of marijuana at coffee shops, but restrictions on production and possession. Notably, as the concentration of THC in marijuana has increased, Dutch coffee shops have begun to close, as perception of marijuana as a “soft” drug transitions to perceptions of marijuana as a “hard” drug.

Like the Netherlands, the United States currently has a mixed drug policy; marijuana is an illegalSchedule I drug under U.S. Federal law. However, marijuana policies vary by state, with some states (e.g., Colorado and Washington) legalizing the use of recreational marijuana (i.e., allowing the legal possession and use of marijuana under state law), and other states decriminalizing marijuana (i.e., reducing the penalties for possession and/or use of small amounts of marijuana to fines or civil penalties). Furthermore, as of this review, 23 states and the District of Columbia have passed legislation allowing medical marijuana (i.e., individuals can defend themselves against criminal charges related to marijuana possession if a medical need is documented) for the treatment of a variety of medical and psychological conditions. Though the list of conditions for which medical marijuana has been allowed varies at the state level, the majority of states agree on its use for Alzheimer’s disease (AD), amyotrophic lateral sclerosis (ALS), cachexia/wasting syndrome, cancer, Crohn’s disease (CD), epilepsy and seizures, glaucoma, hepatitis C virus (HCV), human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), multiple sclerosis (MS) and muscle spasticity, severe and chronic pain, severe nausea, and post-traumatic stress disorder (PTSD).

The aim of the present review is to provide a summary of the existing empirical literature regarding the effects of marijuana/cannabinoids on each of the above-noted conditions. Though some recent work has reviewed the adverse effects of marijuana [4] or the efficacy of marijuana for certain conditions (e.g., neurologic) [5], there has yet to be a comprehensive review of the effects of marijuana for each of the medical and psychiatric conditions for which it is currently used.

Methods

The list of all conditions for which medical marijuana is allowed, according to the legislation of each U.S. state for which medical marijuana has been approved, was obtained and examined [6]. From this list, common conditions for which medical marijuana is allowed (i.e., those conditions shared by at least 80 percent of medical marijuana states) were identified as: AD, ALS, cachexia/wasting syndrome, cancer, CD, epilepsy and seizures, glaucoma, HCV, HIV/AIDS, MS and muscle spasticity, severe and chronic pain, and severe nausea. Though not presently a qualifying condition in at least 80 percent of states with medical marijuana laws, PTSD was also included in the review, as it is rapidly gaining attention and recognition as the sole psychological disorder for which medical marijuana is allowed.

Studies for this narrative review were included based on a literature search in the following databases: PsycINFO, MEDLINE, and Google Scholar. Within each database, each combination of the following key marijuana terms and the above-listed conditions were used to conduct a search: cannabis, marijuana, marihuana, cannabinoid, delta-9-tetrahydrocannabinol, THC, cannabidiol, CBD, cannabinol, cannabigerol, Marinol, dronabinol, Sativex, Nabilone, and Nabiximols. References within each obtained article were also examined to assure that no studies were overlooked. Only published, English-language studies were included in this review.

Though the primary focus of this review is on studies of marijuana plant effects, as these are most relevant to recent medical marijuana legislation, synthetic or plant-derived cannabinoids (e.g., dronabinol, Nabilone) were also included due to the general dearth of marijuana plant studies for a number of conditions. Indeed, for purposes of the review, references to oral administrations of marijuana constitute a pharmaceutical grade extraction administered in tablet or liquid form (e.g., dronabinol, Nabilone, Nabiximols), while references to smoked administration of marijuana constitute the inhalation of smoke from burned marijuana leaves and flowers. Finally, the present review is organized alphabetically by condition for which marijuana is allowed, rather than in order of disorder for which it is most to least commonly recommended, or strength of the evidence. We chose this approach as there is currently only state-level data [7]-[9], rather than national, representative data on the primary conditions for which medical marijuana is used or recommended, and the existing literature and state of the evidence for many conditions remains relatively poor.

Results

Alzheimer’s disease

AD, the leading form of dementia in the elderly, is a progressive, age-related disorder characterized by cognitive and memory deterioration [10]. AD has several neuropathological markers, including neuritic plaques and neurofibrillary tangles [11]. Although several researchers have suggested dronabinol and Nabilone may act on these mechanisms to confer therapeutic effects for patients with AD [12],[13], a recent Cochrane systematic review found no evidence that dronabinol was effective in reducing symptoms of dementia [14]. The authors of a placebo-controlled crossover study of 15 patients with AD who were refusing to eat suggest that dronabinol increases weight gain and decreases disturbed behavior [15], but there is insufficient quantitative data to support this conclusion [14], and one study participant had a grand mal seizure following dronabinol administration [15]. Another pilot study of two patients with dementia found that dronabinol reduced nocturnal motor activity [16]. No studies have examined the effects of smoked marijuana in patients with AD. In sum, there is insufficient evidence to recommend marijuana for the treatment of AD. Future directions should include conducting randomized controlled trials (RCTs) comparing both smoked and oral marijuana to placebo and existing treatments, with sample sizes large enough to detect treatment effects and the safety and tolerability of marijuana.

Amyotrophic lateral sclerosis

ALS is a fatal neurological disease with symptoms that include weakness, spasticity, and respiratory difficulties. Cannabinoids are hypothesized to act in the regions of established pathophysiology for ALS [17] and could be used for symptom management (e.g., pain, spasticity, wasting, respiratory failure, dysphagia, negative mood, and dysautonomia) [18]. Although there is limited evidence from a survey of patients with ALS that marijuana consumed in a variety of forms (i.e., oral, smoked, vaporized, and eaten) improves speech and swallowing [19], the anti-salivatory components of marijuana may reduce the risk of aspiration pneumonia, while also increasing patient comfort [18],[19]. These survey findings indicate that up to 10 percent of patients use marijuana for symptom management, and these self-reports suggest efficacy in increasing appetite and mood and decreasing pain, spasticity, and drooling. However, as is consistent with the half-life of smoked marijuana, the beneficial effects of marijuana on symptoms of ALS were fewer than 3 hours in duration [19]. The only randomized, double-blind, placebo-controlled crossover trial of marijuana in patients with ALS has a small sample size (N = 27) and indicates that while 5 mg of dronabinol is well-tolerated, there was no effect on number or intensity of cramps, quality of life, appetite, sleep, or mood [20]. There is currently insufficient clinical evidence in humans with ALS to recommend cannabinoids as primary or adjunctive therapy.

Cachexia/wasting syndrome

Cachexia is the general wasting and malnutrition that occurs in the context of chronic diseases such as HIV/AIDS and cancer. In patients with HIV or cancer, smoked marijuana and dronabinol have been shown to increase weight gain [21],[22] and food intake [22],[23] compared to placebo. In a within-subject, double-blind, staggered, double-dummy study of nine individuals with muscle mass loss, dronabinol resulted in significantly greater calorie consumption than smoked marijuana [24]. A within-subject, double-blind, placebo-controlled trial with seven HIV-positive marijuana smokers taking antiretroviral medications found that compared to placebo, dronabinol increased caloric intake [25]. Additional studies indicate that dronabinol administration increases appetite, decreases nausea, and protects against weight loss [26], with effects on appetite and weight stability enduring in long-term follow-up [27].

Both dronabinol and smoked marijuana increase the number of eating occasions [22],[25], and smoked marijuana may also affect weight gain and calorie intake by modulating appetite hormones [28]. Importantly, weight gain in one study was greater than would have been expected based on increased calorie consumption alone [23], which may be particularly relevant for those who have impaired food intake and/or nausea. These studies demonstrate that marijuana has positive effects on cachexia resulting from a medical condition, but are largely limited by small sample sizes. Additionally, studies comparing THC to FDA-approved medication (i.e., megestrol) indicate that THC is less effective in promoting appetite and weight gain [29]. In sum, there is moderate support for the use of cannabinoids for cachexia/wasting, and dronabinol has been FDA-approved for anorexia associated with weight loss in individuals with AIDS. Additional studies with larger sample sizes that examine the efficacy of marijuana compared to nutritional support/calorie augmentation in the treatment of cachexia are indicated.

Cancer

Cancer is a qualifying medical condition in every state that has approved marijuana for medical use [30]. The majority of clinical research examining the relation between THC and cancer has evaluated the effect of smoked THC on the risk for cancer, or the palliative effects of THC on chemotherapy-related nausea and emesis, chronic pain, and wasting (reviewed in respective sections); few studies have studied the effect of marijuana in any form on the treatment of primary cancer pathology. In vitro and in vivo research suggests that cannabinoids inhibit tumor growth [30] via several proposed mechanisms (e.g., suppression of cell proliferation, reduced cell migration, increased apoptosis) [31]; however, in vitro and in vivo studies also have shown that THC increases tumor growth due to reduced immune response to cancer [32]. The only clinical trial of THC on cancer examined intracranial administration of THC to nine patients with recurrent glioblastoma multiforme who had failed surgical- and radiotherapy, and results indicated that THC decreased tumor growth, while being well-tolerated with few psychotropic effects [33]. This study is limited by lack of generalizability, and clinical trials with larger representative samples that examine oral or smoked administration of THC are essential to elucidate the effects on cancer pathology. There is currently insufficient evidence to recommend marijuana for the treatment of cancer, but there may be secondary treatment effects on appetite and pain.

Crohn’s disease

CD is an inflammatory bowel disease (IBD) that has no cure; treatment targets include reducing inflammation and secondary symptoms. Between 16 percent and 50 percent of patients use marijuana to relieve symptoms of IBD [34]-[36], and patients using marijuana for 6 months or longer are five times more likely to have had surgery for their IBD [34]; whether marijuana exacerbates disease progression or more severe disease results in self-medication is unclear. Only one placebo-controlled study of the effects of marijuana in patients with CD has been conducted[37]. This study found that there was no difference between placebo and smoked marijuana on CD remission (defined as a CD Activity Index (CDAI) of less than 100), and that marijuana was superior to placebo in promoting clinical response (a decrease in CDAI score greater than 100), reducing steroid use, and improving sleep and appetite [37]. Importantly, this study did not include objective measurement of inflammatory activity, and there was no significant difference in placebo and treatment groups 2 weeks after treatment cessation [37]. Until clinical trials with objective measurement of treatment effects over an extended period of time are conducted to examine the safety and efficacy of marijuana for the treatment of IBD, there is insufficient evidence for the use of marijuana for the treatment of IBD.

Epilepsy and seizures

The known effects of cannabinoids on epilepsy and seizures are largely from animal studies, surveys, and case studies. Several animal studies indicate that marijuana and its constituents exhibit anticonvulsant effects [38]-[41] and reduce seizure-related mortality [39], but there is also evidence that cannabinoids can lower the threshold for seizures [42], and THC withdrawal increases susceptibility for convulsions [42]. Cross-sectional surveys indicate that 16–21 percent of patients with epilepsy smoke marijuana [43],[44], with some reporting positive effects (e.g., spasm reduction) and a belief that marijuana is an effective therapy [44], and others reporting increased seizure frequency and intensity [43]. Based on a Cochrane review, the few RCTs that have been conducted in humans include a total of 48 participants [45] and only examine treatment with cannabidiol. These trials exhibited heterogeneity of effects: some indicated a reduction in seizure frequency [46],[47], while others demonstrated no effect compared to placebo [48]. In addition, none of the studies examined response at greater than 6-month follow-up [45]. Systematic reviews of the literature have concluded that there is insufficient clinical data to support or refute the use of cannabinoids for the treatment of epilepsy and seizures [5],[45].

Glaucoma

Glaucoma is a neurodegenerative eye disease that can cause blindness by damaging retinal ganglion cells and axons of the optic nerve. Intraocular pressure (IOP) can influence both onset and progression of glaucoma and is often a target for intervention. Small samples have demonstrated reduced IOP following smoked marijuana [49],[50], but the effect is only present in 60–65 percent of individuals [51] and lasts for 3–4 hours, requiring repeated dosing throughout the day [52]. Furthermore, patients discontinue marijuana use due to side effects (e.g., dizziness, anxiety, dry mouth, sedation, depression, confusion, weight gain, and distortion of perception[53]), and this treatment discontinuity may exacerbate optic nerve damage and obviate the benefits of reduced IOP [54]. Limited research and documented toxicity have resulted in the American Glaucoma Society [54], Canadian Opthalmological Society [55], and the American Academy of Ophthalmology’s Complementary Therapies Task Force [52] determining that there is insufficient evidence to indicate that marijuana is safer or more effective than existing pharmacotherapy or surgery for the reduction of IOP. Development of eye drops for topical application of THC would minimize psychoactive and other side effects but is complicated by the high lipophilicity and low water solubility of cannabinoids [52],[56]. Additionally, the distance from the application site to the retina may be too great to afford neuroprotective benefits [52], given that only 5 percent of an applied dose penetrates the cornea to the intraocular space [56].

Hepatitis C virus

There have been no RCTs examining the use of cannabinoids on HCV infection. Of the studies that have been conducted, one longitudinal study demonstrates that smoked marijuana has no effect on HCV progression in individuals with HIV [57]. In contrast, individuals with HCV who smoke marijuana have a higher fibrosis progression rate [58] and more severe steatosis [59], with daily smokers having a more rapid rate of progression and greater severity [60] than occasional marijuana users [58],[59]. Marijuana may have independent negative effects on steatosis [59], but because none of these findings were in the context of a clinical trial, these correlations are not causal and it is possible that individuals who use marijuana do so to manage greater symptom severity [60].

There may be secondary effects of cannabinoids on HCV treatment side effects: dronabinol and Nabilone stabilized treatment-induced weight-loss [61]; and dronabinol, Nabilone, and marijuana procured from a marijuana club (dose and method of administration unspecified) increased HCV treatment duration and reduced post-treatment virological relapse [61],[62]. However, there is also a potential drug-drug interaction between ribavirin, a traditional HCV treatment, and marijuana due to shared cytochrome 450 metabolism [63]. Because 90 percent of HCV infections are the result of injection drug use [64], treatment of symptoms with marijuana may be contraindicated for this subpopulation, particularly because marijuana use in the context of other substance use (i.e., alcohol) has multiplicative effects on the odds of fibrosis severity [60]. Given that newer treatments for HCV (e.g., sofosbuvir) are replacing ribavirin, there will likely be less need for use of marijuana in management of treatment-related side effects. In sum, there is currently insufficient empirical support to recommend marijuana for the treatment of HCV.

HIV/AIDS

Marijuana use in HIV-infected patients is typically for the management of side effects (e.g., nausea) of older antiretroviral treatments and AIDS-related symptoms, including weight-loss and HIV-associated neuropathy (covered in cachexia and pain sections, respectively). Survey studies indicate that 23 percent of patients with HIV/AIDS smoked marijuana in the past month and do so largely to improve mood and appetite and reduce pain [65]; these patients may exhibit tolerance and need higher doses of THC than are currently approved by the FDA for use in clinical trials [25] to experience treatment effects. The few RCTs that have been conducted in a small number of patients with HIV/AIDS largely examined the effects of marijuana (synthetic or natural marijuana that is smoked or ingested) on symptoms (e.g., nausea and appetite) over a short treatment window (21–84 days; see [66] for systematic review). Studies examining the effects of marijuana on the pharmacokinetics of antiretroviral medication demonstrated that neither smoked marijuana nor dronabinol affects short-term clinical outcomes (e.g., viral load, CD4 and CD8 counts [67]), influences the efficacy of antiretroviral medication [68], or indicates that dose adjustments for protease inhibitors are necessary [21]. However, individuals who are dependent on marijuana have demonstrated poorer medication adherence and greater HIV symptoms and side effects than nonusers and nondependent users [69]. Furthermore, while some studies have no participant withdrawal due to adverse events [21],[70],[71], others reported treatment-limiting adverse events [26],[72],[73]. Finally, because drug use is a risk factor for HIV infection [74], treatment of symptoms with marijuana may be contraindicated for this subpopulation. In sum, there is variability in short-term outcomes and insufficient long-term data addressing the safety and efficacy of marijuana when used to manage symptoms of HIV/AIDS and its role in those also using newer, better-tolerated antiretroviral agents.

Multiple sclerosis and muscle spasticity

Muscle spasticity, a common feature of MS, is disordered sensorimotor control that leads to involuntary muscle activation [75] that results in pain, sleep disturbance, and increased morbidity[76]. The majority of studies examining spasticity have compared oral or sublingual forms of cannabinoids to placebo and found reduced spasm severity [77]-[84], with symptom improvement enduring at long-term follow-up [85]-[87], and also reduced spasm frequency and spasm-related pain and sleep disturbances [77],[88],[89]. With regard to smoked marijuana, one study found reductions in muscle spasticity [90]; however, another study showed that smoking marijuana impaired posture and balance in individuals with spasticity [91], so there is currently insufficient evidence to determine the efficacy of smoked marijuana on spasticity [5].

Surveys of patient populations show that between 14 and 16 percent of patients with MS report using marijuana for symptom management [92],[93] and that compared to non-marijuana-using individuals with MS, marijuana-using individuals with MS have decreased cognitive functioning[90],[94],[95]. Because cognitive dysfunction is present in 40–60 percent of individuals with MS before marijuana administration [96], marijuana use may further compromise impaired cerebral functioning in a neurologically vulnerable population. Additionally, future studies should carefully consider outcome assessment. The primary methods of measuring spasticity, the Ashworth Scale and patient self-report, may not be appropriate measures because antispastic drugs do not decrease Ashworth ratings, and patient-reported spasticity severity may be poorly correlated with patient functioning (i.e., a patient whose spasticity compensated for motor weakness may be unable to ambulate with reduced spasticity) [97]. Importantly for both MS and other neurological disorders, the American Academy of Neurology does not advocate the use of marijuana for the treatment of neurological disorders, due to insufficient evidence regarding treatment efficacy [98].

Post-traumatic stress disorder

There has been a recent emergence of empirical studies of the effects of marijuana on symptoms of PTSD, borne primarily out of the observation that individuals with PTSD report using marijuana to cope with PTSD symptoms; specifically, hyperarousal, negative affect, and sleep disturbances[99]-[101]. Empirical work has consistently demonstrated that the endocannabinoid system plays a significant role in the etiology of PTSD, with greater availability of cannabinoid type 1 receptors documented among those with PTSD than in trauma-exposed or healthy controls [102],[103]. Though the use of marijuana and oral THC [104],[105] have been implicated as a potential mechanism for the mitigation of many PTSD symptoms by way of their effects on the endocannabinoid system, some researchers caution that endocannabinoid activation with plant-based extracts over extended periods may lead to a number of deleterious consequences, including receptor downregulation and addiction [102].

There have been no RCTs of marijuana for the treatment of PTSD, though there has been one small RCT of Nabilone that showed promise for reducing nightmares associated with PTSD [106]. One unpublished pilot study of 29 Israeli combat veterans showed reductions in PTSD symptoms following the administration of smoked marijuana, with effects seen up to one year post-treatment[107]. Remaining studies have been primarily observational in nature, documenting that PTSD is associated with greater odds of a cannabis use disorder diagnosis [108] and greater marijuana craving and withdrawal immediately prior to a marijuana cessation attempt [109]. Indeed, sleep difficulties (a hallmark of PTSD) have been associated with poor marijuana cessation outcomes[110],[111], while cannabis use disorders have been associated with poorer PTSD treatment outcomes [112]. Given the lack of RCTs studying marijuana as a treatment for PTSD, there is insufficient scientific evidence for its use at this time.

Severe and chronic pain

Clinical trials have examined smoked and oral administration of cannabinoids on different types of pain (e.g., neuropathic, post-operative, experimentally induced) in multiple patient populations (e.g., HIV, cancer, and fibromyalgia). Two meta-analyses have been conducted examining the association between marijuana and pain. In the first, 18 RCTs demonstrated that any marijuana preparation containing THC, applied by any route of administration, significantly decreased pain scores from baseline compared to placebo [113]. The second examined 19 RCTs of smoked marijuana in individuals with HIV, which also indicated greater efficacy in reducing pain (i.e., sensory neuropathy) compared to placebo [114]. Importantly, the first meta-analysis showed that marijuana increased the odds of altered perception, motor function, and cognition by 4 to 5 times[113], and the second study did not recommend marijuana as routine therapy [114]. Dosage is an important factor to consider for administration of cannabinoids for pain management, as some studies have found that higher doses of smoked marijuana are associated with improved analgesia[115], whereas other studies show that higher doses of smoked marijuana increase pain response[116]. Because the analgesic effects of marijuana are comparable to those of traditional pain medications [117], future research should aim to identify which analgesics provide the lowest risk profile for the management of severe and chronic pain. Although there is preliminary support to suggest that marijuana may have analgesic effects, there is insufficient research on dosing and side effect profile, which precludes recommending marijuana for the management of severe and chronic pain.

Severe nausea

The majority of research related to the effects of marijuana on severe nausea has involved oral administration of marijuana to individuals with chemotherapy-induced nausea and vomiting (CINV). Oral marijuana (i.e., THC suspension in sesame oil and gelatin) has been shown to be more effective in reducing CINV than placebo [118], including the number and volume of vomiting episodes, and the severity and duration of nausea [119]. When compared to traditional anti-emetics, some meta-analytic reviews indicate that oral THC is more effective in reducing CINV[120]-[123], others find no significant difference [122],[124]-[126], and another suggests that combining both is the most effective at reducing the duration and severity of CINV than either alone [127]. Recent advances in both anti-emetic agents and the mechanisms of cannabinoid administration (i.e., sublingual application) warrant future research.

Importantly, patients receiving cannabinoids for severe nausea reported toxicities, including paranoid delusions (5%), hallucinations (6%), and dysphoria (13%) [122]. Additionally, cannabinoid hyperemesis syndrome has been documented, in which persistent and regular marijuana use (i.e., daily or weekly use for more than 1 year) is associated with cyclic vomiting (i.e., episodic nausea and vomiting) [128] and nonresponse to treatment for cyclic vomiting [129]. Dronabinol has been FDA-approved for CINV in individuals who have not shown a treatment response to traditional anti-emetics, but in line with recommendations from the American Society of Clinical Oncology [130] and the European Society for Medical Oncology [131], cannabinoids should not be utilized as a first-line treatment for nausea and vomiting.

Conclusions

The reviewed literature highlights the dearth of rigorous research on the effects of marijuana for the most common conditions for which it is currently recommended. It is paramount that well-designed RCTs with larger sample sizes be conducted to determine the actual medical benefits and adverse effects of marijuana for each of the above conditions. Indeed, recent reviews [4],[132] comprehensively discuss adverse events associated with marijuana use, and while it is beyond the scope of the current paper to review these effects in-depth, they are important to consider when evaluating whether or not to recommend marijuana for a medical or psychiatric disorder in place of other existing treatment options.

Given the extensive literature speaking to the harms associated with marijuana use, research on the comparative safety, tolerability, efficacy, and risk of marijuana compared to existing pharmacological agents is needed. The present literature also illuminates the need for research into the effects of isolated cannabinoids (e.g., THC, CBD) as well as species of smoked marijuana (e.g., indica and sativa), as the majority of medical marijuana users ingest marijuana by smoking the marijuana plant [133],[134], which contains a wide variety of phytocannabinoids at varying potencies [135],[136]. Furthermore, improved and objective measurement of clinical outcomes should be implemented in clinical trials to determine treatment efficacy. Finally, little research has considered the issues of dose, duration, and potency. If research identifies a therapeutic effect of marijuana for medical or psychiatric conditions, there will need to be revisions in marijuana policy to increase quality control so that dose and potency are valid and reliable. Additionally, risk of abuse and diversion can be decreased by developing prescribing practices with continued supervision of a medical professional, creating prescription monitoring programs to reduce the risk of “doctor shopping”, and identifying provisions for the safe disposal of unused cannabinoids. In sum, the current literature does not adequately support the widespread adoption and use of marijuana for medical and psychiatric conditions at this time.

Source: :http://www.ascpjournal.org/content/10/1/10 21st April 2015

Abbreviations

THC: Δ9-tetrahydrocannabinol

HIV: Human immunodeficiency virus

AIDS: Acquired immunodeficiency syndrome

RCTs: Randomized controlled trials

IOP: Intraocular pressure

MS: Multiple sclerosis

CINV: Chemotherapy-induced nausea and vomiting

HCV: Hepatitis C virus

ALS: Amyotrophic lateral sclerosis

CD: Crohn’s disease

IBD: Inflammatory bowel disease

AD: Alzheimer’s disease

PTSD: Post-traumatic stress disorder

CB1: Cannabinoid type 1

CBD: Cannabidiol

Competing interests

Dr. Belendiuk holds stock in Shire Pharmaceuticals.

Authors’ contributions

Dr. KAB synthesized the literature and authored sections of the manuscript. Ms. LLB assisted with the literature search and synthesis. Dr. MOB-M conceived the review, assisted in the search and synthesis of existing literature, and authored sections of the manuscript. All authors read and approved the final manuscript.

Acknowledgements

Dr. Belendiuk’s salary was supported by National Institute of Mental Health R01 MH40564.

Dr. Bonn-Miller’s salary was supported by the VA Center of Excellence for Substance Abuse Treatment and Education.

Literature review and synthesis was supported by a grant from the VA Substance Use Disorder Quality Enhancement Research Initiative (SUDQ-LIP1410).

The above funding agencies played no role in the writing of the manuscript or decision to submit the manuscript for publication. The expressed views do not necessarily represent those of the Department of Veterans Affairs.

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    1. Babson KA, Boden MT, Bonn-Miller MO: The impact of perceived sleep quality and sleep efficiency/duration on cannabis use during a self-guided quit attempt.

    Addict Behav 2013, 38:2707-13. PubMed Abstract | Publisher Full Text

    1. Bonn-Miller MO, Boden MT, Vujanovic AA, Drescher KD: Prospective investigation of the impact of cannabis use disorders on posttraumatic stress disorder symptoms among veterans in residential treatment.

    Psychological Trauma: Theory, Research, Practice, and Policy 2013, 5:193-200.

    1. Martín-Sánchez E, Furukawa TA, Taylor J, Martin JL: Systematic review and meta-analysis of cannabis treatment for chronic pain.

    Pain Med 2009, 10:1353-68. PubMed Abstract | Publisher Full Text

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    PLoS One 2010, 5:e14433. PubMed Abstract | Publisher Full Text

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    N Engl J Med 1975, 293:795-7. PubMed Abstract | Publisher Full Text

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    Ann Intern Med 1979, 91:819-24. PubMed Abstract | Publisher Full Text

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    Eur J Cancer Care (Engl) 2008, 17:431-43.

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    BMJ 2001, 323:16-21. PubMed Abstract | Publisher Full Text

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    Ann Intern Med 1979, 91:825-30. PubMed Abstract | Publisher Full Text

    1. Ungerleider JT, Andrysiak T, Fairbanks L, Goodnight J, Sarna G, Jamison K: Cannabis and cancer chemotherapy: a comparison of oral delta-9-THC and prochlorperazine.

    Cancer 1982, 50:636-45. PubMed Abstract | Publisher Full Text

    1. Meiri E, Jhangiani H, Vredenburgh JJ, Barbato LM, Carter FJ, Yang HM, et al.: Efficacy of dronabinol alone and in combination with ondansetron versus ondansetron alone for delayed chemotherapy-induced nausea and vomiting.

    Curr Med Res Opin 2007, 23:533-43. PubMed Abstract | Publisher Full Text

    1. Lane M, Vogel CL, Ferguson J, Krasnow S, Saiers JL, Hamm J, et al.: Dronabinol and prochlorperazine in combination for treatment of cancer chemotherapy-induced nausea and vomiting.

    J Pain Symptom Manage 1991, 6:352-9. PubMed Abstract | Publisher Full Text

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    Hosp Pharm 2013, 48:650-5. PubMed Abstract | Publisher Full Text

    1. Hejazi RA, McCallum RW: Review article: cyclic vomiting syndrome in adults–rediscovering and redefining an old entity.

    Aliment Pharmacol Ther 2011, 34:263-73. PubMed Abstract | Publisher Full Text

    1. Basch E, Prestrud AA, Hesketh PJ, Kris MG, Feyer PC, Somerfield MR, et al.: Antiemetics: American society of clinical oncology clinical practice guideline update.

    J Clin Oncol 2011, 29:4189-98. PubMed Abstract | Publisher Full Text

    1. Roila F, Herrstedt J, Aapro M, Gralla RJ, Einhorn LH, Ballatori E, et al.: Guideline update for MASCC and ESMO in the prevention of chemotherapy-and radiotherapy-induced nausea and vomiting: results of the Perugia consensus conference.

    Ann Onco 2010, 21(5):232-43.

    1. Gordon AJ, Conley JW, Gordon JM: Medical consequences of marijuana use: a review of current literature.

    Curr Psychiatry Rep 2013, 15:419. PubMed Abstract | Publisher Full Text

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    J Psychoactive Drugs 2011, 43:128-35. PubMed Abstract | Publisher Full Text

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    Int J Drug Policy 2013, 24:511-6. PubMed Abstract | Publisher Full Text

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Filed under: Effects of Drugs,Medicine and Marijuana,Psychiatric drugs :

Do manualized psychosocial interventions help reduce relapse among alcohol-dependent adults treated with naltrexone or placebo? A meta-analysis.

Agosti V., Nunes E.V., O’Shea D. et al.

Unable to obtain a copy by clicking title? Try asking the author for a reprint by adapting this prepared e-mail or by writing to Dr Agosti at agostiv@pi.cpmc.columbia.edu.

Supplementing the medication naltrexone with psychosocial relapse-prevention therapies has not helped prevent relapse among alcohol-dependent patients. However, these therapies have elevated outcomes among placebo patients to the level of those prescribed naltrexone.

SUMMARY Medications such as naltrexone and acamprosate are used in the treatment of alcohol dependence to combat frequent relapse to heavy drinking, but their impact has overall been modest, and many patients leave treatment early or do not take medication as intended. Researchers have tried to address these shortcomings by supplementing medication with psychosocial interventions. The featured review assessed whether these attempts have been successful by conducting a meta-analytic synthesis of results from studies which used psychosocial relapse-prevention interventions (typically cognitive-behavioural in approach) to support adult, alcohol-dependent patients who had achieved abstinence, and then randomly been allocated either to naltrexone or a placebo. Relapse was defined as a return to drinking at least 70g alcohol a day for men or 56g for women.

Key points

The review synthesised results from relevant studies to test whether supplementing the medication naltrexone with psychosocial relapse-prevention therapies helps prevent relapse among adult, alcohol-dependent patients.

It concluded this was not the case, though one finding suggested that psychosocial therapies can elevate outcomes for patients prescribed a placebo to the level of those prescribed naltrexone.

The implications of this and of other studies are that naltrexone can be a valuable supplement to medical counselling of dependent drinkers, especially when specialist therapies such as cognitive-behavioural therapy are refused or unavailable.

In some situations these therapies also work better when naltrexone is added. But if the core treatment is naltrexone, good quality medical care or counselling will on average be as effective as specialist structured psychosocial therapies.

Four of the 18 studies which met these criteria had also randomly allocated patients to cognitive-behavioural therapies versus a different approach – specifically either medical management or supportive psychotherapy. These direct tests of the impact of a cognitive-behavioural approach were analysed separately from the remaining 20 studies, in which all the patients were offered the same psychosocial therapies, either cognitive-behavioural or one typical of that type of service.

All 18 studies had recruited nearly 2,600 patients on average about 42 years old. Where this was known, three-quarters were men, 71% were employed, and about half were married.

Main findings

Within each of the four studies which had randomly allocated patients to these therapies, generally the proportions who relapsed when supported by cognitive-behavioural therapies were about the same as those who relapsed when supported in other ways. This was the case both among patients given naltrexone and those allocated to a placebo. When results from these studies were pooled, relapse rates among patients allocated to naltrexone or placebo were virtually the same regardless of the type of psychosocial support.

Among the remaining studies which each allocated all their patients to the same form of psychosocial support, results were available from seven in which this was a structured, manualised programme, usually cognitive-behavioural in nature. Across these studies, virtually the same proportion of patients (about half) relapsed whether prescribed naltrexone or placebo. In contrast, when support took a typical, less structured form such as counselling, fewer naltrexone patients relapsed (33%) than did patients prescribed a placebo (43%). This contrast was statistically significant, and was largely due to results from older studies published between 1992 and 1997. Another unexpected finding was that whether prescribed naltrexone or a placebo, fewer patients relapsed when the treatment was a typical approach than when it was a structured psychosocial therapy.

The authors’ conclusions

Results show that relative to other approaches, cognitive-behavioural therapy did not significantly decrease the likelihood of relapse to heavy drinking among patients prescribed naltrexone or among those prescribed a placebo, and did not augment the impacts of naltrexone relative to an inactive placebo. In the four studies which made direct comparisons, supportive psychotherapy and medical management interventions worked as well. Among the remaining studies, overall those which used a manualised programme such as cognitive-behavioural therapy actually recorded higher rates of relapse than studies which used a more typical, less structured approach.

These results should be viewed in the light of several major limitations. No adjustments could be made for important factors related to the chance of successful treatment such as severity of dependence, and relapse to heavy drinking was the only drinking outcome sufficiently commonly reported to be amalgamated across the studies. Also, the results derived from studies that required initial abstinence and excluded patients with major comorbid disorders, diminishing their applicability to routine practice.

Source: American Journal on Addictions: 2012, 21(6), p. 501–507. April 2015

COMMENTARY The weight of the evidence in respect of treating alcohol or drug dependence is that despite the prominence of cognitive-behavioural therapies, their theoretical pedigree, and an extensive research effort which has distilled them in to expert manuals (for example, 1 2), overall the advantage they confer over alternatives is minor, and especially so when added to a drug-based treatment. In respect of alcohol problems, an analysis has concluded that any variation in outcomes across different psychosocial therapies is likely to have been due to chance or to the allegiance of the researchers.

However, the large US COMBINE trial did find that supplementing inactive placebo pills with psychological therapy incorporating cognitive-behavioural elements raised outcomes to the level of patients prescribed naltrexone. A similar message emerged from another US study which found that as long as naltrexone was prescribed, primary care-style consultations were as effective as specialist cognitive-behavioural therapy in initiating and sustaining recovery from alcohol dependence. Without the medication, cognitive-behavioural therapy was the more effective option. A similar result emerged from the featured review’s analysis of studies which offered the same psychosocial support to all patients; when this was a structured therapy (generally cognitive-behavioural), it helped raise outcomes for placebo patients to the level of those prescribed naltrexone.

All these results suggest that structured therapies can elevate the outcomes of patients not prescribed an active medication to the level of those prescribed naltrexone – that either medication or structured therapy help relative no medication plus typical care. Combining the two does not augment the drug’s impacts – a surprise, since relapse-prevention therapies would be expected to have their own impacts and to give medication greater leverage by persuading more patients to complete treatment and take the pills as intended.

Even if adding structured cognitive-behavioural therapy to naltrexone does not help, the reverse may still be the case – that supplementing cognitive-behavioural therapy with naltrexone makes a more effective package. In several studies (described in these notes) this has indeed been the case. The findings are in line with guidance from the UK’s National Institute for Health and Clinical Excellence (NICE) that in addition to evidence-based psychological interventions, patients whose alcohol dependence is moderate or severe should also be able to access relapse prevention medication, including naltrexone.

Practice implications seem to be that naltrexone can be a valuable supplement to the medical counselling (by GPs or nurses) of dependent drinkers of the kind who might be treated in primary care, especially when specialist therapies such as cognitive-behavioural therapy are refused or unavailable. In some situations these therapies also work better when naltrexone is added. But if the core treatment is naltrexone, a good quality medical care approach or counselling will on average be as effective as specialist structured psychosocial therapies.

Last revised 17 April 2015. First uploaded 10 April 2015

Filed under: Addiction (Papers),Alcohol,Drug Specifics,Effects of Drugs,Intervention (including testing) (Papers) :

By Jeanette McDougal, MM, CCDP, Chair
William R. Walluks, Member Hemp Committee, Drug Watch Intl.
August 2000

Fiber Cannabis hemp seed, though containing tetrahydrocannabinol (THC, the main psychoactive ingredient in hemp/marijuana) and other cannabinoid residue, is being heavily marketed and promoted by the hemp industry as a source of food, nutraceuticals, and cosmetics. The harmful effects of THC on humans and other animals is well documented. Hemp advocates, however, mimicking the tactics of tobacco industry apologist, challenge and “call into question” every statement substantiating harm caused by the use of Cannabis sativa L. hemp. (Where used in this paper, the term hemp refers to cannabis sativa, aka marijuana, and not to any of the numerous other plant fibers also commonly referred to as hemp.)

The campaign to use hemp fiber for paper, biomass, textiles, etc. has largely failed because hemp is neither economically viable nor technically feasible. However, because the handling, storage, and processing of hemp seed is more adaptable to present technologies than for hemp fiber, hemp seed production and products are now being aggressively promoted.

Low THC Cannabis sativa hemp that contains less than .3% (w/w) THC became legal to grow in Canada in March, 1998. THC and the other cannabinoids are found in food and other products made from fiber hemp seed. According to Canada’s national health department, Health Canada, “In theory the ripened seeds of Cannabis contain no detectable quantity of THC. However, because of the nature of the material it is almost impossible to obtain the seeds free from extraneous THC in the form of residues arising from other parts of the plant which are in close proximity to the seeds. Although it is required for the seeds to be cleaned before any subsequent use, the resinous nature of some of the material makes complete cleaning extremely difficult.” [1]

Since THC and the over 60 other cannabinoids are fat-soluble, i.e., store themselves in the fatty tissues of the brain and body, even a very small amount may be damaging, especially if ingested regularly. Fat-soluble substances accumulate in the body.

THC has a half-life of about seven days, meaning that one-half of the THC ingested or inhaled stays in the brain and body tissue for seven days. Traces can stay in body tissues for a month or more. The only important substance that exceeds THC in fat solubility is DDT. [2]

A risk assessment done for Health Canada states that, “New food products and cosmetics made from hemp – the marijuana plant – pose an unacceptable risk to the health of consumers. It also says that hemp products may not be safe because even small amounts of THC may cause developmental problems. “Those most at risk,” the study says, “are children exposed in the womb or through breast milk, or teen-agers whose reproductive systems are developing.” [3]

“Hazards associated with exposure to THC include acute neurological effects and long-term effects on brain development, the reproductive system and the immune system,” the study says. “Overall, the data considered for this assessment support the conclusions that inadequate margins of safety exist between potential exposure and adverse effect levels for cannabinoids (the bio-active ingredients) in cosmetics, food and nutraceutical products made from hemp.” [3]

The study reviewed the results of existing tests on lab animals. Health Canada may require warning labels or new regulations that could stop some products from being sold. It is considering new animal studies to examine the effects of low-level exposure to THC over several generations. [3]

To cast further doubt about safety, the Journal of Immunology (July 2000) recently reported that THC, the major psychoactive component of marijuana (hemp), “can promote tumor growth by impairing the body’s anti-tumour immunity system.” [4]

Another unknown is hemp as forage for animals. According to Stan Blade, a director of crop diversification for Alberta Agriculture, a program that will test hemp over the next year as feed for livestock is being considered in Canada. Forage hemp will be tested on cattle against a more traditional mixture of oats and barley. [5]

Buffalo, the common dairy animal of Pakistan, are allowed to graze on Cannabis sativa (hemp), which, after absorption, is metabolized into a number of psychoactive agents. These agents are ultimately excreted through the urine and milk, making the milk, used by the people of the region, subject to contamination. Depending on the amount of milk ingested and the degree of contamination, the milk could result in a low to moderate level of chronic exposure to THC and other metabolites, especially among the children raised on this milk. Analysis from the urine obtained from children who were being raised on the milk from these animals, indicated that 29% of them had low levels of THC-COOH (THC-carboxylixc acid, which is a major metabolite for THC) in their urine. This study indicates that the passive consumption of marijuana through milk products is a serious problem in this region where wild marijuana grows unrestricted, and that children are likely to be exposed more than adults.” [6]

Hemp use could compromise drug testing. In his book, “Fats that Heal, Fats that Kill,” Udo Erasmus warns that people whose jobs require mandatory drug screening should avoid the use of hemp products, since THC residues in hemp products can show up in urine tests. 7. THC-positive urine tests from hemp product use were also reported in the August 1997 Journal of Analytical Toxicology. 8. For drug-testing reasons, the U.S. Air Force, the Air Force National Guard, the New York Police Dept., and the U.S. Coast Guard have banned the use of hemp foods and health supplements by their personnel. [8. & 9]

“Dr. Hugh Davis, Acting Head of Microbiology and Cosmetics at Health Canada, is quoted as saying that he has been looking at studies on hemp and has found research showing hemp (i.e., fat soluble cannabinoids) is accumulative in the body because of its long half-life and has the same adverse physiological (but not hallucinatory) effects that smoking marijuana does. One study states that cannabinoids may postpone puberty. There are 60 known cannabinoids, only three of which have been widely studied. This means that the potential harmful aspects of the remaining 57 cannabinoids, when used in a cream or shampoo, are unknown.” [10]

John Bailey, Microbiology and Cosmetics Division, US-FDA, (US-Federal Drug Administration) is concerned as well, stating that there is no definitive information about THC in food and cosmetics. [10]

Dr. Mohmoud ElSohly, Ph.D., Marijuana Project Director, NIDA (National Institute of Drug Abuse), states that “Fiber hemp can have significant potential for narcotic application….The threshold THC concentration (below which Cannabis would have no significant psychoactive properties) has not been determined.” [11] [Emphasis added] Dr. Roy H. Hart, Clinical Psychiatrist and research chemist (ret.), asserts that it is possible to experience chronic intoxication without being high. [12]

In addition to THC, there are other bioactive, but non-psychoactive, cannabinoids [cannabinol (CBN), cannabidiol (CBD), and cannabigerol (CG)] in Cannabis sativa marijuana(hemp). [13] David West, Ph.D., pro-hemp activist (HI), claims that CBD blocks the effects of THC in the nervous system. [14] However, Dr. Carlton Turner, Director of the Federal NIDA Marijuana Project (1970-1981) and former US Drug Czar (1980s) counters that “CBD is abundant in hashish and if CBD blocked THC’s action, why would hashish be so popular? I know of no known definitive study that shows that CBD blocks THC’s affects. Fiber cannabis is rich in CBD with little THC. However, naive users can sometimes get high but regular users will not.” [15]

The non-psychoactive cannabinoids may be even more toxic than THC. According to Dr. Roy Hart, “Cannabidiol (CBD) exerts an important effect on the hippocampus which is part of the limbic system of the brain, a collection of inter-functioning units concerned with emotion. CBD produces a depression of hippocampal function…Thus far experimental evidence indicates that CBD is even more toxic to tissues than THC.” [16] [Emphasis added] Dr. Gabriel Nahas, Research Professor, New York University, states that cannabionids other than THC (CBN and CBD) also impair dividing cells, and “are even more potent than THC when it comes to inhibiting DNA production.” [17]

Dr. Hart further states that “Both the psychoactive and non-psychoactive cannabinoids occurring in nature interfere with protein synthesis, deoxyribonucleic acid (DNA) synthesis, and ribonucleic acid (RNA) synthesis. This is without doubt the most important statement to be made about marijuana(hemp) and is based upon the burgeoning literature of basic and applied research into cannabis. Cell-tissue-organ damage follows inevitably from these alternations occurring at the molecular level.” [18]

Longtime and internationally renowned Cannabis researcher, Dr. Gabriel Nahas says that research has shown that the most serious adverse consequences of consumption of THC and other cannabinoids have been observed at the earliest state of reproductive function, on the “gametes” or germ cells of man. These drugs cause damage to the genetic information contained in DNA, causing apoptosis (programmed cell death and deletion). This threatens future generations before they are conceived. [19]

A 1996 study conducted in the Ukraine (formerly Russia) showed that there are no varieties that completely lack(ed) cannabinoids. A rather high content of these substances (cannabinoids) was found in some varieties. The results obtained have shown that hemp cultivated in more northerly areas is naturally rich in cannabinoids. [20]

European Union (EU) hemp regulations for the year 2000 state that hemp subsidies will be paid on condition the farmer uses certified seed of hemp varieties with a THC content of less than 0.3%. From the years 2001/02, that upper limit will be lowered to 0.2%. [21]

The European Union (EU) too is concerned about any inclusion of hemp products’ in food, stating in their regulations, “…Hemp seed has one traditional but limited application as food for fish and birds. The oil from hemp seed can be used for specialist cosmetics applications. The use of hemp seed or the leafed parts of the plant for human consumption would, however, even in the absence of THC, contribute towards making the narcotic use of cannabis acceptable and, in any event, there is no nutritional justification for this. [Emphasis added] None of these products should be encouraged in their own right by Community aid….Moreover, the International Narcotics Control Board (INCB, a United Nations body) states that: ‘while illicit cannabis cultivation (sic) have soared, a considerable market for food products and beverages produced with cannabis has developed in the European Union (…). The health effects of these products have not been adequately researched.’(…) [Emphasis added] The wide and unrestricted availability of such products in shops, where cannabis candy bars can be sold to minors without restriction, contribute to the overall benign image of cannabis, a drug under international control.” [OICS note of 12.3.1999.] [21]

“It is therefore important to remain vigilant and step up controls to ensure that illegal crops do not tarnish the reputation of the sector producing hemp for fibre. To avert such dangers, the cultivation of hemp for fibre must be strictly controlled, which means the area cultivated will have to be restricted, and the uses to which it is put must NOT include human nutrition.” [Emphasis added] These EU regulations apply from July 1, 2000. [21]

The findings of the previously mentioned Health Canada THC Assessment are quite alarming from a consumer health and safety standpoint. Two key areas of health hazards to humans were reviewed, and the potential for risks from consumption of hemp products was characterized. [22]

One health area was neuroendocrine disruption during developmental states (perinatal, pre-pubertal and pubertal) that leads to permanent adverse effects on the brain and reproductive systems. The second area was neurological impairment manifested as deficits in cognitive and motor skills’ performance. [22]

The study could not, due to data gaps, develop definitive conclusions regarding the degree of potential risk from ingesting THC through hemp products. However, even without considering the bio-accumulative hazard potential of THC through repeated or multiple-product use, or the risk from chemicals other than THC in Cannabis sativa hemp, it nevertheless came to the following conclusions:

CHARACTERIZATIONS OF RISKS FROM THC
IN HEMP PRODUCTS FOR HUMAN USE & CONSUMPTION
HEALTH CANADA STUDY (DRAFT of November 23, 1999)

HEALTH RISK/ PRODUCT FOOD COSMETICS NUTRACEUTICALS
RISK OF
NEUROENDOCRINE
DISRUPTION *		 LIKELY POSSIBLE LIKELY
RISK OF NEUROLOGICALIMPAIRMENT ANDPSYCHOACTIVITY LIKELY, PARTICULARLYFOR CHILDREN
(also risk ofpsychoactivity for children) 		UNLIKELY, THOUGH CANNOT BE EXCLUDED ENTIRELY DUE TO LIMITATIONS OF STUDY POSSIBLE,PARTICULARLY IN CHILDREN.

*Developing fetus, nursing infant, and prepubertal/pubertal child are at greatest risk of long-term effects. THC is rapidly transferred from mother to fetus within minutes of exposure. THC accumulates and is transferred via breast-milk. [22]

The in-depth Health Canada Risk Assessment on THC and Other Cannabinoids (in products) Made with Industrial Hemp (11/23/99) warns “On the basis of currently available data it is concluded that the present Canadian limit of 10ug/g (i.e.,10 ppm) THC in raw materials and products made from industrial hemp (Cannabis sativa cultivars with less than 0.3% THC) would likely not protect the Canadian consumer using industrial hemp-based food, cosmetic and personal care, and nutraceutical products from potential health risks of neurological impairment and neuroendocrine disruption associated with low level exposure to THC and other cannabinoids.” [22]

In the United States even salad oils must be examined and certified by the US-FDA as “generally recognized as safe.” This has not been done for hemp.

Allowing or introducing toxic chemicals in our food and cosmetic systems through use of THC-containing industrial hemp products is unthinkable. To do so would jeopardize public health and safety. U.S. citizens and government agencies and officials should do everything possible to prevent this from happening, thus protecting future generations from both known and unknown health and genetic hazards.

REFERENCES: THC in Food and Cosmetics

1. Industrial Hemp Technical Manual, Health Canada, Standard Operating Procedures for Sampling and Testing Methodology Basic Method for determination of THC in hempseed oil, 1998.

2. Hart, R.H.: Bitter Grass, The Bitter Truth About Marijuana, April 1980,13-14.

3. Mcilroy, A.: “Health Canada study says THC poses health risk,” Globe and Mail, Ottawa Canada, July 27, 1999.

4. Zhu,LX., Sharma,S., Stolina,M., Gardner,B., Roth,MD., Tashkin,DP., Dubinett,SM., -9-Tetrahydrocannabinol Inhibits Antitumor Immunity by a CB2 Receptor-Mediated, Cytokine-Dependent Pathway, The Journal of Immunology, 2000, 165: 373-380.

5. “Alberta Farmers Slow To Try Growing Hemp,” Calgary Herald, Calgary Canada, August 14, 1999.

6. Ahmad, GR; Ahmad, N., “Passive consumption of marijuana through milk: a low level chronic exposure to Delta-9-tetrahydrocannabinol (THC)., Journal of Toxicology, Clinical Toxicology, 1990,28:2,255-260;ref.

7. Erasmus, U., Fats that Heal, Fats that Kill, Alive Books, 1993, p. 287.

8. Pulley, J., Air Force Snuffs Out Hemp-Seed Extract, Air Force Times, 2/8/99.

9. Cooper, M., New Police Policy Takes On Hemp Oil!, New York Times, 7/22/99.

10. Begoun, P., “Hemp Claims Can’t be Confirmed,” Tampa Tribune (FL), February 4, 2000.

11. Report to the (KY) Governor’s Hemp and Related Fiber Crops Task Force, June 13, 1995, Letter from Mahmoud A. Elsohly, Project Director, NIDA, Marijuana Project, University of Mississippi, to Prof. M. Scott Smith, Ph.D., University of Kentucky College of Agriculture, 1995.

12. Hart, R.H.: Bitter Grass, The Bitter Truth About Marijuana, April 1980, p 17

13. Ibid, p 17.

14. West, DP., Hemp and Marijuana: Myths & Realities, North American Industrial Hemp Council, Inc., 1998, p5.

15. Personal Correspondence from: Carlton Turner, Ph.D., Carrington Laboratories, Inc., Irving, TX., March 22, 1999, to: Jeanette McDougal.

16. Hart, R.H.: Bitter Grass, The Bitter Truth About Marijuana, April 1980, p 18.

17. Nahas, GG, M.D., PhD., D.Sc., Keep Off The Grass; Paul S. Ericksson, Publisher, 1990, p148

18. Hart, R.H.: Bitter Grass, The Bitter Truth About Marijuana, April 1980, p 17.

19. Nahas, GG, M.D., PhD.,D.Sc., Keep Off The Grass; Paul S. Ericksson, Publisher, 1990, p282. and Stedman’s Medical Dictionary, Lippincott Williams & Wilkins, Baltimore 2000.

20. Virovets, V.G.: Selection for Non-Psychoactive Hemp Varieties (Cannabis sativa L.) In the CIS (former USSR), 1996, Journal of the International Hemp Association 3(1): 13-15.

21. Community preparatory acts, Document 599PC0576(02): Http://europe.eu.int/eur- lex/en/com/dat/1999/en_599PC0576_02.html

22. Tetrahydrocannabinol (THC) and Other Cannabinoids in Foods, Cosmetics and Nutraceuticals Made with Industrial Hemp – A risk Assessment – (Draft) Prepared for Health Canada, November 23, 1999 (available through Access of Information, Canada). Final Report due fall of 2000, available through Health Canada.

Source: www.drugwatch.org/resources Aug.2000

Filed under: Cannabis/Marijuana,Drug use-various effects on foetus, babies, children and youth,Effects of Drugs,Environment,USA :

Introduction

This essay is about the drug problem in society, particularly in the United States. By “drug” I mean alcohol, tobacco, and illegal drugs such as marijuana, hallucinogens, stimulants, depressants, and opiates. In regard to youth, inhalants (household chemicals inhaled to get a “high”) are also included.

This is not about the struggles faced by individuals who are addicted, or who struggle with any of the many life problems that can arise from drug use. Others are well addressing those issues in the treatment programs they offer and the publications they write. That society should be more diligent in ensuring availability of treatment for all who need it has been well stated by others. This essay is not about people’s drug problems so much as society’s drug problem.

The problem is that drugs are significantly decreasing our collective quality of life: decreasing our capacity to solve the problems that we collectively face in living. Whether you turn to issues of economics, health, social justice, family life, or the strength of the work force, the magnitude of the damage done by drugs is striking:

  • The number of deaths due to drugs in the United States alone each year exceeds 400,000 from tobacco, 100,000 from alcohol, and 35,000 from other drugs.
  • The most recent estimate of cost to U.S. society (not to users) of alcohol and other drug abuse was 246 billion dollars: 148 billion from alcohol abuse and 98 billion from other drug abuse.
  • A large percentage of health problems and health care costs are due to alcohol or other drugs.
  • Substance abuse in a single year costs American businesses 37 billion dollars due to premature deaths and another 44.6 billion dollars due to employee illness. Drug dependence and alcohol together cost businesses 200 billion dollars. A majority of the alcohol problems are caused by light and moderate drinkers, rather than alcoholics.
  • A high percentage of child abuse and neglect is associated with parental AOD (alcohol or other drug) abuse.
  • A recent study of teen marijuana users found they were 4 times more likely than non-users to attack someone, 3 times more likely to destroy others’ property, and 5 times more likely to have stolen things.
  • The combination of alcohol-related accidents, assaults, and suicides makes alcohol the leading risk factor for adolescent death and injury.

Whether or not you have directly experienced a drug problem in your life, society’s drug problem is shared by all of us. Most of the people who are aware of the impact of drugs on families and other relationships would argue forcefully one person’s drug use hurts more than just that person. The issue may be debatable in the case of any single individual, but collectively there can be no doubt: the drug problem is a problem for all of us.

In the twelve years I have worked in drug prevention, I have learned a lot about how drug use develops, and how it can be prevented. I have discovered that there is tremendous energy and potential in drug prevention, but progress has sometimes been slow, for good reason. The reason is that the general public, and in some cases even prevention professionals, hold some core assumptions about the drug problem that are actually incorrect. As a result, much of the effort put into prevention strays slightly, but significantly, from what is needed.

This essay is an attempt to identify, describe, and correct those faulty assumptions. This is not a “how to” book on prevention. I have written such a book (Best Practices in ATOD Prevention, 1997), with much help. But having the right tools are not enough to become a builder. To be successful with “how to,” you have to start with, “what’s that?” This essay is about understanding the drug problem: what causes it and what is needed to stop it. The application of this knowledge is up to each reader. I hope you find some valuable insights here, or perhaps find support for some of your own observations.

I am convinced that if we stop going down dead-end streets, we can really get places in prevention. Thanks for letting me share the results of my explorations in drug prevention.

Fallacy #1: The primary target of drug prevention should be hard-core drug abuse.

This fallacy has three main parts: (a.) which drugs are the problem, (b.) which drug users are the problem, and (c.) the relation of addiction to drug abuse.

a. “Shouldn’t crack, speed, and heroin be our number one concern?”

No. Ounce for ounce these drugs are certainly among the most potent, but they are (or should be) of secondary concern to drug prevention because of the developmental nature of drug abuse, the limitations of prevention, and the greater amount of societal problems associated with other drugs.

Development of Drug Abuse

It is exceedingly rare for an adult who has never used any drug to use drugs like cocaine or heroin. Nearly as rare is a youth or adult who uses one of these drugs without a history of use of at least one, and often all three, “gateway” drugs: alcohol, tobacco, and marijuana.

Don’t misunderstand the gateway drug phenomenon: obviously not all people who use alcohol, tobacco, or marijuana progress to other drug use. But, the odds of other drug use depend on gateway use because those who don’t use gateway drugs are so extremely unlikely to use other drugs.

The gateway phenomenon includes two other notable features in addition to the issue of whether or not gateway drugs are used. One is that the younger a person is when they begin gateway use, the greater their likelihood of drug problems (with gateway and other drugs) later in life. The other is that people who use two or three gateway drugs are more likely to progress to other drugs than people who use one (use of all three is most significant).

So alcohol, tobacco, and marijuana are truly “gateways” to other drug use. Although most of the people who go through the gate don’t do on to other drug use, nearly everyone who goes on to other drugs passes first through the threshold of gateway use. This alone doesn’t conclude the case for where to direct drug prevention, but sets the stage for two other two facts.

Limitations of Prevention

Prevention is just one of the major strands of anti-drug efforts. The other two are treatment and legal restrictions (regarding use, possession, and sale of drugs). To a great extent the target population for prevention and the target for treatment are opposite. By the time people go through gateway use and begin using other drugs, they have become (due to some combination of self-selection and the results of earlier gateway use) fairly habituated to drugs. In many cases they are already addicted. The habit formed from regular drug use is hard to break. When addiction is also present, the strong forces involved are not only psychological but also bio-chemical. We like to think our minds are in control, but addiction can rule behavior at a level so deep and powerful that rational thought pales in comparison.

As a result, prevention efforts that may be appropriate for youth who are non-users or experimenters with drugs are simply not effective with more committed users, and certainly not with addicts. Addiction calls for drug treatment: prevention is inadequate for those trying to back away from heavy drug use.

On the other hand, treatment is not appropriate for first-time experimenters. The treatment process is not designed for that population, and the cost of providing such intensive services is neither justified for the individual drug experimenter nor remotely available for the whole population of experimenters. For them and for those who are yet to experiment, prevention is the key.

Of those who use gateway drugs, some require treatment (or cessation aid, in the case of tobacco), but most do not. Of those who use other drugs, a large proportion requires treatment, and few would benefit from prevention. This strengthens the case for targeting gateway drugs in prevention, and leads to the third point.

Societal Cost of Gateway Drug Problems

Recall that ounce per ounce, gateway drugs are not as destructive as crack, crank, and heroin. But the scope of any one drug’s impact on society depends on the amount of use (including number of users and degree of use by each) as well as the drug’s dangers. Unlike crack and heroin, gateway drugs are used by a large portion of the population. And, though gateway drugs seem less dangerous than so called “hard” drugs, research and bitter experience have shown that the gateway drugs are dangerous enough:

  • Tobacco kills four times as many Americans as does alcohol, and alcohol kills three times as many as all illegal drugs combined.
  • Alcohol seems to be the leading cause of teen deaths, based on the high percent of instances in which alcohol is a major factor in car crashes, suicides, homicides, drownings, and other unintended injuries.
  • Marijuana combines the cancer potential of tobacco with the cognitive impairment of alcohol, except that impaired thought lasts longer after each marijuana use than after each alcohol use.

As a result, the benefit to society of cutting gateway drug use in half would be much greater than cutting other drug use in half. Combine this point with the point about prevention’s limits and the point about the development of drug abuse, and you get a strong case for making gateway drug use (particularly by youth) the prime target of prevention.

b. Shouldn’t prevention always target “high risk” youth?

No. Although it may be appropriate to devote extra preventive effort to some groups of youth, conceiving ATOD prevention in only those terms is problematic for reasons that include the breadth of risk, the importance of environmental risk, and the need for different approaches according to the nature of different risk conditions.

Breadth of Risk

While some characteristics act as “risk factors” for youth ATOD use, the absence of those risk factors doesn’t guarantee a drug-free youth. To some extent, everyone is at risk. The older a persons gets without using, the lower the risk that they will use. Furthermore, while the primary aim of ATOD prevention is to prevent use, an important secondary function is to help prepare all youth for addressing the drug problem in society: as family members, co-workers, or citizens. We are currently a society at risk.

This is not to say that community risk conditions shouldn’t be considered, nor that “selective” ATOD prevention efforts can’t be done for groups of medium risk youth or families. I use the term “medium risk” to refer to youth who haven’t begun ATOD use, but whose family or personal characteristics include some risk factors (e.g., poverty, low academic achievement, parental drug use or addiction, etc.) for youth ATOD use. But these efforts are a supplement to prevention efforts for all youth, rather than a replacement.

Environmental Risk

Preoccupation with risk profiles of individual youths, or even groups of youths, diverts attention away from the strongest influences of whether most youth will try drugs or avoid drugs. The combination of youths’ peer social environment, family environment, school environment, media environment, and their community’s adult social environment account for the vast majority of variation in youth drug behavior. A “low risk” youth who enters a “high risk” environment (e.g., a “no-use” youth who moves to a school where drinking is the norm) is no longer low risk.

Prevention planners who only look at what’s “inside” youth can miss the environmental factors (including media influences) that shape youths’ attitudes. If not directly addressed, these environmental factors can misdirect youths’ attitudes and behaviors as fast or faster than youth-focused programs can positively affect them.

Different Risks – Different Approaches

The risk factor that is most important to the largest number of youth in regard to initiation of gateway drug use is their perception of peer attitudes about drugs, as will be discussed in regard to “Fallacy #3.” However, for a smaller number of youth other factors play a major role. For example, children raised in households with parental violence, neglect, or addiction are more likely than average to develop their own problems with alcohol or other drugs. The number of children in this kind of situation, though much larger than it should be, is small compared to the overall number of children and families.

For a child in a household with parental violence (domestic violence and/or child abuse), what happens to that violence may be the most important “risk factor” for their future mental health, including their relation to drugs. Their greatest need may have little to do with drug prevention, and everything to do with appropriate resolution of the violence.

For a youth failing school, the greatest need may be assistance with whatever is interfering with school achievement.

In each case, the most effective form of drug prevention may be to resolve the problem(s) that increase risk for drug use, rather than to directly address the issue of drugs. On the other hand, a youth who has started to experiment with drugs may need intervention services, sometimes called “indicated prevention”, but actually more closely akin to some forms of substance abuse treatment counseling. In all these instances, the kinds of programs that constitute “universal” drug prevention programs may be less relevant. So, these kinds of “high risk” youth need more focused and intensive assistance than is available through what I am calling drug prevention, i.e. programs designed to impact the gateway drug attitudes and behaviors of large groups of youth. They may be helped somewhat by such programs, and so should not be excluded, but to limit participation in prevention programs only to such “high risk” youths is probably not appropriate, particularly given the risk of a norm of gateway drug use arising among program participants if all are “high risk.”

c. Isn’t addiction prevention the main goal of substance abuse prevention?

No. Addiction is one major outcome of drug use, but the impairment of rational thought, the plethora of anti-social and injurious behaviors caused or heightened by that impairment, and the direct toxic effects of drugs are all substantial societal problems worthy of prevention. Addiction increases these other problems, but a person need not be addicted in order to seriously injure of kill themselves or others while impaired, typically due to negligence (as in DUI crashes) rather than violent intent.

Further, since the number of alcohol or other drug users at any given point in time far exceeds the number of addicts (including alcoholics), the societal damage done by non-addicted persons can cumulatively exceed the damage done by addicts. Even though individual addicted persons are more problematic to society than individual non-addicted AOD (alcohol and other drug) users, the much larger number of non-addicted users makes them a major part of societal AOD problems.

Efforts to make the public more aware of realities of addiction should continue, but preventing addiction is one main goal of drug prevention: not the main goal.

Fallacy # 2: Alcohol and other drug problems are mainly a result of other problems, and drug prevention can best be accomplished by addressing those other problems.

Drug abuse has multiple causative factors: this has become an oft stated truism. Unfortunately, people tend to notice and magnify the causative strand that is most evident in their personal or professional experience. Their observations are strengthened by studies which demonstrate the connection between each of a variety of “risk factors” and drug abuse, but which fail to consider the larger context of the societal drug problem, including which of the many risk factors play the most important roles within the largest numbers of people. Rather than starting with convergence on the most prevalent and powerful risks, people therefore tend to diverge into various less central issues:

  • Persons who focus on poverty see poverty as the main root of drug problems.
  • Persons concerned with stimulating positive youth development see their work as the best form of drug prevention.
  • Persons familiar with dysfunctional family systems see family dysfunction as the main root of drug problems.

Attention to this whole range of negative factors may be appropriate, but mistaking any one of these for the “main” cause of drug problems is not. One person or subgroup may be profoundly influenced by one of these factors, but the prevalence of each factor in the population is far less than the prevalence of drug problems.

Family Dysfunction: Major dysfunction (such as family violence) greatly heightens the chance of youth drug problems, but the majority of youth AOD users (and hence, most of the future AOD abusers) do not come from dysfunctional families. Dysfunctional family life is a potent risk factor but not a prevalent one, in comparison to the scope of youth AOD problems.

Poverty: Poverty makes drug problems more likely, but only slightly more likely: a large number of well-to-do people are among those who children use and abuse alcohol and other drugs.

Positive Youth Development: Policies that empower youth development are a good idea, but aren’t sufficient to prevent youth drug use. The notion that positive youth development can substitute for specific attention to drug prevention is similar to the 1970’s notion that good self-esteem is the key to drug prevention. Unfortunately, ignoring drug prevention in favor of self-esteem tends to produce drug users with high self-esteem. Self-esteem doesn’t protect from the destructive effects of drugs. Youth development programs can be an important aid for youths who lack key developmental assets, but will only impact drug use if:

  1. anti-drug norms are already present in the lives of those youth, or
  2. the youth development program includes building anti-drug norms as part of its mission.

Two kinds of problems arise from the mis-attribution of heightened importance of these factors as causes of substance abuse:

  1. More global causes of ATOD problems, such as youths’ and parents’ attitudes about drug use, may be glossed over in the design of prevention strategies. In other words, potentially efficacious approaches to prevention may be ignored in favor of less broadly effective approaches.
  2. Parents may believe that avoiding family dysfunction is sufficient to prevent youth drug problems.

The worst instances of this fallacy in action have parents or other adults allowing and enabling youth alcohol or other drug use under the misguided notion that only troubled individuals abuse substances. Statements like, “It’s no big deal,” or “They’re just going through a phase,” or “It’s part of growing up” tend to be evidence of this. While it’s true that troubled youth are more likely to develop a drug problem, also true is that alcohol or other drug use can cause a person to become troubled – especially if addiction is involved.

Youth alcohol and other drug use is a bad idea no matter how positive an individual’s circumstances. Youth with substantial personal or family problems are more likely to experience significant problems with drugs, but the initial absence of personal disturbance is no insurance policy against addiction or other ATOD problems. And, although family problems constitute a risk factor for youth ATOD use, family wellness is not a sufficient protective factor to counter other negative influences on youth ATOD decisions. Parents who don’t have general problems with family management can take steps (particularly in regard to monitoring youth activities) to decrease their children’s likelihood of ATOD use, but just being a “good” parent isn’t a cure-all. Drug prevention needs to go beyond the foundation of healthy families and positive youth development, to build attitudes and behaviors that especially counter ATOD influences in society.

Fallacy #3: The main essence of successful drug prevention is communication about the dangers of drugs.

This very common misperception probably sidetracks more prevention efforts than any other single error. Actually the essence of success in preventing youth use of gateway drugs is making drug use unpopular: destroying the myth that peers approve of drug use. This can be supplemented by fact-based approaches and parent programs, but the most basic reason youth as a whole start gateway drug use is because they believe their peers approve of it. No matter how dangerous they are told drug use may be, if they think many others are doing it they will tend to do the same, unless they consistently see very negative effects on those believed to be using.

There are two reasons I see for the continuing strength of Fallacy #3 in spite of evidence to the contrary. The first is our nature as human beings. We like to think we are logical, sensible beings. To some extent we are, but most of us, and especially children and youth, base our actions first on what we observe from those around us, and only secondly on what we believe.

Remember that we are talking about society as a whole here: there are certainly some people who are less prone to be influenced by others (psychology calls them “field independent” as opposed to field dependent), and all of us vary in our susceptibility. But as a whole, we’re just not as logical as we like to think. To be human is to be influenced by our observations of others.

The second reason for the fallacy is a more complex one having to do with the nature of scientific studies of youth alcohol and other drug use. Common scientific method in the social sciences involves looking for things that go together in large populations. The question is what “factors” tend to go with, and particularly to predict, youth ATOD use. A basic premise is that correlation does not necessarily equate to causation, especially in cross-sectional one-time studies. However, when a factor such as “perception of harm” is closely matched with drug use over a period of years, as has been the case in the national “Monitoring the Future” study, observers are hard pressed to ignore the likely conclusion that changing perception of harm is the key to prevention.

The problem is, how does one change perception of harm? The common assumption is that you do this by communicating drug dangers. Often overlooked is that there is an equally strong association with perceived peer approval or disapproval for use of drugs: what youth believe their peers think of drugs. I think that, contrary to common assumptions, the perception of peer attitude drives youths’ own attitudes about drugs (both perceived harmfulness and intent to use). Perception of harm then ends up being a strong indicator of whether a youth will use a drug, especially because it is probably also affected by other risk factors. But the route to turning around perception of harm usually has to go through perceptions of peer approval/ disapproval. When we present logical facts about drug dangers to youth, if they think most of their peers approve of drug use, and indeed use drugs, then the warnings seem ungrounded and are easily ignored.

I base this point on a variety of research, but some of the most striking and easiest to communicate is research about what works in prevention. Of all the things that have been tried in prevention curricula for young teens, the most powerful is simply to correct their typically exaggerated assumptions about how many peers use drugs. When they are shown that far fewer than thought peers use, their attitudes change to a degree not seen with mere truth about drugs.

This is not to say that education about drug dangers is not important for youth: it is! These facts back up the facts about peer attitudes, and may be especially important for some youth who are able to base their behavior on rational truth about drug dangers. Even if this weren’t the case, it would simply not be right to let youth grow up in this society without exposing them to the truth about drugs. But to assume that exposure is the key element of prevention is to severely limit the effectiveness of one’s prevention efforts.

One of the important implications of this is that the images presented by mass media, especially in regard to images of youth attitudes and behaviors, should be a vital concern of prevention. We all like to think that we are too sophisticated to be influenced by the images of television and other media, but it’s just not so. We are influenced. That’s why advertising works. While any one youth may be more influenced by their parents than by the media, youth as a whole are dramatically influenced (as has been demonstrated by studies showing that youth smoke those cigarette brands that are most heavily advertised to youth). Media plays the role of a “super-peer,” playing directly into the heart of youth decisions by telling them what is cool and what isn’t. Prevention cannot afford to ignore this. Luckily, the same principles currently used by alcohol and tobacco advertisers to snare youth users can also be used in prevention. But, first we have to get past this fallacy that drug facts are the key.

Fallacy # 4: Making and enforcing laws against the use of drugs, and against underage use of alcohol and tobacco, is contrary to prevention and treatment of drug use.

This premise has been advanced by legalization groups, claiming all would be well if we did away with laws against drug use and relied solely on prevention and treatment. But the truth is that prevention, treatment, and legal barriers to use all depend on each other for effectiveness. The kind of “prevention” touted by legalization groups is not prevention of use but facilitation of “safe” use, called “harm reduction.” The role of prevention in this scenario is to teach people how to use drugs safely. The problem with this is that the laws against each particular drug are enacted because its use is inherently unsafe. An analogy would be explosives manufacturers lobbying to take the funds used to enforce laws against possessing bombs and instead just teaching youth how to use them “safely,” and of course not until they were 18 or 21. Would the public stand for that? Would even the most avid libertarians be crazy enough to support it? Legalizers suggest that drugs hurt only the user, but impacts of our society’s drug problem go far beyond the circle of users, as was discussed earlier.

Even if, after legalization, the current drug-free message of prevention were maintained, a country that tolerates drug use would be giving a strange message that would undercut any such “no-use” message. “Drugs are dangerous and hurt society, but you can go ahead and do them if you want.” Use would soon rise, not so much from drug-free adults starting use but from every new generation of teens becoming more and more enmeshed in drug use, in spite of any legal age restrictions. This is what has happened when legalization has been tried. Similarly, the number of people entering treatment, cooperating with treatment, and avoiding relapse would be far less without the force of law to compel users to quit.

