Cannabis/Marijuana

Cancer is a word that conjures up many images. It is a varied disease that affects many people and can leave families distraught. There are fortunately treatments for a large number of these cancers, which work by restricting tumour growth and inducing cell death. However, there are cancers which pose more of a challenge, and so finding new drugs that can fight these ones becomes even more important.

The methods for discovering and developing new drugs, or chemotherapies, simply fall into two camps. The more recent approach has been the design of drugs with a particular molecular target in mind. This is arguably best exemplified by the drug imatinib, notably used to eat leukaemia. After scientists understood that the BCR-ABL hybrid gene was the cause of a certain type of leukaemia it allowed them to develop pharmacological ways to specifically counteract it – by inhibiting the signals inside the cancer cell used to grow and divide. The drug that was born to much fanfare and arguably revolutionised drug development.

Continued improvements in the understanding of the mechanisms inside cells that are hijacked by cancer have helped to improve the way that compounds are designed and then tested clinically. Those that are able to restore the normal function of the signalling pathways disrupted by cancer are an attractive target for drug development.

At least three major pharmaceutical players are in a fight to negate the cancer-supporting action of AKT, for example. This protein kinase – a key regulator of cell function – is a central player in determining cell proliferation and growth, and is intimately linked with a number of other cell communications systems that all work in unison to support a cancer developing. Its level is over-expressed in a number of cancers, and is linked to a poorer prognosis. Consequently, therapeutic interventions to counteract its effects are particularly attractive and potentially lucrative.

Isolating the compound

It was however, never like this. Before the mystery of cancer was opened up, drug discovery was empirical in nature. Through antiquity, a range of flora were said to cure ailments and, using these anecdotes as guides, active ingredients have been extracted, purified and improved. This has been successful, and a number of drugs now form normal members of the pharmacopeia, including aspirin, which was isolated from the white willow, and less familiar anti-cancer drugs such as etoposide, irinotecan and taxol, which were derived from mayapples, camptotheca trees and Pacific yews. There is no doubt of their value in treatment and they’ve been used successfully for over 40 years.

Then there is the cannabis plant. The putative medicinal property of cannabis has been known for some time; indeed, history records show they were used to ease symptoms of gout, malaria and even childbirth. However, the fundamental issue with using cannabis in its whole form as a medicine is its psychoactive properties, so it would make sense to identify the important anti-cancer parts and remove the psychoactive components. Cannabinoids are these. They number around 80, with cannabidiol (CBD) and tetrahydrocannabinol (THC) the two lead medicinal candidates. However, unlike the mayapple and Pacific yew, their development has been seriously curtailed.

Cannabis. M a n u e l, CC BY

It’s likely that the widespread use of cannabis as a recreational drug has affected research into the potential in cannabis – and the result was death by association. I wonder how the early development of CBD and THC would have progressed if it was known by any other name.

Chequered pasts

Drugs with chequered pasts have found redemption; take the thalidomide story. This drug was infamously linked to babies born with deformations; however, serendipitous observations of improvements in leprosy in a patient taking thalidomide in 1965 led to the discovery that it also had important effects on the immune system. Refinements to the chemistry of the drug were made and the result was a new family of drugs that are valuable tools in anti-cancer research and treatment.

The story emphasises the point that medicinal potential of drugs should be seen objectively and guided scientifically. Cannabinoids and cannabis are not the same thing – it’s just that cannabinoids are derived from cannabis. Cannabinoids possess anti-cancer properties, which they achieve through their fundamental interactions with proteins embedded in the signalling pathways in cells that are now seen as particularly interesting for research.

In addition to this direct anti-cancer action, cannabinoids also have the capacity to disrupt the ability of cancer to feed itself by a process called angiogenesis as well as being able to modulate the immune system to make it more hostile towards cancer. Furthermore, CBD and THC appear to support the activity and efficacy of other chemotherapy drugs. Indeed, we recently showed that the cancer-killing property of radiotherapy was dramatically enhanced when cannabinoids were used in combination with this treatment – certain forms of brain cancer were reduced to sizes that were difficult to detect. Taken together, all of these features show a profile with great anti-cancer potential.

However slow things have been, a sea-change has been occurring; there is a palpable sense that legislators are becoming open to the scientific evidence that suggests cannabinoids may possess medicinal quality. Clinical trials using various forms of cannabinoids are now taking place in a number of countries, and we all await the results of these studies.

I hope to be able to change the answer that I give to patients who contact me to ask: “do you think I should be using cannabinoids for my cancer?” from the negative to the affirmative. My frustrating answer has always been it is too early to say, as promising laboratory data has not yet been confirmed by objective clinical studies. This is not a criticism of the drug development system, as convincing clinical trials are needed to ensure patients are given drugs that have been thoroughly tested to ensure the best chance of them fighting their disease.

The flip side of those who passionately shout for the “legalisation of cannabis” is that their call may inadvertently hamper the medical development of cannabinoids, which is a shame. My aim is to deliver a drug that can be used in patients with cancer. And for a headache, no one would suggest you chew on a white willow plant, especially when you could be taking an aspirin. The same is true of cannabis and cannabinoids.

Source:    https://theconversation.com/profiles/wai-liu-144882 

 

From edibles appealing to children to increased use among parents, youth are on the frontlines as America grapples with loosened marijuana access

 

 

In states where marijuana has been legalized, revenues for edibles have skyrocketed. Edibles are food products that contain THC, the substance in marijuana that produces psychological effects, or Cannabidiol (CBD). As marijuana businesses are profiting from these sales, some states are considering the taxation of marijuana products to fill budget gaps. However, most states have seen far less revenue from the taxation of marijuana products than legalization advocates would lead the public to believe, with California receiving less than half of the tax revenue initially projected.

Today, makers of edibles infuse varying quantities of THC into frequently consumed food products such as gummy bears, chocolate bars, beef jerky, soda, and more. With so much money to be made, even major corporations are entering the edibles marketplace. In 2018 Heineken launched “HiFi Hops” a non-alcoholic beer infused with THC; last month the inventor of Jelly Belly® launched a line of CBD-infused jelly beans which promptly sold out; and on April 20th (a noted holiday among marijuana consumers), a Carl’s Junior restaurant will serve the “CheeseBurger Delight,” featuring a CBD-infused sauce. There has been limited research on the effects of CBD among children and adolescents or whether CBD usage normalizes the use of marijuana in general. Therefore, we must be cautious about what the acceptance of marijuana-infused products will have on our society’s understanding of safe marijuana consumption and regulation.

The rise of edibles mimicking popular children’s candies and other frequently purchased family food products has resulted in a troubling increase in marijuana-related hospital visits for minors and adults alike, with legislatures in Colorado and California enacting laws to restrict marketing of edible products and prevent accidental ingestion by minors. However, even with these new marketing restrictions, emergency room visits for minors caused by inhaling or ingesting marijuana continue to rise. In fact, a recent study in the Annals of Internal Medicine reported that “edible products accounted for 10.7% of marijuana-attributable visits between 2014 and 2016 but represented only 0.32% of total marijuana sales in Colorado (in kilograms of tetrahydrocannabinol) during that period.”

Since legalization, marijuana-related traffic deaths increased 151 percent in Colorado, killing drivers, passengers, pedestrians and bicyclists. Furthermore, 48 percent of pediatric marijuana intoxication cases reported to poison control centers in Colorado were attributed to the ingestion of edibles. This double-whammy of decreased regulation of marijuana and increased marketing of marijuana-laced products is detrimental to public health, substance misuse prevention efforts, and puts our kids and teens at risk. Science has taught us that the age of first use of any addictive substance– whether it be marijuana, alcohol, tobacco or another drug– increases the likelihood of that individual going on to develop a substance use disorder in their lifetime, as does exposure to caregiver substance misuse.

The United States is in the midst of an overdose epidemic that is killing more people in one year than car accidents and gun violence. It is imperative that we learn from our mistakes and the actions that could have been taken to prevent the current epidemic, such as investing in evidence-based prevention education, and implement safeguards to prevent future epidemics.

 

Casey Elliott: **Author’s Note: This piece was originally published by Fox News.

Source:  https://www.addictionpolicy.org/blog/edible-marijuana-kids-at-risk   Apr 20, 2019

 

Pregnant women who smoke cannabis almost double the risk of their baby being born autistic, warns a new study.

In the largest ever study of its kind, researchers found that children whose mothers reported using cannabis during pregnancy were at greater risk of autism.

The incidence of autism was four per 1,000 person-years among children exposed to cannabis in pregnancy, compared to 2.42 among unexposed children.

‘There is evidence that more people are using cannabis during pregnancy,’ said senior study author Professor Mark Walker, of the University of Ottawa in Canada.

‘This is concerning, because we know so little about how cannabis affects pregnant women and their babies.

‘Parents-to-be should inform themselves of the possible risks, and we hope studies like ours can help.’

The researchers reviewed data from every birth in Ontario between 2007 and 2012, before recreational cannabis was legalised in Canada.

Of the half a million women in the study, about 3,000 (0.6 per cent) reported using cannabis during pregnancy.

Importantly, these women reported using only cannabis.

The team had previously found that cannabis use in pregnancy was linked to an increased risk of premature birth.

In that study, they found that women who used cannabis during pregnancy often used other substances including tobacco, alcohol and opioids.

Considering those findings, in the current study the researchers specifically looked at the 2,200 women who reported using only cannabis during pregnancy, and no other substances.

The findings, published in the medical journal Nature Medicine. showed that babies born to this group still had an increased risk of autism compared to those who didn’t use cannabis.

The researchers do not know exactly how much cannabis the women were using, how often, at what time during their pregnancy, or how it was consumed.

But as cannabis becomes more socially acceptable, doctors are concerned that some parents-to-be might think it can be used to treat morning sickness.

Dr Daniel Corsi, an epidemiologist at The Ottawa Hospital, said: ‘In the past, we haven’t had good data on the effect of cannabis on pregnancies.’

He added: ‘This is one of the largest studies on this topic to date.

‘We hope our findings will help women and their health-care providers make informed decisions.’

Autism is fairly common, but still poorly understood.

In the US, about one in every 59 children born will fall somewhere on the autism spectrum.

About one in every 66 children in Canada are autistic and, globally, the rate is approximately one in every 160 children.

Research suggests that there is likely some genetic basis for autism,  which is about four-times more common among boys than girls.

But scientists believe exposures in the womb likely play a role as well.

The effects of cannabis are similarly poorly understood to the origins of autism.

Although doctors caution against it, cannabis use has not been linked to miscarriages in humans (though animal studies have suggested an increased risk) and evidence on the link between weed and low birth-weight is mixed.

Marijuana use during pregnancy has been linked, however, to up to 2.3 times greater risks of stillbirth.

The Ottawa Hospital study did not investigate how exactly marijuana use in pregnancy might lead to autism in a child, but scientists believe that the drug’s interaction with the so-called endocannabinoid system within the nervous system could play a role in the development of the behavioral condition.

 

Source:  https://www.eurekalert.org/pub_releases/2020-08/toh-cui080620.php

 

Researchers from Dartmouth’s Geisel School of Medicine, whose crest is pictured above, and other academic medical institutions, surveyed 2630 14- to 18-year-olds via Facebook who live in states that have legalized marijuana for medical use (MMJ states), recreational use (RMJ states), and not legalized the drug (NMJ states).

MMJ and RMJ states vary in what they allow, and the researchers wanted to learn if different provisions influence when adolescents begin marijuana use and which provisions may result in increasing use among young people.

The researchers say it is crucial to understand how marijuana legalization laws affect youth because they are more vulnerable to the drug’s harmful effects. Chronic use during adolescence has been associated with impaired brain development, educational achievement, and psychosocial functioning, as well as an increased risk of developing addiction.

Legalization has spurred the development of new marijuana products with higher potencies, such as marijuana-infused foods called edibles and electronic vaping devices that enable a user to inhale the psychoactive ingredients of tobacco and marijuana without the smoke.

Edibles sold in most legal states lack safety standards or products regulations and are marketed in ways that are attractive to youth, the researchers note. These factors are contributing to the sharp increase in marijuana overdoses among young people. Vaping devices are becoming increasingly popular among middle school and high school children who use them to vape marijuana more often than adults. Moreover, data show adolescents are vaping high-potency marijuana products whose impact on neurodevelopment is unknown but concerning because they may place youth at higher risk for psychosis.

The researchers find that youth in legalization states are twice as likely as those in nonlegalization states to have tried vaping. Moreover, youth in legalization states with high dispensary density are twice as likely to have tried vaping and three times more likely to have tried edibles than youth in nonlegalization states.

The kind and duration of marijuana legalization laws also impact youth. Youth in MMJ states are significantly more likely to have tried vaping and edibles than youth in nonlegalization states, and youth in RMJ states are significantly more likely to have tried both than youth in MMJ states. Youth in legal states that allow home cultivation are twice as likely to have tried edibles (but not vaping) as their peers in legal states that prohibit home grows. States with the oldest legalization laws also see increases in youth lifetime vaping and edible use.

Read Science Daily summary here. Read Drug and Alcohol Dependence journal abstract here.

Source: Email from National Families In Action June 2017

Three months ago, National Families in Action published a report, Tracking the Money that is Legalizing Marijuana and Why It Matters, that details where the money comes from to legalize marijuana for medical and recreational use. Most of it was raised by three billionaires and two organizations they fund, the Drug Policy Alliance (DPA) and the Marijuana Policy Project (MPP) to do the work of legalization. The first decade of legalization was accomplished via ballot measures which DPA and/or MPP wrote, paid for collecting voters’ signatures, and paid heavily for advertising with less than accurate information to convince voters to pass them. This effort created a medical marijuana industry that made so much money it began contributing to the legalization effort as well.

In February 2017, five US Representatives formed the Congressional Cannabis Caucus to issue a spate of bills that would set the stage and then ultimately legalize marijuana at the federal level. It turns out that DPA and MPP donations to Congressional campaigns are over-represented among Caucus members and other legislators who are partnering with them to reach this goal. Together, Caucus members, pictured above, and colleagues have introduced more than 20 bills since February.

Rep. Earl Blumenauer (D-OR), who received $3,000 from MPP, has introduced three of those bills and is co-sponsoring seven more.

Rep. Ed Perlmutter (D-CO) received $2,000 from MPP, has introduced one bill, and co-sponsored four more.

Rep. Ed Polis (D-CO), the only Caucus member who has not received donations from either group, has introduced one bill and co-sponsored six more.

Rep. Young (R-AK) received $1,000 from MPP, introduced one bill, and co-sponsored five more.

Rep. Dana Rohrabacher (R-CA) received $7,000 from MPP and $4,700 from DPA, introduced one bill, and co-sponsored five more bills.

Here are the representatives and senators who signed on as co-sponsors of the 20-plus bills who also received donations from DPA and/or MPP as of June 28:

  • Rep. Ruben Gallego (D-AZ) — $5,000/MPP – co-sponsoring 1 bill.
  • Rep. Raul Grijalva (D-AZ) — $1,000/MPP – co-sponsoring 2 bills.
  • Rep. Pete Aguilar (D-CA) — $8,000/MPP — co-sponsoring 1 bill.
  • Rep. Jared Huffman (D-CA) — $3,000/MPP – co-sponsoring 2 bills.
  • Rep. Duncan Hunter (R-CA) — $1,000/MPP – co-sponsoring 3 bills.
  • Rep. Barbara Lee (D-CA) — $4,500/MPP/$500/DPA – sponsoring 1 bill, co-sponsoring 5 bills.
  • Rep. Alan Lowenthal (D-CA) — $1,000/MPP — co-sponsoring 1 bill.
  • Rep. Mike Coffman (R-CO) — $1,000/MPP — sponsoring 1 bill, co-sponsoring 3 bills.
  • Rep. Diana DeGette (D-CO) — $1,000/DPA – sponsoring 1 bill, co-sponsoring 2 bills.
  • Rep. Joe Courtney (D-CT) — $2,600/MPP – co-sponsoring 2 bills.
  • Rep. Carlos Curbelo (R-FL) — $1,000/MPP – co-sponsoring 1 bill.
  • Rep. Ted Yoho (R-FL) — $1,000/MPP — co-sponsoring 1 bill.
  • Rep. Thomas Massie (R-KY) — $1,000/MPP — co-sponsoring 1 bill.
  • Sen. Rand Paul (R-KY) — $3,500/MPP – co-sponsoring 3 bills.
  • Rep. Jamie Raskin (D-MD) — $5,000/MPP — co-sponsoring 2 bills.
  • Rep. Justin Amash (R-MI) — $5,750/MPP/$1,000/DPA — co-sponsoring 3 bills.
  • Rep. John Conyers (D-MI) — $2,500/DPA – co-sponsoring 1 bill.
  • Sen. Roy Blunt (R-MO) — $1,000/MPP — co-sponsoring 1 bill.
  • Rep. Ruben Kihuen (D-NV) — $1,00/MPP – co-sponsoring 2 bills.
  • Sen. Cory Booker (D-NJ) — $1,000/DPA — sponsoring 1 bill.
  • Rep. Steve Cohen (D-TN) — $5,500/MPP — sponsoring 1 bill, co-sponsoring 7 bills.
  • Rep. Jim Cooper (D-TN) — $1,000/MPP – co-sponsoring 1 bill.
  • Rep. Beto O’Rourke (D-TX) — $6,000/MPP/$4,500/DPA — co-sponsoring 5 bills.
  • Rep. Mark Pocan (D-WI) — $4,000/MPP — co-sponsoring 3 bills.
  • Sen. Tammy Baldwin (D-WI) — $1,500/MPP — co-sponsoring 1 bill.

People who don’t want to see Congress legalize marijuana nationwide can pay to play too. With few exceptions, these are not large amounts of money. They could be matched to replace MPP’s and DPA’s donations so legislators can work for healthy families and healthy communities instead of the marijuana industry.

The Cannabist, the Denver Post’s marijuana website, published a list of bills these folks have introduced in Congress since the Caucus was formed in February. You can read it here.
Note: a few bills in the list do not deal with legalization.

Source: Email from National Families In Action  June 2017

Items 1 – 193 of 193    (Display the 193 citations in PubMed)

 

