Health

Yngvild Olsen and Sunny Patel – February 25, 2026

Ms. B (identified by first initial of last name for privacy) had never told anyone about the sexual abuse she had suffered at the hands of her uncle as a young child. For years during her adolescence, the secret festered, driving her to run away from home, drop out of school, and begin drinking and taking opioids to numb the pain.

It wasn’t until she was sitting in a brightly lit room with other women at the clinic where she had started treatment for her opioid use disorder, surrounded by rainbow-colored positive affirmations, drinking a cup of hot coffee, and laughing at a joke the peer specialist had just told, that she felt safe enough to start telling her story.

Substance Abuse and Mental Health Services Administration (SAMHSA) grant funds had paid for the affirmation signs, the coffee, and the salary for the peer specialist. Ms. B was one of many women that year who benefitted from this care designed specifically to address the trauma that contributed to the development of their substance use disorders. And it was working.

Yet on January 13, that progress for Ms. B and many others was threatened. With no announcement or reasoning, the federal government abruptly cut $2 billion in already awarded grants to SAMHSA—an agency likely unfamiliar to most Americans, but one that undergirds and forms the safety net for the country’s behavioral health system. There was no warning for an agency already cut by $1 billion last year, hit with significant staff reductions, and poised to be subsumed under a new proposed entity, the Administration for a Healthy America, within the Department of Health and Human Services (HHS). Programs across the country were zeroed out overnight. Only after intense public outcry did the administration reverse course.

In early February, Congress passed bipartisan appropriations to preserve SAMHSA’s structure and funding, clearly signaling the little agency and its work is essential to the nation’s behavioral health system. This is welcome relief to the uncertainty just weeks ago. Adding to a recent focus on behavioral health, President Trump issued a related Executive Order, Addressing Addiction Through the Great American Recovery Initiative, on January 29. This order establishes a new interagency taskforce to provide recommendations and guidance for better coordination and alignment of relevant federal programs. On February 2, HHS Secretary Kennedy announced a new $100 million SAMHSA grant program, the Safety Through Recovery, Engagement, and Evidence-based Treatment and Supports, or STREETS Initiative, to fund outreach, mental health care, medical stabilization, crisis intervention, and linkages to housing for people experiencing homelessness and addiction.

These are welcome, if unclear, actions, and they come on the heels of the whiplash caused by mass grant cancellation and reversal—a terrifying stress test that exposed just how fragile America’s behavioral health infrastructure has become.

This is juxtaposed with recent data from the Centers for Disease Control and Prevention that demonstrated another remarkable and welcome increase in life expectancy in America on the heels of reductions in overdose mortality. However, much of the federal infrastructure that contributed to this progress was nearly dismantled overnight.

Confusion About Behavioral Health Care And The Role Of SAMHSA

What happened in mid-January reveals a deeper misunderstanding of how behavioral health care actually works in America, and why weakening SAMHSA puts lives at risk.

Despite progress, substance-related conditions, including accidents and unintentional injuries, and suicides remain among leading causes of death for people ages 25–64 in the United States. Millions of Americans continue to struggle with untreated or inadequately treated substance use disorders and mental illness. And communities everywhere—urban, rural, tribal—are grappling with shortages of trained providers, fragmented systems, and rising demand for services.

SAMHSA is the only federal public health agency whose sole mission is to address the full continuum of behavioral health needs—from prevention to treatment to supporting individuals in recovery. Its work does not replace direct clinical care. It often funds services that fall outside of traditional insurance models yet exist as glue in a system.

Take overdoses, for instance. SAMHSA funding has enabled states to saturate their communities with naloxone, a life-saving overdose reversal medication. SAMHSA investments have supported training for first responders and community organizations on how to recognize and respond to overdose. These investments are not abstract. They show up in emergency departments, resulting in fewer fatal overdoses, and in communities where people survive long enough because of SAMHSA funding to engage with treatment and sustain recovery.

As former career federal officials at SAMHSA and as physicians who continue to see patients, we’ve seen the agency’s work and impacts firsthand at the individual, family, and community levels. We’ve also seen how the programmatic expertise SAMHSA brings has helped other federal agencies make major systems level changes; examples include 1) the Drug Enforcement Administration’s regulatory flexibilities allowing for telehealth initiation of buprenorphine for the treatment of opioid use disorder, and 2) the Centers for Medicare & Medicaid Services promulgating a new billing code for peer support services in the 2024 Physician Fee Schedule. SAMHSA’s unique focus on the behavioral health needs of the country is what makes its role and work so special.

SAMHSA also recognizes that the work of saving lives and improving behavioral health wellbeing is done on the ground by trained and knowledgeable individuals. Few federal agencies other than SAMHSA fund the ongoing training and technical assistance needed to make sure the public health, public safety, and health care professionals serving people with, or at risk for, behavioral health conditions are up on the latest research and best practices. For example, grant programs such as the Addiction and Prevention Technology Transfer Centers, Center for Mental Health Implementation Support, and Opioid Response Network have provided cutting-edge support to thousands of public health and health care professionals, first responders and other public safety officials, state level professionals, and policymakers.

Many of these services and training/technical assistance grants were on the chopping block just a few weeks ago. Even though the cuts were ultimately restored, the whiplash furthered an unnerving sense of instability that began in spring 2025 with Secretary Kennedy’s announcement of a planned new Administration for a Healthy America that would comprise SAMHSA and several other HHS operating divisions. Collectively, these actions have undermined workforce morale, disrupted planning, and eroded trust in the federal government being a reliable partner. The grant funds were restored; the trust was not.

Looking Forward

The next question is what happens now that the fiscal year funding has passed.

Appropriations language alone does not ensure implementation. Take, for instance, the prior massive workforce reductions at the agency and the sudden $1 billion cut last year that required 23 states and the District of Columbia to file suit and obtain injunctions to continue the flow of funding. Most recently, on January 23, $5 billion in essential public health infrastructure funding by CDC to local health departments around the country was suddenly paused and then “unpaused” 24 hours later; these dollars were also appropriated by Congress. And a recent article in Health Affairs Forefront found that SAMHSA had spent only 34.6 percent of its FY 2025 budget allocation, based on a review of USAspending.gov accounts.

Congress must exercise sustained oversight to ensure the administration fully executes on the will of Congress, that grants are reliably administered, and that the workforce and technical assistance infrastructure are rebuilt rather than quietly hollowed out. Such robust oversight and accountability functions have been lacking. Thus, it will be important for SAMHSA grantees, state behavioral health administrators, family members, and others with a vested interest to raise issues and concerns with their Congressional representatives regularly and urgently when there are future drastic changes to funding and programs. Ensuring that individuals, families, and communities impacted by substance use get the help they need is a bipartisan concern.

We also need hearings on what has happened, as well as Office of Inspector General and Government Accountability Office reports on the work SAMHSA and related agencies are doing and where they are falling short. We need active engagement with Congressional representatives where these dollars are awarded (and that’s every state and territory in the United States) to ensure that the money allocated is being disbursed by the government and reaching the communities it is intended to serve. The lesson of January is that sustained advocacy works, but vigilance is required to ensure follow-through on Congressional intent for appropriated funding.

SAMHSA may be little known to the general public, but its work touches millions of lives. Weakening it when the nation is finally turning the corner on the overdose crisis is a risk we cannot afford to take. Saving it once is not enough; ensuring its stability is the next test. Ultimately, the measure of our national commitment will be whether Congress secures long-term stability for SAMHSA.

Ms. B found her voice in a room funded by a government grant. We must ensure that those healing spaces continue to exist, the lights are still on, and the peer specialist is still employed when the next person walks through the door seeking help.

Authors’ Note:

Manatt Health works with a diverse group of clients, including states; state and federal policy makers and agencies; payers; health care providers and systems; foundations; associations; consumer organizations; and pharmaceutical, biotech, and device companies.

Dr. Olsen is a member of the American Society for Addiction Medicine (ASAM), serves on an ASAM Criteria Implementation Committee, and has a small clinical advisory role with them.

Source: https://www.healthaffairs.org/content/forefront/congress-has-preserved-substance-abuse-and-mental-health-services-administration-samhsa

Filed under: Addiction,Drug use-various effects,Health,Latest News,Mental Health,Prevention and Intervention,Strategy and Policy,Treatment and Addiction,USA :

Sir,

The article by Sophie Christie (Telegraph Business 22 June ) could be read as a paean for Cannabis based medications and CBD particularly.

While we have long suspected and said, that CBD in particular may well have clinical uses, that is with caution.

Evidence for the epigenetic and teratogenic effects of cannabis can easily be found via Google Scholar.

The NHS Wales lists the risk for Gastroschisis (babies with large intestines outside their bodies). Cannabis and Cocaine are both suspect.

There has been a gastroschisis outbreak in South Wales.

CBD is not off the hook, therefore self-medication and mass marketing of it and products containing it, may not be a good idea.

As long ago as 1973 Professor Gabriel Nahas MD, PhD, DSc of Columbia University gave evidence to a Senate Committee that, in vitro at least, molecules of the cannabinoids CBD and CBN, were, like THC, potent inhibitors of DNA production.

There seems to be a danger of CBD being oversold in the rush to market.

The last Teratogen that was marketed extensively was Thalidomide, we all know how that turned out.

The pharmaceutical regulation system, in a 1^st world nation like the UK, is onerous for very good reason.

We should trust that system , not seek to by-pass it

David Raynes

National Drug Prevention Alliance

Slough.

Source: Email from David to dtletters@telegraph.co.uk June 2018

Filed under: Cannabis/Marijuana,Drug use-various effects on foetus, babies, children and youth,Genes,Health,Latest News,Marijuana and Medicine :

Submitted by Dave Evans via Drug Watch International – 12 February 2026

If America’s pot problem is becoming so evident that even the legacy media is pumping the brakes, how bad is it?

By Zach Jewell – DailyWire.com – Feb 11, 2026

The New York Times editorial board expressed concern this week that the massive marijuana craze in America might have some major side effects — besides drowsiness and the munchies.

The Times editorial board, which dedicated a series of articles to pushing for marijuana legalization over 10 years ago, admitted on Monday that some of its arguments for legalized weed have been proven wrong after states began allowing recreational and medicinal marijuana use. It seems that many talking points from the pro-marijuana legalization side are falling apart as research uncovers some brutal truths about America’s pot craze.

“In our editorials, we described marijuana addiction and dependence as ‘relatively minor problems.’ Many advocates went further and claimed that marijuana was a harmless drug that might even bring net health benefits. They also said that legalization might not lead to greater use,” the Times editorial board wrote. “It is now clear that many of these predictions were wrong. Legalization has led to much more use. Surveys suggest that about 18 million people in the United States have used marijuana almost daily (or about five times a week) in recent years. That was up from around six million in 2012 and less than one million in 1992. More Americans now use marijuana daily than alcohol.”

Later, the editorial board added, “The unfortunate truth is that the loosening of marijuana policies — especially the decision to legalize pot without adequately regulating it — has led to worse outcomes than many Americans expected. It is time to acknowledge reality and change course.”

It’s rare for the Times to admit to so clearly pushing a narrative that turned out to be wrong. So, if America’s pot problem is becoming so evident that even the legacy media is pumping the brakes, how bad is it?

Addiction and other health issues stemming from marijuana use have spiked in the past decade as more states hopped on the pot bandwagon. As the Times pointed out, a large percentage of marijuana users aren’t just smoking a joint or two on the weekend; they’re consuming marijuana on a daily basis. According to research from Yale Medicine, a staggering 30% of cannabis users “meet the criteria for addiction.”

This heavy reliance on marijuana comes with multiple potential health risks, including cannabinoid hyperemesis syndrome, which gives users intense stomach pain and can cause vomiting. At least one recent study has also linked cannabis use to schizophrenia. The study, published in “Psychological Medicine,” found that up to 30% of schizophrenia cases in young men can be linked to cannabis use disorder.

A study conducted by UC San Diego School of Medicine and the New York University Grossman School of Medicine, meanwhile, found that employees who use cannabis regularly were more likely to miss work.

The advocacy group Smart Approaches to Marijuana has also pointed to research showing that driving fatalities involving marijuana skyrocketed between 2000 and 2018. Kevin Sabet, the president and CEO of Smart Approaches to Marijuana, told The Daily Wire that legalization leading to Increases in addiction was “absolutely predictable.”

Despite the promises of the legalizers, federal data show that (just as the Times notes) legalization drives use, including youth use increases,” Sabet said. “This is true in the national aggregate and in individual state data. It’s not rocket science: If you make a powerful addictive drug easier to access (and send the signal that it’s OK to use in the process), more people are going to use it. That is what I and many other people who were aware of the danger warned would happen and it is precisely what did happen.”

Now that nearly half the country has legalized marijuana in some or all forms, Sabet said the best path forward is for “states to focus on making sure that people, and above all young people, know how dangerous and destructive marijuana is: a permanent investment in infrastructure meant to promote prevention and awareness.”

“And it’s beyond important to remember here what the Times piece truly reveals,” he added. “Namely, that while people may disagree about policies and execution, they are now all agreed on the same set of facts. And those facts show beyond doubt that marijuana is dangerous, addictive, and creating havoc across America.”

The data pointing to some of these issues was available when the Times editorial board began publishing its series arguing for federal legalization. In a 2014 paper, researchers Hefei Wen, Jason M. Hockenberry, and Janet R. Cummings found that marijuana legalization led to an increase in marijuana abuse and dependence. The 2014 paper also found that as legalization surged, so did the rate at which adolescents experimented with the drug.

Ironically, the Times editorial board’s shift on marijuana coincides with the federal government in the process of reforming how it regulates the drug. In December, President Donald Trump signed an order to open the door to reclassifying marijuana as a Schedule III drug, meaning marijuana would be in the same category as drugs that have “a moderate to low potential for physical and psychological dependence.” For decades, the U.S. government has categorized marijuana as a Schedule I substance, which is defined as “no currently accepted medical use and a high potential for abuse.”

The U.S. government’s potential reclassification would not legalize marijuana at the federal level, but it could reduce the scale of marijuana-related offenses. As the president was considering the marijuana reclassification last year, nearly 50 organizations signed a letter urging Trump to keep marijuana classified as a Schedule I drug, arguing that marijuana “fits squarely” in the definition of a Schedule I drug, “a fact acknowledged in every scheduling review prior to 2023.”

Source: www.drugwatch.org

Filed under: Addiction,Cannabis/Marijuana,Culture,Drug use-various effects,Health,Marijuana and Medicine,Strategy and Policy :

Submitted by Maggie Petito – Drug watch International – 01 February 2026

By Nav Rahi with Ben Simon in Toronto – AFP NEWS Jan 31, 2026

Over 35 years as a drug user, Vancouver resident Garth Mullins said he’s had “hundreds and hundreds” of interactions with police, and long believed drug decriminalization was smart policy.

“I was first arrested for drug possession when I was 19, and it changes your life,” said Mullins, who is now in his 50s and was an early backer of Canadian province British Columbia’s decriminalization program that ended on Saturday.

“That time served inside can add up for a lot of people. They do a lifetime jolt in a series of three‑month bits,” he told AFP.

BC’s three-year experiment with drug decriminalization, which launched in 2023 and shielded people from arrest for possession of up to 2.5 grams of hard drugs, was ground-breaking for Canada.

Many praised it as a bold effort to ensure the intensifying addiction crisis devastating communities across the country was treated as a healthcare challenge, not a criminal justice issue.

But on January 14, BC’s Health Minister Josie Osborne announced the province would not be extending the program.

“The intention was clear: to make it easier for people struggling with addiction to reach out for help without fear of being criminalized,” Osborne said.

The program “has not delivered the results we hoped for,” she told reporters. For Mullins, the province’s desired results were never realistic.

The former heroin user, who currently takes methadone, is an activist and broadcaster who co‑founded the Vancouver Area Network of Drug Users (VANDU), which advised BC’s government on decriminalization.

At VANDU’s office in Vancouver’s Downtown Eastside neighborhood, home to many drug users, the walls are full of pictures honoring those who have died from overdose.

“The idea behind decriminalization was one simple thing: to stop all of us from going to jail again and again and again,” he said.

Breaking the cycle of arrests is crucial because criminal records make it more difficult to find work and housing, often perpetuating addiction, experts say.

But thinking decriminalization could help steer waves of users into rehab was misguided, and misinforming the public about the possible outcomes of the policy risked a backlash, Mullins said.

“For everybody out there, in society, sending fewer junkies to jail might not sound like a good thing to do.”

After the province announced the program’s expiration, Canadian media was filled with critics who said it had been mishandled.

Vancouver police chief Steven Rai said his force had been willing to support the plan, but “it quickly became evident that it just wasn’t working.”

Decriminalization “was not matched with sufficient investments in prevention, drug education, access to treatment, or support for appropriate enforcement,” he added.

Cheryl Forchuk, a mental health professor at Western University who has worked on addiction for five decades, said BC “never really fully implemented” decriminalization because the essential complementary programs — especially affordable housing supply — were never ramped up. “It was like they wanted to do something, but then really didn’t put the effort into it and then said, gee, it didn’t work,” she told AFP.

BC’s experience mirrors that in the US state of Oregon, which rolled back its pioneering drug decriminalization program in 2024 after a four-year trial.

Like in Oregon, BC’s program faced fierce criticism, with many saying public safety was threatened by a tolerance of open use.

A flashpoint moment in the western Canadian province was a 2024 incident where a person was filmed smoking what appeared to be a narcotic inside a Tim Hortons, the popular coffee shop chain frequented by families across the country.

Local politicians in Maple Ridge, BC, attributed the incident to a permissiveness about drugs ushered in by decriminalization. But for Mullins, the incident spoke to broader misconceptions about the intent of the policy.

Decriminalization did not allow for drug use inside a restaurant, and the person could have been arrested. Drug user advocates, he added, don’t want policy that makes the broader public feel threatened.

“We need something where everybody feels safe, right? If people who are walking with their kids don’t feel safe, that’s a problem for me,” he said. But, he added, security also matters to users for whom “the world feels very scary and unsafe.”

Source: www.drugwatch.org

—

Filed under: Canada,Crime/Violence/Prison,Culture,Drug use-various effects,Health,Political Sector,Prevention and Intervention,Strategy and Policy,Treatment and Addiction :

The previous site of the overdose prevention site is seen on the intersection of Seymour Street and Helmcken Street. The site moved to Howe Street in April 2024, which has now closed. (Justine Boulin/CBC)

A Vancouver overdose prevention site has closed less than two years after it moved from its previous location, raising concerns among health officials and harm reduction advocates as the province sees record number of overdose calls to emergency services.

The Thomus Donaghy Overdose Prevention Site, located at 1060 Howe St., shut its doors Saturday, according to Vancouver Coastal Health.

The health authority says the owner of the building, Prima Properties, notified them to leave the property by the end of January after hearing a number of complaints from nearby residents.

CBC News reached out to the building’s owner to understand the scope and nature of the complaints but did not hear back by deadline.

Dr. Patricia Daly, VCH’s chief medical health officer said the health authority took steps to address neighbourhood concerns, including hiring security, conducting needle sweeps, and placing staff on the sidewalk to prevent disorder.

“I myself frequently went down and observed that things seemed to be operating as they should,” Daly said.

The Howe Street location opened after the site was moved from Seymour Street in Yaletown in April 2024 following public safety concerns and backlash from nearby residents.

“It was actually a very good location, not visible to people on the street,” Daly said.

It was the only one of its kind in what VCH calls the Vancouver City Centre area, which includes most of downtown, the West End and Fairview.

“That neighbourhood has the second highest rate of overdose deaths in our region, and the third highest rate in the entire province,” Daly said.

Daly says the OPS typically saw about 400 to 500 visits per week and has reversed more than 300 overdoses since its opening.

Across Vancouver, there are 12 overdose prevention sites, most of them located in the Downtown Eastside. But with the latest closure, that number drops to 11.

People who relied on the site will be directed to services in the Downtown Eastside, which is about a 30-minute walk away.

************

Earlier this week, the B.C. Centre for Disease Control issued a province-wide drug alert, noting new substances in the unregulated drug supply are putting people at risk province-wide.

It says medetomidine, used primarily by veterinarians to sedate animals, is now being mixed with opioids like fentanyl.

Harm reduction and recovery advocate Guy Felicella said closing overdose prevention sites at a time like this is “disappointing and sad.”

“With the drug supply this deadly, not only you’re going to see people consuming substances out in the community, we could also witness people dying out in the community,” he said.

Felicella says overdose prevention sites played a critical role in his personal life.

“I struggled in this area and the Downtown Eastside for decades and I was brought back to life multiple times at these services,” he said.

Daly says the health authority is working with the City of Vancouver and other partners to identify a permanent or at least a temporary replacement location but she says it has become increasingly difficult to find a location that would host overdose prevention services.

“We hope to have something available on at least a temporary basis within the next week or two,” she said.

Source: https://www.cbc.ca/news/canada/british-columbia/thomus-donaghy-overdose-prevention-site-closing-9.7069806

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by Deborah Brauser, Medscape Medical News – January 16, 2026

Researchers have identified the specific number of weekly delta-9-tetrahydrocannabinol (THC) units beyond which the risk for cannabis use disorder (CUD) increases.

Using standard THC units — defined as 5 mg of THC per unit — the investigators found that consuming more than 8.3 units per week among adults (about 41 mg of THC) and more than 6.0 units per week among adolescents (about 30 mg of THC) represented the optimal cutoffs for increased risk for any CUD.

Higher thresholds — 13.4 units per week for adults and 6.45 units per week for adolescents — were associated with the risk for moderate-to-severe CUD. The UK study, which included adults and teens, showed the accuracy of using weekly standard THC units to identify CUD was high across all models assessed.

Lead author Rachel Lees Thorne, MD, Addiction and Mental Health Group, Department of Psychology at the University of Bath, Bath, England, noted that 8 units per week equate to approximately 0.33 g of herbal cannabis on the UK market.

“This will likely be a lower amount than people who use cannabis regularly would typically consume and highlights that CUD can occur even with relatively lower levels of consumption,” Thorne told Medscape Medical News.

She added that although the findings may not be generalizable to other settings where cannabis products and use patterns differ, the investigators hope that framing use in THC units could help clinicians have more informed conversations with patients and better track cannabis-related behaviors.

The investigators also noted that theirs is the first study to estimate risk thresholds for CUD based on standard THC units mirroring the way alcohol units are used to calculate higher risk for drinking.

The findings were published online on January 12 in Addiction.

Risk Threshold

About 22% of individuals who use cannabis go on to develop CUD, a pattern of use that leads to clinically significant distress and/or impairment. The investigators noted that in the UK, cannabis use is cited as a problem drug by 87% of patients younger than 18 years who are in drug treatment programs.

A paper published in 2019 proposed that in the US, a “standard THC unit” should be set at 5 mg of THC across all cannabis products and methods of administration.

In 2021, NOT-DA-21-049: Notice of Information: Establishment of a Standard THC Unit to be used in Research the US National Institutes of Health (NIH) agreed, defining a standard THC unit as “any formulation of cannabis plant material or extract that contains 5 mg of THC.” In its announcement, the NIH added that the definition would apply to any future applications proposing research on cannabis or THC.

In the current study, the investigators used data from the observational CannTeen study of 65 adults aged 26-29 years (54% men) and 85 teens aged 16-17 years (56% girls) from London who reported using cannabis at least once during the 1-year study period.

The Enhanced Cannabis Timeline Followback was used to estimate mean weekly THC units by assessing quantity, frequency, and potency of consumed cannabis. A diagnosis of CUD was assessed using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, with “any CUD” describing a composite of mild, moderate, or severe versions of the condition.

Receiver operating characteristic curve models were used to determine how well weekly standard THC units could distinguish between no CUD and either any CUD or moderate/severe CUD.

Results showed an area under the curve (AUC) of < 0.7 for all models assessing discrimination accuracy of weekly standard THC units on CUD.

For determining no CUD from any CUD, the AUC was 0.79 in the adult-only model and an “outstanding” 0.94 for adolescents. The AUCs were 0.82 and 0.94, respectively, for determining no CUD from moderate/severe CUD.

The optimal risk cutoffs for any CUD were 8.3 units of THC per week for adults and 6.0 units per week for adolescents; for moderate/severe CUD, the optimal risk thresholds were 13.4 and 6.45 units per week, respectively.

Measuring cannabis use with standard THC units “appears to show good discrimination accuracy of [CUD] at different severities and in different age groups,” the investigators wrote.

“Safer levels of cannabis use, defined by low weekly standard THC unit consumption, could be recommended in lower risk cannabis use guidelines,” they added.

‘A Much Needed Start’

In an expert roundup by the Science Media Centre, Marta Di Forti, MD, PhD , Institute of Psychiatry, Psychology & Neuroscience at King’s College London in London, England, noted that using this type of standardized measurement could become an “important tool” in both research and clinical settings — in about the same way standardized alcohol units have become.

However, “it is important to remember that cannabis, unlike alcohol, does not contain only one active ingredient but over 144 cannabinoids,” said Di Forti, who was not involved in the current research.

Still, THC units are, “undoubtedly, a very important and much needed start,” she added.

David Nutt, DM, Edmond J. Safra Professor of Neuropsychopharmacology and director of the Neuropsychopharmacology Unit in the Division of Brain Sciences – Faculty of Medicine at Imperial College London in London, noted in the roundup that the analysis provided a “welcome update” on recreational THC risks that can lead to dependence.

“What needs to be done now is to facilitate recreational cannabis users in determining exactly how much they are using to help them control their risk,” Nutt said.

“The best way would be through a regulated cannabis market with clear product quality and identification of unit amounts…plus a credible and honest educational program,” he added.

Source: Medscape Medical News

Filed under: Addiction,Cannabis/Marijuana,Drug use-various effects,Health,Prevention and Intervention,Treatment and Addiction,UK :

Published by Michigan State University College of Human Medicine:

Michigan State University College of Human Medicine. (2025). At least 1 in 6 pregnant Michigan women uses cannabis. MSUToday. https://humanmedicine.msu.edu/news/2025-at-least-1-in-6-pregnant-michigan-women-uses-cannabis.html

Marijuana use among pregnant women has exponentially increased over the last 20 years. According to the American College of Obstetricians and Gynecologists (ACOG), pregnant women, especially those from high-income countries like the United States, have reported use ranging from 3.9% to 22.6%. This change in the landscape of substance use is observed in states like Michigan where both medical and recreational marijuana are legal. As access expands and perception shifts, researchers are racing to understand the number of pregnant women using marijuana and what factors shape that decision.

A recent study from the University of Michigan analyzed data of self-reported marijuana use and urine toxicology testing from 1,100 mothers in Michigan between 2017 and 2023, finding that 1 in 6 pregnant mothers used marijuana and in some parts of the state, that number is as high as 1 in 4.

Other key findings include:

· 25% reported using marijuana 3 months prior to becoming pregnant

· 12.3% self-reported using marijuana while pregnant

· 13.3% tested positive from urine toxicology testing

When self-reported use was considered together with urine toxicology results, the prevalence reached 16.8%, substantially higher than the national average of 9.8%. This study also found that single pregnant individuals, those with lower educational attainment, individuals who presented with symptoms of depression, or who had a history of Adverse Childhood Experiences (ACEs) had a higher likelihood of prenatal marijuana use.

Why are pregnant women turning to marijuana?

· Perceived safety: nearly 1 in 5 pregnant women believed that weekly marijuana use poses “no risk”

· Affordability: Michigan’s cannabis market is one the largest in the country, with prices dropping from ~$267 to $65/ounce in 2025

· Symptom relief: 81.5% reported using it to relieve stress, anxiety

· Ease of acquisition: 91.7% of pregnant users said that it was easy to obtain

The increased prevalence of marijuana use discovered in this and many other studies, suggest that many pregnant individuals may not fully understand the risks or may be using marijuana for symptom relief without the guidance of their healthcare provider.

To learn more about the risks of marijuana use during pregnancy and parenthood, visit marijuanaknowthetruth.org/marijuana-and-pregnancy for science-based resources, including fast facts, videos, and the latest research.

Source: Drug Free America Foundation | 333 3rd Ave N Suite 200 | St. Petersburg, FL 33701 US

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Commentary- Articles| – January 18, 2026

by Brian Walker, RPh

Substances marketed as “legal” or “natural” alternatives are increasingly accessible to adolescents through gas stations, convenience stores, and vape shops. Although legality may reassure consumers, pharmacists are seeing a growing disconnect between regulatory status and clinical risk. Products such as nitrous oxide inhalants, kratom, Delta-8 and Delta-9 tetrahydrocannabinol (THC), and Salvia divinorum are associated with dependence, neurologic injury, psychiatric effects, and accidental harm—particularly in younger populations.

As medication experts, pharmacists are uniquely positioned to recognize the public health implications of these products and to educate patients, caregivers, and policymakers on risks that often remain hidden in plain sight.

Nitrous Oxide: Retail Availability, Clinical Consequences

Nitrous oxide—commonly referred to as “whippets” or “laughing gas” and increasingly marketed under brand names such as “Galaxy Gas”—has gained popularity among adolescents through social media exposure. Although intended for culinary use, flavored nitrous oxide canisters are frequently misused for their euphoric effects.³

Clinically, nitrous oxide misuse has been associated with hypoxia, syncope, cardiac arrhythmias, and vitamin B12 depletion leading to myeloneuropathy.^4-6 Chronic exposure can result in irreversible neurologic injury, including gait disturbance and sensory loss. Of concern to pharmacists, no standardized manufacturing or purity requirements exist for recreational nitrous oxide products sold at retail, contributing to unpredictable dosing and adverse outcomes.⁷

Kratom: Opioid Activity Without Oversight

Kratom (Mitragyna speciosa) is marketed as a dietary supplement for pain relief, anxiety, and opioid withdrawal. Its primary alkaloids—mitragynine and 7-hydroxymitragynine—exert activity at μ-opioid receptors, conferring both analgesic and addictive potential.^8.9

Although not federally scheduled, kratom has been linked to seizures, hepatotoxicity, hypertension, and opioid-like withdrawal symptoms.^10,11 FDA analyses have identified contamination with heavy metals and pathogenic organisms in unregulated products.¹² Regulatory approaches vary by state, creating inconsistent consumer protections and increasing the likelihood of misuse.

Delta-8 and Delta-9 THC: Potency and Labeling Concerns

Delta-8 THC and Delta-9 THC products are widely marketed as legal cannabis alternatives in the form of edibles, vape cartridges, and tinctures. Delta-9 THC is the primary psychoactive component of cannabis, and Delta-8 THC is a synthetically derived isomer with similar psychoactive effects.¹³

FDA and CDC warnings have highlighted concerns regarding inaccurate labeling, excessive THC concentrations, and contamination with residual solvents from chemical synthesis.^14,15 Adverse events reported include anxiety, paranoia, impaired cognition, and psychosis—effects that may be amplified in adolescents and young adults.¹⁶

Salvia Divinorum: A Legal Hallucinogen

Salvia divinorum, a potent kappa-opioid receptor agonist, remains legal in several US jurisdictions despite its intense psychoactive effects. When smoked or chewed, salvinorin A produces rapid-onset hallucinations, dissociation, and loss of environmental awareness.¹⁷

From a safety perspective, Salvia use has been associated with panic reactions, accidental injuries, and prolonged psychological distress.¹⁸ Its sale as a novelty or incense product may obscure its clinical risks.

Implications for Pharmacy Practice

The normalization of these substances—amplified by influencer culture and online marketing—has outpaced regulatory oversight. Many do not appear on standard toxicology screens, complicating detection and counseling.¹⁹

Pharmacists can play a critical role by:

Educating patients and caregivers on risks associated with legally marketed substances
Monitoring emerging substance-use trends
Encouraging age restrictions and improved labeling standards
Collaborating with clinicians and public health organizations

Legality does not equate to safety. Increased awareness and pharmacist engagement are essential to addressing the public health risks posed by these widely available products.

Source: https://www.drugtopics.com/view/hidden-in-plain-sight-legal-substances-putting-children-at-risk

Filed under: Age-related,Drug use-various effects,Drug use-various effects on foetus, babies, children and youth,Health,Kratom,Marijuana and Medicine,Prevention and Intervention,USA,Youth :

by Mark S. Gold M.D. – Addiction Outlook – Posted December 26, 2025

The change was made despite lack of evidence of medicinal benefits.

Key points

President Trump directed federal agencies to expedite the process of reclassifying cannabis to Schedule III.
Now what? Many actions are needed, including new research and protection of adolescents.
Placebo-controlled, double-blind trials of pharmaceutical-grade cannabis constituents are needed.

The most consequential shift in cannabis policy in more than 50 years is now happening. A December 2025 executive order from President Trump has directed the federal government to down-schedule cannabis from Schedule I (illegal) to Schedule III (a lawful drug designation with a lower level of harm than Schedules I or II) . This is despite the alarming lack of research evidence for medicinal cannabis.

Rescheduling cannabis will provide significant tax advantages to the industry, allowing billions in previously banned business expense deductions that could hugely boost marketing efforts, research, or both. The executive order (EO) does not explicitly recognize cannabis as medicine. It also does not set national standards for cannabis labeling, dosages, or youth protection, all of which are essential.

Whether you view the EO as long overdue or ill-advised, the key questions now are how this change will be implemented, who will control the downstream effects of cannabis, and whether public health experts or lobbyists seeking to accelerate commercial momentum will define what happens next.

Currently, any cannabis warning labels are inconsistent across states, often minimal, and frequently omit critical risks, such as mental health effects, breastfeeding harms, and other dangers stemming from high-potency cannabis products.

The executive order simultaneously instructs federal agencies—particularly the National Institutes of Health and the Food and Drug Administration—to expand, streamline, and lower barriers to cannabis/cannabinoid research.

Indeed, the now-history LSD-like Schedule I status of cannabis imposed hurdles to research. Nevertheless, considerable research has been done, even though a special license was necessary to use the drug in studies. However, rescheduling marijuana doesn’t guarantee adequate research funding, FDA approval for cannabis, THC, or CBD, or high-quality research.

What Drug Experts Say

Among the EO’s most vocal critics is Kevin Sabet, drug policy expert who served both Republican and Democratic administrations and now president of Smart Approaches to Marijuana, who sees the order as devoid of public health wisdom. Sabet warns that rescheduling signals medical endorsement despite cannabis’s association with significant health risks, especially for young users. Sabet highlights that the EO moves cannabis from Schedule I (not legal) to Schedule III (controlled but legal), although the medicinal effects of cannabis have never been FDA-proven or approved.

Harvard’s Kevin Hill, M.D., supports rescheduling for improving research facilitation, arguing that current cannabis use lacks clinical guidance. He emphasizes funding as crucial for quality research. Hill ‘s position is pragmatic: Lack of scientific certainty is not a reason to avoid research—it’s the reason research is needed.

Hill also places responsibility for research funding on states and industry. Legal cannabis markets generate billions in revenue, yet only a fraction is reinvested in rigorous research, prevention, or treatment. Ethical stewardship, he argues, demands that those profiting from cannabis bear responsibility for understanding its risks and benefits.

Thirty percent of cannabis users, including adolescents, develop a substance use disorder, according to Mt Sinai School of Medicine’s Dr. Yasmin Hurd. She emphasizes the importance of pairing research expansion with clear regulations to avoid exacerbating risks linked with cannabis.

A crucial area for future research is safe and effective dosing of THC (the intoxicant in cannabis) amid imminently rising sales of high-potency products. Large-scale, longitudinal studies tracking neurodevelopmental outcomes in relation to timing and potency of cannabis exposure are essential.

At the same time, policymakers face a proliferation of unregulated intoxicating cannabinoids sold outside state-licensed cannabis systems. Products such as delta-8 and other synthetic or semi-synthetic cannabinoids are widely available in gas stations and convenience stores, often with minimal oversight. These products disproportionately attract youth, undermining consumer safety. Closing loopholes has become a public-health necessity.

Recognizing the Rising Risks

Some media reports suggest the EO was pushed through despite vociferous objections highlighting the risks of cannabis use among adolescents and young adults. The link between early-age cannabis exposure and increased risk of schizophrenia, mood disorders, and long-term functional impairment is no longer speculative. The disorders carry lifelong healthcare, social, and economic costs. Yet current data are insufficient to guide prevention efforts. Without guidelines, prevention efforts will remain reactive and politically vulnerable. Nowhere are the stakes higher than among adolescents and young adults.

One of the nation’s leading scientists and long-time vocal opponents of legalizing cannabis, Yale’s Deepak D’Souza, M.D., has focused on the increasing amount of cannabis, its increased potency, frequency of use, and duration of effects, causing severe consequences in young people. Cannabis and some of its constituents produce acute impairments in memory, attention, executive function, impulsivity and risk-taking behaviour, and psychomotor coordination, critical for driving a car. Nora Volkow, M.D., director of the National Institute for Drug Abuse (NIDA) has underscored the need for balanced research, acknowledging both benefits and risks of cannabis.

Dose is another urgent research priority, since higher THC concentrations are associated with increased risks of psychosis, cannabis use disorder, cardiovascular events, and cognitive impairment. More isn’t always better. A post-rescheduling agenda should include an investigation into minimum effective doses, upper safety thresholds, and the feasibility of reducing THC concentrations while preserving potential therapeutic effects.

Since rescheduling will be interpreted as an implicit medical endorsement, regardless of official intent, a national, evidence-based prevention strategy is needed, modeled on successful tobacco-control frameworks Such a strategy needs to include school-based education, clinician training, parental guidance, and public-health messaging that’s scientifically grounded rather than moralistic/alarmist.

Federal consumer protection agencies need to become empowered to monitor misleading cannabis advertising.

Finally, the integrity of emerging research depends on maintaining a firewall between scientific inquiry and commercial influence. Industry participation in research isn’t inherently problematic, but it must be governed by transparency, independent oversight, and conflict-of-interest safeguards.

Acceptance Without Complacency

The December 2025 executive order is now a reality. There is likely to be a huge cash infusion without regulation, causing a commercialization boom in cannabis, with the potential to harm our youth more than ever. Industry needs to step up and fund academic research.

Youth protection and guardrails are indispensable. A good start would be warning labels, funding of prevention efforts directed toward teens and young adults, and increasing NIDA’s funding for cannabis/THC/CBD translational research .

If cannabis products remain legal and available, consumers need clear, standardized warnings reflecting the best available evidence on cannabis use disorder and psychosis risk; impaired driving; memory effects; and adolescent brain vulnerability. Public health warnings should not be optional, nor diluted by marketing language implying medical endorsement where none exists.

Source: https://www.psychologytoday.com/au/blog/addiction-outlook/202512/marijuana-rescheduling-is-now-real

Filed under: Cannabis/Marijuana,Culture,Drug use-various effects,Health,Hemp,Marijuana and Medicine,Prevention and Intervention,Strategy and Policy,Treatment and Addiction,USA,Youth :

by Ryan Mancini – The Hill – 12/03/25

A vomiting disorder linked to frequent marijuana use is on the rise, prompting global health officials to allow researchers to track the condition and study it.

Dubbed on social media as “scromiting,” short for screaming and vomiting, cannabis hyperemesis syndrome (CHS) cases saw a jump in emergency department visits between 2016 and 2022, according to a November study by the medical journal JAMA Network Open released in November. CHS was first identified in Australia in 2004.

Specifically, researchers found that the jump in visits was isolated to 2020 and 2021, when there were 188 million reported emergency department visits among adults between 18 and 35 years old.

Symptoms of CHS include cyclical nausea and vomiting, with abdominal pain with no organic cause, according to the National Institutes of Health’s (NIH) National Library of Medicine. Those with CHS will compulsively bathe in hot water, which long-term marijuana use of more than a year can induce.

“It’s pretty universal for these patients to say they need a really, really hot shower, or a really hot bath, to improve their symptoms,” Dr. Sam Wang, pediatric emergency medicine specialist and toxicologist at Children’s Hospital Colorado, told CNN.

Wang described patients who were “writhing, holding their stomach, complaining of really bad abdominal pain and nausea,” with painful vomiting that lasted for hours before they took “a scalding hot shower before they came to the ER but it didn’t help.”

The hot water side-effect of CHS appears to be a learned behavior, NIH noted. After a short while, the hot water bathing can become a compulsion.

How someone can develop CHS is unclear, as researchers do not yet know how much marijuana use on a daily or weekly basis can cause it. Patients could go through years of suffering from debilitating CHS symptoms and, even with several diagnostic tests, still not have a clear diagnosis or treatment plan, NIH stated.

It can take days, weeks or months for someone with CHS to recover after a “scromiting” incident. This can be fueled by general wellness and normal eating patterns, along with regained weight and a regular bathing routine, NIH stated. If someone continues to use marijuana, CHS symptoms can start all over again.

A study conducted by the George Washington University School of Medicine and Health Sciences found that 44 percent of those surveyed were hospitalized once due to CHS symptoms. The study also found that 40 percent of respondents used marijuana over five times a day before CHS symptoms developed. Using marijuana at an early age was also more likely to lead to CHS.

Researchers argue that while there are limitations in understanding CHS, including why patients bathe themselves with scalding water, there is a need for greater clinical awareness.

“Targeted screening for cannabis use and recognition of symptom patterns could improve diagnostic accuracy,” JAMA Network Open wrote, adding that more studies can help prevent a misdiagnosis for someone with CHS symptoms.

Source: drug-watch-international@googlegroups.com

—
www.drugwatch.org
drug-watch-international@googlegroups.com

Filed under: Cannabis/Marijuana,Drug use-various effects,Health,Marijuana and Medicine,Prevention and Intervention,USA :

There is “insufficient” evidence supporting the use of cannabis or cannabinoids for most medical purposes, a new review has concluded.

“We reviewed the totality of the evidence—over a thousand studies with emphasis on randomized trials, meta-analyses, and systematic reviews,” Dr Kevin Hill, one of the review authors, and director of addiction psychiatry at Beth Israel Deaconess Medical Center, and a professor of psychiatry at Harvard University, told Newsweek.

He said that “beyond the FDA-approved indications, the evidence for cannabis and cannabinoids as a medical treatment is limited.”

The review was published online in the peer-reviewed medical journal JAMA Network on November 26.

Why It Matters

There has been increasing use of cannabis and cannabinoids for medical treatment in recent years. It has gained popularity among cancer patients, for managing nausea, pain and reduced appetite, and it is favored among patients with chronic pain for its analgesic properties.

However, its use medically has gathered some concern, as while certain patients may experience benefits, some medical professionals have said that there is not enough research to determine if the positives outweigh any future negatives.

More recently research has also highlighted how cannabis use among cancer patients may reduce the effectiveness of immunotherapy treatments, and that its use can impact female egg quality and embryo development.

After the Senate passed its funding package to end the U.S. government shutdown, which included a measure that will lead to the banning of many THC products, the issue of cannabis use has been in the spotlight.

What The Review Found

The review found that 27 percent of adults from the U.S. and Canada have used cannabis for medical purposes, while 10.5 percent of Americans report using cannabidiol (CBD) for therapeutic purposes.

“Cannabis and cannabinoids like CBD have a broad range of effects, so, with so many people suffering from medical problems, it is not hard to see why they might consider cannabis and cannabinoids as treatments,” Hill said.

However, he said that “the evidence is not strong” for their use medically.

While doctors may “consider cannabis and cannabinoids as third-line treatments in various clinical scenarios,” Hill said, “the lack of evidence coupled with significant risks means that, most often, the risks outweigh the benefits.”

The review found that almost a third of adult users of medical cannabis go on to develop a cannabis use disorder—a complex condition that is a type of substance use disorder, where a patient can experience a problematic pattern of cannabis use that causes them distress or impairs their life.

It also found that daily inhaled cannabis use compared to nondaily use was associated with higher risks of coronary heart disease, heart attack, and stroke,

“The adverse effects of cannabis upon one’s physical health are becoming more well-defined,” Hill said.

He said that the purpose of this review was to provide clinicians and patients with “better information with which to have sensible, evidence-based conversations,” conversations about medical treatment which he said should take place between doctors and patients, and “not between budtenders and customers in dispensaries.”

What Other Experts Think

Jonathan Caulkins, a professor of operations research and public policy at Carnegie Mellon University, who was not involved in the review, told Newsweek that while there is “high-quality evidence supporting certain very specific medical uses,” most medical use is “predicated on much less evidentiary basis, and below what is expected for FDA approval.”

He said that what is “important” about this review is that it helps “counter the messaging from cannabis treatment advocates, who promote the good news, and the hopes, without balance or caution.”

“The actual situation is nuanced, and more gets written that pushes for an overly optimistic view of cannabis’ medical value,” he said.

Yasmin Hurd, chair of translational neuroscience and the director of the Addiction Institute at Mount Sinai, also told Newsweek that the findings are “notable” because it “confirms what has been previously published from other reviews and consensus reports like those from the National Academies, noting that there is insufficient evidence for the use of cannabis to treat most medical conditions.”

While the authors have “done a very comprehensive and in my view very useful review of this topic,” Dr Igor Grant, a professor of psychiatry and director of the HIV Neurobehavioral Research Program and Center for Medicinal Cannabis Research, at the University of California, San Diego, told Newsweek, “it is clear from the way the article is written that the authors have significant concerns about the use of medicinal cannabis, and as such have tended to emphasize many of the negatives, including potential side effects.”

He said that this “does not mean that the side effects are not there, nor does it negate the fact that evidence for efficacy of medicinal cannabis is weak in many areas. But there does seem to be a definite slant.”

He also said that while this review highlights cardiovascular risks, other research has also shown there is “actually no statistically reliable evidence to suggest that cannabis users suffer more cardiovascular risk, including no effect on hypertension, myocardial infarction, and presence of coronary atherosclerosis.”

What People Are Saying

Caulkins told Newsweek: “We customarily expect medicinal drugs to be produced in a way that guarantees consistency from dose to dose. Every pill in a bottle of pills that is prescribed by a physician, manufactured by a pharmaceutical company and distributed by a licensed pharmacy should have essentially the exact same dose. With the exception of the FDA-approved and regulated cannabinoids (which account for a tiny share of all consumption that is described or understood to be “medical cannabis”), there is not that same quality control for medical cannabis.”

He added: “Cannabis smoke contains known carcinogens. Sometimes good medical practice exposes patients to carcinogenic risk, notably radiation treatment does. But we do that carefully and knowingly, because the risk of untreated cancer is greater than the risk that radiation therapy will create new cancer. But given that in many cases the upside benefit of medical cannabis is not well established, it is striking how cavalier the system is with respect to known carcinogens present in cannabis smoke. For most categories of consumer products, the presence of known carcinogens is sufficient to have that product taken off the shelves, even if there are not epidemiological studies documenting effects on cancer rates at the population level. For whatever reason or reasons, we collectively seem surprisingly unconcerned about that risk regarding smoked cannabis, medical or non-medical.”

Hurd told Newsweek: “There remain numerous concerns about cannabis for medical use since there is so little known about whether it works, what particular conditions it might be helpful to treat and what dose and dosing regime for clinicians to recommend. In addition, there are also concerns that individuals will use ‘medicinal cannabis’ obtained from sources where the contents are not verified and cannabis with high THC concentration has well known significant side effects. Cannabis should be used with caution in medical settings. As such, like many medicines, especially where there is very limited information available, it is best to start low dose and go slow. Also, cannabis should not be the first line therapy and instead used only for conditions where conventional therapies have failed.”

She added: “It is important that the public also begins to better understand that cannabis is a very complex plant with hundreds of chemicals whereas ‘medicine’ is normally a product that has specific, well studied components. Also, cannabis is different from specific cannabinoids, like cannabidiol (CBD), which has FDA approval for the treatment of certain epilepsy conditions.”

Grant told Newsweek: “While I agree that physicians who are counseling patients about potential use of cannabis for various indications need to both warn patients about lack of evidence in many cases, the possibility of side effects, and certainly evaluate a patient in the event they have major psychiatric or substance use disorder, there are, as they note protocols for doing this, and in some ways, assuring safety. I believe also that the risk of people who use medicinal cannabis, who are often people who are older with various kinds of chronic conditions, is rather low that they will systematically increase their use to the point of developing a cannabis use disorder. Cannabis use disorder is real, and a concern, but very unlikely to be a problem in the clinical setting. The article tends at times to conflate recreational and medicinal use: that’s a bit like using data from opioid addiction to comment on appropriate use of opioids in a clinical setting.”

Source: https://www.newsweek.com/does-cannabis-actually-have-medical-benefits-11118810

Filed under: Brain and Behaviour,Cannabis/Marijuana,Drug use-various effects,Health,Marijuana and Medicine,Prevention and Intervention,Strategy and Policy,USA :

The number of people admitted to hospital in Scotland with alcohol-related brain damage has reached a 10-year high.

A total of 661 people required treatment for brain injury after alcohol misuse between 2016-17, the equivalent of nearly two people a day.

Alcohol-related brain damage can lead to problems with memory and learning.

NHS Greater Glasgow and Clyde had the most admissions at 230, followed by 99 in NHS Lothian.

The figures were released in response to a parliamentary question by the Scottish Conservative health spokesman Miles Briggs.

He said it was worrying that the statistics were continuing to rise despite efforts to combat alcohol misuse.

He said: “Scotland already has one of the worst records in Europe for alcohol consumption and, despite increased awareness, the problem only seems to be getting worse.”

He added: “The decision by SNP ministers to cut funding for alcohol and drug partnerships was wrong, and has clearly impacted on the delivery of services to support people addicted to alcohol.”

Mr Briggs called for more emphasis on recovery programmes and pilot schemes for new treatments.

The Scottish government said it had invested £746m to tackle alcohol and drug abuse in the past 10 years and would be delivering an additional £20m a year to further improve services.

‘Alcohol services’

A spokesman added: “We’ve recently implemented Minimum Unit Pricing to tackle the cheap, high strength alcohol that causes so much damage to families and communities across the country.

“We also provide funding to NHS boards to treat local health needs, including people with alcohol-related brain injury.

“We expect alcohol services, mental health services and social services to work jointly in these cases to ensure those injured receive the help they need to recover and any underlying mental health issues are addressed.”

Source: https://www.bbc.co.uk/news/uk-scotland-44791463 July 2018

Filed under: Alcohol,Brain and Behaviour,Health,UK :

301 deaths. 301 names, ages, faces removed. 301 families, communities, homes (or home equivalents) emptied.

In 2023, there were 301 opioid-related overdose deaths in Alameda County. Standing alone, that figure isn’t alarming to those of us reading behind “safe” walls on our expensive devices.

Nothing exposes us to the truth more than cold numbers. This data-driven meta-analysis will show there is far more to concern about the complexities that eventually result in the plague of opioids claiming those 301, and thousands more, lives.

The acceleration of the Alameda County crisis

Those 301 Alameda County lives claimed by opioids in 2023 represent a 60% increase from 2022. Alameda County experienced the worst increase of all Bay Area counties in opioid overdose deaths from 2018-2021; Alameda’s rates tripled over this time while neighboring (Courtesy Alameda County)

There is an apparent inequity within the county. African-Americans’ fatal overdose rates are triple that of the county average, and the homeless comprise 30% of all overdose deaths.

The teen paradox: Less use, more deaths

The focus is on teens, right? That would make sense. After all, teen substance use excluding cannabis is DOWN, compared to the 20.9% of high school juniors in 2002, the 8% figure of 2022 represents major improvement.

Despite this, death rates are not improving. In fact, teen overdose deaths doubled in the eight short months between August 2019 and March 2020. As of 2022, 22 teens were dying WEEKLY from drug overdose in the United States. And overdoses are now the third leading cause of death for the youth, after guns and cars.

Fentanyl changed it all.

Now, over 75% of teen overdose victims’ lives are claimed by fentanyl. There was nearly a 300% INCREASE in fentanyl deaths aged 15-19 from 2018 to 2021.

The problem isn’t necessarily addiction. It’s contamination.

84% of teen overdose deaths are unintentional, and around a quarter of teen overdose deaths involve fake prescriptions. Fatal drugs like fentanyl spread through adult markets due to their potency and make their way to teens by accident. Most teens do not even get hooked onto the drugs that kill them.

Treatment inequality and solutions

Teen treatment right now is almost a scandal. While 42% of adults aged 45+ receive medications for opioid use disorder within three months of diagnosis, only 5% of teens do. Out of every five teens with substance use disorder, only one gets treatment.

Regardless of everything, prevention programs are still a solution. Project Towards No Drug Abuse (Project TND) has shown a 25% reduction in hard drug use. Medication-Assisted Treatment (MAT) reduces overdose deaths by 70-80%. Endless life-saving rescues by naloxone have been documented by near-death survivors.

It is not that there are no solutions. Ironically, teens are the ones with the least access to drugs. We know what works, and Alameda County cares for its people. The change to prevent teen opioid overdose deaths must originate in expanding access and awareness to the systems proven to save lives.

Source: https://www.pleasantonweekly.com/alameda-county/2025/11/17/the-data-driven-paradox-of-prevention/

This article was written as part of a program to educate youth and others about Alameda County’s opioid crisis, prevention and treatment options. The program is funded by the Alameda County Behavioral Health Department and the grant is administered by Three Valleys Community Foundation.

Filed under: Addiction,Culture,Drug use-various effects,Health,Opioids,Prevention and Intervention,Strategy and Policy,Treatment and Addiction,USA :

The United Nations Office on Drugs and Crime (UNODC)’s new youth peer-to-peer drug prevention programme, Friends in Focus, continues to expand its reach through successive pre-pilot implementations. First piloted in Serbia in February 2025, Friends in Focus aims to build youth-engaged communities that foster resilience through drug prevention efforts grounded in positive peer influence. Following successful pilots in Serbia, Italy, and Central Asia, the programme returned to the South-Eastern European region, with Montenegro as the latest host country.

As the second launch in the region, the Montenegro Friends in Focus pilot was made possible thanks to the support of the Government of Italy to UNODC. Another ingredient making the pilot possible is the strong local partnerships. The Ministry of Education warmly welcomed the programme and is endorsing the active participation of youth and schools in the cascade training sessions. And the key contributor to this pilot launch was CAZAS, a local non-governmental organization dedicated to promoting the healthy development of young people and advocating for youth education and drug use prevention. As the key implementing partner, CAZAS played a central role in organizing the Training of Trainers and recruiting youth trainers who will lead the dissemination of the programme in high schools of their communities.

Master trainers continue to be the core resource persons for each implementation round, providing essential knowledge and skills that enable youth trainers to confidently lead their own peer sessions on drug prevention. During 20 – 22 October, young people from Podgorica, Nikšić, and Bijelo Polje came together in Podgorica for a three-day Training of Trainers (ToT). Throughout the training, participants explored key topics around risk and protective factors related to drug use, challenged common misconceptions about substances, and reflected on the impact of social and group dynamics.

A key milestone of the training in Montenegro was the certification of a new Master Trainer for the South-Eastern European region. By equipping the region with a locally-based expert capable of leading Friends in Focus trainings, this development builds on the sustained engagement initiated in Serbia earlier in 2025. This advancement strengthens regional capacity by reducing reliance on external trainers and fosters greater ownership of the programme within the region. It also creates opportunities for neighbouring countries with similar languages to benefit from shared resources, expertise, and cross-border collaboration in youth-led drug prevention efforts.

The successful launch of Friends in Focus in Montenegro marks a step forward in strengthening youth-led drug prevention efforts across South-Eastern Europe. With a newly certified regional Master Trainer and a cohort of empowered youth trainers, the programme is now better equipped to strengthen its content, expand its reach, deepen its local impact, and foster stronger regional collaboration. UNODC remains committed to supporting young people by creating spaces for learning, leadership, and resilience, ensuring that youth voices continue to shape the future of prevention in their communities and beyond.

Source: https://www.unodc.org/unodc/prevention/youth-initiative/youth-action/2025/October/regional-momentum-builds-as-friends-in-focus-reaches-montenegro.html

Filed under: Europe,Health,Prevention and Intervention,Youth :

by Rebecca Dyer – Sat, November 1, 2025

Cannabis use may leave lasting fingerprints on the human body, a study of over 1,000 adults published in 2023 suggests – not in our DNA code itself, but in how that code is expressed.

US researchers found it may cause changes in the epigenome, which acts like a set of switches that activate or deactivate genes involved in how our bodies function; findings that were validated by a systematic literature review published in 2024 by researchers in Portugal.

“We observed associations between cumulative marijuana use and multiple epigenetic markers across time,” epidemiologist Lifang Hou from Northwestern University explained of his team’s findings in 2023.

Cannabis is a commonly used substance in the US, with nearly half of Americans having tried it at least once, Hou and team report in their published paper.

To investigate this, the researchers analyzed data from a long-running health study that had tracked around 1,000 adults over two decades.

Participants, who were between 18 and 30 years old when the study began, were surveyed about their cannabis use over the years and gave blood samples at the 15- and 20-year marks.

Using these blood samples from five years apart, Hou and her team looked at the epigenetic changes, specifically DNA methylation levels, of people who had used cannabis recently or for a long time.

*When epigenetic factors, which can come from other genes or the environment inside a cell or beyond, recruit*

*a methyl group, it changes the expression of our genes. (ttsz/iStock/Getty Images)*

Without changing the genomic sequence, DNA methylation affects how easily cells ‘read’ and interpret genes, much like someone covering up key lines in your set of instructions.

Environmental and lifestyle factors can trigger these methylation changes, which can be passed to future generations, and blood biomarkers can provide information about both recent and historical exposures.

“We previously identified associations between marijuana use and the aging process as captured through DNA methylation,” Hou said.

The comprehensive data on the participants’ cannabis use allowed the researchers to estimate cumulative use over time as well as recent use and compare it with DNA methylation markers in their blood for analysis.

They found numerous DNA methylation markers in the 15-year blood samples, 22 that were associated with recent use, and 31 associated with cumulative cannabis use.

In the samples taken at the 20-year point, they identified 132 markers linked to recent use and 16 linked to cumulative use.

“Interestingly, we consistently identified one marker that has previously been associated with tobacco use,” Hou explained, “suggesting a potential shared epigenetic regulation between tobacco and marijuana use.”

It’s important to note that this study doesn’t prove that cannabis directly causes these changes or causes health problems.

“This research has provided novel insights into the association between marijuana use and epigenetic factors,” said epidemiologist Drew Nannini from Northwestern University.

“Additional studies are needed to determine whether these associations are consistently observed in different populations. Moreover, studies examining the effect of marijuana on age-related health outcomes may provide further insight into the long-term effect of marijuana on health.”

Source: https://www.yahoo.com/news/articles/cannabis-linked-epigenetic-changes-scientists-215447890.html?

Filed under: Australia,Cannabis/Marijuana,Genes,Health :

Dr Elinore McCance-Katz,
Assistant Secretary Mental Health and Substance Abuse,
Substance Abuse and Mental Health Services Administration
Health and Human Services Administration,
5600 Fishers Lane,
Rockville,
MD,
USA, 20857.

Dear Dr. McCance-Katz,
Re:
Deteriorating Drug Use Social Pathologies in Colorado and California And Increase of Cannabis Associated Birth Defects
Thank you for your public opposition to the increased cannabis use implicit in cannabis legalization across USA. I wish to strongly assure you that your well informed professional stance has a positive and beneficial impact worldwide.

As you are aware I am concerned about the impact of cannabis on developing babies. My attention was therefore captured by the publication last week of a fascinating report of the tripling of the incidence of gastroschisis in California 1995-2012 reported in JAMA Surgery (7/25/2018 Anderson JE, doi: 10.1001/jamasurg.2018.1744, “Incidence of Gastrsochisis in California”)).

I was further impressed by the similarity of the gastroschisis map to the SAMHSA NSDUH maps for cannabis use across California, which seem to have changed little over time (attached). The SAMHSA NSDUH maps show:
1) A clear increased incidence of cannabis use in the north of California
2) The same areas as highest incidence of gastroschisis
3) A spatial association of cannabis use with:
i) Other illicit drug use,
ii) Cocaine use
iii) Binge alcohol use
iv) Any mental illness
v) Suicidal thoughts
vi) Serious mental illness
vii) Analgesic abuse
viii)Illicit drug dependence

All of these considerations made me wonder what might be happening in Colorado, another state famous for its cannabis industry.

I have attached an analysis I prepared recently relating to the incidence of various major birth defects in Colorado with data taken from the Colorado Public Health Website at Colorado Responds to Children with Special Needs (CRCSN). It shows growth in many major congenital malformations especially those relating to the heart and a 70% rise in both total congenital anomalies and major cardiovascular anomalies in the period 2000-2013.

SAMHSA NSDUH maps are also attached for Colorado drug use. Whilst the rate of cannabis use in Colorado is rising, the rate of use of other drugs is falling – an important finding which implies that other drug use cannot be cited as a possible cause for the rising pattern of defects in Colorado.

The SAMHSA NSDUH maps are fascinating and reveal that cannabis use is correlated spatially at the substate level with:
1) Cocaine use
2) Binge alcohol use
3) Suicidal ideation
4) Depressive episodes
5) That the rate of alcoholism in the western part of Colorado – Area 1 – is rising quickly from the 2012-2014 to 2014-2016 triennium
6) That the rate of depression has increased rapidly also in the western cannabis using part of Colorado
7) That the rate of suicidal thoughts has also increased rapidly in the western part of Colorado from 2012-2014 to 2014-2016.

In summary the SAMHSA NSDUH maps paint a very concerning picture of the public health implications of increased cannabis use / abuse. Associations in both states with significantly rising patterns of cannabis related congenital defects implies far reaching paediatric and public health aspects to this industry which have not been widely considered.

It seems to me that SAMHSA together with partners at CDC, NIDA and reputable schools of public health would be well positioned to apply sophisticated spatial modelling statistical analysis to define and understand these relationships at the substate and national level by cannabis legalization states and over time.

Thank you for your consideration of the evidence which I now seek to place before you.
Thank you also for the fabulous maps produced by your service which are so useful and allow one to quickly understand multiple overlying and closely intertwined epidemics.

Yours sincerely,
Prof. Dr. Stuart Reece.

Email from Prof. Dr. Stuart Reece to Dr Elinore McCance-Katz, posted to Drug Watch International https://www.drugwatch.org/ July 2018

Filed under: Cannabis/Marijuana,Drug use-various effects on foetus, babies, children and youth,Health :

By Kathy Gyngell – Editor of The Conservative Woman – October 2, 2025

The study covers the period between 2000 and 2019. The aim was clear: to test the hypothesis that the increasing incidence of testis and breast cancer in adolescent and young adult (AYA) Americans correlates with their increasing cannabis use. Its conclusions are stark: that North America has evidence which implicates cannabis as a potential etiologic factor contributing to the increasing incidence of breast carcinoma in young females and testis cancer in older adolescent and young adult males, and in most races and ethnicities. Temporal correlations suggest that a carcinogenic effect of cannabis is rapid, leading to cancer within a few years after cannabis exposure. You can read this extremely detailed and careful study here.

Its overall study design involved comparing breast and testis cancer incidence trends in jurisdictions that had and had not legalised cannabis use. In the US, both breast carcinoma in 20- to 34-year-old females and testis cancer in 15- to 39-year-old males had annual incidence rate increases that were highly correlated (Pearson’s r = 0.95) with the increase in the number of cannabis-legalising jurisdictions during the period 2000–2019. Both were significantly greater during the period 2000–2019 in the cannabis-legalising than non-legalising states. (My italics)

During the period 2000–2019, registries in cannabis-legalising versus non-legalising states documented a 26 per cent versus 17 per cent increase in breast carcinoma and 24 per cent versus 14 per cent increase in testis cancer.

In the same age groups, the study (predictably) found Canada had an even greater increase in both breast and testis cancer incidence than the US. A UNICEF study on the well-being of children had already confirmed that Canadian adolescents (aged 11 to 15) have the highest rate of cannabis use among the 29 advanced economies of the world. Of particular concern that legalising advocates would do well to note is the considerable percentage of the Canadian youth who are daily or weekly users – approximately 22 per cent of boys and 10 per cent of girls. And that amongst the older 16-19s the upward trend in use which increased to 43 per cent in 2023 compared with 36 per cent in 2018 follows the country’s nationwide legalisation of cannabis for over-18s in 2018.

This link between cannabis and these forms of cancer should come as no surprise. A report from the American Cancer Society (ACS) in February this year identified non-seminoma testis cancer as the cancer type most closely linked to cannabis use.

More shocking is that this relationship has been known about for years. In 2009, scientists at the Fred Hutchinson Cancer Research Centre in Seattle investigated the possibility of a link ‘after learning that the testes were one of the few organs in the body to contain receptors for the main psychoactive substance in the drug, tetrahydrocannabinol (THC)‘. The same scientists noted that there had also been a rise in testicular cancer cases that had ‘mirrored the rise in marijuana use since the 1950s’.

The 2025 study is of course of a different type and order of magnitude. It was certainly needed. Its findings warrant the utmost attention of our national and local public health authorities which were so zealous to promote child covid vaccination but have remained over the years so strangely silent about cannabis.

This valuable study should also serve as a warning to cannabis legalisers including Sir Sadiq Khan that their endorsement of the drug and indifference to the impact of legalisation on teen health is not just irresponsible but near-criminal.

Postscript: There are other disturbing elements regarding the underlying mechanisms noted in the study’s findings. These, its authors state, ‘may involve genotoxic effects, oxidative stress, and mitochondrial dysfunction caused by cannabis, leading to genomic instability’. For further elucidation of this a 2024 study published in Addiction Biology provides some key insights into cannabis-cancer pathobiology and genotoxicity. You can read this report here.

Source: https://www.conservativewoman.co.uk/the-irrefutable-link-between-cannabis-and-cancer-in-young-americans/

Filed under: Cannabis/Marijuana,Drug use-various effects,Health,Marijuana and Medicine,Mental Health,UK,Youth :

NIH – National Library of Medicine – National Center for Biotechnology Information

2025 Oct;178(10):1429-1440.

doi: 10.7326/ANNALS-24-03819. Epub 2025 Aug 26.

by Thanitsara Rittiphairoj¹, Louis Leslie², Jean-Pierre Oberste², Tsz Wing Yim², Gregory Tung³, Lisa Bero⁴, Paula Riggs⁵, Kent Hutchison⁶, Jonathan Samet⁷, Tianjing Li⁸

Abstract

Background: Rapid changes in the legalized cannabis market have led to the predominance of high-concentration delta-9-tetrahydrocannabinol (THC) cannabis products.

Purpose: To systematically review associations of high-concentration THC cannabis products with mental health outcomes.

Data sources: Ovid MEDLINE through May 2025; EMBASE, Allied and Complementary Medicine Database, Cochrane Library, Database of Abstracts of Reviews of Effects, CINAHL, and Toxicology Literature Online through August 2024.

Study selection: Two reviewers independently selected studies with high-concentration THC defined as greater than 5 mg or greater than 10% THC per serving or labeled as “high-potency concentrate,” “shatter,” or “dab.”

Data extraction: Outcomes included anxiety, depression, psychosis or schizophrenia, and cannabis use disorder (CUD). Results were categorized by association direction and by study characteristics. Therapeutic studies were defined by use of cannabis to treat medical conditions or symptoms.

Data synthesis: Ninety-nine studies (221 097 participants) were included: randomized trials (42%), observational studies (47%), and other interventional study designs (11%); more than 95% had moderate or high risk of bias. In studies not testing for therapeutic effects, high-concentration THC products showed consistent unfavorable associations with psychosis or schizophrenia (70%) and CUD (75%). No therapeutic studies reported favorable results for psychosis or schizophrenia. For anxiety and depression, 53% and 41% of nontherapeutic studies, respectively, reported unfavorable associations, especially among healthy populations. Among therapeutic studies, nearly half found benefits for anxiety (47%) and depression (48%), although some also found unfavorable associations (24% and 30%, respectively).

Limitation: Moderate and high risk of bias of individual studies and limited evaluation of contemporary products.

Conclusion: High-concentration THC products are associated with unfavorable mental health outcomes, particularly for psychosis or schizophrenia and CUD. There was some low-quality evidence, inconsistent by population, for therapeutic benefits for anxiety and depression.

Primary funding source: Colorado General Assembly, House Bill 21-1317

Source: https://pubmed.ncbi.nlm.nih.gov/40854216/

Filed under: Cannabis/Marijuana,Drug use-various effects,Effects of Drugs (Papers),Health,Mental Health,Strategy and Policy,USA :

17 October 2025

Sleep is essential for human survival; it affects an individual’s physical and mental health. Although the amount of sleep required varies throughout a person’s lifetime, the quality of it remains essential. Quality sleep restores the body, consolidates memories, supports emotional regulation, and plays a key role in maintaining the immune system. When sleep quality is compromised—such as in cases of insomnia—it can significantly disrupt daily life, prompting many to seek alternative remedies for relief.

One substance often misrepresented as a sleep aid is marijuana; however, research consistently shows that tetrahydrocannabinol (THC) interferes with the very sleep processes it claims to improve. A recent randomized controlled trial examining the effects of a single dose of THC and cannabidiol (CBD), the two primary compounds in marijuana, on individuals with clinical insomnia raised serious concerns about using marijuana as a treatment for sleep problems.

THC and REM sleep

In this study, those who took a one-time dose of 10mg of THC and 20mg of CBD experienced significantly less total sleep time and spent less time in rapid eye movement (REM) sleep, the phase associated with dreaming, emotional processing and memory consolidation, supporting previous research that pointed to THC disrupting deep REM sleep. THC also disrupted restorative stages, meaning that individuals may fall asleep faster but may never get the kind of sleep the body truly needs.