High quality drug prevention and treatment are currently vital to our society, but their success would be lessened, not increased, if legal sanctions against use were eliminated. The specific workings of the legal and criminal justice system in regard to drug use can always be examined for improvement, but most groups who currently call for drug law “reform” are using the term as a euphemism for legalization.

Fallacy # 5: Marijuana is not dangerous.

We tend to think of drugs as poisons to the body, and measure the potency of a drug by how fast and how completely it can interfere with physical health. We are less quick to recognize that the most crucial characteristics of drugs are their “psychoactive” effect: their alteration of thought, feelings, and behavior. Measured by physical effects only, marijuana is not as dangerous as many other drugs (though it has the potential to kill as many people as tobacco does, if it were as popular as tobacco). But, examined for its behavioral effect, marijuana is quite potent. The subtlety with which it alters behavior, typically over a period of weeks or months, makes it all the more effective as a behavioral change agent. The data that has begun to emerge as younger teens and pre-teens smoke more potent marijuana shows a devastating effect on the social functioning of many users. Some users may have been self-centered when they began use, but marijuana heightens that characteristic, killing the empathy and capacity for altruism that embody the best qualities of society. What is left is a person addicted to marijuana and concerned about marijuana, but not so much about relationships, achievement, or even obeying the law. People sometimes discount the effects of marijuana because many users do not seem to be greatly impaired, but the luck of some in warding off clear impairment is a poor balance to the studies and accumulated life experiences of those who have been severely changed by marijuana use.

Fallacy # 6: Anti-drug laws and anti-drug law enforcement is driven by national bureaucracy and the zealousness of federal officials.

People who travel in a sub-culture of drug tolerance tend to perceive the government’s anti-drug actions as being out of touch with the populace, but polls show that a large majority of the American (and other) public opposes drug legalization. The greatest passion in favor of enforcing drug laws comes not from any government but from families that have seen the worst that drugs do. The proper balance between society’s interest in stopping drugs and the freedom of individuals becomes clear when one has witnessed a family or community ravaged by drug use and addiction. The social value of drugs is far below zero. Any loosening of restrictions on drug use has tended to lead to a cycle of increased use, increased damage to society, and a resulting determination to toughen enforcement of laws against drug use. Ultimately, the source of calls for strict enforcement of laws against drugs come not from any one group but from the power of drugs to damage people, and damage society.

Alan Markwood is the Prevention Projects Coordinator at Chestnut Health Systems, Inc. in Bloomington, Illinois. Responsibilities include:

  • Participating in prevention research, development, and training projects as a contractor to the Illinois Department of Human Services.
  • Directing prevention coalitions in three counties, funded by the federal Center for Substance Abuse Prevention and the Illinois Department of Human Services under grants he wrote.

Mr. Markwood is the principal author of the Best Practices in ATOD Prevention Handbook (1997), and has managed a series of statewide studies on youth substance use in Illinois. He served as InTouch Area 14 Prevention Coordinator at Chestnut Health Systems from 1987 until promoted to his current position in 1995. Prior to his work in prevention, he worked as a School Psychologist for seven years in Illinois and Massachusetts. He has a Master of Arts degree in Psychology from Alfred University and a Certificate of Advanced Graduate Study in Education from Boston University.

Source: www.drugwatch.org Sept.1999

Filed under: Drug use-various effects,Effects of Drugs,Health,Prevention and Intervention,Social Affairs,USA :

flakka-surge-in-florida

Law enforcement officials in Florida say use of the synthetic drug known as “flakka” is surging there, ABC News reports.

The drug, also called gravel, is available for $5 a vial or less, the article notes. Officials say people are ordering small quantities of flakka through the mail. Its main ingredient is a chemical compound called alpha-PVP.

According to the National Institute on Drug Abuse (NIDA), alpha-PVP is chemically similar to other drugs known as “bath salts,” and takes the form of a white or pink crystal that can be eaten, snorted, injected, or vaporized in an e-cigarette or similar device.

Vaporizing, which sends the drug very quickly into the bloodstream, may make it particularly easy to overdose, NIDA notes. Alpha-PVP can cause a condition called “excited delirium” that involves extreme stimulation, paranoia, and hallucinations that can lead to violent aggression and self-injury. “The drug has been linked to deaths by suicide as well as heart attack. It can also dangerously raise body temperature and lead to kidney damage or kidney failure,” NIDA explains on its website.

The laboratory of the Broward Sheriff’s Office in Fort Lauderdale reports 275 flakka submissions already in the first three months of 2015, compared with fewer than 200 in all of last year.

Flakka makers are continually changing the chemical makeup of the drug, and often mix it with other substances such as crack cocaine or heroin, according to Don Maines, a drug treatment counselor with the Broward Sheriff’s Office. In as little as three days of use, a person’s behavior can undergo striking changes, he said.

“It actually starts to rewire the brain chemistry. They have no control over their thoughts. They can’t control their actions,” Maines said. “It seems to be universal that they think someone is chasing them. It’s just a dangerous, dangerous drug.”

Source: drugfree.org 5th May 2015

Filed under: Drug Specifics,Effects of Drugs,Synthetics :

The impact that so-called medical marijuana and later the legalisation of marijuana in Colorado, USA has had serious consequences, a few are show in snippets below.  The items shown are taken from the Rocky Mountain High Intensity Drug Trafficking Area Report.  The complete report can be found at:

http://www.rmhidta.org/default.aspx/MenuItemID/687/MenuGroup/RMHIDTAHome.htm.

The Legalization of Marijuana in Colorado: The Impact Vol. 3 Preview 2015 

Medical Marijuana Registry Identification Cards 

December 31, 2009 – 41,039

December 31, 2010 – 116,198

December 31, 2011 – 82,089

December 31, 2012 – 108,526

December 31, 2013 – 110,979

December 31, 2014 – 115,467

Colorado: 

505 medical marijuana centers (“dispensaries”)1

322 recreational marijuana stores1

405 Starbucks coffee shops2

227 McDonalds restaurants3

Denver: 

198 licensed medical marijuana centers (“dispensaries”)1

117 pharmacies (as of February 12, 2015

  • In one year, from 2013 to 2014 when retail marijuana businesses began operating, there was a 167 percent increase in explosions involving THC extraction labs.

 

 

 

Findings 

There has been an upward trend of marijuana-related emergency room visits and hospitalizations since medical marijuana was commercialized in 2009.

There has also been a significant increase in both categories in the first six months of 2014 when retail marijuana businesses began operating

It is important to note that, for purposes of the debate on legalizing marijuana in Colorado, there are three distinct timeframes to consider. Those are:

The early medical marijuana era (2000 – 2008), the medical marijuana commercialization era (2009 – current) and the recreational marijuana era (2013 – current).

2000 – 2008: In November 2000, Colorado voters passed Amendment 20 which permitted a qualifying patient and/or caregiver of a patient to possess up to 2 ounces of marijuana and grow 6 marijuana plants for medical purposes. During that time there were between 1,000 and 4,800 medical marijuana cardholders and no known dispensaries operating in the state.

2009 – Current: Beginning in 2009 due to a number of events, marijuana became de facto legalized through the commercialization of the medical marijuana industry. By the end of 2012, there were over 100,000 medical marijuana cardholders and 500 licensed dispensaries operating in Colorado. There were also licensed cultivation operations and edible manufacturers.

2013 – Current: In November 2012, Colorado voters passed Constitutional Amendment 64 which legalized marijuana for recreational purposes for anyone over the age of 21. The amendment also allowed for licensed marijuana retail stores, cultivation operations and edible manufacturers.

Findings 

Youth (ages 12 to 17 years) Past Month Marijuana Use,

2013 o National average for youth was 7.15 percent

o Colorado average for youth was 11.16 percent

Colorado was ranked 3rd in the nation for current marijuana use among youth (56.08 percent higher than the national average)

In 2006, Colorado ranked 14th in the nation for current marijuana use among youth

In just one year when Colorado legalized marijuana (2013), past month marijuana use among those ages 12 to 17 years increased 6.6 percent.

Filed under: Economic,Effects of Drugs,Global Drug Legalisation Efforts,Legal Sector,USA :

THE methadone programme has failed drug addicts in Clydebank, a leading addictions worker said this week.

methadone-is-a-monsterDonnie McGilveray is the manager of Alternatives, a West Dunbartonshire charity that helps reform drug addicts, many of them methadone users.

He told the Post the methadone programme used to treat heroin addicts has gone unregulated — and described the green liquid as a “monster” that keeps people hooked for good.

His comments come after shock statistics were released last week showing that Clydebank pharmacies claimed £153,000 for methadone prescriptions in 2014.

Donnie told the Post: “I think methadone is helpful for a small cohort of people, the five to ten per cent of people who are chaotic, suicidal or maybe sex workers being used and abused by people. There is a small group of people who need to be made safe.

“But that’s not what is happening. We’ve got this monster, a jolly green giant, that many, many addicts are stuck on. And again, it’s not just them who are stuck in this it’s the doctors and nurses who have an obligation to keep them safe.”

National data obtained by BBC Scotland showed pharmacists were paid £17.8 million for handling nearly half a million prescriptions of methadone in 2014. In Clydebank, £153,000 was paid to eight pharmacies to deliver 3,165 prescriptions of the heroin substitute. In Dalmuir Lloyds, £31,671 was claimed for prescribing and supervising methadone to addicts in 2014. But topping the chart was Lloyds Pharmacy on 375 Kilbowie Road which received £38,207 in payments. Pharmacists are paid around £2.32 for dispensing every dose of methadone and about £1.33 for supervising addicts while they take it. Chemists pay the wholesale cost of buying methadone from the government money they claim.

Around 60 per cent of the cash they are paid is made up of their handling fee for the drug and their charges for dishing it out to addicts. In 2013, pharmacies claimed back more than £17.9 million from the Scottish Government for handling 470,256 prescriptions of methadone — 22,980 prescriptions more than in 2014.

Donnie also told the Post he believes West Dunbartonshire, which has a long history of drug problems, is making progress tackling addiction. He said: “At the end of the day, the statistics don’t tell you how many people are on methadone or any details of the prescription, but what we can tell is the drug companies are making a killing from it.”

Figures released by the NHS in 2012 revealed that methadone-implicated deaths increased dramatically in cases where the individual had been prescribed the drug for more than a year.

The addictions worker told the Post he believes methadone should be reserved for the chaotic drug users and other substitutes such as Buprenorphine, Subutex and Dihydrocodiene should be implemented. He continued: “Methadone is not just a medical or pharmaceutical matter but a human rights issue. “The dilemma is that if you reduce someone’s methadone they become unstable and could relapse. Some of the people we work with at Alternatives have relapsed, it’s a regular situation.

“If you start to reduce this person they could relapse and relapse significantly, and they might think they can go back onto heroin and inevitably could end up overdosing.”

He added: “That’s my position and I don’t envy the medical side of it in trying to square this problem.”

Top researcher Dr Neil McKeganey, from the Centre for Drug Misuse Research, said the methadone programme “is literally a black hole into which people are disappearing”.

The statistics of methadone prescriptions can be viewed online at:    www.marcellison.com/bbc/methadone

Alternatives is an organisation funded by West Dunbartonshire Council that helps bring recovering addicts back into society. The project has been around since January 1995, firstly covering Dumbarton and the Vale of Leven, latterly broadening out to Clydebank.

Source: http://www.archive.clydebankpost.co.uk/ 7th April 2015

Filed under: Economic,Effects of Drugs,Heroin/Methadone,Prescription Drugs,Social Affairs (Papers) :

 

  • There is high risk of overdose with flakka, which can lead to violent behavior, hyperthermia and superhuman strength
  • The chemical in flakka is similar to a key ingredient in “bath salts,” which were banned in 2012
  • Flakka and “bath salts” could be more dangerous than stimulants such as cocaine

(CNN)It goes by the name flakka. In some parts of the country, it is also called “gravel” because of its white crystal chunks that have been compared to aquarium gravel.

The man-made drug causes a high similar to cocaine. But like “bath salts,” a group of related synthetic drugs that were banned in 2012, flakka has the potential to be much more dangerous than cocaine.

“It’s so difficult to control the exact dose [of flakka],” said Jim Hall, a drug abuse epidemiologist at Nova Southeastern University in Fort Lauderdale, Florida. “Just a little bit of difference in how much is consumed can be the difference between getting high and dying. It’s that critical.”

A small overdose of the drug, which can be smoked, injected, snorted or injected, can lead to a range of extreme symptoms: “excited delirium,” as experts call it, marked by violent behavior; spikes in body temperature (105 degrees and higher, Hall said); paranoia. Probably what has brought flakka the most attention is that it gives users what feels like the strength and fury of the Incredible Hulk.

Flakka stories are starting to pile up. A man in South Florida who broke down the hurricane-proof doors of a police department admitted to being on flakka. A girl in Melbourne, Florida, ran through the street screaming that she was Satan while on a flakka trip. Authorities in the state are warning people about the dangers of the drug.

Florida seems to be particularly hard hit by flakka overdoses.

Hall said that there are about three or four hospitalizations a day in Broward County in South Florida, and more on weekends. It is unclear why the Sunshine State is a hotbed for flakka abuse; “it’s a major question in our community,” Hall said.

Cases have also been reported in Alabama, Mississippi and New Jersey.

Flakka, which gets its name from Spanish slang for a beautiful woman (“la flaca”), contains a chemical that is a close cousin to MDPV, a key ingredient in “bath salts.” These chemicals bind and thwart molecules on the surface of neurons that normally keep the levels of mood-regulating neurotransmitters, dopamine and serotonin, in check. The result is to “flood the brain” with these chemicals, Hall said. Cocaine and methamphetamine have similar modes of action in the brain, but the chemicals in flakka have longer-lasting effects, Hall said.

Although a typical flakka high can last one to several hours, it is possible that the neurological effects can be permanent. Not only does the drug sit on neurons, it could also destroy them, Hall said. And because flakka, like bath salts, hang around in the brain for longer than cocaine, the extent of the destruction could be greater.

Another serious, potentially lingering side effect of flakka is the effect on kidneys. The drug can cause muscles to break down, as a result of hyperthermia, taking a toll on kidneys. Experts worry that some survivors of flakka overdoses may be on dialysis for the rest of their life.

Like most synthetic drugs, the bulk of flakka seems to come from China and is either sold over the Internet or through gas stations or other dealers. A dose can go for $3 to $5, which makes it a cheap alternative to cocaine. Dealers often target young and poor people and also try to enlist homeless people to buy and sell, Hall said. These are “people who are already disadvantaged in terms of chronic disease and access to health care,” he added.

It is unclear at this point whether flakka is more dangerous than the “bath salts” that came before it. But it does have one advantage over its predecessor: it has not been banned — yet.

“Flakka largely emerged as a replacement to MDVP [in ‘bath salts’],” said Lucas Watterson, a postdoctoral researcher at Temple University School of Medicine Center for Substance Abuse Research.

Although the Drug Enforcement Administration has placed a temporary ban on flakka, drug makers can work around this ban, such as by sticking a “not for human consumption” label on the drug, Watterson said. It will probably take several years to get the data necessary to put a federal ban on flakka, he added. And a ban can be effective, at least in discouraging potential users.

“The problem is when one of these drugs is banned or illegal, the drug manufacturer responds by producing a number of different alternatives,” Watterson said. “It’s sort of a flavor of the month.”

Source:  http://edition.cnn.com/2015/05/26

Filed under: Effects of Drugs,Global Drug Legalisation Efforts,Synthetics :

mark-hinkel

daniel-juarez

 

 

 

 

 

 

Mark Hinkel, a Lexington, Kentucky lawyer, left, was struck by a black pickup truck and killed while participating in a cycling race last Saturday. The driver of the truck told police he had drunk six beers and smoked marijuana before the crash. When hit, Mr. Hinkel was thrown from his bike onto the windshield of the truck and landed in its bed, bleeding but alive.   Apparently unaware that Mr. Hinkel  lay mortally wounded in his truck, the driver continued driving for three more miles before being stopped by police. Mr. Hinkel was taken to the hospital where he was pronounced dead. The driver was arrested and charged with murder, driving under the influence, wanton endangerment, leaving the scene of an accident, and fleeing and evading.   While this death involved marijuana in combination with alcohol, CBS4 investigative reporter Brian Maass in Denver, Colorado has tracked down several deaths caused by marijuana alone.

Daniel Juarez, right, was a high-school student who died in 2012 after stabbing himself 20 times. He had almost 11 times more THC in his blood than the average found in male marijuana users. Mr. Maass obtained Mr. Juarez’s autopsy report never before made public, which revealed Mr. Juarez had 38.2 nanograms of THC in his blood at the time of his death. The level in Colorado that denotes intoxication is 5 nanograms.

 

 

levy-thambakristine-kirk

 

 

 

 

 

 

Two marijuana deaths received a fair amount of publicity because they occurred shortly after Colorado implemented legalization in 2014.

Levy Thamba Pongi, left, was a 19-year-old Wyoming college student visiting Denver. Friends said he began acting crazy after eating six times the recommended amount—one-sixth—of a marijuana-infused cookie. He started upending furniture, tipping over lamps, then rushed out to the hotel balcony and jumped to his death. The coroner listed marijuana intoxication as a significant factor in his death. A toxicology report showed he had 7.2 nanograms of THC in his blood.

Kristine Kirk of Denver, right, called 911 to report that her husband was acting erratically after eating marijuana edibles. While on the phone with police, her husband shot and killed her in front of their three children. Mr. Kirk is charged with her murder and has pled not guilty. His lawyer may argue Mr. Kirk was not responsible for his actions due to “involuntary” intoxication, according to news reports.

 

 

brant-clarktron-doshe

 

 

 

 

 

 

Brant Clark, left, a 17-year-old Boulder, Colorado high-school student, committed suicide eight years ago. His mother is convinced his death is due to marijuana. She says her son consumed a large amount of marijuana at a party and then suffered a major psychotic break that required emergency care at two hospitals over the next three days. Three weeks later, he took his own life, leaving behind a note that said, “Sorry for what I have done. I wasn’t thinking the night I smoked myself out.”

Tron Doshe, right, returned from a Colorado Rockies game in 2012 but apparently lost his keys. He attempted to climb the outside of his apartment building to reach his balcony but fell to his death, which was ruled an accident. Mr. Maass obtained his autopsy report, which revealed that Mr. Doshe’s THC level was 27.3 nanograms, more than five times Colorado’s legal limit. No other drugs were found in his system.

 

 

luke-goodman

 

 

 

 

 

 

Luke Goodman, above, a college student who accompanied his family on a skiing vacation to Colorado’s Keystone Resort, bought marijuana edibles in the form of candies. He ate two and nothing happened, so he ate some more. In all, he consumed more than five times the recommended amount. Soon after, he became agitated and incoherent. When family members left the condo, he refused to go with them. Soon after they left, he shot himself and died. His mother said, “It was 100% because of the drugs.” His cousin agreed that ingesting so much marijuana triggered the suicide, saying, “He was the happiest guy in the world. He had everything going for him.”   Read the report of Mr. Hinkel’s death here.

Read Brian Maass’s report here.

Filed under: Cannabis/Marijuana,Drugs and Accidents,Effects of Drugs,Global Drug Legalisation Efforts :

Summary

The 2012/13 New Zealand Health Survey (NZHS) provides valuable information about cannabis use by adults aged 15 years and over. It builds upon and adds value to the findings of the 2007/08 New Zealand Alcohol and Drug Use Survey report on cannabis.

This report presents information on cannabis use in New Zealand, including patterns of use, drug-driving, harms from use (productivity and learning, and mental health), legal problems, and cutting down and seeking help. Information on the medicinal use of cannabis is also presented.

Patterns of cannabis use

Eleven percent of adults aged 15 years and over reported using cannabis in the last 12 months (defined here as cannabis users). Cannabis was used by 15% of men and 8.0% of women. Māori adults and adults living in the most deprived areas were more likely to report using cannabis in the last 12 months. Thirty-four percent of cannabis users reported using cannabis at least weekly in the last 12 months. Male cannabis users were more likely to report using cannabis at least weekly in the last 12 months.

Cannabis and driving

Thirty-six percent of cannabis users who drove in the past year reported driving under the influence of cannabis in the last 12 months. Men were more likely to have done so.

Cannabis-related learning and productivity harms

Six percent of cannabis users reported harmful effects on work, studies or employment opportunities, 4.9% reported difficulty learning, and 1.7% reported absence from work or school in the last 12 months due to cannabis use.

Cannabis and mental health harms

Eight percent of cannabis users reported a time in the last 12 months that cannabis use had a harmful effect on their mental health. Younger cannabis users (aged 25–34 years) were most affected, with reported harm to mental health decreasing markedly by age 55+ years.

Cannabis and legal problems

Two percent (2.1%) of cannabis users reported experiencing legal problems because of their use in the last 12 months.

Cutting down and help to reduce cannabis use

Most cannabis users (87%) did not report any concerns from others about their use. Seven percent of cannabis users reported that others had expressed concern about their drug use or had suggested cutting down drug use within the last 12 months. Of cannabis users, 1.2% had received help to reduce their level of drug use in the last 12 months. Few cannabis users who wanted help did not get it (3.6%).

Cannabis use for medicinal purposes

Forty-two percent of cannabis users reported medicinal use (ie, to treat pain or another medical condition) in the last 12 months. Rates were similar for men and women. Older cannabis users (aged 55+ years) reported higher rates of medicinal use.

An  infographic (PDF, 174 KB)  provides a short overview of these findings.

The methodology report for the 2012/13 New Zealand Health Survey is also available on this website.

If you have any queries please email hdi@moh.govt.nz

Downloads

Source:  Ministry of Health. 2015. Cannabis Use 2012/13: New Zealand Health Survey. Wellington: Ministry of Health. Published online:  28 May 2015

http://www.health.govt.nz/publication/cannabis-use-2012-13-new-zealand-health-survey

Filed under: Cannabis/Marijuana,Drug Specifics,Drug use-various effects,Drugs and Accidents,Education,Effects of Drugs,Marijuana and Medicine,New Zealand :

Two years ago, the Georgia Legislature tried but failed to legalize artisanal cannabidiol (CBD) oils for children suffering from epilepsy. Artisanal CBD oils are products marijuana growers are making in states that have legalized marijuana for medical use. No grower in these states has submitted its CBD product to FDA for approval as a safe or effective medicine.

In contrast, two pharmaceutical companies, GW Pharmaceuticals of Great Britain and Insys Therapeutics of the US, are developing pharmaceutical-grade CBD oils. GW’s version, Epidiolex, is in FDA Phase III clinical trials and Insys Therapeutics is about to undergo FDA testing. The Insys drug is 100% synthesized CBD, meaning it is an exact chemical duplicate of cannabidiol found in the marijuana plant but is made of pure chemicals to eliminate impurities and contaminants. Epidiolex is an extract of marijuana that has been purified to remove impurities and contaminants and is 98% CBD with trace amounts of THC and other cannabinoids. Both drugs must be tested in animals to ensure safety before companies can apply to FDA for permission to test their drugs in humans.

Artisanal CBD oils offer no such protections to patients. Random tests have shown that many contain THC, which can cause seizures, contaminants, and in some cases little to no CBD.

When the Georgia bill failed last year, Governor Nathan Deal formed a partnership with GW to conduct clinical trials of Epidiolex in Georgia as well as a statewide FDA expanded access program for children not able to enroll in the clinical trials. Both programs are up and running.

Despite this, the legislature came back with a bill this year to legalize artisanal CBD oils not only for childhood epilepsy but also for seven other diseases. Moreover, this bill permits possession of up to 20 ounces of CBD oil containing up to 5% THC. The bill passed and the governor signed it in April. It provides immunity from prosecution to those who possess CBD and calls for a special commission to recommend how best to grow marijuana, process it into CBD oils, and distribute it to patients.

Like the researchers whose work is published in JAMA today, specialists who treat epilepsy also are beginning to speak out. The NBC-TV affiliate in Atlanta interviewed several this week. Dr. Yong Park, who is helping run the clinical trials in Georgia, says doctors don’t know what the drug interactions are or what the side effects might be because they don’t have the evidence yet. Nor do they know how many pesticides artisanal CBD oils may contain nor what the long-term effects of daily exposure on the brain might be.

Under the new state law, when doctors sign a letter approving patients for the state registry that allows them to possess CBD oils, says Atlanta pediatrician Cynthia Wetmore, M.D., Ph.D., “they are required to keep track of the patients. But how do we know what dose to recommend? The oil patients have access to is not standardized. Each batch can be different. There’s a lot of variability in each batch. What side effects is it causing, if any? We have to report to the state on each patient, quarterly. It will be hard to know if it’s helping or hurting.”

Perhaps the most haunting concerns come from Dr. Amy Brooks-Kayal, a Colorado pediatric neurologist and president of the American Epilepsy Society. The Atlanta NBC-TV affiliate published her letter to a Pennsylvania representative who held hearings a few months ago on a similar bill in his state. In part, she writes:

The families and children coming to Colorado are receiving unregulated, highly variable artisanal preparations of cannabis oil prescribed, in most cases, by physicians with no training in pediatrics, neurology, or epilepsy. As a result, the epilepsy specialists in Colorado have been at the bedside of children having severe dystonic reactions and other movement disorders, developmental regression, intractable vomiting, and worsening seizures that can be so severe they have to put the child into a coma to get the seizures to stop. Because these products are unregulated, it is impossible to know if these dangerous adverse reactions are due to the CBD or because of contaminants found in these artisanal preparations. The Colorado team has also seen families who have gone into significant debt, paying hundreds of dollars a month for oils that do not appear to work for the vast majority. For all these reasons not a single pediatric neurologist in Colorado recommends the use of artisanal cannabis preparations. Possibly of most concern is that some families are now opting out of proven treatments, such as surgery or the ketogenic diet, or newer antiseizure medications because they have put all their hope in CBD oils.

All three epilepsy specialists want parents to know that giving artisanal CBD oils to children exposes them to risks that cannot be defined. They urge parents instead to enroll their children in clinical trials or expanded access programs that are testing pharmaceutical-grade CBD where doctors can monitor the children closely.

Read Atlanta story and full text of Dr. Brooks-Kayal’s letter here

Source:

http://us2.campaign-archive2.com/?u=2138d91b74dd79cbf58e302bf&id=71df2f126e&e=7ee41d6c49

Filed under: Drug use-various effects on foetus, babies, children and youth,Effects of Drugs,Medicine and Marijuana,USA :

SUSAN SCHENK AND DAVID HARPER

REUTERS

Ecstasy deserves to remain an illegal drug, as there is substantial evidence of it causing harm.

A dangerous case is being made in New Zealand for the legalisation of MDMA, the primary active ingredient of the street drug, Ecstasy.

Ecstasy rose in popularity among the rave party scene in the early 1980s. Use has since spread to more mainstream groups. New Zealanders are some of the heaviest users of ecstasy worldwide, with an estimated 13 per cent of Kiwi respondents to the Global Drug Survey having used ecstasy in the past year.  Supporters of the move to legalise claim the drug is safe, and recent comments made by Wellington Hospital emergency department specialist, Dr Paul Quigley, would seem to support this position.  Quigley has reported few emergency admissions related to ecstasy use, and from this he has incorrectly assumed this means that MDMA use poses minimal harm.

Emergency room admissions are a flawed benchmark for determining the safety of a drug, such as MDMA, as the major harm associated with MDMA is the death of brain cells, and associated behaviour changes.   These effects are generally not life-threatening and would therefore not lead users to seek emergency care.

This does not, however, indicate that MDMA is safe.

Rather, considerable published evidence has demonstrated that memory loss and attention issues are common in MDMA users and there is compelling evidence for the loss of the brain chemical, serotonin, which leads to further problems associated with sleep patterns and emotional wellbeing.

These effects can seriously impact the individual’s ability to lead a productive life, and it is common for users to experience negative emotional after-effects of ecstasy. Importantly, there are no quick fixes for the many detrimental effects of ecstasy and these effects may persist for years.

It has also been suggested that MDMA dependence is not a likely consequence of use, providing proponents of legalisation another indication that MDMA use poses minimal harm.   This too is unsupported in the scientific literature.

* John Key unconvinced by emergency doctor’s call to legalise MDMA

* Don’t freak out over changing drug laws

For most drugs of abuse, including cocaine and methamphetamine (P), about 10-15 per cent of users become dependent on the drug. The same is true of ecstasy users.

Studies have suggested that a subset of ecstasy users progress to misuse and consume the drug frequently and in high dosages.  In New Zealand, the Illicit Drug Monitoring System provides a snapshot of heavy drug users over time.

According to this authoritative survey, ecstasy use among heavy drug users is substantial, and 15 per cent use ecstasy weekly.  An online survey in Britain suggests MDMA users were more likely to report dependence symptoms than users of cocaine.

Another assumption is that by regulating the supply of MDMA, both producers and users will engage in safe drug production and use.  While it is true that most users don’t know what else they are actually taking when taking an ecstasy pill – it is frequently mixed with any range of other substances, some harmful, some not – that doesn’t mean that pure MDMA is actually safe.

Perhaps ‘safer’, but not ‘safe’.

New Zealand has toyed with legalisation of psychoactive substances for many years. First there were the BZP-TFMPP “legal highs” that were subsequently banned as they were shown to be dangerous after all.  The same was true of synthetic cannabis products that have also recently been banned because they were shown to pose more than an acceptable risk of harm.

Despite what has recently been suggested in the media, there is substantial evidence of harm and risk arising from the use of MDMA.  We have been studying the effects of MDMA on brain and behaviour for about 10 years, and the negative effects of ecstasy have been well-documented by us and many other researchers.

Knowing what we know about ecstasy use, and the well-documented negative consequences of its use, the potential for misuse and the persistent and prolific adverse consequences of MDMA use, it is clear that unrestricted use of MDMA poses a great risk of harm, and that it would be irresponsible to provide MDMA for legal sale in New Zealand.

Professor Susan Schenk is from Victoria University’s school of psychology, and Professor David Harper is the dean of science.

Source:  stuff.co.nz  29th June 2015

Filed under: Drug Specifics,Drug use-various effects,Ecstasy,Effects of Drugs,New Zealand :

Freisthler B1, Gruenewald PJ2, Wolf JP2.

Abstract

The current study extends previous research by examining whether and how current marijuana use and the physical availability of marijuana are related to child physical abuse, supervisory neglect, or physical neglect by parents while controlling for child, caregiver, and family characteristics in a general population survey in California.

Individual level data on marijuana use and abusive and neglectful parenting were collected during a telephone survey of 3,023 respondents living in 50 mid-size cities in California.

Medical marijuana dispensaries and delivery services data were obtained via six websites and official city lists. Data were analyzed using negative binomial and linear mixed effects multilevel models with individuals nested within cities.

Current marijuana use was positively related to frequency of child physical abuse and negatively related to physical neglect.

There was no relationship between supervisory neglect and marijuana use. Density of medical marijuana dispensaries and delivery services was positively related to frequency of physical abuse.

As marijuana use becomes more prevalent, those who work with families, including child welfare workers must screen for how marijuana use may affect a parent’s ability to provide for care for their children, particularly related to physical abuse.

Copyright © 2015 Elsevier Ltd. All rights reserved.

Source:  Child Abuse Negl. 2015 Jul 18. pii: S0145-2134(15)00237-9. doi: 10.1016/j.chiabu.2015.07.008.  [Epub ahead of print]

Filed under: Drug use-various effects,Effects of Drugs,Parents,Social Affairs :

Rancho Mirage. It is so unbelievably hot here it’s well, it’s unbelievable. That’s how hot it is. 106 degrees with no breeze at all.

I am not at all sure why we are even here, but the son of a close relative is visiting and he had expressed an interest in playing golf. We have a super course here at the Club at Morningside and we might have played a few holes but it’s far too hot now. It is heat stroke, sunstroke weather. Cruel.

As I drove our guest to dinner, on my disk of Civil War songs, what should we hear but the stirring strains of “Dixie.” Our guest, age 27, a family man who had gone to college in the deep, rural south, and who now lives in the deep, semi-rural south, had no idea of what the song was or what it represented. None at all.

This young man, extremely eloquent with language, is high all day long. Literally there is no waking moment when he is not high. He smokes powerful pot all day long and late into the night. He used to have a great high school athletic career and intellectual ambitions. Then, in 11th grade, he discovered marijuana and all of his drive, all of his motivation, all of his discipline disappeared.

Marijuana ate this young man’s soul. It was very much like that movie, Invasion of the Body Snatchers, where space aliens invade the bodies of humans. I have never known any chronic user of the chronic whose ambitions and good sense have not been either demolished or very substantially lessened by the use of the weed. It is eating up the soul of the nation altogether.

The most bitter enemies of the United States could not have imagined a more wicked attack on a society based on individual initiative than the mass use of marijuana. To think we have a President in favor of its legalization, a Mayor of Gotham who is a huge proponent of the poison, a rap culture that celebrates this vile poison, is heart breaking.

At dinner, our guest had to excuse himself from the table repeatedly. Each time, he came back smelling like reefer. He was far too stupefied to make conversation. The other people at the table began to talk about a nearby retirement community called “Sun City.” Meals available. Nurses available. Shuffleboard. Many channels of cable TV.

“That sounds perfect for me,” said our young guest. “I could just spend all day getting high.”

We stared at him. “You’re twenty-seven,” I said to this former high school football star.

“I know,” he answered. “Hospice sounds even better. Just a slow morphine drip until I die, with everyone bringing me food and a remote control in my hand for The Simpsons. High on morphine all of the time. Can you believe how great that would be? Like for forty years.”

If ISIS could have its fondest wishes granted, it could ask for no more ruinous fate for America than a drug addicted last, formerly best hope for mankind.

Late that night I spoke to a super-smart friend who has a Ph.D. in psychology from UC. “There used to be studies about how marijuana use destroys motivation,” he said. “They aren’t allowed to do them any longer. It isn’t PC to even question what marijuana use does to young people. Cannot even be questioned.”

By the way, how did our young guest — who stayed at a hotel — get his super-strong ganja? One 20-minute visit with a “pot doctor” he had never seen before out here in the desert. Then a five-minute visit to a “dispensary.”

“All I had to do,” said the guest, “was tell him I had trouble sleeping.”

So much for pot as a salvation in terminal cancer. Pot is the cancer.
Read more at http://spectator.org/articles/62926/marijuana-cancer

Filed under: Cannabis/Marijuana,Effects of Drugs,Global Drug Legalisation Efforts,Social Affairs,USA :

This is an excellent report.  It shows how seemingly accurate information is being disseminated by pro-marijuana groups heavily funded by George Soros.  Every claim is disputed by scientific evidence from responsible contributors.

University of Florida Drug Policy Institute Joins Senior Researchers at Harvard, Boston Children’s Hospital, University of Texas, and Others in Responding to Latest Claims by the International Centre for Science in Drug Policy

A team of researchers from the UF Drug Policy Institute, Harvard University, and other institutions authored a lengthy response to a recent monograph written by the George Soros-funded ICSDP claiming that cannabis health claims have been overblown.

The team, led by former American Society of Addiction Medicine President Stu Gitlow, and other researchers with leadership ties to groups like the American Academy of Pediatrics, Boston Children’s Hospital, the University of Texas, the University of Pennsylvania, and other institutions found that the ICSDP report is an example of deceptive and biased research and that it contains abundant factual errors and logical flaws.

The report’s introduction reads: “The ICSDP conveniently cites evidence that supports its own predetermined narrative, concluding that only the pro-marijuana lobby has any substantive evidence in its favor-and ignores evidence to the contrary. Its main strategy is to attribute overblown “straw man” arguments to established marijuana researchers, misstating their positions and then claiming to “rebut” these positions with research.

“This response/critique reveals the lack of objectivity present in the report and, point-by-point, shows how the interests of the nascent Big Marijuana industry, private equity firms, and lobbyists lining up to capitalize on a new marijuana industry, are served.”

 

About the UF Drug Policy Institute

The UF Drug Policy Institute (DPI) serves the state of Florida, the Nation, and the global community in delivering evidence-based, policy-relevant, information to policymakers, practitioners, scholars, and the community to make educated decisions about issues of policy significance in the field of substance use, abuse, and addiction.

Read about our Distinguished Fellows Here

Filed under: Effects of Drugs,Global Drug Legalisation Efforts,USA :

There are at least two sides to every debate, but in the case of marijuana legalization, only proponents’ side is being heard. That changes with the publication this month of Marijuana Debunked.

One of the favorite claims of marijuana-legalization proponents (and biased journalists, see next story) is that marijuana cures cancer. Like most other claims for the drug’s ability to cure or relieve some 250 different diseases, this one originates from 1) a lack of understanding about how science works and 2) plain, old-fashioned greed.

Ed Gogek, MD, is an addiction psychiatrist who has treated more than 10,000 addicts over his 30-year practice. Like all doctors, he has been trained to evaluate evidence that leads to FDA drug approval as well as insufficient evidence that fails to support such medical claims.

In Marijuana Debunked, Dr. Gogek exposes medical marijuana for what it is: the camel’s nose under the recreational marijuana tent. The four states and the District of Columbia that have legalized recreational pot got there by first legalizing medical pot. And medical pot provided the opening for a commercial industry to develop that already rivals the tobacco and alcohol industries in targeting children and the addicted as lifetime consumers.

Dr. Gogek analyzes the substantial research that shows how marijuana hurts people, especially children. He calls out the media for biased reporting about the drug and the entertainment industry for promoting it’s use. He asks us to rethink marijauna policy to find a “third way” between prohibition and legalization and describes what that might look like.

In short, Dr. Gogek has made a powerful, passionate case against legalization and its inevitable consequences. He shows that we have a choice: we can base marijuana policy on science and find an alternative to current policy or we can succumb to the siren call of free-market profits and increased tax revenues (that won’t cover costs) and legalize a third addictive drug. Everyone concerned about health, justice, and the ability of our citizens to thrive should read his book.

Did the National Cancer Institute “Finally Admit that Marijuana Cures Cancer”?
When a news story begins like this—“For the medical industrial complex, there is nothing as terrifying as a cure, or remedy, for a highly profitable and fatal disease like cancer”—you know you are in for a biased read.

Politicususa.com published a story Sunday that asserts the National Cancer Institute (NCI) is now “advising that cannabinoids are useful in treating cancer and its side effects by smoking, eating it in a baked product, drinking herbal teas, or even spraying it under the tongue.”

Deconstructing this quotation word-for-word reveals it is actually a combination of phrases from different questions in Cannabis and Cannabinoids (PDQ): Questions and Answers about Cannabis on NCI’s website:

advising–not found anywhere in “Cannabis and Cannabinoids.”

that cannabinoids are useful in treating cancer and its side effects—these words are from Question 2, What are cannabinoids, second paragraph: “Cannabinoids may be useful in treating the side effects of cancer and cancer treatment” (emphasis added).

by smoking, eating it in a baked product, drinking herbal teas, or even spraying it under the tongue—these words and phrases are lifted from different parts of Question 5, How is cannabis administered?

“Cannabis may be taken by mouth or may be inhaled. When taken by mouth (in baked products or as an herbal tea), the main psychoactive ingredient in Cannabis (delta-9-THC) is processed by the liver, making an additional psychoactive chemical.  . . . A growing number of clinical trials are studying a medicine made from a whole-plant extract of Cannabis that contains specific amounts of cannabinoids. This medicine is sprayed under the tongue.”

[The medicine is nabiximols, trade-name Sativex, which is 50 percent THC and 50 percent cannabidiol extracted from the marijuana plant and purified.]

In addition to doctoring his quotation, the author presents his claim as information NCI quietly slipped onto its website only two weeks ago. He fails to notice that the mid-July date is an update, not a brand new “admission” of information “previously concealed from the public.”

He also fails to report Questions 9 and 10 which point out that FDA has not approved cannabis or cannabinoids for cancer treatment, not approved cannabis for treating the side effects of chemotherapy, but has approved two drugs which are synthetic THC, Dronabinol and Nabilone, for relieving chemotherapy-related nausea and vomiting in patients who do not respond to standard therapy.

But reporting that would make it hard to conclude, as the author does, that “it is absolutely despicable, and frankly evil, that the medical industry helped keep an incredibly inexpensive and highly-effective cancer-killing drug out of reach.”

Politicususa.com gets an “A” for spin, but an “F” for accuracy. File this story in the trash can where it belongs.

Read Politicususa.com story here. Read National Cancer Institute Cannabis and Cannabinoids Q&A here.

Source: TheMarijuanaReport.org  26th August 2015

Filed under: Effects of Drugs,Global Drug Legalisation Efforts :

Let us provide a rational answer to a nonsensical question. It is a nonsensical question because blood is never impaired by THC. Never. Alcohol doesn’t impair blood either. These drugs only impair the brain, not the blood.

We can only test for drug content in the brain by means of an autopsy, something most drivers would reasonably object to.

We test blood as a surrogate for what’s in the brain. For alcohol, blood is a very good surrogate. Alcohol is a tiny, water-soluble molecule that rapidly crosses the blood-brain barrier and quickly establishes and maintains an equilibrium concentration between what’s in the blood and what’s in the brain.

Blood is a terrible surrogate for learning the amount of THC in the brain. It’s used because we blindly follow the precedence set by alcohol, perhaps even believing the pot lobby’s mantra that marijuana should be regulated like alcohol. It’s also used because we haven’t proven anything else that’s any better. Oral fluid likely is somewhat better, but that may only be because it can be collected more quickly at the roadside.

Blood is a terrible surrogate because unlike alcohol, THC is a very large fat-soluble molecule. This results in three major differences in behavior compared to alcohol:

  1. THC crosses the blood-brain barrier much more slowly than alcohol. This is why studies show that the blood level of THC can be dropping at the same time that the feeling of being high is increasing.
  2. THC migrates very rapidly from the blood to the body’s fat stores. This is why the THC level in blood drops by 90% within the first hour after smoking, even though the metabolic half-life of THC is estimated to be about four days.
  3. Because of the high fat content in the brain, THC remains in the brain long after it can no longer be detected in the blood. This is why pot users consistently have higher levels of THC in their brains than in their blood, according to autopsy results.

Perhaps this explains why researchers agree that marijuana impairs driving, but none claim there is a good correlation between blood levels of THC and impairment.

The fact is that there is no level of THC above which, everyone is impaired, and below which, no one is impaired.

The same is true of alcohol. In spite of common belief, the .08 BAC limit wasn’t determined by science. It can’t be, due to the reality of biological variability. The .08 BAC limit was determined by politicians, using scientific input as well as societal input. That explains why the alcohol per se limit varies from .02 to .08 gm/dl in various developed countries of the world, and those countries based their decision all on the same science! It’s other societal inputs such as risk tolerance and desire for freedom that come into play to make that decision.

None of this proves it’s safe to drive after smoking pot. It’s not. It simply explains why a defined per se limit of THC in blood that proves someone is impaired can never be supported by science.

This also may explain why the preferred means to deal with drug impaired driving is not to establish per se limits, but rather to establish a zero tolerance policy for mind altering drugs in a driver that has been shown to be impaired.

Source:  http://www.duidvictimvoices.org/   April 2015

Filed under: Effects of Drugs,Legal Sector :

New drunken-driving laws in British Columbia have led to a dramatic decrease (roughly 50%). Officials ramped up penalties on drivers who tested at a lower blood alcohol level (.05, as opposed to the current .08 legal standard) and authorized police to immediately impound cars.

TRANSCRIPT

WILLIAM BRANGHAM: Six years ago, a terrible family tragedy occurred here in rural British Columbia.  But over time, it became much more than that. This tragedy set in motion dramatic changes to the laws governing drinking and driving — changes that supporters say have already saved dozens of lives. That tragedy involved a four year old girl. Her name was Alexa Middelaer

LAUREL MIDDELAER: Well, it was a beautiful May long weekend and my daughter, Alexa, loved this one particular horse and she really wanted to show her grandparents that horse.  I remember saying good bye to her, and then very shortly after that we heard all kinds of sirens. And at that moment I just– I just knew.  I said, “It– it’s Alexa.  Something happened to Alexa.”

WILLIAM BRANGHAM: A 56 year-old woman doing nearly twice the speed limit, lost control of her car and smashed into the exact spot where Alexa stood feeding the horse on the side of the road.  The woman – – who was later convicted and sent to prison — admitted to police she’d had three glasses of wine before getting into her car.

LAUREL MIDDELAER: When we knew, roadside, that our daughter was dead, I remember my husband just — in the ambulance — we both held each other and he said, “This will not break us.  This will define us.  There will be some good in this.”

WILLIAM BRANGHAM: After the accident, Alexa’s parents – Michael and Laurel – launched a campaign to try and change the culture around drinking and driving … and to deter people from doing it….  Their events became a regular feature on local news

LAUREL MIDDELAER (from local news) We will honor our daughter and we will make the necessary changes that, number one…

WILLIAM BRANGHAM: But they soon realized it would take more than that – they realized they’d have to change the drunk driving laws, which, like in the U.S., sets the legal blood alcohol limit at .08 percent.  After lobbying the government for nearly a year — alongside groups like Mothers Against Drunk Driving – their efforts paid off.   In 2010, the Provincial Government not only stiffened penalties against driving at.08, but more importantly, it targeted drivers who fall below that level — to .05 — drivers who are not legally drunk.  The rationale?  Even a few drinks – as few as two for a woman, and three for a man — can impair your driving ability

The big change was that if you were now caught driving with a .05 blood alcohol level, the police were authorized – on the spot — to fine you, suspend your drivers license, and immediately impound your car for at least three days.  They’d get you out of the vehicle, and a tow truck would haul it away. 

In late 2010, police began enforcing the new laws, and police impound lots across British Columbia began filling up. The changes sparked an uproar.  Civil libertarians argued it gave the police too much power – and restaurant owners like  Mark Roberts said the new laws damaged the economy… he says his business dropped between 10 and 20 percent.

MARK ROBERTS: When the change of drinking-driving laws came out, we knew that was going to have a strong impact on our business.

WILLIAM BRANGHAM: What did you think?  That customers would suddenly be afraid and that they wouldn’t come to your door?

MARK ROBERTS: We thought that there was a lot of unknowns about what that meant.  How many drinks could people have?  There was very little information about how that was going to be enforced, how it was going to impact what people could drink. We were creating non-alcoholic drinks to make up for the lost sales.  It was a lot of fear, a lot of unknowns, and some real changes in people’s behavior.

WILLIAM BRANGHAM: And the impact was immediate.  During the first year the new law was in effect, the number of drunk driving deaths in British Columbia plunged. Critics argued that first year was just a fluke.  But the second year?  The number declined again.  A 55% reduction in deaths in just two years.

The message, it seemed, had started getting through to drivers

TIM STOCKWELL: So it was quite well-publicized.  And for deterrence to work it’s as much about knowing and expecting there being a consequence than it actually be likely.  People’s perception that they were likely to be caught was probably way higher than it actually was.

WILLIAM BRANGHAM: And that’s key?

TIM STOCKWELL: That is key.  It’s very important….

WILLIAM BRANGHAM: Tim Stockwell is an expert on alcohol policy at the University of Victoria. He told us he can’t think of a single reform that’s had this big an impact, this quickly.  He and his colleagues recently published a peer-reviewed study of the effectiveness of the new laws.

TIM STOCKWELL: These laws epitomize a perfect deterrence theory in action.  And it is very important to understand that you don’t need draconian, severe penalties. They have to be severe enough.  It’s more important that they are certain, and that they are swift.  So on the spot, losing your car for three days, a week, that’s severe enough.

WILLIAM BRANGHAM: The new laws have faced some setbacks: the police had problems with some of their breathalyzers, the government had to ammend the laws when courts ruled that drivers deserved a better appeals process.  And last fall a judge ruled in favor of a driver who appealed his 2012 driving suspension.  Critics say that ruling that could force a rewriting of the laws.  For now, the heart of the new laws though remain intact.

WILLIAM BRANGHAM: What about the argument that there have been so many lives saved by these new rules that yes, it may have taken a hit out of your business, but that to save a bunch of people’s lives that that’s an OK price to pay?

MARK ROBERTS:  Yeah.  Well, it’s hard to argue that.  I’m certainly not going to sit here and say well, we should allow people to drink whatever, and whatever the consequences are, that’s the way it is going to be.  I certainly wouldn’t advocate that.

WILLIAM BRANGHAM: Why do you think this has been so effective?

LAUREL MIDDELAER: I think because the consequence is firm.  I think that people respond when there’s a harsher consequence.  And I think, too, because it’s aligned to a larger goal.  Just like secondhand smoke, we have no tolerance for that anymore, just like when seatbelts came in, there was that fundamental shift.  My goal has always been that there will be a fundamental shift that it’s not OK to drink and drive.  Drinking is fine.  Absolutely — drink whatever you like and enjoy and partake, but just don’t mix it with driving.

Source:   http://www.pbs.org/newshour  Jan.2014

Filed under: Effects of Drugs,Legal Sector :

Looking inside the dome of the National Advanced Driving Simulator -1. Photo by University of Iowa National Advanced Driving Simulator

Virtual reality is shedding light on the dangers of driving stoned.

Currently in the U.S., police officers have limited resources to assess just how high a person is when driving under the influence of marijuana. Also unclear is the degree to which driving both drunk and stoned – the most common combination of substances seen among DUI cases — impairs one’s ability to pilot a vehicle.

Marilyn Huestis, a scientist at the National Institute on Drug Abuse, used the National Advanced Driving Simulator to tackle these issues one virtual road trip at a time.

The simulator consists of a car surrounded by a dome. Inside the dome is a 360-degree screen displaying the outside virtual world. The dome can tilt and move, mimicking the sensation of accelerating and braking.

This study was the first to record people’s saliva, blood and breath samples before, during and after driving under the influence. In the U.S., the only way to identify the amount of tetrahydrocannabinol (THC), the psychoactive ingredient in marijuana, in a driver’s body is through blood samples. These samples are typically taken 90 minutes to four hours after being pulled over. However, other countries use saliva samples, which provide more rapid results.

The team began by asking occasional marijuana and alcohol users to participate in a 45-minute driving simulation. Each participant drove the simulator multiple times under various states of inebriation: sober, after inhaling THC, after drinking alcohol, and under the influence of both THC and alcohol. The route changed each session, but always included interstate driving and city driving at nighttime.

Among the researcher’s findings: THC impairs the ability to stay within traffic lanes.

“A concentration of 13.1 nanograms per milliliter THC was an equivalent impairment to that of the illegal limit for alcohol at 0.08 percent at the time of driving,” said Huestis, lead author of the study, which was published in the journal Drug and Alcohol Dependence.

To put that in perspective, THC levels peak around 100 to 200 nanograms per milliliter within minutes of inhalation, but drop drastically into the single digits within a couple hours. Because of this plummet, the THC concentration measured while driving is much higher than what you would find in blood drawn hours after being suspected of driving under the influence.

This study found that the effects of driving both high and drunk were additive, meaning that if you smoke a joint and drink a beer, you are more impaired than if you had only smoked.

A view from inside the dome of the National Advanced Driving Simulator – 2. Photo by University of Iowa National Advanced Driving Simulator

Researchers also studied the effectiveness of roadside exams at detecting THC. In the U.S., if an officer suspects someone is driving while high, they are required by law to take the driver to a hospital to secure a blood sample. However, in Belgium, officers take an oral swab during the arrest that gets tested at the scene and later in a lab. Meanwhile In Germany, if someone tests positive for THC during a roadside saliva test, they have to submit a blood sample to confirm.

The team found that two saliva tests for THC — Dräger DrugTest® 5000and Alere DDS2 — were as accurate as blood testing. The saliva tests remained accurate when participants were under the influence of both THC and alcohol.

A view from the outside of the National Advanced Driving Simulator – 3. The virtual screen and car sit inside the dome. Photo credit: University of Iowa National Advanced Driving Simulator

They also found that alcohol increases the body’s ability to absorb THC, meaning that you get more stoned if you smoke while drinking versus if you smoke while sober.

“When alcohol was present with cannabis, you had a significantly higher of peak THC,” Huestis said.

Cannabis also slows the rate at which alcohol is metabolized, dulling concentration. If you smoke before you drink, you’ll have to wait longer to sober up.

Source:  http://www.pbs.org/newshour   June 27th 2015

Filed under: Effects of Drugs :

A woman who was admitted to rehab three times because of her severe drug addiction has turned her life around by becoming an addiction therapist helping others going through what she did.

Vicky, from Hale, Manchester, reveals that her drug addiction started at a young age; she was smoking weed when she was 11 and took acid and mushrooms by the age of 16.

The 49-year-old, who attended Altrincham Grammar School, comes from a wealthy background and was expected to go into medicine or dentistry.

However, her parents split when she was young and she hasn’t seen her biological father since she was seven years old. The breakdown of the family unit, she explains, led her to feel as though there was a deficit in her life.

As a result, she began to use food, substances and sex to fill the void to help her feel better about herself.

Vicky explains that she’s had obsessive behaviours towards food – often bingeing on a whole box of crisps at once – since a young age.

At the age of 11 she moved to Canada for six months to live with relatives where she started smoking cannabis. By 16 she was aware her drinking habits weren’t ‘normal’. Vicky felt she had no cut off point and regularly had memory loss. She also started taking what she considered to be recreational drugs: cannabis, acid and mushrooms.

When she was 17, she was introduced to amphetamine. Looking back, Vicky says she considers that her recreational drug use was about helping her to feel better about herself.

After college, Vicky flitted between working for her mother’s business and restaurants jobs in Hale, during which time the Cheshire-set friendships and free-flowing champagne encouraged her drinking and drug taking habits.

She admits that she was living for the moment, seeking fun and excitement but her lifestyle choices were slowly ruining the opportunities she had been given. When she was 20, Vicky returned to Canada and dated a cocaine dealer – a time that she describes as her ‘Nirvana’ with cocaine on tap.

When her visa expired, she moved back to the UK and began dating someone who had a similar background of drug misuse. She started using heroin and crack for two years and whilst she was able to hold down a job, she admits she started to function less and less.

She started to steal to pay for drugs, received a drink driving conviction at aged 22 and received multiple cautions for drug possession and related incidents. Vicky believes she was merely given a slap on the wrist due to her background.

Aged 23, Vicky felt very isolated and ended up living back at home at which point her parents became aware there was a problem. They called a psychiatrist for help and Vicky was admitted to rehab for eight weeks in 1988, she returned on two more occasions.

Following Vicky’s third admittance to rehab, the alcohol and drug induced death of a close friend and former boyfriend on her 25th birthday hit Vicky very hard. She reached her lowest point and attempted suicide more than once. However, she began to turn her life around.

She had to sign a contract to agree to secondary care treatment at a female-only facility where she was taught to take personal responsibility for her own happiness.

Vicky, who now lives with the father of her two youngest children that she met in recovery 18 years ago, studied for a Diploma in Counselling at the University of the West of England and a Masters at Bristol University; she has been qualified as a counsellor for 18 years.

She met her partner and father of her two youngest children in recovery 18 years ago. Vicky is dedicated to helping others affected by addiction, and has a particular passion for helping and working with families and the ‘forgotten others’. Helping others through her own business, Victoria Abadi Therapies, has helped Vicky’s own recovery.

She said: ‘I had always thought I was fascinated by substances and drugs, but over the years I’ve come to realise that what really interests me is addiction itself. I knew from as young as 21 that I wanted to be an addiction therapist. A lot has changed since my days in detox and rehab, we know so much more about addiction but there’s still more to learn.

‘My main advice to anyone affected by addiction, whether it’s yourself or someone you care about, is to talk. It might seem obvious but it’s not always easy to reach that stage.

‘Once you reach the point of realisation that addiction is a medical issue not simply a moral choice the path to recovery will come easier. Likewise, for families shedding the shame and stigma by talking about your experience will open up the possibility of helping your loved one through it.

‘There are some great impartial services, such as Port of Call, who can help with pointing you in the right direction and getting you or a loved the help they need. ‘The best thing that comes out recovery is the ability to have close meaningful relationships.’

For help and advice on addiction recovery visit Port of Call, Victoria Abadi Therapies or call 0800 0029010.

Source: http://www.dailymail.co.uk

Filed under: Drug use-various effects,Effects of Drugs,Social Affairs,Treatment and Addiction :

From time-to-time proponents of marijuana legalization throw out some fuzzy statistics claiming no one has ever died from marijuana.

Case-in-point, earlier this month a group in Arkansas advocating major changes in our state’s marijuana laws tweeted the following:

“No one has ever died from cannabis.” Let’s investigate this claim.

Unpacking the Statistics on Alcohol and Marijuana

In the tweet above, Arkansans for Compassionate Care is apparently citing a statistic from the Center for Disease Controlon the number of deaths from alcohol every year (88,000, on average). If we read how the CDC arrived at that figure, we see it was by calculating the number of alcohol-related accidents and health problems.

In other words, it isn’t simply that 88,000 people die from blood alcohol poisoning (which some might describe as an “alcohol overdose”) each year. Alcohol is contributing to the deaths of about 88,000 people each year in the form of heart and liver problems, car crashes, and so on.

These are what the CDC calls “alcohol attributable deaths” (you can see a full list of them here). They are deaths caused by something that was a direct effect of alcohol use.

So let’s take a look at marijuana-attributable deaths. Has marijuana really never killed anyone, as so many of its proponents claim?

Kevin Sabet with Smart Approaches to Marijuana did an interview with The Daily Signal last year in which he took the claim to task, saying,

“Saying marijuana…has never killed anyone is like saying tobacco has never killed anyone. Nobody dies from a tobacco overdose. You can’t smoke yourself to death. And yet nobody would dispute that tobacco causes death. … You die from lung cancer–you don’t die from smoking. You die from what smoking did to your lungs, which is a direct effect from smoking. And so in that same way marijuana does kill people in the form of mental illnesses and suicide, in the form of car crashes. … You can’t say marijuana doesn’t kill.”

Marijuana-Attributable Deaths

A little research reveals news articles, police reports, and academic studies on a number of marijuana-attributable deaths:

1. December, 2014: The National Institute on Drug Abuse updated its marijuana research paper, saying, “Marijuana is the illicit drug most frequently found in the blood of drivers who have been involved in accidents, including fatal ones,” and citing research that marijuana is increasingly detected in fatal vehicle accidents.

2. December, 2014: Oklahoma authorities reported a man with marijuana both in his system and on his person drove into oncoming traffic, crashing into another vehicle and killing its driver.

3. May, 2014: found that, “the proportion of marijuana-positive drivers involved in fatal motor vehicle crashes in Colorado has increased dramatically since the commercialization of medical marijuana in the middle of 2009.”

4. April, 2014: A 47-year-old Denver man allegedly shot his wife while she spoke with a 911 dispatcher over the phone. According to various reports, the wife called 911 after her husband consumed candy laced with marijuana and began hallucinating and frightening the couple’s children. Some sources indicate the man may have taken prescription drugs with the marijuana. CBS News reports that 12 minutes into the call with 911, the wife “told dispatchers her husband was getting a gun from a safe before a gunshot sounded and the line went quiet.” The marijuana candy had, apparently, been purchased a licensed shop in the Denver area.

5. April, 2014: Researchers writing in the Journal of the American Heart Association investigated marijuana’s effects on cardiovascular health. They reviewed 1,979 incidents from 2006 to 2011, and found, “there were 22 cardiac complications (20 acute coronary syndromes), 10 peripheral complications (lower limb or juvenile arteriopathies and Buerger‐like diseases), and 3 cerebral complications (acute cerebral angiopathy, transient cortical blindness, and spasm of cerebral artery). In 9 cases, the event led to patient death.” (Emphasis added).

6. March, 2014: A 19-year-old college student jumped to his death after eating a marijuana-laced cookie purchased at a licensed marijuana store in Colorado. Reports indicate the man began shaking, screaming, and throwing objects in his hotel room after eating the marijuana “edible.” He ultimately jumped over the fourth-floor railing, into the lobby of the hotel at which he was staying. According to CBS News, the autopsy report listed marijuana as a “significant contributing factor” to his death.

7. February, 2014: researchers from Germany determined the deaths of two apparently-healthy, young men were in fact the result of marijuana. According to their article published in the journal Forensic Science International. Researchers concluded, “After exclusion of other causes of death, we assume that the young men died from cardiovascular complications evoked by smoking cannabis.”

8. November, 2013: Seattle news outlets reported an elderly Washington resident was killed after a neighbor’s apartment exploded as a result of a hash oil operation. Hash oil is a highly-potent extract produced from marijuana using flammable chemicals such as butane.

9. June, 2013: A 35-year-old Oregon man died as a result of an explosion and fire caused by a hash oil operation he and a friend were conducting in a garage.

10. October, 2011: The Office of National Drug Control Policy released a report analyzing traffic accidents from 2005 – 2009. The report noted, “Among fatally injured males who tested positive for drugs, 28 percent tested positive for cannabinoids compared with 17 percent of females,” and that, “Cannabinoids were reported in 43 percent of fatally injured drivers under age 24 who tested positive for drugs.”

11. 2004: A study in the official journal of the American Academy of Pediatrics examined case studies of three otherwise-healthy adolescent boys who were admitted to hospitals due to stroke following heavy marijuana use; two of the boys ultimately died, and the study concluded marijuana may cause stroke and death.

These are just a few reports on deaths linked to marijuana. According to well-publicized FOIA responses, from 1997 to 2005 the FDA recorded 279 marijuana-related deaths–long before Colorado voters decided to legalize the drug.

We have brought up many of these statistics before in our discussions on marijuana. Each time we did, marijuana supporters tried to evade by arguing that marijuana hasn’t caused as many deaths as other drugs. However, there is a world of difference between claiming marijuana has never killed a single person and claiming marijuana has not killed as many people as other substances.

Emergencies Caused by Marijuana

Besides death, marijuana has caused or contributed to many well-documented emergencies. Some of these emergencies easily could have resulted in death or serious injury.

Here are just a few examples of emergency situations caused by marijuana:

1. March, 2015: Four high school students were hospitalized after eating brownies laced with marijuana hash oil. One student was actually found unresponsive in a school bathroom after eating a marijuana-laced brownie.

2. February, 2015: A 20-month-old Canadian toddler overdosed after eating a marijuana-laced cookie authorities say his father baked. The child survived, but suffered seizures and had to be admitted to a hospital.

3. February, 2015: guests at Colorado hotels often leave unused food and beverages as tips for housekeeping staff. However, with the legalization of marijuana–and marijuana-infused foods–in Colorado, some guests are leaving marijuana edibles behind. One Breckenridge hotel employee reported accidentally overdosing when she ate a candy she did not realize was laced with marijuana.

4. February, 2015: An explosion occurred . Witnesses indicated one of the people involved in the explosion was attempting to extract hash oil from marijuana using butane.

5. January, 2015: News outlets in Oregon reported a woman overdosed after she ate three gummy candies laced with marijuana.

6. December, 2014: A high school teacher in Maryland was hospitalized after a student gave her a brownie containing marijuana.

7. December, 2014: were rushed to the hospital after one of them reportedly passed out following marijuana-use at school.

8. November, 2014: from school after she started having difficulty breathing following ingestion of a marijuana-laced gummy bear.

9. June, 2014: , a seven-year-old girl was taken to the hospital after eating marijuana-laced candy her mother brought home from work at an area hotel. The candy was left by a hotel guest–presumably as a tip.

10. March, 2014: A Colorado man attempting to extract hash oil from his marijuana was taken to the hospital after the butane used to extract the oil ignited.

11. December, 2013: A two-year-old in Colorado overdosed and was hospitalized after eating a cookie laced with marijuana. News outlet indicate the girl found the cookie in the yard of an apartment complex.

Recurring Themes: Kids and Accidental Overdoses

A recurring theme in many of these news stories is that children and teens are becoming severely ill after ingesting marijuana-laced food (often referred to as “edibles”).

In July of 2013, determined accidental ingestion of marijuana by young children is on the rise and carries serious risks.

The greatest dangers appear to be toddlers and young children who accidentally find cookies or candy laced with marijuana and teens acquiring marijuana edibles at school without realizing how potent the drug-infused food is.

In both scenarios, children accidentally overdose on marijuana and must be taken to the ER. In some cases, as noted above, the children even pass out or become unresponsive.

A child who loses consciousness from marijuana overdose could easily fall and strike their head or suffer another serious injury. A teen who ingests a marijuana edible–without realizing its potency–before climbing behind the wheel of a car to drive away from school could easily be involved in a serious traffic accident.

Side-Effects May Including Exploding Apartments

A few of the cases we have cited include explosions caused by marijuana hash oil operations.

Many marijuana users produce their own hash oil at home by extracting the oil from marijuana using flammable chemicals like butane. In many cases, the room fills up with butane and is ignited by a stray spark, causing a serious explosion.

The people most at-risk are apartment dwellers. A person who lives in an apartment complex may have their home destroyed because a neighbor’s hash oil operation exploded. In Washington, at least one person was actually killed as a result of a hash oil operation that exploded in a neighbor’s apartment.

The legality of hash oil extraction is questionable under state laws in Washington, Colorado, and elsewhere. Colorado’s Attorney General released an opined in December that home production of marijuana hash oil is illegal. However, many people disagree. Regardless of its legality, it is clearly dangerous to the marijuana users and their family members and neighbors.

Conclusion: Marijuana Has Caused Far More Than 0 Deaths

Given the amount of evidence–both scientific and anecdotal–there simply does not seem to be any way around it: Marijuana is responsible for many deaths.

Moreover, marijuana has caused numerous medical emergencies that could have been fatal under different circumstances.

We continue to say it over and over again: Marijuana may be many things, but “harmless” simply

Source: www.familycouncil.org March 19, 2015 By Jerry Cox

Filed under: Effects of Drugs,Global Drug Legalisation Efforts,Social Affairs :

 

Another death in Colorado has been listed as having “marijuana intoxication” as a factor, according to a CBS4 investigation, and several other families are now saying they believed the deaths of their loved ones can be traced to recreational marijuana use.

Daniel Juarez, an 18-year-old from Brighton, died Sept. 26, 2012 after stabbing himself 20 times. In an autopsy report that had never been made public before, but was obtained by CBS4, his THC level — the active ingredient in marijuana — was measured at 38.2 nanograms. In Colorado, anything over 5 nanograms is considered impaired for driving.

Juarez was nearly eight times the legal limit. “If he had not smoked marijuana that night he would still be here,” said his sister, Erika Juarez. “He was extremely high. There’s no other reason he would do it,” said his older sister.

According to police reports and interviews obtained by CBS4, Juarez and a friend were smoking marijuana that night when Juarez told his friend “he didn’t want anymore because he was too high.” Juarez, who was a standout soccer player for Brighton High School, then told his friend “I just had an epiphany.”

(RELATED STORIES: Marijuana Legalization Story Archive)

 

Police and witnesses then say Juarez literally ran wild, stripping off most of his clothing and running into his nearby apartment. There, he got a knife and stabbed himself 20 times, one of the stab wounds piercing his heart. Juarez’s autopsy report lists his manner of death as suicide with “marijuana intoxication” as a “significant condition.”

A police report in the death notes that the THC in the teenager’s blood was “almost 11 times more than the average amount found in a male using marijuana.”

Police and medical personnel suspected the marijuana Juarez smoked might have been laced with methamphetamine or another substance that could have triggered the irrational behavior. The autopsy shows that tests were done for amphetamines, synthetic stimulants and synthetic cannabinoid drugs, but all those tests were negative.

“I lost my brother to it,” said Erika Juarez. “It’s not harmless, it can kill people and most people don’t see that.”

Up until now, just three other deaths in Colorado were seen as having links to marijuana. Levy Thamba Pongi, a 19-year-old college student jumped from a Denver balcony to his death in 2014 after eating marijuana edibles. Marijuana intoxication was listed as a factor in his death.

 

Richard Kirk of Denver is accused of killing his wife, Kristine. Before her death, she called police and said her husband seemed to be hallucinating after ingesting marijuana edibles and prescription medications.

And college student Luke Goodman killed himself in Keystone in March shortly after ingesting marijuana edibles. His mother told CBS4 she believes the marijuana caused her son to kill himself. An autopsy report showed Goodman’s THC level at 3.1 nanograms, below the impaired driving limit.

 

The Juarez case adds another to the list of death cases with links to marijuana.

CBS4 found another Colorado death with strong ties to recreational marijuana. On May 18, 2012, Tron Dohse was returning to his Thornton apartment after attending a Rockies game. When he arrived home he had apparently lost his keys so he attempted to climb the outside of the apartment building to get to his balcony and gain access to his apartment.

He fell to his death, which was ruled an accident.

According to his autopsy report obtained by CBS4, Dohse’s THC level was 27.3 nanograms, more than five times the Colorado limit for impaired driving.

An autopsy on the 26-year-old restaurant worker showed no other drugs or alcohol in his system. His older sister, Tori Castagna, told CBS4 she now believes marijuana impairment led her brother to make poor decisions the night of his death.

“I couldn’t believe how high the (THC) level was,” said Castagna. “I think it had a very strong impact on what he did that night. I think his judgment was completely skewed. I really believe that was the main contributor.”

According to a Thornton police report, the first officer to arrive wrote that he smelled “a strong odor of an unknown alcoholic beverage coming from his person/breath.” And a witness told police that prior to the late night fall, Dohse “was intoxicated.” But by the time Dohse’s blood was drawn, no alcohol was present, only an elevated level of THC.

“I do believe he was very impaired from that high level,” said Castagna. “We’re seeing more things like this that are showing how serious it can be.”

Dr. Chris Colwell, Chief of Emergency Medicine at Denver Health Medical Center, said since the legalization of recreational marijuana in Colorado, he has seen more and more cases like these of people who have ingested marijuana making poor decisions, decisions they would not otherwise make.  ‘In some cases they will ingest marijuana and behave in a way we would describe as psychotic,” he said.

Colwell said several times each week people enter the Denver Health emergency department after ingesting marijuana and acting suicidal.  “We’ll see several of those every week … that we have to restrain to insure they aren’t a danger to themselves or other people,” Colwell said.  Colwell said after ingesting marijuana he has seen people jumping off balconies, driving at high speeds and driving erratically.

“They’re making decisions they would not have made when not under the influence of marijuana,” he said.  Colwell said recalled one particular case from last Halloween when a man ingested marijuana edibles, dressed up as Superman, and then jumped off a balcony, “Almost as if he could fly as the costume would imply.” Colwell said the man suffered seven fractures but survived.  “It was a very dangerous situation.”He said later he didn’t know why he did what he did. Colwell said his ER is seeing more and more of the same issues from marijuana that it has historically seen from alcohol.

Marijuana activists call these kinds of stories scare tactics and say the problems associated with marijuana ingestion are infinitesimal when compared to alcohol and prescription drugs.

Mason Tvert, a pro-marijuana activist, said he wasn’t buying stories of suicides following pot ingestion.  “There is no evidence that using marijuana makes you want to kill yourself,” said Tvert. “There is no science, no research that says by using marijuana you are going to become suicidal. There is evidence that people who tend to be suicidal may be more likely to use marijuana.”  Tvert went on to say that the number of adverse incidents following the ingestion of marijuana are infinitesimal when compared to alcohol.  “The fact that we are talking about the handful of incidents over the past several years suggests that this is not an exceptionally large problem, but it is something that needs to be talked about,” he said.  Tvert said these deaths are “absolutely” being blown out of proportion by the media, especially when compared to deaths connected to alcohol.

 

In Boulder, eight years after her son’s death, Ann Clark believes her son’s own words show that marijuana led him to kill himself.

Her son Brant was a 17-year-old high school student who attended a party, and according to his mother, smoked a large amount of marijuana. She said that session caused a “major psychotic break. The changes in my son were so intense that in the next three days he required emergency care at two hospitals.”