1. The Living the Example Social Media Substance Use Prevention Program: A Pilot Evaluation.
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2. Pregnenolone does not interfere with the effects of cannabinoids on synaptic transmission in the cerebellum and the nucleus accumbens.
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3. Tobacco smoking is associated with psychotic experiences in the general population of South London.
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Psychol Med. 2017 Jun 28:1-9. doi: 10.1017/S0033291717001556. [Epub ahead of print]
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4. Seller’s reputation and capacity on the illicit drug markets: 11-month study on the Finnish version of the Silk Road.
Nurmi J, Kaskela T, Perälä J, Oksanen A.
Drug Alcohol Depend. 2017 Jun 21;178:201-207. doi: 10.1016/j.drugalcdep.2017.05.018. [Epub ahead of print]
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5. The effects of using answer sheets on reported drug use and data quality in a classroom survey: A cluster-randomized study.
Castillo-Carniglia A, Pizarro E, Marín JD, Rodríguez N, Casas-Cordero C, Cerdá M.
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6. Can a rapid measure of self-exposure to drugs of abuse provide dimensional information on depression comorbidity?
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7. Commentary: Navigating the complexities of marijuana.
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8. The role of marijuana use disorder in predicting emergency department and inpatient encounters: A retrospective cohort study.
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Drug Alcohol Depend. 2017 Jun 10;178:170-175. doi: 10.1016/j.drugalcdep.2017.04.017. [Epub ahead of print]
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9. Get Real: Evaluation of a Community-Level HIV Prevention Intervention for Young MSM Who Engage in Episodic Substance Use.
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10. Δ9-tetrahydrocannabinol (Δ9-THC) administration after neonatal exposure to phencyclidine potentiates schizophrenia-related behavioral phenotypes in mice.
Rodríguez G, Neugebauer NM, Yao KL, Meltzer HY, Csernansky JG, Dong H.
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11. Healthcare contact and treatment uptake following hepatitis C virus screening and counseling among rural Appalachian people who use drugs.
Stephens DB, Young AM, Havens JR.
Int J Drug Policy. 2017 Jun 22. pii: S0955-3959(17)30149-4. doi: 10.1016/j.drugpo.2017.05.045. [Epub ahead of print]
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12. [Adolescence and psychoactive substances].
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13. [Drug use and addictive practices in France].
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14. Psychological symptomatology and impaired prepulse inhibition of the startle reflex are associated with cannabis-induced psychosis.
Morales-Muñoz I, Martínez-Gras I, Ponce G, de la Cruz J, Lora D, Rodríguez-Jiménez R, Jurado-Barba R, Navarrete F, García-Gutiérrez MS, Manzanares J, Rubio G.
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15. Daily associations between cannabis motives and consumption in emerging adults.
Bonar EE, Goldstick JE, Collins RL, Cranford JA, Cunningham RM, Chermack ST, Blow FC, Walton MA.
Drug Alcohol Depend. 2017 Jun 15;178:136-142. doi: 10.1016/j.drugalcdep.2017.05.006. [Epub ahead of print]
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16. Substance use among HIV-infected patients in Rio de Janeiro, Brazil: Agreement between medical records and the ASSIST questionnaire.
Machado IK, Luz PM, Lake JE, Castro R, Velasque L, Clark JL, Veloso VG, Grinsztejn B, De Boni RB.
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17. Prediction of vocational participation and global role functioning in help-seeking young adults, from neurocognitive, demographic and clinical variables.
Cairns AJ, Kavanagh DJ, Dark F, McPhail SM.
J Affect Disord. 2017 Jun 13;221:158-164. doi: 10.1016/j.jad.2017.06.008. [Epub ahead of print]
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18. Structural Neuroimaging Correlates of Alcohol and Cannabis Use in Adolescents and Adults.
Thayer RE, YorkWilliams S, Karoly HC, Sabbineni A, Ewing SF, Bryan AD, Hutchison KE.
Addiction. 2017 Jun 23. doi: 10.1111/add.13923. [Epub ahead of print]
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19. Epidemiological and sociodemographic factors associated with complicated alcohol withdrawal syndrome.
Monte-Secades R, Blanco-Soto M, Díaz-Peromingo JA, Sanvisens-Bergé A, Martín-González MC, Barbosa A, Rosón-Hernández B, Tejero-Delgado MA, Puerta-Louro R, Rabuñal-Rey R; Grupo de Trabajo Alcohol y Alcoholismo, Sociedad Española de Medicina Interna.
Rev Clin Esp. 2017 Jun 20. pii: S0014-2565(17)30131-5. doi: 10.1016/j.rce.2017.05.002. [Epub ahead of print] English, Spanish.
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20. PLACENTA AS ALTERNATIVE SPECIMEN TO DETECT IN UTERO CANNABIS EXPOSURE: A SYSTEMATIC REVIEW OF THE LITERATURE.
Marchetti D, Di Masi G, Cittadini F, La Monaca G, De Giovanni N.
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21. Childhood Traumatic Experiences and the Association with Marijuana and Cocaine Use in Adolescence through Adulthood.
Scheidell JD, Quinn K, McGorray SP, Frueh BC, Beharie NN, Cottler LB, Khan MR.
Addiction. 2017 Jun 23. doi: 10.1111/add.13921. [Epub ahead of print]
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22. Young people who use drugs engaged in harm reduction programs in New York City: Overdose and other risks.
Calvo M, MacFarlane J, Zaccaro H, Curtis M, Cabán M, Favaro J, Passannante MR, Frost T.
Drug Alcohol Depend. 2017 Jun 15;178:106-114. doi: 10.1016/j.drugalcdep.2017.04.032. [Epub ahead of print]
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23. Medical Cannabis for Pain: Anecdote or Evidence.
Lipman AG.
J Pain Palliat Care Pharmacother. 2017 Jun;31(2):96-97. doi: 10.1080/15360288.2017.1313358. No abstract available.
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24. A little “dab” will do ya’ in: a case report of neuro-and cardiotoxicity following use of cannabis concentrates.
Rickner SS, Cao D, Kleinschmidt K, Fleming S.
Clin Toxicol (Phila). 2017 Jun 23:1-3. doi: 10.1080/15563650.2017.1334914. [Epub ahead of print]
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25. Lower-Risk Cannabis Use Guidelines: A Comprehensive Update of Evidence and Recommendations.
Fischer B, Russell C, Sabioni P, van den Brink W, Le Foll B, Hall W, Rehm J, Room R.
Am J Public Health. 2017 Jun 23:e1-e12. doi: 10.2105/AJPH.2017.303818. [Epub ahead of print]
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26. Tetrahydrocannabinol (THC) impairs encoding but not retrieval of verbal information.
Ranganathan M, Radhakrishnan R, Addy PH, Schnakenberg A, Williams A, Carbuto M, Elander J, Pittman B, Andrew Sewell R, Skosnik PD, D’Souza DC.
Prog Neuropsychopharmacol Biol Psychiatry. 2017 Jun 19. pii: S0278-5846(17)30040-4. doi: 10.1016/j.pnpbp.2017.06.019. [Epub ahead of print]
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27. Pharmaceutical and biomedical analysis of cannabinoids: A critical review.
Citti C, Braghiroli D, Vandelli MA, Cannazza G.
J Pharm Biomed Anal. 2017 Jun 4. pii: S0731-7085(17)31189-5. doi: 10.1016/j.jpba.2017.06.003. [Epub ahead of print] Review.
PMID: 28641906 [PubMed – as supplied by publisher]
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28. Guanfacine Attenuates Adverse Effects of Dronabinol (THC) on Working Memory in Adolescent-Onset Heavy Cannabis Users: A Pilot Study.
Mathai DS, Holst M, Rodgman C, Haile CN, Keller J, Hussain MZ, Kosten TR, Newton TF, Verrico CD.
J Neuropsychiatry Clin Neurosci. 2017 Jun 23:appineuropsych16120328. doi: 10.1176/appi.neuropsych.16120328. [Epub ahead of print]
PMID: 28641496 [PubMed – as supplied by publisher]
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29. Sexual orientation, minority stress, social norms, and substance use among racially diverse adolescents.
Mereish EH, Goldbach JT, Burgess C, DiBello AM.
Drug Alcohol Depend. 2017 Jun 8;178:49-56. doi: 10.1016/j.drugalcdep.2017.04.013. [Epub ahead of print]
PMID: 28641130 [PubMed – as supplied by publisher]
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30. Moderate and vigorous physical activity patterns among marijuana users: Results from the 2007-2014 National Health and Nutrition Examination Surveys.
Vidot DC, Bispo JB, Hlaing WM, Prado G, Messiah SE.
Drug Alcohol Depend. 2017 Jun 13;178:43-48. doi: 10.1016/j.drugalcdep.2017.05.004. [Epub ahead of print]
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31. Expectancy of impairment attenuates marijuana-induced risk taking.
Gunn RL, Skalski L, Metrik J.
Drug Alcohol Depend. 2017 Jun 13;178:39-42. doi: 10.1016/j.drugalcdep.2017.04.027. [Epub ahead of print]
PMID: 28641128 [PubMed – as supplied by publisher]
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32. Changes in hemp secondary fiber production related to technical fiber variability revealed by light microscopy and attenuated total reflectance Fourier transform infrared spectroscopy.
Fernandez-Tendero E, Day A, Legros S, Habrant A, Hawkins S, Chabbert B.
PLoS One. 2017 Jun 22;12(6):e0179794. doi: 10.1371/journal.pone.0179794. eCollection 2017.
PMID: 28640922 [PubMed – in process] Free Article
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33. Polysubstance Use Among US Women of Reproductive Age Who Use Opioids for Nonmedical Reasons.
Jarlenski M, Barry CL, Gollust S, Graves AJ, Kennedy-Hendricks A, Kozhimannil K.
Am J Public Health. 2017 Jun 22:e1-e3. doi: 10.2105/AJPH.2017.303825. [Epub ahead of print]
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34. Crash Fatality Rates After Recreational Marijuana Legalization in Washington and Colorado.
Aydelotte JD, Brown LH, Luftman KM, Mardock AL, Teixeira PGR, Coopwood B, Brown CVR.
Am J Public Health. 2017 Jun 22:e1-e3. doi: 10.2105/AJPH.2017.303848. [Epub ahead of print]
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35. An Atmospheric Pressure Ionization MS/MS Assay using Online Extraction for the Analysis of 11 Cannabinoids and Metabolites in Human Plasma and Urine.
Klawitter J, Sempio C, Mörlein S, De Bloois E, Klepacki J, Henthorn T, Leehey MA, Hoffenberg EJ, Knupp K, Wang GS, Hopfer C, Kinney G, Bowler R, Foreman N, Galinkin J, Christians U, Klawitter J.
Ther Drug Monit. 2017 Jun 19. doi: 10.1097/FTD.0000000000000427. [Epub ahead of print]
PMID: 28640062 [PubMed – as supplied by publisher]
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36. Substance use and misuse among children and youth with mental illness : A pilot study.
Herz V, Franzin N, Huemer J, Mairhofer D, Philipp J, Skala K.
Neuropsychiatr. 2017 Jun 21. doi: 10.1007/s40211-017-0231-4. [Epub ahead of print]
PMID: 28639209 [PubMed – as supplied by publisher]
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37. Is cannabis treatment for anxiety, mood, and related disorders ready for prime time?
Turna J, Patterson B, Van Ameringen M.
Depress Anxiety. 2017 Jun 21. doi: 10.1002/da.22664. [Epub ahead of print] Review.
PMID: 28636769 [PubMed – as supplied by publisher]
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38. Adolescent Exposure to the Synthetic Cannabinoid WIN 55212-2 Modifies Cocaine Withdrawal Symptoms in Adult Mice.
Aguilar MA, Ledesma JC, Rodríguez-Arias M, Penalva C, Manzanedo C, Miñarro J, Arenas MC.
Int J Mol Sci. 2017 Jun 21;18(6). pii: E1326. doi: 10.3390/ijms18061326.
PMID: 28635664 [PubMed – in process] Free Article
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39. Cannabis and cognitive functioning in multiple sclerosis: The role of gender.
Patel VP, Feinstein A.
Mult Scler J Exp Transl Clin. 2017 Jun 8;3(2):2055217317713027. doi: 10.1177/2055217317713027. eCollection 2017 Apr-Jun.
PMID: 28634543 [PubMed – in process] Free PMC Article
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40. Cannabis-associated psychosis: Neural substrate and clinical impact.
Murray RM, Englund A, Abi-Dargham A, Lewis D, Di Forti M, Davies C, Sherif M, McGuire P, D’Souza C.
Neuropharmacology. 2017 Jun 17. pii: S0028-3908(17)30291-5. doi: 10.1016/j.neuropharm.2017.06.018. [Epub ahead of print] Review.
PMID: 28634109 [PubMed – as supplied by publisher]
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41. Evaluation of Oral Fluid as a Specimen for DUID.
Veitenheimer AM, Wagner JR.
J Anal Toxicol. 2017 Jun 13:1-6. doi: 10.1093/jat/bkx036. [Epub ahead of print]
PMID: 28633318 [PubMed – as supplied by publisher]
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42. Lifetime experience with (classic) psychedelics predicts pro-environmental behavior through an increase in nature relatedness.
Forstmann M, Sagioglou C.
J Psychopharmacol. 2017 Jun 1:269881117714049. doi: 10.1177/0269881117714049. [Epub ahead of print]
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43. A Two-Year Study of Δ 9 Tetrahydrocannabinol Concentrations in Drivers; Part 2: Physiological Signs on Drug Recognition Expert (DRE) and non-DRE Examinations,.
Declues K, Perez S, Figueroa A.
J Forensic Sci. 2017 Jun 20. doi: 10.1111/1556-4029.13550. [Epub ahead of print]
PMID: 28631315 [PubMed – as supplied by publisher]
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44. Drug Policy and Indigenous Peoples.
Burger J, Kapron M.
Health Hum Rights. 2017 Jun;19(1):269-278.
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45. A Reinforcement Sensitivity Model of Affective and Behavioral Dysregulation in Marijuana Use and Associated Problems.
Emery NN, Simons JS.
Exp Clin Psychopharmacol. 2017 Jun 19. doi: 10.1037/pha0000131. [Epub ahead of print]
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46. Predictors of Substance Use in Youth With Borderline Personality Disorder.
Scalzo F, Hulbert CA, Betts JK, Cotton SM, Chanen AM.
Personal Disord. 2017 Jun 19. doi: 10.1037/per0000257. [Epub ahead of print]
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47. The opioid epidemic is an historic opportunity to improve both prevention and treatment.
DuPont RL.
Brain Res Bull. 2017 Jun 13. pii: S0361-9230(17)30292-7. doi: 10.1016/j.brainresbull.2017.06.008. [Epub ahead of print]
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48. User characteristics and effect profile of Butane Hash Oil: An extremely high-potency cannabis concentrate.
Chan GCK, Hall W, Freeman TP, Ferris J, Kelly AB, Winstock A.
Drug Alcohol Depend. 2017 Jun 8;178:32-38. doi: 10.1016/j.drugalcdep.2017.04.014. [Epub ahead of print]
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49. Associations between anhedonia and marijuana use escalation across mid-adolescence.
Leventhal AM, Cho J, Stone MD, Barrington-Trimis JL, Chou CP, Sussman SY, Riggs NR, Unger JB, Audrain-McGovern J, Strong DR.
Addiction. 2017 Jun 17. doi: 10.1111/add.13912. [Epub ahead of print]
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50. Self-reported Cognitive Scales in a U.S. National Survey: Reliability, Validity, and Preliminary Evidence for Associations with Alcohol and Drug Use.
Aharonovich E, Shmulewitz D, Wall MM, Grant BF, Hasin DS.
Addiction. 2017 Jun 17. doi: 10.1111/add.13911. [Epub ahead of print]
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51. A randomized placebo-controlled trial of N-acetylcysteine for cannabis use disorder in adults.
Gray KM, Sonne SC, McClure EA, Ghitza UE, Matthews AG, McRae-Clark AL, Carroll KM, Potter JS, Wiest K, Mooney LJ, Hasson A, Walsh SL, Lofwall MR, Babalonis S, Lindblad RW, Sparenborg S, Wahle A, King JS, Baker NL, Tomko RL, Haynes LF, Vandrey RG, Levin FR.
Drug Alcohol Depend. 2017 Jun 10;177:249-257. doi: 10.1016/j.drugalcdep.2017.04.020. [Epub ahead of print]
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52. Substantiated childhood maltreatment and young adulthood cannabis use disorders: A pre-birth cohort study.
Abajobir AA, Najman JM, Williams G, Strathearn L, Clavarino A, Kisely S.
Psychiatry Res. 2017 Jun 9;256:21-31. doi: 10.1016/j.psychres.2017.06.017. [Epub ahead of print]
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53. Weeding Out the Justification for Marijuana Treatment in Patients with Developmental and Behavioral Conditions.
Nelson T, Liu YH, Bagot KS, Stein MT.
J Dev Behav Pediatr. 2017 Jun 15. doi: 10.1097/DBP.0000000000000464. [Epub ahead of print]
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54. Prevalence of substance use among middle school-aged e-cigarette users compared with cigarette smokers, non-users and dual users: Implications for primary prevention.
Kristjansson AL, Mann MJ, Smith ML.
Subst Abus. 2017 Jun 16:0. doi: 10.1080/08897077.2017.1343218. [Epub ahead of print]
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55. Patterns and factors of problematic marijuana use in the Canadian population: Evidence from three cross-sectional surveys.
Bonner WIA, Andkhoie M, Thompson C, Farag M, Szafron M.
Can J Public Health. 2017 Jun 16;108(2):e110-e116. doi: 10.17269/cjph.108.5926.
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56. Testing the Amotivational Syndrome: Marijuana Use Longitudinally Predicts Lower Self-Efficacy Even After Controlling for Demographics, Personality, and Alcohol and Cigarette Use.
Lac A, Luk JW.
Prev Sci. 2017 Jun 16. doi: 10.1007/s11121-017-0811-3. [Epub ahead of print]
PMID: 28620722 [PubMed – as supplied by publisher]
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57. Criminal Charges for Child Harm from Substance Use in Pregnancy.
Angelotta C, Appelbaum PS.
J Am Acad Psychiatry Law. 2017 Jun;45(2):193-203.
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58. The new front in the war on doping: Amateur athletes.
Henning AD, Dimeo P.
Int J Drug Policy. 2017 Jun 12. pii: S0955-3959(17)30140-8. doi: 10.1016/j.drugpo.2017.05.036. [Epub ahead of print]
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59. Daily-level associations between PTSD and cannabis use among young sexual minority women.
Dworkin ER, Kaysen D, Bedard-Gilligan M, Rhew IC, Lee CM.
Addict Behav. 2017 Jun 8;74:118-121. doi: 10.1016/j.addbeh.2017.06.007. [Epub ahead of print]
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60. Freshman Year Alcohol and Marijuana use Prospectively Predict Time to College Graduation and Subsequent Adult Roles and Independence.
Wilhite ER, Ashenhurst JR, Marino EN, Fromme K.
J Am Coll Health. 2017 Jun 15:0. doi: 10.1080/07448481.2017.1341892. [Epub ahead of print]
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61. Utilizing Big Data and Twitter to Discover Emergent Online Communities of Cannabis Users.
Baumgartner P, Peiper N.
Subst Abuse. 2017 Jun 6;11:1178221817711425. doi: 10.1177/1178221817711425. eCollection 2017.
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62. Contextual Effects of Neighborhoods and Schools on Adolescent and Young Adult Marijuana Use in the United States.
Milliren CE, Richmond TK, Evans CR, Dunn EC, Johnson RM.
Subst Abuse. 2017 Jun 6;11:1178221817711417. doi: 10.1177/1178221817711417. eCollection 2017.
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63. Marijuana Use, Recent Marijuana Initiation, and Progression to Marijuana Use Disorder Among Young Male and Female Adolescents Aged 12-14 Living in US Households.
Forman-Hoffman VL, Glasheen C, Batts KR.
Subst Abuse. 2017 Jun 6;11:1178221817711159. doi: 10.1177/1178221817711159. eCollection 2017.
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64. Toxicity, Marijuana.
Turner A, Agrawal S.
StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2017 Jun-.
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65. Marijuana.
Turner A, Agrawal S.
StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2017 Jun-.
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66. Multiple Cerebral Infarcts in a Young Patient Associated With Marijuana Use.
Volpon LC, Sousa CLMM, Moreira SKK, Teixeira SR, Carlotti APCP.
J Addict Med. 2017 Jun 13. doi: 10.1097/ADM.0000000000000326. [Epub ahead of print]
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67. The association of cannabis use on inpatient psychiatric hospital outcomes.
Rylander M, Winston HR, Medlin H, Hull M, Nussbaum A.
Am J Drug Alcohol Abuse. 2017 Jun 14:1-12. doi: 10.1080/00952990.2017.1329313. [Epub ahead of print]
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68. Changes in undergraduates’ marijuana, heavy alcohol, and cigarette use following legalization of recreational marijuana use in Oregon.
Kerr DCR, Bae H, Phibbs S, Kern AC.
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69. Influence of Substance Use Disorders on 2-Year HIV Care Retention in the United States.
Hartzler B, Dombrowski JC, Williams JR, Crane HM, Eron JJ, Geng EH, Mathews C, Mayer KH, Moore RD, Mugavero MJ, Napravnik S, Rodriguez B, Donovan DM.
AIDS Behav. 2017 Jun 13. doi: 10.1007/s10461-017-1826-2. [Epub ahead of print]
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70. Herbal laxatives and antiemetics in pregnancy.
Samavati R, Ducza E, Hajagos-Tóth J, Gaspar R.
Reprod Toxicol. 2017 Jun 10. pii: S0890-6238(17)30057-6. doi: 10.1016/j.reprotox.2017.06.041. [Epub ahead of print]
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71. Examining the influence of adolescent marijuana use on adult intelligence: Further evidence in the causation versus spuriousness debate.
Boccio CM, Beaver KM.
Drug Alcohol Depend. 2017 Jun 6;177:199-206. doi: 10.1016/j.drugalcdep.2017.04.007. [Epub ahead of print]
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72. Development of a new extraction technique and HPLC method for the analysis of non-psychoactive cannabinoids in fibre-type Cannabis sativa L. (hemp).
Brighenti V, Pellati F, Steinbach M, Maran D, Benvenuti S.
J Pharm Biomed Anal. 2017 Jun 4;143:228-236. doi: 10.1016/j.jpba.2017.05.049. [Epub ahead of print]
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73. Impulsivity as a mechanism linking child abuse and neglect with substance use in adolescence and adulthood.
Oshri A, Kogan SM, Kwon JA, Wickrama KAS, Vanderbroek L, Palmer AA, MacKillop J.
Dev Psychopathol. 2017 Jun 13:1-19. doi: 10.1017/S0954579417000943. [Epub ahead of print]
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74. Two steps forward, one step back: current harm reduction policy and politics in the United States.
Nadelmann E, LaSalle L.
Harm Reduct J. 2017 Jun 12;14(1):37. doi: 10.1186/s12954-017-0157-y.
PMID: 28606093 [PubMed – in process] Free PMC Article
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75. Cannabis increased the risk of primary spontaneous pneumothorax in tobacco smokers: a case-control study.
Hedevang Olesen W, Katballe N, Sindby JE, Titlestad IL, Andersen PE, Ekholm O, Lindahl-Jacobsen R, Licht PB.
Eur J Cardiothorac Surg. 2017 Jun 12. doi: 10.1093/ejcts/ezx160. [Epub ahead of print]
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76. Attitudes Toward Medical Cannabis Legalization Among Serbian Medical Students.
Vujcic I, Pavlovic A, Dubljanin E, Maksimovic J, Nikolic A, Sipetic-Grujicic S.
Subst Use Misuse. 2017 Jun 12:1-7. doi: 10.1080/10826084.2017.1302959. [Epub ahead of print]
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77. Family Structure and Adolescent Substance Use: An International Perspective.
Hoffmann JP.
Subst Use Misuse. 2017 Jun 12:1-17. doi: 10.1080/10826084.2017.1305413. [Epub ahead of print]
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78. Drug-Avoidance Self-Efficacy Among Exclusive Cannabis Users vs. Other Drug Users Visiting the Emergency Department.
Clingan SE, Woodruff SI.
Subst Use Misuse. 2017 Jun 12:1-7. doi: 10.1080/10826084.2017.1305412. [Epub ahead of print]
PMID: 28605216 [PubMed – as supplied by publisher]
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79. Associations of Bullying and Cyberbullying With Substance Use and Sexual Risk Taking in Young Adults.
Kritsotakis G, Papanikolaou M, Androulakis E, Philalithis AE.
J Nurs Scholarsh. 2017 Jun 12. doi: 10.1111/jnu.12299. [Epub ahead of print]
PMID: 28605163 [PubMed – as supplied by publisher]
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80. Health considerations in regulating marijuana in Vermont.
Chen H, Searles JS.
Prev Med. 2017 Jun 8. pii: S0091-7435(17)30208-6. doi: 10.1016/j.ypmed.2017.06.004. [Epub ahead of print]
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81. Online self-help forums on cannabis: A content assessment.
Greiner C, Chatton A, Khazaal Y.
Patient Educ Couns. 2017 Jun 3. pii: S0738-3991(17)30345-2. doi: 10.1016/j.pec.2017.06.001. [Epub ahead of print]
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82. Development and initial validation of a marijuana cessation expectancies questionnaire.
Metrik J, Farris SG, Aston ER, Kahler CW.
Drug Alcohol Depend. 2017 Jun 1;177:163-170. doi: 10.1016/j.drugalcdep.2017.04.005. [Epub ahead of print]
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83. Examination of cumulative effects of early adolescent depression on cannabis and alcohol use disorder in late adolescence in a community-based cohort.
Rhew IC, Fleming CB, Stoep AV, Nicodimos S, Zheng C, McCauley E.
Addiction. 2017 Jun 10. doi: 10.1111/add.13907. [Epub ahead of print]
PMID: 28600897 [PubMed – as supplied by publisher]
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84. Ready, willing, and able: The role of cannabis use opportunities in understanding adolescent cannabis use.
Andreas JB, Bretteville-Jensen AL.
Addiction. 2017 Jun 10. doi: 10.1111/add.13901. [Epub ahead of print]
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85. Loose regulation of medical marijuana programs associated with higher rates of adult marijuana use but not cannabis use disorder.
Williams AR, Santaella-Tenorio J, Mauro CM, Levin FR, Martins SS.
Addiction. 2017 Jun 10. doi: 10.1111/add.13904. [Epub ahead of print]
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86. Substance Use Disorder Treatment Following Clinician-Initiated Discontinuation of Long-Term Opioid Therapy Resulting from an Aberrant Urine Drug Test.
Nugent SM, Dobscha SK, Morasco BJ, Demidenko MI, Meath THA, Frank JW, Lovejoy TI.
J Gen Intern Med. 2017 Jun 9. doi: 10.1007/s11606-017-4084-0. [Epub ahead of print]
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87. Treating tobacco dependence: guidance for primary care on life-saving interventions. Position statement of the IPCRG.
Van Schayck OCP, Williams S, Barchilon V, Baxter N, Jawad M, Katsaounou PA, Kirenga BJ, Panaitescu C, Tsiligianni KWIG, Zwar N, Ostrem A.
NPJ Prim Care Respir Med. 2017 Jun 9;27(1):38. doi: 10.1038/s41533-017-0039-5.
PMID: 28600490 [PubMed – in process] Free PMC Article
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88. Pharmacologic Implications of Marijuana Use During Pregnancy.
Fantasia HC.
Nurs Womens Health. 2017 Jun – Jul;21(3):217-223. doi: 10.1016/j.nwh.2017.04.002.
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89. Assessing Marijuana Use During Pregnancy.
Harris AL, Okorie CS.
Nurs Womens Health. 2017 Jun – Jul;21(3):207-216. doi: 10.1016/j.nwh.2017.04.001.
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90. Identification of Eight Synthetic Cannabinoids, Including 5F-AKB48 in Seized Herbal Products Using DART-TOF-MS and LC-QTOF-MS as Nontargeted Screening Methods.
Moore KN, Garvin D, Thomas BF, Grabenauer M.
J Forensic Sci. 2017 Jun 9. doi: 10.1111/1556-4029.13367. [Epub ahead of print]
PMID: 28597943 [PubMed – as supplied by publisher]
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91. Pharmaco-toxicological effects of the novel third-generation fluorinate synthetic cannabinoids, 5F-ADBINACA, AB-FUBINACA, and STS-135 in mice. In vitro and in vivo studies.
Canazza I, Ossato A, Vincenzi F, Gregori A, Di Rosa F, Nigro F, Rimessi A, Pinton P, Varani K, Borea PA, Marti M.
Hum Psychopharmacol. 2017 May;32(3). doi: 10.1002/hup.2601. Epub 2017 Jun 9.
PMID: 28597570 [PubMed – in process]
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92. Teens who use cannabis show higher risk of taking other illicit drugs.
Kmietowicz Z.
BMJ. 2017 Jun 7;357:j2791. doi: 10.1136/bmj.j2791. No abstract available.
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93. Hemorrhagic stroke after cannabis use in a young man.
El Mesbahy J, Chraa M, Louhab N, Kissani N.
Rev Neurol (Paris). 2017 Jun 5. pii: S0035-3787(17)30018-8. doi: 10.1016/j.neurol.2017.05.002. [Epub ahead of print] No abstract available.
PMID: 28595976 [PubMed – as supplied by publisher]
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94. Marijuana Use in the Elderly: Implications and Considerations.
Mahvan TD, Hilaire ML, Mann A, Brown A, Linn B, Gardner T, Lai B.
Consult Pharm. 2017 Jun 1;32(6):341-351. doi: 10.4140/TCP.n.2017.341.
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95. Neuroprotective effects of drug-induced therapeutic hypothermia in central nervous system diseases.
Ma J, Wang Y, Wang Z, Li H, Wang Z, Chen G.
Curr Drug Targets. 2017 Jun 6. doi: 10.2174/1389450118666170607104251. [Epub ahead of print]
PMID: 28595536 [PubMed – as supplied by publisher]
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96. Atrial fibrillation following synthetic cannabinoid abuse.
Efe TH, Felekoglu MA, Çimen T, Doğan M.
Turk Kardiyol Dern Ars. 2017 Jun;45(4):362-364. doi: 10.5543/tkda.2016.70367.
PMID: 28595208 [PubMed – in process] Free Article
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97. Comparing Medical and Recreational Cannabis Users on Socio-Demographic, Substance and Medication Use, and Health and Disability Characteristics.
Goulet-Stock S, Rueda S, Vafaei A, Ialomiteanu A, Manthey J, Rehm J, Fischer B.
Eur Addict Res. 2017 Jun 9;23(3):129-135. doi: 10.1159/000475987. [Epub ahead of print]
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98. The role of mindfulness skills in terms of anxiety-related cognitive risk factors among college students with problematic alcohol use.
Kraemer KM, O’Bryan EM, Johnson AL, McLeish AC.
Subst Abus. 2017 Jun 8:1-7. doi: 10.1080/08897077.2017.1340394. [Epub ahead of print]
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99. Patterns of cannabis use during adolescence and their association with harmful substance use behaviour: findings from a UK birth cohort.
Taylor M, Collin SM, Munafò MR, MacLeod J, Hickman M, Heron J.
J Epidemiol Community Health. 2017 Jun 7. pii: jech-2016-208503. doi: 10.1136/jech-2016-208503. [Epub ahead of print]
PMID: 28592420 [PubMed – as supplied by publisher] Free Article
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100. Pilot Studies Examining Feasibility of Substance Use Disorder Screening and Treatment Linkage at Urban Sexually Transmitted Disease Clinics.
Gryczynski J, Nordeck CD, Mitchell SG, Page KR, Johnsen LL, O’Grady KE, Schwartz RP.
J Addict Med. 2017 Jun 5. doi: 10.1097/ADM.0000000000000327. [Epub ahead of print]
PMID: 28590392 [PubMed – as supplied by publisher]
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101. Cigarette Smoking among Women Who Are Homeless or Unstably Housed: Examining the Role of Food Insecurity.
Kim JE, Flentje A, Tsoh JY, Riley ED.
J Urban Health. 2017 Jun 6. doi: 10.1007/s11524-017-0166-x. [Epub ahead of print]
PMID: 28589340 [PubMed – as supplied by publisher]
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102. The cannabis paradox: when age matters.
Ozaita A, Aso E.
Nat Med. 2017 Jun 6;23(6):661-662. doi: 10.1038/nm.4348. No abstract available.
PMID: 28586333 [PubMed – in process]
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103. Microorganism design for heterologous biosynthesis of cannabinoids.
Ângela C, Hansen EH, Kayser O, Carlsen S, Stehle F.
FEMS Yeast Res. 2017 Jun 4. doi: 10.1093/femsyr/fox037. [Epub ahead of print]
PMID: 28582498 [PubMed – as supplied by publisher]
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104. Recommendation to reconsider examining cannabis subtypes together due to opposing effects on brain, cognition and behavior.
Rømer Thomsen K, Callesen MB, Feldstein Ewing SW.
Neurosci Biobehav Rev. 2017 Jun 1;80:156-158. doi: 10.1016/j.neubiorev.2017.05.025. [Epub ahead of print]
PMID: 28579491 [PubMed – as supplied by publisher]
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105. Intoxication by gamma hydroxybutyrate and related analogues: Clinical characteristics and comparison between pure intoxication and that combined with other substances of abuse.
Miró Ò, Galicia M, Dargan P, Dines AM, Giraudon I, Heyerdahl F, Hovda KE, Yates C, Wood DM; Euro-DEN Research Group.
Toxicol Lett. 2017 Jun 1;277:84-91. doi: 10.1016/j.toxlet.2017.05.030. [Epub ahead of print]
PMID: 28579487 [PubMed – as supplied by publisher]
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106. Suppression of STAT3 Signaling by Δ9-Tetrahydrocannabinol (THC) Induces Trophoblast Dysfunction.
Chang X, Bian Y, He Q, Yao J, Zhu J, Wu J, Wang K, Duan T.
Cell Physiol Biochem. 2017 Jun 5;42(2):537-550. doi: 10.1159/000477603. [Epub ahead of print]
PMID: 28578322 [PubMed – as supplied by publisher] Free Article
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107. Marijuana Liberalization, Research, and Policy: Contributions to Current Knowledge and Practice.
Sevigny EL.
J Prim Prev. 2017 Jun;38(3):211-216. doi: 10.1007/s10935-017-0480-9. No abstract available.
PMID: 28573421 [PubMed – in process]
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108. Oral fluid testing for marijuana intoxication: enhancing objectivity for roadside DUI testing.
Doucette ML, Frattaroli S, Vernick JS.
Inj Prev. 2017 Jun 1. pii: injuryprev-2016-042264. doi: 10.1136/injuryprev-2016-042264. [Epub ahead of print]
PMID: 28572268 [PubMed – as supplied by publisher]
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109. Cannabinoid hyperemesis syndrome: A disorder of the HPA axis and sympathetic nervous system?
Richards JR.
Med Hypotheses. 2017 Jun;103:90-95. doi: 10.1016/j.mehy.2017.04.018. Epub 2017 Apr 24.
PMID: 28571820 [PubMed – in process]
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110. The effect of antioxidants on the long-term stability of THC and related cannabinoids in sampled whole blood.
Sørensen LK, Hasselstrøm JB.
Drug Test Anal. 2017 Jun 1. doi: 10.1002/dta.2221. [Epub ahead of print]
PMID: 28570781 [PubMed – as supplied by publisher]
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111. NBOMe hallucinogenic drug exposures reported to the Danish Poison Information Centre.
Madsen GR, Petersen TS, Dalhoff KP.
Dan Med J. 2017 Jun;64(6). pii: A5386.
PMID: 28566118 [PubMed – in process]
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112. Biodegradation of phenol and benzene by endophytic bacterial strains isolated from refinery wastewater-fed Cannabis sativa.
Iqbal A, Arshad M, Hashmi I, Karthikeyan R, Gentry TJ, Schwab AP.
Environ Technol. 2017 Jun 13:1-10. doi: 10.1080/09593330.2017.1337232. [Epub ahead of print]
PMID: 28562230 [PubMed – as supplied by publisher]
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113. Use of Marijuana Among Pregnant Women Increases.
Rosenberg K.
Am J Nurs. 2017 Jun;117(6):70-71. doi: 10.1097/01.NAJ.0000520260.72706.3c. No abstract available.
PMID: 28541996 [PubMed – in process]
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114. Characteristics of clients currently accessing a national online alcohol and drug counselling service.
Garde EL, Manning V, Lubman DI.
Australas Psychiatry. 2017 Jun;25(3):250-253. doi: 10.1177/1039856216689623. Epub 2017 Feb 1.
PMID: 28541729 [PubMed – in process]
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115. Special Issue of the Journal of Primary Prevention: Research Related to Marijuana Use and Possession Policies.
Friend KB, Friese B, Freisthler B.
J Prim Prev. 2017 Jun;38(3):217-220. doi: 10.1007/s10935-017-0477-4. No abstract available.
PMID: 28536744 [PubMed – in process]
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116. Erratum to: Evaluating the Change in Medical Marijuana Dispensary Locations in Los Angeles Following the Passage of Local Legislation.
Thomas C, Freisthler B.
J Prim Prev. 2017 Jun;38(3):343. doi: 10.1007/s10935-017-0479-2. No abstract available.
PMID: 28527026 [PubMed – in process]
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117. [CNS metabolism in high-risk drug abuse, German version : Insights gained from <sup>1</sup>H- and <sup>31</sup>P MRS and PET].
Bodea SV.
Radiologe. 2017 Jun;57(6):443-449. doi: 10.1007/s00117-017-0254-7. Review. German.
PMID: 28516232 [PubMed – in process]
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118. Marijuana and the Risk of Fatal Car Crashes: What Can We Learn from FARS and NRS Data?
Romano E, Torres-Saavedra P, Voas RB, Lacey JH.
J Prim Prev. 2017 Jun;38(3):315-328. doi: 10.1007/s10935-017-0478-3.
PMID: 28500615 [PubMed – in process]
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119. Changing Demographics of Marijuana Initiation: Bad News or Good?
Grucza RA.
Am J Public Health. 2017 Jun;107(6):833-834. doi: 10.2105/AJPH.2017.303804. No abstract available.
PMID: 28498750 [PubMed – in process]
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120. School Protective Factors and Substance Use Among Lesbian, Gay, and Bisexual Adolescents in California Public Schools.
De Pedro KT, Esqueda MC, Gilreath TD.
LGBT Health. 2017 Jun;4(3):210-216. doi: 10.1089/lgbt.2016.0132. Epub 2017 May 12.
PMID: 28498005 [PubMed – in process]
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121. The 2017 CALDAR Summer Institute and International Conference Promoting Global Health-Precision Research in Substance Abuse, HIV, and Care.
Hser YI, Li MD, Grella C, Brecht L, Chen Z, Chang SL, Chang L, Normand J, Tai B.
J Neuroimmune Pharmacol. 2017 Jun;12(Suppl 2):79-80. doi: 10.1007/s11481-017-9750-9.
PMID: 28497234 [PubMed – in process]
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122. The synthetic cannabinoid WIN-55,212 induced-apoptosis in cytotrophoblasts cells by a mechanism dependent on CB1 receptor.
Almada M, Costa L, Fonseca BM, Amaral C, Teixeira N, Correia-da-Silva G.
Toxicology. 2017 Jun 15;385:67-73. doi: 10.1016/j.tox.2017.04.013. Epub 2017 May 8.
PMID: 28495606 [PubMed – indexed for MEDLINE]
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123. Medical Marijuana Legalization and Marijuana Use Among Youth in Oregon.
Paschall MJ, Grube JW, Biglan A.
J Prim Prev. 2017 Jun;38(3):329-341. doi: 10.1007/s10935-017-0476-5.
PMID: 28484894 [PubMed – in process]
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124. The New Cannabis Policy Taxonomy on APIS: Making Sense of the Cannabis Policy Universe.
Klitzner MD, Thomas S, Schuler J, Hilton M, Mosher J.
J Prim Prev. 2017 Jun;38(3):295-314. doi: 10.1007/s10935-017-0475-6.
PMID: 28477299 [PubMed – in process]
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125. Medical cannabis use among patients with chronic pain in an interdisciplinary pain rehabilitation program: Characterization and treatment outcomes.
Shah A, Craner J, Cunningham JL.
J Subst Abuse Treat. 2017 Jun;77:95-100. doi: 10.1016/j.jsat.2017.03.012. Epub 2017 Apr 6.
PMID: 28476279 [PubMed – in process]
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126. Outcomes of a family-based HIV prevention intervention for substance using juvenile offenders.
Tolou-Shams M, Dauria E, Conrad SM, Kemp K, Johnson S, Brown LK.
J Subst Abuse Treat. 2017 Jun;77:115-125. doi: 10.1016/j.jsat.2017.03.013. Epub 2017 Apr 5.
PMID: 28476263 [PubMed – in process]
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127. Comparative in silico analyses of Cannabis sativa, Prunella vulgaris and Withania somnifera compounds elucidating the medicinal properties against rheumatoid arthritis.
Zaka M, Sehgal SA, Shafique S, Abbasi BH.
J Mol Graph Model. 2017 Jun;74:296-304. doi: 10.1016/j.jmgm.2017.04.013. Epub 2017 Apr 19.
PMID: 28472734 [PubMed – in process]
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128. The Experiences of Medical Marijuana Patients: A Scoping Review of the Qualitative Literature.
Ryan J, Sharts-Hopko N.
J Neurosci Nurs. 2017 Jun;49(3):185-190. doi: 10.1097/JNN.0000000000000283.
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129. Use of Marijuana Edibles by Adolescents in California.
Friese B, Slater MD, Battle RS.
J Prim Prev. 2017 Jun;38(3):279-294. doi: 10.1007/s10935-017-0474-7.
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130. Early Impacts of Marijuana Legalization: An Evaluation of Prices in Colorado and Washington.
Hunt P, Pacula RL.
J Prim Prev. 2017 Jun;38(3):221-248. doi: 10.1007/s10935-017-0471-x.
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131. Substance use and suicide risk in a sample of young Colombian adults: An exploration of psychosocial factors.
Pereira-Morales AJ, Adan A, Camargo A, Forero DA.
Am J Addict. 2017 Jun;26(4):388-394. doi: 10.1111/ajad.12552. Epub 2017 Apr 28.
PMID: 28456010 [PubMed – in process]
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132. Evaluating the Change in Medical Marijuana Dispensary Locations in Los Angeles Following the Passage of Local Legislation.
Thomas C, Freisthler B.
J Prim Prev. 2017 Jun;38(3):265-277. doi: 10.1007/s10935-017-0473-8. Erratum in: J Prim Prev. 2017 Jun;38(3):343.
PMID: 28455643 [PubMed – in process]
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133. From Medical to Recreational Marijuana Sales: Marijuana Outlets and Crime in an Era of Changing Marijuana Legislation.
Freisthler B, Gaidus A, Tam C, Ponicki WR, Gruenewald PJ.
J Prim Prev. 2017 Jun;38(3):249-263. doi: 10.1007/s10935-017-0472-9.
PMID: 28451984 [PubMed – in process]
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134. Support for marijuana legalization in the US state of Washington has continued to increase through 2016.
Subbaraman MS, Kerr WC.
Drug Alcohol Depend. 2017 Jun 1;175:205-209. doi: 10.1016/j.drugalcdep.2017.02.015. Epub 2017 Apr 19.
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135. Characteristics of socially withdrawn youth in France: A retrospective study.
Chauliac N, Couillet A, Faivre S, Brochard N, Terra JL.
Int J Soc Psychiatry. 2017 Jun;63(4):339-344. doi: 10.1177/0020764017704474. Epub 2017 Apr 26.
PMID: 28446040 [PubMed – in process]
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136. Medical Marijuana Laws and Cannabis Use: Intersections of Health and Policy.
Compton WM, Volkow ND, Lopez MF.
JAMA Psychiatry. 2017 Jun 1;74(6):559-560. doi: 10.1001/jamapsychiatry.2017.0723. No abstract available.
PMID: 28445570 [PubMed – in process]
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137. US Adult Illicit Cannabis Use, Cannabis Use Disorder, and Medical Marijuana Laws: 1991-1992 to 2012-2013.
Hasin DS, Sarvet AL, Cerdá M, Keyes KM, Stohl M, Galea S, Wall MM.
JAMA Psychiatry. 2017 Jun 1;74(6):579-588. doi: 10.1001/jamapsychiatry.2017.0724.
PMID: 28445557 [PubMed – indexed for MEDLINE]
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138. Marijuana and tobacco cigarettes: Estimating their behavioral economic relationship using purchasing tasks.
Peters EN, Rosenberry ZR, Schauer GL, O’Grady KE, Johnson PS.
Exp Clin Psychopharmacol. 2017 Jun;25(3):208-215. doi: 10.1037/pha0000122. Epub 2017 Apr 24.
PMID: 28437124 [PubMed – in process]
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139. Follow-up treatment effects of contingency management and motivational interviewing on substance use: A meta-analysis.
Sayegh CS, Huey SJ, Zara EJ, Jhaveri K.
Psychol Addict Behav. 2017 Jun;31(4):403-414. doi: 10.1037/adb0000277. Epub 2017 Apr 24.
PMID: 28437121 [PubMed – in process]
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140. The association of psychiatric comorbidity with treatment completion among clients admitted to substance use treatment programs in a U.S. national sample.
Krawczyk N, Feder KA, Saloner B, Crum RM, Kealhofer M, Mojtabai R.
Drug Alcohol Depend. 2017 Jun 1;175:157-163. doi: 10.1016/j.drugalcdep.2017.02.006. Epub 2017 Apr 19.
PMID: 28432939 [PubMed – in process]
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141. What is the Current Knowledge About the Cardiovascular Risk for Users of Cannabis-Based Products? A Systematic Review.
Jouanjus E, Raymond V, Lapeyre-Mestre M, Wolff V.
Curr Atheroscler Rep. 2017 Jun;19(6):26. doi: 10.1007/s11883-017-0663-0. Review.
PMID: 28432636 [PubMed – indexed for MEDLINE]
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142. The Influence of College Attendance on Risk for Marijuana Initiation in the United States: 1977 to 2015.
Miech RA, Patrick ME, O’Malley PM, Johnston LD.
Am J Public Health. 2017 Jun;107(6):996-1002. doi: 10.2105/AJPH.2017.303745. Epub 2017 Apr 20.
PMID: 28426314 [PubMed – indexed for MEDLINE]
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143. The influence of substance use on depressive symptoms among young adult black men: The sensitizing effect of early adversity.
Kogan SM, Cho J, Oshri A, MacKillop J.
Am J Addict. 2017 Jun;26(4):400-406. doi: 10.1111/ajad.12555. Epub 2017 Apr 20.
PMID: 28426146 [PubMed – in process]
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144. Eveningness and Later Sleep Timing Are Associated with Greater Risk for Alcohol and Marijuana Use in Adolescence: Initial Findings from the National Consortium on Alcohol and Neurodevelopment in Adolescence Study.
Hasler BP, Franzen PL, de Zambotti M, Prouty D, Brown SA, Tapert SF, Pfefferbaum A, Pohl KM, Sullivan EV, De Bellis MD, Nagel BJ, Baker FC, Colrain IM, Clark DB.
Alcohol Clin Exp Res. 2017 Jun;41(6):1154-1165. doi: 10.1111/acer.13401. Epub 2017 May 29.
PMID: 28421617 [PubMed – in process]
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145. <i>S100A10</i> identified in a genome-wide gene × cannabis dependence interaction analysis of risky sexual behaviours.
Polimanti R, Meda SA, Pearlson GD, Zhao H, Sherva R, Farrer LA, Kranzler HR, Gelernter J.
J Psychiatry Neurosci. 2017 Jun;42(4):252-261.
PMID: 28418321 [PubMed – in process] Free Article
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146. Cognitive functioning of adolescent and young adult cannabis users in the Philadelphia Neurodevelopmental Cohort.
Scott JC, Wolf DH, Calkins ME, Bach EC, Weidner J, Ruparel K, Moore TM, Jones JD, Jackson CT, Gur RE, Gur RC.
Psychol Addict Behav. 2017 Jun;31(4):423-434. doi: 10.1037/adb0000268. Epub 2017 Apr 17.
PMID: 28414475 [PubMed – in process]
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147. Abstinence based incentives plus parent training for adolescent alcohol and other substance misuse.
Stanger C, Scherer EA, Babbin SF, Ryan SR, Budney AJ.
Psychol Addict Behav. 2017 Jun;31(4):385-392. doi: 10.1037/adb0000279. Epub 2017 Apr 17.
PMID: 28414474 [PubMed – in process]
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148. The role of illicit, licit, and designer drugs in the traffic in Hungary.
Institóris L, Hidvégi E, Dobos A, Sija É, Kereszty ÉM, Tajti LB, Somogyi GP, Varga T.
Forensic Sci Int. 2017 Jun;275:234-241. doi: 10.1016/j.forsciint.2017.03.021. Epub 2017 Apr 3.
PMID: 28412575 [PubMed – in process]
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149. Work place drug testing of police officers after THC exposure during large volume cannabis seizures.
Doran GS, Deans R, De Filippis C, Kostakis C, Howitt JA.
Forensic Sci Int. 2017 Jun;275:224-233. doi: 10.1016/j.forsciint.2017.03.023. Epub 2017 Apr 2.
PMID: 28412574 [PubMed – in process]
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150. Selective attention moderates the relationship between attentional capture by signals of nondrug reward and illicit drug use.
Albertella L, Copeland J, Pearson D, Watson P, Wiers RW, Le Pelley ME.
Drug Alcohol Depend. 2017 Jun 1;175:99-105. doi: 10.1016/j.drugalcdep.2017.01.041. Epub 2017 Mar 30.
PMID: 28411561 [PubMed – in process]
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151. Subjective and physiological effects, and expired carbon monoxide concentrations in frequent and occasional cannabis smokers following smoked, vaporized, and oral cannabis administration.
Newmeyer MN, Swortwood MJ, Abulseoud OA, Huestis MA.
Drug Alcohol Depend. 2017 Jun 1;175:67-76. doi: 10.1016/j.drugalcdep.2017.02.003. Epub 2017 Mar 29.
PMID: 28407543 [PubMed – in process]
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152. Patterns of marijuana and tobacco use associated with suboptimal self-rated health among US adult ever users of marijuana.
Tsai J, Rolle IV, Singh T, Boulet SL, McAfee TA, Grant AM.
Prev Med Rep. 2017 Mar 23;6:251-257. doi: 10.1016/j.pmedr.2017.03.014. eCollection 2017 Jun.
PMID: 28392993 [PubMed – in process] Free PMC Article
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153. Street racing among the Ontario adult population: Prevalence and association with collision risk.
Wickens CM, Smart RG, Vingilis E, Ialomiteanu AR, Stoduto G, Mann RE.
Accid Anal Prev. 2017 Jun;103:85-91. doi: 10.1016/j.aap.2017.03.021. Epub 2017 Apr 6.
PMID: 28391091 [PubMed – in process]
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154. In Reply: “The importance of recognizing cannabinoid hyperemesis syndrome from synthetic marijuana use”.
Sorensen CJ, DeSanto K, Borgelt L, Phillips KT, Monte AA.
J Med Toxicol. 2017 Jun;13(2):201. doi: 10.1007/s13181-017-0613-9. Epub 2017 Apr 5. No abstract available.
PMID: 28382464 [PubMed – in process]
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155. E-cigarette use of young adults motivations and associations with combustible cigarette alcohol, marijuana, and other illicit drugs.
Temple JR, Shorey RC, Lu Y, Torres E, Stuart GL, Le VD.
Am J Addict. 2017 Jun;26(4):343-348. doi: 10.1111/ajad.12530. Epub 2017 Mar 31.
PMID: 28370717 [PubMed – in process]
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156. The feasibility and acceptability of a population-level antenatal risk factor survey: Cross-sectional pilot study.
Price AM, Bryson HE, Mensah F, Kemp L, Bishop L, Goldfeld S.
J Paediatr Child Health. 2017 Jun;53(6):572-577. doi: 10.1111/jpc.13510. Epub 2017 Mar 29.
PMID: 28370603 [PubMed – in process]
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157. Pharmacologic Treatment of Cannabinoid Hyperemesis Syndrome: A Systematic Review.
Richards JR, Gordon BK, Danielson AR, Moulin AK.
Pharmacotherapy. 2017 Jun;37(6):725-734. doi: 10.1002/phar.1931. Epub 2017 May 12. Review.
PMID: 28370228 [PubMed – in process]
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158. A natural product from Cannabis sativa subsp. sativa inhibits homeodomain-interacting protein kinase 2 (HIPK2), attenuating MPP<sup>+</sup>-induced apoptosis in human neuroblastoma SH-SY5Y cells.
Wang G, Zhu L, Zhao Y, Gao S, Sun D, Yuan J, Huang Y, Zhang X, Yao X.
Bioorg Chem. 2017 Jun;72:64-73. doi: 10.1016/j.bioorg.2017.03.011. Epub 2017 Mar 30.
PMID: 28366826 [PubMed – indexed for MEDLINE]
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159. Relations between mental health diagnoses, mental health treatment, and substance use in homeless youth.
Narendorf SC, Cross MB, Santa Maria D, Swank PR, Bordnick PS.
Drug Alcohol Depend. 2017 Jun 1;175:1-8. doi: 10.1016/j.drugalcdep.2017.01.028. Epub 2017 Mar 16.
PMID: 28364629 [PubMed – in process]
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160. The Importance of Recognizing Cannabinoid Hyperemesis Syndrome from Synthetic Marijuana Use.
Liu X, Villamagna A, Yoo J.
J Med Toxicol. 2017 Jun;13(2):199-200. doi: 10.1007/s13181-017-0612-x. Epub 2017 Mar 28. No abstract available.
PMID: 28353201 [PubMed – in process]
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161. Low-Dose Cannabidiol Is Safe but Not Effective in the Treatment for Crohn’s Disease, a Randomized Controlled Trial.
Naftali T, Mechulam R, Marii A, Gabay G, Stein A, Bronshtain M, Laish I, Benjaminov F, Konikoff FM.
Dig Dis Sci. 2017 Jun;62(6):1615-1620. doi: 10.1007/s10620-017-4540-z. Epub 2017 Mar 27.
PMID: 28349233 [PubMed – in process]
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162. Functional Neuroimaging Predictors of Self-Reported Psychotic Symptoms in Adolescents.
Bourque J, Spechler PA, Potvin S, Whelan R, Banaschewski T, Bokde ALW, Bromberg U, Büchel C, Quinlan EB, Desrivières S, Flor H, Frouin V, Gowland P, Heinz A, Ittermann B, Martinot JL, Paillère-Martinot ML, McEwen SC, Nees F, Orfanos DP, Paus T, Poustka L, Smolka MN, Vetter NC, Walter H, Schumann G, Garavan H, Conrod PJ; IMAGEN Consortium.
Am J Psychiatry. 2017 Jun 1;174(6):566-575. doi: 10.1176/appi.ajp.2017.16080897. Epub 2017 Mar 21.
PMID: 28320226 [PubMed – indexed for MEDLINE]
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163. Cannabis Use, Polysubstance Use, and Psychosis Spectrum Symptoms in a Community-Based Sample of U.S. Youth.
Jones JD, Calkins ME, Scott JC, Bach EC, Gur RE.
J Adolesc Health. 2017 Jun;60(6):653-659. doi: 10.1016/j.jadohealth.2017.01.006. Epub 2017 Mar 17.
PMID: 28318911 [PubMed – in process]
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164. Long lasting effects of chronic heavy cannabis abuse.
Nestoros JN, Vakonaki E, Tzatzarakis MN, Alegakis A, Skondras MD, Tsatsakis AM.
Am J Addict. 2017 Jun;26(4):335-342. doi: 10.1111/ajad.12529. Epub 2017 Mar 17.
PMID: 28314070 [PubMed – in process]
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165. Social mediation of persuasive media in adolescent substance prevention.
Crano WD, Alvaro EM, Tan CN, Siegel JT.
Psychol Addict Behav. 2017 Jun;31(4):479-487. doi: 10.1037/adb0000265. Epub 2017 Mar 16.
PMID: 28301181 [PubMed – in process]
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166. In Response to Letter to the Editor Regarding: Cannabinoid Hyperemesis Syndrome: Diagnosis, Pathophysiology, and Treatment-a Systematic Review.
Sorensen CJ, DeSanto K, Borgelt L, Phillips KT, Monte AA.
J Med Toxicol. 2017 Jun;13(2):198. doi: 10.1007/s13181-017-0610-z. Epub 2017 Mar 10. No abstract available.
PMID: 28283940 [PubMed – in process]
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167. Effects of a brief, parent-focused intervention for substance using adolescents and their sibling.
Spirito A, Hernandez L, Marceau K, Cancilliere MK, Barnett NP, Graves HR, Rodriguez AM, Knopik VS.
J Subst Abuse Treat. 2017 Jun;77:156-165. doi: 10.1016/j.jsat.2017.02.002. Epub 2017 Mar 2.
PMID: 28259500 [PubMed – in process]
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168. Eveningness among late adolescent males predicts neural reactivity to reward and alcohol dependence 2 years later.
Hasler BP, Casement MD, Sitnick SL, Shaw DS, Forbes EE.
Behav Brain Res. 2017 Jun 1;327:112-120. doi: 10.1016/j.bbr.2017.02.024. Epub 2017 Feb 28.
PMID: 28254633 [PubMed – in process]
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169. The association between traumatic life events and psychological symptoms from a conservative, transdiagnostic perspective.
Gibson LE, Cooper S, Reeves LE, Anglin DM, Ellman LM.
Psychiatry Res. 2017 Jun;252:70-74. doi: 10.1016/j.psychres.2017.02.047. Epub 2017 Feb 22.
PMID: 28254578 [PubMed – in process]
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170. Electronic Cigarette Use by Youth: Prevalence, Correlates, and Use Trajectories From Middle to High School.
Westling E, Rusby JC, Crowley R, Light JM.
J Adolesc Health. 2017 Jun;60(6):660-666. doi: 10.1016/j.jadohealth.2016.12.019. Epub 2017 Feb 24.
PMID: 28242187 [PubMed – in process]
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171. Improved Social Interaction, Recognition and Working Memory with Cannabidiol Treatment in a Prenatal Infection (poly I:C) Rat Model.
Osborne AL, Solowij N, Babic I, Huang XF, Weston-Green K.
Neuropsychopharmacology. 2017 Jun;42(7):1447-1457. doi: 10.1038/npp.2017.40. Epub 2017 Feb 23.
PMID: 28230072 [PubMed – in process]
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172. Older adults who use or have used marijuana: Help-seeking for marijuana and other substance use problems.
Choi NG, DiNitto DM, Marti CN.
J Subst Abuse Treat. 2017 Jun;77:185-192. doi: 10.1016/j.jsat.2017.02.005. Epub 2017 Feb 16.
PMID: 28216197 [PubMed – in process]
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173. Association Between Substance Use Diagnoses and Psychiatric Disorders in an Adolescent and Young Adult Clinic-Based Population.
Welsh JW, Knight JR, Hou SS, Malowney M, Schram P, Sherritt L, Boyd JW.
J Adolesc Health. 2017 Jun;60(6):648-652. doi: 10.1016/j.jadohealth.2016.12.018. Epub 2017 Feb 12.
PMID: 28202303 [PubMed – in process]
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174. Public perceptions of arguments supporting and opposing recreational marijuana legalization.
McGinty EE, Niederdeppe J, Heley K, Barry CL.
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175. Trends of Cannabis Use Disorder in the Inpatient: 2002 to 2011.
Charilaou P, Agnihotri K, Garcia P, Badheka A, Frenia D, Yegneswaran B.
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176. The effect of attitudinal barriers to mental health treatment on cannabis use and mediation through coping motives.
Fanale CM, Maarhuis P, Wright BR, Caffrey K.
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178. A cannabigerol-rich Cannabis sativa extract, devoid of [INCREMENT]9-tetrahydrocannabinol, elicits hyperphagia in rats.
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179. Urine drug screen findings among ambulatory oncology patients in a supportive care clinic.
Rauenzahn S, Sima A, Cassel B, Noreika D, Gomez TH, Ryan L, Wolf CE, Legakis L, Del Fabbro E.
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Bravo AJ, Anthenien AM, Prince MA, Pearson MR; Marijuana Outcomes Study Team.
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181. Behavioral Determinants of Cannabinoid Self-Administration in Old World Monkeys.
John WS, Martin TJ, Nader MA.
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187. The replicability of cannabis use prevalence estimates in the United States.
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Filed under: Cannabis/Marijuana :

The Colorado Attorney General announced another round of indictments, this time over marijuana tax evasion. Only recently the state indicted 74 individuals and facilities that were growing marijuana legally but shipping it illegally out of state. That was the largest marijuana black market bust in the state’s history.

In this case, thirteen people were charged with allegedly running a criminal enterprise that distributed 200 pounds of marijuana. Those indicted include the owners and others affiliated with a head shop called Hoppz’ Cropz in Colorado Springs. They allegedly sold small items like a lighter worth 5 cents for $15 and gave away an ounce of marijuana for free, and evaded paying fees associated with the retail marijuana licensing system in Colorado and avoided paying excise taxes.

Hoppz’ Cropz owners, managers, and employees also allegedly avoided paying wage withholding taxes by receiving “under the table” wages. Managers allegedly told employees to tell government officials who might inquire that they were volunteers who worked for free.

At the announcement of the indictments, a district attorney said marijuana is the gateway drug for murder. Colorado Springs had 22 homicides in 2016. Eight were directly connected to illegal marijuana grows, he said. Local authorities are overwhelmed trying to stop marijuana crimes. Colorado pot is pouring out of the state, and is worth more on New York streets than in Denver, he added. Homelessness has gone up 50 percent a year since the state legalized.

Read KKTV.com story here.

Source: Email from National Families In Action The Marijuana Report The Marijuana Report.Org August 2017

California will launch a fully legal, commercial marijuana industry January 1, 2018. TV celebrity Montel Williams, who has advocated for medical and recreational legalization for the past two decades, is entering the business with a brand of his own called LenitivLabs.
 
He’s not in it for the money, he says. “A lot of people are jumping into the green rush and want to make as much cash as fast as they can. I am a person who helped create this green rush. But I want to sell medication. You want to buy some Bob Marley or some O.G. Kush — go ahead. If you want to pick up something for your aunt who has epilepsy, get something produced with the highest standards.”
 
Because no uniform, national standards for purity, safety, or efficacy exist for marijuana produced in states that have legalized it, it is difficult to say how the highest standards might be reached, and Mr. Williams does not enlighten us.
 
His line of products, already available at select dispensaries, include “cannabinoid oils” of varying potency. Some oils, he explains, contain THC levels of 70 percent, CBD levels of 30 percent while others reverse those ratios.
 
He has attracted to his advisory board such heavy hitters as a former CIA director, a retired vice admiral, a former congressman, and an ex-NFL player – all good men but none with the pharmacological expertise to guide the development of the “medicines” Mr. Williams is marketing.

Source: Email from National Families In Action The Marijuana Report The Marijuana Report.Org August 2017

We are pleased to announce that a new online course at Auburn University Outreach will feature The Marijuana Report website and e-newsletter. Titled “The Harmfulness of Marijuana Use and Public Policy Approaches to Address the Challenges,” the three-week course will be taught by Paula Gordon, PhD, who has worked as a staff member and/or consultant to several federal agencies concerned about addiction treatment and prevention. Course topics will address:

  • The need to defend the brain while nurturing mental and physical well-being: fostering a mental and public health approach to addressing the challenges of drug use and addiction.
  • An extraordinary look at the addiction cycle: the lessons and insights from an October 30, 2013, videotaped exchange between Dr. Nora Volkow and the Dalai Lama in Dharamshala, the morning of Day 3 of the workshop series (See the link here).
  • Comprehensive coordinated strategies aimed at stopping the use of marijuana and other psychoactive and addictive substances in the US: proposed comprehensive and coordinated public health oriented strategies involving all sectors of society, including government, the justice system, and educational institutions.

Register here

Source: Email from National Families In Action The Marijuana Report The Marijuana Report.Org August 2017

The Coalition to Regulate Marijuana Like Alcohol is seeking signatures to place an initiative on Michigan’s November 2018 ballot. The measure would legalize marijuana for recreational use and allow residents to possess 880 joints at a time, the largest amount of any state in the nation.

Michigan News has done an admirable job of explaining this with pictures as well as words. See how here. The paper also provides a link to the proposed initiative.

Source: Email from National Families In Action The Marijuana Report The Marijuana Report.Org August 2017

The authors compare the clinical features of idiopathic psychosis (eg, schizophrenia) with cannabis-induced psychosis.

As cannabis consumption rises, there has been significant emerging evidence for cannabis-related risks. Here: a comparison of the clinical features of idiopathic psychosis (eg, schizophrenia) versus cannabis-induced psychosis (CIP). Scroll through the slides for 8 distinguishing features

Source: https://www.psychiatrictimes.com/view/8-distinguishing-features-primary-psychosis-versus-cannabis-induced-psychosis August 2017

Marijuana use increases the risk of death from high blood pressure, a new study has found.

A survey published in the European Journal of Preventive Cardiology calculated the risk of death resulting from cardiovascular and cerebrovascular causes. In the years 2005-2006 a total of 1,213 participants were asked if they smoked marijuana.

Those who answered ‘yes’ were then considered to be marijuana users, and the age they said they first tried the drug was subtracted from their current age. This calculated the duration of use.

Results found that 34 per cent used neither marijuana nor cigarettes, 21 per cent used only marijuana, 16 per cent used marijuana and were past smokers and 4 per cent smoked only cigarettes.

The average duration of marijuana use based on the calculations was 11 and a half years.

Those who smoked marijuana had a 3.42 times higher risk of dying from hypertension, and the risk grew by 1.04 each year of use.

There was however, no association between marijuana use and death from heart disease or cerebrovascular disease.

Lead author of the study, Barbara A Yankey, a PhD student in the School of Public Health, Georgia State University, Atlanta told Science Daily: “Our results suggest a possible risk of hypertension mortality from marijuana use. This is not surprising since marijuana is known to have a number of effects on the cardiovascular system. Marijuana stimulates the sympathetic nervous system, leading to increases in heart rate, blood pressure and oxygen demand. Emergency rooms have reported cases of angina and heart attacks after marijuana use.

“We found higher estimated cardiovascular risks associated with marijuana use than cigarette smoking.

“This indicates that marijuana use may carry even heavier consequences on the cardiovascular system than that already established for cigarette smoking. However, the number of smokers in our study was small and this needs to be examined in a larger study.

“Needless to say, the detrimental effects of marijuana on brain function far exceed that of cigarette smoking.”

The study does not deny the medicinal properties of the herb, but cautions against prolonged recreational use, stating: “We are not disputing the possible medicinal benefits of standardised cannabis formulations; however, recreational use of marijuana should be approached with caution. It is possible that discouraging recreational marijuana use may ultimately impact reductions in mortality from cardiovascular causes.”

Source: https://www.independent.co.uk/news/world/marijuana-use-high-blood-pressure-risk-death-study-cannabis-weed-cigarettes-a7888711.html August 2017

Filed under: Cannabis/Marijuana,Health :

Source:Drug Use in Colorado 2000 – 2013 SAMHSA NSDUH data

 

In a pre-clinical study, researchers from Western University in Ontario, Canada, studied the effects of long-term exposure to THC in both adolescent and adult rats.

They found changes in behavior as well as in brain cells in the adolescent rats that were identical to those found in schizophrenia. These changes lasted into early adulthood long after the initial THC exposure.

The young rats were “socially withdrawn and demonstrated increased anxiety, cognitive disorganization, and abnormal levels of dopamine, all of which are features of schizophrenia,” according to the article. The same effects were not seen in the adult rats.

“With the current rise in cannabis use and the increase in THC content, it is critically important to highlight the risk factors associated with exposure to marijuana, particularly during adolescence,” the researchers warn.

Read Medical News Today story here. Read study abstract in the journal Cerebral Cortex here.

Email from Monte Stiles, National Families in Action January 2016

A University of Pittsburgh Medical Center study published in the journal Psychology of Addictive Behaviors last September found that chronic marijuana use during adolescence did not lead to depression, anxiety, psychosis, or asthma by mid-life.

The U.K.’s Independent was one of many newspapers that celebrated the news, scoffing at the National Health Service help page that warns: “Your risk of developing a psychotic illness is higher if you start using cannabis in your teens.”
 
Now, however, the journal has run a correction. It turns out that the researchers misinterpreted their data. They checked it again after criticism of their study and found that there was a two-and-one-half-fold increase in psychotic disorders in midlife after chronic marijuana use that began in adolescence.
 
The director of the Maryland chapter of SAM (Smart Approaches to Marijuana) caught the error and notified the journal which lead to the correction. SAM is calling on all media who reported the original incorrect story to correct their account of it now.
 
Read Independent story here.  Read SAM account of the correction here.

Source: Email from Monte Stiles, National Families in Action, January 2016

Marijuana reporter Joel Warner asks if the media is currently biased in support of marijuana legalization.

He cites a recent incident brought to his attention by Kevin Sabet, founder of SAM (Smart Approaches to Marijuana), who had received a tip that the next-day release of the 2014 National Survey on Drug Use and Health would show that marijuana use in Colorado has reached the highest levels in the nation. Sabet wrote a press release which fell on deaf ears. A Google analysis shows only 17 stories were written about this consequence of legalization in Colorado.

In contrast, a few weeks before, the release of the 2015 Monitoring the Future Survey showed a slight downturn in past-month marijuana use among 8th, 10th, and 12th grade students nationwide. It was hyped by some in the press as a signal that legalization is of no consequence. A total of 156 news stories covered the results of this survey.

Warner notes that there are now “marijuana-business newspapers and marijuana culture magazines, full-time marijuana-industry reporters (this writer included), and even a marijuana-editorial division at the Denver Post called the Cannabist, staffed with a marijuana editor and cannabis strain reviewers,” like Jake Browne, pictured above.
 
He asks if the data supports it, could marijuana journalists “be expected to conclude that legalization has been a failure, if that means they would also be writing the obituaries for their own jobs?”
 
Read Joel Warner’s thoughtful International Business Times article here.

Source: Email from Monte Stiles, National Families in Action January 2016

Two recent studies, one in Great Britain and this one from the University of Southern California, contradict the findings of a rigorous 25-year-long study done with a birth cohort in Dunedin, New Zealand a few years ago. That study found that persistent marijuana use that continued into adulthood resulted in an 8-point drop in IQ. The two new studies find the opposite.

The UCLA study looked at 789 pairs of adolescent twins from two ongoing studies—one in Los Angeles and one in Minnesota—who enrolled between ages 9 and 11. Over 10 years, five IQ tests were administered along with confidential surveys of marijuana use. Marijuana-using twins lost 4 IQ points, but so did their non-using twins, leading researchers to conclude that something other than marijuana was lowering IQ.

The other study compared teens who reported daily marijuana use for six months or longer with teens who used the drug less than 30 times and found no difference in IQ.
 
But critics say both studies are flawed in that they did not measure heavy marijuana use over a long 25-year period like the Dunedin study did.
 
Dr. Madeline Meier, lead researcher of the Dunedin study, writes, “Our 2012 study (Meier et al. PNAS 2012) reported cognitive decline among individuals with a far more serious and far more long-term level of cannabis use. That is, we found cognitive decline in individuals followed up to age 38 who started cannabis use as a teen and who thereafter remained dependent on cannabis for many years as an adult. This new study is different; the two papers report about completely different doses of cannabis, and about participants 2 decades apart in age.  The new study reports cognitive test scores for individuals followed up to only age 17-20, fewer than half of whom had used cannabis more than 30 times, and only a fifth of whom used cannabis daily for > 6 months. This new study and our prior study agree and both report the same finding: no cognitive decline in short-term low-level cannabis users. The message from both studies is that short-term, low-level cannabis use is probably safer than very long-term heavy cannabis use. The big problem remains that for some teens, short-term low-level teenaged cannabis use leads onward to long-term dependence on cannabis when they become adults. That is what is cause for concern.”
 
Read Science story here. Read Dr. Meier’s rebuttal here.

Source: Email from Monte Stiles, National Families in Action January 2016

Almost all cannabis sold on British streets can cause psychosis after weaker forms were driven from the market.

The most potent “skunk” accounts for 94 per cent of all cannabis seized by police, up from half in 2005, according to the first study for almost a decade.

Dealers are thought to be pushing higher-strength products to get recreational users hooked, with the milder hashish form barely available, researchers say.

Teenager cannabis smokers have been told that skunk is more dangerous and that they must watch out for paranoia and other symptoms of psychosis.

Skunk, also known as sinsemilla, is made from unpollinated cannabis and contains higher levels of THC, a psychoactive compound, than herbal marijuana or resin, also known as hashish.

A Home Office study of police seizures in 2005 found that 51 per cent were skunk and 43 per cent resin. Three years later skunk seemed to be becoming stronger and more common, but the study has not been repeated since 2008.

Now researchers at King’s College London have analysed almost 1,000 samples seized by police in London, Merseyside, Derbyshire, Kent and Sussex. Resin accounted for just 6 per cent of samples, falling to 3 per cent in London, and even that had become stronger since 2008, according to results published in Drug Testing and Analysis.

“The increase of high-potency cannabis on the streets poses a significant hazard to users’ mental health,” said Marta Di Forti, senior author of the paper. “It’s a big worry. It’s pretty much the only kind of cannabis you can buy out there.”

Her previous work suggests that skunk users are five times more likely to develop psychosis than non-users, while there is no extra risk for hash smokers. Britain is largely self-sufficient in skunk as farms take over from hash grown in Morocco and Dr Di Forti said that the stronger product could be a deliberate policy by gangs.

“If high potency is more likely to induce dependence, that’s an advantage for the drug dealer because he wants people to come back as much as possible, rather than recreational users who only use at the weekend when they’re listening to music or going to a party,” she said.

Skunk has not got stronger since 2005, which she said could be because users could not tolerate higher THC concentrations without side-effects.

About 2.2 million people are estimated to have smoked cannabis in the past year, a million of them aged 16-24.

While there is some evidence that users can partially detect higher strength cannabis and cut back, Ian Hamilton, a lecturer in mental health at the University of York, said: “If the cannabis market is saturated with higher potency cannabis this increases the risk of younger and more naive users developing problems as they are less likely to adjust the amount of cannabis they ingest than more experienced users.”

Source: https://www.thetimes.co.uk/edition/news/mental-illness-risk-as-skunk-drives-out-milder-cannabis-wgd58b56l# February 2018 

Marijuana farming is a big business, and marijuana growers are raking in billions.

In California, the crop ranks between lettuce and grapes; total sales in the state, according the Los Angeles Times, will top $21 billion by 2021. In Colorado, where marijuana is also legal, revenues stood at just over $1 billion last year, adding $2.4 billion to the state’s economy.

Those numbers are for legal farms. Illegal marijuana cultivation is much larger. It is estimated that there may be as many as ten million illegal plants grown annually, yielding over $30 billion worth of product.

In California, illegal pot is being grown on literally thousands of acres of the state’s national and state forests and parks, including in Stanislaus National Forest adjacent to Yosemite National Park. A one acre illegal patch can produce well over $1 million worth of marijuana per year. Much of the illegal harvest is sold in states where marijuana remains illegal – but where there is also huge demand, jacking up prices. Commerce in illegal marijuana is often controlled by the same Mexican drug lords who sell cocaine, heroin and contraband opioids; to make things worse, their illegal plots are often tended by illegal immigrants who are virtual slaves, guarded by thugs with high-powered weapons.

Pot production may rake in billions of dollars, but at immense environmental cost. Research has documented that marijuana cultivation, legal and illegal, is polluting water, land and air at an alarming rate. Both legal and illegal growers use large amounts of pesticides, insecticides and other chemicals and fertilizers banned in the U.S., illegally divert streams, and discharge polluted waste into waterways, poisoning the water supply, fish and animals. Growers have also clear cut trees and excavated forests illegally creating vast wastelands. When they move on to another illegal site, the old one is often the equivalent of a toxic waste site, saturated with poisons and fertilizers.

Despite evidence of significant criminal toxic waste discharge and other environmental crimes, not surprisingly the Obama Justice Department largely ignored the problem. In the liberal mindset, marijuana, unlike coal, oil and gas, is sacred stuff and considered outside the reach of the law. And there is little noise from the environmental movement which, if oil and gas or timber were the product, would be all over the issue like a wet blanket. But not marijuana.

A good example of the problems is Calaveras County made famous by Mark Twain, in the foothills of California’s Sierra Mountains. About the size of Rhode Island, it has a population of some 44,000 people. The County Board recently voted to ban commercial marijuana production – a prerogative under California’s law legalizing it. Their sheriff estimates there are at least 1200 illegal farms scattered through the mountainous terrain, all discharging large quantities of chemical waste into the water supply (nearly 10% of California’s water originates in little Calaveras County) and fouling the surrounding land with illegal herbicides, insecticides and rodenticides. Cleaning up those sites – just in Calaveras County — will cost, according to U.S. Forest Service estimates, at least $240 million; perhaps much more. Expand Calaveras’s problems across 15 other Northern California counties and the problem becomes almost unimaginable.

Environmental groups such as the Sierra Club and the Natural Resources Defense Council are nowhere to be found. Ironically it was these very mountains where Sierra Club founder John Muir hiked and studied for decades. I spoke with Dennis Mills, a member of the Calaveras County Board of Supervisors, who told me he has begged local and national environmentalist groups to get involved, but his pleas are always met, he said, with a yawn. Mills documented the abuses in a study Cultivating Disaster conducted by The Communications Institute.