Those who took this THC and CBD combination also took about an hour longer to reach REM sleep compared to placebo. Studies have shown that the suppression of REM sleep can have long term consequences. While in this study a single dose did not affect next-day function, researchers cautioned that regular use may lead to tolerance and eventual withdrawal symptoms that could lead to worse quality sleep over time. Withdrawal from marijuana can also cause more sleep issues that may lead to relapse, adding challenges for people struggling with substance use or mental health.

While CBD is often marketed as the “calming” component of marijuana, in this formulation it may have intensified THC’s effects due to unknown metabolizing processes of both substances together. As marijuana and CBD products become more widely available and socially accepted—often under misleading claims—more people may turn to them as “natural” sleep remedies. However, as this study underscores, natural does not necessarily mean safe or effective. Just because something is derived from a plant does not mean it is harmless or beneficial.

Source: Drug Free America Foundation | 333 3rd Ave N Suite 200 | St. Petersburg, FL 33701 US

Filed under: Cannabis/Marijuana,Drug use-various effects,Health,USA :

by Shalini Ramachandran and Betsy McKay – Wall Street Journal – July 31, 2025

Hundreds of thousands of veterans with PTSD have been prescribed simultaneous doses of powerful psychiatric drugs. The practice, known as “polypharmacy,” can tranquilize patients to the point of numbness, cause weight gain and increase suicidal thoughts when it involves pharmaceuticals that target the central nervous system, according to scientific studies and veterans’ accounts.

The VA’s own guidelines say no data support drug combinations to treat PTSD. The Food and Drug Administration warns that combining certain medications such as opioids and benzodiazepines can cause serious side effects, including death.

Nonetheless, prescribing cocktails of such drugs is one of the VA’s most common treatments for veterans with PTSD, and the number of veterans on multiple psychiatric drugs is a growing concern at the agency, according to interviews with more than 50 veterans, VA health practitioners, researchers and former officials, and a review of VA medical records and studies.

Polypharmacy has multiple definitions when it comes to central nervous system drugs. The VA defines it as taking five or more medications at the same time, while some medical researchers say it’s two or more and the American Geriatrics Society defines it as three or more.

There is an emerging medical consensus among VA doctors and researchers that taking multiple central nervous system drugs can wreak havoc on patients. Interactions between such drugs aren’t well understood, and their effects in combination can be unpredictable and extreme.

SOME CASE HISTORIES …

Mark Miller

U.S. Navy, Security Forces (1992-2007)

In 2007, Mark Miller was diagnosed with PTSD. The military put him on fluoxetine, otherwise known as Prozac. He became suicidal. Miller eventually weaned himself off medications and used “neuroplasticity” therapy which forms new connections in the brain. This April, returning suicidal thoughts prompted Miller to visit a VA hospital in San Antonio. A nurse practitioner prescribed a powerful antipsychotic in a five-minute appointment. Six days later, Miller returned, stepped off a shuttle bus and fatally shot himself in the head. “He did it clearly to speak for all the veterans who have no voice,” his father said.

Aripiprazole
Bupropion
Cyclobenzaprine
Fluoxetine
Lithium
Quetiapine
Tramadol

‘They did not even listen to anything I said — just prescribed stuff. Unreal’— Text from Mark Miller to his father days before his suicide

The VA maintains that the best treatment for PTSD is talk therapy. But therapists are scarce and wait times are long, so overwhelmed doctors default to pills. Because there is no single drug designed specifically to treat PTSD, veterans often end up on drug cocktails as multiple specialists try to ease a variety of symptoms and prevent harm or suicide, according to VA clinical staff, studies and veterans.

“When it comes to the challenge of polypharmacy in these populations, it’s constantly chasing your tail,” said Dr. Ryan Vega, a chief healthcare innovation official at the VA until 2023, who still treats veterans. “It is where medicine is more art than science. We have medications that treat those symptoms but are we addressing the root cause?”

Nearly 60% of VA patients with PTSD were taking two or more central nervous system drugs at the same time in 2019, the latest year for which data are publicly available, according to a VA study. That works out to more than 520,000 patients, up 62% from a decade earlier, driven by a near doubling of the number of VA patients with PTSD due to more combat tours and better screening.

One silver lining highlighted by the study was that the percentage of PTSD veterans on five or more CNS medications declined to 7% from 12%, largely due to internal efforts to deprescribe opioids and benzodiazepines. (Central nervous system drugs affect the brain and spinal cord; psychiatric medications are a subset of CNS drugs). The VA declined requests from The Wall Street Journal to provide more recent polypharmacy numbers for veterans in its care.

The VA has long been aware of the risks of overprescribing, and has internal research since at least 2016 showing the potential harms, including increased risk of suicide. The internal polypharmacy data “was pretty concerning,” said Dr. Shereef Elnahal, who headed the VA health system until early this year. He recalled a veteran advocate who told him about three veterans on more than five psychiatric drugs each who died by suicide, one after the other. They had been “walking around like zombies” before they took their own lives, the advocate told him.

The VA’s use of psychiatric drugs has come under scrutiny from members of Congress and advocacy groups as the veteran suicide rate is roughly double that of U.S. adults who didn’t serve. Studies by VA researchers link the simultaneous use of multiple psychiatric drugs to suicide risk among veterans, including a 2016 paper that found Iraq and Afghanistan war veterans taking five or more central nervous system drugs faced higher risks of overdose and suicidal behaviors.

Lucas Hamrick

U.S. Army, Special Forces (1996-2019)

Lucas Hamrick was diagnosed with PTSD in the Army. There, and then at the VA, he was prescribed multiple central nervous system drugs. Some put him in a daze, others made him feel like he might want to kill himself. After losing 12 friends on similar drug combinations to suicide, Hamrick quit all the medications by 2023 and turned to meditation, mindfulness and breathing exercises. “It’s about structuring life around how not to let things spill over,” he said.

Chlordiazepoxide
Diazepam
Gabapentin
Hydrocodone-acetaminophen
Lorazepam
Naltrexone
Paroxetine
Phenobarbital
Prazosin
Propranolol
Rizatriptan
Sertraline
Trazodone

‘The quality of mental health care made me feel like I was there to check a box and complete the process instead of working toward any type of changes in perspective or disposition.’

Yet the agency has been slow to mandate changes. It has failed to implement nationwide electronic systems to alert doctors when they prescribe multiple psychiatric drugs, despite evidence from its own studies that these alerts improve care. The VA doesn’t uniformly require written informed consent for all psychiatric drugs with suicide risk, something that veterans groups and some members of Congress are urging. Some veterans who have resisted taking cocktails of drugs say they were warned by VA and military doctors that refusing them could jeopardize their eligibility for disability benefits, which can reach $4,500 a month.

“I’ve been mortified by practically every veteran I’ve seen having been prescribed multiple psychiatric medications, often without a timely referral to therapy or without any referral at all,” said Janie Gendron, a therapist who worked for the Defense Department and has seen hundreds of active-duty service members and veterans in the past 25 years.

A VA spokesman said the agency is looking into the issues raised by the Journal, and that the Trump administration is seeking to address serious problems it has identified in veterans’ healthcare that weren’t solved by the Biden administration.

VA Secretary Doug Collins said at a congressional hearing in May that the agency is pursuing the potential use of alternative therapies, such as psychedelics, to offer more options and reduce the risk of suicide among veterans.

The rise of the combat cocktail for PTSD has its roots in the overreliance on a single class of drugs: benzodiazepines. By the 1970s, the military and VA relied heavily on Valium and, later, Xanax as a primary treatment for traumatized service members and veterans returning from deployment. But in the 1990s, Defense Department researchers observed that high doses often yielded poor clinical outcomes, and, along with the VA, ultimately advised against their long-term use on veterans in 2004.

Still, against the guideline, the VA has doled out benzodiazepines to more than 1.7 million patients with PTSD diagnoses since 2005, its own data show. It took nearly a decade for the use of those drugs to start to decline.

At the same time, prescriptions to veterans with PTSD rose for other powerful psychiatric drugs.

VA doctors and patients say that existing tools to limit the number of psychiatric drugs a patient takes, and guidance to avoid the use of benzodiazepines and certain antipsychotics for veterans with PTSD, are frequently ignored.

A friend’s suicide

After his best friend’s suicide in 2013, Iraq war veteran Doug Gresenz was diagnosed with PTSD and borderline personality disorder and eventually put on six psychotropic drugs. After one medication’s dosage was increased, he attempted suicide and was hospitalized. When he protested the volume of medications there, he said VA doctors questioned his commitment to recovery and told him he needed the pills to lead a normal life. “I was guilt-tripped,” he said.

Doug Gresenz

U.S. Marine Corps, Assaultman (2006-2010)

Baclofen
Bupropion
Citalopram
Clonazepam
Clonidine
Cyclobenzaprine
Divalproex
Doxepin
Erenumab-aooe
Eszopiclone
Gabapentin
Hydroxyzine
Melatonin
Methocarbamol
Mirtazapine
Olanzapine
Oxycodone
Prazosin
Propranolol
Sumatriptan
Quetiapine
Tizanidine
Tramadol
Trazodone
Venlafaxine
Zolpidem

‘I remember thinking: I’m literally poisoning myself.’

In 2016 alone, VA doctors prescribed him more than a dozen drugs, including antidepressants, antipsychotics, muscle relaxants and medications for nightmares, anxiety, pain and sleep, medical records show. Over little more than a decade, he received more than two dozen central nervous system medications. He recalled complaining to VA doctors that he was “so doped up” he would have accidents before getting to the bathroom.

“I remember thinking: I’m literally poisoning myself,” he said. In 2018, he quit benzodiazepines cold turkey and began to taper off the other drugs.

Within a couple of weeks, he collapsed, unable to use his legs. He developed a stutter and extreme light sensitivity. Violent spasms led to another fall, which caused complications that resulted in a severe foot injury and, eventually, an amputation last year.

The VA recommends any one of three antidepressants for PTSD—sertraline (Zoloft), paroxetine (Paxil) and venlafaxine (Effexor). But doctors are free to prescribe other additional drugs off-label—and many do.

“It’s super normal to see someone on five or six medications,” said Mary Neal Vieten, a retired Navy psychologist who has worked with thousands of members of the military and veterans. “That’s like an everyday thing.” Trauma has been medicalized, she said. “They’re acting as if the problem is in the person,” she said. Instead, it’s a normal response to an overwhelming experience, she said.

‘Stop-and-go’ pills

The culture of combat cocktails begins for some who are diagnosed with PTSD while still on active duty. In the military, too, drugs have long been given priority over psychotherapy, according to many veterans, former VA officials and therapists.

One Navy chaplain said his repeated calls to the Navy for more mental health resources went unanswered despite his documentation of more than 70 critical events, including suicide attempts, at a high-stress installation with nuclear submarines. When the chaplain himself grew suicidal, Navy doctors suggested that refusing the three-medication cocktail they prescribed could lead to discharge without benefits, instead of medical retirement with care.

Some veterans enter VA care dependent on psychiatric drugs that they were prescribed to improve combat readiness. They include Air Force veterans given “stop-and-go” pills—stimulants followed by sleeping pills.

Michael Valentino, who was chief pharmacist at the VA until 2021, said he grew alarmed by the rising numbers of service members entering VA care on stimulants without a diagnosis justifying it. “Then the VA has the burden of trying to undo it.”

Heather King

U.S. Air Force, Aircraft Maintenance Craftsman (2001-2010)

Heather King struggled with sleep after the Air Force prescribed Ambien following long flights. After her discharge, she was diagnosed with PTSD, and the VA added eight central nervous system drugs by 2020. King begged for help weaning off. Her VA doctor’s response: “Heather, under no circumstances are you ever going to be a person who is going to operate without meds.” She’s lately been sleeping soundly without pills for the first time, thanks to cognitive behavioral therapy for insomnia—something the VA only told her about recently.

Amitriptyline
Buspirone
Cyclobenzaprine
Doxazosin
Doxepin
Duloxetine
Fluoxetine
Gabapentin
Hydroxyzine
Lamotrigine
Lorazepam
Mirtazapine
Prazosin
Propranolol
Ramelteon
Trazodone
Zaleplon
Zolpidem

‘It was like a death sentence. All these medications, they just made me numb. I wanted to feel my feelings, I wanted to actually heal.’

A Pentagon official said several medications at once are sometimes necessary for patients with multiple medical problems or who are treatment-resistant, adding that “records are reviewed to determine if the treating provider has provided clinical justification for the use of polypharmacy.” Service members and their families are offered “a robust and comprehensive array” of mental health programs, the official said.

Chemical messengers

Psychiatric drugs work by affecting levels of chemical messengers in the brain called neurotransmitters, which send signals between nerve cells and other cells in the body. For instance, many antidepressants increase levels of serotonin, a neurotransmitter associated with mood. Benzodiazepines enhance the activity of a neurotransmitter called GABA, while some antipsychotics block dopamine receptors. Layering on several of these central nervous system agents at once can magnify their effects.

Combining an antipsychotic drug that activates dopamine receptors with one that blocks dopamine can exacerbate psychosis, said Dr. Sanket Raut, a research fellow specializing in polypharmacy at Gallipoli Medical Research in Brisbane, Australia. By the same token, benzodiazepines and opioids taken together can increase the risk of overdose. “Polypharmacy is a big problem,” said Raut. “There are many side effects: cognitive impairment, dizziness and the risk of falls.”

Erika Downey

U.S. Army, Military Police (2007-2013)

Amphetamine-Dextroamphetamine

Clonazepam
Erenumab-aooe
Fluoxetine
Lorazepam
Trazodone

‘They give out these giant paper bags filled with medicine after your first psychiatrist appointment.’

“They give out these giant paper bags filled with medicine after your first psychiatrist appointment,” said Erika Downey, a 35-year-old retired Army sergeant with PTSD. Women are more likely to be prescribed multiple drugs concurrently against guidelines, VA researchers have found.

Downey’s bouts of suicidal ideation while taking antidepressants, benzodiazepines and stimulants were so bad she once called a friend to come take away her gun. After that, she decided talk therapy would be the best medicine. She weaned herself off the drugs on her own over two years. She had to wait three years for a VA psychotherapy appointment. “At the VA, you are more quick to get into a psychiatrist”—someone who can prescribe meds—“than a psychologist,” she said. Gray for WSJ

Only 15% of veterans diagnosed with depression, PTSD or anxiety are offered psychotherapy in lieu of medication, according to a 2019 report by the Government Accountability Office. “They’re really leveraging the prescribing to keep up with patient demand,” said Derek Blumke of the Grunt Style Foundation, a nonprofit veterans’ care group. Many VA providers’ impulse is to “get them in and get them out,” said Chris Figura, a patient advocate at a VA in St. Louis.

Navy veteran Dick Johnson, in the VA system for three decades and diagnosed with PTSD and bipolar disorder, was prescribed more than 25 different central nervous system drugs, including antipsychotics, antidepressants and epilepsy medications, sometimes on six concurrently, his medical records show. He blames them for the collapse of his two marriages. “They pretty much destroyed my life,” Johnson said. When he worsened on one antipsychotic and experienced intense withdrawal tapering off, VA doctors tried to patch him up with a cocktail of other medicines including benzodiazepines. In 2006, he started a prolonged dose of Seroquel, a powerful antipsychotic, to get off benzodiazepines, because doctors said it was supposed to be easier to stop. His weight soared and he developed diabetes. Quitting Seroquel “nearly killed” him, as he suffered intense vomiting, diarrhea and a near-inability to digest. He’s still tapering off Paxil and Tegretol today, using a jewelry scale and sandpaper.

Drugged for Decades

Dick Johnson, who joined the Navy in 1989, was diagnosed with bipolar disorder. After he was medically discharged in 1994, the VA put him on a heavy regimen of psychiatric drugs that made matters worse.

Medications prescribed, by class and date
Mood Stabilizers Anti- Psychotics Anti- Anxiety Anti-Depressant Medicated with lithium, which makes him severely ill 1995
Lithium Divorce with first wife 2000
Second marriage ’05 PTSD diagnosis
Divorce with second wife Seroquel ’10
Retires with disability from power plant ’15
Side effects of medications lead to ICU visit. Seeks help outside VA to taper off meds ’20
After cutting backmeds, joinssupport groupsand shares hisexperience
Note: Does not include all medications, including those prescribed for short durations.

Dr. Saraswathy Battar, a VA geriatrician, launched a passion project in 2016 to decrease the use of potentially inappropriate medications. After noticing veterans suffering from debilitating symptoms that she attributed to overprescription, she developed an electronic tool that has helped providers discontinue more than three million prescriptions. About half of VA providers are using the optional tool, she said, but they’re mostly caring for older veterans or those in palliative care, while it’s been hard to get mental health providers to adopt the tool. Some said they were unaware of its existence. “Suicide and homicide get attention,” but “there’s no penalty for not prioritizing polypharmacy reduction,” she said.

A path forward

After years on psychiatric drug regimens prescribed by military and VA doctors, a growing number of veterans are taking healing into their own hands, often exploring unconventional treatments. Many veterans said they are frustrated and angry that the country spends heavily training them to be lethal, but there’s little support for their fragile mental health as they reintegrate back into society.

Scott Griffin, the former special operations soldier who contemplated suicide last year, reached out to a group called Veterans Exploring Treatment Solutions, or VETS, after the episode. Their suggestion: ibogaine, a powerful psychedelic derived from an African plant and illegal in the U.S., but only after tapering off his current medications. When Griffin asked his VA prescriber for help tapering, “he point-blank refused,” Griffin said.

He embarked on a gruelling self-taper. “I was white knuckling. I broke my teeth from clenching,” he recalled, battling intense vertigo and suicidality.

After 12 hours of altered consciousness on ibogaine in Mexico, Griffin took 5-MeO-DMT, a psychoactive compound most famously found in Colorado River toads’ poison, which he says was a profound spiritual experience. Since returning home in March, he has discarded his pills, prays daily and spends time with family, reconnecting after years of being “consumed by panic and anxiety.”

A Stanford study of 30 special operations forces veterans published last year found that ibogaine sharply reduced PTSD and related symptoms. A bipartisan bill in the House aims to fund VA research into psychedelics, which doctors caution remain largely unproven in clinical trials.

Says Griffin, “How does bark from a tree and venom off the back of a toad beat all this crap, all these pharmaceuticals they push down your throat?”

Source: Maggie Petito – www.drugwatch.org

Filed under: Culture,Drug use-various effects,Health,Mental Health,Prevention and Intervention,Treatment and Addiction,USA :

by Rebecca H. Johnson, Ashley Speckhart, Franklin Chien, Archie Bleyer – Academia Oncology – June 06, 2025

Abstract

Introduction: The aim of this study was to test the a priori hypothesis that the increasing incidence of testis and breast cancer in adolescent and young adult (AYA) Americans correlates with their increasing cannabis use.

Methods: The overall study design involved comparing breast and testis cancer incidence trends in jurisdictions that had or had not legalized cannabis use. Cancer incidence was assessed for the U.S. using the U.S. Surveillance, Epidemiology, and End Results (SEER) data, and for Canada, using Institute for Health Metrics and Evaluation data.

Results: In the U.S., both breast carcinoma in 20- to 34-year-old females and testis cancer in 15- to 39-year-old males had annual incidence rate increases that were highly correlated (Pearson’s r = 0.95) with the increase in the number of cannabis-legalizing jurisdictions during the period 2000–2019. Both were significantly greater during the period 2000–2019 in the SEER registries of cannabis-legalizing than non-legalizing states (Joinpoint-derived average annual percent change, AAPC1.3, p << 0.001 vs. 0.7, p << 0.001, respectively, for breast cancer, and AAPC1.2, p << 0.001 vs. no increase during the period 2000–2011 for testis cancer). During the period 2000–2019, registries in cannabis-legalizing versus non-legalizing states had a 26% versus 17% increase in breast carcinoma and 24% versus 14% increase in testis cancer. In the same age groups, Canada had a greater increase in both breast and testis cancer incidence than the U.S., and in both countries, breast and cancer trends were both correlated with the country’s cannabis use disorder prevalence by age.

Conclusions: North America shows evidence that cannabis is a potential etiologic factor contributing to the rising incidence of breast carcinoma and testis cancer in young adults. Canada’s greater increases than in the U.S. are consistent with its earlier and broader cannabis legalization. Given the increasing use and potency of cannabis facilitated by jurisdiction legalization and expanded availability, cannabis’ potential as a cause of breast and testis cancer merits national consideration.

Source: https://www.academia.edu/2998-7741/2/2/10.20935/AcadOnco7758

Filed under: Cannabis/Marijuana,Drug use-various effects,Health,Prevention and Intervention,USA,Youth :

by Shane Varcoe – Executive Director for the Dalgarno Institute, Australia – Jul 23, 2025

Alcohol affects 15 of the 17 United Nations Sustainable Development Goals, yet remains one of the most overlooked barriers to global progress. Behind the marketing messages and cultural acceptance lies a stark reality: alcohol is a Group 1 carcinogen causing seven types of cancer, with no safe level of consumption.

This week on the Unnecessary Harm Podcast, we welcomed Kristina Sperkova , President of Movendi International , a global network of over 170 organizations across 63 countries working to reduce alcohol-related harm. Kristina shared powerful insights from her decade of leadership at the forefront of international alcohol policy advocacy, including her recent work at the World Health Assembly.

Kristina reveals how alcohol undermines everything from poverty reduction to gender equality, the predatory tactics of Big Alcohol at UN meetings, and the groundbreaking policy wins that are reshaping how the world views alcohol taxation and regulation.

Key Takeaways From This Episode

Massive Global Impact: Alcohol directly affects 15 of 17 UN Sustainable Development Goals, from perpetuating poverty cycles to fueling intimate partner violence (50-80% of violent acts are alcohol-related).
Environmental Devastation: Producing one liter of beer requires 270 liters of water, highlighting alcohol’s massive environmental footprint through water depletion and agricultural monocultures.
Cancer Connection: Since 1988, alcohol has been classified as a Group 1 carcinogen alongside tobacco and asbestos, yet public awareness remains dangerously low.
Industry Deception: Big Alcohol uses front groups, creates dependency through corporate partnerships, and spreads lies about employment impacts and illegal production to derail effective policies.
Policy Solutions Work: WHO’s “best buys” – availability restrictions, marketing bans, and public health taxation – are proven, fast-acting interventions that reduce consumption and generate revenue.

Recent Victory: After 10 years of advocacy, alcohol taxation was officially recognised as a source of domestic resource mobilisation at the Financing for Development conference – a major breakthrough for global policy.

Source: https://www.linkedin.com/pulse/alcohols-global-impact-fight-evidence-based-policy-shane-varcoe-fmc8c

Filed under: Alcohol,Australia,Environment,Health,Strategy and Policy :

OPENING REMARK BY NDPA:

Dianova presents itself as a “Swiss NGO recognized as a Public Utility organization, committed to social progress”. Examination of their publications places them as an organisation which is less committed to primary prevention than to reactive approaches, such as harm reduction. A telling quote in this context comes in their publication entitled “Between Music and Substances: a Look at Drug Use at Festivals” … they introduce this by saying “Drug use is a common occurrence at most music festivals: how can we promote self-care and harm reduction among participants?” – there is no mention of prevention as a policy option.

In their ‘history’ Dianova take a position found not infrequently in some other other critics of prevention i.e. any prevention program which does not achieve 100% success is deemed a failure … but no such assessment is made of reactive or accepting policies.

In this publication they dismiss the ‘Just Say No’ program as “…focusing mainly on white, middle-class children, it simply pointed the finger at others, particularly black communities, who were held responsible for the problem.” And yet immediately below this statement they include a photo of a White House ‘Just Say No’ rally, with Nancy Regan surrounded by black youngsters.

Dianova make judgemental remarks – without supporting evidence – in several places, and NDPA take would issue with several of these, but we have elected to retain this paper complete with their judgemental remarks, to illustrate their position on the ‘history’ as they see it.

by the Dianova.org team – 27/07/2025

From the early 20th century to the present day, an overview of the origins of drug use prevention, past mistakes and the current situation in this field

By the Dianova team – Over the past 40 years, prevention has become a key focus of public intervention in many areas, including responses to social issues such as alcohol and other drug use. Prevention strategies are now most often part of a comprehensive approach combining prevention, treatment and harm reduction, and taking into account the needs of people who use drugs and those of society as a whole.

These initiatives are developed on the basis of applied research in the humanities and social sciences, and their implementation and evaluation are based on scientifically validated strategies designed to answer one key question: do they work?

Understanding risk factors is crucial in modern drug prevention interventions, as it enables us to address the root causes of substance use and promote protective factors such as strong family bonds, engagement with school, and community support – Image by stokpic from pixabay, via Canva

Rather than raising awareness of the ‘dangers of drugs’, most initiatives today prefer to target risk factors and protective factors at the individual, family, community and environmental levels. These interventions are designed to be person-centred, while taking into account the many complex interactions between personal and environmental factors that may make certain populations more vulnerable to substance use or addiction. However, this has not always been the case. So what was prevention like before? Is prevention today so different from what it was in the past?

The origins of prevention: combating the ravages of alcohol

All forms of prevention stem from the 19th-century school of thought influenced by Pasteur’s work on the spread of disease: hygienism. This developed in a society plagued by diseases such as tuberculosis and cholera, which were widespread in most European countries, as well as in India, the United States and Canada.

With regard to substance use, it was alcohol that initially became the focus of efforts in Western countries. . In the countries concerned, the Industrial Revolution caused a profound change in drinking habits and exacerbated related problems. The advent of industrialization precipitated a period of exponential growth in the production, transportation and commercialization of alcohol. In urban areas, which experienced a significant increase in population following the rural exodus, millions of workers, reliant on their employers and lacking in social rights, found solace in alcohol, which had become readily available and inexpensive. Alcohol consumption increased significantly, as did the associated problems.

At the time, excessive drinkers were seen as a threat to their jobs, their families and society as a whole. In response, the temperance movement gained strength in America and Europe in an effort to combat alcoholism.

The temperance movement, a group of religious associations and leagues committed to combating the social ills of alcoholism, fought against the consumption of alcohol in the name of morality, good manners and the protection of the family unit. The influence of this movement grew until it reached its zenith in the early 20th century with the advent of alcohol prohibition laws, not only in the United States, but also in Canada, Finland and Russia – with the results we all know.

“The voluntary slave” – press illustration published in “La Fraternité” (France) for the Popular Anti-alcoholic league, author Adolphe Willette – circa 1875 – Adapted from screenshot from L’histoire par l’image

What about illegal drugs?

At the dawn of the 20th century, the concept of ‘illegal’ drugs had yet to be established. Europe and America had recently discovered a ‘remarkable substance’ – cocaine – lauded for its medicinal properties, touted as a panacea for all maladies. Initially imported in small quantities for medical research, its use grew rapidly, particularly within the medical community, and it was prescribed to treat a wide range of ailments, from toothache to morphine addiction. Sigmund Freud himself considered at the time cocaine to be a highly effective medicine for depression and stomach problems without causing addiction or side effects. With regard to cannabis and hashish, these were still available for purchase in all reputable pharmacies, while heroin, a registered trademark of the Bayer pharmaceutical company, was regarded as a sovereign remedy for… coughs.

It should be noted that the issue of substance addiction had not yet manifested itself in the context of affluent, colonizing nations. Elsewhere, the perspective was somewhat different: in a distant country – China – opium had already been wreaking havoc for several decades.

Introduced and marketed by Europeans, it had become a pervasive national scourge affecting millions of Chinese people. Opium addiction is a prime example of the impact of colonialism on local societies: not only did it trigger two wars against Western powers concerned solely with their economic interests (profits from the opium trade), but it also had profound social and political consequences that are still felt today.

The Western countries’ ‘honeymoon’ with drugs was not to last. The problems they posed became apparent rapidly and, under the influence of American temperance leagues, they swiftly transitioned from being regarded as a universal remedy to being perceived as a threat to society and moral values. This marked the beginning of American policies predicated on drug control (or the war on drugs, depending on one’s perspective), which would shape global policies in this domain for over a century.

The demonization of ‘drugs’

The demonisation of drugs, the effects of which were felt from the beginning of the 20th century, is closely associated with a set of social, racial, political and economic dynamics that resulted in the stigmatization of both the substances themselves and the people who consumed them. As early as 1906, the United States initiated the legislative process, and the phenomenon grew until it culminated in a particularly restrictive and repressive international drug control policy – but that is another matter.

In the 1930s, the American government initiated a media offensive involving the use of racist stereotypes, sensationalist media, and political propaganda to portray cannabis as a dangerous substance that led to violence, insanity, and moral decay.

The process of demonizing drugs was gradual yet unstoppable. The discourse surrounding narcotics such as morphine, opium and heroin was initially shaped by their association with specific demographic groups, namely minorities, the economically disadvantaged, and migrants. This demonization continued over the following decades, fuelled by media sensationalism and public panic, particularly around the use of cocaine and cannabis – substances that were claimed to be the root cause of criminal behaviour and moral corruption.

The criminalization and stigmatization of substances and those who use them have had a profound impact. Not only have they perpetuated and reinforced racist prejudices against Afro-descendant, Latin American and other historically marginalized communities, but they have also completely distorted the approaches and prevention efforts implemented subsequently.

Early drug prevention initiatives

Before the 1960s, the ‘drug phenomenon’ was virtually non-existent in industrialised countries. Apart from a few opium enthusiasts, alcohol and tobacco reigned supreme in the field of substance addiction.

From the 1960s onwards, there was a rapid increase in the use of illegal drugs in the United States, particularly among the counterculture movement. The use of LSD and cannabis – and, to a lesser extent, amphetamines and heroin – spread and became a symbol of rebellion against authority, as part of a broader movement focused on social change.

Within the collective imagination, the 1960s are often regarded as the golden age of illegal drug use. This period was characterised by widespread use of cannabis, as well as the significant distribution of heroin among children in impoverished neighbourhoods. Notable figures such as Timothy Leary, a prominent Harvard professor, popularised the effects of LSD. However, an analysis of historical data reveals that the phenomenon was not as widespread as is commonly believed. Conversely, however, there was a marked increase in the perception of risk associated with drugs. For instance, in 1969, a mere 4% of American adults reported having used cannabis at least once. However, 48% of respondents indicated that drug use was a serious problem.

While many current prevention efforts have a solid theoretical basis and evidence of effectiveness, historic prevention strategies were often based on intuition and guesswork, with an emphasis on such scare tactics as the one depicted above (“Your brain on drugs” campaign, initially launched in 1987)

The notion of prevention as a concept was first developed in the early 1960s within the domain of mental health and behavioural disorders. In the context of drug policy, the first initiatives were echoing the pervasive fear of drugs that was prevalent in both America and Europe during that period. Logically, the primary initiatives were consistent with the propaganda campaigns initiated in previous decades with the objective of demonizing cannabis. The objective of these initial prevention initiatives was not to promote education, but rather to instil a sense of fear and intimidation.

‘People of my generation were taught that cannabis caused acne, blindness and sterility. It was a tactic based on fear, not on educating people.’

Children and young people in the 1960s and 1970s were no more stupid than anyone else and just as observant. They quickly realised that the messages promoted by schools and families did not correspond to reality.

So simple, ‘Just Say No’.

In 1971, Richard Nixon declared drug abuse ‘public enemy number one’ and launched a widespread campaign against drug use, distribution and trafficking. This marked the beginning of a government policy that led to the incarceration of both traffickers and users. The policy would have far-reaching consequences for many countries, whilst in the United States it would have a disproportionately negative impact on the Black community.

The notion that one should ‘Just Say No’ to drugs is predicated on a rudimentary interpretation of the rational choice model, according to which people choose their behaviour in order to maximize rewards and minimize costs (negative consequences).

Nancy Reagan at a “Just Say No” rally at the White House in May 1986 – White House Photographic Collection, public domain

The D.A.R.E. programme: information is not enough

From 1983 onwards, this concept became central to the D.A.R.E. (Drug Abuse Resistance Education) programme. Initially implemented in Los Angeles, this school-based programme aimed to help young people understand that the harmful consequences of drug use far outweigh any perceived benefits. Young people can therefore avoid these consequences by refusing to take drugs.

The D.A.R.E programme’s model was based on three key elements: 1) drugs are bad; 2) when children understand how bad drugs are, they will avoid using them; and 3) the message is more effective when delivered by police officers, who are considered credible.

The programme was subsequently developed in the United Kingdom, and a similar model was adopted elsewhere in Europe during the same period — notably by associations of rehabilitated individuals — which replaced the credibility of police officers with that of former drug users ‘who could speak from experience’.

In response to findings on the ineffectiveness of the DARE programme, a new curriculum was developed (2009) with a stronger focus on interactive activities and decision-making skills, moving away from the traditional lecture-based approach by a police officer – AI-generated image, via Canva

Over the years, the programme has been the subject of extensive study. One study found that people who completed the programme had higher levels of drug use than those who did not. Another study found that teenagers enrolled in the D.A.R.E programme “were just as likely to use drugs as those who received no intervention”.

The impact of popular culture

The aim here is not to portray the D.A.R.E. programme or similar interventions solely in an unfavourable or ridiculous light. Even though it has lost its central position, the programme is still implemented in most US states, and according to its website, it has been developed in 29 countries since its creation. It is true that the programme has since been adapted to incorporate various aspects, such as resistance to peer pressure and the development of social skills.

However, these initiatives face a major difficulty from the outset. As we know, experimentation and risk-taking are part of normal adolescent development, which is why providing young people with detailed information about different substances is likely to arouse their interest in these drugs, especially if the information is not presented in an appropriate manner. Secondly, this type of strategy only has an impact on young people who are susceptible to alarmist messages because of their cognitive patterns, and is not effective for everyone else, as we now know.

Officers in the DARE programme would sometimes arrive in sports cars seized from drug traffickers to exemplify their message on drugs and crime (Crime does not pay) – A Pontiac Firebird in D.A.R.E. livery in Evesham Township, New Jersey – image: Jay Reed – Flickr, licence: CC BY-SA 2.0

Furthermore, when talking about drugs, one must also consider the influence of popular culture, which, without openly glorifying substance use, often portrays alcohol, tobacco, and other drugs in a favourable light, particularly at an age when young people are most receptive.

We now know that providing information about drugs is not enough to make for a good prevention policy. While education and awareness can always play an important role, they are not sufficient, nor even necessary, to prevent addiction.

Should we talk about drugs to prevent drug use?

According to Dr Rebecca Haines-Saah, who spoke at a webinar organised by Dianova last May, the most effective drug prevention strategies do not focus on drugs, but on much broader social issues, such as reducing poverty, combating discrimination and implementing targeted community programmes.

Some prevention strategies even choose not to mention drugs at all, yet they have proven effective in reducing substance use by focusing on broader social, environmental and behavioural factors.

These approaches aim to create conditions that indirectly discourage drug use, particularly by strengthening social skills and improving people’s living conditions. For example, programmes focused on improving the school environment, teaching social skills or promoting healthy lifestyles can have a positive impact on reducing substance use without explicitly targeting drugs.

Similarly, family interventions that strengthen parent-child relationships and improve communication can also help prevent substance misuse by targeting underlying risk factors. These strategies highlight the importance of a holistic approach to prevention that goes far beyond direct drug education.

Prevention is a science

Preventing substance use – i.e. the use of all psychoactive substances regardless of their legal status – involves helping people, particularly young people, to avoid using substances. If they have already used substances, the objective is to prevent them from developing substance use disorders (problematic use or dependence).

However, the overall objective is much broader, as highlighted by the UNODC in the second edition of the International Standards on Drug Use Prevention. It also involves ensuring that children and adolescents grow up healthy and safe, so they can fulfil their potential and become active and productive members of society.

Drug prevention is now grounded in research and evidence-based practices. This multi-disciplinary field has developed over the last forty years, aiming to improve public health by identifying risk and protective factors, assessing the efficacy of preventive interventions, and identifying optimal means for dissemination and diffusion – AndreyPopov from Getty Images, via Canva

There is now a vast body of literature on substance use prevention. Its aim is to highlight effective and less effective strategies based on scientific evidence in order to guide decision-makers and practitioners in the field in their choices. Despite this, prevention activities are still sometimes poorly prepared and based primarily on beliefs or ideologies rather than scientific knowledge.

At Dianova, we believe that addiction prevention, particularly among young people, must take into account societal changes (new drugs, new patterns of use, changes in legislation, etc.) using scientifically validated strategies based on standards and methodological guidelines.

These strategies are based in particular on:

The acquisition of psychosocial skills (problem solving, decision-making, interpersonal skills, stress management, etc.),
Interventions aimed at developing parenting skills (e.g. communication skills, conflict management, setting boundaries, etc.),
Prevention strategies tailored to young people with vulnerability factors (e.g. those whose parents suffer from substance use disorders) and taking into account gender perspectives, abandoning androcentric strategies that obscure the situation of girls and LGBTQI+ communities.

In conclusion, we must bear in mind the mistakes of the past so as not to repeat them and, above all, understand that no prevention system is sufficient on its own. Whatever approach is chosen, effective prevention systems must be evidence-based and integrated into broader, balanced systems that focus on health promotion, the treatment of substance use disorders, risk and harm reduction, and countering drug trafficking.

Effective, science-based programmes that can make a real difference to people’s lives can only be developed by integrating all these elements.

Source: https://www.dianova.org/publications/a-brief-history-of-drug-prevention/

Filed under: Addiction,Culture,Drug use-various effects,Harm Reduction,Health,Others (International News),Parents,Prevalence,Prevention and Intervention,Strategy and Policy,Treatment and Addiction,Youth :

by Yousef al Habsi – Oman Observer – Muscat, Jul 13, 2025

6,741 narcotic cases recorded in Oman between 2023 and 2024

The Public Prosecution disclosed that 6,741 drug cases were recorded in the Sultanate of Oman between 2023 and 2024, warning of an increase in drug abuse among various society segments including women.

The Public Prosecution called for increased awareness and family monitoring to protect children from falling into drug addiction.

Dr Rashid al Kaabi, the official spokesperson for the Public Prosecution, said that international criminal networks use social media to lure young people, turn them into addicts and then exploit them in drug trafficking or committing crimes. He explained that drugs are smuggled into the country via land, sea and air, noting that the Sultanate of Oman’s strategic location makes it a potential transit point for drugs.

The most common types of drugs are: hashish, shabu, heroin and painkillers, he said, pointing to the devastating health, social and economic impacts of drugs including psychological and physical illnesses, family disintegration, theft and violence as well as the economic loss. He called for a greater role for the family, educational, religious and media institutions.

He added that the Sultanate of Oman is applying the national strategy (2023–2028) for combating drugs and is intensifying prevention, treatment and rehabilitation efforts. He praised the role of the Royal Oman Police, the Ministry of Health, the Public Prosecution, the Ministry of Education, and other relevant authorities in combating the drug phenomenon.

The Public Prosecution spokesman stressed the importance of monitoring children, adding that families should not hesitate to seek treatment when necessary as addiction is not just a deviation but a disease that requires early and comprehensive intervention.

The Sultanate of Oman had taken a series of important legislative and regulatory steps, the first of which was passing the Law on Combating Narcotic Drugs and Psychotropic Substances pursuant to Royal Decree No 99/17.

In addition, the National Strategy for Combating Narcotics and Psychotropic Substances (2023-2028) was laid out, outlining the policies, programmes and regulatory activities necessary to address contemporary challenges in this field, the Public Prosecution spokesman said.

The Royal Oman Police (ROP), through the Directorate-General for Combating Narcotics and Psychotropic Substances, continues making significant efforts to implement the necessary security measures to prevent drug smuggling across land, sea and air. The ROP has significant capabilities to confront cross-border smuggling networks.

In the same context, the Public Prosecution is responsible for handling drug and addiction cases through the Drug Cases Department, he said, adding that the number of drug cases reported in 2024 saw a significant increase compared to 2023.

Source: https://www.omanobserver.om/article/1173442/oman/call-for-awareness-as-drug-abuse-hits-a-high

Filed under: Addiction,Drug use-various effects,Health,Others (International News),Prevalence,Prevention and Intervention :

Photo: Jimmy Dean // Unsplash

Parents are the No. 1 influence in their child’s life and in their decisions regarding alcohol, making early conversations and clear expectations essential for keeping kids safe

SUMMIT COUNTY, Utah — Parents and caregivers play a crucial role in helping kids stay safe from alcohol and other drug use. In fact, the American Academy of Pediatrics recommends talking to kids about underage drinking as early as age 9. Kids are making up their minds about alcohol between the ages of 9 and 13. If your child is older, it’s never too late to start the discussion. Often, though, we don’t know where to begin. Here are some ideas and resources.

Know the harms

Research from the National Library of Medicine indicates that alcohol can harm the developing brain, impairing memory, learning, and judgment.

Have fun together

When you spend quality time with your child, you build strong bonds – this creates trust between you and your child so that they come to you and you can talk with them about the difficult things in life, like underage drinking and drug use.

Set clear expectations

Parents Empowered reports that “Most children naturally become more independent as they mature. Yet parental involvement drops by half between the 6th and 12th grades when kids need their parents’ help most to stay alcohol-free. Parents are the No. 1 influence in their child’s life and in their decisions regarding alcohol, too.”

“We urge parents to be clear with their children that underage drinking and drug use are never acceptable, especially not in their own home,” says Betty Morin, Substance Abuse Prevention Program Specialist at Summit County Health Department. “Children should also know what to do if they find themselves in a risky situation.”

Keeping your kids in a safe, alcohol-free environment is essential because we know that the folks we hang out with influence our choices. Brainstorm ways for your child to have fun with their friends without using substances, encourage them to avoid situations where there might be drugs or alcohol, and never allow underage use in your own home.

Teach refusal skills

You can practice “refusal skills” with your child by role-playing different situations and helping them say “no” in various ways. They can change the subject, suggest an alternative activity, create an excuse, or even walk away.

Be a safe place for your child. Let them know that they could text or call you if they’re in a situation where drugs or alcohol are present and that you will pick them up. It’s even a great idea to have a safe word with your child that they can call, say the word, and they know you’re on your way.

Be involved in your child’s life

In addition to setting expectations, parents can foster safety by getting to know their child’s friends and their families, attending school events, staying engaged with their child’s online activities, and consistently enforcing agreed-upon rules.

Source: https://townlift.com/2025/07/underage-drinking-prevention-5-essential-strategies-every-parent-needs/

Filed under: Alcohol,Education,Health,USA,Youth :

Dear Surgeon General Adams,

I am an Australian Professor of Addiction Medicine and researcher at the University of Western Australia and Edith Cowan University both in Perth, Western Australia.

I have been becoming increasingly concerned at the implications of cannabis legalization across USA for patterns of congenital anomalies both in USA and across the world.

The incidence of many congenital anomalies are rising in many places. This rise is even more marked if therapeutic early termination for anomaly (ETOPFA) are taken into account.

In 2007 the American Academy of Pediatrics issued a position statement which noted that cannabis was a known teratogen for cardiovascular anomalies based on three studies. They cited ASD, VSD and Ebstein’s anomaly in particular as major concerns. This is also important as cardiovascular anomalies form the largest single group of congenital anomalies. As you would be well aware foetal anomalies is the single major cause of death in the first year of life. The aetiological pathway is further strengthened by the fact that the endocardial cushions have high density expression of CB1R’s cannabinoid type 1 receptors from very early in embryonic life. This fits with the significant association of cannabis with defects of structures derived from the endocardial cushions and the associated conoventricular ridges including the cardiac valves and the interatrial and interventricular septa.

Prof. Peter Fried in Ottawa has headed up a comprehensive, careful and detailed longitudinal study of brain damage in children exposed to cannabis in utero. They have been publishing positive findings from this study for forty years showing documented deficits of executive and higher brain function, the need to recruit more brain to perform tested tasks documented on fMRI, in primary school, middle school, high school and even into young adulthood. It has now been convincingly demonstrated that endocannabinoids send the “off” signal halting synaptic neurotransmission at both stimulatory and inhibitory synapses and hence shutting down the brain’s normal oscillatory processes. Brain oscillations are known to form a key an pivotal function early in brain development guiding the migration and axonal projection of developing neuronal progenitor cells, and also guiding synapse formation.

As you would be aware many neural progenitor cells fail to integrate into the neural network and die due to lack of circuit stimulated connectivity. This applies to both stimulatory and inhibitory synapses. Hence synaptic firing is therefore critical for synapse formation and integration and survival of the new nerve cells. Since cannabis and its constituent cannabinoids shut down this firing and resultant neural oscillations they necessarily impede brain development both in the cortex and in key subcortical major centres including the thalamus and hypothalamus. Hence the demonstration by the Fried group that cannabis users have smaller cortical thickness and hippocampal volumes – the hippocampus first encodes memory – fits well with the known developmental biological mechanisms.

Given that cannabis in Colorado now is commonly at or above 30%, and was historically only 1-2% when most of its epidemiological studies were done; and given also that cannabis oils at up to 99% THC content are also increasingly widely available the conclusion becomes inescapable that the vast majority of children significantly exposed to these concentrations of cannabis in utero will be adversely and permanently affected. Importantly no population measure of this very important damage I easily accessible.

10 studies have linked cannabis exposure to incidence or severity of gastroschisis. This case is strengthened by the high density of CB1R’s on the omphalovitelline artery, and the many studies now which implicate vasoactive drugs in the pathogenesis of this condition. Indeed although the activity of cannabinoids on arterial structure is not widely understood is has been documented in minute detail by no lesser a resource that Nature Reviews of Cardiology. And obviously cannabis arteriopathy underlies the elevated rate of both myocardial infarction and stroke seen in adults with cannabis exposure about which Dr Nora Volkow, Director of NIDA has commented in New England Journal of Medicine.

A spectacular study from Hawaii in 2007 demonstrated that cannabis use was associated with Down’s syndrome incidence at a rate 526% elevated above background.

This is significant for several reasons. Firstly a substantial body of evidence shows that cannabis has been known to test positive in the micronucleus assay since the 1960’s. This is a major test for genotoxicity. The implications of this devastating genetic damage were worked out for the whole world to see by David Pellman’s lab in New York and links cannabis exposure directly with abnormalities of cellular division including the three major clinical trisomies – trisomies 21, 18 and 13 – and Turner’s syndrome, XO.

Furthermore this implies that since cannabis is linked with cardiovascular, neuropsychiatric and chromosomal defects, these being the three major groups of congenital disorders.

If one goes to Colorado as a rather obvious test case indeed one finds a rise there of 70% in both total major congenital anomalies, and also cardiovascular anomalies, especially atrial septal defect and ventricular septal defects, which are the most common, exactly as predicted by the embryology.

Indeed, the particular thoroughness of the way in which all kinds of social and health data is collected and made available in the USA, together with the very considerable spread in attitudes to drug legalization in different states, make USA the perfect teratological laboratory to study the mutagenic and genotoxic effects of cannabinoid exposure. My colleagues in addiction medicine and I at my university, aided by some of the top statisticians in this country have now commenced the enormous task of analyzing the US cannabis exposure data by state from the National Survey on Drug Use and Health, together with cannabis concentration data quoted by Dr Nora Volkow the Director of NIDA in New England Journal of Medicine, together with projections of the applicable therapeutic termination rates taken from the Western Australian Register of Developmental Anomalies are analyzing this data at this time.

Whilst our findings have not been finalized the following remarks can already be made:

In socially conservative states cannabis use is falling or flat whilst it is rising in more liberal states;
When one takes into account the dramatically increased cannabis concentration – to only 15% in 2015 in this series – the population exposure to cannabinoids has risen in all states regardless of social ethos;
The rate of almost all congenital anomalies in the USA has risen when reasonable estimates for ETOPFA rates are employed;
Cannabis exposure is significant for all 62 anomalies combined considered as a group;
Not only are congenital anomalies uniformly rising against time, they are also rising against this metric of community cannabis exposure – defined as the product of the national mean cannabis concentration and the state based cannabis use rates;
If one considers the groups of:

1. Cannabis related disorders (as defined by the Hawaiian investigators);
2. Chromosomal defects;
3. Cardiovascular defects;
4. Derivatives of the endocardial cushions

The population exposure to cannabinoids remains highly significant including consideration of state and year

Considering all 62 defects collected by the US National Birth Defects Prevention Network :
1. In 43 cases (69.3%) the community cannabinoid exposure remains significant on linear regression testing before correction for multiple testing;
2. When one adjusts for multiple testing 38 defects (61.3%) remain significant – mostly as described by the Hawaiian researchers;
3. For example the national rate of the effect of cannabis exposure on Ebsteins anomaly is P<0.0001 for the effect of cannabis exposure alone and P<0.0001 for the interaction between cannabis exposure and time (multiple testing corrected results). The beta estimate for this effect is 18%, and the P value is much less than P < 10 ^-16 .

Please note that none of these metrics quantitate what I regard as the most serious area of all – the neurobehavioural toxicology so carefully documented and chronicled with every imaginable psychological and imaging test at every developmental stage into young adult by the methodical Ottawa investigators referenced above.

I am aware of course of the signal service performed in this area by your predecessor Dr Murthy in relation to his report on “Facing Addiction in America.”

Naturally I am very concerned indeed that the USA, having avoided the horrors of thalidomide directly due to the due diligence of your FDA staff at the time, is sailing directly into an even worse teratological morass related to the legalization of cannabis in your country, which apparently even your President appears to be powerless to avert. It is of the greatest concern to me that the carefully orchestrated US cannabis legalization campaign seems to be operating is such a manner as to at once bypass and simultaneously intimidate the FDA quality control and checks and safety balances processes.

The medical conclusion appears inescapable to me that cannabis use should be avoided by males and females in the reproductive age group especially if involved in pregnancy or even considering pregnancy – because of the long half lives involved and its sluggish release from the body’s fat stores. It is well known that these same young adults is the group most keen to use cannabis products! Indeed it is well documented that cannabis both increases sexual libido and reduces inhibitions; albeit after time and habituation it reduces both sexual desire and performance. This sets up an inescapable and unavoidable reproductive and genotoxic paradox – which also greatly escalates the present discussion beyond the arena of personal civil liberties to the future of our coming generations.

Naturally I am particularly keen to discuss these issues with yourself at your earliest available opportunity.

The teratological aspects of this epidemic seem to have been completely and systematically overlooked in the current discussions.

Please help me assist your wonderful, beautiful, noble and courageous nation at this critical juncture in your history.

And I am sure it will be self-evident to you that anything that happens in USA has enormous ramifications around the world, as you are obviously that world’s leading democratic nation.

Hence USA is not only legislating for America – but for all citizens of the planet – present and future. Because of the epigenetic implications – not discussed above but very well substantiated nonetheless – for the next four generations – this is the next 100 years.

In such a circumstance – truth can be your only meaningful defence. And it must be your final bastion – and the last great hope of civilization.

I am very keen to set up a time which would be suitable to yourself to discuss these issues on the phone.

Oddly it seems to me that few professionals understand these issues thoroughly.

And even more strangely – it seems to me strange that USA, having alone amongst the family of nations done so extremely well with thalidomide, at the present time gives every appearance of acting before she has thought carefully, methodically and deeply about the ramifications of her present actions in this field.

With very best wishes,

Yours sincerely,

Dr. Stuart Reece,

Australia.

Email sent in copy to Drug Watch International June 2018 drug-watch-international@googlegroups.com

Filed under: Cannabis/Marijuana,Drug use-various effects on foetus, babies, children and youth,Genes,Global Drug Legalisation Efforts,Health,Legal Sector,Political Sector,USA :

Alcohol damages the brain, heart, liver and pancreas, and it increases the risk of some cancers, such as mouth and bowel cancer. It also weakens the immune system, making people more vulnerable to infectious diseases, such as pneumonia and tuberculosis. Taken in excess, it can kill.

Given these significant health consequences, it’s not surprising that many people who are addicted to the substance, try to quit. However, if it’s not done properly, withdrawal from alcohol can have terrible health consequences of its own, including death.

The body adapts to long-term change in order to survive. An example of this is angina, where the vessels supplying the heart with blood become narrow. Evidence suggests that people with the condition can slowly improve and adapt to the reduced blood flow by developing new blood vessels.

Similarly, there are physiological changes as a result of long-term alcohol abuse.

Alcohol suppresses the production of certain neurotransmitters (chemicals that carry messages between nerve cells). After a while, the body adjust to the continual presence of high amounts of alcohol by producing more of these neurotransmitters and their receptors – the proteins on the surface of nerve cells that neurotransmitters latch on to.

When people who are dependent on alcohol suddenly quit drinking, there is a surge in neurotransmitters, way above what the body needs. This surge explains many of the symptoms of sudden withdrawal, including sweating, racing heart, restlessness and feelings of anxiety.

Alcohol affects neurotransmitters – the chemicals that send signals between nerve cells. Andrii Vodolazhsky/Shutterstock.com

The sudden removal of alcohol can cause fatal arrhythmias, where the heartbeat becomes so irregular the heart fails. This complicated biological process is due to the fact that alcohol interferes with the balance of GABA (an inhibitory neurotransmitter) and glutamate (an excitatory neurotransmitter).

The excitatory and inhibitory pathways in the brain control the central nervous system and heart. Once alcohol is removed, the huge levels of neurotransmitters that are present can overstimulate organs, including the heart.

This is often made worse by the fact that the heart’s structure changes with long-term alcohol use. Muscle strength and thickness, for example, are significantly reduced in people who consume more than 90g of alcohol per day (one unit of alcohol is equal to 8g of pure alcohol) over a period of five years or more.

The sudden removal of alcohol can also cause kidney failure. Alcohol has to be broken down and cleared from the body as urine. This needs water, as the products of the breakdown have to be in solution.

Alcohol also inhibits the production of an anti-diuretic hormone, so large quantities of alcohol make you urinate a lot and become dehydrated. Electrolytes in the body, such as sodium, magnesium, calcium and potassium, are usually in solution (water) and excessive amounts of alcohol can cause an imbalance in these electrolytes as well as an acid-base imbalance. These imbalances can eventually lead to acute kidney failure.

Dangerous drug

The risk of dying from sudden alcohol withdrawal are very real and very high, with estimates ranging from 6% to 25%, depending on their symptoms. Sadly, the unpleasant experience of withdrawal – both physical and mental – causes many addicts to relapse to heavy drinking.

If you drink alcohol, it is advisable that you stick to the government guidelines of not drinking more than 14 units of alcohol a week, which equates to about six pints of lager or six glasses of wine (175ml).

Source: https://theconversation.com/alcohol-withdrawal-can-be-deadly-heres-why-96487 June 2018

Filed under: Alcohol,Health :

by Robyn Oster – Associate Director, Health Law and Policy – July 2025

Reminder: The U.S. Preventive Services Task Force (USPSTF), an expert panel, evaluates preventive services and recommends which should be provided at no cost.

Why it’s important: Services currently required to be covered at no cost include certain mental health screenings, drug/alcohol screenings, PrEP for HIV, etc.
A group of conservative Christian employers in Texas led a lawsuit challenging the requirement. They argued that having the independent panel determine national health coverage violated the appointments clause of the Constitution and that covering PrEP violated religious freedom (though the Supreme Court only weighed in on the appointments clause argument).

The details:

The employers argued that USPSTF members were not appointed as either of two types of executive branch officers that the Constitution allows to make certain national policy decisions. They argued that the task force recommendations requiring them to cover certain preventive services in their employer-sponsored health plans were unconstitutional because task force members are not confirmed by the Senate.
The government defended the task force, arguing that it is constitutional because HHS officials appoint USPSTF members, and the HHS secretary can remove members at will and veto recommendations.
The Supreme Court agreed with the government and affirmed that the HHS secretary has these powers over USPSTF and its recommendations.

The bigger context:

The decision is a win for health advocates, who wanted to maintain the no-cost coverage requirement for preventive services. Providing preventive services at no cost is key to increasing access to and receipt of important screenings and other preventive services. Decreasing access to such services would lead to worse health outcomes.
But: The ruling could challenge USPSTF’s independence and credibility. It cements a strong role for the HHS secretary in overseeing the USPSTF, including removing members and modifying its rulings. This paves the way for HHS Secretary Kennedy to reject recommendations he disagrees with, allowing insurers to charge for those services or avoid covering them in some cases. It also opens the door for Kennedy to remove all the task force members and appoint new people, and a new task force could reject previous recommendations.

Source: https://drugfree.org/drug-and-alcohol-news/supreme-court-upholds-aca-preventive-care/

Filed under: Drug use-various effects,Health,Legal Sector,Mental Health,Prevention and Intervention,Strategy and Policy,Treatment and Addiction,USA :

In Christian Daily – Forum 2025 – News & Stories – July 9, 2025

According to a report in ChristianDaily.com, a June 2025 study published in a peer-reviewed journal of the British Medical Association, found that daily cannabis users are 34% more likely to develop heart failure than non-users.

The study by researchers from France drew on data from over 150,000 U.S. adults tracked over several years, and also linked marijuana use with an increased risk of heart attack and stroke. The objective was to evaluate the possible association between major adverse cardiovascular events (MACE) and the use of cannabis or cannabinoids.

Dr. Matthew Springer, a heart disease biologist at the University of California, San Francisco (UCSF), told the New York Times that marijuana inhalation delivers “thousands of chemicals deep into the lungs,” potentially increasing cardiovascular risk. His lab recently found that both edible and inhaled forms of marijuana were associated with comparable levels of blood vessel dysfunction.

An accompanying editorial by researchers from California USA said about the study:

Legalisation of medical and recreational cannabis commerce is spreading around the world, associated with increased use1 and falling perception of the risk. Frequent cannabis use has increased in several countries, and many users believe that it is a safe and natural way to relieve pain or stress. In contrast, a growing body of evidence links cannabis use to significant harms throughout life, including cardiovascular health of adults. The robust meta-analysis of cannabis use and cardiovascular disease by Storck et al4 in this issue of Heart raises serious questions about the assumption that cannabis imposes little cardiovascular risk.

This study is backed up by a March 2025 publication by the American College of Cardiology which revealed that cannabis users under the age of 50 are six times more likely to suffer a heart attack and three times more likely to die from cardiovascular causes compared to non-users.

According to a review article in JACC: Journal of the American College of Cardiology – “Marijuana is becoming increasingly potent, and smoking marijuana carries many of the same cardiovascular health hazards as smoking tobacco.”

As reported by Christian Daily International, in 2019, the Christian Medical & Dental Associations (CMDA) — a U.S.-based nonprofit representing thousands of Christian healthcare professionals — issued a position statement cautioning against recreational and medicinal marijuana use. “[T]here is a need for limiting access to marijuana,” the CMDA said. It warned of addiction, cognitive impairment, psychosis, and long-term health effects, especially among youth. “The adolescent brain is still developing and more vulnerable to the adverse effects of marijuana,” the statement emphasised.

Source: https://www.christiandaily.com/news/new-study-links-marijuana-to-heart-failure-echoing-christian-medical-professionals-long-standing-warnings-against-recrea

Filed under: Cannabis/Marijuana,Drug use-various effects,Health,Marijuana and Medicine,Mental Health,Prevention and Intervention,Treatment and Addiction,USA :

Drug and Alcohol Dependence – Volume 273, 1 August 2025, 112714

by Gustave Maffre Maviel, Camilla Somma, Camille Davisse-Paturet, Guillaume Airagnes, Maria Melchior.

Highlights

•
Studies reveal a significant association between cannabis use and suicidality, independent of depression.
•
Existing research is inconsistent regarding whether the association differs between individuals with and without depression.
•
More research is needed to identify the pathways linking cannabis use to suicidality.

Abstract

Background

Depression has been cited as a possible confounder, moderator, and mediator of the relationship between cannabis use and suicidal behaviours. We aimed to assess the role of depression in the relationship between cannabis use and suicidal behaviours by systematically reviewing existing literature in the general population.

Methods

We systematically searched PubMed, Science Direct and Psych Articles from database inception to May 20th 2024, for quantitative observational studies investigating the role of depression in the association between cannabis use and suicidal behaviours. We conducted a meta-analysis to examine the confounding role of depression and search for qualitative arguments in favour of moderating and/or mediating roles of depression.

Results

We screened 1081 articles, selected 43 for full-text screening and finally included 25. Among adolescents, cannabis use was associated with suicidal ideation (OR = 1.46 [1.17, 1.83]) and suicide attempts (OR = 2.17 [1.56, 3.03]) in studies adjusting for depression. Among adults, cannabis use was associated with suicidal ideation (OR = 1.78 [1.28, 2.46]) in studies adjusting for depression. 12 out of 25 studies found no association between cannabis use and suicidality after adjustment for depression. Six studies investigated a potential moderating role of depression, with four reporting significant but conflicting results. No article investigated the mediating role of depression.

Discussion

There is a clear relationship between cannabis use and suicidal behaviours, which is partly confounded by depression. Studies investigating a moderating role of depression did not agree about the direction of moderation. Further research using methodologies that consider the chronology of events is needed.

Keywords

Cannabis

Cannabis use

Cannabis use disorder

Suicidal behaviours

Suicide

Depression

Source: https://www.sciencedirect.com/science/article/pii/S037687162500167X?

Elsevier Science has two locations: one in New York, United States, and the other in Amsterdam, Netherlands.

Filed under: Cannabis/Marijuana,Drug use-various effects,Europe,Health,Mental Health,Prevention and Intervention,USA :

by Shane Varcoe – Executive Director – Dalgarno Institute

Wine has long been a symbol of sophistication, celebration, and relaxation. From vineyard tours to candlelit dinners, it’s often associated with nature, tradition, and wellness. However, a closer look uncovers the hidden dangers in wine. A recent report reveals that wine is not just about ethanol; today’s bottles are also tainted with toxins like trifluoroacetic acid (TFA) and synthetic pesticides, posing significant risks to both health and the environment.

The findings force us to confront the polished image of wine and reconsider its real impact. Below, we explore these “hidden dangers in wine,” how they’ve arisen, and what they mean for consumers and the planet.

Toxic Truths Unveiled: A groundbreaking report from PAN Europe (Pesticide Action Network Europe) investigated 49 wines from ten European countries. Their findings reveal an alarming rise in TFA contamination. Known as a persistent and toxic chemical derived from PFAS (per- and polyfluoroalkyl substances), TFA builds up in water, soil, plants, and now, wine.

Elin Engdahl, an expert on environmental toxins at the Swedish Society for Nature Conservation, highlighted the gravity of this contamination. “We are seeing an explosive increase, especially in the last ten years,” she stated.

Key findings of the report include:
• Wines produced between 2021 and 2023 contain an average of 122 micrograms of TFA per litre.
• Some bottles spike to over 300 micrograms per litre.
• Wines from earlier vintages, particularly before 1988, were completely free of TFA.
“TFA is found all over the planet today. We have high concentrations in water, soil, plants, and even human blood,” explained Ioannis Liagkouridis, a PFAS researcher at the Swedish Environmental Institute IVL.
These concerning levels demand urgent attention, as TFA meets the criteria for posing a risk to vital planetary boundaries.

Source: https://www.dalgarnoinstitute.org.au

Filed under: Alcohol,Australia,Drug use-various effects,Environment,Health :

If you’re a small business owner, you probably wear a lot of hats: manager, mentor, HR rep, sometimes even IT support. You already know that building a successful company today means adapting to change, especially when it comes to supporting your team. How we approach substance use and mental health on the job is where workplaces need to be evolving quickly!

You might think serious conversations about substance use, behavioral health, and mental wellness are reserved for big corporations with large HR departments and employee wellness budgets. But in today’s world, even the smallest teams need modern, compassionate policies.

Why? Because the way we work—and what employees expect—has changed. Employees today want to know that their employer cares about their whole well-being, not just their productivity. That includes creating space to talk about tough topics like stress, burnout, and yes, substance use.

Modern leadership means recognizing that substance use is something that impacts real people—people you may work with every day. It doesn’t always look like someone missing work or failing a drug test. It can be more subtle: someone relying on alcohol to decompress every night, using prescription stimulants to keep up with unrealistic demands, or struggling quietly with a dependence on marijuana.

Ignoring these issues won’t make them go away. But addressing them with care and structure? That’s leadership.

Here’s how small business owners can modernize their workplace by making room for this kind of support:

1. Update Your Workplace Culture, Not Just Your Tech

You wouldn’t run your business on a five-year-old software system. So why stick with outdated workplace norms around health and performance?

A modern workplace recognizes that stress, mental health, and substance use challenges are part of the human experience—and responds with resources, not judgment. Whether that’s offering access to support programs or simply encouraging open dialogue, small steps make a big difference.

2. Create a Clear, Supportive Policy

Yes, even small businesses should have a written policy about substance use. Not to scare people—but to protect them. A good policy:

· Explains your company’s stance (supportive, not punitive)

· Details how employees can seek help confidentially

· Trains supervisors to spot concerns and respond appropriately

· Builds in support and resources—like referrals, time off for treatment, or check-ins

It shows employees that they don’t have to hide what they’re going through.

3. Lead With Curiosity, Not Control

You don’t need to be a counselor. But you can ask thoughtful questions, listen without judgment, and point people in the right direction. A curious, compassionate conversation can open the door to real change—especially when someone is already feeling vulnerable.

Modern support means meeting people where they are. Whether someone is cutting back, abstaining, or just starting to question their habits, having your workplace be part of the solution helps them take the next step.

4. Set the Tone From the Top

As a business owner, your attitude sets the culture. Talking openly about stress, supporting mental health days, and encouraging balance gives your employees permission to take care of themselves. And when people feel safe, they perform better. It’s that simple.

Addressing substance use isn’t about policing your team. It’s about building a workplace where people can show up as they are, get the support they need, and grow. That’s what today’s employees are looking for—and it’s how small businesses build loyalty, retention, and a reputation for doing things the right way.

Source: McConnell, K. (2024, April 1). The Challenge of Change: How employers can modernize workplace substance use support. How Employers Can Modernize Workplace Substance Use Support | Spring Health. https://www.springhealth.com/blog/how-employers-can-modernize-workplace-substance-use-support

Source: Drug Free America Foundation | 333 3rd Avenue N Suite 200 | St. Petersburg, FL 33701 US

<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<DFAF>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

NATIONAL DRUG-FREE WORKPLACE ALLIANCE

As the workplace division of Drug Free America Foundation, NDWA’s mission is to be a national leader in the drug-free workplace industry by directly assisting employers and stakeholders, providing drug-free workplace program resources and assistance, and supporting a national coalition of drug-free workplace service providers.

For more information and drug-free workplace resources, visit NDWA at www.ndwa.org.

Filed under: Culture,Drug use-various effects,Health,Mental Health,Prevention and Intervention,Treatment and Addiction,USA,Workplace :

by Ingrid Fadelli, Phys.org – edited by Gaby Clark, reviewed by Robert Egan – The GIST – June 26, 2025

Omicron Limited’ 36 Hope Street, Douglas, IM1 1AR, Isle of Man

Cannabis, also known as marijuana or weed, is widely consumed worldwide, whether for recreational or medicinal purposes. Over the past decades, the use of cannabis has been fully legalized or decriminalized in various countries worldwide, including Canada, many U.S. states, the Netherlands, Germany, Spain and Portugal.

While some studies have found that cannabis and especially cannabidiol (i.e., the non-intoxicating compound contained in it) can have medicinal effects, others have linked the abuse of its psychoactive variations (i.e., containing tetrahydrocannabinol or THC) with a greater risk of being diagnosed with psychiatric disorders.

As many individuals worldwide use cannabis on a regular basis, understanding the mechanisms that could link its consumption with psychiatric disorders could be highly valuable, as it might help to identify factors that increase the risk of developing specific disorders.

In a paper published in Nature Mental Health, researchers at Yale University School of Medicine, the Veterans Affairs Connecticut Healthcare System and Washington University School of Medicine shed new light on the genetic associations between cannabis use, cannabis use disorder (CanUD) and various psychiatric disorders.

CanUD is a mental health disorder characterized by a continued use of cannabis, difficulties experienced when trying to cut down its consumption or cease using it altogether, and an interference of the substance with daily activities, relationships or responsibilities.

“Increasing prevalence of cannabis use and CanUD may increase risk for psychiatric disorders,” wrote Marco Galimberti, Cassie Overstreet and their colleagues in their paper. “We evaluated the relationships between these cannabis traits and a range of psychiatric traits, running global and local genetic correlations, genomic structural equation modeling, colocalization analyses and Mendelian randomization analyses for causality.”

Genomic-SEM. Genomic-SEM analyses of cannabis traits (CanUD and cannabis use) and
psychiatric disorders for a three-factor model. Credit: Galimberti et al.
(*Nature Mental Health*, 2025).

The researchers analyzed genetic, psychiatric and psychological data collected as part of earlier studies, using various statistical techniques. First, they tried to detect genetic patterns that linked cannabis use with specific psychiatric and personality traits, using a technique known as genomic structural equation modeling.

Subsequently, they ran colocalization analyses, a statistical analysis that allowed them to uncover instances where two traits shared the same underlying genetic variant. Finally, they used a technique called Mendelian randomization to uncover causal relationships between traits, or in other words, if a sporadic or problematic use of cannabis caused specific disorders via genetic factors and vice versa.

“Global genetic analyses identified significantly different correlations between CanUD and cannabis use,” wrote Galimberti, Overstreet and their colleagues. “A variant in strong linkage disequilibrium to one regulating CHRNA2 was significantly shared by CanUD and schizophrenia in colocalization analysis and included in a significant region in local genetic correlations between these traits. A three-factor model from genomic structural equation modeling showed that CanUD and cannabis use partially map together onto a factor with major depressive disorder and ADHD.”