Hospital documents examined by CBS4 from December 2007 say Brant told doctors, “Marijuana really messed me up.” Brant “reported feelings of paranoia after marijuana that he couldn’t shake.”  Three weeks later, Brant Clark took his own life leaving behind two notes, one for his mother and a second addressed to God.   “Sorry for what I have done I wasn’t thinking the night I smoked myself out’, the note said.

“I believe my son would be alive today if he had never used marijuana,” said Ann Clark.

In a 2014 article in the New England Journal of Medicine, doctors from the National Institutes of Health published an article entitled, “Adverse Health Effects of Marijuana Use” and wrote, “Both immediate exposure and long-term exposure to marijuana impair driving ability; marijuana is the illicit drug most frequently reported in connection with impaired driving and accidents, including fatal accidents. There is a relationship between the blood THC concentration and performance in controlled driving-simulation studies.”

The authors go on to write, “Recent marijuana smoking and blood THC levels of 2 to 5 ng per milliliter are associated with substantial driving impairment.”

The doctors who wrote the article concluded, “During intoxication, marijuana can interfere with cognitive function and motor function and these effects can have detrimental consequences.”

CBS4 Investigator Brian Maass has been with the station more than 30 years uncovering waste, fraud and corruption. Follow him on Twitter@Briancbs4

 

Source:  http://denver.cbslocal.com/2015/05/18/marijuana-intoxication-blamed-in-more-deaths-injuries/

Filed under: Cannabis/Marijuana,Effects of Drugs,Global Drug Legalisation Efforts,USA :

Posh Spectator and Sunday Times journalist James Delingpole has got his Y-fronts in a twist over outing the PM as former closet stoner. His former mates in the PM’s inner circle don’t approve and have been letting him have it. I can imagine why he’s felt such an urgent need to justify breaking this public school ‘omerta’. He hadn’t anticipated the fall out, he says, in a mea culpa in the Sunday Times. He hadn’t anticipated the impact his revelation to Cameron biographer Isabel Oakeshott would have because he thought that ‘puffing on a reefer’ at Oxford  was no big deal. It was barmy that it was ever a criminal act, he argues in self defence. And he still thinks so.

So since the law’s an ass, what was wrong with putting up two fingers to it? Nor does he see any reason to change his mind about dope now, thirty years later:

“Marijuana is being decriminalised across the world. Quite soon we’ll find the idea that (it) was ever a criminal act about as barmy and illiberal as the notion, that, not so long ago, a man could be imprisoned for sleeping with another man.”

So ‘me lud’, he effectively argued in mitigation, under the impression that we all (not least Dave and his inner sanctum) share liberal views about dope smoking, his and the future PM’s casual disregard for the law (then) was OK.

And besides what was the worst that could have happened as a result of his revelation in today’s modern and progressive world? Dave looking a hypocrite if he ever votes against the decriminalisation of cannabis or Barack Obama cracking a few retro Cheech and Chong jokes next time he meets our PM for a hamburger/baseball love in?

Ho, ho – all very amusing and just about how flippant Mr Delingpole perceives drug use. He really didn’t need to tell us of the state of arrested adolescence he says he is in.

The irony of this self observation is that arrested development is indeed one of the effects of cannabis on the brain. It affects normal maturity (as any drug counsellor will tell you) and specifically the brain development of adolescents. It affects attention, memory and executive functions in the brain. Its use risks worse effects  – from psychotic episodes to full blown schizophrenia for those with a genetic vulnerability. Its victims often do not know until it too late.

Delingpole, although a journalist, seems blissfully unaware of these research findings. It is also hard to believe he is unaware of cases where this apparently ‘innocent’ activity has destroyed the lives of children from affluent families similar to those he and his former friend Dave hail from.

It is hard too to believe as a journalist he’s remained oblivious to the crisis of NHS mental health and psychiatric units, which are bursting at the seams with young male psychotic cannabis addicts –  many incurable.

Maybe it’s a matter of I’m all right Jack. Maybe, he has no children of his own to worry about. Maybe, he’s naive enough to think by some magic of making cannabis freely available these cases would not exist. I have no idea.

As a journalist he should, at the very least, acknowledge that cannabis is a dangerous and for young people, in particular, a very undesirable and addictive drug.

His self-serving attempt to claim the moral high ground (he is not a slave to anyone you’ll be pleased to hear; he does not ingratiate himself with the powerful and he deplores those who do and have compromised themselves to benefit from the Cameron regime) is no substitute for responsible  journalism.

Before he so blithely downplays this drug again and so casually assumes its eventual legalisation is a world wide done deal, I suggest he first acquaint himself with a few more facts and then attend this debate where Dr Kevin Sabet, author of Reefer Sanity: Seven Great Myths About Marijuana, President of Smart Approaches to Marihuana (SAM) and a former advisor on drug policy to President Obama will be speaking.

Source: By Kathy Gyngell www.conservativewoman.co.uk  Sept.2015

Filed under: Cannabis/Marijuana,Effects of Drugs,Global Drug Legalisation Efforts,Social Affairs,Social Affairs (Papers) :

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

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

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

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

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

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

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

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

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

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

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

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

Source:    www.preventdontpromote.org   16th April  2016

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

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

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

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

Filed under: Effects of Drugs,Global Drug Legalisation Efforts :

By Mark H. Moore; Mark H. Moore is professor of criminal justice at Harvard’s Kennedy School of Government.

CAMBRIDGE, Mass.— History has valuable lessons to teach policy makers but it reveals its lessons only grudgingly.

Close analyses of the facts and their relevance is required lest policy makers fall victim to the persuasive power of false analogies and are misled into imprudent judgments. Just such a danger is posed by those who casually invoke the ”lessons of Prohibition” to argue for the legalization of drugs.

What everyone ”knows” about Prohibition is that it was a failure. It did not eliminate drinking; it did create a black market. That in turn spawned criminal syndicates and random violence. Corruption and widespread disrespect for law were incubated and, most tellingly, Prohibition was repealed only 14 years after it was enshrined in the Constitution.

The lesson drawn by commentators is that it is fruitless to allow moralists to use criminal law to control intoxicating substances. Many now say it is equally unwise to rely on the law to solve the nation’s drug problem.

But the conventional view of Prohibition is not supported by the facts.

First, the regime created in 1919 by the 18th Amendment and the Volstead Act, which charged the Treasury Department with enforcement of the new restrictions, was far from all-embracing. The amendment prohibited the commercial manufacture and distribution of alcoholic beverages; it did not prohibit use, nor production for one’s own consumption. Moreover, the provisions did not take effect until a year after passage -plenty of time for people to stockpile supplies.

Second, alcohol consumption declined dramatically during Prohibition. Cirrhosis death rates for men were 29.5 per 100,000 in 1911 and 10.7 in 1929. Admissions to state mental hospitals for alcoholic psychosis declined from 10.1 per 100,000 in 1919 to 4.7 in 1928.

Arrests for public drunkenness and disorderly conduct declined 50 percent between 1916 and 1922. For the population as a whole, the best estimates are that consumption of alcohol declined by 30 percent to 50 percent.

Third, violent crime did not increase dramatically during Prohibition. Homicide rates rose dramatically from 1900 to 1910 but remained roughly constant during Prohibition’s 14 year rule. Organized crime may have become more visible and lurid during Prohibition, but it existed before and after.

Fourth, following the repeal of Prohibition, alcohol consumption increased. Today, alcohol is estimated to be the cause of more than 23,000 motor vehicle deaths and is implicated in more than half of the nation’s 20,000 homicides. In contrast, drugs have not yet been persuasively linked to highway fatalities and are believed to account for 10 percent to 20 percent of homicides.

Prohibition did not end alcohol use. What is remarkable, however, is that a relatively narrow political movement, relying on a relatively weak set of statutes, succeeded in reducing, by one-third, the consumption of a drug that had wide historical and popular sanction.

This is not to say that society was wrong to repeal Prohibition. A democratic society may decide that recreational drinking is worth the price in traffic fatalities and other consequences. But the common claim that laws backed by morally motivated political movements cannot reduce drug use is wrong.

Not only are the facts of Prohibition misunderstood, but the lessons are misapplied to the current situation.

The U.S. is in the early to middle stages of a potentially widespread cocaine epidemic.    (in 2001)   If the line is held now, we can prevent new users and increasing casualties. So this is exactly not the time to be considering a liberalization of our laws on cocaine. We need a firm stand by society against cocaine use to extend and reinforce the messages that are being learned through painful personal experience and testimony.

The real lesson of Prohibition is that the society can, indeed, make a dent in the consumption of drugs through laws. There is a price to be paid for such restrictions, of course. But for drugs such as heroin and cocaine, which are dangerous but currently largely unpopular, that price is small relative to the benefits.

Source:  http://nyti.ms/U1QHdN  Published October 16 1989

1.     Prohibited the commercial manufacture, and distribution of alcoholic beverages

It DID NOT prohibit use, or production for one’s own consumption

2.     Alcohol consumption declined dramatically during prohibition.

Cirrhosis death rates for men were 29.5 per 100,000 in 1911 and 10.7 inn 1929

Mental hospital admission for alcoholic psychosis declined from 10.1 per 100,000 in 1919 to 4.7 in 1928.

Arrests for public drunkenness and disorderly conducted declined 50% between 1916 and 1922

Consumption of alcohol declined by 30 to 50%

3.     Violent crimes DID NOT increase dramatically during prohibition.  Homicide rates rose dramatically from 1900 to 1910 but remained roughly constant during prohibition’s 14-year rule.  Organized crime did become more visible during prohibition but it existed before and after.

4.     Following the repeal of prohibition, alcohol consumption increased.  Today alcohol is estimated to be the cause of 50% of traffic deaths and is implicated in more than half of the nation’s homicides.

Source:  J.McDougal 2001  –  re-printed Drug Watch International e-mails.

Filed under: Alcohol,Effects of Drugs,Global Drug Legalisation Efforts,Legal Sector,USA :

Easy-to-use technology provides alternative to injectable form of lifesaving medication.

The National Institute on Drug Abuse (NIDA), part of the National Institutes of Health, is pleased to announce that intranasal naloxone –a nasal spray formulation of the medication designed to rapidly reverse opioid overdose – has been approved by the U.S. Food and Drug Administration (FDA). The new technology has an easy-to-use, needle-free design, providing family members, caregivers and first responders with an alternative to injectable naloxone for use during a suspected opioid overdose.

The new technology will be marketed by Adapt Pharma Limited, a partner of Lightlake Therapeutics Inc. NIDA and Lightlake, a biopharmaceutical company developing novel treatments for addiction, entered into a partnership in 2013 to apply new technology towards developing a lifesaving intervention for opioid overdose. The product will be marketed under the brand name NARCAN® Nasal Spray.

In 2013, more than 16,000 people died from a prescription opioid overdose, or approximately 44 people per day. In addition, another 8,000 died from heroin-related overdoses, a rate that has nearly quadrupled between 2002 and 2013. This FDA-approved intranasal delivery system could reduce the thousands of opioid-related deaths each year, and give patients a second chance to enter into long term addiction treatment. Family members can ask their health providers or pharmacists how to obtain the nasal spray, which is expected to be commercially available by early next year.

Source:    https://www.drugabuse.gov/news-events/news-releases/2015/11/18

Filed under: Effects of Drugs :

Piscataway, NJ – Although there have been calls to lower the legal drinking age from 21, a new study raises the possibility that it could have the unintended effect of boosting the high school dropout rate.

The report, published in the September issue of the Journal of Studies on Alcohol and Drugs, looked back at high school dropout rates in the 1970s to mid-80s — a time when many U.S. states lowered the age at which young people could legally buy alcohol.

Researchers found that when the minimum drinking age was lowered to 18, high school dropout rates rose by 4 to 13 percent, depending on the data source. Black and Hispanic students — who were already more vulnerable to dropping out — appeared more affected than white students.

The findings do not prove that the 18 drinking age was to blame, according to lead researcher Andrew Plunk, Ph.D., an assistant professor of paediatrics at Eastern Virginia Medical School, in Norfolk. However, he said, state drinking-age policies would likely be unrelated to the personal factors that put kids at risk of drinking problems or dropping out.

Plus, Plunk explained, states made those policy changes based on national trends at the time — mainly, the belief that with the voting age lowered to 18, the legal drinking age should drop, too. So it’s unlikely that other events happening within states would explain the connection to high school dropout rates.

And why would the legal drinking age matter when it comes to high school dropout rates?

“The minimum legal drinking age changes how easy it is for a young person to get alcohol,” Plunk said. “In places where it was lowered to 18, it’s likely that more high school students were able to get alcohol from their friends.”

And for certain vulnerable kids, that access might lower their chances of finishing high school. Policies that allowed 18-year-olds to buy alcohol showed a particular impact on minority students, as well as young people whose parents had drinking problems. In that latter group, the dropout rate rose by 40 percent.

In the mid-1980s, federal legislation returned the legal drinking age to 21 nationwide.

However, there is an ongoing debate about lowering it again — largely as a way to combat clandestine binge drinking on college campuses. The argument is that college students who can legally buy alcohol at bars and restaurants will drink more responsibly.

But Plunk said that debate is missing something: What might the effects be in high schools?

“I think this study gives us some idea of what could happen if we lower the legal drinking age,” Plunk said. “It suggests to me that we’d see this same dropout phenomenon again.”

###

Plunk, A. D., Agrawal, A., Tate, W. F., Cavazos-Rehg, P., Bierut, L. J., & Grucza, R. A. (September 2015). Did the 18 drinking age promote high school dropout? Implications for current policy.  76(5), 680-689.

The Journal of Studies on Alcohol and Drugs is published by the Center of Alcohol Studies at Rutgers, The State University of New Jersey. It is the oldest substance-related journal published in the United States

Source: Journal of Studies on Alcohol and Drugs,  28th  September 2015

Filed under: Education Sector,Effects of Drugs,USA :

According to the National Institute on Drug Abuse, “Besides the risk of spontaneous abortion, heroin abuse during pregnancy (together with related factors like poor nutrition and inadequate prenatal care) is also associated with low birth weight, an important risk factor for later delays in development. Additionally, if the mother is regularly abusing the drug, the infant may be born physically dependent on heroin and could suffer from neonatal abstinence syndrome (NAS), a drug withdrawal syndrome in infants that requires hospitalization. According to a recent study, treating opioid-addicted pregnant mothers with buprenorphine (a medication for opioid dependence) can reduce NAS symptoms in babies and shorten their hospital stays.”

Source:   http://www.wmdt.com/news    Sept 18th 2015

Filed under: Drug use-various effects on foetus, babies, children and youth,Effects of Drugs,USA :

A new study has caused quite a stir among would-be marijuana cognoscenti because it contradicts major research about the impact of marijuana on physical and mental health. The Marijuana Report asked neuroscientist, Bertha K. Madras of Harvard Medical School, to look briefly at the study. Dr. Madras served as Deputy Director for Demand Reduction at ONDCP.

Bertha K. Madras, PhD

A recent manuscript by Bechtold et al,1 describes a longitudinal assessment of a population of marijuana users which, after data collection, were divided into four user groups: (1) nonusers to low use (48%, n=186); (2) limited to adolescent use (10%, n=38); (3) late initiators and increasing (20%, n=76); and (4) early onset with chronic use (22%, n=86). Marijuana use was monitored from adolescence (age 15) into young adulthood (age 26). Ten years later, and ten years after the last determination of marijuana use, study authors asked the subjects, now at an average age of 35.8 years, to report their health status. Each of the four groups self-reported no differences in physical or mental health problems in their mid-thirties. The authors concluded that regardless of how much and how long marijuana was used, and regardless of race, the physical and mental health problems of these four groups were similar. That is, high marijuana use for prolonged periods was not associated with any physical or mental health problems. They also claimed that this is a definitive study because it was longitudinal and superior to other published reports on long-term health consequences of marijuana.

A critical evaluation of the validity of the findings and sweeping conclusions is essential, lest they are interpreted inappropriately. A perusal of the study and the authors’ stated caveats in the manuscript reveal significant weaknesses, with the use of an unrepresentative, possible archaic population, inadequate sample size, inadequate methodologies to assess mental health and physical problems, (self-reports, evaluation of psychiatric status without considering the “spectrum” nature of psychiatric conditions, and absence of addiction evaluation). The findings conflict with other well designed longitudinal studies that assess long-term consequences of marijuana use with early age of initiation of marijuana.

This type of study would not approach or fulfill rigorous criteria for longitudinal research, as exemplified by the 2014 NIDA funding opportunity with similar goals (see “An example of a well-designed study,” last section). The conclusions conceivably are compromised by the following perceived shortcomings of the study.

Population Concerns

  1. The sample size, 386 people, was too small to detect a marijuana effect on psychotic disorders or on other health conditions. NIDA recommends a sample size of 10,000 to detect differences (see final paragraphs). About 50% of the subjects – age 14 – were selected on the basis of their high scores on anti-social behaviors 1 (conduct problems) and the remainder from adolescents without high anti-social behavior scores, but it is not clear whether the drop-out rate from the study was equally represented by both categories. Did more people with early onset anti-social behaviors drop out and does this skew the conclusions? Was there under-sampling of a population at highest risk? There is strong and accumulating evidence that marijuana use is associated with psychosis, with earlier age of onset of schizophrenia, and with worsening of psychotic/schizophrenic symptoms. These association studies were gleaned from thousands of people, not from fewer than 400 subjects, especially when only 100 people are in the high risk group. The small sample size would also make it difficult to detect other serious marijuana-associated medical problems. Reporting of cardiovascular complications related to marijuana and the extreme seriousness of these events (death rate of 25.6%) is increasing, but this occurs in a small number of users (one estimate is 1.8%).

Marijuana is a possible risk factor for cardiovascular disease in young adults,6 with a temporal association between marijuana use and heart attacks, sudden cardiac death, and for stroke, transient ischemic attack, and marijuana-induced arteritis.7 Pulmonary symptoms attributable to marijuana use, even with less intense use, include chronic bronchitis, daily cough, and phlegm production (four quality studies document these findings). No power analysis indicates adequacy of sample size.

Think about this: The prevalence of schizophrenia is 1 in 100. If you sample only 86 subjects of the riskiest group, “early onset chronic users” category, it is unlikely that you can detect a significant increase in prevalence of psychosis or schizophrenia. Another example: a recent study found the incidence of serious cardiac effects of marijuana in 1.8% of heavy users. Was the sample of early onset chronic users (86 people) large enough to detect serous cardiac effects, especially from self-reports?

  1. The study does not have a drug-naïve population for comparative measures of outcomes. The authors report that the amount of marijuana used during adolescence and early adulthood had no effect on the occurrence of a range of health problems.

Think about this: The study has no group that controls for a general, representative population, a non-drug using population. Some other studies have shown different outcomes among youth or young adults who choose not to use, those who use occasionally, or heavy users. What populations are these groups compared to? Are the group sizes large enough to detect differences?

  1. The populations and use patterns investigated in this study are anachronistic and conceivably irrelevant for 2015. Subjects were initially screened in 1987-1988, with a majority of users recruited that did not fall into the heavy use range (daily or near daily use), a use pattern increasingly observed at the present time. The majority of subjects used marijuana during the 1990’s when the psychoactive THC content of marijuana was relatively low, compared with current concentrations.

Think about this: The most serious health outcomes associated with marijuana use, including addiction, occur in heavy users (daily or near daily use) using for long periods of time. Currently, marijuana access has risen rapidly as its legal status changes, its perception of harm has plummeted among youth, along with a rising perception that as a medicine it is safe and can be used daily. Daily use of high potency 2 marijuana among adolescents and young adults is near or at its highest level in nearly three decades. The populations of this study may be irrelevant to current trends, especially since 2009, as marijuana potency is at its highest level ever, availability is greater because of reduced federal and state oversight, as daily use increases, and perception of harm declines. These factors conceivably influence self-reporting of effects and their magnitude. Are the outcomes of this study relevant to current use patterns and marijuana potency?

  1. The population is not representative of the general population: (a) the prevalence of concussions (27.7%) is inordinately high. (b) Death by gunfire is inordinately high. No explanations are offered for the abnormally high prevalence of concussions or death by gunfire, and whether this population has a higher than average prevalence of cognitive impairment. Was there a relationship between concussions and marijuana use or self-reporting of adverse health problems?

Think about this: The overall rate of traumatic brain injury (concussions) presenting in emergency departments in the United States (recent CDC statistics) is 19 per 100,000 persons; for males in this age group, it is about 470 per 100,000 persons (or 4.7 for each 1,000 persons). A concussion rate of 27% of this population (270 per 1000 persons) is about 60 times higher than the general population within this age range. Some rigorous research criteria exclude subjects with traumatic brain injury because of the potential for cognitive impairment. The high numbers of concussions and deaths due to gunfire are anomalous if compared to statistics within the general population. Is this sample representative?

  1. Self-reported medical health problems by these subjects differ from population statistics, on the basis of occurrence by race. According to CDC statistics in 2010, the prevalence of diseases in the general population among African American (AA) adults compared to white (W) adults is different than reported in this study. The CDC ratios (AA:W) for the general population are: Diabetes, CDC = 1.6:1; this study = 4:0. Chronic kidney disease, CDC = 1.14:1, this study = 0:0.6. Sexually transmitted diseases, CDC = 4:1; this study = 0.5:1.1.

Think about this: The health problems self-reported by the African-Americans and white subjects may or may not be accurate, but they differ from the CDC prevalence data for the general population. Differences highlight the need for recruiting sufficiently large numbers of subjects to be representative of the population as a whole. Do differences reflect the unusual populations of this study, which may not generalize to the entire population?

Methodological Concerns: Outcome measures

6. The purpose of the study was to determine whether different patterns of marijuana use among youth affected mental and physical health. All findings are based on an inadequate method for measuring outcomes – self reports, because of potential bias, recall errors, and reliance on self-knowledge of medical conditions. The authors did not investigate medical records, did not confirm marijuana and other drug use with biometric tests, did not interrogate contacts, and did not inquire about sequence of use of other drugs.

Think about this: More than 75% of people harbouring a substance use disorder (SUD), based on objective DSM-IV criteria (Diagnostic and Statistical Manual-IV), do not think they have a SUD and do not seek treatment.2 To rely solely on self-reporting of mental or physical health problems with a questionnaire, raises doubts about the overall study design and conclusions. Other examples: Fifty percent of men who died of heart disease had no obvious symptoms. A diagnosis of diabetes or high blood pressure is made by biometric testing, not by self-reports. Without confirmation from medical records or physician-initiated tests, is it possible to know high blood pressure or diabetes with certainty?

7. Following from #6 above, there is no evidence that subjects reported health outcomes based on their medical records. Authors did not question whether study participants had visited a physician during the past year, past five years or ten years since the last contact. Confirmation of medical conditions by a medical record would strengthen the conclusions. The core outcomes of this study are mental and physical health. Knowing whether the mental and physical health of subjects in this study had been objectively diagnosed by a physician or specialist (psychiatrist, addiction medicine) is critical. The unknown medical record, combined with an assumption that subjects’ self-reports were accurate, diminish the convictions of the authors’ conclusions.

Think about this: Many health problems are not apparent to individuals until they are referred to, or measured by a professional; addiction, high blood pressure, diabetes, cancer, and cognitive impairment. Were all subjects reporting results from a recent annual check-up? Unless this information and results are provided, can one assume that self-reports are accurate?

8. Following from #6, #7 above, mental health diagnoses were based on questionnaires, not on biometric testing or long-term assessment (mental health diagnosis requires more than a single session and long-term evaluation). The diagnosis of psychosis, mood disorders, and anxiety disorders, does not rely solely on a person’s response to a single oral or written questionnaire or impressions of their own health. Definitive diagnosis for a serious mental health problem such as schizophrenia, requires systematic questioning, and over a significant period of time to determine whether symptoms persist and are not temporary aberrations. Moreover, mental health problems including substance use disorders (addiction), occur along a continuum of mild to severe. It is possible that the focus on a diagnosis of a psychotic disorder in the current study limited their ability to detect subtle effects of marijuana use on brain function, thought processes, or early psychotic symptoms. Scores were not generated that reflect this continuum. Authors arbitrarily selected a cut-off point to rate the presence or absence of a diagnosis.

Think about this: It is simple to detect one’s own asthma or headache but, for many mental health problems, self-diagnosis may be inaccurate. Can one know if they are developing subtle signs of a mental problem or cognitive impairment unless measured objectively? Can one know if an early stage of cancer is present unless discovered by imaging, by biopsy, or gene expression profiling? Can one know if 4 asymptomatic heart disease is present without ECG testing? Is self-diagnosis of an early stage of mental illness reliable?

Methodological concerns: Marijuana use

9. The investigators divided marijuana users over time into four groups, using model fit statistics. The chart showing marijuana use over time for these four groups provides no error bars indicating whether these groups are significantly different at each age during the study.

Think about this: One would assume the groups were different, based on the four-group solution that was selected on the basis of model fit statistics, substantive interpretation, face validity of classes, parsimony, and consistency of findings with prior research. But, it would be helpful if error bars representing range of use at each age were included to assure the reader that the group divisions based on subjective criteria (interpretation, face validity of classes, parsimony, and consistency of findings with prior research) are transparently clear at each age.

Some data of the marijuana use component are missing: 46% of the subjects had voids in data. Almost half of the subjects did not report marijuana use at various times during the 10 years of survey. This partial set of data is problematic, even though authors claim missing data were from people similar to those who yielded full data sets, and it is possible to interpolate missing data. Reasons for these data gaps should be provided.

Think about this: If a segment of data is not available, does it invalidate or skew the chart showing trends of the four groups? Uncertain.

10. Marijuana use was not questioned at the end of the study (age 36 years). Strong longitudinal studies have shown that early onset and heavy use of marijuana is associated with or is a causative agent in long-term adverse effects on educational achievement, employment, welfare dependency, use of other illicit drugs, psychotic symptoms, I.Q. reduction, and others.3-5 This study provides marijuana use rates until age 26, measures life outcomes at age 36 but doesn’t ask subjects whether they used marijuana from age 26-36 and at age 36. Most users apparently were not consuming daily or nearly daily and three of the four groups had largely stopped using by the age of 26. Why was marijuana use not measured at the end of the study?

Think about this: It is critical to know whether the people using marijuana from age 15-26 years, were still using at age 36, at the time the health outcomes were questioned. If you are studying whether marijuana has interfered with the mental and physical health of subjects at the present time, is it not logical to interrogate whether they are currently using, or if they stopped and when they stopped? If they stopped 10 years before the study, then long-term consequences may be less likely.

11. Marijuana potency was far lower (1980’s to 1990’s) during the period of marijuana consumption of this population. This conceivably affects outcomes and consequences.5.

12 Quantity, frequency, and potency of marijuana use is a critical measure. Frequency and potency were not questioned. The main outcome measure was the number of times marijuana was used during the year. The patterns of use, number of times used each day, and potency, were not interrogated during each annual survey.

Methodological concerns: Outcomes not measured

13. Marijuana addiction (cannabis use disorder or CUD), among the most significant of the adverse effects of marijuana, was not interrogated. The prevalence of CUD is related to age of onset, quantity and frequency of use and is closely linked to other life outcomes.

Think about this: Addiction is among the most prominent effects of chronic marijuana use, and yet the study did not ask about addiction.

14. Life outcomes were not measured (employment, educational achievement) at the

end of the study. Other strong longitudinal studies have interrogated life outcomes and concluded that marijuana has adverse long-term effects on employment and educational achievement, and other social consequences, as a function of age of onset and quantity used.3-5

Think about this: Longitudinal studies indicate that heavy continuous marijuana use leads to lower socioeconomic status and achievement (e.g. college education, employment) than infrequent or no use. When an individual is using marijuana very frequently for a number of years, are they more or less likely to maintain a job, complete high school or college, or be on welfare?

15. Cognitive testing was not measured. Cognitive impairment is one of the hallmarks of acute and possibly long-term marijuana use. It is also associated with other adverse life outcomes.

Think about this: If you were designing a study to learn whether an intoxicant that is known to interfere with learning, memory, and executive function, would you omit evaluating learning and memory from the study?

16. A number of health problems questioned (e.g. cancer, high blood pressure, heart attacks, strokes) arise later than the average age of the subjects (mid- 30’s). The health questionnaire was filled out by marijuana users in their mid-30’s, an age at which most significant health problems are not yet manifest.

17. Acute effects of marijuana were not asked: intoxication, accidents, emergency department mentions, unplanned pregnancies, and HIV-AIDS. For example, a recent European study collected Emergency Department data from 14 European centers for six months to determine acute toxicity of marijuana. Of the sample, 356 (16.2 %) involved marijuana alone or together with other drugs/alcohol and 1.6 % with marijuana alone. Of the 35 non-fatal lone marijuana presentations, the most commonly reported features were agitation/aggression (22.9 %), psychosis (20.0 %), anxiety (20.0 %), and vomiting (17.1 %). There was one fatality due to prolonged cardiac arrest, with no other drugs detected.6

Think about this: Acute marijuana toxicity can lead to emergencies requiring medical attention. Does omission of this from the questionnaire achieve a comprehensive view of medical consequences of marijuana?

Citations and Comparison with other Studies

18. Authors omit mention of important recent longitudinal studies that show different outcomes than their own study. Other carefully controlled and longitudinal studies have shown that early age of onset of marijuana use is associated with a number of mental and physical consequences, including addiction, cognitive deficits, mental health problems, educational and employment outcomes, and others. Citations 3 and 4 are not mentioned, others are dismissed with a list of weaknesses, even though the current study is fraught with significant weaknesses.

19. The authors attempt to support their conclusions by dismissing well designed reports by others. In the introduction, they do not discuss severe limitations of their own study: (e.g. daily use of high potency marijuana is currently at its highest level in 30 years of surveys, in contrast with their subjects; weaknesses of self-reported medical and psychiatric conditions, and others as stated above). Instead, the introduction curiously offers a critique, entitled Limitations in Prior Research. In it they conclude that “prior research has produced mixed findings regarding the associations between chronic marijuana use and indicators of physical and mental health, …and that individuals who begin using marijuana frequently during early adolescence and those who use at high frequencies throughout adolescence and young adulthood tend to develop more health problems (i.e., psychotic symptoms, respiratory problems) than infrequent/nonusers, in contradistinction to their own findings.

Think about this: In their critique:

(1) The authors claim this study is among a “handful of studies that have been able to prospectively delineate subgroups of individuals with varying developmental patterns of marijuana use from adolescence into young adulthood.” The strength of the present study was to document marijuana use, but not in depth and not confirmed by biometric testing, annually for the decade of life encompassing adolescence and early adulthood. Yet, other research has interrogated key variables, age of onset, frequency and quantity of marijuana use (confirmed with biometric testing), some in prospective, longitudinal studies, others in cross-sectional studies. The medical record at the study’s inception is of limited value because it is neither comprehensive nor independently verified. The initial assessment of 15-year-old boys was inadequate and was not followed by a longitudinal assessment, except for marijuana use. The 10 year hiatus in data collection is a weakness. Self-reports of mental and physical health are inappropriate.

(2) They claim that “few longitudinal studies have examined whether young men who exhibit early and chronic developmental patterns of marijuana use are more likely to exhibit both physical and mental health problems in their mid-30s.” Unfortunately, this study does not answer this question because of the quality of the outcome measures, no marijuana use patterns recorded for 10 years, and the only medical and 7 mental health outcomes are reported by mothers of the subjects around age 15 and by the subjects themselves at ~ age 36.

(3) They claim that “Many studies have failed to control for important confounding factors, such as health problems that predated the onset of regular marijuana use and co-occurring use of tobacco, alcohol, and hard drug.” Yet, the documented and age appropriate deficits associated with marijuana use, in-depth psychiatric status, cognitive impairment, declining academic performance, school drop-out rates, accidents, and others were not interrogated in this survey.

Limited references

1. Bechtold, J., Simpson, T., White, H. R., & Pardini, D. Chronic Adolescent Marijuana Use as a Risk Factor for Physical and Mental Health Problems in Young Adult Men Online First Publication, August 3, 2015. http://dx.doi.org/10.1037/adb0000103 Psychology of Addictive Behaviors.

2. Substance Abuse and Mental Health Services Administration, Results from the 2013 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-48, HHS Publication No. (SMA) 14-4863. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014.

3. Fergusson DM, Boden JM, Horwood LJ. Psychosocial sequelae of cannabis use and implications for policy: findings from the Christchurch Health and Development Study. Soc Psychiatry Psychiatr Epidemiol. 2015 May 26. [Epub ahead of print]

4. Fergusson DM, Boden JM. Cannabis use and later life outcomes. Addiction. 2008 Jun;103(6):969-76; discussion 977-8.

5. Meier MH, Caspi A, Ambler A, Harrington H, Houts R, Keefe RS, McDonald K, Ward A, Poulton R, Moffitt TE. Persistent cannabis users show neuropsychological decline from childhood to midlife. Proc Natl Acad Sci U S A. 2012 Oct 2;109(40):E2657-64.

6. Dines AM, Wood DM, Galicia M, Yates CM, Heyerdahl F, Hovda KE, Giraudon I, Sedefov R; Euro-DEN Research Group, Dargan PI. Presentations to the Emergency Department Following Cannabis use-a Multi-Centre Case Series from Ten European Countries. J Med Toxicol. 2015 Feb 5. [Epub ahead of print]

7. Jouanjus E, Lapeyre-Mestre M, Micallef J; French Association of the Regional Abuse and Dependence Monitoring Centres (CEIP-A) Working Group on Cannabis Complications*. Cannabis use: signal of increasing risk of serious cardiovascular disorders. J Am Heart Assoc. 2014 Apr 23;3(2):e000638. doi:10.1161/JAHA.113.000638.

8. Thomas G, Kloner RA, Rezkalla S. Adverse cardiovascular, cerebrovascular, and peripheral vascular effects of marijuana inhalation: what cardiologists need to know. Am J Cardiol. 2014 Jan 1;113(1):187-90.

An example of a well-designed longitudinal study

NIDA Funding Opportunity http://grants.nih.gov/grants/guide/rfa-files/RFA-DA-15-015.html

Research Design and sample should describe the following:

• A longitudinal single-cohort design to prospectively examine the neurodevelopmental and behavioral effects of substance use from early adolescence through the period of risk for substance use and substance use disorders.

• Participants, approximately ages 9-10 at baseline, who are largely naïve to substance use at the time of study enrollment; the focus on a largely asymptomatic population at baseline provides the opportunity to define brain and behavioral risk factors and trajectories before the onset of substance use;

• A design with a sample size that is sufficiently large to achieve the study goals; preliminary estimates indicate a sample size of approximately 10,000 participants (combined across sites) at the end of the 5-year funding cycle would be needed, though a smaller sample can be proposed if justified by feasibility and statistical-power analyses;

• A sampling strategy designed to establish a community-based sample that is broadly representative of and generalizable to the U.S. general population as a whole, including males and females, as well as major racial, ethnic, and sociodemographic subgroups of the population; it is recognized that the level of precision achieved for various subgroups may vary, and that probability-based sampling and oversampling of certain demographic subgroups or geographical regions may be required;

• A sampling design that considers oversampling of population subgroups at greater risk for uptake of substance use during adolescence (e.g., positive family history of substance use disorders, externalizing psychopathology, disinhibitory traits, prenatal exposure to substances);

• A research approach that considers incorporating genetically informative designs (e.g., family based) or subjects (e.g., twins, siblings);

• A sampling design to produce geographical variation of macro-level factors associated with substance use (e.g., state-level policies concerning the permissiveness of marijuana, alcohol, and tobacco use; regional variation in prevalence of marijuana, alcohol, and tobacco use; rural, urban and suburban populations);

• State-of-the-art data-collection procedures (e.g., computer-administered/assisted interviews), practices (e.g., cultural matching) and quality-control processes (e.g., random verification, logic-checking);

• Standardized measures that, where possible, are compatible with data-harmonization efforts (e.g., PhenX Toolkit) and ongoing studies of substance use and neurodevelopment;

• Comprehensive multi-informant (e.g., respondent, parent/guardian, sibling, etc. as appropriate) assessment of substance use to permit estimates of prevalence, incidence, and change in use patterns (e.g., quantity, frequency) by specific substances (e.g., nicotine, alcohol, marijuana), products and product types (cigarettes, e-cigarettes, snuff, beer, liquor, joints, blunts), and modes of administration (e.g., inhalation, oral, drinking, nasal); measures of change should be sensitive enough to detect dynamic patterns among adolescents as they enter and pass through the period of risk for substance use;

Behavioral Measures and Biospecimens should describe the following:

• Comprehensive and multi-level assessment of predictors, mediators, moderators, and outcomes associated with substance use (e.g., demographics, pubertal status, personality traits, parental monitoring, peer group deviance, family structure, parent-child relationships, prosocial behaviors, romantic relationships, stressful events, availability of substances, state and local policies related to marijuana, alcohol, and tobacco use, educational attainment, learning 9 disability designation or receipt of services, crime, unemployment, experience and/or witnessing of trauma or violence);

• Assessment of concurrent and historical participation in interventions that may prevent or mitigate substance use and its consequences (e.g., pre- and post-natal prevention programs; Head Start; receipt of counseling, psychotherapy and other behavioral health interventions or services; family or classroom-based prevention interventions);

• Comprehensive measurement of confounders and other risk factors (e.g., prenatal exposure, abuse or trauma, drug availability, exposure to environmental risk factors, sport injuries especially to the head, etc.);

• Rigorous quantitative and categorical assessment of symptomatology and psychiatric disorders, including severity;

• Family history assessment of substance use disorders and other psychopathology;

• Age-appropriate assessment of HIV-risk knowledge and behaviors;

• Neuropsychological battery of tests that is developmentally sensitive and that allows for the assessment of major neurobehavioral dimensions associated with substance use (e.g., attention, information processing, learning and memory, cognitive control, motivation, emotional regulation, disinhibition, risk taking);

• Screening for drug intoxication prior to behavioral, cognitive, or functional imaging sessions and neuropsychological assessment, with delineated thresholds for inclusion/exclusion;

• Clear and justified inclusion/exclusion criteria to identify individuals unable to complete the assessment protocol for various reasons (e.g., use of certain prescribed medications, language/reading impairments, brain injury, severe mental illness, etc.);

• Detailed plans and procedures to collect, process, analyze, and store biospecimens (e.g., urine, blood, saliva, hair) indicative of substance exposure; • Additional biospecimens should be collected for subsequent research on genetic/epigenetic factors influencing or affected by substance use, with accompanying plans for analyses.

Filed under: Effects of Drugs,Social Affairs :

The Rocky Mountain High Intensity Drug Trafficking Area released its third annual report this week. The organization has been tracking the impact of marijuana legalization in Colorado since the state first legalized the drug for medical use in 2000, passed legislation to allow dispensaries beginning in 2009–which spawned a commercial marijuana industry–and legalized pot for recreational use in 2012. The 2015 report shows that by 2013, Colorado marijuana use was nearly double the national usage rate. The state ranked 3rd in the nation for youth use in 2013, up from 14th in 2006; 2nd in the nation for young adult use in 2013, up from 8th in 2006; and 5th in the nation for adults, up from 8th in 2006.

Drug-related school expulsions, most of which are marijuana-related, far exceed school expulsions for alcohol use. Note the sudden jump in drug expulsions that began in 2009 when Colorado allowed a commercial marijuana industry to emerge. Total school suspensions and expulsions rose from 3,736 by the end of the 2008-2009 school year to 5,249 by the end of the 2013-2014 school year.

Marijuana-related traffic fatalities in Colorado also began rising with the introduction and growth of the commercial marijuana industry in 2009. While total State wide fatalities decreased between 2006 and 2014, marijuana-related fatalities increased over that time.

Colorado marijuana-related emergency room visits increased to 18,255 in in 2014.

Marijuana-related hospitalizations have nearly quintupled since Colorado first legalized marijuana for medical use. Again, note the surge starting in 2009 when growers, processors, and dispensaries were first authorized, and a commercial industry began developing extensive marijuana products such as edibles, vape pens, and butane hash oils (BHO) to attract new customers. BHO has elevated THC levels to the highest seen in the nation; some contain 75 percent to 100 percent THC.

Although there is no data to document whether the increase in homelessness in Denver and other Colorado cities is marijuana-related, those who provide services to the homeless report that many say they relocated to Colorado because of marijuana’s legality.

In Colorado, marijuana is not available in about three-fourths of the state. Of a total 321 local jurisdictions, 228 (71 percent) ban all forms of marijuana businesses; 67 (21 percent) allow both medical and recreational marijuana businesses; and 26 (8 percent) allow only medical or recreational marijuana businesses.

Read report here.

Filed under: Effects of Drugs,Global Drug Legalisation Efforts :

This wonderful book tells much of the story about cannabis that we are not allowed to hear.

I strongly commend it to you all. It does the neuroscience very well, and reviews much of the brain and neuroscience nicely and in a sensible and balanced way, and also indicates how the crazy side skews their presentation of evidence to aid and abet their grossly dishonest agenda. It actually gives a list of 21 social harms directly related to drug addiction – and then says that there are several dozen more which have not been mentioned!!!!

It is written by a senior practising psychiatrist majoring in addiction medicine, who was also a cannabis addict from 17-19 years of age. So he has known both sides of the fence.

Source: Book reviewed by Stuart Reece sreece@bigpond.net.au  Sept 2015

https://books.google.co.uk/

Filed under: Drug Specifics,Effects of Drugs,Global Drug Legalisation Efforts,Social Affairs :

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

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

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

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

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

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

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

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

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

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

Filed under: Drug Specifics,Effects of Drugs,Social Affairs :

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

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

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

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

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

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

Source:  www.drugfree.org 28th April 2015

Filed under: Effects of Drugs,Legal Highs :

There’s a new drug in town.

It’s called Shatter and it looks like dark-amber toffee. It’s THC, the chemical that causes the high in marijuana, extracted from the plant and has highly addictive qualities, said Stratford police Insp. Sam Theocharis.

It’s been around for a while but it’s new to Stratford, Theocharis said.  Police have started to see the drug a bit more frequently and wanted to get the message out to the public.

“When you look at it, it just looks like goo but it’s a new form of marijuana drug,” he said.

Shatter is clear, smooth and solid. It can consist of more than 80% THC, according to the High Times website.

Police seized some Tuesday along with methamphetamine, cocaine, marijuana and prescription drugs after an investigation by the Street Crime Unit.  Two men in their 40s were arrested and face several charges including possession for the purpose of trafficking. The drugs seized are valued at more than $1,500. Cell phones, scales and baggies were also seized, police said.

Shatter sells for about $100 a gram on the streets. It’s dangerous and often leads to overdose, police said.  Whether it will overshadow crystal meth and oxycodone in popularity has yet to be seen.

“I can’t predict but anything that gives you a better high is going to be sought after,” Theocharis said.

Source: http://www.stratfordbeaconherald.com/

 

Filed under: Cannabis/Marijuana,Cocaine,Effects of Drugs,Methamphetamine/GHB/Hallucinogens/Oxycodone,Prevention and Intervention,Treatment and Addiction,USA :

“Even at normal doses, taking psychiatric drugs can produce suicidal thinking, violent behavior,  aggressiveness, extreme anger,  hostility, irritability, loss of ability to control impulses, rage reactions, hallucinations, mania, acute psychotic episodes, akathisia, and bizarre, grandiose, highly elaborated destructive plans, including mass murder.

“Withdrawal from psychiatric drugs can cause agitation, severe depression, hallucinations, aggressiveness, hypomania, akathisia, fear, terror, panic, fear of insanity, failing self-confidence, restlessness, irritability, aggression, an urge to destroy and, in the worst cases, an urge to kill.” -  From “Drug Studies Connecting Psychotropic Drugs with Acts of Violence” – unpublished.

My previous article on Global Research discussed the frustration of large numbers of aware observers around the world that were certain that Andreas Lubitz, the suicidal mass murderer of 149 passengers and crewmembers of the of the Lufthansa airliner crash, was under the intoxicating influence of brain-disabling, brain-altering, psychotropic medicines that had been prescribed for him by his German psychiatrists and/or neurologists who were known to have been prescribing for him.

These inquiring folks wanted and needed to know precisely what drugs he had been taking or withdrawing from so that the event could become a teachable moment that would help explain what had really happened and then possibly prevent other “irrational” acts from happening in the future. For the first week after the crash, the “authorities” were closed mouthed about the specifics, but most folks were willing to wait a bit to find out the truth.

However, another week has gone by, and there has still been no revelations from the “authorities” as to the exact medications, exact doses, exact combinations of drugs, who were the prescribing clinics and physicians and what was the rationale for the drugs having been  prescribed. Inquiring minds want to know and they deserve to be informed.

There are probably plenty of reasons why the information is not being revealed. There are big toes that could be stepped on, especially the giant pharmaceutical industries. There are medico-legal implications for the physicians and clinics that did the prescribing and there are serious implications for the airline corporations because their industry is at high risk of losing consumer confidence in their products if the truth isn’t adequately covered up. And the loss of consumer confidence is a great concern for both the pharmaceutical industry and its indoctrinated medical providers.

It looks like heavily drugged German society is dealing with the situation the same way the heavily drugged United States has dealt with psychiatric drug-induced suicidality and drug-induced mass murders (such as have been known to be in a cause and effect relationship in the American epidemic of school shootings – see www.ssristories.net).

The Traffickers of Illicit Drugs That Cause Dangerous and Irrational Behaviors Such as Murders and Suicides are Punished. Why not Legal Drug Traffickers as Well?

But there is a myth out there that illegal brain-altering drugs are dangerous but prescribed brain-altering drugs are safe. But anyone who knows the molecular structure and understands the molecular biology of these drugs and has seen the horrific adverse effects of usage or withdrawal of legal psychotropic drugs knows that the myth is false, and that there is a double standard being applied, thanks to the cunning advertising campaigns from Big Pharma.

But there is an epidemic of legal drug-related deaths in America, so I submit a few questions that people – as well as journalists and lawyers who are representing drug-injured plaintiffs – need to have answered, if only for educational and preventive practice purposes:

1) What cocktail of 9 different VA-prescribed psych drugs was “American Sniper” Chris Kyle’s Marine Corps killer taking after he was discharged from his psychiatric hospital the week before the infamous murder?

2) What were the psych drugs that Robin Williams got from Hazelden just before he hung himself?

3) What were the myriad of psych drugs, tranquilizers, opioids, etc that caused the overdose deaths of Philip Seymour Hoffman, Michael Jackson, Whitney Houston, Heath Ledger, Anna Nicole Smith, etc, etc, etc (not to mention Jimi Hendrix, Bruce Lee, Elvis Presley and Marilyn Monroe) – and who were the “pushers” of those drugs?

4) What was the cocktail of psychiatric and neurologic brain-altering drugs that Andreas Lubitz was taking before he intentionally crashed the passenger jet in the French Alps – and who were the prescribers?

5) What are the correctly prescribed drugs that annually kill over 100,000 hospitalized Americans per year and are estimated to kill twice that number of out-patients?

(See http://www.collective-evolution.com/2013/05/07/death-by-prescription-drugs-is-a-growing-problem/)

Because the giant pharmaceutical companies want these serious matters hushed up until the news cycle blows over (so that they can get on with business as usual), and because many prescribing physicians seem to be innocently unaware that any combination of two or more brain-altering psychiatric drugs have never been tested for safety (either short or long-term), even in the rat labs, future celebrities and millions of other patient-victims will continue dying – or just be sickened from a deadly but highly preventable reality.

But what about “patient confidentiality”, a common excuse for withholding specific information about patients (even if crimes such as mass murder are involved)? It turns out that what is actually being protected by that assertion are the drug providers and manufacturers. Common sense demands that such information should not be withheld in a criminal situation.

America’s corporate controlled media makes a lot of money from its relationships with its wealthy and influential corporate sponsors, contributors, advertisers, political action committees and politicians, but, tragically, the media has been clearly abandoning its historically-important investigative journalistic responsibilities (that are guaranteed and protected by the Constitution). It is obvious that the media has allied itself with the corporate “authorities” that withhold, any way they can, the important information that forensic psychiatrists (and everybody else) needs to know.

We should be calling out and condemning the authorities that are withholding the information about the reported “plethora of drugs” that is known to have been prescribed for Lubitz by his treating “neurologists and psychiatrists”, drugs that were found in his apartment on the day of the crash and identified by those same authorities who have not revealed the information to the people who need to know. Two weeks into the story and there still has been no further information given, or as far as I can ascertain, or asked for by journalists.

So, since the facts are being withheld by the authorities, I submit some useful lists of common adverse effects of commonly prescribed crazy-making psych drugs that Lubitz may have been taking. Also included are a number of withdrawal symptoms that are routinely  and conveniently mis-diagnosed as symptoms of a mental illness of unknown cause.

And at the end of the column are some excerpts from the FAA on psych drug use for American pilots. I do not know how different are the rules in Germany, but certainly both nations have to rely on voluntary information from the pilots.

1) Common Adverse Symptoms of Antidepressant Drug Use

Agitation, akathisia (severe restlessness, often resulting in suicidality), anxiety, bizarre dreams, confusion, delusions, emotional numbing, hallucinations, headache, heart attacks  hostility, hypomania (abnormal excitement), impotence, indifference (an “I don’t give a damn attitude”), insomnia, loss of appetite, mania, memory lapses, nausea, panic attacks, paranoia, psychotic episodes, restlessness, seizures, sexual dysfunction, suicidal thoughts or behaviors, violent behavior, weight loss, withdrawal symptoms (including deeper depression)

2) Common Adverse Psychological Symptoms of Antidepressant Drug Withdrawal

Depressed mood, low energy, crying uncontrollably, anxiety, insomnia, irritability, agitation, impulsivity, hallucinations or suicidal and violent urges. The physical symptoms of antidepressant withdrawal include disabling dizziness, imbalance, nausea, vomiting, flu-like aches and pains, sweating, headaches, tremors, burning sensations or electric shock-like zaps in the brain

3) Common Symptoms of Minor Tranquilizer Drug Withdrawal

Abdominal pains and cramps, agoraphobia , anxiety, blurred vision, changes in perception (faces distorting and inanimate objects moving), depression, dizziness, extreme lethargy, fears, feelings of unreality, heavy limbs, heart palpitations, hypersensitivity to light, insomnia, irritability, lack of concentration, lack of co-ordination, loss of balance, loss of memory, nightmares, panic attacks, rapid mood changes, restlessness, severe headaches, shaking, sweating, tightness in the chest, tight-headedness

4) Common (Usually Late Onset) Adverse Psychological Symptoms From Anti-Psychotic Drug Use

Blurred vision, breast enlargement/breast milk flow,  constipation, decreased sweating, dizziness, low blood pressure, imbalance and falls, drowsiness, dry mouth, headache, hyperprolactinemia (pituitary gland dysfunction), increased skin-sensitivity to sunlight, lightheadedness, menstrual irregularity (or absence of menstruation), sexual difficulty, (decline in libido, anorgasmia, genital pain).

The lethal adverse effects of antipsychotic drugs include Catatonic decline, Neuroleptic Malignant Syndrome (NMS, a condition marked by muscle stiffness or rigidity, dark urine, fast heartbeat or irregular pulse, increased sweating, high fever, and high or low blood pressure); Torsades de Pointes (a condition that affects the heart rhythm and can lead to sudden cardiac arrest”; Sudden death

5) Late and Persistent Adverse Effects of Antipsychotic Drug Use  (Some of these symptoms may even start when tapering down or discontinuing the drug!)

Aggression, akathisia (inner restlessness, often intolerable and leading to suicidality), brain atrophy (shrinkage), caffeine or other psychostimulant addiction, cataracts, creativity decline, depression, diabetes, difficulty urinating, difficulty talking, difficulty swallowing, fatigue and tiredness, hypercholesterolemia, hypothyroidism, intellectual decline (loss of IQ points), obesity, pituitary tumors, premature death, smoking – often heavy – (nicotine addiction), tardive dyskinesia (involuntary, disfiguring movement disorder), tongue edge “snaking” (early sign of movement disorder), jerky movements of head, face, mouth or neck, muscle spasms of face, neck or back, twisting the neck muscles, restlessness – physical and mental (resulting in sleep difficulty), restless legs syndrome, drooling, seizure threshold lowered, skin rashes (itching, discoloration), sore throat, staring, stiffness of arms or legs, swelling of feet, trembling of hands, uncontrollable chewing movements, uncontrollable lip movements, puckering of the mouth, uncontrollable movements of arms and legs, unusual twisting movements of body, weight gain, liver toxicity

6) Common Symptoms of Antipsychotic Drug Withdrawal

Nausea and vomiting, diarrhea, rhinorrhea (runny nose), heavy sweating, muscle pains, odd sensations such as burning, tingling, numbness,  anxiety, hypersexuality, agitation, mania, insomnia, tremor, voice-hearing

FAA Medical Certification Requirements for Psychotropic Medications

https://www.leftseat.com/psychotropic.htm

Pilots can only take one of four antidepressant drugs – Celexa (Citalopram), Lexapro (Escitalopram), Prozac (Fluoxetine) and Zoloft (Sertraline).

Most psychiatric drugs are not approved under any circumstances.

These include but are not limited to:

  • Abilify (Aripiprazole)
  • Effexor (Venlafaxine)
  • Elavil (Amitriptyline)
  • Luvox (Fluvoxamine Maleate)
  • Monoamine Oxidase Inhibitors
  • Paxil (Paroxetine)
  • Remeron (Mirtazapine)
  • Serzone (Nefazodone)
  • Sinequan (Doxepin)
  • Tofranil (Imipramine)
  • Trazodone
  • Tricyclic Antidepressants
  • Wellbutrin (Bupropion)

To assure favorable FAA consideration, the treating physician should establish that you do not need psychotropic medication. The medication should be discontinued and the condition and circumstances should be evaluated after you have been off medication for at least 60 and in most cases 90 days.

Should your physician believe you are an ideal candidate, you may be considered by the FAA on a case by case basis only. Applicants may be considered after extensive testing and evidence of successful use for one year without adverse effects. Medications used for psychiatric conditions are rarely approved by the FAA. The FAA has approved less than fifty (50) airmen under the FAA’s SSRI protocol.

After discontinuing the medication, a detailed psychiatric evaluation should be obtained. Resolved issues and stability off the medication are usually the primary factors for approval.

Dr Kohls is a retired physician who practiced holistic mental health care for the last decade of his family practice career. He writes a weekly column on various topics for the Reader Weekly, an alternative newsweekly published in Duluth, Minnesota, USA. Many of Dr Kohls’ weekly columns are archived at http://duluthreader.com/articles/categories/200_Duty_to_Warn.

Source:  http://www.globalresearch.ca/the-connections-between-psychotropic-drugs-and-irrational-acts-of-violence/5441484  April 08, 2015

 

Filed under: Addiction,Brain and Behaviour,Drug use-various effects,Effects of Drugs,Europe,Global Drug Legalisation Efforts,Health,Psychiatric drugs,Social Affairs,USA :

Lynne Featherstone accepts advisory council’s recommendation of 12-month ban on substances including most widely used alternative to cocaine

Mephedrone, also known as 4-MMC and used as an alternative to cocaine, has already been banned in the UK. Photograph: Rex

Five legal highs, including an alternative to cocaine that is one of the most common in Britain, are to be banned from midnight on Thursday, ministers have announced.

The drug minister, Lynne Featherstone, said she had accepted a recommendation from the government’s official drug advisers that the five legal highs should face a temporary ban of 12 months while a full assessment of the harm they posed was undertaken.

The Advisory Council on the Misuse of Drugs has said one of the five legal highs, ethylphenidate, which users inject and is widely marketed as a “research chemical” or as a component in branded products such as Gogaine, Nopaine, Burst and Banshee Dust, has been available over the internet in Britain for four years. They said it was one of the most commonly encountered new psychoactive substances (NPSs), as legal highs are officially known, in Britain and has emerged as an alternative to cocaine.

The ACMD recommended the ban on ethylphenidate based on evidence that it had caused serious problems, particularly in Edinburgh and Taunton, Somerset. Four related compounds are to banned at the same time to prevent users switching.

Ethylphenidate is typically sold at £15 a gram for powder, £20 a gram in crystal form and £1 for a 50mg tablet. Professor Les Iversen, the chair of ACMD, said injecting users were putting themselves at risk of blood-borne disease and infections.

Police Scotland said Burst, as it is marketed in Edinburgh, was responsible for the majority of legal-high casualties seeking emergency hospital treatment in the city last summer.

Avon and Somerset police said an epidemic of injecting legal highs in public places in Taunton last summer had led to more than 200 needles being recovered in one clean-up day. In December, the high street “head shop” selling the products was closed down.

The banned substances are closely related to methylphenidate, a licensed stimulant marketed under the brand name of Ritalin that is regularly prescribed to children for the treatment of attention deficit hyperactivity disorder.

The temporary ban means anyone caught making, supplying or importing the drugs will face up to 14 years in prison and an unlimited fine. Possession is not illegal but police and border officials are allowed to search or detain anyone they suspect of having the drugs and seize, keep or dispose of the banned substance.

Drug law reform campaigners said such bans were simply trapping authorities in an “endless game of whack-a-mole” as they tried to play catch-up with drugs chemists. They said that while the government had responded to the frenzy over legal highs, drug misuse deaths overall had risen sharply.

The decision to ban methylphenidate-related substances while continuing to use the parent chemical as a medicine might raise questions over the safety of a drug often prescribed to children.

Ethylphenidate-based products are a growing issue and their use is associated with bizarre and violent behaviour

Advisory Council on the Misuse of Drugs

“The methylphenidate-related materials being marketed as NPS have psychoactive effects so similar to the parent compound that they can be expected to present similar risks to users,” Iversen said in the letter.

Although it has been marketed as a party drug, the ACMD’s advice warns that some ethylphenidate users appear to have developed chronic problems, continually redosing the drug intravenously in binges.

The ACMD report says that in Edinburgh “there has recently been a report of an outbreak of Staphylococcus aureus and Streptococcus pyogenes infections in this area associated with NPS injecting, which is believed to involve ethylphenidate.”

It added: “Ethylphenidate-based products are a growing issue in Edinburgh and their use is associated with bizarre and violent behaviour.”

Drugs reform campaigners said the government’s use of temporary bans on new substances had authorities constantly playing catch up with drugs chemists. The only answer was wholesale reform of drug policy, they said. Danny Kushlick, head of external affairs for Transform, said: “These substances have been brought out because of the success in enforcing the ban on ecstasy and cocaine in particular. Really we have to recognise that this is a self-inflicted trade.

 

 

 

 

 

 

 

Legal high drug deaths soar in UK

“If we were to have a regulated trade in drugs these ones would not exist. You would not have ‘fake cocaine’ if you could get real cocaine. The whole NPS market is a product of prohibition.

“This is a never-ending game of whack-a-mole because even using the analogues legislation there are new analogues; they can churn these out by the hundreds. This is the opposite of control and regulation. It’s fuelling anarchy in the market and we need to look at regulating frameworks for more benign drugs.”

Niamh Eastwood, director of Release, said new bans on substances only served to push drug use further underground and spur the development of new chemicals with unknown risks to users.

She said: “Speaking more broadly, the government appears to have made NPS something of a cause célèbre in its fight against drugs, apparently in response to the media frenzy over what many unhelpfully term ‘legal highs’. While NPS are indeed a part of the modern debate on drugs, they form a comparatively small part of the market.

“At a time when the associated harms are increasing for other substances – drug misuse deaths rose 21% in 2013, 32% when focusing solely on heroin/morphine deaths – there is a real risk that the government is turning its attention away from addressing the failures of its drug policy holistically in order to pander to poorly-founded fears over this new phenomenon.”

Ethylphenidate is already banned in Denmark, Austria, Germany, Hungary, Portugal, Sweden, Jersey and Turkey. It is also classified under analogue scheduling in the US and Australia.

The other substances recommended for the temporary ban by the ACMD included 3,4-dichloromethylphenidate, methylnaphthidate, isopropylphenidate and propylphenidate. It wasn’t clear how widespread their use was.

Methylphenidate, the drug from which ethylphenidate and its related compounds is derived, is currently controlled as a class B drug in Britain but also licensed as a medicine for conditions including ADHD and narcolepsy. It has also been widely used recreationally, and as a study aid. Research has found it can offer modest improvements in working memory and episodic memory.

Source:   http://www.theguardian.com/science/2015/apr/09/

Filed under: Effects of Drugs,Health,Legal Highs,Prevention and Intervention :

The most obvious characteristic of marijuana-legalisation campaigners – apart from billionaire interests on the scale of Big Tobacco – is that their lobbying and promises are based on theories not facts.

Legalisers regularly use the words “science” and “evidence base” but rarely cite research references. Never has this chasm between theory and fact been so powerfully and conspicuously exposed as in the March analysis by local media in Clearing the Haze of events a year after marijuana was legalised for recreational use in Colorado.

Here in the UK, a decade-long follow up by researchers into Britain’s disastrous 2004 ‘Lambeth experiment’ of depenalisation proved that it led to more crime and hospitalisations not less. The Colorado aftermath of legalisation is on a vaster scale.

CLAIM:“We view our top priority as creating an environment where negative impacts on children from marijuana legalisation are avoided completely,” Colorado’s governor promised.

FACT:There are growing concerns over exposure, potency and availability of marijuana to children. Even before legalisation, Governor John Hickenlooper predicted the need for “a project to analyse the correlation between marijuana use during pregnancy and birth defects” (FYI, here’sa listand one on perils tochildren). Colorado hospitals have admitted more children for marijuana harms. A June 2014 survey of 100 Colorado school officers found that 89 per cent witnessed a rise in marijuana-related incidents since legalisation.

CLAIM:Legalisation will fund prevention, education.

FACT:Colorado budgeted only about $34,000 for its Office of Behavioral Health’s prevention work in the 2014-2105 fiscal year; nothingwas received. Its Department of Public Health and EnvironmentGood to Knowcampaign, crafted with marijuana business owners, tells children how to use pot. “It’s like inviting a tobacco company to help us learn how to use tobacco and develop our next anti-smoking campaign.”

CLAIM:Regulation works.

FACT:How regulation would work was described only in soundbites before voting. Hickenlooper later admitted it was “reckless” and “a bad idea”. This February, Colorado Attorney General Cynthia Coffman declared it “not worth it”. Ben Cort at the University of Colorado Hospital disclosed that “Colorado has been met by an industry that fights tooth and nail any restrictions that limit profitability. Like Big Tobacco, the marijuana industry derives profits from addiction and its survival depends on turning a percentage of kids into lifelong customers.”

CLAIM:Legalisation of marijuana will unclog prisons.

FACT:There aren’t enough offenders in prison for simple possession of pot to unclog the system if they were freed: only 103. In 2011, the federal government convicted only 48 marijuana offenders with under 5,000 grams of marijuana: almost 12,000 joints.

CLAIM:Legalisation will produce new revenue for the general fund.

FACT:Tax revenues failed to meet projections – taxpayers could even get two refunds. The Governor’s Office of Marijuana Coordination director said the first priority for tax revenue is to cover regulatory costs. Moreover, Colorado isn’t equipped to gather cost-benefit analysis to quantify costs linked with cannabis abuse. This is alongside lawsuits against the state, manufacturing hazards, pressured resources for the homeless, concerns over children’s welfare and more: “Voters didn’t understand how difficult, resource-intensive and costly the enforcement of even just marijuana driving laws would be”.

CLAIM:Legalisation of marijuana will hobble drug cartels.

FACT:Cheaper marijuana prices mean cartels turn to ‘harder’ drugs including ‘black tar’ heroin and methamphetamine, as well as cybercrime and continued people-trafficking.

CLAIM:By regulating sales of marijuana, Colorado will make money otherwise locked into the black market.

FACT:Black-market sales are booming so much that they are blamed for cannabis tax revenues falling short of claims. “Don’t buy the argument that regulating sales will eliminate the black market, reduce associated criminal activity and free up law enforcement agencies’ resources,” Coffman urged in February. Worse is that “Colorado is the black market for the rest of the US”: neighbouring Denver suffered an almost 1,000 per cent spike in marijuana seizures.

CLAIM:Legalisation and regulation will see people using lower strengths of drugs.

FACT:Colorado permits one ounce of tetrahydrocannabinol (THC), the active ingredient giving a euphoric high. Many people envision an ounce of dried marijuana plant, about 40 standard cigarettes. But one ounce of concentrated THC equals over 2,800 average-size brownies or candy; an ounce of hash oil is roughly 560 standard ‘vaping’ hits.

CLAIM:Medical marijuana works, only legalisation allows research.

FACT:Treating marijuana – sold in dispensaries without FDA approval and shown to be more carcinogenic than tobacco when combusted – as if exempt from the approval process others drugs must undergo for public safety, is seen as derailing legitimate research on specific parts of the marijuana plant for new clinically-proven medicines without addiction risks. As the prevention charity, Cannabis Skunk Sense, puts it: “it’s like getting penicillin by eating mouldy bread”. Non-legalisation has not stopped 70+ scientific studies on cannabinoids elsewhere, and the National Institutes of Health awarded over $14million for such research.

CLAIM:Marijuana is safer than alcohol.

FACT:“Not when it comes to driving – and officers are seeing people using both substances, which is worse,” revealed one police chief.In the first six months of 2014, 77 per centDUIDs (driving under influence of drugs) involved marijuana. Accident risk doubles with any measurable amount of THC in the bloodstream, rising when alcohol is added.

The tragic fact above all else is that these downsides were predicted by authoritative individuals and organisations – and ignored. The good of many people was sacrificed for the greed of a few: be it for money, power or a drugged delusion. Deirdre Boyd

Source: www.conservativewoman.co.uk 1st April 2015

Filed under: Cannabis/Marijuana,Drug Specifics,Drug use-various effects,Economic,Effects of Drugs,Environment,Health,USA :

A new political party is planning to field as many as 100 candidates at the general election to force the issue of cannabis legalisation centre stage.

Cista – Cannabis is Safer than Alcohol – is inspired by legalisation of the drug in some US states. The party’s election candidates will include Paul Birch, who co-founded Bebo before it was sold to AOL for $850m (£548m) in 2008 and says he is investing up to £100,000 in the venture.

Other candidates around the UK are soon to be named; this week the party said Shane O’Donnell, a former Conservative party activist, would stand against Labour’s Keir Starmer and the Green party leader, Natalie Bennett, in the London constituency of Holborn and St Pancras.

According to YouGov polling commissioned by Cista and provided to the Guardian, 44% of voters support the legalisation of cannabis against 42% who don’t (with 14% undecided).

The two mainstream parties with the most to lose from some voters being tempted to opt for Cista in marginal constituencies are the Greens, which supports decriminalisation, and the Liberal Democrats, which has been looking at the decriminalisation of all drugs for personal use and allowing cannabis to be sold on the open market.

However, Birch’s party has made a policy decision not to run in Brighton, where the sole Green MP Caroline Lucas is defending her seat, and in constituencies with incumbent Lib Dem MPs. The decision was taken after Lib Dem MP Julian Huppert, one of parliament’s most visible advocates of the decriminalisation of drugs, raised the issue of a candidate from Cista standing against him.

Birch said that in the main the other parties were keen not to talk about the issue of legalisation because they were embarrassed by it. “In the absence of this party forming I doubt that it would be an election issue. The Greens are the most explicit but even they don’t make it a prominent issue,” he added.

“With what has been happening in US states though, it now feels like it’s within touching distance. It’s like this is the final push and the time is right.”

Birch suggested that parallels with the road to legalisation in US states were forming on the basis of another of his party’s YouGov poll findings, which was that 18% of people believed that cannabis was safer than alcohol, while more than half thought that they were the same in safety terms.

He said: “In Colorado [one of the first US states to legalise the recreational use and sale of marijuana] the basis of their campaign was to juxtapose cannabis and alcohol. They knew that once they moved people to understand that it was safer then people would be happy to legalise it.”

Principally, Birch has faith that the public will come around to the idea in greater numbers as a result of becoming ever more informed. Of a recent experiment where the Channel 4 News anchor Jon Snow took large amounts of skunk-type cannabis, resulting in him feeling “as if his soul had been wrenched from his body”, Birch said that this was akin to forcing a teetotaller to down a bottle of illegally distilled moonshine. In a regulated industry, he argued, the risk to consumers could be considerably reduced.

Cista’s candidates will campaign for a royal commission to review the UK’s drug laws relating to cannabis – a relatively modest initial aim calibrated to maximise its appeal. They will also push the economic argument for legalisation, which the party argues could net the exchequer as much as £900m if cannabis were legalised and properly controlled.

The party, which is keen to establish itself as a professional outfit in contrast to previous electoral attempts at highlighting the decriminalisation cause, is signing up members and candidates using online forms. It is eager to push back against stereotypes and, in particular, encourage women to become involved.

Five candidates, including Birch, are signed up to stand for election on 7 May, while he and his team will this week begin travelling around the UK in search of other candidates who they expect will include academics, existing campaigners, students and people who work or have experience of working in the criminal justice system.

Source:  http://www.theguardian.com/society/2015/feb/25

Filed under: Cannabis/Marijuana,Drug Specifics,Effects of Drugs,Europe,Global Drug Legalisation Efforts,USA :

The family of a Tulsa man who shot himself Saturday night in Keystone is blaming his suicide on his ingestion of edible marijuana candies.

“It was completely a reaction to the drugs,” Kim Goodman said about her son Luke’s Saturday night suicide.

Luke Goodman’s death is now the third death in Colorado linked to marijuana edibles.

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

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

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

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

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

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

Fowler says Goodman became “pretty weird and relatively incoherent. It was almost like something else was speaking through him.” When family members left the condo Goodman refused to join them. After they left he got a handgun that he typically traveled with for protection, and turned it on himself.

Summit County Coroner Regan Wood says the preliminary cause of death is a self-inflicted gunshot wound. As for the impact of the marijuana edibles, she said, “That’s what we’ve heard consistently.” She said the impact the edibles had on Goodman will be more clear when toxicology results come back in a few weeks. “It’s still under investigation,” said Wood.

While definitive answers may be weeks away, Kim Goodman, Luke Goodman’s mother, told CBS4 she knows why her son took his own life. “It was 100 percent the drugs,” she said. “It was completely because of the drugs — he had consumed so much of it.” She said her son was well adapted, well-adjusted and had no signs of depression or suicidal thoughts. “It was completely out of character for Luke … there was no depression or anything that would leave us being concerned, nothing like that.”

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

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

Richard Kirk of Denver faces first-degree murder charges stemming from the fatal shooting of his wife in Denver last year. Before her death his wife called 911 and said her husband had eaten marijuana candy and taken prescription medication and was hallucinating.

Kristine Kirk and Richard Kirk (credit CBS)

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

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

Kim Goodman told CBS4 she believes marijuana edibles should be removed from store shelves.

“I would love to see edibles taken off the market … I think edibles are so much more dangerous.”

Source: CBS4 26th March 2015

Filed under: Cannabis/Marijuana,Drug use-various effects,Drug use-various effects on foetus, babies, children and youth,Effects of Drugs,Health,USA :

Source: https://learnaboutsam.org/

Filed under: Cannabis/Marijuana,Effects of Drugs,Effects of Drugs (Papers),Environment,Social Affairs,Social Affairs (Papers),USA :

The information comes from the Indiana Youth Institute’s annual Kids Count report.

The data is worrisome to area health professionals, like Dr. Ahmed Elmaadawi, who says marijuana is mentally addictive. 

“Cannabis, in general, works in an area of the brain that’s responsible for judgment and well-being. We actually know if you use marijuana for a long period of time, it affects your judgment [and] self-esteem. And longtime use of cannabis can actually cause psychosis,” said Dr. Elmaadawi, a child and adolescent psychiatrist.

Dr. Elmaadawi is concerned mainly for teen use. He says there is proven research marijuana can be healing to cancer patients and others suffering from chronic pain, but use for teens is dangerous. He says those who try the drug before age 18 are 67% more likely to continue using. The number drops to 27% for adults who try it for the first time.

“The pleasurable response is there. They want to have more to get that same feeling from the first time they used marijuana,” said Dr. Elmaadawi.