So where is the federal government? Illegal and many legal marijuana farmers are likely in flagrant violation of numerous federal environmental criminal laws ranging from pollution crimes, wildlife and animal welfare crimes, and could be subject to large fines and restitution as well as lengthy prison sentences.

The Environmental Protection Agency, the Interior Department and Agriculture Department all have jurisdiction, and the Justice Department, complete with an Environmental Crimes Unit, together with California’s U.S. Attorneys, should be actively investigating these crimes, empaneling grand juries, and issuing indictments against these criminals.

The Trump Administration would do well to unleash its environmental lawyers on this nasty problem. It would greatly assist local and state agencies in dealing with the serious environmental mess caused by pot cultivation. It might not gain much support from marijuana users, but an aggressive campaign would undoubtedly create plenty of good will among the rest of the population and deal with a serious environmental problem.

Mr. Regnery, an Attorney, served in the Reagan Justice Department. He is Chairman of the Law Enforcement Legal Defense Fund.

Source: https://www.breitbart.com/politics/2018/02/25/regnery-feds-prosecute-california-marijuana-farmers-devastating-environment/February 2018

Cannabis hyperemesis syndrome (CHS) is nothing new, but nonetheless lacks a diagnosis code. This means that nobody—including the Centers for Disease Control and Prevention, which is meant to track such things—knows the prevalence of the condition. It is, however, relatively rare. Medical sources say that it’s likely, as you’d expect, to become more common as nationwide cannabis use increases.

No one claims that CHS is lethal, but it is uncomfortable—and in an emergency room situation requires such medications as haloperidol, an antipsychotic, to relieve vomiting and pain. Business Insider recently reported the story of 29-year-old Alice Moon, who began using cannabis regularly to treat pain and nausea. She did so without problems for five years, but then began experiencing CHS symptoms monthly, and eventually weekly.

People who use any substance deserve access to relevant health information, without exaggeration in either direction. “Marijuana is somehow making millions violently sick” and “Mysterious Syndrome Related To Marijuana Use Begins To Worry Doctors” are two CHS-related news headlines from the past month alone. But CHS likely doesn’t affect millions, and it is less mysterious than some imply.

So this isn’t a Reefer Madness story, designed to scare people, nor a head-in-the-sand story, designed to appeal to those who see cannabis as a risk-free panacea.

Even pro-cannabis advocates agree that CHS exists. “It’s a diagnosis of exclusion,” Peter Grinspoon, MD, a primary care physician at an inner-city clinic in Boston, told Filter. Grinspoon is also on staff at Massachusetts General Hospital, teaches at Harvard Medical School, and authored the memoir Free Refills: A Doctor Confronts His Addiction (2016). “I’m not sure how you can really differentiate it from cyclic vomiting syndrome (CVS), idiopathic [unknown cause] vomiting, or just something else causing the vomiting—except for a cannabis history.”

 CHS is caused by heavy long-term use of cannabis—i.e., it’s not a result of overdose or acute toxicity.

Experts believe that the action of the cannabinoid THC on our CB1 receptors, which are found all over the body but mainly in the brain, produces the symptoms of CHS—though the amounts of THC required, the duration of use in months or years, and why some people experience CHS and not others, are still unexplained.

One thing everyone seems to agree on: CHS is caused by heavy long-term use of cannabis—i.e., it’s not a result of overdose or acute toxicity. And it has one unusual manifestation: People afflicted like to take many hot baths or showers for relief.

study published last month, based on emergency room visits in a Colorado hospital, also found that CHS is more likely to be associated with smoked than edible cannabis. Of 2,567 ER visits that were at least partly attributed to cannabis use, 18 percent of patients who inhaled it were said to have CHS, versus 8.4 percent of those who ate it.

Emergency Physicians’ Experiences

 “It’s very dramatic—patients are sometimes writhing on the floor, and they’re vomiting so much. It’s a horrible syndrome,” said Andrew C. Meltzer, MD, associate professor in the Department of Emergency Medicine and Clinical Research Director of GWU School of Medicine and Health Sciences. “It’s very different from any other kind of vomiting thing, and very disruptive to the ED.”

And in the worst cases, “repeated aggressive vomiting can cause tears in the esophagus.”  

 Unlike gastroenteritis, with CHS there is no diarrhea, no fever and more of a hypersensitivity to pain in the abdomen, Meltzer told Filter. There is an “overlap” with cyclical vomiting syndrome (CVS), in that many symptoms are the same. Blood work might be needed to rule out pancreatitis and hepatitis, and some patients get radiology.

Toxicology testing, on the other hand, is not very useful, because so many people use marijuana without showing these symptoms. Rather, it’s important to get a history of the extent and duration of marijuana use from the patient, said Meltzer. “Confusion exists in the medical literature,” he noted. In addition, he believes there is a pervasive failure to recognize chronic cannabis use as a possible cause of vomiting.

“We’re still trying to figure out how to make them feel better,” said Meltzer of CHS patients. “Typical anti-emetics like Phenergan and Zofran don’t work. Instead, we use antipsychotics, like haloperidol.” In fact, if the haloperidol works, Meltzer views that as diagnostic of CHS in some ways. The heat from capsaicin rubbed on the abdomen also provides some relief from pain.

In the patients Meltzer has seen with CHS, all “would qualify as addicted” to cannabis, he said. He doesn’t recommend using morphine for CHS pain because of what he sees as the addiction risk in this population.

Some CHS patients can’t be treated with emergency room management alone. Meltzer said he had to admit one patient for dehydration, fluids replacement, renal insufficiency, and other problems. “But now we’re getting more used to how to manage this with haloperidol and even Ativan. They are sedated, they sleep, and they go home.”

“I don’t care what people do in their free time, but in the medical history I try to include things that are pertinent.”

Ryan Marino, MD, an emergency medicine physician and medical toxicologist at the University of Pittsburgh, sees CHS about two-to-three times a month—but acknowledges it could be more, because sometimes it’s hard to be sure.

“The big issue is [CHS] is under-recognized,” said Marino, agreeing with Meltzer. “So a lot of patients get unnecessary testing.” For someone who comes in with a lot of nausea and vomiting, and is young and otherwise healthy, he says it’s important to ask about their marijuana use.

“I try to be as non-judgemental as possible” in asking those questions, he said. “I don’t care what people do in their free time, but in the medical history I try to include things that are pertinent.”

With emergency patients, the differential diagnosis is crucial and must be done quickly. “When there’s belly pain, you worry about things that need surgery, like appendicitis and the gallbladder,” said Marino. “CVS is kind of similar [to CHS], but people aren’t using cannabis.” So asking about marijuana use history can clearly help.

“The main thing seems to be people who use heavily and regularly: daily use or near-daily use,” said Marino. “With the rise of medical cannabis, more people have access to it, so maybe there are more presentations now than there used to be. But with no ICD [International Classification of Diseases] code, I don’t think you’d be able to say whether you can find prevalence.”

Marino acknowledges that there’s a fine line to tread in questioning patients, especially in situations where they are worried about law enforcement, and some healthcare providers are better than others at getting honest histories. “There are going to be people on the provide side who don’t get the truth out of patients, and there are patients who won’t disclose. This is why the way we treat patients is important.”

Gastroenterologists’ Perspectives

 Whether they’re called in to consult in the emergency department or see a person in their office, gastroenterologists have a big role to play for CHS patients. CHS has been known about since 2004, but a seminal 2011 Current Drug Abuse Reviews article put gastroenterologists on the alert.

A year ago, Healio interviewed gastroenterologist Joseph Habboushe, MD for an article titled “Cannabinoid hyperemesis syndrome: What GIs should know.” Habboushe had surveyed 155 patients in an emergency department who reported smoking marijuana frequently and found that 32.9 percent of them met criteria for CHS. He concluded that the syndrome is vastly underreported.

“I would definitely ask” about marijuana use in the case of an otherwise-healthy, vomiting patient, said Lisa Gangarosa MD, AGAF, FACP, professor of Medicine at the UNC Division of Gastroenterology and Hepatology, speaking for the American Gastroenterological Association. “The diagnosis is largely made on the history.”

There is no clear test. “Basically, if the history fits, and if the patient stops smoking and gets better, that’s what it was.”

Some testing would be done to exclude other problems, such as stomach cancer, a large ulcer or gallstones, Gangarosa told Filter. It’s also important to conduct basic lab testing, such as for pregnancy, and then, if all of that testing comes back negative, to think about endoscopy and ultrasound of the gallbladder.

Gangarosa has only seen CHS in patients who have been “smoking pot,” not in anyone who has been prescribed dronabinol, which is synthetic THC.

There is no clear test for the syndrome. “In some cases you can say your impression is suspected marijuana-induced hyperemesis,” she said. “Basically, if the history fits, and if the patient stops smoking and gets better, that’s what it was.”

Surprisingly, many patients who use cannabis haven’t heard of CHS, said Gangarosa. For others, they don’t want to stop smoking, “and they don’t want to believe that this is the cause of their problems. It’s the same thing with pancreatitis—just because of the health harms, doesn’t mean people want to give up drinking.”

The Hot Bath Phenomenon

Andrew Meltzer, the ED physician, said that some of his patients have taken six-to-eight warm baths a day to relieve symptoms.

This reminds me of a personal experience. A member of my family had acute gastritis at the age of six, with a lot of vomiting, and was hospitalized for a week. All she wanted to do was lie in the hospital bathtub with the water as hot as possible. There was no marijuana involved, but bells went off in my head when I heard about the hot shower “cure.” Could this be a common way of responding to extreme vomiting and pain in general?

Experts stress that the hot shower treatment is anecdotal, and can’t be used as a sure sign of CHS. “But it’s something I ask people,” said Ryan Marino. “It seems as if most people have figured out” that it works. “It might be that they’re so symptomatic they try anything, and find the one thing that works.”

Like the capsaicin, which provides heat, and heating pads, heat from the hot shower on the belly might relieve the pain, said Marino. However, “I don’t think anyone has a good reason for the link” between CHS and hot showers.

A Researcher’s View

The National Institute on Drug Abuse (NIDA) referred Filter to Kiran Vemuri, PhD, a research assistant professor at Northeastern University in Boston, who has a grant from the agency to find an antidote for synthetic cannabinoid intoxication.

That, of course, is a very different issue from CHS. But as an organic chemist, Vemuri has studied emesis from a CB1 antagonist perspective. He is aware of the paradox with THC: The synthetic version, dronabinol, is approved by the FDA to treat the nausea and vomiting associated with chemotherapy, as well as to increase appetite in wasting associated with AIDS, and for many other conditions.

How would the same substance that treats nausea induce it?

“This only happens in people who have been consuming cannabis for a long time,” Vemuri said. But he noted that most information in the literature is anecdotal and based on case histories. “People try to come up with a number”— how much cannabis, for how long—“but you can never really tell as to what causes the hyperemesis. Is it the dose, is it the strain?”

“If you know the CB1 receptor is implicated … the best treatment option would be an antagonist.” Except there isn’t one.

Vemuri has studied antagonists which induce nausea, with the CB1 receptor the biological target. CB1 receptors are all over the body, but most are in the brain, he said.

If you want to know everything the top researcher in emesis (vomiting) knows about the topic, look up the work of Linda Parker. It’s hard to study in animals, because not all of them even vomit.

There is no antidote for emesis itself, said Vemuri. “But if you know that the CB1 receptor is implicated, and the patient is presenting with an overdose of THC or synthetic cannabinoids, the best treatment option would be an antagonist.” Except there isn’t one.

As for the hot showers, CB1 receptors could indeed be involved, but there is no “concrete connection” to CHS or its treatment, said Vemuri.

And he cautions that “‘overdose’ is a big word when it comes to THC.” The dose, the strain, the route of administration all matter, he said. And because THC can reside in fat, and build up, it makes sense that some of the side effects could be worse in people who have consumed THC over a long period of time. “At the end of the day, anything in excess is not good.”  

No Easy Cure

There was one medication which briefly showed promise for CHS—ribonabant—but it was removed from the market due to psychiatric side effects (suicidal ideation). “The target is so new,” Vemuri said. “But NIDA is definitely interested, and no one ever gave up on the target, and no one ever gave up on cannabis, and no one ever gave up on the antagonists. Recently I was at a conference where I got to know companies that are pursuing both CB1 and CB2.”

While hot showers may provide temporary relief, and anti-emetics and intravenous hydration can help “someone in the throes of repetitive vomiting,” for now, the best way for CHS patients to avoid further symptoms for good is to stop using cannabis, said Lisa Gangarosa, the gastroenterologist.

“That is always the recommendation,” agreed Marino. “It seems to be the only thing that makes it better or makes it go away. But it’s not always the easiest thing. It’s easy for me to say.”

The implications of quitting for people who use cannabis for medical reasons—and the difficulties for people who are addicted—are clear. But for now, the unknown minority of cannabis users unfortunate enough to experience cannabis hyperemesis syndrome have no other reliable recourse.

Source:  https://www.dbrecoveryresources.com/2019/04/what-is-cannabis-hyperemesis-syndrome/ April 2019

Britain could set off a schizophrenia timebomb if it ignores the dangers of super-strength ‘skunk’ cannabis, one of the UK’s most eminent psychiatrists warns today.

Strong evidence now shows that smoking potent forms of the Class B drug increases the chance of psychosis, paranoid delusions and schizophrenia.

But too many people – from teenagers to top officials – have little idea of the terrible toll it can take on the mind, says Professor Sir Robin Murray.

Labour, the Liberal Democrats and the Scottish National Party all back legalisation of cannabis in some form. But Prof Murray said the dangers were not being recognised – and legalising skunk would amount to ‘a major pharmaceutical experiment’ with the brains of young people.

Prof Murray, from the Institute of Psychiatry at King’s College London, said: ‘I don’t think any serious researcher or psychiatrist would now dispute that cannabis consumption is a component cause of psychosis.’

He warned that:

  • MRI scans show long-term use of skunk can shrink a vital part of the brain;
  • The substance – now dominant on Britain’s streets – is four times stronger on average than cannabis smoked in the past;
  • A clear majority of studies show those who regularly smoke cannabis are at ‘significant increased risk’ of developing psychosis or schizophrenia-like illness;
  • Heavy users of skunk are up to four times more likely than non-users to develop psychotic symptoms.

Prof Murray said the cannabis being sold on our streets had changed almost beyond recognition in the past 20 years. Dealers have dropped weaker varieties in favour of skunk, which is made from non-pollinated parts of the plant, and provides a stronger ‘hit’ that may be more addictive.

A recent study revealed that almost all cannabis sold in the UK is now skunk. On average, skunk is 16 per cent tetrahydrocannabinol (THC), the main psychoactive compound – four times more than the THC in marijuana and hash.

Brain scans show skunk has a far stronger impact on the mind, said Prof Murray, due to both its high THC content and its very low content of the protective compound cannabidiol.

Experiments on volunteers at King’s College show THC boosts the brain’s natural fear response – making the merely worrisome seem positively frightening.

And MRI scans reveal that long-term use of skunk shrinks the hippocampus – the part of the brain essential for regulating emotions and long-term memory – by 11 per cent, according to researchers at Monash University in Australia. Only ‘prolonged abstinence’ could reverse the brain atrophy, they concluded.

MRI scans reveal that long-term use of skunk shrinks the hippocampus – the part of the brain essential for regulating emotions and long-term memory – by 11 per cent 

Prof Murray and colleague Dr Marco Colizzi have emphasised their concerns in a hard-hitting article for the British Journal Of Psychiatry, titled Cannabis And Psychosis: What Do We Know And What Should We Do?

They say UK authorities should watch what happens in America, where a number of states have recently legalised cannabis use.

‘The USA has embarked on a major pharmaceutical experiment with the brains of its youth and we should wait and see the outcome of the experiment,’ they write. ‘While we wait, we need education to make the public aware of the risks associated with heavy cannabis use.

‘It would be a shame when we are in sight of ridding the country of the scourge of tobacco use, if it were to be replaced by use of a drug that, although less harmful to the body, is more toxic to the mind.’

To help educate people about the dangers, Prof Murray is giving a series of talks in London, organised by events company Funzing. And he believes that health officials should be playing a far more active role in warning of the perils of skunk.

His intervention comes three years after The Mail on Sunday revealed his groundbreaking research suggesting up to a quarter of all new psychosis cases could be caused by skunk. Among those deeply affected is hereditary peer Nicholas Monson, whose son Rupert, 21, took his own life last year after developing drug-related psychosis.

Lord Monson said: ‘He descended into complete, utter madness.’

Rupert Green (pictured) the son of Lord Monson, was just 21 when he killed himself last year after descending into drug-related pyschosis, having gone in a few short years from ‘the occasional spliff’ to habitually smoking skunk

Rupert first admitted smoking ‘the occasional spliff’ at 19 and, like many parents, his father reacted with relief that it was nothing harder. But his behaviour gradually became ‘more and more peculiar’, said Lord Monson, adding: ‘He was a mixture of self-pity and outright aggression. I found him very difficult to deal with.’

The family managed to get Rupert referred to an NHS mental health team, and after being diagnosed, the youngster stopped smoking skunk and went on medication. However, he later killed himself.

Lord Monson said: ‘He hadn’t touched skunk for four months. But his mind continued to be overwhelmed. What I’ve learnt since his death is once a young man gets into a state of drug-induced psychosis, he doesn’t get out of it.’

Lord Monson has lobbied hard for better public education, including writing to the Prime Minister. He said he wanted cannabis below five per cent THC legalised to take it out of criminals’ hands, but anything stronger to be banned.

Incredibly, Government agencies provide almost no information on the risks of skunk, despite millions smoking it. Three years ago, the Advisory Council on the Misuse of Drugs said there was ‘strong evidence’ that ‘standalone’ information or warning campaigns were ‘ineffective’. But Lord Monson said: ‘The Government is doing an enormous disservice by not educating people about skunk’s dangers.’

Last night Public Health England said its Rise Above programme helped young people cope with a range of ‘diverse challenges’ including drug misuse, while its dedicated drug information website, Talk To Frank, provides ‘easily accessible information for young people about the risks and harms of drug misuse’.

Yet Rise Above, which is aimed at teenagers, does not mention cannabis at all. Talk To Frank, for an older audience, does state that regular cannabis use is ‘associated with an increase in the risk of later developing psychotic illnesses including schizophrenia’. But it contains no information on the greater danger posed by skunk. 

Source: https://www.dailymail.co.uk/health/article-5539941/Top-doctor-warns-psychosis-paranoid-delusions-superskunk-schizophrenia-timebomb.html

Police forces in the province collected 795 blood samples from motorists suspected of driving while under the influence.

One year after the legalization of recreational use of cannabis in Canada, the black market for the drug — as well as its use behind the wheel — continues to keep Quebec police forces busy.

In 2018, police collected 795 blood samples from motorists suspected of driving while under the influence, and sent them to Quebec’s medical legal centre for processing. That’s 254 more than in the previous year.

The presence of cannabis was detected in 46 per cent of those cases.

The Sûreté du Québec says cannabis is the most commonly detected drug in its traffic stops.

The provincial force said that since legalization, cannabis was detected in the systems of 113 persons pulled over for impaired driving, compared with 73 cases a year earlier — an increase of 54 per cent.

More than 670 officers trained in drug use evaluation have been deployed across the province.

In a statement issued Thursday detailing its operations over the past year, the SQ said it had opened 1,409 investigations into the illegal production, supply and distribution of cannabis, which led to 1,458 warrants being executed and charges filed against 1,403 individuals.

Meanwhile, raids on illegal outdoor cannabis fields were carried out in August and September, and saw 37,000 plants seized.

Over the past year, the SQ seized 71,500 cannabis plants, 161 kilograms of cannabis, 15.8 kilograms of cannabis oil and resin, 23,460 units of edible cannabis and $180,000 in cash.

Source:  https://montrealgazette.com/news/local-news/quebec-pot-arrests-behind-the-wheel-up-54-since-legalization October 2019

 

As a growing number of U.S. states legalize the medicinal and recreational use of marijuana, an increasing number of American women are using cannabis before becoming pregnant and during early pregnancy often to treat morning sickness, anxiety, and lower back pain. Although emerging evidence indicates that this may have long-term consequences for their babies’ brain development, how this occurs remains unclear.

A University of Maryland School of Medicine study using a preclinical animal model suggests that prenatal exposure to THC, the psychoactive component of cannabis, makes the brain’s dopamine neurons (an integral component of the reward system) hyperactive and increases sensitivity to the behavioral effects of THC during pre-adolescence. This may contribute to the increased risk of psychiatric disorders like schizophrenia and other forms of psychosis later in adolescence that previous research has linked to prenatal cannabis use, according to the study published today in journal Nature Neuroscience.

The team of researchers, from UMSOM, the University of Cagliari (Italy) and the Hungarian Academy of Sciences (Hungary), found that exposure to THC in the womb increased susceptibility to THC in offspring on several behavioral tasks that mirrors the effects observed in many psychiatric diseases. These behavioral effects were caused, at least in part, by hyperactivity of dopamine neurons in a brain region called the ventral tegmental area (VTA), which regulates motivated behaviors.

More importantly, the researchers were able to correct these behavioral problems and brain abnormalities by treating experimental animals with pregnenolone, an FDA-approved drug currently under investigation in clinical trials for cannabis use disorder, schizophrenia, autism, and bipolar disorder.

The researchers concluded that as physicians caution pregnant women against alcohol and cocaine intake because of their detrimental effects to the fetus, they should also, based on these new findings, advise them on the potential negative consequences of using cannabis specifically during pregnancy.

Recent data from the Kollins lab (‘Cannabinoid exposure and altered DNA methylation in rat and human sperm’ Epigenetics 2018; 13: 1208–1221) indicated epigenetic effects of cannabis use on sperm in man parallel those in rats and showed substantial shifts in both hypo- and hyper-DNA methylation with the latter predominating. This provides one likely mechanism for the transgenerational transmission of epigenomic instability with sperm as the vector. It therefore contributes important pathophysiological insights into the probable mechanisms underlying the epidemiology of prenatal cannabis exposure potentially explaining diverse features of cannabis-related teratology including effects on the neuraxis, cardiovasculature, immune stimulation, secondary genomic instability and carcinogenesis related to both adult and pediatric cancers.

The potentially inheritable and therefore multigenerational nature of these defects needs to be carefully considered in the light of recent teratological and neurobehavioural trends in diverse jurisdictions such as the USA nationally, Hawaii, Colorado, Canada, France and Australia, particularly relating to mental retardation, age-related morbidity and oncogenesis including inheritable cancerogenesis. Increasing demonstrations that the epigenome can respond directly and in real time and retain memories of environmental exposures of many kinds implies that the genome-epigenome is much more sensitive to environmental toxicants than has been generally realized. Issues of long-term multigenerational inheritance amplify these concerns. Further research particularly on the epigenomic toxicology of many cannabinoids is also required.

Introduction

Physiology and pathobiology of the epigenome and its complex interactions with the genome, metabolome and immunometabolome, and cannabinoid physiopharmacology represents some of the most exciting areas of modern biological research. Type 1 and 2 cannabinoid receptors (CB1R and CB2R) are involved in a host of endogenous processes with potential therapeutic applications in numerous fields as diverse as pain, nausea, temperature regulation and weight control amongst others. Several recent detailed structural descriptions of the CB1R and CB2R complexed with high affinity agonists and antagonists, and pathways for the bulk biological synthesis of cannabinoids open the way to the rational design of high affinity molecules to differentially modulate these key receptors which are involved in a host of endogenous processes with diverse potential therapeutic applications. The use of exogenous cannabinoid compounds that bind to CB1R and CB2R may however also produce unwanted side effects including through modulation of DNA methylation states.

Within each nucleated cell, 2 m of DNA is normally stored coiled around four histones known as a nucleosome. A total of 147 bases of DNA are wrapped twice around two sets of H2A, H2B, H3 and H4 which together form the histone octamer. The bases of DNA itself may have a methyl group (CH3-) attached to them, usually to cytosine-phosphate-guanine (CpG), which when it occurs in the region of the gene promoter, blocks the transcription machinery and prevents the gene from becoming activated. The tails of the four histone proteins protrude from the central globular core and normally bind by electrostatic forces to the coiled DNA. Addition of an acetyl group to these histone tails, particularly on H3 and H4, disrupts the salt bridges opening up the DNA code for active transcription. Histone tails can also be methylated or indeed be modified by many groups (mono-, di- and trimethyl, acetyl, phosphoryl, crotonyl, citrulline, ubiquitin and ADP-ribosyl, etc.) which control gene transcription . DNA is transcribed into RNA some of which is made into the many proteins from which our bodies are made. However, much of the RNA also has purely informatic roles, and short and long non-coding RNA’s (ncRNA) controls DNA availability and transcription, RNA processing and splicing and can form a scaffold upon which layers of DNA regulation can be built. These various mechanisms, DNA methylation, post-translational modification of histone tails, nucleosome positioning, histone replacement, nuclear positioning and ncRNA’s form the basis of epigenetic regulation and appear to undergo an ‘epigenetic conversation’ amongst these different layers.

Chromatin loops are extruded through cohesin rings giving rise to transcription factories (topologically active domains) where different regions of the DNA including proximal promoters and distal enhancers are brought into close proximity to control transcription either on the same chromosome (in cis) or sometimes on nearby chromosomes (in trans). Super-enhancers, enhancer cross-talk, and extensive 3D remodelling of euchromatin looping during development are also described.

Moreover, a variety of studies in animals and several epidemiological studies in humans show that the epigenetic code can form a mechanism for inheritable changes across generations from both father and mother to subsequent generations which do not involve changes in the genetic code itself. Such epigenetic inheritance has been shown clinically for starvation, obesity, bariatric surgery and for tobacco and alcohol consumption. It has also been demonstrated in rodents for alcohol, cocaine and opioids, and in rodents’ immune system, nucleus accumbens and sperm following cannabinoid exposure in the parents.

If DNA is thought of as the cells’ bioinformatic ‘hardware’ then the epigenome can be considered its programming ‘software’. The epigenome controls gene expression and is key to cell differentiation into different tissue fates, different states of cellular differentiation, to cellular reprogramming into induced pluripotential stem cell states, cancer, numerous neuropsychiatric diseases including addiction, immune, metabolic and brain memory, aging, and the response of the cell to changes in its environment by way of gene-environment interactions including the development of so-called ‘epigenetic scars’.

This powerful informatic system has recently been shown to have a host of unforeseen capabilities. It has been shown that histone tails sense oxygen tension rapidly within 1 h with resulting modification of gene expression cassettes. Lysine (K) demethylase 5A (KDM5A) is a Jumanji-C domain containing molecular dioxygenase which is inactivated by hypoxia in a hypoxia-inducible factor-independent manner, controls H3K4me3 and H3K36me3 histone trimethylations and governs the transcriptome expression several hours after brief hypoxia. Similarly, KDM6A is also an oxygen sensitive dioxygenase and histone demethylase which controls H3K27me3. Its blockade by hypoxia interferes with cell differentiation and maintains cells in an undifferentiated state. Since the ten eleven translocase enzymes and are key demethylators of DNA and are dioxygenases also sensitive to profound hypoxia, and since hypoxia exists in most stem cell niches and at the centre of many tumours, such histone- and DNA-centred mechanisms are likely to be important in stem cell, aging, cellular differentiation and cancer biology.

Epigenomic regulation of tumour immunometabolome

Similarly, one of the great paradoxes of cancer biology is the presence within tumours of numerous effector T-cells which are able to expand and eradicate large metastatic tumours effectively, but do not do so within clinical cancers. It was recently shown that this effect is due to the very elevated nucleocytosolic potassium level within tumour lymphocytes which stalls metabolism and runs down acetyl-coenzyme A levels, the main acetyl donor for histone acetylation and induces a form of calorie restriction (like starvation) including autophagy and mitophagy and impairs the normal mTOR (mammalian target of rapamycin)-dependent T-cell receptor-mediated activation response. This program was mediated by reduced levels of H3K9 and H3K27 acetylation. Hence, tumour lymphocyte anergy and stemness were both mediated epigenetically and were shown to be reversible when the immunometabolic defect was corrected either genetically or by substrate supplementation. This work elegantly demonstrates the close relationship between the metabolic state of cells, cell differentiation state and starvation response, the control of cell fate by the epigenetic landscape and disease outcome.

Metabolomic supply of epigenetic substrate

Several studies similarly link the supply of metabolic intermediates required as inputs by the epigenetic machinery to epigenetic state and downstream gene control. Indeed, the well-known supplementation of staple foods by folic acid is believed to act because of the central role played by this vitamin in the methyl cycle and the supply of single carbon units to the methylation machinery for DNA and histones. A moments reflection shows that expression of the DNA of the mitochondria and the DNA of the nucleus need to be tightly coordinated to supply the correct number of subunits for the complex machineries of the mitochondrion including electron transport. This mitonuclear balance acts at several levels including RNA transfer, metabolic substrate (acetyl-coenzyme A, nicotinamide mononucleotide) transfer and the control of the epigenetic regulators PARP (polyadenosineribosyl polymerase) and Sirt1 (a major histone deacetylase).

Cannabinoid signalling impacts mitochondria

As noted above the identification of CB1R and CB2R on the plasma membrane has been a major milestone in cellular cannabinoid physiology. It is less well known that CB1R’s also exist on the mitochondrial outer membrane, and that the inner and outer leaflet of the mitochondria, together with the intermembrane space host the same cannabinoid transduction machinery as the plasmalemma. Neuronal mitochondrial CB1R’s have been implicated in memory and several critical neural processes. Hence, the well-substantiated findings that diverse cannabinoids generally suppress mitochondrial activity (in neurons, lung, liver and sperm), lower the mitochondrial transmembrane potential and interfere with oxidative phosphorylation carry major epigenetic implications not only for mitonuclear balance and trafficking including the mitochondrial stress response, but also for the supply of the requisite metabolic intermediates in terms of acetyl-coenzyme A which is an absolute requirement for histone acetylation and normal gene activation.

Histone serotonylation and dopaminylation

Serotonin, which has long been implicated in mood dysregulation and drug addiction was recently shown to act as a novel post-translational modification of the tail of H3 at lysine 4 via serotonylation where it increases the binding of the transcription machinery and allows correct cell differentiation. It is likely that dopamine will soon be similarly implicated.

Almost accompanying the modern bioinformatic explosion of knowledge related to the sequencing of the human genome has been a parallel increase in knowledge of the complexities and intricacies of epigenomic regulation. Nowhere is this more evident than in cancer. Indeed, it has become apparent that there are numerous forms of cross-talk, interaction and cross-regulation between the genome and the epigenome and the two are in fact highly inter-related. This is of particular relevance to chromosomal integrity and cancerogenic mechanisms. Several mechanisms have been described for such interactions including alterations of DNA methylation, altered cytosine hydroxymethylation, alteration of TERT function which is a key catalytic component of the telomerase enzyme which protects chromosome ends and altered architecture of enhancers and their looping interactions with promoters which control gene expression. Indeed, pharmacological modulation of the bromodomain ‘readers’ of epigenomic information has become a very exciting area within modern cancer therapeutic research , and forms an area into which large pharmaceutical companies are presently investing several billion dollars.

Gamete cannabinoid epigenomics – Murphy et. al

In this powerful context, the masterful epigenetic work from the Kollins laboratory of Murphy and colleagues was situated. These workers studied 12 control men who self-reported no psychoactive drug use in the last 6 months, and 12 subjects who reported more than weekly use of cannabis only, with all results confirmed by urine toxicology and ultra performance liquid chromatography/tandem mass spectrometry and enzyme immunoassay. In parallel two groups of 9-week-old male rats were administered solvent or 2 mg/kg THC by gastric lavage for 12 days prior to sacrifice and the epididymis was harvested. Sperm were assayed by the ‘swim out’ method where sperm swam out into normal saline bath solution. Cannabis exposed men had lower sperm counts, and it was found that there was differential sperm DNA methylation at 6,640 CpG sites including at 3,979 CpG islands in gene promoters where methylation was changed by more than 10% (which is alot). Significant changes were in both the hypomethylation and hypermethylation direction were noted with the changes in the hypomethylation group being more marked across the genome and at gene promoters. Pathways in cancer (including the BRAF, PRCACA, APC2 PIK3R2, LAMA1, LAMB1, AKT1 and FGF genes), hippo pathways (which are also important in cancer and in embryonic body pattern formation), the MAP kinase pathway (also involved in growth and cancer), AMPA, NMDA and kainate glutamate receptor subunits, and the Wnt genes 3A, 5A, 9A, 10A (involved in cancer and in body patterning and morphogensis) were found to be particularly affected. A dose–response effect was demonstrated at 183 CpG sites on 177 genes including the PTG1R gene which encodes the prostacyclin (a powerful vasodilator and antithrombotic agent) receptor which was down-regulated.

Twenty-three genes involved in platelet activation and 21 genes involved in glutamate metabolism were also modulated. LAMB1, whose gene product laminin B has been implicated in progeria and is increasingly implicated in genetic ageing pathways through its role in nuclear positioning of chromatin and the maintenance of heterochromatin (including female X-chromosome inactivation) in an inactive state inside the nuclear membrane, and its role in establishing integrity of the nuclear envelope, was also identified.

Results in the rats closely paralleled those found in humans. Fifty-five genes were found to overlap between altered sperm methylation patterns and a previous study of brain Nuclear Accumbens DNA methylation in prenatally cannaboid exposed rats which showing increased heroin self-administration, a highly statistically significant result. These results support the hypothesis that the transgenerational transmission of defects following pre-conceptual exposure to cannabis found in the immune system and limbic system of the brain including increased tendency for drug use in later life in rodents may be transmitted through alterations in the DNA methylation of the male germ line. More work is clearly needed in this area with exhaustive epigenetic, transcriptomic and genomic characterization of these results with larger sample sizes and in other species.

Cannabis – cancer links

Mechanistically these results have very far-reaching implications indeed and appear to account for much of the epidemiologically documented associations of cannabis use. Cannabis has been associated with cancer of the mouth and throat, lung, bladder, leukaemia, larynx, prostate and cervix and in four out of four studies with testicular teratomas with a relative risk of three in meta-analysis. Cannabis has also been implicated with increased rates of the childhood cancers acute lymphocytic leukaemia, acute myeloid leukaemia, acute myelomonocytic leukaemia, neuroblastoma and rhabdomyosarcoma.

These are believed to be due to inheritable genetic or epigenetic problems from the parents, albeit the mechanism of such transmission was not understood in the pre-epigenomic era. Results of Murphy and colleagues may potentially explain mechanistically much of the epidemiologically documented morbidity that has in the past been associated with cannabis use. As noted, cannabis contains the same tars as tobacco and also several known genotoxic compounds, and is also immunoactive. Such actions imply several mechanisms by which cannabis may be implicated in carcinogenic mechanisms.

That cannabis is associated with heritable paediatric cancers where the parents themselves do not harbour such tumours is suggestive evidence that non-genetic and likely epigenetic mechanisms are involved in the childhood cancers which are observed. Detailed delineation of such putative pathways will require further research.

Cannabis has also been shown to be associated with increased rates of gastroschisis in seven of seven studies to examine this association. This pathology, where the bowels of the neonate protrude through the abdominal wall usually to the right of the umbilicus, is believed to be due to a disruption of blood flow to the forming abdominal wall. If cannabinoid exposure powerfully activates platelets through multiple mechanisms and disrupts major vasodilator systems such as the prostacyclin receptor then such a pathway could well damage the tiny blood vessels of the developing foetus and account for the development of gastroschisis. Cannabis use in adults has been linked with both myocardial infarction and stroke possibly by similar mechanisms. It has been shown elsewhere that cannabis use can also stimulate inflammation and be proinflammatory.

Epigenomics of foetal alcohol syndrome

Indeed, foetal alcohol syndrome disorder (FASD) is said to be mediated in part by the CB1R , to be epigenetically mediated, and to comprise amongst other features small heads, microcephaly, impaired visuospatial coordination and to be commonly associated with ventricular septal defect and atrial septal defect all of which have been described in association with prenatal cannabis exposure. However, the facial features of FASD are not described in the congenital cannabis literature.

Cannabis and congenital anomalies

Indeed, one Hawaiian statewide epidemiological report found elevated rates of 21 congenital defects in prenatally cannabis exposed infants. Whilst this paper is unique in the literature it helps explain much about the presently reported patterns of congenital anomalies across USA in relation to atrial septal defect, Downs’ syndrome, Trisomy 18, ventricular septal defect, limb reduction defects, anotia, gastroschisis and autism, all of which crude rates are more common in states with liberal cannabis policies. Similar morbidity patterns were observed in Canada with crude rates of all congenital defects, gastroschisis, total cardiovascular defects and orofacial clefts more common in areas with higher cannabis use. The Colorado birth defects registry has also reported a three-fold increase in the crude (unadjusted) rate of atrial septal defects 2000–2014 spanning the period of cannabis legalization together with increases of 30% or more over the same period in crude rates of total cardiovascular defects, ventricular septal defects, Down’s syndrome and anencephaly. This is highly significant as atrial septal defect has only been found to be linked with cannabis in the Hawaiian study, suggesting that our list of cannabis-related defects is as yet incomplete. As mentioned above the putative link between atrial septal defect and cannabis use has also been found in the generality of states across the USA. It should also be noted that according to a major nationally representative recurrent survey the use of all other drugs in Colorado fell during this period, making cannabis the most likely pharmacological suspect for the surge in congenital anomalies.

These findings are also consistent with data arising from France, wherein three separate regions which have permitted cannabis to be used as feed for the dairy industry calves are born without legs, and an increase in the rate of phocomelia (no arms) in human infants has similarly been observed. In the French northeast region of Ain which is adjacent to Switzerland, the crude rate of phocomelia is said to be elevated 58 times above background, whilst in nearby Switzerland which has not permitted cannabis to be used as a feed crop no such anomalies are observed.

Neuroteratogenesis and beyond

The above comments in relation to epigenetic modulation of the glutamate system have been shown in recent studies to be related to many neuropsychiatric disorders. However, the recent demonstration at least in insects that glutamate could also act as a key morphogen in body patterning processes and major organ formation may have much wider implications well beyond the neuraxis Cannabis and epigenetic ageing.

The finding of overall DNA hypomethylation by Murphy’s group carries particular significance especially in the context of disordered lamin B metabolism. Chronic inflammation is known to be a major risk factor for carcinogenesis in humans in many organs including the skin, oropharynx, bronchi, lungs, oesophagus, stomach, pancreas, liver, biliary tree, colon, bladder and prostate. Inflammatory conditions are invariably strongly pro-oxidative and damage to DNA is not unusual. Because CpGs in gene promoters are more often largely unmethylated and therefore exposed the guanine in these positions is a common target for oxidative damage. Oxo-guanine is strongly mutagenic. This form of DNA damage recruits the maintenance DNA methyltransferase DNMT1 from the gene body to the gene promoter. There DNMT1 recruits Sirt1, a histone deacetylase which tends to epigenetically silence gene expression, and also EZH2 part of the polycomb repressive complexes 2 and 4 which epigenetically silences gene expression and tends to spread the silencing of chromatin. Hence, one of the end results of this form of oxidative DNA damage is to move the DNA methylation from the gene bodies to the gene promoters, thereby hypermethylating the promoters, the CpG Island Methylator Phenotype (CIMP) and hypomethylating the gene bodies and intergenic regions. By this epigenetic means chronic inflammation and tobacco smoke have been shown to induce widespread epigenomic field change right across tissues such as colon, bronchi or bone marrow. Furthermore, this mechanism moves gene expression from the control of histone modification to DNA methylation which tends to be more fixed and less plastic than histone alterations. Such findings are consistent with a previous demonstration of accelerated ageing in cannabis exposed clinical populations.

Epigenomic control of mobile transposable genetic elements

Reducing the global level of DNA methylation also has the effect of reducing the control of mobile transposable repeat elements in the genome. Forty-two per cent of the human genome has been shown to be comprised of these mobile elements of various varieties. Long Interspersed Repeat Elements (LINE-1) are believed to be retroviral repeat elements which long ago became incorporated in the genome and are able when expressed to induce their own reverse transcription back into the genome via endogenous reverse transcriptases. For this reason, they are also called ‘jumping genes.’ Because they become randomly incorporated into the genome after reverse transcription their activity is very damaging to genetic integrity. Whilst retrotransposon mobility is normally controlled by three mechanisms these defences can be overcome in advanced cellular senescence. The presence of double-stranded DNA (dsDNA) in the cytoplasm is strongly stimulating for the immune system and stimulates a type-1 interferon proinflammatory response, which further exacerbates the cycle and directly drives the Senescence Associated Secretory Phenotype (SASP) of advanced senescence and the ‘inflamm-aging’ which is well described in advanced age. Accelerated ageing in patients exposed clinically to cannabis has previously been described using a well validated metric of arterial stiffness. Whilst neither Murphy nor Watson found evidence following cannabinoid exposure for altered methylation of repeat elements the presence of chronic inflammation in the context of widespread preneoplastic change and documented neoplasia suggest that this newly described ageing mechanism might well merit further investigation.

These changes are likely exacerbated by several classical descriptions that cannabinoids reduce the overall level of histone protein synthesis. Since the overall length of DNA does not change this is likely to further open up the genome to dysregulated transcription. Severe morphological abnormalities of human and rodent sperm have been reported.

Similarly classical descriptions exist of grossly disrupted mitoses, particularly in oocytes, which are said to be seriously deficient in DNA repair machinery. Morishima reported as long ago as 1984, evidence of nuclear blebs and bridges due to deranged meiotic divisions in cannabinoid-exposed rodent oocytes . Similar blebs and bridges have been reported by others. It has since been shown that these nuclear blebs represent areas of weakness of the nuclear membrane which are often disrupted spilling their contents into the cytoplasm. They are also a sign of nuclear ageing.

Cannabinoids and micronuclei

Cannabis has long been known to test positive in the micronuclear assay due to interference with the function of the mitotic spindle. This is a major cause of chromosomal disruption and downstream severe genetic damage in surviving cells, has previously been linked with teratogenesis and carcinogenesis, and which is also potently proinflammatory by releasing dsDNA into the cytoplasm and stimulating cGAS-STING (Cyclic GMP-AMP synthase – STimulator of INterferon Gamma) signalling and downstream innate immune pathways.

Cytoplasmic dsDNA has also been shown to be an important factor driving the lethal process of cancer metastasis.

Cannabis and wnt signalling

The findings of Murphy in relation to Wnt signalling are also of great interest. It has been found by several investigators that prenatal cannabis exposure is related to encephalocoele or anencephaly defects. Non-canonical Wnt signalling has been shown to control the closure of the anterior neuropore providing a mechanistic underpinning for this fascinating finding. Wnt signalling has also been implicated in cancer development in numerous studies and in controlling limb development which have been previously linked with cannabis exposure (as noted above).

Cannabis and autism

It was recently demonstrated that the rising use of cannabis parallels the rising incidence of autism in 50 of 51 US states and territories including Washington D.C., and that cannabis legalization was associated with increased rates of autism in legal states. Several cannabinoids in addition to Δ9-tetrahydrocannabinol (THC) were implicated in such actions including cannabidiol, cannabinol, cannabichromene, cannabigerol and tetrahydrocannabivarin. A rich literature demonstrates the impacts of epigenomics on brain development and its involvement in autistic spectrum disorders. Whether cannabis is acting by epigenetic or other routes including those outlined above remains to be demonstrated. Further research is indicated.

Cannabidiol and other cannabinoids

These findings raise the larger issue of the extent to which the described changes reflect the involvement of THC as compared to other cannabinoids in the more general genotoxicity and epigenotoxicity of both oral (edible) and inhaled (smoked) cannabis. THC, cannabidiol, cannabidivarin, and cannabinol have previously been shown to be genotoxic to chromosomes and associated with micronucleus development. American cannabis has been selectively bred for its THC content and the ratio of THC to cannabidiol (CBD) was noted to have increased from 14:1 to 80:1 1998–2018. However in more recent times, cannabidiol is being widely used across the USA for numerous (nonmedical) recommendations.

Cannabidiol is known to inhibit mitochondrial oxidative phosphorylation including calcium metabolism which is known to have a negative effect on genome maintenance and is believed to secondarily restrict the supply of acetyl and other groups for epigenetic modifications. Cannabidiol is known to act via CB1R’s particularly at higher doses. Cannabidiol acts via PPARγ (Peroxisome Proliferator Activator Receptor) which is a nuclear receptor which is implicated in various physiological and pathological states including adipogenesis, obesity, diabetes, atherogenesis, neurodegenerative disease, fertility and cancer. In a human skin cell culture experiment, cannabidiol was shown to act via CB1R’s as a transcriptional repressor by increasing the level of global DNA methylation by enhancing the expression of the maintenance DNA methylase DNMT1 which in turn suppressed the expression of skin differentiation genes and returned the cells to a less differentiated state. One notes, importantly, that this DNA hypermethylation paralleled exactly the changes reported by Murphy for THC hypermethylation. The de-differentiation reported or implied in both studies is clearly a more proliferative and proto-oncogenic state. Hence, while more research is clearly required to carefully delineate the epigenetic actions of cannabidiol, its activity at CB1R’s, its mitochondrial inhibitory action, its implication of PPARγ and particularly its THC-like induction of epigenetic and cellular de-differentiation, together with its implication in chromosomal fragmentation and micronucleus induction would suggest that caution is prudent whilst the results of further research are awaited.

Other cannabinoid receptors and notch signalling

The above discussion is intended to be indicative and suggestive rather than exhaustive as the cannabinoids’ pharmacological effects are very pleiotropic, partly because CB1R’s, CB2R’s – and six other cannabinoid sensing receptors are widely distributed across most tissues. One notes that the mechanisms described above do not obviously account for very important finding that in both Colorado and Canada increasing rates of cannabis use were associated with higher rates of total congenital cardiovascular disease. One observes that in both cases the cited rise in rates refers to an elevation of crude rates unadjusted for other covariates. This finding is important for several reasons not the least of which is that cardiovascular disease is the commonest class of congenital disorders. It may be that this action is related to the effects of cannabinoids binding high-density endovascular CB1R’s from early in foetal life and interacting with the notch signalling system. Notch is a key morphogen involved in the patterning particularly of the brain, heart, vasculature and haemopoietic systems and also in many cancers. Notch signalling both acts upon the epigenome and is acted upon by the epigenome both in benign (atherosclerotic and haemopoietic) and cancerous (ovarian, biliary, colonic, leukaemic) diseases. Clearly in view of their salience, the interactions between cannabinoids and both notch and Wnt signalling pathways constitute fertile areas for ongoing research.

Conclusion

In short the timely paper by Murphy and colleagues nicely fills the gap between extant studies documenting that pre-conception exposure to cannabis is related to widespread changes in epigenetic regulation of the immune and central nervous systems and confirms that male germ cells are a key vector of this inheritance and has given new gravity to epidemiological data on the downstream teratological manifestations of prenatal cannabinoid exposure. The reasonably close parallels in findings between rats and man confirm the usefulness of this experimental model. Since guinea pigs and white rabbits are known to form the most predictive preclinical models for human teratogenicity studies it would be prudent to investigate how epigenomic results in these species compared to those identified in man and rodents. Finally the considerable and significant clinical teratogenicity of cannabis, including its very substantial neurobehavioural teratogenicity imply that such studies need to be prioritized by the research community and the research resourcing community alike, particularly if the alarming findings of recent European experience in terms of cannabinoids allowed in the food chain is not to be repeated elsewhere. Indeed, the recent passage of the nearly $USD1trillion USA Farm Act which encourages hemp to be widely grown for general use together with the advent in some US cafés of ‘hempburgers’ and ‘cannabis cookies’ would appear to have ushered in just such an era. Hemp oil has recently been marketed in Australian supermarkets completely unsupervised. Meanwhile, the rapidly accumulating and stellar discoveries relating to the pathobiology of the epigenome and its remarkable bioinformatical secrets continue to be of general medical and community importance. In some areas, particularly relating to the epigenotoxicology of the non-THC cannabinoids, further research is clearly indicated, especially in view of the widespread use and relatively innocuous reputation of cannabis derivates including particularly cannabidiol.