Interestingly, the researchers found that although cannabis use and CanUD are in some ways related, they had different genetic relationships with psychiatric disorders. In fact, they found that variations in the regulation of the gene CHRNA2, which has also been linked to nicotine consumption and dopamine signaling, were common to both schizophrenia and CanUD, but not to casual or general cannabis use.

“In terms of causality, CanUD showed bidirectional causal relationships with most tested psychiatric disorders, differently from cannabis use,” wrote Galimberti, Overstreet and their colleagues. “Increasing use of cannabis can increase rates of psychiatric disorders over time, especially in individuals who progress from cannabis use to CanUD.”

Overall, the findings of this recent study suggest that there is a bi-directional genetic relationship between the abuse of cannabis, specifically CanUD, and various psychiatric disorders, including schizophrenia, ADHD, depression, and bipolar disorder. In other words, it appears that CanUD could increase the risk of developing mental health disorders, and being diagnosed with some psychiatric disorders could also prompt abuse of cannabis.

This recent work could potentially inform the development of public health interventions aimed at monitoring or limiting people’s consumption of cannabis early, to reduce the risk that they will later develop psychiatric disorders. In addition, the analyses could inspire other research groups to delve deeper into the genetic associations they uncovered, potentially by analyzing a wider pool of genetic, psychological and medical data.

Written for you by our author Ingrid Fadelli, edited by Gaby Clark , and fact-checked and reviewed by Robert Egan —this article is the result of careful human work. We rely on readers like you to keep independent science journalism alive. If this reporting matters to you, please consider a donation (especially monthly). You’ll get an ad-free account as a thank-you.

More information: Marco Galimberti et al, The genetic relationship between cannabis use disorder, cannabis use and psychiatric disorders, Nature Mental Health (2025). DOI: 10.1038/s44220-025-00440-4.

Journal information: Nature Mental Health

Source: https://medicalxpress.com/news/2025-06-explores-genetic-link-cannabis-psychiatric.html

Filed under: Brain and Behaviour,Cannabis/Marijuana,Drug use-various effects,Health,Marijuana and Medicine,Mental Health,Prevention and Intervention,Treatment and Addiction,UK,Uncategorized :

OPENING REMARKS BY NDPA:

This book, and its review, engage with differing viewpoint s about addiction and addicts. Flanagan prefers to avoid the word ‘disease’ – characterising the condition as a behavioural ‘disorder’ – much in the way that Stanton Peele, in his classic 1975 text ‘Love and Addiction’ – (Peele and Brodsky – Pubd, Taplinger, New York) similarly views the condition. But in the professional field of today additional concepts have been introduced, what some might call ‘influencers’ – longest established is the notion of ‘harm reduction’ – this (in our opinion) has a valid purpose in limiting harm that users can experience, but it has also been ‘abused’ by campaigners who argue that ‘laws are harmful, so legalisation reduces harm’. More recently the notion of ‘stigma’ has become more prominent in the drug policy arena … and again, whilst there is a valid role for addressing gratuitous stigmatisation of users, the liberalising campaigners can be seen to abuse the notion, arguing that ‘all stigma is bad, therefore all stigma should be removed.’ In fact, society has long rationally deployed stigma where it can be seen as criticising an individuals drug abuse when this damages and jeopardises a healthful society, or threatens the health of people around the user … this is echoed in Flanagan’s text where, for example he says addicts are ‘… are by no means blameless just because they supposedly have a disease’. This dialogue will of course run and run, and NDPA will endeavour to maintain a balanced and rational journey through this jungle!

A new book looks at addiction through the lens of choice and responsibility.

Book Review by Daniel Akst – Reason Magazine – 6.15.2025

Addiction is a problem that defenders of liberty need to face, for if citizens cannot control their appetites, the state may be inclined to take over the job for them. Freedom depends on self-command supported by a fragile web of norms and relationships that lets us keep our own lives in order and get along with one another. Addiction is the acute case of the appetites run amok, as they often do when unfettered by such constraints as wealth, religion, and community.

Owen Flanagan’s new book, What Is It Like To Be an Addict?, should be welcomed by anyone concerned with these issues. Despite its modest size, this is a work of large ambition and broad range informed not just by the author’s long career as a prominent philosopher but by his many years as a desperately addicted abuser of alcohol and sedatives.

“This is a deeply personal book,” he writes. “I was addicted to booze and benzos for twenty years on and off from the late 1970s until the early 2000s. The last years were especially ugly, requiring several hospitalizations, and involving constant self-loathing and suicidal despair.”

Unsurprisingly given his experience, Flanagan stresses that we should pay close attention to what the addicted have to tell us. And among the most important things addicts say is that they are by no means blameless just because they supposedly have a disease. On the contrary, many feel shame (for being an addict) and guilt (for behaviors that are slowly destroying them and harming their loved ones).

To Flanagan, these feelings are right and good. That stance may inspire horror from some people, who will see it as victim-blaming. But it’s consistent with Flanagan’s view that addicts can’t be reduced to flesh-and-blood automatons jerked about by their cravings. As he notes, even people who claim to believe this will then earnestly implore an addict to get help—a plea that could only be directed at someone presumed to have the ability to make choices. “Every treatment that works to unseat addiction,” he writes, “assumes that addicts are responsible and must participate in undoing their own addiction.”

Flanagan doesn’t even think addiction is a disease, exactly—more of a multifactorial disorder of enormous social, physical, psychological, and pharmacological complexity. Indeed, one of his book’s main points is that addiction cannot be seen as any one simple thing. But he doggedly insists that addicts retain some agency during their plight.

“Practices of compassion, forgiveness, and excusing are distinct from whether or not we hold the addict responsible,” he writes. “We hold addicts responsible in many respects and rightly so. Thus, the determination that addiction is a disease or mental disorder is much less consequential as far as holding addicts responsible goes than many suggest.”

Flanagan takes care to distinguish between unwilling addicts, willing addicts, and resigned addicts, helping us through these categories to think about what we mean by addiction and how best to mitigate it. Particularly notable are the minority who are willing addicts—he mentions as an example Keith Richards, who has said he was a longtime heroin user. At least some of these individuals are in control of the consequences of their habit and satisfied with their lives. Is their addiction any more meaningful than a coffee habit?

Unwilling addicts want to quit, and many will eventually succeed. And resigned addicts are those who wanted to quit, couldn’t, and just gave up, surrendering to hopelessness. They are in a sense beyond unwilling; by not trying to quit, they effectively acquiesce. Here, the author says, a kind of accommodation may help. One nonprofit in Europe helps resigned addicts to lead orderly lives through more disciplined consumption—in one methadone-like program, six pints of beer spread throughout the day—as well as suitable paid employment.

As for himself, the author credits Alcoholics Anonymous with saving his life by enabling his sobriety, but he also thinks it has a certain cultishness; like any good rationalist, he insists on “the distinction between the belief in a Higher Power having an effect and the Higher Power having an effect.”

Flanagan is also a capable researcher and reporter. Who knew that many addicts call the rest of us “earth people”? Or, more significantly, that there is so much overlap between addiction and other psychiatric disorders? “Twenty-five percent of individuals with severe mental illness, defined as a disorder that severely compromises normal functioning—schizophrenia with delusions or immobilizing depression—have a substance use disorder,” the author says. “In the other direction, 15 percent of individuals with a substance use disorder also have a severe mental illness.”

This book’s focus is substance abuse rather than, say, Facebook addiction, if such a thing exists. Flanagan is properly skeptical of the movement to medicalize all of life’s setbacks and sadnesses. He notes that men in most cultures are more likely than women to abuse alcohol and drugs, but that women are gaining. “There is no country where female alcoholism…rates are near 10 percent. But there are many countries in which the male alcoholism rate is above 10 percent and a few that top 13 percent: Russia (16.29 percent), Hungary (15.29 percent), Lithuania (13.35 percent), and South Korea (13.10 percent).”

He reminds us that while the war on drugs appears to be a costly failure, we can’t say for sure that many addictions wouldn’t be worse in its absence. And he notes some of the problems that have accompanied legalization initiatives. In Portugal, after a decade of good results, “substance use is on the rise, and fewer and fewer people in need are getting treatment. Recent data indicate that both overall drug use and drug overdose rates are up.” In Oregon, decriminalization Measure 110 “is being unwound” after evictions and fentanyl supplies surged. But he cautions: “The data do not mean, as some are quick to insist, that decriminalization, harm reduction, and treatment are not for the best.”

What Is It Like To Be an Addict? has its shortcomings, which largely stem from the author’s academic tribe. The book is not particularly well-organized or well-written; again and again, Flanagan tells us what he’s going to tell us, and then tells us the thing a couple more times to be on the safe side. And the book can be heavy on jargon. At one point, despite his professed sobriety, he writes: “When I report on the experiences of fellow addicts based on their autophenomenological reports, I am doing heterophenomenology.”

Particularly nettlesome is the author’s claim that, although addicts are responsible for their addiction, the rest of us are responsible too because of the woeful conditions we’ve allowed to persist. He wheels out the usual suspects including “social displacement,” poverty, inequality, racism, depression, “lack of good life options,” and other all-purpose woes that “are not caused by addicts.”

Blinkered by his ready-made list of villains, the author takes little account of other potential factors. Affluence in particular seems at least as likely a culprit as poverty. Today’s poor are often richer than middle-class Americans were in the middle of the last century, and today’s American middle class is extraordinarily affluent by historical and global standards. That means more of us can afford substance abuse of all kinds, not to mention addictions to shopping and other costly behaviors.

How about changes to family life or to levels of church attendance? Isn’t it possible that the religious and familial dimensions of A.A. are essential to its remarkable success? It’s noteworthy that the author’s own salvation came not from any arm of government but from a private, apolitical institution operating on a shoestring and making no attempt to end inequality or racism. Drunks come to A.A. and somehow get sober anyway.

But in truth, the author’s gestures toward collective responsibility feel more obligatory than emphatic. What he really wants is a humane, evidence-based approach to the problem of addiction consistent with individual agency, and that’s an approach fully in accord with a faith in human liberty. At the same time, we might as well recognize that voters will quickly lose their enthusiasm for legalizing drugs if they blame it for public chaos. Freedom always and everywhere relies on self-regulation.

These are tough times for individual agency. Many philosophers and psychologists scoff at the notion of free will, which others seem to regard as the sole province of the “privileged.” A therapeutic culture and the nanny state give us all incentives to see ourselves as victims, helpless in the face of implacable forces of oppression. It is refreshing to read a book that refuses to dehumanize addicts by depriving them of responsibility or delegitimizing the shame they feel for their actions.

Source: https://reason.com/2025/06/15/how-freedom-lovers-can-reckon-with-addicts-and-addiction/

Filed under: Addiction,Brain and Behaviour,Culture,Drug use-various effects,Health,Mental Health,Prevention and Intervention,Treatment and Addiction,USA :

Abstract

Introduction

In the USA, opioid analgesic use and overdoses have increased dramatically. One rapidly expanding strategy to manage chronic pain in the context of this epidemic is medical cannabis. Cannabis has analgesic effects, but it also has potential adverse effects. Further, its impact on opioid analgesic use is not well studied. Managing pain in people living with HIV is particularly challenging, given the high prevalence of opioid analgesic and cannabis use. This study’s overarching goal is to understand how medical cannabis use affects opioid analgesic use, with attention to Δ9-tetrahydrocannabinol and cannabidiol content, HIV outcomes and adverse events.

Methods and analyses

We are conducting a cohort study of 250 adults with and without HIV infection with (a) severe or chronic pain, (b) current opioid use and (c) who are newly certified for medical cannabis in New York. Over 18 months, we collect data via in-person visits every 3 months and web-based questionnaires every 2 weeks. Data sources include: questionnaires; medical, pharmacy and Prescription Monitoring Program records; urine and blood samples; and physical function tests. Using marginal structural models and comparisons within participants’ 2-week time periods (unit of analysis), we will examine how medical cannabis use (primary exposure) affects (1) opioid analgesic use (primary outcome), (2) HIV outcomes (HIV viral load, CD4 count, antiretroviral adherence, HIV risk behaviours) and (3) adverse events (cannabis use disorder, illicit drug use, diversion, overdose/deaths, accidents/injuries, acute care utilisation).

Ethics and dissemination

This study is approved by the Montefiore Medical Center/Albert Einstein College of Medicine institutional review board. Findings will be disseminated through conferences, peer-reviewed publications and meetings with medical cannabis stakeholders.

Source: https://pmc.ncbi.nlm.nih.gov/articles/PMC7778768/ Dec 2020

Filed under: Health,Marijuana and Medicine,Opioids :

Experts warn that millions of people are drinking way more than they should
This week a US report showed 1 in 8 Americans are now deemed alcoholics
But how do you know if ‘happy hour’ has turned into a concerning issue?
Take this 10-step test, made in association with the World Health Organization, to find out

From wine o’clock to the infamous ‘one for the road’, there are countless opportunities for us to booze on a regular basis.

But have you crossed the line from a ‘harmless’ drink to dependency? And would you be able to spot the signs?

Experts are warning that millions of us are overdoing it – and it could be more difficult to cut down or quit than we think.

Not only can heavy drinking devastate our livers, bones and brain cells, it also increases the risk of depression, divorce and redundancy.

Indeed, the Royal College of Psychiatrists has stated that alcohol causes much more harm than illegal drugs like heroin and cannabis. ‘It is a tranquilizer, it is addictive, and is the cause of many hospital admissions for physical illnesses and accidents,’ experts there warn.

What’s even more concerning is that many of us vastly underestimate how much we drink – and the effect it has on us.

‘Heavy drinking has become normalized – alcohol is ingrained in so many areas of our lives and there is a lot of pressure to drink,’ says Dr Iqbal Mohiuddin, a consultant psychiatrist with a special interest in addictions and clinical lead at Serena House a medical detox and treatment center in London’s Harley Street.

‘Many people I see either don’t realize or are in denial about their alcohol consumption – I often suspect it’s double what people admit to.

‘Part of the problem is many of us have no idea how many units are in various drinks – its nearly always more than you think – and can vary widely even among different types of wine and beers.’

SIZING UP YOUR DRINK

In the UK

This graphic by DrinkAware explains the UK’s guidelines for drinking.

They explain that the alcoholic content in similar types of drinks varies a lot, and just one pint of strong lager or a large glass of wine can contain more than three units of alcohol.

On a bottle of wine or a can of lager and you’ll see either a percentage, followed by the abbreviation ‘ABV’ (alcohol by volume), or sometimes just the word ‘vol’.

Wine that says ‘13 ABV’ on its label contains 13 percent pure alcohol.

While some ales are 3.5 percent, some lagers can be around 6 percent.

Some wines can contain upwards of 14 percent alcohol.

In the US

This graphic is by Substance Abuse and Mental Health Services Administration (SAMHSA).

It explains how the US advises people on drinking limits.

They offer examples of four different drinks of varying sizes, to show how alcohol content is different.

A DANGEROUS LINE

But when do your long lunches, after-work drinks or that ‘decompression’ glass of wine at home become a cause for concern?

‘Not everyone who drinks heavily will become dependent, or an alcoholic,’ explains Dr Mohiuddin. ‘But some of us are definitely predisposed to it.

‘It’s a mixture of genes and environment. Many people with a drinking problem have a family history of it – a parent, aunt/uncle, a grandparent. It doesn’t mean everyone in a family will suffer.

‘However, if the environment is there – perhaps a job with a heavy drinking culture – a problem can develop.’

Around 20 percent of people in Britain and the USA drink to a hazardous level, figures show.

‘It’s easy for many people to get through a bottle of wine a night, and over time, this can creep steadily upwards, to two or even three,’ says Dr Mohiuddin.

‘In my experience, a lot of heavy drinkers – both men and women – steadily move onto harder things.

‘They may start with beer or perhaps wine and then progress on to heavy spirits such as vodka or whiskey.

‘However it’s not necessarily what you are drinking or where, it’s the amount and the effect it’s having on your life (see below). Some people will be able to cut down, while others will try and then realise they can’t – a sign of dependence.

‘There is a significant proportion of heavy drinkers who don’t realise or are in denial that they could be functioning – albeit progressively less functioning – alcoholics.’

THE WARNING SIGNS

‘The main problem is that it’s quite easy for some people to slip into drinking regularly – and the soothing effect it gives you becomes like using a tranquilizing medication such as diazepam,’ explains Dr Mohiuddin.

‘But over time, the benefits wear off quicker and you need more alcohol to get the same effect.’

‘Many people associate being an alcoholic with drinking in the morning, the old adage of ‘vodka on the cornflakes’ or sitting on a park bench with a can of cider – but there are many more subtle signs of dependence and/or alcoholism.’

This graphic by SAMHSA outlines how alcohol can detrimentally affect your health

The Royal College of Psychiatrists has produced a list of classic symptoms that show your drinking has stepped up to a worrying level. These include:

You regularly use alcohol to cope with anger, frustration, anxiety or depression – instead of choosing to have a drink, you feel you have to have it.
You regularly use alcohol to feel confident
Your drinking affects your relationships with other people – they may tell you that, when you drink, you become gloomy or aggressive. Or, people around/with you look embarrassed or uncomfortable when you are drinking.
You stop doing other things to spend more time drinking – these other things become less important to you than alcohol.
You carry on drinking even though you can see it is interfering with your work, family and relationships.
You hide the amount you drink from friends and family
Your drinking makes you feel disgusted, angry, or suicidal – but you carry on in spite of the problems it causes
You start to drink earlier and earlier in the day and/or need to drink more and more to feel good/get the same effect
You start to feel shaky and anxious the morning after drinking the night before
You get ‘memory blanks’ where you can’t remember what happened for a period of hours or even days

FROM CANCER TO DEPRESSION, HOW HEAVY DRINKING WRECKS YOUR HEALTH

We all know the dangerous of heavy boozing on the liver – but there’s much more at stake.

‘One thing many people seem oblivious to is the massively increased risk of cancer from drinking alcohol excessively,’ says Dr Mohiuddin. ‘The risk is similar to smoking – and goes through the roof when it comes to breast, mouth and bowel cancer.’

In fact, alcohol is linked to over 60 illnesses and diseases, including heart disease, and it’s estimated that around one in three men and one in six women will develop some sort of health problem caused by it.

On top of physical damage, alcohol and depression go hand-in-hand. This is because it affects the chemistry of the brain – plus hangovers can create a cycle of waking up feeling ill, anxious, jittery and guilty.

The risk of suicide and self-harm also increases when alcohol is added into the mix.

‘There is the issue of cause and effect when it comes to alcohol and depression,’ explains Dr Mohiuddin.

‘More often than not, it’s alcohol making a person depressed rather than drinking because they’re depressed – although they may not realize it. Most people find their mood starts to lift when they stop drinking for a few weeks, which is a tell-tale sign.’

Source: https://www.dailymail.co.uk/health/article-4778704/Are-drinking-quiz-out.html August 2017

Filed under: Alcohol,Drug use-various effects,Health :

This is a copy of an article which was submitted to BMJ but was deemed unsuitable for publication

Short Title:
Case for Caution with Cannabis
Albert Stuart Reece 1,2
Moira Sim 2
Gary Kenneth Hulse 1,2
1 – Division of Psychiatry,
University of Western Australia,
Crawley, Western Australia 6009, Australia.
2 – School of Medical and Health Sciences,
Edith Cowan University,
Joondalup, Western Australia, 6027, Australia.

There exists sufficient empirical data from cellular to epidemiological studies to warrant caution in the use cannabinoids including cannabidiol as recreational and therapeutic agents.
Cannabinoids bind to CB1R receptors on neuronal mitochondrial membranes ^1-7 where they can directly disrupt key functions ^8-12; including cellular energy generation, DNA maintenance and repair, memory and learning ^{1-7,9,10,13-24}.
Empirical literature associates cannabinoid use with CB1R-mediated vasospastic and vasothrombotic strokes, myocardial infarcts, arrhythmias ^25-98 and arteritis ^{25,77,78,99-106}.

Cannabis has been associated with increased cardiovascular stiffness and vascular aging, a major surrogate for organismal aging ¹⁰⁷. In the pediatric-congenital context CB1R-mediated cannabis vasculopathy forms a major pathway to teratogenesis including VSD, ASD, endocardial cushion defects, several other cardiovascular anomalies 75,108 and, via the omphalo-vitelline arterial CB1R’s ²⁵, gastroschisis ^108-114. Cannabis has been linked with several other malformations including hydrocephaly ¹⁰⁸. Cannabinoids also induce epigenetic perturbations ^115-123; and, like thalidomide ^124-126, interfere with tubulin polymerization ^127-132 and the stability of the mitotic spindle precipitating micronucleus formation ^129,133-142, chromosomal shattering (chromothripsis) ^129,143-157 providing further major pathways to genotoxicity .
Assuming validity of the above data, increased levels of both adult and neonatal morbidity should accompany increased cannabis use. The “Colorado Responds to Children with Special Needs” (CRCSN) program tracked congenital anomalies 2000-2013 ¹⁵⁸. Importantly this data monitors the teratological history of Colorado since 2001 when the state was first advised that intrastate cannabis would not be prosecuted by the Federal Government. In 2012 medical cannabis was legalized and in 2014 cannabis was completely legalized.

Over the period 2000-2013 Colorado almost doubled its already high congenital anomaly rate rising from 4,830 anomalies / 65,429 births (7.4%) to 8,165 / 65,004 (12.6%; Figure 1); the US mean is 3.1%. Major cardiovascular defects rose 61% (number and rate); microcephaly
rose 96% (from 30 to 60 cases peaking at 72 in 2009); and chromosomal anomalies rose 28% (from 175 to 225, peaking at 264 in 2010; Figure 2-7). Over the whole period this totals to 87,772 major congenital anomalies from 949,317 live births (9.25%).
The use of cannabis in Colorado can be determined from the SAMHSA National Survey on Drug Use and Health. A close correlation is noted between major congenital anomaly rates and rates of cannabis use in Coloradans >12 years (R=0.8825; P=0.000029; Figure 8).
Although data is not strictly comparable across U.S. registries, the Colorado registry is a passive rather than active case-finding registry and so might be expected to underestimate anomaly rates. Given the Colorado birth rate remained almost constant over the period 2000-2013, rising only 3.6%, a simple way to quantitate historical trends is to simply project forwards the historical anomaly rate and compare it to the rise in birth numbers. However rather than remaining relatively stable in line with population births, selected defects (left hand column Table 1) have risen several times more than the birth rate (right hand column).
Colorado had an average of 67,808 births over the period 2000-2013 and experienced a total of 87,772 birth defects, 20,152 more than would have been predicted using 2000 rates. Given the association between cannabis use and birth defects and the plausible biological mechanisms, cannabis may be a major factor contributing to birth congenital morbidity in Colorado. If we accept this and apply the “Colorado effect” to the over 3,945,875 births in USA in 2016 we calculate an excess of 83,762 major congenital anomalies annually nationwide if cannabis use rises in the US to the level that it was in Colorado in 2013.
In reality both cannabis use and cannabis concentration is rising across USA following legalization which further implies that the above calculations represent significant underestimations 159,160. This CRCSN data series terminates in 2013 prior to full legalization in 2014. Moreover parents of children harbouring severe anomalies may frequently elect for termination, which will again underestimate numbers of abnormal live births.
In California 7% of all pregnant mothers were recently shown to test positive for cannabis exposure, including almost 25% of teenage mothers in 2015 so cannabinoids clearly constitute a significant population-wide teratological exposure ¹⁶¹. This is particularly relevant to cannabis genotoxicity as many studies show a dramatic up-tick in genotoxic effect in the dose-response curve for both tetrahydrocannabinol and cannabidiol above a certain threshold dose as higher, sedating levels are reached ^{132,136,162-166}. Cannabis is usually used amongst humans for its sedative effects.
Other examples of high congenital anomaly rates accompanying increased cannabis use include North Carolina ^167-169, Mexico ^170-175, Northern Canada ^111,176-178, New Zealand ¹⁷⁹ and the Nimbin area in Australia ^180-183.
The above data leave open the distinct possibility that the rate of congenital anomalies from significant prenatal paternal or maternal cannabis exposure may become substantial. With over 1,000 trials listed on clincaltrials.gov the chance of a type I experimental error for
cannabinoid therapeutics and a falsely positive trial finding is at least 25/1,000 trials at the 5% level. The major anomaly rate is just the “tip of the iceberg” of the often subtle neurobehavioral teratology of Foetal Cannabinoid Syndrome (FCS) following antenatal cannabinoid exposure characterized by attention, learning, behavioral and social deficits which in the longer term impose significant educational, other addiction and welfare costs – and is clearly more common ^121,184-226. Foetal Alcohol Syndrome (FAS) is known to be epigenetically mediated ^227-252 and foetal alcohol is known to act via CB1R’s ^{187,204,207-209,211,217,253-260}.

Cannabis has significant and heritable epigenetic imprints in neural, immune and germ cell (sperm) tissues ^{20,117,119,120,122,261-263}, and epigenomic disruption has been implicated in FCS ²⁴². CB1R-mediated disruption by disinhibition of the normal gamma and theta oscillatory rhythms of the forebrain which underpin thinking, learning and sanity have been implicated both in adult psychiatric disease and the neurodevelopmental aspects of FCS ²¹².
All of this implies that in addition to usually short-term therapy-oriented clinical trials, longer term studies and careful twenty-first century next generation studies will be required to carefully review inter-related genotoxic, teratologic, epigenetic, transcriptomic, metabolomic, epitranscriptomic and long term cardiovascular outcomes which appears to have been largely overlooked in extant studies – effects which would appear rather to have taken Coloradans by surprise. Congenital registry data also needs to be open and transparent which it presently is not. We note that cannabidiol is now solidly implicated in genotoxicity ^134,264-270.

Governments are duty-bound to carefully weigh and balance the implications of their social policies; lest like Colorado, we too unwittingly create a “Children with Special Needs Program” ¹⁵⁸.

These data also directly imply that young adults, as the very group which most consumes cannabis ^{160,161,271-274} is the very group which most requires protection from its reproductive, genotoxic and teratogenic effects.

Yours sincerely,
Assoc. Prof. Dr. Stuart Reece.
University of Western Australia and
Edith Cowan University,
Perth,
Australia.

An original copy of the article with full references and figures is available here

Case for Caution with Cannabis JAMA 5.1 – With Full References

Source: Article from Dr Stuart Reece June 2018

Filed under: Cannabis/Marijuana,Drug use-various effects on foetus, babies, children and youth,Genes,Health :

The trends are clear: Americans are in the midst of a marijuana high. Over the past 30 years, daily or near-daily marijuana use soared 15-fold, surpassing daily alcohol use for the first time in 2022. That same year, marijuana use reached historic levels among Americans aged 19-50 — with 11% of 19- to 30-year-olds saying they used the drug every day.

A key reason for the surge is that more states are legalizing both medical and recreational marijuana use. Another driver, which is closely tied to legalization, is the changing public perceptions around marijuana: Many people just don’t see much harm in the habit, or at least view a daily marijuana joint as safer than smoking cigarettes.

And they’re not necessarily wrong: Although it’s obvious marijuana use can have consequences — including intoxication, dependence, and respiratory symptoms such as chronic bronchitis — there is little, or not enough, evidence to definitively conclude that it’s a cancer risk.

But that also doesn’t mean marijuana is completely in the clear.

“Insufficient evidence doesn’t mean the risk isn’t there,” said Nigar Nargis, PhD, senior scientific director of tobacco control research, American Cancer Society (ACS).

‘The Crux of the Problem’

Marijuana smoke does contain many of the same carcinogens found in tobacco smoke, so it seems logical that a cannabis habit could contribute to some cancers. Yet studies have largely failed to bear that logic out.

In 2017, the National Academies of Sciences, Engineering, and Medicine (NASEM) published a comprehensive research review on cannabis smoking and cancer risk. It found modest evidence of an association with just one cancer: a subtype of testicular cancer. In the cases of lung and head and neck cancers, studies indicated no significant association between habitual cannabis use and risk for these cancers. When it came to other cannabis-cancer relationships, the evidence was mostly deemed insufficient or simply absent.

However, the overarching conclusion from the NASEM review was that studies to date have been hampered by limitations, such as small sample sizes and survey-based measurements of cannabis use that lack details on frequency and duration of use. In addition, many marijuana users may also smoke cigarettes, making it difficult to untangle the effects of marijuana itself.

“That’s the crux of the problem,” Nargis said. “We have a huge knowledge gap where existing evidence doesn’t allow us to draw conclusions.”

That long-standing gap is becoming more concerning, she said, because legalization may now be sending a “signal” to the public that cannabis is safe.

This concern prompted Nargis and her colleagues to explore whether studies conducted since the 2017 NASEM report have lifted the marijuana-cancer risk haze at all. Their conclusion, published in February in The Lancet Public Health: not really.

“Unfortunately, the evidence base hasn’t improved much,” Nargis said. However, she added, some studies have hinted at links between cannabis use and certain cancers beyond testicular. Although these studies have their own limitations, Nargis stressed, they do point to directions for future research.

Head and Neck Cancers

While the NASEM report cited reassuring data on head and neck cancers, a study published last year in JAMA Otolaryngology-Head & Neck Surgery reached a different conclusion. The researchers tried to overcome some limitations of prior research — including small sample sizes and relatively light and self-reported marijuana use — by analyzing records from patients diagnosed with cannabis use disorder at 64 US healthcare organizations.

The study involved over 116,000 patients with cannabis use disorder, matched against a control group without that diagnosis. Head and neck cancers were rare in both groups, but the overall incidence over 20 years was about three times higher among patients with cannabis use disorder (0.28% vs 0.09%).

After propensity score matching — based on factors such as age and tobacco and alcohol use — patients with cannabis use disorder had a 2.5-8.5 times higher risk for head and neck cancers, especially laryngeal cancer: any type (risk ratio [RR], 3.49), laryngeal cancer (RR, 8.39), oropharyngeal cancer (RR, 4.90), salivary gland cancer (RR, 2.70), nasopharyngeal cancer (RR, 2.60), and oral cancer (RR, 2.51).

But although the study was large, “it’s not particularly strong evidence,” said Gideon Meyerowitz-Katz, MPH, PhD, an epidemiologist and senior research fellow at the University of Wollongong, Australia.

Meyerowitz-Katz pointed to some key limitations, including the focus on people with cannabis use disorder, who are not representative of users in general. The study also lacked information on factors that aren’t captured in patient records, such as occupation — which, Meyerowitz-Katz noted, is known to be associated with both head and neck cancer risk and cannabis use.

Beyond that, the risk increases were generally small, even with extensive use of the drug.

“If we assume the study results are causal,” Meyerowitz-Katz said, “they suggest that people who use cannabis enough to get a diagnosis of cannabis use disorder get head and neck cancer at a rate of around 3 per 1000 people, compared to 1 per 1000 people who don’t use cannabis.”

Cannabis and Childhood Cancers

As marijuana use has shot up among Americans generally, so too has prenatal use. One study found, for instance, that the rates almost doubled from about 3.4%-7% of pregnant women in the US between 2002 and 2017. Many women say they use it to manage morning sickness.

Given the growing prenatal use, however, there is a need to better understand the potential risks of fetal exposure to the drug, said Kyle M. Walsh, PhD, associate professor in neurosurgery and pediatrics, Duke University School of Medicine, Durham, North Carolina.

The fortunate rarity of childhood cancers makes it challenging to study whether maternal substance use is a pediatric cancer risk factor. It’s also hard to define a control group, Walsh said, because parents of children with cancer often have difficulty recollecting their exposures before and during pregnancy.

To get past these limitations, Walsh and his colleagues took a different approach. Instead of trying to track cannabis use and tie it to cancer risk, Walsh’s team focused on families of children with cancer to see whether prenatal substance use was associated with any particular cancer subtypes. Their study, published last year in Cancer Epidemiology, Biomarkers & Prevention, surveyed 3145 US families with a child diagnosed with cancer before age 18. The study, however, did not focus on just marijuana; it looked at illicit drug use during pregnancy more generally. Although the authors assumed that would mostly mean marijuana, it could include other illicit drugs, such as cocaine.

Overall, 4% of mothers reported using illicit drugs during pregnancy. Prenatal use of illicit drugs was associated with an increased prevalence of two tumor types: intracranial embryonal tumors, including medulloblastoma and primitive neuroectodermal tumors (prevalence ratio [PR], 1.94), and retinoblastoma (PR, 3.11).

“Seeing those two subtypes emerge was quite interesting to us, because they’re both derived from a cell type in the developing fetal brain,” Walsh said. That, he added, “aligns in some ways” with research finding associations between prenatal cannabis use and increased frequencies of ADHD and autism spectrum disorders in children.

Interestingly, Walsh noted, prenatal cigarette smoking — which was also examined in the study — was not associated with any cancer subtype, suggesting that smoking might not explain the observed associations between prenatal drug use and central nervous system tumors. But, he stressed, it will take much more research to establish whether prenatal marijuana use, specifically, is associated with any childhood cancers, including studies in mice to examine whether cannabis exposure in utero affects neurodevelopment in ways that could promote cancer.

Testicular Cancer

Testicular cancer is the one cancer that has been linked to cannabis use with some consistency. But even those findings are shaky, according to Meyerowitz-Katz.

A 2019 meta-analysis in JAMA Network Open concluded that long-term marijuana use (over more than a decade) was associated with a significantly higher risk for nonseminomatous testicular germ cell tumors (odds ratio, 1.85). But the authors called the strength of the evidence — from three small case-control studies — low. All three had minimal controls for confounding, according to Meyerowitz-Katz.

“Whether this association is due to cannabis or other factors is hard to know,” he said. “People who use cannabis regularly are, of course, very different from people who rarely or never use it.”

In their 2025 Lancet Public Health review, Nargis and her colleagues pointed to a more recent study, published in 2021 in BMC Pharmacology and Toxicology, that looked at the issue in broader strokes. The study found parallels between population marijuana use and testicular cancer rates, as well as higher rates of the cancer in US states where marijuana was legal vs those where it wasn’t.

However, Nargis said, observational studies such as this must be interpreted with caution because they lack data on individuals.

If regular cannabis use does have effects on testicular cancer risk, the mechanisms are speculative at best. Researchers have noted that the testes harbor cannabinoid receptors, and there is experimental evidence that binding those receptors may alter normal hormonal and testicular function. But the path from smoking weed to developing testicular cancer is far from mapped out.

Risk for Other Cancers?

The recent Lancet Public Health overview also highlights emerging evidence suggesting a relationship between cannabis use and risks for a range of other cancer types.

A handful of observational studies, for instance, showed correlations between population-level cannabis use and risks for several cancers, such as breast, liver, thyroid, and prostate. The observational studies, mostly from a research team at the University of Western Australia, made headlines last year with a perspectives piece published in Addiction Biology, claiming there is “compelling” evidence that cannabis is “genotoxic” and raises cancer risk.

But, as Meyerowitz-Katz pointed out, the paper is only a perspective, not a study. And the human data it cites are from the same limited evidence base critiqued in the NASEM and ACS reports.

Meyerowitz-Katz does not discount the possibility that marijuana use contributes to some cancers. “I wouldn’t be surprised if we find that extensive cannabis use — particularly smoking — is related to cancer risk,” he said. But based on the existing evidence, he noted, the risk, if real, is “quite small.”

Where to Go From Here?

What’s needed, Nargis said, are large-scale cohort studies like those that showed cigarette smoking is a cancer risk factor. For the ACS, she said, the next step is to analyze decades of data from its own Cancer Prevention Studies, which included participants with a history of cannabis use and cancer diagnoses verified using state registries.

Nargis also noted that nearly all studies to date have focused on marijuana smoking, and “almost nothing” is known about the long-term health risks of newer ways to use cannabis, including vaping and edibles.

“What’s concerning,” she said, “is that the regulatory environment is not keeping up with this new product development.”

With the evolving laws and attitudes around cannabis use, Nargis said, it’s the responsibility of the research community to find out “the truth” about its long-term health effects.

“People should be able to make their choices based on evidence,” she said.

Source: https://www.medscape.com/viewarticle/marijuana-use-rising-it-cancer-risk-2025a1000br5?

Filed under: Addiction,Cannabis/Marijuana,Crime/Violence/Prison,Culture,Drug use-various effects,Education,Health,Marijuana and Medicine,Mental Health,Prevention and Intervention,USA,Youth :

This is an email from Professor Stuart Reece sent to the Drug Watch International mailing list:

Yes indeed there is certainly more to the Cannabis in Canada story than given in Pam McColl’s Oped.

If one looks at the places where the most cannabis is smoked in Canada it is in those same northern reaches where congenital anomalies are commonest – serious defects amongst children like heart defects and born with bowels hanging out.

That is to say – Canada has shown the world what not to do!!!!

Why is this story not being widely told when the maps are so clear???

Canada’s Trudeau’s claims to be following Colorado….

And indeed he is. Colorado’s congenital anomaly rate – and especially congenital heart defect rate rose 70% 2000-2013 – prior to legalization in 2014 – it is almost certainly way north of that now – the only question is how far???.

In 2000 only 7.6% of Colorado children had a major congenital anomaly rate – that is more than twice the national USA average about 3.1%.

In 2013 12.6% of children had a major congenital anomaly – four times the national average – and 1 in 8 Coloradan children!!!!!!!

And we are continuing down this path… because….???

So both Canada – and Colorado – have taught the world what NOT to do….

So why are we rushing as fast as we can in so many places to repeat their mistakes???

Because the media told us to????

Sorry this story is not making sense at all….

Thanks so much,

Prof. Dr. Stuart Reece,

Australia.

Email sent to Drug Watch International (DWI) drug-watch-international@googlegroups.com June 2018

Filed under: Canada,Cannabis/Marijuana,Drug use-various effects on foetus, babies, children and youth,Genes,Global Drug Legalisation Efforts,Health,Youth :

by Michael Deacon Columnist & Assistant Editor – The Telegraph of London (UK) 28 May 2025

The Mayor of London has called for law reform because he believes that stop-and-search powers disproportionately affect black communities

Mayor of London Sadiq Khan walking through cannabis plants at a licensed factory in Los Angeles Credit: PA

Sadiq Khan, the Mayor of London, says he believes the police should stop arresting people for possessing cannabis. Frankly, I’m shocked.

Mainly because I didn’t know the police were arresting people for it in the first place.

It certainly doesn’t smell like it. These days, practically all our towns and cities – including the one run by Mr Khan – stink of weed. Which suggests that a very large number of people now feel able to smoke it with absolutely no fear of getting arrested. Whether this is because the police can no longer be bothered to enforce the law, or they’re too busy carrying out dawn raids on the bookshelves of Spectator readers, I don’t know. But either way, it hardly seems worth clamouring for decriminalisation, when in effect we’ve already got it.

Even so, Mr Khan has backed calls to change the law. And these calls seem to have something to do with race.

According to an independent commission, set up by the Mayor, the policing of cannabis use is shamefully unjust to people who aren’t white. In a new report, the commission says: “The law with respect to cannabis possession is experienced disproportionately by those from ethnic minority (excluding white minority) groups, particularly London’s black communities. While more likely to be stopped and searched by police on suspicion of cannabis possession than white people, black Londoners are no more likely to be found carrying the drug.”

If so, that plainly is unfair. But it’s not an argument for decriminalisation. It’s an argument for stopping and searching greater numbers of white people. Which, of course, would be completely fine. Go right ahead. Even if today’s over-anxious police chiefs would probably misunderstand such an edict, and tell their officers: “When investigating crime, we must never treat any community with more suspicion than any other. Which is why, this afternoon, I’m sending you all to a WI jumble sale, to search little old ladies for machetes.”

None the less, the report maintains that the way forward is to decriminalise possession. At the same time, though, it says producing and dealing should remain illegal. Which is odd, because it implies that the blame for the trade lies solely with the people doing the latter. But if it weren’t for all the people wishing to possess the drug, no one would produce or deal it. Ultimately, therefore, it’s their fault.

Anyway, if possession does get decriminalised, you can bet there’ll soon be calls to loosen the law further. Which would be even more unwise. Just look at what’s happened to New York, which in 2021 decided not only that people should be allowed to smoke cannabis, but that shops should be granted licences to sell it. Has this put criminals out of business, while raising lots of lovely extra cash through tax?

Funnily enough, no. Illegal vendors simply undercut the legal ones. Kathy Hochul, who is New York’s governor (and a Democrat, rather than some stereotypically stuffy Republican), has called it “a disaster”. Even The New Yorker, proud tribune of liberal America, ran a dismayed article asking: “What happened?”

All the same, the Mayor of London insists that his commission’s report makes a “compelling” case. I don’t think it does. And I especially think we could have done without the irrelevant wittering about ethnicity. We’ve got quite enough “community tensions” in this country as it is. So we certainly don’t want people thinking: “What? They want to allow possession of a dangerous drug, just because they think it will improve ‘police relations’ with ‘black communities’? That sounds awfully like special treatment. Mind you, I suppose they need to free up the cells, to make more space for middle-aged women who post problematic opinions on the internet.”

This, in short, is why Mr Khan’s plan for cannabis isn’t just naive. It’s dangerously divisive.

I note, incidentally, that the Mayor has just proposed a 20 per cent rise in London’s congestion charge. But don’t worry. I’ve prepared a report arguing that the charge is unjust, because it’s experienced disproportionately by the motoring community, while the cycling and walking communities get off scot-free. So the whole thing should be scrapped.

Source: (Via Drugwatch International): www.telegraph.co.uk

Filed under: Cannabis/Marijuana,Culture,Drug use-various effects,Health,Marijuana and Medicine,UK :

Opening comment by NDPA: Although this item is a fairly unashamed promo for AI, it nevertheless gives a useful summary of how AI can be applied to this field, so we have retained it.

by Dianova – 25/05/2025

A New Era in Health Begins with Intelligence — Artificial and Human

Artificial Intelligence (AI) is not just a buzzword — it’s one of the most transformative forces reshaping modern healthcare. From revolutionizing diagnostics and personalizing treatments to advancing drug prevention strategies, AI is enhancing the way we understand, predict, and treat human health. As the world embraces the potential of AI, organizations working in prevention and treatment must also evolve — strategically and ethically.

Artificial Intelligence in Healthcare: The Global Landscape

AI is redefining care on a global scale. According to the European Commission, AI technologies are already supporting physicians, analyzing large datasets in seconds, and optimizing hospital workflows. Countries like the US, UK, Canada, China, and the EU are implementing large-scale AI integration strategies to support digital health systems.

The AI Act of the European Union is the world’s first legal framework on AI, emphasizing risk-based regulation. For health-focused organizations, this framework ensures safety, transparency, and human oversight in the deployment of AI tools.

AI’s Role in Drug Discovery, Prevention, and Treatment

AI accelerates drug discovery and improves accuracy in substance use disorder (SUD) diagnosis and treatment planning. According to ScienceDirect, machine learning models can predict relapse risks, personalize therapy plans, and even detect substance use through digital biomarkers such as speech or behavioral patterns.

As Gubra outlines, AI is enabling:

Simulation of molecular interactions to discover new therapeutic targets
Automation in toxicology screenings
Integration of patient data for tailored treatment

Best Practices in AI-Driven Drug Prevention and Education

From chatbots offering 24/7 counseling to AI-curated educational content, innovative prevention models are emerging worldwide:

USA: The NIH’s 2025 HHS AI Strategic Plan promotes AI for early screening of addiction risks, especially in underserved populations.
Denmark: National efforts combine AI with social data to map out drug-use hotspots and target community outreach.
India & Brazil: AI is integrated into mobile health (mHealth) apps that detect mood changes and alert caregivers, reducing dropout rates in prevention programs.

Platforms like Listen First by UNODC could benefit from AI enhancements to deliver content tailored to emotional tone and local language patterns.

AI and the Prevention of Drug Use and Online Gaming Disorders

One of the most exciting — and necessary — frontiers of AI is its application in preventing drug use and behavioral addictions such as online gaming disorder. Emerging research shows how predictive algorithms can identify vulnerable individuals and intervene early.

According to a 2023 article in the American Journal of Preventive Medicine, AI tools are being developed to detect substance use behaviors through digital footprints, social media interactions, and app usage patterns. These tools can flag at-risk youth in real time, prompting early outreach.

The Ashdin Foundation reports that AI-powered interventions, including conversational agents and real-time behavioral monitoring, are revolutionizing how we approach drug prevention — making it more personalized, scalable, and responsive.

In Portugal, the NOVA University Lisbon project is pioneering AI models that track user behavior on gambling platforms to intervene before addiction escalates. This approach is equally relevant for youth struggling with excessive gaming — an issue increasingly associated with anxiety, depression, and even substance use.

As a recent Nature Medicine article highlights, AI is becoming a cornerstone in the personalization of behavioral health interventions, offering adaptive content, peer support suggestions, and gamified learning modules.

A comprehensive review confirms that AI algorithms can be trained to predict not only who is likely to use substances but also who is most likely to benefit from specific prevention programs. Moreover, NACADA Kenya is investing in AI to power community mapping tools that identify high-risk zones and recommend targeted prevention messaging.

Ethical and Educational Considerations

AI offers vast promise, but not without limitations. As explored in BMC Medical Education, there is a growing need to train healthcare professionals and community workers to interpret AI results critically. Meanwhile, UMaryland highlights challenges around algorithmic bias, data privacy, and accountability.

Source: https://www.dianova.org/news/how-ai-is-transforming-drug-prevention-and-healthcare-worldwide/

Dianova is a Swiss-based NGO.

Filed under: Europe,Health,Internet,Prevention and Intervention :

This is an Email – Sent: 24 May 2025 – from Stuart Reece: stuart.reece@bigpond.com

To: Ms. Erika Olson, Chargé d’Affaires, Embassy of the United States of America, Canberra, Australia. (askembassycanberra@state.gov)

Dear Chargé d’Affaires Olson,

It has been reported in several news pieces lately that President Trump is becoming concerned about exponential autism epidemic in USA which particularly affects boys. We and many other research have demonstrated beyond reasonable doubt that this epidemic is driven by cannabis as you can see in this paper, this 2,500 page book, this video and the attached references.

Even worse that the exponentiating USA autism epidemic is the epidemic of holes in the heart (atrial septal defect) which is growing hyper-exponentially as you can see in the attached unpublished report. This is also driven by cannabis.

Cannabinoid genotoxicity has long been known. As you can see in the attached references its implications across diverse domains including aging, birth defects, cancers, and mental retardation are clinically significant and impose a vast burden on public health and health infrastructures internationally.

Cannabinoid genotoxicity is due to all the cannabinoids as they all share the genotoxic chemical moiety, known as olivetol on their C-ring.

Cannabinoid genotoxicity and epigenotoxicity (their toxic effects on the epigenetic regulatory machinery which controls gene expression) acts for three to four generations. The subject is covered at length in our recently published book.

Contamination of the food chain as is happening in several places in USA, including Kentucky, Tennessee, Mississippi, Missouri and possibly Louisiana, means that the whole community is exposed without their knowledge or consent.

Breast cancer is the commonest cancer of all. Please find below graphs showing that both breast cancer and cannabis use increased across both Europe and USA together in coordinated fashion across space and time which strongly implicates cannabis in this commonest of cancers in a casual manner. Note where the graphs turn pink where both covariates increase at the same time in the same place. The “pinking of Europe” is clearly demonstrated. Similar changes albeit less well developed are clearly seen in USA.

Videos which explain these issues may be found as follows:

Cannabis and Autism – https://www.youtube.com/watch?v=x8bDLzEInWA
Cannabis and babies born limbless https://www.youtube.com/watch?v=EOQpy69HIEw&t=60s
Cannabis and birth defects https://www.youtube.com/watch?v=aLQFvY-Z19g&t=19s
Cannabis – effect on genome and epigenome https://www.youtube.com/watch?v=CEKdLD60TcE&t=4s
Cannabis and cancers https://www.youtube.com/watch?v=4T_RKFbkNFo
Cannabis and aging https://www.youtube.com/watch?v=JyyUG2A6RnE
Cannabis summary https://www.youtube.com/watch?v=j0HwgyOfSEQ
Cannabis and hole in the heart https://www.youtube.com/watch?v=zIg0gHg4HmA

I have also included a recent review on cannabinoid teratogenicity prepared for the EU for your benefit.

Thank you for your assistance.

Yours sincerely,

Professor Dr Stuart Reece, University of Western Australia, Edith Cowan University.

Source: Email from stuart.reece@bigpond.com Sent: 24 May 2025

Filed under: Brain and Behaviour,Cannabis/Marijuana,Drug use-various effects,Health,USA :

This is a copy of an email sent by Stuart Reece to members of the Australian Northern Territory government, particularly addressing Dr Jennifer Buckley.

Dear Dr Buckley,

I am a Professor of Addiction Medicine at Edith Cowan University on Western Australia, and an Associate Professor of Addiction Medicine at the University of Western Australia. I hold an earned Doctorate of Medicine from the University of New South Wales in addiction to my basic medical degree.

I understand that your committee is considering adopting a harm reduction strategy focussed view of the management of drug addiction in the Northern Territory including the potential legalization and or decriminalization of all drugs in your jurisdiction.

I wish to place before you my carefully considered opinion that such a strategy would be an unmitigated disaster for the people in your care.

The strategies employed by the harm minimization lobby globally make it very plain that their rhetoric is merely the soft front edge of the full legalization approach sponsored by George Soros. In this country it has been championed by its unparalleled champion Dr Alex Wodak, President of Australia’s Drug Reform Foundation which unashamedly openly and overtly proposes the legalization of all drugs – goodness only knows why…

Why indeed … when there is overwhelming evidence of the innumerable harms directly attributable to drug addiction itself.

I work with drug addicts all day long. Most of those I work with in my clinic agree that slackening off of the laws in this area would be an unmitigated disaster – and that is drug addicts in treatment!!!!

One of the very obvious features of drug addicted patients – of all sorts – is the accelerated pattern of disease which they virtually all get. Disorders of brain, heart, circulation, liver, muscle wasting, psychology, bones, reproductive system and immunity together with cancers, elevated death rates and major anomalies in the babies born to addicted parents – have all been described in virtually every addiction.

It has recently been shown that the maintenance of cellular energy stores is critical to the upkeep and maintenance od NA. Without good energy stores DNA become fractured and broken, cells age, cancers form and abnormal babies are born and infertility rises. The community pays the cost – obviously; and individual patients bear the brunt of the illnesses.

It is known moreover that from age 20 the energy inside cells halves every 20 years. Declining cellular energy stores therefore form one of the key cellular measures of ageing. Restoring those energy stores is therefore a major project within anti-ageing medicine and a major therapeutic goal for clinical medicine.

IT HAS BEEN KNOWN FOR SEVERAL DECADES THAT ALL THE ADDICTIONS DRAMATICALLY REDUCE CELLULAR ENERGY STORES – AND THEREBY DIRECTLY PHENOCOPY CELLULAR AGING –WHICH OBVIOUSLY EXPLAINS THE POLY-SYNDROMIC MULTISYSTEMIC CLINICAL PRESENTATIONS OF DRUG ADDICTION.

For example data emerging from our still on-going analysis of the rates of deformed babies in Colorado show that most of the cannabis related anomalies are rising, which includes all of the fastest growing anomalies, and that the overall rate of congenital heart defects and total defects has almost doubled 2000-2013; Cannabis was only fully legalized in Colorado in 2014!!! That is the good news – for it has also been shown that cannabis interferes with the basic processes of brain formation also. The babies born to drug dependent parents are very obviously very far from normal in most cases – certainly when the addictions are severe – when indeed children are lucky to survive even until birth! So cannabis is a known teratogen and its widespread use is likely to cost the community very dearly in the years to come.

I have attached for your benefit some submissions I recently made to the FDA and WHO on the subject of cannabis genotoxicity and cannabis teratogenicity. With your permission I would also like to place this material which explores these themes in much greater depth, in evidence before your committee.

Since I have spent a whole professional lifetime studying these issues I trust it is clear that I could place mush more evidence before you.

I am happy to answer any other questions you might have.

Similar remarks can be made in relation to opioid and amphetamine abuse.

I understand clearly that in parts of the Northern Territory drug use is rife. I also understand that in parts drug use if forbidden by local community law and alcohol is banned in many places, so-called “dry communities.” The answer to this is proper education of the community and appropriate constraint of drug use and drug trafficking by law enforcement in line with our international obligations under the Single Convention, the United Nations Convention of the Rights of the Child and many others.

I would point out that it is my view, and also that of many other well informed experts and individuals, that the very obvious gaping hole in the our drug education for the community is an obvious major breech in our community response to the issues of drug enforcement, which almost alone allows the media-driven misinformation and disinformation of the crazy ideologues with virtually unlimited financial resources to push our society in directions which we would never normally go if the truth was well known and widely disseminated and widely taught and widely practised. It is the yawning gaping hole in the public education program alone which allows the lies, dissembling and dissimulation of the crazy anarchists to threaten not only the wellbeing of our communities, but indeed the sustainability of western culture into the future.

And I might add their genetic and epigenetic pool for the next hundred years….

That is to say – it is not the threats of the lies of the media barons and dysfunctional popular rock idol darlings – who keep committing suicide – which is the major threat to our culture – but the absence of truth in the public place – which is obviously officially sponsored – which allows these lies to flourish in the first place. The implication is that a modicum of well-informed public health education would quickly drown out a whole cacophony of media-driven highly-paid lies. It is therefore our joint responsibility to make sure that the popular narratives of our culture are fact-based and evidence-driven rather than purely ideological and agenda-driven as at present.

Thankyou for considering my material.

I am happy to work further with your committee to assist you in your deliberations.

Yours sincerely,

Prof. Dr. Albert Stuart Reece,

MBBS(Hons.), FRCS(Ed.), FRCS(Glas.), FRACGP, MD(UNSW).

Edith Cowan University, Joondalup,

Source: Copy of email sent to Drug Watch International for distribution by Stuart Reece. May 2018

Filed under: Addiction,Australia,Genes,Health,Legal Sector,Political Sector :

Published by NIH/NIDA 14 May 2025

Cannabis vaping is making headlines worldwide, often promoted as a “safer” alternative to smoking. Meanwhile, Drug Trends data from Australia reveal that non-prescribed cannabis use remains high among people who regularly use drugs. But are wider permission models and positive propaganda about cannabis leading to greater engagement, especially among those most at risk? This article dives into Australian data from the Ecstasy and Related Drugs Reporting System (EDRS) and Illicit Drugs Reporting System (IDRS), exploring what’s really happening with cannabis products, vaping, and why honest health education is more critical than ever.

Cannabis Vaping and Drug Trends in Australia (2014–2024): What the Data Tells Us

Cannabis vaping, once an afterthought, now claims a growing share of the global market. Many believe vaping to be less harmful, with marketers highlighting vaping’s lack of smoke and alleged respiratory benefits. However, recent Drug Trends research in Australia challenges some of these assumptions and uncovers troubling patterns.

The Rise of Electronic Vaping Products

Electronic vaping products started as oversized gadgets in the late 1990s. Initially intended to vaporise dried cannabis herb, they eventually shrank, morphing into today’s sleek e-cigarettes. While vaping nicotine products has become mainstream, cannabis vaping is following close behind, spurred in part by changes to medicinal and recreational cannabis laws overseas.

A North American review found a seven-fold increase in monthly cannabis vaping among adolescents, with notable shifts from dried herb to potent cannabis oils. However, the situation in Australia is different, shaped by stricter regulations and unique market conditions.

Drug Trends in Non-Prescribed Cannabis Use

Australia’s EDRS and IDRS surveys collect real-world data on non-prescribed cannabis and cannabinoid-related products. Between 2014 and 2024, most participants in both systems reported using cannabis recently, with rates as high as 90% in the EDRS and 74% in the IDRS.

Hydroponic and Bush Cannabis Still Dominate

Hydroponic cannabis was the most popular, with usage rates ranging from 63%–83% among EDRS respondents, and a remarkable 88%–94% for IDRS participants.
Bush cannabis also stayed common, with 51%–77% (EDRS) and 37%–54% (IDRS) reporting use.
Other cannabis products, such as THC extracts and commercially-prepared edibles, have appeared in recent years, showing increased product diversity—but are far less popular than traditional forms.

Cannabis Vaping Emerges, But Smoking Prevails

Despite media attention around cannabis vaping, the majority of Australians captured in these studies still smoke cannabis. From 2014 to 2024:

Smoking remained the dominant route of administration (ROA) in both groups.
Cannabis vaping (inhaling/vaporising) trended upward, but stayed a minority choice. Vaporising among EDRS participants increased from 12% to 25%, and from 2% to 9% for IDRS.

Notably, few users chose vaping as their only method. Most combined it with smoking, suggesting the rise in vaping hasn’t replaced traditional habits.

Concerns About Cannabis Vaping and Permission Models

The Problem with Changing Perceptions

There is growing concern that permission models and positive messaging around cannabis use (whether through legislation or social media) may downplay its risks. Vaping, in particular, is surrounded by claims of being a “safer” alternative to smoking. While it’s true that vaping doesn’t involve combustion and may expose users to fewer toxic chemicals, it’s not risk-free.

Key Issues Include:

Potency extremes: Some vape oils and extracts reach THC concentrations of 70–90%, far higher than the average 10%–20% in cannabis herb. Highly potent products carry greater risks for dependence, anxiety, and psychosis.
Unknown health risks: The long-term effects of inhaling cannabis vapour, especially from unregulated or home-made devices, are not fully understood.
Discreet use and normalisation: Portability and subtlety make vaping easier to hide, particularly from parents and teachers. For some users, this can enable more frequent use or uptake at a younger age.
Unhealthy dual use: Most vapers continue smoking, increasing overall exposure to both methods. (for complete research WRD News)

Source: https://www.dalgarnoinstitute.org.au/index.php/resources/drug-information-sheets/2672-cannabis-vaping-and-drug-trends-among-youth-in-australia-2014-2024-a-growing-concern?

To maximize their effectiveness, prevention programs must reach adolescents before they are exposed to substance use in their peer groups. Yet nearly one-third of 12- to 17-year-olds reported that they did not see or hear any substance use prevention messages in school, according to the 2023 National Survey on Drug Use and Health. This lack of prevention education has serious implications for health equity, as racial and ethnic minority youth are less likely to report seeing these messages in their schools.

Prevention takes a village. All sectors of a community must be aligned in order to set healthy norms. This approach guides the Drug-Free Communities Support Program, which involves sectors from businesses and media to schools and religious organizations.

Unfortunately, numerous actors that pursue private profits at the expense of public health actively undermine these efforts. These include marijuana shops and, more recently, psychedelics shops. Our children are given conflicting messages when we tell them not to use addictive substances now being promoted throughout their neighborhoods.

Given the increasing embrace of mind-altering drugs at the state level, it’s no surprise that drug use has risen. A study published in the Journal of the American Academy of Child and Adolescent Psychiatry found that recreational marijuana legalization was associated with a 13 percent increase in past-month marijuana use among youth ages 12 to 17, and a 22 percent increase among young adults ages 18 to 25. Between 2012 and 2023, the prevalence of marijuana use among 19- to 30-year-olds increased from 28.1 percent to 42.4 percent, while it more than doubled from 13.1 percent to 29.3 percent among 35- to 50-year-olds, according to the Monitoring the Future survey. Over this same period, annual overdose deaths nationwide more than doubled from 41,502 to 105,007.

As highlighted in the Foundation for Drug Policy Solutions’ The Hyannis Consensus: The Blueprint for Effective Drug Policy, the nation’s drug policy “should promote a health standard that normalizes the non-use of substances.” Our drug policies should not make it easier to use licit and illicit substances.

Other things being equal, the harms of drug use will decline as the prevalence of drug use declines. Notably, the White House recently estimated that the societal cost of illicit opioids was $2.7 trillion––with a “t”––in 2023, which is “equivalent to 9.7 percent of GDP.” Viewed through this lens, prevention is essential and must remain central to drug policy efforts. A proactive, upstream approach premised on prevention will also reduce strain on downstream systems like treatment and recovery.

Policymakers must remember that prevention programs are cost-effective. A 2016 report from the surgeon general explained:

Interventions that prevent substance use disorders can yield an even greater economic return than the services that treat them. For example, a recent study of prevention programs estimated that every dollar spent on effective, school-based prevention programs can save an estimated $18 in costs related to problems later in life.

National Prevention Week is also a fitting time to spotlight novel approaches to prevention. The Icelandic Model is particularly promising. A 2019 study explained that “by working to increase social and environmental protective factors associated with preventing or delaying substance use and decreasing corresponding risk factors, the model prevents substance use by intervening on society itself and across a broad spectrum of opportunities for community intervention.” In practice, this approach may encourage youth to join community groups and participate in extracurricular activities, which are protective factors against substance use.

To scale what we know works, White House Office of National Drug Control Policy director nominee Sara Carter should relaunch a national prevention campaign, similar to the National Youth Anti-Drug Media Campaign. Those public awareness efforts were particularly effective in reducing rates of tobacco use, and will help set strong anti-drug cultural norms and promote health.

The current administration deserves praise for centering prevention in a recent statement of its drug policy priorities. We fully support its plan to “encourage educational campaigns and evidence-based prevention programs, particularly in schools and communities.” But it’s time we back it up with dollars and programs. As we recognize National Prevention Week, we must not forget about the importance of prevention and its role in helping more Americans live healthy, drug-free lives.

Dr. Kevin Sabet is President of Smart Approaches to Marijuana (SAM) and the Foundation for Drug Policy Solutions (FDPS) and a former White House drug policy advisor across three administrations.

The views expressed in this article are the writer’s own.

Source: https://www.newsweek.com/save-americas-youth-lawmakers-should-invest-drug-prevention-opinion-2071582

Filed under: Health,Law (Papers),Legal Sector,Prevention and Intervention,USA,Youth :

From sfunes@drugfreeamericafoundation.ccsend.com – 16 May 2025

Today you can find marijuana everywhere, dispensaries around every corner or easily accessible through social media. This normalization is leading researchers to investigate its effects on various health conditions and the dangers associated with overconsumption of marijuana. This research shows that there is an association between marijuana use and the weakening of our immune system. Its consumption affects key parts of our defences against cancer while contributing to faster tumor progression, particularly for gastrointestinal conditions.

In general, individuals with substance use disorders, including cannabis use disorder (CUD), are more likely to experience delays in diagnosis and reduced involvement in their medical care. In addition, behavioral and psychiatric conditions linked to marijuana use such as anxiety and depression may prevent the adherence to the required treatment leading to negative prognosis.

Two recent studies, one on chronic pancreatitis and the other on colorectal cancer, highlight how CUD is linked to poorer outcomes in individuals suffering from chronic pancreatitis and colorectal cancer.

In the first study, researchers analyzed over 1,000 patients and found that those with pre-existing CUD were more likely to die within 5 years of receiving a colon cancer diagnosis. Among those who had a documented history of CUD prior to being diagnosed, the difference in outcomes were stark:

Five-year mortality rate:

Patients with CUD: 55.9%
Patients without CUD: 5.1%

In the second study, researchers linked CUD to worsened clinical outcomes in individuals with chronic pancreatitis, a painful and progressive condition where the pancreas becomes inflamed and damaged over time. These patients were found to be at greater risk of pancreatic flare up, pancreatic cancer, all-cause mortality, and pancreatic necrosis.

This association held firm even after the researchers accounted for opioid use, suggesting that marijuana itself may contribute to disease progression and complications.

CUD affects 3 in 10 users in the U.S., according to the CDC. As it becomes more normalized, the risks for vulnerable populations, in this case those with colon cancer and pancreatitis, continue to grow. These risks are too significant and call for more research, awareness and education, serving as a critical reminder that marijuana use is not harmless, especially when dependence develops.

For resources related to marijuana, check out www.dfaf.org/education.

Source:

From sfunes@drugfreeamericafoundation.ccsend.com

And for further related information. visit:

Centers for Disease Control and Prevention. (2024). Cannabis use disorder. https://www.cdc.gov/cannabis/health-effects/cannabis-use-disorder.html
Brooks, A. (2025). Cannabis use, dependence linked to worse clinical outcomes in chronic pancreatitis. HCPLive. https://www.hcplive.com/view/cannabis-use-dependence-linked-worse-clinical-outcomes-chronic-pancreatitis
The ASCO Post Staff. (2025). Cannabis use disorder significantly increases mortality risk in colorectal cancer. The ASCO Post. https://ascopost.com/news/may-2025/cannabis-use-disorder-significantly-increases-mortality-risk-in-colorectal-cancer/
Cuomo, R. (2025). Cannabis use disorder and mortality among patients with colon cancer. Annals of Epidemiology, 35(4), 140-147. https://doi.org/10.1016/j.annepidem.2025.04.012

Filed under: Cannabis/Marijuana,Drug use-various effects,Health,Marijuana and Medicine,Prevention and Intervention,Treatment and Addiction,USA :

Scott Strode and his company have an active take on recovery and sobriety.

Wall Street Journal Andy Kessler March 23, 2025

It wasn’t hard to find Scott Strode when we first met. He was the big guy in a black T-shirt with the word “SOBER” splashed across it. Mr. Strode is founder of the Phoenix, a national “sober active” community. Addiction statistics in the U.S. are sobering. According to Mr. Strode’s book, “Rise. Recover. Thrive,” one-third of Americans have substance-abuse issues or mental disorders.

When drinking, Mr. Strode felt valued. “People wanted to spend time with me. And I found community,” he says. “It’s just what we were building it around wasn’t healthy.” Alcohol. Cocaine. Dependency. Until one night he finally hit bottom. “I couldn’t imagine someone having to tell my mom this is how I died.”

The road to sobriety wasn’t easy for Mr. Strode, but he found solace in physical challenges. “I saw a poster for ice climbing,” he said. “It gave me something to strive for, and that led me into the boxing gym and triathlons and racing Iron Mans.” But it wasn’t enough. “I realized when I took other people with me, I felt lifted in a different way.”

I wasn’t sure what he meant. “Getting into recovery is like getting out of a burning building,” he said. “But there are other people in there, so you have to reach back in to help get them out. By using my passion to help others, it filled a void. That was really what the Phoenix was born from.”

The Phoenix Multisport active recovery community, its original name, started in Boulder, Colo., roughly 20 years ago. It was funded by friends and a few grants—no fees. Others might have been content with helping one community. Not Mr. Strode. After a few years, he started helping active-duty service members and many others in Colorado Springs and set up a location in Denver.

What’s the magic? “Your life gets so much bigger, and you start to realize what’s possible. You connect somewhere where you feel valued, accepted and loved.” Climbing. Hiking. Running. Yoga. A fellow rider and Phoenix member, Ben Cort, told him, “I got sober because I didn’t want to die. I stayed sober because I wanted to live.”

A mother who heard about the Phoenix approached Mr. Strode and offered him $200,000 to expand to San Diego to help her son. Sadly, her son passed away before they could get there, but the idea of scaling to other communities kicked in for Mr. Strode. Maybe people’s desire to help others could be leveraged and help the Phoenix scale. “We opened up this opportunity on our website for folks to raise their hand to become volunteers,” Mr. Strode said. “We thought we’d get a few. We got 700.” Over the next 10 years, they were in 28 locations.

In 2016 the Phoenix received some funding from the philanthropic organization Stand Together. One of their pillars is to help solve addiction. They discussed scaling, and Mr. Strode told them that for each location, “it starts with a man and a bike.” In January 2020 they mutually agreed on $50 million in funding with a goal of “serving one million people impacted by substance use” in five years. A stretch, for sure. But it had to go from push to pull—“stimulating volunteers in places where we can’t reach.”

What started in Boulder with a deal with CrossFit is now in every state—almost 200 communities with more than 5,000 volunteers. “We have served over 800,000 since Phoenix started.” It scales because it works—83% of Phoenix participants stay sober after three months, compared with an average of 40% to 60% from other programs.

That’s the power of volunteers. And technology. The Phoenix has a mobile app called NewForm. Anyone can have a profile. The Phoenix isn’t in your community? Start one yourself. The app links to other nonprofits, such as SeekHealing, that help people overcoming trauma, a potential cause of addiction. The Phoenix also sets up sober supportive spaces at concerts and festivals—the app can reveal “thousands of other sober people in those spaces.”

“We distribute tablets in prisons across the country, so you can come to Phoenix virtually,” Mr. Strode says. “We joke that we’re the sober Peloton in prisons.” Smart. Plus, “you don’t have to turn to those old cellphone numbers in your phone when you return home. You can actually find new connections and community to help support you on your healing journey.”

What about other addiction programs? “At the Phoenix, we’re really focused on helping people with what’s possible in their recovery. So it’s very forward-looking. We start to dream of what’s possible in our sober life. In the 12-step community, people often identify as their disease. ‘I’m Scott, I’m an addict, I’m an alcoholic.’ But I always say, ‘I’m Scott, I’m in recovery, I’m an ice climber and so much more.’ We see everybody for their intrinsic strength, not a problem to be fixed.”

The Phoenix should hit its goal of one million people helped later this year. I’m convinced after talking to Mr. Strode that 10 million is a reachable goal.

Source: https://www.wsj.com/opinion/a-new-approach-to-addiction-phoenix-fitness-community-mental-health-a3591f99

Filed under: Addiction,Brain and Behaviour,Drug use-various effects,Health,Mental Health,Treatment and Addiction,USA :

This blog was also published in the American Society of Addiction Medicine (ASAM) Weekly, on March 18, 2025.