While health professionals are standing strong in the dangers, there is an overwhelming support for legalization at the national level. According to a Pew Research Poll, millennials are setting aside partisan politics with 77% of Democrats between ages 18-34 and 63% of Republicans agreeing laws that prohibit pot are outdated.

But, not all young people agree, including one local teen who struggled with abuse at an early age. The teen, called “John” for the purpose of this story, went to rehab at age 16. He started using pot at 13. His legal trouble started when he was caught on camera stealing from parked cars with a friend. Both were high and had a history of theft.

“There was an adrenaline part that didn’t make me worry about it. The money part is what made me do it, but the thrill is what didn’t make me afraid of it,” said John.

After his first arrest, John went to the Juvenile Justice Center (JJC) for 10 days. After his release, he started using synthetic marijuana. His mom caught him sometime later, called his parole officer, and he was again arrested. This time, John went to JJC for a month and rehab for 6 months.

“I stopped mainly because it was hurting a lot of the relationships I had, and I wanted to do stuff for myself. I knew if I wanted to go as far as I wanted to, I was going to get backtracked all the time if I smoked weed,” said John.

An arrest record and rehab aren’t enough for everyone. The Indiana Youth Institute (IYI) says while overall substance abuse is declining in terms of alcohol and cigarettes, marijuana use is increasing in teens.

“A big key to being successful to keeping our kids away from any illicit substance is open communication with their parents and other caring adults in their lives,” said Bill Stanczykiewicz, the President and CEO at IYI.

Dr. Elmaadawi and Stanczykiewicz agree there are mixed messages about marijuana legalization and the longtime effects. They agree open communication and community resources are key in helping teens make tough choices. Dr. Elmaadawi says there needs to be more education in schools in addition to collaboration between the resources in the community. Stanczykiewicz says teens are most influenced in their personal decision making by people they know directly.

“Kids benefit when they hear consistent messages about right and wrong from all of the caring adults in their lives. There’s no 100% guarantee that kids are going to make good choices, but what we are trying to do is increase the odds,” said Stanczykiewicz.

To read the Kids Count Data, click here.

Source: www.wndu.com  9th March 2015

Filed under: Alcohol,Cannabis/Marijuana,Drug use-various effects on foetus, babies, children and youth,Effects of Drugs,Social Affairs,Treatment and Addiction,USA :

This article shows how drug use in an area can impact more than the individual and their families and friends.  The local economy and small businesses are having to cope with lower productivity due to ‘functioning’ drug dependents in the workforce.    NDPA

New Hampshire drug czar: Addiction dragging state’s economy down

Providing more treatment and recovery options for drug addicts is as much about the addicts as it is about helping spur the state’s economy, said the state’s new drug czar.

“For me, it’s all about the money,” said John G. “Jack” Wozmak, senior director for substance misuse and behavioral health.  Wozmak was appointed in January by Gov. Maggie Hassan. The position is funded by a grant from the New Hampshire Charitable Foundation. Wozmak spent nearly a decade as the administrator of the Beech Hill substance abuse treatment facility in Dublin, and since 1998 had been the Cheshire County administrator.

“With a broad range of experience dealing with substance misuse through his roles in the public sector and in private substance abuse treatment, Jack will help strengthen our efforts to improve the health and safety of Granite Staters, and I thank him for his commitment to serving the people of New Hampshire, as well the New Hampshire Charitable Foundation for making his position possible,” Hassan said in a statement.

Wozmak’s task: Get a host of agencies and organizations to work together to reduce the state’s drug abuse, particularly heroin addiction.  Wozmak takes the post at a time when heroin overdoses and deaths are at an all-time high in New Hampshire. The Centers for Disease Control reports that New Hampshire is among 28 states that saw big increases in heroin deaths.

But Wozmak said drug addiction is more than the headline-generating heroin overdoses and drug-related burglaries and robberies that dominate the news.
“Yes, the number of heroin deaths is doubling (from the previous year). But that’s just the tip of the iceberg” of the state’s drug epidemic, he said.

Functioning addicts

The underlying problem – and what the drug czar said will help him get more money for treatment and prevention efforts from state legislators – is the thousands of drug abusers who do not necessarily overdose but drive up costs for employers, he said.
“You don’t hear about the day-to-day drug exposure that companies have because it’s all below the surface, like an iceberg,” he said.

Employers see everything from diminished production to having to overstaff or pay overtime to cover for employees addicted to drugs who miss work, he said. This hurts profit and, in turn, decreases the state’s revenue from business profits taxes. He said estimates from the state’s hospitality sector indicate that as many as 20 percent of that field’s employees may have drug addiction issues.

“I want to increase jobs and this is getting in the way,” he said. “It’s just interfering with productivity. It’s interfering with the economy.”  Wozmak said the drug problem as been exacerbated by a myriad of issues, including budget cuts for treatment programs, along with insurance companies cutting or capping policy coverage for substance abuse treatment.

In the 1980s, he said, the state had more than 600 beds at six private centers providing treatment for substance abuse. After all the cuts by insurance companies, the state now has 62 beds available, he said.

Further, the state ranks second-to-last – after Texas – in providing treatment for drug addiction and has the lowest rate in the country – 6 percent – of people who get treatment for their addictions.  “We have decimated the system of treatment and recovery, and we have to rebuild it,” he said. “Imagine the outrage if diabetes were treated this way.”

More money

Hassan has proposed more than tripling the state’s spending for the Commission on Alcohol and Drug Abuse Prevention, Treatment and Recovery in her proposed two-year budget, from a total of nearly $2.9 million in the 2014-15 budget, to nearly $9.6 million in 2016-17.

The way to convince legislators that the funding is necessary is by appealing to their desire for job growth in a state that has had anemic population growth, Wozmak said.  To get population and job growth, he said, the state has to make its work force healthier and the best way to do that is to reduce drug addiction.

“If you ran on a platform of job growth, you have to deal with this issue,” he said. “If (job growth is) not going to be from people moving here, then you have to improve the work force that’s here.  “If you’re not looking to take care of this problem, then you’re falling down on your promise,” he said. “If you want to create jobs, you have to make the work force more viable.”

Wozmak said the problem can be solved. He said his role includes getting the affected parties – including law enforcement, public resources, private or nonprofit organizations, charities and treatment facilities – working together. He said a provision of the Affordable Care Act that requires insurers to cover substance abuse again should help spur private investment in treatment and recovery facilities.

“There is no easy answer, but I believe there are many opportunities to make the change now on a variety of levels and a myriad of fronts,” he said. “I think we’re going to have a lot of success.”  He said getting help from the state’s medical professionals will also be key, as most heroin addicts, he said, start with addictions to prescription painkillers. He said medical professionals are “not the sole source” of the issue, but could be involved in changing the way pain is managed to help prevent addictions.

“None of them wanted to become addicts,” he said.

– See more at: http://www.unionleader.com/article/    8th March 2015

Filed under: Economic,Education,Effects of Drugs,Environment,Europe,Health,Prevention and Intervention :

Nick Clegg’s most recent contribution to the drugs debate has been to call for an end to imprisonment for the possession of drugs for personal use, and to move leadership of the UK drug strategy from what he sees as an enforcement obsessed Home Office to a treatment focused Department of Health. His rationale for this is that we are currently wasting resources locking up the ” victims “of the drug trade while allowing “health harm to go untreated”. 

Ending the use of imprisonment to protect people from themselves has much to commend it. The detailed legal drafting will be trickier than the deputy PM seems to realise, and it is unlikely to free up much resource, given the small numbers involved and the short periods actually served in custody. Nevertheless this reform, particularly if it were allied to amendments to the Rehabilitation of Offenders Act to prevent minor convictions having a disproportionate impact on people’s future life chances, offers a sensible measured step to correct the negative consequences of the Misuse of Drugs Act. Furthermore this could be achieved without opening the Pandora’s box of legalisation, from which may flow increased drug use, and increasing harm, reversing the trend of young people turning away from drugs we have seen over the last decade.

So three cheers for proposal number one. Proposal number two, at first glance seems like common sense. If you want to focus on treatment the Department of Health is the obvious home for policy. My view based on 12 years in Whitehall responsible for the English treatment system is that it could be a disaster. Here is why.

Drug policy and drug treatment has never been a priority for the Department of Health or the NHS. The financial crisis, the interface between health and social care, waiting times, cancer, dementia, and a host of other issues dominate the DH/NHS agenda. Even when policies focus on the wider social determinants of health in an effort to reduce the burden on scarce NHS resources the priorities are :smoking: 80,000 deaths a year, obesity 30,000 deaths a year, alcohol 6500 deaths a year, not illegal drugs: 2000 deaths a year. Drug use simply doesn’t kill enough people or cause as much ill-health as over risky behaviours, and the priority accorded to it by successive Health leaderships reflects that.

Although illegal drug use causes less health harm than either alcohol or tobacco it is neither safe nor harmless. Overall, government estimate drug misuse causes £15 billion worth of harm to society, dwarfing the 5 billion of health harm from smoking. 13 billion of this is the cost of drug-related crime. Home Office research estimates that 50% of the marked rise in crime that occurred in the 1980s and 90s is attributable to the successive waves of heroin epidemics that swept over the country during those decades. Addressing this escalation in criminality by making treatment readily available across the country was the rationale behind the government’s hugely increased investment in treatment following 2001, up from 50 million a year to 600 million. Public Health England estimate that providing rapid access to treatment for around 200,000 individuals, more than twice as many as in 2001, currently prevents almost 5 million crimes each year.

Given the Home Secretary’s responsibility for crime it is not surprising that the Home Office have a very different view of the priority of drug treatment to the Department of Health. The private view in the Department of Health is that the current level of drug spend is a misdirection of scarce health resources which are needed to respond to more pressing health priorities. The Home Office view is that the current spend on treatment is cost-effective yielding, according to the National Audit Office, £2.50 worth of value for the taxpayer from every £1 invested, largely from reduced crime.

Put simply the Home Office see drug treatment as value for money the Department of Health see it as a misallocation of resources. On a number of occasions over the last decade the Department of Health has sought to disinvest from drug treatment, only stepping back when this has been resisted by successive Home Secretaries. These different orientations are particularly important at the moment as the resources currently spent on drug treatment across England come under threat of disinvestment by hard-pressed Local Authorities(who were given responsibility for drug treatment under the Lansley NHS reforms) looking to raid their public health grants to prop up core services.

So what may appear at first sight as commonsense will be very likely to result in drug policy becoming the responsibility of a department that isn’t very interested, has a wealth of competing priorities, and a track record of seeking to disinvest from the very intervention that the proposal is designed to promote. Meanwhile a department that has a powerful rationale for championing treatment, and a track record of doing so, is sidelined. If Mr Clegg is as committed to drug policy based on evidence as he maintains, perhaps he needs to reconsider.

Source:  www.huffingtonpost.co.uk  9th March 2015

Filed under: Economic,Effects of Drugs,Environment,Europe,Health :

The largest recent US national survey of drink and drug problems shows that outside the addiction treatment clinic, remission is the norm and recovery common. After 14 years half the people at some time dependent on alcohol were in remission, a milestone reached for cannabis after six years, and for cocaine after just five.

SUMMARY Among the US general adult population, and for each of nicotine, alcohol, cannabis and cocaine (including crack), this study sought to estimate the time from onset of dependence to remission, the cumulative probability of remission in different racial/ethnic groups, and to identify factors related to the probability of remission.

It drew its data from the National Epidemiological Survey of Alcohol and Related Conditions (NESARC) conducted in 2000–2001, which focused on drinking disorders but also asked about other forms of drug use and psychological problems. The aim was to interview a representative sample of civilian, non-institutionalised adults aged 18 and over living in households and group residences such as college halls, boarding houses and non-transient hotels. About 8 in 10 of the sample responded to the survey yielding 43,093 respondents. The featured report investigated the subgroups who had some time in their lives been dependent on nicotine (of which there were 6937), alcohol (4781), cannabis (530) or cocaine (408).

Dependence was defined as meeting the dependence criteria of the applicable version of the American Psychiatric Association’s DSM manual, DSM-IV. ‘Lifetime’ dependence was diagnosed if the respondent reported having experienced at least three specific signs of this syndrome within the same 12-month period at some point in their life. The age this first happened for any particular substance was the onset year, while the remission year was based on the age when the respondent’s answers indicatedthey had last stopped meeting dependence criteria for the drug, and had continued to do so for at least a year until interviewed for the survey – essentially, the most recent (at least so far) lastinglysuccessful remission. It was on this basis that the study calculated remission rates for individual substances and related them to the time between the onset of dependence and remission.

Main findings

Proportion of dependent users in remission

Within a year of first becoming dependent, 3% each of smokers and drinkers were in remission and remained so until they were surveyed. For cannabis the figure was nearly 5% and for cocaine, nearly 9%. After ten years the proportions in remission had risen to 18% for nicotine, 37% for alcohol, 66% for cannabis and 76% for cocaine  chart. It could be estimated that by the end of their lives 84% of formerly dependent smokers would be in remission, 91% for alcohol, 97% for cannabis and 99% for cocaine. About 26 years after first becoming dependent, half the people at some time dependent on nicotine were in remission, a milestone reached for alcohol after 14 years, for cannabis six years, and for cocaine five years.

Once other factors had been taken in to account, for each of the substances, men who had been dependent at some time were significantly less likely than women to be in remission, especially in respect of the two illegal drugs, cannabis and cocaine; for every 10 women only about six men were in remission from dependence on these drugs. Black Americans once dependent on nicotine or cocaine were less likely to be in remission than white Americans – for cocaine, half as likely. After four years, about 50% of whites had sustained remission from dependence on cocaine; African Americans took nine years to reach the same milestone.

About 80% of people at some time dependent on nicotine or alcohol and almost all those once dependent on cannabis or cocaine had also at some time met diagnostic criteria for another psychiatric disorder, including conduct (antisocial behaviour in early life) and personality disorders. Once other factors had been taken in to account, people who had met criteria for conduct disorder were much more likely than others to have overcome their dependence on cannabis. In contrast, a diagnosis of a personality disorder was associated with a lower probability of remission from cannabis (and also alcohol) dependence. Having once experienced mood and anxiety disorders was unrelated to remission from dependence on any of the four substances.

The authors’ conclusions

The general picture is that the vast majority of people in the USA once dependent on nicotine, alcohol, cannabis or cocaine stop being dependent at some point in their lives, and this happens after fewer years for cannabis or cocaine than for nicotine or alcohol. Black Americans stay dependent longer on nicotine and cocaine than white Americans, and probabilities of remission are associated with social and psychological characteristics and dependence on other substances. However, the fact that that many people once dependent were no longer at the time of the survey should be interpreted with caution given the irregular course of addictions punctuated by remissions and relapses; their remission may have been temporary. Possible explanations for these findings are considered below.

More than two thirds of remissions from cannabis and cocaine dependence occurred within the first decade after onset of dependence, but only a fifth for nicotine and a third for alcohol. These differences may be explained in part by how quickly adverse physical, psychological and social consequences become apparent. For instance, the risk of early cardiovascular problems is much higher among individuals dependent on cocaine than among those dependent on nicotine or alcohol. Behavioural disturbances resulting from cannabis or cocaine dependence and their illegal status impose stronger social pressures to remit. The pervasive availability of alcohol and nicotine also means pervasive environmental prompts to using the drugs. Particularly for nicotine, perceived immediate benefits including anxiety and stress reduction, improved cognitive performance, and weight control, may initially outweigh perceived potential harms from long-term use.

Consistent with previous studies, black Americans once dependent on cocaine were less likely to remit than their white counterparts. Psychosocial factors that commonly affect black populations, including discrimination and lower levels of social capital, have been recognised as barriers to remission and triggers to use or relapse; genetic factors may also contribute.

Men were less likely than women to remit from dependence, perhaps because substance use is more damaging (physically, mentally and socially) for women, heightening motivation to stop using. Feelings of guilt and concerns about substance use during pregnancy and child-rearing may also play a particular part in prompting remission among women.

Individuals who met criteria for a personality disorder were less likely to remit from alcohol or cannabis dependence. This may be because characteristics of these disorders such as being impulsive, intolerant to stress, anxious, and craving new experiences, also predispose to substance use, and these characteristics tend to persist.

Among the limitations of the study were that it omitted institutionalised individuals including prisoners. People whose substance use led to their early death would also have been missed, as may some with severe but non-fatal consequences. These omissions may have caused an overestimation of the probability of remission across the entire population. The study also had no information on the number and duration of remission episodes over an individual’s lifetime; it could only relate other factors to the latest of these remissions.

 

 COMMENTARY The good news from this analysis is that, in the US context, rather than continued dependence, remission is the norm. Most people overcome or grow out of their dependence on the drugs analysed by the study – for cocaine and cannabis, after just five or six years, and for alcohol, after 14, and over their lives people continue to remit until nearly all are no longer dependent. But at least in respect of drinking, there are a set of multiply problematic drinkers who despite treatment, take many more years to stop being dependent. The findings on black versus white Americans suggest that remission rates depend on socioeconomic factors; sampled at another period in the USA’s economic cycles or in respect of drugs used predominantly by more or less advantaged sections of the population, remission rates too might differ, and look more or less like the chronic disease model.

The data presented in the featured article did not show whether the user ‘in remission’ had simply become dependent on another drug. Within the set of illegal drugs and medicines, this seemed uncommon, because the total remission rate was so high. But it seems more than possible that some who matured out of illegal drug use instead took up heavy drinking, in social and legal terms, a dependence easier to live with as an adult.

Remission rates looking forward

An acknowledged weakness of the featured report is that it asked respondents to recall changes which may have happened many years ago. However, the survey was repeated about three years later when 87% of the people who still qualified for the survey were re-interviewed. The follow-up offered an opportunity to see how many dependent at the time of the first survey had recovered three years later. These analyses seem only to have been done for drinking, for which they confirm that most people cease to be dependent though most too continue to experience drink-related problems and to sometimes drink heavily, and remain vulnerable to relapse. This average impression results from the pooling of dramatically different trajectories, from older multiply problematic alcoholics who usually do not remit despite treatment, to youngsters who generally quickly remit without formal help. Details below.

Among the re-interviewed sample were 1172 of the 1484 people who had been dependent on alcohol in the year before the first interview three years before. Nearly two thirds were longer dependent in the year before the follow-up interview. So complete was their recovery that a fifth of those previously dependent had in the past year experienced no indications of abuse or dependence; of these, three quarters were still drinking. About 11% not only had no symptoms, but were exclusively drinking within low-risk guidelines, evenly split between those drinking moderately and those not drinking at all.

But this broad-brush picture hid substantial variation in the fates of different types of dependent drinkers. At one extreme were the most severely affected drinkers with multiple psychological problems and on average about nine years of dependence behind them, two thirds of whom were still dependent at the second interview. At the other were young adults and older drinkers with few complicating psychological disorders and few years of dependent drinking. For most of these the dip in to dependence was a phase which (at least for time being) was over by the the second interview, when just under 30% were still dependent.

At least for the three years between the surveys, remission was very stable. Among the re-interviewed sample were 1772 of the 2109 who three years before had been in “full remission” from past dependence on alcohol, meaning that even though they may sometimes have drunk above low-risk guidelines, for the past 12 months they had reported no symptoms of alcohol abuse or dependence. Of these just 5% had slipped back to being dependent in the year before the second interview, though a third who had been drinking above low-risk guidelines had re-experienced some symptoms of alcohol abuse or dependence. Most stable in their recovery were the abstainers, of whom just 1 in 50 experienced such symptoms. The much greater stability of recovery in abstainers and low-risk drinkers was confirmed when other factors had been taken in to account, but was not apparent among the younger adults in the sample.

Treatment’s impact

Few dependent drug users recover through treatment and fewer still dependent on alcohol – in theNESARC survey on which the featured analysis was based, of those no longer dependent on alcohol,just 24% had at any time been in any kind of treatment for their drinking problems. Over two thirds of those who achieved more complete forms of recovery also did so without treatment.

While this shows that in the USA, treatment is generally not needed to recover from substance dependence, treatment may still make recovery more likely. In respect of dependence on alcohol, one analysis of data from the NESARC survey was consistent with formal treatment promoting recovery characterised by abstinence or low-risk drinking and no symptoms of abuse or dependence, but another and perhaps more reliable analysis found no such association.

Both however found that when treatment had been accompanied by attendance at 12-step mutual aid groups, recovery was more likely – especially abstinent recovery. These analyses could not however disentangle the possible effects of the motivation and conditions which drive someone to seek help, from the effect of actually receiving that help. Complicating the picture is the fact in this survey, the most severely affected and multiply comorbid drinkers with many years of dependence behind them were far more likely to seek treatment than less severely affected types of dependent drinkers. Despite seeking help, they were by a large margin the ones most likely to still be dependent when the survey was repeated three years later.

What about heroin and other opiates?

A notable omission from the illicit drugs included in the featured report was heroin and other opiates. Fortunately these were the subject of the greatest number of relevant studies in another review of follow-up studies of remission from dependence on amphetamine, cannabis, cocaine or opiate-type drugs. It included only studies of general populations or people who entered treatment in the normal way rather than enrolling in treatment trials.

Across the ten studies relevant to opiate-type drugs, every year on average between 22% and 9% of people were either abstinent or no longer dependent; the higher figure is the average of the proportions remitted among people who could be followed up, while the lower estimate includes cases who could not be followed and assumes they are still dependent. Generally the subjects were patients in treatment. Based mainly on patients in treatment, corresponding figures for cocaine were between 14% and 5%. The single study (from the USA) of a general population sample of cocaine-dependent people found that 39% had remitted four years after initially surveyed. For cannabis, the estimate was 17% per annum based on general population surveys and assuming people not followed up were still dependent.

In accordance with the featured article, such figures imply that within 10 years most dependent users of these drugs will no longer be dependent and may have entirely ceased use.

Racial differences reflect socioeconomic status

An analysis of data from the NESARC survey showed that taking alcohol and other drugs together, the longer dependence careers of black versus white Americans was associated with their having less social and socioeconomic resources, signified by fewer being married and fewer having completed their schooling. Once these were taken in to account, racial differences were no longer significant. The implication is that it is not race as such which makes the difference, but the position black people tend to occupy in US society. Given the same disadvantages, white Americans has dependence careers just as extended as black Americans.

Diagnostic system affects remission rate

Much in this analysis depends on the definitions used in the survey. Specifically, the probability of remission equates to the probability that someone will for at least the past 12 months have dropped below experiencing three or more dependence symptoms together in respect of the same drug. From the same survey, it is known for alcohol that many will still be consuming heavily, experiencing symptoms of dependence such as withdrawal and compulsive use, and suffering poor physical and mental health (1 2). They may be remitted from their dependence, but not according to most understandings, ‘recovered’.

Had the line been drawn elsewhere, the chances of remission might have been substantially lower – for example, as commonly in NESARC reports on drinking (1 2 3 4), if remission had been defined as non-problem moderate use or abstinence.

The latest version of the DSM manual (DSM-5) softens this binary system by diagnosing a substance use disorder when at least two symptoms are present in the same 12 months, and rating this as moderate if there were two or three, severe if four or more. ‘Abuse’ and ‘dependence’ are now subsumed within this continuum. The change seems likely to bring many more less severely affected people under the same substance use disorder umbrella as the three-symptom population investigated by the featured analysis. Their remission rates too may differ.

It is also theoretically possible that ‘remission’ may partly reflect the lack of noticeable change or struggle as with the years dependence becomes more deeply embedded and dominant in one’s life, and the change processes probed by some diagnostic questions cease to be live issues – not a sign of recovery, but of the lack such a prospect and the narrowing of life to substance use. For example, having plateaued in their use levels, long-term dependent users may no longer (or not for the past 12 months) have found themselves needing to take more of the drug to feel the desired effects, or taking more than they intended. Perhaps too in the past they had tried unsuccessfully to stop using, or had at least persistently wanted to, but now no longer tried or even wanted to. Ensuring a steady supply of drink or drugs they made no attempt to interrupt would minimise experience of withdrawal. They may also have no important interests and activities left to sacrifice to their dependence – all among the symptoms used to diagnose dependence.

Some findings from NESARC are consistent with this possibility. In the three years between the first interview and the re-interview, the alcohol dependence symptoms which fell away most often and most consistently across different types of drinkers were “taking alcohol often in larger amounts or over a longer period than was intended”, “a persistent desire or unsuccessful efforts to cut down or control use”, and withdrawal.

Similarly, young adult dependent drinkers tend not to endorse the dependence symptom relating to inability to stop drinking or cut back, presumably because they have yet to try.

Related analyses

This data from the featured report has been reanalysed to show that for each of these drugs, the probability that someone would have ceased being dependent remained the same no matter how long ago they had first become dependent. For the author this falsified theories which assume that the longer it lasts, the deeper dependence becomes embedded in neural circuits or lifestyles.

The survey on which the featured article was based and other US national surveys were among those included in a synthesisof hundreds of studies of remission and recovery from substance use problems. This too concluded that “Recovery is not an aberration achieved by a small and morally enlightened minority of addicted people. If there is a natural developmental momentum within the course of [these] problems, it is toward remission and recovery”.

Last revised 24 October 2013. First uploaded 19 October 2013

Source:  Probability and predictors of remission from life-time nicotine, alcohol, cannabis or cocaine dependence: results from the National Epidemiologic Survey on Alcohol and Related Conditions.

Lopez-Quintero C., Hasin D.S., Pérez de los Cobos J. et al.
Addiction: 2011, 106(3), p. 657–669.

Filed under: Alcohol,Cannabis/Marijuana,Cocaine,Effects of Drugs,Nicotine,Treatment and Addiction,USA :

The main points are that it seems to target teens and college students and could easily be abused by underage persons. Powdered alcohol comes in packets and can be hidden from parents and  teachers, and sneaked into homes, schools, parties, bars, etc. The product may be abused by making it with less liquid (concentrating the alcohol), possibly snorting it. Underage drinking prevention is the main concern. Senator Flores is sponsoring senate bill 536 which would ban Palcohol/ powdered alcohol. Several other states have already banned it. AG Pam Bondi wants it banned. 

The makers of powdered alcohol, Palcohol, say it will be available for sale soon, but several states are already moving to ban the product. So far, Alaska, Delaware, Louisiana, South Carolina and Vermont have banned Palcohol – even though it is not yet available – and Florida, New York, Virginia and several other states are also considering a ban. Florida Attorney General Pam Bondi publicly announced that prohibiting the product is one of her legislative priorities this year. Bondi said, “We want to flat-out ban it in our state.” 

Palcohol is powdered alcohol, developed by Mark Phillips. Phillips said he wanted a “refreshing adult beverage” after engaging in activities such as biking or kayaking, where carrying large bottles of alcohol was not possible. He then spearheaded the creation of powdered alcohol. The product is available either in V powder, which is quadruple-distilled vodka, or R powder, which is premium Puerto Rican rum. Simply add water to the powder and you have an alcoholic beverage.

According to the Palcohol website, Palcohol will be sold in one ounce packages that contain the equivalent of one shot of alcohol each. Each bag is about 80 calories and is gluten-free. The website also notes that Palcohol is “for the legitimate and responsible enjoyment by lawful consumers.” The website explains it can be used by “outdoors enthusiasts such as campers, hikers and others who wanted to enjoy adult beverages responsibly without having the undue burden of carrying heavy bottles of liquid.” Or “adult travlers journeying to destinations far from home could conveniently and lawfully carry their favorite cocktail in powder format.”

Phillips is known in the wine community for producing and hosting the television show, “Enjoying Wine with Mark Phillips” and his book, “Swallow This: The Progressive Approach to Wine.” He also served as a wine expert to the Smithsonian.
However, Palcohol has faced difficulty almost from the beginning. Last April, the Alcohol and Tobacco Tax and Trade Bureau approved the product. However, 13 days later, it rescinded its approval and said it had issued the approval “in error.” The TTB announced, “Those label approvals were issued in error and have since been surrendered.”

As soon as the product hit the media headlines, criticism exploded over the possibility of minors gaining access to the product and users snorting the powdered alcohol. Palcohol dismisses these concerns and counters them on its web site. It notes that snorting the product is “painful” and “impractical…It takes approximately 60 minutes to snort the equivalent of one shot of vodka. Why would anyone do that when they can do a shot of liquid vodka in two seconds?”

The company also says it is not easier to “sneak into venues” and because it does not dissolve instantly, it can’t be used to spike a drink. Finally, the company says kids will not have easier access to powdered alcohol than to regular alcohol.
Unfortunately, however, early versions of the Palcohol web site did not help its cause. SB Nation reported that Palcohol’s website originally included the following wording:
Let’s talk about the elephant in the room….snorting Palcohol. Yes, you can snort it. And you’ll get drunk almost instantly because the alcohol will be absorbed so quickly in your nose. Good idea? No. It will mess you up. Use Palcohol responsibly.
Palcohol subsequently removed that wording and explained, “There was a page visible on this site where we were experimenting with some humorous and edgy verbiage about Palcohol. It was not meant to be our final presentation of Palcohol.”
Despite the controversy, the company says it will be available this Spring. It also is planning to introduce powdered cocktails, including Cosmopolitan, Mojito, and “Powderita,” which it says takes like a Margarita, and Lemon Drop.
However, so far, it is unclear where exactly you will be able to buy it.

 Source:  http://www.commdiginews.com/life/controversy-brews-over-powdered-alcohol-34291/   January 31, 2015 

Filed under: Alcohol,Drug use-various effects,Drug use-various effects on foetus, babies, children and youth,Effects of Drugs,Health,Synthetics,USA :

In 1990s Britain a common reaction to allocating resources to treating cannabis users was, ‘Why bother? We have more than enough patients with problems with serious drugs like heroin.’ Calls for a treatment response were seen as pathologising what in many societies is both normal and in some ways desirable youth development: trying new experiences, challenging conventions, exposing the hypocrisy of alcohol-drinking adults. The typically calming use of the drug by adults was seen as preferable to the main alternative, alcohol and its associated violence and disorder. 

Those views retain some validity for the vast majority of cannabis users, but this has become, and/or become seen more clearly as, a drug with a problem tail which justifies therapeutic intervention. As heroin use and treatment numbers fall way, cannabis treatment numbers are on the rise – not, according to Public Health England, because more people are using the drug, but perhaps because services relieved of some of the recent pressure of opiate user numbers are giving more priority to cannabis, because they are making themselves more amenable to cannabis users, and because stronger strains of the drug are creating more problems.

Cannabis accounts for half of all new drug treatment patients

Whatever the causes, across the UK figures submitted to the European drug misuse monitoring centre show that the proportion of patients starting treatment for drug problems who did so primarily due to their cannabis use rose steadily from 11% in 2003/04 to 27% in 2013, that year amounting to about 27,270 individuals. Among first ever treatment presentations, the increase was more pronounced, from 19% to 49%, meaning that by 2013 their cannabis use had became the main prompt for half the patients who sought treatment for the first time  chart right. Showing that more users was not the reason for more starting treatment, over about the same period, in England and Wales the proportion of 16–59-year-olds who in a survey said that had used cannabis in the past year fell from about 11% to about 7% in 2013/14, having hovered at 6–7% since 2009/10.

The treatment figures largely reflect trends in England, where in 2013/14 the number of patients starting treatment due primarily to their cannabis use had continued to rise to 11,821, 17% of all treatment starters, up from around 7,500 and 9% just seven years before. The greater ‘stickiness’ of opiate use meant that in the total treatment population – new and continuing – the proportionate trends were less steep, cannabis numbers rising from around 11,000 in 2005/06 to 17,229 in 2013/14, and in proportion from 6% to 9%. Among younger adults, cannabis dominates; in 2013/14, far more 18–24s started treatment for cannabis than for opiate use problems – 5,039 versus 3,142 – and they constituted 43% of all treatment starters.

Further down the age range, among under-18s in treatment in England, cannabis is even more dominant. In 2013/14, of the 19,126 young people who received help for alcohol or drug problems, 13,659 or 71% did so mainly in relation to cannabis, continuing the generally upward trend since 2005/06.

Though the crime reduction justification for treating adult heroin and crack users is not so clear among young cannabis users, still immediate impacts plus the longer term benefits of forestalling further problems has been calculated to more than justify the costs of treating under-18 patients, among whom cannabis is the major player.

Cannabis users rarely stay in long-term treatment

Relative to the main legal drugs, at least in the USA dependence on cannabis is more quickly overcome. A survey of the US general adult population found that within a year of first becoming dependent, 3% each of smokers and drinkers were in remission and remained so until they were surveyed. For cannabis the figure was nearly 5% and for cocaine, nearly 9%. After ten years the proportions in remission had risen to 18% for nicotine, 37% for alcohol, 66% for cannabis and 76% for cocaine  chart right. About 26 years after first becoming dependent, half the people at some time dependent on nicotine were in remission, a milestone reached for alcohol after 14 years, for cannabis six years, and for cocaine, five.

Unlike heroin users, regular users of cannabis have been seen as sufficiently amenable to intervention to warrant trying brief interventions along the lines established for risky but not dependent drinkers, and sufficiently numerous in some countries to make routine screening in general medical and other settings a worthwhile way of identifying problem users. When the World Health Organization trialled its ASSIST substance use screening and brief advice programme in Australia, India, the United States and Brazil, just over half the identified patients (all had to be at moderate risk of harm but probably not dependent) were primarily problem cannabis users. Among these, risk reduction in relation to this drug was significantly greater among patients allocated to a brief advice session than among those placed on a three-month waiting list for advice. In each country too, risk reduction was greater among intervention patients, except for the USA, where the order was reversed. Suggesting that severity of use was not a barrier to reacting well to brief intervention, only patients at the higher end of the moderate risk spectrum further reduced their cannabis use/risk scores following intervention. The ASSIST study was confined to adults, but young people in secondary schools in the USA whose problem substance use focused mainly on cannabis also reacted well to brief advice.

In some studies brief interventions have been found to work just as well as more intensive treatment, but when the patients are heavily dependent, and the most difficult cases are not filtered out by the research, longer and more individualised therapies can have the advantage. These studies on adults might not translate to adolescents, for whom approaches which address family, school and other factors in the child’s environment are considered most appropriate for what are often multiply troubled youngsters.

The relative persistence of opiate use problems and transitory nature of those primarily related to cannabis seemed reflected in an analysis of treatment entrants in England from 1 April 2005 to the end of 2013/14. At the end of this period just 7% of primary cannabis users were still in or back in treatment compared to the 30% overall figure and 36% for primary opiate users. The figure peaked at 43% for users of opiates and crack. Over half – 53% – of primary cannabis users had left treatment as planned, apparently having overcome their cannabis problems, compared to 27% of primary opiate users and just 20% with dual opiates and crack use problems. Another 40% of cannabis users had left treatment in an unplanned manner not having overcome their dependence, a slightly higher proportion than among opiate users. The figures tell a tale of relatively high level of success which enables cannabis users to leave treatment, though even in the absence of recorded success, few stay long-term.

However, the forms patients in England complete with their keyworkers while in treatment seem to tell a different story. Compared to how they started treatment, around six months later 45% of primary cannabis users were assessed as using just as often (including a few using more), compared to 29% of opiate users and 38% whose main problem drugs were both opiates and crack, suggesting more rapid and/or more complete remission for opiate users than for cannabis users. One interpretation is that the widespread use of substitute drugs like methadone more reliably reduced the illegal opiate use of opiate users and also helped retain them in treatment, while cannabis users tended quickly to leave treatment, having done well or not. However, these figures relate only to patients who completed the forms at their six-month review, which in practice could have happened anywhere from about one to six months after their assessment for treatment. What proportion of primary cannabis users were still in treatment at that point and available to complete the forms is not clear, but they may have been the patients whose problems were deep seated enough to require extended treatment.

These are some of the issues thrown up by a set of patients and a set of interventions rather different from those associated with the drugs treatment in the UK has normally focused on. If current trends continue, understanding the findings of these and other studies will become yet more important to British treatment services.

Source:  www.findings.org.uk     03 March 2015

Filed under: Alcohol,Cannabis/Marijuana,Drug use-various effects on foetus, babies, children and youth,Effects of Drugs,Europe,Treatment and Addiction :

To go or not to go? That is the question when invited to take part in supposedly objective drugs conferences and television investigations, behind which  looms the constant presence of one Sir Richard Branson. Two seemingly flattering invitations to drugs policy events came my way this month.

The first was to be invited to a Home Affairs Select Committee event at the University of Cambridge’s Homerton College on March 12th.  At first sight, it felt a welcome recognition of my longstanding work in the field of drug addiction, and of my new recovery solutions service (DB Recovery Resources). Moreover, it seemed like an opportunity to guide and inform public opinion – even as far as the United Nations. But I was torn for days on whether to accept or not. Finally, I regretfully declined.

Why? The Home Affairs Select Committee’s invitation was entitled “The International Conference on Drugs Policy” and its findings at the end of the day were to be fed into the influential UNGASS, the United Nations General Assembly’s Special Session on world drug problems in 2016. Tempting. But a closer look raised concerns. What exactly was a Parliamentary select committee doing hosting a drugs policy conference? Why had they chosen deputy prime minister Nick Clegg who, at the time of my invitation, was scheduled to chair it? He is a recognised proponent of drugs legalisation, going so far as to include it in his election pledge.

So I was aware of the agenda and bias of the conference before I was invited.  The list of speakers spoke for itself. Every single speaker bar one  – Sarah Graham, an addiction therapist – turned out to be  a high-profile legalisation campaigner, several from organisations funded by the convicted insider trader and fomenter  George Soros. Only after I had publicised the biased agenda on my daily newsletter did HASC kindly invited me to attend. They also at the same time added a second ‘non-legalisation’ speaker to their invite list: Professor Neil McKeganey. But I could see it was still skewed. We would be the minority underdog against high-profile and well-funded legalisation campaigners, like Dr Julian Huppert MP, Baroness Molly Meacher, Roberto Dondisch from Mexico, Danny Kushlick of Transform, Professor David Nutt, who famously said taking ecstasy was less risky than horse riding, former policeman and cannabis activist Tom Lloyd, and last but not least Mike Trace, who was forced to resign his UN role when the Daily Mail revealed him to be the driving force behind an effort to disband the world’s anti-drug laws by stealth.

What chance would I have to support my colleagues? Would this be like National Treatment Agency meetings I had attended too many times in the past (before it was abolished)  where vested-interest findings and recommendations were written before the meeting and then presented as an impartial consensus of all those present – and absent?

Would it be like the self-styled United Kingdom Drug Policy Commission meetings (before it closed) which exploited the names of attendees as supporting its predetermined ‘consensus agreement’, when in reality there was a dearth of support? Was I confident that any anti-legalisation points would be included in the final report to UNGASS? That I sadly declined the invitation gives you the answer.

No. The worry is now that UNGASS may believe this Home Affairs Select Committee report, that UK taxpayers are unwittingly funding, to be impartial.  Better to blog, I thought, and hopefully open their eyes to the truth.

The second ‘flattering’  invitation was to appear on Channel 4’s Cannabis Live programme on 3 March. Although warned in advance about its inherent bias – it was funded by both C4 and Soros-supported organisations, and known legalisation proponents were booked as its speakers – I decided to accept in the hope I would be able to capture some airtime for anti-legalisation views.

(Declaration: my view is informed by the basic laws of supply and demand: increased availability leads to increased consumption. In addition there is, to my very real knowledge, so much disinformation about pot in the public domain that few people can make an informed choice). It was the right decision; although it was questionable whether there was a need for a programme experimenting ‘live’ with substances that are already known to have significant and very negative side effects. It was also worrying that Professor Nutt was  an “independent” scientific expert on it, given his obsession with cannabis legalisation and his well known insistence that it is less harmful than alcohol.

A plus turned out to be Jon Snow’s and Andrew Marr’s very negative experiences when skunk was tested on them. Perhaps that’s why presenter Snow carefully inched my neighbour off his seat to interview me, allowing time for me to make some pivotal points.  These were particularly in response to Branson’s call for regulation [legalisation] of cannabis as a solution to the world’s drug problems. I pointed out  that tobacco is regulated yet kills  more people than any other drug in the world;   that alcohol, benzos and methadone are all regulated but follow tobacco in killing more people each than illicit drugs.

I also pointed out that the first paper linking cannabis and psychosis was published 170 years ago –  in 1845  – so this is not new. All my points were transmitted unedited. A number of ‘silent’ audience members in Narcotics Anonymous introduced themselves and thanked me as we were leaving the studio.  It reminded  me of  US drug czar Michael Botticelli’s recent comment: “I do wish the recovery community was much more involved in anti-legalisation efforts”.

However the trouble with Cannabis Live – posing as science when it was exhibitionist entertainment, as one distinguished former Professor of pharmacology commented to me afterwards  – is that it provided a launchpad for the differences between “beneficent” hash and “nightmarish” skunk to be exploited by the legalisation lobbyists. Their hidden agenda. It was worrying that the programme ignored the harms from hash (as opposed to skunk):  yet these include the risk of psychosis, behavioural changes, lack of motivation, lowering of IQ, lung cancer, mouth cancer, motor crashes, lowering of fertility (a mixed blessing) – and the fact that pregnant women using hash can give birth to addicted babies with a range of mental-health problems and medical problems, including leukaemia.

At a press conference the next day, billionaire legalisation campaigner Branson was still calling for regulation (legalisation of cannabis) as a solution despite all the downsides he’d witnessed at Cannabis Live. Of course he did not mention that tobacco is regulated and it kills more people than any other drug in the world, for the simple reason that it is the most widely used drug in the world.

In his cloud cuckoo land, the 80 per cent of cannabis users who use skunk would downgrade to the milder version if they were both legal. I don’t think so. It’s against human nature. Finally, it was left to David Nutt to round up the programme – with his extraordinary recommendation that skunk should remain low in the index of drug harms, in cannabis’s current place, while hash should plummet to the lowest ranking. Maybe he was too close to the skunk factory set up beside his artificial brain in the studio. Had anyone in the audience changed their mind about being pro- or anti-legalisation, asked Snow at the end of the programme? Not one hand went up. I leave you to decide whether this infotainment fulfilled Channel 4’s mission to “keep public service values to the fore”.

Source:   www.the Conservative Woman.co.uk    7th March 2015

Filed under: Drug Specifics,Drug use-various effects,Effects of Drugs,Social Affairs :

Though many young people seem to perceive marijuana as harmless, its use may pose serious risk for adverse behaviors and health consequences.

An extensive research review published June 5 in the New England Journal of Medicineconcluded that marijuana use is linked to multiple adverse effects—particularly in youth.

“Despite some contentious discussions regarding the addictiveness of marijuana, the evidence clearly indicates that long-term marijuana use can lead to addiction,” said lead author Nora Volkow, M.D., director of the National Institute on Drug Abuse (NIDA), and three of NIDA’s top officials.

Stanimir G.Stoev/Shutterstock

According to the 2012 National Survey on Drug Use and Health, marijuana is the most commonly used “illicit” drug in the United States, with an estimated 12 percent of people aged 12 or older reporting its use in the prior year. The 2013 Monitoring the Future Survey—supported by NIDA—found that 6.5 percent of 12th graders report daily or near-daily marijuana use, with 60 percent perceiving regular use of marijuana not to be harmful (Psychiatric News, February 6). Volkow and colleagues suggested that as more states move toward policies that legalize cannabis for medical or recreational purposes, rates for marijuana use among teenagers and young adults will increase, as will the negative health consequences associated with its use.

“The regular use of marijuana during adolescence is of particular concern, since use by this age group is associated with an increased likelihood of deleterious consequences,” Volkow and colleagues cautioned.

The review, “Adverse Health Effects of Marijuana Use,” provided science-based reasoning to explain the onset of marijuana addiction and gave an overview of the adverse health consequences associated with marijuana use from data of 77 studies and literature reviews.

From animal studies, the authors concluded that exposure to tetrahydrocannabinol (THC)—the primary psychoactive chemical in cannabis—in early life can recalibrate the dopaminergic system, the reward system of the brain, to become more sensitive to stimulation with drugs. The authors speculated that the findings may help to explain the increased vulnerability to abuse of marijuana and other substances in later life, which have been reported by adults who initiated cannabis use during adolescence.

The review also highlighted studies showing an association between marijuana use and impaired regions of the human brain, including the precuneas, a key node that is involved in alertness and self-conscious awareness, and the hippocampus, which is important in learning and memory. Other adverse consequences of cannabis use included impaired driving, lowered IQ scores into adulthood, and a potential risk to exacerbate psychotic symptoms in those with mental disorders. The review suggested that risks for adverse effects increase when the drug is used along with alcohol.

“Some physicians continue to prescribe marijuana for medicinal purposes despite limited evidence of a benefit,” noted Volkow and colleagues. “Because older studies are based on the effects of marijuana containing lower levels of THC, stronger adverse health effects may occur with the use of today’s more-potent marijuana.”

The authors emphasized that more research must be done on the potential health consequences of second hand marijuana smoke, the long-term impact of prenatal cannabis exposure, and the effects of marijuana legalization policies on public health.

“It is important to alert the public that using marijuana in the teen years brings health, social, and academic risk,” said Volkow. “Physicians in particular can play a role in conveying to families that early marijuana use can interfere with crucial social and developmental milestones and can impair cognitive development.”

Source: http://psychnews.psychiatryonline.org/ June 26, 2014

Filed under: Cannabis/Marijuana,Drug use-various effects on foetus, babies, children and youth,Effects of Drugs,Health,Legal Sector,Social Affairs,Treatment and Addiction,USA :

Cannabis substitute smoked in a pipe appears to be a soft drug, but it is addictive and can be lethal

Spice is just the latest horror drug to hit Russia. Photograph: Boris Roessler/EPA/Corbis

Valentina sifts a flaky mixture from a purple sachet into the end of a small pipe, holds a lighter to it, and inhales. Her voice becomes tense and high-pitched for a moment, then she relaxes. A faint, almost Christmassy odour of lightly stewed fruits wafts through the room.

This is a hit of spice, the collective name given to various synthetic smoking mixtures making headlines in Russia. On the market for five years, spice has the potential to be deadly.

According to Russian authorities, in recent weeks the spice epidemic has taken 25 lives and led to 700 people seeking medical attention. Hardly a day goes by without a fresh horror story of adolescents dying from the drug. Earlier this month a refugee from Luhansk in east Ukraine died after smoking with her friends in a town in southern Russia. Four others were taken to hospital.

Valentina has smoked for nearly two years. Now in her mid-30s, she was a heroin addict for a year after leaving university, but kicked the habit and was clean for more than a decade. She and her husband would occasionally smoke marijuana, and one day two years ago a friend brought a packet of spice over to their house and suggested they try it.

“We thought it was just like hash – not that addictive,” she recalls. She was wrong. Now, she and her husband buy their supply from a dealer each morning after dropping their children at school.

Much of the product is believed to be imported from China, though many say that labs in Russia are also churning out the mixtures. Along with older users such as Valentina, thousands of teenage Russians are using the substance.

Yevgeny Roizman, an anti-drug campaigner known for his rehabilitation centres for heroin addicts, warned this year of the consequences of the spice epidemic. “These drugs, unlike heroin, are much more widely used, they can be distributed more quickly and easily, they are harder to detect, and kids are starting to use them much younger,” he said. “The consequences are quick addiction, fast-paced decline, and as far as I can see, irreversible consequences which cannot be cured. Heroin in Russia is yesterday’s problem.”

Spice is a cannabis substitute made from various herbs with the addition of lab-synthesised chemicals. Authorities say the problem is that each time a smoking mixture is analysed and banned by authorities, the formula is altered and the newly legal mix can be sold again. Parliament is considering passing a bill to ban all synthetic smoking mixtures.

“The current system of fighting spice simply doesn’t work,” said Sultan Khamzayev, a member of Russia’s public chamber and an anti-drug campaigner, in a recent interview with a Russian website. “Chemists need just three hours to change the formula, but all the necessary bureaucratic work to identify and then ban a particular drug takes five months. That means for the whole period, people can simply sell any old poison.”

An MP from the far-right Liberal Democratic party, Roman Khudyakov, wrote recently that the death penalty should be introduced for spice dealers. “In a way, spice is much more dangerous than heroin,” says Valentina. “Most people have a hang-up about injecting, whereas spice you just smoke it in a pipe. By the time you realise how serious it is, it’s too late.”

The formula of the drug varies from batch to batch, and the way different versions interact with different people is always slightly different, but the main bonus for users is that any kind of fear and inhibition disappears. But withdrawal kicks in within a couple of hours and is often punishing.

“You lose all your coordination,” says one Muscovite spice addict. “You can’t think properly, and you can’t walk. It’s like being catastrophically drunk, but there is also a panic and terror. You begin to sweat, have crashing palpitations and feel sick. Often, you’ll simply begin projectile vomiting, with no warning. If I stop smoking now, within two hours I will be vomiting. It’s no better than heroin withdrawal, perhaps it’s even worse.”

Most dangerous is the withdrawal period for early-stage addicts, when the physical symptoms are mild but intense depression sets in. Valentina remembers days of total panic, and not realising until later that she was experiencing withdrawal symptoms.

“One day I stood up and I understood with absolute clarity that the only way for me to escape from the awful life I was in was to murder both of my children, and then kill myself,” she says. “I was crystal clear that this was the only course of action open to me. Luckily, my husband stopped me, and calmed me down. But what about people who don’t have that support?”

A typical week sees several news stories in Russian local press detailing horrendous deaths and suicides attributed to spice: children jumping from windows, heart attacks, even self-immolation. Valentina is convinced that the deaths that are reported are just the tip of the iceberg. Spice does not show up on ordinary toxicology tests and she thinks it could be a hidden trigger in violent crimes where there are no signs of mental illness or other drug use.

Spice is just the latest horror drug to hit Russia. Several years ago krokodil, a synthetic heroin substitute made from boiling codeine tablets with other ingredients, became popular. Devastatingly addictive, the drug would literally rot the flesh of users, leading to appalling wounds and a quick death. When the sale of codeine was banned two years ago, spice began to pick up in popularity.

“They ban one nightmare drug and another one pops up,” says Anya Sarang, a Russian activist who works on rights for drugs users. “It’s a natural consequence of the firefighting approach we have to drug use. Of course we need to ban spice, but if marijuana was legal, nobody would turn to these awful spice mixes to smoke. But of course, that’s a fairly unrealistic policy in the Russian climate.”

Source:   www.theguardian.com  20th October 2014

Filed under: Effects of Drugs,Health,Others (International News),Synthetics :

On Nov. 4, Alaskans will consider Ballot Measure 2, an initiative to legalize the sale and use of marijuana for recreational purposes. And those who support that commercial trade are investing heavily in hoping you will vote “yes.” Make no mistake about it, marijuana — like tobacco and alcohol — is big business.

Like alcohol and tobacco, the costs of marijuana to public health, public safety, our youth and lost productivity, are similarly high. It’s not surprising that Outside investors would regard Alaska as fertile territory for unconditional legalization.

In 1975, our Supreme Court found a right for Alaskans to consume small amounts of marijuana in their homes in the privacy provisions of the Alaska Constitution. And in 1998, Alaskans voted to legalize marijuana for medical purposes with 58 percent support. But Ballot Measure 2 is not about “medical marijuana,” nor is it necessary in order to protect adult Alaskans who consume marijuana in their homes from police intrusion. The measure is less about freedom than it is about profit at the expense of public health. That’s why I plan to vote “no” on Ballot Measure 2.

I came to this decision after careful consideration of the medical evidence. My guide through the scientific literature was Dr. Nora Volkow, the director of the National Institute on Drug Abuse (NIDA). Earlier this year, Dr. Volkow published a peer-reviewed paper about the health effects of marijuana in the New England Journal of Medicine, one of the nation’s most eminent medical publications. Volkow directs a component of our National Institutes of Health which is, of course, neutral on state level policy initiatives. Fortunately for all of us, NIH does not prohibit its scientists from entering the discussion by objectively sharing the science with policymakers and the public.

Here’s what Volkow has to say about the state of the evidence: “The popular notion seems to be that marijuana is a harmless pleasure, access to which should not be regulated or considered illegal.”

However popular notions are not always correct. One of the detrimental effects is addiction. “The evidence clearly indicates that long term marijuana usage can lead to addiction,” Volkow states. “About 16 (percent) of those who begin marijuana usage as teenagers will become addicted. And there seems to be a strong association between repeated use and addiction. About a quarter to a half of those who use marijuana everyday are addicted. …Marijuana use by adolescents is particularly troublesome.”

Those who begin using marijuana as teenagers, when the brain is still developing, are two to four times more likely to demonstrate dependence symptoms within two years of first use than those who first use marijuana as adults. And since marijuana use “impairs critical cognitive functions … for days after use many students could be functioning at a cognitive level that is below their natural capability for considerable period of times,” according to Volkow.

These effects could be even longer lasting. Adults who smoked marijuana during adolescence have fewer fibers in specific brain regions that are important to things like alertness, self-consciousness, learning and memory.

NIDA-funded research provides some support for long standing fears that use of marijuana may be a gateway to use of other drugs with even greater known adverse health effects. Truthfully, the same may be said of alcohol and tobacco. Whether the mechanism is chemical, cultural or some combination of the two, is less well known. No evidence is cited to suggest that marijuana use keeps young people away from other drugs.

The prevalence of impaired driving in Alaska is well known and deeply troublesome. On this, Volkow observes that “both immediate and long term exposure to marijuana impair driving ability; marijuana is the illicit drug most frequently reported in connection with impaired driving and accidents, including fatal accidents.” Moreover, the mixing of marijuana and alcohol can further exacerbate the dangers to public safety.

Perhaps the most startling revelation of Volkow’s research is that all marijuana is not alike. The potency of marijuana is determined by its Tetrahydrocannabinol, or THC, content. Analysis of seized marijuana for sale on the street demonstrates that THC concentrations have been rising from about 3 percent in 1980 to about 12 percent today. Volkow suggests that this may be the reason for increased emergency room visits associated with marijuana and a higher level of fatal crashes. Also, the initiative specifically defines marijuana to include concentrates, which can contain 80-90 percent THC. Marijuana edibles would also be legalized and commercialized under the initiative. In Colorado, child-attractive edibles like lollipops, flavored drinks and gummy bears, with multiple doses of THC, are being sold.

Marijuana is a drug and with all drugs there are risks and benefits. Research suggests that use of marijuana or some of its component chemicals can be beneficial for the alleviation of a variety of medical conditions. But patients with these conditions benefit from discussions with their healthcare providers about the risks and benefits.

The state should examine the most appropriate access for this class of users. That said, the evidence that marijuana is harmful for non-medical use is growing. That should give Alaskans pause as we enter the voting booth.

I believe strongly in working for the health, safety, educational achievement, productivity and community welfare of Alaskans. That is why I am voting “no” on Ballot Measure 2.

• Lisa Murkowski is a Republican U.S. Senator representing Alaska.

Source: www.juneauempire.com/opinion/2014-10-22

Filed under: Addiction,Cannabis/Marijuana,Drug use-various effects on foetus, babies, children and youth,Effects of Drugs,Health,Social Affairs,USA :

The polarized legalization debate leads to exaggerated claims and denials about pot’s potential harms. The truth lies in between.

Pretty much everyone who has spent time smoking marijuana knows at least one diehard stoner. The guy whose eyes are always red, the girl who doesn’t use the term “wake and bake” ironically, the person who just can’t seem to ever get it together. These heavy smokers might work at a low-level job or they may be unemployed—but everyone who knows them well knows that they are capable of much more, if only they had any ambition.

Is this really addiction? I believe that it is (and I don’t think that’s an argument against legalization). In fact, the reasons why marijuana is addictive elucidate the true nature of addiction itself.  Addiction is a relationship between a person and a substance or activity; addictiveness is not a simple matter of a drug “hijacking the brain.” In fact, with all potentially addictive experiences, only a minority of those who try them get hooked—and people can even become addicted to apparently “nonaddictive” things, like carrots. Addiction depends on learning, context and psychology, not just neurotransmitters.

With two states having already legalized recreational marijuana use and several more considering doing so, understanding the nature of addiction is more important than ever. Partisans on both sides of the debate have made extreme claims here; some legalizers saying there’s no such thing as marijuana addiction, while some prohibitionists claim “cannabis as addictive as heroin.”

Our concepts of addiction, however, come primarily from cultural experience with alcohol, heroin and, later, cocaine. No one has ever argued that opioids like heroin don’t have the potential to cause addiction because the withdrawal symptoms—vomiting, shaking, pallor, sweating and diarrhea—are objectively measurable. Opioids cause physical dependence that is evident when they become unavailable. The same is true for alcohol, where withdrawal is even more severe and can sometimes even be deadly.

So early researchers focused on these measurable symptoms related to alcoholism and opioid addictions in defining addiction: Using a drug could lead to becoming tolerant to it, tolerance could lead to dose escalation, which could in turn lead to physical dependence, and then the addiction could be driven by the need to avoid the painful symptoms of withdrawal. It was simple and physical.

In this view, however, cocaine and marijuana were not “really” addictive. While people can experience withdrawal symptoms like irritability, depression, craving and sleep problems when quitting these drugs, these are much more subjective and therefore can be dismissed as “psychological” rather than physical. You might really want coke or pot, but you didn’t need it like a real junkie, the thinking went.

And since most of us like to believe that we have much more control over our minds than we do over physical symptoms, “psychological” addiction is seen as far less serious than the “physical” type. It’s the remnants of this kind of thinking that mainly underlie the idea that marijuana addiction doesn’t exist. Unfortunately, that view of addiction is stuck in the 1970s.

In the 1980s—ironically, not long after Scientific American caused a big controversy by arguing that snorted cocaine is no more addictive than eating potato chips—entrepreneurs began marketing a ready-made smokeable form of the drug. The birth of crack shattered the idea that “physical” dependence is more serious than psychological dependence because people with cocaine addictions don’t vomit or have diarrhea when they quit; while they may appear desperate, it’s not in the physically obvious way of heroin or alcohol withdrawal. And so, if you are going to argue that marijuana is not addictive because you don’t get sick when you quit, you also have to argue the same for crack.

In the 1970s view, cocaine and marijuana were not “really” addictive: You might really want coke or pot, but you didn’t need it like a real junkie, the thinking went.

Good luck with that one, I say. Clearly, crack-addicted people are every bit as compulsive as those with heroin problems—and their criminal involvement if they can’t afford the drug is at least equally likely, though not as common as has been claimed. Crack dealt a deathblow to the “psychological” vs. “physical” distinction—and if it hadn’t, neuroscience was creeping up to show that the psychological and the physical aren’t exactly distinct anyway.

In the ‘70s and ‘80s, researchers also began recognizing that simply detoxing heroin addicts—getting them through the two-week period of intense physical withdrawal symptoms—is not effective treatment. If heroin addiction was driven primarily by the need to avoid withdrawal, addicted people should be out of the woods after they complete cold turkey. But as those of us who have been through it know, that is far from the hardest part.

While kicking heroin isn’t fun, staying off it in the long run is the problem—those “mere” psychological cravings are what drive addiction. Physical dependence isn’t the main problem; it isn’t even necessary. Indeed, we now know that you can actually have physical dependence without any addiction at all: There are some blood pressure medications, for example, that can have deadly withdrawal symptoms if not tapered properly, but people on these meds don’t crave them even though they are quite dependent. Similarly, antidepressants like Paxil have physical withdrawal symptoms, but because they don’t produce a high, you don’t see people robbing drug stores to get them.

So what is addiction, then, if tolerance, withdrawal and physical dependence aren’t essential to it? All of these facts point to one definition that can sum up the problem: Addiction is compulsive use of a substance or engagement in a behavior despite negative consequences. (Put more in neuroscience, addiction is a learned distortion in the brain’s motivational systems that make us persist in pursuing things linked to evolutionary fitness like food and sex.) Anything that causes pleasure via these systems—and that’s basically anything that is possible to enjoy—can be addictive to some person at some time. And that includes marijuana (and, for that matter potato chips).

This doesn’t mean that marijuana addiction is necessarily as severe as cocaine, heroin or alcohol addiction—in fact, it typically isn’t. If given the choice, most families would vociferously prefer having a member addicted to marijuana rather than to cocaine, heroin or alcohol. The negative consequences associated with marijuana addiction tend to be subtler: lost promotions, for example, rather than lostjobs; worse relationships, not no relationships. And of course, no risk of overdose death.

Marijuana addiction may quietly make your life worse without ever getting bad enough to seem worth addressing; it may not destroy your life but it may make you miss opportunities.

But this is also what can make it insidious. Marijuana addiction may quietly make your life worse without ever getting bad enough to seem worth addressing; it may not destroy your life but it may make you miss opportunities. With any pattern of regular drug use, it’s important to continually track whether the risks outweigh the benefits, keeping in mind that addiction itself may distort this calculation. This is especially true with marijuana.

However, as with all other drugs, only a minority of marijuana users ever struggle with addiction. Research suggests that about 10% get hooked—and on average, marijuana addiction lasts six years. Even more than other addictions, marijuana addiction seems to be driven by self-medication of mental health problems—90% of people with marijuana addiction also have another addiction or mental illness, typically alcoholism or antisocial personality disorder.

This suggests that exposing more of the population to marijuana won’t necessarily increase the addicted population. First, people with antisocial personality disorder, by definition, tend not to be law abiding, so most have probably already tried it. Second, the percent of people with other pre-existing mental illness will not change because marijuana becomes legal—in fact, in the UK, when they reversed their prior liberalization of marijuana law because of fears related to increased schizophrenia, psychosis rates actually went up. (The link probably wasn’t causal, but it does suggest that legal crackdowns on cannabis don’t prevent related psychosis).

If some people with alcohol, cocaine or heroin addiction switch to marijuana instead, overall harm would be reduced. As I and others have been reporting at least since 2001, using marijuana as an “exit” drug is a real phenomenon, both in cocaine and opioid addiction.

When we consider the risks of various substances, we tend to do so in isolation—but that’s not how choices are made in the real world. Most people would rather their partners have no addictions—but again, some are clearly worse than others. Marijuana craving is rarely as severe as crack craving, as is obvious.

Still, like anything that can be pleasurable, marijuana can be addictive. This doesn’t mean all addictions are the same or that it is as addictive as the currently legal drugs alcohol and tobacco—the data shows it is less so.

Pretending it can’t do any harm at all, however—or that there aren’t people who are addicted to it—does no one any good. If we want better drug policy, as with other types of recovery, we need to avoid denial.

Maia Szalavitz is one of the nation’s leading neuroscience and addiction journalists, and a columnist at Substance.com. She has contributed to Time, the New York Times, Scientific American Mind, the Washington Post and many other publications. She has also published five books, including Help at Any Cost: How the Troubled-Teen Industry Cons Parents and Hurts Kids (Riverhead, 2006), and is currently finishing her sixth, Unbroken Brain, which examines why seeing addiction as a developmental or learning disorder can help us better understand, prevent and treat it. Her last column for Substance.com was about why the oft-documented fact that most people age, or grow, out of substance misuse is not common knowledge.

Source: www.substance.com 15th October 2014

Filed under: Addiction,Alcohol,Cannabis/Marijuana,Cocaine,Drug use-various effects,Effects of Drugs,Health,Heroin/Methadone,Social Affairs,USA :

The drugs sent 28,000 people nationwide to the emergency room in 2011.

Attorneys general are fighting the illegal sale of synthetic marijuana with their pens.

A letter signed by 43 attorneys general — including Roy Cooper from North Carolina — was sent to nine major oil companies last Tuesday, urging them to eliminate synthetic marijuana from their gas stations’ convenience stores and retail locations.

Use of the drugs is a national problem — sending 28,000 people to the emergency room in 2011.

“Given the significant danger synthetic drugs present to users, especially our young people, we are extremely troubled that these drugs have been readily available in well-known retail locations,” the attorneys’ letter said.

Synthetic marijuana is often marketed under names like “K2” and “Spice” and is not tested for safety, according to the American Association of Poison Control Centers, which received 3,679 calls due to exposure to the drug in 2014.

Kelly Alanis-Hirsch, a researcher who studies substance abuse disorders at UNC, said the synthetic drug is not comparable to the organic drug, and the lack of regulation poses a serious threat to users’ health.

“It is created by spraying various chemicals on herbs or other leafy material,” Alanis-Hirsch said. “The chemicals mimic the effect of THC that appears naturally in organic marijuana, but the synthetic marijuana compounds vary by manufacturer.”

Federal and state laws prohibit the manufacture, sale and consumption of synthetic marijuana. Synthetic marijuana was made illegal in the state in 2011 when the N.C. General Assembly classified it as a controlled substance.

In 2012, President Barack Obama signed the Synthetic Drug Abuse Prevention Act, which categorized 26 synthetic cannabinoids as Schedule 1 drugs under the Controlled Substances Act — outlawing the drugs at the federal level.

But Alanis-Hirsch said that drug companies have evaded the federal law by manufacturing substances similar, but not identical, to those prohibited by the federal government.

“Recipes are changed in response to governmental efforts to make the product illegal; thus, it’s marketed as a ‘legal high,’” she said.

Mary-Nel Saarloos, a medical doctor in Asheville, said she often treats patients who have overdosed, but the constantly changing chemical components make it difficult to diagnose. Blood and urine tests often can’t detect these components of the drug, she said.

The National Association of Attorneys General called for major oil companies to revoke franchises of gas stations that violate the federal controlled substances laws.

“Young people should not die or be seriously injured from using products bought at gas stations or convenience stores,” the letter says.

Source: www.dailytarheel.com17th February 2015

Filed under: Effects of Drugs,Legal Sector,Synthetics,USA :

Can marijuana use put offspring at heightened risk for opiate addiction, even if the use stops before the offspring are conceived? Recent animal research by NIDA-supported scientists suggests that the answer may be yes.

Dr. Yasmin L. Hurd and colleagues at the Icahn School of Medicine at Mount Sinai in New York City showed that rats whose parents had been exposed as adolescents to the main psychoactive ingredient in marijuana sought heroin more vigorously than the offspring of unexposed animals. Although more research is needed to confirm and explain the findings, they are consistent with other studies suggesting that a parent’s history of drug use, even preconception, may affect a child’s brain function and behavior.

Lasting Imprint

Scientists have known for a while that drugs of abuse produce some of their effects epigenetically—that is, by increasing or decreasing the rates at which the body’s genetic machinery produces certain proteins. Researchers recently reported that some epigenetic changes produced by cocaine appear to be inherited and affect the behavior of subsequent generations. In that experiment, rats whose parents had been exposed to cocaine responded differently when introduced to the drug than did rats whose parents had not been exposed.

Dr. Hurd and colleagues hypothesized that rats whose parents were exposed as adolescents to the main psychoactive ingredient in marijuana (delta-9 tetrahydrocannabinol, or THC) would inherit epigenetic changes that would alter their responses to heroin. To test the hypothesis, the researchers injected adolescent male and female rats with THC for 3 weeks on an intermittent schedule (1.5 milligram per kilogram of body weight every 3 days) that corresponds to the amounts consumed by a typical recreational marijuana user. They waited 2 to 4 weeks for the drug to wash out of the rats’ bodies, then paired and mated them.

Figure 1. Offspring of THC-Exposed Parents Work Harder To Get Heroin  When only a single press of a lever was required to obtain a dose of heroin, the offspring of THC-exposed and unexposed rats self-administered similar amounts of the drug. However, when the researchers raised the work requirement to 5 lever presses for a single dose, the rats whose parents had been exposed to THC pressed almost 3 times as often as the offspring of unexposed rats.

When the offspring of these matings reached adulthood, the researchers presented them with a lever that, when pressed, delivered heroin (30 micrograms per kilogram of body weight). At first, the animals self-administered the drug at roughly the same rates as a group of control animals whose parents had not been exposed to THC. However, when the researchers made the animals work harder for the drug—requiring them to press the active lever at least 5 times to receive a dose—those whose parents had been exposed to the drug pressed on average nearly 3 times as often as the control rats (see Figure 1).

When the researchers removed the animals’ access to heroin, the THC-exposed rats’ offspring exhibited more pronounced withdrawal symptoms, such as increased locomotion and repetitive behaviors. Also during withdrawal, the two groups of rats differed in their readiness to approach a novel stimulus in their environment.

Figure 2. Offspring of THC-Exposed Rats Show Long-Term Depression of Synaptic Activity in the Striatum Medium spiny neurons in the dorsal striatum of rats whose parents had been exposed to THC responded less to electrophysiological stimulation than the neurons in rats whose parents had not been exposed to THC.

Using electrophysiology, the researchers also demonstrated that the offspring of the THC-exposed rats had altered neuronal functioning (see Figure 2). The specific alteration that they observed—enhanced long-term synaptic depression of medium spiny neurons in the dorsal striatum—has been associated with addiction in previous studies. The neurons are less responsive to stimulation, which inhibits an individual’s ability to adjust to experience and results in habitual and compulsive behaviors rather than adaptive ones.

To identify the epigenetic factors that might underlie the differences they had observed in the offspring of the THC-exposed animals, the researchers assayed concentrations of messenger RNA (mRNA) for key proteins in the brain. The formation of mRNA is the first step in the process of protein production, and mRNA levels indicate how much protein is being produced at a given time. The researchers’ analysis showed that, during adolescence, the THC-exposed animals’ offspring had higher levels of mRNA for glutamate receptors and for the cannabinoid 1 receptor in the ventral striatum. During adulthood, the offspring of the THC-exposed rats had less mRNA for N-methyl-D-aspartate (NMDA)-type glutamate receptors in the dorsal striatum (see Figure 3). Reduced production of glutamate receptors could underlie the reduced responsiveness to stimulation researchers observed in that brain region.

Figure 3. Offspring of THC-Exposed Parents Show Decreased Expression of Genes for Key Receptor Genes in the Brain Expression of genes for the glutamate-responsive receptors NMDA (Grin1 and Grin2A) and α-amino-3-hydroxy-5-methyl-4-isoxazole propionate (AMPA) (Gria1) and for the endocannabinoid receptor CB1 (CNR1) was lower in the dorsal striatum of adult rats whose parents had been exposed to THC. These changes in gene expression suggest an epigenetic effect of THC on glutamate and endocannabinoid signalling in the brain.

Is It Real?

The Mount Sinai researchers took pains to rule out potential nonepigenetic explanations for the differences they observed between their groups of rats. One concern was that the THC-exposed rats’ pups might themselves be exposed to the drug during gestation, resulting in altered brain development. To preclude this possibility, the researchers postponed mating their THC-exposed animals until sensitive gas chromatography and mass spectrometry confirmed that no drug remained in the animals’ blood or brain tissue. Another concern was that the THC-exposed animals might parent differently than the unexposed animals, potentially altering their offspring’s responses to heroin. To prevent this, the researchers removed the THC-exposed animals’ pups from their parents immediately after birth and had unexposed dams raise both groups of offspring in mixed litters.

Despite these careful controls, Dr. Hurd and colleagues say that they cannot completely rule out nonepigenetic explanations for the alterations they observed in their THC-exposed rats’ offspring until they see what happens in the next two generations of their germ line. The researchers are proceeding with this work.

“The idea of cross-generational transmission of complex traits such as drug responses without alterations to the genome is contentious,” says Dr. John Satterlee, Project Officer at NIDA’sGenetics and Molecular Neurobiology Research Branch. “Is it real? And if it’s real, how is it transmitted?” he asks.

Dr. Satterlee agrees with Dr. Hurd that studies on future generations are needed to definitively rule out the possibility that nonepigenetic factors led to the observed effects in the offspring. Previous exposure to THC theoretically could affect the womb or placental formation, he says, or lead to changes in the parents’ microbiome—the assemblage of microorganisms in the gut controlling a variety of conditions and behaviors—that were then transmitted to their offspring.

“If the effect is real, it’s important,” Dr. Satterlee says. “If studies show that marijuana use also shows cross-generational effects in people, those results would add to the known dangers of the drug and amplify the importance of prevention efforts, especially those aimed at youth,” he adds.

This study was supported by NIH grants DA030359 and DA033660.