Such issues suggest that in the pharmacologically exciting era of the development of novel intelligently designed cannabinoids intended for human therapeutics, considerations of genomic and epigenomic toxicity including mutagenicity, teratogenicity, carcinogenicity, pro-ageing and heritable multigenerational effects warrant special caution and attention prior to the widespread exposure of whole populations either to phytocannabinoids or to their synthetic derivatives. Equally, the possibility of locus-specific epigenetic medication development as modifiers of the epigenetic reading, writing and erasing machinery suggests that very exciting developments are also beginning in this area.

Author Note

While this paper was in review our paper examining the epidemiological pattern and trends of Colorado birth defects of 2000-2014 and entitled “Cannabis Teratology Explains Current Patterns of Coloradan Congenital Defects: The Contribution of Increased Cannabinoid Exposure to Rising Teratological Trends” was accepted by the journal Clinical Pediatrics. It provides further details and confirmation on some of the issues discussed in the present paper. It also contains a detailed ecological investigation of the role of cannabidiol at the epidemiological level which confirms and extends the mechanistic observations and the quantitative remarks relating to the epidemiology of birth defects in Colorado made in the present manuscript. The interested reader may also wish to consult this resource.

Source: https://www.tandfonline.com/doi/full/10.1080/15592294.2019.1633868 July 2019

Abstract
Marijuana is currently a growing risk to the public in the United States. Following expanding public opinion that marijuana provides little risk to health, state and federal legislatures have begun changing laws that will significantly increase accessibility of marijuana. Greater marijuana accessibility, resulting in more use, will lead to increased health risks in all demographic categories across the country. Violence is a well-publicized, prominent risk from the more potent, current marijuana available.
We present cases that are highly popularized storylines in which marijuana led to unnecessary violence, health risks, and, in many cases, both. Through the analysis of these cases, we will identify the adverse effects of marijuana use and the role it played in the tragic outcomes in these and other instances. In the analysis of these cases, we found marijuana as the single most common, correlative variable in otherwise diverse populations and circumstances surrounding the association of violence and marijuana.

Conclusion
According to research studies, marijuana use causes aggressive behavior, causes or exacerbates psychosis and produce paranoias. These effects have been illustrated through case studies of highly publicized incidents and heightened political profiles.
These cases contain examples of repeated illustrations of aggression, psychosis and paranoia by marijuana users and intoxication.
Ultimately, without the use and intoxication of marijuana, the poor judgment and misperceptions displayed by these individuals would not have been present, reducing the risk for actions that result in senseless deaths.

Import to these assertions, is that the current marijuana is far more potent in THC concentrations, the psychoactive component. Accordingly, and demonstrated in direct studies, more potent marijuana results in a greater risk for paranoid thinking and psychosis.
In turn, paranoid behavior increases the risk for paranoid behaviors and predictably associated with aggressive and violent behaviors. Marijuana use causes violent behavior through increased aggressiveness, paranoia and personality changes (more suspicious, aggressive and anger).
Recent illicit and “medical marijuana” (especially grown by care givers for medical marijuana) is of much high potency and more likely to cause violent behavior. Marijuana use and its adverse effects should be considered in cases of acts of violence as its role is properly assigned to its high association.
Recognize that high potency marijuana is a predictable and preventable cause of tragic violent consequences.

Source: https://www.omicsonline.org/open-access/marijuana-violence-and-law-2155-6105-S11-014.pdf January 2017

Researchers at the University of Exeter and UCL (University College London) have identified a gene which can be used to predict how susceptible a young person is to the mind-altering effects of smoking cannabis. The finding could help identify otherwise healthy users who are most at risk of developing psychosis.

The research, funded by the Medical Research Council and published in Translational Psychiatry, also show that female cannabis smokers are potentially more susceptible to short-term memory loss than males. Previous studies in this field have looked at people who already have psychosis, but this is the first study to look at healthy people and to examine their acute response — or how the drug affects their minds.

Previous research has found a link between the AKT1 gene and people who have gone on to develop psychosis. In the new study, Celia Morgan, Professor of Psychopharmacology at the University of Exeter and Professor Val Curran and her team from UCL found that young people with variation in the ‘AKT1’ gene experienced visual distortions, paranoia and other psychotic-like symptoms more strongly when they were under the influence of cannabis.

Around one per cent of cannabis users develop psychosis. Although low in number, the impact can be devastating and long lasting. It is known that smoking cannabis daily doubles an individual’s risk of developing a psychotic disorder, but it has been difficult to establish who is most vulnerable. Researchers have previously found a high prevalence of one variant of the AKT1 genotype in cannabis users who went on to develop psychosis as a result of their use. This is the first research that shows the link between the same gene and the effects of smoked cannabis in healthy young people.

It is hoped that it will help identify those most at risk of the negative effects of cannabis smoking and may aid the development of genotype targeted medication.

Professor Morgan said: “These findings are the first to demonstrate that people with this AKT1 genotype are far more likely to experience strong effects from smoking cannabis, even if they are otherwise healthy. To find that having this gene variant means that you are more prone to mind-altering affects of cannabis when you don’t have psychosis gives us a clue as to how it increases risk in healthy people. Putting yourself repeatedly in a psychotic or paranoid state might be one reason why these people could go on to develop psychosis when they might not have done otherwise. Although cannabis-induced psychosis is very rare, when it happens it can have a terrible impact on the lives of young people. This research could help pave the way towards the prevention and treatment of cannabis psychosis.”

Professor Curran added: “The current study is the largest ever to be conducted on the acute response to cannabis. Our finding that psychotic-like symptoms when young people are ‘stoned’ are predicted by AKT1 variants is an exciting breakthrough as this acute reaction is thought to be a marker of a person’s risk of developing psychosis from smoking the drug.”

The study involved 442 young cannabis users who were tested while under the influence of the drug, and while sober. The researchers measured the extent of the symptoms of intoxication and effect on memory loss and compared it to results seven days later when the young people were drug free. They found that those who with this variation in the AKT1 geneotpye were more likely to experience a psychotic response.

As part of the study, researchers gained permission from the Home Office to analyse the cannabis samples for their make-up and strength. Samples were dropped off at a police station and analysed by the forensic science service.

The research also found that females were more vulnerable than males to impairment in short term memory after smoking cannabis.

“Animal studies have found that males have more of the receptors that cannabis works on in parts of the brain important in short term memory, such as the prefrontal cortex. We need further research in this area, but our findings indicate that men could be less sensitive to the memory impairing effects of cannabis than females,” added Professor Morgan.

Source: https://www.sciencedaily.com/releases/2016/02/160216111357.htm February 2016

Marijuana legalization is on the ballot in 2016 in California, Arizona, Nevada, and elsewhere
The marijuana movement received a big jolt last November. No, it wasn’t another celebrity endorsement or cable news special glorifying the drug. Rather, in the midst of what we’ve been told was an inevitable march to victory, marijuana lost. And it lost big.

Many of us interested in this off-year Ohio race were expecting to be up all night. But at 8:32 p.m. Nov. 3, the Associated Press recorded one of the biggest losses ever for pot, as voters rejected legalization there by more than 2-1. (Full disclosure: The organization I head up, SAM, played a role in the campaign and defeat through our affiliate partners.)

Sure, the question was asked in a year no one usually votes, taking place in a sensible Midwestern state not known for its indulgences. Most of us thought it would lose, despite the victory “polls” constantly trumpeted out by the legalizers , but none of us thought it would lose this big.

What does that tell us for the 2016 races, when five states — California, Arizona, Nevada, Massachusetts, and Maine — are likely to have ballot questions on full legalization? A lot. Here’s what we’ve learned:

Big business wants to take over the marijuana movement — and voters don’t like that, even if profiteers do.

The Ohio initiative would have legalized a constitutionally mandated oligopoly for a few dozen investors to make millions on marijuana. The “No” campaign quickly pivoted from “marijuana is bad” to “marijuana monopolies with people making tons of cash are bad” — and it worked. The Ohio election was the first that tested the “Big Marijuana” message out. Groups like SAM have been saying it now for years, and videos showing the parallels are out there on social media, but it had not been tested out in a real campaign.

Money isn’t everything.

The pro side in Ohio spent more than $12 million to convince Buckeye voters that legalizing a pot monopoly was a good thing, and they still lost bad. While it’s true that money is required to get political messages out, especially when spent in a smart(er) way via targeted social media campaigns, Ohio proved that money isn’t everything.

The “no” side, while gathering an impressive group of organizations to oppose the measure, didn’t even pass the $1-million spending mark. But the message of opposing Big Pot stuck, and the amount of free media gained was remarkable. Every article mentioned the investor scheme.

Marijuana legalization isn’t inevitable.
The five states up for grabs in 2016 are critical, and voters will decide pot’s fate in an important presidential election year. But, all five states have different critical issues.

The granddaddy of the 2016 states, California will once again vote on legalized pot. In 2010, despite outspending the opposition by more than 5-1, voters soundly rejected a marijuana measure. This year, some traditional activists (notably the Reform CA folks) were pushed out by the billionaire Napster-founder Sean Parker, who is pouring his fortune into legalized pot via the “Control, Regulate and Tax Adult Use of Marijuana Act.” Parker’s net worth will likely take the effort a long way, but given the importance of the Hispanic voter bloc, a group of people traditionally against legalization, the campaign won’t be a cakewalk.

A state known for sin and vice — Nevada — might seem the perfect one to try legalizing pot. Except for one man: Sheldon Adelson. The billionaire is dead-set against legalization, and he put his money where his mouth is in 2014 when he helped narrowly defeat a pot initiative in Florida. This time around, legalizers are gunning for his home state, but there’s talk of a well-respected state legislator and a handful of other bipartisan officials coming out against Nevada’s initiative. Stay tuned.

In Arizona, a legalization push has barely gotten off the ground, but is already finding opposition. And in Massachusetts, Democrat Attorney General Maura Healey and Republican Gov. Charlie Baker both oppose the initiative. In Maine, legalizers are trying to sanction pot smoking “social clubs,” though a recent conference highlighted dissension among traditional allies.

If we have learned anything from the brief time marijuana has been legal in Colorado, it is this: We have now entered the age of ‘corporate cannabis’ — slick advertising, child-friendly product placement.

In all of these states, laws are being written largely by lobbyists who have one goal — to make money. And one does not get rich in the drug business from casual users. They must rely on heavy users.

If we have learned anything from the brief time marijuana has been legal in Colorado it is this: We have now entered the age of ‘corporate cannabis’ — slick advertising, child-friendly product placement and companies that spend more on PR and lawyers than they do creating safe products.

The sky may not fall if legalization passes in these states, but voters should ask themselves something before getting into the ballot box. Are your relationships enhanced when your friends or family are smoking marijuana? Does marijuana make for safer roads? Better workplaces? Smarter students?

Despite strong evidence to the contrary, we are being told pot will fund our schools, get rid of drug cartels and cure cancer, all at once. And worst of all, we’re being sold this false dichotomy — that our only choices for drug policy are legalize or lock ‘em up. Promote Pot Tarts or fund private prisons. Give a kid a criminal record for holding a joint or allow another addictive industry to take over meetings in state capitals.

But that is false. No one I know wants to see a young kid marred forever because he happened to get caught with a joint in his pocket. But the alternative to that is not simply to ignore an unhealthy, unproductive behavior and promote its use. With the increasing research linking mental illness and marijuana, we at least should press the pause button before going any further.

We can’t build a great, compassionate society by promoting addiction for profit.

BY 

Source: https://www.lifezette.com/2015/12/legalized-pot-no-its-not-inevitable/
December 2015

  • Polly Ross, 32, suffered with Hyperemesis Gravidarum during second pregnancy
  • Mother smoked cannabis and magic mushrooms to ease pain, an inquest heard
  • ‘Talented and clever’ translator took her life in 2015 after battling with psychosis

A mother-to-be who took cannabis after developing the same morning sickness condition as the Duchess of Cambridge killed herself after developing a drug-induced psychosis, an inquest heard.  

Talented translator Polly Ross, 32, suffered Hyperemesis Gravidarum (HG), the condition which saw Kate Middleton rushed to hospital in August while visiting the queen in Aberdeen.

Hull Coroner’s Court in East Yorkshire was told today how a desperate Mrs Ross took cannabis and magic mushrooms in a bid to tackle the severe bouts of sickness.

However in July 2015, just a year after the birth of her second daughter, she died after stepping out in front of a train.  

A coroner heard Mrs Ross had developed ‘drug induced psychosis’ after taking cannabis to stop symptoms of HG.

Mrs Ross told her GP, Dr Daniella Malesknasr, she had taken cannabis during her pregnancy after visiting the doctors suffering from post natal depression.

Dr Malesknasr told the hearing: ‘She had told me when she was pregnant with her second child that she was taking cannabis and magic mushrooms to help combat HG during her pregnancy – but she was no longer taking it.’

Talented Polly Ross, 32, suffered the same condition but tried to soothe symptoms herself by taking cannabis and magic mushrooms

Professor Paul Marks, the senior coroner, questioned: ‘And does taking cannabis actual benefit those suffering from HG?.’

The doctor replied: ‘I can’t possibly comment on that.’

Dr Malesknasr said ‘alarm bells were ringing’ after Polly had told her she wanted to commit suicide on February 13, 2015.

Mrs Ross tried to take her life three times with self harm and taking an overdose twice in a three month period

The inquest heard the GP had called in at her home to find her in a psychotic episode and Mrs Ross was sectioned the following month.

By March 18, Dr Malesknasr said Mrs Ross was diagnosed with drug induced psychosis following the amounts of magic mushrooms and cannabis she had been taking.

The GP said she was then given Respiradon to help battle the psychosis.

Mrs Ross tried to take her life three times with self harm and taking an overdose twice in a three month period.

However, the court heard she was remarkably allowed to discharge herself voluntarily following the last attempt to take her own life.

Professor Marks said: ‘So after taking an overdose of paracetamol tablets, Polly was allowed to just leave voluntarily?’

Dr Malesknasr said: ‘I can’t comment on that because it is a hospital matter.’

However, in May 2015 a psychiatrist in the community said that psychosis was no longer a problem and she should come off the anti-psychosis drug Respiradon.

The translator was given help by a crisis team to give her a ‘higher and intense level of support’, but Mrs Ross had refused them entry to her house in Driffield, East Yorkshire.

Mrs Ross died on July 12, 2015, by stepping in front of a train in Hull, East Yorkshire, and ‘death was instant’, Hull Royal Infirmary Consultant Histopathologist Dr Ian Richmond told the hearing.

She had told mental health workers at the women-only care centre at Westlands voluntary care unit in Hull, East Yorkshire, that she was going to the shop.

Mrs Ross died on July 12, 2015, by stepping in front of a train in Hull, East Yorkshire

A statement from Mrs Ross’s aunt Emma May, who cared for her during her final months, read: ‘With the right guidance, medication and support, Mrs Ross could have made a full recovery.

‘There should be systems in place to protect that life especially because there are so many suicides attempts of post natal women.

‘I cannot understand why she was allowed to leave the hospital unit before she died.

‘Polly clearly said many times that she would kill herself, many months before she did.

‘I feel that she posed a significant risk to herself, did not have sufficient capacity to make decision and more should have been done to protect and care for her.’

Mrs Ross, who ran her own ‘very good’ translation business in Paris, was described as ‘an extremely intelligent lady and very driven in her own ambition’, by Mrs May.

She was also described as ‘frighteningly clever’.

She met her English husband Samuel Ross in 2011 in the French capital and the pair quickly married and had two daughters born in June 2012 and June 2014 respectively.

Mrs Ross suffered HG during pregnancy with both children and had post natal depression following the birth of both children.

The inquest, expected to last three days, continues.

WHAT IS HG?

Excessive nausea and vomiting during pregnancy is known as hyperemesis gravidarum (HG), and often needs hospital treatment.
Unlike regular morning sickness, HG may not get better by 14 weeks.
It may not clear up completely until the baby is born, although some symptoms may improve at around 20 weeks.
Some pregnant women be sick many times a day and be unable to keep food or drink down, which can have a negative effect on their daily life.
Exactly how many pregnant women get HG is not known as some cases may go unreported, but it’s thought to be around 1 in every 100.
Signs and symptoms of HG include prolonged and severe nausea and vomiting, dehydration and low blood pressure. Source: NHS Choices  

Source: https://www.dailymail.co.uk/news/article-5063227/Pregnant-mum-killed-developing-drug-habit.html November 2017

Abstract

Synthetic cannabinoids (SCs) are marketed worldwide as legal surrogates for marihuana. In order to predict potential health effects in consumers and to elucidate the underlying mechanisms of action, we investigated the impact of a representative of the cyclohexylphenols, CP47,497-C8, which binds to both cannabinoid receptors, on protein expression patterns, genomic stability and on induction of inflammatory cytokines in human lymphocytes. After treatment of the cells with the drug, we found pronounced up-regulation of a variety of enzymes in nuclear extracts which are involved in lipid metabolism and inflammatory signaling; some of the identified proteins are also involved in the endogenous synthesis of endocannabinoids. The assumption that the drug causes inflammation is further supported by results obtained in additional experiments with cytosols of LPS-stimulated lymphocytes which showed that the SC induces pro-inflammatory cytokines (IL12p40 and IL-6) as well as TNF-α. Furthermore, the proteome analyses revealed that the drug causes down-regulation of proteins which are involved in DNA repair. This observation provides an explanation for the formation of comets which was seen in single-cell gel electrophoresis assays and for the induction of micronuclei (which reflect structural and numerical chromosomal aberrations) by the drug. These effects were seen in experiments with human lymphocytes which were conducted under identical conditions as the proteome analysis. Taken together, the present findings indicate that the drug (and possibly other structurally related SCs) may cause DNA damage and inflammation in directly exposed cells of consumers.

Source: https://www.ncbi.nlm.nih.gov/pubmed/26194647 June 2016

The Centers for Disease Control (CDC) recently issued a warning about vaping following a multistate outbreak of severe lung problems linked to the use of electronic cigarettes. According to the CDC, there are, as of September 6, 450 reported cases of possible vaping-linked lung problems across 33 states and 1 territory, resulting in 6 deaths. Officials have not identified a specific e-cigarette product as a cause of the illnesses, meaning that various devices on the market could be contributing to this alarming pattern. Patients admitted for lung problems report difficulty breathing, fatigue, fever, nausea, and vomiting. Somehow, to proponents and purveyors of e-cigarettes, the very idea that vaping could be dangerous seems to have come as a surprise. 

The CDC updated its warning to suggest that e-cigarette and vaping device users refrain from using the products at all during the course of its investigation. It has also warned against buying counterfeit or street vaping products, including those with THC or other cannabinoids, and against modifying e-cigarette products. Moreover, the CDC urges youth, pregnant women, and adults who do not currently use tobacco products to refrain from using e-cigarette products, and encourages individuals who smoke and want to quit to use FDA-approved medications instead of e-cigarettes. Some health officials and experts believe that street vaping products with illicit or tainted substances may be behind the outbreak of lung problems, but no one can be certain at this point. Some patients have reported using vaping cartridges with THC or cannabinoids, but others have reported using different vaping cartridges without such substances. Most contain ingredients not generally tested for chronic inhalation in humans, and, to make matters worse, they can become contaminated in ways detrimental to respiratory and heart health. It is unlikely that any substance you inhale has been tested for safety for weeks, months, or over the long haul. But inhalation from vaping has effects on the lungs that are dramatic, can be easily seen on imaging, and do not seem easy to reverse.

Tobacco smoking in the English colonies of North America started early and peaked in the U.S. in the 1960s and 1970s, credible evidence proving its causal links to cancer, emphysema, and bronchitis emerging only over a century after its explosive growth and wild popularity. Why would boosters and defenders of today’s e-cigarettes, looking back at this history, believe that research would come to indicate the product’s benefits for the lungs, or for the respiratory health of those they may expose to vaping?

While experts and officials will continue to study this outbreak and may identify particular illicit substances as the culprit, the headlines have naturally raised questions for individuals who vape about long term consequences. What we know about cigarette smoking is bad enough, but there are few surprises. Here, we’re in uncharted territory. Yes, the FDA and other agencies will look at the broader health and safety of e-cigarette products and devices, but in the meantime, users will need to be evaluated and hope that their own lungs are not compromised in ways that only become clearly understood after they stop, or years down the line. While receiving considerably less media coverage, journalists recently found that the FDA began investigating vaping-associated seizures after some users of JUUL, the top-selling vaping product in the U.S., submitted claims of seizures to the administration’s safety portal.

It is important to note that Research You Can Use previously observed that there is not yet enough evidence to conclude whether e-cigarettes are suitable for smoking cessation. Some researchers now suggest that vaping nicotine may not be safer than smoking tobacco cigarettes. More recently, the FDA has agreed that JUUL’s claims of comparative safety are unproven. Other new studies have looked at the relative health of ingredients in some e-cigarette products, and the effects of vaping on the vascular system. The truth is that it’s risky and scientifically invalid to start from the premise that drugs are safe until proven dangerous. It reminds me of cocaine being touted as safe, or non-addicting, or even as “the champagne of drugs” until the aftermath of widespread use in the 1970s and 80s demonstrated that it was highly addictive and led to heart problems, brain damage, and other diseases.

What did these studies find?

One study, led by Yale’s Julie Zimmerman, found that chemical interactions in some of JUUL’s inhaled liquid nicotine mixtures yield unanticipated new chemicals that can cause breathing problems. In this study, researchers created a machine to trap JUUL aerosol and investigate its chemical composition. They found that the alcohols hosting flavors and nicotine in JUUL’s e-liquid react with vanillin, a flavor prohibited in tobacco cigarettes, to produce acetals. The effects of inhaling acetal chemicals are unknown, but the study notes that they can cause inflammation and lung irritation. The study found acetals in JUUL’s ‘Crème Brulée’ flavor. One researcher told Yale in an interview that the team was surprised to find such high vanillin chemical levels, pointing out that the detected levels reached those established for health limits on vanillin in bakeries and flavoring businesses.

This study also found menthol in 4 of the 8 JUUL flavors it tested. Menthol, the researchers note, can expand nicotine intake. This could be concerning in part because JUUL pods already have high nicotine content relative to other nicotine products—individuals absorb from one JUUL pod as much nicotine as an entire pack of cigarettes. The researchers also observe that the findings are notable because users of the product often believe that the ingredients and chemical makeup of e-liquids are stable, without realizing that the included chemicals can combine, alter each other, or produce potentially harmful new compounds. The study calls for vaping regulations that tackle the creation of new and possibly toxic chemical elements in e-liquids, exposure to flavorings, and menthol levels.

Another new study, this time from the University of Pennsylvania, examined the effects of vaping on the vascular system and found that e-cigarette use, even without nicotine, can damage blood flow. Researchers studied 31 nonsmokers between the ages of 18 and 35, with no prior history of cardiovascular problems, hypertension, asthma, respiratory tract infections, or cancer. Participants in the study inhaled from e-cigarette devices 16 times each, at three seconds per inhalation. The researchers then used MRIs to measure the participants’ blood vessel health, having evaluated it before and after the vaping exercises. In the participants’ post-vaping leg veins, oxygen levels fell 20 percent, and their peak blood flow velocity fell 17 percent. Their femoral arteries also dilated 34 percent less. The researchers call for additional research on the topic to corroborate their findings in larger groups, and their results focus only on the ECO e-cigarette device, but they nonetheless point to serious concerns about chronic use of vaping products, which may not give time for users’ blood vessel health to normalize or reset.

Why is this important?

Individuals who use vaping products can assume, on the basis consumer-focused “evidence,” that because e-cigarette makers claim that their products are a healthier alternative to tobacco products, they must be “healthy” overall. Some evidence does support the idea that vaping is preferable to smoking tobacco, which is why the United Kingdom’s government asserts that vaping is 95 percent less harmful than e-cigarette use and encourages e-cigarette users to switch to vaping. The dispute over this assertion may come down to the exact meaning of “less harmful,” but those with vaping-related lung disease would certainly argue that vaping is not safer than smoking tobacco. It’s also true that news reports on vaping can often overstate claims in the other direction, alleging or implying that e-cigarettes alone are responsible for severe lung distress. On this point, it may be useful to consider a similar research problem: attempting to determine whether smoking cannabis causes lung cancer when most cannabis smokers also smoke other drugs, and when many also smoke tobacco. By the time health officials and experts reach a definitive conclusion, it may be too late for those vaping. While exaggerations or misleading reports exist, they should not be used to support denial of mounting evidence, or instill confidence in vapers when new research shows obvious reasons to worry—and to worry about health more seriously than the “long-term effects are unknown” talking point.

The CDC’s overall position on vaping in recent years, subject to change,  is that e-cigarettes “have the potential” to help adult smokers quit if they are not pregnant and can entirely substitute vaping for smoking tobacco products. Again, the CDC is now suggesting that individuals avoid vaping while investigations into the associated outbreak continue. It also says that scientists still have much to learn about e-cigarettes and warns that they are not safe for youth. The CDC, FDA, NIDA, and other authorities have recognized youth vaping as a growing epidemic, and have begun taking measures to confront it. Federal officials are now reportedly creating a plan to ban flavored e-cigarette products, which have a particular appeal to youth. Given the recent outbreak of severe lung problems and continued youth interest in e-cigarettes, additional action on this front will likely be required. Another recent study, for example, found 25 distinct “vape tricks” in 59 sample videos on YouTube with a median count of over 32,000 views. “Vape tricks” are stylized and playfully affected techniques for vaping, such as exhaling clouds in unique shapes, that attract the young. 48 percent of the videos were linked to industry posting accounts. This study recommended restrictions on e-cigarette social media marketing to help curb youth vaping, which sounds like a promising avenue for public health. Officials may also find it beneficial to take account of new studies about vaping’s effects on lung and blood vessel health as they deal with the increasingly apparent reality that e-cigarette use is not merely problematic in associated outbreaks, but in legal use, too.

Source: https://www.addictionpolicy.org/blog/tag/research-you-can-use/vaping-and-lungs September 2019

The United States is confronting a public health crisis of rising adult drug addiction, most visibly documented by an unprecedented number of opioid overdose deaths. Most of these overdose deaths are not from the use of a single substance – opioids – but rather are underreported polysubstance deaths. This is happening in the context of a swelling national interest in legalizing marijuana use for recreational and/or medical use. As these two epic drug policy developments roil the nation, there is an opportunity to embrace a powerful initiative. Ninety percent of all adult substance use disorders trace back to origins in adolescence.a New prevention efforts are needed that inform young people, the age group most at-risk for the onset of substance use problems, of the dangerous minefield of substance use that could have a profound negative impact on their future plans and dreams.

MOVING BEYOND A SUBSTANCE-SPECIFIC APPROACH TO YOUTH PREVENTION

The adolescent brain is uniquely vulnerable to developing substance use disorders because it is actively and rapidly developing until about age 25. This biological fact means that the earlier substance use is initiated the more likely an individual is to develop addiction. Preventing or delaying all adolescent substance use reduces the risk of developing later addiction.

Nationally representative data from the National Survey on Drug Use and Health shows that alcohol, tobacco and marijuana are by far the most widely used drugs among teens. This is no surprise because of the legal status of these entry level, or gateway, drugs for adultsb and because of their wide availability. Importantly, among American teens age 12 to 17, the use of any one of these three substances is highly correlated with the use of the other two and with the use of other illegal drugs. Similarly for youth, not using any one substance is highly correlated with not using the other two or other illegal drugs.

For example, as shown in Figure 1, teen marijuana users compared to their non-marijuana using peers, are 8.9 times more likely to report smoking cigarettes, 5.6, 7.9 and 15.8 times more likely to report using alcohol, binge drink, and drink heavily, respectively, and 9.9 times more likely to report using other illicit drugs, including opioids. There are similar data for youth who use any alcohol or any cigarettes showing that youth who do not use those drugs are unlikely to use the other two drugs. Together, these data show how closely linked is the use by youth of all three of these commonly used drugs.


aAmong Americans age 12 and older who meet criteria for substance use disorders specified in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV). bMarijuana remains illegal under federal law but is legal in some states for recreational use the legal age is 21, and in some states for medical use, the legal age is 18. Nationally the legal age for tobacco products is 18 and for alcohol it is 21.

Figure 1. Past Month Use of Other Drugs, if Marijuana is Used, Ages 12-17

These findings show that prevention messaging targeting youth must address all of these three substances specifically. Most current prevention efforts are specific to individual substances or kinds and amounts of use of individual drugs (e.g., cigarette smoking, binge drinking, drunk driving, etc.), all of which have value, but miss a vital broader prevention message. What is needed, based on these new data showing the linkage of all drug use by youth, is a comprehensive drug prevention message: One Choice: no use of any alcohol, nicotine, marijuana or other drugs for youth under age 21 for reasons of health. This no use prevention message provides clarity for young people, parents, physicians, educators, communities and for policymakers. It is not intended to replace public health prevention messages on specific substances, but enhances them with a clear focus on youth.

Some claim adolescent use of alcohol, cigarettes and marijuana is inevitable, a goal of no use of any drug as unrealistic and that the appropriate goal of youth prevention is to prevent the progression of experimentation to later heavy use or problem-generating use. These opinions are misleading and reflect a poor understanding of neurodevelopment that underpins drug use. Teens are driven to seek new and exciting behaviors which can include substance use if the culture makes them available and promotes them. This need not be the case. New data in Figure 2 (below) show over the last four decades, the percentage of American high school seniors who do not use any alcohol, cigarettes, marijuana or other drugs has increased steadily. In 2014, 52% of high school seniors had not used any alcohol, cigarettes, marijuana or other drugs in the past month and 26% had not used any alcohol, cigarettes, marijuana or other drugs in their lifetimes. Clearly making the choice of no use of any substances is indeed possible – and growing.

 

Key lessons for the future of youth prevention can be learned from the past. Substance use peaked among high school seniors in 1978 when 72% used alcohol, 37% used cigarettes, and 37% used marijuana in the past month. These figures have since dropped significantly (see Figure 3 below). In 2016, 33% of high school seniors used alcohol, 10% used cigarettes and 22% used marijuana in the past month. This impressive public health achievement is largely unrecognized.

Although the use of all substances has declined over the last four decades, their use has not fallen uniformly. The prevalence of alcohol use, illicit drug use and marijuana use took similar trajectories, declining from 1978 to 1992. During this time a grassroots effort known as the Parents’ Movement changed the nation’s thinking about youth marijuana use with the result that youth drug use declined a remarkable 63%. Rates of adolescent alcohol use have continued to decline dramatically as have rates of adolescent cigarette use. Campaigns and corresponding policies focused on reducing alcohol use by teens seem to have made an impact on adolescent drinking behavior. The impressive decline in youth tobacco use has largely been influenced by the Tobacco Master Settlement Agreement which provided funding to anti-smoking advocacy groups and the highly-respected Truth media campaign. The good news from these long-term trends is that alcohol and tobacco use by adolescents now are at historic lows.

It is regrettable but understandable that youth marijuana use, as well as use of the other drugs, has risen since 1991 and now has plateaued. The divergence of marijuana trends from those for alcohol and cigarettes began around the time of the collapse of the Parents’ Movement and the birth of a massive, increasingly well-funded marijuana industry promoting marijuana use. Shifting national attitudes to favor legalizing marijuana sale and use for adults both for medical and for recreational use now are at their highest level and contribute to the use by adolescents. Although overall the national rate of marijuana use for Americans age 12 and older has declined since the late seventies, a greater segment of marijuana users are heavy users (see Figure 4). Notably, from 1992 to 2014, the number of daily or near-daily marijuana uses increased 772%. This trend is particularly ominous considering the breathtaking increase in the potency of today’s marijuana compared to the product consumed in earlier decades. These two factors – higher potency products and more daily use – plus the greater social tolerance of marijuana use make the current marijuana scene far more threatening than was the case four decades ago.

Figure 4. Millions of Americans Reporting Marijuana Use, by Number of Days of Use Reported in the Past Month

Through the Parents’ Movement, the nation united in its opposition to adolescent marijuana use, driving down the use of all youth drug use. Now is the time for a new movement backed by all concerned citizens to call for One Choice: no use of any alcohol, nicotine, marijuana or other drugs for youth under age 21 for reasons of health. This campaign would not be a second iteration of the earlier “Just Say No” campaign. This new no-use message focuses on all of the big three drugs together, not singly and only in certain circumstances such as driving.

We are at a bitterly contentious time in US drug policy, with front page headlines and back page articles about the impact of the rising death rate from opioids, the human impact of these deaths and the addiction itself. At the same time there are frequent heated debates about legalizing adult marijuana and other drug use. Opposing youth substance use as a separate issue is supported by new scientific evidence about the vulnerability of the adolescent brain and is noncontroversial. Even the Drug Policy Alliance, a leading pro-marijuana legalization organization, states “the safest path for teens is to avoid drugs, including alcohol, cigarettes, and prescription drugs outside of a doctor’s recommendations.”

This rare commonality of opinion in an otherwise perfect storm of disagreement provides an opportunity to protect adolescent health and thereby reduce future adult addiction. Young people who do not use substances in their teens are much less likely to use them or other drugs in later decades. The nation is searching for policies to reduce the burden of addiction on our nation’s families, communities and health systems, as well as how to save lives from opioid and other drug overdoses. Now is precisely the time to unite in developing strong, clear public health prevention efforts based on the steady, sound message of no use of any alcohol, nicotine, marijuana or other drugs for youth under age 21 for reasons of health.

Robert L. DuPont, MD, President, Institute for Behavior and Health, Inc.

Source: https://www.ibhinc.org/blog/reducing-adult-addiction-youth-prevention  February 2018

Ontario’s proposal to allow people to consume marijuana in hotel rooms opens the door to a boom in cannabis tourism, says lawyer Matt Maurer.

Maurer heads the cannabis law group at Minden Gross in Toronto, and says he knows businesspeople who are interested in opening cannabis-friendly hotels and resorts.

Maurer says he was surprised by the province’s proposal to loosen up the ban on consuming cannabis anywhere other than private homes. The government has also asked for public comments on whether to allow cannabis lounges.

Maurer said he assumed the provincial government would eventually consider exemptions to the cannabis act passed in December, which bans consumption in public places.

 “I was surprised that it happened so quickly.”

Maurer calls consumption in hotels “step No. 1” in the development of a cannabis tourism industry.

“You could come to Ontario, go to the government-owned retail store, pick up your cannabis, head out to the hotel room, consume it there and head out to where ever you are going that evening, to a show or an event.”

The provincial regulations unveiled last month propose that cannabis could be consumed by residents and their guests at rooms in hotels, motels and inns, as long as the drug is not smoked or vaped. Smoking and vaping marijuana would be allowed in designated smoking rooms.

The regulations have been posted for public comment. The government plans to put them into effect when recreational marijuana is legalized across the country, expected in July.

Ontario has also opened the door to cannabis consumption lounges, asking for public comments on the idea. There’s no time frame for the lounges, but rules won’t be in place be by July. The province says the comments it receives will “inform future policy development and consultations.”

Abi Roach, who runs a cannabis vaping lounge in Toronto called Hotbox Cafe, says she’s interested in opening more if they become legal. She dreams of the day when lounges will be allowed to sell single servings of cannabis, just like drinks are served in a bar or restaurant. 

At the Hotbox (slogan: “serving potheads since … ahh I forget”), guests pay a $5 entry fee and bring their own pot.

If Ontario allows lounges, they probably won’t feature smoking inside because of concerns over the health dangers of second-hand smoke to both customers and employees, said Roach. “I don’t like to be in a big smoky room, either.”

At the Hotbox, only vaping is allowed inside. Pot smokers puff at an outdoor patio.

Roach also sees a demand for pot-friendly hotels. She’s helping design a cannabis-themed room at a hotel to be built in downtown Toronto. Each room in the hotel is owned by a private investor and offers a themed experience. If cannabis consumption is made legal in hotel rooms, they’ll go ahead with that project.

However, Roach said she doubts if Canada will see a big influx of cannabis tourists from the U.S. because we’ll be competing with a growing number of American states that are legalizing pot, some of which have taken a more creative, freewheeling approach. Ontario plans to sell cannabis from behind the counter at a restricted number of government-run stores. That won’t appeal to people who want convenience and innovative products from craft producers, said Roach.

“Canada really has to be careful in terms of blocking innovation in this industry.”

Roach said she recently drove from Vancouver to Washington State, where she stopped at a gas station and bought a joint. “To me as a tourist, it was like, ‘Wow, this is great!’ ”

In the lvillage of Embrun 40 kilometres southeast of Ottawa, Frank Medewar says he plans to open a lounge if they are made legal. He already runs InfoCannabis, a service that advises people about medical marijuana, and Seed 2 Weed, a store that sells growing equipment.

Medewar says his lounge will be modern and upscale, similar to an old-fashioned cigar lounge.

At the headquarters of the world’s largest medical marijuana company, Canopy Growth Corp. in Smiths Falls, spokesman Jordan Sinclair said the company would love to make the huge grow-op a tourist destination.

Canopy is in a former Hershey chocolate factory that was famous for tours taken by thousands of schoolchildren and tourists.

Canopy plans to have the plant open for public tours this summer, said Sinclair.

The company would also like to run a retail store on site, so the experience would be similar to a winery tour. However, the province has nixed that idea.

At Ottawa Tourism, spokesperson Jantine Van Kregten said the legalization of cannabis is on the radar. However, she hasn’t heard of any specific plans for hotels or other tourist ventures. “I think everybody is kind of taking a wait-and-see approach. I haven’t heard a lot of talk, a lot of scuttlebutt, in the industry of what their plans are. I think a lot of questions are unanswered about exactly how the legislation will roll out.”

Source: https://ottawacitizen.com/news/local-news/ontario-proposal-to-allow-cannabis-consumption-in-hotel-rooms-could-jump-start-pot-tourism February 2018

Study drawing on data from the Netherlands is the first to show how admissions to treatment centres rise and fall in line with cannabis strength

Many countries have seen far stronger cannabis come on to the market in the past few decades

Researchers have found fresh evidence to suggest that more potent strains of cannabis are at least partly to blame for the number of people seeking help from drug treatment programmes.

Scientists at King’s College London drew on data from the Netherlands to show that admissions to specialist treatment centres rose when coffee shops sold increasingly more potent cannabis, but fell again when the cannabis weakened.

The work is the first to investigate how admissions to drug treatment programmes rise and fall in line with the strength of cannabis available to users. It found that changes in demand for treatment typically lagged five to seven years behind changes to cannabis strength.

“This is the first study to provide evidence for an association between changes in potency and health-related outcomes,” said Tom Freeman, an addiction scientist at King’s.

The demand for specialist treatment among cannabis users has risen steadily in recent years, with more people now citing the drug on admission than any other illicit substance. In Europe, the number of first-time referrals for cannabis rose 53% from 2006 to 2014.

Cannabis plants produce more than 100 active compounds called cannabinoids but THC, or delta-9 tetrahydrocannabinol, is largely responsible for the drug-related high. A second compound called CBD, or cannabidiol, appears to reduce some of the mental health risks linked to heavy cannabis use by counterbalancing the effects of THC.

In work funded by the Society for the Study of Addiction, Freeman and others studied data gathered by the Trimbos Institute, a non-profit mental health and addiction organisation in the Netherlands. Each year, the institute conducts anonymous tests on cannabis for sale at a random selection of coffee shops in the country.

Writing in the journal, Psychological Medicine, the researchers show that THC levels in cannabis soared from an average of 8.6% to 20.4% from 2000 to 2004, then slowly fell to 15.3% by 2015. When the researchers looked at the impact on drug treatment programmes, they found that first-time cannabis admissions nearly quadrupled from seven to 26 per 100,000 inhabitants from 2000 to 2010, and then dropped to less than 20 per 100,000 inhabitants in 2015. It means that for every 1% increase in THC, about 60 more people entered treatment.

“We see a rapid increase in THC between 2000 and 2004 followed by a slower decline, and then you see a very similar profile in drug treatment admissions,” Freeman said. The rise in cannabis potency was one of a number of factors driving admissions to specialist drug services.

Val Curran, professor of psychopharmacology at UCL, said: “This adds to a growing number of scientific studies which suggest rising THC potency of cannabis is associated with greater incidence of mental health problems including addiction and possibly psychosis.”

But she added that stronger cannabis was not solely responsible for increasing demand for drug treatment. “Other factors include the marked decrease in levels of cannabidiol (CBD) in cannabis. There is evidence that CBD can protect against some mental health harms of THC,” she said.

Ian Hamilton, a mental health lecturer at the University of York, agreed that other factors beyond the potency of the drug were important. “It is possible that seeking help for problems with cannabis has become more acceptable by users and treatment providers. Over the same period that cannabis referrals to treatment have been increasing, referrals for problems with opiates such as heroin have been in decline. So although cannabis has traditionally been viewed as relatively benign by treatment workers they may now be more inclined to offer support,” he said.

Source: https://www.theguardian.com/science/2018/jan/31/stronger-cannabis-linked-to-rise-in-demand-for-drug-treatment-programmes January 2018

Millions of Americans are trapped in a cycle of drug abuse and addiction: In 2013, over 24 million reported that they had abused illicit drugs or prescription medication in just the past month. More than 1.7 million were admitted to treatment programs for substance abuse in 2012. The pursuit of a drug habit can cost these people everything – their friends and family, their home and livelihood. And nowhere is that impact more evident than in the faces of addicts themselves.

Here, the catastrophic health effects of drug abuse are plain to see, ranging from skin scabs to decayed and missing teeth. While meth is often seen as one of the most visibly destructive drugs, leading to facial wasting and open sores,various other illicit drugs, and even prescription medications can cause equally severe symptoms when continuously abused. The use of opioids like OxyContin or heroin can cause flushing and a rash of red bumps all over the skin, while cocaine abuse can result in a significant drop in appetite and dangerous malnutrition and weight loss. Ecstasy may cause grinding of teeth, and smoking cannabis releases carcinogens and other chemicals that can diminish skin collagen and produce an appearance of premature aging. Even alcohol abuse can lead to wrinkles, redness, and loss of skin elasticity.

Beyond the direct effects of substance abuse, perhaps its most damaging result is addiction itself. The compulsion of addiction makes drug use the most important purpose in an addict’s life, leading them to pursue it at any cost and treat anything else as secondary. Self-neglect becomes normal – an accepted cost of continuing to use drugs. And the consequences of addiction can remain etched in their very skin for years.

Click here for an animated infographic

Source: https://www.rehabs.com/explore/faces-of-addiction/

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

Using a well-established method of biological age assessment based on arterial stiffness adult patients exposed to cannabis were shown to be have increased arterial stiffness and so to be biologically older [1]. This finding is consistent with pro-inflammatory actions of cannabis [2-7] which are also linked with advancing biological age [8-10]. It was recently shown in advanced cellular senescence that LINE-1 mobile transposable elements, so-called “jumping genes” or retrotransposons, which comprise 17% of the genome, can become mobilized and re-insert into the genome in a random manner using endogenous reverse transcriptases [11]. Not only is this destructive to the genomic sequence with downstream consequences including teratogenesis, carcinogenesis, aging and age-related degenerative disease, but this also activates cytoplasmic cGAS-STING signalling and autocrine and paracrine senescence programs [11-15]. Whilst this novel and fascinating aging mechanism is yet to be evaluated following cannabis exposure several lines of evidence implicate LINE-1 in cannabis-related pathologies including autism [16, 17] and pediatric leukaemias [18] and cancers [19-21] especially germ cell tumours [19] where all four studies to examine the relationship between cannabis use and testicular cancer have found a positive relationship [22-25].

Intriguingly addition of serotonin to the tail of histone 3 (H3) on the glutamine at position 5 (Q5) – right beside the well-known transcription-activating trimethylation post-translational modification (PTM) at H3K4 (lysine 4) – has been shown to be an essential permissive and facilitative histone PTM at many gene promoters to permit proper differentiation of brain and body tissues [26, 27]. This PTM is known as Q5ser. H3K4Q5ser occurs at high density in brain and testes. It is likely that other monoamines such as histamine and dopamine may soon be similarly implicated [26, 27]. The monoamines serotonin and dopamine are well known to be intimately involved in cannabis dependency syndromes [28, 29]. Further thickening the plot the N-terminal tail of H3 was recently shown to be a hot spot for oncomutations amongst histone proteins which allow genes to be made accessible for transcription, often in an activating manner which is independent of SWI/SNF signalling and thus renders it constitutively active [30]. Cannabis use has previously been linked with four pediatric cancers and eight cancers in adults including the germ cell tumours mentioned above [31-33].

Source: Nature Journal 2019

January 2019 • Volume 48, Number 1 • Alex Berenson
Alex Berenson Author, Tell Your Children: The Truth About Marijuana, Mental Illness, and Violence

The following is adapted from a speech delivered on January 15, 2019, at Hillsdale College’s Allan P. Kirby, Jr. Center for Constitutional Studies and Citizenship in Washington, D.C.

Seventy miles northwest of New York City is a hospital that looks like a prison, its drab brick buildings wrapped in layers of fencing and barbed wire. This grim facility is called the Mid-Hudson Forensic Psychiatric Institute. It’s one of three places the state of New York sends the criminally mentally ill—defendants judged not guilty by reason of insanity.
Until recently, my wife Jackie—Dr. Jacqueline Berenson—was a senior psychiatrist there. Many of Mid-Hudson’s 300 patients are killers and arsonists. At least one is a cannibal. Most have been diagnosed with psychotic disorders like schizophrenia that provoked them to violence against family members or strangers.
A couple of years ago, Jackie was telling me about a patient. In passing, she said something like, Of course he’d been smoking pot his whole life.
Of course? I said.
Yes, they all smoke.

So marijuana causes schizophrenia?
I was surprised, to say the least. I tended to be a libertarian on drugs. Years before, I’d covered the pharmaceutical industry for The New York Times. I was aware of the claims about marijuana as medicine, and I’d watched the slow spread of legalized cannabis without much interest.
Jackie would have been within her rights to say, I know what I’m talking about, unlike you. Instead she offered something neutral like, I think that’s what the big studies say. You should read them.
So I did. The big studies, the little ones, and all the rest. I read everything I could find. I talked to every psychiatrist and brain scientist who would talk to me. And I soon realized that in all my years as a journalist I had never seen a story where the gap between insider and outsider knowledge was so great, or the stakes so high.

I began to wonder why—with the stocks of cannabis companies soaring and politicians promoting legalization as a low-risk way to raise tax revenue and reduce crime—I had never heard the truth about marijuana, mental illness, and violence.
***
Over the last 30 years, psychiatrists and epidemiologists have turned speculation about marijuana’s dangers into science. Yet over the same period, a shrewd and expensive lobbying campaign has pushed public attitudes about marijuana the other way. And the effects are now becoming apparent.
Almost everything you think you know about the health effects of cannabis, almost everything advocates and the media have told you for a generation, is wrong.
They’ve told you marijuana has many different medical uses. In reality marijuana and THC, its active ingredient, have been shown to work only in a few narrow conditions. They are most commonly prescribed for pain relief. But they are rarely tested against other pain relief drugs like ibuprofen—and in July, a large four-year study of patients with chronic pain in Australia showed cannabis use was associated with greater pain over time.
They’ve told you cannabis can stem opioid use—“Two new studies show how marijuana can help fight the opioid epidemic,” according to Wonkblog, a Washington Post website, in April 2018— and that marijuana’s effects as a painkiller make it a potential substitute for opiates. In reality, like alcohol, marijuana is too weak as a painkiller to work for most people who truly need opiates, such as terminal cancer patients. Even cannabis advocates, like Rob Kampia, the co-founder of the Marijuana Policy Project, acknowledge that they have always viewed medical marijuana laws primarily as a way to protect recreational users.