For many people trying to recover from a substance use disorder, perhaps for the majority, abstinence may be the most appropriate treatment objective. But complete abstinence is sometimes not achievable, even in the long-term, and there is a need for new treatment approaches that recognize the clinical value of reduced use.

According to a recently published analysis of data from the 2022 National Survey on Drug Use and Health, two thirds (65.2 percent) of adults in self-identified recovery used alcohol or other drugs in the past month¹. There is increasing scientific evidence to support the clinical benefits of reduced substance use and its viability as a path to recovery for some patients. Reducing drug use has clear public health benefits, including reducing overdoses, reducing infectious disease transmission, and reducing automobile accidents and emergency department visits, not to mention potentially reducing adverse health effects such as cancer and other diseases associated with tobacco or alcohol.

The FDA has historically favored abstinence as the endpoint in trials to develop medications for substance use disorders. Abstinence has been evaluated using absence of positive urine drug tests, absence of self-reported drug use, and regularly attending sessions where drug use is assessed. But abstinence is a high bar comparable to requiring that an antidepressant produce complete remission of depression or that an analgesic completely eliminate pain. Recognizing this limitation, the FDA encourages developers of opioid² and stimulant³ use disorder medications to discuss with FDA alternative approaches to measure changes in drug use patterns.

A model for reduced use as an endpoint exists with treatments for alcohol use disorder. Reduction in alcohol use is relatively easy to measure since alcoholic beverages tend to be purchased and consumed in standard quantities, and substantial evidence supports the clinical benefit of reduction in heavy drinking days (defined as 5 or more drinks/day for men and 4 or more drinks/day for women). Consequently, the percentage of participants with no heavy drinking days is accepted by the FDA as a valid outcome measure in trials of medications for alcohol use disorder⁴. The FDA recently announced a new tool through which investigators can determine if proposed treatments for alcohol use disorder (AUD) work based on whether they reduce “risk drinking” levels. The new tool can be used as an acceptable primary endpoint in studies of medications to treat adults with moderate to severe AUD.

Use reduction could readily be used as an endpoint in the development of treatments for tobacco use disorder too, since the number of cigarettes smoked per day is easily measured and there is evidence that 50 percent reduction in cigarette use produces meaningful reduction in cancer risk⁵. Thus, the NIH and FDA have recently called for consideration of meaningful study endpoints in addition to abstinence in research on new smoking-cessation products⁶; though abstinence is still required as the main outcome for medication approval.

Objective assessment of use reduction for illicit substances presents a greater difficulty given variability and uncertainty of the composition and purity of illicit drugs purchased. This challenge may account for part of the reluctance of the pharmaceutical industry to invest in developing new medications aimed at reducing drug use. Also, anecdotally, the expectation that medications that can produce complete cessation are the only treatments that will advance to market has discouraged addiction neuroscientists and some in the pharmaceutical industry from advancing new medication targets or compounds relevant to reduced use or other endpoints besides abstinence. Nevertheless, there is increasing research demonstrating the relative strength of quantitative measures of drug use frequency versus binary measures of abstinence in assessing the efficacy of drug use disorder treatments.

A 2023 analysis of pooled data from 11 clinical trials of treatments for cocaine use disorder found that reduction in use, as defined by achieving at least 75 percent cocaine-negative urine screens, was associated with short- and long-term improvement in psychosocial functioning and measures of addiction severity⁷. A 2024 secondary analysis of data from 13 clinical trials of treatments for stimulant use disorders (cocaine and methamphetamine) found that reduced use was associated with improvement in several indicators of recovery, including measures of depression severity, craving, and domains of symptom improvement (legal, family/social, psychiatric, etc.)⁸.

A secondary analysis of seven clinical trials of treatments for cannabis use disorder found that reductions in use short of abstinence were associated with meaningful improvements in sleep quality and reduction of cannabis use disorder symptoms⁹. Fifty percent reductions in days of cannabis use and 75 percent reductions in amount of cannabis used were associated with the greatest clinician-rated improvement.

Little research has been conducted on alternative endpoints in opioid use disorder treatment, but it will be needed to advance medication development in this area. Among the important research questions that still need answering is whether treatment aimed at reducing opioid use could produce better overdose-related outcomes than treatment aimed at cessation of use, since many fatalities arise from a return to use after tolerance to the drug is lost following periods of abstinence. Even in the absence of clinical trial evidence, however, any reduction in illicit substance use can reasonably be argued as beneficial, entailing less risk of overdose or of infectious disease transmission, less frequent need to obtain an illegal substance with the attendant dangers, and so on¹⁰. Decreased substance use also makes it more likely that the individual can hold a job, be a supportive family member, and so on.

Broadening the goals of treatment to include reduced use or other clinically meaningful outcomes as a main outcome for medication approval could potentially expand therapeutic interventions and help increase the number of people in treatment. It could also reduce the stigma that is typically associated with return to use. Setting abstinence as the goal of treatment can be obstacle to treatment engagement for those who are unready or unwilling to make that commitment. And when attempts at abstinence falter, these expectations can compound the sense of failure the patient experiences.

There is little scientific evidence to support the stereotype that people who return to use after a period of abstinence inevitably do so at the same intensity. Some research on post-treatment patterns of alcohol and other drug use in adolescents suggests that returns to use, when they occur, are often at a lower intensity than before¹¹. People in recovery sometimes draw a distinction between resumption of a heavy and compulsive use pattern and isolated, one-time returns to substance use, recognizing that brief “slips” or “lapses” don’t need to be catastrophic to recovery efforts and may even strengthen the person’s resolve to recover.

When returns to use are catastrophic, the sense of failure at living up to the abstinence expectation could play a role in exacerbating further substance use. So could the rules of treatment programs or recovery communities that require abstinence. It too often happens that patients are discharged from addiction treatment if they return to use, which as the American Society of Addiction Medicine notes in its recent guidance document Engagement and Retention of Nonabstinent Patients in Substance Use Treatment, is illogical and inconsistent with our understanding of addiction as a chronic disease: excluding a person from treatment for displaying symptoms of the disorder for which they are being treated¹².

Recognizing that recovery is often nonlinear, a more nuanced view of treatment is needed, one that acknowledges that there are multiple paths to recovery. Expecting complete abstinence may be unrealistic in some cases and can even be harmful. It can pose a barrier to seeking and entering treatment and perpetuate stigma and shame at treatment setbacks. By the same token, reduction of substance use has important public health benefits as well as clinical benefits for patients, and recognition of this could greatly advance medication development for treatment of addiction and its symptoms.

Source: https://nida.nih.gov/about-nida/noras-blog/2025/03/advancing-reduction-drug-use-endpoint-in-addiction-treatment-trials

Filed under: Addiction,Drug use-various effects,Health,Prevention and Intervention,USA :

This article gives a useful summary of the viewpoints of the various Canadian candidates for premiership

“After briefly approaching overdose deaths as a health problem, the ‘war on drugs’ appears to be making a comeback.”

(Opening remark by article author – Michelle Gamage, Local Journalism Initiative Reporter, The Tyee Apr 20, 2025 7:00 PM)

Tyler Sekulic, a volunteer with the Tri-Cities Community Action Team, plants some of the 1,500 purple flags around Coquitlam’s Lafarge Lake April 14 to mark the the ninth anniversary of British Columbia’s declaration of a toxic drug emergency.MARIO BARTEL/TRI-CITY NEWS

Close to 51,000 Canadians died from apparent opioid toxicity between January 2016 and September 2024, making the unregulated toxic drug supply one of the most pressing health issues in Canada.

For context, that’s nearly 16,000 more Canadians than were killed in the Second World War, and more than double the number of people killed in Canada by AIDS.

The spike in deaths began when the synthetic opioid fentanyl began to appear in illicit drugs sold on the street starting around 2014. Fentanyl can be relatively cheaply manufactured locally and is 20 to 40 times more potent than heroin. The illicit, unregulated supply has only become more unpredictable and deadly since.

Over the last decade there’s been a push in Canada to move addiction away from the realm of the criminal — what is often referred to as the “war on drugs” — and to recognize it as a public health problem. Broadly speaking, that means that instead of arresting people who use drugs for possession, doctors and advocates have pushed for people who use drugs to be able to access evidence-based harm reduction interventions, opioid agonist therapy and, in some cases, safer, predictable prescription drugs such as hydromorphone or benzodiazepines.

Today, however, the move away from the “war on drugs” seems to be in flux.

There’s widespread discontent in the visible increase in homelessness, mental health crises and drug use across the country, with people on the left criticizing the government for not rolling out more accessible harm reduction programs and housing solutions and people on the right calling for involuntary treatment and increased criminal sentences for drug-related offences.

As The Tyee waits for official platforms to drop, we take a look at how each federal party has been framing the crisis and fact check some of their proposed policies.

This article won’t be covering Bloc Québécois because the party doesn’t table policies that directly affect British Columbians.

The Liberal Party of Canada

The Liberals’ 2021 platform promised to introduce a comprehensive strategy to end the opioid crisis, invest $25 million in public education to reduce stigma, invest $500 million to support provinces and territories in providing evidence-based treatment, create standards for treatment programs and reform the Criminal Code to repeal mandatory minimum penalties for substance use-related infractions to keep lower-risk and first-time offenders out of the criminal justice system.

DJ Larkin, executive director of the Canadian Drug Policy Coalition, says that while the Liberals had some early commitments to evidence-based policy reform, such as support for decriminalization and prescribed alternatives, things fell flat because there was no followup.

The Liberals didn’t bother to explain what decriminalization or safer supply was, “or help the public understand and combat some of the misinformation around how those programs work,” Larkin said.

Funding ‘goes towards enforcement efforts’

In October 2023 the federal government released its Canadian Drugs and Substances Strategy, in which the “preponderance of funding goes towards enforcement efforts, with very little going towards harm reduction,” Larkin said.

Funding for “treatment” seems to go towards research and prison-based health care, Larkin added, noting “it’s quite unclear the extent to which they’ve really made that investment.”

Limited decriminalization

Health Canada supported B.C.’s request to implement a decriminalization pilot project in January 2023, and then-party leader Justin Trudeau said the government would support other provincial or territorial decisions implementing similar programs.

But in 2022, Health Canada denied the Drug User Liberation Front’s request for an exemption under the Controlled Drugs and Substances Act, which DULF had sought so it could buy, test and sell drugs at cost through its compassion club safer supply project.

From a policy perspective this was a “huge error,” Larkin said. The request was “well supported by evidence, it was well thought out and it was very well structured.” The exemption could have been a “huge turning point” in the crisis and would have helped generate evidence for how a compassion club model of safer supply distribution worked, Larkin said.

DULF asked pharmaceutical companies if it could buy pharmaceutical-grade drugs from them but was told it had to get permission from Health Canada first. When that permission was denied, DULF was punished for buying drugs illegally.

Harm reduction, treatment funding

It also invested $150 million over three years for an Emergency Treatment Fund in 2024, which helped municipalities and Indigenous communities respond to issues around substance use and overdoses.

The government has not yet published standards for treatment programs, something former chief coroner Lisa Lapointe emphasized a need for.

Larkin said the treatment industry has a “total lack of transparency,” where it’s not known how much a private facility is charging, what its policies are, what happens when someone is discharged or if they’re allowed to be on opioid agonist treatment.

The Conservative Party of Canada

The 2025 Conservative stance on drugs is dramatically different from the party’s 2021 platform, in which the party supported widespread distribution of naloxone, building 1,000 treatment beds and treating “the opioid epidemic as the health issue that it is.”

Back to criminalization

This time around, the party is framing the crisis as a criminal issue and promoting abstinence-only treatment while working to shut down harm reduction programs across the country.

Poilievre is “going back to criminalization” by proposing heavy criminal sentences for fentanyl and calling supervised consumption sites “drug dens,” Larkin said. This term has racist origins in 1907-era Vancouver, where Chinese and Japanese businesses were called “opium dens,” they added.

None of this rhetoric has been shown to decrease toxic drug deaths, Larkin said.

On April 6, Poilievre said he would prevent provinces and territories from opening overdose prevention sites, fire bureaucrats who support prescribed alternatives, introduce abstinence-only treatment and cut funding to federal supervised consumption sites and prescribed alternatives programs, according to the Globe and Mail.

Mandatory life sentences for amounts equivalent to less than half a baby Aspirin

In February, Poilievre said he’d introduce mandatory life sentences for anyone caught with 40 milligrams of fentanyl.

That’s “absurd,” said Leslie McBain, who co-founded Moms Stop the Harm after her son Jordan died from toxic drugs in 2014.

Forty milligrams is smaller than half a baby Aspirin, less than one-fifth of what someone with a regular fentanyl habit might use in a day, and 1.6 per cent of what a person can legally have to use in their own residence, a legal shelter or an overdose prevention site under B.C.’s decriminalization.

When it was first introduced, even the BC Association of Chiefs of Police gave decriminalization and its 2.5-gram limit the stamp of approval, saying that’s what a person who uses drugs might carry around for personal use.

The Tyee asked the association what it thought of the 40-milligram policy but did not hear back by press time.

McBain said many people sell drugs to fuel their own habit, not because they’re some “hardened criminal.”

Preventing the opening of overdose prevention sites — an unconstitutional promise?

When it comes to Poilievre’s promise to prevent provinces and territories from opening overdose prevention sites, he could do that if he lets an exemption under the Controlled Drugs and Substances Act expire in September, said M-J Milloy, an associate professor in the University of British Columbia department of medicine. The exemption is what gives provincial health officers the authority to open overdose prevention sites.

Stephen Harper tried to do the same thing in 2008 and in 2011 was ordered by the Supreme Court of Canada to grant the exemption because ending it would be unconstitutional.

B.C. currently has 39 overdose prevention sites, four supervised consumption sites (which are under federal jurisdiction) and additional unsanctioned sites being operated by doctors volunteering their time.

The day after Poilievre said he’d close the sites down, B.C. Health Minister Josie Osborne said she would not let a federal government shut down “life-saving overdose prevention sites.”

Governments can also “choke” the funding of harm reduction sites to close them down, as the Albertan and Ontarian governments have done, Milloy said.

Health Canada says more than 488,400 Canadians visited supervised consumption sites more than 5,103,000 times between January 2017 and November 2024, with 62,200 non-fatal overdoses and more than half a million referrals to drug treatment, rehabilitation and other health services, or referrals to social services like housing or employment supports.

Firing bureaucrats

Poilievre’s promise to fire bureaucrats who support safer supply would be difficult, Milloy said, because public service workers at the federal and provincial levels are unionized and protected by collective bargaining agreements and well-established labour rights.

Safer supply pilot projects rolled out through Health Canada and non-government initiatives have shown the program reduced participants’ risk of overdose and death, improved their health and well-being and helped participants stabilize their lives.

McBain said the BC Coroners Service has consistently said fentanyl is killing people — not hydromorphone, which is commonly prescribed for safer supply.

Around 3,900 British Columbians are being prescribed safer supply out of the 100,000 British Columbians estimated to have opioid use disorder.

Does Poilievre’s math on treatment add up?

On April 6, Poilievre said he’d fund treatment for 50,000 Canadians by defunding safer supply and supervised consumption sites and suing opioid manufacturers.

A Canada-wide lawsuit against pharmaceutical companies that downplayed the risks of opioids is already underway.

Funding for treatment would be “results-based,” where “organizations are going to be paid a set fee for the number of months they keep addicts drug-free,” Poilievre said, according to the Globe and Mail.

Abstinence-based treatment can be dangerous because opioid use disorder is a chronic relapsing disease, meaning people will generally cycle in and out of substance use in their life, Milloy said. Most people will go to treatment a number of times before they achieve periods of lasting sobriety, he added.

When a person stops using opioids, their body starts to lose its high tolerance for the drug in as little as three days, meaning they’re at much higher risk of overdose when they use again.

Opioid agonist treatment is considered the gold-standard treatment for opioid use disorder, but it’s not clear if it would be allowed under Poilievre’s definition of “drug-free.”

“Simply detoxing individuals and putting them into a 12-step program, which is what the majority of recovery houses do, is not recommended because of the risk of death,” Milloy said.

Poilievre said each patient would get around $20,000 for treatment, for a total of $1 billion in funding. The party’s 2021 platform pledged $325 million over three years to fund 1,000 treatment beds, meaning there was $325,000 per bed.

The B.C. Ministry of Health said in an email it currently has 3,751 publicly funded treatment beds and the cost of a single patient’s treatment is between $20,000 and $183,000 per year.

The New Democratic Party

In its 2021 platform the NDP said it would declare a national public health emergency, “end the criminalization and stigma of drug addiction,” create a national medically regulated safer supply program, support overdose prevention sites, expand access to treatment on demand and launch an investigation into the role of pharmaceutical companies in the current crisis.

Drugs not on the party’s radar

For the last two years drugs haven’t been on the NDP’s radar. The party puts out a press release roughly every two days, and the last one that directly addressed the toxic drug crisis was in November 2023, marking National Addictions Awareness Week. The party didn’t mark the week in 2024.

Defeated private member’s bill

Shortly after the 2021 election, NDP mental health and harm reduction critic Gord Johns tabled a private member’s bill to decriminalize certain substances nationally and to expunge certain drug-related convictions, but it was defeated.

The Green Party of Canada

As part of its 2021 platform, the Green Party of Canada said it would declare a national public health emergency, legislate decriminalization for personal possession and all use of drugs, increase funding for community drug checking, implement a national education and distribution program for naloxone and create a national safer supply program for “drugs of choice.” A regular criticism of safer supply from people who use drugs is that it offers a limited number of pharmaceuticals that often aren’t able to replace the unregulated substances people use. This policy would have addressed that issue.

Larkin said it was a “very good sign” that the Greens’ platform recognized the intersectionality and nuance of the crisis and promoted programs and policies that are “supported by considerable academic evidence,” such as supervised consumption sites, decriminalization, prescribed alternatives and access to regulated treatment.

No current drug-related policies

The Greens don’t currently have drug-related policies on their website. But in August 2024 the party put out a press release calling for Canada to adopt an evidence-based approach by offering safer supply, safe consumption sites and barrier-free regulated treatment facilities, integrating pharmacare and mental health care in Canada’s universal health care, increased harm reduction services and action to address poverty and homelessness like guaranteed livable income and affordable and accessible housing.

Source: https://www.bowenislandundercurrent.com/highlights/where-the-parties-stand-on-the-toxic-drug-crisis-10532543

Filed under: Addiction,Canada,Drug use-various effects,Health,Opioids,Political Sector,Prevalence,Prevention and Intervention :

by Amanda Zong, BS et al.

Collation by Lynda Charters – Ophthalmology Times- March 24, 2025

Key Takeaways

Cannabis users with autoimmune hyperthyroidism have a higher risk of developing TED outcomes, particularly within the first year.
The study utilized a cohort design with data from 36,186 patients, including cannabis users, cigarette smokers, and controls.

The authors noted that while an association between cigarette smoking and TED has been well established, an association between TED and cannabis use has not been determined.

Amanda Zong, BS, and Anne Barmettler, MD, from the Department of Ophthalmology and Visual Sciences, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, reported that cannabis users had a significantly increased risk for thyroid eye disease (TED) outcomes.¹ They published their study in Ophthalmic Plastic and Reconstructive Surgery.

They conducted this study to identify an association between TED and cannabis use in patients who were diagnosed with autoimmune hyperthyroidism. The investigators pointed out that while the association between cigarette smoking and TED has been well established, an association between TED and cannabis use has not been determined.

Study design and results

The researchers conducted a cohort study that included patient data in TriNetX, an electronic health record platform, for patients with autoimmune hyperthyroidism over a 20-year period.

The primary study outcomes were TED presentation, ie, exophthalmos, eyelid retraction, eyelid edema, orbital edema, strabismus, and optic neuropathy, and treatments (teprotumumab, Tepezza, Horizon Therapeutics), methylprednisolone, tarsorrhaphy, and orbital decompression, among patients who used cannabis, those who smoked cigarettes, and control patients.

The relative risks among the cohorts were calculated for each outcome in 6-month and 1- and 2-year intervals after autoimmune hyperthyroidism was diagnosed.

The investigators identified 36,186 patients with autoimmune hyperthyroidism, of whom 783 used cannabis, 17,310 used nicotine, and 18,093 were control patients who used neither substance.

“Compared with control patients, cannabis users were more likely to be younger, male, Black/African American, and have anxiety or depression. After propensity matching, cannabis users were 1.9 times more likely to develop exophthalmos (p = 0.03) and 1.6 times more likely to develop any TED presentation (p = 0.049) during the 1-year interval. The differences were not significant in the 2-year interval,” Zong and Barmettler reported.

The authors concluded that patients with autoimmune hyperthyroidism who used cannabis had a significantly increased risk for TED outcomes in the 1-year interval. They advised that further research is needed regarding the management of TED.

Source: https://www.ophthalmologytimes.com/view/study-finds-cannabis-users-face-higher-risk-of-thyroid-eye-disease

Filed under: Cannabis/Marijuana,Drug use-various effects,Health,USA :

This article, reporting on research by Profs Stuart Reece and Gary Hulse, is seen as seminal contribution to the current concerns about the effects of cannabis use on autism. Accordingly, NDPA has written to JF Kennedy Jnr as below:

Date: 20th April 2025

Importance: High

To Robert F. Kennedy Jnr, Secretary of Health and Human Services, Government of the United States

Sir,

I understand that you and President Trump are becoming extremely concerned about the US autism epidemic.

Please see the attached paper above suggesting that Maternal Cannabis use and CUD may be a factor.

This paper attached is independently supportive of the other Australian work by Professors Reese and Hulse.

https://www.youtube.com/watch?v=x8bDLzEInWA&t=935s

The Reese/Hulse work indicates strong concordance between Cannabis legalization States and an those same States having an increase in ASD.

Yours sincerely,

David Raynes, Senior Advisor, NDPA (UK)

UK NATIONAL DRUG PREVENTION ALLIANCE

+44 7967708568

<<<<<<<<<<<<<<<<<<<<<<<<NDPA>>>>>>>>>>>>>>>>>>>>>>>>>>

Psychiatry Research

Volume 337, July 2024, 115971

Exposure to maternal cannabis use disorder and risk of autism spectrum disorder in offspring: A data linkage cohort study.

by Abay Woday Tadesse et al. School of Population Health, Curtin University, Kent Street, Bentley, WA, 6102, Australia

Highlights

• This study involved over 222,000 mother-offspring pairs.
• Maternal prenatal CUD is linked to higher ASD risk, with a stronger risk in male offspring.
• More research is needed to understand these gender-specific effects.

Abstract

This study aimed to investigate the association between pre-pregnancy, prenatal and perinatal exposures to cannabis use disorder (CUD) and the risk of autism spectrum disoder (ASD) in offspring. Data were drawn from the New South Wales (NSW) Perinatal Data Collection (PDC), population-based, linked administrative health data encompassing all-live birth cohort from January 2003 to December 2005. This study involved 222 534 mother-offspring pairs. . The exposure variable (CUD) and the outcome of interest (ASD) were identified using the 10th international disease classification criteria, Australian Modified (ICD-10-AM). We found a three-fold increased risk of ASD in the offspring of mothers with maternal CUD compared to non-exposed offspring. In our sensitivity analyses, male offspring have a higher risk of ASD associated with maternal CUD than their female counterparts. In conclusion, exposure to maternal CUD is linked to a higher risk of ASD in offspring, with a stronger risk in male offspring. Further research is needed to understand these gender-specific effects and the relationship between maternal CUD and ASD risk in children.

To access the full document:

Click on the ‘Source’ link below.

Source: https://www.sciencedirect.com/science/article/pii/S0165178124002567

Filed under: Australia,Cannabis/Marijuana,Drug use-various effects,Drug use-various effects on foetus, babies, children and youth,Health,Marijuana and Medicine,Psychiatric drugs,UK :

by AddictionPolicy Forum – Apr 3, 2025

Adults under 50 who use marijuana may face a significantly higher risk of heart attack, according to a new study published in the Journal of the American College of Cardiology (JACC).

Researchers analyzed data from more than 4.6 million adults and found that individuals under 50 who use cannabis were more than six times as likely to suffer a heart attack compared to non-users. The study also found that those who use cannabis are four times more likely to experience an ischemic stroke, three times more likely to experience major adverse cardiovascular events, and twice as likely to experience heart failure.

“Asking about cannabis use should be part of clinicians’ workup to understand patients’ overall cardiovascular risk, similar to asking about smoking cigarettes,” said Ibrahim Kamel, MD, clinical instructor at the Boston University Chobanian & Avedisian School of Medicine and internal medicine resident at St. Elizabeth’s Medical Center in Boston and the study’s lead author in a press release. “At a policy level, a fair warning should be made so that the people who are consuming cannabis know that there are risks.”

The findings applied even to individuals who did not use tobacco products, suggesting marijuana may be an independent risk factor for cardiovascular disease.

The Centers for Disease Control and Prevention (CDC) notes that marijuana use can increase heart rate and blood pressure — both of which may contribute to cardiovascular strain. Researchers believe these effects could play a role in damaging blood vessels and increasing the risk of blood clots.

Experts advise that cannabis should be considered alongside other recognized risk factors when evaluating heart health, particularly in younger adults. “Until we have more solid data, I advise users to try to somehow put some regulation in the using of cannabis,” said Ahmed Mahmoud with Boston University. “We are not sure if it’s totally, 100% safe for your heart by any amount or any duration of exposure.”

Source: https://mailchi.mp/addictionpolicy.org/halt-fentanyl-act-sign-on-letter-16446882?e=67079d94e3

Filed under: Cannabis/Marijuana,Drug use-various effects,Health,USA :

As reports show highest rates of deaths after drug misuse among older people, experts take a look at the health risks

by Damon Syson – Daily Telegraph, London – 12 April 2025

A recent report from the Office for National Statistics revealed that older people continue to register the highest rates of drug misuse mortality. According to the ONS, there were 1,118 deaths involving cocaine registered in 2023, which was 30.5 per cent higher than the previous year and nearly 10 times higher than in 2011.

“I actually think those figures are an underestimate,” says Dr Niall Campbell, a Priory consultant psychiatrist specialising in addictions. “When people die from drug-related causes, it’s often not recorded.”

Campbell is quick to point out that far from being the preserve of urban professionals, this phenomenon occurs throughout the UK: “A significant number of people will be partying on coke, whether it’s in central London or at a middle-class dinner party in the Cotswolds.

It’s a national problem. I have a patient in his sixties who was taking a lot of cocaine and ended up experiencing chest pains. He stopped, sought help, and he’s now much, much better. He lives in a small provincial town; he set up a Cocaine Anonymous support group there.”

The dangers of common drugs

Cocaine is by far the most serious source of concern when it comes to accidental death, but the other drugs that are commonly misused in the UK (according to the most recent ONS statistics) can also damage your health.

Used chronically, ecstasy (MDMA) depletes your serotonin levels, which can lead to depression, anxiety and lethargy.

Despite the growing numbers of people microdosing psilocybin as a treatment for depression, so-called “magic” mushrooms have been known to bring on panic attacks and can also exacerbate existing mental health problems.

Regular use of cannabis, especially when smoked together with tobacco, has been linked to chronic respiratory conditions, depression, impaired memory, motor skills and cardiovascular function – and its negative effects increase as the user gets older.

The dangers of excessive ketamine use, meanwhile, are well-documented, with chronic users risking bladder damage, cognitive impairment and personality change. But the over-50s have not embraced it as a drug of choice.

Aside from its toxicity, there are two other factors that make cocaine more of an immediate cause for concern than any of these drugs. Firstly, accessibility: it is the second-most used drug in the UK after cannabis; it’s easily available, and its relative cost has gone down over the past decade.

Secondly, cocaine is frequently – and incorrectly – perceived to be less harmful than it is. “Today, what we tend to see is a lot of intermittent cocaine users,” says Campbell, who is based at Priory Hospital Roehampton. “Often they’ve stopped regular use. But for whatever reason, it has caught up with them.”

Why are so many over-50s dying from cocaine poisoning?

The ONS reported in 2019 that the reason Generation X cohort are dying in greater numbers by suicide or drug poisoning is partly because “during the 1980s and ’90s more people started using hard drugs habitually”.

“These people still feel young at heart,” says Campbell. “They think they can still do what they used to do in the old days. Unfortunately, they can’t. Even if they’re aware of the health risk – say for example another person in their group has previously had an episode – they choose to ignore it.”

In essence, a certain group, now in their fifties, have either continued to take drugs since their twenties or now occasionally dabble “for old time’s sake”.

But the body of a 55-year-old is very different to that of a 25-year-old. The stakes become much higher because of the increased vulnerability of ageing bodies to the physiological and cognitive effects of cocaine.

“The typical scenario is a group of men in their fifties who say, ‘Come on, lads, let’s go to Ibiza and party like we did in 1999,’” says Campbell. “The trouble is, their bodies can’t take it, and they end up facing severe cardiac problems, or even death. As you get older, every time you take cocaine you’re playing Russian Roulette.”

The critical factor, he adds, is the cardiac toxicity of cocaine: “Cocaine gives you a massive release of dopamine from your limbic system into your brain, and it also speeds up your heart rate. That may be survivable if you’re 20 or 30, but as you get older, your heart isn’t as robust as it was. For them, doing a line of cocaine is like putting a supercharger onto a Ford Anglia.”

How does taking cocaine affect your brain and body – and how does this change as you get older?

Older adults are more susceptible to the effects of drugs and alcohol, because as the body ages, it cannot metabolise these substances as easily as it once did.

The short-term physical effects of using cocaine include constricted blood vessels, increased heart rate and high blood pressure. These factors can dramatically increase the risk of having a heart attack.

“What we commonly see when we’re called to A&E is arrhythmias, which are irregularities of heart rhythm,” says Dr Farhan Shahid, a consultant interventional cardiologist at The Harborne Hospital, part of HCA Healthcare UK.

“What happens when you take cocaine is that you’re stimulating the body’s flight and fight response, and the heart responds appropriately by speeding up. In the older population you’re often dealing with a patient who has other underlying medical problems – which makes treating them a lot less straightforward. They may be on blood pressure tablets, for example, or they might have had a stroke in the past.”

Long-term cocaine use brings with it a whole suite of potential health problems. It can increase an individual’s chances of suffering an aneurysm, because constricting the blood vessels over a long period may reduce the amount of oxygen the brain receives. It can raise the risk of strokes and lead to impaired cognitive function. And it can also cause damage to kidneys and liver, especially when used – as it almost invariably is – in tandem with excessive amounts of alcohol.

Shahid confirms that he frequently treats patients who display the chronic effects of taking cocaine: “It might, for example, be a 56-year-old who has high blood pressure as a background, regardless of the misuse. Taking cocaine on top of that will send their blood pressure off the chart, so to speak.

Over time, they become resistant to medication, and they may require admission into hospital and intravenous medication to bring their blood pressure down.

Cocaine causes a compromise in the demand and supply of the heart muscle: it causes a constriction of the arteries and a state where the blood is thicker and has a greater predisposition to clot.

It’s also worth noting that chronic cocaine use is linked with mental health issues like anxiety, panic attacks and psychosis. Even a one-off line at a party can cause an individual to behave erratically and recklessly, leading to accident and injury.

“Cocaine-induced paranoid states get worse as you get older,” says Campbell. “I had a patient who got together with friends to relive old times. They went away for the weekend, took cocaine, and as a result, he had a huge depressive crisis. He went back to the hotel and attempted suicide. Fortunately, he didn’t succeed.”

How to counteract the damage of cocaine

“The simple answer is – stop,” says Campbell. “If you’ve taken cocaine and you’ve experienced palpitations, for example, that’s a serious red flag. A user needs to get themselves checked out. If you’re worried, talk to your doctor and be honest about it. Your GP can perform an ECG and arrange a full cardio workup.”

Anyone concerned should also take encouragement from the fact that it’s never too late to take a positive step. “With the right treatment and the cessation of the misuse, you can reverse the effects of cocaine misuse,” says Shahid. “Cocaine drives up blood pressure, so if you stop the cocaine use, you can reduce that blood pressure change, and – with the correct medications in the background – bring it down to safe levels.”

Of course, not everyone can afford to seek treatment at Priory, but as a first port of call, Campbell advises contacting Cocaine Anonymous, which he says is “free and widespread, and staffed by people who really know what they’re talking about”.

“This phenomenon is certainly a matter for concern,” he says on a final note, “and it’s on the increase, as the generation comes through that were partying in 1999. Could it get worse? I think it will, because people are reluctant to seek help. Unfortunately, they have no idea how much of a risk they’re taking.”

Source: https://www.telegraph.co.uk/health-fitness/conditions/ageing/the-devastating-effects-of-drug-misuse-in-the-middle-aged/

Filed under: Addiction,Drug use-various effects,Health,Mental Health,UK :

From NIHCM Newsletter / April 2025

Alcohol & Substance Use

Learn about the latest news on substance use, including views on alcohol, and how fentanyl deaths are declining.

Alcohol Awareness: April is alcohol-awareness month and an opportunity to reflect on the impacts of alcohol use and how alcohol-related deaths have increased over the last decade, with a sharp increase during early-pandemic years. A new Pew Research Center survey explores Americans’ views on the risks and benefits of alcohol consumption. A majority of routine drinkers, 59%, say their alcohol use increases their risk of serious physical health problems at least a little.
Fentanyl Deaths Declining: Recent preliminary data from the Centers for Disease Control and Prevention (CDC) indicates a 25% decrease in opioid overdose deaths for the 12-month period ending in October 2024, compared to the same timeframe in 2023. This is driven in large part by a reduction in the number of deaths involving fentanyl. The Wall Street Journal examines the decline in a series of charts. KFF Health News discusses how misinformation about fentanyl is impacting the overdose response.
Federal Funding: A federal judge has temporarily blocked the Department of Health and Human Services (HHS) from terminating a variety of public health funds that had been allocated to states during the Covid-19 pandemic, including funding that was being used to support opioid addiction and mental health treatments. The administration also closed the office that tracked alcohol-related deaths and harms and helped develop policies to reduce them.

Resources & Initiatives

The US Surgeon General’s 2025 Advisory, Alcohol and Cancer Risk, describes the scientific evidence for the causal link between alcohol consumption and an increased risk for cancer.
NPR dives into 8 theories from experts on why fentanyl overdose deaths are declining, including increased access to Naloxone, better public health, and the waning effects of the COVID pandemic.
The National Academy for State Health Policy’s State Opioid Settlement Spending Decisions tracker shares state-level settlement funding decisions and priorities.
With support from a $5.4 million Elevance Health Foundation grant, Shatterproof created an online training curriculum for healthcare professionals that aims to dispel myths and misunderstandings about substance use disorder, and promote person-centered, culturally responsive care.

Source: https://nihcm.org/newsletter/the-relationship-between-alcohol-and-health

Filed under: Alcohol,Drug use-various effects,Health,Prevention and Intervention,Treatment and Addiction,USA :

Photo: Nikoleta Haffar

Vienna (Austria), 10 March 2025 — The 68^th session of the Commission on Narcotic Drugs (CND) commenced today, gathering 2100 representatives from over 100 Member States to discuss international drug policy.

At the opening, the UN Office on Drugs and Crime (UNODC) Executive Director Ghada Waly delivered a warning on the evolving drug landscape, highlighting the surge in synthetic drugs and the expansion of cocaine markets. “The drug market is undermining peace, security and development,” she cautioned, pointing to trafficking routes that fuel instability in conflict zones.

However, she stressed that UNODC remained committed to its critical work to keep people safe and healthy. In 2024 alone, she noted, UNODC supported the seizure of over 300 tonnes of cocaine, 240 tonnes of synthetic drugs, and 100 tonnes of precursors, while facilitating investigations and safe disposal, flagging emerging drug threats, providing scientific and forensic support to countries to implement CND scheduling decisions and more.

In that connection, Ms Waly raised urgent concerns about funding constraints. “We cannot deliver ‘more with less’ when the illicit drug market has more and more at its disposal every day,” she warned, calling on Member States to invest in global health and security. She expressed hope that the session would serve as a rallying point for a balanced, effective and united approach to drug policy, ensuring that multilateral efforts keep pace with a rapidly evolving threat.

The Chair of the Commission, H.E. Shambhu S. Kumaran of India, opened the session by emphasizing the severity of current drug challenges. “The range of drugs available to most people today are more diverse, potent and harmful than ever before. When drugs and precursors flow across borders, only organized crime wins,” he stated, calling on Member States to invest in community security and the global fight against drugs.

In a call to action, General Assembly President Philémon Yang and Economic and Social Council (ECOSOC) President Bob Rae highlighted the urgent need for a comprehensive response to the world’s drug problem. PGA Yang warned that drug trafficking weakens institutions, fuels instability and harms the environment through deforestation, soil degradation and toxic waste. He stressed the importance of tackling root causes and engaging youth in prevention and policymaking. Ambassador Rae echoed the need for a balanced approach, from prevention and treatment to recovery and reintegration, while also underscoring the urgency of equitable access to medicines. Their messages made it clear: solving the drug problem demands urgent, coordinated and inclusive global action.

In a video message, World Health Organization (WHO) Director-General Dr. Tedros Adhanom Ghebreyesus urged policies that protect people from drug-related harms while ensuring access to essential medicines under universal health coverage. He reaffirmed WHO’s commitment to working with the International Narcotics Control Board (INCB), UNODC, Member States, and civil society towards evidence-based, human rights-centred solutions. INCB President Jallal Toufiq warned about the rise in synthetic drugs and persistent disparities in medical access despite sufficient global supply. He called for a coordinated global strategy to tackle illicit synthetic drug production, trafficking and use.

Throughout the session, the Commission will deliberate on draft resolutions covering various issues, including evidence-based drug prevention for children, research on stimulant use disorder treatment, alternative development, officer safety in dismantling opioid labs, strengthening the global drug control framework and addressing the environmental impacts of drugs.

A total of 179 side events and 32 exhibitions are scheduled during the session. Additionally, the General Debate will see several countries pledging concrete actions under the Pledge4Action initiative, with updates from Member States on the progress of commitments made during the 67th session.

The CND will also consider WHO’s recommendations on placing six substances under international control.

Source: https://www.unodc.org/unodc/frontpage/2025/March/shaping-global-drug-policies_-cnd-opens-its-68th-session-in-vienna.html

Filed under: Cocaine,Drug use-various effects,Health,Mental Health,Others (International News),Synthetics,Youth :

Delegation of the European Union to the International Organisations in Vienna

Statement by Press and information team of the Delegation to UN and OSCE in Vienna:

Distinguished Chair, Excellencies, Ladies and Gentlemen,

It is an honour to be here and to speak on behalf of the European Union and its Member States. Albania, Andorra, Bosnia and Herzegovina, Georgia, Iceland, Montenegro, North Macedonia, Republic of Moldova, San Marino and Ukraine align themselves with this statement.

Mr Chair,

We remain committed to strengthening the global cooperation to address drug-related challenges in accordance with an evidence-based, integrated, balanced and comprehensive approach. We acknowledge the important role of UNODC in monitoring the world drug situation, developing strategies on international drug control and recommending measures to address drug-related challenges.

As we meet today, conflicts and violence are unfolding in numerous parts of the world. The EU and its Member States call for the full respect for the UN Charter andinternational law, including international humanitarian law, whether in relation to Russia’s war of aggression against Ukraine, or the ongoing conflicts in the Middle East, Sudan, Ethiopia, DRC and elsewhere.

Drug trafficking controlled by organised crime groupsthreatens public health, our security, our economies and prosperous development worldwide, and even our democratic institutions and the rule of law. This is an important security challenge that Europe is currently facing. As demonstrated by the European Drug Report 2024, as a consequence of the high availability of drugs, large-volume trafficking and competition between criminal groups in Europe, some countries are experiencing an increase in violence and other forms of criminality linked to the operation of the drug market.

To address this concern, last November the EU hosted the European Conference on Drug-related Violenceas part of the implementation of the EU Roadmap to combat drug trafficking and organised crime. At the conference, the EU Drugs Agency called for action on drug-related violence, to encourage and support efforts to enhance safety and security across all sectors of society with measures to anticipate, alert, respond and learn from the growing complexities of drug-related violence. This initiative reflects our collective determination to address the increasing violence linked to drug trafficking.

In line with the pledge of the Global Coalition to address Synthetic Drug Threats that the EUcommitted to in September 2024, we are currently closely monitoring the risks of a potential increase in the supply and demand for synthetic opioids in Europe. This possible shift could represent unique challenges for public health systems and law enforcement.

Among such challenges is the growing number of illegal laboratories that produce synthetic drugs. Considering the threat they pose, Poland – on behalf of the EU – has tabled a resolution that draws attention to the protection of all those that are at the forefront of dismantling drug laboratories. Our aim is to set the ground for global standards in ensuring the safety of law enforcement officers, and we count on your support for this important resolution.

The EU and its Member States also call for greater consideration of development-oriented drug policies and alternative development measures, as well as the environmental damage linked to the direct and indirect impact of illicit drug crop cultivation, drug production and manufacture and drug policy responses. Conscious of the realities that shape our world, a resolution addressing the environmental impact of drugs has been tabled by France on behalf of the EU. This is atopic that needs more engagement from all of us, and we hope that you will back this resolution as well.

The EU and its Member States continue to emphasise that States are obliged to protect, promote and fulfilhuman rights, including when they develop and implement drug policies. All human beings are born free and equal in dignity and rights, and the EU and its Member States recall that the death penalty should be abolished globally. We condemn the use of capital punishment at all times and under all circumstances, including for drug-related offences. Additional measures should be taken for people in vulnerable and marginalised situations and to reduce stigma and discrimination. We underline that substance use disorders are a health issue requiring compassionateand evidence-based interventions. Stigmatisation and criminalisation of individuals with substance use disorders should be replaced with a health-centredapproach to reduce risks and harm.

Addressing drug-related harm also remains an important pillar of EU drug policy and the EU Drugs Strategy. The EU and its Member States are implementing a human rights-based approach with a range of measures in compliance with the three international drug conventions. The aim is to reduce drug supply and to take prevention, treatment, care and recovery measures, to reduce risk and harm to society and to the individual. We also ensure a meaningful involvement of scientific experts, civil society and affected communities. We urge the international community to further embrace pragmatic measures aimed at reducing the health and social harms, both for the individual and for society, associated with drug use. From needle and syringe exchange programmes to opioid agonist therapies, such evidence-based initiatives are essential for safeguarding public health and dignity. Prevention, treatment, care and recovery measures, risk and harm reduction must be expanded, adequately resourced, and firmly rooted in respect for human rights, as also set out in last year’s CND resolution 67/4 [on preventing and responding to drug overdose through prevention, treatment, care and recovery measures, as well as other public health interventions, to address the harms associated with illicit drug use as part of a balanced, comprehensive, scientific evidence-based approach].

In the context of current global drug-related challenges, it is important to stress that effective solutions can only be achieved through a balanced and whole-of-society approach as well as by engaging all relevant stakeholders, including health-care personnel, who provide critical support to those affected by substance use disorders; law enforcement officers, who risk their lives in targeting organised crime groups involved in drug production and trafficking; academia, which contributes with evidence-based research and innovative solutions; civil society organisations, which play an important role in prevention, and in risk and harm reduction initiatives. International cooperation is also indispensable to tackle the global drugs phenomenon and we count on the close involvement ofall relevant United Nations entities, including human rights bodies, to foster coordinated international action and inter-agency cooperation.

As set out in the high-level declaration by the CND on the 2024 mid-term review, we stress the urgent need for further ambitious, effective, improved and decisive actions as well as for more proactive, scientific evidence-based, comprehensive, balanced approaches to address drug-related challenges.

For that, we emphasise the critical importance of thorough data collection, monitoring, and scientific research. The European Union Drugs Agency is therefore key in developing Europe’s capacity to react to both current and future drug-related challenges, and we have made a concrete pledge in this regard at last year’s High-level segment of the CND.

Mr. Chair, to conclude,

Continuous drug-related challenges require our united front and cooperation to address them in the most effective and sustainable manner, and we count on global efforts to do so together. The EU and its Member States reaffirm their own commitment to fostering a comprehensive, inclusive, and balanced approach to addressing the world drug situation. We call on all Member States and stakeholders to join us in prioritising health, dignity, and human rights in all aspects of drug policy.

Thank you.

SOURCE: https://www.eeas.europa.eu/delegations/vienna-international-organisations/eu-statement-general-debate-68th-session-commission-narcotic-drugs-10-march-2025_en

Filed under: Addiction,Brain and Behaviour,Culture,Education,Health,Mental Health,Others (International News),Prevention and Intervention,Treatment and Addiction,Youth :

By Tina Underwood – February 23, 2025

Data from the Centers for Disease Control and Prevention show there were about 107,000 drug overdose deaths in the United States in 2023. Of those, about 75 percent, or 81,000, involved opioids.

With the aim of reducing those statistics, Lauren Jones ’22, who is in a post-baccalaureate at Harvard University, Brenna Outten ’22, a third-year doctoral student at Caltech and Leah Juechter ’24, who is working temporarily as a medical assistant, used computational chemistry as undergraduates at Furman to study the impacts of synthetic opioids.

Their work, with collaborators at Hendrix College and California State University, Los Angeles, was published in December in The Journal of Physical Chemistry B.

To say the project was formative for Jones and Outten is an understatement. They laid the foundation for the study during the height of COVID when traditional wet labs were all but shuttered.

“It’s amazing we were able to continue the work virtually during the pandemic,” said Jones, who researches sensory processing in children with autism and brain activity in children with rare neurodevelopmental and neurogenetic disorders at Boston Children’s Hospital.

Outten said the project “opened my eyes to how a scientist can contribute to fields like neuroscience, chemistry, biology and physics in ways I had never considered before.”

The paper focuses on work targeting the mu opioid receptor, or MOR. It resides mainly in the central nervous system and the GI tract. It’s like a molecular lock waiting for the right key (a drug like morphine or fentanyl) to unlock or activate a favorable response, such as reduced pain signals. But the same drugs can activate negative responses like drug tolerance, constipation, respiratory depression, addiction and overdose.

“There’s a lot we don’t understand about how opioids interact with the receptors embedded on nerves that mitigate the pain-signaling process,” Juechter said. “So the more we can uncover about how these drugs are interacting with the receptors in our bodies and the responses we feel, the better we’re able to help create pain therapeutics with reduced adverse effects and more beneficial safety profiles.”

What makes the researchers’ study unique is the application of both quantum mechanics conducted by Juechter, Outten and Jones, led by chemistry Professor George Shields, and molecular dynamics carried out by teams at Cal State and Hendrix College.

“It was interesting to see two drugs (morphine and fentanyl) that elicit almost identical effects are binding to the receptor in completely different ways,” Juechter said. “And to demonstrate that with highly accurate quantum mechanics was one of the first times we’ve seen that done.”

The manner in which opioids bind to MOR is diverse and complex. “So the need for a precise computing model becomes essential,” Juechter explained. “Even slight variations in calculations can drastically affect the data and subsequent conclusions.”

The ability to do research computationally can make drug development faster and cheaper, Juechter added. “Being able to paint the picture of what’s going on using empirically-supported mathematical theories, we can streamline the initial process of drug development.”

Impactful undergraduate research is a hallmark of The Furman Advantage, a four-year approach to education that creates a pathway for students to determine who they want to be and how they want to contribute to the world once they leave the university.

Juechter spent about eight months post-graduation fine-tuning the work with her co-authors before the paper was published.

“It was exceedingly evident Dr. Shields wanted to elevate me and give me the opportunity to pursue research,” Outten said.

Juechter hopes the project will set the tone for organic chemists involved in drug research and development.

“I want a role in the health care industry because I like the idea of affecting someone’s life in real time, in a positive way,” she said.

Source: https://www.furman.edu/news/neuroscience-grads-studied-how-to-make-opioids-safer

Filed under: Culture,Drug use-various effects,Education,Health,Opioids,Prevention and Intervention,Treatment and Addiction,USA :

In November, Donald Trump made significant electoral gains in New York’s black and Latino neighborhoods, and in the city’s least affluent communities. Now he is poised to take an important step to improve public safety in these voters’ neighborhoods.

Rep. Nicole Malliotakis (R-SI) last week wrote to new Attorney General Pam Bondi, pleading for the administration to shut down the city’s two “safe injection sites.”

These facilities, located in East Harlem and Washington Heights, provide supervision to drug abusers as they consume harmful substances like fentanyl, meth, heroin and cocaine.

Yes, these are illegal drugs under federal law — and the aptly nicknamed federal “crack house statute” prevents individuals from retaining property for their consumption.

Indeed, Trump’s Justice Department successfully shuttered similar sites in the past – In 2019, his first administration sued to stop a Philadelphia injection center from opening, and in 2024 a US District Court judge in Pennsylvania finally agreed that the center was not exempt from federal drug laws.

Now Trump should listen to his NYC minority constituents and close the injection sites that are harming their neighborhoods.

New York’s two centers, both run by non-profit OnPoint, were the first in the nation, opening in 2021 under then-Mayor Bill de Blasio — who never met an injurious policy he wouldn’t support in the name of racial justice.

De Blasio gambled successfully that the Biden administration wouldn’t intervene.

OnPoint claims to have saved over 1,000 lives by preventing overdoses. But as my colleague Charles Fain Lehman has pointed out, the sites do not reduce addiction — so they are likely just delaying fatalities: More than 15% of those administered naloxone are dead within a year.

Indeed, data shows that NYC overdose rates have continued to rise since the centers opened.

That’s no surprise, since a rigorous look at the data from even the most touted injection sites in other countries provide no evidence of their effectiveness

But rigor has never been the calling card for politicians and advocates who happily sacrifice other people’s communities in the name of compassion.

State Sen. Gustavo Rivera (D-Bronx) has had the chutzpah to claim that “public drug use, syringe litter and drug-related crime goes down” around sites. In 2023, Rivera urged Gov. Hochul to expand supervised consumption sites statewide, and sponsored Senate legislation — still in committee — to do so.

In 2023, Mayor Eric Adams also proposed adding three more facilities to NYC — but he might be amenable to updating his views with some pressure from Washington.

And that pressure will come if Trump cares about the lives of local residents.

While major crimes fell 13% in northern Manhattan over the past two years, the predominantly black and Hispanic precinct around the East Harlem drug site has seen an almost 8% rise in major crime.

I’ve toured that location with the Greater Harlem Coalition. Members pointed out the large early-childhood education center directly across the street from the injection site, as parents hurried their tots into school in plain view of ongoing drug deals.

The perimeter of the block is dotted with addicts nodding off. Nearby restaurants have had to invest in private security to defend against the criminality the center attracts to the neighborhood.

What’s been keeping this site open despite four years in which the only evidenced change is neighborhood degradation?

Shameless advocacy by pompous, ideologically motivated and race-obsessed elites . . . whose kids don’t go to preschool in Harlem.

In August, Greater Harlem Coalition co-founder Shawn Hill was interviewed by one such far-left advocate: Ryan McNeil, director of harm reduction research at Yale’s School of Medicine.

McNeil was conducting funded “research” into safe injection sites — but a “hot mic” recording revealed his and his colleagues’ woke bias in favor of supporting safe injection sites (and drug decriminalization, more broadly).

But Trump has every reason to listen to these locals, three-quarters of whom are black or Latino.

And it would behove Adams, who faces a crowded primary race this summer, to reverse his past stance and voice support for a federal closure of the city’s two drug consumption sites.

In East Harlem, Trump won about 860 more votes last year than in 2020. Now these supporters, and their neighbors he has yet to persuade, are depending on his help.

Source: https://nypost.com/2025/02/16/opinion/inject-some-common-sense-shut-down-nycs-safe-drug-sites/

Filed under: Addiction,Crime/Violence/Prison,Culture,Drug use-various effects,Education,Health,HIV/Injecting-Drug-Users,Needle Exchange,Prevention and Intervention,Treatment and Addiction,USA :

(1) Use of Alternative Payment Models for Substance Use Disorder Prevention in the United States: Development of a Conceptual Framework

Journal: Substance Abuse Treatment, Prevention, and Policy, 2025, doi: 10.1186/ s13011-025-00635-z

Authors: Elian Rosenfeld, Sarah Potter, Jennifer Caputo, Sushmita Shoma Ghose, Nelia Nadal, Christopher M. Jones, … Michael T. French

Abstract:

Background: Alternative payment models (APMs) are methods through which insurers reimburse health care providers and are widely used to improve the quality and value of health care. While there is a growing movement to utilize APMs for substance use disorder (SUD) treatment services, they have rarely included SUD prevention strategies. Challenges to using APMs for SUD prevention include underdeveloped program outcome measures, inadequate SUD prevention funding, and lack of clarity regarding what prevention strategies might fit within the scope of APMs.

Methods: In November 2023, the Substance Abuse and Mental Health Services Administration (SAMHSA), through a contract with Westat, convened an expert panel to refine a preliminary conceptual framework developed for utilizing APMs for SUD prevention and to identify strategies to encourage their adoption.

Results: The conceptual framework agreed upon by the panel provides expert consensus on how APMs could finance a variety of prevention programs across diverse populations and settings. Additional efforts are needed to accelerate the support for and adoption of APMs for SUD prevention, and the principles of health equity and community engagement should underpin these efforts. Opportunities to increase the use of APMs for SUD prevention include educating key groups, expanding and promoting the SUD prevention workforce, establishing funding for pilot studies, identifying evidence-based core components of SUD prevention, analyzing the cost effectiveness of APMs for SUD prevention, and aligning funding across federal agencies.

Conclusion: Given that the use of APMs for SUD prevention is a new practice, additional research, education, and resources are needed. The conceptual framework and strategies generated by the expert panel offer a path for future research. SUD health care stakeholders should consider ways that SUD prevention can be effectively and equitably implemented within APMs.

To read the full text of the article, please visit the publisher’s website.

(2) Quitline-Based Young Adult Vaping Cessation: A Randomized Clinical Trial Examining NRT and mHealth

Journal: American Journal of Preventive Medicine, 2025, doi: 10.1016/j.amepre.2024 .10.019

Authors: Katrina A. Vickerman, Kelly M. Carpenter, Kristina Mullis, Abigail B. Shoben, Julianna Nemeth, Elizabeth Mayers, & Elizabeth G. Klein

Abstract:

Introduction: Broad-reaching, effective e-cigarette cessation interventions are needed.

Study design: This remote, randomized clinical trial tested a mHealth program and nicotine replacement therapy (NRT) for young adult vaping cessation.

Setting/participants: Social media was used from 2021 to 2022 to recruit 508 young adults (aged 18-24 years) in the U.S. who exclusively and regularly (20+ days of last 30) used e-cigarettes and were interested in quitting.

Intervention: All were offered 2 coaching calls and needed to complete the first call for full study enrollment. Participants were randomized to one of 4 groups in the 2×2 design: mailed NRT (8 weeks versus none) and/or mHealth (yes versus no; stand-alone text program including links to videos and online content).

Main outcome measures: Self-reported 7-day point prevalence vaping abstinence at 3 months.

Results: A total of 981 participants were eligible and randomized; 508 (52%) fully enrolled by completing the first call. Enrolled participants were 71% female, 31% non-White, and 78% vaped daily. Overall, 74% completed the 3-month survey. Overall, 83% in the mailed NRT groups and 24% in the no-mailed NRT groups self-reported NRT use. Intent-to-treat 7-day point prevalence abstinence rates (missing assumed vaping) were 41% for calls only, 43% for Calls+mHealth, 48% for Calls+NRT, and 48% for Calls+NRT+mHealth. There were no statistically significant differences for mailed NRT (versus no-mailed NRT; OR=1.3; 95% CI=0.91, 1.84; p=0.14) or mHealth (versus no mHealth; OR=1.04; 95% CI=0.73, 1.47; p=0.84).

Conclusions: This quitline-delivered intervention was successful at helping young adults quit vaping, with almost half abstinent after 3 months. Higher than anticipated quit rates reduced power to identify significant group differences. Mailed NRT and mHealth did not significantly improve quit rates, in the context of an active control of a 2-call coaching program. Future research is needed to examine the independent effects of coaching calls, NRT, and mHealth in a fully-powered randomized control trial.

To read the full text of the article, please visit the publisher’s website.

(3) The Alcohol Exposome

Journal: Alcohol, 2025, doi: 10.1016/j.alcohol.2024.12.003

Authors: Nousha H. Sabet, & Todd A. Wyatt

Abstract:
Science is now in a new era of exposome research that strives to build a more all-inclusive, panoramic view in the quest for answers; this is especially true in the field of toxicology. Alcohol exposure researchers have been examining the multivariate co-exposures that may either exacerbate or initiate alcohol-related tissue/organ injuries. This manuscript presents selected key variables that represent the Alcohol Exposome. The primary variables that make up the Alcohol Exposome can include comorbidities such as cigarettes, poor diet, occupational hazards, environmental hazards, infectious agents, and aging. In addition to representing multiple factors, the Alcohol Exposome examines the various types of intercellular communications that are carried from one organ system to another and may greatly impact the types of injuries and metabolites caused by alcohol exposure. The intent of defining the Alcohol Exposome is to bring the newly expanded definition of Exposomics, meaning the study of the exposome, to the field of alcohol research and to emphasize the need for examining research results in a non-isolated environment representing a more relevant manner in which all human physiology exists.

To read the full text of the article, please visit the publisher’s website.

(4) Neural Variability and Cognitive Control in Individuals with Opioid Use Disorder

Journal: JAMA Network Open, 2025, doi: 10.1001/jamanetworkopen.2024.55165

Authors: Jean Ye, Saloni Mehta, Hannah Peterson, Ahmad Ibrahim, Gul Saeed, Sarah Linsky, … Dustin Scheinost

Abstract:

Importance: Opioid use disorder (OUD) impacts millions of people worldwide. Prior studies investigating its underpinning neural mechanisms have not often considered how brain signals evolve over time, so it remains unclear whether brain dynamics are altered in OUD and have subsequent behavioral implications.

Objective: To characterize brain dynamic alterations and their association with cognitive control in individuals with OUD.

Design, setting, and participants: This case-control study collected functional magnetic resonance imaging (fMRI) data from individuals with OUD and healthy control (HC) participants. The study was performed at an academic research center and an outpatient clinic from August 2019 to May 2024.

Exposure: Individuals with OUD were all recently stabilized on medications for OUD (<24 weeks). Main outcomes and measures: Recurring brain states supporting different cognitive processes were first identified in an independent sample with 390 participants. A multivariate computational framework extended these brain states to the current dataset to assess their moment-to-moment engagement within each individual. Resting-state and naturalistic fMRI investigated whether brain dynamic alterations were consistently observed in OUD. Using a drug cue paradigm in participants with OUD, the association between cognitive control and brain dynamics during exposure to opioid-related information was studied. Variations in continuous brain state engagement (ie, state engagement variability [SEV]) were extracted during resting-state, naturalistic, and drug-cue paradigms. Stroop assessed cognitive control.

Results: Overall, 99 HC participants (54 [54.5%] female; mean [SD] age, 31.71 [12.16] years) and 76 individuals with OUD (31 [40.8%] female; mean [SD] age, 39.37 [10.47] years) were included. Compared with HC participants, individuals with OUD demonstrated consistent SEV alterations during resting-state (99 HC participants; 71 individuals with OUD; F4,161 = 6.83; P < .001) and naturalistic (96 HC participants; 76 individuals with OUD; F4,163 = 9.93; P < .001) fMRI. Decreased cognitive control was associated with lower SEV during the rest period of a drug cue paradigm among 70 participants with OUD. For example, lower incongruent accuracy scores were associated with decreased transition SEV (ρ58 = 0.34; P = .008). Conclusions and relevance: In this case-control study of brain dynamics in OUD, individuals with OUD experienced greater difficulty in effectively engaging various brain states to meet changing demands. Decreased cognitive control during the rest period of a drug cue paradigm suggests that these individuals had an impaired ability to disengage from opioid-related information. The current study introduces novel information that may serve as groundwork to strengthen cognitive control and reduce opioid-related preoccupation in OUD.

To read the full text of the article, please visit the publisher’s website.

Source: https://drugfree.org/drug-and-alcohol-news/research-news-roundup-february-13-2025/

Filed under: Addiction,Brain and Behaviour,Culture,Health,Marijuana and Medicine,Mental Health,Treatment and Addiction,USA,Vaping,Youth :

They’re not old enough yet to drink in bars, but a group of Washington students wants to make nightlife in the state safer.

A bill in the state Legislature requested by Lake Washington High School students aims to protect people from drink spiking.

The measure would require some establishments selling alcohol, including bars and nightclubs, to have testing kits on hand so patrons can see if their drinks have been drugged. Sponsors amended the bill this week in light of concerns of overreach lodged by a hospitality trade group.

Businesses covered by the proposal would also have to post a notice that test kits are available.

Bars would sell the test strips, stickers or straws to customers for a “reasonable amount based on the wholesale cost of the device.”

Usually, the tests look for drugs like Rohypnol, also known as “roofies.” When placed in alcoholic drinks, the drugs can incapacitate people unexpectedly so they can’t resist sexual assault, according to the federal Drug Enforcement Administration. The tests also detect ketamine and gamma hydroxybutyric acid.

“As a group of young women entering college, we are scared for our future,” Lake Washington senior Ava Brisimitzis told a Senate panel last week. “While nightlife is still years away, there are thousands of Washingtonians right now affected by this problem. No one should question whether or not they might return home safely.”

Senate Bill 5330 would take effect Jan. 1, 2026. It has a committee vote set for Friday.

The proposal is patterned after a similar law passed in California that went into effect last July. That law affected 2,400 establishments.

When a drink is spiked, “many times, it’s too late to prevent that person from falling victim to another crime, and that’s why prevention awareness is so important,” said Sen. Manka Dhingra, D-Redmond, the bill’s prime sponsor.

Critics said the original bill in Washington goes far beyond the California law. The initial version included taverns, nightclubs, theaters, hotels and more. The California legislation only applies to establishments like nightclubs that exclude minors and aren’t required to serve food.

Last week, Washington Hospitality Association lobbyist Julia Gorton said the bill “needs many more conversations.”

The hospitality association would support a version like California’s law, said Jeff Reading, a spokesperson for the trade group.

Now, a revised version of the bill looks to more closely align Washington’s proposal with California’s by focusing on establishments that don’t allow minors.

Washington’s unusual liquor licensing system has made drafting the bill difficult, Dhingra said. The state simply has too many types of licenses. She wants to “clean up” Washington’s liquor license statute.

“This is really not meant to be onerous, but really meant to be a partnership to make sure all the patrons are safe,” Dhingra told the Senate Labor & Commerce Committee last week.

California’s legislation also stated the signage must say “Don’t get roofied! Drink spiking drug test kits available here.” But Dhingra felt that language may be seen as blaming the victim, so the new version of the Washington bill doesn’t require specific verbiage in the sign.

A 2016 study published in the American Psychological Association’s journal Psychology of Violence found nearly 8% of 6,064 students surveyed at three universities believed they’d been drugged.

Source: https://washingtonstatestandard.com/briefs/washington-could-require-bars-to-carry-spiked-drink-drug-tests/

Filed under: Alcohol,Culture,Health,Mental Health,Sexual Behaviour,USA,Youth :

This is a response from Pamela McColl by email to the then BMJ editor-in-chief Dr Fiona Godlee to the article Drugs should be legalised, regulated and taxed

Dear Dr. Godlee

Every nation state, representing billions of individuals, on this planet opposes your view on the legalization of all drugs- aside from Uruguay who has in small measures legalized marijuana – with the misguided and pot using Prime Minister of Canada setting his own country up for the same fall sometime in 2018.

Nations who support the UN drug conventions and The Rights of the Child Treaty, spend on drug prevention and education, have the lowest rates in the world. Those who dabble in Sorosian drug ideology loose out and pay the price with populations suffering the impact of these harmful substances.

I have one simple question for you in light of your decision to focus on legal aspects of harm versus a serious consideration of health harms. Those who say the worst consequences of using marijuana are the penalties that can be imposed by the legal system is factually incorrect – unless the death penalty is included which I do not agree with nor does the United Nations and the drug preventions.

FACT: The legal ramifications are vastly over-rated including incarceration compared to the damage to an individual that can follow use.

Would you as a parent prefer to have your young adult child receive a ticket or intervention involving government agencies or law enforcement or even spend a couple of days in jail or would you prefer to see these drugs legalized – providing greater access, acceptability and normalization, and promotion by an addiction-for-profit industry ?

You need to compare the consequences of the use of marijuana that can be imposed on an individual with the risks of harm to body, and brain, including testicular cancer, a 7x fold increased risk of suicide, and significant increased risk of death by driving drugged – something 50% of users admit to doing ?

Is being charged with simple possession and serving a day or two in jail or being placed on probation or a handed a ticket in your view as harsh an experience and detrimental to an individual as living through a marijuana induced psychotic break from reality that may or not excite violence towards yourself or others?

Health rules the day and if the judicial penalties need to be addressed so be it – that is no reason to legalize a drug that is so dangerous to human health. There is every reason to educate the public on the vast array of marijuana harms and the harms other illicit substances pose.

Health Canada has this to say about the use of marijuana for any reason – including a medical reason. This information is being ignored by the Canadian government. We are about to repeat the thalidomide mistake once again, and all because a group of rogue bureaucrats and unenlightened politicians rule this day.

When the product should not be used

Cannabis should not be used if you:

- - are under the age of 25
  - are allergic to any cannabinoid or to smoke
  - have serious liver, kidney, heart or lung disease
  - have a personal or family history of serious mental disorders such as schizophrenia, psychosis, depression, or bipolar disorder
  - are pregnant, are planning to get pregnant, or are breast-feeding
  - are a man who wishes to start a family
  - have a history of alcohol or drug abuse or substance dependence

Talk to your health care practitioner if you have any of these conditions. There may be other conditions where this product should not be used, but which are unknown due to limited scientific information.

Pamela McColl

http://www.preventdontpromote.org /;

Vancouver BC Canada

Source: Email from Pamela McColl May 2018

Filed under: Canada,Cannabis/Marijuana,Global Drug Legalisation Efforts,Health,Political Sector,Social Affairs :

Prevention is key, and we cannot forget that today’s marijuana is highly potent. In 2025 and beyond, federal agencies must prioritize public health and safety and work to undo legalization’s harmful consequences.

The Department of Health and Human Services (HHS) is positioned to implement a wide range of policy initiatives to prevent marijuana use and hold the industry accountable. For example, marijuana legalization has re-elevated the conversation about second-hand smoke. California recently passed a law permitting “cannabis cafes” in which users can openly smoke marijuana. Second-hand marijuana smoke has been found to be more harmful than second-hand tobacco smoke and contains many of the same cancer-causing substances. Our country has legally and culturally rejected indoor cigarette smoking. HHS must stand on science and reject indoor marijuana smoking by publishing strict guidelines prohibiting it, just as it did with indoor cigarette smoking.

Transparency within the “medical” marijuana industry is also desperately needed. As it did with opioids, HHS should create a registry of medical marijuana recommendation practices and make the information available to the public. The database could include information regarding regional breakdowns, a list of overprescribing doctors, and pot-industry kickbacks received by doctors.

Sunlight is the best disinfectant when it comes to quack doctors. In August, a Spotlight PA article uncovered Pennsylvania medical pot doctors who were doling out thousands of medical marijuana cards per year. These are similar to the “pill mills” that fueled the opioid epidemic.

Last year, the Food and Drug Administration (FDA) bucked federal legal precedent around marijuana rescheduling by inventing new, lower standards. Its flawed marijuana rescheduling review was designed to permit marijuana rescheduling. The ramifications of changing this precedent aren’t limited to marijuana; other dangerous drugs (e.g., psychedelics) could be reclassified to a lower schedule based on the new lax standards. HHS should issue internal agency guidance that advises FDA to adhere to the established five-factor test for determining currently accepted medical use. This will ensure that drug scheduling, which has direct implications for the availability of drugs, remains science based.

The Trump-Vance administration must soundly reject moving marijuana from Schedule I to Schedule III for one simple reason: marijuana fails to meet the legal definition of a Schedule III drug. It has not been approved by the FDA for the treatment of any disease or condition. Moving marijuana to Schedule III is a handout to corporations, as it would allow companies to deduct advertising and other expenses from their taxes, fueling the growth of an industry that profits from addiction.

Far from being a legitimate medicine, marijuana is harming the millions of Americans who misuse it. Given that 3 in 10 users develop a marijuana use disorder, better known as addiction to marijuana, the incoming administration needs to focus on helping connect Americans to treatment.

Federal law enforcement also plays a crucial role in curbing marijuana legalization and its effects. In 2013, the Obama administration issued the Cole Memo, a document that cemented the federal government’s non-enforcement policy on marijuana. The first Trump administration rescinded the memo, but more must be done to enforce federal laws already on the books. The Justice Department has the power to prevent distribution to minors, curtail drugged driving, and investigate state-legal dispensaries being used as a cover for illegal drug trafficking—all things the Obama administration promised to do. By beginning with this targeted enforcement strategy, law enforcement can shut down the operations of the industry’s worst actors.

To promote public safety, the Trump-Vance administration should also crack down on illegal marijuana grows, particularly those in remote areas on federal lands. These operations are often controlled by cartels and poison the surrounding natural environment with toxic chemicals.