Source: Neuropsychopharmacology. 39(6):1315-1323, 2014. Abstract

Szutorisz, H.; DiNieri, J.A.; Sweet, E. et al. Parental THC exposure leads to compulsive heroin-seeking and altered striatal synaptic plasticity in the subsequent generation.

Filed under: Cannabis/Marijuana,Drug use-various effects,Effects of Drugs,Parents,USA :

Feb. 24, 2015 8:30am

Jennifer Kerns is a branded contributor to The Blaze and other publications where she writes about the 2nd Amendment, religious liberty, the future of the GOP, limited government battles and other political hot topics. She served as Spokeswoman for the historic Colorado recalls, as Spokeswoman for the California Republican Party, twice as an Appointee of Governor Arnold Schwarzenegger, and as Spokeswoman for Prop. 8 which went all the way to the U.S. Supreme Court.

During her career as a GOP strategist, she has been described as one of “the most relevant Press Secretaries in the West” — winning every major newspaper endorsement for her candidates. Proud of her ability to win over tough liberal reporters and coalitions, she made her mark by being the first known Press Secretary in history (Republican or Democrat) to win 52 unanimous endorsements from such liberal publications as the Los Angeles Times, San Francisco Chronicle and the Spanish-language La Opinion – arguably among the toughest Press Corps, in the most populous State in the nation.

What a long, strange trip it’s been for pot legalization in Colorado. First, the law came under fire last year for not protecting youth as scores of children were taken to emergency rooms after ingesting their parents’ pot edibles.

Just a few days ago, nine former heads of the Drug Enforcement Administration — both Republican and Democrat — signed onto an amicus brief urging the U.S. Supreme Court to overturn Colorado’s legalization of marijuana citing numerous public safety concerns.

Now, Colorado health professionals are coming forward to report an emerging trend: expectant mothers who are addicted to pot.

The emerging health crisis is creating what is undoubtedly our generation’s version of 1980s “crack babies.” Health practitioners specializing in the field of Obstetrics & Gynecology spoke to me on condition of anonymity to report an alarming rise in pregnant patients showing up in emergency rooms and doctors’ offices and presenting mysterious complications including abdominal pains, cold sweats, shakiness, insomnia, weight loss and a host of psychological problems. According to the physicians, as routine pot smokers cease consumption of marijuana upon learning they are pregnant, it can lead to violent or painful withdrawal from tetrahydrocannabinol — also known as THC — the addictive substance found in marijuana.

The emerging situation is not unlike babies who are addicted to crack.

Physicians say the exact cause and treatment of symptoms are initially difficult to pinpoint as patients either don’t admit to prior pot use, or aren’t aware that weeks-old or even months-old marijuana consumption can remain in the body and cause such withdrawals, thus affecting children in the womb.

While the physicians in Colorado commend pot users for refraining from the use of marijuana during pregnancy, they regret to inform the patient that it is the first step in a potentially long battle.

According to the Cleveland Clinic, the presence of THC in foetuses can lead to impairment of foetus growth and low birth weight.

The March of Dimes reports that the presence of marijuana can lead to premature birth. It can also create problems with brain development which may later affect a child’s “behavior, memory, problem-solving skills and ability to pay attention.” It can also create neonatal abstinence syndrome, in which a baby gets addicted to a drug before birth “then goes through withdrawal after birth.”

In order to treat symptoms as well as help alleviate the pain of the withdrawal process, the physicians in Colorado report they have had to reintroduce doses of THC to expectant mothers, which of course leaves their babies susceptible to addiction and the complications above which often must be treated in neonatal units. The emerging situation is not unlike babies who are addicted to crack.

Cases of THC addictions during pregnancy are so much on the rise that Colorado’s health professionals have begun to bone up on the subject matter of THC and other complications from pot.

At a recent three-day nursing conference, Colorado OB-GYN nurses spent the entire final day of the conference covering THC-related topics. All of this presents new challenges for Colorado which is already struggling to keep up with demands placed upon the state by Obamacare.

And now that another state has legalized pot, these cases could become an epidemic.

These gestations, which I call “pot pregnancies,” are yet another chapter in a legalization experiment that has gone horribly awry at an expense to public health and to children — both born and unborn — who have no say in the matter.

While the Colorado legislature rushes to fix many side effects of legalization one has to ask, “Does the benefit of legalizing this substance outweigh the risk to public health?”

Those who suggest it does are simply blowing smoke.

Source: http://www.theblaze.com/ 24th Feb. 2015

Filed under: Cannabis/Marijuana,Drug use-various effects on foetus, babies, children and youth,Effects of Drugs,USA :

The Northern Grampians Highway Patrol said roughly one in two drivers tested positive for drugs like cannabis or methamphetamines.

Acting Sergeant Shaun Allen said they were disappointed in the results.

“They’re certainly over-represented now in our statistics and especially in relation to serious collisions, we’re finding that more and more are positive in regards to drugs,” he said.

He is urging people not to get behind the wheel if they have been using drugs.

“We random drug test drivers and if they become positive with our tests, they get sent away for a proper laboratory test and then if it comes back then we prosecute on that,” he said.

“There’s no level with drugs, you’ve either got them in your system or you haven’t.”

Source:  http://www.abc.net.au/   Feb.2015

Filed under: Australia,Effects of Drugs,Social Affairs :

By Kathy Gyngell

I have always loathed cannabis and what I’ve seen it does to people. From my very first encounter at university when I watched the making and the passing of the spliff ritual, I thought it was pathetic and that the people doing it were boring.

I avoided them and their singularly ‘funless’ parties. Stoned, introverted and unattractive young men became even less attractive as they became more introverted. Maybe it helped their relations with men, but not with women.

Nor, in my early days working in TV, was I impressed to find food laced at parties – to have a bit of a laugh with non-using guests. The choice was made clear – between being stoned or stuffy. I chose stuffy. Why you had to be drugged up to socialise escaped me. It seemed to have the very opposite effect – dulling,  stupefying and rather unpleasant.

So when, as a mother,  I encountered teenage boys using the evil weed I was alarmed. These were no ‘uni’ students but little more than children. It did not take great powers of observation to see how it affected their behaviour, their motivation and how addictive it was. Worse, noxious skunk was beginning to dominate the market

I came down like a ton of bricks – boys who ‘did drugs’ were absolutely not welcome in my home.  I  ‘banned’, as far as I could, all social contact with families where the parents had a liberal attitude to drugs. It was a revelation to find myself  unpopular and on my own in daring to make my views public and clear.

Since then I have observed one tragedy after another: some in families anguished by their own naivety that they became aware of drug-taking or its risks too late; others distraught at the life-time sentences to which they and their sons had been condemned.

Their futures – with their sons’ lives suspended between secure mental units or so-called community care on compulsory injected anti-psychotics – were no future at all.  Only the very brave shouted  their plight from the rooftops to alert everyone else; for many the shame was too huge. And there was still denial too.

What is so shocking is that the science detailing these very real risks has been in the public domain for years,  that resistance to acknowledging it goes back years and right to the top of our political establishment. For a historical account, Peter Hitchens’s book is a must read.

As a result of this liberal ‘cannabis conspiracy’, over the years ever younger children have begun taking the drug and in ever stronger doses.

The extent of this silent cultural  revolution can be seen in a  Conservative-led Coalition  happy for children to be left to make their own ‘informed choices’ about  cannabis use.  Yes, the mantra of ‘informed choice’ is still official policy bleated out by every health minister since 2010.

What’s more, it is still based on outdated, inadequate (in places downright wrong) official information.  This is despite the persistent representations of the campaigner Mary Brett of the charity Cannabis Skunk Sense.

The simple fact the Government ignores is that children aged 12, 14 or even 16,  are not equipped to make such a choice. They are immature and their brains are still forming. So the question is whether new research, published this week, will make a difference and act as a wake-up call. It is the work of a team of 23 scientists under the direction of the impressive and indefatigable Sir Robin Murray, Professor of Psychiatric Research at King’s College, London.

It shows that cannabis use triples psychosis risk and that use of high potency strains is responsible for 24 per cent of new cases of psychotic mental illness.

It should, as Professor Murray says, see an end to the sceptics’ claim that cannabis use is not an important cause of schizophrenia-like psychosis.  It should alert government to the fact  that “we could prevent almost one quarter of cases of psychosis if no-one smoked high potency cannabis (saving) young patients a lot of suffering and the health services a lot of money.”

It should indeed.  But the jury is out on whether it will change the UK’s persistent culture of denial about cannabis,  which has peopled  mental health units with psychotic young men and which is still priming a public health time-bomb.

Depressed motivation, significantly lowered IQ, impaired cognitive functioning, cancer and paranoia are all outcomes of early and regular cannabis use, details of which research can be found on the new Cannabis Skunk Sense website.

Will this new evidence stop in his tracks our arch drug-liberalising deputy PM Nick Clegg, desperate in his search of the youth vote? It ought to. That is why I will be watching carefully when he gives keynote speech to the Home Affairs Select Committee’s ‘International Conference on Drugs Policy’ on March 12th. Will he even refer to this latest and most comprehensive and irrefutable of research?

Or following  HASC’s bizarre recommendation of two years ago to downgrade cannabis to Class C, will Clegg continue to bang the Lib Dem drum  for outright legalisation?

That, sadly, is my bet.

Source:  http://conservativewoman.co.uk/    17th Feb.2015

Filed under: Effects of Drugs,Global Drug Legalisation Efforts,Social Affairs :

Can you put two and two together? Have a try. The authorities, and most of the media, cannot.

Did you know that the Copenhagen killer, Omar El-Hussein, had twice been arrested (and twice let off) for cannabis possession? Probably not.

It was reported in Denmark but not prominently mentioned amid the usual swirling speculation about ‘links’ between El-Hussein and ‘Islamic State’, for which there is no evidence at all.

El-Hussein, a promising school student, mysteriously became so violent and ill- tempered that his own gang of petty criminals, The Brothers, actually expelled him. Something similar happened in the lives of Lee Rigby’s killers, who underwent violent personality changes in their teens after becoming cannabis users.

The recent Paris killers were also known users of cannabis. So were the chaotic drifters who killed soldiers in Canada last year. So is the chief suspect in the Boston Marathon bombings of April 2013.

I might add that though these are all Muslims, who for rather obvious reasons are to be found among the marginalised in Europe and North America, it is not confined to them.

Jared Loughner, who killed six people and severely injured Congresswoman Gabrielle Giffords in Arizona in 2011, was also a confirmed heavy cannabis user. When I searched newspaper archives for instances of violent crimes in this country in which culprits were said to be cannabis users, I found many.

One notable example was the pointless killing of Sheffield church organist Alan Greaves, randomly beaten to death by two laughing youths on Christmas Eve 2012. Both were cannabis smokers.

By itself, the link is interesting. I wonder how many other violent criminals would turn out to be heavy cannabis users, if only anyone ever asked. But put it together with The Mail on Sunday’s exclusive story last week, showing a strong link between cannabis use and episodes of mental illness.

And then combine it with the confessions of two prominent British Left-wing figures, the former Tory MP and BBC favourite Matthew Parris, and Channel 4 news presenter Jon Snow, who both tried ‘skunk’ cannabis (by far the most commonly available type in the Western world) for a TV documentary.

Mr Parris wrote: ‘The effect was stunning – and not (for me) in a good way. Short-term memory went walkabout. I would forget what I was talking about even while talking. I became shaky. Time went haywire.’

But immediate effects are one thing. What about long-term use? Mr Parris recounted that he had ‘too many friends’ for whom cannabis had seemed destructive. He quoted one as saying: ‘I think it changed me permanently as a person.’

He said his mainly socially liberal friends, including health workers, generally agreed that ‘heavy use of cannabis, particularly skunk, can be associated with big changes in behaviour’.

Jon Snow said simply: ‘By the time I was completely stoned, I felt utterly bereft. I felt as if my soul had been wrenched from my body.

‘There was no one in my world. I was frightened, paranoid, and felt physically and mentally wrapped in a dense blanket of fog. I’ve worked in war zones, but I’ve never been as overwhelmingly frightened as I was when I was in the MRI scanner after taking skunk. I would never do it again.’

This is not some mild ‘soft’ thing. It is a potent, frightening mindbender. If it does this to men in late middle age who are educated, prosperous, successful and self-disciplined, what do you think it is doing to all those 13-year-olds who – thanks to its virtual decriminalisation – can buy it at a school near you, while the police do nothing?

And yet it is still fashionable in our elite to believe that cannabis should be even easier to get than it already is.

It is hard to think of a social evil so urgently in need of action to curb it. Why is nothing done? Need you ask?

 Source: http://hitchensblog.mailonsunday.co.uk/2015/02

Filed under: Cannabis/Marijuana,Effects of Drugs,Global Drug Legalisation Efforts,Legal Sector,Social Affairs :

Risk of developing psychosis up to five times greater for those who smoke ‘skunk’ cannabis every day

One in four new cases of psychotic conditions such as schizophrenia could be the direct result of smoking extra-strong varieties of cannabis, a major new study concludes.

The finding suggests that about 60,000 people in Britain are currently living with conditions involving hallucinations and paranoid episodes brought on by abuse of high-potency cannabis, known as skunk, and more than 300,000 people who have smoked skunk will experience such problems in their lifetime.

The six-year study, the first of its kind in Britain, calculates that daily users of skunk are five times more likely to suffer psychosis than those who never touch it.

Psychiatrists said there is now an “urgent need” for a drive to educate the public about the risks involved with the substance. It is believed that even newer varieties, some of them more than twice as potent as those currently available on British streets, have already been developed in the Netherlands.

The findings reopen the debate about the classification of cannabis as an illegal drug, with some supporters of liberalisation now considering tougher restrictions on some varieties.

Chris Grayling, the Justice Secretary, said the findings underlined arguments against decriminalisation. Norman Baker, the Liberal Democrat former Home Office minister who has called for drug laws to be relaxed, said that there may be a case for giving skunk a new classification. The study, by researchers from the Institute of Psychiatry, Psychology & Neuroscience at King’s College London, is due to be published in the journal Lancet Psychiatry later this week.

They studied almost 800 working-age adults from one area of south London, half of whom had been recently treated for a psychotic episode for the first time. The incidence of schizophrenia in the area has doubled since the mid-Sixties, a trend widely thought to be linked to drug use. Cannabis use in the UK overall has fallen by about 40 per cent in the past decade but, for those using it, the typical potency has increased sharply in that time.

Levels of tetrahydrocannabinol (or THC), the main psychoactive compound, are arbout 15 per cent in skunk, compared with about four per cent in traditional “hash” cannabis.

The study concluded that the strength of cannabis and the frequency of use play a crucial role in determining the mental health risks.

“Compared with those who never used cannabis, individuals who mostly used skunk-like cannabis were nearly twice as likely to be diagnosed with a psychotic disorder if they used it less than once per week, almost three times as likely if they used it at weekends, and more than five times as likely if they were daily users,” the paper notes. It found that skunk use was the “strongest predictor” of psychotic illness in those studied and that 24 per cent of new cases in the area could be attributed to skunk.

It also noted that those who started smoking cannabis before the age of 15 had higher risk of developing psychotic disorders than others. “Our findings show the importance of raising public awareness of the risk associated with use of high-potency cannabis, especially when such varieties of cannabis are becoming more available,” the paper concludes.

“The worldwide trend of liberalisation of the legal constraints on the use of cannabis further emphasises the urgent need to develop public education to inform young people about the risks of high-potency cannabis.” Dr Marta Di Forti, the lead author, said the significance of how regularly people smoked cannabis has often been overlooked in day-to-day treatment. “When a GP or psychiatrist asks if a patient uses cannabis it’s not helpful – it’s like asking whether someone drinks,” she said. “As with alcohol, the relevant questions are how often and what type of cannabis.”

Prof Sir Robin Murray, professor of psychiatric research at King’s, said: “It is now well known that use of cannabis increases the risk of psychosis. However, sceptics still claim that this is not an important cause of schizophrenia-like psychosis. “This paper suggests that we could prevent almost one quarter of cases of psychosis if no-one smoked high potency cannabis.” He added: “Education is the important thing – people need to know the risks of regular use of high potency cannabis.

Mr Grayling said: “Far too many of those who end up in our criminal justice system have got drug and mental health problems. “It’s clear to me that drug addiction is at the root of a large proportion of crimes in the UK and that it causes mental health problems which are all too apparent in our prisons. “That’s why mental health will be our next big reform focus – but it’s also why decriminalisation is not the right option.”

Mark Winstanley, the chief executive of Rethink Mental Illness, said: “Essentially, smoking cannabis is like playing a very real game of Russian roulette with your mental health. Reclassifying cannabis isn’t the answer.” A Home Office spokesman said: “Our approach remains clear: we must prevent drug use in our communities and help dependent individuals through treatment and recovery, while ensuring law enforcement protects society by stopping supply and tackling the organised crime that is associated with the drugs trade.”

Edward Boyd, deputy policy director of the Centre for Social Justice, the think-tank founded by the Work and pensions Secretary Iain Duncan Smith, said: “This study provides yet more evidence that liberalising drugs laws is not the way to go. “It will only lead to more people suffering from the misery of drug addiction, which, as this study shows, could well include psychosis. “Instead, politicians should focus on improving the UK’s poor level of treatment for addicts by investing in residential rehabilitation.”

Marjorie Wallace, chief executive of the mental health charity SANE, said: “This is yet another study that should worry all those who deny any direct link between skunk, a potent cannabis derivative, and psychotic breakdown. “While the scientists and politicians debate, we face the daily heartbreak of young people whose minds and thoughts have been altered through continued use and whose families feel helpless.

“What we need is a strong, uncompromising message so that parents, teachers, the police and young people themselves know that a significant percentage who take skunk risk acute, and in some cases lasting, mental illness.”

Source: http://www.telegraph.co.uk/news/health/news/11414605 26th Feb. 2015

Filed under: Cannabis/Marijuana,Effects of Drugs,Health,Legal Sector :

Binge Drinking

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

 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Binge drinking

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Filed under: Drug use-various effects on foetus, babies, children and youth,Economic,Effects of Drugs,Social Affairs,USA :

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

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

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

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

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

Little Substantive Evidence

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

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

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

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

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

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

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

Surprise Finding

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

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

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

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

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

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

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

A Band-Aid Solution?

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

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

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

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

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

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

Filed under: Cannabis/Marijuana,Effects of Drugs,Global Drug Legalisation Efforts,Legal Sector :

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

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

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

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

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

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

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

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

Filed under: Cannabis/Marijuana,Drug use-various effects on foetus, babies, children and youth,Effects of Drugs,Health :

Drawing a straight line between recreational drug use and the recent spate of gang shootings in Ottawa is a little like revealing the truth behind the real source of all those gifts under the Christmas tree: Which is to say, the truth tends spoil the party even though we all know where they really come from.

Truth is local drugs are managed from source to the marketplace by sophisticated criminal networks responsible for much of the violence that is now plaguing some Ottawa neighbourhoods. That includes Friday’s incident at the Tanger Mall and a recent spate of other shootings that have left residents of some west end social housing communities ducking in fear.

Those gangs lure recruits through the promise of easy money and sustain a culture of violence to protect their interests. They use the profits to buy guns to enforce their control of communities, and they don’t care who gets hurt or worse in the process.

Recreational drug users choose to ignore these simple facts because it would ruin the buzz, or at least force them to face the true consequences of their actions.

Nancy Worsfold, director of Crime Prevention Ottawa, was absolutely right to pin some blame for recent shootings on the many recreational drug users across the city who choose to avoid the truth about where the money goes and who really profits.  “I’m deeply concerned that the violence that we’ve seen is related to a lucrative drug market and the drug market is driven by two kinds of users — the recreational user and people who are addicted,” said Worsfold.

Crime Prevention Ottawa is one player in a city-wide effort to reduce gang activity, an effort that is severely compromised every time a recreational drug user puts another dollar into the hands of some thug. Even pot use isn’t entirely victim free as its distribution is often managed by gangs bent on protecting their piece of the illicit drug market.

There isn’t much ordinary citizens can do to reduce the supply of drugs.

Criminal interests will always find a way to supply a ready marketplace.

But we can do something about the demand for illicit drugs.

That is, if those who are creating the demand are ready to face up to the true consequences of their actions.

Those who won’t are silent allies of the very gangs that are plaguing this city.

Source:  http://www.ottawasun.com/2014/12/27

Filed under: Effects of Drugs,Social Affairs,USA :

Over at Ezra Klein’s new site, Vox.com, German Lopez has an article claiming to show that Colorado’s recent marijuana legalization experiment hasn’t increased crime rates in Denver. In contrast, when we actually look at the raw data Lopez uses, the message isn’t so clear. In fact, using Lopez’s own methods, we might conclude pot legalization has dramatically increased crime in Denver.

Lopez claims that “three months into its legalization experiment, Denver isn’t seeing a widespread rise in crime.” To reach this conclusion, Lopez uses Denver’s crime data (available here) for the months of January and February in 2013 and 2014. When I look at the data, I see some potentially different findings.

Over the first two months of 2014, “simple assaults” in Denver are up an astonishing 70% over the same timeframe in 2013. The crime of “intimidation” is up 86%, and all “crimes against persons” have increased 32% compared to 2013. But the real changes are evident in the “all other offenses” category. Here we see that “disorderly conduct/disturbing the peace” has increased 1,144% (from only 18 offenses in 2013 to 224 in 2014), “family offences/nonviolent” are up 97%, “liquor law/drunkeness” is up 1,150%, “violation of a restraining/court order” increased 87%, “criminal trespassing” is up 339%, and the “all other offenses” subcategory have increased 400%.

Of course there is also data available back to 2009 that illustrates the anomalously high incidence level for these offenses during the first two months of 2014 following marijuana legalization, as shown in the table below.

The number of offenses in each of these categories during January and February of 2014 are, by far, the highest over Denver’s available historical record, in some cases by more than an order of magnitude.

Source:   Sierra Rayne       www.AMERICAN THINKER   4th Sept. 2014

Filed under: Effects of Drugs,Legal Sector,USA :

On March 10, a college student from Wyoming bought four marijuana cookies for herself and her three friends at the 16th Street Mall in Denver.

Late into the night, restless and exhibiting erratic behavior, 19-year-old Levy Thamba leapt over the fourth-floor railing of a Holiday Inn into the lobby. He was pronounced dead at 3:51 a.m.  Thamba’s tragic death highlighted the deceptive nature of THC-infused foods: They affect the human body later in time after ingestion than smoked bud.

The case is not the only disturbing episode connected to marijuana edibles since Colorado opened up the market for legal recreational marijuana eight months ago. Some children have gotten their hands on edibles, and landed in the emergency room, while one man who allegedly killed his wife—and faces a first-degree murder charge—was said to have eaten pot candy beforehand.  The incidents have prompted changes in marijuana policies that are intended to make edibles safer to consume, keep them away from minors, and educate Coloradans and visitors on the differences between marijuana food and pot that you smoke.

Eating an edible is not like taking a shot of whiskey or smoking marijuana, said Ron Kammerzell, senior director of enforcement with the Colorado Department of Revenue. “You need to give yourself enough time to make sure you are feeling the effects of marijuana before you consume additional edibles,” he said in a phone interview.

While the effects of smoked bud are rather immediate, edibles are deceptive because it can take hours to feel anything from the THC, the psychoactive ingredient in marijuana. Thamba, a native of Africa who was on spring break from Northwest College in Powell, Wyoming, may not have known that.

Bessie Gondwe, one of his college friends with whom he was staying at the Holiday Inn, told Denver police she had purchased the cookies and it was the first time she believed Thamba had ingested marijuana. During a search of the hotel room, police found wrappers with labels that identified the marijuana products as “Sweet Grass Kitchen, lemon poppy seed cookie.”  Gondwe and another friend staying in the room with Thamba told authorities the college students had begun eating the cookies around midnight. Each of the four cookies contained 65 milligrams (mg) of THC, or the equivalent of 6.5 servings; an employee at the marijuana store advised the students that they should split the cookie into six pieces and eat one piece at a time, according to the police report.

But Thamba revealed he wasn’t feeling anything from the marijuana cookie so he ate the rest of the edible all at once, Gondwe told police. Later in the night, the police report detailed, Thamba exhibited strange behaviour—screaming, speaking in French, apologizing for criminal behaviour that he had not committed, smashing fixtures and finally jumping off the balcony.

Thamba’s autopsy report said the cause of death was the result of “multiple injuries due to a fall from a height” and listed “marijuana intoxication” as “a significant contributing factor.” The college friends weren’t aware that Thamba had consumed any alcohol or other drugs, and other than detecting THC in his system, the blood results revealed no other “positive findings of toxicological significance.”

Limiting THC in Each Edible

In the wake of his death, Colorado regulators have adopted rules that are designed to encourage marijuana edible companies to make pot treats that contain no more than 10 mg of THC. Under emergency rules that were adopted on August 1, if a marijuana edible is more than 10 mg and up to 100 mg, “you have to score it or demark it in such a way that it is intuitively obvious to the consumer how to break off a serving size of that edible,” said Kammerzell of the Colorado Department of Revenue.

State regulators also gave marijuana edible makers an incentive to make products containing no more than 10 mg. If they do so, their products will be tested for potency fewer times than other edibles. Even before the emergency rule was adopted, a number of manufacturers had moved toward individual serving sizes of 10 mg, Kammerzell said.

“There is no lethal dose for marijuana other than maybe a 500-pound brick of it falling on your head, but we don’t want people to have a bad experience or get to the point where they are not functional,” said Andy Williams, president of Medicine Man, a marijuana dispensary in Denver.

As part of a responsible vendor training program modeled after one administered by the state’s liquor enforcement division, it is expected that marijuana establishments will educate consumers on the differences between eating an edible and smoking marijuana.

Williams and the owner of a recreational marijuana dispensary north of Boulder said their employees, or budtenders as they are affectionately known, already warn customers about edibles – “We take the extra step at the counter to really educate people on how to use them safely, how to get familiar with the effect of edibles,” said Dylan Donaldson of Karing Kind, who estimated edibles constitute 30 to 40 percent of sales on an average day. “It is quite different. It’s a whole other beast.”

Protecting Kids from Inadvertent Consumption

That beast has sickened some kids in Colorado. Since recreational marijuana was legalized on Jan. 1, “Children’s [Hospital] Colorado has treated 13 children, six of whom became critically ill from edible marijuana,” said Natalie Goldstein, a spokeswoman with the hospital, in an email last month.

In a May interview with the Denver Post, Michael DiStefano, the medical director of the hospital’s emergency department, said a number of children who accidentally ingested marijuana had been admitted for sedation or agitation and one child suffered breathing problems that required a respirator.

Earlier this year, a 10-year-old boy in Greeley, Colorado admitted to selling marijuana to other students on the playground while another child came to school with a THC-infused candy bar, according to CBS4. The kids reportedly obtained the pot from home where it was purchased by their grandparents.

Edibles today hardly are limited to the marijuana brownies of the 1990s. Other than the THC, the treats are the same ones kids savor at home and school: cookies, gummy bears, Lollipops.

“In Colorado, there is almost no limit to what marijuana can be put into whether that is infused or baked or sprayed,” said Rachel O’Bryan of Smart Colorado, an organization that is dedicating to protecting Colorado youth and advocates for policies that limit early marijuana consumption.  Said state Rep. Frank McNulty: “Many of these marijuana edibles look just like kids’ snacks.”

The Colorado Marijuana Enforcement Division requires that a seal be placed on packaging of marijuana products, but “that doesn’t mean anything to most kids or parents,” said McNulty, a Republican who represents Highlands Ranch, a suburb south of Denver.

Colorado lawmakers have moved to solve the problem. House Bill 1366, signed in May by Gov. John Hickenlooper, required that Colorado’s state licensing authority convene a stakeholder group to discuss recommendations on how to make edibles clearly identifiable.

Members of the working group include a wide range of interests from law enforcement representatives and a school resource officer to a marijuana baker and testing facility owner. An initial meeting was held on Aug. 1, and a second meeting is scheduled for Sept. 11 in Denver.  Rules will be adopted no later than January 2016.

“It’s going to be a challenging topic for sure,” Kammerzell said.  But the edibles rule, once implemented, could save Colorado kids from unnecessary trips to the ER.

Source:   www.naturalproductsinsider.com      5th Sept. 2014

Filed under: Effects of Drugs,Legal Sector,Social Affairs :

The Washington Post  came out  against the legalising of pot in the District of Columbia in an editorial last weekend. 

Though a supporter of the decriminalisation of medical marijuana, when it was on the ballot a few years ago, the Post has drawn the line at outright legalisation (which is what’s on the ballot this November in D.C.).

The Post commented that “the rush to legalise marijuana gives us – and we hope voters – serious pause”. It refused too to buy into that pot-pusher canard that pot is no different than alcohol, saying clearly that marijuana “is not harmless.”

This is hardly rocket science so why I am I blogging about it? Does it matter?  The answer is Yes.  For such an influential ‘liberal’ organ to come out with this caution is significant. Whether it marks a turning of the pro-pot and pro-legalisation tide remains to be seen. But what it does prove is that hearts and minds – even those of liberal diehards – are there for the winning once the bald facts are in the public domain.

That is where Kevin Sabet, co-founder of the project Smart Approaches to Marijuana  (SAM) and author of Reefer Sanity: Seven Great Myths About Marijuana, has been putting them. It was his cataloguing of what’s been going on in Colorado since legalisation that provoked the Post’s  concern about bringing a Colorado-style experiment to its home turf.  The editorial had also picked up on a report that found that teenagers who smoke marijuana daily are 60 per cent less likely to complete high school (one I wrote about here last week).

But it is not just in Colorado that the pot pusher’s paradise is being seen through. In Uruguay too, their new marijuana law is under fire.

All the money spent persuading members of Uruguayan parliament to vote Yes to legalisation has left the public cold. The majority are as against legalisation now as they were before;  none believe that the real motive behind it was to improve health. The argument that legalisation is necessary for health and human rights is of course a fallacious one.

That hasn’t stopped the Global Commission on Drugs Policy from using it. This is the body that Neil Mckeganey revealed here to be a front for drug legalisation. It is also on a mission to throw over the international drug conventions in 2016, at a special session of the United Nations General Assembly on the world drug problem.

Though presented by some former heads of state,  the Global Commission’s challenge to the international drug control regime was drafted with the assistance of Steve Rolles, Danny Kushlick, Martin Jelsma, Mike Trace, and Ethan Nadelmann, all of whom are long term and passionate advocates and lobbyists for drugs legalisation.

And a healthy dose of scepticism is advised before reading their thinly veiled propaganda. It is based on the straw man that current international policy is naïve and offers false promises. Far from it.  No one who actually  reads the detailed publications of either the International Narcotics Board or  the United Nations Office of Drugs and Crime  or follows their pragmatic responses to this complex problem could possibly accuse them of this.

It is the Global Commission that is naive – to think that  normalising  drug use and removing any constraints will improve health or protect human rights.

There is already evidence that the opposite is the case now that recreational use of cannabis is legal in Colorado and Washington State, and pot can be purchased for medicinal use in 23 other states and Washington, D.C.

Today nearly 1 in 10 Americans show up to work high on marijuana, a new report has revealed.  And last week’s publication of national Drug Testing data revealed that the percentage of positive drug tests among American workers has increased for the first time in more than a decade, fuelled by a rise in marijuana and amphetamines use; and that marijuana positivity increased 6.2 per cent nationally in urine drug tests, and by double digits in Colorado and Washington

As more states fall into normalisation and legalisation of pot such stats will only get worse. Business however will be ever more eager to exploit the growing  habit.

Indeed it was with much fanfare, that, with the ex-president of Mexico, Vicente Fox, the passionate legalising advocate and member of the GCDP in tow,  the former head of Microsoft corporate strategy, James Shivley, announced earlier this year that he was creating “the Starbucks of marijuana.”

The Washington Post’s next step will be, I hope, to editorialise on this.      Kathy Gyngell

Source: www.conservativewoman.co.uk   20th Sept.2014 

 

Filed under: Effects of Drugs,Global Drug Legalisation Efforts :

The pro-drug brigade vilified me for saying cannabis wrecks lives. Now their lies have finally been exposed

With a mix of sneering condescension and intolerant certainty, pro- drugs campaigners are fond of saying cannabis is essentially harmless. Indeed, this claim has become one of the central planks of their propaganda in favour of the decriminalisation of the drug.   But now their argument, so eagerly repeated by a host of self-appointed experts, liberal politicians and cheer-leading celebrities, has been blown apart by an authoritative report from a drugs adviser to the World Health Organisation. 

Users can find themselves in a downward spiral. They drop out of school, fail to find employment, grow alienated from family and friends and become fully dependent on not just drugs but also welfare benefits .  Based on in-depth research conducted over 20 years, the study by Professor Wayne Hall comprehensively refutes the fashionable pretence that cannabis is safe. 

Through his wide-ranging analysis, he shows that the drug triggers psychotic disorders such as schizophrenia, traps its users in a spiral of dependency and inhibits brain development in young people. 

Habitual users also suffer an increased risk of cancer and heart problems, he warns.

The terrible truth about cannabis: Expert’s devastating 20-year study finally demolishes claims that…

As a GP long concerned about the health problems caused by drug abuse, I could not be more pleased that this devastating study has been published. 

In my work in a deprived area of Manchester, I have regularly seen how cannabis not only wrecks the lives of some of my patients, but can also cause social damage by fuelling family breakdown, crime and unemployment. 

Yet for far too long, the decriminalisation lobby has been allowed to peddle the dangerous idea that this drug should not be too much of a worry to us. At last, thanks to Professor Hall, they are facing a challenge based on hard, long-term evidence. While I welcome this report as a powerful weapon against pro-drugs propagandists, I also see it as a personal vindication. For years, I have taken an uncompromising public stand against the decriminalisation of cannabis — and been vilified for it. 

My interest in this field led to my appointment by the Home Office in early 2011 to an unpaid, voluntary position on the Advisory Council on the Misuse of Drugs (the official government body that makes recommendations on the control of dangerous or otherwise harmful drugs). I had planned to give up at least a day a week to help. But I had not reckoned on the insidious influence of the decriminalisation brigade. 

The moment my appointment was announced, a campaign against me started. Appalled at my robust, anti-drug views, my opponents launched a hysterical vendetta.  If their attacks had been confined to my supposedly ‘outdated’ opinions about cannabis, that would have been one thing.  But they also resorted to character assassination. An attempt was made to paint me as an old-fashioned, backwards-looking reactionary because of my Christian faith. 

And during this cynical orchestrated campaign, the ridiculous charge of homophobia was added to the charge sheet. Dredged up were my previously expressed reservations about gay marriage — though not civil partnerships.  This view was based on my Christian belief (shared by many of faith and those with no faith) that marriage should be between a man and a woman. 

They also highlighted a parliamentary briefing paper I and a number of other doctors had written in Canada that briefly mentioned studies that linked homosexuality and paedophilia. Though I can understand why this might have caused concern, and I would distance myself from such views today, no one who knows me could possibly describe me as anti-gay. 

Yet I was called ‘a bigot’ and ‘scum’. One campaigner wrote that I was ‘no good with evidence’; another said appointing me to the Advisory Council on the Misuse of Drugs would be ‘a waste of a place’. 

In this hysterical atmosphere, the Home Office proved spineless. Within less than a fortnight, my invitation to join the council was withdrawn. I never got to attend a single meeting.

What was so disturbing was the aggressive intolerance of my opponents.  My presence on the council was deemed unacceptable simply because I did not abide by the progressive orthodoxy. 

Yet in the wake of Professor Hall’s reports, it is the decriminalisation campaigners and their celebrity backers who look misguided. Their case has been weakened irrevocably.

To them, the harmlessness of cannabis has been an article of faith. Now it can be seen as a superstitious myth.

In every respect, my experience in general medical practice matches the findings of Professor Hall’s study. 

Many cannabis users start taking the drug in their early teens while their brains are still developing. The brain does not stop its development until the early 20s, so cannabis could cause irreversible damage.

Some studies have shown those who start cannabis use in their adolescence and continue until adulthood can lose up to eight points of their IQ: a drastic decline that affects academic performance and motivation.

Users can find themselves in a downward spiral. They drop out of school, fail to find employment, grow alienated from family and friends and become fully dependent on not just drugs but also welfare benefits.

Crucially, as Professor Hall points out, the risk of developing addiction to cannabis can be compared with the risk of developing addiction to heroin or cocaine. The use of the drug itself also leads to depression and other serious mental illnesses such as schizophrenia.

A study of 18-year-old conscripts to the Swedish army showed those who smoked a cannabis joint once a week were far more at risk of psychosis than those who did not. Cannabis can bring other problems — such as increased suicide risk, criminality and danger on the roads since users are twice as likely to have car accidents as non-users. And as I have seen, many who try to give up cannabis suffer serious withdrawal symptoms, including restlessness, sleeplessness, mood changes, anxiety and even severe depression. 

Yet none of this seems to matter to the campaigners and their celebrity supporters. Typical is the Liberal Democrat party, which loves to parade its metropolitan ‘sophistication’ by pushing for decriminalisation of cannabis. Like their fellow ideologues, such people think that by doing so they appear cool and ultra modern. But in reality they are pathetic, timid defeatists. 

Have we learned nothing from the problems caused by alcohol and tobacco? Legalisation of cannabis would be another public health disaster.  

They justify their approach by claiming the war on drugs has been ‘lost’. But it has never been properly fought. For the authorities, from police to politicians, have been reluctant to adopt a realistic drug prevention strategy that would involve not only enforcement of the law, but also effective rehabilitation programmes for addicts. 

Yet other countries have shown there is no need to give up and that the war on drugs can be won. 

Over the past few decades, Sweden and Japan have seen dramatic falls in drug use with an approach that combines vigour with rehabilitation. Sweden has shown it is possible to create a society where drug use is only a marginal phenomenon, thanks to the wide-ranging consensus on the need to create a drug-free society.

Above all, there is a remarkable paradox in the way progressive campaigners are only too keen to banish tobacco from society — through measures such as the ban on smoking in public or the insistence on plain packaging — yet the same toughness about drugs appears to be anathema to them. While they are happy to create ‘nicotine-free’ zones, they don’t want ‘drug-free’ ones. This contradiction only serves to illustrate the incoherence of their cause. The fact is that if you legalise cannabis, you would normalise its use. 

Have we learned nothing from the problems caused by alcohol and tobacco? Legalisation of cannabis would be another public health disaster.

Instead, we should be fighting fiercely and passionately to reduce the use of this dangerous substance that causes such terrible, lasting damage. 

DR HANS CHRISTIAN RAABE a GP in Manchester.  

Source:  http://www.dailymail.co.uk/debate/article-2784370/The-pro-drug-brigade-vilified-saying-cannabis-wrecks-lives-Now-lies-finally-exposed.html#ixzz3FnGio7e7    8 October 2014 |

Filed under: Effects of Drugs,Legal Sector :

“The toxic properties of chemical molecules and their cellular damage are not matters of opinion or debate.

They are not determined by adolescent servicemen, or by scientifically uneducated lawyers, legislators, judges, or ‘doctors’ without the facts. Certainly they are not determined  by Ted Koppel, Abbie Hoffman, Benjamin Spock, William Buckley, Geraldo Rivera, Oprah Winfrey, Dan Rather, or the mayors of our beleaguered cities.

We cannot vote for or against the ‘toxicity’ of a drug. How much a drug impairs cell structure or chemical function is neither subject to nor governed by congressional committee, public referendum, or the federal constitution.

We cannot govern the electromagnetic behavior of chemical molecules by popular vote, judicial proclamation, personal opinion or individual desire.

Everyone is entitled to his own ‘opinion.’ He is not entitled to his own ‘facts.’

Chemically, marijuana is far more dangerous drug than most scientifically ignorant media and American consumers have been duped into believing.”

Robert C. Gilkeson, M.D.,

Child and Adolescent Neuro-psychiatrist

 

Filed under: Drug Specifics,Effects of Drugs :

The fall of the Roman Empire is the subject of much debate, and includes attention to the possible role of their aqueducts, lined with lead. More likely, the decline was the result of lead poisoning caused by the consumption of grape juice boiled in lead cooking pots. The aristocracy of Rome consumed as much as two liters of wine a day — almost three bottles — adding alcoholism to the risk of lead poisoning. 

Lead poisoning has an impact on intelligence, even at concentrations as low as 10 micrograms per deciliter. In the New England Journal of Medicine on April 17, 2003, Richard L. Canfield writes that children between the ages of 3 and 5 suffer a decline of 7.4 IQ points from environmental lead exposure. That figure represents a substantial loss of intellectual capacity. There is no effective treatment for children so exposed. One can be grateful for a dedicated public health campaign to mitigate this powerful yet avoidable toxin in the lives of children.

That said, no one is advocating that pregnant woman splash lead-based paint in their nursery. Unlike another substance that also holds high risk during the prenatal period. Incredibly, it is a substance that for pregnant women is more than permitted, it is encouraged by some advocates. That substance is marijuana. In the life of the developing adolescent, heavy marijuana exposure is associated with brain abnormalities, emotional disruption, memory decline, and yes, loss of IQ; a decline of an estimated 8 points into adulthood, according to research by M. Meier in the Proceedings of the National Academy of Sciences in October, 2012. But what of prenatal exposure, from maternal marijuana use?

The website Cannabis Culture provides an answer in a 1998 article. The opening graphic is of a dreamy, topless woman who is in the late-term of her pregnancy. She is curled around a hookah. Under advice from a “Dr. Kate,” she is told that smoking marijuana while pregnant is not only safe, but that “cannabis can be a special friend to pregnant women in times of need.” It is said to mellow out those periods of morning sickness and to reduce anxiety.

The potential impact of such misinformation is widespread. According to the 2012 National Survey of Drug Use and Health, the rate of illicit drug use in 2012 was 18.3 percent among pregnant women aged 15 to 17. The drug being used is overwhelmingly marijuana.

An article by L. Goldschmidt in Neurotoxical Teratology in April/May 2000 concluded “Prenatal marijuana use was significantly related to increased hyperactivity, impulsivity and inattention syndrome (as well as) increased delinquency.” The marijuana used by pregnant women in this study would almost certainly be seen today as low-potency.

Recent research is even more specific concerning the damage. For instance, Xinyu Wang published on Dec. 15, 2004 in Biological Psychiatry results from examination of foetal brains. It noted, “Marijuana is the illicit drug most used by pregnant women, and behavioral and cognitive impairments have been documented in cannabis-exposed offspring.”

Their results showed “specific alterations of gene expression in distinct neuronal populations of the fetal brain as a consequence of maternal cannabis use.” The reduction was correlated with the amount of maternal marijuana intake during pregnancy, and particularly affected male fetuses. The THC “readily crosses the placenta and can thus affect the fetus,” while “longitudinal human studies have shown motor, social, and cognitive disturbances in offspring who were exposed to cannabis prenatally.” Finally, “school children exposed in utero to marijuana were also weak in planning, integration and judgment skills.”

The authors also note “Depending on the community, 3 percent to 41 percent of neonates born in North America are exposed in utero to marijuana.” Marijuana, the president has assured us in an interview with  David Remnick  (The New Yorker, Jan. 27, 2014), is “no more dangerous than alcohol.” To which he could now add, “and for the newly born, only marginally more dangerous than lead.” With this president, you take your assurances where you may.

In Colorado today, marijuana is treated as a legal recreational indulgence and is hawked as a medicine. Moreover, adolescent use of this substance, in the form of the new, highly potent industrial dope now being produced, is soaring. Included in that population of adolescent users are young females, some of whom are, or shortly will be, pregnant.

Murray is a former White House chief scientist and currently a senior fellow at the Center for Substance Abuse Policy at Hudson Institute in Washington, D.C.

Source:http://www.utsandiego.com/news/2014/sep/25/pregnancy-marijuana/    Sept   2014

Filed under: Drug use-various effects,Effects of Drugs,Effects of Drugs (Papers),Marijuana and Medicine,Medicine and Marijuana,Parents,Social Affairs :

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

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

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

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

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

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

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

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

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

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

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

Source: www.usatoday.com 9th August 2014

Filed under: Drug use-various effects on foetus, babies, children and youth,Effects of Drugs,Marijuana and Medicine,USA :

Prescription Drugs ‘Orphan’ Children In Eastern Kentucky

Orphaned by prescription drug overdoses .   Story highlights

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

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

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

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

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

Prescription drugs can be dangerous 

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

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

‘You’re always worried’

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

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

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

His mother was dead after overdosing on Oxycontin.

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

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

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

Gupta: Let’s end the prescription drug death epidemic

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

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

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

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

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

Guardians’ Day

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

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

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

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

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

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

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

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

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

Prescription drug deaths: Two stories

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

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

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

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

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

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

‘It’s time for it to stop’

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

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

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

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

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

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

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

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

Filed under: Effects of Drugs,Health,INTERNATIONAL NEWS,Others (International News),Political Sector,Social Affairs (Papers),USA :

One of the original chemists who designed synthetic cannabis for research purposes, John W. Huffman, PhD  once said that he couldn’t imagine why anyone would try it recreationally. Because of its deadly toxicity, he likened it to playing Russian roulette, and said that those who tried it must be “idiots.” Whether that’s the case or not, the numbers of users is certainly rising, and so are overdoses. New Hampshire has declared a state of emergency, and the number of emergency room visits for overdose from the synthetic drug has jumped. One teen died earlier this month after slipping into a coma, reportedly from using the drug. 

Synthetic pot also goes by hundreds of names: Spice, K-2, fake weed, Yucatan Fire, Bliss, Blaze, Skunk, Moon Rocks, and JWH-018, -073 (and other numerical suffixes), after Huffman’s initials. Synthetic cannabis, unlike pot, however, can cause a huge variety of symptoms, which can be severe: Agitation, vomiting, hallucination, paranoia, tremor, seizure, tachycardia, hypokalemia, chest pain, cardiac problems, stroke, kidney damage, acute psychosis, brain damage, and death.

Why are the effects of synthetic cannabis so varied and so toxic? Researchers are starting to understand more about the drugs, and finding that synthetic cannabis is not even close to being the same drug as pot. Its name, which is utterly misleading, is where the similarity ends. Here’s what we know about what synthetic cannabis is doing to the brain, and why it can be deadly.

1. It’s much more efficient at binding and acting in the brain 

One reason that synthetic cannabis can trigger everything from seizures to psychosis is how it acts in the brain. Like the active ingredient in pot, THC, synthetic cannabis binds the CB1 receptor. But when it binds, it acts as a full agonist, rather than a partial agonist, meaning that it can activate a CB1receptor on a brain cell with maximum efficacy, rather than only partially, as with THC. “The first rule of toxicology is, the dose makes the poison,” says Jeff Lapoint, MD, an emergency room doctor and medical toxicologist. “I drink a cup of water, and I’m fine. I drink gallons of it in some college contest, and I could have a seizure and die. Synthetic cannabinoids are tailor-made to hit cannabinoid receptors – and hit it hard. This is NOT marijuana. Its action in the brain may be similar but the physical effect is so different.”

Another issue with synthetic is its potency, which is huge. “Its potency can be up to one hundred or more times greater than THC – that’s how much drug it takes to produce an effect,” says Paul Prather, PhD, professor of pharmacology and toxicology at the at University of Arkansas for Medical Sciences. “So it takes much less of them to produce maximal effects in the brain. So these things have higher efficacy and potency…These things are clearly very different from THC and thus not surprising that their use may result in development of life-threatening adverse effects.”

2. CB1 receptors are EVERYWHERE in the brain 

A central reason that synthetic cannabis can produce such an enormous variety of side effects is likely because CB1 receptors are present in just about every brain region there is. When you have a strong-binding and long-lasting compound going to lots of different areas of the brain, you’re going to get some very bad effects.

Yasmin Hurd, PhD, Professor of Psychiatry, Pharmacology and Systems Therapeutics, and Neuroscience at Mount Sinai Medical Center, says that the wide distribution of CB1 receptors in the brain is exactly why they’re so toxic. “Where they’re located is important – their presence in the hippocampus would be behind their memory effects; their presence in seizure initiation areas in the temporal cortex is why they lead to seizures. And in the prefrontal cortex, this is probably why you see stronger psychosis with synthetic cannabinoids.” The cardiac, respiratory, and gastrointestinal effects probably come from the CB1receptors in the brain stem. It might be any one of these that produces the greatest risk of death.

3. A synthetic cannabis overdose looks totally different from a pot “overdose” 

The clearest proof that synthetic cannabis is a different thing all together is that overdose with the drug looks totally different from an “overdose” with natural marijuana. “Clinically, they just don’t look like people who smoke marijuana,” says Lewis Nelson, MD, at NYU’s Department of Emergency Medicine, Division of Medical Toxicology. “Pot users are usually interactive, mellow, funny. Everyone once in a while we see a bad trip with natural marijuana. But it goes away quickly. With people using synthetic, they look like people who are using amphetamines: they’re angry, sweaty, agitated.”

Whatever’s happening, he says, it may be more than just the replacement of THC with JWH. “It’s almost hard to imagine that it could be related to the partial vs. full agonist aspect of the drug.”

4. The body doesn’t know how to deactivate synthetic

One possibility is that the metabolites of synthetic cannabis are also doing damage to the brain. Usually our bodies deactivate a drug as it metabolizes it, but this may not be the case with synthetic. “What we’re finding from our research,” says Prather, “is that some of the metabolites of synthetic cannabis bind to the receptor just as well as the drug itself – this isn’t the case with THC. The synthetic metabolites seem to retain full activity relative to the parent compound. So the ability of our bodies to deactivate them may be decreased.”

He also points out that what’s lacking in synthetic cannabis is cannabidiol, which is present in natural marijuana and appears to blunt some of the adverse actions of the THC. But if it’s not there in synthetic cannabis, then this is one more way the drug’s toxicity may act unchecked.

5. Quality control is non-existent

Synthetic cannabis is made in underground labs, often in China, and probably elsewhere. The only consistent thing is that there’s no quality control in the formulation process. “Is Crazy Monkey today the same as Crazy Monkey tomorrow?” Prather asks. “No way. The makers take some random herb, and spray it with cannabinoid. They’re probably using some cheap sprayer to spray it by hand. How MUCH synthetic cannabis is in there? You have no idea how much you’re getting.” He adds that there are almost always “hot spots” present in the drug – places where the drug is way more concentrated than others. “Plus, there’s almost always more than one synthetic cannabinoid present in these things – usually four or five different ones.” The bottom line: There’s no telling what you’re getting in a bag of Spice or K-2.

6. The drugs are always evolving

“Someone’s just kind of riffing off JWH,” says Lapoint. There are hundreds of different forms of JWH, and of other synthetic cannabinoids designed by different labs, and the next one is always waiting to go. “It only takes a grad school chemist level to pull it off,” he says. “The first JWH in incense blends was found in Germany around 2008 – it was the JWH-018 in Spice. It took months for the local authorities to figure out what was in it and regulate it. The next week incense blends with another compound, JWH-073, came out. They already had it ready to go – and they’re making something that’s not even illegal yet. Since we started the conversation 10 minutes ago, we’re already behind.”

Would legalizing marijuana kill the synthetic industry? 

The demand for a “legal high” has been so great in recent history that it’s set the stage for the synthetic market to take off, says Lapoint. “It’s like the perfect storm. First we created black market by making marijuana illegal. Then there are all these loopholes in the legislation, so you can feed synthetics through when you change one molecule and call it a different drug.” As mentioned, it takes so long for the FDA to catch up – a year or more – that by the time one drug is made illegal, dozens of other iterations of the synthetic are already formulated and poised for release into the market.

His solution is a three-pronged: Changing the laws, by moving form a rule-based to a standards-based system, is the first step. “Right now, you either apply analogue, act to a new drug or make a new law. There will always be a loophole. So you have to move to standards-base. We really need good designer drug legislation reform.”

The second step is that get the public health message across that synthetic cannabinoids can kill. “Science has a poor understanding of how these drugs will affect you,” says Lapoint, “and the public has an even poorer understanding. People think ‘oh it’s just weed, just fake marijuana.’ Clearly the safety perception is way off. Let parents know, let kids know – this is not the same thing. You are experimenting with unknown compounds. You’re being a guinea pig. It’s not the same chemical, even among same brand. Medically, these drugs are a world of difference from THC.”

The last step, he says, is to continue the legalization discussion. Some states are leading the way. “You have to ask if you’re pushing people towards the scarier thing? The answer is ‘yes.’ It’s like prohibition where people made bathtub gin with methanol. We know people are going to use it. No athlete, soldier, student, or parolee wants to test positive for THC. So they just go to the head shop and get the ‘legal’ kind.”

Of course, it’s not legal at all, and it can lead to irreversible health problems and death. Whether legalization of natural marijuana is the solution isn’t totally clear. But remind your friends or kids that being a human subject in an uncontrolled synthetic drug experiment is just stupid. “This was never intended to be used in people,” says Lapoint. “It even says on the label, ‘Not for human consumption.’ Ironically, that’s the only accurate thing on the label. This is [not]marijuana. It should not be thought of like marijuana. We have to get this out there: Its effects are serious. It’s a totally different drug.”

http://www.forbes.com/sites/alicegwalton/2014/08/28/6-reasons-synthetic-marijuana-spice-k2-is-so-toxic-to-the-brain/    28th August 2014

Filed under: Brain and Behaviour,Effects of Drugs,Legal Highs :

CORRESPONDENCE FROM TEN DOCTORS

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

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

To the Editor:

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

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

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

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

To the Editor:

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

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

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

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

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

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

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

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

Filed under: Effects of Drugs,Medicine and Marijuana,USA :

As I  reported a few weeks ago, some professors published a peer-reviewed article on the negative social costs to outright legalization. I noted that although overall traffic fatalities in Colorado have gone down since 2007, they went up by 100 percent for operators testing positive for marijuana—from 39 in 2007 to 78 in 2012. (Colorado legalized marijuana for medical usage in 2009, before legalizing marijuana for other uses in 2012.) Furthermore, in 2007, those pot-positive drivers represented only 7 percent of total fatalities in Colorado, but in 2012 they represented 16 percent of total Colorado fatalities. 

Now, there is even more proof from Colorado that legalizing pot, as I have  argued before, is terrible public policy.  This new report paints an even bleaker picture of what is happening in Colorado since it legalized the possession, sale, and consumption of marijuana.    According to the new  report  by the Rocky Mountain High Intensity Drug Trafficking Area entitled “The Legalization of Marijuana in Colorado: The Impact,” the impact of legalized marijuana in Colorado has resulted in:

1. The majority of DUI drug arrests involve marijuana and 25 to 40 percent were marijuana alone. 

2. In 2012, 10.47 percent of Colorado youth ages 12 to 17 were considered current marijuana users compared to 7.55 percent nationally. Colorado ranked fourth in the nation, and was 39 percent higher than the national average.

3. Drug-related student suspensions/expulsions increased 32 percent from school years 2008-09 through 2012-13, the vast majority were for marijuana violations.

4. In 2012, 26.81 percent of college age students were considered current marijuana users compared to 18.89 percent nationally, which ranks Colorado third in the nation and 42 percent above the national average.

5. In 2013, 48.4 percent of Denver adult arrestees tested positive for marijuana, which is a 16 percent increase from 2008.

6. From 2011 through 2013 there was a 57 percent increase in marijuana-related emergency room visits.

7. Hospitalizations related to marijuana has increased 82 percent since 2008.

The  report includes other data about the negative effect of legalizing marijuana in Colorado, including marijuana-related exposure to children, treatment, the flood of marijuana in and out of Colorado, the dangers of pot extraction labs and other disturbing factual trends. 

Don’t expect this data to impact the push to legalize pot in Colorado, or elsewhere for that matter. Big pot is big business, and the push to legalize is really all about profit, despite inconvenient facts.  Drug policy should be based on hard science and reliable data. And the data coming out of Colorado points to one and only one conclusion: the legalization of marijuana in the state is terrible public policy.

Source:  http://dailysignal.com/2014/08/20/7

Charles “Cully” D. Stimson is a leading expert in criminal law, military law, military commissions and detention policy at The Heritage Foundation’s Center for Legal and Judicial Studies. Read his research.

Filed under: Drug use-various effects on foetus, babies, children and youth,Drugs and Accidents,Effects of Drugs,Marijuana and Medicine,Social Affairs,Youth :

Since the premiere of Dr. Sanjay Gupta’s documentary “Weed” back in August, the general public has quickly come to understand the miraculous healing power of cannabidiol, or CBD.

The political perception of medical marijuana changed forever when parents saw little Charlotte Figi, the girl with intractable epilepsy, go from hundreds of seizures a week to just one or two, thanks to CBD treatments.

But that change in perception isn’t a good one.

For now there are two types of medical marijuana – CBD-Only and “euphoric marijuana”, as New Jersey Gov. Chris Christie calls medical marijuana that contains THC.

Just as “We’re Patients, Not Criminals” cast non-patients as criminals, the lobbying for these new CBD-Only laws relies heavily on pointing out that CBD is a “medicine that doesn’t get you high”, which casts THC at best as a medicine with an undesirable side effect and at worst as not a medicine but a drug of abuse.

This is a disaster both politically and medically; let’s begin with the former.

Politically, whole plant medical marijuana (the kind with THC in it) began in 1996 in California and from that point, it took eleven years before there were a dozen whole plant medical marijuana states in America.

CBD-Only medical marijuana began in March in Utah and from that point, it’s taken only four months to put us on the brink of a dozen CBD-Only medical marijuana states.

Also consider that of those first dozen whole plant states, eight of them were passed by citizen ballot initiative.

All twelve of the CBD-Only laws were passed by state legislatures, often by unanimous or near-unanimous votes.

Every legislature that has taken up the issue of CBD-Only medical marijuana has seen the legislation fly through the committees and both chambers (except Georgia, and that state was only derailed by some parliamentary shenanigans by one legislator).

Take North Carolina this week as an example.  On Tuesday, a committee of the North Carolina House of Representatives cancelled a meeting to discuss a CBD-Only bill.  No rescheduled date for the meeting was announced.

Local newspapers on Wednesday posted headlines that the bill’s passage was unlikely.

The Senate wasn’t likely to pass the bill in this short session that ends next week.

There would be no good reason for the House to move forward with the bill.

But on Wednesday afternoon, the meeting was suddenly rescheduled and the CBD-Only bill passed unanimously.  This morning (Thursday) the bill was heard by a second committee and passed immediately.  This afternoon it was heard and amended on the House floor where it passed 111-2.   It now awaits passage by the state Senate.

By the end of this week, it seems North Carolina could become the 12th CBD-Only state, joining Alabama, Florida, Iowa, Kentucky, Mississippi, Missouri (awaiting governor’s signature), New York (governor’s executive order), South Carolina, Tennessee, Utah, and Wisconsin.

Why are legislators so fast to pass these CBD-Only bills?  It’s fair to assume politicians are moved by the plight of epileptic children.

With CBD-Only, there’s no downside of being the guy or gal who voted for legalizing something that “gets you high”.   But even so, how do these bills move so fast and garner little to no opposition?  Because CBD-Only bills are political cover.

Voting for the CBD-Only bill allows the politicians to say they’re sympathetic to the plight of sick people and want to help patients get any medicine that will ease their suffering.

But they can also still play the “tough on drugs” game and maintain their support from law enforcement and prison lobbies.  Their vote garners headlines that a politician formerly considered “anti-medical marijuana” has “changed his mind” or “altered her stance” on medical marijuana.

Best of all, it gets the sick kids and their parents out of the legislative galleries and off the evening news.  For the politicians in these conservative states, it makes the medical marijuana issue go away, or at least puts the remaining advocates in the “we want the marijuana that gets you high” frame where they are more easily dismissed.

Medically, the CBD-Only laws are also a disaster.

Cannabidiol is just one constituent of cannabis and by itself, it doesn’t work as well as it does with the rest of the plant.   Dr. Raphael Machoulem, the Israeli researcher who discovered THC (the cannabinoid that “gets you high”), called it “the entourage effect”, the concept of many cannabinoids and other constituents working in concert, synergistically.

To make an overly-simple analogy, it’s as if we discovered oranges have vitamin C in them, but banned oranges completely and only allowed people with scurvy to eat vitamin C pills.    Yes, those pills can help you if you’re vitamin deficient, but any nutritionist will tell you eating the whole orange will not only allow your body to absorb the vitamin C better, the fiber from the orange is also good for your body, and oranges taste delicious, which makes you a little happier.  Plus, if oranges are in your diet, you’re not going to get scurvy in the first place.

The authors of these CBD-Only bills aren’t writing them for optimal medical efficacy, however, they’re writing them for political cover.

The parents treating their children in Colorado with CBD oil will tell you that it takes quite a bit of tinkering with the ratio of CBD to THC in the oil to find what works best for their child’s type of seizures.   Some of these kids need a higher dose of THC.

But the legislators write the laws mostly to ensure that the THC “that gets you high” is nearly non-existent.  The North Carolina law, for instance, mandates that the oil contains at least 10 percent CBD and less than 0.3 percent THC.

That’s a CBD:THC ratio of at least 34:1.

For comparison, an article by Pure Analytics, a California cannabis testing lab, discusses the high-CBD varietals most in demand by patients are “strains with CBD:THC ratios of 1:1, 2:1, and 20:1.”   The article explains how a breeding experiment with males and females with 2:1 ratios produced 20:1 ratio plants about one-fourth of the time.

It also describes a strain called “ACDC” that “consistently exhibited 16-20% CBD and 0.5-1% THC by weight.”

That’s one variety with a range of 16:1 to 40:1.  But you must only use the ones that are 34:1 or higher.

In another indicator that politicians are more interested in political cover than helping sick kids, many of these laws are written with no mechanism for in-state production and distribution of the CBD oil.  Some expressly protect the parent who goes out of state to acquire the oil (likely from Colorado) and brings it back home.

So parents are given hope for their kids, but they have to go to Colorado, establish three months residency to qualify for a medical marijuana card, clear the hurdles necessary to get their child signed up for the card, purchase the high-CBD oil, break Colorado law by taking it out of state, and break federal law by being an interstate drug trafficker.

Then back home, the parents are safe, assuming the oil they purchased in Colorado meets the CBD:THC ratio mandated by law.  The ratio listed on the label or mentioned by the provider is no guarantee.

At The Werc Shop, a cannabis testing lab in Los Angeles, an intern writes about how she was sold a strain promised to be 15 percent CBD and 0.6 percent THC, a 25:1 ratio that would be illegal in North Carolina if processed into oil.

When she ran liquid chromatography tests on the sample, it turned out to be 9.63 percent CBD to 6.11 percent THC, a 1.6:1 ratio.  CBD-Only isn’t just a political and medical disaster in the states that adopt it.

These laws also have a detrimental effect on the process of passing whole plant medical marijuana in other states.   Every medical marijuana state since California has enacted increasing restrictions on its access based on the need to keep out the illegitimate marijuana users – the ones who just want to get high.

First, qualifying conditions were restricted.  Then, home cultivation of marijuana was eliminated.

Now, medical marijuana laws are being debated and passed that ban all marijuana smoking and allow no access to the plant itself, just pills, oils, and tinctures.

Thus, it is no surprise that as Wisconsin, New York, and Florida are hotly debating and likely to pass whole plant medical marijuana laws, the legislatures and governors of those two states rushed to pass CBD-Only laws first.

It’s reminiscent of then Governor Arnold Schwarzenegger rushing to sign a marijuana decriminalization bill in summer of 2010 to take the talking point of California arrests for personal possession away from Prop 19′s campaign to legalize marijuana.

Every press conference and public debate about the CBD-Only bills will emphasize “it doesn’t have the THC that gets you high”, forcing whole plant advocates into a defense of THC’s medical efficacy in spite of the “high” even more than they’re already forced to.

This is why any fight to allow patients to grow whole plant medical marijuana with the high-inducing THC in it must now pivot to the support of all adults’ right to grow marijuana if they want to get high.

Every new restriction on medical marijuana, whole plant or CBD-Only, arises from the perceived need to keep the healthy high-seekers out of the medical marijuana.

Eventually, pharmaceutical companies will perfect the CBD:THC ratios and dosages in sprays, tinctures, and inhalers that will surpass the consistency and efficacy of the plant with its natural variety.

Those companies will be glad to supply the 34:1 CBD oil North Carolina requires and whatever ratio any other state requires, for a hefty profit, of course.

Source: Russ Belville  June 23, 2014  

Filed under: Effects of Drugs,Global Drug Legalisation Efforts,Legal Highs,Social Affairs,USA :

California cannabis growers may be making millions, but their thirsty plants are sucking up a priceless resource: water. Now scientists say that if no action is taken in the drought-wracked state, the consequences for fisheries and wildlife will be dire.

“If this activity continues on the trajectory it’s on, we’re looking at potentially streams going dry, streams that harbor endangered fish species like salmon, steelhead,” said Scott Bauer of the California Department of Fish

Studying aerial photographs of four watersheds within northern California’s so-called Emerald Triangle, Bauer found that the area under marijuana cultivationdoubled between 2009 and 2012. It continues to grow, with increasing environmental consequences.

Bauer presented data to CNBC indicating that growers are drawing more than 156,000 gallons of water from a single tributary of the Eel River, in Mendocino County, every day.

The average marijuana plant needs about 6 gallons of water a day, depending on its size and whether it’s grown inside or outside, according to a local report that cited research. Pot growers object to that number, saying that the actual water use of a pot plant is much less.

Although the marijuana business has helped revive the local economy, residents may now be feeling the effects of living alongside growers. And, as growers—some legal, some not—face a severe drought, local law enforcement officers expect the fight over natural resources to intensify.

“I never want to see crime increase, but I have a feeling it will, because of the commodities that are up here,” said Humboldt County Sheriff Mike Downey. “When we get to the end of the grow season, which is August and September, the need for enhanced water availability is gonna be there, and I don’t think the water’s going to be there, so you’re going to see people, I believe, having some conflict over water rights.”

Stream water rules in California are the same for growers of marijuana as they are for growers of any crop: Growers should divert no more than 10 percent of a stream’s flow, and they should halt diversion altogether during late summer, when fish are most vulnerable to low water levels. But Bauer pointed out that those rules apply to permit holders, and most marijuana growers haven’t bothered to get permits.

With so much of California’s cannabis business operating in the more lucrative underground market, and with so many growers across the region, the California Department of Fish and Wildlife and the Humboldt County Sheriff’s office say they lack the resources to take action against all offenders. So they target the most egregious.

“We get those calls daily. People are upset. Somebody has dried up a stream, somebody is building a road across sensitive fish and wildlife habitat, so that is happening on a daily basis,” Bauer said. “And we do our best with the personnel we have to respond to those calls.” Sheriff Downey concurred with Bauer about the manpower challenge authorities face.

“We have a very active marijuana unit that is out there, especially during the grow season. But we have so many grows here that we have a hard time keeping up or making a valiant dent in the marijuana growing in the county,” said Downey.

“With the increase in water usage and pressure upon that, that lucrative business becomes even more lucrative because the price of the marijuana, the value of it, goes up even though we’ve had a glut on the market the last few years,” he added.

One increasingly popular solution among some growers is the collection of rain water during the wetter, winter months that they can use to water crops during the dry, summer season.

“As long as cannabis farms remain small and decentralized, there’s no reason why we can’t grow everything we need to meet the state’s demands using all stored rain water,” says Hezekiah Allen, an environmental consultant and director of public affairs for the Emerald Growers Association.

And for some, it’s a business opportunity.   “I’ve heard people shut down their grow operations, bought water trucks and have changed from growing to supplying waters to the other growers,” said Chip Perry, a consultant for MC2, a service that helps people obtain medical marijuana cards.

Source:  nbcnews.com  July 7th 2014

Filed under: Effects of Drugs,Environment,Global Drug Legalisation Efforts,USA :

‘Go on, have a chooff, it’s harmless!’ Well so has been the mantra of the pro-drug lobby. However, can one play Russian Roulette ‘safely? The answer is NO you can’t! The mounting and irrefutable scientific evidence against Cannabis remains conclusive – This illicit drug will damage you!

Researchers from the UK’s Bristol University have broken new ground in tracking THC (the psychoactive compound in Cannabis) impact in the brain of laboratory rats, by using electrodes connected directly into ‘the grey matter’ – not something that can be done on humans.

The results were not only disturbing, but reinforced many other studies, including one major break-through study carried out in Australian earlier this year; that is that Cannabis and the potential for mental illness are inseparable.

Two parts of their brain were shown to be affected – the hippocampus which is essential for forming new memories and prefrontal cortex which integrates those memories and uses them for future behaviour and decision-making…Disruption of the brain waves which allow these two areas to communicate is what happens in schizophrenia, a mental disorder.

The lead author of the study, Dr Matt Jones stated: ‘Cannabis is making normal people behave more like schizophrenia patients when they take it and that’s something they should bear in mind…Previous studies have shown a link but we didn’t have this level of detail.’

The Dutch Professor van Os and his team in conjunction with the Institute of Psychiatry in London and other researchers in Germany, conducting follow-up studies have verified that cannabis users are potentially doubling their risk of developing schizo-affective states or other psychotic manifestations such as paranoia and audio-hallucinations.3 The Dalgarno Institute continues to advocate for…

  •  Continued illicit status of cannabis
  •  Compulsory seizure of all assets of Drug traffickers and tougher sentences for same.
  •  More thorough Demand Reduction strategies for young people
  •  Recovery focused rehabilitation for drug

References:

1 www.dailymail.co.uk/health/article-2053486/One-cannabis-joint-bring-schizophrenia.html

2 Ibid

3 http://www.bmj.com/content/342/bmj.d738

Source: Press Release from dalgarnoinstitute.org.au October 2011

Filed under: Brain and Behaviour,Cannabis/Marijuana,Drug use-various effects,Effects of Drugs,Health,Social Affairs :

Lawmakers have expressed concern over a new form of alcohol that could hit the market as early as the fall. In early April, the Alcohol and Tobacco Tax and Trade Bureau (TTB) approved labels for seven varieties of Palcohol, a brand of dehydrated alcohol, ranging from straight vodka to a powdered margarita. Derided as “the Kool-Aid of teen binge drinking,” lawmakers and other concerned parties say Palcohol poses a particular risk for youth who may be attracted to this easily portable, easily hidden form of alcohol. 

Dehydrated or powdered alcohol is not a new product. Patents have been held for various formulas since 1970, but never came to market due to either a lackluster market or difficulty with government regulation. However, the labelling approval of Palcohol, which the TTB has since revoked, drew attention to the many dangers inherent in dehydrated alcohol, many of which seemed to be not only acknowledged, but advertised by Palcohol creator Mark Phillips.The original Palcohol website, written in language Phillips describes as “edgy,” encouraged users to sneak the product into banned venues, sprinkle it onto food, and even discussed snorting the product. From the original website: “Let’s talk about the elephant in the room….snorting Palcohol. Yes, you can snort it. And you’ll get drunk almost instantly because the alcohol will be absorbed so quickly in your nose. Good idea? No. It will mess you up. Use Palcohol responsibly.”This flippant approach of the manufacturer only highlighted growing concerns with the product, particularly: youth access, spiking food or beverages, and snorting or inhaling the product. The Palcohol site has now been modified to remove the offending remarks and provide more information on how the product will be difficult to abuse.

The modified FAQ section on snorting now reads: “Can I snort it? We have seen comments about goofballs wanting to snort it. Don’t do it! You wouldn’t want to anyway. It would take you approximately 60 minutes of painful snorting to get the equivalent of one shot of vodka up your nose. Why would you do that when drinking a shot of liquid vodka takes about two seconds?”

While Phillips has modified his marketing approach and resubmitted Palcohol for TTB review, concerned lawmakers, such as Senator Chuck Schumer (D-N.Y.) are calling for the product to be banned before it enters the market.

“It’s absurd. It’s scary,” Schumer told WCBS Radio and other news outlets recently. “I’m calling on the Food and Drug Administration to immediately step in, investigate Palcohol based on its obvious health risks and prohibit this ludicrous product from going to market.”