As for the marijuana-reduces-opiate-use theory, it is based largely on a single paper comparing overdose deaths by state before 2010 to the spread of medical marijuana laws— and the paper’s finding is probably a result of simple geographic coincidence. The opiate epidemic began in Appalachia, while the first states to legalize medical marijuana were in the West. Since 2010, as both the epidemic and medical marijuana laws have spread nationally, the finding has vanished. And the United States, the Western country with the most cannabis use, also has by far the worst problem with opioids.
Research on individual users—a better way to trace cause and effect than looking at aggregate state-level data—consistently shows that marijuana use leads to other drug use. For example, a January 2018 paper in the American Journal of Psychiatry showed that people who used cannabis in 2001 were almost three times as likely to use opiates three years later, even after adjusting for other potential risks.
Most of all, advocates have told you that marijuana is not just safe for people with psychiatric problems like depression, but that it is a potential treatment for those patients. On its website, the cannabis delivery service Eaze offers the “Best Marijuana Strains and Products for Treating Anxiety.” “How Does Cannabis Help Depression?” is the topic of an article on Leafly, the largest cannabis website. But a mountain of peer-reviewed research in top medical journals shows that marijuana can cause or worsen severe mental illness, especially psychosis, the medical term for a break from reality. Teenagers who smoke marijuana regularly are about three times as likely to develop schizophrenia, the most devastating psychotic disorder.

After an exhaustive review, the National Academy of Medicine found in 2017 that “cannabis use is likely to increase the risk of developing schizophrenia and other psychoses; the higher the use, the greater the risk.” Also that “regular cannabis use is likely to increase the risk for developing social anxiety disorder.”
***
Over the past decade, as legalization has spread, patterns of marijuana use—and the drug itself—have changed in dangerous ways.
Legalization has not led to a huge increase in people using the drug casually. About 15 percent of Americans used cannabis at least once in 2017, up from ten percent in 2006, according to a large federal study called the National Survey on Drug Use and Health. (By contrast, about 65 percent of Americans had a drink in the last year.) But the number of Americans who use cannabis heavily is soaring. In 2006, about three million Americans reported using cannabis at least 300 times a year, the standard for daily use. By 2017, that number had nearly tripled, to eight million, approaching the twelve million Americans who drank alcohol every day. Put another way, one in 15 drinkers consumed alcohol daily; about one in five marijuana users used cannabis that often.
Cannabis users today are also consuming a drug that is far more potent than ever before, as measured by the amount of THC—delta-9-tetrahydrocannabinol, the chemical in cannabis responsible for its psychoactive effects—it contains. In the 1970s, the last time this many Americans used cannabis, most marijuana contained less than two percent THC. Today, marijuana routinely contains 20 to 25 percent THC, thanks to sophisticated farming and cloning techniques—as well as to a demand by users for cannabis that produces a stronger high more quickly. In states where cannabis is legal, many users prefer extracts that are nearly pure THC. Think of the difference between near-beer and a martini, or even grain alcohol, to understand the difference.

These new patterns of use have caused problems with the drug to soar. In 2014, people who had diagnosable cannabis use disorder, the medical term for marijuana abuse or addiction, made up about 1.5 percent of Americans. But they accounted for eleven percent of all the psychosis cases in emergency rooms—90,000 cases, 250 a day, triple the number in 2006. In states like Colorado, emergency room physicians have become experts on dealing with cannabis-induced psychosis.
Cannabis advocates often argue that the drug can’t be as neurotoxic as studies suggest, because otherwise Western countries would have seen population-wide increases in psychosis alongside rising use. In reality, accurately tracking psychosis cases is impossible in the United States. The government carefully tracks diseases like cancer with central registries, but no such registry exists for schizophrenia or other severe mental illnesses.

On the other hand, research from Finland and Denmark, two countries that track mental illness more comprehensively, shows a significant increase in psychosis since 2000, following an increase in cannabis use. And in September of last year, a large federal survey found a rise in serious mental illness in the United States as well, especially among young adults, the heaviest users of cannabis.
According to this latter study, 7.5 percent of adults age 18-25 met the criteria for serious mental illness in 2017, double the rate in 2008. What’s especially striking is that adolescents age 12-17 don’t show these increases in cannabis use and severe mental illness.

A caveat: this federal survey doesn’t count individual cases, and it lumps psychosis with other severe mental illness. So it isn’t as accurate as the Finnish or Danish studies. Nor do any of these studies prove that rising cannabis use has caused population-wide increases in psychosis or other mental illness. The most that can be said is that they offer intriguing evidence of a link.
Advocates for people with mental illness do not like discussing the link between schizophrenia and crime. They fear it will stigmatize people with the disease. “Most people with mental illness are not violent,” the National Alliance on Mental Illness (NAMI) explains on its website. But wishing away the link can’t make it disappear. In truth, psychosis is a shockingly high risk factor for violence. The best analysis came in a 2009 paper in PLOS Medicine by Dr.Seena Fazel, an Oxford University psychiatrist and epidemiologist. Drawing on earlier studies, the paper found that people with schizophrenia are five times as likely to commit violent crimes as healthy people, and almost 20 times as likely to commit homicide.

NAMI’s statement that most people with mental illness are not violent is of course accurate, given that “most” simply means “more than half”; but it is deeply misleading. Schizophrenia is rare. But people with the disorder commit an appreciable fraction of all murders, in the range of six to nine percent.
“The best way to deal with the stigma is to reduce the violence,” says Dr. Sheilagh Hodgins, a professor at the University of Montreal who has studied mental illness and violence for more than 30 years.

The marijuana-psychosis-violence connection is even stronger than those figures suggest. People with schizophrenia are only moderately more likely to become violent than healthy people when they are taking antipsychotic medicine and avoiding recreational drugs. But when they use drugs, their risk of violence skyrockets. “You don’t just have an increased risk of one thing—these things occur in clusters,” Dr. Fazel told me.

Along with alcohol, the drug that psychotic patients use more than any other is cannabis: a 2010 review of earlier studies in Schizophrenia Bulletin found that 27 percent of people with schizophrenia had been diagnosed with cannabis use disorder in their lives. And unfortunately—despite its reputation for making users relaxed and calm—cannabis appears to provoke many of them to violence.
A Swiss study of 265 psychotic patients published in Frontiers of Forensic Psychiatry last June found that over a three-year period, young men with psychosis who used cannabis had a 50 percent chance of becoming violent. That risk was four times higher than for those with psychosis who didn’t use, even after adjusting for factors such as alcohol use. Other researchers have produced similar findings. A 2013 paper in an Italian psychiatric journal examined almost 1,600 psychiatric patients in southern Italy and found that cannabis use was associated with a ten-fold increase in violence.

The most obvious way that cannabis fuels violence in psychotic people is through its tendency to cause paranoia—something even cannabis advocates acknowledge the drug can cause. The risk is so obvious that users joke about it and dispensaries advertise certain strains as less likely to induce paranoia. And for people with psychotic disorders, paranoia can fuel extreme violence. A 2007 paper in the Medical Journal of Australia on 88 defendants who had committed homicide during psychotic episodes found that most believed they were in danger from the victim, and almost two-thirds reported misusing cannabis—more than alcohol and amphetamines combined.

Yet the link between marijuana and violence doesn’t appear limited to people with pre-existing psychosis. Researchers have studied alcohol and violence for generations, proving that alcohol is a risk factor for domestic abuse, assault, and even murder. Far less work has been done on marijuana, in part because advocates have stigmatized anyone who raises the issue. But studies showing that marijuana use is a significant risk factor for violence have quietly piled up. Many of them weren’t even designed to catch the link, but they did. Dozens of such studies exist, covering everything from bullying by high school students to fighting among vacationers in Spain.

In most cases, studies find that the risk is at least as significant as with alcohol. A 2012 paper in the Journal of Interpersonal Violence examined a federal survey of more than 9,000 adolescents and found that marijuana use was associated with a doubling of domestic violence; a 2017 paper in Social Psychiatry and Psychiatric Epidemiology examined drivers of violence among 6,000 British and Chinese men and found that drug use—the drug nearly always being cannabis—translated into a five-fold increase in violence.

Today that risk is translating into real-world impacts. Before states legalized recreational cannabis, advocates said that legalization would let police focus on hardened criminals rather than marijuana smokers and thus reduce violent crime. Some advocates go so far as to claim that legalization has reduced violent crime. In a 2017 speech calling for federal legalization, U.S. Senator Cory Booker said that “states [that have legalized marijuana] are seeing decreases in violent crime.” He was wrong.

The first four states to legalize marijuana for recreational use were Colorado and Washington in 2014 and Alaska and Oregon in 2015. Combined, those four states had about 450 murders and 30,300 aggravated assaults in 2013. Last year, they had almost 620 murders and 38,000 aggravated assaults—an increase of 37 percent for murders and 25 percent for aggravated assaults, far greater than the national increase, even after accounting for differences in population growth.

Knowing exactly how much of the increase is related to cannabis is impossible without researching every crime. But police reports, news stories, and arrest warrants suggest a close link in many cases. For example, last September, police in Longmont, Colorado, arrested Daniel Lopez for stabbing his brother Thomas to death as a neighbour watched. Daniel Lopez had been diagnosed with schizophrenia and was “self-medicating” with marijuana, according to an arrest affidavit.

In every state, not just those where marijuana is legal, cases like Lopez’s are far more common than either cannabis or mental illness advocates acknowledge. Cannabis is also associated with a disturbing number of child deaths from abuse and neglect—many more than alcohol, and more than cocaine, methamphetamines, and opioids combined—according to reports from Texas, one of the few states to provide detailed information on drug use by perpetrators.

These crimes rarely receive more than local attention. Psychosis-induced violence takes particularly ugly forms and is frequently directed at helpless family members. The elite national media prefers to ignore the crimes as tabloid fodder. Even police departments, which see this violence up close, have been slow to recognize the trend, in part because the epidemic of opioid overdose deaths has overwhelmed them.
So the black tide of psychosis and the red tide of violence are rising steadily, almost unnoticed, on a slow green wave.
***
For centuries, people worldwide have understood that cannabis causes mental illness and violence—just as they’ve known that opiates cause addiction and overdose. Hard data on the relationship between marijuana and madness dates back 150 years, to British asylum registers in India. Yet 20 years ago, the United States moved to encourage wider use of cannabis and opiates.
In both cases, we decided we could outsmart these drugs—that we could have their benefits without their costs. And in both cases we were wrong. Opiates are riskier, and the overdose deaths they cause a more imminent crisis, so we have focused on those. But soon enough the mental illness and violence that follow cannabis use will also be too widespread to ignore.

Whether to use cannabis, or any drug, is a personal decision. Whether cannabis should be legal is a political issue. But its precise legal status is far less important than making sure that anyone who uses it is aware of its risks. Most cigarette smokers don’t die of lung cancer. But we have made it widely known that cigarettes cause cancer, full stop. Most people who drink and drive don’t have fatal accidents. But we have highlighted the cases of those who do.
We need equally unambiguous and well-funded advertising campaigns on the risks of cannabis. Instead, we are now in the worst of all worlds. Marijuana is legal in some states, illegal in others, dangerously potent, and sold without warnings everywhere.

But before we can do anything, we—especially cannabis advocates and those in the elite media who have for too long credulously accepted their claims—need to come to terms with the truth about the science on marijuana. That adjustment may be painful. But the alternative is far worse, as the patients at Mid-Hudson Forensic Psychiatric Institute—and their victims—know.

Source: Imprimis January 2019 • Volume 48, Number 1

Abstract

Marijuana is the most commonly abused illicit drug by pregnant women. Its major psychoactive constituent, Delta(9)-THC (Delta(9)-tetrahydrocannabinol), crosses the placenta and accumulates in the foetus, potentially harming its development. In humans, marijuana use in early pregnancy is associated with miscarriage, a fetal alcohol-like syndrome, as well as learning disabilities, memory impairment, and ADHD in the offspring. Classical studies in the 1970 s have reached disparate conclusions as to the teratogenic effects of cannabinoids in animal models. Further, there is very little known about the immediate effects of Delta(9)-THC on early embryogenesis. We have used the chick embryo as a model in order to characterize the effects of a water-soluble Delta(9)-THC analogue, O-2545, on early development. Embryos were exposed to the drug (0.035 to 0.35 mg/ml) at gastrulation and assessed for morphological defects at stages equivalent to 9-14 somites. We report that O-2545 impairs the formation of brain, heart, somite, and spinal cord primordia. Shorter incubation times following exposure to the drug show that O-2545 interferes with the initial steps of head process and neural plate formation. Our results indicate that the administration of the cannabinoid O-2545 during early embryogenesis results in embryotoxic effects and serves to illuminate the risks of marijuana exposure during the second week of pregnancy, a time point at which most women are unaware of their pregnancies.

Source: https://www.ncbi.nlm.nih.gov/pubmed/19040278 October 2008

Abstract

Background: Given current drug policy reforms to decriminalize or legalize cannabis in numerous countries worldwide, the current study assesses the relation between cannabis use and the development of testicular cancer.

Methods: The study included a population-based sample (n = 49,343) of young men ages 18–21 years who underwent conscription assessment for Swedish military service in 1969–1970. The conscription process included a nonanonymous questionnaire eliciting information about drug use. Conscription information was linked to Swedish health and administrative registry data. Testicular cancers diagnosed between 1970 and 2011 were identified by International Classification of Diseases-7/8/9/10 testicular cancer codes in the Swedish National Patient Register, the Cancer Register, or the Cause of Death Register. Cox regression modeling was used to estimate the hazards associated with cannabis use and time to diagnosis of testicular cancer.

Results: No evidence was found of a significant relation between lifetime “ever” cannabis use and the subsequent development of testicular cancer [n = 45,250; 119 testicular cancer cases; adjusted HR (aHR), 1.42; 95% confidence interval (CI), 0.83–2.45]. “Heavy” cannabis use (defined as usage of more than 50 times in lifetime, as measured at conscription) was associated with the incidence of testicular cancer (n = 45,250; 119 testicular cancer cases; aHR 2.57; 95% CI, 1.02–6.50).

Conclusions: The current study provides additional evidence to the limited prior literature suggesting cannabis use may contribute to the development of testicular cancer.

Impact: Emerging changes to cannabis drug policy should consider the potential role of cannabis use in the development of testicular cancer. Cancer Epidemiol Biomarkers Prev; 26(11); 1644–52. ©2017 AACR.

Source: http://cebp.aacrjournals.org/content/26/11/1644 November 2017

Filed under: Cannabis/Marijuana,Health :

New research from Northern Medical Program Professor Dr. Russ Callaghan has found that use of marijuana is associated with the development of testicular cancer.

As part of a retrospective study, Dr. Callaghan and his team looked at data from young men conscripted for military service in Sweden in 1969 and 1970, and tracked their health conditions over the following 42 years. They found that heavy cannabis use (defined as more than 50 times in a lifetime, as measured at conscription) was associated with a 2.5-fold increased risk of developing testicular cancer.

“At this time, surprisingly little is known about the impacts of cannabis on the development of cancer in humans,” said Dr. Callaghan, the study’s lead author. “With Canada and other countries currently experimenting with the decriminalization or legalization of recreational cannabis use, it is critically important to understand the potential harms of this type of substance use.”

The results from the recent study, as well as three prior case-control studies in this area, suggest that cannabis use may facilitate later onset of testicular cancer.

“Our study is the first longitudinal study showing that cannabis use, as measured in late adolescence, is significantly associated with the subsequent development of testicular cancer. My hope is that these findings will help medical professionals, public health officials and cannabis users to more accurately assess the possible risks and benefits of cannabis use.”

The project included an international team of researchers from Karolinska University in Sweden and the Division of Cancer Epidemiology and Genetics at the National Cancer Institute in the U.S. The study is part of Dr. Callaghan’s ongoing research assessing the potential health risks associated with cannabis use and the potential impacts of cannabis legalization on use and related harms.

Source: https://www.unbc.ca/newsroom/unbc-stories/research-finds-link-between-marijuana-use-and-testicular-cancer November 2017

Filed under: Cannabis/Marijuana,Health :

Dear Friend, 

Let’s take a second to talk about Colorado. 

As you know, Colorado was the first state to commercialize the marijuana industry – and today it stands as the top state in the country for first-time youth marijuana use. The state also suffers from record stoned driving crashes, increased workplace drug positives, and unprecedented levels of opioid deaths.

The pot industry has taken Colorado hostage

A few days ago, Colorado Governor Jared Polis announced he had appointed Ean Seeb to serve as the state’s new “Special Adviser on Cannabis.” From this position, he will help guide Governor Polis’ position on bills as they move through the legislature. 

An example of one such bill is presumably HB 1230 – a bill that would exempt bars, restaurants, and other public places from the Clean Air Indoor Act and allow marijuana use indoors

What is so concerning about this appointment?

You see, Mr. Seeb has been profiting from marijuana for more than a decade. He is a two-time chair of the National Cannabis Industry Association, a former co-owner of Denver Relief dispensary and Denver Relief Consulting. He has lobbied in the past in support of pot deliveries, loosening restrictions on investments into then industry, and social consumption – better known as pot bars. 

The Colorado Springs Gazette stated that this is “like the Marlboro Man monitoring cigarette sales.” I couldn’t agree more.

The fact is, in the short years since it was implemented, legalization in Colorado has been a disaster. Traffic deaths from marijuana-impaired driving have skyrocketed. Emergency room visits from high potency marijuana are through the roof. There has been a 400% increase in exposure of children less than nine years old to the drug. 

The overwhelming majority of pot shops are located in minority and low-income communities and they are recommending highly potent pot to pregnant mothers. Criminal gangs and foreign cartels are setting up shop in housing developments and on public land to grow illegal marijuana next to legal grows and law enforcement is being stretched to its limits to combat the thriving black market. 

And now Governor Polis chooses to put an industry lackey in an oversight position to regulate the industry.

SAM and our Colorado affiliate, the Marijuana Accountability Coalition (MAC), are working tirelessly to combat the industry as it moves to oppose any form of regulation it once favored being imposed on it. We have begun an awareness campaign by covering Denver with billboards pointing out the failures of the marijuana industry in Colorado to help convince Coloradans and Governor Polis to wake up and take action. 

You can help take action, too. Click here to send an email to your member of Congress telling them to oppose legalization of marijuana at the federal level and prevent the spread of this addiction-for-profit industry nationwide. Once you have done that, click here to chip in with a tax-deductible gift to help SAM continue educating lawmakers and the public on the failures of marijuana legalization. 

The industry is strong and deceptive, but together, we can push back,beat them at their own game, and save lives.

All the best, 

Kevin Sabet, PhD

Source: Email from SAM (Smart Approaches to Marijuana) <reply@learnaboutsam.org> May 2019

Why don’t we start with a short quiz of general knowledge of current events and topical issues in the community??

 Questions:

 Brain:

Which American state has 500 students with autism in every graduating year group across the whole state?

Which American state has current legislation afoot to declare autism at epidemic proportions in their state?

Which American state has the fastest growing autism epidemic by recent metrics (at 30% every two years)?

Which smoked illegal drug is now linked with causing strokes???

Which smoked illegal drug is linked with causing most major psychiatric diseases – including schizophrenia, bipolar disorder, depression and anxiety.

Which illicit drug is known to cause failure of achievement of major life goals – forming a long term stable relationship, getting a job, having a career, paying tax???

In which US state have city after city been trashed by out of control mental illness, drug use, homelessness, poverty and law enforcement and social relief services completely overwhelmed?

 Heart:

Which American state is amongst the top four for rates of children born with holes in their heart (known as atrial septal defect)?

In which American state did the rate of holes in the heart (atrial septal defect) increase more than threefold from 299 to 912 cases 2000-2012?

Which smoked illegal drug is now recognized to cause heart attacks?

Which illegal drug is known to stop the heart by causing major cardiac arrythmias?

 Head:

Which two American states share the highest rates of children born without ears or with tiny little ears (like peas – called anotia or microtia)???

 Chromosomes:

Which four American states have the highest rates of Downs syndrome in the nation??

What do all four of these states have in common??

Which American state has the highest rates in the nation for all four major chromosomal abnormalities of birth namely Trisomies 13, 18, 21 (Down’s syndrome) and Turner’s syndrome???

 Limbs:

Which are the two leading states for babies born without arms??

What do these two states have in common??

 Drugs:

Drug use is known to damage babies when they are growing inside their mothers. 

In which leading American state, which was also home to most of the above waves of recent deformed babies, was the rate of all drug use actually falling – all except one drug.  Which state was that?

And which drug was the exception??

 Cancer:

Drug use is well recognized as leading to cancer in many organs.  This is widely recognized for both tobacco and alcohol. 

Which drug has been linked with causing cancer of the testicles in 100% of the studies – four out of four – which have examined this question?

Which is the only illicit drug linked to four inheritable cancers in the children born to infants exposed in utero exposed?

Which drug was examined in detail in a 150 page report by the Californian environmental Protection agency and found to be a proven carcinogen in 2009?

Why are virtually all carcinogens considered teratogens – known to harm developing babies?

 Reproduction:

Which smoked illicit drug causes major genetic damage to both eggs and sperm?

Which smoked illicit drug reduces fertility in both males and females?

Our genes not only carry our DNA sequence, but also the software which programs those genes and turns them on and off – which scientists call the “epigenome”. 

Which smoked illicit drug is known to damage the epigenome?

For how many generations does epigenetic inheritance continue?

Is this period more or less than 100 years???

 

 Answers:

 The above series of questions relate to the recent experience of the US state of Colorado following its progressive legalization of cannabis over the period 2000-2014. 

If you answered “Colorado” to most of the questions about congenital defects you were correct.  The two exceptions were the question about babies born without limbs – the two commonest US states for these defects are Alaska and Oregon; and babies born with tiny ears – which are Alaska and Oregon.

 The leading states for cannabis use according to major recent US surveys are Colorado, Alaska, Oregon, Maine, Vermont and Washington.  Scarily Alaska comes at or near the top of the list for: Down’s syndrome, atrial septal defect (ASD), ventricular septal defect (VSD) a defect called Encephalocoele where babies are born with a big bubble blown out the back of their skull where the neck joins, no arms, no ears and gastroschisis which is where the bowels are hanging out.  Colorado leads or co-leads the charge on the three chromosomal trisomies trisomy 21, 18 and 13 and no ears (anotia).  The four states which lead the pack on Downs syndrome are all cannabis liberal states: Colorado, Alaska, Oregon and Massachusetts.

 Downs syndrome, ASD and VSD are relatively common congenital defects.  Congenital defects as a whole affect around 3% of the community – unless you live in Colorado which up until September 2018 reported a major congenital abnormality rate four times higher than that at 12.6%.  One notes that after that the problem “went away” because the state then changed all of their official congenital anomaly figures for the past 15 years after attention was drawn to these facts internationally.

And one cannot attribute these severe changes in Colorado to the use of other drugs as the national survey showed that the use of most other drugs has actually fallen across this recent period.  So it is obviously a cannabis signal.

 This strong “red flag” warning signal for cannabis also shows up loud and clear in the US nation’s leading mental health survey where cannabis use grew most strongly across the nation in the 18-25 year age group, which was also the age group with by far the worse mental health, which was also declining most rapidly.  This implies that the decline in both the US nation’s minds and their gene pool is occurring in close relationship to cannabis use both across the nation geographically, across time with temporal variability, and also within defined demographic groups.

Cannabis is known to damage the epigenome of the sperm in a way which affects brain heart and immune development and has also been traced in human foetal tissue from live born babies.  This damage is presently believed to be inheritable for four generations or 100 years.  Scientists are very concerned about this serious risk.  In one study over 6,000 sites of DNA methylation were affected and thus reprogrammed, and that is a substantial number compared to our around 25,000 genes.

And most worryingly it was recently reported from Ain in the east of France near the Swiss border that the incidence of babies born without arms is 58 times higher than the normal background.  And the same thing was seen in the cattle in the area.  However this was not seen in nearby Switzerland where it is not permitted to add hemp to the food chain via stock feed.  Cannabis has previously been linked with such defects in a major Hawaiian study of over 300,000 births published in 2007.

Most of the cannabis teratological literature is fairly conservative.  The Centres for Disease Control in Atlanta Georgia have admitted in 2014 that cannabis is linked with four defects – no brain (anencephaly – babies die within an hour or two mostly), bowels having out (|gastroschisis) diaphragmatic hernia and oesophageal atresia with or without tracheooesophageal fistula.  The American Academy of paediatrics has issued a position statement in 2007 saying that both ventricular septal defect (holes in the heart) and Ebsteins anomaly (damaged tricuspid valve) are known to be linked with cannabis use. 

And the three longitudinal studies of babies born after prenatal cannabis exposure presently being conducted in Pittsburgh, Ottawa and Netherlands, all very consistently find persistent and subtle brain damage of executive functioning to be major issues.  This finding in three nations is the most concerning and likely by far the most common of all.

Certainly physicians in both Colorado and in Australia are seeing just this pattern of subtle brain abnormalities in the patients who present to our clinics.  This is therefore the most concerning aspect of the cannabis free for all which is being falsely foisted on the west by a relentless media mantra.  If India has its holy cows, then the theistically allergic media are no less as enamoured with their own devoutly protected “deep green god” – regardless of the painfully obvious fallout.

Most worryingly of all – consider these few final major issues.  Of the two perspective described above – the conservative one espoused by well recognized international authorities – and the more worrying picture of 21 defects reported from the massive epidemiological Hawaiian study – which one is the more correct – especially in an era when as is widely known cannabis, cannabis oils and hashish butane oils are rapidly becoming so much more concentrated than in past eras??  It is said that the most stringent test of any theory is its ability to make predictions about future events.  By this criterion only the 2007 Hawaiian report by Forrester predicted the links in Ain in France with the armless defect, and the patterns of chromosomal abnormalities, atrial septal defect and anotia / microtia across USA.  In this important respect then the Forrester – Menz report is more accurate – and of course much more concerning – than the “standard received wisdom”.  It appears to be acting as a kind of a roadmap – as the tide both of cannabis use and of cannabis concentration – rises all around us.

And most concerning of all is that many papers in the cannabinoid genotoxicity literature show an exponential relationship between cannabis dose exposure and the genotoxic damage which is directly responsible for cancers in patients, their children and foetal abnormalities including mental retardation and brain damage.  That is to say that beyond a certain threshold dose doubling the exposure produces not twice as much genetic damage- but 10-20 times as much. Cannabis use during pregnancy has been linked with the following four cancers which are all believed to be due to genotoxic damage uncurred during in utero exposure: acute lymphatic leukaemia, acute myelomonocytic leukemia, neuroblastoma and rhabdomyosarcoma.

 It is very important to appreciate that these concerns relate not just to Δ9 -tetrahydrocannabinol itself, but, since cannabis contains at least 108 cannabinoids, all of them have been implicated in genotoxic damage through the above mentioned epidemiological studies.  Studies in animals and cells have found that cannabidiol, cannabinol, cannabidivarin and cannabichromene – at least – all have direct genotoxic and / or epigenetic effects which are of great concern.  In many cases this effect is worse than that observed with Δ9 -tetrahydrocannabinol.  They all also damage mitochondrial function which exerts severe indirect genotoxicity partly by limiting energy supply to growing, dividing and metabolically active tissues, and partly by close and multichannel signaling from the mitochondria directly to the nucleus and its architecture and genetic management machinery.

And… despite what one might think from the deafening silence from the popular press, the genotoxicity of cannabinoids is not even controversial!  Serious warnings relating to reproductive health are prominently featured in the formally registered patient information inserts for both cannabidiol “Epidiolex” and the cannabidiol / THC mixture “Sativex”.

All of which paints an horrific and ghoulish picture of the drug-wrecked future.  In the USA it is obvious that the guardians of the culture are radically missing in action.  CDC which is charged with protecting the public health; FDA which are charged with protecting the food and pharmaceutical supply and the USA President all seem be absent from the foray.  One can only wonder why…  Intimidated??  Cultural groupthink??  Personal money at stake?? Careers on the line??

My father always taught me:  “If everybody else was jumping over a cliff, would you jump to??”  Paradoxically indeed in 1958 it was the FDA which protected the USA from the holocaust that became the completely avoidable international thalidomide teratogenesis epidemic, whilst societies in Australia, England and in Europe were duped and succumbed to the commercial marketing campaign and the deliberate subversion of the then known truth.  Cannabis was recently been found to be recommended to 78% of pregnant women in Colorado.  Just as in that era, thalidomide was also used for anxiety, sleeplessness, nausea, unwellness and “dis-ease”.  Today America has obviously succumbed to the siren voice of the modern media darling – the “green holy cow” of the west. 

 One can only wonder if anyone in this country has the courage to see the obvious and call “Enough Already” and insist that our public agencies do their duty and discharge their office with honour.       Dr. Stuart Reece.

Source:  January 2019 edition of Family World News

 

What is synthetic cannabis?

Synthetic cannabis is a new psychoactive substance that was originally designed to mimic or produce similar effects to cannabis and has been sold online since 2004. However, some of the newer substances claiming to be synthetic cannabis do not actually mimic the effects of THC (delta-9 tetrahydrocannabinol, the active ingredient in cannabis).

Reports suggest it also produces additional negative effects. These powdered chemicals are mixed with solvents and added to herbs and sold in colourful, branded packets. The chemicals usually vary from batch to batch as manufacturers try to stay ahead of the law, so different packets can produce different effects even if the name and branding on the package looks the same.

Other names

Synthetic cannabis is marketed under different brand names.

Spice was the earliest in a series of synthetic cannabis products sold in many European countries. Since then a number of similar products have been developed, such as Kronic, Northern Lights, Mojo, Lightning Gold, Blue Lotus and Godfather.

Synthetic cannabis is also marketed as aphrodisiac tea, herbal incense and potpourri.

How is it used?

It’s most commonly smoked and is sometimes drunk as a tea.

Effects of synthetic cannabis

There is no safe level of drug use. Use of any drug always carries some risk. It’s important to be careful when taking any type of drug.

Synthetic cannabis affects everyone differently, based on:

  • Size, weight and health
  • Whether the person is used to taking it
  • Whether other drugs are taken around the same time
  • The amount taken
  • The chemical that is used and its strength (varies from batch to batch)

Synthetic cannabis is relatively new, so there is limited information available about its short- and long-term effects, including how safe or unsafe it is to use. However, it has been reported to have similar effects to cannabis along with some additional negative and potentially more harmful ones including:

  • Fast and irregular heartbeat
  • Racing thoughts
  • Agitation, anxiety and paranoia
  • Psychosis
  • Aggressive and violent behaviour
  • Chest pain
  • Vomiting
  • Acute kidney injury
  • Seizures
  • Stroke
  • Death

Long-term effects

There has been limited research into synthetic cannabis dependence. However, anecdotal evidence suggests that long term, regular use can cause tolerance and dependence.

Withdrawal

Giving up synthetic cannabis after using it for a long time is challenging because the body has to get used to functioning without it.

It has been reported that some people who use synthetic cannabis heavily on a regular basis may experience withdrawal symptoms when they try to stop, including:

  • Insomnia
  • Paranoia
  • Panic attacks
  • Agitation and irritability
  • Anxiety
  • Mood swings
  • Rapid heartbeat

The risk of tolerance and dependence on synthetic cannabis and their associated effects may be reduced by taking regular breaks from smoking the drug and avoiding using a lot of it at once.

Health and safety

There is no safe way to use synthetic cannabis. If you do decide to use the drug, it’s important to consider the following

Regulating intake

  • It is difficult to predict the strength and effects of synthetic cannabis (even if it has been taken before) as its strength varies from batch to batch.
  • Trying a very small dose first (less than the size of a match head) could help gauge the strength and possible effects. Dose size should only be increased slowly – time should be given for the previous dose to wear off.
  • Taking synthetic cannabis on its own without a ‘mixer’ such as tobacco or dried parsley should always be avoided. Similarly, inhaling the drug via bongs or pipes can increase the risk of an overdose or bad reaction.

Misleading packaging

  • The packaging of synthetic cannabis can be misleading. Although contents may be described as ‘herbal’, the actual psychoactive material is synthetic.
  • Not all ingredients or their correct amounts might be listed, which can increase the risk of overdose.
  • Chemicals usually vary from batch to batch, so different packets can produce different effects, even if the packaging looks the same.

Mental health risks

  • People with mental health conditions or a family history of these conditions should avoid using synthetic cannabis. The drug can intensify the symptoms of anxiety and paranoia.
  • Taking synthetic cannabis in a familiar environment in the company of people who are known and trusted may alleviate any unpleasant emotional effects. Anxiety can be counteracted by taking deep, regular breaths while sitting down.

When it absolutely shouldn’t be used

Use of synthetic cannabis is likely to be more dangerous when:

  • Taken in combination with alcohol or other drugs, particularly stimulants such as crystal methamphetamine (‘ice’) or ecstasy
  • Driving or operating heavy machinery
  • Judgment or motor coordination is required
  • Alone (in case medical assistance is required)
  • The person has a mental health problem
  • The person has an existing heart problem

In an emergency

There have been a number of deaths caused by synthetic cannabis. Call triple zero (000) immediately if someone is experiencing negative effects such as:

  • Fast/irregular heart rate
  • Chest pain
  • Breathing difficulties
  • Delusional behaviour

Ambulance officers don’t have to involve the police.

Synthetic cannabis statistics

National

  • 2.8% of Australians aged 14 years and over have used synthetic cannabis at some stage in their lives.
  • 0.3% of Australians aged 14 years and over have used synthetic cannabis in the previous 12 months.

According to Australian data from the Global Drug Survey, synthetic cannabis was the 33rd most commonly used drug – 1.1% of respondents had used this type of drug in the last 12 months

Synthetic cannabis and the law

The laws surrounding NPS are complex, constantly changing and differ between states/territories, but in general they are increasingly becoming stronger.

In Queensland, New South Wales, South Australia and Victoria there is now a ‘blanket ban’ on possessing or selling any substance that has a psychoactive effect other than alcohol, tobacco and food.
In other states and territories in Australia specific NPS substances are banned and new ones are regularly added to the list. This means that a drug that was legal to sell or possess today, may be illegal tomorrow. The substances banned differ between these states/territories.

Source: https://adf.org.au/drug-facts/synthetic-cannabis/ May 2019

People who are mentally ill or addicted can’t work effectively, if at all, so they have to turn to crime and/or public support for survival.  Marijuana escalates the risk of mental illness 5 times.[i] On average, 17% of adolescents and 9% of adults  will become addicted.[ii]Based on federal research  7,000 people use marijuana for the first time each day.[iii] Taking an average of 13%, nationally over 332,000 new marijuana addicts will be created.  California’s share at 13% of the population will be over 33,000 new addicts annually, adding another 1.3 billion in cost at $40,000 each.  Instead of preventing these problems, we can expect more academic failure, lost productivity, mental illness, addiction and crime. In Sacramento, 59% of all arrestees for any crime tested positive just for marijuana; 83% for any drug[iv]. Jail overcrowding is also a factor as those deemed mentally ill languish there for weeks and months, waiting for space in a mental health facility.

Marijuana causes permanent brain damage and loss of IQ for anyone under 25.[v]  It causes psychotic breaks leading to gruesome acts, including decapitations, stabbings, mass murders and suicides. Other harms include DNA damage causing birth abnormalities[vi] not just in the next generation, but the next four (100 years).  Because marijuana is fat soluble, it stays in the body and brain for one month, compounding with each additional use.  The impairment adversely affects cognition, judgement and memory all of which contribute to traffic deaths. [vii]

MARIJUANA – THE ECONOMIC COSTS 
Aside from the devastating environmental cost, the social costs are huge.  For alcohol and tobacco, the social costs exceed tax revenues by 9 to 1. The black market won’t disappear. In Colorado the black market is still about 50% of the total.  In California only about 16% of cultivators have signed up to be licensed and taxed. The rest will avoid taxes and sell to the black market throughout the US. In 2009, a study called Shoveling Up: The Impact of Substance Abuse on Federal, State and Local Governments[viii] was done which showed in 2005, California spent 19.5% of its budget ($19.9 billion) on substance abuse, of which only $38 million (1/3rd of 1%) on prevention, and the rest shoveling up the damage. This is horrible economic policy, and its much worse today.  Instead of preventing this preventable disease, we cultivate it.

Voters bought the Gavin Newsom lie that Prop 64 would be a good thing. The orchestrated legislative analysis, approved by our Attorney General, Secretary of State, et al., suggested the state would save $100 million in prison costs, get rid of the black market and earn up to $1 billion in tax revenues. No mention of the environmental devastation and reclamation costs.  It outrageously suggested marijuana had no serious health impacts.  To cap it off, the illicit drug trade and out-of-state billionaires spent $35 million to back the campaign. If we care about our kids, and our future, its time to fight back.

[i] https////health.harvard.edu/Teens who smoke pot at risk for later schizophrenia

[ii] www.drugabuse.gov

[iii] www.theatlantic.com/Everyday 7,000 Americans try weed for the first time

[iv] www.ncjrs.gov/pdfiles1/ondcp/ADAMII Arrestee Drug Abuse Monitoring Program

[v] www.healthline.com.  The Effects of Marijuana on your body.

[vi] www.sciencedaily.com.  Marijuana Damages DNA and may cause cancer

[vii] www.nbcnews.com/health/healt-news/Pot Fuels Surge In Driving Deaths

[viii] www.casacolumbia.org/Shoveling Up:  The Impact of Substance Abuse on Federal, State and Local Budgets

Source: http://tbac.us/2018/09/15/marijuana-causes-mental-illness-and-addiction-in-turn-more-homelessness-poverty-and-crime/ September 2018

Estimated reclamation costs in Calaveras County California alone could reach $2 billion for 1,200 grow sites. 50,000 grow sites in the state could amount to over $50 billion, according to the Calaveras County study (www.silentpoison.com/CultivatingDisaster).

Aside from killing wildlife, fish and depleting streams and water tables, the poisons seeping into the ground are contaminating watersheds that serve farm animals and millions of people.  Poisons are also decimating the famed spotted owl that shut down the lumber industry.  Money and manpower for reclamation are non-existent.      

Our national forests are no longer safe. Millions of birds, animals and fish are essentially murdered. Pristine ecosystems are being destroyed. Poisons and fertilizers seeping into the soil are contaminating streams that serve millions of people while our federal and state governments stand on the sidelines.

Under the guise of medicine, at the end of 2017, produced 8 times more pot than is consumed within our own borders. California supplies 60 to 75% of the entire US black market for marijuana, 93% of which is known to be contaminated with pesticides.  Rather than limit production, in the 1st quarter 2018, the state issued 2,000 additional licenses to grow pot, obviously to serve export markets. In the meantime, Congress is withholding funds for federal enforcement of their own laws.  The FDA and EPA have done nothing to protect the people and planet.  Now, contrary to federal laws which he is supposed to enforce, the President unwisely says States have a right to set their own marijuana laws.  Then, is it OK that California has become a cartel, bigger than all others combined?

The nation has been hijacked. We have become a lawless, narco nation where money for personal political futures is more important than an oath to defend the constitution and protect the people.   To the chagrin or our international allies, the US is now a rogue nation in violation of three international treaties. Unless America returns to the rule of law, the America will never regain its former glory.

Don’t Believe It?  Please take 11 ½ minutes and watch Youtube.com/Environmental Damage of Marijuana In the West.

Source: http://tbac.us/2018/09/15/californias-ill-conceived-marijuana-program-has-inflicted-irreparable-environmental-human-and-economic-harm-on-our-once-fine-state/ September 2018

People who turn to medical marijuana are often drawn to the fact that it’s natural. This is indeed a great quality from a health standpoint, but environment-minded marijuana buyers, take note: New research shows that marijuana farming in remote locations is having a negative effect on the environment.

After studying the ecological consequences that marijuana farming had in Northern California, researchers from Ithaca College discovered that small farms were having a surprisingly big impact.

In a press release, the college’s Environmental Science Associate Professor Jake Brenner wrote that cannabis has significant environmental impacts despite its small spatial footprint. He suggests that policymakers put land-use and environmental regulations in place to help control the expansion of cannabis crops before the situation grows more widespread, given the increase in legalization and popularity of the plant. Cannabis now enjoys legalization for varying degrees of medicinal and/or recreational use across 30 states in the U.S. and several other countries.

They reached their conclusions after comparing cannabis cultivation’s environmental effects, including forest fragmentation, the loss of habitats, and deforestation. In fact, the researchers pointed out that cannabis causes bigger changes in several key metrics in terms of unit area compared to timber, although the latter’s overall landscape impact remains greater.

For example, after looking at pot farms in 62 random watersheds in Humboldt County from 2000 to 2013, the crop was shown to cause 1.5 times greater forest loss and 2.5 times more forest fragmentation than timber harvest.

California laws on marijuana cultivation inadvertently hurting the environment

Little is known about the long-term impact of marijuana farming or regulations in the industry as policymaking struggles to stay on top of the industry’s growth. Part of the problem is that California laws state marijuana cultivation must be confined to just one acre per land parcel. By preventing wide-scale industrial marijuana farms, this law is actually encouraging small farms with big environmental impacts to proliferate, breaking up the forest and hurting wildlife habitats.

This adds on to previous studies carried out by the same research team showing that the pesticides used on marijuana farms to keep rodents away can hurt mammals in the area, while irrigation is having a negative impact on local wildlife. Moreover, because their locations are typically quite remote, access roads must be created and land must be cleared for production. That report suggested that growing marijuana in places with gentler slopes, plenty of water sources, and better access to roads could help reduce the threats to the environment significantly. Marijuana can also be cultivated indoors.

Those growing the crop should avoid using chemical pesticides for obvious reasons. It’s not just bad for the environment; it’s also terrible for your health. Indeed, pesticide exposure could be behind the cancer that spurs many people to seek medical marijuana in the first place. Some illegal forest growers have been using pesticides like carbofuran, which has long been banned in the country, and it’s now making its way into the water. This causes headaches, vomiting, muscle twitches, dizziness, convulsions and even death in some cases. California is home to more than 90 percent of the illegal pot farms found in the nation.

Profits coming at expense of environment

Unfortunately, there are a lot of profits to be made here, and some of the less scrupulous growers are focusing on profits at the expense of the environment. By raising awareness about the potential impact, it is hoped that such parties will turn to more responsible growing practices in the future. As the scientists in these studies point out, however, there isn’t much research available about land-use science when it comes to cannabis agriculture.

Source: https://www.naturalnews.com/2017-11-20-marijuana-farmers-are-destroying-natural-ecosystems-as-quest-for-profits-outweighs-green-agricultural-practices.html November 2017

Abstract

Major self-mutilation (amputation, castration, self-inflicted eye injuries) is frequently associated with psychiatric disorders and/or substance abuse. A 35-year-old man presented with behavioral disturbances of sudden onset after oral cannabis consumption and major self-mutilation (attempted amputation of the right arm, self-enucleation of both eyes and impalement) which resulted in death. During the enquiry, four fragments of a substance resembling cannabis resin were seized at the victim’s home. Autopsy confirmed that death was related to hemorrhage following the mutilations. Toxicological findings showed cannabinoids in femoral blood (tetrahydrocannabinol (THC) 13.5 ng/mL, 11-hydroxy-tetrahydrocannabinol (11-OH-THC) 4.1 ng/mL, 11-nor-9-carboxy-THC (THC-COOH) 14.7 ng/mL, cannabidiol (CBD) 1.3 ng/mL, cannabinol (CBN) 0.7 ng/mL). Cannabinoid concentrations in hair (1.5 cm brown hair strand/1 segment) were consistent with concentrations measured in chronic users (THC 137 pg/mg, 11-OH-THC 1 pg/mg, CBD 9 pg/mg, CBN 94 pg/mg). Analysis of the fragments seized confirmed that this was cannabis resin with high levels of THC (31-35%). We discuss the implications of oral consumption of cannabis with a very high THC content.

Source: https://www.ncbi.nlm.nih.gov/pubmed/29125965 January 2018

Abstract

BACKGROUND:

With the Canadian government legalizing cannabis in the year 2018, the potential harms to certain populations-including those with opioid use disorder-must be investigated. Cannabis is one of the most commonly used substances by patients who are engaged in medication-assisted treatment for opioid use disorder, the effects of which are largely unknown. In this study, we examine the impact of baseline and ongoing cannabis use, and whether these are impacted differentially by gender.

METHODS:

We conducted a retrospective cohort study using anonymized electronic medical records from 58 clinics offering opioid agonist therapy in Ontario, Canada. One-year treatment retention was the primary outcome of interest and was measured for patients who did and did not have a cannabis positive urine sample in their first month of treatment, and as a function of the proportion of cannabis-positive urine samples throughout treatment.

RESULTS:

Our cohort consisted of 644 patients, 328 of which were considered baseline cannabis users and 256 considered heavy users. Patients with baseline cannabis use and heavy cannabis use were at increased risk of dropout (38.9% and 48.1%, respectively). When evaluating these trends by gender, only female baseline users and male heavy users are at increased risk of premature dropout.

INTERPRETATION:

Both baseline and heavy cannabis use are predictive of decreased treatment retention, and differences do exist between genders. With cannabis being legalized in the near future, physicians should closely monitor cannabis-using patients and provide education surrounding the potential harms of using cannabis while receiving treatment for opioid use disorder.

Source: https://www.ncbi.nlm.nih.gov/pubmed/29117267 November 2017

University of Pennsylvania researchers performed Internet searches for slightly more than a month in 2016 to identify CBD products that displayed contents on their labels and were for sale online. They bought 84 products from 31 companies, blinded their labels, and had their contents tested.

A full 70 percent of the labels turned out to be incorrect. The products either contained more CBD than their labels specified, or less. Thirty percent of the labels were “accurate” within a range of 10 percent.

Of particular concern was that testing detected THC in 18 of the 84 samples, and the amounts of THC in some products were sufficient to cause intoxication or impairment, especially in children.

The publication of this article in JAMA took place just days after the FDA sent warning letters to four major CBD producers asking them to eliminate all medical claims they make for their products. All have been marketing their products with unproven medical claims. They have 15 business days from last week to remove the claims or FDA can seize their merchandise and put them out of business.

Source: Email from National Families In Action http://www.nationalfamilies.org November 2017

Psychologist Robert Margolis, PhD, has spent the past 40 years treating substance abuse disorders in adolescents. He founded and ran Solutions, an after-school alcohol and drug treatment program for young people in Atlanta, Georgia. When he retired recently, he merged Solutions with Caron Treatment Center, a nonprofit organization with treatment facilities in several states.

Dr. Margolis wrote an op-ed for the Atlanta Journal Constitution in 2002 calling for careful, reasoned debate about the legalization of marijuana. Today, he writes that that debate still hasn’t happened. He lays out what science says about the impact of marijuana use on young people and asks if we are prepared to allow next generations to be so drug damaged.
 
Read his essay here.

Source: Email from National Families In Action http://www.nationalfamilies.org November 2017

Researchers from the University of Connecticut Health Center studied data from 1,165 young adults who took part in the Collaborative Study on the Genetics of Alcoholism. People in the alchol study were assessed at age 12 and then every two years over a span of the next 13 to 22 years.

Those who became dependent on both marijuana and alcohol were found to have lower levels of educational achievement, were less likely to be employed full time, less likely to be married, and had lower social and economic potential.

“This study found that chronic marijuana use in adolescence was negatively associated with achieving important developmental milestones in young adulthood. Awareness of marijuana’s potential deleterious effects will be important moving forward given the current move in the U.S. toward marijuana legalization for recreational / medicinal use,” says study author Elizabeth Harari, MD.

She presented her study at the annual meeting of the American Public Health Association being held in Atlanta, Georgia this week.

Read abstract here.

Email from National Families In Action http://www.nationalfamilies.org November 2017

Abstract:

Purpose: This study aims to assess potential health care costs and adverse health effects related to cannabis use in an acute care community hospital in Colorado, comparing study findings to those medical diagnoses noted in the literature. Little information is available about specific hospital health care costs, thus this study will add to the knowledge gap and describe charges and collections from visits of these patients in one hospital’s Emergency Department (ED).