We also need a new national anti-drug media campaign, updated for the 21st century. This campaign must broadcast messages widely through traditional and social media and talk about the dangers and truth behind the use of drugs. The Office of National Drug Control Policy (ONDCP), the drug policy office within the White House, has a key role to play, too, particularly in drug use prevention. ONDCP helps oversee the Drug-Free Communities Support Program, which is responsible for much of our federally funded drug prevention work. In an era in which drugs are sold and marketed via social media, it’s more important than ever that effective anti-drug prevention messages reach young people. ONDCP also oversees the High Intensity Drug Trafficking Areas program, which forms a crucial partnership between local, state, and federal law enforcement to curtail drug trafficking. Both these programs’ funding should be protected and prioritized.

A good strategy must focus on all drugs, but we can’t ignore the politically inconvenient ones. If President Trump wants to make America healthy again, the conversation must include marijuana, a drug with an addiction rate of up to 30 percent that is being pushed by a profit-driven industry that desperately needs federal accountability.

Dr. Kevin Sabet is the President of Smart Approaches to Marijuana (SAM) and the Foundation for Drug Policy Solutions (FDPS) and a former White House drug policy advisor to Presidents Obama, Bush and Clinton.

SOURCE: https://www.newsweek.com/making-america-healthy-again-must-start-better-drug-policy-opinion-2014657

Filed under: Addiction,Economic,Education,Health,Marijuana and Medicine,Political Sector,Prevalence,Prevention and Intervention,Treatment and Addiction,USA :

This past year, NIDA commemorated its 50th anniversary, which made me reflect on how far addiction science has come in a half century—from the barest beginnings of an understanding of how drugs work in the brain, and only a few treatment and prevention tools, to a robustly developed science and multiple opportunities to translate that science into clinical practice. Yet the challenges we face around drug use and addiction have never been greater, with annual deaths from overdose that have vastly exceeded anything seen in previous eras and the proliferation of increasingly more potent addictive drugs.

Our 50th year brought hope, as we finally saw evidence of a sustained downturn in drug overdose deaths. From July 2023 to July 2024, the number of fatal overdoses dropped nearly 17 percent, from over 113,000 to 94,000. We still don’t know all the factors contributing to this reversal, so investigating the drivers of this decline will be crucial for sustaining and accelerating the downturn. We also need to recognize that the decline is not homogenous across populations: Black and American Indian/Alaskan Native persons continue to die at increased rates. And 94,000 people dying of overdose in a year is still 94,000 too many.

As we begin a new year, I see four major areas deserving special focus for our efforts: preventing drug use and addiction, preventing overdose, increasing access to effective addiction treatments, and leveraging new technologies to help advance substance use disorder (SUD) treatment and the science of drug use and addiction.

Preventing drug use and addiction

The brain undergoes continuous development from the prenatal period through young adulthood, and substance exposures and myriad other environmental exposures can influence that development. Prenatal drug exposure can lead to learning and behavioral difficulties and raise the risk of later substance use. Adverse childhood experiences, including neglect, abuse, and the impacts of poverty, as well as childhood mental disorders, can negatively impact brain development in ways that make an individual more vulnerable for drug use and addiction. Early drug experimentation in adolescence is also associated with greater risk of developing an SUD.

Early intervention in emerging psychiatric disorders as well as prevention interventions aimed at decreasing risk factors and enhancing protective factors can reduce initiation of drug use and improve a host of mental health outcomes. Research on prevention interventions has shown that mitigating the impact of socioeconomic disadvantage counteracts the effects of poverty on brain development,¹ and some studies have even documented evidence of intergenerational benefits, improving outcomes for the children of the children who received the intervention.² Studies have also shown them to be enormously cost-effective by reducing later costs to healthcare and other services, providing health and economic benefits to communities that put them in place.³

Yet, in the United States, efforts to prevent substance use have been largely fragmented, and the infrastructure and funding required to bring effective programs to scale is lacking. What kinds of policy innovations could we put into place to ensure that everyone who could benefit from evidence-based prevention services has access to them, whether through school, healthcare, justice, or community settings? NIDA, along with other NIH Institutes, the Centers for Disease Control and Prevention, and the Substance Abuse and Mental Health Services Administration, have charged the National Academy of Sciences, Engineering, and Medicine with creating an actionable blueprint for supporting the implementation of prevention interventions that promote behavioral health. The report is due out early this year and has the potential for tremendous public health impact.⁴

Preventing overdose

We also need to continue research toward mitigating fatal overdoses. Comprehensive data on overdose reversals do not currently exist, but recipients of SAMHSA State Opioid Response grants alone reported more than 92 thousand overdose reversals with naloxone in the year ending March 31, 2023, and this is likely just a small fraction of the lives saved. We do not yet know the extent to which greater use of naloxone has played a role in the recent declines in overdose fatalities, but this medication, the first intranasal formulation of which was developed by NIDA in partnership with Adapt Pharma, is a real public health success.

NIDA is supporting research to evaluate approaches to naloxone distribution, for instance through mobile vans and peer-run community services that also provide sterile injection equipment to prevent HIV and HCV transmission. We are also supporting research on new approaches to reversing drug overdoses, such as wearable devices that would auto-inject naloxone when an overdose is detected and electrical stimulation of the phrenic nerve to restore breathing, a method already used in resuscitation devices.⁵ We are also supporting research on compounds that could potentially reverse methamphetamine overdoses, such as monoclonal antibodies and molecules called sequestrants that bind and encapsulate methamphetamine in the body.⁶

Improving access to addiction treatment

In 2023, only 14.6 percent of people with an SUD received treatment, and only 18 percent of people with an opioid use disorder (OUD) received medication.⁷ Stigma, along with inadequate coverage of addiction treatment by both public and private insurers, contributes to this gap. To fix this will require partnering with payors to develop and evaluate new models for incentivizing the provision of evidence-based SUD care.

Increased access to methadone is a particularly high priority in the era of fentanyl and other potent synthetic opioids. Results from a recent study in British Columbia showed that risk of leaving treatment was lower for methadone than for buprenorphine. Risk of dying was similarly low for both groups.⁸ Currently in the United States, methadone is only available from specialized opioid treatment centers, but studies piloting access through pharmacies have shown promise.

OUD medications also need to be accessible to people with SUD in jails and prisons. Research conducted in justice settings has shown that providing access to all three FDA-approved medications for OUD during incarceration reduced fatal overdose risk after release by nearly 32 percent.⁹ Access to buprenorphine during incarceration was also associated with a 32 percent reduction in recidivism risk.¹⁰ Through NIDA’s Justice Community Overdose Innovation Network (JCOIN), we continue to promote research into innovative models and strategies for integrating medications for OUD in justice settings.

I am also hopeful that we will soon see increased utilization of contingency management for treating stimulant use disorders. Providing incentives for treatment participation and negative drug tests is the most effective treatment we have for methamphetamine and cocaine addictions, but implementation has been hindered by regulatory ambiguities around caps on the dollar value of those incentives. However, demonstration projects underway in four states (California, Washington, Montana, and Delaware) are implementing contingency management with higher incentives and could further bolster evidence for the effectiveness—including cost effectiveness—of this approach.

Leveraging new treatments and technologies

There are many promising new technologies that could transform the treatment of addiction, including central and peripheral neuromodulation approaches. Transcranial magnetic stimulation (TMS) was already approved by the FDA as an adjunct treatment for smoking cessation and peripheral auricular nerve stimulation was approved for the treatment of acute opioid withdrawal. TMS, transcranial direct current stimulation (tDCS), and peripheral vagal nerve stimulation are under investigation for treating other SUDs. Low-intensity focused ultrasound—a non-invasive method that can reach targets deep in the brain—is also showing promise for the treatment of SUD. NIDA is currently funding clinical trials to determine its safety and preliminary efficacy for treating cocaine use disorder¹¹ and OUD with or without co-occurring pain.¹²

Advances in pharmacology have helped identify multiple new targets for treating addiction that are not limited to a specific SUDs like OUD. Instead, these targets aim to modulate brain circuits that are common across addictions; they include among many others D3 receptor partial agonists/antagonists, orexin antagonists and glucagon-like peptide 1 (GLP-1) agonists. The latter are particularly promising, as these types of drugs, including semaglutide and tirzepatide, are already being used for the treatment of diabetes and obesity.

Anecdotally, patients taking GLP-1 agonists report less interest in drinking, smoking, or consuming other drugs. Recent studies based on electronic health records have revealed that people with SUDs taking GLP-1 medications to treat their obesity or diabetes had improved outcomes associated with their addiction, such as reduced incidence and recurrence of alcohol use disorder,¹³ reduced health consequences of smoking,¹⁴and reduced opioid overdose risk.¹⁵ NIDA is currently funding randomized clinical studies to assess the efficacy of GLP-1 agonists for the treatment of opioid and stimulant use disorders and for smoking cessation.

Creation of large data sources and repositories in parallel with advances in computation and analytical modeling including AI are helping in the design of new therapeutics based on the 3D molecular structure of addictive drugs and the receptors they interact with.¹⁶ NIDA-funded researchers have published studies showing that AI could be used to provide more timely, comprehensive data on overdose, such as by using social-media to predict overdose deaths.¹⁷ It could be used to enable higher-resolution analyses in basic neuroscience research¹⁸ and facilitate studies using large data sources like electronic health records.¹⁹ AI is also being used to support delivery of behavioral therapies and relapse prevention in virtual chatbots and is being studied in wearable devices. Although there is much work to be done to ensure that AI is deployed safely and ethically, particularly in clinical settings, this technology has considerable potential to enhance and expand access to care.

AI will also be transformative for analyzing big data sets like those being generated by the Adolescent Brain Cognitive Development^SM (ABCD) Study and HEALthy Brain and Child Development Study. These landmark NIH-funded studies are gathering vast quantities of neuroimaging, biometric, psychometric, and other data across the first two decades of life. They will be able to answer important questions about the impacts of drugs and other environmental exposures on the developing brain, inform prevention and treatment interventions, and establish a valuable—and unprecedented—baseline of neurodevelopment that will be a crucial resource in pediatric neurology.

The field of addiction science has progressed at a breathtaking pace. These advances could not have been made without the commitment of an interconnected community of people. Researchers, clinicians, policymakers, community groups, and people living with SUDs and the families that support them all play a role in collaboratively finding solutions to some of the most challenging questions in substance use and addiction research. Together, we turn our eye to 2025 and the challenges and opportunities ahead.

Filed under: Addiction,Culture,Economic,Education,Health,Prevalence,Prevention and Intervention,USA :

Contemporary issues on drugs

As well as providing an in-depth analysis of key developments and emerging trends in selected drug markets, the Contemporary issues on drugs booklet looks at several other developments of policy relevance. The booklet opens with a look at the 2022 Taliban ban on the cultivation and production of and trafficking in drugs in Afghanistan and its implications both within the country and in transit and destination markets elsewhere. This is followed by a chapter examining the convergence of drug trafficking and other activities and how they affect natural ecosystems and communities in the Golden Triangle in South-East Asia. The chapter also assesses the extent to which drug production and trafficking are linked with other illicit economies that challenge the rule of law and fuel conflict. Another chapter analyses how the dynamics of demand for and supply of synthetic drugs vary when the gender and age of market participants are considered. The booklet continues with an update on regulatory approaches to and the impact of legalization on the non-medical cannabis market in different countries, and a review of the enabling environment that provides broad access to the unsupervised, “quasi-therapeutic” and non-medical use of psychedelic substances. Finally, the booklet offers a multi-dimensional framework on the right to health in the context of drug use; these dimensions include availability, accessibility, acceptability, quality, non-discrimination, non-stigmatization and participation.

Key findings and conclusions

The Key findings and conclusions booklet provides an overview of selected findings from the analysis presented in the Drug market patterns and trends module and the thematic Contemporary issues on drugs booklet, while the Special points of interest fascicle offers a framework for the main takeaways and policy implications that can be drawn from those findings.

Sources:

Issues: https://www.unodc.org/unodc/en/data-and-analysis/wdr2024-contemporary-issues.html

Findings and Conclusions: https://www.unodc.org/unodc/en/data-and-analysis/wdr2024-key-findings-conclusions.html

Filed under: Addiction,Drug use-various effects,Economic,Health,Mental Health,Others (International News),Prevalence,Prevention and Intervention :

KCUR-FM – Radio station – | by Suzanne King – Published December 28, 2024 at 3:55 PM CST

Since Missouri legalized marijuana in 2018, Dr. Bob Batterson has noticed a change in attitudes.

The Children’s Mercy Hospital psychiatrist more often hears from parents wondering if cannabis could help their child’s anxiety, autism or OCD.

“I tell them there are no studies,” said Batterson, the medical associate director of the hospital’s Division of Developmental and Behavioral Health. “A lot of hype, but no studies.”

And even if Children’s Mercy allowed its doctors to prescribe weed (it doesn’t), Batterson wouldn’t know what dose to recommend. He also couldn’t say which patient might experience a marijuana-induced psychotic episode or other serious reaction.

No one could.

Years of federal prohibition and the resulting limits on research mean the science about marijuana is skimpy at best. Public health experts say that should trigger caution in a world where legal marijuana is increasingly accessible and more widely consumed.

“There has been relatively little research on cannabis,” said Steven Teutsch, who chaired a year-long study for the National Academies of Sciences, Engineering and Medicine about the impact legal cannabis is having on public health. “Many of the benefits are often over-promoted and are iffy in many cases. And the harms are often not fully appreciated.”

Despite a well-known and largely accepted narrative that marijuana is safe and not addictive, the reality — especially when people consume greater and stronger amounts of the drug — is often different, health experts said.

Some 30% of cannabis users report having a physical dependency on the drug, according to the U.S. Centers for Disease Control and Prevention. Scientists believe the drug could hurt brain function, heart health and can lead to impaired driving. It also correlates with social anxiety, depression and schizophrenia.

The federal government, which Teutsch said has “ largely been missing in action in all of this,” needs to step in with campaigns to educate the public, with model legislation to help states regulate the drug and with research funding to study health effects — good and bad.

Marijuana rules to protect health up to the states

Marijuana is still illegal at the federal level, and classified by federal law as a Schedule I drug, defined as a highly addictive substance with no known medical use. Hearings on a proposal to reclassify it as a Schedule III drug will begin in January.

That change would remove barriers — and free more money — for research that could give doctors a better understanding of the health effects of all those gummies, pre-rolled joints and THC-spiked drinks at your neighborhood dispensary.

It also could pave the way for more drug development. To date, the U.S. Food and Drug Administration has only approved three drugs related to cannabis.

Some experts also contend that Congress needs to undo federal law adopted in 2018 that allowed hemp products containing THC (tetrahydrocannabinol), the primary psychoactive compound in cannabis, to be sold in gas stations and grocery stores, free from regulatory oversight.

Under the current system, every state with legal weed takes a different approach to the drug.

California became the first to legalize medical marijuana in 1996. And Colorado and Washington led the way in legalizing recreational pot in 2012.

In the years since, only a handful of states, including Kansas, have resisted passing some level of legalization. Missouri voters adopted a constitutional amendment allowing medical marijuana use in 2018, and one legalizing recreational weed in 2022.

The state has a responsibility, said Dr. Heidi Miller, chief medical officer for the Missouri Department of Health and Senior Services, to make sure people know the risks that come with marijuana.

“Cannabis has multiple potential therapeutic effects, but also potential adverse effects,” she said. “We need to inform the public of what we know and what we don’t know.”

Missouri has budgeted $2.5 million (less than 0.2% of what people in the state spend on weed in a year) for a public information campaign to get this message out.

Miller said the campaign, which is in early planning stages and not yet scheduled, should warn vulnerable populations — young people, pregnant or breastfeeding women and people with a personal or family history of mental illness — about the risks of getting high.

It should also alert people, she said, that the marijuana they may have smoked a few decades ago has little resemblance to the potent variety sold at dispensaries.

The stuff sold today may have four times more THC. And that doesn’t include concentrates, which can have THC levels reaching 90%.

“Clearly, the adverse effects are going to be heightened, the higher the potency,” Miller said. “We can’t assume that all cannabis is safe because it’s, quote, natural. We also want folks to understand that cannabis is potentially addictive.”

More people are using cannabis

Since sales began in Missouri four years ago, the Division of Cannabis Regulation says more than $3 billion has been spent on cannabis products in the state. In fiscal year 2024, recreational sales, referred to as “adult use,” reached $1.16 billion, while medical weed sales totaled just under $166 million.

As in other states that have legalized cannabis, use of the drug is on the rise.

Dutchie, a technology company whose software powers the payment platforms and other backend systems in dispensaries, reported that on the Wednesday before Thanksgiving — known in the industry as “Green Wednesday” — average orders in Missouri dispensaries jumped 18% above a regular Wednesday to more than $84.

The number of people using the drug, which experts said will only continue to rise, is raising alarms.

A November 2023 report from the Substance Abuse and Mental Health Services Administration found that 61.9 million Americans — 22% of those 12 and older — reported using cannabis in the past year. More than 13 million 18 to 25 year olds — 38% — said they’d used the drug. The same was true for 11.5% of 12 to 17 year olds.

As people consume marijuana more frequently and in higher doses, anecdotal stories related to health problems are becoming more common. They include reports of cannabinoid hyperemesis syndrome, a gastrointestinal condition that leads to bouts of vomiting and intense pain, and instances of cannabis-induced psychosis, a mental illness that can lead to violence and suicide.

“They didn’t legalize old school hippy weed,” said Aubree Adams, a Colorado mother whose son became psychotic after using marijuana. “We’re dealing with a really hard drug.”

Every day, Adams said, the organization she founded to educate the public about the dangers of marijuana use, receives inquiries from a handful of families across the country dealing with issues related to marijuana use.

Her organization, Every Brain Matters, is pushing for potency caps on the marijuana being sold in the United States; an end to the sale of edibles, which often look like candy; and a ban on sugary-flavored vapes.

Adams also wants it to be illegal for marijuana companies to market products as medicine that have not been approved for medical use. States need to be out front telling the public the truth, she said.

“I don’t know why we have to sugar coat things and play politics,” she said. “Tell them the truth. Tell them the science.”

Her son is 24 now. He’s come in and out of sobriety since first getting into trouble “dabbing” highly concentrated marijuana when he was 15. She believes he would be fine if he hadn’t used the drug.

“My son fights for his mental well being on a daily basis,” she said.

Adams wants other parents to know the potential risks. And she wants adolescents and young adults — who she believes are a primary target of marijuana companies — to realize what they might be getting into. Doctors say that developing brains are more vulnerable to problems

“This is not a soft drug,” she said. “This is a hard drug that can change your brain chemistry.”

Lack of federal oversight

But getting meaningful regulatory change in an industry that lacks federal oversight is difficult.

Under the current system, every state has its own set of rules about everything from how cannabis products are packaged, tested and sold to what training the budtender at your local cannabis store needs to have. States decide who can buy cannabis, how much someone can buy during a certain period and how potent weed can be.

The states also oversee what’s in the marijuana, including setting maximum levels for contaminants like heavy metals and pesticides. Missouri’s Cannabis Division established rules based on the amendments voters adopted.

The state has licensed 10 private laboratories, which marijuana producers hire to test products for compliance with state rules. Cannabis regulators also are opening a “reference laboratory” by mid-2025 to verify those results.

Because the state legalized weed later than other states, it adopted standards that are among the most stringent in the country, said Anthony David, chief operations officer with Green Precision Analytics, a private marijuana testing lab in Kansas City. Before opening the lab with three partners, he grew marijuana in the Pacific Northwest.

“Cannabis that Missourians are smoking,” he said, “is safer than probably anywhere in the world.”

The National Academies of Sciences’ report on cannabis and public health, which was commissioned by the CDC and the National Institutes of Health, recommended several policy changes states could make to protect the public.

Those include things like limiting the potency of marijuana (Missouri has no such limit), and restricting retail hours at dispensaries. While Kansas City limits how late a dispensary can stay open, the state does not, and some weed shops in neighboring communities offer 24-hour-a-day drive-thrus. Other suggested policies from the report involve implementing strategies to protect kids. In short, they want cannabis products to be controlled much like alcohol and tobacco.

“Almost every state does something right, but there are a lot of things they don’t do,” Teutsch said. “We advise the states to look at what was done for tobacco and alcohol because there’s many years of experience there implementing policies that have a public health focus.”

David G. Evans, a New Jersey attorney representing people who claim they’ve been harmed by marijuana, also believes there is wisdom to be gained from what unfolded in the tobacco industry.

He contends that the legal system needs to step in where regulators have failed. Evans is suing marijuana companies for harming clients and marshalling lawyers across the country to do the same. He hopes the legal actions will bring public awareness about risks of marijuana and rein in the industry.

“The marijuana industry is low-hanging fruit,” Evans said. “They’ve been allowed to be reckless. They’ve not been controlled, not disciplined. And the state governments have played right along with them. Now there’s starting to be a reckoning.”

Source: https://www.ksmu.org/news/2024-12-28/with-weed-legal-missouri-is-now-looking-at-the-public-health-consequences

This story was originally published by The Beacon, a fellow member of the KC Media Collective.

Filed under: Culture,Health,Marijuana and Medicine,Mental Health,USA :

People smoke the stuff perfectly openly, without fear, with the threatened £90 fine seemingly a remote possibility.

by Zoe Strimpel – The Telegraph London author – 14 December 2024 4:09pm GMT

Sir Elton John Credit: Ben Gibson

Zoe Strimpel writes: I was about 23 and was still finding my feet socially in London. I’d always really been a champagne girl at heart but cannabis smoking was common in some of the circles I spent time in. It seemed so tacky and boring, the province of the sorts of bores one met while “travelling”, so I usually said no.

But one night in a run-down flat somewhere in north London, I went along with everyone else. Not long afterwards my heart began to pound like never before and a wave of horrible panic crashed over me, like I was trapped in a physiological nightmare and might die.

This was combined with a much more familiar sense of self-recrimination: why had I got myself into this? It wasn’t tempting in the first place and it could never have been worth it. And now I was paying the price – and so was the friend, now more like a sister to me, who had to tend to me in my tearful panic.

Since then, the pressure to imbibe cannabis has only grown and spread, from tatty student settings to (upper)-middle class and middle-aged environs.

Those who prefer to avoid the smoke element can still mainline the active ingredient – THC – by choosing from a wide range of edibles, which are generally like jelly babies. These make you (me) feel just as dreadful as the smoke sort, though mercifully without the stink.

All of which is why I am in full agreement with Elton John who, as Time magazine’s “icon of the year”, has lambasted the legalisation of pot in North America as “one of the greatest mistakes of all time”.

Sir Elton, himself an addict until he got sober 34 years ago, pointed out that: “It leads to other drugs. And when you’re stoned – and I’ve been stoned – you don’t think normally.”

This is a statement of blinding obviousness, and yet in our strange society it sounds reactionary, refreshing, courageous. How is it that a drug known – outside of carefully managed medical settings where it can help with pain and sleep – to trigger psychosis and turn people into paranoiacs and dullards, and, when smoked, to cause damage to the lungs and body, came to be considered safe by North American lawmakers?

To be seen as so perfectly respectable, fine and dandy that states explicitly give their blessing to recreational use of it? And this in an America that doesn’t let people drink until they are 21 or even touch containers of alcohol till that age, or in public.

In the UK, it is not legal and classed as a class B drug. But that does not mean that ‘it is not ubiquitous’.

This is depressing. I’m all for the exploration and titration of psychoactive drugs to help people in desperate need of pain relief. I am interested in, though not yet convinced by, use of mushrooms (psilocybin) and ecstasy (MDMA) in treating depression.

But the general prevalence of cannabis is a much drearier, bigger, more worrying issue, connected to a general sense of inconsistency and disconnected logic among law-makers and enforcers on one hand, and a sense that all we want to do is bury ourselves in escapist hedonism that alters our minds and our worlds so as to reduce the stress associated with, for instance, responsibility, reality and work.

Labour has indicated that it does not wish to legalise cannabis. But it seems happy, as do the police, with the fact that nobody cares about its technical illegality. People smoke the stuff perfectly openly, without fear, with the threatened £90 fine seemingly a remote possibility. Children therefore have to inhale it in parks. It is a gateway drug for hard drugs and criminality, and forms a familiar backdrop for the insouciant menace of gangs.

But according 2023 figures from the ONS, cannabis was by far the most-commonly used recreational drug in the UK, with 7.4 per cent of adults aged 16 to 59 saying they had consumed it in the last year.

The counter-currents in state attitudes to recreational drugs are just weird. Why does the state look benignly on the smoking of this illegal substance, and fail to promote information about the dangers of inhaling it via smoke (and edibles), but noisily pursue the outlawing of cigarette smoking for those born after a certain date?

Fags are toxic and cancer-causing, and nobody should have to regularly breathe second-hand smoke. But so long as the harm of smoking (the tar in tobacco) is limited to the smoker, and those who voluntarily inhale their smoke, the wider mental effects are not disturbing.

Nicotine alone doesn’t tend to ‘alter personality beyond recognition’ or induce fits of paranoia, depression, criminality or addiction to other substances.

And let’s face it: a waft of cigarette smoke is quite pleasant. Cigarettes retain a kind of aesthetic glamour; their use is not at odds with beauty, comfort, decadence and good conversation. Pot-smokers, instead, give off a polluting stink that lowers the tone of whatever environment one is in, makes conversation a thousand times more inane, and seems to celebrate the urge to do less, or nothing, smugly. Cannabis is deadening, however it is consumed.

Even among those who work hard and have children, cannabis rules, becoming a fixation without which no relaxation is possible, whipped out as soon as the working day ends or the children are asleep. Perhaps what we need is to find other ways to relax, like reading a good book. Or, of course, to stop chasing relaxation and indolence at all costs, full stop.

SOURCE: https://www.telegraph.co.uk/news/2024/12/14/elton-john-is-right-cannabis-deadening-to-soul/

Filed under: Cannabis/Marijuana,Drug use-various effects,Health,Marijuana and Medicine,Mental Health,Prevention and Intervention,UK :

COMMENT BY NATIONAL DRUG PREVENTION ALLIANCE ON THE ARTICLE BY DREXEL – 15 DECEMBER 2024:

NDPA has significant reservations about his article. Drexel (a ‘private university’ in Philadelphia) are asserting that all drug use is stigmatised ,and that such stigmatisation as they observe should be negated. But other specialists in the field counter by giving comments on stigma/human behaviour etc, as follows:

There is no doubt that language which stigmatises a situation or a person is something to be avoided, and there should be an un-stigmatised opening for people to access healthful interventions, but
Drug use and addiction is a ‘chicken and egg’ situation, and
Writers like this one start half way through the situation, when a person has made a decision to stop being a ‘drug-free’ person; they are already moving down a path which can lead to consequences which were not what they wanted when deciding to use, so
They are already a user, and what one might call the ‘pre-addictive’ stage is ignored. Addicted users are portrayed as no less or more than victims, seduced by profiteering suppliers, which
Circumvents the initial chapter in the story i.e. the stage in which a person decides to use a substance which
In retrospect ca be seen as a bad decision, which should be the target of productive prevention. This is
‘pre the event’ – the heart of the word ‘prevention’ which in its Latin-base (‘praevenire’) means ‘to come before’ – not to come ‘during’!

Take the following paragraph in this paper:

“Awareness of stigma as an impediment to treatment has grown in the last two decades. In the wake of America’s opioid epidemic — when strategic, deceitful marketing, promotion and overprescription of addictive painkillers resulted in millions of individuals unwittingly becoming addicted — the general public began to recognize addiction as a disease to be treated, rather than a moral failure to be punished — as it was often portrayed during the “War on Drugs” in the 1970s and ‘80s”.

Whilst we can harmonise with the authors of this paper in seeking to remove ‘stigma as an impediment to treatment’, we part company with them when they classify all addicts as ‘unwitting victims of deceitful marketing and promotion’. The simple fact is that they made a bad decision, for whatever reason … in some cases suckered, yes, or in other cases not looking down that road and its consequences on themselves and others around them (‘short termism’) – this was not a ‘moral wrong’, it was what it was.

Prevention should therefore assist people to make healthful decisions – the kind of decision which countless former users make for themselves, thereby moving themselves off the ‘pre-addictive’ road onto a healthful one.

This paper does not include this wider picture, and is the less for that.

<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<NDPA>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

DREXEL PRIVATE UNIVERSITY TEXT:

December 11, 2024

Drug addiction has been one of America’s growing public health concerns for decades. Despite the development of effective treatments and support resources, few people who are suffering from a substance use disorder seek help. Reluctance to seek help has been attributed to the stigma often attached to the condition. So, in an effort to address this problem, researchers at Drexel University are raising awareness of the stigmatizing language present in online forums and they have created an artificial intelligence tool to help educate users and offer alternative language.

Presented at the recent Conference on Empirical Methods in Natural Language Processing (EMNLP), the tool uses large language models (LLMs), such as GPT-4 and Llama to identify stigmatizing language and suggest alternative wording — the way spelling and grammar checking programs flag typos.

“Stigmatized language is so engrained that people often don’t even know they’re doing it,” said Shadi Rezapour, PhD, an assistant professor in the College of Computing & Informatics who leads Drexel’s Social NLP Lab, and the research that developed the tool. “Words that attack the person, rather than the disease of addiction, only serve to further isolate individuals who are suffering — making it difficult for them to come to grips with the affliction and seek the help they need. Addressing stigmatizing language in online communities is a key first step to educating the public and reducing its use.”

According to the Substance Abuse and Mental Health Services Administration, only 7% of people living with substance use disorder receive any form of treatment, despite tens of billions of dollars being allocated to support treatment and recovery programs. Studies show that people who felt they needed treatment did not seek it for fear of being stigmatized.

“Framing addiction as a weakness or failure is neither accurate nor helpful as our society attempts to address this public health crisis,” Rezapour said. “People who have fallen victim in America suffer both from their addiction, as well as a social stigma that has formed around it. As a result, few people seek help, despite significant resources being committed to addiction recovery in recent decades.”

Awareness of stigma as an impediment to treatment has grown in the last two decades. In the wake of America’s opioid epidemic — when strategic, deceitful marketing, promotion and overprescription of addictive painkillers resulted in millions of individuals unwittingly becoming addicted — the general public began to recognize addiction as a disease to be treated, rather than a moral failure to be punished — as it was often portrayed during the “War on Drugs” in the 1970s and ‘80s.

But according to a study by the Centers for Disease Control and Prevention, while stigmatizing language in traditional media has decreased over time, its use on social media platforms has increased. The Drexel researchers suggest that encountering such language in an online forum can be particularly harmful because people often turn to these communities to seek comfort and support.

“Despite the potential for support, the digital space can mirror and magnify the very societal stigmas it has the power to dismantle, affecting individuals’ mental health and recovery process adversely,” Rezapour said. “Our objective was to develop a framework that could help to preserve these supportive spaces.”

By harnessing the power of LLMs — the machine learning systems that power chatbots, spelling and grammar checkers, and word suggestion tools— the researchers developed a framework that could potentially help digital forum users become more aware of how their word choices might affect fellow community members suffering from substance use disorder.

To do it, they first set out to understand the forms that stigmatizing language takes on digital forums. The team used manually annotated posts to evaluate an LLM’s ability to detect and revise problematic language patterns in online discussions about substance abuse.

Once it has able to classify language to a high degree of accuracy, they employed it on more than 1.2 million posts from four popular Reddit forums. The model identified more than 3,000 posts with some form of stigmatizing language toward people with substance use disorder.

Using this dataset as a guide, the team prepared its GPT-4 LLM to become an agent of change. Incorporating non-stigmatizing language guidance from the National Institute on Drug Abuse, the researchers prompt-engineered the model to offer a non-stigmatizing alternative whenever it encountered stigmatizing language in a post. Suggestions focused on using sympathetic narratives, removing blame and highlighting structural barriers to treatment.

The programs ultimately produced more than 1,600 de-stigmatized phrases, each paired as an alternative to a type of stigmatizing language.

destigmatized text

Using a combination of human reviewers and natural language processing programs, the team evaluated the model on the overall quality of the responses, extended de-stigmatization, and fidelity to the original post.

“Fidelity to the original post is very important,” said Layla Bouzoubaa, a doctoral student in the College of Computing & Informatics who was a lead author of the research. “The last thing we want to do is remove agency from any user or censor their authentic voice. What we envision for this pipeline is that if it were integrated onto a social media platform, for example, it will merely offer an alternate way to phrase their text if their text contains stigmatizing language towards people who use drugs. The user can choose to accept this or not. Kind of like a Grammarly for bad language.”

Bouzoubaa also noted the importance of providing clear, transparent explanations of why the suggestions were offered and strong privacy protections of user data when it comes to widespread adoption of the program.

To promote transparency in the process, as well as helping to educate users, the team took the step of incorporating an explanation layer in the model so that when it identified an instance of stigmatizing language it would automatically provide a detailed explanation for its classification, based on the four elements of stigma identified in the initial analysis of Reddit posts.

“We believe this automated feedback may feel less judgmental or confrontational than direct human feedback, potentially making users more receptive to the suggested changes,” Bouzoubaa said.

This effort is the most recent addition to the group’s foundational work examining how people share personal stories online about experiences with drugs and the communities that have formed around these conversations on Reddit.

“To our knowledge, there has not been any research on addressing or countering the language people use (computationally) that can make people in a vulnerable population feel stigmatized against,” Bouzoubaa said. “I think this is the biggest advantage of LLM technology and the benefit of our work. The idea behind this work is not overly complex; however, we are using LLMs as a tool to reach lengths that we could never achieve before on a problem that is also very challenging and that is where the novelty and strength of our work lies.”

In addition to making public the programs, the dataset of posts with stigmatizing language, as well as the de-stigmatized alternatives, the researchers plan to continue their work by studying how stigma is perceived and felt in the lived experiences of people with substance use disorders.

In addition to Rezapour and Bouzoubaa, Elham Aghakhani contributed to this research.

Read the full paper here: https://aclanthology.org/2024.emnlp-main.516/

This is an RTE component

Contact: Britt Faulstick –

Filed under: Addiction,Cannabis/Marijuana,Culture,Education,Health,Prevention and Intervention,Social Affairs,USA,Youth :

Source : https://marijuanahealthreport.colorado.gov/literature-review/evidence-statements May 2018

Filed under: Cannabis/Marijuana,Health :

EXECUTIVE HIGHLIGHTS
Today’s highly potent marijuana represents a growing and significant threat to public health and safety, a threat that is amplified by a new
marijuana industry intent on profiting from heavy use.
State laws allowing marijuana sales and consumption have permitted the marijuana industry to flourish, and in turn, the marijuana industry has influenced both policies and policy-makers. While the consequences of these policies will not be known for decades, early indicators are
troubling.
This report, reviewed by prominent scientists and researchers, serves as an evidence-based guide to what we currently observe in various states. We attempted to highlight studies from all the “legal” marijuana states (i.e., states that have legalized the non-medical use of marijuana). Unfortunately, data does not exist for several “legal” states, and so this document synthesizes the latest research on marijuana impacts in states where information is available

For more information please read the full information below:

2019LessonsFinal

Source: https://learnaboutsam.org/wp-content/uploads/2019/07/2019LessonsFinal.pdf July 2019

Filed under: Cannabis/Marijuana,Drug use-various effects,Economic,Global Drug Legalisation Efforts,Health,Political Sector,USA :

Attached is a submission from Professor Stuart Reece to the Food and Drug Administration in USA for forwarding to the World Health Organization relating to the re-scheduling of cannabis

FDA Federal Register Submission for WHO Review and Consideration – Colorado Teratogenicity Patterns Illustrated

Email from Stuart Reece April 2018

Filed under: Cannabis/Marijuana,Drug use-various effects on foetus, babies, children and youth,Genes,Global Drug Legalisation Efforts,Health,Political Sector,Social Affairs :

The Pennsylvania State University Oct 12 2024

Students who feel a sense of belonging at their university are more likely to binge drink than those who do not feel the same connection, according to a new study by researchers at Penn State, the University of California, Santa Cruz and University of Oregon.

In the study, published in the Journal of Studies on Alcohol and Drugs, scientists -; including researchers in the Penn State College of Health and Human Development -; found that college students with “good” mental health who felt connected to their university were more likely to binge drink than those who did not feel as connected to their university.

Stephane Lanza, professor of biobehavioral health and Edna P. Bennett Faculty Fellow in Prevention Research, studied the topic with Danny Rahal and Kristin Perry when both were postdoctoral trainees in the Penn State Prevention and Methodology Training Program. The researchers examined the ways that both positive and negative aspects of mental health can contribute to the risk of binge drinking, cannabis use and nicotine use.

“In 2021, students at many universities were returning to campus after the COVID-19 shutdown -; and some students were attending in-person college classes for the first time,” said Rahal, lead author of this research and assistant professor of psychology at University of California Santa Cruz.

Data from that time indicated that many students felt disconnected from their school. Universities wanted to foster a sense of connectedness among their students for many good reasons, but we wanted to know if there was something positive -; specifically a sense of belonging -; that is related to substance use. Our study showed that feeling connected to one’s university is associated with higher rates of substance use.”

Danny Rahal, The Pennsylvania State University

The researchers examined data from 4,018 university students collected during the 2022-23 school year. Participants answered questions about substance use, their sense of belonging at their school and their mental health -; specifically about anxiety, depressive symptoms, perceived stress, flourishing in life and confidence in their academic success.

A statistical modeling technique called latent profile analysis allowed the researchers to simultaneously account for all these measures by combining them to identify five profiles of student mental health. In this study, a student was considered to have good mental health if they had lower levels of stress, depressive symptoms and anxiety, as well as higher flourishing and academic confidence than their peers.

The researchers found that students with average or good mental health were more likely to have engaged in binge drinking in the past month if they felt connected to their university than if they did not feel that connection.

The researchers said this does not mean that connectedness is bad for students to experience; rather, the results are nuanced.

“We want to cultivate connectedness among students,” said Perry, assistant professor of family and human services at University of Oregon. “Connectedness gets them involved. It can be a really powerful protective factor against negative mental health outcomes and can help keep students in school. But connectedness at school can go hand in hand with binge drinking if there is a culture of drinking at the school.”

Though the researchers said they expected these results about drinking, they were surprised to learn that students with poor mental health who felt connected to their university were more likely to use non-vaped tobacco products than students with poor mental health who did not feel connected to their university. The results around cannabis were less conclusive, but the researchers said the trend was clear.

“Generally, students who felt connected to their university were more likely to use substances than disconnected students with the same level of mental health,” Rahal said.

While a sense of belonging was related to substance use, it could also be part of the solution, according to the researchers.

“Cultivating belonging for all students is an important way that universities can embrace diversity and help all students thrive,” Lanza said.

Though drinking is common on university campuses, many students believe that it is far more common than it is, the researchers explained. In this dataset, slightly fewer than one-third of students reported binge drinking in the last month. Despite the fact that two-thirds of students had not engaged in binge drinking, the researchers also found that students believed a typical student consumed three to five drinks multiple times each week. The researchers said this disconnect between perception and reality points to an opportunity to change the culture -; by creating ample opportunities for all students to socially engage and participate in alcohol-free environments -; so that alcohol feels less central to student life.

Minoritized college students, in particular, often face messages that make them feel unwelcome based on their race, gender, socioeconomic status or other factors, according to the researchers.

“We cannot expect students to stay enrolled unless they are engaged with the campus community,” Lanza continued. “If universities lose students from a specific group, the campus becomes less diverse, and the entire university community becomes less rich. Additionally, when members of those groups leave school, they miss educational opportunities and the earning potential that comes with a college degree. By providing all students with diverse opportunities to build a real sense of belonging at their universities, we can improve campus life while putting people on the path to a healthier life.”

The National Institute on Drug Abuse and Penn State funded this research.

Source: https://www.news-medical.net/news/20241012/New-research-explores-how-campus-belonging-impacts-binge-drinking-and-substance-use.aspxThe Pennsylvania State University

Filed under: Addiction,Alcohol,Education,Health,Mental Health,USA,Youth :

By Ian Webster Oct 28, 2024

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

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

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

Do summits achieve worthwhile outcomes?

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

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

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

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

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

Contemporary drug problems

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

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

NSW Ice Inquiry

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

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

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

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

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

Will the Summit achieve?

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

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

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

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

What will not be achieved

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

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

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

Kind Regards

Herschel Baker

Source: Drug Free Australia

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

Washington, D.C. – Today, White House Office of National Drug Control Policy (ONDCP) Director Dr. Rahul Gupta released the following statement on the latest provisional data from the Centers for Disease Control and Prevention (CDC), showing drug overdose deaths decreased by 12.7% year-over-year (in the 12-months ending May 2024). This is the largest recorded reduction in overdose deaths, and the sixth consecutive month of reported decreases in predicted 12-month total numbers of drug overdose deaths.

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

Source: https://www.whitehouse.gov/ondcp/briefing-room/2024/10/16/white-house-drug-policy-director-statement-on-latest-drug-overdose-death-data/

Filed under: Drug use-various effects,Health,Treatment and Addiction,USA :

Source: https://static1.squarespace.com/static/599a426ee45a7ccab72c77d2/t/5f3ad99ce4a6280272c97cb6/1597692318766/Marijuana_%2BA%2Bman%2Bmade%2Bdisaster.pdf April 2018

Filed under: Brain and Behaviour,Cannabis/Marijuana,Crime/Violence/Prison,Drug use-various effects,Drug use-various effects on foetus, babies, children and youth,Economic,Environment,Health :

Manuel Balce Ceneta/Associated Press by CARMEN PAUN – 10/27/2024 04:00 PM EDT

Traffickers are to blame, the candidates say. Virtually no one’s talking about treatment.

The Harris and Trump campaigns said the presidential candidates are talking about drug treatment, albeit more quietly than they are border security. |

There’s a rare point of agreement among Republican and Democratic candidates this election year: America has a drug problem and it’s fentanyl traffickers’ fault.

Republicans, including former President Donald Trump, are hammering Democrats over border policies they say have allowed fentanyl to surge into the country. Democrats, including Vice President Kamala Harris, respond that they, too, have cracked down on traffickers and want stricter border enforcement.

The consensus reflects the resonance of border control among voters — most of the country’s fentanyl comes from Mexico — and a hardening of the nation’s attitude toward addiction. Troubled by drug use, homelessness and crime, voters even in the country’s most progressive states favor cracking down. Politicians from Trump and Harris on down the ballot say they will.

“It’s one of those things that people don’t want in their community,” said Rep. Jahana Hayes, a Democrat running for a fourth term representing a district including suburbs of Hartford, Connecticut, and rural areas to their west, of illicit drugs. “They want a tough-on-crime stance on it. They want it to go away. They’re afraid for their families, they’re afraid for their children.”

That view worries public health experts and treatment advocates, who see a backsliding toward the law enforcement focus that once looked futile in the face of Americans’ insatiable appetite for drugs. They fear it bodes ill for additional efforts from Washington to expand addiction care.

“There are a lot of things that both parties can point to, as far as progress that’s been made in addressing overdoses: We’ve seen bipartisan efforts to expand access to treatment, to expand access to health services for people who use drugs, and I wish they would talk about that more,” said Maritza Perez Medina, federal affairs director at Drug Policy Action, an advocacy group that opposes the law enforcement-first approach.

Six years ago, when a bipartisan majority in Congress passed the SUPPORT Act to inject billions of dollars into treatment and recovery services, and then-President Trump signed it, the vibes in Washington around drug use were more empathetic.

President Donald Trump declared the opioid crisis a nationwide public health emergency in October 2017. | Brendan Smialowski/AFP via Getty Images But after it passed, fatal drug overdoses driven by illicit fentanyl skyrocketed, hitting a record 111,451 in the 12 months ending in August 2023 before starting to recede. Homelessness, sometimes tied to drug addiction, also spiked.

When the SUPPORT Act came up for renewal last year, Congress wasn’t as motivated. The Democratic Senate hasn’t voted on a bill, while a House-passed measure from the chamber’s GOP majority offers few new initiatives and no new money.

Attitudes are similar in the states. Oregon, where voters legalized drugs for personal use in 2020, reimposed criminal penalties this year after its largest city, Portland, was overrun with homeless drug users. Polls indicate California voters, frustrated, too, by homelessness and crime, are likely to boost penalties for drug users by ballot initiative next month.

Candidates aim to prove they share voters’ frustration.

Republicans have spent more than $11 million on TV ads in the past month attacking Democratic opponents on fentanyl trafficking, according to a tally by tracking firm AdImpact. And Democrats have spent nearly $18 million defending themselves, mostly by highlighting their efforts or plans to provide more resources and personnel to combat trafficking.

“It’s an easy shortcut in a 30-second commercial to tie a broader issue to one that has an easy explanation,” said Erika Franklin Fowler, a professor of government at Wesleyan University who directs a project analyzing political advertising.

Trump’s not talking about the SUPPORT Act, one of his most consequential legislative successes. Vice President Kamala Harris is not touting the treatment policies of the president she serves, Joe Biden, who expanded access to medications that help people addicted to fentanyl, as well as to drugs that can reverse overdoses. Some public health specialists credit increased access to the drugs with reducing overdose death rates in the past 12 months after years of grim ascent.

Trump used his first anti-Harris ad this summer to blame her for the more than 250,000 deaths from fentanyl during the Biden-Harris administration.

Vice President Kamala Harris met state attorneys general in July 2023 to discuss possible actions against fentanyl. | Saul Loeb/AFP via Getty Images Harris responded by touting her prosecution of drug traffickers when she was California’s attorney general and a promise to strengthen the border.

“Here’s her plan,” a deep-voiced narrator intoned in Harris’ ad: “Hire thousands more border agents, enforce the law and step up technology — and stop fentanyl smuggling.”

‘A political cudgel’

Similar attacks and responses have played out in Senate and House races across the country.

In the tight Arizona race to replace Sen. Kirsten Synema (I-Ariz.), Republican Kari Lake has accused her opponent, Democratic Rep. Ruben Gallego, of empowering drug cartels to import fentanyl by supporting Biden-Harris administration border policies.

“We’re losing an entire generation of people, and you should know better, Ruben,” Lake told Gallego in a debate earlier this month, referencing the deaths of teens who took counterfeit pills laced with fentanyl.

Gallego, who was elected to Congress in 2014 as a progressive but has shied from that label in his Senate run, responded by touting bills he’s supported or introduced to fund more technology at the border and track fentanyl money flows across Mexico and China, where chemicals to make the drug are manufactured.

A mother visit her son’s grave, who died of a fentanyl overdose at 15. | Jae C. Hong/AP In Colorado’s hotly contested 8th congressional district, which encompasses Denver suburbs and rural areas to the north, Republican state Rep. Gabe Evans has blamed the incumbent, Democrat Yadira Caraveo, for the fentanyl crisis.

“This is our reality now: a 100 percent increase in fentanyl deaths because liberals open the border, legalize fentanyl and let criminals out of jail,” says a police officer in an ad for Evans. “And Yadira Caraveo voted for it all,” Evans adds.

Caraveo defended herself in a debate with Evans earlier this month, noting the bill he’s referring to was state legislation that “tried to balance the need to punish drug dealers and cartels but not incarcerate every single person that is addicted.”

In Connecticut, the National Republican Congressional Committee attacked Hayes for voting against a bill to permanently subject fentanyl to the strictest government regulation, reserved for those drugs with high likelihood of abuse and no medical uses.

Hayes said she opposed the bill because it included mandatory minimum prison sentences for people caught with drugs and no provisions supporting prevention, treatment or harm reduction.

“I hate that this is being used as a political cudgel because we’re missing out on an opportunity to say: ‘How do we address the root causes?’” Hayes said in an interview.

Hayes said she has responded to the attacks on the campaign trail and talked to constituents about the need for treatment, despite some advice to the contrary.

“Even amongst Democrats, there were people who were like: ‘You don’t want the headache, you don’t want people to think that you’re soft on crime or soft on drugs.’ And I was like: ‘This has to be about more than optics if we truly are trying to save people’s lives,’” Hayes said. ‘If we don’t keep the momentum going’

Oregon, where voters legalized drugs for personal use in 2020, reimposed criminal penalties this year after its largest city, Portland, was overrun with homeless drug users. | Patrick T. Fallon/AFP via Getty Images The lesson the Drug Policy Action’s Medina takes from the campaigns is that talking about drug treatment doesn’t sell in American politics.

“People are struggling. Social services aren’t where they need to be, health services aren’t where they need to be,” she said. “It’s easier to run a fear-based campaign rather than talking about really tough issues,” like breaking the cycle of addiction.

Ironically, the tough talk on the border comes as policymakers, for the first time in years, have evidence that the tide of fatal drug overdoses is receding.

The CDC estimates that overdose deaths, most caused by fentanyl, declined by nearly 13 percent between May 2023 and May 2024, to just under 100,000.

Harris’ running mate, Tim Walz, mentioned the dip during his debate with Trump’s vice-presidential pick, JD Vance, earlier this month.

The number is now about where it was when Biden took office, though still 50 percent higher than when Trump did in January 2017.

Expanding access to treatment, the Food and Drug Administration’s decision to make the opioid-overdose-reversal medication naloxone available over the counter last year, increased fentanyl seizures at the border, and the arrest and sanctioning of Mexican drug cartel leaders have contributed to the recent drop, Biden said last month.

Advocates for drug treatment say that’s all good cause for candidates to tout their access-to-treatment efforts and promise to expand them.

“The worst outcome for overdose prevention coming out of this election would be if we don’t keep the momentum going,” said Libby Jones, who leads the Overdose Prevention Initiative, an advocacy group.

But there’s not the groundswell of interest on Capitol Hill that there was in 2018, when Congress passed the SUPPORT Act.

Congress has continued to fund opioid treatment authorized in that law, but it mostly hasn’t taken the law’s 2023 expiration as an opportunity to increase funding or try big new ideas.

The Food and Drug Administration decision to make the opioid-overdose-reversal medication naloxone available over the counter last year has contributed to a drop in fatal overdoses over the past year, President Joe Biden said last month. | Diane Bondareff/AP The 2024 federal funding law Congress passed in March included some minor changes in the form of bipartisan legislation to require state Medicaid plans to cover medication-assisted treatment for substance use disorder. It also created a permanent state Medicaid option allowing treatment of substance use disorder at institutions that treat mental illness, in an effort to expand access to care.

But bipartisan legislation approved by the Senate committee responsible for health care to make it easier for others to gain access to methadone, a drug effective in helping fentanyl users, hasn’t gone to the floor and faces opposition from key Republicans in the House.

The Harris and Trump campaigns said the presidential candidates are talking about drug treatment, albeit more quietly than they are border security.

Vice President Harris’ campaign pointed to her web site, where she touts her prosecution of drug traffickers and the Biden-Harris administration’s investment in “lifesaving programs.”

Republican National Committee spokesperson Anna Kelly said “President Trump is uniquely able to connect with families combating addiction,” pointing to times when he’s talked about his brother’s struggles with alcohol use disorder and to his administration’s efforts to contain the opioid crisis.

But she added that the tough talk on the border is relevant: “Combating fentanyl is a public health issue and stopping it begins with securing the border.”

Source: https://www.politico.com/news/2024/10/27/fentanyl-drugs-elections-00185576

Filed under: Drug use-various effects,Economic,Health,Political Sector,Prevention and Intervention,Treatment and Addiction,USA :

“Smart Choices, Safe Workplaces: Educate on Drug Risks”
National Drug Free Work Week 2024

This file was produced in relation to Join the National Drug Free Workplace Alliance (NDWA) in recognizing the Drug Free Work Week 2024 which ran from October 14th through 18th!

Check out these resources that provide essential information on the effects of various drugs and their potential impact on workplace dynamics and safety. Each resource breaks down the signs, symptoms, and behavioral changes associated with substance misuse, helping you recognize warning signs early. With this knowledge, you can better protect and support your employees, fostering a healthy work environment where risks are minimized, and everyone feels valued and safeguarded. These one-pagers are also a useful tool for reinforcing drug-free policies and engaging employees in health and wellness conversations. Resources can be found here.

NATIONAL DRUG-FREE WORKPLACE ALLIANCE

For more information and drug-free workplace resources, visit NDWA at www.ndwa.org.

Source: www.dfaf.org

Filed under: Drugs and Accidents,Education,Health,USA,Workplace :

Summary

Federal and state governments impose restrictions on both physician and non-physician opioid prescribers
To dispense opioids, federal law requires licensed physicians to register with DEA, have an active license, and fulfill educational and training requirements
All states have licensing and registration requirements for providers who prescribe opioids

To help combat the ongoing opioid crisis, the federal government and many state governments have enacted statutes to help health care practitioners, including physicians, qualified NPPs, such as nurse practitioners and physician assistants (PAs), and health care facilities, respond to OUDs. These statutes establish protocols for handling pain management and OUDs, which address, among other things, treatment plans and the relationship between health care providers and patients.

This article highlights key federal and state legislation governing health care practitioners and facilities treating patients with opioids for pain management and OUDs, focusing on states with greater opioid misuse.

Source: https://www.reuters.com/practical-law-the-journal/legalindustry/opioid-crisis-issues-health-care-providers-2024-11-01/

Filed under: Health,Heroin/Methadone,USA :

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

Marsha F. Lopez, Ph.D., M.H.S. marsha.lopez@nih.gov, MeLisa R. Creamer, Ph.D., M.P.H., and Erin M. Parker, Ph.D.Authors Info & Affiliations Publication: FOCUS – Volume 22, Number 4 Published Online: 15 October 2024

Abstract

In the 50 years since its establishment, the National Institute on Drug Abuse has made significant investment and strides toward improving individual and public health. Epidemiology serves as the foundation for understanding the how many, why, how, where, and who of drug use and its consequences, and effective epidemiology research and training are geared toward actionable findings that can inform real-world responses. Epidemiologic findings enhance clinicians’ ability to provide ongoing care by incorporating information about the patterns and outcomes of drug use that their patients may experience. The goal of this article is to provide a context for epidemiology of substance use as a foundation for prevention, with examples of how epidemiology can provide targets for prevention, and to set the stage for addressing the importance of prevention in clinical settings.

Source: https://psychiatryonline.org/doi/10.1176/appi.focus.20240018

Filed under: Health,Prevalence,Prevention and Intervention,USA :

Prevention typically consists of methods or activities that seek to reduce or deter specific or predictable problems. It protects individual well-being and promotes desired behaviors.

Education is a key element of prevention. To understand how to contribute to the prevention of substance use disorders, all individuals need to know two important facts:

Substance use disorders are diseases. They are progressive, chronic, and fatal. They are classified as primary diseases, meaning they are caused by something else, such as an emotional problem or poor choices. Substance use disorders are medical conditions of the brain.

Substance use disorders are treatable. Just as heart disease or diabetes can be treated, so can substance use disorders. In addition to medication, effective treatments usually involve therapy and connecting to community support.

Sharing these facts helps remove stigma around substance use and makes people more comfortable talking about it. This opens up opportunities to:

Increase collaboration among state agencies, community organizations, and special populations
Develop culturally appropriate strategies and implement plans to reduce risks and increase protective factors across the state and in specific communities
Expand citizen participation in community activity

The most promising way to reduce alcohol and drug problems is to use a comprehensive, multi-faceted approach to prevention. There are evidence-based tools that organizations and communities can use to guide these efforts. For example, organizations that adopt a Strategic Prevention Framework and develop logic models are more likely to achieve positive outcomes.

Experts Dedicated to Building Healthy Communities

The RAAD campaign is coordinated by DAABHS (rhymes with “abs”). That’s our abbreviated way of saying the Arkansas Department of Human Services Division of Aging, Adult and Behavioral Health Services the Substance Abuse Prevention team.

The DAABHS team is passionate about uniting individuals and communities in prevention efforts. Each member of the team contributes unique skills and energy to advance the RAAD mission.

They are receptive to questions and ideas and can connect you to existing programs or provide guidance to help you launch new prevention initiatives in your area.

Source: https://humanservices.arkansas.gov/divisions-shared-services/shared-services/office-of-substance-abuse-and-mental-health/prevention-ar/

Filed under: Education,Health,Prevention and Intervention,USA :

Overview

In recent years, police forces in England and Wales have worked more closely with health, education and other local partners to address social issues, such as drug use, youth violence and people in mental health crisis.[1] This aims to ensure that vulnerable people are supported by the most appropriate professional, and that certain complex social issues are not automatically met with a criminal justice response.

These initiatives are sometimes referred to as public health approaches to policing.[2] They can include interventions aimed at preventing offending altogether (for example, early years school-based programmes), as well as ones covering offenders or people coming into contact with the police.^[3]

In 2018, organisations representing public health bodies, health services, voluntary organisations and police forces signed an agreement to work more closely together to prevent crime and protect the most vulnerable people in England.^[4] Public Health Scotland and Police Scotland announced a formal collaboration in 2021.[5] In 2019, Public Health England and the College of Policing published a discussion paper on public health approaches to policing,^[6] and the Association of Police and Crime Commissioners issued guidance in 2023 to support implementation of such approaches.³

Research has found that cooperation between police and health services can help to improve social outcomes. For example:

a 2017 study in the USA suggested that health services and police forces have worked effectively together to improve police responses to mental health-related encounters^[7]
research in 2017 highlighted international examples of how formal collaboration between criminal justice and public health agencies helped to reduce youth violence[8]
a 2022 study found that nurses and police officers could develop collaborative teamwork practices in police custody suites in England^[9] ^[10]

There are examples of police forces working with health partners and other agencies to improve responses to vulnerable people in England and Wales:

Under drug diversion schemes, police refer people caught in possession of small quantities to voluntary sector treatment services, rather than prosecute for a possession offence. As of 2024, diversion schemes were operating in Thames Valley,^[11] West Midlands,^[12] and Durham police force areas.[13] The College of Policing and the University of Kent have received funding to evaluate these schemes, which is expected to be completed in 2025.^[14]
The Right Care, Right Person model aims to reduce the deployment of police to incidents related to mental health and concern for welfare, and instead ensure that people receive support from the most appropriate health or social care professional. Humberside Police developed the model, which includes training for police staff and partnership agreements between police, health and social services.^[15] From 2023, police forces nationally were beginning to adopt it, with support from the National Police Chiefs’ Council and the College of Policing.[16]
Violence Reduction Units (VRUs) bring together police, local government, health and education professionals, community groups and other stakeholders to provide a joint response to serious violence, including knife crime. The London Mayor’s Office for Policing and Crime established the first VRU in England and Wales in 2019. It states that it takes a public health approach to violence prevention,^[17] including deploying youth workers in hospitals and police custody suites.^[18] Between 2019 and 2022, the government funded 20 VRUs across England and Wales.[19] In 2019, the government provided funding for the Youth Endowment Fund, which funds and evaluates programmes in England and Wales that aim to prevent children and young people from becoming involved in violence.^[20]

Since 2020, Scotland has seen increasing use of diversion from prosecution schemes.[21] In October 2024, the UK’s first official consumption facility for illegal drugs, including heroin and cocaine, was opened in Glasgow.[22]

Challenges and opportunities

In 2023, HM Inspectorate of Constabulary and Fire & Rescue Services noted how police forces were often the “service of last resort” doing the work of other public services, especially with regards to mental ill health.[23] For some vulnerable people, police custody may provide their only space for healthcare interventions.¹⁰ Both police forces and voluntary organisations suggest that, at a time when police capacity is under pressure, public health approaches can reduce the amount of time police officers spend dealing with people with complex health needs, who may be referred to other health, care or support services.^[24]^,[25] However, this can also lead to demand and capacity pressures being displaced onto these services.

For example, drug diversion schemes may increase the demand on local drug treatment services, which themselves are facing significant pressures. In her independent review of drugs for the government in 2021, Dame Carol Black raised significant concerns about the capacity and resourcing of drug treatment services in England, and the impact of funding reductions.^[26] The Criminal Justice Alliance has called for increased funding for local drug services, to accommodate people being diverted away from the criminal justice system.[27]

The government’s 10-year drug strategy (2021) committed to invest £533 million into local authority commissioned substance misuse treatment services in England from 2022/23 to 2024/25, as part of its aim to “rebuild local authority commissioned substance misuse treatment services in England”.^[28] In 2023, the Home Affairs Committee called for all police forces in England and Wales to adopt drug diversion schemes.^[29] It also expressed concern about the long-term sustainability and security of funding for the drug treatment and recovery sector.²⁶

Similar pressures in mental health services have led to concerns about the safety of the national rollout of Right Care, Right Person. In November 2023, the Health and Social Care Committee identified urgent questions around the available funding for health services, and the lack of evaluation, in the rollout of the scheme[30] The Royal College of Psychiatrists and the Royal College of Nurses agreed that people with mental illness should be seen as quickly as possible by a mental health professional.^[31]^,[32] However, they and other health, local government, and mental health charities, have expressed several concerns about the programme. These include: the speed and consistency of implementation, lack of funding, the potential for gaps in provision, and increased welfare risks.^[33]^{,[34],[35],[36]}

Key uncertainties/unknowns

Outside the UK, some public health approaches have involved a significant shift away from enforcing drug possession for personal use through the criminal justice system.^[37] For example:

Portugal decriminalised possession of drugs for personal use in 2001 and instead refers drug users to support and treatment.^[38] Analysis of these measures from researchers and policy experts suggests decriminalisation led to reductions in problematic use, drug-related harms and criminal justice overcrowding.³⁸^,[39]
In the USA, Oregon trialled a policy in 2020 making drug possession a fineable offence.^[40]
In Canada, British Columbia trialled an approach in 2023 that decriminalised possession of small amounts of certain drugs for personal use in specific non-public locations.[41]

Citing international examples, some drug policy experts have called on the government to go further in its adoption of a public health approach to drug use.³⁷ The Home Affairs Committee stated in 2023 that the government’s drug strategy should have adopted a broader public health approach, and called for responsibility for misuse of drugs to be jointly owned by the Home Office and Department of Health and Social Care.²⁶ In 2019, the Health and Social Care Committee recommended the government shift responsibility for drugs policy from the Home Office to the Department of Health and Social Care, and for the government to “look closely” at the Portugal model for decriminalisation of drug possession for personal use.^[42]

However, Portugal’s approach has also faced criticism. For example, a research review in 2021 highlighted continued social and political resistance to some of the measures 20 years after being introduced.^[43] A 2023 editorial in the Lancet highlighted how a recent rise in the use of illicit drugs in Portugal had led to renewed criticism of the policy.^[44] More recently, some states in North America have reversed decriminalisation policies, reportedly due to adverse consequences of drug decriminalisation.³³^,[45], [46]

This points to a mixed evidence base internationally for a fully public health approach to drug use. However, it may be difficult to compare international examples, given the different models of decriminalisation that have been adopted, and in a variety of social, economic, political and legal systems.^[47]

Key questions for Parliament

Should the government do more to support the implementation of public health approaches to policing across England and Wales, considering both the police, and health, care and other local services?
Should the police continue to implement the Right Care, Right Person model? Do mental health services have sufficient resource and capacity to bridge the gap?
Should drug diversion schemes be rolled out across England and Wales? Do drug treatment services have sufficient capacity and resource to respond to increased demand on services?
Should the government go further in taking a public health approach to drugs by decriminalising drug possession for personal use?
How effective have government measures to reduce youth violence been?
What international comparisons are useful for implementation of public health approaches to policing?

Source: DOI: https://doi.org/10.58248/HS62

Filed under: Crime/Violence/Prison,Health,Mental Health,Prevention and Intervention,Social Affairs,Treatment and Addiction,UK :

Photo: © Francis Odeyemi

Torrential rains last week caused a dam to collapse and flood north-east Nigeria, affecting more than four million people in 14 countries. Over 550,000 hectares of cropland were flooded, compounding an existing food security crisis.

“I have never in my life experienced a disaster as terrible as this,” writes Yakura*, a UN Office on Drugs and Crime (UNODC) Youth Peace Champion. Youth Peace Champions are a network of young leaders dedicated to promoting prevention, rehabilitation and reintegration for children affected by adversity.

Yakura is one of tens of thousands of young people taking action in their communities, organizing rescue efforts and distributing essential food and water supplies.

“So many souls lost, so many properties destroyed. But one thing we still have is our resilience. Our resilience shines through even in the face of adversity,” she continues.

But where do resilience and adaptability come from? How can we unlock brain science to leverage the powers of youth creativity and cooperation and overcome the multiple crises faced by Yakura’s community and millions of other young people?

The European Brain Council and partner organizations, including UNICEF and UNODC, are joining forces to explore the ways in which brain health and brain science can reshape and improve policy and practice to support the advancement of humanity and the planet. The two entities are co-sponsoring a two-day summit, held from 19 to 20 September at the 79^th UN General Assembly, on adolescent brain development and systemic policy change.

A series of UNODC-UNICEF papers being launched at the summit combine neuroscience and mental health research with data; exploration of community-driven innovations; and voices of youth such as Yakura’s from the frontline of climate change, violence and inequality. The papers highlight the potential that scientific understanding of the adolescent brain has for advancing policy change and protecting and uplifting vulnerable children and adolescents.

As Dr. Joanna Lai, Health Specialist at UNICEF explains: “Adolescents are full of potential but at the same time uniquely vulnerable, especially when faced with adverse experiences. To uplift them, we are advocating for policy and practice change across sectors that is based on a deep understanding of their development, ensuring timely, empathetic, and empowering intervention.”

Support in adversity

As noted by Alexandra Martins, Global Team Leader, END Violence Against Children at UNODC and co-panelist at the joint session, such research is needed now more than ever: “Hundreds of millions of children and adolescents are not able to grow up in an environment that supports healthy development and protection¹. Every seven minutes, an adolescent dies as a result of violence. 15 to 19 year-olds are three times more likely to die violently than 10 to 14-year-olds. 15 million girls are victims of rape in their lifetime. At least 130 million adolescents, between the ages of 13 and 15, endure bullying in school. And we are not even accounting for the trauma being endured by young people affected by climate change and forced displacement.”

Chronic stress and violence can profoundly affect the development of the human brain, particularly during early childhood and teenage years. It may disrupt the developmental stages of neural networks; cause physical health degradation and brain aging; and modify learning and social connectedness. In the context of criminal justice and community safety, we know that children and adolescents who offend are disproportionately more likely to have experienced victimization and trauma.

But the adolescent brain, UNODC and UNICEF contend, is not only vulnerable to adversity and violence; it is also resilient, creative and flexible.

Adaptive and resilient – with the right support

As the UNODC-UNICEF papers highlight, adolescents’ brains are adaptive and young people are resilient problem-solvers when provided with the proper social support.Adolescents – be they survivors of adversity, violence or crime – can be co-authors and creative agents of policy change and innovation.

It is not only important to build awareness of the way in which adversity, violence and trauma negatively alter adolescent brain development but also to understand that the brain – especially the adolescent brain – is neither a static organ nor a fixed story. Science tells us that the adolescent brain has a unique and adaptive ability to rewire itself on the basis of its environment. A young person’s brain is particularly well-designed to rapidly forge new circuitry and behavioral pathways for resilience if health, education and justice systems provide the appropriate support.

Mohammed*, another Nigerian UNODC Youth Peace Champion, recently took part in an innovative peacebuilding training programme that combined neuroeducation with capacity building on the relationship between brain development, chronic stress, adversity and violence. “I was limited and could not see outside the box, but now I’m more open-minded and see things in better proportion,” he says. “I can now understand their [children’s] challenges and come up with a solution for them to be resilient and overcome their challenges and low self-esteem”.

“My rehabilitation and reintegration skills have been improved,” he continues. “I’m confident that within the context of insecurity, I can play a significant role in engaging with victims.”

Source: https://www.unodc.org/unodc/frontpage/2024/September/unlocking-the-science-of-adolescence-to-promote-effective-policy-and-practice.html

Filed under: Brain and Behaviour,Health,Mental Health,Others (International News),Youth :

By Sandee LaMotte, CNN / Sat August 10, 2024

Using marijuana daily for years may raise the overall risk of head and neck cancers three- to five-fold, according to a new study that analyzed millions of medical records.

“Our research shows that people who use cannabis, particularly those with a cannabis use disorder, are significantly more likely to develop head and neck cancers compared to those who do not use cannabis,” said senior study author Dr. Niels Kokot, a professor of clinical otolaryngology-head and neck surgery at the Keck School of Medicine at the University of Southern California in Los Angeles.

“While our study did not differentiate between methods of cannabis consumption, cannabis is most commonly consumed by smoking,” Kokot said in an email. “The association we found likely pertains mainly to smoked cannabis.”

Some 69% of people with a diagnosis of oral or throat cancer will survive five years or longer after their diagnosis, according to the National Cancer Institute. If the cancer metastasizes, however, that rate drops to 14%. About 61% of people diagnosed with cancer of the larynx will be alive five years later — a rate that drops to 16% if the cancer spreads.

The study used insurance data to look at the association of cannabis use disorder with head and neck cancers, said Dr. Joseph Califano, the Iris and Matthew Strauss Chancellor’s Endowed Chair in Head and Neck Surgery at the University of California, San Diego. He was not involved in the study.

“The researchers used a huge, huge dataset, which is really extraordinary, and there is enormous power in looking at numbers this large when we typically only see small studies,” said Califano, who is also the director of UC San Diego’s Hanna and Mark Gleiberman Head and Neck Cancer Center.

“On average, people with cannabis use disorder smoke about a joint today and do so for at least a couple years, if not longer,” said Califano, who coauthored an editorial published Thursday in JAMA Otolaryngology–Head & Neck Surgery in conjunction with the new study.