Schumer was a driving force behind the ban of Four Loko and other dangerous caffeinated alcohol products, the last alcoholic fad abused by teens and young adults.

CADCA agrees with Sen. Schumer.

“Palcohol is a ridiculous product and really just an attempt to appeal to young people. CADCA believes that there’s nothing good that can come out of powdered alcohol and we support efforts to restrict it.  It’s important to remain vigilant about new and emerging novelty products like these and that’s why it’s critical that we have community coalitions across the country that are alerting us to these products and trends before they wreak havoc on our communities,” said Gen. Arthur T. Dean, CADCA Chairman and CEO.

While Palcohol is being resubmitted to the TTB for further review, some states are working to ban the product before it enters the national market. While Mark Phillips notes that Palcohol would federally be processed and sold in the same venues as traditional alcohol, in Vermont, state Senator Kevin Mullin is concerned that current state laws only address liquid alcohol, making the powdered form difficult to regulate, and more accessible to youth.

“You can’t buy a bottle of gin at the liquor store if you’re 16. But there’s nothing that I can see in Vermont statute that would prohibit you from buying powdered alcohol, if it was available,” he told Vermont’s NPR affiliate.

In Minnesota, state Representative Joe Atkins has introduced a bill to enact a statewide ban as quickly as possible, noting “with how quickly this is moving, we shouldn’t wait until next session to deal with this issue. We need to move quickly to protect public health.”

Alcohol Justice, an alcohol industry watchdog group, agrees that immediate action is necessary to prevent powered alcohol from ever reaching the market. The group has asked concerned parties to write letters to federal officials through their online tool, calling for the ban of powdered alcohol before it ever is available to teens or young adults.

Source:  CADCA May 07, 2014

Filed under: Alcohol,Economic,Effects of Drugs,Global Drug Legalisation Efforts,Legal Sector,USA :

This morning the letter below was sent to the editor of the Denver Post and their marijuana publication The Cannabist .  The letter was expressing alarm at their promotion of numerous marijuana strains to treat serious mental health issues without any medical protocols.  We did receive a response and a news release will follow tomorrow. This letter will be sent to individuals and organizations in our state and nationally working on public health (including mental health and substance abuse) , public policy and enforcement. 

 Feel free to forward this information to anyone you feel appropriate.

Here is the letter sent this morning:

Greg Moore,   Editor,  Denver Post

Ricardo Baca,   EditorThe Cannabist

Dear Mr. Moore and Mr. Baca,

We are writing to express serious concerns regarding The Denver Post’s The Cannabist website’s recommendations of various marijuana strains to “treat” mental illnesses, including attention-deficit/hyperactivity disorder (ADHD), bipolar disorder, depression and post-traumatic stress disorder (PTSD).  We are writing as concerned professionals with extensive experience in mental health treatment, medicine, and/or public health.

The Denver Post’s web site provides information from Leafly.com listing 92 Colorado specific strains of marijuana with 88 claimed to treat depression, 25 to treat PTSD, 23 for bipolar, and 40 for ADHD (see attached document assembled by Bob Doyle, Chair, Colorado SAM (Smart Approaches to Marijuana) Coalition).  And a few strains are noted to treat cancer.  The improper treatment or delay in effective treatment of mental health issues and major psychiatric illnesses can exacerbate the problem and could lead to additional harm to the patient and/or those around them.

In light of the serious potential impact of your recommendations, including possible delay in medical treatment for serious and potentially life threatening mental illnesses, and the potential for worsening of those illnesses by the marijuana you recommend, we request that you release the data upon which these recommendations for dispensing the specific marijuana strains as a treatment for bipolar disorder, PTSD, ADHD, and depression are based.  We are sending a copy of this letter to medical authorities with knowledge of science and regulatory policies and procedures.

The absence of critical information on the web site for those accepting your advice to use the various marijuana strains is alarming and demonstrates a failure to appreciate the potential implications of your protocol.  For each of the strains, we request to know the recommended dosage, duration, the THC and CBD content, whether you’re recommending they be used with or without FDA approved medication or behavioral treatment for the condition, what contraindications are known, and whether other physical or mental health issues should preclude certain people from using the strain.

We look forward to your prompt reply given the seriousness of the claims on your web site and their potential negative impact on serious psychiatric conditions your web site claims will be “treated” by particular strains of marijuana.

Sincerely,

Bob Doyle,  Chair, Colorado SAM (Smart Approaches to Marijuana) Coalition Christian Thurstone, MD   General, child and addiction psychiatrist

A. Eden Evins, MD, MPH, Associate Professor of Psychiatry, Harvard Med School Director, Center for Addiction Medicine, Mass.Gen.Hospital

Filed under: Effects of Drugs,Global Drug Legalisation Efforts,Legal Sector,USA :

Two new drugs are detected each week across Europe with researchers trying to alert the public to the dangers of new chemicals. Young people have died “horrific deaths” from taking multiple drugs, a senior member of the Forensic Science service in Northern Ireland has said. Twenty people have died in the last year from drugs known as “speckled cherries”. Many more have died from taking a cocktail of other substances.

Forensic expert Peter Barker said it was time for an anti-drugs campaign along the lines of road safety adverts. “We’ve seen some really horrific deaths where people have killed themselves after taking multiple drugs,” he said. “I think we need to be much more stark in the message we send to the public – adverts similar to those we’ve seen in road safety campaigns.” The forensic labs are based in Carrickfergus and they use state of the art equipment to carry out toxicology reports after someone has died.

‘Bucket chemistry’

Mr Barker said so-called legal highs are presenting significant challenges. “We call it bucket chemistry – these drugs are developed in back alley garages,” he added. “They haven’t had clinical trials and no one knows what is in them. They are not safe for people to take, even if they have taken a similar compound before.”

About two new drugs are detected each week across Europe and that means researchers are always trying to stay ahead of the game to alert the public to the dangers of new chemicals. They have the same machines used by the Olympics dope-testers – cutting edge technology that can detect tiny amounts of different substances.

At a recent inquest, Coroner John Leckey described the recent drugs deaths as being similar to having a serial killer on the loose. Mr Barker said the deaths were extremely unpleasant: “They can cause convulsions, palpitations and heart attacks.

“Children do need to be educated about the dangers.”

Source: http://www.bbc.co.uk/news/uk-northern-ireland 21st August 2014

Filed under: Effects of Drugs,Health,Legal Highs,Legal Sector :

Yesterday, the checkout line at my favorite Lowe’s Home Improvement store was so long that I watched an obviously frustrated man walk away from a shopping cart that easily contained what would have been a $250 purchase. The people in front of me and behind me were steamed, too. “The problem isn’t just here in the garden center,” one woman said. “The whole store is understaffed.”

She was right — but I wasn’t going to give up my spot in that line to wander inside the main store building to find a manager to address the situation. So, I held my ground, whipped out my mobile phone and called Lowe’s toll-free, customer-service number (thanks, Lowe’s, for posting that right over the register) to relay the problem — and what I’d just witnessed in terms of lost business.

What I ultimately learned from that conversation is that Lowe’s corporate executives should have a hard discussion with Colorado Gov. John Hickenlooper and economic-development offices in the cities where their stores operate in this state. Why? Because Lowe’s doesn’t want to hire people who can’t pass drug tests — and here in Cannabis, er, Colorful Colorado, the company is greeted with too many job applicants who test positive for THC, the active ingredient in marijuana.

Wonder of wonders, Lowe’s doesn’t want people acutely or sub-acutely under the influence of marijuana operating forklifts, using circular saws, cutting ceramic tiles, driving company trucks — or cleaning its toilets. And no, the company isn’t interested in lowering its hiring standards, either, said Amy, the friendly and always-approachable manager at my favorite Lowe’s store.

Within minutes of the customer-service center alerting her of my call, Amy was on the line with me to apologize. I assured her that I wasn’t at all angry. Instead, my call was motivated by a love of the place. It was by working for Lowe’s that my younger brother picked up a lot of the skills that eventually helped him open his own residential remodeling company. I have dear friends who work for Lowe’s. All my son wanted to do for his 4th birthday was invite a dozen of his best buddies to Lowe’s to build wooden race cars during one of the company’s Saturday build-it workshops for kids. It’s a longstanding joke in my family that we should own shares of the company given how many times my father visits his favorite Lowe’s store every week. Dr. T, who serves in the U.S. Army, really appreciates Lowe’s stated appreciation — and discounts — for those in the armed services.

So, call me crazy, but I’m actually protective of the company and its brand.

“We’re trying to find the best people to hire, and it’s really hard these days,” Amy the manager told me.

“Why do you think it’s so difficult?” I asked.

“Because hardly anybody passes a drug test,” she quickly replied. “It’s a real problem.”

When I probed a little more, I learned that marijuana use is the chief reason for the applicants’ failed test results — and by a long shot.

Perhaps Lowe’s is painfully aware that marijuana isn’t like alcohol in all sorts of ways vital to workforce readiness. Maybe its executive ranks know how tough it is to pinpoint a marijuana user’s level of impairment. Maybe the company is also versed in studies the world over showing the risk of a traffic accident significantly increases when a person has even 1 ng/ml THC in his or her system.

However, one thing is certain: Lowe’s isn’t the only Colorado employer struggling to find drug-free workers to fill decent jobs. Conspire!, a drug-testing company based in Colorado Springs, reports that THC-positive, workplace drug tests it has administered in that city have increased 30 percent since the start of 2013.

So, I get it: Lowe’s, which stands by the slogan “Never stop improving,” faces a dilemma — and one that IS affecting its shoppers. I’m willing to wait a little longer in line because I like the company so much — but I suspect I’m an exception, not the rule.

And as a longstanding and loyal customer, I certainly don’t want Lowe’s to lower its hiring standards — or even feel pressured to do so.

Source:   dthurstone.com  14th May 2014

Filed under: Effects of Drugs,Global Drug Legalisation Efforts,Social Affairs,USA :

Prisoners increasingly using ‘spice’, which is undetectable but has put growing numbers of users in hospital Spice: the drug ‘more devilish than weed’ sweeping British prisons Link to video: Spice: the drug ‘more devilish than weed’ sweeping British prisons

Synthetic cannabis known as “spice” or “black mamba” is a growing problem in UK prisons with serious physical and mental health consequences, the chief inspector of prisons, Nick Hardwick has said.

Its popularity with inmates has surged because the psychoactive designer drug can be passed off as a tobacco roll-up, has no distinctive smell and it evades current drug testing capabilities in prisons.

In a Guardian Films investigation, we spoke to several prisoners, former prisoners and officials and analysed Her Majesty of Prisons Inspectorate (HMIP) reports that revealed it had become a problem in at least 28 prisons in England.

Several former prisoners said the drug was rife inside, having been thrown over the walls or otherwise smuggled in, and one said its lack of smell meant it could be smoked in front of the guards. Another, a remand prisoner currently at HMP Forest Bank near Manchester, said in a telephone interview that some of those using it were “going down like flies”. He said it had led to multiple calls to the emergency services.

“I’ve never seen anything like it in prison. Guys are taking it and having psychotic episodes all over the place. Ambulances are coming in and out of the place more frequently than the escort vans,” he said. It is not clear how many of these incidents involved other drugs in combination. The recent annual Global Drug Survey (GDS), which surveys thousands of drug users on their experiences, indicated that users of synthetic cannabis were seven times more likely to need hospital treatment than users of the natural form of the drug. Several deaths in the US have been blamed on spice, which is made from dried plants sprayed with engineered chemicals.

“What we can say for definitive is that spice is a significant problem in a number of prisons and it is rising,” Hardwick told the Guardian.

“As opiate-based drugs become less popular, spice has become a more favoured option. We’ve seen examples where its affected people’s heart and so have had to have emergency treatment. It has affected people’s mental health and what it it seems to do is exacerbate people’s existing conditions”.

There was currently no effective test for the drug, he said.

The HMIP reports describe prisoners who have taken the drug experiencing seizures, psychosis, loss of motor control and an irregular heartbeat. At HM Prison Ford in West Sussex, the prison’s drugs and alcohol recovery team said 85% of its prisoners were using or supplying spice.

A government ban on spice-like drugs in place since 2009 does not cover many newer and often more potent versions as the chemicals used to synthesise them are different. .

Spice-like drugs can still be bought on the high street and online on the basis that they are not for human consumption.

At HMP Wealstun in West Yorkshire, a notice issued to practitioners and visitors to the prison and made available to the Guardian reveals that in a two-week period in March, 13 prisoners required medical attention after using synthetic cannabis, and five cases were so severe that they were rushed to hospital.

Glyn White, 35, who has served time in more than 15 prisons including Norwich, Leicester, Weyland and Ranby, said he first noticed synthetic cannabis in 2006. He first smoked it in 2012, and said he witnessed grown men experiencing breakdowns. “I saw people pass out. I saw people cut themselves. I took it and had to go to my cell for a couple hours because that buzz is intense when you ain’t had no weed,” he said.

“I went to Weyland. It just exploded there. It was selling for £100 a gram. That is better than selling the buds [natural cannabis]. It don’t smell and is easier to conceal. When I got out of prison I started smoking a bit of it, but I reckon its worse than weed.”

Dr John Ramsey, a toxicologist based at St Georges University London, told the Guardian that testing for drugs such as spice was difficult because manufacturers change their composition changes so often. “The number of chemicals you can think of that would mimic cannabis is a very, very large number. Whatever you do, you can probably tinker with the molecule and find a way around it because they are a very diverse group of compounds.”

The list of drugs prisoners are tested for has not been updated for five years and does not include synthetic agents, but a Ministry of Justice spokesman said it had commissioned scientists to devise a test for new psychoactive substances.

The government has also introduced an amendment to the criminal justice and courts bill to expand prisons’ power to test for non-controlled drugs.

The spokesperson told the Guardian: “Prison staff take the use of any illicit substances in prison extremely seriously and use a range of robust measures to find them, including interrogation, intelligence, searches, specially trained dogs and random drug tests. Anyone caught with them will be dealt with severely and may be referred to the police for prosecution.

“The misuse of new psychoactive substances is an issue affecting many parts of society, including prisons.”

The psychoactive chemicals tend to be imported from pharmaceutical companies abroad, most notably in China, and then blended in the UK.

The terms spice initially referred one brand of synthetic cannabis, but now all forms of the drug. Other names also include K2 and clockwork orange.

Source:   www.theguardian.com  15th  May 2014

Filed under: Drug Specifics,Effects of Drugs,Social Affairs :

Here in California, marijuana is now treated as a minimal vice, with legalization inevitable and decriminalization for possession amounting to a tap on the hand. Medical marijuana cards are so easy to obtain, they’re the butts of endless popular jokes.

On the famed Venice Beach boardwalk, booths tout on-the-spot “evaluations” and customers walk out the door with newly minted photo ID cards in under an hour. High schools across the country celebrate April 20th as “420 Day”, a fact I know because my daughter’s high school, San Rafael High, is nationally famous (or infamous, depending on your perspective) as the birthplace of the term 420. (Coined, supposedly, because 4:20 pm was the time at which kids would meet after school to light up.)

So, as we move towards viewing pot with the same tolerance with which we view alcohol (in other words, it’s bad for your health if you become addicted, but casual use is harmless), let’s look at the evidence. Is it really relatively harmless for young men — and women — to get high?

Pot Smoking May Double Risk of Testicular Cancer

Today’s headline was pretty bold: Smoking pot leads to double the risk of developing testicular cancer. Testicular cancer is on the rise, and experts have been trying for a while to figure out why. Now, after comparing groups of young men who smoked and those who didn’t, there’s a possible answer. Those who smoked pot recreationally were twice as likely to develop testicular germ cell tumors, or nonseminomas, the most common kind in men under 35, says a study in Cancer. Nonseminomas are faster growing and harder to treat – a deadly combination – say researchers at the University of Southern California.

This study, though small, is actually the third study to link nonseminomas to pot use; the first two were also published in Cancer. The first word of the connection came out in 2009 from research out of the Fred Hutchinson Cancer Center in Seattle. The pot use researchers studied was described as “once a week or more”, and it’s important to note that many smokers toke up every day. No studies have contradicted the link, experts point out. It’s important to note that the risk of testicular cancer is relatively low, slightly more than 1 percent, so even when the risk is doubled, it’s still extremely small.

Pot Smoking May Lower IQ

Last week’s headline was at least as alarming as this week’s. Researchers followed a group of youngsters from age 13 to age 38, and found that the IQs of regular pot smokers fell up to 8 points during the 25-year period, compared with the IQs of those who didn’t smoke pot, which stayed the same. The study, published in the Proceedings of the National Academy of Sciences, also found an increase in memory and attention problems among those deemed marijuana-dependent.

Pot Smoking May Trigger Schizophrenia

There should have been headlines, “Marijuana May Make You Psychotic” at least a couple times over the past few years, but somehow the studies documenting this issue haven’t gotten as much attention as you might expect. Maybe it’s because this link is much harder to prove, which it is. That’s because the association could work backward: Those who smoke pot could be self-medicating for symptoms of schizophrenia that hasn’t become full-blown yet.

However, there have been several studies, and they’ve controlled for a backwards causation pretty well. In a  German study  that followed a group of teenagers for ten years, those who smoked pot at least 5 times were more than twice as likely to develop schizophrenia. The biggest and probably best known study followed 45,000 young men in Sweden starting when they enlisted in the military. As I reported in a previous article, synthetic marijuana, also known as “Spice”, has also been linked to psychosis as well as to paranoia and violence.

Fifteen years later, those who smoked pot at least once were more than twice as likely to develop schizophrenia. A third study followed young men whose family genetic history predisposed them to develop schizophrenia. In these kids, who are considered to have a one in ten chance of developing schizophrenia, pot use doubled that risk to one in five.

Pot Smoking Lowers Fertility and Causes Genetic Damage

The health risks of marijuana for women are much less well known, as of yet. But what is known is that pot smoking decreases fertility for both men and women, and appears to have the potential for genetic damage to future children. Though a complex mechanism, cannabinoids — the chemicals in cannabis — affect the production of sperm and the ability of the sperm and egg to join together. The research on pot and testicular cancer has implicated the endocannabinoid system, which is the cellular network that reacts to cannabis, the active ingredient in pot. The endocannabinoid system also plays a central role in sperm production.

There’s also been considerable research on the issue of marijuana use causing genetic mutations that are then passed on to children. Of course most folks under 20 aren’t looking ahead to the health of their future offspring — or to the possibility of not being able to have said offspring — so this health issue is less influential with teens and young adults. But it’s something everyone should be paying more attention to.

Source: www.forbes.com   10.09.2012

Filed under: Drug use-various effects,Drug use-various effects on foetus, babies, children and youth,Effects of Drugs,Health,Marijuana and Medicine :

As stoners prepare for their annual 420 smoking “holiday” on April 20, the broadcast networks have done little to educate users on the risks of their leafy drug of choice in spite of extensive reporting on state legalization of pot.

Network evening news reported the growth and legalization of recreational marijuana in Washington state and Colorado. ABC, CBS and NBC evening news programs spent more than 30 minutes discussing the newly legal drug between Oct. 1, 2013, and March 31, 2014. However, the networks rarely addressed marijuana-related health or safety risks, despite blunt support for such education among pot advocates.

Leading marijuana advocates, such as those at the National Organization for the Reform of Marijuana admit that research into health risks “benefits everybody” and that “impaired drivers [should] be taken off the road.”

Colorado and Washington both legalized recreational marijuana in 2012, and Colorado ushered in commercial pot sales on Jan. 1, 2014. But over six months, including two months leading up to Colorado’s pot sales, and the four months that followed the networks focused heavily on marijuana legalization, devoting 30 minutes and 30 seconds in 23 stories.

However, the networks spent only 54 seconds on health risks, ignoring them 97 percent of the time. Similarly, they took only 1 minute and 20 seconds to address stoned driving, ignoring this issue more than 95 percent of the time.

The networks hyped legalization, while concealing possible risks. On Jan. 1, ABC correspondent Clayton Sandell,  promoted the economic benefits of marijuana legalization on “World News.” He called it the “Colorado green rush.” That same day, NBC’s “Nightly News” correspondent Gabe Gutierrez called it a “historic day” before declaring that “the world is watching.”

Yet, even marijuana activists agree that the public must be educated on the health and public safety risks of widespread pot use. Rachel Gillette, the Colorado executive director of the pot advocates at the National Organization for the Reform of Marijuana Laws (NORML) told the Los Angeles Times that research “benefits everybody” because “any drug… are going to have health risks.”

Mental Health Risks Mentioned in Just 3 Percent of Pot Stories

Marijuana has legitimate health risks and may contribute to mental health problems, but the networks aired only 3 stories mentioning pot-related health risks. Each of these segments briefly mentioned risks and focused on pot’s dangerous effect on teen users. None of these three stories addressed mental health risks for adult users.

Scientific research has connected marijuana use with severe mental illnesses, such as schizophrenia. The British Royal College of Psychiatrists published a leaflet warning that “regular use of the drug has appeared to double the risk of developing a psychotic episode or long-term schizophrenia.”

The non-profit Erowid Center publishes information on a wide variety of drugs and is widely regarded as promoting drug use. Still, Erowid co-founder Earth Erowid wrote that marijuana use “probably worsens symptoms in some of those vulnerable to psychotic disorders.”

Marijuana may also cause anxiety or panic attacks in some users. Harvard University, in a 2010 newsletter, wrote that “about 20% to 30% of recreational users experience [intense anxiety and panic attacks] after smoking marijuana.” Harvard specified that this is especially common among new users.

A small study just published in The Journal of Neuroscience looked into the way marijuana may alter the brain, according to news reports including USA Today.

While such research does not prove that marijuana use alone causes mental illness, it does show that use can trigger or exacerbate pre-existing mental conditions.

Driving High: Networks Rarely Mention Safe Driving Concerns

Pot legalization has also raised widespread concerns over the risks of users driving stoned. The networks only covered these concerns in four brief stories, spending only 1 minute, 20 seconds on the issue. One of these segments discussed law enforcement attempts to crack down on stoned driving and the frequency of the problem for almost a minute. But that story was the exception to network coverage, since none of the other three stories were longer than 15 seconds. Research has indicated that marijuana, while less impairing than alcohol, does negatively affect the user’s ability to drive. In February, NPR reported the National Institute on Drug Abuses’s Marilyn Huestis saying that stoned drivers “have more trouble staying in lanes, they struggle to do multiple tasks at once.”

Pot advocates agree that driving while stoned is a problem. NORML’s Principles of Responsible Cannabis Use contains the assertion that “Public safety demands not only that impaired drivers be taken off the roads, but that objective measures of impairment be developed and used.”

The issue of stoned driving is quite complex and bears discussion. It is difficult to tell if somebody has smoked based on blood or urine samples because, as The New York Times reported marijuana “returns a positive result days or weeks after someone has actually smoked it.”

Source:  http://newsbusters.org/blogs/sean-long/2014/04/17/reefer-madness-only-3-percent-pot-stories-mention-health-risks

 

Filed under: Effects of Drugs,Global Drug Legalisation Efforts,USA :

LAS VEGAS — Metro Police said they have a huge problem on their hands when it comes to people using marijuana and driving. During the last three years, Metro’s forensics lab screened 4,500 blood samples for marijuana with the bulk of those being impaired drivers. In Crystal Hill’s home, there are memories and pictures of her 18-year-old son Jesse. Jesse died January 1 while walking with his girlfriend. The two were near the family’s home when a car slammed into them. Court records show the driver, Christian Diaz, had seven times the legal amount of marijuana in his blood.  “I had to file his first and last tax return yesterday. His brother doesn’t talk about him,” Crystal Hill said. “They’re twenty months apart in age. They were book ends. That was his hero.”     Metro Police said marijuana impairment is a problem, and it’s getting worse. Metro said drug impairment, unlike alcohol impairment, isn’t easy to detect. Department statistics show if police tested each impaired driver involved in a fatal crash today, one in ten would likely test positive for marijuana. “If it continues on this path, in the next five or six years, we could see marijuana and other non-alcoholic drugs overtake our DUI problem with alcohol,” Sgt. Todd Raybuck of Metro’s Traffic Bureau said. “We have a short memory when it comes to these accidents, and, unfortunately, that short memory lasts a lifetime for the victims.” Metro said marijuana is dangerous because it slows down mental reactions and a driver’s judgment of time and distance. Statewide records from 2002 to 2012 show 45 percent of drivers who were impaired by drugs had marijuana in their system. Meanwhile, the remains of Jesse Hill now sit in an urn at his mother’s house. Crystal said time won’t heal her wounds. She says she hopes another family won’t have to go through the pain.  “Prior to this, I was for legalizing it for recreational use. Tax it, we’ll have more jobs. Maybe we won’t have to get bonds for schools, things like that. Now that my son has been killed, I see the other side, “ Hill said.

Source:  http://www.8newsnow.com/story/25269474/metro-marijuana-impairment-rising-among-drivers   Apr 16, 2014

Filed under: Effects of Drugs,Global Drug Legalisation Efforts,USA :

There are consequences of the increased prevalence of marijuana use in society—one of which is undoubtedly drugged driving. According to a new study from Columbia University’s Mailman School of Public Health, fatal car accidents that involved marijuana have tripled in the last decade, which suggests that the issue will likely become worse as more states push for the legalization of marijuana.

“Currently, one of nine drivers involved in fatal crashes would test positive for marijuana,” co-author Dr. Guohua Li, director of the Center for Injury Epidemiology and Prevention at Columbia, told HealthDay News. “If this trend continues, in five or six years non-alcohol drugs will overtake alcohol to become the most common substance involved in deaths related to impaired driving.”

The research team drew its conclusions from crash statistics from six states that routinely perform toxicology tests on drivers involved in fatal car wrecks — California, Hawaii, Illinois, New Hampshire, Rhode Island and West Virginia. The statistics included more than 23,500 drivers who died within one hour of a crash between 1999 and 2010.

Alcohol contributed to about the same percentage of traffic fatalities throughout the decade, about 40 percent, Li said.  But drugs played an increasingly prevalent role in fatal crashes, the researchers found. Drugged driving accounted for more than 28 percent of traffic deaths in 2010, up from more than 16 percent in 1999.

Marijuana proved to be the main drug involved in the increase, contributing to 12 percent of 2010 crashes compared with 4 percent in 1999.

An even deadlier combination is the mixture of alcohol and marijuana. “If a driver is under the influence of alcohol, their risk of a fatal crash is 13 times higher than the risk of the driver who is not under the influence of alcohol,” Li told HealthDaily News. “But if the driver is under the influence of both alcohol and marijuana, their risk increases to 24 times that of a sober person.”

Similar to alcohol, marijuana affects a driver’s judgment, vision, and makes a person more distractible, Deputy Executive Director of the Governors Highway Safety Association Jonathan Adkins explained to HealthDaily.

And groups like Mothers Against Drunk Driving are concerned because drugged driving is completely preventable. “When it comes to drugged driving versus drunk driving, the substances may be different but the consequences are the same—needless deaths and injuries,” Jan Withers, national president of MADD, told HealthDaily.

“The public knows about drunk driving, but I don’t think they have awareness of drugged driving, so this is a huge issue,” Adkins said. “We need to alert the public that if you’ve used any type of substance, you should not get behind the wheel. We need to create that culture where, like drunk driving, it is not acceptable.”

Source:  townhall.com  Feb 9th 2014

Filed under: Cannabis/Marijuana,Drug use-various effects,Drugs and Accidents,Effects of Drugs :

Devout Christian mother-of-three, 31, becomes first woman in Britain to DIE from cannabis poisoning after smoking a joint in bed

Gemma Moss, a 31-year-old churchgoer, of Boscombe, in Bournemouth, Dorset, collapsed in bed after smoking a cannabis cigarette that led her to have moderate to high levels of the class B drug in her system. Tests of her vital organs found nothing wrong with them although it was suggested she might have suffered a cardiac arrest triggered by cannabis toxicity.

Miss Moss’ death was registered as cannabis toxicity and a coroner has recorded a verdict of death by cannabis abuse.  Deaths directly from cannabis are highly unusual. In 2004 a 36-year-old man from Pembrokeshire became the first person in the UK to died from cannabis toxicity.

David Raynes, of the National Drug Prevention Alliance, said: ‘It is extremely rare and unusual for a coroner to rule death from cannabis abuse.  ‘In 40 years I have never come across deaths from cannabis alone. There have been cases where it has been combined with other drugs or alcohol.  ‘It has often been said that cannabis doesn’t cause death. Users usually pass out before they can take enough cannabis to kill them.  ‘This case serves as a warning that cannabis can cause immense harm.   ‘Cannabis is known to increase heart rate and blood pressure. Cannabis these days is designed to be much stronger than cannabis used in the sixties to meet demand of users who want a stronger hit.’

Miss Moss, a devout Christian, had frequently used cannabis during her adult life but had stopped for two years before her death last October. She started using it again to help her sleep after becoming depressed and anxious due to breaking up with her boyfriend.

An inquest heard Miss Moss smoked half a joint a night to help get her to sleep. Her friend, Zara Hill, said she and Miss Moss smoked cannabis worth about £20 together in the week before her death. Miss Hill told police that Miss Moss smoked as much as £60 of the drug a week, although this was disputed by her family. On the night of October 28 last year, Miss Moss, who had two sons, Tyler, 15, and Tessiah, eight, and a daughter, went to bed after rolling a joint. She was found unresponsive in bed the following morning by Chloe Wilkinson, the girlfriend of Miss Moss’ teenage son. She summoned an ambulance to the flat in Boscombe but Miss Moss was pronounced dead at the scene.

Her friend said she and Miss Moss smoked cannabis worth about £20 together in the week before her death.  Half of a joint was found underneath her body and a wrapper containing brown and green leaves of the class B drug was discovered in her handbag. A post-mortem examination revealed that there were no obvious signs of abnormality in Miss Moss’ body.

But Dr Kudair Hussein, a pathologist, told the inquest in Bournemouth, that there were moderate to heavy levels of canabinoids in her blood. He said: ‘The physical examination and the examination of various organs including the heart and the liver showed no abnormality that could account for her death. ‘The level of canabinoids in the blood were 0.1 to 0.15 miligrams per litre, this is considered as moderate to heavy cannabis use. ‘I looked through literature and it’s well known that cannabis is of very low toxicity. ‘But there are reports which say cannabis can be considered as a cause of death because it can induce a cardiac arrest.’

Tests of her vital organs found nothing wrong with them although it was suggested she might have suffered a cardiac arrest triggered by cannabis toxicity

Mr Sheriff Payne, the Bournemouth coroner, asked Dr Hussein: ‘You are satisfied it was the affects of cannabis that caused her death.’  Dr Hussain replied: ‘Yes sir.’

The inquest heard Miss Moss grew up in London but moved to Bournemouth about five years ago. She was said to have changed her lifestyle and found faith since relocating to the south coast. She regularly attended the evangelical Citygate Church in Bournemouth and was baptised there last year. Her mother, Kim Furness, told the inquest her daughter struggled to sleep and had admitted that she had started smoking a ‘small amount’ of cannabis at night. Miss Furness said: ‘For years she smoked it (cannabis) every day. ‘When she moved to Bournemouth she stopped for two years and then had a break up with her relationship and started again+6

‘It was one half of a joint to get to sleep. She never smoked in the day. She was really honest about cannabis because from where we come from its normal to smoke cannabis. ‘She was trying to stop again. She rang me and said “mum, I have just started again, I will stop but I needed half to get to sleep”.’ ‘She said she would go to the doctors to get something to help her sleep to stop her doing it. She wasn’t excessively smoking.’

Detective Inspector Peter Little read a statement from Miss Hill.

She also Miss Moss was stressed about her benefit money being stopped and because her son had been excluded from school. In recording a verdict that Miss Moss died from drug abuse, Mr Payne said: ‘Gemma had been a long term user of cannabis. ‘She suffered from depression and was on prescription drugs to try and deal with that although it would not appear she was taking them at the time of her death. ‘She usually used it (cannabis) in the evenings to try and help her to get to sleep and did not use it in the day time. The post mortem could find no natural cause for her death.

‘With the balance of probability that it is more likely than not that she died from the effects of cannabis.’ Carolyn Stuart, a coroner’s officer, said: ‘It is very rare to have cannabis toxicity as a cause of death. She was a healthy 31-year-old woman who had nothing wrong with her.’ Russell White, a leader at the Citygate Church, said: ‘Gemma was a good mother and brought up her children mainly on her own. ‘She was full of fun and loved life and loved coming to church. She was a committed member of the church and brought her children along.  ‘I think she came from a difficult background but she I think she was clean to a large degree in terms of drugs. ‘She is very much missed and her death was a real shock to us.’

Miss Moss lived with her two sons but it believed her daughter lived with her father in Jamaica. Last October Miss Moss posted on her Facebook page about how excited she was about travelling to the Caribbean to visit her daughter over Christmas. Lucy Dawe, from the anti-cannabis group Cannabis Skunk Sense, said: ‘People who are pro-cannabis will say it won’t kill anybody but unfortunately it does. It is very upsetting because we now have three young people with no mother and the mother probably thought she was doing something perfectly safe.

‘Along with death, cannabis can also cause a lot of other problems like psychosis, chronic depression, strokes, and anxiety.

‘These effects need to be something that are generally well-known. People think because cannabis is a plant it won’t be dangerous but it leads people to a false sense of security.’ But Peter Reynolds, president of CLEAR Cannabis Law Reform, a group that campaigns legalising the class B drug, said he doesn’t believe anyone can die from taking it. He said: ‘It is popularly believed that there has never been a death because of a toxic effect of cannabis on the body. ‘Clearly, it is possible that somebody may have had an accident while intoxicated through cannabis use but that would be an indirect cause. ‘Unlike opiates, alcohol or other drugs, cannabis cannot depress basic life functions to the point of death. ‘Cannabis is probably the least toxic therapeutically active substance known to man. ‘In conclusion, I would say that it is pretty much unbelievable that anyone’s death could be directly attributable to cannabis.’

Source:  MailOnline  30th January 2014

 

NDPA comment:

Despite increasing evidence of the harmfulness of cannabis, and the Coroner and Pathologist agreeing that Gemma Moss died from cannabis toxicity, Peter Reynolds, of the Cannabis Law Reform group,  unsurprisingly, believes he knows better.  Whenever any article is published from reputable sources – often scientists or doctors – about health risks from the use of cannabis there will inevitably follow hundreds of comments from users of the drug denying the scientific findings.

Filed under: Effects of Drugs :

When President Obama says he thinks marijuana is less dangerous than alcohol in terms of its impact on the individual consumer , I think he’s profoundly wrong. When he says smoking pot is no more dangerous than smoking cigarettes, I think he’s wrong about that too. When I see evidence of what seems to be a global trend in favour of decriminalising or legalising cannabis, I think that’s wrong too.

And I’m otherwise pretty liberal about banned drugs. Most problems associated with banned drugs, it seems to me, stem from the fact of their being illegal rather from the fact of their being taken.  To place the supply of selected drugs in the hands of violent criminals seems to me a very bad idea. Yet I feel differently about cannabis. I think governments should be making it harder to acquire, not easier.

Barack Obama and the many other now middle-aged politicians who smoked a bit of dope in their youth and can’t quite see the harm in it,  need to understand the drug has fundamentally changed since they enjoyed their last toke. Genetically re-engineered, cannabis is now a very different product to the one puffed at parties in the Seventies. The days of a mild innocent high are gone – the prospect of grave mental instability has arrived.

A year ago, in order to write a feature for The Times Magazine, I spent three days at a rehab clinic in the Zurich suburb of Küsnacht. The Küsnacht Practice is reportedly, at close on £7,000 a day, the most expensive such clinic in the world. Patients have included Russian oligarchs, Saudi sheikhs, English aristocrats, German bankers and American film stars. Addictions range from alcohol to cocaine to morphine to food to sex, or various combinations of the above. Patients are quartered in luxury flats and must undertake to stay a minimum of four weeks.

Unsurprisingly, given the amount of care and attention 50 grand a week can buy, the success rates at Küsnacht are very high. High yet not, however, total. His most signal failure, Lowell Monkhouse, the practice’s founder told me, was a young man in his twenties now confined to a secure psychiatric hospital, where he will probably have to remain for the rest of his life. He had cannabis psychosis,  Monkhouse said sadly. “We couldn’t help him.”

Cannabis addiction, Monkhouse explained, is the hardest one to break – harder than heroin, harder than booze, harder than a compulsion to order up a couple of hookers and a big bag of coke. He added that cannabis (certain strains of it at least) was also the drug most capable of causing the most profound and least reversible neurological damage. And cannabis could inflict such damage quickly, in the brains of young and otherwise healthy people.

I’d never much liked cannabis, even before I heard what Monkhouse had to say. I’d dabbled in it perhaps a dozen times in my twenties and thirties, each experience less enjoyable than the last. Under its influence, I became, at best silly and sleepy, at worst paranoid, unstable, offensive. Cannabis seemed to me to be far more powerfully mood-altering than the received wisdom claimed. People I knew who smoked a lot of it were not just boring and a bit dozy, many seemed to be seriously mentally impaired. I haven’t touched the stuff for years. Good decision, one later confirmed during my trip to Zurich.

A big mistake is being made. The illegal drug regarded as the least harmful is the one most likely to send people round the bend.

Source: http://www.thetimes.co.uk/tto/life/article3980960.ece  21.01.14

Filed under: Effects of Drugs,Social Affairs,USA :

By William J. Bennett

Editor’s note: William J. Bennett is the author of “The Book of Man: Readings on the Path to Manhood.” He was U.S. secretary of education from 1985 to 1988 and director of the Office of National Drug Control Policy under President George H.W. Bush.

(CNN) — President George H.W. Bush appointed me as the nation’s first director of national drug control policy — or “drug czar” — in 1989. We took on many big fights, the largest of which was the cocaine epidemic spreading from the jungles of Colombia to the streets of the United States. We conducted an all-out assault on drugs through tough enforcement measures and public education. Contrary to “war on drugs” critics, drug use and addiction dropped across the country.

The issue of marijuana legalization was far less prominent than it is today, although even then, some argued that we should experiment with legalization. I told them not on my watch; the cost to society would be too great.

If you don’t want to take my word that it can be harmful, perhaps you’ll take Lady Gaga’s. In a recent interview, the world-famous pop star admitted she was heavily addicted to marijuana. “I have been addicted to it and it’s ultimately related to anxiety coping and it’s a form of self-medication and I was smoking up to 15 or 20 marijuana cigarettes a day with no tobacco,” she said. “I was living on a totally other psychedelic plane, numbing myself completely.”

Lady Gaga said she was speaking out to bust the myth that marijuana is just a harmless plant. “I just want young kids to know that you actually can become addicted to it, and there’s this sentiment that you can’t and that’s actually not true.”

Today a fully functioning experiment in legal marijuana for adults is going on in Colorado and another one is set to begin later this year in Washington. Supreme Court Justice Louis Brandeis once remarked that in our democratic Republic, the states are the laboratories of democracy. We are running a few labs now and shall see what happens.

But, as with any public debate, we need to hear all sides. So far, the advocates of marijuana legalization have dominated the public arena. It’s certainly had an effect. According to a new CNN poll, a majority of Americans support legalizing marijuana. But where are the voices of the wounded? Where is the outrage from the families who have been hurt? We know they are out there. More Americans are admitted to treatment facilities for marijuana use than any other illegal drug.

I’ve talked to parents all over the country who lost children to drug abuse — not to marijuana alone; though in many cases it was a gateway drug or part of their deadly

drug concoction. People have been deeply hurt by drug related accidents or spent thousands of dollars on drug rehabilitation. We need to hear their voices.

During my tenure as drug czar, I traveled to more than 120 communities to see firsthand the impact of illegal drugs. Among those visits was a trip to Boston to take part in drug busts in some of the city’s most broken and dangerous neighborhoods. Not once during that visit did a parent or community leader advocate for legalization or loosening drug restrictions. Rather, they wanted the drugs confiscated and drug dealers locked up. They knew the damage drugs had inflicted on their children and communities.

That same evening Harvard University held a discussion on drugs and law enforcement. There I listened to scores of academics argue for legalizing or decriminalizing drugs.

It’s hardly an exercise in intellectual rigor for those in the middle- and upper-class who live in areas with little crime and violence to be willing to experiment with drug legalization. They live far removed from the realities of the drug trade.

But travel to its core, to the slums and projects run by ruthless drug dealers, and these intellectuals may rethink their position.

It’s a myth that marijuana, because it is not as harmful as cocaine, heroin or some other illegal hard drugs, is safe or safe enough to warrant legalization.Opponents contest that marijuana hasn’t ravaged communities or that the drug itself isn’t to blame.

But that’s not true. It’s ravaged the community of the young.

Marijuana is the most widely used drug in the country, especially among young people. According to the 2012 National Survey on Drug Use and Health, “of the 7.3 million persons aged 12 or older classified with illicit drug dependence or abuse in 2012, 4.3 million persons had marijuana dependence or abuse,” making marijuana the drug with the largest number of people with dependence or abuse.

The medical community has warned about the danger. A recent Northwestern University study found that marijuana users have abnormal brain structure and poor memory and that chronic marijuana abuse may lead to brain changes resembling schizophrenia. The study also reported that the younger the person starts using marijuana, the worse the effects become.

In its own report arguing against marijuana legalization, the American Medical Association said: “Heavy cannabis use in adolescence causes persistent impairments in neurocognitive performance and IQ, and use is associated with increased rates of anxiety, mood and psychotic thought disorders.”

The country can ill-afford a costly experiment with drugs. While we are undergoing a national debate over improving health care costs and education performance, legalizing marijuana will undercut those vital missions.

We will wait and see what Colorado’s and Washington’s experiments hold, but I expect that after several years, we will see marijuana use rise dramatically, even among adolescents. The states will come to regret their decisions.

As the late, great political scientist James Q. Wilson remarked, “The central problem with legalizing drugs is that it will increase drug consumption” — and all its inherent harm.

Source: http://www.cnn.com/2014/01/16/opinion/bennett-keep-pot-illegal/index.html?iid=article_sidebar     January  2014

Filed under: Effects of Drugs,Social Affairs,USA :

Andrew Jennings killed himself aged 25, after years of mental illness. His mother, Maggie believes his paranoid schizophrenia was triggered by cannabis use. She told Katy Edwards the poignant and disturbing story.   Andrew John Jennings died in April this year, clutching a photograph of his childhood cat, Mr. Wigs , in a fume-filled car down a quiet Suffolk lane. He was 25 years old.

At his funeral in St Peters Church, Charsfield, his mother Maggie and sister Belinda, 27, spoke of his long battle against paranoid schizophrenia, the terrible illness that dominated his whole life and had made him a prisoner in his own body.   Belinda, who works as a senior laboratory technician for Greene King, had said: “None of us can understand how tough it was for him, every hour of every day. In the end he realized this was no life for him.  “Andrew is at peace for the first time. Deep down I know this was the best and only option for him.”

By the end, Andrew was plagued with up to five “characters” – voices and faces, who would torment him constantly — mocking him and goading him ceaselessly.   His mother, a former producer on BBC Radio Suffolk’s John Eley programme, who now runs a B&B in Debach, believes he took his own life, knowing there could be no other escape from the illness.

She described the moment when Andrew left her and her partner Brian, for the very last time, just minutes before he committed suicide.   She said: “He told me that if it did have to happen that I should know there was no other way and that I was not to blame myself in any way. He said at no time in my life could I have done anything different — that this was in him and there was nothing that could have changed it.”

Maggie is certain, however, that had her son not used cannabis for much of his adult life, he might still be alive today.    She said: “I accept that had he not been so heavily into cannabis he could still have been very sensitive and troubled. He might even have needed a bit of help but he wouldn’t have had this dreadful, dreadful thing.”     She referred to recent research carried out by the Institute of Psychiatry, in London, which revealed a strong link between cannabis consumption and schizophrenia.

Professor Robin Murray, who led the study, published in the British Medical Journal earlier this month, has warned that the research should not be ignored. He cited many examples of cases, where, as with Andrew Jennings, bright young boys have suddenly begun to fail at school, displaying bizarre behaviour, before going off the rails altogether, ending up in a psychiatric unit.   Maggie first began to have concerns about Andrew when, aged 14 and a pupil at Ipswich School, he fell in with a group of cannabis users.

He became less communicative and was getting into trouble at school, which Maggie found very strange, given that he had won an award for the most promising student the previous year.   He had also begun to behave strangely.   On one occasion, he went missing for a whole week, having hidden away in a friend’s barn near Woodbridge. Another incident saw him set fire to the kitchen floor.  He was asked to leave Ipswich School, aged 15, owing to his disruptive behaviour and spent one year at Farlingaye High School in Woodbridge.

“He was a lovely, lovely child but he was beginning to change into someone I didn’t know,” Maggie said. “I am sure it was the drugs.”   She took him to the family doctor, who told her she did not need to worry, adding that “boys will be boys”.  Maggie also insisted that Andrew saw a drugs counsellor, but came away feeling she had been dismissed as an over-anxious mother.

Andrew did very poorly in his GCSE examinations and tried a few college courses, but could not settle. It was when he was working as a forklift truck driver in Felixstowe and living in his own flat that, Maggie believes, real paranoia took hold.   “He would come back with very strange stories about his work mates,” she said.  “He thought everyone was looking at him and calling him   names.”

Andrew was becoming a loner and had begun to drink heavily. He went through a string of part time jobs. He would complain to his mother that the man living above his flat made too much noise and would call him names.  “You could never tell what was real and what wasn’t,” Maggie said.  “He took no pride in anything. He would dress in black and curl up in his dirty flat.”   Even the habitual Friday night curries with his mother and sister were becoming very strained.   “It was obviously awkward for him to come,” Maggie   added.

When Andrew was in his early 20s, he tried to kill himself by slashing his wrists in the bath.

For some reason – Maggie believes he was frightened – he got out of the bath and went outside where he held up a car with a knife, intending to hi-jack the vehicle and drive it off a cliff.   The police intervened before Andrew had left the scene.

It was after seeing a community psychiatric nurse that he was finally diagnosed as a paranoid schizophrenic and admitted to St Clements Hospital in Ipswich. “Even then, the real Andrew was still there, somewhere,” Maggie said.   “He was such a lovely person. He checked with the man whose car he took that he had insurance as he didn’t want to see him out of pocket.”   Sadly, Andrew’s medication never fully controlled his illness. He would drink alcohol, interrupting the efficacy of the drugs and, his mother believes, was still smoking cannabis regularly.   On his release from St Clements, Maggie tried to care for him at home but as the voices in his head began to take over, she became increasingly frightened.   A case in the media of a schizophrenic son having killed his mother because she refused to “back off”, eventually prompted Maggie to seek help.

“I had become terrified of him. I was going to bed with the car keys under my pillow so I could make a quick getaway,” she said.   Maggie was advised to take a back seat and allow carers at East Suffolk Mind to look after Andrew at The Moorings, in Ipswich.  Andrew had his own flat, which he loved, a television and a music system. He got on very well with his carers and enjoyed good food — smoked salmon, olives and feta cheese were his favourites. He was also a talented artist, although his illness would never allow him to concentrate for any period of time.

Maggie keeps a sketch of her niece, which Andrew completed just months before he died and also one of his beloved cat, Mr. Wigs.   She described how the voices would change Andrew’s face — from a smiling, “rubbery” texture, to a pinched, tortured face. She could always tell when he was having a particularly bad episode.

Andrew had told Maggie to watch the film A Beautiful Mind, which shows actor Russell Crowe’s character slump into the depths of mental illness, surrounded by the imaginary characters which dog his every waking moment. “Andrew said that was what life was like for him,” she added.   On one occasion, in February of this year, Maggie remembers Andrew asking her to cook him a Moussaka, which they enjoyed together, sitting on her patio in Debach.   She said: “Afterwards he took my hand and he said ‘It’s OK mum, I’m going to be around for a little while yet but I don’t think I can live like this for much longer.

“I cried and tried to talk him through it. I said that a miracle could always happen — there could be some new drug. He said he had nothing to look forward to. I was running out of things to suggest.”   At Maggie’s suggestion, Andrew bought himself a bicycle and set about planning a marathon journey to Wales.   “The planning was keeping him going,” Maggie said.

In the event, he only got as far as Debenham, realising there could be no real refuge from the voices.    Eventually, Maggie believes, he decided he could go on no longer.

He visited his mother’s house at around 11pm on April 24 this year to borrow a hosepipe, telling his mother he had hit an animal and wanted to clean blood from his car.  She was half-asleep and confused — she had come to suspect strange behaviour from her son. On leaving the house, Andrew had tapped Maggie’s partner Brian on the arm and asked him to take good care of Maggie.  It was only after Andrew had left that Maggie realised what he had meant. She and Brian sped after him in their car but were not able to catch him. They found his flat empty and feared the worst.

Andrew’s body was discovered, near Maggie’s home, down a quiet country lane. It was the only reprieve he could find from the horrifying illness that had made his life a living nightmare.   As far as Maggie is aware, her son never took any drug stronger than cannabis, apart from one experiment with ecstasy, which he had vowed never to try again.

“We’ve got to stop youngsters dying needlessly from cannabis,” she said.  “I hope Andrew’s example will make people think again.”

Mary Canon, a senior lecturer at the Institute of Psychiatry in London, with a specialist interest in the link between adolescent cannabis use and schizophrenia, said: “Cannabis definitely worsens the symptoms of schizophrenia, if it already exists. The prognosis is much worse if patients are heavy cannabis smokers. There is very little doubt about that.”

She added that cannabis could also be a trigger in those people who may have be susceptible to the illness.  Tina Graves, housing services manager for East Suffolk Mind, which cared for Andrew during the last few years of his life, said: “There is some evidence to suggest a link between cannabis use and schizophrenia but it has not been proven one way or the other. Everyone here was very distressed about what happened to Andrew and we have every sympathy with his family.”

Source: East Anglian Daily Times (UK) 2003

Filed under: Effects of Drugs,Parents :

The Knesset is moving to regulate the drug, though it might be a hazard without scrupulous supervision, the Pharmacists’ Association warns.

In the wake of new regulations concerning the use of medical cannabis, the Israel Pharmacists’ Association this week published a professional survey on the subject. The report discusses the side effects of cannabis, and the interactions between it and other medications.

The association is publishing this information in the midst of a process whereby the use of cannabis is being regulated, which is expected to be completed in the coming months. The new rules stipulate an increase in the number of doctors authorized to prescribe the drug to patients ranging in age from 20 to 30, and also relate to the composition of medical marijuana and the way it is locally grown, packed and distributed; eventually pharmacies will be responsible for the latter stage.

The purpose of the report, according to the association, is to provide various professional bodies with concise and up-to-date information that will help them to examine the benefits versus the possible damage involved in the use of medical cannabis.

“The effects of cannabis differ from one person to the next,” says the document, “and depend on the dosage, the method of delivery, the past experience of the user with the medication, the patients’ surroundings (his expectations of treatment, his attitude toward the effects of the substance, his mood and the social environment), and the amount of use.”

The effects of cannabis, the report continues, can be euphoria or dysphoria, calm, anxiety or even psychosis. Additional phenomena include heightened wakefulness followed by drowsiness, a sharpening of the senses followed by slower comprehension, and increased motor activity followed by problems of coordination. “Many of these side effects of cannabis stems from a high dosage or chronic use,” writes the pharmacists’ association.

In bold letters they state that patients suffering from schizophrenia and bipolar disorders should refrain from using medical cannabis. As for older patients who suffer from cardiovascular diseases, use of the drug can lead to increased risks of blood pressure fluctuations, heart attacks, ongoing cardiac distress and even sudden cardiac death, as well as such problems as strokes, damage to peripheral blood vessels, limping and even gangrene in the fingers.

The report also states that older people who suffer from impaired neuro-cognitive functioning and use cannabis could suffer further decline in memory and concentration, and a tendency to fall. The pharmacists also cite potential negative effects among persons with pulmonary disease, mainly when the cannabis is smoked, and write: “Long-term use of cannabis through aspiration increases the risk of inflammation of the jaw and the tonsils, asthma, bronchitis, pneumonia and lung cancer.”

The report also warns that the process of growing cannabis at present is not monitored as carefully as development of other medical preparations. The cannabis is liable to contain pollutants such as bacteria, fungi and molds, heavy metals and so on; in addition, the concentration of its active ingredients is not fixed.  Source: http://www.haaretz.com/mobile/.premium-1.568591?v=36D3EAC732D590E09348654B6B03414B   14th January 2014

Filed under: Effects of Drugs,Others (International News) :

January 1, 2014, should be remembered as the day that legalized the doping of the American mind. But it’s hard to tell how many Colorado residents, where “recreational” use of marijuana becomes legal at the stroke of midnight, will be able to remember the day because their “memory-related structure will shrivel and collapse.”

Memory loss is but one effect caused by frequent marijuana use, as proven by researchers at Northwestern University. The study also found “evidence of brain alterations … significant deterioration in the thalamus, a key structure for learning, memory and communications between brain regions.”  If this were not enough, the study concluded, “chronic marijuana use could boost the underlying process driving schizophrenia.

This study is the latest to document scientifically the devastating long term harm caused by marijuana use. According to the National Institute on Drug Abuse (NIDA), “marijuana smoke contains 50% to 70% more carcinogenic hydrocarbons than does tobacco smoke … which further increases the lungs’ exposure to carcinogenic smoke.” Moreover, “marijuana users have a 4.8-fold increase in the risk of heart attack in the first hour after smoking the drug. … This risk may be greater in aging populations or those with cardiac vulnerabilities.”

In addition, marijuana use (whether obtained legally or not) causes “distorted perceptions, impaired coordination, difficulty in thinking and problem solving, and problems with learning and memory,” lasting weeks after the initial use. “As a result, someone who smokes marijuana every day may be functioning at a suboptimal intellectual level all of the time.” In conclusion: “Research clearly demonstrates that marijuana has the potential to cause problems in daily life or make a person’s existing problems worse. In fact, heavy marijuana users generally report lower life satisfaction, poorer mental and physical health, relationship problems, and less academic and career success compared to their peers who came from similar backgrounds. For example, marijuana use is associated with a higher likelihood of dropping out from school. Several studies also associate workers’ marijuana smoking with increased absences, tardiness, accidents, workers’ compensation claims, and job turnover.”

The impresario who staged the unfolding scenario of how best to dope the American mind is George Soros.

His first foray into U.S. domestic politics began in earnest in 1993, after he allegedly made $1-$3 billion “raiding the Bank of England.” Soros launched his drug-legalization crusade declaring, “The war on drugs is doing more harm to our society than drug abuse itself;” and he proceeded with “checkbook advocacy” through his Open Society Institute (OSI). He started by giving some $15 million to establish and fund several pro-drug-legalization organizations. Since then, Soros, whose motto is, “If I spend enough, I make it right,” has been funding campaigns for drug legalization and “medical marijuana,” which is described as a “compassionate drug.”

On February 7, 1996, I opined in The Wall Street Journal that Soros’s “sponsorship unified the movement to legalize drugs and gave it the respectability and credibility it lacked.” I suggested that unchallenged, Soros would change the political landscape of America. It took 20 years and lots of his money to achieve what he set out to get. For him, legalizing marijuana was a necessary stepping-stone to advancing drug policies in the U.S. and elsewhere toward legalizing the use of all drugs.

Pretending to support an “open society,” Soros has been working diligently to advance the greatest slavery ever–drug addiction.

Making money is but one of the many possible speculations on Soros’s motivation to legalize drugs. If asked, he’ll respond with gibberish that makes no sense.  However, the revenues from the illegal drug trade are enormous. There are no other commodities on the market that yield such high and fast a return. In 2014, legally listed marijuana producing and distributing companies will generate huge revenues. Soros seems to believe that state-controlled drug distribution will best serve to increase dependency on the state, while controlling the doping. Indeed, moving in that direction, Soros’s emissaries “made history” on December 10, 2013, making Uruguay “the first country in the world to establish a legal, government-controlled marijuana market.”

It has to be emphasized here that legalizing marijuana as a “medicinal” and “recreational” drug in various U.S. states effectively renders the federal law that criminalizes it null and void.

An August 29, 2013, a Department of Justice memo clarified the government’s prosecutorial priorities and stated that the federal government would rely on state and local law enforcement to “address marijuana activity through enforcement of their own narcotics laws.”

A good example of how this works is the TSA announcement that beginning January 1, 2014, there will be no drug-smelling dogs in Colorado airports, even though these dogs are usually trained to smell also heroine, ecstasy, cocaine, peyote, crystal meth, and more. Was this statement anything other than an open invitation to carry/transport these drugs also?

Given all of the above, it seems that the Obama administration’s efforts to hook Americans on the opiates of social welfare (food stamps, government health care, a greater share of the wealth through minimum wage increases, public housing, free cell phones, and other services) is now extending to allowing the use of and facilitating addiction to mind-altering drugs. Marijuana today, opiates, and the rest, tomorrow.

What better way to assure a large number of dependent, ready-to-oblige voters? Unlike drug-free citizens who maintain their potential to think independently and even protest to demand this or that, the large numbers of new drug addicts with compromised brain functions will be ready to do anything to get their next drug supply.

This is real, and this will be coming soon to your neigborhood.

New Year’s 2014 should be remembered as the year in which the Obama administration moved one step closer to obscuring the memory of many unhappy duped Americans by making dope so easy to obtain and use.

 

Give him drugs and give him candy

Anything to make him think he’s happy

And he won’t ever come for us

And he won’t ever come.

– Tracy Chapman –  A pop singer.

Source: www.americancenterfordemocracy.com  January2014

Filed under: Effects of Drugs,Global Drug Legalisation Efforts,USA :

A highly concentrated form of marijuana challenges the drug’s benign reputation.

The organizers of this summer’s Hempfest in Seattle had to ban something that you might not expect to be a common item at a marijuana-themed festival: blowtorches. And despite that effort, people still showed up with them. Blowtorches are used for dabbing, which is a newish way of getting high that’s becoming increasingly popular, especially in states with some degree of marijuana legalization. It has some parents and doctors concerned, and it puts advocates of legal marijuana in a rather uncomfortable position. That’s because it gets you really high really fast, and sometimes people doing it blow up their houses.

If you’re not from Colorado, Washington, California, or Oregon, odds are you’re not familiar with dabbing. That’s because it’s most popular in the states with the loosest marijuana laws. Producing dabs — the technical term is “butane hash oil” — is a fairly complex process. The short version is that you extract resins from marijuana with liquid butane, then evaporate the butane to leave behind a highly concentrated form of THC. The residue usually weighs 10 to 20 percent of what the original marijuana did.  You consume the resultant product, called dabs or BHO, by using a blowtorch and what’s called an oil rig to heat the concentrate until it smokes. Then you breathe the smoke in and get extremely high.

“Isaac,” a black-market dealer based in a Denver suburb, tells NATIONAL REVIEW ONLINE that people should use extreme caution when first dabbing: “Most people I know who try it for the first time don’t say much for about an hour and a half, two hours,” he says. “They just sit there — ‘Oh sh*t.’”   He adds that he’s seen people throw up and pass out when trying it, and that dabbing once is like smoking an entire eighth (1/8 ounce, or 3.5 grams) of marijuana. In general, he’s not a huge fan of the process. “It’s less of a social thing,” he says. “It’s like you’re chewing on coca leaves or you’re doing cocaine. It’s kind of the same. You’re smoking a joint and you’re passing it around to your friends and having a good time, or you’re sitting in the corner with a torch.”

But from the perspective of those in the cannabis industry, the increasing popularity of dabbing is good news. If you’re in the black market, it’s a boon because BHO is much more compact, and thus easier to transport, than marijuana flowers (the usual form in which the drug is consumed). Isaac says he can mail the BHO derived from a quarter pound of marijuana — worth up to $1,500 — for about five bucks. Flowers are much

more fragrant and take up more space, which makes them a lot more likely than concentrate to be noticed by postal workers. And if you get pulled over with ten grams or so in your car, Isaac says, you can just eat it without getting especially high. Problem solved!

Dabbing is also making a splash in the legal marijuana industry. Kayvan Khalatbari, who works as a consultant for marijuana businesses and owns a dispensary in Denver, tells NATIONAL REVIEW ONLINE that concentrates are becoming a much bigger part of his market share than they were a few years ago: “It’s definitely a huge part of where this industry’s headed.”

And it’s lucrative. Producing the concentrates isn’t very expensive, and as demand has gone up, so have prices. Khalatbari says concentrates were selling for $5 to $15 a gram wholesale six months ago but now go for about $30. Retail prices of concentrates have gotten as high as $90 in the state. And naturally, it’s even pricier in places like Atlanta that are far outside the perimeter of states with lax marijuana laws. So a mail-order dabbing business can be very profitable. Isaac thinks that in ten years, half the marijuana consumed in this country will be through dabbing.

From a PR perspective, though, dabbing isn’t great for advocates of looser cannabis laws. For starters, some of the implements you can use to dab look a lot like crack pipes. There’s also the risk that you’ll inhale butane, which isn’t fantastic for your lungs. On top of that, there can be flashy accidents when the steps involved in producing and consuming dabs aren’t followed properly (houses blow up, people get third-degree burns all over their bodies, etc.).. An organization called notMYkid has issued a “Parent Alert” on the subject, and news stories detailing doctors’ concerns are starting to crop up.

Source:  WWW.NATIONALREVIEW.COM         DECEMBER 6, 2013 4:20 PM 

Filed under: Cannabis/Marijuana,Drug Specifics,Effects of Drugs,USA :

Hospital emergency department visits related to the dangerous hallucinogenic drug Ecstasy, sometimes known as “Molly,” increased 128 percent between 2005 and 2011 (from 4,460 visits in 2005 to 10,176 visits in 2011) for visits among patients younger than 21 years old, according to a new report from the Substance Abuse and Mental Health Services Administration (SAMHSA).  Overall in 2011, there were approximately 1.25 million emergency department visits related to the use of illicit drugs.  Ecstasy (3,4-methylenedioxy-methamphetamine) has both stimulant and hallucinogenic properties, and produces feelings of increased energy and euphoria among users. Abuse of Ecstasy can produce a variety of undesirable health effects such as anxiety and confusion, which can last one week or longer after using the drug. Other serious health risks associated with the use of Ecstasy include becoming dangerously overheated, high blood pressure, and kidney and heart failure.  Recently there have been several deaths associated with Molly, a variant of Ecstasy, among young people taking it at concerts and raves.  Another key finding shows that a substantial proportion of hospital emergency departments visits associated with Ecstasy during the six year period also involved underage drinking. In each year from 2005 to 2011, an average of 33 percent of emergency department visits among those younger than age 21 involved Ecstasy and involved alcohol. This unsafe combination causes a longer-lasting euphoria than Ecstasy or alcohol use alone and may increase the risk for potential abuse.  “These findings raise concerns about the increase in popularity of this potentially harmful drug, especially in young people,” said Dr. Peter Delany, Director of SAMHSA’s Center for Behavioral Health Statistics and Quality. “Ecstasy is a street drug that can include other substances that can render it even more potentially harmful. We need to increase awareness about this drug’s dangers and take other measures to help prevent its use.”  The report, titled Ecstasy-Related Emergency Department Visits by Young People Increased between 2005 and 2011; Alcohol Involvement Remains a Concern, is based on 2005 to 2011 findings from the Drug Abuse Warning Network (DAWN). DAWN is a public health surveillance system that monitors drug-related hospital emergency department visits and drug-related deaths to track the impact of drug use, misuse and abuse in the United States. The complete survey findings are available on the SAMHSA website at: http://www.samhsa.gov/data/spotlight/spot127-youth-ecstasy-2013.pdf.

Source:  www.cadca.org  5.12.13

Filed under: Drug Specifics,Effects of Drugs,USA,Youth :

The number of people suspected of being sickened by synthetic marijuana in Colorado has risen to 150, NPR reports. Last week, the Colorado Department of Public Health and the Centers for Disease Control (CDC) said they were investigating three deaths and 75 hospitalizations potentially caused by the drug.

Synthetic marijuana, commonly known as K2 or Spice, is a mixture of herbs, spices or shredded plant material that is typically sprayed with a synthetic compound chemically similar to THC, the psychoactive ingredient in marijuana. K2 is typically sold in small, silvery plastic bags of dried leaves and marketed as incense that can be smoked.

Short-term effects of using synthetic marijuana include loss of control, lack of pain response, increased agitation, pale skin, seizures, vomiting, profuse sweating, uncontrolled/spastic body movements, elevated blood pressure, heart rate and palpitations.

According to Colorado’s Acting Chief Medical Officer, Dr. Tista Ghosh, hospital emergency rooms across the state are reporting people coming in with agitation, delirium and confusion, as well as unresponsiveness, extreme sleepiness and seizures. About one-fifth of the hospitalized patients appear to be teenagers, the article notes. “We’re not exactly sure what molecule or chemical we’re looking for,” Dr. Ghosh said. “It’s pretty rare to be able to do this kind of testing. There’s not that many labs in the country that can do this.” Last year, the CDC found Spice caused kidney failure in three young people, and vomiting and back pain in a dozen others in Wyoming. “In [the Wyoming] investigation, they did find a novel compound that was being put into the synthetic marijuana,” Dr. Ghosh said. “That makes this kind of investigation more challenging, because they are constantly changing the chemical compositions that are in synthetic marijuana.”

Source:  http://www.drugfree.org/join-together/prescription-drugs   Sept 20th 2013

Filed under: Drug Specifics,Effects of Drugs,USA :

A west Cumbrian drugs charity has issued a warning over a deadly ecstasy-type drug. People taking PMA are risking their lives, the Rising Sun Trust says, as it can be stronger than ecstasy.  The warning comes as the government agency responsible for drug prevention said it was concerned with an apparent rise in the number of ecstasy-related deaths.

It is feared some tablets being sold as ecstasy actually contain PMA which can be stronger than MDMA (ecstasy).  Mark Dixon, 16, of Penrith, died last year after taking a cocktail of substances that included PMA pills.  The charity claims effects of PMA also take longer than MDMA to begin to be felt – so some users have overdosed by mistakenly taking pill after pill thinking nothing is happening.

Emma Pooley, of the Trust, said: “This seems to be right up there with the more dangerous drugs. This is not a case of scare mongering. It’s not a case of a bad batch. It’s the drug itself that is causing the problems. People take it thinking it’s ecstasy but it takes longer to get into your system. It could take up to an hour. People think the pills aren’t working and will take another lot and overdose.

“There are some really nasty side effects and the main one is over-heating which causes seizures.”

 

Source: www.newsandstar.co.uk  20th Aug.2013

Filed under: Effects of Drugs :

A report by the B.C. Centre for Excellence in HIV/AIDS on harm reduction programs and Insite released last month is not science; it’s public relations.  Authors Drs. Julio Montaner, Thomas Kerr and Evan Wood have produced nearly two dozen papers on the use of Insite. They boast of good results in connecting addicts to treatment but convincing evidence is lacking.

The current campaign reports significant reductions in drug overdoses, yet the Government of British Columbia Selected Vital Statistics and Health Status Indicators show that the number of deaths from drug overdose in Vancouver’s Downtown Eastside has increased each year (with one exception) since the site opened in 2003. In addition, the federal government’s Advisory Committee on Drug Injection Sites report only five per cent of drug addicts use the injection site, three per cent were referred for treatment and there was no indication the crime rate has decreased, as well as no indication of a decrease in AIDS and hepatitis C since the injection site was opened.

Claims of success for Insite made in The Lancet, the British medical journal, in 2011 were challenged in a 15-page, heavily-documented response penned by addictions specialists from Australia, the U.S. and Canada, and by a former VPD officer who worked the DTES for years.

In A Critical Evaluation of the Effects of Safe Injection Facilities for The Institute on Global Drug Policy, Dr. Garth Davies, SFU associate professor wrote: “The methodological and analytic approaches used in these studies are compromised by an array of deficiencies, including a lack of baseline data, insufficient conceptual and operational clarity, inadequate evaluation criteria, absent statistical controls, dearth of longitudinal designs, and inattention to intrasite variation. None of the impacts attributed to SIFs can be unambiguously verified.”

The doctors evaluating Insite are the same people who created Insite and who have been awarded more than $18 million of taxpayers’ money for their initiatives in recent years. Dr. Colin Mangham, on our Board of Directors, has been a researcher in this field since 1979.

“The proposal for Insite was written by the same people who are evaluating it – a clear conflict of interest. Any serious evaluation must be independent. All external critiques or reviews of the Insite evaluations, there are four of them – found profound overstatements and evidence of interpretation bias. All of the evidence – on public disorder, overdose deaths, entry into treatment, containment of serum borne viruses, and so on – is weak or non-existent and certainly does not support the claims of success. There is every appearance of the setting of an agenda before Insite ever started, then a pursuit of that agenda, bending or overstating results wherever necessary.”

Our President, Chuck Doucette, asks to see an independent and unbiased cost/benefit analysis.

“The four pillar approach only works when each pillar is properly funded. Prevention reduces the flow of people into addiction. Treatment reduces the number of addicts including those living in the DTES. Policing keeps a lid on the open drug dealing and the

affects of the associated problems on the community. Only after these three pillars are properly funded can we afford to spend money on Harm Reduction initiatives that do not encourage abstinence. Putting HR first is like running up debt on your credit card and never paying more than your minimum payments.”

No one would object to free needles, crack pipe kits, methadone, heroin and places to shoot up if only they were the side show and not the main event, if only they ever led to real health.  Harm reduction and Insite are palliative. They both spring from a deeply cynical and arrogant world view: You are an addict and you are hopeless. We will keep you “comfortable” while you continue to die.

This is a curious position considering the millions of men and women who admit they are addicts and choose every day not to pick up their poison. I know many such clean and sober citizens.  We owe one another a chance at dignity. To offer less is not only costly, it is monstrous.

David Berner is the executive director of the Drug Prevention Network of Canada.

Source:  Vancouver Sun July 19, 2013 

Filed under: Australia,Canada,Effects of Drugs,USA :

People who take “Molly,” the powder or crystal form of MDMA, the chemical used in Ecstasy, don’t know what they are actually ingesting, experts say. They warn many powders sold as Molly do not contain any MDMA.

“Anyone can call something Molly to try to make it sound less harmful,” Rusty Payne, an agent at the Drug Enforcement Administration’s (DEA) national office, told The New York Times. “But it can be anything.” The DEA considers MDMA to be a Schedule I controlled substance, which means it has a high potential for abuse, and no accepted use in medical treatment.

Dr. John Halpern, a psychiatrist at Harvard who has conducted several MDMA studies, said some powders sold as Molly are synthetic versions that are designed to imitate the drug’s effects. The drug is now thought to be as adulterated as Ecstasy once was, he noted, adding, “You’re fooling yourself if you think it’s somehow safer because it’s sold in powdered form.” Molly has been a popular drug at music festivals. It has also been popularized by rappers. The drug costs between $20 and $50 a dose.

Dr. Robert Glatter, an emergency room physician at Lenox Hill Hospital in New York, says he now sees about four patients a month who come in with common side effects of Molly, including teeth grinding, dehydration, anxiety, insomnia, loss of appetite and

fever. More serious side effects can include uncontrollable seizures, high blood pressure, elevated body temperature and depression, the article notes.

“Typically in the past we’d see rave kids, but now we’re seeing more people into their 30s and 40s experimenting with it,” he told the newspaper. “MDMA use has increased dramatically. It’s really a global phenomenon now.” According to the national Drug Abuse Warning Network, MDMA-related emergency department visits increased from 10,227 in 2004 to 22,498 in 2011.

Source:  By Join Together Staff | www.drugfree.org    June 24, 2013

Filed under: Drug Specifics,Effects of Drugs :

Within the United Kingdom, data from England and Wales show that drug misuse was responsible for 10 percent of deaths from all causes for those aged 20-39 in 2011.