Objective: Review diagnoses of cannabis users visiting a local ED and outline the potential financial and health effects of these patients on the health care system.

Design: An Institutional Review Board (IRB) approved retrospective observational study of patients seen in the ED from 2009 to 2014 with cannabis diagnoses and positive urine drug analyses (UDA) matched with hospital billing records. Randomized patient records were reviewed to determine completeness of documentation and coding related to cannabis use.

Setting: An acute care hospital in one city in Colorado. The city has nearly 100 medical marijuana dispensaries, but has not legalized recreational cannabis use. The city decided to not allow recreational stores in city limits as they were allowed to make that determination as a result of Amendment 64, which allowed municipalities to determine if they wanted recreational marijuana in their town. As of this publication, more than 70% of Colorado’s municipalities have opted out of recreation marijuana sales.

Participants: Subjects seen through the ED who had both a diagnosis code listing cannabis and a positive UDA for cannabis. Exclusions were subjects with UDA for cannabis but also tested positive for other substances, subjects who had cannabis diagnosis but no UDA result or those who had no UDA but did have a cannabis diagnosis.

Conclusion: Subjects seen in the ED had similar diagnoses as those reviewed in the literature, confirming the serious side effects of marijuana use. During the study period, the study hospital incurred a true loss of twenty million dollars in uncollected charges after allowing for contractual obligations. While adverse health effects have been described in the literature, there is little data on the financial impact of marijuana use on the health care system. This study demonstrated an increasing number of patients who are seen in the ED also have used cannabis. These patients are not always able to pay their bills, resulting in a financial loss to the hospital. The authors encourage the collection of hospital financial data for analysis in the states where medicinal (MMJ) and/or recreational marijuana is legal

https://www.researchgate.net/publication/314140400_The_Hidden_Costs_of_Marijuana_Use_in_Colorado_One_Emergency_Department’s_Experience

Kenneth Finn, MD,

The problem of increased marijuana use has origin in its purported use for pain, but the medical literature is completely void of evidence for the treatment.

Pain is the most common diagnosis associated with marijuana being recommended for medical use. With more states moving towards accepting marijuana use for medical purposes, there is a call from the
medical and scientific community for more research and evidence that it actually works for common pain conditions.

Out of the top 20 medical diagnoses presenting to the primary care physician nationally, there are only three that are associated with a painful condition:
spinal disorders (i.e., lower back pain), arthropathies and related disorders (i.e., knee arthritis), and abdominal pain.

There were no other pain diagnoses in the top 20 diagnoses that present to the primary care physician for treatment, including cancer pain or neuropathic pain. What does the medical literature tell us about the
use of marijuana for pain? In 2011, The British Journal of Pharmacology released a paper looking at the use for cannabinoids for the treatment of chronic non-cancer pain.

They narrowed a broad literature review to only 18 trials with a total of 925 participants. Most of the trials studied neuropathic pain (72%), including HIV neuropathy and multiple sclerosis related neuropathy (three trials), with single studies looking at arthritis and chronic spinal pain.

There were four studies that looked at smoked cannabis and neuropathic pain only. Six studies evaluated synthetic cannabinoids (Dronabinol, Nabilione) for pain (offlabel use).
From these trials, the average number of patients was 49 with average duration of 22 days, some of which were one week long. Despite their conclusion that cannabinoids may help for chronic non-cancer pain, they noted study limitations of small sample size, modest effects, and the need for larger trials of longer duration to determine safety and efficacy.

In 2015, the Journal of the American Medical Association (JAMA) released an article on cannabinoids for medical use.4 Chronic pain was assessed in 28 studies, involving 63 reports and 2,454 participants. Thirteen studies evaluated nabiximols (not available in the United States), four smoked THC, six synthetic THC, three oromucosal spray, one oral THC, and one vaporized cannabis. The majority of studies looked at some form of neuropathic pain or cancer pain. Two studies were at low risk of bias, nine at unclear risk, and 17 at high risk. Studies generally suggested improvements in pain measures associated with cannabinoids but did not reach statistical significance in most individual studies.

Despite these difficulties, the authors concluded there was moderate-quality evidence to suggest that cannabinoids may be beneficial for the treatment of chronic neuropathic or cancer pain (smoked THC and nabiximols). Note these are less common pain conditions presentimg to the physician for treatment nationally. The authors noted an increased risk of short-term adverse effects with cannabinoid use, including some serious adverse effects. Common adverse effects included asthenia, balance problems, confusion, dizziness, disorientation, diarrhea, euphoria, drowsiness, dry mouth, fatigue, hallucination, nausea, somnolence, and vomiting.

In 2017, the National Academies of Science, Engineering, and Medicine released a paper on the health effects of cannabis and cannabinoids. It may be important to note that none of the authors had a background in Anesthesia or Pain Medicine. The authors felt the referenced JAMA article was the most comprehensive and that the medical condition most often associated with chronic pain in that article was neuropathy, and a majority of studies evaluated treatment with nabiximols, which are not available in the United States. The committee found that only a handful of studies evaluated the use of cannabis and that many of the cannabis products sold in state regulated markets bear little resemblance to the products available for research at the federal level in the United States. They also note that very little is known regarding efficacy, dose, routes of administration, or side effects of commonly used and commercially available products in the U.S. Despite this, they concluded that “cannabis is an effective treatment for chronic pain in adults.” The above noted papers demonstrate the limited data available to the public and medical community, and represent the only information available regarding treatment of pain with marijuana. Despite that, the public has embraced that marijuana can treat all pain conditions, and state governments have followed suit, without scientific evidence, and have allowed an industry to prosper on the thin ice of what is currently and scientifically available.

It is important to understand that pain covers a broad spectrum of disorders and pain of different origins does not necessarily respond the same to different medications. Additionally, dispensary cannabis is considered a generic substance without defined or accepted dosing guidelines, and will vary in purity as well as potency. It may also contain hundreds of other compounds, some of which may have physiologic activity. Cannabinoids are purified components of the plant which have been isolated in a laboratory and have more scientific foundation, but are currently not available for study or use in pain conditions in the U.S.

Since de facto legalization in Colorado in 2009, there has been a significant increase in public health and safety concerns, which include utilization of the health care system, an increase in adolescent substance use treatment for cannabis, and an increase in marijuana-related driving fatalities. The addiction rates are reportedly 9% in the adult and roughly 18% in the adolescent, which was based on the potency of marijuana from nearly 20 years ago. The potency has significantly increased in the past five years alone, so we are now in uncharted waters and unable to predict the long term effects or addiction rates of currently available, highly potent products, with variable delivery systems.

As the number of medical marijuana patients increased in Colorado, there appeared to be a parallel increase in the number of adolescents needing substance use treatment, most often for cannabis. Colorado is now contending with a huge opioid and heroin epidemic, and despite the widespread availability of Narcan, does not appear to have leveled off or curbed the number of opioid or heroin deaths in the state which continue to rise.

Although the concept of using marijuana to decrease opioid use is attractive, there is little data to suggest that may be the case. According to the Centers for Disease Control, the number of drug overdose deaths in Colorado has continued to increase, ahead of the national average. The above problems are now falling into the laps of other groups including law enforcement and mental health providers who are pushing back and straining their respective resources.

In summary, the problem of increased marijuana use has origin in its purported use for pain, but the medical literature is completely void of evidence for the treatment of common pain conditions with cannabinoids or cannabis. Current medical literature suggests benefit in less common pain conditions, with products not commercially available in the U.S., or with synthetic THC, not with dispensary cannabis. The variability of available products changes regularly and their use in medicine, particularly pain, is unproven. The end game is in the court of law enforcement, mental health providers, the medical community, and our educational systems, at unknown societal costs, which are only now becoming apparent.

Source: http://www.omagdigital.com/publication/?i=450168#{%22issue_id%22:450168,%22page%22:8} September/October 2017

U.S. marijuana growers’ and processors’ greatest fear has just been realized. One of the largest international producers and marketers of beer, wine, and spirits, Constellation Brands, has bought a 9.9 percent stake in a Canadian marijuana grower, Canopy Growth Corporation. The two companies plan to develop a line of marijuana-infused drinks to sell in Canada, expected to legalize the drug for recreational use in 2018

US marijuana growers and processors have long feared that mega corporations like those that make up the alcohol and tobacco industries would swoop in and put them out of business if pot is legalized nationwide. They just didn’t think it would happen in Canada first.
 
Business analysts say this is a smart move on the part of Constellation Brands, given now-Prime Minister Justin Trudeau’s campaign promise to legalize the drug if elected.
 
Whether parents, public health officials, scientists, and doctors agree is another matter. Marijuana beverages being marketed by an alcoholic beverages company with Constellation Brand’s clout is hardly likely to reduce auto traffic injuries and deaths.
 
Read story here and here.

Source: Email from National Families in Action http://nationalfamilies.org November 2017

MOUNT SHASTA, Siskiyou County (KPIX 5) — It’s happening in the shadow of Mount Shasta — hundreds of marijuana gardens pockmarking the landscape in neighborhoods that have little in the way of housing.

For law enforcement officials in Siskiyou County, it’s a state of emergency.

“This is a monumental effort but, then again, we’ve got a monumental problem,” says Sheriff Jon E. Lopey.

What’s unfolding in this county is a race between growers and the law to see who can get to the countless grow gardens first.

“We’re in harvest season. We’re really putting a lot of resources into it and a lot of personnel, trying to take out as much as we can before it gets harvested and goes off back east or wherever it’s going,” said Siskiyou County Sheriff’s Deputy Mike Gilley.

You can see the enormous extent of the grow gardens from space. Fire up Google Earth and you can count grow after grow dotting the high desert landscape like an outbreak of measles.

“I have a one-mile-square photograph and you can pick out 80 gardens in that one square mile,” said Sgt. Gilley.

All of this is happening in a county that is decidedly not part of the “Emerald Triangle.” In fact, elected officials and voters have passed laws aimed at keeping marijuana out of Siskiyou County.

“Our county does not allow outdoor cultivation of cannabis,” asserts Sheriff Lopey.

Siskiyou County has some of the cheapest — as well as most scenic — land you can find in California. You can purchase nearly three acres for about $16,000. That brings in people who see an opportunity. The sheriff thinks those people represent a nationwide problem.

“I think … that this is an organized-crime effort. (They) basically take over large geographic areas to grow illegal marijuana. That’s basically what it amounts to,” Lopey said.

Source: https://sanfrancisco.cbslocal.com/2017/10/27/marijuana-illegal-grow-mount-shasta-siskiyou-county/(contains video report)  October 2017

MEDICINAL cannabis is no better than conventional drugs for treating children with severe epilepsy, according to a top Victorian doctor.

After months of treatment, none of the 29 Victorian children accessing $1 million worth of medicinal cannabis product, imported from Canada, has been seizure free.

FIRST COMMERCIAL CANNABIS CROP TO HELP VICTORIAN CHILDREN

UNIVERSITY OF MELBOURNE GETS $500K FROM TURNBULL GOVERNMENT FOR RESEARCH INTO MEDICINAL CANNABIS PLANTS

Paediatric neurologist Professor Ingrid Scheffer told the Sunday Herald Sun medicinal cannabis had been effective in some of the cases by reducing fits among some of the group.

However, the results had been similar to outcomes achieved on other pharmaceutical drugs and it was not the miracle solution families were hoping for

Families hear the news kids who need cannabis to help with chronic illness will gain access. Picture: Jason Edwards

“Initially we all had a sense of hope but that didn’t last but that is the nature of these diseases,” Prof Scheffer said.

For more http://www.heraldsun.com.au/news/victoria/medicinal-cannabis-not-miracle-epilepsy-drug-says-professor-treating-victorian-children/news-story/9107a6249aec2e59a7c0a49f6c8b0b71 October 2017

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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Randi Melissa Schuster, PhD; Jodi Gilman, PhD; David Schoenfeld, PhD; John Evenden, PhD; Maya Hareli, BA; Christine Ulysse, MS; Emily Nip, BA; Ailish Hanly, BA; Haiyue Zhang, MS; and A. Eden Evins, MD, MPH

J Clin Psychiatry 2018;79(6):17m11977

10.4088/JCP.17m11977

Objective: Associations between adolescent cannabis use and poor neurocognitive functioning have been reported from cross-sectional studies that cannot determine causality. Prospective designs can assess whether extended cannabis abstinence has a beneficial effect on cognition.

Methods: Eighty-eight adolescents and young adults (aged 16–25 years) who used cannabis regularly were recruited from the community and a local high school between July 2015 and December 2016. Participants were randomly assigned to 4 weeks of cannabis abstinence, verified by decreasing 11-nor-9-carboxy-∆9-tetrahydrocannabinol urine concentration (MJ-Abst; n = 62), or a monitoring control condition with no abstinence requirement (MJ-Mon; n = 26). Attention and memory were assessed at baseline and weekly for 4 weeks with the Cambridge Neuropsychological Test Automated Battery.

Results: Among MJ-Abst participants, 55 (88.7%) met a priori criteria for biochemically confirmed 30-day continuous abstinence. There was an effect of abstinence on verbal memory (P = .002) that was consistent across 4 weeks of abstinence, with no time-by-abstinence interaction, and was driven by improved verbal learning in the first week of abstinence. MJ-Abst participants had better memory overall and at weeks 1, 2, 3 than MJ-Mon participants, and only MJ-Abst participants improved in memory from baseline to week 1. There was no effect of abstinence on attention: both groups improved similarly, consistent with a practice effect.

Conclusions: This study suggests that cannabis abstinence is associated with improvements in verbal learning that appear to occur largely in the first week following last use. Future studies are needed to determine whether the improvement in cognition with abstinence is associated with improvement in academic and other functional outcomes.

Trial Registration: ClinicalTrials.gov identifier: NCT03276221

When people like the headline writer of this HealthDay news article talk about “medical marijuana,” they usually mean everything. The plant’s dried flowers which people smoke. Concentrates that can contain up to 90 percent THC, whose extraordinarily high levels are almost certainly what is sending toddlers and children who accidentally consume them and adults who consume them on purpose to emergency rooms with many needing to be hospitalized. “Edibles” – cookies, candies, and soft drinks infused with marijuana that are now in the food chain. And hundreds more, all sold as “medicines.”

 
The HealthDay author does a good job of covering a new study in Pediatrics, the journal of the American Association of Pediatrics. But notice the study’s title: “Medical Cannabinoids – not Medical Marijuana – in Children and Adolescents: A Systematic Review.”
 
What’s the difference?  
 
The marijuana plant contains about 500 different chemicals. Most have not been studied. Some 100 of those are called cannabinoids, so-called because they are unique to the cannabis plant. Most of these have not been studied either, but that is changing. Some cannabinoids show scientific promise and may become medicines. Two already are.
 
By medicines, we mean they have gone through rigorous preclinical (test tubes and animals) and clinical (humans) research. They have proven to FDA that they are both safe and effective, can be manufactured with a consistent dose, and most importantly are pure. They contain no contaminants unlike most of the products in legal states. A further FDA safeguard is that sometimes approved medicines cause dangerous side effects in the larger population after approval. FDA has a notification system that requires doctors to report any that occur so the medicine can be pulled from the market, if necessary.
 
The most studied cannabinoids are delta-9 THC and cannabidiol (CBD). The former makes people high. The latter doesn’t. The two medicines that FDA has approved are nabilone (trade name Cesamet®) and dronabinol (trade names Marinol® and Syndros®). Cesamet® and Marinol® are pills. Syndros® is an oral liquid. They are used to reduce chemotherapy-related nausea and AIDS wasting in patients who do not respond to standard medications.
 
Two more cannabinoids, nabiximols (trade name Sativex®, approved in other countries but not yet in the US yet) and CBD (trade name Epidiolex® which has completed clinical trials and is applying for FDA approval) are in the pipeline.
 
About half our medicines originated in plants. But when drug makers create a new medicine from them, they use pure chemicals to make a molecule-for-molecule carbon copy of the plant’s component. Nabilone and dronabinol are made that way. Patients know when they take these medicines that they will not contain any contaminants and FDA has approved them.
 
Not so the “medical” marijuana products being produced and sold in states that have legalized the drug for medical use. In fact, the American Epilepsy Society calls such CBD products “artisanal CBD” to differentiate them all from Epidiolex®, which may be available as early as next year to treat children and adolescents suffering intractable seizures.
 
Not one of the marijuana products states allow to be sold as medicines has been approved by FDA.
 
This new study searched several databases for scientific articles about pharmaceutical-grade cannabinoids that are being studied to treat a variety of illnesses in children and adolescents. They found 2,743 citations that might meet their search criteria and reviewed the full texts of 103. From these, they found 21 articles about 22 studies with a total sample of 795 participants: 

  • Five were randomized controlled trials, the gold standard of knowledge development.
  • Five were retrospective chart reviews.
  • Five were case reports.
  • Four were open-label trials.
  • Two were parent surveys.
  • One was a case series. 

The medicines used in these studies were nabilone, dronabinol, Epidiolex®, a formulation of delta-8 THC, and other pharmaceutical-grade preparations, not Charlotte’s Web, Haleigh’s Hope, Cannatol, or any of the hundreds of other artisanal CBD products states allow to be shipped – and Amazon sells – to all 50 states in violation of federal law.
 
The researchers found that in children and adolescents:

  • “Evidence for benefit was strongest for chemotherapy-induced nausea and vomiting (four RCTs), with increasing evidence of benefit for epilepsy [1 RTC using Epidiolex® rather than artisanal products]. At this time, there is insufficient evidence to support use for spasticity, neuropathic pain, posttraumatic stress disorder, and Tourette syndrome.
  • “The methodological quality of studies varied, with the majority of studies lacking control groups, limited by small sample size, and not designed to test for the statistical significance of outcome measures. Studies were heterogeneous [varied] in the cannabinoid composition and dosage and lacked long-term follow-up to identify potential adverse effects.
  • “Additional research is needed to evaluate the potential role of medical cannabinoids in children and adolescents, especially given increasing accessibility from state legalization and potential psychiatric and neurocognitive adverse effects identified from studies of recreational cannabis use.” 

Read HealthDay account of this study here.
Read American Association of Pediatrics study abstract here.
Read what Colorado Children’s Hospital tells families who want artisanal CBD for their children here.

Source: Email from National Families In Action http://www.nationalfamilies.org October 2017

Strongest evidence supports use to reduce seizures, side effects of chemotherapy

A systematic review of published studies on the use of medical cannabis in children and adolescents finds a notable lack of studies and a minimal number of the randomized, controlled trials needed to confirm the effectiveness of a treatment. In their paper published in the journal Pediatrics, Massachusetts General Hospital (MGH) investigators Shane Shucheng Wong, MD, and Timothy Wilens, MD — both of the MGH Department of Psychiatry — report that their review suggests only two pediatric uses of medical cannabis — to relieve chemotherapy-induced nausea and vomiting and to reduce seizures — are supported by existing studies.

“Medical cannabis is now legal in 29 states and the District of Columbia, and in those areas with active programs, children and adolescents can legally access medical cannabis with certification from their doctor and consent from a parent or guardian,” says lead author Wong. “This means that doctors and families need to understand what we know and what we don’t yet know about medical cannabis in order to make the best decision for the health of the individual child.”

Two synthetic cannabinoids — compounds that act on specific receptors in the brain — have been approved for medical use in the U.S., both of which mimic a form of THC (tetrahydrocannabinol), the compound responsible for the “high” of recreational cannabis use. Dronabinol (Marinol) is approved to treat chemotherapy-induced nausea and vomiting in both children and adults, while the pediatric use of nabilone (Cesamet) carries a caution. A third cannabinoid, cannabidiol, is currently in phase 3 trials for treatment of seizures.

The researchers followed established procedures in searching for studies of medical cannabis use listed in major research indexes and selected out those that primarily enrolled participants aged 18 and under and included original data about a clinical use. Only 21 papers reporting on a total of 22 studies met their criteria. The papers were published from 1979 to 2017, 14 within the last five years. Only 5 were randomized controlled trials, the others being case reports, open-label trials, parent surveys or case series. The most common conditions studied were chemotherapy-induced nausea and vomiting (6 studies) and seizures (11 studies).

The trials for chemotherapy side effects — 4 of which were randomized controlled trials — found that medical cannabis was significantly better than anti-nausea drugs standard at the time of study for reducing nausea and vomiting. Similarly the epilepsy studies, including a single randomized trial, found that medical cannabis reduced the frequency of seizures in participants, some with treatment-resistant seizures. Limitations of these studies include lack of a control group for many, small sample size, differences in the medications used and lack of long-term follow-up.

Two studies investigating the use of cannabis for spasticity and three case report on use for neuropathic pain, post-traumatic stress disorder or Tourette syndrome all lacked controls or blinding, conferring a high risk of biased findings. “At this time,” Wong says, “we do not have good evidence that cannabis can be useful in children and adolescents for any conditions other than seizures or chemotherapy-induced nausea and vomiting.”

He and Wilens also note that decisions regarding medical cannabis use need to weigh the likely benefits against the known risks, which — based on the results of studies in recreational cannabis users — are probably even greater for children and adolescents. Their still-developing brains may make them even more vulnerable than adults to cannabis’s negative effects on learning, memory, attention and problem solving. Additional research is needed to better understand the risks and long-term effects of cannabis-based drugs in this population.

When asked how he would advise the parents of a child with a condition that could be alleviated with medical cannabis, Wong states, “I would recommend they have a thorough discussion of the risks and benefits with a physician who has specialized knowledge and experience in the area. For chemotherapy side effects, that could be a pediatric oncologist or palliative care specialist; for seizures, that could be a pediatric neurologist, especially at an academic medical center involved in the ongoing clinical trials of medical cannabis for seizure disorders.”

Source: https://www.sciencedaily.com/releases/2017/10/171023094606.htm October 2017

Trevor Hughes

CALISTOGA, Calif. — Marijuana farmers and dispensary owners across Northern California are nervously watching as wildfires burn through some of the state’s prime cannabis growing areas and destroy valuable crops, which could drive up prices for consumers across the country.

“This is right smack in the middle of people’s harvests,” said Eli Melrod, the CEO of Solful Dispensary in Sebastopol, in northern California. “It couldn’t have been worse timing, frankly.”

A single marijuana plant can be worth up to $5,000, but pot growers can’t get crop insurance like traditional farmers or the vintners whose grapevines tend to get most of the attention here.

Wildfires are burning across parts of Napa, Sonoma and Mendocino counties, which are known for both wine and marijuana, particularly among high-end consumers willing to pay a premium for the name.

Complicating matters: Marijuana farms are built in remote areas with poor road access and don’t necessarily appear on firefighters’ maps of buildings to be protected. The growers often live largely off the radar, without health insurance or access to traditional job support systems such as unemployment insurance. Black market growers may be reluctant to tell friends and family members of the losses they’ve suffered.

“It’s just sad that we live in this underground world where we can’t discuss the true extent of the damage,” said Jessica Lilga of Alta Supply, a statewide wholesale cannabis distribution based in Oakland. “All remaining growers who did not literally lose their crops will be affected.”

A helicopter drops water on a wildfire in Sonoma County outside of Geyserville, Calif., on Oct. 11, 2017.
Paul Kitagaki Jr., The Sacramento Bee, via AP
It’s unclear exactly how many people work in the cannabis industry in northern California and how many cultivation operations exist. Lilga said she’s aware of “thousands” of grow operations but was reluctant to speculate, given the industry’s secretive nature.

But any interruption could have widespread implications for American marijuana consumers, legal or otherwise.

Millions of Californians consume medical marijuana, but even more pot is illegally shipped across state lines for black markets around the U.S. California’s legal cannabis market is worth an estimated $2.76 billion, according to marijuana analytics firm New Frontier Data, while the state’s black market is worth $13.5 billion, according to GreenWave Advisors.

GreenWave estimates that nearly $11 billion worth of the state’s black-market cannabis is grown in Northern California, with a “significant” amount of that shipped to neighboring states. In comparison, the California wine industry is worth an estimated $114 billion nationally, although the two industries are hard to compare side-by-side because one is illegal.

Lilga, who lives in Santa Rosa, was evacuated herself when the wildfire ran over her neighborhood. She’s not sure she has a home to return to: “That cash that all these growers should be bringing in next month would help rebuild our burning cities if it were not all taken away.”

Lilga predicted that an otherwise good crop year means the state’s overall supply should be enough to meet demand without significantly impacting price. Still, many cannabis dispensaries and distributors are setting up GoFundMe accounts to help growers who have lost their crops.

Farmer Kim Tate of One Feather Ranch in Mendocino’s Redwood Valley said wildfires forced her to evacuate with her horses, leaving behind her entire year’s crop that was expected to yield about 350 pounds of cannabis. About two-thirds of the crop had been harvested and stored before the fire broke out, she said, but the rest remained in the fields and growing rooms.

As with wine, marijuana contaminated by wildfire smoke may leave behind an unpleasant taste for consumers, Melrod said. Tate said she hoped to use ozone to flush her organically raised plants of any toxins. Every bit will matter: A pound of high-quality marijuana is worth about $1,200 on the wholesale market.

“We’re going to see have to see how smoky it is,” she said as she tried to return to the ranch Thursday.

Source: https://eu.usatoday.com/story/news/nation/2017/10/12/californias-marijuana-farmers-fear-crops-could-go-up-smoke/758721001/ October 2017

By Peter Fimrite

The legalization of cannabis in California has done almost nothing to halt illegal marijuana growing by Mexican drug cartels, which are laying bare large swaths of national forest in California, poisoning wildlife, and siphoning precious water out of creeks and rivers, U.S. Attorney McGregor Scott said Tuesday.

The situation is so dire that federal, state and local law enforcement officials are using $2.5 million from the Trump administration this year to crack down on illegal growers, who Scott said have been brazenly setting booby traps, confronting hikers and attacking federal drug-sniffing dogs with knives.

Instead of fading away after legal marijuana retail sales went into effect this year, the problem has gotten worse, according to Scott, who was joined in a news conference Tuesday in Sacramento by California Attorney General Xavier Becerra and other federal forestry and law enforcement officials.

Most alarming, Scott said, is the increasing use of carbofuran, a federally restricted insecticide so powerful that a teaspoon of it can kill a 600-pound African lion. The insecticide is banned in California.

The problem of illegal growing operations and contaminated lands “is biblical in proportion,” he said. “The chemicals have gone to a different level.”

The cartels, mainly from Mexico, use 760 tons of fertilizer on 400 grows every year hidden on the 20 million acres of national forest land in California, officials said.

The growers clear-cut trees, remove native vegetation, cause erosion, shoot deer and other animals, and litter the landscape with garbage and human waste. They also divert hundreds of millions of gallons of water from streams and creeks, and the runoff is generally contaminated with pesticides, which are also found in the plants, soil and wildlife in the area.

This year, 70 percent of the endangered spotted owls tested near sites that had been used for illegal marijuana cultivation were found to have one rodenticide or more in their systems, officials said. One owl died, leaving a clutch of eggs. Last year, 43 poisoned animals were found, including deer, bears, foxes, coyotes, rabbits and rare Pacific fishers. Another 47 animals had been shot, most likely by illegal growers, authorities said.

Since 2012, 17 Pacific fishers have been killed by pesticides at grow sites, said Mourad Gabriel, the director of the Integral Ecology Research Center, a wildlife and environmental research nonprofit. He said carbofuran was found in 78 percent of the plantations eradicated in 2017. That’s compared with 40 percent in 2015 and only 10 to 12 percent in 2012, when he conducted the first scientific study of illegal marijuana grow sites.

“It’s concerning, because now when we go into these sites we find contamination in the native vegetation, the soil, the water; and it’s increasing,” said Gabriel, whose research is funded by state and federal grants. “Those sites are still contaminated two or three years later.”

In all, 1.4 million illegally grown marijuana plants were destroyed in raids in national forests in California in 2017.

Bill Ruzzamenti, the former director of the Campaign Against Marijuana Planting, said California supplies 60 to 80 percent of all the marijuana consumed in the nation. In 2016, he said, 11 million pounds left the state, which is illegal under Proposition 64, the initiative that legalized the drug for recreational use in the state.

The people guarding the grow sites are inevitably armed and “a public safety risk to all of us,” said Becerra.

Margaret Mims, the sheriff of Fresno County, said hikers, backpackers and nature lovers have reported running across fishhooks hanging at eye level and trip wires possibly attached to shotguns.

“I have grandkids and I like to go fishing, but there are places we will not go because I am afraid for my grandkids,” said Ruzzamenti, who is now director of the federal High Intensity Drug Trafficking Areas program. “That should be unacceptable to everybody.”

The problem isn’t new. Bootleg cannabis has been circulating around Mendocino, Humboldt and Trinity counties — the famed Emerald Triangle — for decades, and backwoods growing is ingrained in the culture.

Ruzzamenti said he has been trying to eradicate black-market growing on public lands since 1983. And Mexican cartels aren’t the only problem. Only a few hundred of the estimated 12,500 retail operators in the state last year have become licensed so far, according to industry officials.

In Mendocino County alone, as many as 75 percent of residents in some remote areas are marijuana growers, and only about 10 percent of the crop is being grown legally.

The issue has taken on a new level of importance as the multibillion-dollar California cannabis industry begins to ramp up. Legal growers and retailers want desperately to protect the regulated, taxed marijuana market in California.

The hope is that taxes collected by the government can fund law enforcement efforts, which will, in turn, deter illegal operations and generate additional taxes. Wholesale prices for marijuana are also expected to drop with the mainstreaming of the industry, providing less incentive for bad actors.

But so far that hasn’t worked. In all, California collected $60.9 million in excise, cultivation and sales taxes related to legal marijuana for the first three months of 2018. Gov. Jerry Brown’s January budget proposal predicted that $175 million would pour in over the first six months from the new taxes. That would have translated to $87.5 million in January, February and March.

In his updated budget plan released earlier this month, Brown proposed spending $14 million to create four investigative teams and one interdiction team to combat illegal activities, tax evasion and crime. The money would come from tax revenue and licensing fees over two years.

Even though marijuana is still illegal on the federal level, Scott said the U.S. Attorney’s office plans to focus only on illegal growers on public lands.

Becerra said that without the help of the federal government, California wouldn’t be able to handle the problem.

“You gotta make it so crime doesn’t pay,” he said.

Source: https://www.sfchronicle.com/green/article/Illegal-pot-grows-spread-deadly-pesticides-other-12952302.php May 2018

Moe Ainsley, a grower with Kaya Collection, tends to marijuana plants at the company’s Wacky Tabacky facility near Gold Bar. (Matt M. McKnight/Crosscut)

Washington’s pot is a bit more potent than the national average. And the state’s teens are more likely to smoke marijuana than young people nationwide.

Although we have the same problems with marijuana as we do with liquor abuse, no blockbuster conclusions came from a recent report on Washington’s marijuana universe.

But a couple of somewhat unexpected environmental wrinkles from Washington’s marijuana industry — both legal and illegal — also emerge in the second annual look at the state’s experience since passage of a 2012 initiative allowing recreational pot sales.

Marijuana growers and processors use 1.63 percent of the state’s electricity, which is a lot, according to the report by the Northwest High Intensity Drug Trafficking Area — a combined effort by several federal, state and local government agencies. By way of comparison, all forms of lighting — in homes, commercial buildings and manufacturing — account for just 7 to 11 percent of electrical consumption nationally. Or, as the report puts it, the power is enough for 2 million homes.

The high power consumption stems from the heat lamps and the accompanying air conditioning for indoor marijuana growing operations. “They are exceedingly energy-consumptive,” said Steven Freng, manager for prevention and treatment for the High Intensity Drug Trafficking Area.

The carbon footprint, according to the report, equals that of about 3 million cars.

And illegal pot growers siphoned off 43.2 million gallons of water from streams and aquifers during the 2016 growing season — water that tribes, farmers and cities would otherwise use as carefully as possible, in part to protect salmon.

Sixty percent of Washington’s illegal pot was grown on state-owned land in 2016. That’s because black-market growers tend to worry about gun-toting owners on private lands, according to Freng and Luci McKean, the organization’s deputy director. The black-market operations use the water during a roughly 120-day growing season.

Marijuana purchases have boomed in Washington. Legal marijuana sales were almost $1 billion in fiscal year 2016 and were on track to be about $1.5 billion in fiscal 2017, which ended June 30. As of February, the state had 1,121 licensed producers, 1,106 licensed processors and 470 licensed retailers.

What Washington’s marijuana users are getting is above average in potency. According to the report, nationwide marijuana products average a THC percentage of 13.2 percent, while Washington state’s THC average percentage was 21.6 percent.

Teen use of marijuana has grown slightly. Depending on how the numbers are crunched, marijuana use among Washington’s young adults and teens ranges from 2 to 5 percent above the national average. Five percent of Washingtonians age 18-to-25 use pot daily, slightly above the national average, the report said.

According to a survey cited in the report, 17 percent of high school seniors and 9 percent of high school sophomores have driven within three hours after smoking pot.

Adult use before driving is still a fuzzy picture. A third of Washingtonians arrested for driving under the influence had THC, the active ingredient in marijuana, in their bloodstreams. One study found an increase in dead drivers with THC above the legal limit in their blood from 7.8 percent in 2013 to 12.8 percent in 2014.

“Adults still don’t understand the effects of impairment behind the wheel of a car,” Freng said.

McKean said that one major unknown is marijuana-laced edibles, which authorities believe have become a significant factor in THC-impaired drivers, but has not been studied enough to provide solid numbers.

Another major unknown, McKean and Freng said, is how marijuana consumption contributes to emergency room and hospital cases because the state hospitals have not agreed to release that data to government officials.

This story has been updated since it first appeared to add a link to the report.

  Source: https://crosscut.com/2017/10/washingtons-pot-industry-not-environmentally-friendly-marijuana October 2017

Christina Brezing, MD, Frances Levin, MD

It is vital that physicians—particularly psychiatrists who are on the frontlines with patients who struggle with cannabis use—are able to identify and characterize cannabis use disorders; provide education; and offer effective, evidence-based treatments. This article provides a brief overview of each of these topics by walking through clinical decision-making with a case vignette that touches on common experiences in treating a patient with cannabis use disorder.

A separate and important issue is screening for emerging drugs of abuse, including synthetic “marijuana” products such as K2 and spice. Although these products are chemically distinct from the psychoactive compounds in the traditional cannabis plant, some cannabis users have tried synthetic “marijuana” products because of their gross physical similarity to cannabis plant matter.

CASE VIGNETTE

Mr. M is a 43-year-old legal clerk who has been working in the same office for 20 years. He presents as a referral from his primary care physician to your outpatient psychiatry office for an initial evaluation regarding “managing some mid-life issues.” He states that while he likes his job, it is the only job he has had since graduating college and he finds the work boring, noting that most of his co-workers have gone on to law school or more senior positions in the firm. When asked what factors have prevented him from seeking different career opportunities, he states that he would “fail a drug test.” Upon further inquiry, Mr. M says he has been smoking 2 or 3 “joints” or taking a few hits off of his “vaping pen” of cannabis daily for many years, for which he spends approximately $70 to $100 a week.

He first used cannabis in college and initially only smoked “a couple hits” in social settings. Over time, he has needed more cannabis to “take the edge off” and has strong cravings to use daily. He reports liking how cannabis decreases his anxiety and helps him fall asleep, although he thinks the cannabis sometimes makes him “paranoid,” which results in his avoidance of family and friends.

More recently, he identifies conflict and regular arguments with his wife over his cannabis use—she feels it prevents him from being present with his family and is a financial burden. He admits missing an important awards ceremony for her work and sporting events for his children, for which he had to “come up with excuses,” but the truth is that he ended up smoking more than he had intended and lost track of the time.

Mr. M reports multiple previous unsuccessful attempts to reduce his use and 2 days when he stopped completely, which resulted in “terrible dreams,” poor sleep, sweating, no appetite, anxiety, irritability, and strong cravings for cannabis. Resumption of his cannabis use relieved these symptoms. He denies tobacco or other drug use, including use of synthetic marijuana products such as K2 or spice, and reports having a glass of wine or champagne once or twice a year for special occasions.

The diagnosis

In the transition from DSM IV-TR to DSM-5, cannabis use disorders, along with all substance use disorders, have been redefined in line with characterizing a spectrum of pathology and impairment. The criteria to qualify for a cannabis use disorder remain the same except for the following:

1. The criterion for recurrent legal problems has been removed.

2. A new criterion for craving or a strong desire or urge to use cannabis has been added, and the terms abuse and dependence were eliminated.

To qualify as having a cannabis use disorder, a threshold of 2 criteria must be met. Severity of the disorder is characterized as “mild” if 2 or 3 criteria are met, “moderate” if 4 or 5 criteria are met, and “severe” if 6 or more criteria are met. Mr. M demonstrates 3 symptoms of impaired control: using longer than intended, unsuccessful efforts to cut back, and craving; 3 symptoms of social impairment: failure to fulfill home obligations, persistent problems with his wife, and reduced pursuit of occupational opportunities; 1 symptom of risky use: continued use despite paranoia; and 2 symptoms of pharmacological properties: tolerance and withdrawal. As such, he meets 9 criteria, which qualify him for a diagnosis of severe cannabis use disorder.

You summarize Mr. M’s 9 symptoms and counsel him about severe cannabis use disorder. He becomes upset and states that he was not aware one could develop an “addiction” to cannabis. He expresses an interest in treatment and asks what options are available.

Treatment options

Psychotherapeutic treatments, including motivational enhancement treatment (MET), cognitive behavioral therapy (CBT), and contingency management (CM), have demonstrated effectiveness in reducing frequency and quantity of cannabis use, but abstinence rates remain modest and decline after treatment. Generally, MET is effective at engaging individuals who are ambivalent about treatment; CM can lead to longer periods of abstinence during treatment by incentivizing abstinence; and CBT can work to enhance abstinence following treatment (preventing relapse). Longer duration of psychotherapy is associated with better outcomes. However, access to evidence-based psychotherapy is frequently limited, and poor adherence to evidence-based psychotherapy is common.

In conjunction with psychotherapy, medication strategies should be considered. Because there are no FDA-approved pharmacological agents for cannabis use disorder, patients should understand during the informed consent process that all pharmacotherapies used to treat this disorder are off-label. A number of clinical trials provide evidence for the off-label use of medications in the treatment of cannabis use disorder. The current strategies for the off-label treatment of cannabis use disorder target withdrawal symptoms, aim to initiate abstinence and prevent relapse or reduce use depending on the patient’s goals, and treat psychiatric comorbidity and symptoms that may be driving cannabis use. Here we focus on the evidence supporting these key strategies.

Targeting withdrawal and craving

Cannabis withdrawal is defined by DSM-5 as having 3 or more of the following signs and symptoms that develop after the cessation of prolonged cannabis use:

• Irritability, anger, or aggression

• Nervousness or anxiety

• Sleep difficulty

• Decreased appetite or weight loss

• Restlessness

• Depressed mood

• At least one of the following physical symptoms that causes discomfort: abdominal pain, shakiness/tremors, sweating, fever, chills, or headache

Withdrawal symptoms may be present within the first 24 hours. Overall, they peak within the first week and persist up to 1 month following the last use of cannabis. In the case of Mr. M, insomnia, poor appetite, and irritability as well as sweating are identified, which meet DSM-5 criteria for cannabis withdrawal during the 2 days he abstained from use. He also identifies strong craving and vivid dreams, which are additional withdrawal symptoms included on marijuana withdrawal checklists in research studies, although not included in DSM-5 criteria. These and other symptoms should be considered in clinical treatment.

Medication treatment studies for cannabis withdrawal have hypothesized that if withdrawal symptoms can be reduced or alleviated during cessation from regular cannabis use, people will be less likely to resume cannabis use and will have better treatment outcomes. Studies have shown that dronabinol and nabilone improved multiple withdrawal symptoms, including craving; and quetiapine, zolpidem, and mirtazapine help with withdrawal-induced sleep disturbances.

Combining dronabinol and lofexidine (an alpha-2 agonist) was superior to placebo in reducing craving, withdrawal, and self-administration during abstinence in a laboratory model. However, in a subsequent treatment trial, the combined medication treatment was not superior to placebo in reducing cannabis use or promoting abstinence.

Six double-blind placebo-controlled pharmacotherapy trials in adults with cannabis use disorder have looked at withdrawal as an outcome. Of these studies, only dronabinol, bupropion, and gabapentin reduced withdrawal symptoms. In addition to reducing withdrawal symptoms, nabiximols/Sativex (a combination tetrahydrocannabinol [THC] and cannabidiol nasal spray not available in the US) increased retention (while actively on the medication in an inpatient setting) but did not reduce outpatient cannabis use at follow-up.

All of the medications available for prescription in the US can be monitored reliably with urine drug screening to assess for illicit cannabis use except dronabinol, which will result in a positive screen for cannabis. When using urine drug screening, remember that for heavy cannabis users the qualitative urine drug screen can be positive for cannabis up to a month following cessation. When selecting a medication, take into account the cost of the medication, particularly since insurance will likely not cover THC agonists such as dronabinol for this indication, and possible misuse or diversion of scheduled substances (eg, dronabinol, nabilone). In addition, monitoring for reductions in substance use and withdrawal symptoms is key.

Abstinence initiation and relapse prevention

Other clinical trials have looked at medications to promote abstinence by reducing stress-induced relapse, craving (not as a component of withdrawal), and the reinforcing aspects of cannabis. Of these trials, the following results show potential promise with positive findings: gabapentin reduced quantitative THC urine levels and improved cognitive functioning (in addition to decreasing withdrawal), and buspirone led to more negative urine drug screens for cannabis (although the difference was not significant compared with placebo). However, in a follow-up larger study, no differences were seen compared with placebo and women had worse cannabis use outcomes on buspirone.

N-acetylcysteine resulted in twice the odds of a negative urine drug screen in young adults and adolescents (although there was no difference between adolescent groups in self-report of cannabis use).Gray and colleagues reported that no differences were seen between N-acetylcysteine and placebo (results of the trial are soon to be published). Topiramate resulted in significantly decreased grams of cannabis used but no difference in percent days used or proportion of positive urine drug screens.16 In a recent small clinical trial, reductions in cannabis use were seen with oxytocin in combination with MET.17Studies with nabilone and long-term naltrexone administration reduced relapse and cannabis self-administration and subjective effects, respectively, which suggests promising avenues yet to be explored by clinical trials.

Treatment of psychiatric comorbidity

Other studies have looked at the effects of treating common comorbid psychiatric disorders in adults with cannabis use disorder, postulating that if the psychiatric disorder is treated, the individual may be more likely to abstain or reduce his or her cannabis use. For example, if a person is less depressed, he may better engage in CBT for relapse prevention.

Fluoxetine for depression and cannabis use disorder in adolescents decreased cannabis use and depression, although there was no difference compared with placebo. A trial of venlafaxine for adults with depression and cannabis use disorder demonstrated less abstinence with greater withdrawal-like symptoms compared with placebo. These findings suggest that this antidepressant might not be beneficial for treatment-seeking individuals with cannabis use disorder and may actually negatively affect outcomes.

 

CASE VIGNETTE CONT’D

After discussing and presenting the different psychotherapy and medication treatment options to Mr. M, you and he decide to start CBT to help with abstinence initiation. In addition, you prescribe 20 mg of dronabinol up to 2 times daily in combination with 50 mg of naltrexone daily, to help globally target Mr. M’s withdrawal symptoms and prevent relapse once abstinence is achieved. However, a few days later, Mr. M calls to say that his insurance will not cover the prescription for dronabinol and he cannot afford the high cost. Given his main concerns of cannabis withdrawal symptoms, you select gabapentin up to 400 mg 3 times daily and continue weekly individual CBT.

Mr. M calls back several days later and reports that he has made some improvements in reducing the frequency of his cannabis use, which he attributes to the medication, but he thinks he needs additional assistance. After reviewing the treatment options again, he gives informed consent to start 1200 mg of N-acetylcysteine twice daily. After 10 weeks of this medication, his urine screens are negative.

You continue to provide relapse prevention CBT. He reports to you that his anxiety and insomnia are almost resolved, and you suspect that withdrawal was the cause of these symptoms. He reports significant improvement in his relationship with his family and recently received a promotion at work for “going above and beyond” on a project he was given the lead.

Over the next 6 months, he has 2 relapses that in functional analysis with you are determined to be triggered by unsolicited contact from his former drug dealer. Together, you develop a plan to block any further contact from the drug dealer. After several months, both the gabapentin and N-acetylcysteine are tapered and discontinued. Mr. M continues to see you for biweekly therapy sessions with random drug screens every 4 to 6 weeks.

 

Conclusion

Based on the available evidence, gabapentin, THC agonists, naltrexone, and possibly N-acetylcysteine show the greatest promise in the off-label treatment of cannabis use disorders. System considerations, such as medication cost, need to be factored into the decision-making as well as combination medication and psychotherapy approaches, which—as demonstrated in the case of Mr. M—may ultimately work best. Until further research elucidates the standard of medication practices for cannabis use disorder, the best off-label medication strategy should target any co-occurring disorders as well as any identified problematic symptoms related to cannabis use and cessation of use. When available, referral for evidence-based psychotherapy should be made.

Source: https://www.psychiatrictimes.com/special-reports/treatment-cannabis-use-disorders-case-report/ August 2017

 

Häuser W1Fitzcharles MARadbruch LPetzke F.

Abstract

BACKGROUND:

There are conflicting interpretations of the evidence regarding the efficacy, tolerability, and safety of cannabinoids in pain management and palliative medicine.

METHODS:

We conducted a systematic review (SR) of systematic reviews of randomized controlled trials (RCT) and prospective long-term observational studies of the use of cannabinoids in pain management and palliative medicine. Pertinent publications from January 2009 to January 2017 were retrieved by a selective search in the Cochrane Database of Systematic Reviews, the Database of Abstracts of Reviews of Effects, and Medline. The methodological quality of the SRs was assessed with the AMSTAR instrument, and the clinical relevance of quantitative data syntheses was assessed according to the standards of the Cochrane Collaboration.

RESULTS:

Of the 750 publications identified, 11 SRs met the inclusion criteria; 3 of them were of high and 8 of moderate methodological quality. 2 prospective long-term observational studies with medical cannabis and 1 with tetrahydrocannabinol/cannabidiol spray (THC/CBD spray) were also analyzed. There is limited evidence for a benefit of THC/CBD spray in the treatment of neuropathic pain. There is inadequate evidence for any benefit of cannabinoids (dronabinol, nabilone, medical cannabis, or THC/CBD spray) to treat cancer pain, pain of rheumatic or gastrointestinal origin, or anorexia in cancer or AIDS. Treatment with cannabis-based medicines is associated with central nervous and psychiatric side effects.

CONCLUSION:

The public perception of the efficacy, tolerability, and safety of cannabis-based medicines in pain management and palliative medicine conflicts with the findings of systematic reviews and prospective observational studies conducted according to the standards of evidence-based medicine.

Source: https://www.ncbi.nlm.nih.gov/pubmed/29017688 September 2017

In a backpacking hostel during a stag weekend 10 years ago, I fell asleep on a top bunk next to an open window. Of course, that now strikes me as a stupid thing to have done, but at the time I didn’t give it a thought. I was on a weekend away, not a health-and-safety awareness course. At some point during the night, I tried getting out of the bunk, but instead of turning left and using the ladder, I turned right and hopped straight out of the window.

I fell 24ft on to concrete. From a survival point of view, I was lucky to land on my feet. The downside was that some rather important sections of my legs did not come out of it so well.

My left heel was crushed, while over on the right, my tibia and fibula – the two long bones in the lower leg – detached from their couplings and shattered. The next few weeks involved operations, plates, screws and quite unimaginable levels of agony. At one point, I felt a kind of blinding calm, as though the pain had gone all the way up the scale and rung a bell at the top.