However, he added, the study does not find an association between “the occasional recreational use of marijuana and head and neck cancer.”

Just like tobacco, smoking marijuana raise the risk of head and neck cancers, experts say.

Causes of head and neck cancers

In the United States, head and neck cancers make up 4% of all cancers, with more than 71,000 new cases and more than 16,000 deaths expected in 2024, according to the National Foundation for Cancer Research.

Tobacco use, which includes smoking cigarettes, cigars, pipes and smokeless tobacco, and the use of alcohol are the two most common causes of head and neck cancers, experts say. Other risk factors include poor oral hygiene;gastroesophageal reflux disease, or GERD; a weakened immune system; and a diet low in fruits and vegetables. Occupational risk factors include exposure to asbestos and wood dust.

Epstein-Barr virus is linked to infectious mononucleosis, also called the “kissing disease,” as well as various cancers. Researchers estimate that 90% of the world’s population is infected with EBV. A vaccine is available for HPV, which is linked to a high risk of developing cervical cancer and some non-Hodgkin lymphomas.

It’s possible to be infected with both viruses at once, and that combination is responsible for 38% of all virus-associated cancers, according to research.

How might cannabis cause cancers?

The study, published Thursday in JAMA Otolaryngology–Head & Neck Surgery, analyzed a database of 4 million electronic health records and found more than 116,000 diagnoses of cannabis use disorder among people with head and neck cancers. Those men and women, whose average age was 46, were then matched with people who also had head and neck cancers but were not diagnosed with cannabis use disorder.

The analysis showed that people with cannabis use disorder were about 2.5 times more likely to develop an oral cancer; nearly five times more likely to develop oropharyngeal cancer, which is cancer of the soft palate, tonsils and back of the throat; and over eight times more likely to develop cancer of the larynx. The findings held true for all age groups, according to the study.

Due to the way marijuana is smoked — unfiltered and breathed in deeply and held in the lungs and throat for a few seconds — the risk from cannabis smoke could be even greater, experts say.

Another key to the puzzle of how cannabis causes cancer: Research has found a link between various cannabinoids and tumor growth. There are more than 100 cannabinoids — biological compounds in the cannabis plant that bind to cannabinoid receptors in the human body, according to the National Center for Complementary and Integrative Health. All told, there are about 540 chemicals in each marijuana plant.

Tetrahydrocannabinol, or THC, is the substance that makes one euphoric, while cannabidiol, or CBD, has been shown to have medicinal uses for childhood seizures and epilepsy.

“Part of the research we have already published shows that THC or THC-like compounds can certainly accelerate tumor growth,” Califano said. “We also have some data to show that cannabinoids enhance the growth of HPV-related throat cancers.”

“Especially as (marijuana) becomes more widely legalized and socially accepted, we may see a corresponding rise in head and neck cancer cases if the association is confirmed,” he said.

“This underscores the importance to inform people about the potential risks and conduct further research to understand the long-term impacts of cannabis use on cancer development.”

Source: https://edition.cnn.com/2024/08/08/health/marijuana-head-and-neck-cancer-wellness/index.html

Filed under: Cannabis/Marijuana,Drug use-various effects,Health,USA :

Published: August 11, 2024

Abstract

Shivering is a frequently encountered perioperative complication in patients undergoing spinal anesthesia. Numerous different pharmacological agents have been employed to mitigate this issue. This scoping review aims to evaluate the efficacy of ketamine in mitigating the incidence of shivering. This review process utilized PubMed, JAMA, and Cochrane as primary databases. Searches were performed using combinations of key terms: “Ketamine,” “Shivering,” “Spinal Anesthesia,” and “Hypothermia.” Reviews of reference lists for additional pertinent data were performed. When ketamine was compared against a saline control, three out of five studies found ketamine to be more effective (p < 0.05, p < 0.001, p < 0.001) in the prevention of shivering. When compared with tramadol, two studies found ketamine to be more effective (p < 0.001, p < 0.001), one found no difference (p = 0.261), and one found tramadol to be more effective (p < 0.001). Two studies found dexmedetomidine more effective (p < 0.022, p < 0.027) than ketamine and tramadol. When comparing ketamine, ondansetron, and meperidine, all three were effective (p < 0.001) versus saline, with no significant difference between the three. Meperidine demonstrated more efficacy (p < 0.05) in reducing the intensity of shivering than ketamine. Ketamine’s effects on hemodynamics were shown to be equivocal or more favorable across several studies. While there is mixed evidence on whether it is better than other treatments, ketamine may have advantages from a hemodynamic standpoint. Dosages of 0.2-0.5 mg/kg with or without a subsequent infusion of 0.1 mg/kg per hour may aid in the prevention of perioperative shivering. Overall, ketamine is a safe and effective drug for the prevention of perioperative shivering. However, other drugs may be equally or more effective; therefore, patient population, hemodynamic status, patient preferences, and provider familiarity with different agents should be considered.

Introduction & Background

Shivering is an involuntary somatic muscle response typically triggered by prolonged exposure to cold environments or fever to raise body temperature by generating heat through repetitive contraction of skeletal muscles. Shivering is primarily controlled by the median preoptic nucleus (MnPO) in the anterior thalamus of the brain which contains the central efferent pathways for cold-defensive and febrile shivering. Some common causes of shivering include movement disorders, excitement, fear, stress, tremors, low blood sugar, anxiety, fever, cold exposure, postanesthetic shivering, and shivering with spinal anesthesia.

Patients frequently experience shivering following surgery with general or spinal anesthesia. This shivering may be due to a natural thermoregulatory response to central hypothermia or as a result of the release of cytokines throughout the surgical process [1]. This is unpleasant for the patient and occurs following surgery in 30-65% of patients who have received general anesthetics [1].

The exact mechanism underlying post-spinal anesthesia shivering is not fully understood but may involve thermoregulatory responses to hypothermia, affecting neurons in specific brain regions. Shivering with spinal anesthesia is an involuntary, oscillatory muscular activity that significantly increases metabolic heat production by up to 600% and increases oxygen consumption up to 400% [2]. This may lead to arterial hypoxia and is associated with an increased risk to patients with myocardial infarction [1]. These sequelae of shivering may prolong post-operative recovery time and contribute to poor patient outcomes.

A variety of medications have been studied to prevent or treat post-anesthesia shivering; recent studies indicate ketamine shows promise in controlling shivering. Ketamine is a competitive N-methyl-D-aspartate (NMDA) receptor antagonist and is involved in the regulation of heat. As a NMDA agonist, it increases the rate of neuronal discharge in the anterior hypothalamic preoptic region modulating serotonergic and noradrenergic neurons in the locus coeruleus [3]. The mechanism of action by which ketamine controls shivering has yet to be determined, but it is believed that it regulates shivering by producing non-vibration-induced heat, acting on the hypothalamus and beta-adrenergic effects.

As there is not yet a determined most effective agent this scoping review of current literature was conducted to determine the benefits of ketamine in the prevention of perioperative spinal anesthetic shivering. Hemodynamic effects of ketamine and other anesthetic agents were examined as a secondary objective.

The full article is available to read by clicking the source link below:

Source: https://www.cureus.com/articles/277061-a-scoping-review-ketamine-for-the-prevention-of-perioperative-shivering-in-patients-undergoing-spinal-anesthesia#!/

Filed under: Drug use-various effects,Health,Ketamine :

August 15, 2024

The National Institutes of Health (NIH) has launched a program that will support Native American communities to lead public health research to address overdose, substance use, and pain, including related factors such as mental health and wellness. Despite the inherent strengths in Tribal communities, and driven in part by social determinants of health, Native American communities face unique health disparities related to the opioid crisis. For instance, in recent years, overdose death rates have been highest among American Indian and Alaska Native people. Research prioritized by Native communities is essential for enhancing effective, culturally grounded public health interventions and promoting positive health outcomes.

“Elevating the knowledge, expertise, and inherent strengths of Native people in research is crucial for creating sustainable solutions that can effectively promote public health and health equity,” said Nora D. Volkow, M.D., director of NIH’s National Institute on Drug Abuse (NIDA). “As we look for ways to best respond to the overdose crisis across the country, it is crucial to recognize that Native American communities have the best perspective for developing prevention and therapeutic interventions consistent with their traditions and needs. This program will facilitate research that is led by Native American communities, for Native American communities.”

Totaling approximately $268 million over seven years, pending the availability of funds, the Native Collective Research Effort to Enhance Wellness (N CREW) Program will support research projects that are led directly by Tribes and organizations that serve Native American communities, and was established in direct response to priorities identified by Tribes and Native American communities.

Many Tribal Nations have developed and continue to develop innovative approaches and systems of care for community members with substance use and pain disorders. During NIH Tribal Consultations in 2018 and 2022, Tribal leaders categorized the opioid overdose crisis as one of their highest priority issues and called for research and support to respond. They shared that Native communities must lead the science and highlighted the need for research capacity building, useful real-time data, and approaches that rely on Indigenous Knowledge and community strengths to meet the needs of Native people.

The N CREW Program focuses on:

Supporting research prioritized by Native communities, including research elevating and integrating Indigenous Knowledge and culture
Enhancing capacity for research led by Tribes and Native American Serving Organizations by developing and providing novel, accessible, and culturally grounded technical assistance and training, resources, and tools
Improving access to, and quality of, data on substance use, pain, and related factors to maximize the potential for use of these data in local decision-making.

“Native American communities have been treating pain in their communities for centuries, and this program will uplift that knowledge to support research that is built around cultural strengths and priorities,” said Walter Koroshetz, M.D., director of NIH’s National Institute of Neurological Disorders and Stroke (NINDS). “These projects will further our collective understanding of key programs and initiatives that can effectively improve chronic pain management for Native American and other communities.”

The first phase of the program will support projects to plan, develop, and pilot community-driven research and/or data improvement projects to address substance use and pain. In this phase, NIH will also support the development of a Native Research Resource Network to provide comprehensive training, resources, and real-time support to N CREW participants.

The second phase of the program, anticipated to begin in fall 2026, will build on the work conducted in the initial phase of the program to further capacity building efforts and implement community-driven research and/or data improvements projects. Additional activities that support the overarching goals of the N CREW Program may also be identified as the program develops.

The N CREW Program is led by the NIH’s NIDA, NINDS, and National Center for Advancing Translational Sciences (NCATS), with participation from numerous other NIH Institutes, Centers, and Offices. The N CREW Program is funded through the NIH Helping to End Addiction Long-term Initiative (or NIH HEAL Initiative), which is jointly managed by NIDA and NINDS. For the purposes of the N CREW Program, Native Americans include American Indians, Alaska Natives, and Native Hawaiians. Projects will be awarded on a rolling basis and publicly listed.

This new program is part of work to advance the President’s Unity Agenda and the HHS Overdose Prevention Strategy.

Source: https://nida.nih.gov/news-events/news-releases/2024/08/nih-launches-program-to-advance-research-led-by-native-american-communities-on-substance-use-and-pain

Filed under: Addiction,Education,Health,Prevention and Intervention,USA :

August 4, 2024

By Lauren Biscaldi, MS, Managing Editor

Lifestyle changes—including eating fruits, vegetables, and whole grains—can help patients, especially those with diabetes or hypertension, improve outcomes.

Robert Ostfeld, MD, ScM, director of preventive cardiology at Montefiore Health System and professor of medicine at Albert Einstein College of Medicine in New York sat down with Drug Topics ahead of the American Society for Preventive Cardiology Congress on CVD Prevention to discuss the role that dietary patterns and nutrition decisions play in living a healthful lifestyle.

Drug Topics: What specific nutrients or dietary patterns have been shown to benefit patients with hypertension and diabetes, and how can this information be incorporated into patient counseling?

Robert Ostfeld, MD, ScM: That’s a very important question. A healthful diet, of course, can very positively impact cardiometabolic health—including blood pressure, diabetes, [and] lipids—and cardiovascular health and overall health in general.

Reassuringly, there is broad [alignment] in terms of what defines a healthful dietary pattern. For example, multiple medical societies—like the American Heart Association, the American College of Cardiology, the American Society for Preventive Cardiology, the Canadian Cardiovascular Society, the European Society of Cardiology—are all broadly aligned; consuming more plant-based nutrition, less ultra-processed foods, less red and processed meats, is helpful both cardiometabolically and [for] cardiovascular health overall.

Unfortunately, that recommendation hasn’t necessarily percolated down well, at least into the US. There was an interesting recent analysis where from the NHANES database—the National Health and Nutrition Examination Survey database—published in 2021, where they looked at a little over 11,000 people…where they used 5 elements to define diet. One element was consuming at least 4 and a half servings of fruits and vegetables a day, at least 3 servings of whole grains each day, low sugar or sweetened beverage consumption, low salt consumption, and 2 servings of fatty fish each week. If you had 0 or 1 of those, then they felt you had a poor diet; 2 or 3 an intermediate [diet], and 4 or 5, an ideal dietary pattern. About 75% of the US has a poor, 0 to 1 of those [elements] dietary pattern; 25% [have] intermediate, and 0.7% of the US has an ideal dietary pattern.

There’s a huge gap between where we are and where we could. You could ask, “Does it even really matter?” Of course it does. In this study, they modeled if everyone adopted an ideal dietary pattern—so 4 or 5 of those 5 elements—for 1 year, what would happen? Well, it was estimated that cardiovascular event rates would fall by about 42%. The gap matters. There’s randomized prospective cohort data that eating a healthful dietary pattern, more plant based [and] aligned with American College of Cardiology and American Heart Association recommendations, can also be helpful for high blood pressure, particularly the DASH [Dietary Approaches to Stop Hypertension] dietary pattern for high cholesterol, the dietary portfolio pattern, which is a high fiber plant based diet, and also, similar recommendations broadly for diabetes.

What I should reinforce is, it’s not really that there’s 1 diet for high blood pressure, high cholesterol, and diabetes. They’re really broadly aligned that consuming more healthful, plant-based foods—fruits, vegetables, whole grains, beans, lentils—less ultra-processed foods and less red and processed meats, is helpful for all of the above: cardiovascular health and cardiometabolic health.

Drug Topics: How can patients be supported in overcoming common barriers to healthy eating, such as budget constraints and limited access to nutritious foods, in the management of hypertension and diabetes?

Ostfeld: Helping the individual patient in the office embrace a more healthful diet can be a challenge. Society does not make…it easy for the healthy choice to be the easy choice. And behavior change, getting someone to change how they eat, how they live, can be very, very difficult. These are big hurdles that we face.

As an individual practitioner, it can be overwhelming to overcome some of these things; at least we can try and start. As an individual [health care provider], you’ll have your team around you who can support you and reinforce your message. Nurses, support staff, and registered dietitians can be incredibly helpful to reinforce and educate about this topic.

In the clinic specifically, I will try to find a specific reason that the patient may be interested in living more healthfully. Maybe they want to lose weight or improve their skin complexion, maybe they want to lower their blood pressure, lower their cholesterol, come off a medication… Whatever the case may be, I try to highlight how consistently eating more healthfully can address that particular issue. I will give them some very specific steps—some simple specific steps, because everyone’s busy and there’s so much information to take in—that they can hopefully do when they get home to live more healthily. I have a handout that I give them that I try to keep very simple.

Sometimes in clinic, because we’re all so busy, I’ll just say, “Let’s just start with 222.” [That’s] 2 servings of green leafy vegetables a day, 2 servings of fruit each day, 2 servings of other vegetables each day: 222. I’ll do that a little bit weirdly, deliberately, so they’ll remember it. Then when they go home, depending on where they live, there may be more or [fewer] access or cost issues. [I’ll explain that] for ease, [they] could cook in bulk; we certainly don’t have to buy, you know, organic green juices. You can get frozen vegetables, frozen fruits, big sacks of potatoes, oatmeal, and beans, and those things can be much less expensive and more doable.

Another way to help patients adopt a more healthful lifestyle is—there may be the hurdle of costs here—but there are services that can deliver meals, healthful meals, to patients; they may be able to access registered dieticians, and of course there are multiple online resources that are free for patients. The Physicians Committee for Responsible Medicine has a 21-day kickstart for more plant-based nutrition should, the [health care provider] feel that that’s appropriate for the patient. There are a variety of resources that people can have access to; some may cost a little bit more, but some are also free. The American College of Lifestyle Medicine also has multiple online resources.

Source: https://www.drugtopics.com/view/q-a-examining-the-key-drivers-of-a-healthful-lifestyle

Filed under: Education,Health,Prevention (Papers),Prevention and Intervention,USA :

In 2023, 1.5 million adolescents aged 12 to 17 initiated nicotine vaping in the past year.

Posted Mon, Aug 5, 2024

The U.S. Department of Health and Human Services’ (HHS) Substance Abuse and Mental Health Services Administration (SAMHSA) released the results of its annual National Survey on Drug Use and Health (NSDUH), which shows how people living in America reported about their experience with mental health conditions, substance use, mental health and pursuit of treatment in 2023. The report includes selected estimates by race, ethnicity, and age group. The 2023 sample size was 67,679 and used varied collection methods in gathering data from respondents who are noninstitutionalized and age 12 or older.

Key findings of people aged 12 or older who used tobacco products or vaped nicotine in the past month:

Among people aged 12 or older- 22.7 % (or 64.4 million people) was highest among young adults aged 18 to 25 – 30.0 % or 10.2 million people
Adults aged 26 or older -23.4% or 52.3 million people
Adolescents aged 12 to 17 – 7.4% or 1.9 million people
Higher among American Indian or Alaska Native (34 %) or Multiracial people (30.6 %) than among White (24.7%), Black (24.2%), Hispanic (17.9%), or Asian people (10.3%)
The percentage of people who vaped nicotine was higher among young adults aged 18 to 25 (24.1% or 8.2 million people) than among adults aged 26 or older (7.4% or 16.6 million people) or adolescents aged 12 to 17 (6.8% or 1.8 million people)

Legislation in December 2019 raised the federal minimum age for sale of tobacco products (along with e-cigarettes) from 18 to 21 years.25 All 50 states and the District of Columbia prohibit the sale of tobacco products to people younger than 21.

In 2023, 1.5 million adolescents aged 12 to 17, 1.4 million young adults aged 18 to 25, and 3.1 million adults aged 26 or older initiated nicotine vaping in the past year.
About two thirds (62.5%) of the 5.9 million people in 2023 who initiated nicotine vaping in the past year did so at age 21 or older (3.7 million people) compared with 37.5 percent (or 2.2 million people) who did so before age 21.

It is evident that several safety and mental health concerns have arisen due to the growing popularity of e-cigarettes. E-cigarettes heat liquids known as vape juices or e-liquids and transform them into an inhalable vapor containing nicotine and other hazardous compounds. It has been purported by the National Institute on Drug Abuse (NIDA), that Vaping, which was originally marketed to quit smoking, has become a problematic behavior in itself. Vaping can be harmful to a person’s physical and mental health, self-control, mindfulness, and other interventions can help people resist the lure of vaping.

Vaping can be especially dangerous for young people because their brains are still developing. Nicotine is highly addictive and can harm brain development until around age 25 and can negatively impact a developing brain in terms of mood/impulse control disorders, interference with memory and attention processing and negatively affect planning and decision-making.

Find out what’s happening in Glen Covewith free, real-time updates from Patch.

As individuals, being mindful, prevention education and making health choices and cultivating self-control can play an important role safeguarding our well-being. At the societal level, grassroot efforts for increased regulation over entities seeking to profit from harmful products and promote interventions that are accessible and beneficial to all is most effective. There is a large body of research that tackling nicotine dependence with vaping with the same vigor as combustibles is a growing need.

According to SAFE, the best method of protecting is prevention education and encouraging a goal to “Live SAFE” and substance free and changing the societal norms regarding these products to help curb youth initiation and a lifelong nicotine addiction.

For information on how to quit smoking or vaping tobacco or nicotine, the NYS Smoker’ provides free and confidential services that include information, tools, quit coaching, and support in both English and Spanish. Services are available by calling 1-866-NY-QUITS (1-866-697-8487), texting (716) 309-4688, or visiting www.nysmokefree.com, for information, to chat online with a Quit Coach, or to sign up for Learn2QuitNY, a six-week, step-by-step text messaging program to build the skills you need to quit any tobacco product. Individuals aged 13 to 24 can text “DropTheVape” to 88709 to receive age-appropriate quit assistance.

SAFE, Inc. is the only alcohol and substance abuse prevention, intervention, and education agency in the City of Glen Cove. The Coalition is concerned about all combustible and electronic products with marijuana and tobacco. The Agency is employing environmental strategies to educate and update the community regarding the negative consequences in collaboration with Carol Meschkow, Manager- Tobacco Action Coalition of Long Island. To learn more about the SAFE Glen Cove Coalition please follow www.facebook.com/safeglencove or to learn more about electronic products visit the Vaping Facts and Myths Page of SAFE’s website to learn more about how vaping is detrimental to your health www.safeglencove.org.

Filed under: Addiction,Drug use-various effects,Education,Health,Prevalence,USA,Youth :

The implications of these findings on the propagation of cannabis genotoxicity and epigenotoxicity to the next generation extremely significant.

Prior to this research, the field was aware of the effects in the male but the work in females is more recent.

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HUMAN REPRO AND GENOTOXICITY ARTICLE

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

By Dr. Liji Thomas, MDReviewed by Benedette Cuffari, M.Sc. Aug 28 2024

How can modern psychedelic research and traditional approaches integrate to address substance use disorders and mental health challenges?

A recent study published in the Journal of Studies on Alcohol and Drugs discusses the history and current state of psychedelic research for the treatment of substance abuse disorders (SUDs).

Psychedelics

Psychedelics are consciousness-altering drugs, some of which include lysergic acid diethylamide (LSD), dimethyltryptamine (DMT), psilocybin, and mescaline. Methylenedioxymethamphetamine (MDMA) and ketamine are also considered psychedelics; however, these drugs have different mechanisms of action.

Although psychedelics have been exploited for centuries to induce altered states of consciousness, their use, as opposed to their abuse, has largely been unexplored in modern medicine. In fact, several studies have indicated the potential utility of psychedelics for individuals who have mental illness due to traumatic experiences, false beliefs, and unhealthy behavioral patterns, such as posttraumatic stress disorder (PTSD) and depression.

The recent coronavirus disease 2019 (COVID-19) pandemic led to global changes in the use of methamphetamine, alcohol, and cannabis, as well as a significant increase in opioid overdoses in the United States. Thus, another promising application of psychedelics is their potential use for treating SUDs.

However, restrictive policies, poor funding, lack of equitable and diverse recruitment and access, as well as the multiplicity of small-scale psychedelic research programs have prevented researchers from effectively investigating the effects of psychedelics in the treatment of SUDs.

Overview

Over the past seven decades, researchers have become increasingly interested in examining the potential use of psychedelics in traditional medicine. Despite federal policies banning recreational drug use, researchers have elucidated some of the biological effects of psychedelics on the central nervous system (CNS) and their potential role in the treatment of SUDs. Nevertheless, there remains a lack of well-controlled multi-center trials and systematic reviews in this area.

As researchers continue to examine the pharmacological potential of these drugs, it is crucial to address their addiction and abuse potential, the legalization of recreational drugs, and the attempts of pharmaceutical companies to introduce high-selling psychedelics as therapies for mental illness.

History and current use of psychedelics

Psychedelics like ayahuasca, Peyote, and psilocybin-containing mushrooms have been used throughout history by traditional healers and indigenous communities for both spiritual and health purposes. By recognizing these contributions, researchers can benefit from the potential benefits of traditional usage patterns while investigating the use of these drugs for treating SUDs and other mental health disorders.

For example, a hybridized SUD therapy program in Peru utilizes ayahuasca to treat alcohol and drug use. At one year following treatment, reduced depression and anxiety, higher quality of life, and reduced severity of addiction have been reported.

One notable contribution is the acknowledgment that key experiences of treatment participants might provide more insight than the search for putative “active ingredients” of interventions as complex as psychedelic-assisted treatment.”

Purging in psychedelic treatment

Psychedelic use, specifically ayahuasca use, is closely linked to vomiting as a means of purging the body. This is reported to have spiritual, Amazonian, and clinical benefits.

These spiritual benefits are linked to Christian mystical experience and the Amazonian goals of restoring the internal balance of the individual, whereas clinical benefits are reflected in terms of improved wellness measures. Rather than being a negative effect of ayahuasca use, purging may be an integral part of its healing effects in some situations.

Conclusions

The optimal approach to psychedelic-assisted treatment involves mutual respect for and recognition of the value of both traditional and modern applications. Thus, mixed-methods research is crucial, as traditional approaches may help identify a better therapeutic agent or program than traditional approaches to identifying and isolating active ingredients.

However, it is essential to evaluate and quantify the success rates of traditional approaches to psychedelic use, as well as elucidate the biological mechanisms that may contribute to their therapeutic effects. Researchers must recognize and credit traditional history and practices throughout these efforts to protect these cultures from being exploited, ignored, and suppressed by pharmaceutical industries.

The rush to patent processes in psychedelic treatments of addiction and other psychiatric conditions reflects the enormous greed of private commercial entities to benefit financially from vulnerable patients in need of effective therapies.

Thus, regulatory control of psychedelic therapies is vital to establish rigorous research standards that can lead to the generation of sufficient evidence in this area. Without this type of overview, private corporate interests may seek to exploit governmental support for crucial research needed to address these mental health issues.

Source: https://www.news-medical.net/news/20240828/Psychedelics-A-new-hope-for-substance-abuse-treatment.aspx

Filed under: Brain and Behaviour,Drug use-various effects,Health,Methamphetamine/GHB/Hallucinogens/Oxycodone,Prevention and Intervention,Psychiatric drugs,USA :

A 48-year-old woman in California developed meningitis after between three and six medical marijuana blunts contaminated by a fungus daily
Meningitis causes potentially fatal brain and spinal cord inflammation
This is the first known case of meningitis coming from cannabis
The soil in Bakersfield, where the woman lived is known to be contaminated with another fungus that causes the flu-like ‘valley fever’
The dispensary and area soil are being investigated, though similar infections are unlikely for healthy people who smoke smaller quantities

A 48-year-old woman in California contracted a potentially deadly meningitis infection in 2016 from smoking her favourite medical marijuana strain three to six times a day, according to a British Medical Journal case study report published last month.

The infection came from a fungus, called cryptococcus, that most people contract from inhaling contaminated dust or eating food that mouse faeces have touched.

Meningitis is the most common illness to develop from exposure to cryptococcus, and causes potentially fatal inflammation in the brain and spinal cord.

Dr Bryan Shapiro, who treated the woman, says that cannabis smokers in California should be sure to know where their marijuana came from, especially if their immune systems are compromised in any way, as meningitis could be lethal for them.

The unnamed woman’s sister brought her to the Cedars-Sinai Medical Center (CSMC) in Los Angeles, California. She had ‘strange symptoms,’ Dr Shapiro said, including being dizzy, tired, struggling to recall even her own name, and behaving aggressively.

In fact, her behaviour had become so erratic that she was fired from her job as an administrative assistant before being admitted to the hospital.

At CSMC, the emergency room team could not figure out what was ailing the otherwise healthy patient. When she assaulted a nurse, the team called in the psychiatric department.

‘We thought it might be catatonia [abnormal movement triggered by mental issues], and it took us some time to rule out a psychiatric illness,’ Dr Shapiro said.

Still unable to diagnose her, they took a sample of her brain fluid, which tested positive for Cryptococcus neoformans, ‘a rare fungal infection usually only seen in people with late stage HIV or transplant patients,’ Dr Shapiro explained.

But the woman was otherwise in reasonably good health. The only things that stood out in her medical history were high blood pressure and a significant marijuana habit.

‘She said she had smoked between three and six marijuana blunts about daily since her teenage years,’ Shapiro said, ‘I’ve never known a patient who smokes that heavily and wondered if there could be a link between her heavy cannabis use for a lifetime.’

They treated the woman for meningitis, but if they hadn’t done so ‘prudently…there is a strong possibility she would have died, she was very, very severe at the time we saw her,’ he says.

As she was recovering, Dr Shapiro and his team investigated her favourite medical marijuana dispensary in Bakersfield where she always purchased one of the shop’s cheaper strains, which was grown locally outdoors.

DNA sequencing of nine samples revealed small amounts of the rare fungus.

‘That lent credibility to the idea that the cryptococcus in the cannabis may have caused the woman’s systemic malfunction, and smoking might actually predispose someone to invasive fungal infection,’ Dr Shapiro said.

Fungus spores are actually grow on cannabis quite commonly.

A study conducted last year identified evidence of mould, pesticides and other contaminants on much of the weed grown in the state.

More than 90 percent of the marijuana plants tested were contaminated with pesticides, and crops from 20 farms were positive for mold.

The soil in Bakersfield and the surrounding Central Valley area is known to be a breeding ground for another fungus called Coccidioides immitis, which is to blame for a slew of cases of an infection, dubbed ‘valley fever.’

Valley fever is a potentially sever lung infection and its symptoms can mirror those of the flu that has killed nearly 100 people in California since the start of the year.

The prevalence of the valley fever fungus – which causes infection when it is inhaled – in the area ‘raised suspicions’ for Dr Shapiro and his team that the soil could harbour cryptococcus as well.

The spores of these fungi are very heat resistant, so they survive even as the weed they are attached to is smoked.

Even so, it is rare for someone with an otherwise healthy immune system to get such an infection, and Dr Shapiro points to other research that has suggested that THC – the psychoactive component of weed – may itself suppress the immune system.

‘So, the more you smoke, the greater the exposure [to the fungus and] the more likely it is that your body is unable to fight off the infection,’ he says.

Dr Shapiro was unable to disclose the name of the particular dispensary that the contaminated marijuana came from, but said that it is under investigation.

This case was the first of its kind that Dr Shapiro or his team had seen, so it’s too early to make formal recommendations, he says, but advises: ‘Make sure you know where your marijuana is coming from.

‘I recommend buying indoor-grown strains and, for people who are immuno-compromised like those with HIV or other infections, I would recommend avoiding inhaled marijuana products,’ he says. Edible products, on the other hand are probably safer for consumption.

Source: https://www.dailymail.co.uk/health/article-5327367/California-woman-caught-meningitis-CANNABIS.html January 2018

Filed under: Cannabis/Marijuana,Drug use-various effects,Health,Marijuana and Medicine :

Overdose deaths are a widespread problem North Carolinians have been struggling to combat in recent years.

According to the state health department, American Indian/Indigenous and Black communities are the most at risk. From 2019 to 2021, both populations saw reports of overdoses more than double. The number of overdoses is up 117% for the Indigenous population and 139% for Black people. Overdoses increased 53% among white people during the same timeframe.

The problem has only been exacerbated by a rise in illegally manufactured fentanyl.

The state reports an estimated 77% of overdose deaths in 2021 likely involved fentanyl.

Estimates from the North Carolina Office of the Chief Medical Examiner show roughly 11.4 people died each day from overdoses in 2023.

In Wake County in 2023:

Wake County EMS responded to 1,268 suspected overdoses
Wake County EMS administered 1,578 doses of Narcan
Wake County EMS left behind 132 Narcan overdose reversal kits

The danger of fentanyl not only lies in its widespread availability state-wide, but in the drug’s potency itself.

According to the U.S. Drug Enforcement Administration, fentanyl is considered 100 times more potent than morphine.

How quickly the drug can lead to an overdose largely depends on how fentanyl gets into someone’s body. Your body may take more time to absorb the drug than if

fentanyl is inhaled or injected.

The National Institute on Drug Abuse reports synthetic fentanyl is illegally sold in several ways including as a powder, eye drops, nasal spray, pills or dropped onto blotted paper.

Once fentanyl gets into your system, the drug binds to opioid receptors in the brain. These receptors control things like emotions and pain.

Fentanyl can then keep your brain from telling your vital organs how to function properly by depressing the central nervous system and respiratory function, according to the Centers for Disease Control and Prevention.

When someone’s lungs aren’t told to expand and contract properly, their body starts to lack sufficient oxygen supply.

Without enough oxygen, someone can lose consciousness in a matter of seconds. Studies of patients who have needed help breathing after a traumatic brain injury or stroke found the brain uses about 20% of the body’s oxygen.

Without enough oxygen supply, the brain can shut down within minutes. This can then lead to permanent brain damage or death once other organs stop functioning properly due to a lack of blood flow.

The medication naloxone has emerged as a powerful antidote for opioid overdoses.

The CDC reports that naloxone can reduce the effects of several opioids including, fentanyl, morphine, heroin, oxycodone, methadone, hydrocodone, codeine and hydromorphone.

When the overdose-reversal medication was first approved, it was sold under the brand name Narcan.

Naloxone works by binding to opioid receptors in the brain and essentially blocks and reverses the effects of other opioids.

The medication allows for the body’s response system to switch back ‘on’ and restore normal breathing.

The medication comes in two FDA-approved forms: a nasal spray or an injection. Naloxone is available for over-the-counter purchase.

North Carolina has 50 Syringe Service Programs across 58 counties. The state health department reports the programs collectively distributed over 109,000 naloxone kits from 2022-2023.

During the same timeframe, the state tells WRAL News there were nearly 17,000 overdose reversal reports.

Naloxone will not harm someone who hasn’t taken an opioid, so it is recommended even when it is unclear what kind of drug a person has taken.

More than one dose may be needed because some opioids, like fentanyl, can take a stronger hold on the opioid receptors.

Narcan may only work for 30-90 minutes, but some opioids remain in the body for a longer time. Those administering naloxone are highly encouraged to call 911, because someone may once experience the effects of an overdose again after the medication wears off.

North Carolina became the first state in the country to begin an EMS Naloxone Leave-Behind Program in 2018. The initiative allows first responders to leave a naloxone kit with an individual who refuses the option to go to a hospital after an overdose.

Other states, including Arizona, and cities like San Franscico, have since molded similar programs on North Carolina’s success.

Other states, including Arizona and San Franscico, have since molded similar programs on North Carolina’s success.

Source: https://www.wral.com/amp/21525957/ July 2024

Filed under: Fentanyl,Health,Social Affairs :

Illicit use of the veterinary tranquilizer xylazine continues to spread across the United States. The drug, which is increasingly mixed with fentanyl, often fails to respond to the opioid overdose reversal medication naloxone and can cause severe necrotic lesions.

A report released by Millennium Health, a specialty lab that provides medication monitoring for pain management, drug treatment, and behavioral and substance use disorder treatment centers across the country, showed the number of urine specimens collected and tested at the US drug treatment centers were positive for xylazine in the most recent 6 months.

As previously reported by Medscape Medical News, in late 2022, the US Food and Drug Administration (FDA) issued a communication alerting clinicians about the special management required for opioid overdoses tainted with xylazine, which is also known as “tranq” or “tranq dope.”

Subsequently, in early 2023, The White House Office of National Drug Control Policy designated xylazine combined with fentanyl as an emerging threat to the United States.

Both the FDA and the Drug Enforcement Administration have taken steps to try to stop trafficking of the combination. However, despite these efforts, xylazine use has continued to spread.

The Millennium Health Signals report showed that the greatest increase in xylazine use was largely in the western United States. In the first 6 months of 2023, 3% of urine drug tests (UDTs) in Washington, Oregon, and California were positive for xylazine. From November 2023 to April 2024, this rose to 8%, a 147% increase. In the Mountain West, xylazine-positive UDTs increased from 2% in 2023 to 4% in 2024, an increase of 94%. In addition to growth in the West, the report showed that xylazine use increased by more than 100% in New England — from 14% in 2023 to 28% in 2024.

Nationally, 16% of all urine specimens were positive for xylazine from late 2023 to April 2024, up slightly from 14% from April to October 2023.

Xylazine use was highest in the East and in the mid-Atlantic United States. Still, positivity rates in the mid-Atlantic dropped from 44% to 33%. The states included in that group were New York, Pennsylvania, Delaware, and New Jersey. East North Central states (Ohio, Michigan, Wisconsin, Indiana, and Illinois) also experienced a decline in positive tests from 32% to 30%.

The South Atlantic states, which include Maryland, Virginia, West Virginia, North and South Carolina, Georgia, and Florida, had a 17% increase in positivity — from 22% to 26%.

From April 2023 to April 2024 state-level UDT positivity rates were 40% in Pennsylvania, 37% in New York, and 35% in Ohio. But rates vary by locality. In Clermont and Hamilton counties in Ohio — both in the Cincinnati area — about 70% of specimens were positive for xylazine.

About one third of specimens in Maryland and South Carolina contained xylazine.

“Because xylazine exposure remains a significant challenge in the East and is a growing concern in the West, clinicians across the US need to be prepared to recognize and address the consequences of xylazine use — like diminished responses to naloxone and severe skin wounds that may lead to amputation — among people who use fentanyl,” said Millennium Health Chief Clinical Officer Angela Huskey, PharmD, in a press release.

The Health Signals Alert analyzed more than 50,000 fentanyl-positive UDT specimens collected between April 12, 2023, and April 11, 2024. Millennium Health researchers analyzed xylazine positivity rates in fentanyl-positive UDT specimens by the US Census Division and state.

Source: https://www.medscape.com/viewarticle/emerging-threat-xylazine-use-continues-spread-across-united-2024a1000d1h July 2024

Filed under: Fentanyl,Health :

Abstract

Studies examining lifestyle and cognitive decline often use healthy lifestyle indices, making it difficult to understand implications for interventions. We examined associations of 16 lifestyles with cognitive decline. Data from 32,033 cognitively-healthy adults aged 50-104 years participating in prospective cohort studies of aging from 14 European countries were used to examine associations of lifestyle with memory and fluency decline over 10 years. The reference lifestyle comprised not smoking, no-to-moderate alcohol consumption, weekly moderate-plus-vigorous physical activity, and weekly social contact. We found that memory and fluency decline was generally similar for non-smoking lifestyles. By contrast, memory scores declined up to 0.17 standard deviations (95% confidence interval= 0.08 – 0.27) and fluency scores up to 0.16 standard deviations (0.07 – 0.25) more over 10 years for those reporting smoking lifestyles compared with the reference lifestyle. We thus show that differences in cognitive decline between lifestyles were primarily dependent on smoking status.

Source: https://www.nature.com/articles/s41467-024-49262-5 June 2024

Filed under: Brain and Behaviour,Health,Nicotine :

360info: 05/07/2024 23:30 MYT

Countries are looking at evidence-based alternatives, with a shift towards public health strategies, to fight the drug scourge – Michael Joiner/360info

THE UN’s annual World Drug Report warns of a rise in drug use and trafficking globally.

The report, released in conjunction with the International Day against Drug Abuse and Illicit Trafficking, or World Drug Day on June 26, found the number of drug users reached 292 million in 2022, with cannabis being the most common drug used.

However, the emergence of new synthetic opioids such as nitazenes is causing concern due to their potency and potential for overdose deaths.

The report also highlighted how drug cartels in Southeast Asia are weaving themselves into a web of illegal activities, including wildlife trafficking and deforestation. This devastates the environment and displaces communities. Increased cocaine production fuels violence along transportation routes, while high-THC cannabis legalisation in some countries is associated with a rise in attempted suicides.

The traditional criminal justice approach, prioritising arrests and punishment, is proving ineffective. Countries are looking at evidence-based alternatives, with a shift towards public health strategies.

This week, Malaysia tabled new amendments to the Drug Dependants (Treatment and Rehabilitation) Act 1983 which would empower officers from the country’s drug agency to arrest, treat, and rehabilitate “drug dependants or misusers” in a bid to ease overcrowding in prisons.

The bill is seen as a step away from the country’s draconian anti-drug laws, shifting the focus from locking up people who use drugs to treatment and rehabilitation. But experts are worried about making rehabilitation mandatory for all and whether the current rehabilitation centres are well equipped to accommodate the influx of patients.

Australia offers a fascinating case study on the complexities of drug policy reform. While the government allocates significant resources to law enforcement, harm reduction and prevention programmes receive a fraction of the funding. This imbalance raises questions about the effectiveness of the current approach.

Pill testing will be introduced in the state of Victoria later in the year, aimed at reducing the risk of overdose deaths, especially at music festivals. It follows similar schemes in the Australian Capital Territory and Queensland which have so far shown to save lives. This has encouraged the state of New South Wales to implement a similar approach.

Australia has also taken a progressive step by making naloxone, a life-saving medication that reverses opioid overdoses, free and available without a prescription, although uptake has been slow.

The illegal drug trade poses a significant threat to national security in some countries. India’s northeast states, bordering Myanmar, serve as a stark example. The drug trade fuels violence and instability, highlighting the need for a comprehensive approach that addresses security concerns and public health.

The situation in Punjab also struggles with widespread substance use and trafficking. Addressing the underlying factors that contribute to drug use, such as lack of economic opportunities, is crucial to tackling this issue effectively.

This year’s World Drug Day theme acknowledges that it is crucial to adopt a scientific evidence-based approach that prioritises prevention and treatment as a step for drug policy reform.

A public health approach that prioritises harm reduction, treatment, prevention, and dismantling accessibility barriers offers a more promising path forward, promoting public health and safety while fostering global stability.

By Shahirah Hamid: Senior Commissioning Editor at 360info Southeast Asia

Source: https://www.astroawani.com/berita-dunia/rethinking-drug-policy-punishment-public-health-477633

Filed under: Crime/Violence/Prison,Health,Others (International News),Prevalence,Prevention and Intervention :

26 June 2024

Drugs are at the root of immeasurable human suffering.

Drug use eats away at people’s health and wellbeing. Overdoses claim hundreds of thousands of lives every year.

Meanwhile, synthetic drugs are becoming more lethal and addictive, and the illicit drug market is breaking production records, feeding crime and violence in communities around the world.

At every turn, the most vulnerable people — including young people — suffer the worst effects of this crisis. People who use drugs and those living with substance abuse disorders are victimized again and again: by the drugs themselves, by stigma and discrimination, and by heavy-handed, inhumane responses to the problem.

As this year’s theme reminds us, breaking the cycle of suffering means starting at the beginning, before drugs take hold, by investing in prevention.

Evidence-based drug prevention programmes can protect people and communities alike, while taking a bite out of illicit economies that profit from human misery.

When I was Prime Minster of Portugal, we demonstrated the value of prevention in fighting this scourge. From rehabilitation and reintegration strategies, to public health education campaigns, to increasing investment in drug-prevention, treatment and harm-reduction measures, prevention pays off.

On this important day, let’s recommit to continuing our fight to end the plague of drug abuse and trafficking, once and for all.

Source: https://www.unodc.org/islamicrepublicofiran/en/the-secretary-general-message-on-the-occasion-of-the-international-day-against-drug-abuse-and-illicit-trafficking.html

Filed under: Environment,Health,Others (International News),Prevalence,Prevention and Intervention,Social Affairs :

Key Points

Question What reasons do physicians give for not addressing substance use and addiction in their clinical practice?

Findings In this systematic review of 283 articles, the institutional environment (81.2% of articles) was the most common reason given for physicians not intervening in addiction, followed by lack of skill (73.9%), cognitive capacity (73.5%), and knowledge (71.9%).

Meaning These findings suggest effort should be directed at creating institutional environments that facilitate delivery of evidence-based addiction care while improving access to both education and training opportunities for physicians to practice necessary skills.

Abstract

Importance The overdose epidemic continues in the US, with 107 941 overdose deaths in 2022 and countless lives affected by the addiction crisis. Although widespread efforts to train and support physicians to implement medications and other evidence-based substance use disorder interventions have been ongoing, adoption of these evidence-based practices (EBPs) by physicians remains low.

Objective To describe physician-reported reasons for reluctance to address substance use and addiction in their clinical practices using screening, treatment, harm reduction, or recovery support interventions.

Data Sources A literature search of PubMed, Embase, Scopus, medRxiv, and SSRN Medical Research Network was conducted and returned articles published from January 1, 1960, through October 5, 2021.

Study Selection Publications that included physicians, discussed substance use interventions, and presented data on reasons for reluctance to intervene in addiction were included.

Data Extraction and Synthesis Two reviewers (L.N., M.C., L.F., J.P., C.S., and S.W.) independently reviewed each publication; a third reviewer resolved discordant votes (M.C. and W.C.). This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines and the theoretical domains framework was used to systematically extract reluctance reasons.

Main Outcomes and Measures The primary outcome was reasons for physician reluctance to address substance use disorder. The association of reasons for reluctance with practice setting and drug type was also measured. Reasons and other variables were determined according to predefined criteria.

Results A total of 183 of 9308 returned studies reporting data collected from 66 732 physicians were included. Most studies reported survey data. Alcohol, nicotine, and opioids were the most often studied substances; screening and treatment were the most often studied interventions. The most common reluctance reasons were lack of institutional support (173 of 213 articles [81.2%]), knowledge (174 of 242 articles [71.9%]), skill (170 of 230 articles [73.9%]), and cognitive capacity (136 of 185 articles [73.5%]). Reimbursement concerns were also noted. Bivariate analysis revealed associations between these reasons and physician specialty, intervention type, and drug.

Conclusions and Relevance In this systematic review of reasons for physician reluctance to intervene in addiction, the most common reasons were lack of institutional support, knowledge, skill, and cognitive capacity. Targeting these reasons with education and training, policy development, and program implementation may improve adoption by physicians of EBPs for substance use and addiction care. Future studies of physician-reported reasons for reluctance to adopt EBPs may be improved through use of a theoretical framework and improved adherence to and reporting of survey development best practices; development of a validated survey instrument may further improve study results.

Introduction

NDPA WEBSITE: Note – In the interests of relative brevity, the References have been omitted from this published version.

Overdose is a leading cause of injury-related death in the US,¹ with 107 941 such deaths occurring in 2022² and annual deaths due to alcohol exceeding 140 000 from 2015 to 2019.³ The more than 46.3 million people in the US with a past-year substance use disorder⁴ and a nationwide economic impact of alcohol misuse and illicit drug use that tops $442 billion⁵ further evidences the magnitude of this crisis.

A variety of safe and effective evidence-based practices (EBPs) to identify, reduce the morbidity and mortality of, and treat substance use disorders exist. Examples include screening, brief intervention, and referral to treatment,⁶^–10 as well as behavioral therapies and pharmacotherapies for nicotine, alcohol, and opioid use disorders.¹¹^–13 Furthermore, harm reduction approaches (eg, naloxone training and coprescribing, drug checking and testing, and syringe service programs) offer significant individual and public health benefits for people who use drugs and for those who do not have abstinence-based treatment goals.¹⁴^–16

Clinician adoption of EBPs is necessary; however, screening for substance use disorders remains low,⁷ creating missed opportunities to intervene in harmful substance use or recognize and discuss potential progression to a severe disorder. Treatment capacity is inadequate to meet demand,¹⁷ with only 6.3% of people with a past-year substance use disorder receiving treatment in the US in 2021.⁴ Our goal is to summarize published data on physician-described barriers to adoption of EBPs for addiction in clinical practice and recommend actions to address them.

Methods

Data Sources and Searches

This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines. The search strategy was developed iteratively with a National Library of Medicine informationist specializing in systematic reviews. We applied this strategy on October 4, 2021, to PubMed, Embase, and Scopus and on October 5, 2021, to medRxiv and SSRN Medical Research Network. In addition, a gray literature search of relevant government and nongovernment websites was conducted on October 5, 2021. We found no previous similar systematic reviews. The systematic review protocol was registered in PROSPERO (CRD42022286208) and accepted on January 14, 2022.

Study Selection

A 12-person team used Covidence to apply exclusion criteria first to the title and abstract of each study then to the full text of studies not already excluded. Two people (L.N., M.C., L.F., J.P., C.S., and S.W.) reviewed each study in both rounds. Discordant opinions were resolved by a third reviewer (M.C. and W.C.). To be included, the study had to present data on: (1) physicians at any practice level; (2) any substance use intervention(s) (Box); and (3) physician reasons for reluctance to intervene in addiction. Studies not in English, letters, editorials, narrative reviews, and commentaries were excluded. Data collection on reasons for reluctance were systemized using the theoretical domains framework (TDF),¹⁸^,19 a comprehensive approach for identifying behavioral determinants and for assessing implementation problems (eg, clinicians’ behavior) to inform intervention development. The team created a data extraction template with 10 reluctance reason categories (Box). We did not formally assess risk of bias in included studies because few used experimental or controlled study designs. Due to patterns observed during data extraction, the team approved the ad hoc collection of data on factors (eg, using a theoretical framework, obtaining target audience input in survey design, and piloting surveys) that could affect the internal validity of individual studies or precision of results. We conducted a limited exploration of facilitators because we observed that many included studies provided at least some data on possible facilitators of intervention in addiction.

Definitions of Intervention Type and Reluctance Reasons

Intervention type and definition

Harm reduction: syringe services, overdose prevention, naloxone, or drug user health.
Screening and assessment: screening, assessment of positive screening, or diagnosis.
Treatment: brief intervention, medication management, or behavioral services.
Recovery support: care coordination, care integration, or relapse prevention.

Reason and definition^a

Knowledge: beliefs about having the necessary knowledge, awareness, or understanding, including knowledge of condition or scientific rationale, procedural knowledge, or knowledge of task environment.
Institutional environment: beliefs about support from institution or employer, including material resources, organizational culture, competing demands.
Skills: beliefs about having the necessary skills, ability, or proficiency to deliver the intervention.
Cognitive capacity: beliefs about the cognitive capacity to manage a level of expected complexity of care, possibly related to cognitive overload and mental fatigue.
Expectation of benefit: beliefs about the likelihood of the patient benefiting or the course of the disease being altered due to the intervention.
Social influences: beliefs about public or community acceptance or support for the intervention, including willingness to allocate or develop needed resources.
Emotion: feelings of fear, dislike, worry, negative judgement, worthiness of patient population.
Relationship: concern about harming or losing the patient-physician relationship by causing offense, provoking avoidance, or other negative consequence.
Reinforcement: beliefs about the adequacy of reimbursement, professional rewards, and other positive reinforcement.
Professional role/identity: beliefs about professional role, boundaries, and group identity, excluding the intervention.

^a Reasons are derived from the theoretical domains framework, a comprehensive approach for identifying behavioral determinants and assessing implementation problems (eg, clinicians’ behavior) to inform intervention development.

Data Analysis

We conducted a series of quantitative analyses using SPSS, version 27 (IBM). Analyses were selected based on their purpose; independent variable; dependent variable; and statistical requirements, including measurement levels. We examined reasons for reluctance by specialty, intervention, drug type, and year and common combinations of reasons for reluctance using bivariate analysis and cross-tabulation. We conducted a regression analysis of reasons for reluctance by year. Statistical significance was considered a 2-sided P value less than .05. The exploratory analyses of ad hoc study quality data were not part of the planned analysis and are descriptive only. We used Atlas.ti version 24 (Atlas.ti) to conduct thematic analysis to examine facilitators using the following themes: knowledge and skills, intrapersonal and interpersonal factors, infrastructure, and regulation reform.

Results

Study Characteristics

Our search yielded 9308 studies published between January 1, 1960, and October 5, 2021, with 1280 remaining after removal of duplicates and 552 assessed for eligibility (eFigure 1 in Supplement 1). Of 283 studies²⁰^–302 included (eTable 1 in Supplement 1), 97.30% were published in 2000 or later (Table 1). The number of studies increased over time. For example, 4 studies⁸⁹^,156^,184^,236were published in 2000 and 21³³^,48^,49,66^,68^,75^,77^,79^,93^,107^,108,113^,139^,142^,148^,240^,251^,255^,302^,306^,313 in 2021, with a high of 31 ⁸^,27^,47^,50^,52^,54^,69^,74^,92^,100^,114^,121^,146^,147,161^,165^,174^,182^,191^,193^,199^,204^,206^,209^,221^,247^,263^,270^,275^,287^,300 in 2020 (eTable 2, eTable 3, eTable 4, eTable 5, and eFigure 2 in Supplement 1). Together, the included studies describe the views of 66 732 physicians who largely practiced general practice, internal medicine, or family medicine primarily in an office setting in the US. Most studies reported survey-based research results. Of the 4 general categories of addiction interventions (Table 2), treatment was most often addressed, followed by screening and assessment, with harm reduction and recovery support least discussed. Some studies addressed more than 1 intervention. Alcohol (86 studies²⁰^,21,23^,25^,26,29^,31^,34^,36^,38^,41^,44^,51^,53^,54,57^,59^,60,62^,69^–72,81^,82,86^,88^,89,94^,95,103^,105^,111^,113^,117^,119^,123^–127,131^,132,138^,141^,150^,153^,155^,158^,160^,162^,164^,168^,170^,171,173^,176^,191^–193,196^–201,204^,205,210^,219^,235^,237^,248^,250^,254^,256^,258^,271^,281^,283^,285^,291^,294^,296^,299^,300), nicotine (30 studies²⁸^,40^,48^,49,52^,61^,73^,85^,97^,109^,118^,129^,134^,140^,142^,149^,179^,188^,190^,212^,218^,223^,231^,249^,252^,265^,270^,286^,288^,298), and opioids (104 studies³⁰^,32^,33,35^,37^,42^,46^,47,50^,55^,56,58^,64^,66^,74^–80,83^,84,87^,90^–92,98^–100,104^,106^–108,110^,112^,114^,115,121^,122,130^,133^,135^,137^,139^,143^,144,146^–148,151^,152,154^,156^,163^,165^,167^,172^,174^,180^,182^,184^,186^,189^,202^,203,206^,207,213^–216,221^,222,225^–228,238^–240,242^–245,247^,251^,253^,255^,257^,259^,262^,269^,272^,275^,277^,280^,282^,284^,287^,290^,292^,293,302) were most often studied alone. Among studies reporting on multiple drugs (44 studies²²^,39^,43^,45^,63^,65^,67^,68,93^,96^,101^,102,116^,120^,136^,145^,166^,181^,183^,185^,194^,195,208^,209,217^,220^,230^,232^–234,241^,246^,260^,263^,264,267^,268,273^,274,278^,279,289^,295^,297), alcohol was included most often (38 studies⁴⁵^,63^,65^,67^,68,93^,96^,101^,102,116^,120^,136^,145^,166^,181^,183^,194^,195,208^,209,217^,230^,232^–234,241^,246^,260^,264^,267^,268,273^,274,278^,279,289^,295^,297). Other substances were often reported as “other” or merely “drugs.” Cross-tabulations of each reason for reluctance with each of the most common specialties, interventions, and drugs produced no significant results; consequently, no P values are reported (Table 2). While this systematic review is of physician reluctance, 110 studies²⁰^,23^–25,28^,30^,31,33^,34,39^,42^,44^,47^,48,50^,52^,54^,57^,59^,63^,64,66^–70,87^,88,90^,92^,93,95^,99^,101^,103^–107,109^,111^–113,116^,120^,122^,123,126^,129^,134^,136^,138^,139,143^,146^,147,151^,156^,157,159^,162^,166^,167,169^,173^,174,177^,178,183^,186^,189^,190,192^,194^,195,199^–201,203^,205^,206,209^,211^,217^,221^,225^,229^,235^,236,243^–245,251^,257^,260^,261,266^,269^,270,275^,277^,280^,283^,286^,287,290^,291,297^,299^,302 mentioned possible facilitators of physician engagement.

Physician Reluctance

Most studies did not gather or report data on all reasons. When queried, institutional environment (173 of 213 articles [81.2%]²⁰^,22^,25^–27,30^–33,35^,37^,38,40^–44,46^,47,49^–51,54^–64,66^,68^,74^–78,80^,82^–84,86^,87,89^–93,95^,97^,99^,100,104^,106^–110,112^–114,116^,117,121^–124,126^,127,129^,134^–139,143^,144,146^–148,150^,151,153^–155,157^–159,161^–165,167^,169^–176,179^,180,182^,183,185^,186,189^,192^,195^,198^,199,201^–204,206^,207,209^,211^,216^–221,223^,226^,228^–230,232^–234,236^,238^,239,241^–243,245^,247^,251^,252,257^–261,263^–265,268^,269,271^,272,275^,277^,280^,284^,287^,290^,291,293^,295^,299^,301^,302) was the most common reason, followed by lack of skill (170 of 230 articles [73.9%]²⁰^–22,24^–33,35^,37^–39,47^–49,51^,53^–55,58^,59,61^,63^–68,75^,76,78^,80^–82,84^,85,88^,89,91^–93,95^,97^–100,102^–107,109^–114,116^–121,123^–125,130^–132,134^,136^,138^,139,142^,143,145^,147^,149^,150,152^,154^,159^–161,167^,168,172^–174,176^,178^,180^,182^,183,186^,188^,190^,191,193^,194,197^–202,204^,206^–211,213^,214,216^,218^–221,224^–226,229^,231^,233^,235^,236,238^,241^,242,246^,247,249^,256^,259^,264^–266,268^,269,271^,273^,274,276^–279,281^–283,285^–287,290^–295,297^,298,301^,302), cognitive capacity (136 of 185 articles [73.5%]²²^,25^,26,30^,32^,34^,37^,40^,41,47^–49,52^,55^,58^–61,63^–66,68^,69,71^,74^,75,77^,78,80^,82^,85^,87^–91,93^,95^,97^,100^,101,104^–107,109^–114,116^,117,119^,120,122^–126,129^,134^–136,138^,139,142^,146^–151,154^–156,159^–162,167^,172^,174^,180^,181,185^–187,190^–192,196^–199,205^,206,209^,211^,213^,214,216^,217,219^,225^,229^–232,235^,237^,239^,241^–243,254^,256^,260^,264^,265,268^–270,272^,275^,277^,283^,286^,287,290^–292,299^,301^,302), and knowledge (174 of 242 articles [71.9%]²⁰^–22,25^–33,36^,37,39^,42^,43,49^,53^–59,61^,62,64^–66,68^–70,73^,76^,78^,81^,82,84^,85,91^–93,95^,97^–100,102^–107,109^,110,113^,114,116^–121,126^,128^,130^,131,136^,138^,139,141^–143,147^,149^–152,154^,155,157^,159^–161,163^,166^–168,170^–174,176^–180,182^–186,188^,190^–194,197^–204,206^–210,212^–215,219^,221^,224^,226^,236^–238,241^,242,244^,246^,247,251^,252,256^–258,264^,266^–269,271^,273^,274,276^–281,283^–288,292^–295,297^–302); and social influences (121 of 184 articles [65.8%]²⁶^,27,30^–32,41^,42,46^,47,49^,51^,57^,58,60^,62^,63,68^,71^,77^,79^,80,82^,83,88^,90^,92^,95^,99^,101^,102,106^–110,112^–114,118^,121^–124,126^,127,129^,134^–138,146^,147,151^,153^,155^,157^–159,161^,165^,167^,169^,170,176^,177,180^,182^,185^,189^,195^,197^–208,210^–212,216^,217,219^,221^,223^,227^,228,233^–235,238^,242^,245^,247^,249^,254^,255,257^,260^,261,264^,266^,268^,269,282^,283,286^,287,289^,291^,296^–298,301^,302) (Table 2). We conducted bivariate analyses of reasons for reluctance and specialty, drug type, intervention, and time (Table 2; eFigure 3 in Supplement 1). Too few studies of recovery support existed to conduct a bivariate analysis with reasons for reluctance. Analysis of combinations of the top 4 reasons for reluctance found the most often paired reluctance reasons were knowledge and skill (135 of 221 articles [61.1%]²⁰^–22,25^–33,37^,39^,49^,53^–55,58^,59,61^,64^–66,68^,76^,78^,81^,82,84^,85,91^–93,95^,97^–100,102^–107,109^,110,113^,114,116^–121,130^,131,136^,138^,139,142^,143,147^,149^,150,152^,154^,159^–161,167^,168,172^–174,176^,178^,180^,182^,183,186^,188^,190^,191,193^,194,197^–202,204^,206^–210,213^,214,219^,221^,224^,226^,236^,238^,241^,242,246^,247,256^,264^,266^,268^,269,271^,273^,274,276^–279,281^,283^,285^–287,292^–295,297^,298,301^,302), followed by cognitive capacity and institutional environment (99 of 165 articles [60.0%]²²^,25^,26,30^,32^,37^,40^,41,47^,49^,55^,58^–61,63^,64,66^,68^,74^,75,77^,78,80^,82^,87^,89^–91,93^,95^,97^,100^,104^,106^,107,109^,110,112^–114,116^,117,122^–124,126^,129^,134^–136,138^,139,146^–148,150^,151,154^,155,159^,161^,162,167^,172^,174^,180^,185^,186,192^,198^,199,206^,209^,211^,216^,217,219^,229^,230,232^,239^,241^–243,260^,264^,265,268^,269,272^,275^,277^,287^,290^,291,299^,301^,302) (Table 3). Institutional environment appeared in combination with other reasons more often than any other reason (7 of 12 pairings). Reasons not in our data extraction template were described in a few studies, including lack of demand (13 articles⁸⁷^,92^,112^,122^,143^,167^,171^,214^,216^,232^,257^,280^,292), cost to the patient (8 articles⁵⁸^,69^,148^,155^,171^,174^,288^,292), and patient refusal (6 articles⁶¹^,146^,170^,174^,182^,206). Analysis of the trend over time for each reason for reluctance revealed a significant increase in identification of social influence (F_1,20 = 4.91; P = .04) and relationship (F_1,20 = 4.54; P = .046) (eFigure 3 in Supplement 1). We extracted exemplar text from included studies for the top 4 reasons for reluctance (Table 4), discussed in the following section.

Institutional Environment

Reasons for reluctance related to the institutional environment included lack of trained staff⁶⁶^,154^,167^,182^,186^,207^,242^,260 or resources to train staff,⁵⁹^,92^,221 acceptance of addiction interventions by staff¹⁰⁷^,259 or leadership,⁵⁷^,80^,155^,169^,175^,261^,275 and clinician backup.⁵⁴^,56^,64^,75^,76,90 Regulatory and liability concerns were frequently reported,³²^,35^,50^,75^,76,87^,90^,99^,107^,163^,165^,167^,174^,245^,259^,261 as were record-keeping or confidentiality concerns²⁰⁷^,259^,275 and staff time required for prior authorizations.⁹² Often mentioned were also cost to the patient or lack of insurance coverage,¹⁴⁸^,155^,170^,171,173^,174,182 along with medication unavailability at pharmacies⁹⁵^,144^,148^,170 and the absence of population-specific patient education materials.²⁶⁰^,291 Less frequently cited but noteworthy reasons for reluctance include contractual limitations,²⁹¹ nonexistent or unimplemented treatment algorithms,⁹⁹^,287 mental health programs not accepting patients with addiction,²⁶⁴ addiction treatment programs rejecting patients deemed insufficiently ready to change or having difficulty matching the level of care needed,²²⁹ and difficulty obtaining records from addiction treatment programs.¹⁰⁷ Reimbursement can be viewed as a component of institutional environment. In the TDF, reimbursement is 1 part of reinforcement as a reason for reluctance (Box). While reinforcement was 1 of the 2 least often identified reasons for reluctance, data specific to reimbursement was extracted because it is a perennial point of concern in adopting evidence-based interventions for addiction. Physician reimbursement was viewed as insufficient to cover both the staff time necessary to intervene in addiction and the expense of additional staff training.¹⁷⁴^,207^,277 Medicaid reimbursement was specifically highlighted as inadequate.¹⁸⁶ In some cases, physicians perceived the reimbursement to be inadequate but were not certain of the reimbursed amount.⁵⁶

Lack of Knowledge

In studies identifying lack of knowledge as a reason for reluctance, knowledge was more deficient for treatment than for screening or diagnosis and for drug use more than for alcohol or tobacco use.²⁰^,65^,70^,93^,99^,102^,117^,152^,194^,221^,252^,273 Physicians were unfamiliar with the evidence for substance use disorders as biomedical conditions,¹¹⁹^,138^,199^,257 harm reduction strategies,⁵⁸^,154 and screening for risky substance use.⁵⁹^,161 Some physicians lacked awareness of the extent of substance use by their patients.²⁵⁶

Lack of Skill

Physicians reported lacking skills to conduct interventions effective enough to produce behavior change, including counseling²¹^,38^,51^,59^,117^,291 and brief intervention.⁹³^,209^,229 They also described a lack of skill needed to initiate or manage treatment,⁹²^,152^,221^,273 especially for substance use disorders other than alcohol or tobacco.⁶³^,194 In some studies, they equated their lack of skill with lack of experience with observing or delivering a substance use disorder intervention under supervision.²²^,75^,91^,238^,256 Inabilities to assemble or demonstrate naloxone administration devices⁵⁸^,277 or to deliver appropriate training in its use to patients⁹⁹ were also noted.

Lack of Cognitive Capacity

Lack of cognitive capacity was not often characterized beyond a general sense of overwhelm with clinical tasks (eg, “just too busy”)⁶⁴^,291 and the need to prioritize patients’ competing needs.⁵⁸^,107^,109^,268 In some cases, physicians perceived intervening in addiction as too time-consuming, both during the appointment and for monitoring,⁶⁹^,87^,90^,93^,287 or that addiction treatment demand would be too great.⁶⁶^,75^,91 Even delegating screening to other clinical team members was viewed as diverting time from the physician visit²²⁹; available tools were considered time-consuming.²⁶⁰ Some physicians expected meeting the care needs of patients with addiction to be too time-consuming.

Facilitators

We analyzed 4 main themes related to facilitators. First, physicians need the knowledge and skills to intervene; they need adequate education and training in areas like managing pharmacology. Second, intrapersonal and interpersonal factors exist that facilitate physician intervention. Intrapersonal factors include physician characteristics (eg, work experience, confidence, and practice type) and motivation (eg, desire to improve patient outcomes, reimbursement, and understanding addiction as within their scope of practice). Interpersonal factors include the physician-patient relationship, specifically the patient characteristics that may compel the physician to intervene (eg, the patient is receptive to help). Third, an infrastructure is needed that supports physician interventions and includes institutional changes at the practice level to implement protocols to standardize care (eg, screening and improved technology). An environment that fosters collaboration with other professionals or entities (eg, multidisciplinary teams and referral systems) and offers resources that would support the intervention (eg, materials or tools for use with patients, follow-up care, or treatment facilities) is also essential. Finally, regulation reforms (eg, eliminating prior authorization requirements, expanding substance use disorder insurance coverage, and simplifying laws and policies governing prescribing and medication distribution to patients) would facilitate physician intervention.

Discussion

The number and growth of publications meeting inclusion criteria for this systematic review demonstrates increasing interest in the perceived and actual barriers to physician engagement with addiction in clinical practice. The significant increase in social influence and relationship as reasons for reluctance over time may indicate increased awareness of stigma and associated social harms. Regarding intervention types, the availability of effective alcohol use disorder and opioid use disorder pharmacotherapies likely accounts for the literature’s focus on those therapies, corresponding with efforts to increase access to medications for opioid use disorder and to promote the adoption of screening, brief intervention, and referral to treatment practices. As the evidence base for a wider array of harm reduction strategies grows, it will be important to understand and address physicians’ perceived and actual barriers to their acceptance and adoption of those strategies. Information is limited on the adoption of recovery support interventions by physicians, a finding that also merits investigation.

That institutional environment is associated with physician reluctance to intervene may not surprise practicing clinicians. The pairing of institutional environment and cognitive capacity may signify the cost in time physicians expend overcoming institutional barriers to EBP for addiction (eg, inefficient workflows and communication and coordination of care across silos). The association of institutional environment with treatment and opioids may reflect the push to increase buprenorphine access despite regulatory impediments and health systems being unprepared for this responsibility.

Strategies to reduce physician reluctance related to institutional environment include greater commitment by health systems to make essential workflow and staffing changes, the breaking down of barriers between addiction services and both medical and mental health care, and commitment by insurers to provide reimbursement that covers the actual cost of providing addiction interventions. The analysis of facilitators supports a specific need for protocols to adequately intervene with patients with either at-risk substance use or substance use disorders. Institutional environment changes (eg, investing in staffing and staff training, implementing standard practices or protocols, and conducting addiction-specific quality assurance) could also facilitate intervention.

Lack of knowledge and skill are top reasons for reluctance, both separately and combined. It is unclear whether survey respondents understood knowledge and skill as the researchers intended because these terms were rarely defined in the studies. Only a few studies allowed for future replication by including objective measures of knowledge or skill (eg, counting successfully delivered services and interviewing patients).

True lack of knowledge and skill can be understood in several ways, including as a manifestation of the volume of information practicing clinicians are required to possess, acquire, and update. For example, physicians need updated information on dosing, pharmacology, and overall efficacy of interventions and medications. This challenge is made harder if interventions (eg, screening practices, initiating pharmacotherapy) are insufficiently adapted for different practice settings. Delivering these interventions effectively, efficiently, and in a nonstigmatizing manner requires skill mastery. Physicians, like other clinicians, acquire their skills by observing and then practicing under supervision. Medical education and postgraduate training have only recently begun to prepare physicians for these tasks.³⁰³^,304

Ongoing training is critical for physicians to acquire and apply advanced skills in the care of this patient population,³⁰⁵^–307 but few opportunities exist to observe and be observed practicing new skills once required medical training is complete. The analysis of facilitators suggests skill training should focus on brief intervention (eg, screening or assessment) and on communication with patients. Trainings accessible to physicians (eg, free or incentivized, hands-on, or delivered in clinical settings) and delivered by specialized trainers and/or mentors would facilitate the growth of a pool of experts to intervene in substance use. Physicians who expand their knowledge and skills should be eligible for continuing medical education credits and increased compensation.