Heroin and morphine accounted for most of the deaths, but between 2010 and 2011 the number of deaths associated with these two drugs declined by 25 per cent, from 791 to 596. This decline might have been associated with the heroin “drought” experienced in the United Kingdom starting in 2010. However, over the same time period, the number of deaths related to the use of methadone, reportedly mixed with benzodiazepines and/or alcohol, increased by 37 per cent, from 355 to 486.

A similar situation was observed in Scotland, where there was a 19 per cent decline in the number of deaths involving heroin and morphine, from 254 in 2010 to 206 in 2011, with a simultaneous 58 per cent increase in the number of deaths associated with methadone, from 174 in 2010 to 275 deaths in 2011.

Across the United Kingdom, the involvement of multiple substances implicated in drug-related deaths, notably the use of opiates/opioid analgesics, benzodiazepines and alcohol, has been noted, highlighting the increased risk associated with polydrug use.

Source:  World Drug Report 2013  www.unodc.org  June 2013

Filed under: Effects of Drugs :

Written by Sheila Polk and Carolyn Short

Marijuana brings dangerous consequences.

If you weren’t afraid to share the road before, a recent survey result should send chills up your spine: most teenagers who drive under the influence of marijuana said the drug either improves their performance behind the wheel or is no hindrance at all.

The survey, by insurer Liberty Mutual Holding Co. and Students against Destructive Decisions, reveals that teens aren’t just saying that – they believe it, and they’re driving while stoned.

Ironically, a leading cause of death for teens is the car crash; and marijuana use, even in small amounts, significantly increases that risk.

Who – or what – is responsible for this incredible ignorance? In perhaps another chilling development, we are seeing the social norming of pot through the medical marijuana movement: “It can’t be harmful; it’s medicine!” Call something medicine and its perceived risks decline while its acceptance spreads.

Political rhetoric on the legalization of marijuana is highly charged. Meanwhile, nobody is hearing the truth: Marijuana is harmful for both the user and society.

Marijuana contains more than 400 chemicals. The primary psychoactive chemical is delta-9-tetrahydrocannabinol (THC) and is the component of marijuana principally responsible for the “high” experienced by pot smokers. Along with the high, users exhibit slower reflexes and decreased coordination. Marijuana also impairs judgment.

Slower reaction times, impaired judgment, and problems responding to signals and sounds equal dangerous drivers. No wonder those who drive within three hours of smoking marijuana are twice as likely to be involved in a major car crash.

The THC content of marijuana varies widely depending on the strain of plant, how grown, and the part of the plant that is used. The pot of the 60’s had an average THC content of .5 to 3%. Today’s pot is much more potent. As the THC content increases, so do the potential adverse effects.

This is one of several reasons why the FDA and medical associations say smoked marijuana isn’t “medicine.” It can’t be delivered in discreet, consistent and measurable doses. It also has a high potential for dependence and abuse.

Smoked marijuana use is also associated with respiratory ailments, mental illness, impaired cognitive and immune functioning, and poor academic performance. Recent studies show teen pot smokers do worse in school, can have lower IQs as adults and are more likely to develop serious mental health issues.

Pot use harms society as well. Increased costs of substance abuse treatment, health care, high school and college drop-outs, and decreased productivity typically are borne by the public.

It should come as no surprise that the idea for “medical” marijuana came from the pot lobby, not from medical doctors. Medical doctors already have access to prescription Marinol which accesses the effective aspects of THC in a controlled dose and has

withstood the rigorous approval process by the FDA. Pot is big business, promoted by a well-funded, well organized and politically influential pot lobby.

Meanwhile, our teens have heard adults declare via the ballot box that marijuana is medicine and so they conclude that its use is not risky. And now we learn that most teens who drive stoned actually think they are safe.

How dangerous. How frightening. How sad.

Source:http://www.prescottenews.com/index.php/news/current-news/item/21636-marijuana-is-not-harmless

Filed under: Effects of Drugs,Parents :

An official at an Everett drug treatment center and former pot user believes we’re setting ourselves up for big problems

When he was 15, Robert McCullough knew he was addicted to marijuana. As a high school student in the 1970s, he skipped class to smoke, stole money from his parents to support his habit, and scraped his pipe for resin when he didn’t have pot to get high.

Today, McCullough, 43, still considers himself an addict. He attends weekly meetings and recognizes if it weren’t for treatment, he would have never gotten clean.

“I will always be an addict,” said McCullough, now clinical manager at Evergreen Manor, a treatment facility in Everett. “It is something I will have to acknowledge my whole life.”

In the aftermath of Washington’s legalization of marijuana, critics of the law are pointing to a rarely discussed issue: addiction. Last year, marijuana use accounted for nearly half of youth admissions to treatment facilities in Washington state, according to data released in October from the Substance Abuse and Mental Health Services Administration. More than 4,200 young people were treated in the state for marijuana use, more than any other drug.

“People are failing to notice that youth use rates are high, availability of marijuana has increased and the perception of harm associated with the drug has dropped,” said Dr. Sharon Levy, director of the American Academy of Pediatrics’ committee on substance abuse. “These factors have been shown to cause large increases in not only use, but daily use.”

Washington’s law allows adults 21 and older to possess up to an ounce of marijuana, but drug counselors worry that increased availability will also lead to more underage use. Individuals who start using marijuana at a young age are more likely to become dependent on the drug, according to the National Institute on Drug Abuse.

“It’s frightening. We’re seeing that the average age of first use has dropped and that more and more kids are using daily,” said Levy, who is also an assistant professor of Pediatrics at Harvard Medical School. “I think we’re really setting ourselves up for some big problems.”

Kevin Oliver, executive director of Washington’s National Organization for the Reform of Marijuana Laws (NORML), acknowledged that marijuana dependence can occur if the drug is abused but believes the substance is not addictive enough to pose a significant threat.

“I know users that have no problem consuming cannabis responsibly,” Oliver said. “I smoke pot on a regular basis, but I don’t let the desire to get high control my life or my actions.”

In Snohomish County, more people seek treatment for marijuana addiction than they do for methamphetamine abuse, said Linda Grant, chief executive of Evergreen Manor in Everett.

“I do not think the public is aware of the extent to which marijuana impacts everyday activities,” Grant said. “Many patients who come to us arrive for driving under the influence. Other patients arrive knowing they have a problem.”

Regardless of the perception of marijuana addiction, treatment statistics are showing growth in marijuana-related problems. In just one month, outpatient admissions for marijuana treatment among Washington state youth increased by 23 percent, growing by 41 new patients from August to September, according to data taken from the Division of Alcohol and Substance Abuse.

Deb Schnellman, spokeswoman for Washington’s Division of Behavioral Health and Recovery, said she expects to see an increase in the use of marijuana after its legalization.

“Research shows that when the availability of a substance increases, use goes up as well,” Schnellman said.

“The young, developing brain is especially vulnerable to substance use,” Schnellman said. “This is why youth are at an increased risk for problems related to drug use.”

Levy said tetrahydrocannabinol, or THC, the active ingredient in marijuana, can be addictive.

THC is stored in the user’s fat tissue and can linger in the body, so withdrawal symptoms may not be immediately observable.

“Because marijuana dependence looks different than heroin dependence or cocaine dependence, people may be confused into thinking there is no such thing,” Levy said.

McCullough recalls sleepless nights filled with discomfort and irritability when he was not able to use the drug. McCullough said he was in a haze while using. “I didn’t think I had a problem because of the effect of the drug,” McCullough said. “My ability to rationalize was affected, my whole scope of life was different, I couldn’t assess if I was out of control, and I was.”

Oliver said he experienced some sleeplessness and irritability when he had to stop consuming marijuana in the past but said it was “no big deal” and didn’t “affect his ability to function.”

“There is still a social stigma attached to using marijuana that creates a negative view of cannabis being harmful and dangerous,” Oliver said. “You can be addicted to anything that causes mental euphoria, sex, gambling, even caffeine. It just depends on the person involved, and if they’re in-control or not.”

Source: www.heraldnet.com 9th Dec. 2012

Filed under: Effects of Drugs,Social Affairs :

A United Nations panel today agreed on a set of measures to prevent the use of illicit drugs and strengthen national and regional responses, including using treatment instead of incarceration to stem a worrying global trend in the abuse of narcotics.

Wrapping up its week-long 55th session in Vienna, the Commission on Narcotic Drugs (CND), adopted 12 resolutions, including on the treatment, rehabilitation and social reintegration of drug-dependent prisoners; treatment as an alternative to incarceration; and preventing death from overdose.

The commission, which is made up of 53 member States, underlined the need for gender-specific interventions and called for the promotion of drug prevention, treatment and care for female drug addicts. It also called for more evidence-based strategies to prevent the use of illicit drugs, especially among young people.

Yury Fedotov, the Executive Director of the UN Office on Drugs and Crime (UNODC), hailed the fundamental role of existing international drugs conventions in safeguarding public health.

“It is only by acknowledging the drug conventions as the foundation for our shared responsibility that we can make successive generations safe from illicit drugs,” he said.

The commission acknowledged the role played by developing countries in sharing best practices, including through continental and inter-regional cooperation to promote alternative development programmes in poor rural communities dependent on the cultivation of illicit drug crops.

One of the new issues that emerged during the current session is the increasing diversion of chemicals to manufacture illicit amphetamine-type stimulants, a group of synthetic drugs that includes ecstasy and methamphetamine.

The commission called for international cooperation to curb the manufacture of new psychoactive substances. It also recommended the development of an international electronic authorization system for the trade in controlled substances.

This year’s session drew some 1,200 participants from 120 countries, observers, international organizations and non-governmental organizations.

Source:www.un.org 16th March

Filed under: Effects of Drugs,Others (International News),Social Affairs,Treatment and Addiction :

Position Statement – December 2011

The flawed proposition of drug legalisation

Various well funded pressure groups have mounted campaigns to overturn the United Nations Conventions on drugs. These groups claim that society should accept the fact of drugs as a problem that will remain and, therefore, should be managed in a way that would enable millions of people to take advantage of an alleged ‘legal right’ to use drugs of their choice.

It is important to note that international law makes a distinction between “hard law” and “soft law.” Hard law is legally binding upon the States. Soft law is not binding. UN Conventions, such as the Conventions on Drugs, are considered hard law and must be upheld by the countries that have ratified the UN Drug Conventions.

International narcotics legislation is mainly made up of the three UN Conventions from 1961 (Single Convention on Narcotic Drugs), 1971 (Convention on Psychotropic Substances), and 1988 (Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances):

• The 1961 Convention sets out that “the possession, use, trade in, distribution,import, export, manufacture and the production of drugs is exclusively limited to medical and scientific purposes”. Penal cooperation is to be established so as to ensure that drugs are only used licitly (for prescribed medical purposes).

• The 1971 Convention resembles closely the 1961 Convention, whilst
establishing an international control system for Psychotropic Substances.

• The 1988 Convention reflects the response of the international community to increasing illicit cultivation, production, manufacture, and trafficking activities. International narcotics legislation draws a line between licit (medical) and illicit (non-medical) use, and sets out measures for prevention of illicit use, including penal measures. The preamble to the 1961 Convention states that the parties to the Convention are “Recognizing that addiction to narcotic drugs constitutes a serious evil for the individual and is fraught with social and economic danger to mankind”. The Conventions are reviewed every ten years and have consistently been upheld.

The UN system of drug control includes the Office of Drugs and Crime, the International Narcotics Control Board, and the Commission on Narcotic Drugs. The works of these bodies are positive and essential in international drug demand and supply reduction. They are also attacked by those seeking to legalise drugs.

It is frequently and falsely asserted that the so-called “War on Drugs” is inappropriate and has become a very costly and demonstrable failure. It is declared by some that vast resources have been poured into the prevention of drug use and the suppression of illicit manufacturing, trafficking, and supply. It is further claimed that what is essentially a chronic medical problem has been turned into a criminal justice issue with inappropriate remedies that make “innocent” people criminals. In short, the flawed argument is that “prohibition” monies have been wasted and the immeasurable financial resources applied to this activity would be better spent for the general benefit of the community.

The groups supporting legalisation are: people who use drugs, those who believe that the present system of control does more harm than good, and those who are keen to make significant profits from marketing newly authorised addictive substances. In addition to pernicious distribution of drugs, dealers circulate specious and misleading information. They foster the erroneous belief that drugs are harmless, thus adding to even more confused thinking.

Superficially crafted, yet pseudo-persuasive arguments are put forward that can be accepted by many concerned, well intentioned people who have neither the time nor the knowledge to research the matter thoroughly, but accept them in good faith. Frequently high profile people claim that legalisation is the best way of addressing a major social problem without cogent supporting evidence. This too influences others, especially the ill informed who accept statements as being accurate and well informed. Through this ill-informed propaganda, people are asked to believe that such action would defeat the traffickers, take the profit out of the drug trade and solve the drug problem completely.

The total case for legalisation seems to be based on the assertion that the government assault on alleged civil liberties has been disastrously and expensively ineffective and counter-productive. In short, it is alleged, in contradiction to evidence, that prohibition has produced more costs than benefits and, therefore, the use of drugs on a personal basis should be permitted. Advocates claim that legalisation would eliminate the massive expenditure incurred by prohibition and would take the profit out of crime for suppliers and dealers. They further claim that it would decriminalise what they consider “understandable” human behaviour and thus prevent the overburdening of the criminal justice system that is manifestly failing to cope. It is further argued irrationally that police time would not be wasted on minor drug offences, the courts would be freed from the backlog of trivial cases and the prisons would not be used as warehouses for those who choose to use drugs, and the saved resources could be used more effectively.

Types of drug legalisation

The term “legalisation” can have any one of the following meanings:

1. Total Legalisation – All illicit drugs such as heroin, cocaine, methamphetamine, and marijuana would be legal and treated as commercial products. No government regulation would be required to oversee production, marketing, or distribution.

2. Regulated Legalisation – The production and distribution of drugs would be regulated by the government with limits on amounts that can be purchased and the age of purchasers. There would be no criminal or civil sanctions for possessing, manufacturing, or distributing drugs unless these actions violated the regulatory system. Drug sales could be taxed.

3. Decriminalisation – Decriminalisation eliminates criminal sanctions for drug use and provides civil sanctions for possession of drugs. To achieve the agenda of drug legalisation, advocates argue for:

• legalising drugs by lowering or ending penalties for drug possession and use – particularly marijuana;

• legalising marijuana and other illicit drugs as a so-called medicine;
• harm reduction programmes such as needle exchange programmes, drug injection sites, heroin distribution to addicts, and facilitation of so-called safe use of drugs that normalize drug use, create the illusion that drugs can be used safely if one just knows how, and eliminates a goal of abstinence from drugs;

• legalised growing of industrial hemp;
• an inclusion of drug users as equal partners in establishing and enforcing drug policy; and

• protection for drug users at the expense and to the detriment of non-users under the pretence of “human rights.”

The problem is with the drugs and not the drug policies

Legalisation of current illicit drugs, including marijuana, is not a viable solution to the global drug problem and would actually exacerbate the problem. The UN Drug Conventions were adopted because of the recognition by the international community that drugs are an enormous social problem and that the trade adversely affects the global economy and the viability of some countries that have become transit routes.

The huge sums of illegal money generated by the drug trade encourage money laundering and have become inextricably linked with other international organised criminal activities such as terrorism, human trafficking, prostitution and the arms trade. Drug Lords have subverted the democratic governments of some countries to the great detriment of law abiding citizens.

Drug abuse has had a major adverse effect on global health and the spread of communicable diseases such as AIDS/HIV. Control is vitally important for the protection of communities against these problems. There is international agreement in the UN Conventions that drugs should be produced legally under strict supervision to ensure adequate supplies only for medical and research purposes. The cumulative effects of prohibition and interdiction combined with education and treatment during 100 years of international drug control have had a significant impact in stemming the drug problem. Control is working and one can only imagine how much worse the problem would have become without it. For instance:

• In 2007, drug control had reduced the global opium supply to one-third the level in 1907 and even though current reports indicate recent increased cultivation in Afghanistan and production in Southeast Asia, overall production has not increased.

• During the last decade, world output of cocaine and amphetamines has stabilized; cannabis output has declined since 2004; and opium production has declined since 2008. We, therefore, strongly urge nations to uphold and enhance current efforts to prevent the use, cultivation, production, traffic, and sale of illegal drugs. We further urge our leaders to reject the legalisation of currently illicit drugs as an acceptable solution to the world’s drug problem because of the following reasons:

• Only 6.1% of people globally between the ages of 15 and 64 use drugs (World Drug Report 2011 UNODC) and there is little public support for the legalisation of highly dangerous substances. Prohibition has ensured that the total number of users is low because legal sanctions do influence people’s behaviour.

• There is a specific obligation to protect children from the harms of drugs, as is
evidenced through the ratification by the majority of United Nations Member States of the UN Convention on the Rights of the Child (CRC). Article 33 states that Member States “shall take all appropriate measures, including legislative, administrative, social and educational measures, to protect children from the illicit use of narcotic drugs and psychotropic substances as defined in the relevant international treaties, and to prevent the use of children in the illicit production and trafficking of such substances”.

• Legalisation sends the dangerous tacit message of approval, that drug use is
acceptable and cannot be very harmful.

• Permissibility, availability and accessibility of dangerous drugs will result in
increased consumption by many who otherwise would not consider using them.

• Enforcement of laws creates risks that discourage drug use. Laws clearly define what is legal and illegal and emphasise the boundaries.

• Legalisation would increase the risks to individuals, families, communities and world regions without any compensating benefits.

• Legalisation would remove the social sanctions normally supported by a legal system and expose people to additional risk, especially the young and vulnerable.

• The legalisation of drugs would lead inevitably to a greater number of dependencies and addictions likely to match the levels of licit addictive substances. In turn, this would lead to increasing related morbidity and mortality, the spread of communicable diseases such as AIDS/HIV and the other blood borne viruses exacerbated by the sharing of needles and drugs paraphernalia, and an increased burden on the health and social services.

• There would be no diminution in criminal justice costs as, contrary to the view held by those who support legalisation, crime would not be eliminated or reduced. Dependency often brings with it dysfunctional families together with increased domestic child abuse.

• There will be increases in drugged driving and industrial accidents.

• Drug Control is a safeguard protecting millions from the effects of drug abuse and addiction particularly, but not exclusively, in developing countries.

• Statements about taxation offsetting any additional costs are demonstrably flawed and this has been shown in the case of alcohol and tobacco taxes. Short of governments distributing free drugs, those who commit crime now to obtain them would continue to do so if they became legal.

• Legalisation would not take the profit out of the drug trade as criminals will always find ways of countering legislation. They would continue their dangerous activities including cutting drugs with harmful substances to maximise sales and profits. Aggressive marketing techniques, designed to promote increased sales and use, would be applied rigorously to devastating effect.

• Other ‘legal’ drugs – alcohol and tobacco, are regularly traded on the black market and are an international smuggling problem; an estimated 600 billion cigarettes are smuggled annually (World Drug report 2009). Taxation monies raised from these products go nowhere near addressing consequential costs.

• Many prisons have become incubators for infection and the spread of drug related diseases at great risk to individual prisoners, prison staff and the general public. Failure to eliminate drug use in these institutions exacerbates the problem.

• The prisons are not full of people who have been convicted for mere possession of drugs for personal use. This sanction is usually reserved for dealers and those who commit crime in the furtherance of their possession.

• The claim that alcohol and tobacco may cause more harm than some drugs is not a pharmacokinetics of psychotropic substances suggest that more, not less, control of their access is warranted.

• Research regularly and increasingly demonstrates the harms associated with drug use and misuse. There is uncertainty, yet growing evidence, about the long-term detrimental effects of drug use on the physical, psychological and emotional health of substance users.

• It is inaccurate to suggest that the personal use of drugs has no consequential and damaging effects. Apart from the harm to the individual users, drugs affect others by addiction, violence, criminal behaviour and road accidents. Some drugs remain in the body for long periods and adversely affect performance and behaviour beyond the time of so-called ‘private’ use. Legalisation would not diminish the adverse effects associated with drug misuse such as criminal, irrational and violent behaviour and the mental and physical harm that occurs in many users.

• All drugs can be dangerous including prescription and over the counter medicines if they are taken without attention to medical guidance. Recent research has confirmed just how harmful drug use can be and there is now overwhelming evidence (certainly in the case of cannabis) to make consideration of legalisation irresponsible.

• The toxicity of drugs is not a matter for debate or a vote. People are entitled to their own opinions but not their own facts. Those who advocate freedom of choice cannot create freedom from adverse consequences.

• Drug production causes huge ecological damage and crop erosion in drug producing areas.

• Nearly every nation has signed the UN Conventions on drug control. Any government of signatory countries contemplating legalisation would be in breach of agreements under the UN Conventions which recognise that unity is the best approach to combating the global drug problem. The administrative burden associated with legalisation would become enormous and probably unaffordable to most governments. Legalisation would require a massive government commitment to production, supply, security and a bureaucracy that would necessarily increase the need for the employment at great and unaffordable cost for all of the staff necessary to facilitate that development.

• Any government policy must be motivated by the consideration that it must first do no harm. There is an obligation to protect citizens and the compassionate and sensible method must be to do everything possible to reduce drug dependency and misuse, not to encourage or facilitate it. Any failures in a common approach to a problem would result in a complete breakdown in effectiveness. Differing and fragmented responses to a common predicament are unacceptable for the wellbeing of the international community. It is incumbent on national governments to cooperate in securing the greatest good for the greatest number.

ISSUED this 21st day of December, 2011 by the following groups:
Drug Prevention Network of the Americas (DPNA)
Institute on Global Drug Policy
International Scientific and Medical Forum on Drug Abuse
International Task Force on Strategic Drug Policy
People Against Drug Dependence & Ignorance (PADDI), Nigeria
Europe Against Drugs (EURAD)
World Federation Against Drugs (WFAD)
Peoples Recovery, Empowerment and Development Assistance (PREDA)
Drug Free Scotland

Filed under: Alcohol,Crime/Violence/Prison,Drug Specifics,Drugs and Accidents,Education Sector,Effects of Drugs,Global Drug Legalisation Efforts,Legal Sector,Others (International News),Prevention and Intervention,Social Affairs,Treatment and Addiction,Youth :

Following the Scottish example, England has piloted drug courts using specially trained magistrates to closely supervise treatment-based community sentences. This initial report found no major glitches but low throughput and uncertain cost-benefits.

Summary The Dedicated Drug Court framework for England and Wales provides for specialist courts which exclusively handle cases relating to drug misusing offenders from conviction through sentence to completion (or breach) of a community order with a Drug Rehabilitation Requirement (DRR). Two magistrates’ courts (Leeds Magistrates’ Court and West London Magistrates’ Court) have been piloting drug courts implemented in line with the Ministry of Justice’s framework.

The critical factors for implementation success are an understanding of local context and scale of need, the enthusiasm of the local judiciary and partner agencies, good partnership working, availability of resources to deliver the drug court and its associated treatment services, the depth of understanding by all staff of offender motivation and, in particular, recognition of the points at which an offender is most likely to make progress in reducing or stopping drug use. Continuity of judiciary is key to successful implementation of a drug court. It provides the focus for communication between the court and the offender and across magistrate panels. Continuity of judiciary was a strong planned feature of both courts. Based on analysis undertaken with data from the Leeds pilot, there is strong evidence that continuity of magistrates has a statistically significant impact on several key drug court outcomes. Greater continuity of magistrates experienced by offenders is associated with their being less likely to miss a court hearing, more likely to complete their sentence, and less likely to be reconvicted.

Break-even analysis showed that (compared to normal adjudication) an extra 8% of offenders seen by the courts would need to stop taking drugs for five years or more following completion of the sentence to provide a net economic benefit to the wider society, and 14% in order to provide a net economic benefit to the criminal justice system. A robust quantification of impact was not possible because of the difficulties in collecting sufficient data on a comparison group of offenders not processed through drug courts.

Findings Commissioned by the UK Ministry of Justice, the report describes the implementation rather than the outcomes of England’s pilot drug courts. In line with international understandings, the courts were intended to specialise in drug-related offenders, presided over by sentencers specially trained for this task who order treatment-based sentences and closely supervise the offender’s progress, aided by regular tests for illegal drug use. The aim is maximise the rehabilitative impact of the sentence by increasing compliance and engagement with treatment through criminal justice pressure (ultimately the prospect of receiving a more typical punishment-based sentence if the drug court’s order fails) and rewards (of which one of the most powerful seems to be the unfamiliar experience of being congratulated by a judge or magistrate).

The report identified no critical fault lines in the implementation of the courts. However, these were particularly promising sites: the Leeds court built on a pre-existing system and in London, court staff were enthusiastic about the proposal and had already been working towards creating a drug court. Nevertheless, offender throughput was lower than expected. Over the 17 months of the evaluation, the London court sentenced just 60 new offenders while in Leeds the total was 276. Low throughput raised costs per offender. Compared to a standard 12-month drug rehabilitation requirement order implemented through normal adjudication, supervising the order through the drug courts cost £4633 extra per offender.

With no comparison group of normally adjudicated offenders, the evaluation was unable to say whether this was money well spent. They were, however, able to calculate the drug use reductions the courts would have to ‘buy’ in order to meet their extra costs – as noted in the abstract, the answer was 8% of offenders ceasing drug use for at least five years compared to the numbers doing so on a normally adjudicated drug rehabilitation requirement order. This calculation though excludes the base costs of normal adjudication and of a normally supervised drug rehabilitation requirement order. This seems to mean that the 8% would also have to be over and above the proportion of offenders who remain abstinent after normal judicial processing. The report gives no indication of how much success would be needed to match the total costs incurred by the criminal justice system in implementing all the elements of a drug court-supervised drug rehabilitation requirement order.

The report’s emphasis on offenders seeing the same magistrate(s) for their sentencing and throughout subsequent progress reviews is backed by evidence from Leeds that continuity is substantially associated with better compliance and drug use and crime outcomes. Steps were taken to reduce the risk that continuity was caused by high compliance and good progress rather than vice versa. However, without actually allocating offenders at random to see or not see the same magistrates, it is impossible to eliminate this possibility. Assuming the effect was real, it is of concern that organising continuity was a challenge, and especially so for ‘breach’ hearings dealing with unacceptable failures to comply with the order, which national regulations required to occur within a set period. Unfortunately, these crucial junctures are just when continuity is most needed, requiring an understanding of whether the offender will do better on a revised order, or the order has failed and should be revoked, often resulting in imprisonment.

A final caution over any such report is that some leading criminologists accuse the UK government of manipulating and distorting criminological research for political gain, to the point where the professor of criminology at the Open University has called for a boycott of government-commissioned work. The featured report was commissioned by the UK Ministry of Justice, a ministry carved out in part from the Home Office, one of the main targets of these accusations.

Scotland preceded England in formally piloting drug courts in Glasgow from 2001 and in Fife the following year. As in England, implementation was not entirely smooth but better than might have been expected. There was a high but it was thought acceptable failure rate, probably aided by Scotland’s more flexible application of drug treatment and testing orders, predecessors to the drug rehabilitation requirements used later by the English courts. However, crime impacts were questionable. Within one year 50% of drug court offenders had been reconvicted and within two years 71%, and the average frequency of reconvictions only slightly dipped in the two years after the order was imposed compared to the two years before. There was no clear crime-reduction benefit from supervising the orders through the drug courts (at an average cost of nearly £18,500 per order) as opposed to normal adjudication. But, as in England, the costs imposed on society by persistent, high-rate offending and drug-related mortality and morbidity, are such that even modest improvements might be cost-beneficial overall.

International experience and research relating to drug courts suggests it is important for courts to emphasise rewards as well as punishments, see offenders frequently enough to apply these swiftly in response to progress, deploy a range of rewards and sanctions short of revocation which are consistently applied, have a strong and sure ultimate sanction when the programme fails, make these consequences absolutely clear to offenders, have rapid access to a range of treatment options, maintain continuity in the judge dealing with the case, and to attend to the range of the individual’s needs. Willingness to continue despite some initial offending makes the structure imposed by stringent requirements and monitoring a positive feature rather than one which leads most offenders to fail. Consistent judicial supervision, the fact that this forces addicts (back) in to treatment, and drug testing which provides a shared measure of how treatment is progressing, probably all play their parts.

Source: www.findings.org.uk March 2009

Filed under: Drug use-various effects,Education Sector,Effects of Drugs,Legal Sector,Social Affairs,Treatment and Addiction :

The fashionable party drug mephedrone has been linked to up to 98 recent deaths in Britain, the Government’s advisers warned last night, as they called for tougher action to combat the proliferation of legal highs.

The Advisory Council on the Misuse of Drugs (ACMD) said unscrupulous manufacturers made a mockery of the law by falsely advertising addictive substances as “plant food” or “bath salts”. Its chairman, Professor Les Iverson, warned young users of “designer drugs” were playing “Russian roulette” with their lives – and said the effects were already being seen in hospitals. He said: “We are not seeing just a nice party drug but something that can kill.”

Prof Iverson released figures showing that in the past two years mephedrone had been confirmed as a factor in 42 deaths and had not been ruled out as contributing to another 56.
Users of designer drugs – created in labs to mimic the make-up of banned substances such as ecstasy and amphetamines – suffered such extreme side-effects that they had to be sedated. They had also been treated for paranoia, psychosis, high heart rates and raised blood pressure, he said. He added: “Users are playing Russian roulette. They are buying substances marked as research chemicals. The implication is that you should do the research on yourself to find out whether they’re safe or not. This is a totally uncontrolled, unregulated market.”

The first large quantities of legal highs, or psychoactive drugs – many made in China – appeared in Britain two years ago. They can be easily bought online or from shops selling drug paraphernalia and herbal goods. Some undergraduates also sell them to fellow students. The ACMD said: “Many people importing these new substances appear to have had no previous involvement in the illicit drug trade and are just in it to make a quick buck. They have included students who have set up websites to supply nationally and who also supply the local student population.”

Ministers have outlawed several such substances, but the ACMD warned that producers were sidestepping the bans by tweaking the composition of drugs. It backed creating a new system of broader bans in which all substances chemically similar to controlled drugs were automatically made illegal. The ACMD also called for suppliers to have to demonstrate that legal highs were not being produced for human consumption and for a fresh drive to alert the public to their dangers.

Roger Howard, chief executive of the UK Drug Policy Commission, backed the proposals. He said: “We have rapidly growing numbers of psychoactive drugs on the market and it’s increasingly difficult for police to identify the different drugs they are finding.”

The Home Office said it was considering the recommendations and added: “The Government is leading the way in cracking down on legal highs by outlawing not just individual drugs but whole families of related substances.”

By numbers…
2009 The year police made first seizure of mephedrone. It was banned in 2010.
£15 Approximate price of a gram before it was classified.
98 The number of deaths recently linked to mephedrone.

Source: The Independent 26th October

Filed under: Drug Specifics,Effects of Drugs,Europe,Legal Sector :

After only a few years of usage, crystal meth can devastate a user’s health.
A GP in the Dungannon District has warned parents of the alarming rise in illegal drug abuse among young teenagers. “GPs are seeing an increasing number of patients with drug problems and unfortunately this is showing up in kids of as young as 13 or 14”, he said.
“There is a combination of the old drugs such as cannabis and cocaine and some of the newer drugs such as methedrone. “One of the problems is people seem to have the idea that these newer “designer drugs” are safe. However, they have a number of side effects Severe nosebleeds have been reported after snorting as well as anxiety and paranoia.
“There is also the risk of over-stimulating the heart and the nervous system, which would increase the chances of having a fit. “They can also become a gateway to other drugs. Another problem with these newer drugs is that the long term effects are unknown as they have not been around long enough to have been properly studied. “If you have any concerns with drug misuse you can contact your GP for advice. There are also a number of helplines to contact for confidential advice. An excellent local service is Breakthru in Dungannon. “They offer guidance and counselling for drug and alcohol problems. Their number is 02887753228.
Drug dealers in the Coalisland area are giving free doses of crystal meth to young teenagers.
The drug is an intensive stimulant with disinhibitory qualities. It can either be snorted or injected, or in its crystal form ‘ice’ smoked in a pipe, and brings on a feeling of exhilaration and a sharpening of focus. Smoking ice results in an instantaneous dose of almost pure drug to the brain, giving a huge rush followed by a feeling of euphoria for anything from 2-16 hours.
Overuse can bring on paranoia, short term memory loss, wild rages and mood swings as well as damage to your immune system. Overdosing can lead to severe convulsions followed by circulatory and respiratory collapse, coma and death. Some people have died after taking small doses.
The mix of chemicals, method of use and the user’s lifestyle can do serious damage to the mouth (‘Meth mouth’), with teeth rotting to the gum line as a result of the meth vapours.

Source: www.tyronetimes.co.uk 11th March 2012

Filed under: Effects of Drugs :

“National Drug Treatment Monitoring System (NDTMS) data on treatment modalities shows that 131,110 people received substitute prescribing treatment. During the same period, 5,350 people received PTB-funded treatment in residential rehabilitation centres.”

“We should be justly proud of what has been achieved in drug treatment. The sustained investment in recent years has resulted in significantly increased capacity, accessibility and take-up of drug treatment services. However, there is both the need and opportunity to further improve retention and treatment outcomes, not least by ensuring that problem drug users are able to access core services such as housing, employment and training opportunities. It is the time to evaluate where we are and how we can make drug treatment even better.” Martin Barnes Drugscope

 

posted by Peter O’Loughlin on 14 Mar 2009 at 5:05 am:

What Mr. Barnes failed to mention.

1. Drug related deaths in accordance with the UK official definition are at their highest for 5 years. (Health Statistics Quarterly 39. Office of National Statistics)

2. The level of HIV and other blood born diseases among Injecting Drug Users is higher now than at the start of the decade.

3 .In London where the prevalence of HIV is higher than anywhere else in England, 1 in 20 Injecting Drug Users is infected.

4 .In the remainder of England and Wales HIV among IDUs has risen from approximately one in 400 to 1 in 250 in 2006.

5 .The prevalence of hepatitis C among IDUs has increased from 33% in 2000 to 42% in 2006.

6. Approximately on in 5 IDUs has hepatitis B, which represents an increase of something like 200 per cent since 1997.

The foregoing is neither ‘uninformed’, or ‘unwarranted’ criticism, they are however the inescapable facts which Mr. Barnes seems either keen to suppress or is unaware of, In either event his opinion that “we should be justly proud of what has been achieved in drug treatment”, is hardly a balanced judgment of the escalation in both drug related deaths and disease which is being inflicted on our society. Nor the increasing level of drug offences and drug related crime.

Whether or not this catastrophic outcome of our drug treatment strategy can be wholly attributed to the harm reduction treatment protocols which has dominated it for so many years, and of which Mr. Barnes is an enthusiast, is the principle cause of the seemingly out of control increase in death, disease and crime, is debatable, what is not debatable is that we have no reason or justification to be proud that we have presided over an escalating and avoidable loss of life, death and criminal activity; nor is Mr. Barnes justified in claiming that we have.

Follow-Up Opinions

Failings Found In Needle Exchange Services.
posted by Mary Brett on 17 Mar 2009 at 1:49 pm
Among other failings found in a survey by the NTA of needle exchanges in England 2006, 50% of DATS had no access to virus testing on site, 40% no immunisation in place, about a third lacked hygiene and safer technique discussions.

Data collection was poor – DATS able to provide numbers of clients and visits, quantity of equipment distributed and returned were in the minority. Only 74% of DATS, 55% of needle exchange service providers and 48% of pharmacies provided information. There was a lack of training for co-ordinators and access to facilities was mostly limited to the working week. Very few operated at weekends or during the evening or night. Largely missing was any monitoring of discarded needles or injuries arising from them to the public.
Has anything been done to improve this situation? From the latest figures, quoted here, it would appear not to be the case.
|

Quantity V Quality
posted by Peter O’Loughlin on 18 Mar 2009 at 6:11 am
Thank you for your revealing and interesting contribution Mary.

It seems as if the NTA’s obsession with numbers treated, rather than treatment outcomes could be a contributory factor to the spread of blood born disease.

It is also depressing to learn that those hardy souls in the front line for whom I have considerable respect and admiration, are being deprived of the fundamental training and facilities needed to improve outcomes.

No doubt the apparent focus on numbers is to enable those responsible to issue gushing reports of achievement through the simplistic process of counting the numbers of needles issued, rather than positive outcomes of how those who use the facilities might be engaged in recovery.

A case of ‘never mind the quality, feel the width’.

If we add to that the seeming disregard of the danger to the public caused by discarded needles, then harm reduction as it is being practised in this country is creating more problems than it is resolving.

It seems to me that those people who sit in their ‘ivory towers’ dreaming up ‘harm reduction’ solutions have failed to realise that addiction is not confined to office hours and that when the addicted are craving for a fix, the lack of a clean needle will not prevent them from using.

Now exactly what is it that Mr Barnes of DrugScope feels we have reason to be ‘justly proud of’?

Is it the number of needles issued?

The injury to children and others arising from discarded needles?

The lack of training and supervision and hygiene facilities? Or the escalation, in avoidable deaths and disease?

The one thing I do agree with Mr. Barnes on is that more, much more is needed to reduce both drug related deaths and disease, and the most realistic way of achieving that is through abstinence focused recovery.

What Mr Barnes seems unable to grasp is that there is a world of difference between abstinence and recovery. Nor does he seem willing to acknowledge that the outcome of addiction is always abstinence. The latter is not an option as Mr Barnes appears to be suggesting. It is achieved either through premature death, a reality which is already occurring, or abstinence focused treatment followed by on going after care; realities that neither Mr. Barnes or the NTA seem willing or able, to confront.

Source:Posts between Peter O’Loughlin on 18 Mar 2009  and Mary Brett CSS after statement from Drugscope 

Filed under: Effects of Drugs :

EACH year the Scottish Drug Misuse Database releases statistics laying bare the grim reality of drug addiction in Scotland. For a few days politician show angst at the tragedy that lies behind the statistics but somehow attention moves on as if this problem will resolve itself.

It is expected areas of high unemployment and poverty will feature prominently in the SDMD and yesterday’s figures offer little change. Glasgow, Dundee, Inverclyde and West Dunbartonshire all feature as areas showing significant levels of problematic drug abuse, though in truth all of Scotland is affected.

What continues to shock, however, is the numbers of young people under 15 years of age who present as problematic drug users and this year, as the figure records more than 100, that shock does not lessen.

Their first involvement is likely to occur as early as primary school but most often in first or second year secondary, their drug use developing usually from a habit of the illicit drinking of alcohol with school friends. Accessing of drugs builds from that background of irresponsible risk taking in public areas such as parks, isolated school play areas and the likes.

From my experience and talking to young people in prisons, it seems to me likely that school absenteeism arising from heavy drinking and the abuse of drugs (usually cannabis) created for these youngsters a self-imposed understanding of exclusion and thereafter educational failure that ensured that any chances they may have had of early success is denied.

Opportunities for gainful employment were also denied. It is in these circumstances that many turned to heroin, diazepam and cocaine – drugs identified in the most recent statistics as the source of much of the problematic drug misuse recorded. A spiralling downturn in life chances, an increased likelihood of arrest and incarceration and real possibility of drugs-related death beckons.

The latest figures reflect a 131 per cent increase in drugs-related deaths over the ten-year period to 2008 giving us a new yearly total of 574 deaths. 574 tragedies.

It is not the writing of new drugs strategies that will bring about a change in this situation. It’s government leadership to ensure that enforcement, health, education and prisons all work with the voluntary sector towards the sole outcome of reducing problematic drug abuse.

Source: http://news.scotsman.com 31st March 2010

 

Filed under: Effects of Drugs :

On Tuesday, July 20th 2010, internationally recognized anti-drug experts from every region of the world united to oppose a set of dangerous unproven global strategies recommended in the Vienna Declaration. The declaration is based on three false premises: 1) that the criminalization of illegal drug use fuels the HIV/AIDS epidemic, 2) that criminal justice and health promotion are conflicting approaches to drug policy, and 3) that the major costs of illegal drug use are those generated by the criminal justice system.
This document was released in anticipation of the 18th International AIDS Conference and has been under scrutiny by several non-governmental organizations. Calvina Fay, Executive Director of Drug Free America Foundation says, “There is no ‘reasonable evidence’ that supports the strategies outlined in the Vienna Declaration. Further, we should reject ineffective harm reduction tactics that are not based on scientific evidence while accepting drug use and creating an illusion that drugs can be used safely or responsibly. Such ill-conceived schemes foster the misunderstanding that drug use itself is not harmful and increases addiction.”
Many of the experts who opposed the Vienna Declaration know from research and practical experience that the optimal way to truly beat addiction, prevent the spread of AIDS and other sexually transmitted diseases, and prevent drug-related harm are effective strategies that target drug use and include prevention, education, treatment and law enforcement efforts and do not trade one for the other.
“The best foundation for prevention is policy. We know from experience that a balanced and restrictive drug policy is effective in keeping drug use at low levels. Since drug utilization in itself is an important risk factor for being infected by HIV, it is good AIDS-prevention to preclude illicit drug use. We must always strive to protect young people from getting involved with illegal drugs,” says Sven-Olov Carlsson, International President, World Federation Against Drugs.

To view the full joint statement issued opposing the Vienna Declaration, please visit www.wfad.se. If you would like to conduct an interview with Ms. Fay, Mr. Carlsson and/or other drug policy and prevention experts on this statement, please contact Lana Beck, Director of Communications with Drug Free America Foundation, Inc. at 727-828-0211 or 727-403-7571.

The World Federation Against Drugs (www.wfad.se) is a multilateral community of non-governmental organizations and individuals. Founded in 2009, the aim of WFAD is to work for a drug-free world. Drug Free America Foundation (www.dfaf.org) is a national and international nonprofit organization dedicated to fighting drug use, drug addiction and drug trafficking and to promoting effective sound drug policies, education and prevention. Drug Free America Foundation is a Non-Governmental Organization (NGO) in Special Consultative Status with the Economic and Social Council of the United Nations.

For More Info Contact Lana Beck 727-828-0211 or 727-403-7571 after hours

Source: Joint Press Release from www.wfad.se and www.wfad.se July 2010

Filed under: Drug Specifics,Effects of Drugs,USA :

President joins calls for debate after figures reveal extent of violence since launch of military offensive against cartels in 2006.

Murders in Mexico’s drug wars are becoming increasingly gruesome.

Mexico’s president, Felipe Calderón, has joined calls for a debate on the legalisation of drugs as new figures show thousands of Mexicans every year being slaughtered in cartel wars.
“It is a fundamental debate,” the president said, belying his traditional reluctance to accept any questioning of the military-focused offensive against the country’s drug cartels that he launched in late 2006. “You have to analyse carefully the pros and cons and key arguments on both sides.” The president said he personally opposes the idea of legalisation.
Calderón’s new openness comes amid tremendous pressure to justify a strategy that has been accompanied by the spiralling of horrific violence around the country as the cartels fight each other and the government crack down. Official figures released this week put the number of drug war related murders at 28,000.

Until recently the government regularly played down the general impact of the violence by claiming that 90% of the victims were associated with the cartels, with the remainder largely from the security forces. In recent months it has started to acknowledge a growing number of “civilian victims” ranging from toddlers caught in the cross fire to students massacred at parties.
Momentum behind the idea that legalisation could be part of the solution has been growing since three prominent former Latin American presidents signed a document last year arguing the case.
César Gaviria of Colombia, Fernando Cardoso of Brazil and Ernesto Zedillo of Mexico urged existing governments to consider legalising marijuana as a way of slashing cartel profits.
This year Mexico’s national congress began a debate on the possibility that resurfaced again this week during a series of round table discussions between the Calderón, security experts, business leaders and civic groups.
The “Dialogue for Security: Evaluation and Strengthening” is part of a new government effort to counter the growing perception in Mexico that the president’s drug war strategy is a disaster.
“I’m not talking just about legalizing marijuana,” analyst and write Hector Aguilar Camin said during the Tuesday session, “rather all drugs in general.”
After accepting the need to directly address the proposal, Calderón made it clear he did not support it. “It requires a country to take a decision to put several generations of young people at risk,” he said, citing a likely increase in consumption triggered by lower prices, greater availability and social acceptability.
He added that the predicted “important economic effects by reducing income for criminal groups” would be limited by the integration of Mexican drug trafficking into international markets where drugs remain largely underground.  Calderón did not mention current moves to soften drug laws in the US, including a planned vote in California in November on an initiative that would allow marijuana to be sold and taxed. Nor did he address the home grown argument that legalisation would remove the roots of the violence raging in the country.
“Legalisation would render the war pointless as drugs would become just another product like tobacco or alcohol,” Jorge Castañeda, a legalisation advocate and former foreign minister, told W Radio. He added that even if it did prompt an increase in drug use. “It is worth considering whether this is preferable to having 28,000 deaths.”
The new death toll, which was not broken down, is significantly higher than the informal counts kept by newspapers. Milenio newspaper put the number of drug-related deaths in July at 1,234.
Some leading critics of Calderón’s strategy, however, do not believe legalisation is the key to reining in the cartels and the violence, preferring to emphasize the need to increase efforts to go after money laundering and political corruption.
Edgardo Buscaglia, and expert in organised crime around the world, argues that the recent diversification of the Mexican cartels into other criminal activities ranging from systematic extortion to people trafficking would give them ample reason to keep fighting each other, even if drugs were legal. “Legalising drugs would be good public policy,” he said, “but it would not be a tool with which to combat organized crime.”

Source: guardian.co.uk, Wednesday 4 August 2010 20.13 BST

 

Filed under: Effects of Drugs,Legal Sector,Others (International News) :

 Scottish Government figures show 168% increase at Craiginches since 2007
Drug seizures at Craiginches Prison in Aberdeen have nearly trebled in the last three years.
Scottish Government figures show there were 134 seizures at the jail last year, a 168% increase since 2007 when there were 50. The increase was far higher than the total across Scotland where drug seizures went up by 12% from 1,626 to 1,829 over the same period.
Labour called for a redoubling of efforts to rid Scotland’s jails of drugs. Yesterday, Chief Inspector of Prisons Brigadier Hugh Munro warned that drug testing needed to be tightened up because addiction programmes were rendered pointless by ineffective testing regimes.
The only other prison with a similar number of drug seizures in the north-east was Perth where the number has remained relatively static with an average of 138 over three years.
At Inverness Prison seizures were up from 11 to 19. The number at the two open prisons, Castle Huntly and Noranside, in Tayside, fell from 63 to 53, as did those at Peterhead, down from six to one.  North-east MSP and Labour justice spokesman Richard Baker said: “Drugs are far too prevalent in Scotland’s prisons and Brig Munro is quite right to say more needs to be done. “With a rising tide of drugs getting into our prisons there is a need to redouble our efforts to rid our prisons of drugs.”
The Scottish Prison Service (SPS) said increased seizures were a sign that efforts to reduce drug taking and smuggling into jails were working. An SPS spokesman said money had been invested in new technology such as mobile drug tracing and X-ray machines, and the “most effective deterrent” – sniffer dogs.
“New legislation will also tackle the issue of mobile phones which are a key element in drug trafficking in prisons,” he said. “High levels of finds, such as those at HMP Aberdeen which doubled in two years, are an indicator of success.”
The Tories released figures showing a 37% increase in the number of prisoners receiving the heroin substitute methadone. A snapshot of one day showed the number on the drug went up from 1,228 in 2006 to 1,679 this year. The percentage of the prison population on methadone went up from 17.1% to 21.5%.
Tory justice spokesman John Lamont said: “This is extremely worrying. This rise in prisoners in receipt of methadone suggests that efforts to move drug addicts towards abstinence are not working properly.”
A Scottish Government spokesman said the percentage of prisoners prescribed methadone had risen by less than 3% since the current SNP administration came into office in 2007. “Getting people into treatment is the most effective way of reducing drug use and breaking the links between drugs and crime,” he said. “Methadone has a role to play among a range of treatments and support available to help people recover from their drug problems.”
The SPS said 85% of prisoners on methadone were continuing medication prescribed before they were sentenced while 15% were on new prescriptions initiated in custody. “According to the latest prisoner survey in 2009, almost a quarter of prisoners are currently on a reducing methadone dose as part of their recovery programme,” a spokesman said.

Source: www.pressandjournal.co.uk 3rd Sept. 2010

Filed under: Effects of Drugs,Legal Sector :

 

 

Harm Reduction: More than just side effects!

 The recent stance from the managing editor of the South African Medical Journal in favor of the extremely controversial practice of decriminalizing drugs of abuse (Harm Reduction) is both surprising and disconcerting. It shows a mixture of “arm chair medicine”, selective quoting of studies and conventions, and some really flawed reasoning.

 One wonders when last he has sat in front of a drug addict who’s lost their family, through being consumed by an overriding passion for drugs, or lost their job due to multiple accidents in the workplace related to the abuse of cannabis, heroin or other drugs. Or when last has he treated a marijuana smoker who has developed schizophrenia as a result of his marijuana smoking, a complication which has become increasingly well established in medical publications over the last 4 years?

 Medical Science is exploding with new research on virtually a weekly basis, that proves the harmful effects of marijuana use including:

  •  Causing psychosis in healthy people.[1]
  • Harming the brains of teenagers.[2]
  • Increasing the risk of testicular cancer.[3]
  • Poor foetal growth.[4]
  • Suppression of the immune system. [5]

 I suppose he has also not had to treat wash-out drug addicts from Switzerland like some of us have had to, where they have tried to regulate substance abuse through the medical provision of clean needles, syringes and drugs.

 The archaic argument that we cannot root out drug abuse by keeping it a crime is also a strange way of thinking to Doctors for Life. Since time began we have not managed to root out one single crime, but we are far from considering decriminalizing murder, rape, theft and fraud, to name but a few. Really, to use the example of Jackie Selebi’s corruption as a argument to legalize drugs is an illogical and distorted way of reasoning.

 Even though the article has quite a few references and appears very scientific, one is kind of left wondering what has happened to common sense. Dr van Niekerk keeps on quoting the fact that more harm is caused by legal drugs such as tobacco and alcohol (90% of all drug related deaths in theUK!) than illegal drugs, and somehow seems to miss the obvious point that having legalized them did not reduce the harm done by them. On the contrary, it appears to have increased the harm they cause. The implications of legalizing the use of drugs of abuse for the benefit of the economy of the country are vast. To mention just a few:

 Politoxemia, the simultaneous addiction to different drugs.

  • The financial implication of increased accidents in the workplace.
  • An increase in hours off work.
  • Medical expenses for treating the complications of substance abuse.

 It also includes the expense of establishing an infrastructure of medical personal to oversee the handing out of these drugs (and that in a country where our health system is already overloaded). DFL finds the reasoning justifying decriminalization immature.

 Dr. van Niekerk also quotes the UN Single Convention on Narcotic Drugs of 1961, but does not mention the UNODC’s 52nd session of the Annual Commission on Narcotic Drugs March 2009, to whichSouth Africa is a co-signatory. When some parties tried to slip in a Harm Reduction policy (such as Dr. van Niekerk is supporting),Sweden,Russia,Japan,USA,Colombia,Sri Lanka andCuba refused to sign the document unless the reference to harm reduction was removed.

 Experiences of a few countries that have moved in the direction of decriminalisation should also be taken note of:

 The Alaska Supreme Court ruled in 1975 that the state could not interfere with an adult’s possession of marijuana for personal consumption in the home. Although the ruling was limited to persons 19 and over, a 1988 University of Alaskastudy, the state’s 12 to 17-year-olds used marijuana at more than twice the national average for their age group.Alaska’s residents voted in 1990 to re-criminalize the possession of marijuana, demonstrating their belief that increased use was too high a price to pay

 In Holland the Dutch government started closing down a third of their coffee shops because they found that many of the coffee shops had become a legal outlet for the illegal drug trade and after 15 years of legalised marijuana use, they were unable to separate the illegal and crime related activities from the legal trade. With the South African Police Force struggling to effectively police crime in the country, how do we think we ever are going to better the Dutch!

 The U.K.first reclassified marijuana as a less harmful Class C drug, but in January 2009 moved it back to a more dangerous Class B drug.

 Doctors For Life International is all in favour of doing more regarding the rehabilitation of drug addicts. But we do feel that having a prison sentence as an alternative to being sent for rehabilitation is a powerful incentive for many substance abusers to try and get help. To this end we would argue for more government funding to established rehabilitation units, and for NGO’s, who to a large extent have taken over the responsibility of the government in this regard.

 Doctors for Life International, represents more than 1800 medical doctors and specialists, three-quarters of whom practice in South Africa. Since 1991 DFL has been actively promoting sound science in the medical profession and health care that is safe and efficient for all South Africans. For more information visit: http://www.doctorsforlife.co.za

 References:

 [1] Causing psychosis in healthy people:                 

Dr Theresa Moore, Theresa HM Moore MSc, Dr Stanley Zammit PhD, Anne Lingford-Hughes PhD, Thomas RE Barnes DSc, Peter B Jones PhD, Margaret Burke MSc, Glyn Lewis PhD

Cannabis use and risk of psychotic or affective mental health outcomes: a systematic review.UniversityofBristol, InstituteofPsychiatryinCardiffUniversity, Wales.

The Lancet, Volume 370, Issue 9584, Pages 319 – 328, 28 July 2007

 [2] Harming the brains of teenagers:                     

Manzar Ashtari, Ph.D: Children’sHospitalofPhiladelphia

Staci A. Gruber:HarvardMedical School

http://news.harvard.edu/gazette/story/2010/11/marijuana-study/

 [3] Increased risk of testicular cancer:                            

FredHutchinsonCancerResearchCenter: Stephen Schwartz

Association of Marijuana Use and the Incidence of Testicular Germ Cell Tumours

http://www.fhcrc.org/about/ne/news/2009/02/09/marijuana.html

Kristen Woodward, 206-667-5095 or kwoodwar@fhcrc.org

 [4] Poor foetal growth:                                            

Hanan El Marroun, Henning Tiemeier, Eric A.P. Steegers, Vincent W.V. Jaddoe, Albert Hofman, Frank C. Verhulst, Wim van den Brink, Anja C. Huizink.
Intrauterine Cannabis Exposure Affects Fetal Growth Trajectories: The Generation R Study
Journal of the American Academy of Child & Adolescent Psychiatry
December 2009 (Vol. 48, Issue 12, Pages 1173-1181)

 [5] Suppression of the immune system:                     

Venkatesh L. Hegde, Mitzi Nagarkatti and Prakash S. Nagarkatti.

Cannabinoid receptor activation leads to massive mobilization of myeloid-derived suppressor cells with potent immunosuppressive properties.

European Journal of Immunology, 2010; 40 (12): 3358-3371 DOI: 10.1002/eji.201040667

 Source:  Doctors for Life International, Dr.Thomas Gray 032 4815550  Jan 2011

Filed under: Drug Specifics,Effects of Drugs,Others (International News) :

Contrary to the beliefs of those who advocate the legalization of marijuana, the current balanced, restrictive, and bipartisan drug policies of the United States are working reasonably well and they have contributed to reductions in the rate of marijuana use in our nation.

The rate of current, past 30-day use of marijuana by Americans aged 12 and older in 1979 was 13.2 percent. In 2008 that figure stood at 6.1 percent. This 54-percent reduction in marijuana use over that 29-year period is a major public health triumph, not a failure.

Marijuana is the most commonly abused illegal drug in the U.S. and around the world. Those who support its legalization, for medical or for general use, fail to recognize that the greatest costs of marijuana are not related to its prohibition; they are the costs resulting from marijuana use itself.

There is a common misconception that the principle costs of marijuana use are those related to the criminal justice system. This is a false premise. Caulkins & Sevigny (2005) found that the percentage of people in prison for marijuana use is less than one half of one percent (0.1-0.2 percent). An encounter with the criminal justice system through apprehension for a drugrelated crime frequently can benefit the offender because the criminal justice system is often a path to treatment.

“A useful analogy can be made to gambling. Legalized gambling has not reduced illegal gambling in the United States; rather, it has increased it.”

More than a third, 37 percent, of treatment admissions reported in the Treatment Episode Data Set, TEDS, collected from state-funded programs were referred through the criminal justice system. Marijuana was an identified drug of abuse for 57 percent of the individuals referred to treatment from the criminal justice system.

The future of drug policy is not a choice between using the criminal justice system or treatment. The more appropriate goal is to get these two systems to work together more effectively to improve both public safety and public health. In the discussion of legalizing marijuana, a useful analogy can be made to gambling. MacCoun & Reuter (2001) conclude that making the government a beneficiary of legal gambling has encouraged the government to promote gambling, overlooking it as a problem behavior. They point out that “the moral debasement of
state government is a phenomenon that only a few academics and preachers bemoan.”
Legalized gambling has not reduced illegal gambling in the United States; rather, it has increased it. This is particularly evident in sports gambling, most of which is illegal. Legal gambling is taxed and regulated and illegal gambling is not. Legal gambling sets the stage for illegal gambling just the way legal marijuana would set the stage for illegal marijuana trafficking.
The gambling precedent suggests strongly that illegal drug suppliers would thrive by selling more potent marijuana products outside of the legal channels that would be taxed and otherwise restricted. If marijuana were legalized, the only way to eliminate its illegal trade, which is modest in comparison to that of cocaine, would be to sell marijuana untaxed and unregulated to any willing buyer.

Marijuana is currently the leading cause of substance dependence other than alcohol in the U.S. In 2008, marijuana use accounted for 4.2 million of the 7 million people aged 12 or older classified with dependence on or abuse of an illicit drug. This means that about two thirds of Americans suffering from any substance use disorder are suffering from marijuana abuse or marijuana dependence.

If the U.S. were to legalize marijuana, the number of marijuana users would increase. Today there are 15.2 million current marijuana users in comparison to 129 million alcohol users and 70.9 million tobacco users. Though the number of marijuana users might not quickly climb to the current numbers for alcohol and tobacco, if marijuana was legalized, the increase in users would be both large and rapid with subsequent increases in addiction.

Important lessons can be learned from those two widely-used legal drugs. While both alcohol and tobacco are taxed and regulated, the tax benefits to the public are vastly overshadowed by the adverse consequences of their use. Alcohol-related costs total over $185 billion while federal and states collected an estimated $14.5 billion in tax revenue; similarly, tobacco use costs over $200 billion but only $25 billion is collected in taxes. These figures show that the costs of legal alcohol are more than 12 times the total tax revenue collected, and that the costs of legal tobacco are about 8 times the tax revenue collected. This is an economically disastrous tradeoff.

The costs of legalizing marijuana would not only be financial. New marijuana users would not be limited to adults if marijuana were legalized, just as regulations on alcohol and tobacco do not prevent use by youth. Rapidly accumulating new research shows that marijuana use is associated with increases in a range of serious mental and physical problems. Lack of public understanding on this relationship is undermining prevention efforts and adversely affecting the nation’s youth and their families.

Drug-impaired driving will also increase if marijuana is legalized. Marijuana is already a significant causal factor in highway crashes, injuries and deaths. In a recent national roadside survey of weekend nighttime drivers, 8.6 percent tested positive for marijuana or its metabolites, nearly four times the percentage of drivers with a blood alcohol concentration (BAC) of .08 g/dL (2.2 percent). In another study of seriously injured drivers admitted to a Level-1 shock trauma
center, more than a quarter of all drivers (26.9 percent) tested positive for marijuana. In a study of fatally injured drivers in Washington State, 12.7 percent tested positive for marijuana. These studies demonstrate the high prevalence of drugged driving as a result of marijuana use.
Many people who want to legalize marijuana are passionate about their perception of the alleged failures of policies aimed at reducing marijuana use but those legalization proponents seldom—if ever—describe their own plan for taxing and regulating marijuana as a legal drug. There is a reason for this imbalance; they cannot come up with a credible plan for legalization that could deliver on their exaggerated claims for this new policy.

“Reducing marijuana use is essential to improving the nation’s health, education, and productivity.”

Future drug policies must be smarter and more effective in curbing the demand for illegal drugs including marijuana. Smarter-drug prevention policies should start by reducing illegal drug use among the 5 million criminal offenders who are on parole and probation in the U.S. They are among the nation’s heaviest and most problem generating illegal drug users.

Monitoring programs that are linked to swift and certain, but not severe,
consequences for any drug use have demonstrated outstanding results including lower recidivism and lower rates of incarceration. New policies to curb drugged driving will not only make our roads and highways safer and provide an important new path to treatment, but they will also reduce illegal drug use.

Reducing marijuana use is essential to improving the nation’s health, education, and productivity. New policies can greatly improve current performance of prevention strategies which, far from failing, has protected millions of people from the many adverse effects of marijuana use.
Since legalization of marijuana for medical or general use would increase marijuana use rather than reduce it and would lead to increased rates of addiction to marijuana among youth and adults, legalizing marijuana is not a smart public health or public safety strategy for any state or for our nation.

Source: Published: Tuesday, 20 Apr 2010 Robert du Pont,Institute for Behavior and Health

Filed under: Effects of Drugs,Social Affairs :

Wednesday 01 September 2010

The Local Alcohol Profiles for England (LAPE 2010) have just been released by the North West Public Health Observatory – profiling 23 alcohol-related indicators for every local authority and 24 for every primary care trust in England.
The profiles provide a national ‘map’ of alcohol-related harms.
Key findings from the profiles:
• Over the five years to 2008/09 there has been around a 65% increase in the number of people being admitted to hospital due to alcohol to 606,799 individuals – an increase of over 240,000 people.
• There were 945,469 admissions to hospital for alcohol-related harm in England in 2008/09. This is 825 alcohol-related admissions a day more than five years ago.
• Two thirds (65%) of all the local authorities suffering the highest levels of overall harms are in the North West and North East regions of England (1). The ten local authority areas with the highest levels of combined alcohol-related harm (2) are, in descending order, Manchester, Salford, Liverpool, Rochdale, Tameside, Islington, Middlesbrough, Halton, Oldham and Blackpool.
• By comparison East of England and South East region contain two thirds (65%) of all the local authorities with the lowest overall harm (1). The ten local authorities with the lowest levels of alcohol-related harm (2) are, in ascending order, Broadland, East Dorset, South Northamptonshire, Babergh, Three Rivers, South Norfolk, Hart, Sevenoaks, Wokingham and North Kesteven.
• Between 2006 and 2008 there were 11,247 deaths from chronic liver disease in men. The number of male deaths from chronic liver disease continues to rise steadily and increased by 12% for the five years up to 2008.
• Across England, there were 415,059 recorded crimes attributable to alcohol in 2009/10; equivalent to 8.1 crimes per 1,000 population. The highest rates of alcohol-attributable crime occur in the London region where there were 12.2 crimes per 1,000 residents, although this has decreased by 2.1% from the previous year. The lowest rate is in the North East region at 6.2 crimes per 1,000 which also showed the largest decrease (13.5%) from the previous year.
• Trends in alcohol-related harms vary between local authority areas. For instance, 64% saw an increase of over 5% in hospital admissions for alcohol-related harm in 2008/09, whilst only 7% showed a decrease of over 5%.
(1) Local authorities are categorised into five levels of harm using a clustering methodology that assigns LAs which have similar alcohol profiles to the same category. Months of life lost due to alcohol (males), months of life lost due to alcohol (females), NI39 (alcohol-related hospital admissions), alcohol-attributable recorded crimes, claimants of Incapacity Benefits due to alcoholism, increasing risk drinking, and higher risk drinking were used to determine clusters.
(2) Ranking for highest and lowest levels of alcohol-related harm use the same data as above and are ranked according to the highest combined rank across the seven harm indicators. City of London and the Isles of Scilly are excluded (figures for these areas should always be viewed with caution due to their small resident populations).
Visit the Local Alcohol Profiles for England website.

Source: www.alcoholconcern.org.uk 1.09.2010

Filed under: Effects of Drugs,Social Affairs :

The Office of Environmental Health Hazard Assessment (OEHHA) of the California Environmental Protection Agency is adding marijuana smoke to the Proposition 65 list1, effective June 19, 2009.
Marijuana smoke was considered by the Carcinogen Identification Committee (CIC) of the OEHHA Science Advisory Board2 at a public meeting held on May 29, 2009.  The CIC determined that marijuana smoke was clearly shown, through scientifically valid testing according to generally accepted principles, to cause cancer.  Consequently, marijuana smoke is being added to the Proposition 65 list, pursuant to Title 27, California Code of Regulations, section 25305(a)(1) (formerly Title 22, California Code of Regulations, section 12305(a)(1)).
A complete, updated chemical list is published elsewhere in this issue of the California Regulatory Notice Register.
In summary, marijuana smoke is being listed under Proposition 65 as known to the State to cause cancer:
Source:  State of California published announcement l9th June 2009

Filed under: Cannabis/Marijuana,Effects of Drugs,Health,USA :

This study was designed to document knowledge about Kuwaiti drug users and to investigate whether or not there is an association between their poor self-concept and high level of anxiety. One hundred and seven incarcerated drug users, 107 individuals serving prison terms for offenses other than drug use, and 107 “normal” individuals were included in this pilot study. The Arabic version of Rosenberg’s Self-Esteem Scale and Spielberger’s State-Trait Anxiety Inventory were used to measure the subjects’ self-esteem and state-trait anxiety, respectively. The results documented revealed that there is a relationship between levels of self-esteem and anxiety in Kuwaiti drug user behavior.

Source: Substance Use & Misuse 1996, Vol. 31, No. 7, Pages 937-943

Filed under: Effects of Drugs,Others (International News) :

A ground-breaking report into the use of the stimulant MDMA has revealed it claimed 82 Australians over five years from 2000 – and the number fatalities is increasing.
The National Drug and Alcohol Research Centre’s study into MDMA-related deaths is the most comprehensive examination to date, and has prompted calls for more research. Last year, Perth teenager Gemma Thoms collapsed at the Big Day Out and died in hospital. She swallowed three ecstasy pills at the festival gates to avoid being caught by police.
Her mum, Peta, is planning to hand out leaflets at today’s Big Day Out warning revellers about the dangers. Concert organisers had promised to design and print flyers for all the 40,000 people expected to attend the festival.
Additional figures obtained by The Sunday Times this week show 23 people died as a result of taking ecstasy in Australia from 2006 to 2008. There could be more, with a number of cases still under investigation. Of those, 10 deaths were reported in 2006, seven in 2007 and six in 2008, with 65 per cent of victims aged 20-29 and more than 70 per cent male.
More than 80 per cent of the deaths were unintentional and 15 of the 23 victims took other drugs with the MDMA, including cannabis or alcohol. In the earlier cases examined by the National Drug and Alcohol Research Centre, 91 per cent of the deaths were directly caused by drug toxicity and MDMA was the sole drug involved in a quarter of cases.
It also contributed to a number of drownings, cardiovascular problems and car crashes. Last week, The Sunday Times revealed that ecstasy had never been cheaper in Perth, with the street price dropping for the first time last year.
A survey by the National Drug Research Institute also found that young users were taking the party drug more often and in bigger quantities. The number who binged on the drug rose from 22 per cent in 2008, to 40 per cent in 2009.
Funded by the Federal Department of Health and Ageing, a separate National Drug and Alcohol Research Centre report found the median age of ecstasy fatalities was 26, with the youngest victim 17 and the oldest 58.
“There are a lot of accidental deaths where MDMA is thought to have played a role . . . and this seems to be a more prominent and prevalent concern,” the centre’s assistant director Louisa Degenhardt said. “A lot of bad things can happen when combining drugs because accidents happen when people are intoxicated with any drug.”
Royal Perth Hospital emergency 2medicine specialist Daniel Fatovich warned that cheaper prices meant more West Australians could afford more pills, increasing the risk of overdoses.

Source www.perthnow.com.au January 30, 2010

Filed under: Australia,Effects of Drugs :

By Robin Murray
Classification isn’t all-important. What’s crucial is that we recognise cannabis does increase the risk of schizophrenia.
The Advisory Council on the Misuse of Drugs (ACMD), on which Professor David Nutt sits, has an unfortunate history in relation to cannabis. In 2002, it boobed by advising David Blunkett, then home secretary, that there were no serious mental health consequences of cannabis use; the council had done a sloppy job of reviewing the evidence. Since that time, they have been trying to regain credibility, and now accept that heavy use of cannabis is a risk factor for psychotic illnesses including schizophrenia. However, Professor Nutt’s comments demonstrate how difficult it has been for some members of the committee to accept their error.
Professor Nutt states that, in 2007, the ACMD were asked to review the situation again because “supposedly, skunk use had been increasing and it was getting stronger”. In fact, the ACMD itself concluded that street cannabis was getting more potent and a Department of Health survey has shown that skunk has been taking an ever-larger share of the market.
Professor Nutt states that “there has been a lot of commentary and some research as to whether cannabis is associated with schizophrenia.” It is crystal clear that people with schizophrenia use more cannabis than the general population; there is no dispute about this. The question is whether the use of cannabis contributes to the onset of psychosis including schizophrenia in a causal manner. Here the evidence, although not yet conclusive, has been mounting steadily over the past six years.
Professor Nutt contrasts a 2.6 fold increase in risk of psychosis carried by using cannabis with a twentyfold increase in risk of lung cancer if one smokes cigarettes. Unfortunately, he is not comparing like with like. The twentyfold increased risk is not carried by just being a cigarette smoker but rather by being a long-term heavy smoker. For cannabis, the risk of psychosis goes up to about six times if one is a long-term heavy cannabis smoker.
Next Professor Nutt claims that the incidence of schizophrenia is falling while consumption of skunk has been rising. Sadly, the paper he points to is a study of diagnosis in general practice and we know that GP records on psychosis are far from accurate. The only good longitudinal data on the incidence of schizophrenia in the UK comes from south London, where the incidence doubled between 1964 and 1999. There are probably several factors contributing to this but abuse of drugs is likely to be one.
Personally, I care little whether cannabis is classified as a class B or class C drug. Fourteen year olds starting daily cannabis use do not agonise over its exact classification; many do not even think it is a drug and few have any knowledge of its hazards. By comparison, most adults in the UK drink alcohol in moderation, but do so in the knowledge that drinking a bottle of vodka a day is likely to be injurious to health, and few are in favour of daily drinking from age 14 years.
Both Professor Nutt and I agree that what we need is a major educational campaign to inform the public about the risks associated with heavy use of cannabis particularly in early adolescence. Fortunately, there has been some progress in public understanding and, as a consequence, use of cannabis has been falling for the past five years.
Source: guardian.co.uk, Thursday 29 October 2009

Filed under: Effects of Drugs :
Substance Addiction has been recognized “officially” as a disease for many years now, but there is still a great deal of ignorance on the subject -even amongst the medical profession.
Addicts/alcoholics (people tend to separate the two, but from here on in I will use the term “addict” to cover the broad range of substance abusers) are seen as weak people with no will-power.
Want to know what will-power is?
It is waking up in the morning, so nauseous that you race to the bathroom and don’t know which end to use first! After that initial wake-up purge, you then make your way shivering and shaking into the kitchen and drink an open, flat, warm beer that has a cigarette butt floating in it. Or because you are shaking so much, you drink that warm white wine that has been sitting out all night, through a straw since you can’t hold a glass! You do this, choking back the bile that is rising in your throat, because you know that the only way to begin functioning again on some sort of level is to try and build up the alcohol in your system before you take a seizure.
Do you think drinking methylated spirits at 5am in the morning is an easy thing to do?
I have known many addicts whose veins in their arms and legs are so damaged, that they inject themselves in their eyeballs. Because going without their “hit” is a far worse option.
Addicts have plenty of will-power…….
…it’s just focused in the wrong direction. Recovery teaches them us to refocus energy.
Back to the disease concept. Addiction is classified as a disease because it meets the criteria of all other terminal diseases:
– It has pattern of symptoms which are similar across all types of substance abuse
– It is a chronic condition. It doesn’t go away.
– It is progressive. Addiction only gets worse with continued use, and ends with death.
– The person is subject to relapse. In Australia, 66% of addicts who are lucky to live long enough to make it to detox will eventually die as a direct result of the disease.
– It is treatable. Here’s the good news, while substance addiction is a terminal illness, its progression can be arrested at almost any stage. But if you are seeking treatment, it is of the utmost importance that you gain medical advice. Sudden withdrawal, even from “socially acceptable” drugs such as alcohol, can cause death through seizures and coma.
It is crucial that you consult with a medical practitioner that understands addiction and withdrawal. Some well meaning, but uneducated doctors will prescribe large amounts of unsuitable medications that can lead to cross-addiction. This happened to me at one stage, and made a difficult situation worse. If you are addicted to one drug, the likelihood of becoming addicted to others is extremely high.
Wherever possible, detoxification is best carried out in a detox unit, where there is 24 hour patient care. There are a number of these units around the world, and in some cases (especially in Australia) there is no charge for this care.
When world governments begin to understand that the cost in providing this care free of charge is far outweighed by the benefits to society, we will begin to see an incredible drop in poverty, violence and divorce. The cost in providing this care will also be offset by the decrease in need of other hospitalization. 1 in 3 hospital beds in Australia are taken up by people with conditions that can be directly linked to drug abuse. At best, the world health systems overall are only currently providing band-aid solutions to one of the greatest scourges of mankind.
Are you thinking of getting help for yourself or a loved one?… do it now … for tomorrow may be too late.
If you had terminal cancer, would you do anything about it?
Substance addiction is a far worse disease in my opinion -it not only destroys the person, but everyone around them.
To those who helped me all those years ago -doctors, nurses, friends and strangers – even though I may not have been appreciative at the time….. my sincerest thank you. My life means something now.
Addiction is a disease, not just a state of mind. 