While those pain levels have never returned, over the years there have been generous helpings of it; my legs didn’t take too kindly to being smashed up and bolted back together, and they seem to enjoy reminding me of this. After trying many different ways of managing the pain, eight months ago I started taking cannabidiol, or CBD for short – a non-psychoactive compound found in both hemp and cannabis plants.

The effect on the pain has been profound. It comes as an oil that I put under my tongue whenever pain moves from a dull niggle to the kind that is difficult to ignore.

CBD influences the release and uptake of neurotransmitters such as dopamine and serotonin, leading to many potential therapeutic uses. Crucially, it does not contain any THC, the psychoactive component of cannabis; in other words, CBD does not get you high. Since last year, it has been legal to buy in the UK, after the government’s Medicines and Healthcare Products Regulatory Agency (MHPR) approved its use as a medicine under licence.

CBD oil has since been prescribed to an 11-year-old British boy suffering from epilepsy, in what is believed to be the first instance of a cannabis-derivative being prescribed on the NHS.

Last month, a cancer patient diagnosed four years ago with an incurable brain tumour and given just six months to live, ascribed her incredible recovery to turning to cannabis oil as a last resort.

While research into the medical benefits of CBD oil is in its infancy, it is certainly encouraging. Recent reports suggest it could be a more useful anti-inflammatory than ibuprofen.

“There has been some early scientific evidence that CBD can help with inflammation,” says Dr Henry Fisher, of drug policy thinktank Volteface. “There is also a lot of anecdotal evidence that it helps people who do contact sports, because of the tendency to get inflamed joints. Taking other anti-inflammatories like ibuprofen on a long-term basis – as many sportspeople do – is not a good idea because of potential damage to your liver.”

It also has distinct advantages over opioid medicines, says Dr Fisher. “With CBD, there is no evidence of any long-term negative impact, and no likelihood of addiction. And, of course, there are no known cases of anybody overdosing on CBD.”

The comparison to prescription medicine is particularly pertinent for me. For several months after my accident, I took Oxycontin, a common opioid painkiller. It was very useful at that time because it gave me a warm fuzzy feeling, making everything seem okay. But after a while, I started waking up feeling groggy and crushed. So I decided to stop, and the withdrawal was horrendous. It was several days of indescribable misery, so bad that it made the pain from the injuries feel like a slightly over-zealous massage.

Q&A | CBD and cannabis oil

What is CBD oil?

Cannabidiol, or CBD, is one of more than 80 cannabinoids, natural compounds found in the marijuana plant. It is extracted from the plant via steam distillation and usually bottled with a dropper. Unlike THC, Tetrahydrocannabinol – the most abundant cannabinoid, CBD does not have an intoxicating effect.

What does it do?

Most studies of CBD’s effects are preclinical, but is been shown useful in treating social anxiety and lessening episodes of schizophrenia. The most complete research on the benefits of CBD is on treatment of childhood epilepsy and a plant-based medicine, Epidiolex is scheduled for FDA approval in the US.

Another cannabis-based drug, Sativex, is already approved to relive the pain of muscle spasms in people suffering from multiple sclerosis. Clinical trials are also underway to test this category of drugs for cancer pain, glaucoma and appetite loss in people with HIV or AIDS.

Is it legal?

A low-concentration CBD oil is available in UK pharmacies as a health supplement. Campaigners have called for a high-concentration oil to also be made legal here. In December 2016, the government’s Medicines and Healthcare Products Regulatory Agency ruled that “products containing CBD used for medical purposes are a medicine”.

Read more from the NHS on Cannabis: the facts

Getting off that heavy-duty medicine was key for my recovery. Because this kind of medication saps your energy, and the one thing you need to fight back to full fitness is energy. I spent months in a wheelchair, then on crutches, then finally I was able to start taking slow, painful steps on legs that had forgotten what their purpose was. I had always done a lot of sport, particularly martial arts – I got my black belt in kickboxing when I was 21 and spent some time working as an instructor. This training helped after the accident because I was in reasonably good shape – mashed bones notwithstanding – and I was used to pushing myself.

I never thought I would be able to fight again. So I just concentrated on simply being able to take care of myself. I also just got on with my life, somehow managing to acquire a lovely wife, daughter and son along the way. Then three years ago, I decided that the legs must have healed as much as they were ever going to, and I started doing martial arts again.

Rather than risk going back to kickboxing, I took up Brazilian jiu-jitsu, a grappling discipline where you subdue your opponent with chokes and joint-locks. If you watch beginners, it can look a bit like playground wrestling, but done properly it is graceful but deadly. I started off gently, but after a while I put the injuries behind me and trained as hard as ever. It was through the men I train with that I found out about CBD.

Everyone that uses it tells a similar story: they sleep better and feel less pain. While there are ongoing trials for CBD as a treatment for everything from multiple sclerosis to Parkinson’s disease, all I know is that for me it can make the difference being sitting on the sofa and being able to go training. I can now lift and carry my children without wincing.

CBD does not make the pain go away completely, but that is okay – a bit of pain is necessary, an alarm system to warn of imminent peril. But once the message has been received, it is nice to be able to turn the volume down a little bit.

Source: https://www.telegraph.co.uk/health-fitness/body/could-cannabis-extract-cbd-replace-ibuprofen-painkiller/ October 2017

Abstract

BACKGROUND:

Violence is a major concern and is prevalent across several mental disorders. The use of substances has been associated with an exacerbation of psychiatric symptoms as well as with violence. Compared to other substances such as alcohol and cocaine, existing literature on the cannabis-violence relationship has been more limited, with most studies being conducted in the general population, and has shown controversial results. Evidence has suggested a stronger relationship when examining the effects of the persistency of cannabis use on future violent behaviors. Though, while cannabis use is highly prevalent amid psychiatric patients, far less literature on the subject has been conducted in this population. Hence, the present prospective study aims to investigate the persistency of cannabis use in psychiatric patients.

METHOD:

The sample comprised of 1,136 recently discharged psychiatric patients provided by the MacArthur Risk Assessment Study. A multi-wave (five-assessment) follow-up design was employed to allow temporal sequencing between substance use and violent behaviors. Generalized estimating equations (GEE) were used to examine the effect of persistency of cannabis use on violence, while controlling for potential confounding factors. Potential bidirectional association was also investigated using the same statistical approach.

RESULTS:

Our results suggest a unidirectional association between cannabis use and violence. GEE model revealed that the continuity of cannabis use across more than one time wave was associated with increased risks of future violent behavior. Patients who reported having used cannabis at each follow-up periods were 2.44 times more likely to display violent behaviors (OR = 2.44, 95% CI: 1.06-5.63, p < 0.05).

Odds ratios for violent behaviors associated with substance use across each time points. x-Axis represent the number of follow-up periods with substance-use, y-axis represent the Odds Ratios; Reference is no use of substance across time points; Odds Ratios are controlled for the effects of time, other substances used at each time point, age, age at first hospitalization, sex, ethnicity, Schizophrenia-Spectrum disorders (presence/absence), affective disorders (presence/absence), psychopathic traits (PCL), impulsivity (BIS-11) (*p < 0.05; **p < 0.01; ***p < 0.001; N.S., Not statistically significant).

CONCLUSION:

These findings are particularly relevant as they suggest that the longer individuals report having used cannabis after a psychiatric discharge, the more likely they are of being violent in the following time waves. These results add to our understanding of the negative consequences of chronic cannabis use amid psychiatric patients.

Source: https://www.ncbi.nlm.nih.gov/pubmed/28983261 September 2017

Marijuana advocates can no longer claim legalization is devoid of catastrophic results.

The Denver Post, which has embraced legalization, analyzed federal and state data and found results so alarming they published a story last week under the headline “Traffic fatalities linked to marijuana are up sharply in Colorado. Is legalization to blame?”

Of course legalization is to blame. It ushered in a commercial industry that encourages consumption and produces an ever-increasing supply of pot substantially more potent than most users could find when the drug was illegal.

The post reported a 40 percent increase in the number of all drivers, impaired or otherwise, involved in fatal crashes in Colorado between 2013 and 2016. That’s why the Colorado State Patrol posts fatality numbers on electronic signs over the highways.

“Increasingly potent levels of marijuana were found in positive-testing drivers who died in crashes in Front Range counties, according to coroner data since 2013 compiled by The Denver Post. Nearly a dozen in 2016 had levels five times the amount allowed by law, and one was at 22 times the limit. Levels were not as elevated in earlier years,” The Post explained.

All drivers in marijuana-related crashes who survived last year tested at levels indicating use within a few hours of the tests.

“The trends coincide with the legalization of recreational marijuana in Colorado that began with adult use in late 2012, followed by sales in 2014,” the Post reported.

Greenwood Village Police Chief John Jackson called the trend “a huge public safety problem.”

Colorado Springs Councilwoman Jill Gaebler, who wants a ballot measure to legalize recreational pot in Colorado Springs, tried to downplay the Post’s findings in a comment on Gazette.com.

“…33% or 196 of all traffic deaths that occurred in 2016 were alcohol-related,” Gaebler wrote. “Yet you don’t hear anyone trying to ban alcohol, even though it is far more dangerous, in every regard, to marijuana.”

The Post found fatal crashes involving drivers under the influence of alcohol grew 17 percent from 2013 to 2015. Figures for 2016 were not available. Drivers testing positive for pot during that span grew by 145 percent, and “prevalence of testing drivers for marijuana use did not change appreciably, federal fatal-crash data show.”

The entire country has an enormous problem with alcohol-related traffic fatalities. Given our inability to resolve that problem, it is arguably idiotic to throw another intoxicating substance into the mix with the predictable result of more traffic deaths caused by impairment.

El Paso County Commissioner Longinos Gonzalez gets it, as shown by a comment he left on gazette.com

“Recent data indicates crime is up statewide, homelessness up, black and Hispanic teen arrests related to MJ are up a lot,” Gonzalez wrote. “A Denver TV station did a month long data poll last year at a hospital in Pueblo (which has fully embraced MJ) and found that nearly half of all newborns were testing positive for THC in their bloodstream at birth. Who would want to expand MJ sales in face of such data? And the big supporters of rec MJ can only fall back on their ‘go-to’ arguments, that ‘it isn’t as bad as alcohol’ or that the negative articles are biased or not credible.”

Another Gazette commenter expressed surprise at Gaebler’s “casual attitude” about the Denver Post’s findings.

“…We already have alcohol, let’s add MJ, and why stop there — people want and need their opioids. Let there be drinking, toking, shooting up in our beautiful city,” the commenter wrote.

One must stretch the imagination to deny that legalized pot has caused a substantial increase in Colorado highway deaths. Pot is an intoxicating, psychoactive drug. That means it cannot be harmless. Expect emerging and troubling data to make this fact increasingly clear.

Source: https://gazette.com/editorial-surprise-legal-pot-correlates-with-rising-traffic-deaths/article_2b2d9b27-4ab5-56fa-a042-028433ae1044.html August 2017

Cannabis labelled ‘Sativa’ and ‘Indica’ may not come from distinct ancestries, according to a study performed by the Canadian Dalhousie University in cooperation with Bedrocan on the genetic differences between the two types and their hybrids. In this study 149 Dutch cannabis samples were analysed, correlating the genotype and chemotype to their reported ancestries. Indica- and Sativa-labelled samples were not as distinct as sub species would be assumed to be, but the genetic differences between them do correlate to their terpene profile (resin fragrance), which could explain the variation between them. Results of this new study have been presented on the International Association for Cannabis as Medicine (IACM) congress in Cologne, Germany, September 2017.

There is perhaps no debate in the world of cannabis more contentious than that of species. The genus Cannabis sativa L. is the only official species, but the terms ‘Sativa’, ‘Indica’ and ‘Hybrid’ have been widely adopted by cannabis breeders and cultivators as a way of advertising their product’s effects, aromas or purported pedigree. The degree to which these labels correspond to their actual ancestry, however, is dubious, and how this informal classification scheme relates to genotype or phenotype has been largely unexplored.

In the study an analysis of 149 cannabis samples was performed, correlating the genotype and chemotype (based on terpene and cannabinoid content of the flowers) to their reported ‘ancestry’.  The researchers then compared the reported labels to new scales they generated by reclassifying the samples based on their genetic and chemical similarity.

The Indica/Sativa classification of Dutch cannabis does not correspond to distinct genetic lineages or to cannabinoid type, but there are genetic and chemical similarities that explain the variation between the groups. Deconvolution of the Indica-Sativa ancestry showed a strong relationship between the chemical and genetic profiles, suggesting that the distinct terpene contents of the types are heritable and important to the identity of these two groups. It is likely that strains are classified by their distinct aromas, and not their lineages, which has a direct impact on the genetics of this crop.

Bedrocan, worldwide producer of standardised medicinal cannabis, is already working on the terpene profiles that are associated with the current Bedrocan products. Hugo Maassen, head of the phyto engineering department at Bedrocan: “This study shows that the Indica/Sativa differences could be largely based on terpene content, which instead of the current Indica/Sativa labelling might require for more insight in the terpene profiles related to the Bedrocan products available for patient use.”

The terpene profiles of the Bedrocan products are expected to be announced in the near future.

Source: https://bedrocan.com/no-clear-evidence/ September 2017

LASSEN NATIONAL FOREST (KPIX 5) — It’s a massive crime scene, deep in Lassen National Forest.  Through dense ground cover and brutal terrain, federal agents are making their way to what might well qualify as an industrial-scale farm operation. There are living quarters, kitchens, bathrooms and trash dumps, all for the purpose of growing a lot of marijuana.

“This one was in excess of 15,000 plants,” said Stephen Frick, a special agent with the U.S. Forest Service.  A plant count that high requires multiple plots, across several miles, fed by an endless network of pipes, all drawing right from natural waterways. Scattered over all of this, there are the chemicals.  In every single direction there are fertilizers, poisons, and insecticides.

“The malathion, the pesticides a lot of the over the counter stuff, those are pretty common,” says Frick. “The uncommon ones are the restricted use pesticides like the carbofuran.”

Carbofuran, an extremely toxic pesticide that’s effectively banned in the United States, is fast becoming a favorite tool among Mexican drug cartels, which operate in California’s public lands. Once a rare find, it’s now turning up at 60 to 70 percent of illegal grow sites, often mixed in bottles that have no warning label.

“A mountain biker, a hiker, a child, could be hiking out here, find this and think it’s a full bottle of vitamin water,” explained Dr. Mourad Gabriel, field agent for the Integral Ecology Research Center. “An eighth of a teaspoon would kill a 300 pound black bear.”

That is exactly what is happening.  Illegal growers aren’t just using carbofuran as an insecticide, they’re using it to kill anything that wanders into their grow sites. “If you want to kill wildlife, then let’s just go ahead and place poison in food, and have wildlife come,” says Gabriel.

Bears that were photographed walking into camps contaminated with carbofuran were subsequently found dead, and agents are now routinely finding dead wildlife near grows, with testing often proving carbofuran to be the killer.

The situation has become so toxic that hazardous materials experts are now involved, trying to figure out just how long carbofuran hangs around in our soil and water. “In order to determine how lethal this is,” said Gabriel. “Or how harmful this potentially may be for wildlife and humans.”

The forest service is now approaching 400 illegal grow sites this year in California.  There is no specific designated budget for mitigating the sites, which are increasingly complicated and expensive to resolve with the presence of carbofuran.

The grows are an old problem, but the illegal, pink poison is just a new, lethal twist.  The toll it’s taking on our public lands is just starting to surface.  As Dr. Gabriel sees it, “the impact to wildlife and fisheries, this is a whole completely new frontier.”

Source: https://sanfrancisco.cbslocal.com/2017/09/28/toxic-chemicals-california-wildlife-marijuana-grows/ September 2017

As the legalization of marijuana continues to spread among various states within the U.S., researchers, and physicians are trying to fully grasp the potential health hazards of the recreational use of the drug. Since marijuana can be consumed through a variety of methods—e.g., eating, smoking, or vaporizing—it is important to understand if and how drug delivery methods affect users. With that in mind, a recent study from investigators at Portland State University found benzene and other potentially cancer-causing chemicals in the vapor produced by butane hash oil, a cannabis extract.

Findings from the new study—published recently in ACS Omega in an article entitled “Toxicant Formation in Dabbing: The Terpene Story”—raises health concerns about dabbing, or vaporizing hash oil—a practice that is growing in popularity, especially in states that have legalized medical or recreational marijuana. Dabbing is already controversial. The practice consists of placing a small amount of cannabis extract (a dab) on a heated surface and inhaling the resulting vapor. The practice has raised concerns because it produces extremely elevated levels of cannabinoids—the active ingredients in marijuana.

“Given the widespread legalization of marijuana in the U.S., it is imperative to study the full toxicology of its consumption to guide future policy,” noted senior study author Robert Strongin, Ph.D., professor of organic chemistry at Portland State University. “The results of these studies clearly indicate that dabbing, while considered a form of vaporization, may, in fact, deliver significant amounts of toxins.”

Dr. Strongin and his colleagues analyzed the chemical profile of terpenes—the fragrant oils in marijuana and other plants—by vaporizing them in much the same way as a user would vaporize hash oil.

“The practice of ‘dabbing’ with butane hash oil has emerged with great popularity in states that have legalized cannabis,” the authors wrote. “Despite their growing popularity, the degradation product profiles of these new products have not been extensively investigated.”

The authors continued, stating that the current study focused on the “chemistry of myrcene and other common terpenes found in cannabis extracts. Methacrolein, benzene, and several other products of concern to human health were formed under the conditions that simulated real-world dabbing. The terpene degradation products observed are consistent with those reported in the atmospheric chemistry literature.”

Many of the terpenes that the researchers discovered in the vaporized hash oil are also used in e-cigarette liquids. Moreover, previous experiments by Dr. Strongin and his colleagues found similar toxic chemicals in e-cigarette vapor when the devices were used at high-temperature settings. The dabbing experiments in the current study produced benzene—a known carcinogen—at levels many times higher than the ambient air, the researchers noted. It also produced high levels of methacrolein, a chemical similar to acrolein, another carcinogen.

“The results of these studies clearly indicate that dabbing, although considered a form of vaporization, may, in fact, deliver significant amounts of toxic degradation products,” the authors concluded. “The difficulty users find in controlling the nail temperature put[s] users at risk of exposing themselves to not only methacrolein but also benzene. Additionally, the heavy focus on terpenes as additives seen as of late in the cannabis industry is of great concern due to the oxidative liability of these compounds when heated. This research also has significant implications for flavored e-cigarette products due to the extensive use of terpenes as flavorings.”

Source: https://www.genengnews.com/topics/translational-medicine/cancer-causing-compounds-found-in-cannabis-oil/ September 2017

Filed under: Cannabis/Marijuana,Health :

Illegal pot growers have turned public lands into industrial agricultural sites. And the ecosystem effects are alarming.

Research ecologist Mourad Gabriel is one of the few scientists studying illegal grow sites in California’s overrun national forests.

On a hot August morning, Mourad Gabriel steps out of his pickup onto the gravel road that winds up the side of Rattlesnake Peak. Dark-bearded and muscular, the research ecologist sports a uniform of blue work clothes, sturdy boots and a floppy, Army-style camo hat. He straps on a pistol. “Just to let you know,” Gabriel says, sensitive to the impression the gun makes, “it’s public land, so I open-carry.”

Another 100-degree day is promised. Gabriel and his four field assistants are headed to work in California’s Plumas National Forest, a few hours’ drive from Lake Tahoe, at the northern terminus of the Sierra Nevada. The U.S. Forest Service (USFS) has enlisted Gabriel to assess the scars from rampant marijuana cultivation. Today’s field site: an illegal marijuana plantation known as the Rattlesnake Grow.

Gabriel doesn’t take chances because he’s been threatened personally. In 2014, someone poisoned his family dog with a pesticide that’s used at the grow sites. The intruder crept onto Gabriel’s property at night and scattered poisoned meat in his backyard. And last year during raids on plots elsewhere in California, two police dogs were stabbed by men fleeing the scene.

So whenever Gabriel enters a cultivation site with his research team — even one that’s been abandoned, as this one is — he always goes in first.

U.S. Forest Service officers collect coils of plastic pipe used to divert water from springs to marijuana plants at an illegal grow site on public lands.

Most of the U.S. domestic marijuana supply is raised in California. Some pot is grown on private property for legal use by medical marijuana patients. These operations can be monitored, and with Californians having legalized recreational pot last November, the regulation is sure to tighten. But in popular pot-growing regions like Humboldt, Mendocino and Trinity counties — closer to the Northern California coast in the so-called Emerald Triangle — environmental regulation has been slow to catch up. Commandeering streams, growers divert the water into high-tech greenhouses, to the detriment of the aquatic life lower in the drainage, including the threatened coho salmon. Biologists for the California Department of Fish and Wildlife have shown that thirsty marijuana plantations can dry up water sources.

What’s more, the rest of the crop — the vast black-market portion — is planted on public or tribal lands by people who ignore the environmental consequences of their activity. When they’re captured, some turn out to be Mexican drug cartel workers, and others come from smaller independent groups. U.S. authorities concede that the great majority of these “trespass grows” are never detected. Even after sites are cleared, the shadowy growers may reclaim them the next year.

“The public doesn’t understand the industrial scale of this,” says wildlife biologist Craig Thompson.

But if you have heard anything about streams being polluted or animals and birds being poisoned by marijuana production, it’s almost certainly because of Gabriel, a soft-spoken scientist who now and then unleashes his inner Rambo.

After the Bust

Gabriel takes his team of biologists over the top of an open, sunbaked ridge and down the other side of the mountain. Immediately, burnt and toppled trunks of pine and fir and head-high tangles of wild lilac shrubs impede the way.

Ten years ago, the Moonlight Fire destroyed 65,000 acres of forest in the Plumas. The marijuana growers stole into the broad footprint left by the blaze in dozens of places. In the section we’re hiking, they cut trails and cleared a series of plots on a steep slope above a ravine. Then the trespassers dug out three springs and diverted their flow into half-inch black plastic piping, which they threaded through the cover of vegetation to their network of plots below. The waterlines emptied into tarp-sealed pits that could store hundreds of gallons of water. Having started thousands of marijuana seedlings in plastic cups, the growers planted them among the shrubs throughout the plots. Each bright green plant was irrigated via drip lines, some triggered by a battery-powered timer. Although the mountainside faced north and east, light was no problem. Where it used to be blocked by trees, the strong California sun now slathered the crop.

Gabriel was with the rangers and deputies when they busted the site in 2015 and uprooted more than 16,000 plants. Judging by bags left around the site back then, he suspects at least 4,000 pounds of potent fertilizer were used. He also recorded several empty containers of a concentrated organophosphate insecticide — a lethal nerve poison that’s toxic to wildlife.

Gabriel’s non-profit organization, Integral Ecology Research Center (IERC), was hired to assess the damage to water sources, soils and sensitive plants and animals. They also inventoried toxic waste, piping, camp materials and trash. Now it’s up to the Forest Service to decide how to repair the damage. Gabriel, enlisting local volunteer groups, will assist with the cleanup, too. The service he offers is soup-to-nuts.

“He’s passionate. He’s a character,” says USFS’s Thompson, who collaborates with Gabriel on research. “He has continued to shine a light on the issue, though it’s still under the radar.”

Connecting the Dots

The first glimmer of impacts to wildlife came to Gabriel from fishers. A fisher — a type of weasel whose body is about the size of a housecat’s — is a denizen of deep woods. It has a wide face and long furry tail, and it can run up and down trees like the woodrats and squirrels it hunts. Fishers have never been overly abundant in the mountains of the West Coast, and their population plummeted after a century of logging and trapping. In the 21st century, biologists have tried to restore the Pacific fisher by reintroducing young animals and tracking them with radio collars. But the fishers’ expansion has been slow because they have been dying more rapidly than researchers expected.

Gabriel joined the fisher reintroduction project in 2009. At the time, he was completing his Ph.D. at the University of California, Davis. He credits an uncle for interesting him in the outdoors. The uncle was also a taxidermist; hence, young Mourad developed an interest in the interiors of animals. In high school, a vocational aptitude test suggested that he could be a game warden, park ranger or biologist. As an undergrad at Humboldt State University, he took courses supporting all three. Gabriel met his future wife, Greta Wengert, while they were both studying wildlife biology in college. After marrying, the two founded IERC in Blue Lake, Calif.

Craig Thompson, a USFS biologist, drops a water filter into a High Sierra stream near a marijuana grow site. Tests have turned up pesticides and fertilizers coming from the grows.

Gabriel’s work for the fisher reintroduction project was lab-based. He conducted necropsies of dead animals that Thompson’s field researchers had picked up. Examining a fisher carcass one day, Gabriel found that its organs had turned to mush. The fisher had been poisoned by a compound that blocks clotting and prompts unchecked internal bleeding, a so-called second-generation anticoagulant rodenticide (AR). D-CON, commonly used against mice and rats, is a familiar brand of AR. But how did a forest carnivore absorb a pesticide typically used around farms and houses?

Gabriel remembers wondering if this one fisher was an outlier. “So we went back to the archival liver tissue,” he says. When he inspected frozen specimens and collected additional carcasses from colleagues, Gabriel discovered that rodenticides had, if not killed, then at least tainted 85 percent of expired fishers.

“It took a while to connect the dots,” he says. From his field experience he was familiar with illegal pot grows, which had plagued the backcountry terrain for 20 years or more. “We’ve all run into it. We’ve been trained,” Gabriel says. “If you come upon a site, you do a 180 and walk away.”

Mounds of Pesticide

Law enforcement officers from different agencies asked him if rat bait from grow sites might be the culprit. It made sense; woodrats and squirrels would gnaw the marijuana plants.

If the growers scattered AR and the rodents were sapped by internal bleeding, they would become easier prey for fishers. Bioaccumulation, as the process is known, would pass the rodenticide up the food chain, where concentrations increase. The fishers in turn might have become prey for bobcats and mountain lions.

Wildlife biologist Greta Wengert (above) carefully handles a suspected neurotoxin found in a Gatorade bottle.

Raids turned up empty bags of AR and sometimes even mounds of the pesticide. To test their hypothesis about bioaccumulation, Thompson, Gabriel and state toxicologists tried to tie the levels of AR exposure in fishers with the locations of grow sites found by law enforcement.

The researchers analyzed 46 female fishers that died over five years. Their results showed that the animals that lived longest had the least rodenticide in their livers and the fewest grow sites within their home ranges. Conversely, animals with roughly four or more grow sites nearby died the soonest.

In a 2015 paper in the journal PLoS ONE, the researchers stepped back and examined all the causes of mortality in their collared fishers. Predation accounted for 70 percent of the deaths, disease an additional 16 percent, and poisoning, which until lately hadn’t been considered, 10 percent. The new factor might explain why fishers weren’t rebounding as fast as they might be. Pesticides might be the major factor in most of the deaths, even those not poisoned outright. “You can argue that the animals that are affected by rodenticide are weaker,” Thompson says, “and that the predation rates on them, as I suspect, are higher.”

Sounding the Siren

In a parallel case, rodenticides have worked their way into some of California’s northern spotted owls, a threatened species. The owls also eat tainted rodents near grow sites. The evidence here is less direct, and depends on analyses of a competing species, the barred owl. For decades, barred owls from Eastern states have been invading the breeding territory of the northern spotted owl in California, Oregon and Washington. Already on the ropes from the logging of old-growth woods, spotted owls were disappearing, and so biologists tried a desperate measure: shooting barred owls.

At the Hoopa Valley Indian Reservation in Humboldt County, forestry biologist Mark Higley, who has helped with the fisher project, also takes part in the culling of barred owls. Higley says he and his staff have had run-ins with illegal growers, “taking risks we shouldn’t take.” After Gabriel’s breakthrough with AR and fishers, Higley sent him liver samples of more than 155 barred owls that had been collected at Hoopa. More than half were positive for rodenticide. Gabriel also had positive results from two spotted owls that were hit by cars. Since spotted owls are endangered, Higley and Gabriel use barred owls as a surrogate — their dietary habits are similar — and infer that up to half of spotted owls near grow sites might be exposed to rodenticide. Now Thompson is looking for other examples of bioaccumulation. He’s testing mountain lion scat for rat poison and pesticides.

Researchers examine a Pacific fisher carcass (left). The animals are struggling in part due to rat poison used by illegal marijuana growers

Only Gabriel, Thompson and a handful of other biologists are investigating the ecological effects of toxins from the trespass grows. The funding opportunities are scant, and the fieldwork is hard and potentially dangerous. Although growers who have been surprised at their plots haven’t hurt anybody — usually they just run away — sometimes shots are fired.Adding to the frustration, many important questions are nearly impossible to answer. At what levels do agricultural chemicals and rodenticide interfere with fishers’ reproduction? How much poison does it take to weaken an animal enough that it becomes easy prey for fishers and bobcats? Wildlife toxicology’s pitfall is that lab experiments can’t be performed on wild populations, let alone on sensitive and rare species.

“You have these snippets of field-based evidence,” Gabriel says. “Maybe you could do a liver biopsy on a captive fisher, but it would cause bleeding, and if an anticoagulant were affecting the animal, [the test] could push it over the edge. I’ll leave that work to someone else.” His role, as he sees it, is sounding the siren. “The problem is getting worse,” he says, frustrated. “Who’s documenting this?”

The Unseen Grower

Amid the lilac shrubs, pungent with pollen, marks of the Rattlesnake Grow aren’t immediately obvious. Soon the paths and waterlines of the growers can be spotted, and then other items like fertilizer bags, heavy-duty plant shears and matted clothing, which the wilderness is swallowing up.

As Gabriel investigates a stream angling toward the ravine, the four techs split into pairs. Two young field biologists push off in opposite directions, using their GPS trackers to measure plot boundaries.

The slanting plot, still faintly pocked with bare spots where the marijuana grew, is about 50 yards wide and 100 yards long. They crisscross the area with cans of spray paint, tagging empty bags of chemicals as they count them. When they take a break, they huddle in the shade thrown by the charred trees.

Walking on a diagonal line across the site, the biologists collect at least five samples of soil in plastic bags. The samples will be tested for various pesticides. Five samples for 1,500 square yards might not seem like much. “That’s all we can get funded for,” says Gabriel, who has rejoined the others. He reports spotting boot tracks. “I think they came back and took the tent and sleeping bags, probably sometime last spring.”

Growers often squat in primitive camps on public lands, leaving their mess to the Forest Service after harvest time.

Of all the species Gabriel studies, the human animal — the unseen grower — is the hardest for him to figure out. “I’ve visited between 100 and 200 grow sites,” he says, leaning against a fallen tree. He wonders, why would growers plant so high up on this ridge with limited water?

“We saw a different approach last week,” Gabriel says. “Just 60 meters from a paved road they were growing 5,000 plants. Maybe one criminal organization decides, ‘We’ll go deep in the wilderness,’ and another, ‘Let’s put it by the road.’ You’re trading easier access for greater risk.”

He sees each site as a piece of a larger puzzle. If researchers could better understand the selection process, it might be possible to better handle these trespass grows.

Later, over a beer in his motel room, Gabriel says, “There’s no way I can do this physically 15 or 20 years from now.” He figures he’s got eight more years, after which he hopes the field will be big enough for him to exit and do something else, leaving others to carry on the research. He’s trying to spur other biologists to study illegal grows too. He wants to track the long-term effects of the chemicals by incorporating specialties like hydrology and soil science.

“As an ecologist, I love working on species of conservation concern,” he says. “I want a stable population of fishers and owls. I want basic research and applied management. Not science just for the sake of science but science as a solution.”

 

 

[This article originally appeared in print as “High Consequences.”]

Source:  http://discovermagazine.com/2017/sept/high-consequences September 2017

Donald Trump’s choice of his VP running mate, Indiana Gov. Mike Pence, worries the marijuana lobby. They question Pence’s belief that marijuana is a gateway drug and its abuse is a crime, deserving penalty. While the marijuana lobby claims “Marijuana is a happy, healthy, wonderful plant and everybody should have the right to grow it, just as they grow dandelions,” the National Insitute of Drugs (NIDA) findings support Pence’s objection to the legalization of marijuana.  According to NIDA’s latest available data, “illicit drug use in the U.S. is on the rise, and “More than half of new illicit drug users begin with marijuana.” Yet, marijuana legalization has become an issue in the U.S. presidential elections.

How did we get here?

The impresario who staged and pushed to legally dope of the American people is the billionaire financier George Soros. He found a kindred spirit in President Obama who got this dog and pony show on the road. The chosen vehicle was Obama-Care. And the first indication for this came on August 5, 2009, with the National Institute on Drug Abuse (NIDA)’s little noticed tender for the production and distribution of large quantities of marijuana cigarettes, for purposes other than for research, clocked under the DEA control and supposedly in compliance  with FDA regulations

According to pro-legalization activist Sean Williams, “President Obama has suggested that the best way to get the attention of Congress is to legalize marijuana in as many states as possible at the state level. If a majority of states approve marijuana measures, and public opinion continues to swell in favor of cannabis, Congress may have no choice but to consider decriminalization — or legalize the substance.” Not surprisingly, recently  there have been widely-reported leaks from the DEA  that the agency anticipates making “medical” marijuana” legal in all 50 states, even though this requires FDA approval.

Until the early 1990s, the voices to legalize drugs in the United States were not in sync. This changed with Soros’ first foray into U.S. domestic politics in 1992-1993. Soros, who made his fortune by bidding on instability, is known to say, “If I spend enough, I make it right.” While other billionaires give to the arts, higher education and medicine to better the quality of the lives of their fellow men, Soros chose to “right” illegal drug use, under the guise of a social reformer. “The war on drugs is doing more harm to our society than drug abuse itself.” Due to the widespread social and political opposition to illegal drug use, he chose to begin his efforts to “right” the situation, with a popular getaway drug, marijuana – a brain and mind altering drug that creates life-long dependency. To make his decision more palatable, the ultimate opportunistic Soros, declared marijuana is a “compassionate drug,” and for more than two decades poured tens of millions of dollars into campaigns to first legalize the use of “medical marijuana,” and more recently to decriminalize the use of “recreational” marijuana. 

Pretending to support an “open society,” Soros,  uses his philanthropy to “change” or more accurately deconstruct the moral values and attitudes of the Western world, and particularly of the American people. He claims to support humanitarianism, equality and individual and political freedom, what Karl Pooper, the Austrian-born British philosopher argued were necessary for what he considered an “open society.”nominal contact with Popper while studying at the London School of Economics. Although Popper met with Soros once or twice while Soros was a student at the London School of Economics, Soros failed to make much of an impression on the old philosopher. According to Michael T. Kaufman’s 2003 unauthorized biography of the billionaire, when Soros contacted Popper in 1982 to let him know about how he’d been naming funds, foundations, and various other entities after the concepts enshrined in the The Open Society, Popper wrote back: “Let me first thank you for not having forgotten me. I am afraid I forgot you completely; even your name created at first only the most minute resonance. But I made some effort, and now, I think, I just remember you, though I do not think I should recognize you.”

Not surprisingly, Soros’ “open society” Institute and foundations are not about promoting any of Popper’s ideas. Certainly not freedom.  Instead, by working diligently to legalize drugs, Soros advances the greatest slavery ever–drug addiction. This sits well with his rejection of the notion of ordered liberty, in favor of a progressive ideology of rights and entitlements.

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 “unchallenged, Soros would change the political landscape of America.” It took two decades and lots of 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.

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. Since 2014, legally listed marijuana producing and distributing companies will be generating huge revenues. Soros seems to believe that state-controlled drug distribution will best serve to increase dependency on the state.

The overwhelming evidence on the short and long term harm caused by marijuana to the user and to society should have stopped any attempt to legalize the drug. However, the vast amounts of money spent on influencing the public and the politicians generated the desired social acceptance of the “compassionate drug,” marijuana. 

In November 1996, Soros’ efforts succeeded in California, making it the first state to legalize “medical marijuana.”

Recreational use of marijuana has nothing to do with medical marijuana. As with other drugs, the development of marijuana/cannabis as medicine has to follow modern medical rules – advancing with clinical trials with specific compounds, looking for side effects and interactions with other drugs, etc.

But when last November, the DEA Acting Administrator Chuck Rosenberg said, “We can have an intellectually honest debate about whether or not we want to legalize something that is bad and dangerous, but don’t call it medicine. That’s a joke.” Rosenberg opined there was a need for “legitimate research into the efficacy of marijuana for its constituent parts as a medicine. But I think the notion that state legislatures just decree it so is ludicrous.” The pro-drug lobby called for his dismissal. 

Among the ill-effects of marijuana use (whether obtained legally or not) is memory loss, 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 “memory-related structure [to] shrivel and collapse.s..[and] boosts the underlying process driving schizophrenia.”

This study as many others documented the devastating long-term harm caused by marijuana use. Another National Institute on Drug Abuse (NIDA) study found that “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.”

Other studies documented “distorted perceptions, impaired coordination, difficulty in thinking and problem-solving, and problems with learning and memory.”  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.” NIDA’s latest survey from 2013, show that drug users are exacting more than $700 billion annually in costs related to crime, lost work productivity and health care. Add yo this the cost of newly hooked Americans on social welfare, including food stamps, Obamacare, public housing, free cell phones, and other entitlements.

Moving to relax Federal oversight on marijuana use, a Department of Justice memo on August 29, 2013, 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.”

When Colorado legalized the use of “recreational” use of marijuana, on January 1, 2014, the TSA announced it stopped deploying detection dogs in the state’s airports, even though these dogs are trained to also detect other illegal drugs, explosives, blood, contraband electronics, stashed currency, and more. Similar measures will take place once marijuana is legalized, exposing American airport to terrorist attacks.

The Obama’s endorsed and Soros’ funded Democratic presidential candidate Hillary Clinton, has promised to “defend and build on the progress…made under President Obama,” including his and the billionaire’s efforts to legalize marijuana. American voters should keep this in mind when voting for their next President.

Source: http://acdemocracy.org/the-obama-soro-legacy/ July 2016

This week, the Rocky Mountain High Intensity Drug Trafficking Area released its fifth annual report titled The Legalization of Marijuana in Colorado: The Impact, Volume 5. We devote today’s issue of The Marijuana Report newsletter to highlighting a few of many significant findings the report contains.

National Families in Action has remade some of the graphs and charts in the report to emphasize key findings. This one shows how many of Colorado’s students were expelled, referred to law enforcement, or suspended in the 2015-2016 school year. This is the first year the Colorado Department of Education differentiated marijuana violations from all drug violations, and this year’s report will serve as a baseline to determine whether marijuana violations increase, decrease, or stay fundamentally the same.

Read The Legalization of Marijuana in Colorado: The Impact, Volume 5 here. This information appears on page 41 (PDF page 49).
The new report explains that although Colorado created its own Healthy Kids Survey, the combination of a poor response rate and the fact that several major counties with large populations had low or no participation rendered the 2015 survey’s results invalid. For a discussion of this see page 33 (PDF page 41). Volume 5 relies on the National Survey on Drug Use and Health to compare Colorado marijuana use with the national average for ages 12-17, 18-25, and 26 & older over a ten year period (2005-2006 to 2014-2015).

See data for these graphs on the following pages:

  • Ages 12-17, page 36 (PDF page 44)
  • Ages 18-25, page 56 (PDF page 64)
  • Ages 26 & Older, page 60 (PDF page 68)

Read The Legalization of Marijuana in Colorado: The Impact, Volume 5 here.
The report notes that data from the National Highway Traffic Safety Administration, 2006-2011 Fatality Analysis Reporting System (FARS), and 2012-2016 Colorado Department of Transportation show that drivers testing positive for marijuana who were killed in traffic crashes rose from 6 percent of all traffic deaths in 2006 to 20 percent eleven years later. Marijuana-related traffic deaths jumped from 9 percent to 14 percent once the state commercialized marijuana for medical use and from 11 percent to 20 percent after legalizing the drug for recreational use.

Read more about marijuana-related driving in Colorado here starting on page 13 (PDF page 21).
In 2016, more than one-third of Colorado drivers who tested positive for marijuana had marijuana only in their systems. Another 36 percent had marijuana and alcohol. Slightly over one-fifth tested positive for marijuana and other drugs but no alcohol, while 7 percent had marijuana, alcohol, and other drugs on board.

See page 18 (PDF page 26) in The Legalization of Marijuana in Colorado: The Impact, Volume 5 here.
The Marijuana Report is a weekly e-newsletter published by National Families in Action in partnership with SAM (Smart Approaches to Marijuana).

Visit National Families in Action’s website, The Marijuana Report.Org, to learn more about the marijuana story unfolding across the nation.

Our mission is to protect children from addictive drugs
by shining light on the science that underlies their effects.

Addictive drugs harm children, families, and communities.
Legalizing them creates commercial industries that make drugs more available,
increase use, and expand harms.

Science shows that addiction begins in childhood.
It is a pediatric disease that is preventable.

We work to prevent the emergence of commercial
addictive drug industries that will target children.

We support FDA approved medicines.

We support the assessment, treatment, and/or social and educational services
for users and low-level dealers as alternatives to incarceration.

About SAM (Smart Approaches to Marijuana)

SAM is a nonpartisan alliance of lawmakers, scientists and other concerned citizens who want to move beyond simplistic discussions of “incarceration versus legalization” when discussing marijuana use and instead focus on practical changes in marijuana policy that neither demonizes users nor legalizes the drug. SAM supports a treatment, health-first marijuana policy.  SAM has four main goals:

  • To inform public policy with the science of today’s marijuana.
  • To reduce the unintended consequences of current marijuana policies, such as lifelong stigma due to arrest.
  • To prevent the establishment of “Big Marijuana” – and a 21st-Century tobacco industry that would market marijuana to children.
  • To promote research of marijuana’s medical properties and produce, non-smoked, non-psychoactive pharmacy-attainable medications.

Source: Email from National Families in Action http://nationalfamilies.org October 2017 

Tom P. Freeman, Peggy van der Pol, Wil Kuijpers, Jeroen Wisselink,Ravi K. Das, Sander Rigter, Margriet van Laar, Paul Griffiths, Wendy Swift,Raymond Niesink and Michael T. Lynskey

ABSTRACT:

Background

The number of people entering specialist drug treatment for cannabis problems has increased considerably in recent years. The reasons for this are unclear, but rising cannabis potency could be a contributing factor. Methods Cannabis potency data were obtained from an ongoing monitoring programme in the Netherlands. We analysed concentrations of δ -9-tetrahydrocannabinol (THC) from the most popular variety of domestic herbal cannabis sold in each retail outlet (2000–2015). Mixed effects linear regression models examined time-dependent associations between THC and first-time cannabis admissions to specialist drug treatment. Candidate time lags were 0–10 years, based on normative European drug treatment data.

Results

THC increased from a mean (95% CI) of 8.62 (7.97–9.27) to 20.38 (19.09–21.67) from 2000 to 2004 and then decreased to 15.31 (14.24–16.38) in 2015. First-time cannabis admissions (per 100 000 inhabitants) rose from 7.08 to 26.36 from 2000 to 2010, and then decreased to 19.82 in 2015. THC was positively associated with treatment entry at lags of 0–9 years, with the strongest association at 5 years, b = 0.370 (0.317–0.424), p < 0.0001. After adjusting for age, sex and non-cannabis drug treatment admissions, these positive associations were attenuated but remained statistically significant at lags of 5–7 years and were again strongest at 5 years, b = 0.082 (0.052–0.111), p < 0.0001.

Conclusions

In this 16-year observational study, we found positive time-dependent associations between changes in cannabis potency and first-time cannabis admissions to drug treatment. These associations are biologically plausible, but their strength after adjustment suggests that other factors are also important.

Source: https://www.researchgate.net/publication/322830280_Changes_in_cannabis_potency_and_first-time_admissions_to_drug_treatment_A_16-year_study_in_the_Netherlands January 2018

Science Spotlight

New research suggests that marijuana users may be more likely than nonusers to misuse prescription opioids and develop prescription opioid use disorder. The study was conducted by researchers at the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health, and Columbia University.

The investigators analyzed data from the National Epidemiologic Survey on Alcohol and Related Conditions, which interviewed more than 43,000 American adults in 2001-2002, and followed up with more than 34,000 of them in 2004-2005. The analysis indicated that respondents who reported past-year marijuana use in their initial interview had 2.2 times higher odds than nonusers of meeting DSM-IV diagnostic criteria for prescription opioid use disorder by the follow-up. They also had 2.6 times greater odds of initiating prescription opioid misuse, defined as using a drug without a prescription, in higher doses, for longer periods, or for other reasons than prescribed.

A number of recent papers suggest that marijuana may reduce prescription opioid addiction and overdoses by providing an alternate or complementary pain relief option. That suggestion is partly based on comparisons of aggregate data from states that legalized marijuana for medical use vs. those that didn’t. In contrast, the current study focuses on individual marijuana users vs. nonusers and their trajectories with regard to opioid misuse and disorders. These findings are in-line with previous research demonstrating that people who use marijuana are more likely than non-users to use other drugs and develop problems with drug use.

For a copy of the paper, go to – “Cannabis Use and Risk of Prescription Opioid Use Disorder in the United States” – published in the American Journal of Psychiatry.

For information about the link between marijuana use and increased risk of addiction to other drugs, go to: www.drugabuse.gov/news-events/latest-science/marijuana-use-raises-sud-risk.

For more information, contact the NIDA press office at media@nida.nih.gov or 301-443-6245. Follow NIDA on Twitter and Facebook

Source: https://www.drugabuse.gov/news-events/news-releases/2017/09/marijuana-use-associated-increased-risk-prescription-opioid-misuse-use-disorders September 2017

Drug Free America Foundation launched its new Marijuana and the Workplace Tool Kit this morning at a forum co-sponsored with Drug Free Manatee and the Manatee Chamber of Commerce at Pier 22 in Bradenton FL.  The forum featured a presentation by Amy Ronshausen, Deputy Director of Drug Free America Foundation who unveiled the Tool Kit and discussed how the implementation of Florida’s medical marijuana program will affect employers in the state. The forum also included a panel discussion with a group of experts that includes healthcare and labor attorneys, insurance representatives and a state legislator.

            As marijuana legalization efforts gain traction around the country as it has in Florida, the business community needs to be prepared.  “Employers must be diligent and proactive in understanding how the use of marijuana affects individuals, the overall influence to their business, and the level of financial liability that is acceptable,” according to Calvina Fay, executive director of Drug Free America Foundation.  “It is critical that an evaluation be completed based upon legitimate science, the safety-sensitive nature of the business, and risk analysis as opposed to perception and emotion,” she said.

Employees that use marijuana and other drugs negatively impact the bottom line for employers due to increased workplace accidents, injuries, and other effects, increasing the cost of doing business.  “The safety of all employees, vendors, customers, other drivers, pedestrians, or generally anyone encountering an employee while driving under the influence of pot could be impacted,” said Fay.

The tangled web of conflicting and diverse laws and statutes being drawn across the country varies from state to state, from jurisdiction to jurisdiction, making this issue very confusing for all concerned.  No two states’ marijuana laws are identical, further complicating the issue.

Identifying and defining liability related to marijuana use is perhaps one of the most evolving areas of risk management and insurance practices.  “From the viewpoint of an insurer, the conflicting laws are particularly troublesome for insuring a business against unexpected loss with no clear best practice and can potentially impact workers compensation claims and well as health, life and other business insurance coverage and premiums,” Fay suggested.

A smart approach for employers is to implement workplace practices that encourage safe, healthy lifestyles, and discourage behaviors that are counter-productive, both from a personal and a business standpoint. “In this tumultuous time of conflicting laws, confusion, and change, employers are encouraged to stay the course where a drug-free workplace is concerned,” continued Fay.  “We also encourage employers to remain consistent and fair in the application of workplace rules and procedures and to regularly review their program in relation to applicable laws, regulations and statutes that may have changed,” she concluded.