Other reasons for reluctance (eg, negative social influences, negative emotions toward people who use drugs, and fear of harming the relationship with the patient by discussing substance use) could each be viewed as manifestations of stigma associated with substance use disorder and its treatment. Lack of demand may also reflect stigma if it is a manifestation of unwillingness on the part of patients to seek help due to fear of social, legal, and moral judgement or a presumption by the physician that there is no addiction in their community.

These reasons may diminish if effective public and professional education, in particular those developed and led by patient groups or by people who use drugs,³⁰⁸^–312 are delivered to counter stigma.³¹³ The analysis of facilitators suggests the following may be helpful: educational materials for patients and families, community outreach, and public health campaigns promoting nonstigmatizing language.

Reducing stigma will not be enough to address fear of harming the patient relationship, especially for physicians who care for minors and other populations that may be subject to punitive consequences of addiction. These physicians must consider additional confidentiality requirements, and their fear of harming the patient by triggering negative social and legal consequences may be more of a deterrent than previously considered. Interpersonal aspects of the patient-physician relationship and how they create reluctance or facilitate intervention are not well understood, although the analysis of facilitators shows that physicians may be motivated to intervene in substance use disorders when they have an established relationship with the patient, the patient is receptive to help, and/or the desire to improve patient outcomes is strong. Future research should examine unintended impacts of increased physician intervention in addiction like strain on the physician-patient relationship, less opportunity to meet other health care needs, and stigmatizing interactions with other health care clinicians due to the substance use disorder diagnosis being more widely documented.

Limitations

This study has limitations. Inconsistent use of terms across included studies increased the complexity and interpretation of this analysis, but analysis of a sample this size can still inform research and policy. Studies were often developed without the benefit of a theoretical framework. Survey development lacked or failed to report participation of the audience of focus and/or was not piloted, raising concerns about the validity and applicability of results. During the years this systematic review covered, new medications and formulations became available, making comparison across decades challenging. The unregulated drug market also evolved, resulting in changes to illicit substances, methods of using them, and the regulatory environment in which clinicians address substance use. This review was limited to physicians, some of whom may have participated in more than 1 survey or focus group in the included studies. Although the results are relevant to the practice environment of many clinicians, including those specializing in addiction, they do not reflect the unique challenges that may be encountered by specific disciplines. Although we collected and described data about facilitators, the original search was not designed specifically to retrieve publications about facilitators of intervention in addiction.

Conclusions

These data suggest that policy, regulatory, or accreditation changes are needed to systematically address institutional barriers, as well as increases to physician reimbursement and opportunities for clinically relevant training that provides both skill development and knowledge gain. Another systematic review of facilitators and reluctance among other clinical disciplines may refine the recommendations presented here. Future studies of clinician reluctance to adopt EBPs for addiction need to be of higher quality. They, at a minimum, should employ a theoretical framework and adhere to survey development best practices or use a validated survey instrument.

Article Information

Accepted for Publication: May 7, 2024.

Published: July 17, 2024. doi:10.1001/jamanetworkopen.2024.20837

Source: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2821497

Filed under: Addiction,Health,Prevention and Intervention,USA :

Israel, now the largest per capita consumer of opioids, faces a rising crisis. Learn about the challenges, responses from health authorities, and the need for improved treatment and prevention.

By Judy Siegel-Itzkovich

July 21, 2024 03:46

When in 2021, the US Centers for Disease Control and Prevention counted the deaths of over a million Americans from overdosing with opioids – synthetic, painkilling prescription drugs including fentanyl (100 times more powerful than morphine), oxycodone, hydrocodone and many others – Israel’s Health Ministry was asked whether it could happen here. No, its spokesperson said, even though nearly every negative and positive phenomenon in North America inevitably arrives here within a couple of years.

The epidemic began about 25 years ago when drug and healthcare companies began to enthusiastically promote these very-addictive chemicals, claiming they were effective in relieving suffering and did not cause dependency.

A study published this past May by researchers at the Johns Hopkins Bloomberg School of Public Health found that one out of every three Americans have lost someone – a relative or a friend – to an opioid or other drug overdose. The US National Institute on Drug Abuse found that more than 320,000 American children have lost parents from overdoses in the past decade, and the annual financial costs to the US of the opioid crisis is $1 trillion.

Largest consumers of opioids per capita

Incredibly, Israelis today are the largest consumers per capita in the world of opioids, and an untold number of them are addicted or have already died. No one knows the fatality figures here, as the causes of death are described as organ failures, seizures, heart attack or stroke – not listed by what really caused them.

Is this another example of a “misconception” – wishful thinking on the scale of the belief by the government, the IDF, and the security forces that Hamas would “behave” if regularly paid off with suitcases full of cash? Is Israel headed to where the US already is? Perhaps. What is clear is that our various health authorities now have to somehow clean up the opioid mess.

The scandal has been indirectly embarrassing for Israel because among the most notorious companies involved in the opioid disaster is the Sackler family, who own the Purdue Pharma company that manufactured and promoted the powerful and addictive opioid OxyContin and who are now drowning in huge lawsuits. Tel Aviv University’s Medical Faculty that was for decades known as the Sackler Faculty has deleted it from its name.

Last year, the Knesset Health Committee met to discuss the rise in opioid consumption here, with testimony from Ben-Gurion University of the Negev School of Public Health dean and leading epidemiologist Prof. Nadav Davidovitch, who is also the principal researcher and chairman of the Taub Center Health Policy Program. He stressed that inappropriate use of strong pain medications leads to addiction and other severe negative consequences and noted that while most of the rise in consumption is among patients of lower socioeconomic status, the well-off are also hooked. Davidovitch called for the launching of serious programs to treat addicted Israelis based on the experiences of other countries with the crisis.

Opioids attach themselves to opioid-receptor proteins on nerve cells in the brain, gut, spinal cord, and other parts of the body. This obstructs pain messages sent from the body through the spinal cord to the brain. While they can effectively relieve pain, they can be very addictive, especially when they are consumed for more than a few months to ease acute pain, out of habit, or from the patients’ feeling of pleasure (they make some users feel “high”). Patients who suddenly stop taking them can sometimes suffer from insomnia or jittery nerves, so it’s important to taper off before ultimately stopping to take them.

The Health Ministry was forced in 2022 to alter the labels on packaging of opioid drugs to warn about the danger of addiction after the High Court of Justice heard a petition by the Physicians for Human Rights-Israel and the patients’ rights organization Le’altar that claimed the ministry came under pressure from the pharmaceutical companies to oppose this. After ministry documents that showed doctors knew little about the addictions caused by opioids were made public by the petitioners, psychiatrist Dr. Paola Rosca – head of the ministry’s addictions department – told the court that the synthetic painkillers cause addiction. She has not denied the claim that the ministry was squeezed by the drug companies to oppose label changes.

No special prescription, no time limit, no supervision

In an interview with The Jerusalem Post, Prof. Pinhas Dannon – chief psychiatrist of the Herzog Medical Center in Jerusalem and a leading expert on opioid addiction – noted that anyone with a medical degree can prescribe synthetic painkillers to patients. “There is no special prescription, no time limit, no supervision,” he said.

“A person who undergoes surgery who might suffer from serious pain is often automatically given prescriptions for opioids – not just one but several,” Dannon revealed. “Nobody checks afterwards whether the patient took them, handed them over to others (for money or not), whether they took several kinds at once, or whether they stopped taking them. They are also prescribed by family physicians, orthopedists treating chronic back pain, urologists, and other doctors, not only by surgeons.”

Dannon, who runs a hospital clinic that tries to cure opioid addiction, said there are only about three psychiatric hospitals around the country that have small in-house departments to treat severely addicted patients. “Not all those addicted need inpatient treatment, but when we build our new psychiatry center, we would be able to provide such a service.”

Since opioids are relatively cheap and included in the basket of health services, the four public health funds that pay for and supply them have not paid much attention. Once a drug is in the basket, it isn’t removed or questioned. Only now, when threatened by lawsuits over dependency, have the health funds begun to take notice and try to promote reductions in use.

Dannon declared that the health funds, hospitals, and pharmacies must seriously supervise opioid use by tracking and be required by the ministry to report who is taking them, how much, what ages, and for how long. Opioids are meant for acute pain, not for a long period. “The Health Ministry puts out fires but is faulty in prevention and supervision,” he said.

A Canadian research team has just conducted a study at seven hospital emergency departments in Quebec and Ontario to determine the ideal quantity of prescription opioids to control pain in discharged patients and reduce unused opioids available for misuse.

They recommended that doctors could adapt prescribing quantity to the specific condition causing pain, based on estimates to alleviate pain in 80% of patients for two weeks, with the smallest quantity for kidney or abdominal pain (eight tablets) and the highest for back pain (21 tablets) or fractures (24 tablets), and add an expiry date for them. Since half of participants consumed even smaller quantities, pharmacists could provide half this quantity to further reduce unused opioids available for misuse.

No medical instruction on the issue

Rosca, who was born in Italy where she studied medicine and came on aliyah in 1983, has worked in the ministry since 2000; in 2006, she became head of the addictions department.

“In Italy, every psychiatrist must learn about alcohol and other drug addictions including opioids,” she said. “Here, there is no mandatory course in any medical school on the subject. We tried to persuade the Israel Medical Association and its Scientific Council, which decides on curricula and specializations, but we didn’t succeed. Maybe now, in the face of the crisis, it will change its mind. We run optional courses as continuing medical education for physicians who are interested.”

Her department wanted pharmacists to provide electronic monitoring of opioid purchases, but “the Justice Ministry opposed it on the grounds that it would violate privacy. I wasn’t asked for my opinion.”

She concedes that the ministry lacks statistics on the number of addicted people, and Arabs have been excluded from estimates until now. “We’re doing a study with Jerusalem’s Myers-JDC-Brookdale Institute to find out how many. Some say one percent, some say five percent. We hope that by December, we will get more accurate figures. Before the COVID-19 pandemic, the ministry set up a committee on what to do about opioids, but its recommendations were never published, and there was no campaign,” Rosca recalled.

In 1988, the government established the statutory Anti-Drug Authority that was located in Jerusalem’s Givat Shaul neighborhood. It was active in fighting abuse and shared research with foreign experts, but seven years ago, its name was changed to the National Authority for Community Safety and became part of the Ministry for National Security, losing much of its budgets – and, according to observers, its effectiveness as well.

The Health Ministry used to be responsible for setting up and operating clinics for drug rehabilitation, but it handed this over in 1997 to a non-profit organization called the Israel Public Health Association, which employs numerous former ministry professionals. Its director-general, lawyer Yasmin Nachum, told the Post in an interview that the IPHA is very active in fighting drug addiction.

“Israel can’t deny anymore that we are in a worrisome opioid epidemic like that in the US: We are there,” he said. “We see patients every day. Some used to take heroin and other street drugs, but with the easy access and low price, they have switched to opioids. If they are hospitalized for an operation and don’t use all the prescriptions they are given, they sell them to others. We want to have representation in every hospital to warn doctors and patients.”

Of a staff of 1,100, the IPHA has 170 professionals – narcotics experts, social workers, occupational therapists, and others working with 3,000 addicted patients every day. Its other activities include mental health, ensuring safety of food and water, and rehabilitation.

Stopping after six months

“We work in full cooperation with the ministry,” Nachum said. “Our approach is that when opioids are taken for pain for as long as six months, it’s the time to stop taking them. The doctors provide addicted patients with a drug called buprenorphine, sold under the brand name Subutex, which is used to treat opioid-use disorder, acute pain, and chronic pain.”

Buprenorphine is a mixed opioid agonist and antagonist. That means it has some of the effects of opioids but also blocks some of their effects. Before the patient can take it under direct observation, he must have moderate opioid-withdrawal symptoms. The drug relieves withdrawal symptoms from other opioids and induces some euphoria, but it also blocks the efficacy of many other opioids including heroin, to create an effect.

Buprenorphine levels in the blood stay consistent throughout the month. Nachum said the replacement drug is relatively safe, with some side effects, but fortunately, there is no danger of an overdose.

NARCAN (NALOXDONE) is another prescription drug used by some professionals to fight addiction. Not in Israel’s basket of health services, it blocks the effects of opioids by temporarily reversing them, helping the patient to breathe again and wake up from an overdose. While it has saved countless lives, new and more powerful opioids keep appearing, and first responders are finding it increasingly difficult to revive people with it.

Now, US researchers have found an approach that could extend naloxone’s lifesaving power, even in the face of continually more dangerous opioids by using potential drugs that make naloxone more potent and longer lasting. Naloxone is a lifesaver, but it’s not a miracle drug; it has limitations, the team said.

After the Nova massacre on October 7, when significant numbers of participants who were murdered were high on drugs, the IPHA received a huge number of calls. In December, Nachum decided to open a hotline run by professionals about addiction that has been called monthly by some 300 people. “We also hold lectures for pain doctors, family physicians, and others who are interested, because there has been so little awareness.”

All agree that the opioid crisis has been seriously neglected here and that if it is not dealt with seriously and in joint efforts headed by healthcare authorities, it will snowball and add to Israel’s current physical and psychological damage.

Source: https://www.jpost.com/health-and-wellness/article-811126

Filed under: Addiction,Drug Specifics,Drug use-various effects,Health,Others (International News),Prevalence :

Everyone knows illicit drug use in Australia is worsening, but wouldn’t it be helpful if we had precise numbers for gauging the scale of the problem? How useful it would be if we could measure consumption, perhaps even knowing just how much of each substance was being used in what locations and how patterns were changing.

In fact, we do have those figures, through analysis of wastewater; we’re just not paying enough attention to them. They show our current means of minimising harm from drug use isn’t working. We must look beyond treating it as a mainly law enforcement problem.

The Australian Criminal Intelligence Commission released its 21st National Wastewater Drug Monitoring Program report last month. It found that ‘more than 16.5 tonnes of methylamphetamine, cocaine, heroin and MDMA combined was consumed between August 2022 and August 2023 representing a 17 per cent increase in consumption of these drugs from the previous year’.

Reports from the commission’s National Wastewater Drug Monitoring Program ought to be the most consequential inputs for developing illicit drug policy and law enforcement strategy in Australia. Seven years ago, on the eve of the release of the first report, one of Australia’s most senior law enforcement leaders at the time confided to this writer that the program would show, as it has shown, that our law enforcement strategy was having no impact on the availability of illicit drugs. It would show a failure of policy and strategy, that officer said.

Yet, the reports generally result in several print media reports and quickly fade from public and policymaking attention.

The program is a sophisticated initiative focused on gathering intelligence about drug consumption patterns across Australia. It involves collecting and analysing sewage samples from various places, including cities and regional areas, to detect and monitor the presence of illicit drugs and pharmaceuticals in wastewater. By examining the levels of substances such as methamphetamine, cocaine, MDMA, and opioids, it offers valuable insights into drug use trends, geographical distribution and changes in consumption patterns.

It uses advanced analytical techniques to quantify the concentration of targeted substances. By monitoring drug use at a population level it should help identify emerging drug threats, assess the effectiveness of existing interventions and guide efficient allocation of resources to address public health concerns related to substance abuse.

The latest report reveals several trends in drug consumption. One is continued high use of methamphetamine in many urban and regional areas, indicating ongoing challenges in reducing its availability. Additionally, the program has detected fluctuations in consumption of other drugs, such as cocaine, MDMA, and prescription opioids. Drug use patterns are dynamic.

The findings underscore the importance of targeted interventions and evidence-based strategies to address substance abuse, especially the need for a comprehensive approach that combines law enforcement efforts with public health initiatives.

The program’s findings are not mere statistics; they are revelations that should reverberate through policymaking and public-health administration. Outstanding performance by our law enforcement and border officers, with their record levels of drug seizures and arrests, is clearly having negligible effect on drug availability, use or price.

Some argue that, if not for these efforts, the problem would be worse. It’s a hollow argument. Our enforcement strategy aims not to prevent things from worsening but to improve them. In short, the Wastewater Monitoring Program provides seven years of evidence of the need for a paradigm shift in our approach to illicit drugs.

The data should empower policymakers to sculpt interventions that transcend rhetoric, go beyond traditional law enforcement and embrace a comprehensive strategy where public health, harm reduction and treatment intertwine.

Alternatives to a strictly law enforcement approach to illicit drugs focus on public health, harm reduction and treatment strategies. Drug possession for personal use should be treated as a civil offence or a minor infraction rather than a crime. This approach aims to reduce the negative consequences of drug use, such as incarceration and stigma, while prioritising public health interventions. It was introduced in Canberra in 2024 and has not resulted in an influx of drug tourists or a marked increase in organised crime.

Harm reduction programs, such as needle exchanges, safe injecting rooms, and pill testing, are crucial. These initiatives improve the wellbeing of drug users and reduce the spread of infectious diseases without necessarily focusing on drug prohibition.

Investing in accessible and effective drug treatment and rehabilitation programs is also necessary. These efforts should include counselling, detoxification services, medication-assisted treatment (such as methadone or buprenorphine for opioid use disorder) and mental health support. Emphasising treatment over punishment can help individuals overcome addiction and reintegrate into society.

Prevention efforts should continue to aim at reducing drug-use initiation and promoting healthy behaviour. This includes education campaigns in schools and communities, raising awareness about the risks of drug use and focusing on harm.

These alternatives often complement each other, forming a comprehensive approach that acknowledges the complexity of drug use and addiction while prioritising public health and harm reduction.

Law enforcement still has a place in our national illicit drug strategy. It must continue to focus on reducing the availability of illicit drugs and disrupting organised crime. Its success here should not be assessed based on arrests and seizures but by the Wastewater Monitoring Program’s evidence base.

The Australian government’s approach to illicit drugs is shaped by a complex interplay of factors, including political dynamics, international obligations, evidence-based practices, resource considerations and public perceptions. Any changes to drug strategies are typically considered within this broader context to ensure a comprehensive and sustainable approach to addressing drug-related challenges. However, we must recognize what the evidence shows.

AUTHOR

John Coyne is the head of ASPI’s Northern Australia Strategic Policy Centre and strategic policing and law enforcement program.

Source: https://www.aspistrategist.org.au/our-drug-policies-arent-working-the-evidence-is-in-wastewater/

Filed under: Australia,Crime/Violence/Prison,Health :

Young people who smoked marijuana in the 1960s were seen as part of the counterculture. Now the cannabis culture is mainstream. A 2022 survey sponsored by the National Institutes of Health found that 28.8% of Americans age 19 to 30 had used marijuana in the preceding 30 days—more than three times as many as smoked cigarettes. Among those 35 to 50, 17.3% had used weed in the previous month, versus 12.2% for cigarettes.

While marijuana use remains a federal crime, 24 states have legalized it and another 14 permit it for medical purposes. Last week media outlets reported that the Biden administration is moving to reclassify marijuana as a less dangerous Schedule III drug—on par with anabolic steroids and Tylenol with codeine—which would provide tax benefits and a financial boon to the pot industry.

Bertha Madras thinks this would be a colossal mistake. Ms. Madras, 81, is a psychobiology professor at Harvard Medical School and one of the foremost experts on marijuana. “It’s a political decision, not a scientific one,” she says. “And it’s a tragic one.” In 2024, that is a countercultural view.

Ms. Madras has spent 60 years studying drugs, starting with LSD when she was a graduate student at Allan Memorial Institute of Psychiatry, an affiliate of Montreal’s McGill University, in the 1960s. “I was interested in psychoactive drugs because I thought they could not only give us some insight into how the brain works, but also on how the brain undergoes dysfunction and disease states,” she says.

In 2015 the World Health Organization asked her to do a detailed review of cannabis and its medical uses. The 41-page report documented scant evidence of marijuana’s medicinal benefits and reams of research on its harms, from cognitive impairment and psychosis to car accidents.

She continued to study marijuana, including at the addiction neurobiology lab she directs at Mass General Brigham McLean Hospital. In a phone interview this week, she walked me through the scientific literature on marijuana, which runs counter to much of what Americans hear in the media.

For starters, she says, the “addiction potential of marijuana is as high or higher than some other drug,” especially for young people. About 30% of those who use cannabis have some degree of a use disorder. By comparison, only 13.5% of drinkers are estimated to be dependent on alcohol. Sure, alcohol can also cause harm if consumed in excess. But Ms. Madras sees several other distinctions.

One or two drinks will cause only mild inebriation, while “most people who use marijuana are using it to become intoxicated and to get high.” Academic outcomes and college completion rates for young people are much worse for those who use marijuana than for those who drink, though there’s a caveat: “It’s still a chicken and egg whether or not these kids are more susceptible to the effects of marijuana or they’re using marijuana for self-medication or what have you.”

Marijuana and alcohol both interfere with driving, but with the former there are no medical “cutoff points” to determine whether it’s safe to get behind the wheel. As a result, prohibitions against driving under the influence are less likely to be enforced for people who are high. States where marijuana is legal have seen increases in car accidents.

One of the biggest differences between the two substances is how the body metabolizes them. A drink will clear your system within a couple of hours. “You may wake up after binge drinking in the morning with a headache, but the alcohol is gone.” By contrast, “marijuana just sits there and sits there and promotes brain adaptation.”

That’s worse than it sounds. “We always think of the brain as gray matter,” Ms. Madras says. “But the brain uses fat to insulate its electrical activity, so it has a massive amount of fat called white matter, which is fatty. And that’s where marijuana gets soaked up. . . . My lab showed unequivocally that blood levels and brain levels don’t correspond at all—that brain levels are much higher than blood levels. They’re two to three times higher, and they persist once blood levels go way down.” Even if people quit using pot, “it can persist in their brain for a while.”

Thus marijuana does more lasting damage to the brain than alcohol, especially at the high potencies being consumed today. Levels of THC—the main psychoactive ingredient in pot—are four or more times as high as they were 30 years ago. That heightens the risks, which range from anxiety and depression to impaired memory and cannabis hyperemesis syndrome—cycles of severe vomiting caused by long-term use.

There’s mounting evidence that cannabis can cause schizophrenia. A large-scale study last year that examined health histories of some 6.9 million Danes between 1972 and 2021 estimated that up to 30% of young men’s schizophrenia diagnoses could have been prevented had they not become dependent on pot. Marijuana is worse in this regard than many drugs usually perceived as more dangerous. “Users of other potent recreational drugs develop chronic psychosis at much lower rates,” Ms. Madras says. When healthy volunteers in research experiments are given THC—as has been done in 15 studies—they develop transient symptoms of psychosis. “And if you treat them with an antipsychotic drug such as haloperidol, those symptoms will go away.”

Marijuana has also been associated with violent behavior, including in a study published this week in the International Journal of Drug Policy. Data from observational studies are inadequate to demonstrate causal relationships, but Ms. Madras says that the link between marijuana and schizophrenia fits all six criteria that scientists use to determine causality, including the strength of the association and its consistency.

Ms. Madras says at the beginning of the interview that she was operating on three hours of sleep after crashing on scientific projects. Yet she is impressively lucid and energized. She peppers her explanations with citations of studies and is generous in crediting other researchers’ work.

Another cause for concern, she notes, is that more pregnant women are using pot, which has been linked to increased preterm deliveries, admissions of newborns into neonatal intensive care units, lower birth weights and smaller head circumferences. THC crosses the placenta and mimics molecules that our bodies naturally produce that regulate brain development.

“What happens when you examine kids who have been exposed during that critical period?” Ms. Madras asks. During adolescence, she answers, they show an increased incidence of aggressive behavior, cognitive dysfunction, and symptoms of ADHD and obsessive-compulsive disorders. They have reduced white and gray matter.

A drug that carries so many serious side effects would be required by the Food and Drug Administration to carry a black-box warning, the highest-level alert for drugs with severe safety risks. Marijuana doesn’t—but only because the FDA hasn’t cleared it.

The agency has selectively approved cannabis compounds for the treatment of seizures associated with Lennox-Gastaut or Dravet syndrome, nausea associated with chemotherapy for cancer, and anorexia associated with weight loss in AIDS patients. But these approved products are prescribed at significantly less potent doses than the pot being sold in dispensaries that are legal under state law.

What about medicinal benefits? Ms. Madras says she has reviewed “every single case of therapeutic indication for marijuana—and there are over 100 now that people have claimed—and I frankly found that the only one that came close to having some evidence from randomized controlled trials was the neuropathic pain studies.” That’s “a very specific type of pain, which involves damage to nerve endings like in diabetes or where there’s poor blood supply,” she explains.

For other types of pain, and for all other conditions, there is no strong evidence from high-quality randomized trials to support its use. When researchers did a “challenge test on normal people where they induce pain and tried to see whether or not marijuana reduces the pain, it was ineffective.”

Ms. Madras sees parallels between the marketing of pot now and of opioids a few decades ago. “The benefits have been exaggerated, the risks have been minimized, and skeptics in the scientific community have been ignored,” she says. “The playbook is always to say it’s safe and effective and nonaddictive in people.”

Advocates of legalization assert that cannabis can’t be properly studied unless the federal government removes it from Schedule I. Bunk, Ms. Madras says: “I have been able to study THC in my research program.” It requires more paperwork, but “I did all the paperwork. . . . It’s not too difficult.”

Instead of bankrolling ballot initiatives to legalize pot, she says, George Soros and other wealthy donors who “catalyzed this whole movement” should be funding rigorous research: “If these folks, these billionaires, had just taken that money and put it into clinical trials, I would have been at peace.”

It’s a travesty, Ms. Madras adds, that the “FDA has decided that they’re going to listen to that movement rather than to what the science says.” While the reclassification wouldn’t make recreational marijuana legal under federal law, dispensaries and growers would be able to deduct their business expenses on their taxes. The rescheduling would also send a cultural signal that marijuana use is normal.

Her rejoinder to critics who say the war on drugs was a failure? “This is not a war on drugs. It’s a defense of the human brain at every possible age from in utero to old age.”

Source: https://www.wsj.com/articles/what-you-arent-reading-about-marijuana-permanent-brain-damage-biden-schedule-iii-9660395e

Filed under: Cannabis/Marijuana,Drug use-various effects,Health,USA :

A new national state scorecard confirms dramatic inequities, finds regional variations

NICK BUDNICK

|THE LUND REPORT PREMIUM

APRIL 23, 2024

Racial disparities are vast across the nation and in Oregon, a new report shows. But the statistics reveal some surprising differences among states.

In some statistics that measure outcomes for different racial and ethnic groups, Oregon, like Washington, does better than most states. In other measures, it does worse.

For the first time in three years, The Commonwealth Fund, a nonprofit health care research and advocacy group, has issued its state-by-state measurements of health care disparities. The report compiled data on 25 health care measures tracking outcomes, quality, access and use of services by five different racial and ethnic groups — Black, white, Hispanic, American Indian and Alaska Native, as well as Asian American, Native Hawaiian and Pacific Islander. Researchers then aggregated them to create what amounts to a scorecard.

The report is called Advancing Racial Equity in U.S. Health Care: The Commonwealth Fund 2024 State Health Disparities Report. Its findings are similar to earlier research from 2021 that found the performance of Oregon’s health system as experienced by different groups tended to be better in some measures than most states.

But there are still major problems, according to David Radley, the longtime leader of The Commonwealth Fund’s scorecard project. Two years ago he joined the Center for Evidence-Based Policy at Oregon Health & Science University as its director of data and analytics.

“There are still big disparities” in Oregon, he said. “There’s still a lot of improvements to be made.”

For instance? For Black people in Oregon, the rate of deaths before age 75 for causes that are treatable through health care is 141 per 100,000. For white people, however, the rate is slightly less than half that: 69 per 100,000.

Meanwhile, the proportion of people who reported skipping needed health care due to cost was 7% for white people, but double that or more for people who are Black, Hispanic or American Indian and Alaska Native.

The statistics are more complex than they seem on the surface, according to Radley. In effect, they measure not just the provision of health care but the effects of social factors that contribute to health outcomes, such as access to healthy food and stable housing. Other reports, by The Commonwealth Fund as well as the Coalition of Communities of Color in Oregon, have focused on issues like structural racism.

Asked about the study, state Rep. Ricki Ruiz, a Gresham Democrat, said he thinks improvements need to be a priority in access to primary care, affordability and interpreter services. With parents that moved to the United States from Mexico, he served as the family interpreter with health care providers starting when he was six years old — and not exactly fluent in health care terms.

“As a first-generation citizen, one of the things we always struggled to navigate was the health care system,” he said. “Disparities still exist. And that is something that is alarming. That is something we need to continue to study— to be able to minimize that as much as we can.”

State measures show ranking

The report provides a state-by-state overview of statistics and their rankings among states (and Washington, D.C.) where sufficient data was available in all categories for that group.

It found that Oregon and Washington score similarly to one another when it comes to measures broken down by race and ethnicity. And they do better than most other states.

For people who are Asian American, Native Hawaiian, and Pacific Islander:

In health outcomes, Washington ranked 13th and Oregon 19th. among 33 states.
In health care access, Washington ranked 5th and Oregon 7th among 34 states.
In health care quality, Washington ranked 15th and Oregon 16th among 41 states.

For people who are American Indian and Alaska Native:

In health outcomes, Washington ranked 4th among 10 states while Oregon data was insufficient.
In health care access, Washington ranked 3rd among 11 states while Oregon data was insufficient.
In health care quality in 11 states, Washington ranked 8th among 11 states while Oregon data was insufficient.

For people who are Black:

In health outcomes, Washington ranked 4th and Oregon 9th among 40 states..
In health care access, Washington ranked 19th and Oregon 22nd among 40 states.
In health care quality, Oregon ranked 11th and Washington 28th among 41 states.

For people who are Hispanic:

In health outcomes, Oregon ranked 3rd and Washington 9th among 49 states. .
In health care access, Washington ranked 18th and Oregon 22nd among 48 states.
In health care quality, Oregon ranked 10th and Washington 21st among 48 states.

For people who are White:

In health outcomes, Washington ranked 12th and Oregon 21st among 50 states plus Washington, D.C.
In health care access, Washington ranked 15th and Oregon 26th among 50 states plus Washington, D.C.
In health care quality, Washington ranked 14th and Oregon 24th among 50 states plus Washington, D.C.

According to Radley, the findings for Oregon call for making health care more affordable, while also focusing on strengthening the state’s provision of primary care.

That includes ensuring access to care with community health workers and providers that speak the same language as the patient.

“That’s one of the best tools we have to fight these kinds of disparities,” he said.

Source: https://www.thelundreport.org/content/oregon-performs-better-health-equity-disparities-remain?

Filed under: Health,Social Affairs,USA :

April 24, 2024

The Australian community deserve a clear picture of all persons whose Mental Health has come to the attention of the police, hospitals and the community.

When cannabis genotoxicity effects are added to cannabis neurotoxicity effects the argument against the widespread use of cannabis for everything becomes very robust indeed.

The drug prevention taskforce outlines below our real concerns regarding the Stabbing rampage at Sydney. It does appear that here in Australia our State and Federal Medical Department has been testing toxic factors using blood and not using the much better hair test.

Most of the cannabis (80-90%) is excreted within 5 days as hydroxylated and carboxylated metabolites. See attached (Chemistry and Toxicology of cannabis).

Because 90% of THC is gone in 80 minutes from blood. Please demand hair testing of the subject for marijuana use (blood test may not be positive due to rapid clearance). This is very indicative of cannabis induced psychosis most of the cannabis (80-90%) is excreted within 5 days as hydroxylated and carboxylated metabolites . There are eighteen acidic metabolites as per Goulle JP, Saussereau E, Lacroix C. [Delta-9-tetrahydrocannabinol pharmacokinetics]. Ann Pharm Fr 2008; 66: 232-244. Studies attached.

Drug Free Australia is seeking to bring urgent attention to Australian whether Federal or State, regarding extremely important research relating to Mental Health and cannabis use. It appears that Australian public policies have moved from concern for the health and wellbeing of society – by improving and promoting good health – to pushing unnecessary drug use for profiteers while charging the tab to society-at-large. DFA believes that it is time for governments worldwide to promote research and media publicity which avoids the cherry-picked faux studies used by those wanting to legalise cannabis. Rather, the focus should be on its serious harms to mental and physical health particularly related to early use.

TOP 15 RISKS OF MARIJUANA ON HEALTH https://iasic1.org. The Drug Free Australian paper (MENTAL HEALTH AND CANNABIS USE) see attached. (A Panel Study of the Effect of Cannabis Use on Mental Health, Depression and Suicide in the 50 States)see attached.

EXCLUSIVE: Regular cannabis use in people’s mid-20s can cause permanent damage to the brain development and legalizing the drug has WRONGLY presented it as harmless, drug safety expert Dr Nora Volkow, director of the National Institute on Drug Abuse, warned cannabis use among young adults was a ‘concern’. She called for ‘urgent’ research into the potential health risks of the drug. Several papers have suggested regular use could be damaging mental development and affecting users’ social life

But these often also include people regularly using alcohol and tobacco, making it difficult to deduce whether cannabis is behind the changes. About 48million Americans use cannabis annually, a number that is rising. https://www.dailymail.co.uk/health/article-11138001/Taking-cannabis-mid-20s-damages-cognitive-development-NIH-expert-warns.html

Prohibition has worked globally for more than 100 years since the UN Drug Conventions began. These have kept illicit drug use down to 5% use worldwide, whereas legalised tobacco and alcohol have much higher rates.
Legalising and decriminalizing substances inevitably gives a green light for use (as we have seen with increased use of cannabis in parts of the United States where it has been made legal.
Global illicit drug industries are responsible for an enormous amount of environmental destruction

(Illegal Marijuana growers poison forests-these people fight back) https://www.nationalgeographic.com/environment/article/illegal-marijuana-growing-threatens-california-national-forests (Green But Not Green: How Pot Farms Trash the Environment) http://www.slate.com/articles/news_and_politics/uc_breakthroughs_2014/2014/04/green_but_not_green_how_pot_farms_trash_the_environment.html

RECOMMENDATIONS THAT CAN HELP PREVENT THE AUSTRALIAN “LOST GENERATION DYING”

All Australian Governments and community leaders need to take this evidence regarding Mental Health very seriously. The issue of cannabis-caused violence needs to be addressed. For example, the Australian Government must consider organising several Mental Health teams working 24/7 to evaluate the mental health and wellbeing of those involved in animal cruelty, road rage, spousal abuse and child fatalities. These teams should have the authority to place these individuals into detox and rehabilitation centres for three to twelve months according to their progress. They will also need to be constantly reminded that they are very important to the Australian community’s future. Here in Queensland, we have one centre available. .and a third that could be built. They could be equipped at minimum cost and run with existing staff for this mental health program.

The Australian National Drug Strategy 2017-2026 identifies cannabis as a priority substance for action, noting 20% of Australian drug and alcohol treatment services are provided to people identifying cannabis as their principal drug of concern. DFA believes that the number is higher for those under 25 years of age.

We greatly appreciate your time in responding to these extremely important matters in terms of community health, welfare and safety and would value your response early Should you require further information and/or a face-to-face meeting we would be very pleased to accommodate.

Kind Regards

Herschel Baker, International Liaison Director,

>>>>>>>>>>>>>>>>>>>>>>>

Please click on the links below to read the reports:

When you click on the link an image of the report cover will appear
Then please click on the report cover image to open the report.

Filed under: Australia,Cannabis/Marijuana,Drug use-various effects,Health,Mental Health :

Research shows how a major shift in the drug supply could be leading to an increasing amount of overdose deaths. Fentanyl continues to devastate American lives. Now, new research shows how a major shift in the drug supply could be leading to an increasing amount of overdose deaths. (Scripps News)

By: Vanessa Misciagna

Posted at 5:47 PM, Jul 05, 2024

A new study by NYU Langone, funded by the National Institutes of Health and the National Institute on Drug Abuse, shows how fentanyl has taken over America’s illegal drug supply. It has happened fast.

Law enforcement seizure data shows that illicit fentanyl seizures grew more than 1700% in the 6 year span from 2017 to 2023.

Fentanyl pills specifically made up nearly half of fentanyl seizures in 2023, at 49%. Compare that to 10% in 2017.

As much as 85% of these seizures are happening in the western part of the United States.

A lead researcher on the study, Dr. Joseph Palamar, said that though the numbers are staggering, they’re not surprising given recent trends.

“A couple of years ago, most fentanyl was in powder form. The way it began was fentanyl started creeping up into the heroin supply …then pills started coming around — particularly in the West, and pills introduced fentanyl in a whole different manner to people,” he said.

Related stories:

Palamar says fentanyl in pill-form changes the game, so to speak, in terms of who is now able to obtain it.
Pills are easier to take or to smoke, so there’s no need to figure out how to use a needle. Also, because many fentanyl pills are meant to look like legitimate pills, it’s easier for people who don’t necessarily know they’re taking fentanyl to find it, ingest it and overdose.

“My fear in particular is that there are young people who are trying to get their hands on pills like Adderall or Oxy or Xanax and if they buy them illegally, they don’t know that they could have fentanyl in them — just a few milligrams is enough to kill a teenager,” Palamar said.

Rob Sullivan oversees multiple drug detox programs in northwestern Washington state, and has been in the industry for 20 years.

He says he and his colleagues have noticed that it takes longer for someone to detox from fentanyl — prompting requests to insurance companies to extend detox stays. He also says people have a harder time completing detox, and many times people detox without even realizing they’ve taken fentanyl.

“We see right now, we’re about 66% complete. And 44% don’t complete. Whereas we used to be higher when it was just regular opioids, because people knew what to expect, meaning clients, and also professionals knew what to expect,” Sullivan said.

“Whereas with fentanyl — so different, and so powerful — that it’s really, it’s a different ballgame than what it was,” he said.

Palamar hopes that these findings spark a stronger emphasis on drug use prevention

“We need people to be educated about fentanyl and the associated risks, particularly the people who have not used fentanyl. I worry about people starting fentanyl, and I also worry about people being unintentionally exposed to fentanyl — especially young people.”

Source: https://www.ktvq.com/us-news/new-study-shows-the-rising-prevalence-of-fentanyl-pills

Filed under: Cannabis/Marijuana,Fentanyl,Health,USA :

Mary Brett – in memoriam

Mary Brett, Former biology teacher (30 years at Dr Challoner’s Grammar School for boys, Amersham, Buckinghamshire. UK), Trustee of CanSS (Cannabis Skunk Sense), Member of PandA (Centre for Policy Studies) and former Vice President of Eurad. With regret, it is noted that Mary has recently died, in 2024, after a long illness – her expert contribution to the field of drug prevention and education is to be celebrated, and remembered for the quality of her work throughout.

The paper reproduced here below is but one example of Mary’s expert contributions to the field.

Executive Summary

Prevention is the policy of this Government but harm-reduction organisations are being consulted for information and evidence—the Advisory Council on Misuse of Drugs (ACMD), Drugscope and the John Moores University Liverpool.

Information on cannabis from these sources is out-of-date, misleading, inaccurate, has huge omissions and is sometimes wrong. It does not stand comparison with current scientific evidence.

Children do not want to take drugs. They want reliable information to be able to refuse them.

Tips on safer usage and “informed choice” have no place in the classroom.

Prevention works.

Current information about drugs being given to this government comes mainly, if not entirely, from harm-reduction organisations. I find this astonishing. The policy of this Coalition Government is prevention.
I had long suspected, and had it confirmed by BBC’s Mark Easton’s blog 20 January 2011, that “Existing members of the council (ACMD) are avowed “harm-reductionists”. Drugscope, a drugs information charity paid for entirely by the taxpayer, has always had a harm reduction policy. We find statements like, “prevention strategies are not able to prevent experimental use” and “harm minimisation reflects the reality that many young people use both legal and illegal substances”. And the John Moores University in Liverpool has been at the forefront of the harm reduction movement since the eighties. Pat O’Hare, President of the International Harm Reduction Association (IHRA), said: “As founder of the first IHRA conference, which took place in Liverpool in 1990, it gives me a great sense of pride to see it coming “home” after being held all over the world in the intervening 20 years”.
FRANK is the official government website providing information to the public, especially children 11–15. I have learned that the information for the recently re-launched FRANK website came from The John Moores University. A member of the FRANK team, Dr Mark Prunty was involved in a commissioned report, “Summary of Health Harms of Drugs” published in August 2011.
Harm reduction has its place in the treatment of addiction, eg reducing the dose till abstinence is attained. But no place in the classroom where well over 90% of children have no intention of ever taking drugs. Harm reduction can and does sometimes act as a green light.
This government says it wants to stop young people from ever starting to use drugs, but that’s not the aim of harm reductionists. They assume children will take drugs anyway, so give them “tips” on taking them more safely, and offer them “informed choice”. And for some reason I have never understood, they always downplay the harmful effects of cannabis—information is vague, inadequate, misleading, out-of-date and sometimes completely wrong.
Brains are not fully developed till the 20s, the risk-taking part developing before the inhibitory area. Children from seven upwards are simply incapable of making the right decision. They need to be protected, not abandoned to make critical life choices. Only 30–40% will ever try drugs—a world away from regular use. What other illegal activities do we invite them to choose—pilfering, graffiti-spraying? Harm reduction advocates are so wrong. Children don’t actually want to take drugs. They want sound, reliable and full information to help them refuse drugs from peer group users who are pressuring them. I know—they’ve told me. Harm reduction policies are tantamount to condoning drug use.
Prevention works. The prevention campaign in USA 1979–1991 saw illicit drug users drop from 23 to 14 million. Cannabis and cocaine use halved. Over 70% abstained from cannabis use because of concern over physical and/or psychological harm (P.R.I.D.E. survey USA 1983). In Sweden, 2010 “last month use” of cannabis was 0.5% (ages15 to 64), European average—3.7%.
Overall, drug use may have fallen in the last 10 years but the last BCS reported that there had been a 1% increase in the “last year” use of cannabis among 16 to 24 year olds in the UK. This amounts to around 55,000 people—no room for complacency.
At a meeting of the FRANK team, Dr Mark Prunty, asked me to send my large scientific report on cannabis (“Cannabis—A general view of its harmful effects”, written for The Social Justice Policy Group, in 2006, fully endorsed by eminent scientists, and regularly updated), and all new research papers that I received. He also had the two books I have written (“Drug Prevention Education” and “Drugs—it’s just not worth it”¹). I wasted my time. Why is there no scientific researcher on the FRANK team or at least temporarily co-opted?
One of the John Moore’s staff members, Dr Russell Newcombe helped to pioneer the harm-reduction movement in Merseyside from the mid-1980s and was Senior Researcher for Lifeline Publications & Research (Manchester, 2005–10). Lifeline literature on drugs, used in some schools, is hugely harm reduction based. Several leaflets and DVDs on “How to inject” are freely advertised on the Internet and can be easily accessed, as are needles, by children. Children are scared of injecting—now they needn’t worry!
The last paragraph in Lifeline’s Big Blue Book of Cannabis says, “If we look at our crystal ball at the world of tomorrow what can we expect to see? More medical uses for cannabis; stronger types of weed appearing on the streets; more laws; more fiendish ways of catching users and the same old hysterical reactions to people smoking a plant”—That says it all!
My analysis of the cannabis information in the “Summary of Health Harms of Drugs” pages 31–33 follows:
“No cases of fatal overdose have been reported”. Isn’t it the same with tobacco? “No confirmed cases of human death”. “Stoned” drivers kill themselves/others. Cancers recorded, especially head and neck at young age (Donald 1993, Zang 1999). Serotonin, “happiness” neurotransmitter depleted (Gobbi 2009) causing depression—can lead to suicides (Fugelstad (Sweden) 1995). Violence from psychosis or during withdrawal, murders documented in the press and coroners’ reports. Teenagers have had strokes and died after bingeing (Geller 2004).
Strength: No figures are given for Tetrahydrocannabinol (THC) content. Skunk now averages 16.2% but can range up to 46% THC, old herbal 1–2%, Hash 5.9% (Home Office Report 2008). No warning that skunk occupies 80% of the UK market, hash 20%. FRANK says that skunk is 2–4 times stronger than old herbal cannabis—wrong! They mislead the public by comparing it with hash. The enlightened Dutch, who know about drugs, have now banned any skunk with a THC content over 15%, equating it with cocaine and heroin. The vast bulk of our young users are smoking what amounts to a class “A” drug!
50% of THC will remain in cells for a week, 10% for a month. The John Moores report makes no mention of its persistence. Numerous studies show the adverse effects of this on academic results (Grade D student four times more likely to use cannabis than one with A grades, USA 2002) and personality. Users become inflexible, can’t plan their days, can’t find words or solve problems, development stalls, they remain childish. At the same time they feel lonely, miserable and misunderstood (Lundqvist 1995).
Psychosis: Not reported is that anyone (with/without family history) taking cannabis can develop psychosis if they take enough THC (Morrison, Robin Murray team 2009). D’Souza (2007) had also shown this. Cannabis increases dopamine (pleasure neurotransmitter) in the brain. Excess dopamine is found in brains of schizophrenics. The first paper linking psychosis and cannabis was published in 1845! The report says: “Health effects of increases in the potency of cannabis products are not clear”. Skunk users have been found to be seven times more likely to develop psychosis than hash users ( Di Forte, Murray’s team 2009).
No mention of absence of Cannabidiol (CBD) (anti-psychotic) in skunk, so psychotic THC is not counteracted! Old herbal cannabis had equal amounts CBD and THC. (McGuire 2008 and 2009, Morgan (2010), Demirakca (2011) etc. Dependence risks and psychotic symptoms are blamed on bingeing—regular use is enough! It is suggested that psychotic or schizophrenic patients may be self-medicating negative symptoms—disproved in several papers (Degenhardt 2007, Van Os 2005).
They say that likelihood of progressing to other drugs is more to do with personality, lifestyle and accessibility than a gateway effect. Swedish research (Hurd 2006, Ellgren 2007) on animals finds THC primes the brain for use of others, and Fergusson (2006 and 2008) in a 25 year NZ study from birth found cannabis to be the single most significant factor for progressing.
It is claimed that there is “no conclusive evidence that cannabis causes lung cancer” We don’t have conclusive proof for cigarettes and lung cancer! “Evidence for the effects on the immune system is limited”—over 60 references in my report! No warning that people should not drive within 24 hours of consumption (Leirer 1991).
Children born to cannabis-using mothers may have “mild developmental problems”. Fried has followed child development since 1987. He has found cognitive impairment, behaviour and attention problems, babies twice as likely to use the drug at adolescence. Goldschmidt (2002) found delinquent behaviour, Bluhm (2006) warned of an increased risk of neuroblastoma, a childhood cancer.
Now several recent papers demonstrate structural brain damage eg Welch (September 2011) loss of volume in thalamus, Solowij 2011 smaller cerebellum white matter volume, Ashtari (2011) loss in hippocampus volume, (Yucel 2008, Rais 2008).
I have cited only a few references, there are well over 600 in my report.
At least one piece of information in FRANK’s magic mushroom (Psilocybe—Liberty Caps) section is not in the Moore’s report, so where did it come from? The extremely poisonous familiar red/white spotted fungus, the Fly Agaric, is included. This is serious—it should not be there. Its inclusion is even more alarming as the amount used (1–5g) and the fact that it should not be eaten raw are given—blatant harm reduction advice! A child could die!
New posters from FRANK:

www.homeoffice.gov.uk/publications/alcohol-drugs/drugs/frank/coke-poster

www.homeoffice.gov.uk/publications/alcohol-drugs/drugs/frank/meow-poster

www.homeoffice.gov.uk/publications/alcohol-drugs/drugs/frank/skunk-poster

My pupils would have used words like: pathetic, patronising, trite, useless and positively encouraging drug use—and so would I.

I repeat—children don’t want to take drugs. They want a sound education and good grades, free from hassle and the pressure to take drugs.
Drugscope’s cannabis information updated 2011 is even less reliable than FRANK’s. They continue to deny that cannabis can cause physical addiction, say “There are suggestions that the drug can in rare cases trigger psychosis, a factor that led to the government in 2009 to reclassify cannabis” (Drugscope disagreed with the reclassification), state that the strength of skunk is 12–14% THC when in 2008 it averaged 16.2%, and completely ignore all the Swedish and New Zealand evidence for the “Gateway Theory”. Professor Murray’s 2009 papers are not mentioned, and in a reply to me, the writer of Drugscope’s literature, seemed to think it was the THC that caused cancers, not the smoke.
In 2006, Professor David Nutt said that LSD and Ecstasy probably shouldn’t be class A. In May 2008 I attended an open meeting of the ACMD at which a presentation (by Pentag) on ecstasy was given—a meta-analysis commissioned by the ACMD. I was concerned about their conclusions so contacted the foremost ecstasy researcher in Britain, Professor Andrew Parrott of Swansea University.
Incredibly Professor Parrott knew nothing about the proposed down-grading of ecstasy by the ACMD until I alerted him. He was leaving for Australia to Chair an International Conference on Ecstasy and sent me his numerous publications. I passed them to the ACMD. When he returned, having missed the evidence—gathering meeting in September, I alerted him to the open meeting in November. He had to send three e-mails before they answered and allowed his presentation to go ahead. He was given a mere 20 minutes.

In an open letter to the ACMD on November 13 he wrote:

29. I cannot believe that I have spent the past 14 years undertaking numerous scientific studies into Ecstasy/MDMA in humans, then for the ACMD to propose downgrading MDMA without a full and very detailed consideration of the extensive scientific evidence on its damaging effects. My research has been published in numerous top quality journals, and can be accessed via my Swansea University web-page.
Professor Nutt, who was Chairing the ACMD meeting on November 25 2008 for the first time was severely criticized by Professor Parrott. He said that Nutt made numerous factual errors, eg that there were zero dangers from injection of MDMA. Parrott said it was probably safer to inject heroin. Nutt said that ecstasy was not addictive, involved no interpersonal violence, was not responsible for road deaths, did not cause liver cirrhosis or damage the heart. Scientific work demonstrates that users show compulsive and escalating use, midweek aggression, that driving under its influence is extremely dangerous, that it is hepatotoxic—liver transplants have been needed in young people under 30, and profound cardiovascular effects. Professor Nutt did not defend himself in our presence. Nor to my knowledge has he since!
Answers from Anne Milton, Minister for Public Health given to Parliamentary Questions from Charles Walker MP, October 2011 include:
The Medical Research Council (MRC), funded by The Department of Business, Innovation and Skills, is supporting Professor Glyn Lewis in his research on adolescence and psychosis and Professor Val Curran’s research into the vulnerability of people to the harmful effects of cannabis.
Professor Lewis, widely quoted on the Web by Peter Reynolds (CLEAR—Cannabis Law Reform) said that, “there is no certainty of a causal relationship between cannabis use and psychosis”, and announced that the risk of psychosis from cannabis use is at worst 0.013% and perhaps as little as 0.0030%. Professor Curran is a member of Professor Nutt’s Independent Scientific Committee on Drugs (ISCD).
I find it incredible that there is essential sound accurate up-to-date scientific information about the effects of cannabis available in scientific journals and publicised in the press and the public is not being made aware of it by FRANK, the official Government website. Why has FRANK not been taken to task?
While the harm reduction lobby are being consulted, persisting with their own agendas, and the preventionists supporting the Government’s New Strategy not listened to, nothing will change.
Prevention is better than cure. Prevention is what every parent wants for their children. Prevention is common sense and it works.
Meanwhile, while we wait for common sense to prevail, some children will become psychotic, addicted, move on to other drugs, drop out of education or even die. And the parents I work with will be left picking up the pieces.

January 2012

Source: Home Affairs or visit http://www.parliament.uk/business/committees/committees-a-z/commons-select/home-affairs-committee/publications/

Filed under: Cannabis/Marijuana,Education,Education Sector,Health,Marijuana and Medicine,Prevention and Intervention :

PSYCHOPHARMACOLOGY

Medication for reversing overdose is life-saving—if used quickly and correctly.

Posted June 4, 2024

KEY POINTS

Fentanyl is a major threat causing overdose deaths in the United States.
Young people are unknowingly taking fentanyl and dying.
Fentanyl smoking is contributing to overdose and speedballing deaths.
Government and private agencies are cracking down on illegal fentanyl, but it’s an uphill fight.

Seized Fentanyl Pills

Source: National Institute on Drug Abuse

“It is the deadliest drug threat our country has ever faced.” says Anne Milgram, Administrator, Drug Enforcement Administration (DEA), referring to the threat of fentanyl in the United States. She should know.

We still have record deaths, and that’s after the DEA seized more than 80 million fentanyl-laced fake pills and nearly 12,000 pounds of fentanyl powder so far in 2024 . The fentanyl seizures represent more than 157.6 million deadly doses; 70% of the counterfeit pills contain a lethal dose of fentanyl. Sometimes, the drug is smoked and as with intravenous injection, speeds access to the brain, further endangering users.

The best new prevention approach, the “One Pill Can Kill” initiative led by the DEA, is amplified by the Community Anti-Drug Coalitions of America (CADCA) and other volunteers educating the public and seeking to prevent flooding of the U.S. with fentanyl and fentanyl-laced fake pills resembling Xanax, Oxycontin, Adderall, Vicodin and other popular prescription medications—but with a deadly twist. The counterfeit pills, more often than not, contain a lethal dose of fentanyl.

“CADCA and its 7,000 coalition members across the nation have worked tirelessly to address the issue of fentanyl-laced fake pills that are poisoning our nation’s youth by planning and implementing comprehensive, data-driven strategies, with multiple public and private partners to address community conditions causing this problem,” said CADCA’s president and CEO, retired Army general Barrye L. Price.

Across the country, fentanyl has largely fueled a more than doubling of overdose deaths among children ages 12-17 since the start of the pandemic. The deaths were inadvertently hidden by “good news” reported by the CDC on May 15, 2024, announcing that there were an estimated 107,543 drug overdose deaths in the U.S. during 2023—a decrease of 3% from the 111,029 deaths estimated in 2022.

Fentanyl is killing adolescents and people of color, many with no idea they are taking fentanyl. The counterfeit drugs are easy to obtain from friends or buy through social media. Sold online for $2 to $10 apiece, their lethal potency caught policy leaders, emergency rooms, addiction experts, family health providers, and pediatricians nationwide by surprise.

Such is the fentanyl crisis as of June 2024. As i will describe in this blog post, there are treatments of last resort and medications designed to reverse the effects of fentanyl when education, prevention, and treatment have failed. An estimated 80,000 deaths per year are attributed to opioid-induced respiratory depression (OIRD) caused by fentanyl alone. Wonder medicines that counter the effects include the widely-used naloxone (Narcan) and much-less-used (but also effective) opioid overdose reversal drug nalmefene (Opvee).

The Life-Saving Role of Naloxone

Naloxone has gained attention as a wonder drug capable of reviving a person who has overdosed, appeared to have died, or nearly died. I adminishtered, intravenously, my first dose of naloxone in 1975 while working in the Yale New Haven Hospital emergency room.. At the time, naloxone was most often given intravenously by anesthesiologists during surgery to reverse the sedative effects of opioids doctors had administered earlier. When naloxone was approved by the FDA in 1971, total drug overdose deaths in the U.S. were 6,771, rare enough that there was no national call to add it to emergency rooms to reverse overdoses. Since then, the number of overdoses has catastrophically escalated.

When Individuals Overdose on Opioids

What are signs of an opioid overdose? They include unconsciousness, very small eye pupils, slow or shallow breathing, vomiting, inability to speak, faint heartbeat, limp arms and legs, pale skin, and purple lips and fingernails. When a person overdoses on opioids, breathing slows or altogether stops. The overdosed person appears sleepy and is unresponsive.

Opioids

interfere with receptors in the brain, slowing breathing so that insufficient oxygen reaches the brain and other vital organs like the heart; the heart rate may slow or even stop. As breathing slows, oxygen levels fall, which may trigger abnormal heart rhythms. Blue lips and fingernails signal the lack of oxygen. Because insufficient oxygen reaches the brain and heart, the consequences are coma, brain damage, or death.

The antidote, naloxone, attaches to opioid receptors, reversing and blocking effects of opioids. Naloxone can quickly restore normal breathing. Naloxone is so safe we give it immediately to anyone with signs of opioid overdose or when an overdose is suspected. However, the drug has no effect on someone with no opioids in their system.

Reversing Respiratory Depression

The specific mechanism that drives opioid death by overdose is stimulation of one class of endogenous opioid receptors—mu-opioid receptors—in cells in the brainstem; it inhibits breathing. Respiratory depression, or decreased (or terminated) breathing, is a direct effect of opioid use, and, in the case of fentanyl, it appears extremely quickly.

Intravenous naloxone is not available in the community, where first responders depend on intranasal or intramuscular administration. Yet naloxone must be administered much sooner for fentanyl than for heroin because the window for saving the overdosed person is much shorter than with heroin. So, the right dose of naloxone must be given by a friend, loved one, or first responder almost immediately.

Other opioid antagonists, like nalmefene, may be expected to do a better job in fentanyl overdoses. After the person recovers, they should be offered long-term treatment resources, including the ability to initiate treatment for opioid use disorder in the emergency department, as Yale’s Brian Fuerhlein described in an earlier blog post.

Renarcotization

Researchers, addiction experts, and other healthcare providers have documented that when fentanyl is taken chronically, the drug may be absorbed into fat tissue and stay there, accumulating and forming a reservoir of fentanyl. Naloxone might reverse a “normal” fentanyl overdose, but due to the “depot effect,” after a person becomes conscious, they may lose consciousness again and stop breathing. This event is called re-narcotization.

If it is suspected that someone has overdosed on fentanyl and they are given naloxone, they may start breathing again and become conscious. With less potent opioids, naloxone can cover someone for 60 minutes. But someone with a supply of fentanyl in body fat depots can renarcotize several times. It is important to call 911. Additional doses of naloxone may be given as the patient is transported to the ER or hospital, where oxygen and other life support is available.

Narcan Nasal Spray

Naloxone can now be administered by non-health professionals via nasal spray to save lives. Intranasal naloxone works within two to three minutes. If the person has not responded after three minutes, another dose should be given. After administering naloxone, it’s very important to always call 911 because experts need to determine whether respiratory support, more naloxone, or other measures are necessary to reverse the overdose.

The FDA approved Narcan (naloxone) as a nasal spray for over-the-counter use because it is safe, easy to use, and saves lives. In 2021, the Food and Drug Administration approved an 8-mg intranasal naloxone product, twice the amount than the usual 4-mg dose. The FDA also granted a second over-the-counter naloxone agent in early 2024. This drug, RiVive, is a generic naloxone nasal spray available from Harm Reduction Therapeutics, a nonprofit pharmaceutical organization. Nasal naloxone is currently available in 3mg (Revive), 4mg (Narcan), and 8mg (Kloxxado) dosages.

Making naloxone available without a prescription expands its availability to people with an opioid-dependent loved one or who themselves have opioid use disorder (OUD). To save someone from an opioid overdose, you need naloxone or nalmefene. Steps for responding to an opioid overdose can be found here.

Another Opioid Overdose Reversal Drug: Nalmefene

Nalmefene has been saving lives from opioid overdoses since May 2023, when the FDA approved nalmefene hydrochloride nasal spray (Opvee). Nalmefene is a long-duration opioid antagonist first approved for injection in 1995. The original injectable nalmefene was removed from the market for commercial reasons in 2008. However, the dramatic rise in opioid overdose deaths and the emergence of powerful synthetic opioids catalyzed the development of an intranasal (IN) form of nalmefene for emergency treatment of opioid, and especially fentanyl, overdoses.

Nalmefene is an opioid receptor antagonist particularly well-suited for fentanyl overdoses. One reason is it has a longer half-life than naloxone, which means it stays in the body longer. This may protect against re-intoxication but may also make withdrawal symptoms last longer in those with opioid use disorders.

Synthetic opioids like fentanyl are now the most common drugs involved in drug overdose deaths in the U.S. Nalmefene is 10 times more potent than naloxone and has an 8- to 10-fold longer half-life (8 to 11 hours), reducing the likelihood of re-overdosing from long-acting opioids.

Xylazine and other adulterants illegally added to opioids in the U.S. have also received attention for generating zombie-like behavior in people. Such additives make overdose reversal more difficult. However, the key to harm reduction is reversing the effects of synthetic opioids on the heart, lungs, and brain.

The efficacy of frontline, community-based reversal of poisoning events with antidotes such as naloxone has been questioned due to the rise of highly potent synthetic opioids, primarily illicitly manufactured fentanyl (IMF), which causes 90% or more of opioid deaths in the U.S.

In many cases today, community-based first responders have improvised or evolved strategies to cope with fentanyl. Typically, multiple naloxone doses are given to individuals who overdosed on opioids. That was definitely not the case when I was giving naloxone to patients in the Yale emergency department in the 1970s or even back when the opioid crisis was primarily either a prescription-opioid or heroin crisis.

However, it’s unclear whether giving opioid overdose patients more doses sequentially is the optimal strategy in dealing with fentanyl. A very nice study by Strauss suggests it’s a good idea to have higher doses of intranasal naloxone available, as it appears that a large first dose at once is superior to the same dose given sequentially.

Some overdoses might be relatively naloxone-resistant and more easily respond to nalmefene. Additional research is needed to determine the optimal naloxone-dosing schedule for fentanyl overdose reversal. Multi-site studies directly comparing nalmefene to naloxone in the community setting are needed.

Conclusion

More than 1 in 8 Americans have had their lives disrupted by a drug overdose. Nearly 49 million Americans (more than 17%) age 12 and older have a substance use disorder. Among young adults aged 18-25, the share jumps to 28%. More than 6 million people had an opioid use disorder, and another 1.8 million had a methamphetamine use disorder in 2022.

The evolving opioid epidemic has morphed into a counterfeit-pill, multi-drug crisis centered on fentanyl, often paired—knowingly or unknowingly—with other illicit drugs. Smoking fentanyl is the newest opioid crisis or problem we have not prevented.

Overdose deaths are only one measure of the drug epidemic’s severity. An estimated 321,566 children lost a parent to drug overdose between 2011 and 2021.

Since 2000, more than 1.1 million overdose deaths have been reported in the U.S. Overdose reversal with intranasal anti-opioids like naloxone and nalmefene has made a big difference but should not be the centerpiece of opioid crisis strategy. Education and prevention are needed and, as we develop new and better treatments for OUDs, so are overdose reversal and relapse prevention. Some very effective means to reverse opioid overdoses are available today, and future research should provide further information on the best medication and dosages for fentanyl overdose situations.

References

Skolnick P. On the front lines of the opioid epidemic: Rescue by naloxone. Eur J Pharmacol. 2018 Sep 15;835:147-153. doi: 10.1016/j.ejphar.2018.08.004. Epub 2018 Aug 7. PMID: 30092179.

Ellison M, Hutton E, Webster L, Skolnick P. Reversal of Opioid-Induced Respiratory Depression in Healthy Volunteers: Comparison of Intranasal Nalmefene and Intranasal Naloxone. J Clin Pharmacol. 2024 Mar 4. doi: 10.1002/jcph.2421. Epub ahead of print. PMID: 38436495.

Crystal R, Ellison M, Purdon C, Skolnick P. Pharmacokinetic Properties of an FDA-approved Intranasal Nalmefene Formulation for the Treatment of Opioid Overdose. Clin Pharmacol Drug Dev. 2024 Jan;13(1):58-69. doi: 10.1002/cpdd.1312. Epub 2023 Jul 27. PMID: 37496452; PMCID: PMC1081801

Source: https://www.psychologytoday.com/us/blog/addiction-outlook/202406/the-fentanyl-death-crisis-in-america

Filed under: Addiction,Drug Specifics,Health,USA :

There are several principal pathways to inheritable genotoxicity, mutagenicity and teratogenesis induced by cannabis which are known and well established at this time including the following. These three papers discuss different aspects of these effects.

1. Stops Brain Waves and Thinking
The brain has both stimulatory and inhibitory pathways. GABA is the main brain inhibitory pathway. Brain centres talk to each other on gamma (about 40 cycles/sec) and theta frequencies (about 5 cycles/sec), where the theta waves are used as the carrier waves for the gamma wave which then interacts like harmonics in music. The degree to which the waves are in and out of phase carries information which can be monitored externally. GABA (γ-aminobutyric acid) inhibition is key to the generation of the synchronized firing which underpins these various brain oscillations. These GABA transmissions are controlled presynaptically by type 1 cannabinoid receptors (CB1R’s) and CB1R stimulation shuts them down. This is why cannabis users forget and fall asleep.

2. Blocks GABA Pathway and Brain Formation
GABA is also a key neurotransmitter in brain formation in that it guides and direct neural stem cell formation and transmission and development and growth of the cerebral cortex and other major brain areas. Gamma and theta brain waves also direct neural stem cell formation, sculpting and connectivity. Derangements then of GABA physiology imply that the brain will not form properly. Thin frontal cortical plate measurements have been shown in humans prenatally exposed to cannabis by fMRI. This implies that their brains can never be structurally normal which then explains the long lasting and persistent defects identified into adulthood.

3. Epigenetic Damage
DNA not only carries the genetic hardware of our genetic code but it also carries the software of the code which works like traffic lights along the sequence of DNA bases to direct when to switch the genes on and off. This is known as the “epigenetic code”. Fetal alcohol syndrome is
believed to be due to damage to the software epigenetic code. The long lasting intellectual, mood regulation, attention and concentration defects which have been described after in utero cannabis exposure in the primary, middle and high schools and as college age young adults
are likely due to these defects. Epigenetics “sets in stone” the errors of brain structure made in (2) above.

4. Arterial Damage
Cannabis has a well described effect to damage arteries through (CB1R’s) (American Heart Association 2007) which they carry in high concentration (Nature Reviews Cardiology 2018). In adults this causes heart attack (500% elevation in the first hour after smoking), stroke,
severe cardiac arrhythmias including sudden cardiac death; but in developing babies CB1R’s acting on the developing heart tissues can lead to at least six major cardiac defects (Atrial- ventricular- and mixed atrioventricular and septal defects, Tetralogy of Fallot, Epstein’s deformity amongst others), whilst constriction of various babies’ arteries can lead to serious side effects such as gastroschisis (bowels hanging out) and possibly absent limbs (in at least one series).

5. Disruption of Mitotic Spindle
When cells divide the separating chromosomes actually slide along “train tracks” which are long chains made of tubulin. The tubulin chains are called “microtubules” and the whole football-shaped structure is called a “mitotic spindle”. Cannabis inhibits tubulin formation,
disrupting microtubules and the mitotic spindle causing the separating chromosomes to become cut off in tiny micronuclei, where they eventually become smashed up and pulverized into “genetic junk”, which leads to foetal malformations, cancer and cell death. High rates of
Down’s syndrome, chromosomal anomalies and cancers in cannabis exposed babies provide clinical evidence of this.

6. Defective Energy Generation & Downstream DNA Damage
DNA is the crown jewel of the cell and its most complex molecule. Maintaining it in good repair is a very energy intensive process. Without energy DNA cannot be properly maintained. Cannabis has been known to reduce cellular energy production by the cell’s power plants,
mitochondria, for many decades now. This has now been firmly linked with increased DNA damage, cancer formation and aging of the cells and indeed the whole organism. As it is known to occur in eggs and sperm, this will also damage the quality of the germ cells which go into forming the baby and lead directly to damaged babies and babies lost and wasted through spontaneous miscarriage and therapeutic termination for severe deformities.

7. Cancer induction
Cannabis causes 12 cancers and has been identified as a carcinogen by the California Environmental Protection agency (2009). This makes it also a mutagen. 4 of these cancers are inheritable to children; i.e. inheritable carcinogenicity and mutagenicity. All four studies in
testicular cancer are strongly positive (elevation by three fold). Carcinogen = mutagen = teratogen.

8. Colorado’s Teratology Profile
From the above described teratological profile we would expect exactly the profile of congenital defects which have been identified in Colorado(higher total defects and heart defects, and chromosomal defects) and Ottawa in Canada (long lasting and persistent brain
damage seen on both functional testing and fMRI brain scans in children exposed in utero) where cannabis use has become common. Gastroschisis was shown to be higher in all seven studies looking at this; and including in Canada, carefully controlled studies. Moreover in
Australia, Canada, North Carolina, Colorado, Mexico and New Zealand, gastroschisis and sometimes other major congenital defects cluster where cannabis use is highest. Colorado 2000-2013 has experienced an extra 20,152 severely abnormal births above the rates prior to
cannabis liberalization which if applied to the whole USA would equate to more than 83,000 abnormal babies live born annually (and probably about that number again therapeutically aborted); actually much more since both the number of users and concentration of cannabis have risen sharply since 2013, and cannabis has been well proven to be much more severely genotoxic at higher doses.

9. Cannabidiol is also Genotoxic
Cannabidiol tests positive in many genotoxicity assays, just as tetrahydrocannabinol does.

10. Births defects registry data needs to be open and transparent and public.
At present it is not. This looks too much like a cover up.

Source: By Professor Dr. A. S Reece
(Edith Cowan University & University of Western Australia) 2019

Filed under: Drug use-various effects,Genes,Health :

Bertha Madras, a leading expert on weed, outlines the science linking it to psychiatric disorders, permanent brain damage, and other serious harms.

While marijuana use remains a federal crime, 24 states have legalized it and another 14 permit it for medical purposes. Last week media outlets reported that the Biden administration is moving to reclassify marijuana as a less dangerous Schedule III drug—on par with anabolic steroids and Tylenol with codeine— which would provide tax benefits and a financial boon to the pot industry.

“Users of other potent recreational drugs develop chronic psychosis at much lower rates,” Ms. Madras says. When healthy volunteers in research experiments are given THC—as has been done in 15 studies—they develop transient symptoms of psychosis. “And if you treat them with an antipsychotic drug such as haloperidol, those symptoms will go away.”