Source: Jul 10, 2008 WorldWideAddiction.com

Filed under: Effects of Drugs :
The views expressed by the various pro drug lobbies are a distortion of the truth.

Notwithstanding research carried out by the National Treatment Agency (NTA) which clearly established that the majority of those who have developed dependence, wish to become drug free; here in the UK, the focus for the past 10 years has been on ‘harm reduction’, rather than seeking to engage users into abstinence focused recovery. The outcome of this disastrous and misguided policy has been an escalation in drug related deaths which are at their highest for 5 years, 325 of which are attributed to methadone, the flagship of the harm reductionists, together with a devastating increase in the spread of blood born disease among Injecting Drug Users (IDUs) The statistics provided by the Health Protection Agency for England and Wales are as follows:

• The level of HIV infection among Injecting Drug Users (IDUs) in England and Wales is higher now than at the start of the decade.

• In London where the prevalence of HIV in IDUs is higher than elsewhere in England and Wales, 1 in 20 IDUs is infected.

• In the remainder of England and Wales HIV among IDUs has increased from approximately 1 in 400 in 2002 to around 1 in 150 in 2006.

• The prevalence of Hepatitis C among IDUs has increased from 33 percent in 2000 to 42 per cent in 2006.

• Approximately 1 in 5 IDUs has Hepatitis B infection, which extrapolates as an increase approaching 200 per cent since 1997.

The escalating increase in blood born disease has occurred despite the plethora of needle exchange facilities throughout England and Wales, and the growth of supervised drug consumption rooms

It is self evident from the foregoing that here in the UK at least, it is not the lack of harm reduction measures which is contributing to avoidable deaths and the epidemic of blood born disease being wreaked on our society, but the use of toxic psycho active substances.

It is not so called prohibition which has failed, but the encouragement by way of the tacit permission, and in many instances, the not so tacit encouraging of continued use, inherent in the harm reduction ideology, which has failed users and society so abysmally.

The supporters of Harm Reduction, under their various guises have never allowed the truth to interfere with their propaganda, or indeed their more covert agenda, to legalise drug use; the main beneficiaries of which would be the pharmaceutical industry. Such a move would be to inflict further incalculable harm on society, since it would result in a growth of use and addiction, similar, if not more widespread, to that seen in the late 1800’s when most of the drugs which are controlled today, were in fact legal.

The growth of drug use during that period was the direct result of concerted efforts by leading members of the medical profession in promoting drug use, many of whom were influenced by Sigmund Freud, who was so unethical in his dealings that he accepted separate commissions from two competeing, large pharmaceutical companies, both of whom are still in business today, to write papers extolling the benefits of that destructive substance, cocaine, not only as the ‘elixir of life’, but also as a cure for alcohol and morphine addiction. The rest as they say is history

One has to ask is it a coincidence that many of the bodies, who are pressing for an end to what they term as prohibition, receive ‘research grants’ from the pharmaceutical industry?
Source: Daily Dose; posted by Peter O’Loughlin on 13 Mar 2009 at 6:23 am

 

Filed under: Effects of Drugs,Social Affairs :

Professor Susan GreenfieldIt is folly to legalise a drug that is known to leave users with permanent damage to their ability to reason, argues Susan Greenfield, the distinguished expert on brain processes (Sunday August 18 2002, The Observer) now that those anxious to look cool can puff cannabis freely in without fear of arrest, perhaps those of us who have argued that relaxing the laws on cannabis is Irresponsible and dangerous should retreat gracefully behind our chintz curtains. Yet the downgrading of
the classification of cannabis perpetuates the same tired old myths and the same serious problems.

Take the myth that cannabis is ‘just the same as’ alcohol. A glib yet logical riposte might be that if the drugs are truly identical why not just stick with the booze? What is the distinct appeal of cannabis that can be ignored in equating the two drugs? Such sophistry is inappropriate because alcohol and cannabis work on the brain and body in very different ways. Alcohol has a range of non-specific actions that affect the tiny electrical signals between one brain cell and another; cannabis has its own specialised chemical targets, so far less has a more potent effect.

Moreover, although drinking in excess can lead to terrible consequences, there are guidelines for the amount of alcohol that constitutes a ‘safe’ intake. Such a calculation is possible because we know alcohol is eliminated relatively quickly from the body.

With cannabis, it is a different story. The drug will accumulate in your body for days, if not weeks, so, as you roll your next spliff, you never know how much is already working away inside you. I challenge any advocate of cannabis to state what a ‘safe’ dose is. Until they do, surely it is irresponsible to send out positive signals, however muted? Another notion is that cannabis is less harmful than cigarettes. I’m not sure how this idea came about, certainly not as the results of any scientific papers.

We do know cannabis smoke contains the same constituents as that of tobacco: however, it is now thought that three to four cannabis cigarettes a day are equivalent to 20 or more tobacco cigarettes, regarding damage to the lining of the bronchus, while the concentration of carcinogens
in cannabis smoke is actually higher than in cigarettes. And if cannabis were ‘just the same’ as alcohol and cigarettes, why are people not taking those already legal drugs for the much-lauded
pain-relief effects? After all, another case for the relaxation of the laws on cannabis is the ‘medical’ one that it is an effective analgesic. But there is a world of difference between medication prescribed in a hospital, where the cost-benefit balance tips in favour of pain relief, compared to a healthy person endangering their brain and body needlessly. Even the most loony of liberals has not suggested tolerance for morphine or heroin abuse, because they are prescribed clinically as potent painkillers.

And think about it: if cannabis brings effective relief from pain, then how does it do so? Clearly by a large-scale action on the central nervous system. Further wishful thinking is that, because cannabis doesn’t actually kill you, it is OK to send out less negative legal signals, even though the Home Secretary admits that the drug is dangerous. Leaving aside the issue that cannabis could indeed be lethal, in that
the impaired driving it can trigger could well kill, there is more to life than death. It is widely accepted that there is a link between cannabis and schizophrenia: as many as 50 per cent of young people
attending psychiatric clinics may be regular or occasional cannabis users. The drug can also precipitate psychotic attacks, even in those with no previous psychiatric history. Moreover, there appears to be a
severe impairment in attention span and cognitive performance in regular cannabis users, even after the habit has been relinquished.
All these observations testify to a strong, long-lasting action on the brain. Some attempts have been made in laboratories to work out what cannabis could actually be doing to brain cells. So far, some data have suggested that there can be damage to neurons, and at doses comparable to those taken on the street.

None the less, others argue that the experimental scenario of isolated neurons growing in a lab dish are hardly a natural situation, and that such data have to be interpreted with caution. But absence of evidence is not evidence of absence. The effects on the brain in real life are most probably subtle and therefore hard to monitor: it’s not so much that cannabis will create great holes in your brain, or deplete you wholesale of all your best neurons. Instead, by acting on its own special little chemical targets (and because it will therefore work as an impostor to a naturally occurring transmitter), the drug is likely to modify the configuration of the networks of brain cell connections. These configurations of connections make you the unique person you are, since they usually reflect your particular experiences. So a change
will be hard to register from one person to another, and certainly from one slice of rat brain to another: but still, it will make you see the world in a different way – characteristically one depleted of
motivation.

It is hard for me, as a neuroscientist, to accept that a drug that has the biochemical actions that it does, that hangs around in the brain and body, and that has dramatic effects on brain function and dysfunction, could not be leaving its mark, literally, on how our neurons are wired up and work together. It is argued that we will never stamp out cannabis use, and therefore we should
give up trying. But we will not stamp out murder or house break-ins or mugging, yet I’ve never heard an argument for freeing up police time by liberalising the law on these acts. Laws, it is said, are
only enforceable when the majority wants them enforced, yet the arguments used for easing up on cannabis apply equally to promoting ecstasy or other mind-bending substances.
Do we really want a drug-culture lifestyle in the UK? Cynically, one could argue that it is politically expedient to court the youth vote, to open up the inevitable prospect of revenue from a new source of taxes and to help the ailing tobacco industry prosper from a great new product of readymade packets of spliffs. The condoning of chemical consolation also distracts from other problems. We have failed our young people in providing homes and jobs and, by giving them an easy route into a chilled-out oblivion, have turned our backs on the far more challenging prospect of initiating policies to help them realise their potential and live better and more fulfilling lives. They are paying a high price for cool.

Source: www.guardian.co.uk/science Aug.2002

 

Filed under: Drug Specifics,Effects of Drugs :


BYLINE: DR. KEVIN COSTELLO
Published on August 9,  2004- The Press Democrat PAGE: B9

Marijuana … what harm can a little dope do? The short answer is: Plenty.
First, is marijuana addictive? You bet it is. About one in eight people exposed to marijuana will become dependent on it. This makes it a little more addictive than alcohol. How do I define addiction? There’s a fancy medical definition or a more simple one: If you use marijuana every day you are probably addicted to it, especially if you have been doing this for a few months or more.So, let’s say you smoke marijuana every day. Isn’t that your business? Maybe yes, but most likely, no. When you are addicted to a substance your relationships in life are with that substance — not with other people.

In addiction medicine we have found that it is often best to ask the family members of the dependent individual how they feel. Frequently, there is a deep resentment and embitterment about the lack of support or the lack of emotional contact and empathy. A patient of mine was once asked by his wife to stop smoking marijuana for a few weeks, because her father was dying and she needed his support.

He managed to stop for a while, only to return to the addiction after his father-in-law died. It is remarkable how strong the dependency on marijuana can be.

Let’s say you don’t care about anyone else or that all your friends smoke or your significant other is tired of you and just as happy to have you stoned all the time.

What’s wrong with that?

There was an article in the Journal of the American Medical Association a few years ago, that looked at patients who used marijuana at least daily. The authors found that even 19 hours after stopping marijuana, these chronic users were not able to think as well (or memorize, or calculate, or analyze or perform other mental functions). In other words, if you smoke marijuana daily, you are always affected or “stoned” to a certain degree. You will not be able to realize your full intellectual capacity. This is especially important to high school and college students whose futures are determined by how well they do during that critically important eight-year window of academic opportunity.

Marijuana can also affect people in mid-career. A former patient of mine who was a Honda mechanic told me that he would read the shop manuals that came out every year seven or eight times. Despite the repetitive reviews, he was still not able to master the material. After stopping marijuana — which he had been using since high school — he found he only needed to read the manuals once.

One further caveat: some people seem to function very well on marijuana. They hold responsible positions and continue to perform relatively well. These folks are probably very bright and are able to accommodate the decrease in mental capacity. They may not, however, be the people you want performing brain surgery or negotiating an important contract.

Let’s say you really don’t care about any of the things that I’ve mentioned above. All you want is to smoke a little dope. A recent article, also in the Journal of the American Medical Association, showed that people who were using cocaine and methamphetamine (nasty stuff — there is a lot of evidence suggesting that these stimulants cause permanent brain injury) frequently followed a pattern of smoking cigarettes at a young age, then drinking alcohol, smoking marijuana and finally, progressing to harder drugs. The authors concluded that marijuana was not only a “gateway drug,” but seemed to actually precipitate the progression to the stimulants (cocaine and methamphetamine) and even to heroin, in certain individuals. So, you still don’t care. Well, I’ve saved the worst for last. The following is a partial list of the complications associated with the chronic use of marijuana: toxic psychosis (in susceptible individuals), increased heart rate and pain, decreased lung function, impaired fetal growth and development, decreased immune function (important for fighting infections and cancers), weight gain, bronchitis, and more.

Finally, a brief word about “medical marijuana.” The medical marijuana initiative passed by California voters, basically provides for the legalization of marijuana. This is because the initiative states that in addition to several serious illnesses, marijuana may be prescribed for “any other illness for which marijuana provides relief.” There was also no restriction on the age of the patient. Many physicians have no problem with the administration of marijuana to a patient with a terminal illness — but did the people of California really intend (as one United States Supreme Court justice put it) that marijuana be used for “anyone with a stomach ache” or for any reason at all?

I, for one, am not willing to sacrifice the one in eight individuals who are now at increased risk for developing an addiction to this drug due to its significantly increased availability.

I know that this article will raise deeply felt issues with some people. It is not my intention to offend anyone. I have attempted to provide factual information that can be reviewed, and hopefully, help you formulate an opinion about the use of marijuana. If you think that you have an addiction to marijuana, or you have further questions about it, the folks at Marijuana Anonymous can be an excellent source of information and assistance. You could also consult with a specialist in chemical dependency or one of the many local chemical dependency programs.

Dr. Kevin Costello is the chief of the medical division of Chemical Dependency Services for Kaiser in Santa Rosa.

 

Filed under: Effects of Drugs,Social Affairs :

By Jim McDonough Malcolm


TALLAHASSEE – Big excitement has hit the drug legalization world. A recent RAND Drug Policy Research Center study reported that marijuana may look, act, and smell like a gateway drug to abuse of harder drugs, but that possibly it is not a gateway drug after all.

The marijuana normalizers – as in, “let’s make marijuana use normal, or acceptable” – loved it; so did some of the press. Both were quick to misportray the study, so much so that the author of the study himself was dismayed.

Andrew Morral of RAND believes he did everything he could to explain he did not disprove the gateway theory but, as he told me, “The story about it misrepresented both our findings and my comments about the relevance of our findings to US drug policy. RAND and I have taken pains to emphasize that we do not believe we have disproved the gateway theory.”

The study did say that a high incidence of progression from marijuana to heroin and cocaine use is apparent; that the younger you are when you start using marijuana, the more likely you are to end up using cocaine and heroin; that the more often you use marijuana, the more likely you will use cocaine and heroin.

In short, the study shows the correlation between marijuana and other drug abuse to be high.

Indeed, the study accepts previous studies that have demonstrated the probability that heroin and cocaine use increases 85 times for marijuana users when compared with those who are not marijuana users; that early teen use of marijuana is even more highly correlated with other drug use than late teen marijuana use; and that the more puffs of marijuana you take, the more likely you move on to injections and snorting of even more dangerous drugs.

But here’s where the misunderstanding begins. The study says that maybe these terrible things happen because the people who use all these nasty drugs do it because they have a propensity for drug use, and marijuana is the first illegal drug to present itself to the young.

Dr. Morral calls that the “common factor” theory.

In other words, all drug users like all drugs; marijuana just comes along first. He suggests that this theory might be more accurate than the gateway theory.

But is a gateway not a gateway because it happens to present itself in front of where you want to go?

Perhaps this study’s findings appear trivial. They aren’t. If marijuana is merely the door through which those inclined to use drugs pass because it is convenient, all the more reason to keep that door locked.

I’m convinced that’s the best way to view Morrall’s findings, because the pro-marijuana lobby and much of what the press missed in this study, as well as other careful studies, were findings that suggest:

 

  • There is a strong correlation between marijuana and other drug abuse, with marijuana almost always occurring first.
  • Marijuana, all by itself, is a dangerous drug.
  • There is a strong correlation between marijuana use and schizophrenia.
  • Marijuana itself is addictive.
  • Youth marijuana use correlates highly with violence, truancy, and other behavioral problems.
  • The younger the marijuana user, the more psychological and physiological damage done, and the more likely that other drugs will follow.
  • Smoking three marijuana joints a day can cause the equivalent respiratory damage associated with 20 cigarettes a day. Marijuana smokers show significantly more respiratory symptoms than people who don’t smoke it.
  • Prolonged use can cause attention deficit and deterioration in memory.

Over the years, I have talked with hundreds of addicts and treatment counselors. They say that marijuana was virtually always the beginning of a long, ugly journey; that marijuana is the most insidious of the illegal drugs because of the seductive, but often wrong, rationale that you can quit any time you want; that easy access to marijuana is a major part of the problem; and that their lives would have been far better if marijuana had been out of the picture.

As we do more studies, we might turn to these people for insight.

So what of the utility of the “common factor” theory over the “gateway” theory? A weed by any other name still smells the same.

* Jim McDonough is director of the Florida Office of Drug Control. He previously served as director of strategic planning at the Office of National Drug Control Policy.

Source: Christian Science Monitor December 16, 2002

 

Filed under: Effects of Drugs,Social Affairs :

By Malcolm Ritter, Associated Press

NEW YORK — Can Prozac help you kick cocaine? Can Ritalin? How about a blood pressure pill or medicine for muscle spasms?

If you’re an alcoholic, could you get help staying sober by taking an anti-nausea drug used by cancer patients?

Scientists are exploring those questions right now. In fact, in the field of addiction medicine, one of the hottest sources of new drugs is … old drugs.

Despite years of research, there is no drug approved in the United States for treating cocaine dependence. To find such a treatment, the National Institute on Drug Abuse is sponsoring human studies of 21 medicines already on the market for something else. That’s about two-thirds of all the potential cocaine drugs being tested in people, says Frank Vocci, director of NIDA’s pharmacotherapy division.

Over at the National Institute on Alcohol Abuse and Alcoholism, nearly all the potential alcoholism drugs tested in people under institute sponsorship over the past 10 years were previously approved for some other use, says Raye Litten, co-leader of the institute’s medications development team.

While the strategy is hardly new, “it’s been going on maybe just a bit below the radar screen” for most of the public, Vocci said.

It can certainly work. In 1997, for example, the government approved a stop-smoking pill called Zyban, which was in fact the older antidepressant Wellbutrin.

To be sure, experts haven’t given up on developing new drugs. Most NIAAA-funded drug studies for alcoholism that are in early-stage testing — not yet tried on people — are brand-new drugs, Litten said.

But the notion of examining current drugs for addiction-breaking potential holds several advantages. It’s a lot cheaper to get federal approval for a new use of an old drug than to bring a completely new medicine to market. And experience with an existing drug gives an idea of its safety and dose range for possible anti-addiction effects, Vocci said.

He and others caution that people who happen to have medications on hand that show promise in such studies shouldn’t give them to friends and family with addiction problems. That must be left to professionals. Experts also say that even effective anti-addiction medicines usually can’t work by themselves, but must be used along with nondrug therapy.

The most straightforward approach to testing an existing drug is to follow its approved purpose, but in a different way. For example, some scientists are studying how to prolong the effects of naltrexone, now usually given as a daily pill for treating dependence on alcohol or opiates like heroin and morphine.

Dr. David Gastfriend of Massachusetts General Hospital and Harvard Medical School and other researchers recently reported that specially formulated naltrexone helped alcoholic men cut down on their drinking for a month when they received the drug as a shot in the buttocks.

Why is a monthly visit to a doctor better than just taking a pill every day?

“The pill requires a daily awareness that this is a dangerous disease and a rational decision to take the pill,” Gastfriend said. “The problem with this illness is that on any given day, a person can feel, No, it would be better if I could drink. So you take the pill the first day and you have to make 29 more decisions” the rest of the month.

“But if you received an injection the first day, those 29 decisions have already been made,” said Gastfriend, a paid consultant to Alkermes Inc., which is developing the formulation he studied, called Vivitrex.

More striking than just reformulating a drug is finding a new and apparently unrelated use for it. Here, scientists are guided by emerging knowledge about how addiction hijacks the brain.

Addicts apparently suffer from a combination of unusually strong desire for a drug and a weak inhibition against using it, Vocci said.

“These people essentially have a revved-up engine and thin brake pads,” he said.

In the brain, scientists have found that cocaine produces euphoria by stimulating nerve circuits that communicate with a substance called dopamine. So they’ve looked for medications that can affect the activity of this dopamine system.

One is a decades-old old drug called Baclofen (pronounced BAK-loe-fen), used to treat spasms, cramps and muscle tightness in people with multiple sclerosis or spinal problems. Steven Shoptaw, a researcher at the University of California, Los Angeles, recently published a preliminary, federally funded study that suggested it can cut cocaine use in addicts. A much larger study is now under way to confirm that, but for now the drug looks promising, Shoptaw said.

Other drugs that work in a similar way and that are being tested in cocaine addicts include the anti-seizure medications tiagabine, topiramate and a drug sold overseas as Vigabatrin.

Cocaine withdrawal symptoms might be eased by boosting the brain’s depleted dopamine levels. So scientists are studying dopamine-boosting drugs like Ritalin, used for attention deficit hyperactivity disorder, and amantadine, used for flu and Parkinson’s disease.

But addiction is complicated enough to involve many brain circuits, which in turn provide many targets for anti-addiction drugs. Inderal, a blood-pressure medicine, may reduce cocaine craving during early abstinence by interfering with the actions of another brain substance, norepinephrine. The antidepressants Prozac and Effexor, which boost levels of yet another brain chemical called serotonin, are also under study in cocaine dependence.

Then there’s Ondansetron (pronounced on-DAN-se-tron), which is normally used to prevent nausea and vomiting after cancer chemotherapy or surgery. Scientists are studying it for both cocaine and alcohol abuse, again for its action in the serotonin circuitry.

It might seem logical that a single drug could help in multiple kinds of addiction, but even that situation can come with a twist. Consider Antabuse, the anti-alcohol drug that works by making users sick if they drink alcohol. Scientists recently found, unexpectedly, that Antabuse also helps cocaine-dependent people cut back on cocaine, though not by making them sick.

Just how it does that isn’t clear, says researcher Dr. Thomas Kosten of Yale University. Antabuse hampers the normal breakdown of cocaine by the body, and boosts dopamine levels while reducing norepinephrine levels, he said. The net effect may be to reduce both withdrawal symptoms and desire to seek cocaine, he said.

Shoptaw thinks that, within the next five years, some drug will win approval for treating cocaine dependence. Baclofen, Topiramate and Antabuse lead his list of candidates. Each may find a use in a different phase of cocaine dependence, such as getting off the drug or staying off, he said.

And addiction specialists are eagerly looking beyond today’s medicine cabinet toward a drug that isn’t approved for anything in the United States yet. Rimonabant blazed into the headlines in March when researchers reported evidence that it might help people battle both cigarette smoking and obesity.

But why stop there?

Rimonabant blocks the brain’s docking sites for its own marijuana-like substances, part of the “cannabinoid” system that might play a role in addictions beyond food and nicotine, says Dr. Herbert Kleber of Columbia University.

Once the drug is approved for either smoking or obesity, he expects researchers will jump in and test it for things like heroin and cocaine.

And the strategy of squeezing new uses of out existing drugs may score another success. Inside here are some medicines being studied for their potential to stop drug addiction. They are already on the market for these uses:

Prozac and Effexor; prescribed for depression.

Amantadine; flu and Parkinson’s disease.

Baclofen; spasms, cramps and muscle tightness in people with multiple sclerosis or spinal problems.

Ritalin; attention deficit hyperactivity disorder.

Ondansetron; prevention of nausea and vomiting after cancer chemotherapy or surgery.

Tiagabine, Topiramate and a drug sold overseas as Vigabatrin; seizures.

Source:http://www.dailynews.com/Stories/0,1413,200~20954~2380825,00.html

Filed under: Effects of Drugs,Social Affairs :

By Susan Greenfield

Oxford, England — Across Europe and America, the legalization of cannabis for personal use generates intense debate.

Britain has, to all intents and purposes, practically decriminalized marijuana usage.

As a neuroscientist, I am concerned. One common justification for legalization or decriminalization of cannabis centres around the idea that it does not involve a victim. At least four reports in major medical journals — Ramstrom (1998), Moskowitz (1985), Chesher (1995) and Ashton (2001) — show the contrary.

Costs to the community include accidents at work or at home, educational under-attainment, impaired work performance and health-budget costs.

Another argument is over that cannabis is nonaddictive. Of course, defining addiction is hard. But if one regards it as an inability to give up, then there is strong evidence that cannabis incites dependence. Recent scientific papers report many users in the United States, United Kingdom and New Zealand now seek treatment for dependence. Other papers show that 10 percent of users want to stop or cut down but have difficulty doing so. A paper in 1998 reported that 10 to 15 percent of users become dependent on pot.

It was shown recently that withdrawal symptoms were experienced after only three days of light use. Heavy users confront a worse situation. Dr. Bryan Wells, a rehabilitation expert, says that for the first time he’s beginning to see in heavy cannabis users the withdrawal symptoms produced by hard drugs.

Another argument is the beneficial effect of marijuana on pain. So far, that evidence is anecdotal; it is hard to exclude placebo effects. The results from clinical trials are awaited.

But distinctions should be drawn between recreational drugs and medicines, as they are for opiates. If cannabis is a painkiller, then it must have a huge impact on the physical brain.

Indeed, widespread reports exist of the impact of cannabis on the brain, in particular areas concerned with memory (hippocampus), emotion (mesolimbic system) and movement (basal ganglia). Cannabis affects a variety of chemical systems and it works via its own receptor — its own molecular target.

The fact that there is a naturally occurring analogue of cannabis in the body, as there is for morphine, provides a basic reason to differentiate it from alcohol.

For an agent that affects a variety of transmitter systems, it is as though it were a transmitter itself. This is not surprising, for cannabis has a clear effect on psychology. Not only does it produce euphoria, but the effects, often overlooked, may also include anxiety, panic and paranoia. Disorders in psychological performance, attention impairments and memory deficits are well known.

More disturbing — and less frequently acknowledged — is the fact that these effects can be long-term.

In one recent study, the attention spans of ex-users were compared to those of current users, short-term and long-term. The abstainers, who had been users for at least nine years, had quit from three months to six years before the study. Of the current users, one group had at least 10 years of dependence; the other, about three years. Everyone in the study had used cannabis from 10 to 19 days per month.

Although the quitters did better than users, all had attention impairments in comparison with nonusers in a control group. The impairment was related to the duration of use. Most disturbing was the fact that no improvement in performance occurred with increasing abstinence.

It was no surprise, then, that because these long-term effects seem to be irreversible, there is an effect on brain pathology. Because much of this data comes from work with isolated systems, and therefore on all brains, an obvious criticism is that you can’t extrapolate from such data. Yet, the evidence suggests that the long-term effects must have a physical basis. Is there a safe dose of cannabis, with no effect on the brain? Even a dose comparable to one joint, and analogous levels of the active THC ingredient to that in plasma, can kill 50 percent of neurons in the hippocampus (an area related to memory) within six days. People are unaware that the THC in cannabis remains in the body for more than five days. For someone using cannabis routinely, the dose carried in the body is higher than they imagine. It is easy to underestimate the dose because of the wide range in the strength of cannabis. Individual variations in body fat and, worryingly, variations in one’s disposition to psychosis, mean that you cannot predict how much cannabis will affect any person at any time.

Cannabis could well be having a serious effect on the mind, which I define as the personalization of brain circuits that reflect an individual’s experiences. A transmitterlike substance, with such powerful effects, must affect those circuits. So blowing your mind might be exactly what marijuana users are doing.

Source: San Francisco Chronicle (CA): Pubdate: Sun, 6 Jan 2002

Note: Susan A. Greenfield, the Fullerian Professor of Physiology at Oxford University, is director of the Royal Institution of Great Britain. This article was written for Project Syndicate, based in Prague.

Filed under: Effects of Drugs,Social Affairs :

By Joel Becker, Associate Editor

As methamphetamine makes a larger impact in western Wisconsin, more and more people are making an effort to find out just how bad the drug really is.

As a part of an Elk Mound inservice for school staff, Tim Schultz of the Division of Narcotics Enforcement gave a presentation to those 60 staff members and another 160 or so community members.

Schultz’ presentation wasn’t something that was humorous or entertaining. Rather it was more apropos for a Halloween spook show.

In fact, portions of the presentation, that included videos and photos, were simply gruesome.

Schultz told the audience that he gives the same presentation to high school students and some find it too graphic.

Early in the presentation on meth, Schultz showed a video with pictures of a 4-year-old girl who had been slowly bloodied, scarred and burned before being scalded to death in a bathtub by her parents who were meth users and cookers.

And the most disturbing portion of the presentation were pictures of people who couldn’t escape their homes when their meth labs exploded.

Schultz touched on marijuana as a gateway drug, but focused on meth because “that is the biggest problem we have right now.”

Schultz has been a presenter for 17 years and said the Polk and Barron county areas are the worst places for methamphetamine in the state of Wisconsin.

He said 90 percent of crime in those counties can be attributed to meth use as users search for ways to acquire the money they need to keep up their habit.

He noted that meth is different from any other drug out there because every other drug is natural. Meth is totally manmade and is the most potent drug there is.

When smoked or injected, he cited a report that said that 90 out of 100 users will become addicts by the second time they use.

“There’s no such thing as a recreational meth user,” Schultz said.

He said people start to use meth (crystal, crank, speed, lith-fluff, ice, glass shards) for a couple of reasons. Schultz said people use it because meth causes dramatic weight loss. It gives users incredible energy and keeps them awake for days or weeks at a time.

It also gives the user a euphoria beyond anything else because it forces the brain to release all of its dopamine, the body’s feel-good drug (except that with all of the dopamine in use, the feeling is 40,000 times stronger than any release the body gives naturally). The brain usually recycles the dopamine, but meth keeps the dopamine in the system for a long high (four to 16 hours) and eventually destroys it.

So no high is as good as the first, but the addict will continually try to recreate that feeling, destroying all dopamine in the body, which meth then simulates. The person can have no feeling of pleasure on their own after continued abuse and rely on meth to feel good.

But, as Schultz said in the nearly two-hour presentation, addicts basically turn into paranoid schizophrenics. He said the “meth monsters” make addicts unable to grasp reality.

Schultz told stories of how addicts believe law enforcement officers were always watching them and out to get them. They even believed they could see them peeking in their windows or watching them with night-vision goggles from a roof across the street.

Another user said he thought he was driving 60 miles an hour in his car and saw a relative running along side, so he opened his door to let him in.

Addicts also get “crank bugs,” which cause them to scratch and pick at their skin.

The cuts and scabs are just one indication of a meth user. They also usually have bad teeth and gums, bad breath, body odor, sunken in eyes, gaunt faces and a haggard appearance.

Since methamphetamine is relatively new in Wisconsin (there’s more in Polk and Barron counties than in Madison and Milwaukee combined) Schultz said the recently-enacted law that puts pseudophedrine (a key meth ingredient) behind the counter will have little affect. Thirty-seven states have similar laws.

When the law was enacted in Iowa, meth-related arrests dropped 70 percent. But Schultz says 90 percent of the meth in Wisconsin comes from Mexicans, much of which comes from Mexico.

Though every meth addict is a victim, children are the innocent victims.

“Meth users care more about the drug than their children,” Schultz said.

Children are constantly exposed to the chemicals necessary to making meth and are often harmed by the toxins or die in meth lab fires.

“Living in a home with a meth lab is like living in a toxic waste dump,” he said.

Schultz said those trying to recover often reoffend. He said the only way for users to break the meth habit is by participating in a long-term program.

 

For more information, contact Schultz at (715) 839-3830 or by e-mail at Schultz.Tim@gmail.com

 Source: www.dunnconnect.con Nov. 2005

Filed under: Effects of Drugs,Social Affairs :

By Janet C. Greenblatt

Introduction

The National Household Survey on Drug Abuse (NHSDA), sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA), Department of Health and Human Services, has shown that since 1992, the rate of past month marijuana use among youth has more than doubled, going from 3.4 % in 1992 to 7.1 % in 1996. Similar trends are evident among both boys and girls; among whites, blacks and Hispanics; and in metropolitan and non metropolitan areas (SAMHSA 1997a). Other studies have also shown a doubling of marijuana use between 1992 and 1995 among 8th graders, and significant increases among 10th and 12th graders (NIDA 1997). At the same time, the rate of 12 to 17 year olds perceiving great risk in using marijuana has decreased. In the 1992 NHSDA, 39% of youths reported that smoking marijuana once a month is of great risk to people compared with 33% in 1996. Similarly, in 1992, 64% of youths reported smoking marijuana once or twice a week was of great risk to people compared with 57% in 1996 (SAMHSA 1997b).

The National Institute on Drug Abuse (NIDA) has reported that marijuana can be harmful both from immediate effects and damage to health over time. Specifically, studies have shown that marijuana can hinder the users’ short term memory and ability to handle difficult tasks (Schwartz et al. 1989). Students may find it difficult to study and learn. While many of the long-term effects of marijuana use are not yet known, studies have shown that daily marijuana smokers who did not use tobacco had more sick days and doctor visits for respiratory problems than a similar group who did not smoke either substance. A person who smokes marijuana regularly may have many of the same respiratory problems that tobacco smokers have (Tashkin et al. 1987). Other studies have shown that the regular use of marijuana may play a role in cancer and problems of the respiratory, immune and reproductive systems. Heavy marijuana use can affect hormones in both males and females. Both animal and human studies have shown that marijuana impairs the ability of T-cells in the lungs’ immune defense system to fight off some infections. Because of the drug’s effects on perceptions and reaction time, users could be involved in automobile accidents (NIDA 1995). According to the 1996 NHSDA, nearly one million 16-18 year olds (11%) reported driving at least once within two hours of using an illicit drug in the past year (most often marijuana) (SAMHSA 1998).

Although it is not yet known how the use of marijuana relates to mental illness, some scientists maintain that regular marijuana use can lead to chronic anxiety, personality disturbances, and depression (NIDA 1995). Some frequent long-term marijuana users show signs of lack of motivation and tend to perform poorly in school (Pope 1996). A recent study demonstrated similarities between marijuana’s effect on the brain and those produced by such addictive drugs as cocaine, heroin, alcohol, and nicotine (Volkow 1996).

There is substantial interest in the co-occurrence in the general population of illicit drug use with other kinds of behavioral patterns, mental syndromes, and psychiatric disorders (Bourden et al. 1992, Kandel et al. 1997, Kessler et al. 1996, SAMHSA 1996). A number of descriptive studies have demonstrated that people who use drugs are more likely to have mental disorders, physical health problems, and family problems (NIDA 1991). In addition, a recent study (Crowley 1998) was conducted with 165 boys and 64 girls between the ages of 13 and 19 who had been referred by social service or criminal justice agencies to a university-based treatment program for delinquent substance-involved adolescents. Based on interviews, medical examinations, social history, and psychological evaluations, the study showed that marijuana use by teenagers who have prior serious antisocial problems can quickly lead to dependence on the drug. Most of the youths reported that their behavioral problems predated, and were not initially caused by, their drug use.

The 1994, 1995, and 1996 NHSDA incorporated the widely used Youth Self-Report (YSR) Checklist which ranks adolescents on a variety of clinically validated scales of behavioral and emotional problem behaviors (Achenbach 1991). In this paper, the relationship between marijuana use among those age 12-17 and various problem measures, as reported on the YSR, is shown. This paper concentrates primarily on the reported frequency of marijuana use and its relationship with self-reported behaviors.

Methods

The NHSDA, currently conducted by SAMHSA, has provided estimates of the prevalence, consequences, and patterns of drug use and abuse in the United States periodically since 1971. It is the primary source of statistical information on the use of illegal drugs by the United States population age 12 and older. The survey collects data by administering questionnaires to a representative sample of persons living in the U.S. (SAMHSA, 1998).

The respondent universe includes residents of non institutional group quarters such as shelters, rooming houses, dormitories and residents of civilian housing on military bases. Persons excluded from the universe include the homeless not found in shelters, residents of institutional quarters, such as jails and hospitals, and active military personnel. The survey employs a multistage area probability sample design that includes over-sampling of young people, African-Americans, and Hispanics. In 1993, 1994, and 1995, cigarette smokers age 18-34 were also over-sampled.

The household interview takes about an hour to complete, and includes a combination of interviewer-administered and self-administered questions. With this procedure, the answers to sensitive questions (such as those on illicit drug use) are recorded on separate answer sheets by the respondent and are not seen by the interviewer. After the answer sheets are completed, they are placed by the respondent in an envelope, which is sealed and mailed with no name or address information included.

A concern of NHSDA data users is that the data are based on self-reports of drug use, and their value depends on respondents’ truthfulness and memory. Although many studies have generally established the validity of self-report data and the NHSDA procedures were designed to encourage honesty and recall, some underreporting may have taken place (Harrell 1986). The methodology used in the NHSDA has been shown to produce more valid results than other self-report methods such as interviews by telephone (Turner et al. 1992). However, comparisons of NHSDA data with data from surveys conducted in classrooms suggest that underreporting of drug use by youths in their homes may be substantial (Gfroerer 1997).

For this study, data from the 1994, 1995, and 1996 NHSDA datasets were combined, dividing the analytic weights by 3 to produce average annual yearly estimates for the combined dataset. Questionnaires and data collection and estimation methodologies were essentially the same in those three years. The household screening completion rate for the 1994-6 surveys was 94%. This study is restricted to those age 12-17. In 1994, 83% of sample persons age 12-17 completed the interview resulting in a sample size of 4,698. The 1995 NHSDA achieved a response rate of 85% for the 4,595 respondents age 12-17; the 1996 response rate was 82 % for a sample size of 4,538. Three-fourths of the interviews (in the combined dataset) among those age 12-17 were completed in complete privacy or with minor distractions.

In 1994, SAMHSA began collecting mental health data on the NHSDA. A youth mental health module for the age group 12-17 was adopted from work by Thomas M. Achenbach and colleagues (1991a) to obtain youths’ reports of their competencies and problems in a standardized format. The module was designed to measure depression, anxiety, social withdrawal, somatic complains, social problems, thought problems, attention problems, delinquent behavior, and aggressive behavior during the past 6 months. Psycho-social problem behaviors in the past 6 months were measured using a module composed of 118 items from the Youth Self-Report (YSR) which has been used extensively in studies of adolescents. Scores that sum up responses to the YSR have been shown to distinguish adolescents typically seen in clinical settings for counselling or psychotherapy from those seldom referred for treatment, in other words, to identify individuals who are likely to have clinically significant levels of functional, cognitive, or emotional problems. For this study, the responses to each of the 118 items were analyzed separately.

Results

Characteristics of Past Year Marijuana Users Age 12-17

Youths were asked how often in the past 12 months they used marijuana (Table 1). The majority of 12, 13, and 14 year olds (64%, 59%, and 52%, respectively) who used marijuana used less often than monthly (1-11 days in the past year) compared with 47% of 15 year olds and 39% of 16-17 year olds. More than 27% of users age 16 to 17 used marijuana 1 to 7 days a week in the past year compared with 12% of 12 year old users and 21-24% of 13-15 year old users.

The teenagers using monthly or more often were more likely to be older (age 16 to 17). The monthly or more often users were also more likely to be male than those who used less frequently. Those who used monthly or more often were more likely than less frequent users to live in the West and to have moved 2 or more times in the past year. The weekly users were 1.7 times more likely than nonusers to be living in other than a 2-parent family (55% and 33% respectively). As the frequency of use increased, the % of 12-17 year olds living in a 2-parent family decreased.

Self-reported Problem Behaviors Associated With Marijuana Use

In completing the YSR, youths were asked to read the list of 118 statements and indicate if the statement was not true, somewhat or sometimes true, or very or often true for them. Although causal conclusions about the relationship between substance use and problems cannot be drawn from the NHSDA data alone, these data provide a useful complement to other studies. While the reported behaviors are not necessarily caused by the use of marijuana or, conversely, the cause of marijuana use, there appears to be a strong positive correlation between the reporting of certain behaviors and reported frequency of marijuana use. The more frequent the use, the more likely the 12-17 year olds were to report problem behaviors.

Withdrawal:

There were 7 measures that comprised the withdrawal category .+ There was a strong correlation between the reporting of withdrawal items and the frequency of reported marijuana use. Those who used marijuana on 1-7 days a week in the past year were nearly twice as likely as non-users to report they refuse to talk (25% vs. 16%), they don’t have much energy (47% vs. 25%), and they are unhappy, sad or depressed (40% vs. 23%). Those who used marijuana at least monthly in the past year reported being more likely than nonusers to say they were secretive or kept things to themselves.

Somatic Complaints:

Those age 12 to 17 who used marijuana in the past year were more likely than nonusers to report feeling dizzy, overtired, and nauseous or sick. There appeared to be little correlation between frequency of marijuana use and certain reported somatic complaints with the more frequent users being as likely as less frequent users to report symptoms such as having headaches, rashes or other skin problems.

Anxiety/Depression:

Those who used marijuana at least once a month in the past year were nearly 3 times as likely as nonusers to say they think about killing themselves (24% vs. 8%). Those who used marijuana in the past year were more likely than nonusers to report that they deliberately try to hurt or kill themselves, feel lonely and that no one loves them, that other people are out to get them, and they are worthless and inferior. For some items, as the frequency of use increased, the % of adolescents reporting these feelings also increased. For example, weekly users were more likely than less frequent users to feel “others are out to get me”, “I am worthless or inferior” or “I am unhappy or sad”.

Social Problems:

Those who used marijuana in the past year were more likely than nonusers to report that they do not get along with other kids and weekly users were nearly twice as likely as nonusers to report this (33% vs 19%) . The weekly users were less likely than nonusers to report they act too young for their age (27% vs. 36%), they prefer younger kids as friends (15% vs. 22%), and they get teased a lot (17% vs. 25%). However, weekly users were more likely than nonusers to say they are not liked by other kids (25% vs. 18%).

Thought Problems:

Past year marijuana users age 12 to 17 were more likely than nonusers to report four thought problems: “I can not get my mind off certain thoughts”, “I repeat certain actions over and over”, “I do things other people think are strange”, and “I have thoughts people would think are strange”. In addition, monthly or more often users were more likely than nonusers to say they see and hear things that other people think are not there.

Attention Problems:

Those who used marijuana in the past year were more likely than nonusers to report they have trouble concentrating (72% vs. 51%), they feel confused or in a fog (41% vs. 24%), they daydream a lot (68% vs. 52%), they act without stopping to think (63% vs. 44%), and their school work is poor (59% vs. 30%) . As before, the % of those reporting attention problems generally increased with frequency of use.

Delinquent Behavior:

Differences of the greatest magnitude between users and nonusers were found in measures of delinquent behavior . Those who used marijuana weekly were 9 times as likely as nonusers to say they use alcohol or drugs for nonmedical purposes (76% vs. 8%), 6 times as likely to say they had run away from home (24% vs. 4%), nearly 6 times as likely to say they had cut classes or skipped school (60% vs. 11%), 5 times as likely to say they stole from places other than home (34% vs. 6%), and 3 times as likely to say they steal at home (17% vs. 5%). Moreover, a higher proportion of past year marijuana users reported these behaviors than did nonusers. Past year users were also more likely than nonusers to report they do not feel guilty after doing something they shouldn’t, they hang around with kids who get into trouble, and they lie and cheat. As noted elsewhere, the proportion saying these statements were somewhat, very or often true about them generally increased with frequency of marijuana use. For example, weekly marijuana users were about twice as likely as those who used fewer than 12 times in the past year to say they had run away from home or they had cut classes or skipped school in the past 6 months.

Aggressive Behavior:

Past year marijuana users were more likely than nonusers to report all aggressive behaviors . For many items, the percentage reporting the behavior increased as frequency of use increased. Weekly users were nearly 4 times as likely as nonusers to report they physically attack people (26% vs. 7%), and 3 times as likely to report they destroy things that belong to others (22% vs. 7%), they threaten to hurt people (38% vs. 13%), and they get in many fights (37% vs. 14%). The weekly users were also twice as likely as nonusers to report they disobey at school (59% vs. 24%) and they destroy their own things (22% vs. 10%). On average, past year marijuana users, regardless of frequency of use, were twice as likely as nonusers to report they destroy things that belong to others, they disobey at school, they get in many fights, and they threaten to hurt people.

Criminal Behavior:

In addition to the YSR module, the NHSDA included questions about some past-year activities that may have been illegal. In each comparison adolescents age 12 to 17 who used marijuana in the past year were 3 or more times more likely than nonusers to report past-year involvement in these activities. Past year marijuana users were more likely than nonusers to report that in the past year, they were on probation, and they had 1) taken something from a store without paying, 2) purposely damaged property that wasn’t theirs, 3) driven under the influence of alcohol or drugs, 4) hurt someone enough to need a bandage, and 5) sold illegal drugs. As before, in most cases, the %age reporting these behavioral problems increased with the frequency of marijuana use. In particular, weekly users of marijuana were more than 5 times as likely as those who used only 1 to 11 times in the past year to have driven under the influence of drugs (29% vs. 4%) or to have sold illegal drugs in the past year (29% vs. 6%). Weekly users were also 2-3 times more likely than those who used less often than monthly to be on probation (20% vs. 7%), to have driven under the influence of alcohol (20% vs. 9%), or to have purposely damaged property that was not theirs (35% vs. 18%).

Conclusion

This report shows that among those age 12-17, past year marijuana users were more likely than nonusers to report problem behaviors in the past 6 months. Further, for the majority of items measured, the more frequent the use, the more likely the youths were to report problem behaviors.

The more frequent users were more likely to be the older youths (6 out of 10 were age 16-17), white, male, to live in a metropolitan area and the West. They were more likely than less frequent users to have moved in the past year and are less likely to live in a 2-parent family. Frequent marijuana users were more likely than less frequent users to report delinquent behaviors such as running away from home, stealing, and cutting classes or skipping school. They were also more likely than less frequent users to report aggressive behaviors such as destroying things that belong to others and physically attacking people. Monthly or more often users were more likely than less frequent users to have driven under the influence of alcohol or drugs or sold illegal drugs in the past year. From a psychological view, youths who used marijuana in the past year reported many behaviors symptomatic of anxiety and depression. Users were 2 to 4 times more likely than nonusers to report they think about killing themselves or that they deliberately try to hurt or kill themselves. They were more likely than nonusers to say they were unhappy, sad or depressed and that they feel “no one loves me”. The users were more likely than nonusers to report that “others are out to get me” and “I am suspicious”.

Regardless of whether the problem behaviors preceded marijuana use or marijuana use preceded the behaviors (which we are not able to ascertain from the NHSDA), it is apparent from these data that the marijuana users are exhibiting many signs of anxiety and depression and exhibiting delinquent and aggressive behaviors far in excess of the nonusers. Further, there appears to be a high correlation between the presence of many of these reported behaviors and the frequency of marijuana use.

These findings strengthen the argument that marijuana is not a benign substance. Not only can it be associated with many destructive and aggressive behaviors, it can also be associated with severe symptoms of anxiety and depression. Longitudinal studies are needed to determine if the symptoms and behaviors preceded the marijuana use or vice versa. Whether this can be determined or not, this report shows the importance of preventing the use of marijuana in youths and the need for treatment for marijuana use in conjunction with treatment for co-morbid mental disorders.

References

1)Substance Abuse and Mental Health Services Administration (1997a). Drug Abuse Series: H-3. Preliminary Estimates from the 1996 National Household Survey on Drug Abuse. Office of Applied Studies, July 1997.

2)National Institute on Drug Abuse (1997). Press Release for the Monitoring the Future Study, The University of Michigan Institute for Social Research, December 1997.

3)Substance Abuse and Mental Health Services Administration (1997b). 1996 National Household Survey on Drug Abuse: Preliminary Tables (Unpublished). Office of Applied Studies, June 1997.

4)Schwartz, R.H., Gruenewald, P.J., Klitzner, M., and Fedio, P. (1989) Short-term memory impairment in cannabis-dependent adolescents. American J. of Diseases of the Child 1989; 143:1214-1219.

5)Tashkin, D.P., Coulson, A.H., Clark, V.A., et al. Respiratory system and lung function in habitual, heavy smokers of marijuana alone, smokers of marijuana and tobacco, smokers of tobacco alone, and nonsmokers. Am Rev Respir Dis 1987; 135:209-216.

6)National Institute on Drug Abuse (1995) Marijuana: Facts Parents Should know. Booklet NCADI #PHD712, GPO#017-024-01570-0.

7)Substance Abuse and Mental Health Services Administration (1998). Drug Abuse Series: H-5. National Household Survey on Drug Abuse Main Findings 1996, Office of Applied Studies, May 1998.

8)Pope, HG Jr, Yurgelun-Todd,D. The residual cognitive effects of heavy marijuana use in college students. JAMA 1996 Feb 21; 275(7): 521-7.

9)Volkow, N.D., Ding, Y.-S., Fowler, J.S., & Wang, G.-J. 1996. Cocaine Addiction: Hypothesis Derived from Imaging Studies with PET. J. Addictive Diseases, 1996.

10)Bourden, H., Rae, D., Narrow, W., Manderscheid, R., and Regier, D., National Prevalence and Treatment of Mental and Addictive Disorders, Mental Health, United States, Center for Mental Health Services, DHHS Pub. No. (SMA)92-1942 (1992).

11)Kandel, D.B., Johnson, J.G., Bird, H.R., Canino, G., Goodman, S.H., Lahey, B.B., Regier, D.A., and Schwab-Stone, M. Psychiatric Disorders Associated with Substance Use Among Children and Adolescents: Findings from the Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study. Journal of Abnormal Child Psychology 1997, 25(2), pp. 121-132.

12)Kessler, R.C., Nelson, C.B., McGongle, K.A., Edlund, M.J., Frank, R.G., and Leaf, P.J., The Epidemiology of Co-occurring Addictive and Mental Disorders in the National ComorbiditySurvey: Implications for Prevention and Service Utilization. American Journal of Orthopsychiatry 66:17-31 (1996).

13)Substance Abuse and Mental Health Services Administration (1996). Advance Report 15. Mental Health Estimates from the 1994 National Household Survey on Drug Abuse. Office of Applied Studies, July 1996.

14)Crowley, T (1998). Troubled Teens Risk Rapid Dependence on Marijuana. Drug and Alcohol Dependence 50:1.

15)Achenbach, T.M., (1991) Manual for the youth Self-Report and 1991 profile. Burlington, VT: University of Vermont Department of Psychiatry.

16)Harrell, A.V., Kapsak, K.A., Cisin, I.H., and Wirtz, P.W. (1986). The Validity of Self-Reported Drug Use Data: The Accuracy of Responses on Confidential Self-Administered Answer Sheets. Prepared for the National Institute on Drug Abuse, Contract Number 271-85-8305.

17)Turner, C.F., Lessler, J.T., and Gfroerer, J.C. (1992). Survey Measurement of Drug Use: Methodological Studies. National Institute on Drug Abuse. DHHS Pub No. (ADM) 92-1929..

18)Gfroerer, J.C. (1997). Prevalence of youth substance use: the impact of methodological differences between two national surveys. Drug and Alcohol Dependence 47 (1997) 19-30.

Table 1:Percentage Distribution of Past Year Frequency of Marijuana Use Among Past Year Users by Age, 1994-96

Frequency of Use

Age in Years

 

12

13

14

15

16

17
1-7 Days Week

12.2%

23.6%

20.4%

21.3%

27.2%

28.6%
1-4 Days Month

24.0

16.9

27.2

32.1

34.1

32.8
1-11 Days in Past Year

63.7

59.4

52.4

46.7

38.7

38.6
Total

100.0

100.0

100.0

100.0

100.0

100.0

Source:Office of Applied Studies, SAMHSA, National Household Survey on Drug Abuse 

Filed under: Effects of Drugs :

Figures show massive leap in ‘cannabis casualties’

THE number of people detained in hospital for mental and behavioural problems due to cannabis has more than trebled in the Lothians. The new figures come just days after Home Secretary Charles Clarke’s decision not to reclassify the drug from class C to class B.

Statistics set to be released by the Scottish Executive in a parliamentary answer will show that the number of cannabis-related casualties soared from 45 to 136 – the highest rise in Scotland.

In Greater Glasgow during the same period, discharges more than doubled from 74 in 2002-03, to 158 in 2004-05. However, it is unclear whether the rise is due to more people with mental health problems admitting they smoke cannabis, following its reclassification to class C.

The latest Executive figures have been obtained by the Scottish National Party’s health spokeswoman, Shona Robison. She said: “It is obviously concerning that there’s been such a huge jump. There has certainly been evidence of mental health problems linked to cannabis use and these figures add weight to that. “One of the big worries is that there has not been a clear message given out to young people that cannabis is not a cost-free drug and that there are long-term effects on the people who use it.” Mrs Robison said research was needed to establish how much of the rise was a direct result of the drug’s reclassification.

The data also shows that acute hospital discharges for problems related to cocaine also soared by almost 300 per cent in Scotland – up from 56 in 2000-01 to 190 in 2004-05.

Last year, drugs expert Professor Neil McKeganey said that reclassification of cannabis would lead to increased usage. Prof McKeganey, of Glasgow University’s centre for drug misuse, warned that smoking cannabis could lead to lung damage, depression, anxiety and could cause psychotic episodes in people suffering from schizophrenia.

Last week, Mr Clarke said he had decided against reversing the decision two years ago to downgrade cannabis to class C. The Home Secretary said he accepted the drug could trigger serious mental illness but pledged a publicity campaign to warn of the dangers. Mr Clarke said the decision was supported by police and most drug and mental health charities.

Cannabis was reclassified to class C in January 2004 after it was decided that it was not as harmful as other class B drugs such as barbiturates, amphetamine and codeine. Class C means it is ranked alongside anabolic steroids and GHB, a rave drug. The Advisory Council on the Misuse of Drugs told Mr Clarke that although capable of “real and significant” effects on mental health, cannabis was not as harmful as other class B drugs.

A spokeswoman for the Scottish Executive stressed that cannabis remained illegal and harmful. She said: “It brings a risk to physical and mental health and that’s why we are updating our education campaign on it, and our police forces continue to report people to procurators fiscal over it.”

Source: http://news.scotsman.com/health. Mon 23 Jan 2006
Filed under: Effects of Drugs :

The controversial drugs expert Neil McKeganey says it’s time for radical solutions to the epidemic set to overwhelm this country, reports Gillian Bowditch.

The year is 2020, the time 10.30am. In the centre of Glasgow a man lies slumped in a shop doorway, a needle sticking out of his leg. A couple of yards down the road a prostitute in a drug-induced stupor sways on the pavement. The newsstands in George Square announce Holyrood has passed the controversial “ghettos for junkies bill”. There are syringes in the gutter.

This vision does not spring from the pen of Irvine Welsh. According to Professor Neil McKeganey, Scotland’s leading drugs expert, this will be the daily reality on the streets of our towns and cities if we do not find an effective way of tackling the drugs problem, which is threatening to spiral out of control.

What makes his vision so chilling is that he is one of the few Scots with a handle on the extent of the drugs crisis facing Scotland.

McKeganey, who founded Glasgow University’s Centre for Drug Misuse Research in 1994, has frequently found himself out of step with mainstream thought.

Last year, however, George W Bush’s advisers in the White House called on his expertise. The Scottish executive’s lack of understanding of the drugs situation was revealed six months ago when Jack McConnell, the first minister, was forced to admit he did not know how many drug rehabilitation places there were in Scotland and his ministers admitted they had no idea how many addicts were prescribed methadone.

McKeganey is on such intimate terms with the statistics, he could recite them in his sleep. One in 100 Scots is addicted to heroin. Of the 50,000 Scottish heroin addicts, more than half live in Strathclyde, and the drugs trade in Glasgow is worth more than the combined assets of Rangers and Celtic football clubs. In proportional terms, double the number of children live in drug-addicted families in Scotland than in England.

“For many years there has been a perception that society would always be able to accommodate the drug problem,” he says over coffee in his bunker-like office on Glasgow’s Dumbarton Road. Born in Sussex and brought up in Aberdeen, he measures his words carefully. There is a diffidence in his voice completely at odds with the urgency of his message. He believes we have been fooling ourselves and are sleepwalking to disaster.

Only 2% of the adult population of Scotland is addicted, but their impact is enormous. They are responsible for almost 70% of crime in Glasgow. Five hundred million pounds is spent annually on services for addicts, an average of £10,000 a head. At a time when National Health Service budgets are being cut and patients are going to court to secure access to life-saving cancer drugs, it’s a phenomenal amount of money.

“The scale of the problem is small relative to its impact,” explains McKeganey. “You are talking about only 2% of the population creating an enormous problem. But what if it were 3% or 4%? That is still a tiny number of people, but the problems they would generate could overwhelm our existing systems.

“In 30 years the drugs problem has gone from nonexistent to an epidemic. If that can happen in a generation, what more can happen in the next 10 or 20 years? If we are at the margins of what our society can cope with now, what would our society look like if instead of 50,000 addicts we had 100,000?”

There is, he believes, no reason to assume drug addiction in Scotland has reached a plateau. “Just look at the figures for young people who feel disenfranchised,” says McKeganey. “I think it is eminently feasible that it will creep up to 3% or 4%, and many of the things we take for granted now will have to change.”

McKeganey, always a radical thinker, believes the country must be prepared to contemplate radical solutions. “We might have to create drug-free communities using drug testing or restrict addicts from retail areas between certain hours. It would effectively create ghettos. But if we can’t control the addiction, all we can do is control the movement of people.

“We have to consider how sustainable family life would be in our communities if the level of addiction goes much beyond 2%. Already you can go to parts of Scotland where the drug problem is so prevalent it is shaping communities. This gives you a glimpse of what other communities might look like in the future and it is a shocking prospect. I think every aspect of our drugs policy should be aimed at stopping this.”

All of this begs the question: what are we getting for the billions of pounds that have been sunk into drug treatments in the past decade? Listen to McKeganey and the answer is, not a lot. In Strathclyde alone drug deaths are up 70% in a 4½-month period.

“We’re spending £500m a year on a maximum of 50,000 people,” he says. “Most of them are not even in programmes, so we’re talking about a massive amount of funding being targeted on a tiny number of people.”

McKeganey’s research shows that where addicts are enrolled in programmes that focus on abstinence, they do well. If the principal aim is merely to stabilise their drug use, by prescribing methadone for example, the success rates are “pretty meagre”. Yet Scotland’s response to the drug problem is methadone. One-third of addicts are on it. Last year 411,399 prescriptions were issued. By 2012 the figure is expected to be more than 1m.

The policy is currently under review. McKeganey says it is a legacy of the early 1990s, when politicians, concerned that Scotland faced an HIV epidemic fuelled by intravenous drug users, switched from drug prevention and the treatment of addicts to preventing the spread of HIV.

“People are now beginning to ask how effective these services are in reducing criminality,” he says. “The evidence is that they are not effective. I don’t think our methadone programme is working.

“When addicts look for help they say they want to be free of drugs. What we are offering them is methadone. We are substituting a drug they buy on the street for a drug we prescribe. In what other area of treatment would the medical profession get away with that approach to patient care?”

McKeganey, who turned 50 this year, says he has not used drugs and wonders whether people will think his lack of experience diminishes his arguments.

A father to Rebecca, 17, Gabriel, 12, and Danielle, 7, he is a strong advocate of discussing drugs and their capacity to wreck lives with children from an early age. He would like to see more recovered addicts visiting schools.

His call, in The Sunday Times last February, for addicts to lose custody of their children caused outrage in some quarters. He remains unapologetic. The treatment of these children is, he believes, one of the biggest scars on our society.

“Simply stabilising addicts is not enough,” he says. “You have to get the drugs out of the home or the children out of the home. People don’t like that message.”

There are 60,000 Scottish children living in drug-addicted families, according to his research, and their experience of childhood is unrecognisable to most of us.

“Their lives are literally being sacrificed to their parents’ drug addiction,” he says. “These children don’t come second to the drugs; they come sixth or seventh, if they register at all. Are we really saying we have no better way of looking after these children than their experience within a negligent, chaotic, addict household?

“There seems to be an unfathomable acceptance of just how bad our childcare provision is. That is intolerable. The only thing worse than having a childcare system that doesn’t protect children is knowing you have a childcare system that doesn’t protect children and not doing anything about it.”

McKeganey believes that at the heart of any debate about drugs policy must be an acknowledgment of the moral dimension of drug use, whether it is Kate Moss snorting cocaine at a party, middle-class professionals smoking the occasional spliff or hardened crack addicts shooting up in squalid dens.

None of these activities is morally neutral, he argues.

“People talk about illegal drug use as if it is a morally free domain,” he says. “You get the feeling it is unacceptable to raise the question about morality. In the past 15 years we’ve said drug use is neither good nor bad but addiction is a problem. Therefore, if you have middle-class individuals whose drug use does not appear to generate addiction, it is not seen as a problem.”

Our moral agnosticism is perhaps best seen in regard to policy on cannabis.

Downgraded to a class C drug in 2004 by the then home secretary, David Blunkett, it has been subjected to more U-turns than a motorcycle stunt team. Last week it was announced that those caught with more than 5g could in future be jailed for up to 14 years.

“I think cannabis is one of our most dangerous drugs,” says McKeganey.

“That’s not because the medical harm is so acute – although it clearly is for some users – but because it has achieved what no other illegal drug has.

It has divested itself of its association with illegality. It has become so commonplace and that has opened up a portal of willingness to consume mind-altering substances way beyond the drug itself.

“Ecstasy is going the same way. It is associated with lifestyle rather than pharmacology. But if you want to tackle the drugs problem, you have to tackle it at source and that source isn’t heroin but cannabis. If the 40% of teenagers now using cannabis increases, that is not something we can ignore.

It could be of enormous significance.”

He is wary of the clamour of voices, from Lord McCluskey to Ben Elton, calling for heroin to be decriminalised. Last week the former justice minister, Richard Simpson, called for heroin to be made available to addicts on the NHS. “Giving heroin to drug addicts is not a treatment unless it is decreased gradually with a view to their abstinence. Anything else is state-sponsored drug addiction,” he says.

He also remains unconvinced it would halt the drug barons. It could lead them instead to seek out new markets, and be the ultimate quick fix with disastrous consequences. So what should we be doing about drugs in Scotland?

McKeganey believes policy should focus on three areas: prevention, treatments that lead to abstinence, and the vigorous pursuit of criminals deriving income from the drugs trade. “Without success on all three fronts this problem is going to escalate,” he says.

We are dangerously close to reaching a point where we will be unable to distinguish between the legal economy and the drugs economy, he believes.

“Colombia is a country shaped by its drug trade. People say that could never happen here and they might be right, but where are the impediments?”

As I rise to leave, McKeganey’s grim prognosis ringing in my ears, he says apologetically: “I don’t want to be a prophet of doom.” But the nature of the problem means he is doomed to prophesise.

Whether he is fated to be a latter-day Cassandra remains to be seen.

The Sunday Times – Scotland, June 11, 2006

Source: www.dpna.org June 2006
Filed under: Effects of Drugs :

Up to one million dirty needles were dumped by heroin addicts in Scotland last year, sparking calls for a national review of strategies to curb the spread of hepatitis C.

New figures expose the alarming gap between the number of clean needles issued to heroin addicts and potentially infected drug-injecting equipment that is being handed back and safely destroyed.

Statistics released by the Scottish Executive show that more than 2.9 million clean needles were issued to drug users at around 200 clinics nationwide in 2004-5 – but only 1.9 million were returned.

The Executive advises drug workers to give addicts new needles in exchange for dirty ones to prevent them from sharing and spreading hepatitis C, while preventing dirty needles from being discarded in streets and parks.

In Greater Glasgow, 539,896 needles were issued and 327,381 returned, while in Lothian, more than 279,000 were give out but only 82,262 returned. Grampian gave out the second highest number of needles – 520,096 – and 357,991 were handed back.

The Scottish Executive insisted many dirty needles dumped in specially provided safe bins were not counted.

But Professor Neil McKeganey, director of the Centre for Drug Misuse, said thousands of needles were being thrown away and called for a clampdown on clinics which are too ready to give out clean needles.

“Giving ever more needles to drug users does not seem to me to be sensible and we’ve seen a massive increase in needles issued in the last ten years.

“There is growing concern that needle exchanges are adding to the level of discarded needles,” he said.

“These figures necessitate a review of procedures in place in needle exchange clinics. It may be that a proportion of those not returned are safely disposed of in other ways but it would be foolish to think that is the case for all of them.

“We’re not talking about hundreds but hundreds of thousands of needles – that is a worrying situation,” Prof McKeganey said. “In many communities there is an increasing problem with discarded needles and syringes, creating a danger to people, particularly children, of catching hepatitis C. We mustn’t contribute further to that.”

Concern over addicts spreading disease by sharing needles meant that, in 2002, restrictions on the number of clean needles that could be given to them were lifted, with users allowed to receive up to 120 at a time, leading to a near-doubling of the number of needles issued.

But Prof McKeganey said the proportion of drug addicts sharing needles was constant, at about a third, and said “throwing more clean needles” at users was a misguided policy.

There are an estimated 51,000 heroin addicts in Scotland and 30,000 people with the highly infectious hepatitis C, a number which is growing every year.

Dr Richard Simpson, Scotland’s former drugs minister, said the figures raised questions about needle exchange policies across the country.

Dr Simpson added: “The public need to ask questions as to what is happening and services need to demonstrate that they have procedures in place to prevent needles from ending up dumped on our streets.”

Jim Shanley, manager of the harm reduction team at NHS Lothian, said: “Everyone who attends a needle exchange outlet is offered a needle and syringe in accordance with the Lord Advocate’s guidelines.

“At every intervention they will also be offered a robust, kitemarked sin bin to encourage safe needle disposal.”

A spokeswoman for the Scottish Executive said: “Needle exchanges are an essential part of strategies aimed at preventing spread of blood-borne viruses.

“Public safety is always of paramount importance. That’s why guidance makes clear that there should be a requirement to return used equipment for safe disposal at exchanges before fresh equipment is issued.

“Drug workers do, however, need the flexibility to use their professional judgment when dealing with people with chaotic lifestyles,” the spokeswoman said.

Our heroin legacy
HEROIN use in Scotland soared in the 1980s as opiates flooded the country from the “golden cresent” countries of Iran, Pakistan and Turkey.

This type of heroin was originally produced for smoking rather than injecting and its rise followed an increase in the number of Iranian refugees to the UK after the fall of the Shah in 1979. In subsequent years Afghanistan became the main supplier of heroin to Scotland.

Last year, the Scottish Drug Enforcement Agency warned that a 4,000-tonne opium crop in Afghanistan could result in more heroin becoming available in Scotland.

A recent study showed that the numbers of those using heroin had fallen, but the total number of users still remains at 50,000.

Addicts typically buy “tenner” bags which contain about 100mg of heroin. Some 225 people died from heroin overdoses in 2004, compared with 196 in 2000.

Source: www.news.Scotsman.com 10th June 2006

Filed under: Effects of Drugs :

Wednesday, June 20, 2001 – When I say, “Been there! Done that!” I ain’t talking through my hat. At 3 a.m. Sunday, I read an article about the insanity of Colorado’s new medical marijuana law. (Before continuing, I think I should become anonymous. So forget my byline.)

This is not a confessional, and I want to make it clear that I abhor the use of illegal drugs, especially marijuana. It leads people – especially children and teenagers – to believe it is harmless. It truly is a gateway drug.

I took a “hit” from a joint years ago, when I was in college. As opposed to some, I did inhale. Yucksy! As a cigarette smoker, a habit begun at an earlier age, I found the taste was worse than terrible. Also, it was a “downer.” I liked the “upper” I got from nicotine.

Three days after I received my medical degree from Ohio State University, I said goodbye to Columbus, Ohio, and left for New York City.

I have an old snapshot of me partying on fashionable East 80th Street. I was trying to get a drink while everyone else was high on pot, heroin, or cocaine. You see, in those days, the “law” didn’t care about us black folks using drugs.

I visited a barmaid friend at her apartment. She had a pile of marijuana on the table and was rolling joints to sell. I castigated her for exposing me to arrest if her place was raided, and to the possibility of losing my medical license. Selling drugs was still against the law.

Years later, around 1969, I went to a mansion in Sausalito, Calif., with friends. This time I was with upper-class white folks who were zonked out on marijuana, heroin and the most popular drug of that time, LSD. There was not a drink in the house. Disgusted, I napped in a gorgeous bedroom until we piled into a windowless van to return to San Francisco. Back then, the “law” didn’t care about you, either, if you had money and smoked in the privacy of your home.

Even before I became a psychiatrist, my sub-specialty was the treatment of alcohol and drug addiction. Sometimes I was successful with alcohol addiction. I was mostly unsuccessful with drugs.

While in general practice in Harlem, I attempted to treat a young black teacher, a user of pot and heroin. Naively, I thought his sincerity and my treatment would pull him through. No way! Both of us lost.

A musician friend from Washington, D.C., stopped by my office one day and begged me for Dolophine (methadone), saying he had to have a fix. He left crying, partly from my refusal to do so and partly from cold-turkey withdrawal from heroin. I knew he smoked pot, but I was surprised he was a doper. The next day, he was found in his hotel room, dead from an overdose of something he’d bought on the street. Years later, I was confronted by his son, who quietly but angrily accused me of killing his father.

During my tour of duty in Vietnam, I spent most of my time setting up drug treatment programs for heroin addicts, from the DMZ to the Mekong Delta. The military had ignored the fact that approximately 70 percent of soldiers entering Vietnam were already using marijuana. How easy it was to make the transition to smoking pure heroin, which was readily available in that country, often sold by Vietnamese children for $3 an ampule. By January 1971, we were sending 6,000 troops per month back to the United States for addiction to heroin.

After years of research, I have concluded that you can, in fact, become addicted to marijuana. The friend who had taken me to the mansion in Sausalito all those years ago had denied that pot was addictive, or that it could lead to the use of harder drugs. Recently, when we spoke by phone, she admitted that she had been wrong. Although successful in her profession, she had never been able to give up marijuana.

The use of marijuana for any reason should never be legalized, medically or otherwise. Prohibition of alcohol could not work because it is part of our culture. If we legalize marijuana, it too will become part of our culture.

Clotilde Bowen is a physician, a psychiatrist and a retired U.S. Army colonel.

Source: The Denver Post 06-19-01
Filed under: Effects of Drugs,Social Affairs :

White House drug czar John Walters said high-potency marijuana coming from Canada is causing an increase in marijuana-related emergency-room cases in the U.S., “Canada is exporting to us the crack of marijuana and it is a dangerous problem,” Walters said. “We need to have political leadership in Canada that recognizes the problem. Addiction is going to spread in Canada dramatically. It has in many places.”

Walters blamed Canada’s more relaxed attitude towards marijuana and an increase in hydroponically-grown marijuana, which is grown in nutrient-rich solutions rather than soil, for the growing number of ER cases. Walters said such marijuana contains 20 to 30 percent of psychoactive Delta-9-Tetrahydrocannabinol (THC), compared with 1 percent THC of marijuana from the 1960s and 1970s.

“It is extremely dangerous. It is one of the reasons why we believe we have seen a doubling of emergency-room cases involving marijuana in the last several years from 60,000 to 120,000,” Walters said.

Despite U.S. criticism, Canadian Prime Minister Paul Martin said he plans to proceed with his strategy to decriminalize possession of small amounts of marijuana.

Source: Source:Reuters report April 14. 2004
Filed under: Drug Specifics,Effects of Drugs,Legal Sector :

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