The Marijuana and the Workplace Tool Kit can be found at http://www.ndwa.org/resources/marijuana-in-the-workplace-toolkit/ 

Source: Email from Drug Free American Foundation

September 2017

Thomas M. Nappe, DO* and Christopher O. Hoyte, MD

Abstract

Since marijuana legalization, pediatric exposures to cannabis have increased. To date, pediatric deaths from cannabis exposure have not been reported. The authors report an 11-month-old male who, following cannabis exposure, presented with central nervous system depression after seizure, and progressed to cardiac arrest and died. Myocarditis was diagnosed post-mortem and cannabis exposure was confirmed.

Given the temporal relationship of these two rare occurrences – cannabis exposure and sudden death secondary to myocarditis in an 11-month-old – as well as histological consistency with drug-induced myocarditis without confirmed alternate causes, and prior reported cases of cannabis-associated myocarditis, a possible relationship exists between cannabis exposure in this child and myocarditis leading to death. In areas where marijuana is commercially available or decriminalized, the authors urge clinicians to preventively counsel parents and to include cannabis exposure in the differential diagnosis of patients presenting with myocarditis.

INTRODUCTION

Since marijuana legalization, pediatric exposures to cannabis have increased, resulting in increased pediatric emergency department (ED) visits. Neurologic toxicity is most common after pediatric exposure; however, gastrointestinal and cardiopulmonary toxicity are reported. According to a retrospective review of 986 pediatric cannabis ingestions from 2005 to 2011, pediatric exposure has been specifically linked to a multitude of symptoms including, but not limited to, drowsiness, lethargy, irritability, seizures, nausea and vomiting, respiratory depression, bradycardia and hypotension.Prognosis is often reassuring. 

Specific myocardial complications related to cannabis toxicity that are well documented in adolescence through older adulthood include acute coronary syndrome, cardiomyopathy, myocarditis, pericarditis, dysrhythmias and cardiac arrest. To date, there are no reported pediatric deaths from myocarditis after confirmed, recent cannabis exposure. The authors report an 11-month-old male who, following cannabis exposure, presented in cardiac arrest after seizure and died. Myocarditis was diagnosed post-mortem and cannabis exposure was confirmed. Analyses of serum cannabis metabolites, post-mortem infectious testing, cardiac histopathology, as well as clinical course, support a potential link between the cannabis exposure and myocarditis that would justify preventive parental counseling and consideration of urine drug screening in this reported setting.

CASE REPORT

An 11-month-old male with no known past medical history presented to the ED with central nervous system (CNS) depression and then went into cardiac arrest. The patient was lethargic for two hours after awakening that morning and then had a seizure. During the prior 24–48 hours, he was irritable with decreased activity and was later retching. He was noted to be healthy before developing these symptoms. Upon arrival in the ED, he was unresponsive with no gag reflex. Vital signs were temperature 36.1° Celsius, heart rate 156 beats per minute, respiratory rate 8 breaths per minute, oxygen saturation 80% on room air.

Physical exam revealed a well-nourished, 20.5 lb., 11-month-old male, with normal development, no trauma, normal oropharynx, normal tympanic membranes, no lymphadenopathy, tachycardia, clear lungs, normal abdomen and Glasgow Coma Scale rating of 4. He was intubated for significant CNS depression and required no medications for induction or paralysis. Post-intubation chest radiograph is shown in Image 2. He subsequently became bradycardic with a heart rate in the 40s with a wide complex rhythm. Initial electrocardiogram (ECG) was performed and is shown in Image 1.

He then became pulseless, and cardiopulmonary resuscitation was initiated. Laboratory analysis revealed sodium 136 mmol/L, potassium 7.7 mmol/L, chloride 115 mmol/L, bicarbonate 8.0 mmol/L, blood urea nitrogen 24 mg/dL, creatinine 0.9 mg/dL, and glucose 175 mg/dL Venous blood gas pH was 6.77. An ECG was repeated (Image 3). He received intravenous fluid resuscitation, sodium bicarbonate infusion, calcium chloride, insulin, glucose, ceftriaxone and four doses of epinephrine. Resuscitation continued for approximately one hour but the patient ultimately died.

Initial electrocardiogram demonstrating wide-complex tachycardia.

Post-intubation chest radiograph. Measurement indicates distance of endotracheal tube tip above carina.

Repeat electrocardiogram showing disorganized rhythm, peri-arrest.

Further laboratory findings in the ED included a complete blood count (CBC) with differential, liver function tests (LFTs), one blood culture and toxicology screen. CBC demonstrated white blood cell count 13.8 K/mcL with absolute neutrophil count of 2.5 K/mcL and absolute lymphocyte count of 10.7 K/mcL, hemoglobin 10.0 gm/dL, hematocrit 34.7%, and platelet count 321 K/mcL. LFTs showed total bilirubin 0.6 mg/dL, aspartate aminotransferase 77 IU/L, and alanine transferase 97 IU/U. A single blood culture from the right external jugular vein revealed aerobic gram-positive rods that were reported two days later as Bacillus species (not Bacillus anthracis). Toxicology screening revealed urine enzyme-linked immunosorbent assay positive for tetrahydrocannabinol-carboxylic acid (THC-COOH) and undetectable serum acetaminophen and salicylate concentrations. Route and timing of exposure to cannabis were unknown.

Autopsy revealed a non-dilated heart with normal coronary arteries. Microscopic examination showed a severe, diffuse, primarily lymphocytic myocarditis, with a mixed cellular infiltrate in some areas consisting of histiocytes, plasma cells, and eosinophils. Myocyte necrosis was also observed. There was no evidence of concomitant bacterial or viral infection based on post-mortem cultures obtained from cardiac and peripheral blood, lung pleura, nasopharynx and cerebrospinal fluid. Post-mortem cardiac blood analysis confirmed the presence of Δ-9-carboxy-tetrahydrocannabinol (Δ-9-carboxy-THC) at a concentration of 7.8 ng/mL. Additional history disclosed an unstable motel-living situation and parental admission of drug possession, including cannabis.

DISCUSSION

As of this writing, this is the first reported pediatric death associated with cannabis exposure. Given the existing relationship between cannabis and cardiovascular (CV) toxicity, as well as the temporal progression of events, post-mortem analysis, and previously reported cases of cannabis-induced myocarditis, the authors propose a relationship between cannabis exposure in this patient and myocarditis, leading to cardiac arrest and ultimately death. This occurrence should justify consideration of urine drug screening for cannabis in pediatric patients presenting with myocarditis of unknown etiology in areas where cannabis is widely used. In addition, parents should be counseled regarding measures to prevent such exposures.

The progressive clinical presentation of this patient during the prior 24–48 hours, including symptoms of somnolence, lethargy, irritability, nausea, seizure and respiratory depression are consistent with previously documented, known complications of recent cannabis exposure in the pediatric population. It is well known that common CV effects of cannabis exposure include tachycardia and decreased vascular resistance with acute use and bradycardia in more chronic use. These effects are believed to be multifactorial, and evidence suggests that cannabinoid effect on the autonomic nervous system, peripheral vasculature, cardiac microvasculature, and myocardial tissue and Purkinje fibers are all likely contributory. The pathogenesis of myocarditis is not fully understood. In general, myocarditis results from direct damage to myocytes from an offending agent such as a virus, or in this case, potentially a toxin. The resulting cellular injury leads to a local inflammatory response. Destruction of cardiac tissue may result in myocyte necrosis and arrhythmogenic activity, or cellular remodeling in chronic myocarditis.

Autopsy findings in this patient were consistent with noninfectious myocarditis as a cause of death. The histological findings of myocyte necrosis with mature lymphocytic mixed cellular infiltrate are consistent with drug-induced, toxic myocarditis.The presence of THC metabolites in the patient’s urine and serum, most likely secondary to ingestion, is the only uncovered risk factor in the etiology for his myocarditis. This is highly unlikely attributable to passive exposure.

It is difficult to extrapolate a specific time of cannabis ingestion given the unknown dose of THC, the individual variability of metabolism and excretion, as well as the lack of data on this topic in the pediatric population and post-mortem redistribution (PMR) kinetics. However, the THC metabolite detected in the patient’s blood, Δ-9-carboxy-THC, is known to peak in less than six hours and be detectable for at least a day, while the parent compound, tetrahydrocannabinol (THC), is expected to rapidly metabolize and distribute much more quickly, being potentially undetectable six hours after exposure in an infrequent user. 

The parent compound was below threshold for detection in this patient’s blood. In addition, if cannabis ingestion occurred the day of presentation, it would have been more likely that THC would have been detected with its metabolite after PMR. Given this information, the authors deduce that cannabis consumption occurred within the recent two to six days, assuming this was a single, acute high-potency ingestion. This time frame would overlap with the patient’s symptomatology and allow time for the development of myocarditis, thus supporting cannabis as the etiology.

The link between cannabis use and myocarditis has been documented in multiple teenagers and young adults. In 2008 Leontiadis reported a 16-year-old with severe heart failure requiring a left ventricular assist device, associated with biopsy-diagnosed myocarditis.The authors attributed the heart failure to cannabis use of unknown chronicity. In 2014 Rodríguez-Castro reported a 29-year-old male who had two episodes of myopericarditis several months apart.Each episode occurred within two days of smoking cannabis.In 2016, Tournebize reported a 15-year-old male diagnosed with myocarditis, clinically and by cardiac magnetic resonance imaging, after initiating regular cannabis use eight months earlier. There were no other causes for myocarditis, including infectious, uncovered by these authors, and no adulterants were identified in these patients’ consumed marijuana.Unlike our patient, all three of these previously reported patients recovered.

In the age of legalized marijuana, children are at increased risk of exposure, mainly through ingestion of food products, or “edibles.”These products are attractive in appearance and have very high concentrations of THC, which can make small exposures exceptionally more toxic in small children.

Limitations in this report include the case study design, the limitations on interpreting an exact time, dose and route of cannabis exposure, the specificity of histopathology being used to classify etiology of myocarditis, and inconsistent blood culture results. The inconsistency in blood culture results also raises concern of a contributing bacterial etiology in the development of myocarditis, lending to the possibility that cannabis may have potentially induced the fatal symptomatology in an already-developing silent myocarditis. However, due to high contaminant rates associated with bacillus species and negative subsequent blood cultures, the authors believe this was more likely a contaminant. In addition, the patient had no source of infection on exam or recent history and was afebrile without leukocytosis. All of his subsequent cultures from multiple sites were negative.

CONCLUSION

Of all the previously reported cases of cannabis-induced myocarditis, patients were previously healthy and no evidence was found for other etiologies. All of the prior reported cases were associated with full recovery. In this reported case, however, the patient died after myocarditis-associated cardiac arrest. Given two rare occurrences with a clear temporal relationship – the recent exposure to cannabis and the myocarditis-associated cardiac arrest – we believe there exists a plausible relationship that justifies further research into cannabis-associated cardiotoxicity and related practice adjustments. In states where cannabis is legalized, it is important that physicians not only counsel parents on preventing exposure to cannabis, but to also consider cannabis toxicity in unexplained pediatric myocarditis and cardiac deaths as a basis for urine drug screening in this setting.

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5965161/ March 2017

Libby Stuyt, MD spoke at the Oregon Health Forum with Drs. Esther Choo of OHSU and Katrina Hedberg who is the State Epidemiologist and State Health Officer at the Oregon Public Health Division, and at the Oregon Law & Mental Health Conference in June 2017 on the unintended consequences of marijuana legalization.

Stuyt is an addictions psychiatrist and medical director at the Colorado State Hospital in Pueblo. She is also the president of the National Acupuncture Detoxification Association.

Stuyt has a unique and expert view on the effect of increased marijuana availability and use, and as Colorado is about two years ahead of Oregon in the process of legalization and regulation of marijuana.

Stuyt’s data is from information collected by the state of Colorado and from her experience as a clinician and researcher.

  • Colorado has had significant increase in marijuana use by people under 18 years old. All use by under-age persons is illicit use. Most Colorado youth get marijuana from adults they know – not from retail stores.
  • Pueblo Colorado, with a population of 106,000 has over 7000 homeless people (Portland with a population of 583,000 has about 4500); many are people who arrived seeking employment in the marijuana industry.
  • 13% of children given CBD for seizure disorders have had “really bad” reactions; the CBD made seizures worse.
  • Estimates of marijuana addiction at 9-10% is from research on low-potency THC; this data should no longer be used. Scientists don’t know addiction rate to high potency THC, but use by youth is increasing, for daily users addiction rate is about 50%, withdrawal is harder, and violence associated with high potency THC is higher.
  • Stuyt calls marijuana addiction a “learning disorder.”
  • Marijuana use significantly reduces neurogenesis in the brain.
  • Doctors are seeing more psychosis related to high-potency THC marijuana.
  • 75% of Stuyt’s patients have PTSD. 83% of her patients are seeking treatment for marijuana addiction. Marijuana masks symptoms of marijuana, it does not treat or cure PTSD. PTSD is treatable and curable – but not with active marijuana use.
  • Increased correlation – not causation – of suicide in adolescents who use marijuana

Source: http://www.mentalhealthportland.org/report-on-marijuana-use-in-colorado/ August 2017

  • US Department of Veteran Affairs found an increase in PTSD symptoms from veterans who used medical marijuana 
  • Among patients who use medical marijuana, 80% use it for chronic pain and 33% for PTSD
  • Use for chronic pain can lead to increased risk of motor vehicle accidents and short-term cognitive impairment, experts warn
  • Medical marijuana is allowed in 30 states including DC 
  • The NFL is looking into medical marijuana use for its players for pain relief

There is no conclusive evidence that marijuana helps with chronic pain and post-traumatic stress disorder, experts say.

Since legalization, 80 percent of medical marijuana patients use it for chronic pain and about 33 percent use it for PTSD.

However, experts warn that there isn’t enough research to confirm it is effective for users.

Researchers around the country are scrambling to find evidence of the harms and benefits of patients using medical marijuana as it becomes legalized in more states.

And now they have found that there is still an insufficient amount of evidence to prove if medical marijuana can help with chronic pain and PTSD.

Researchers from the US Department of Veterans Affairs analyzed data into the treatment of chronic pain and PTSD in patients.

With chronic pain, the results in one clinical trial showed only 28 percent of participants feeling a change when using nabiximols, which is a mixture THC and CBD.

Also, there was 16 percent of participants who felt a change when taking a placebo.

This suggests psychological symptoms are possible when someone thinks they are feeling pain.

Experts also warn the use of marijuana for chronic pain could lead to an increase risk of harm such as motor vehicle accidents, psychotic symptoms and short-term cognitive impairment.

Dr Thomas O’Brien, who has run his own medical marijuana office in New York City for the past year-and-a-half, told Daily Mail Online that he’s seen high success rates from his patients dealing with chronic pain.

The type of marijuana he gives to his patients is high in CBD, so he says it doesn’t have the psychotic symptoms that critics worry about.

‘My patients do not feel sleepy or experience memory loss when they take it,’ Dr O’Brien said.

The marijuana he prescribes is from an indica-dominant strain. This means there is high CBD and low THC, which he says won’t give patients the same ‘high’ feeling that is felt from recreational marijuana.

NFL says it WILL study marijuana in terms of pain relief for players

Early this month, the NFL confirmed with Daily Mail Online that it will look into using medical marijuana for its players.

The NFL has had a strict stance against their players using marijuana.

But a report came out saying 50 percent of NFL players admitted to using marijuana to relieve pain.

The league usually prescribes highly addictive opioid painkillers to help players deal with game-related injuries and pain.

This change comes after player Calvin Johnson retired due to chronic pain and injury.

He said the players were given opioids from doctors ‘like candy’.

Currently, a player caught with THC in their system will face a fine and full-season suspension.

Source: Bleacher Report

He will prescribe a dose with a higher level of THC only if his patient’s symptoms are so bad that they can’t sleep.

He works with his patients to figure out the best mixture for them and their symptoms based on a spectrum level.

‘They are in pain and suffering from their conditions,’ Dr O’Brien said. ‘This is not recreational.’

Dr O’Brien has worked with more than 600 patients and claims that close to 90 percent have seen success.

‘The key is to educate the community that it is not like you’re going out back and sneaking a puff.’

In a large observational study of veterans, the researchers found an increase in participants who experienced a heightening of their PTSD symptoms when using medical marijuana.

The study looked at evidence from 47,000 veterans dealing with PTSD from 1992 to 2011.

From this group of veterans, the researchers could not conclusively say that medical marijuana has benefits when dealing with people with PTSD.

US Secretary of Veterans Affairs David Shulkin said: ‘My opinion is, is that some of the states that have put in appropriate controls, there may be some evidence that this is beginning to be helpful. And we’re interested in looking at that and learning from that.’

But the VA does not prescribe medical marijuana to its veterans currently.

‘Until the time that federal law changes, we are not able to be able to prescribe medical marijuana for conditions that may be helpful,’ Shulkin said.

Marijuana is legal for medical and recreational use in eight states: Massachusetts, Colorado, Washington, Alaska, Oregon, Nevada, California and Maine.

It is also legal for strictly medical use in the District of Columbia and 21 states: Montana, North Dakota, Arizona, New Mexico, Arkansas, Louisiana, Florida, Illinois, Minnesota, Michigan, Ohio, New York, Pennsylvania, Maryland, Vermont, New Hampshire, New Jersey, Rhode Island, Connecticut, Delaware and Hawaii.

How is THC used and what its effects

Tetrahydrocannabinoil (THC) is a natural element found in a cannabis plant. It is the most common cannabinoid element found in the cannabis plant. THC is found in the recreational form of marijuana.

THC is psychoactive:

This means that the drug has a significant effect on the mental processes of the person taking it.

Effects on people taking it:

  • Produces the ‘high’ feeling
  • Relaxation
  • Altered senses
  • Fatigue
  • Hunger

How it helps medically: 

Marijuana with THC are used to help with chemotherapy, multiple sclerosis and glaucoma.

Medical marijuana practitioners can diagnose a mixture of THC and CBD to the patient for treatment.

How is CBD used and what its effects

Cannabidiol (CBD) is a natural element found in a cannabis plant. It is lesser known than THC and does not produce the same ‘high’ that people experience when they have recreational marijuana.

CBD is an antipsychotic:

This means that the drug helps manage psychosis such as hallucinations, delusions or paranoia. Antipsychotic drugs are used for bipolar disorder and schizophrenia.

Effects on people taking it:

  • Reduces anxiety and paranoia
  • Boosts energy
  • Helps with pain and inflammation

How it helps medically: 

Marijuana with CBD strains are used to help with chronic pain, PTSD and epilepsy

Medical marijuana practitioners can diagnose a mixture of THC and CBD to the patient for treatment.

The study notes that there is still a lack of evidence and clinical trials to conclusively say there are benefits or harms to medical marijuana.

Former Surgeon General Dr Vivek Gupta released a report in November saying: ‘Marijuana is in fact addictive.’

But he supported the idea of easing up restrictions on marijuana studies to help better understand the drug since its legalization is moving fast through the US.

Dr O’Brien said part of the issue was people not understanding the difference between the use of THC and the use of CBD.

‘It is very safe [CBD],’ he said. ‘We need to study it for other medical conditions that haven’t been approved by the states yet.’

The restrictions on marijuana studies are partly due to the Drug Enforcement Agency’s hesitation on allowing medical marijuana across the US.

Last year, the DEA said it would accept applications for new growers to be used for clinical trials and other studies.

Currently, there is only one federally regulated operation that studies marijuana use and it is at the University of Mississippi.

There have been 25 applicants so far to host a new grow operation but none have been approved yet, according to Scientific American.

This has led to many critics saying that the DEA is still trying to slow down the research into medical marijuana to prevent its use federally.

Source: http://www.dailymail.co.uk/health/article-4789388/Medical-marijuana-does-not-help-chronic-pain-PTSD.html August 2017

  • In California, illegal marijuana farms are taking over thousands of acres of land as toxic wastes are increasingly corrupting ecosystems
  • California is responsible for the majority of illegal U.S. marijuana farming
  • New data says the state holds ‘731,000 pounds of solid fertilizer, 491,000 ounces of concentrated liquid fertilizer and 200,000 ounces of toxic pesticides.’
  • The United States Environmental Protection Agency announced in 2011 its planned to ban toxic fertilizers like zinc phosphide 
  • Chemicals of the kind have been linked to serious health effects in both animals and humans

Illegal marijuana farms are taking over thousands of acres of land as toxic waste continues to corrupt ecosystems in areas along the West Coast.

According to a new report accessed by Reuters, the state of California, which is responsible for more than ’90 percent of illegal U.S. marijuana farming,’ has shown a drastic increase in the use of nationally restricted fertilizers and pesticides such as carbofuran and zinc phosphide, ecologists say.

‘Increasingly, dangerous, unregistered pesticides are being encountered by law enforcement officers who investigate illegal marijuana grows,’ Special Agent-in-Charge of the Environmental Protection Agency criminal enforcement program, Jay M. Green, announced in a public release.

  • Illegal marijuana farms are corrupting ecosystems on the West Coast

  • Thousands of used butane cans used to process concentrated marijuana dumped in the forest in Humboldt County, California

  • Fertilizer seen in a makeshift pond with irrigation hoses attached in order to funnel water to grow sites in Mendocino County is California

‘Through their indiscriminate application, these unregistered pesticides pollute our lands and waters, create a significant safety risk to humans and animals, and present a mounting cleanup expense for taxpayers.’

Expert ecologist Mourad Gabriel, who reports over the issue for the U.S. Forest Service, said California is utilizing ’41 times more solid fertilizers and 80 times more liquid pesticides’ than the state’s initial reported cited in 2013.

Chemicals of these kind have been linked to health defects and death in both animals and humans.

The agency cited ‘a single swallow can be fatal to a small child, and carbofuran to be ‘highly toxic to vertebrates and birds. In granular form, a single grain will kill a bird; for humans, one quarter of a teaspoon is a sufficient dose to be fatal.’

  • Blue tinted water with fertilizer at an illegal marijuana growing site in Mendocino County, California

The Environmental Protection Agency announced in 2011 the department would ban the inorganic chemical compound zinc phosphide.

Included in the unpublished data accessed by Reuters, Gabriel said federal land in California currently holds ‘731,000 pounds of solid fertilizer, 491,000 ounces of concentrated liquid fertilizer and 200,000 ounces of toxic pesticides.’

Illegal pot growers could face jail time and numerous charges for growing illegally, while taxpayers could expect to be left with hefty bills to aid in the sterilization of the toxic waste sites.

  • A pot growing greenhouse is nestled into a clearing in Shelter Cove

  • Taxpayers could expect to be left with hefty bills to aid in the sterilization of toxic waste sites

Since marijuana was legalized in the state of California, officials have been pushing to properly license growers and carefully supervise the production, testing and distribution of hemp.

Supervisor of Trinity County Keith Groves said there are roughly 4,000 illegal growers in the region currently.

‘I’ll be happy if we can get 500 of them to become licensed,’ he told Reuters.

The expense and danger of cleanup has created a backlog of 639 illegal marijuana farms awaiting restoration in California, according to U.S. Forest Service data compiled for Reuters. Each farm covers up to 50 acres.

 ‘We’re getting contamination over and over again at those locations,’ said Gabriel, as toxins move from unsafe containers into the soil and water.

At sites that state officials said they had cleaned up completely, his team found 30-50 percent of the chemicals were still there.

‘They are like superfund sites,’ said Assistant U.S. Attorney Karen Escobar,

Source: https://www.dailymail.co.uk/news/article-4768664/Marijuana-farms-forming-toxic-waste-dumps-California.html August 2017

LONDON (Reuters) – People who smoke marijuana have a three times greater risk of dying from hypertension, or high blood pressure, than those who have never used the drug, scientists said on Wednesday. The risk grows with every year of use, they said. The findings, from a study of some 1,200 people, could have implications in the United States among other countries. Several states have legalized marijuana and others are moving toward it. It is decriminalized in a number of other countries.

“Support for liberal marijuana use is partly due to claims that it is beneficial and possibly not harmful to health,” said Barbara Yankey, who co-led the research at the school of public health at Georgia State University in the United States. “It is important to establish whether any health benefits outweigh the potential health, social and economic risks. If marijuana use is implicated in cardiovascular diseases and deaths, then it rests on the health community and policy makers to protect the public.” Marijuana is also sometimes used for medicinal purposes, such as for glaucoma. 

The study, published in the European Journal of Preventive Cardiology, was a retrospective follow-up study of 1,213 people aged 20 or above who had been involved in a large and ongoing National Health and Nutrition Examination Survey. In 2005–2006, they were asked if they had ever used marijuana.

For Yankey’s study, information on marijuana use was merged with mortality data in 2011 from the U.S. National Center for Health Statistics, and adjusted for confounding factors such as tobacco smoking and variables including sex, age and ethnicity. The average duration of use among users of marijuana, or cannabis, was 11.5 years. The results showed marijuana users had a 3.42-times higher risk of death from hypertension than non-users, and a 1.04 greater risk for each year of use. There was no link between marijuana use and dying from heart or cerebrovascular diseases such as strokes.

Yankey said were limitations in the way marijuana use was assessed ― including that researchers could not be sure whether people had used the drug continuously since they first tried it. But she said the results chimed with plausible risks, since marijuana is known to affect the cardiovascular system. “Marijuana stimulates the sympathetic nervous system, leading to increases in heart rate, blood pressure and oxygen demand,” she said.

Experts not directly involved in the study said its findings would need to be replicated, but already raised concerns. “Despite the widely held view that cannabis is benign, this research adds to previous work suggesting otherwise,” said Ian Hamilton, a lecturer in mental health at Britain’s York University.

Reporting by Kate Kelland, editing by Jeremy Gaunt

Source: https://www.huffpost.com/entry/marijuana-use-holds-three-fold-blood-pressure-death-risk_n_598b4b2be4b0d793738c2917 September 2017

Filed under: Cannabis/Marijuana,Health :
  • The rapper is suing insurance company, claiming it is refusing to pay him after he was forced to cancel shows in November last year
  • In legal documents Lloyd’s suggest marijuana may have led to Kanye’s mental health issues in a bid to invalidate the performer’s insurance claim
  • Psychosis affects the mind and causes the sufferer to lose touch with reality
  • Dr Lucy Troup, from Colorado State University, explained it cannabis use could cause a psychotic breakdown
  • She said there are a variety of factors that influence it, but research shows it is linked to psychosis and other mental health issues 

By Abigail Miller

Kanye West is suing his tour’s insurer after the company allegedly refused to pay for his canceled shows in November – and blamed his cannabis use.

The rapper was forced to cancel the last 21 shows of his North American tour after he had a mental breakdown and had to be checked into a hospital.

While his insurer Lloyd’s of London would normally cover the costs, the company said they don’t have to pay because his marijuana use caused the breakdown.

The 40-year-old is asking for $10 million in damages from Lloyd’s, claiming the company has yet to pay him out for his cancelled shows, and has no intent to do so.

His company said in a legal document filed on Tuesday that insurers have yet to pay and is ‘implying that Kanye’s use of marijuana may provide them with the basis to deny the claim’.

Here, Daily Mail Online takes a closer look at how marijuana use could cause psychosis and potentially cause a mental breakdown, as Lloyd’s claims.

Marijuana legalization began in the United States in 1996, when California legalized the drug for medical use.

That sparked a wave.

In the next decade, 14 states followed suit: Oregon, Alaska, Washington, Maine, Hawaii, Nevada, Colorado, Montana, Vermont, New Mexico, Michigan, New Jersey, Arizona and Massachusetts.

Then in 2012, Colorado and Washington state legalized the drug for recreational use.

Now, just five years later, marijuana is legal for medical and recreational use in eight states: Massachusetts, Colorado, Washington, Alaska, Oregon, Nevada, California and Maine.

It is also legal for strictly medical use in the District of Columbia and 21 states: Montana, North Dakota, Arizona, New Mexico, Arkansas, Louisiana, Florida, Illinois, Minnesota, Michigan, Ohio, New York, Pennsylvania, Maryland, Vermont, New Hampshire, New Jersey, Rhode Island, Connecticut, Delaware and Hawaii.

The wave has given rise to a booming industry of edibles, dispensaries, cannabis healthcare professionals, and paraphernalia.

Marijuana is the national favorite according to a report published by Addictions.com, making up more than 70 percent of all drug use in the United States.

But experts warn researchers are struggling to keep up with the pace of legalization, and there are still many gaps in our knowledge.

However, some experts warn people are using the drug to self medicate for things like depression and anxiety despite research showing it does more harm than good.

In fact, there research shows that increased risk of depression as a result of frequent marijuana use is thought to be behind psychosis’ onset. The two mental health conditions have previously been linked.

‘A number of people choose to self medicate, but it could actually make things like anxiety and depression worse,’ Dr Lucy Troup, a professor of cognitive neuroscience at Colorado State University told Daily Mail Online.

‘We can’t fully understand yet the brain mechanisms that cause mental illness, but we’ve seen a clear link between marijuana use and users who report psychotic breaks. But again, it’s different for every person.’

In California medical marijuana can be used as a treatment for anxiety. In the other states and DC, someone suffering from anxiety or depression can apply for a medical marijuana license if their conditions are considered to be severe and debilitating.

COULD CANNABIS TREAT MIGRAINES?

Chemicals in cannabis could be effective at treating painful migraines, research revealed last month.

Cannabinoids, the compounds in marijuana that make you feel high, may be better at treating pain than recommended migraine medication, a study found.

Researchers from the Interuniversity Center in Florence found that pills containing the chemicals reduce the pain felt by migraine sufferers by 43.5 per cent.

The drug also had a number of additional effects, including stopping stomach aches and muscle pain, according to the researchers.

Previous research has found cannabis reduces migraines by targeting cells in the body that control pain relief and inflammation.

CAN MARIJUANA USE CAUSE A PSYCHOTIC BREAK?

Psychosis is defined as a condition that affects the mind and causes the sufferer to lose touch with reality.

Symptoms include:

  • delusions and hallucinations
  • feelings of paranoia and suspiciousness
  • disorganized thinking and speaking
  • loss of or decreased motivation
  • loss of or decreased ability to initiate or come up with new ideas
  • difficulties expressing emotion

Studies have found that marijuana is thought to cause psychosis-like experiences by increasing a user’s risk of depression. The two mental health conditions have been linked.

Frequently abusing the substance also significantly reduces a user’s ability to resist socially unacceptable behavior when provoked, research suggests.

‘We don’t understand the precise mechanisms for psychosis, but there is clear research that supports that cannabis use can lead to it,’ Dr Lucy Troup, a professor of cognitive neuroscience at Colorado State University told Daily Mail Online.

‘I can’t comment particularly on Kanye West’s case, because I don’t know a lot about him other than what the media says. But there are different variables that could have made it more likely such as how long it’s been used, when someone first started, how concentrated or potent the drug is that they are using, how they are taking it, and their specific genotype.’

Drug-induced psychosis is most commonly associated with LSD or amphetamines, but can also be caused by marijuana, cocaine and alcohol.

Results of a study by the University of Montreal revealed that going from being an occasional marijuana user to abusing the substance once a week or as often as every day, increases the risk of psychosis-like experiences by 159 percent.

The results also demonstrated that marijuana use reduces a person’s ability to resist socially unacceptable behavior in response to a particular stimulus.

KANYE WEST’S PAST MARIJUANA USE: COULD THE DRUG HAVE CAUSED THE RAPPER’S MENTAL BREAK?

In the past Kanye has been candid about his weed habit. He’s made multiple references in his songs. He also admitted to smoking before the 2015 Video Music Awards where he infamously announced his 2020 presidential candidacy.

Dr Troup explained that while she doesn’t know much about the rapper’s circumstance in particular, she was surprised to hear that Lloyd’s of London isn’t paying out.

She said that if a bank makes that claim about anyone, be it Kanye or someone less well known, the process to support that claim is long and complicated.

‘There isn’t enough knowledge about his [Kanye’s] medical history for anyone but his doctor to say for sure what caused his mental break,’ Dr Troup explained. ‘It would be a long and complicated process because they would have to look at his blood work, a hospital report, and a number of other things.’

‘I’m guessing when you insure a rock star you have to expect these kinds of things,’ she added.

A source has also told InTouch that Kim and Kanye are now worried footage taken by the rapper’s team in days prior to the tour’s cancellation could be used against him in court.

The video allegedly shows his mental state deteriorating before he broke down in the days leading up to his hospitalization.

Source: https://www.dailymail.co.uk/health/article-4758542/Could-marijuana-caused-Kanye-s-mental-breakdown.html
August 2017

Psychology of Addictive Behaviors journal makes corrections, SAM calls on media to correct stories

A prominent journal article about marijuana and health which resulted in media outlets reporting on marijuana’s harmlessness has now been corrected. A recheck of the statistics has now found that the incidence of psychotic disorders trended toward a 2.5-fold increase in marijuana users, a difference that went beyond a trend to reach significance in a one-tailed statistical test. This degree of impact matches very well the results of many prior studies involving marijuana use and psychosis though falls short of the five-fold increase in psychosis risk for marijuana users seen with the high strength strains that are more recently available.

Dr. Christine Miller, a former schizophrenia researcher from Johns Hopkins University and now Director of SAM Maryland, first alerted the journal, Psychology of Addictive Behaviors, last December. Some media outlets have already corrected their original story. 

“We commend the Washington Post’s Ariana Cha for now updating her story, and hope many more will follow her lead,” remarked Dr. Miller. “The flaw in the original University of Pittsburgh report were certain correction factors applied to the raw data, factors which are strongly affected by psychosis rather than being causes of such a disorder. These inappropriate corrections overpowered the marijuana effect. We’re glad the corrections have been made.”

SAM urges other media outlets to correct their headlines and stories.

The new data comes on the heels of a major report released by the State of Vermont’s Health Department which found that marijuana worsened conditions ranging from mental illness to motor vehicle accidents to negative pregnancy effects – and almost all of them are found to be worsened by marijuana:

Source: Email from SAM (Smart Approaches to Marijuana) <info@learnaboutsam.org>, January 2016

Link to clarification:

https://psycnet.apa.org/record/2015-58335-001

Abstract

BACKGROUND

Cannabis is one of the most abused drugs worldwide, with more than 20 million users in the United States (US). As access to cannabis products increases with expanding US legislation and decriminalization of marijuana, emergency physicians must be adept in recognizing unintentional cannabis toxicity in young children, which can range from altered mental status to encephalopathy and coma.

CASE REPORT

     We report the case of a 13-month-old female presenting with self-limiting altered mental status and lethargy, with a subsequent diagnosis of tetrahydrocannabinol exposure on confirmatory urine gas chromatography-mass spectrometry.

Why Should an Emergency Physician Be Aware of This?

         Considering caretakers rarely report possible cannabis exposure, history-taking must review caretakers’ medicinal and recreational drug exposures to prevent inadvertently missing the diagnosis. In the young child with altered mental status, prompt urine screening for cannabinoid detection can prevent further invasive and costly diagnostic investigations, such as brain imaging and lumbar puncture.

CASE REPORT
               A healthy 13-month-old, 12-kg female presented to the ED with injected conjunctiva and inappropriate staring for 2 h, followed by a half-hour period of somnolence. The mother denied any possible ingestions, fevers, vomiting, seizures, or head trauma. Birth and medical history were unremarkable.
        Growth and development were age appropriate. On presentation, patient was somnolent, but arousable with stimulation. Vital signs were: temperature 36.6C, heart rate of 127 beats/min, respiratory rate of 39 breaths/min, blood pressure of 98/66mmHg, and an SpO2 of 100% on room air. Pupils were equal and dilated to 6mm bilaterally.
Physical examination was otherwise unremarkable. Computed tomography of the head, chest x-ray study, electrocardiogram, complete blood count, comprehensive metabolic panel, and serum toxicology were unremarkable.
       The mother appeared intoxicated, with slurred speech and injected conjunctiva. Maternal cannabinoid intoxication was suspected and urine cannabinoids on the child were sent and returned positive. Upon result disclosure, the mother stated that the child recently consumed hemp seed milk. Urine gas chromatography-mass spectrometry (GC-MS) confirmatory test was positive for d-9- tetrahydrocannabinol (THC). Within 8 h, the child returned to baseline without any medical interventions other than observation. Poison control, social work, and child protection services were all notified and involved.

DISCUSSION
           Cannabis is one of the most abused drugs worldwide. Cannabis formulations, such as marijuana (dried, leaves), hashish (resin), and hashish oil (concentrated resin extract) can be inhaled or ingested. THC is the main psychoactive ingredient that binds to brain cannabinoid receptors, producing dose- and time-dependent stimulant, hallucinogenic, or sedative effects. Effects of inhaled cannabis occur within minutes after ingestion, peak within 15–30 min, and last up to 4 h post ingestion.

INTRODUCTION
          Cannabis is a psychoactive plant composed of more than 500 chemical components called cannabinoids, which exert their psychoactive effect by activating specific receptors in the central nervous system and immune system. Cannabinoids are among the most abused drugs worldwide, with an estimated 22.2 million users in the United States. Since 2017, medical marijuana has been legalized in 31 states, and 9 states have decriminalized recreational marijuana. In such states, emergency department (ED) visits and poison center calls for accidental cannabis intoxication have increased. With these changes, emergency physicians must be adept in recognizing unintentional cannabis toxicity in young children, as intoxication can result in encephalopathy and coma.

     Orally consumed cannabis has delayed effects, with onset ranging from 30 min to 3 h, lasting up to 12 h post ingestion. With the increased bioavailability of cannabis concentrates and the smaller body mass in children, toddler cannabis ingestion results in high serum THC levels, despite a small amount ingested.

     Pediatric cannabis intoxication has variable presentations, ranging from mentation changes to encephalopathy and coma. The most common symptoms are central nervous system depression (i.e., lethargy, coma), confusion, agitation, hypotonia, bilateral reactive mydriasis, and ataxia. Nausea and vomiting have been reported, along with bradycardia, bradypnea, hypotension, and respiratory depression necessitating mechanical ventilation. Other symptoms include tremor, hallucinations, nystagmus, slurred speech, and muscle weakness. With such nonspecific symptomatology, cannabis toxicity can mimic postictal states, encephalitis,or sepsis, which lead to unnecessary diagnostic evaluations.
    Prompt urine screening can prevent further invasive and costly workups, such as brain imaging and lumbar puncture, and may thwart the need for mechanical ventilation or i.v. antibiotics/antivirals for presumed meningoencephalitis. Initial urine screening is typically performed with the highly sensitive enzyme multiplied immunoassay technique, but can have false-positive results, as many drug metabolites can influence the test, including hemp seed products. The confirmatory test, GC-MS, will only test positive for THC, making it highly specific for cannabis ingestion.

       Hemp is derived from a strain of the cannabis sativa plant species that contains a much lower concentration of the psychoactive component, THC, and higher concentrations of cannabidiol. Due to the increased availability in natural grocery stores, hemp products have become increasingly popular as health supplements in children. In order for hemp products to be commercially sold in the United States, strict regulations enforce the THC component to be < 0.3% of the total product weight. Despite these strict regulations on THC content, a recent study byYang et al. demonstrated that hemp products, in fact, have a variable THC component and may contain up to 12 times the legal THC limit. Therefore, prolonged use of hemp seed oil may induce neurologic symptoms of THC.

       A recent case by Chinello et al. described a case of a 2-year-old child who developed neurologic symptoms after taking 2 teaspoons of hemp seed oil per day for 3 weeks. No antidote exists for cannabis toxicity and activated charcoal is not effective. Management is largely supportive and most pediatric patients are observed and return to baseline within 8–12 h. Pediatric cannabis intoxication should be reported to child protection services to identify neglect and at-risk families and enhance child safety.

       Pediatric cannabis ingestions are more frequent due to rising marijuana use in the United States (US). In a comparison of state trends in unintentional pediatric marijuana exposures, as measured by call volume to US poison centers, call rates in states that had passed legislation prior to 2005 were increased by 30%, juxtaposed to non-legal states, where call volume remained unchanged. Despite its increasing availability, reports of unintentional pediatric cannabis ingestion leading to toxicity are uncommon. History taking must review both medicinal and recreational drug exposures to prevent missing the diagnosis. Knowledge of substances that can lead to false positives is imperative. Pertinent to our case, hemp product consumption will not result in a positive cannabinoid urine confirmatory test, as hemp does not contain enough THC to induce toxicity. However, recent data show hemp seed oil products may have substantially more THC than the level acceptable for commercial hemp use, and with prolonged exposure may induce toxicity. Our case involved an acute exposure and is therefore unlikely to cause any related toxicities.

      Lastly, with the growing popularity of edible marijuana products, which typically resemble candy and may be alluring to the exploratory toddler, emergency physicians must be vigilant when considering potential cannabis toxicity.

WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?
As access to cannabis increases, emergency physicians must recognize pediatric unintentional cannabis toxicity. Prompt cannabinoid urine screening can prevent further invasive diagnostic investigations.

Source: https://www.ncbi.nlm.nih.gov/pubmed/30340924 January 2019

 

The new 2016-2017 National Survey on Drug Use and Health State Estimates is out this week. The graphs above illustrate a few of the findings from this annual survey conducted by the Substance Abuse and Mental Health Services Administration. Numbers in graphs are percentages. The graphs can be downloaded starting Thursday, December 6 here. National Families in Action grants permission to reproduce them for educational purposes.

Source: Email from National Families in Action’s The Marijuana Report <nfia@nationalfamilies.org>  December 2018

  • Cannabis interferes with a user’s ability to recognize, process and empathize with human emotions including happiness, sadness and anger
  • Pot smokers were shown faces depicting different emotions in tests
  • They were hooked up to brain monitoring device, looking at activity levels 
  • Cannabis users showed greater response to negative emotions 
  • And those smoking marijuana showed lower response to happy emotions 

Smoking cannabis alters a person’s ability to perceive and judge emotions, a study has found.

The drug interferes with user’s capacity to recognize, process and empathize with human emotions, including happiness, sadness and anger.

But the results also suggest that the brain may be able to counteract these effects depending on whether the emotions are directly, or indirectly detected.

The complex biochemistry of marijuana and how it affects the brain is only beginning to be understood.

Dr Lucy Troup, assistant professor of psychology at Colorado State University, has set out to answer specifically how, if at all, cannabis use affects a person’s ability to process emotions.

She has long been fascinated by the psychology of drugs and addiction.

‘We’re not taking a pro or anti stance, but we just want to know, what does it do? It’s really about making sense of it,’ she said. 

For almost 20 years Dr Troup and her graduate students have been conducting experiments to measure the brain activity of about 70 volunteers.

They all identified themselves as chronic, moderate or non-users of cannabis.

They were all vetted as legal users of cannabis, and were either medical marijuana users aged 18 or older, or recreational users aged 21 or older.

The experiments involved the participants looking at faces depicting four separate expressions: neutral, happy, fearful and angry, while they were hooked up to an electroencephalogram (EEG), which shows the electrical activity of the brain.

Cannabis users showed a greater response to faces showing negative expressions, especially angry faces, when compared with a control group of non-cannabis users. In contrast, those who used the drug showed a smaller response to positive expressions – happy faces – compared with the control group

Cannabis users showed a greater response to faces showing negative expressions, especially angry faces, when compared with a control group of non-cannabis users.

In contrast, those who used the drug showed a smaller response to positive expressions – happy faces – compared with the control group.

Those taking part in the study were also asked to pay attention to the emotion and identify it.

Researchers noted in those cases, users and non-users of cannabis could not be told apart.

But, when they were asked to focus on the sex of the face, and then identify the emotion, cannabis users scored much lower than non-users.

This signified a depressed ability to ‘implicitly’ identify emotions.

Cannabis users were also less able to empathize with the emotions, the scientists found.

They said their findings seem to suggest the brain’s ability to process emotion is affected by cannabis, but there may be some compensation that counteracts those differences.

The study is published in the journal PLOS ONE.

Source: https://www.dailymail.co.uk/health/article-3472039/Cannabis-DOES-alter-brain-s-ability-process-emotions-experts-warn.html  March 2016

Dear David,

I am sending you below a copy of a letter I have sent to the Premiers of Canada – and other members of the worldwide drug prevention community, plus an email to UN HQ in New York.   Since they get so many letters I thought it would be sensible to send you a copy direct as it might take time for you to receive it through UN internal mail.

Dear Premiers,

As members of the worldwide drug prevention community we have been reading with increasing concern and disbelief the way that Canada seems to be bulldozing through legislation that can only damage the citizens of your country – not the least the children.

The Rights of the Child Treaty, under article 33 of the international drug conventions, would be breached if this legislation is allowed to be ratified.

Under the terms of the convention, governments are required to meet children’s basic needs and help them reach their full potential. Since it was adopted by the United Nations in November 1989, 194 countries have signed up to the UNCRC,

United Nations Convention on the Rights of the Child (CRC) is an important international legal instrument that obligates States Parties to protect children and youth from involvement with illicit drugs and the drug trade.

Canada is a signatory to the CRC – which is a legally binding document.  Should your country go ahead with the decision to legalise marijuana – against all the evidence from respected scientists and Health authorities worldwide Canada would be an outcast by those 193 nations who have agreed and signed to Article 33.

We find it astonishing that the wealth of evidence and opinion in Canada and  worldwide,  on the harmfulness of marijuana would seem to have been totally ignored by your parliamentarians.   Indeed new evidence relating to the epidemic of gastrochisis was submitted in good time by our Australian colleague Dr. Stuart Reece and was not allowed to be presented.   Instead you have been persuaded by groups that want marijuana to be ‘the new tobacco’ – headed of course by George Soros, that this will not be harmful to your citizens, that it will bring in tax revenues and that it would destroy the black market. 

However, there was a study done a few weeks ago by the Canadian Centre on Substance Abuse and Addiction finding that just in Canada alone, a much smaller country than the U.S. in population, marijuana-related car crashes cost a billion dollars. That’s just the car crashes, and those were directly related to marijuana. And the report came from a government think tank, not any kind of anti-drug group.

We heard many of these same promises in 2012 when Colorado legalized recreational marijuana. Yet  in the years since, Colorado has seen an increase in marijuana related traffic deaths, poison control calls, and emergency room visits. The marijuana black market has increased in Colorado, not decreased. And, numerous Colorado marijuana regulators have been indicted for corruption.

New reports out of Colorado indicate that legal marijuana  is posing real risks to the safety of young people. As Colorado rethinks marijuana, the rest of the nation should watch carefully this failing experiment.

Healthcare officials representing three hospitals in Pueblo, Colorado, issued a statement on April 27 in support of a ballot measure that would end Marijuana commercialization in the city and county of Pueblo. “We continue to see first-hand the increased patient harm caused by retail marijuana, and we want the Pueblo community to understand that the commercialization of marijuana is a significant public health and safety issue,” said Mike Baxter, president and CEO of Parkview Medical Center.

Among their concerns are  a 51 percent increase in number of children under 18 being treated in Parkview Medical Center emergency rooms.  Furthermore, of newborn babies at St. Mary-Corwin Hospital, drug tested due to suspected prenatal exposure, nearly half tested positive for marijuana.

Having read the above, how can Canadian legislators possibly believe that legalising marijuana would, in any way, be advantageous for their country ?

Yours faithfully,

Peter Stoker,  Director,  National Drug Prevention Alliance  (UK)

Source: A letter forwarded by Peter Stoker to David Dadge, spokesperson for UN Office ON Drugs and Crime (UNODC), originally sent to the Premiers of Canada  September 2017

A three-month-old baby boy died after being left alone overnight while his mother smoked cannabis, a serious case review has found.

Social services dealt repeatedly with the child’s family before his death but closed the case after the woman said she had stopped using drugs.

A police investigation into potential neglect is currently ongoing. The review found the level of support provided to the family was “a proportionate response”.

The baby, who can be identified only as Child E, suffered a cardiac arrest in September 2017 after being found unresponsive with a blanket over his head at a home in Rochdale.

His mother, who also cannot be named, subsequently told police she had been using cannabis on the night before his death and had left the house between 01:00 and 02:00 BST to go to a local garage. The baby had been left lying in his pram for 12 hours without being checked.

Substance misuse

A serious case review by the Rochdale Borough Safeguarding Children Board found the family had interacted with police and health and social care workers repeatedly in the months before his death.