Ms. Madras worries that “it sets a precedent for the future.” She points to the movement in states to legalize psychedelic substances, for whose medicinal benefits there also isn’t strong scientific evidence. Meantime, she says it makes no sense that politicians continuously urge more spending on addiction treatment and harm reduction while weakening laws that prevent people from becoming addicted in the first place.
Her rejoinder to critics who say the war on drugs was a failure? “This is not a war on drugs. It’s a defense of the human brain at every possible age from in utero to old age.”

Ms. Finley is a member of the Journal’s editorial board.

Source: https://www.wsj.com/articles/what-you-arent-reading-about-marijuana-permanent-brain-damage-biden-schedule-iii-9660395e May 2024

Filed under: Addiction,Alcohol,Brain and Behaviour,Cannabis/Marijuana,Drug use-various effects on foetus, babies, children and youth,Global Drug Legalisation Efforts,Health,Marijuana and Medicine :

The lowered rates of substance use that youth reported after the start of the COVID-19 pandemic remained steady into 2023. However, the rate of fatal drug overdoses among youth, which rose in 2020, remained increased well into 2022.

After the COVID-19 pandemic and its associated school closures began in 2020, youth reported that they were using illicit substances significantly less, according to the 2023 Monitoring the Future survey. Among 12th graders, use of any illicit substances in the previous year fell from 36.8% in 2020 to 32% in 2021. Among 10th graders, the rate fell from 30.4% to 18.7%, while it fell from 15.6% to 10.2% among 8th graders.

Rate of Reported Past-Year Illicit Substance Use Among 8th, 10th, and 12th Graders.

Many schools have returned to in-person learning since the fall of 2021, and yet the percentage of students reporting any illicit substance use in 2023 has held steady at the lowered levels reported during the pandemic, according to the most recent Monitoring the Future survey. In 2023, 31.2% of 12th graders, 19.8% of 10th graders, and 10.9% of 8th graders reported any illicit substance use in the past year.

Monitoring the Future has tracked national substance use among 8th, 10th, and 12th graders at hundreds of schools across the country annually since 1975. It is conducted by the University of Michigan and funded by the National Institute on Drug Abuse (NIDA).

Addressing substance use among youth, especially with regard to prevention, should involve not only reaching out to institutions like schools, but also connecting with families to engage them, said Anish Dube, M.D., M.P.H.

“This is encouraging news,” said Anish Dube, M.D., M.P.H., chair of APA’s Council on Children, Adolescents, and Their Families. “Peers have a huge influence on young people and the types of decisions they make. For better or worse, the pandemic limited the amount of time young people physically spent with their peers, and this may be at least one reason why we saw less risk-taking behavior among youth.”

Youth who responded to the survey most commonly reported drinking alcohol, vaping nicotine, and using cannabis in the past year. Compared with 2022 levels, past-year use of alcohol fell among 12th graders and remained stable for 10th and 8th graders. Nicotine vaping declined among 12th and 10th graders and remained stable among 8th graders. Finally, cannabis use remained stable among students in all three grades.

Unintentional Drug Overdose Death Rates Among U.S. Youth Aged 15-19.

Simultaneously, however, in recent years the rate of fatal overdoses among youth has increased. A 2022 study published in JAMA found that, beginning in 2020 until June 2021, adolescents experienced a greater relative increase in overdose mortality compared with the overall population. An analysis by NIDA published last December found that the upward trends previously reported continued into the summer of 2022. Between the end of 2019 and the beginning of 2020, the rate of unintentional overdose deaths per 100,000 population among youth aged 15 to 19 rose from 0.89 to 1.32. The rate has not declined since that increase. In the summer of 2022, the rate was 1.63.

“In my own clinical experience, one of the biggest challenges has been the widespread availability of fentanyl and its derivatives, their lethality, and the ease with which they can be laced into other substances that young people are trying,” Dube said.

When youth weren’t seeing their friends during the COVID-19 pandemic shutdowns, they did not have the peer interactions that may lead to substance use, said Oscar Bukstein, M.D., M.P.H.

The illicit substances available now are highly addictive and can provide a quick and intense high, said Oscar Bukstein, M.D., M.P.H. That is part of the reason the rate of overdose deaths among adults is so high, and the same is likely true for youth.

“Young people in particular are usually novice drug users,” Bukstein pointed out. Just like younger adolescents are more likely to experience alcohol poisoning, youth who are using other illicit substances may similarly be unaware of the true danger of what they are using, he explained. Bukstein is a member of APA’s Council on Children, Adolescents, and Their Families and a professor of psychiatry at Harvard Medical School.

Bukstein also noted that, because Monitoring the Future surveys youth in schools, those who are not in school due to high-risk behaviors such as truancy or dropping out are less likely to be included. That means the survey may not capture youth who are at the highest risk for substance use. These youth need far more resources than are available to them, such as residential treatment for those who need more than intensive outpatient care, Bukstein said.

Overall, Bukstein is optimistic about Generation Z, he added. “I’ve noticed that there’s a greater sense among the general adolescent population that they want something out of life,” he said. “They know these substances are dangerous, that they are not going to get them where they want to go, and they don’t need them.”

Source: https://psychnews.psychiatryonline.org/doi/10.1176/appi.pn.2024.03.3.10

Filed under: Addiction,Health,Social Affairs,USA,Youth :

The United States is knee-deep in what some experts call the opioid epidemic’s “fourth wave,” which is not only placing drug users at greater risk but is also complicating efforts to address the nation’s drug problem.

These waves, according to a report from Millennium Health, were the crisis in prescription opioid use, followed by a significant jump in heroin use, then an increase in the use of synthetic opioids like fentanyl.
The latest wave involves using multiple substances at the same time, combining fentanyl mainly with either methamphetamine or cocaine, the report found. “And I’ve yet to see a peak,” said one of the co-authors, Eric Dawson, vice president of clinical affairs at Millennium, a specialty laboratory that provides drug-testing services to monitor use of prescription medications and illicit drugs.
The report, which takes a deep dive into the nation’s drug trends and breaks usage patterns down by region, is based on 4.1 million urine samples collected from January 2013 to December 2023 from people receiving some kind of drug-addiction care.
Its findings offer staggering statistics and insights. Its major finding is how common polysubstance use has become. According to the report, an overwhelming majority of fentanyl-positive urine samples — nearly 93% — contained additional substances. “That is huge,” said Nora Volkow, director of the National Institute on Drug Abuse at the National Institutes of Health.
The most concerning, Volkow and other addiction experts said, is the dramatic increase in the combination of methamphetamine and fentanyl use. Meth, a highly addictive drug often in powder form that poses several serious cardiovascular and psychiatric risks, was found in 60% of fentanyl-positive tests last year. That is an 875% increase since 2015.
“I never, ever would have thought this,” Volkow said.
Among the report’s other key findings:

The nationwide spike in methse alongside fentanyl marks a change in drug use patterns.
Polydrug use trends complicate overdose treatments. For instance, naloxone, an opioid-overdose reversal medication, is widely available, but there isn’t an FDA-approved medication for stimulant overdose.
Both heroin and prescribed-opioid use alongside fentanyl have dipped. Heroin detected in fentanyl-positive tests dropped by 75% since peaking in 2016. Prescription opioids were found at historic low rates in fentanyl-positive tests in 2023, down 89% since 2013.

But Jarratt Pytell, an addiction medicine specialist and assistant professor at the University of Colorado’s School of Medicine, warned these declines shouldn’t be interpreted as a silver lining.
A lower level of heroin use “just says that fentanyl is everywhere,” Pytell said, “and that we have officially been pushed by our drug supply to the most dangerous opioids that we have available right now.”
“Whenever a drug network is destabilizing and the product changes, it puts the people who use the drugs at the greatest risk,” he said. “That same bag or pill that they have been buying for the last several months now is coming from a different place, a different supplier, and is possibly a different potency.”
In the illicit drug industry, suppliers are the controllers. It may not be that people are seeking out methamphetamine and fentanyl but rather that they’re what drug suppliers have found to be the easiest and most lucrative product to sell.
“I think drug cartels are kind of realizing that it’s a lot easier to have a 500-square-foot lab than it is to have 500 acres of whatever it takes to grow cocaine,” Pytell said.
Dawson said the report’s drug use data, unlike that of some other studies, is based on sample analysis with a quick turnaround — a day or two.
Sometimes researchers face a months-long wait to receive death reports from coroners. Under those circumstances, you are often “staring at today but relying on data sources that are a year or more in the past,” said Dawson.
Self-reported surveys of drug users, another method often used to track drug use, also have long lag times and “often miss people who are active for substance use disorders,” said Jonathan Caulkins, a professor at Carnegie Mellon University. Urine tests “are based on a biology standard” and are good at detecting when someone has been using two or more drugs, he said.
But using data from urine samples also comes with limitations. For starters, the tests don’t reveal users’ intent.
“You don’t know whether or not there was one bag of powder that had both fentanyl and meth in it, or whether there were two bags of powder, one with fentanyl in it and one with meth and they took both,” Caulkins said. It can also be unclear, he said, if people intentionally combined the two drugs for an extra high or if they thought they were using only one, not knowing it contained the other.
Volkow said she is interested in learning more about the demographics of polysubstance drug users. “Is this pattern the same for men and women, and is this pattern the same for middle-age or younger people? Because again, having a better understanding of the characteristics allows you to tailor and personalize interventions.”
All the while, the nation’s crisis continues. According to the Centers for Disease Control and Prevention, more than 107,000 people died in the U.S. in 2021 from drug overdoses, most because of fentanyl.
Caulkins said he’s hesitant to view drug use patterns as waves because that would imply people are transitioning from one to the next.
“Are we looking at people whose first substance use disorder was an opioid use disorder, who have now gotten to the point where they’re polydrug users?” he said. Or, are people now starting substance use disorders with methamphetamine and fentanyl, he asked.
One point was clear, Dawson said: “We’re just losing too many lives.”

Source: https://lexingtonky.news/2024/02/24/opioid-epidemic-is-in-a-fourth-wave-with-multiple-substances-being-used-at-the-same-time-and-fentanyl-is-the-most-common/

Filed under: Drug use-various effects,Health,Methamphetamine/GHB/Hallucinogens/Oxycodone,Prevention and Intervention,Social Affairs,USA :

Why Do People Relapse? Understanding and Overcoming Relapse in Substance Abuse Recovery: Embarking on the journey of addiction recovery is a tough, but worthwhile goal. However, it is not uncommon for you to face setbacks in the form of relapse during your recovery journey.

In this blog post, we will explore the reasons why people relapse in drug addiction, explore the various stages of relapse, and discuss effective strategies for preventing relapse. Understanding these aspects is crucial for you, your family members, and addiction treatment programs to help you best achieve recovery.

Why Relapse Occurs During Drug Abuse Recovery

The biggest stumbling block people face on the path of recovery is when they slip up. Knowing why relapse happens is critical for those working on getting clean and those helping them out. Let’s dive into the four big causes of going back to drugs during recovery – how mental health problems, ineffective ways of dealing with stress or emotions, intense withdrawal symptoms, and not setting solid limits work together to trip people up.

Mental Health Issues Combined With Substance Addiction

Mental health challenges often coexist with substance abuse. Attending a dual diagnosis treatment program, which addresses both mental health issues and substance use disorder, can significantly increase the effectiveness of your recovery efforts.

Your dual diagnosis treatment team understands how substance use disorders are a chronic disease and will work to give you the tools you need to successfully tackle recovery and lay the groundwork for a sober life.

Poor Coping Skills

Many individuals turn to drugs or alcohol as a coping strategy to deal with negative emotions, stress, conflict in relationships, and peer pressure. As the Marlatt and Gordon model establishes, the seeds of relapse are planted in a high-risk scenario and nurtured by unhealthy coping skills.

If you are facing elevated stress levels, coupled with poor coping skills, you are at a much greater risk for addiction relapse. Negative emotions like anger, depression, anxiety, and boredom can also increase your risk for returning to drug and alcohol use for comfort.

Simply put, without effective coping skills, relapse rates drastically increase.

Uncomfortable Withdrawal Symptoms During Detox

The physical discomfort experienced during withdrawal can be overwhelming, leading your to turn to substance use to alleviate these symptoms. All will to stay sober can easily vanish in the face of intense cravings and physical pain, even if you are fully aware of the consequences.

The vulnerability during the withdrawal phase, coupled with the desire to avoid physical and mental distress, underscores the importance of comprehensive support and coping strategies to navigate this critical stage of the recovery journey successfully.

Lack of Healthy Boundaries

A strong contributor to relapse is your social environment- the people you surround yourself with. Having friends or family members who engage in drug abuse and significantly challenge your recovery and your resolve to stay sober. Even just being around them can trigger intense cravings, heightening your risk of relapse.

Establishing and maintaining well-defined boundaries is crucial for preventing relapse. Without clear boundaries, individuals may find themselves in situations that trigger drug use.

The Stages of A Relapse

A relapse can happen in many ways. What is commonly seen as a “traditional” relapse happens when you consciously decide to consume alcohol or use drugs. This might involve choosing to smoke marijuana to reduce stress after a substantial period of sobriety or having a glass of wine with friends, believing you can handle it without spiraling into excessive use.

On the flip side, a “freelapse” is the informal term for an accidental relapse, which occurs when you unintentionally use drugs or alcohol.

This could occur if you mistakenly consume alcohol, thinking it is a non-alcoholic drink at a party.

At times, the path toward a relapse unfolds without you even realizing it, manifesting in actions taken weeks or months before using drugs or alcohol. Specific thoughts, emotions, and events can act as triggers, sparking cravings and urges for drug use. If not effectively addressed, these triggers can significantly elevate the risk of relapse, which is why it is extremely important to proactively manage these risk factors in the recovery process.

Emotional Relapse Stage

The onset of the emotional relapse stage before actually picking up a drug or sipping a drink. In this phase, you may find yourself struggling to manage your negative emotions in a healthy manner. Rather than addressing your feelings openly, there might be a tendency to bottle them up, withdraw from social interactions, deny the existence of problems, and overlook self-care.

Although the thought of drug and alcohol use may not be at the forefront of your mind during this stage, the avoidance of confronting emotional pain and challenging situations sets the stage for potential relapse in the future. Recognizing and addressing these early signs becomes crucial in preventing future relapse and fostering a healthier recovery journey.

Mental Relapse Stage

In the mental relapse phase, you may struggle with conflicting emotions surrounding sobriety. Within this stage, there is an internal struggle: one side strives to remain sober, while the other wrestles with cravings, harboring secret thoughts about a potential relapse.

Mental relapse goes beyond mere internal conflict; it includes romanticizing past drug use, downplaying the negative feelings and consequences, and actively seeking opportunities for using drugs or alcohol. This intricate mental struggle highlights the delicate balance you have to maintain between your substance addiction and your will to recover.

Physical Relapse Stage

The physical relapse stage is where the actual addiction relapse occurs. What starts out as an initial slip, perhaps with just a few sips of a drink or or hit of a drug, can quickly escalate into a full-blown relapse, characterized by a complete loss of control over your actions and total drug dependence.

The importance of recognizing early warning signs and implementing effective strategies to prevent progression towards physical relapse in the ongoing journey of drug recovery.

What To Do If You Relapse

Whether you have relapsed before or not, knowing what to do if you slip back into the throws of drug abuse is critical for getting back on track and preventing future relapse. No relapse is insurmountable and there’s always an opportunity for recovery.
If you have experienced a relapse, quickly follow these proactive steps to minimize the negative effects of drug use and prevent further substance use.

1. Ask for help. Seeking assistance from family members, friends, and other addicts in the recovery process can significantly help you navigate the challenges of relapse. Create a sober support system and immerse yourself in it. The worst thing you can do in early recovery is suffer in silence.

2. Find support groups near you. Both traditional twelve-step support groups like Alcoholics Anonymous (AA) and Narcotics Anonymous (NA), as well as science-based alternatives like SMART Recovery, offer nonjudgmental spaces for you to discuss substance abuse relapses openly. With meetings available on a daily basis, you can quickly find a support group that’s right for you, allowing you to talk about your relapse experiences within 24 hours of it happening.

3. Avoid triggers at all costs. Being around people, places, situations, etc… that are triggering to you, in the aftermath, of a relapse can be detrimental to your recovery, and actually intensify your cravings. By putting distance between yourself and your triggers helps to create an environment ripe for addiction recovery.

4. Establish healthy boundaries. In all stages of substance abuse recovery, but especially shortly after a relapse, it’s vital to set boundaries to protect yourself from threats against your sobriety. A key component to maintaining firm personal boundaries is steering clear of people who are not completely onboard with your choice to be sober. These people will only try to pressure you back into a lifestyle of using drugs or alcohol, so surrounding yourself with your sober support system is the only way to remain sober after a relapse.

5. Prioritize your self-care. Both your mental and physical well-being should be taken care of, especially in the wake of a relapse, and is one of the key components of recovery, and it gives you a way to relieve tension and reduce stress.

6. Self-reflect about why the relapse happened. Rather than seeing a relapse as a setback, you can see it as a learning tool. Dedicate time to reflect on the circumstances leading to the relapse. Explore the events that unfolded before the relapse occurred. Did you try out any other coping mechanisms prior to resorting to substance use? Think about potential alternatives to using or drinking that you could have used.

Asking yourself these questions offers insights into what you can do differently, encouraging a constructive approach to managing challenges that arise along your path to substance use disorder recovery.

7. Come up with a relapse prevention plan. This is a guide designed to be a steadfast companion to help you maintain sobriety. It should be as detailed as possible, and easy to follow when needed.

Acting promptly after a relapse significantly increases your chances of a quick recovery with minimal negative consequences. It is important to remember that recovery is not linear or bound by time constraints. It is never too late to regain control after a relapse.

If early recovery seems too overwhelming, seek drug addiction treatment to help manage the task. Some treatment centers offer an inpatient program with medical detox and behavioral therapies to help you regain your footing and relapse prevention classes to help you assimilate back into your daily life with the help of addiction specialists.

How to Prevent Relapse After Drug Addiction Treatment

Preventing relapse in addiction recovery involves a complex approach that addresses both the physical and psychological aspects of your substance use.

To start off, recognizing the specific situations or emotions that may lead to relapse and developing effective coping strategies, whether through therapy, mindfulness, or healthy activities, is paramount in navigating through moments of weakness. Building and maintaining a strong support system, made up of supportive friends, family, and possibly support groups, provides a crucial safety net.

Additionally, the creation of a personalized relapse prevention plan, including detailed strategies for recognizing and managing triggers, is vital to staying sober. Regular self-reflection and adjustments to the plan over time ensure its continued effectiveness, empowering you to maintain lifelong sobriety.

Compose a Relapse Prevention Plan

Creating a personalized plan to prevent addiction relapse is a crucial component of substance abuse recovery. This plan should include strategies for recognizing triggers and coping with cravings. It should also outline your specific triggers for drug use, as well as at least 3 positive coping skills that work for you.

Additionally, your relapse prevention plan should list specific people who are in your sober support system, with their phone numbers, who you can call for help when you are feeling the urge to use. You should also compile a list of local addiction support groups that can be there for you in your time of need.

Regularly consulting and revising this plan is instrumental, making sure it stay relevant to your evolving life experiences and fortifying your commitment to a sober life.

Build a Supportive, Nurturing Environment

Building a strong support system and fostering a supportive environment are key factors in maintaining long-term sobriety. Creating a nurturing atmosphere involves not only external factors but also the changes you make within yourself.

Most addicts relapse because they do not change both the people they hang around with, as well as the way they approach situations in life after completing an addiction treatment program and in the early stages of recovery. By attending a local support group meeting, you can meet and befriend people who are going through the same things you are and you can be pillars of strength for each other.

Further, you may find it helpful to make a list of fun activities that do not involve drinking alcohol or using drugs. This list may be helpful when you are experiencing cravings and need to divert your attention.

Maintain a Positive Mindset

Cultivating a positive mindset not only enhances your motivation and resilience during challenging times but also reinforces your belief in yourself and your capacity for personal growth and living a fulfilling, sober life. Your positive outlook serves as a powerful ally in overcoming obstacles, nurturing a sustainable foundation for lasting recovery.

Make Your Self Care a Priority

Prioritizing self-care, including healthy habits and activities, contributes to overall well-being and reduces the risk of relapse. Self-care encompasses a range of activities that bring you pleasure without causing harm, including but not limited to yoga, meditation, exercise, reading, journaling, and eating healthy foods.

Why Do People Relapse During the Recovery Process?

Recovery from drug addiction is a complex journey that requires dedication, resilience, and ongoing support. By understanding the reasons behind relapse, implementing effective treatment programs, and adopting preventative strategies, you can increase your chances of achieving and maintaining long-term sobriety.

Remember, relapse does not signify failure but rather serves as an opportunity for growth and reinforcement of your commitment to recovery.

Source: https://www.hippocraticpost.com/addiction/understanding-and-overcoming-substance-abuse-relapse/

Filed under: Health,Prevention and Intervention,Treatment and Addiction :

Cannabis is harmful to the lungs, but in a different way to tobacco, causing significant respiratory symptoms such as bronchitis with evidence to suggest it can result in destructive lung disease – sometimes referred to as ‘bong lung’ – in heavy cannabis users.

These are the key findings from a review of research on the effects of smoking cannabis on the lungs undertaken by respiratory specialists, Professor Bob Hancox, from the University of Otago’s Department of Preventive and Social Medicine and Dr Kathryn Gracie, from Waikato Hospital’s Respiratory Department.

Cannabis is the second-most commonly smoked substance after tobacco and the most widely-used illicit drug world-wide. Although cannabis remains illegal in most countries, many countries – like New Zealand – are considering decriminalising or legalising its use.

Professor Hancox explains that much of the debate about legalising cannabis appears to revolve around the social and mental health effects. Both he and Dr Gracie believe policies around the liberalisation of cannabis should consider the wider health effects of smoking cannabis.

“The potential for adverse effects on respiratory health from smoking cannabis has had much less attention than the social and mental health effects,” Professor Hancox says.

“We believe policies around the liberalisation of cannabis should consider the potential impacts on the lungs.

“Whether liberalising availability will lead to further increases in cannabis use remains to be seen, but it is likely that patterns of cannabis use will change, with resulting health consequences.”

Because cannabis has been an illegal and unregulated substance and the fact most cannabis users also smoke tobacco, making the effects difficult to separate, Dr Gracie explains that it has been difficult to carry out research on cannabis and its direct impact on the lungs.

“Perhaps, most importantly, the individuals who are extremely heavy users of cannabis may not be well represented in the existing epidemiological research. Most case reports of cannabis-related destructive lung disease document very heavy cannabis consumption.

“Despite these limitations there is sufficient evidence that cannabis causes respiratory symptoms and has the potential to damage both the airways and the lungs.”

“Cannabis may also increase the risk of lung cancer, but there is not enough evidence to be sure of this yet,” Dr Gracie says.

Professor Hancox says there is still a lot to learn about cannabis, but there is sufficient evidence to show that smoking cannabis is not harmless to the lungs.

A combination of smoking both cannabis and tobacco is likely to result in poorer health outcomes.

“Many people smoke both cannabis and tobacco and are likely to get the worst of both substances.”

Source: https://www.otago.ac.nz/news/news/smoking-cannabis-causes-bronchitis-and-changes-to-lung-function May 2020

Filed under: Cannabis/Marijuana,Health,Nicotine :

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

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

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

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

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

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

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

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

2024 Midterm Review

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

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

FURTHER INFORMATION

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

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

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

Nowadays, teaching your child to make healthy choices is crucial for their development and well-being. Understanding the importance of nutritious eating and an active lifestyle can set the foundation for a lifetime of health and happiness. This article, which has been developed by www.recoveryproud.com links to a number of sites which can help young people to keep control of their lifestyles. Additionally, a large body of generic information can be derived by visiting the National Drug Prevention Alliance.

Create a Supportive Environment for Healthy Choices

Make your home a haven for healthy choices. Keep nutritious snacks within easy reach and involve your child in meal preparation. This not only makes healthy eating more appealing but also instills a sense of responsibility and appreciation for wholesome food. It’s a practical way to teach them about nutrition and the benefits of eating well. By letting them assist in simple cooking tasks and making choices about the meals, you empower them with knowledge and skills that foster a lifetime of healthy eating habits.

Talking to Your Child About Substance Abuse

Talking to your kids about drugs is a crucial aspect of parenting that can help safeguard their future. Engaging in open and honest conversations about the dangers of drug use builds a foundation of trust and awareness. It empowers children with the knowledge to make informed decisions and resist peer pressure. This dialogue should be age-appropriate, focusing on the health risks, legal implications, and the impact on mental and emotional well-being. By fostering a supportive environment where children feel comfortable discussing their fears and curiosities about drugs, parents can guide their children towards healthy choices and provide them with coping strategies for dealing with life’s challenges.

Champion Physical Activity Over Screen Time

Limiting screen time is more crucial now than ever. Encourage your child to embrace physical activities, which are essential for their health and happiness. Present alternatives that divert their attention from screens, like outdoor adventures or sports. This not only fosters physical well-being but also teaches them to value real-world experiences over digital engagements.

Nurture a Mindful Approach to Nutrition

Instilling the value of good nutrition in your child’s mind is vital. Explain how choosing foods wisely fuels both their body and brain, supporting their growth, learning, and play. This foundation of understanding encourages them to make healthy decisions that contribute to their overall well-being. By discussing the roles of different nutrients and how they affect the body, you can make the concept of eating well more tangible and engaging for them.

Don’t Forget to Declutter

Teaching your kids about decluttering offers numerous benefits that extend well beyond a tidy home. It instills in them the value of organization and cleanliness, fostering an environment where they can think clearly and focus better on their tasks. So the next time you’re cleaning, get your kids involved. This process also nurtures decision-making skills, as children learn to differentiate between what is necessary and what is superfluous. Additionally, decluttering with your kids encourages mindfulness and appreciation for what they have, promoting a lifestyle of minimalism and sustainability. By understanding the importance of decluttering, children can develop healthier habits that contribute to their overall well-being and success in life.

Make Hydration a Habit

Water is the body’s best friend. It keeps everything running smoothly, from digestion to maintaining a healthy temperature. Encouraging kids to drink water throughout the day is pivotal to their overall health. Simple reminders and having water easily accessible can make all the difference.

Embrace the World of New Foods

Encouraging your child to explore new foods is a journey of discovery. Introduce them to the diverse world of fruits, vegetables, and whole grains, highlighting how each contributes to their health. This exploration is not just about tasting new flavors; it’s about teaching them the benefits of a varied diet, rich in nutrients, that powers their body and mind. By making this journey exciting, you help them develop a love for foods that are good for them.

Establish Restorative Sleep Routines

A consistent bedtime routine is key to your child’s health. Establish rituals that promote relaxation and signal to their body that it’s time to rest. Emphasizing the importance of quality sleep can help them understand how it supports their growth and readiness for daily activities, ensuring they prioritize it as part of their healthy lifestyle. This can include activities like dimming the lights, reading a story together, or practicing some gentle yoga, which can all aid in transitioning from the day’s excitement to a peaceful night’s sleep.

Teaching healthy choices to kids lays the foundation for a lifetime of wellness. By leading by example and fostering an environment where making healthy decisions is both encouraged and celebrated, parents can significantly influence their children’s habits. This journey, while requiring patience and consistency, promises a rewarding outcome for the entire family.

Further guidance can be obtained by referring to www.recoveryproud.com and to the National Drug Prevention Alliance.

Source: www.recoveryproud.com

Filed under: Education,Health,Parents,Youth :

Cannabis and cannabinoids are implicated in multiple genotoxic, epigenotoxic and chromosomal-toxic mechanisms and interact with several morphogenic pathways, likely underpinning previous reports of links between cannabis and congenital anomalies and heritable tumours. However the effects of cannabinoid genotoxicity have not been assessed on whole populations and formal consideration of effects as a broadly acting genotoxin remain unexplored. Our study addressed these knowledge gaps in USA datasets. Cancer data from CDC, drug exposure data from National Survey of Drug Use and Health 2003–2017 and congenital anomaly data from National Birth Defects Prevention Network were used. We show that cannabis, THC cannabigerol and cannabichromene exposure fulfill causal criteria towards first Principal Components of both: (A) Down syndrome, Trisomies 18 and 13, Turner syndrome, Deletion 22q11.2, and (B) thyroid, liver, breast and pancreatic cancers and acute myeloid leukaemia, have mostly medium to large effect sizes, are robust to adjustment for ethnicity, other drugs and income in inverse probability-weighted models, show prominent non-linear effects, have 55/56 e-Values > 1.25, and are exacerbated by cannabis liberalization (P = 9.67 × 10 –43 ,2.66 × 10 –15 ). The results confirm experimental studies showing that cannabinoids are an important cause of community-wide genotoxicity impacting both birth defect and cancer epidemiology at the chromosomal hundred-megabase level.

Source: https://www.nature.com/articles/s41598-021-93411-5.epdf July 2021

Filed under: Cannabis/Marijuana,Drug use-various effects,Drug use-various effects on foetus, babies, children and youth,Health :

Democratic Gov. Tina Kotek signed legislation Monday to recriminalize the possession of small amounts of certain drugs as the state grapples with a major overdose crisis, ending a legalization experiment backed by voters four years ago.

The new law makes keeping drugs such as heroin or methamphetamine a misdemeanor punishable by up to six months in prison. It also enables police to confiscate the drugs and crack down on their use on sidewalks and in parks.

Back in 2020, voters backed Measure 110, which made minor possession of personal-use amounts of certain drugs a non-criminal violation on par with a traffic ticket.

It took effect in February 2021, making Oregon the first state to officially decriminalize minor drug possession. Since then, the Beaver State has seen a significant uptick in homelessness, homicides and overdose deaths.

In 2020, unintentional opioid overdose deaths clocked in at 472 and hit at least 628 in 2023, according to state data.

In 2022, Portland set a new record for murders with 101 — breaking the mark of 92 set the previous year. Back in January, Kotek declared a fentanyl state of emergency in the city, saying at the time: “Our country and our state have never seen a drug this deadly and addictive, and all are grappling with how to respond.”

The new law, which will take effect Sept. 1, will let local law enforcement decide whether to give violators the chance to pursue treatment before booking them into jail .

Another bill Kotek signed Monday, Senate Bill 5204, allocates $211 million to mobilize resources for behavioral health and education programs, including expanded access to substance abuse treatment and prevention education.

“Success of this policy framework hinges on the ability of implementing partners to commit to deep coordination at all levels,” Kotek emphasized in a letter to legislative leaders.

The governor further called on the Department of Corrections to ensure a “consistent approach for supervision when an individual is released” from detention and to “exhaust non-jail opportunities for misdemeanor sanctions.”

Source: Oregon recriminalizes drugs after upswing in overdose deaths (nypost.com)

Filed under: Crime/Violence/Prison,Economic,Environment,Health,Political Sector,Social Affairs :

Neither the cause of autism nor the effects of cannabis on a developing fetus are entirely clear
Researchers at the Ottawa Hospital and University of Ottawa studied 2,200 Canadian women who reported using marijuana while pregnant
The rate of autism among their children was four per 1,000 person-years, compared to 2.42 among children whose mothers did not use marijuana

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.’

A Canadian study found that rates of autism were twice as high among the children of women who used marijuana during pregnancy, compared to rates among children of mothers who did not use the drug (file)

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.

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.

By NATALIE RAHHAL ACTING US HEALTH EDITOR

Source: Autism is twice as common in children whose mothers used cannabis in pregnancy | Daily Mail Online

PUBLISHED 17:13, 10 August 2020

Filed under: Cannabis/Marijuana,Drug use-various effects,Drug use-various effects on foetus, babies, children and youth,Health :

Research suggests that smoking marijuana carries many of the same cardiovascular health hazards as smoking tobacco.

Credit…Gracia Lam

Do you have the heart to safely smoke pot? Maybe not, a growing body of medical reports suggests.

Currently, increased smoking of marijuana in public, even in cities like New York where recreational use remains illegal (though no longer prosecuted), has reinforced a popular belief that this practice is safe, even health-promoting.

“Many people think that they have a free pass to smoke marijuana,” Dr. Salomeh Keyhani, professor of medicine at the University of California, San Francisco, told me. “I even heard a suggestion on public radio that tobacco companies should switch to marijuana because then they’d be selling life instead of selling death.”

But if you already are a regular user of recreational marijuana or about to become one, it would be wise to consider medical evidence that contradicts this view, especially for people with underlying cardiovascular diseases.

Compared with tobacco, marijuana smoking causes a fivefold greater impairment of the blood’s oxygen-carrying capacity, Dr. Keyhani and colleagues reported.

In a review of medical evidence, published in January in the Journal of the American College of Cardiology, researchers described a broad range of risks to the heart and blood vessels associated with the use of marijuana.

The authors, led by Dr. Muthiah Vaduganathan, cardiologist at Brigham and Women’s Hospital in Boston, point out that “marijuana is becoming increasingly potent, and smoking marijuana carries many of the same cardiovascular health hazards as smoking tobacco.”

Edible forms of marijuana have also been implicated as a possible cause of a heart attack, especially when high doses of the active ingredient THC are consumed.

With regard to smoking marijuana, Dr. Vaduganathan explained in an interview, “The combustion products a tobacco smoker inhales have a very similar toxin profile to marijuana, so the potential lung and heart effects can be comparable. When dealing with patients, we really have to shift our approach to the use of marijuana.”

His team reported, “Although marijuana is smoked with fewer puffs, larger puff volumes and longer breath holds may yield greater delivery of inhaled elements.” In other words, when compared to tobacco smoking, exposure to chemicals damaging to the heart and lungs may be even greater from smoking marijuana.

Dr. Vaduganathan said he was especially concerned about the increasing number of heart attacks among marijuana users younger than 50. In a registry of cases created by his colleagues, in young patients suffering a first heart attack, “marijuana smoking was identified as one factor that was more common among them.” The registry revealed that, even when tobacco use was taken into account, marijuana use was associated with twice the hazard of death among those under age 50 who suffered their first heart attack.

Other medical reports have suggested possible reasons. A research team headed by Dr. Carl J. Lavie of the John Ochsner Heart and Vascular Institute in New Orleans, writing in the journal Missouri Medicine, cited case reports of inflammation and clots in the arteries and spasms of the coronary arteries in young adults who smoke marijuana.

Another damaging effect that has been linked to marijuana is disruption of the heart’s electrical system, causing abnormal heart rhythms like atrial fibrillation that can result in a stroke. In one survey of marijuana smokers, the risk of stroke was increased more than threefold.

These various findings suggest that a person need not have underlying coronary artery disease to experience cardiovascular dysfunction resulting from the use of marijuana. There are receptors for cannabinoids, the active ingredients in marijuana, on heart muscle cells and blood platelets that are involved in precipitating heart attacks.

Cannabinoids can also interfere with the beneficial effects of various cardiovascular medications, including statins, warfarin, antiarrhythmia drugs, beta-blockers and calcium-channel blockers, the Boston team noted.

The researchers found that in an analysis of 36 studies among people who suffered heart attacks, the top three triggers were use of cocaine, eating a heavy meal and smoking marijuana. And 28 of 33 systematically analyzed studies linked marijuana use to an increased risk of what are called acute coronary syndromes — a reduction of blood flow to the heart that can cause crushing chest pain, shortness of breath or a heart attack.

“In settings of an increased demand on the heart, marijuana use may be the straw on the back, the extra load that triggers a heart attack,” Dr. Vaduganathan said. He suggested that the recent decline in cardiovascular health and life expectancy among Americans may be related in part to the increased use of marijuana by young adults.

“We should be screening and testing for marijuana use, especially in young patients with symptoms of cardiovascular disease,” Dr. Vaduganathan urged.

He expressed special concern about two recent practices: the vaping of marijuana and the use of more potent forms of the drug, including synthetic marijuana products.

“Vaping delivers the chemicals in marijuana smoke more effectively, resulting in increased doses to the heart and potentially adverse effects that are more pronounced,” the cardiologist said. “Marijuana stimulates a sympathetic nervous system response — an increase in blood pressure, heart rate and demands on the heart that can be especially hazardous in people with preexisting heart disease or who are at risk of developing it.”

Dr. Vaduganathan’s team estimated that more than two million American adults who say they have used marijuana also have established cardiovascular disease, according to data from the National Health and Nutrition Examination Surveys in 2015 and 2016.

According to Dr. Keyhani, who works at the San Francisco VA Medical Center, the combination of marijuana smoking and pre-existing heart disease is especially concerning because inhaling particulate matter of any kind can harm the heart and blood vessels.

“Marijuana is a leafy green, and combustion of any plant is probably toxic to human health if the resulting products are inhaled,” she explained. “Unfortunately, the research base is inadequate because marijuana hasn’t been studied in randomized clinical trials.”

A major problem in attempts to clarify the risks of marijuana is its classification by the U.S. Drug Enforcement Administration as a Schedule I drug, making it illegal to study it rigorously in controlled clinical trials.

Scientists must then resort to the next best research method: prospective cohort studies in which large groups of people with known habits and risk factors are followed for long periods to assess their health status. “The challenge is to recruit a cohort of daily cannabis users,” Dr. Keyhani said. “It’s absolutely important to look at the health effects of cannabis now that the prevalence of daily use is increasing. The absence of evidence is not evidence of absence.”

While there are currently no official guidelines, Dr. Vaduganathan’s team urged that anyone known to be at increased risk of cardiovascular disease should be advised to minimize the use of marijuana or, better yet, quit altogether.

Source: https://www.nytimes.com/2020/10/26/well/live/marijuana-heart-health-cardiovascular-risks.html October 2020

Filed under: Cannabis/Marijuana,Drug use-various effects,Health :

Despite stereotypical images of addicts injecting heroin and then dying, new government research finds that smoking drugs such as fentanyl is now the leading cause of fatal overdoses.

In the new research, published Thursday in Morbidity and Mortality Weekly Report, scientists from the U.S. Centers for Disease Control and Prevention found the percentage of overdose deaths between January 2020 and December 2022 linked to smoking increased 73.7% — going from from 13.3% to 23.1% — while the percentage of overdose deaths linked to injection decreased 29.1% — going from from 22.7% to 16.1%.

These changes were most pronounced when fentanyl was the drug of choice: In those cases, the percentage with evidence of injection decreased 41.6%, while the percentage with evidence of smoking increased 78.9%.

CDC officials explained in their report that they decided to tackle the topic after seeing reports from California suggesting that smoking fentanyl was becoming the preferred way to use the deadly drug.

Fentanyl accounts for nearly 70% of overdose deaths in the United States, they noted.

Some early research has suggested that smoking fentanyl is somewhat less deadly than injecting it, and any reduction in injection-related overdose deaths is a positive, report author Lauren Tanz, a CDC senior scientist who studies overdoes, told the Associated Press.

However, “both injection and smoking carry a substantial overdose risk,” and it’s not clear if a shift toward smoking fentanyl will lower the number of U.S. overdose deaths, Tanz said.

Fentanyl is a powerful drug that, in powder form, is cut into heroin or other drugs. In recent years, it’s been fueling the U.S. overdose epidemic. Drug overdose deaths climbed slightly in 2022 after two big leaps during the pandemic, and provisional data for the first nine months of 2023 suggests it inched up again last year, the AP reported.

For years, fentanyl has been injected, but drug users often smoke it now. Users put the powder on tin foil or in a glass pipe, heated from below, and inhale the vapor, Alex Kral, a RTI International researcher who studies drug users in San Francisco, told the AP.

Smoked fentanyl is not as concentrated as fentanyl in a syringe, but some users see upsides to smoking, Kral explained, including the fact that people who inject drugs often deal with pus-filled abscesses on their skin and risk infections with hepatitis and other diseases.

“One person showed me his arms and said, ‘Hey, look at my arm! It looks beautiful! I can now wear T-shirts and I can get a job because I don’t have these track marks,’” Kral said.

In the new report, investigators were able to cull data from the District of Columbia and 27 states for the years 2020 to 2022. From there, they tallied how drugs were taken in about 71,000 of the more than 311,000 total U.S. overdose deaths over those three years.

By late 2022, 23% of the deaths occurred after smoking, 16% after injections, 16% after snorting and 14.5% after swallowing, the researchers reported.

Tanz said she feels the data is nationally representative because it came from states in every region of the country, and all showed increases in smoking and decreases in injecting. Smoking was the most common route in the West and Midwest, and roughly tied with injecting in the Northeast and South, the report found.

Kral noted the study has some limitations.

It can be difficult to determine the exact cause of an overdose death, especially if no witness was present, he said, and injections might be more reported more often because it is easy to spot needle marks on the body. To detect smoking as a cause of death, “they likely would need to find a pipe or foil on the scene and decide whether to write that down,” he said.

Kral added that many people who smoke fentanyl use a straw, and it’s possible investigators saw a straw and assumed it was snorted.

By Robin Foster HealthDay Reporter

SOURCE: Morbidity and Mortality Weekly Report, Feb. 16, 2024; Associated Press

More information

The National Institute on Drug Abuse has more on drug overdose deaths.

Filed under: Drug use-various effects,Health :

To Whom it may concern

On behalf of Drug Free Australia and our coalition of drug prevention researchers, we wish to commend to you, research that could well be a game-changer in informing and preventing a large proportion of Australia’s substance use issues.

The research is in various stages of development and a synopsis of current and emerging research, being done by Dr Stuart Reece and Professor Gary Hulse should be of genuine interest for all Australian Health Professionals. However, it appears that, to date, too many of the world’s researchers have placed this important research in the ‘too hard’ basket, similar to the way the NHS in the United Kingdom did with research into Pandemics.

At present the COVID-19 pandemic and how it is being addressed, should be a ‘wakeup call’ to Australian health authorities that prevention is the single most important goal. A ‘Harm Minimisation’ only approach, fails to achieve best-practice primary prevention outcomes. The passive discounting of the primary pillar of the National Drug Strategy – Demand Reduction over the last 30 years (and particularly the last 10) has seen a very large increase in illegal drug use in this nation.

The only exception to this has been seen in the correct and full use of both demand and supply reduction on the drug Tobacco. There has been little or no use of harm reduction mechanisms and a relentless and unified approach to abstinent/cessation modelling and it has worked spectacularly well, seeing Australia with, arguably, the lowest daily tobacco use in the world.

The research, that we now summarise, should not be placed in Australia’s ‘too hard’ basket. Rather, it warrants recognition by all Australian Health authorities for the world break-through that it is. Such evidence-based data offers timely insights that should promote and resource primary prevention and demand reduction.

Synopsis of the research:
1. Canadian Cannabis Consumption and Patterns of Congenital Anomalies: An Ecological Geospatial Analysis Albert Stuart Reece, MBBS(Hons), FRCS(Ed), FRCS(Glas), FRACGP, MD(UNSW), and Gary Kenneth Hulse, BBSc(Hons), MBSc, PhD
https://journals.lww.com/journaladdictionmedicine/Abstract/publishahead/Canadian_Cannabis_Consumption_and_Patterns_of.99248.aspx

Status
Mapping showed cannabis use was more common in the northern Territories of Canada in the Second National Survey of Cannabis Use 2018. Total congenital anomalies, all cardiovascular defects, orofacial clefts, Downs syndrome and gastroschisis were all found to be more common in these same regions and rose as a function of cannabis exposure.

When Canada was dichotomized into high and low cannabis use zones by Provinces v Territories the Territories had a higher rate of total congenital anomalies 450.026 v 390.413 (O.R.=1.16 95%C.I. 1.08-1.25, P=0.000058; attributable fraction in exposed 13.25%, 95%C.I. 7.04–19.04%). In geospatial analysis in a spreml spatial error model cannabis was significant both alone as a main effect (P<2.0×10-16) and in all its first and second order interactions with both tobacco and opioids from P<2.0×10-16.

Conclusion:

These results show that the northern Territories of Canada share a higher rate of cannabis use together with elevated rates of total congenital anomalies, all cardiovascular defects, Down’s syndrome and gastroschisis. This is the second report of a significant association between cannabis use and both total defects and all cardiovascular anomalies and the fourth published report of a link with Downs syndrome and thereby direct major genotoxicity.

The correlative relationships described in this paper are confounded by many features of social disadvantage in Canada’s northern territories. However, in the context of a similar broad spectrum of defects described both in animals and in epidemiological reports from Hawaii, Colorado, USA and Australia they are cause for particular concern and indicate further research.

139 References – click on this link to access.
https://journals.lww.com/journaladdictionmedicine/Abstract/publishahead/Canadian_Cannabis_Consumption_and_Patterns_of.99248.aspx

2. Cannabis Consumption Patterns Parallel the East-West Gradient in Canadian Neural Tube Defect Incidence – An Ecological Study
https://www.researchgate.net/publication/337911618_Cannabis_Consumption_Patterns_Explain_the_East-West_Gradient_in_Canadian_Neural_Tube_Defect_Incidence_An_Ecological_Study

Status:
Whilst a known link between prenatal cannabis exposure (PCE) and anencephaly exists, the relationship of PCE with neural tube defects (NTD’s) generally has not been defined. Published data from Canada Health and Statistics Canada was used to assess this relationship. Both cannabis use and NTDs were shown to follow an east-west and north-south gradient. Last year cannabis consumption was significantly associated (P<0.0001; Cannabis use: time interaction P<0.0001). These results were confirmed when estimates of termination for anomaly were used. Canada Health population data allowed the calculation of an NTD O.R.=1.27 (95%C.I. 1.19-1.37; P<10-11) for high risk provinces v. the remainder with an attributable fraction in exposed populations of 16.52% (95%C.I. 12.22-20.62). Data show a robust positive statistical association between cannabis consumption as both a qualitative and quantitative variable and NTDs on a background of declining NTD incidence. In the context of multiple mechanistic pathways these strong statistical findings implicate causal mechanisms.

82 References – click on this link to access.
https://www.researchgate.net/publication/337911618_Cannabis_Consumption_Patterns_Explain_the_East-West_Gradient_in_Canadian_Neural_Tube_Defect_Incidence_An_Ecological_Study

3. Cannabis exposure as an interactive cardiovascular risk factor and accelerant of organismal ageing: a longitudinal study. Response to Lane
https://bmjopen.bmj.com/content/6/11/e011891.responses

Status:
We wish to thank Dr Lane for his interest in our study. We are pleased to see statistical input to the issues of cannabis medicine as we feel that sophisticated statistical methodologies have much to offer this field.

Most of the concerns raised are addressed in our very detailed report. As described our research question was whether, in our sizeable body of evidence (N=13,657 RAPWA studies), we could find evidence for the now well-described cannabis vasculopathy and what such implications might be. As this was the first study of its type to apply formal quantitative measures of vascular stiffness to these questions it was not clear at study outset if there would be any effect, much less an estimate of effect size. In the absence of this information power calculations would be mere guesswork. Nor indeed are they mandatory in an exploratory study of this type. Similarly the primary focus of our work was on whether cannabis exposure was an absolute cardiovascular risk factor in its own right, and how it compared to established risk factors. Hence Table 2 contains our main results. The role of Table 1 is to illustrate the bivariate (uncorrected) comparisons which can be made, show the various groups involved, and compare the matching of the groups. It is not intended to be a springboard for effect-size-power calculations which are of merely esoteric interest.
Calculations detailing the observed effect size are clearly described in our text being 11.84% and 8.35% age advance in males and females respectively.

Mixed-effects models are the canonical way to investigate longitudinal data given a usual random error structure 1. We agree with Lane that unusual error structures can affect significance conclusions. Diagnostic tests run on our models confirm that the residuals had the usual spheroidal error structure so that the application of mixed-effects models in the classical way is quite satisfactory. Another way to investigate this issue is that of incremental model building comparing models with and without cannabis exposure terms. If one considers regression equations from our data with cannabis use treated either as a categorical (RA/CA ~ Days_Post-Cannabis * BMI + * Cannabis_Category) or a continuous (RA/(CA*BMI) ~ Cigs*SP + * Cannabis_Use +Chol+DP+HDL+HR+CRH) variable one notes firstly that terms including cannabis use remain significant in final models (after model reduction) and secondly that models which include cannabis exposure are significantly better than ones without (Categorical: AIC = 1088.56 v. 1090.22, Log.Ratio = 19.62, P = 0.0204; Continuous: AIC = 412.33 v. 419.73, Log.Ratio = 9.37, P = 0.0022). Unfortunately formatting rules for BMJ Rapid Responses do not allow us to include a detailed table of regression results in each model in the present reply. We also note that AIC’s are little used in our report, and simply indicate the direction of the ANOVA results comparing models linear, quadratic and cubic in chronological age. They also appear routinely in the display of mixed-effects model results. Their use in such contexts is methodologically unremarkable. Control groups are also spelled out in fine detail in Table 1, in all our Figures and in the text.

We are aware that various algorithms for vascular age have been reported in the literature. The list proposed by Lane is correct but non-exhaustive. Such algorithms are generally derived from known cardiovascular risk factors. As clearly stated in our report the algorithm for vascular age we employed is derived from the proprietary software used. As such its details have not been publicized and indeed are commercially protected information.

We have however been assured by AtCor on many occasions that it includes measures of chronological age, sex, arterial stiffness and height (which is important as it dictates distance and thus speed parameters for the reflected and augmented central arterial pressure waves) and is very well validated and tested. AtCor recently advised that their algorithm is based on a very large series of studies done with arterial stiffness published in 2005 2. As such it has distinct advantages over algorithms which do not include indices of arterial stiffness. The AtCor website includes a very interesting, informative and educative animated loop which clearly illustrates the complex relationship between chronological and vascular age as a function of arterial stiffness and vascular tone 3

We are keen to see advanced statistical methods applied to such questions. We are becoming interested in geospatial and spacetime analyses and its application to the important questions of cannabis epidemiology 4. We find the very breadth of the organ systems impacted by cannabis to be quite remarkable with effects on the brain, cardiovasculature, liver, lungs, testes, ovaries, gastrointestinal, endocrine, reproductive and immune systems being well described and constituting most of the body’s major systems 5 6. Testicular and several pediatric cancers have also been described as being cannabis-associated 5. Such a multisystem generality of toxicity suggests to us that some basic cellular functions may be deleteriously affected – as implied by its well described mitochondriopathy 7, its heavy epigenetic footprint 8, accelerated aging as described in our present report 9 or some multi-way interaction between these and other processes. Given that the cannabis industry is presently entering a major commercialization growth phase, and given the multigenerational implications of mitochondriopathy-epigenotoxicity (by direct: substrate supply including ATP, NAD+ and acetate; and indirect: RNA transfer and malate-aspartate and glycerol-3-phosphate shuttle; pathways 10) further study and elucidation of these points is becoming an increasingly imperative international research priority.

Apropos of the recent Covid-19 pandemic emergency it is also worth noting that since cannabis is immunosuppressive, is known to be damaging to lungs and airways and often carries chemical, microbial and fungal contaminants cannabis use and cannabis vaping is also likely to have a deleterious effect on the coronavirus epidemic. Such data implies an untoward convergence of two public health epidemics. Appropriate controls on cannabis use imply improved public health management of SARS-CoV-2.

10 References – click on this link to access. https://bmjopen.bmj.com/content/6/11/e011891.responses

4. Cannabis Teratology Explains Current Patterns of Coloradan Congenital Defects: The Contribution of Increased Cannabinoid Exposure to Rising Teratological Trends.
https://www.researchgate.net/publication/334368364_Cannabis_Teratology_Explains_Current_Patterns_of_Coloradan_Congenital_Defects_The_Contribution_of_Increased_Cannabinoid_Exposure_to_Rising_Teratological_Trends/link/5d2d4d39a6fdcc2462e3097c/download

Status
Rising Δ9-tetrahydrocannabinol concentrations in modern cannabis invites investigation of the teratological implications of prenatal cannabis exposure.

Data from Colorado Responds to Children with Special Needs (CRCSN), National Survey of Drug Use and Health, and Drug Enforcement Agency was analyzed. Seven, 40, and 2 defects were rising, flat, and falling, respectively, and 10/12 summary indices rose. Atrial septal defect, spina bifida, microcephalus, Down’s syndrome, ventricular septal defect, and patent ductus arteriosus rose, and along with central nervous system, cardiovascular, genitourinary, respiratory, chromosomal, and musculoskeletal defects rose 5 to 37 times faster than the birth rate (3.3%) to generate an excess of 11 753 (22%) major anomalies. Cannabis was the only drug whose use grew from 2000 to 2014 while pain relievers, cocaine, alcohol, and tobacco did not. The correlation of cannabis use with major defects in 2014 (2019 dataset) was R = .77, P = .0011. Multiple cannabinoids were linked with summary measures of congenital anomalies and were robust to multivariate adjustment.

66 References – click on this link to access
https://www.researchgate.net/publication/334368364_Cannabis_Teratology_Explains_Current_Patterns_of_Coloradan_Congenital_Defects_The_Contribution_of_Increased_Cannabinoid_Exposure_to_Rising_Teratological_Trends/link/5d2d4d39a6fdcc2462e3097c/download

5. Impacts of cannabinoid epigenetics on human development: reflections on Murphy et. al. ‘cannabinoid exposure and altered DNA methylation in rat and human sperm’ epigenetics 2018; 13: 1208-1221.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6773386/pdf/kepi-14-11-1633868.pdf
Status

ABSTRACT 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.

206 References – click on this link to access

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6773386/pdf/kepi-14-11-1633868.pdf

6. Canadian Cannabis Consumption and Patterns of Congenital Anomalies: An Ecological Geospatial Analysis.
https://www.ncbi.nlm.nih.gov/pubmed/32187114

Status:
These results show that the northern Territories of Canada share a higher rate of cannabis use together with elevated rates of total congenital anomalies, all cardiovascular defects, Down’s syndrome and gastroschisis. This is the second report of a significant association between cannabis use and both total defects and all cardiovascular anomalies and the fourth published report of a link with Downs syndrome and thereby direct major genotoxicity. The correlative relationships described in this paper are confounded by many features of social disadvantage in Canada’s northern territories. However, in the context of a similar broad spectrum of defects described both in animals and in epidemiological reports from Hawaii, Colorado, USA and Australia they are cause for particular concern and indicate
further.

139 references – click on this link to access https://www.ncbi.nlm.nih.gov/pubmed/32187114

7. The Potential Association Between Prenatal Cannabis use and Congenital Anomalies
https://journals.lww.com/journaladdictionmedicine/Citation/9000/The_Potential_Association_Between_Prenatal.99243.aspx

Status:
Rates of prenatal cannabis use are likely to rise with legalization, increasing social tolerability, and promotion in social media. Cannabis consumption does not appear to be a benign activity, and there may be significant risk factors to the developing fetus when used in pregnancy. Even as epidemiological data continue to emerge, The American College of Obstetricians and Gynecologists and The Society of Obstetricians and Gynecologists of Canada recommend that women avoid the use of cannabis during pregnancy.14 Whether we will definitively establish the risk of prenatal cannabis use on congenital anomalies using epidemiological approaches remains unclear; however, combing data from ecological and patient-level approaches will be crucial. Patient engagement and increasing awareness of the health implications of cannabis are critical first steps to highlight the potential risks of cannabis use in pregnancy.

14. References – click on this link to access
https://journals.lww.com/journaladdictionmedicine/Citation/9000/The_Potential_Association_Between_Prenatal.99243.aspx

8. America Addresses Two Epidemics – Cannabis and Coronavirus and their Interactions: An Ecological Geospatial Study
Status: Embargoed until publication.

Question: Since cannabis is immunosuppressive and is frequently variously contaminated, is its use associated epidemiologically with coronavirus infection rates?

Findings: Geospatial analytical techniques were used to combine coronavirus incidence, drug and cannabinoid use, population, ethnicity, international flight and income data. Cannabis use and daily cannabis use were associated with coronavirus incidence on both bivariate regression and after multivariable spatial regression with high levels of statistical significance. Cannabis use quintiles and cannabis legal status were also highly significant.

Meaning: Significant geospatial statistical associations were shown between cannabis use and coronavirus infection rates consistent with mechanistic reports and environmental exposure concerns.

Extracts from Abstract:

Results. Significant associations of daily cannabis use quintile with CVIR were identified with the highest quintile having a prevalence ratio 5.11 (95%C.I. 4.90-5.33), an attributable fraction in the exposed (AFE) 80.45% (79.61-81.25%) and an attributable fraction in the population of 77.80% (76.88-78.68%) with Chi-squared-for-trend (14,782, df=4) significant at P<10-500. Similarly when cannabis legalization was considered decriminalization was associated with an elevated CVIR prevalence ratio 4.51 (95%C.I. 4.45-4.58), AFE 77.84% (77.50-78.17%) and Chi-squared-for-trend (56,679, df=2) significant at P<10-500. Monthly and daily use were linked with CVIR in bivariate geospatial regression models (P=0.0027, P=0.0059). In multivariable additive models number of flight origins and population density were significant. In interactive geospatial models adjusted for international travel, ethnicity, income, population, population density and drug use, terms including last month cannabis were significant from P=7.3×10-15, daily cannabis use from P=7.3×10-11 and last month cannabis was independently associated (P=0.0365).

Conclusions and Relevance. Data indicate CVIR demonstrates significant trends across cannabis use intensity quintiles and with relaxed cannabis legislation. Recent cannabis use is independently predictive of CVIR in both bivariate and multivariable adjusted models and intensity of use is significant in several interactions. Cannabis thus joins tobacco as a SARS2-CoV-2 risk factor.

Summary and Conclusions

The above research clearly shows the links with substance use and Mental illness, Autism, Congenital anomalies and Paediatric cancer including testicular cancer with marijuana use and abuse. Drug Free Australia respectfully and urgently requests a Position Statement and proposed actions from your Department regarding this research and how it can be further promoted and supported within Australia. We look forward to your timely response.

You can find a list of list of Ngo’s and Medical Professional who written support for Drug Free Australia’s Response to the commercialization of Cannabis/Marijuana/CBD in Australia

https://drugfree.org.au/images/pdf-files/homepagepdf/DRReeceSupport2020_updated6May2020.pdf.

Yours sincerely
Major Brian Watters AO B.A.
President
Drug Free Australia
PO Box 379
Seaford, SA 516

Filed under: Australia,Cannabis/Marijuana,Drug use-various effects,Drug use-various effects on foetus, babies, children and youth,Health :

Abstract

Objectives: Many reports exist of the cardiovascular toxicity of smoked cannabis but none of arterial stiffness measures or vascular age (VA). In view of its diverse toxicology, the possibility that cannabis-exposed patients may be ageing more quickly requires investigation.

Design: Cross-sectional and longitudinal, observational. Prospective.

Setting: Single primary care addiction clinic in Brisbane, Australia.

Participants: 11 cannabis-only smokers, 504 tobacco-only smokers, 114 tobacco and cannabis smokers and 534 non-smokers.

Exclusions: known cardiovascular disease or therapy or acute exposure to alcohol, amphetamine, heroin or methadone.

Intervention: Radial arterial pulse wave tonometry (AtCor, SphygmoCor, Sydney) performed opportunistically and sequentially on patients between 2006 and 2011.

Main outcome measure: Algorithmically calculated VA.

Secondary outcomes: other central haemodynamic variables.

Results: Differences between group chronological ages (CA, 30.47±0.48 to 40.36±2.44, mean±SEM) were controlled with linear regression. Between-group sex differences were controlled by single-sex analysis. Mean cannabis exposure among patients was 37.67±7.16 g-years. In regression models controlling for CA, Body Mass Index (BMI), time and inhalant group, the effect of cannabis use on VA was significant in males (p=0.0156) and females (p=0.0084). The effect size in males was 11.84%. A dose-response relationship was demonstrated with lifetime exposure (p<0.002) additional to that of tobacco and opioids. In both sexes, the effect of cannabis was robust to adjustment and was unrelated to its acute effects. Significant power interactions between cannabis exposure and the square and cube of CA were demonstrated (from p<0.002).

Conclusions: Cannabis is an interactive cardiovascular risk factor (additional to tobacco and opioids), shows a prominent dose-response effect and is robust to adjustment. Cannabis use is associated with an acceleration of the cardiovascular age, which is a powerful surrogate for the organismal-biological age. This likely underlies and bi-directionally interacts with its diverse toxicological profile and is of considerable public health and regulatory importance.

Keywords: Accelerated aging; Biological age; Biomarkers of aging; Cannabis and aging.

Source: Cannabis exposure as an interactive cardiovascular risk factor and accelerant of organismal ageing: a longitudinal study – PubMed (nih.gov) November 2016

Filed under: Cannabis/Marijuana,Health,Nicotine :

In a study published this week, researchers asked tens of thousands of individuals over 12 years of age about their use of tobacco products, e-cigarettes, and their health, and conducted follow-up questions over three years.¹ They found the development of lung problems like emphysema, bronchitis, asthma, and chronic obstructive pulmonary disease in individuals who had used e-cigarettes in the past or currently use them. Combined use of e-cigarette and tobacco products dramatically increased lung disease risks by an incredible 330 percent. The researchers concluded that, “Use of e-cigarettes is an independent risk factor for respiratory disease in addition to combustible tobacco smoking.” The study’s senior author, Stanton Glantz, told CNN, “I was a little surprised that we could find evidence on incident lung disease in the longitudinal study, because three years is a while but most studies that look at the development of lung disease go over 10 to 20 years.”

The Centers for Disease Control (CDC) reports that, as of December 10, 2019, there are 2,409 hospitalization cases of vaping-related lung injuries in the U.S., resulting in 52 deaths across 26 states and Washington, D.C.² The FDA has found THC in most of the samples it’s studying from these cases and has highlighted Vitamin E acetate as a chemical linked to some of the lung injuries. But the CDC warns that it still does not know how many other chemicals and products may be involved, and says that, “the best way for people to ensure that they are not at risk while the investigation continues is to consider refraining from the use of all e-cigarette, or vaping, products.” NIDA just reported that 3.5 percent of 12th graders and 3 percent of 10th graders say they vape on a daily basis, with 14 percent of 12th graders also saying that they vaped marijuana in the previous month. That figure is twice as large as it was last year.

Though federal officials have reportedly backed away from banning flavored vaping products³, some states have implemented such restrictions. And other national lawmakers are still considering similar options to confront the vaping epidemic.⁴ Dr. Scott Gottlieb, the former FDA Commissioner, has now recommended banning all cartridge-based e-cigarette products, which would include popular devices like Juul.⁵ Gottlieb, along with other experts, is worried about the epidemic of youth vaping, nicotine use and dependence which can lead to the use of tobacco-based products, the number one cause of preventable death, and other substances later in life.

Stories about vaping-related severe lung diseases, the epidemic of youth use, and public policy responses are important for patients, families, medical professionals, and consumers to follow. But we should also continue to monitor research that paints an even more distressing picture of e-cigarette products. In a recent study, researchers looked at the association between e-cigarette use and cancer.

What did this study find about e-cigarette use and cancer in mice?

This study found that exposure to e-cigarettes led to tumors and precancerous growths in the lungs and bladders of mice. The nicotine vapor from e-cigarettes damaged DNA in the exposed mice’s organs.

When tobacco burns, it can change nicotine into carcinogens called nitrosamine ketone. In individuals who use electronic cigarettes, these carcinogens in saliva and urine are 95 percent lower than they are individuals who smoke tobacco. That’s why the UK government says that electronic cigarettes are 95 percent safer than tobacco products. But it’s not as certain that nicotine from e-cigarettes gets turned into these carcinogens, so it’s also not clear if their levels in saliva and urine of individuals using e-cigarettes are a good guide to possible damage. The body can also absorb these carcinogens in other ways, as harmful to DNA. This study looked at DNA damage in mice to see if e-cigarettes might cause lung and bladder cancer, instead of carcinogenic impact in blood and urine. It’s also important to note that no experts suggest that vaping or smoking is good for you.

Researchers exposed the full bodies of 40 mice to e-cigarette vapor for 54 weeks. 22.5 percent of these mice developed lung tumors and, in their bladders, 57.5% ended up with precancerous growths. 20 mice in a control group, subjected to e-cigarette vapor but not nicotine, did not develop tumors. E-cigarette exposure in this study is comparable to human e-cigarette use over three to six years. The study’s authors believe that the results probably indicate e-cigarette aerosol nicotine reaching far into lung tissue and causing DNA damage. They also say that, “The public should not equate the risk of ECS [e-cigarette smoke] with that of TS [tobacco smoke]. Our data simply suggest, on the basis of experimental data in model systems, that this issue warrants in-depth study in the future.” This study also had limitations. It used a small sample size and did not focus on the inhalation of e-cigarette nicotine vapor. And animal studies are not necessarily clear guides for related effects in humans.

Why is this important?

This is the first study finding an association between e-cigarette use and cancer. Though the authors are careful to offer caveats about the research’s limitations, not drawing inferences about the relative safety of e-cigarettes and tobacco products, and the need for more extensive studies, this is still a significant and troubling result. It took many decades for experts to agree that tobacco smoke caused cancer. It seems more logical to assume that smoking and vaping are dangerous until proven otherwise. Some countries have seen enough and banned e-cigarettes completely, such as Argentina, Saudi Arabia, and Singapore. Others do not think it is safe but consider e-cigarettes as part of a harm reduction strategy. The study’s lead, New York University’s Dr. Moon-Shong Tang told CNBC, “It’s foreseeable that if you smoke e-cigarettes, all kinds of disease comes out. Long term, some cancer will come out, probably. E-cigarettes are bad news.” He also suggested that because e-cigarette products have only existed for a relatively short period of time, it may take a while for more research to measure their health effects more comprehensively—possibly up to a decade.

It’s always appropriate for researchers to be cautious about their findings and to point to countervailing factors and the need for supplemental work and corroborating studies. Even experts can be surprised. But more studies continue to indicate the dangers of e-cigarette use. It’s also worth pointing out that there are dangers beyond these studies: inhaling nicotine vapors is likely to stimulate its own continued use, while costing time, energy and money. The cost of a pack of cigarettes is quite cheap even with current taxes. Actual costs are difficult to understand. In general, we assume smoking two packs of cigarettes a day for 20 years is more expensive than the $75,000 for the cost of the cigarettes. The long-term costs are closer to $2 million, after factoring in treatments for tobacco-related cancer, lung and heart disease, and the reduction in lifespan and productivity of the individual using cigarettes.

Prevention of adolescent smoking initiation is a very important health goal, one that we were much closer to attaining before vaping. Experts warn that vaping is causing a new nicotine addiction epidemic.⁶ They estimate, for example, that, because of vaping, almost 500,000 individuals between the ages of 12 and 29 who used e-cigarettes also end up using tobacco products.⁷ Use of e-cigarettes paves the way for use of tobacco-based cigarettes, as research suggests.⁸ If the full costs to society were included at the point of purchase, each pack of cigarettes would cost at least $75. Very few people would choose to spend $75/pack. Similarly, we could find a price at which vaping is less attractive to consumers. The science, in other words, is clear about the risks, and tobacco-like public health-related tax initiatives may be appropriate. Vermont recently passed a 92% wholesale tax on vaping and e-cigarette products. Federal lawmakers are also considering tax changes.

Keeping in mind that it took decades, if not centuries, to prove that cigarette smoking causes cancer, these new e-cigarette studies suggest that the products aren’t just understudied and possibly dangerous, but increasingly just dangerous, associated more frequently with chronic disease, heart problems, and even cancer.⁹ This study is also interesting in its full-body exposure of mice to e-cigarette vapor, which suggests that secondhand vaping may be dangerous, too. Other reports are coming out suggesting that e-cigarette inhalation is dangerous for everyone, include individuals who do not use the products but may be exposed to them. Mounting evidence shows that e-cigarette use is a highly risky proposition for current and potential consumers and that officials and experts are justified in pursuing ways to curb use. Reversing use trends will require a great deal of work given the near exponential increases in youth vaping.

References:

Bhatta, D.N., Glantz, S.A. (2019) Association of E-Cigarette Use With Respiratory Disease Among Adults: A Longitudinal Analysis. American Journal of Preventive Medicine
Centers for Disease Control and Prevention (CDC). (2019) Outbreak of Lung Injury Associated with the Use of E-Cigarette, or Vaping, Products. Retrieved from https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html
Karni, A., Kaplan, S. (2019) Trump Warns a Flavor Ban Would Spawn Counterfeit Vaping Products. New York Times. Retrieved from https://www.nytimes.com/2019/11/22/health/trump-vaping.html
Hellmann, J. (2019) House Democrats to vote on flavored e-cigarettes ban next year. The Hill. Retrieved from https://thehill.com/policy/healthcare/474184-house-democrats-to-vote-on-flavored-e-cigarettes-ban-next-year
Florko, N. (2019) Former FDA commissioner calls for a full ban on pod-based e-cigarettes. Stat. Retrieved from https://www.statnews.com/2019/11/12/gottlieb-ban-pod-based-e-cigarettes/
Dinardo, P., Rome, E.S. (2019) Vaping: The new wave of nicotine addiction. Cleve Clin J Med.
Soneji, S., Wills, T.A. (2019) Challenges and Opportunities for Tobacco Control Policies in the 21st Century. JAMA Pediatr
National Academies of Sciences, Engineering, and Medicine. (2018) Public health consequences of e-cigarettes. The National Academies Press, Washington, DC
Proctor, R.N. (2012) The history of the discovery of the cigarette-lung cancer link: evidentiary traditions, corporate denial, global toll. Tob Control

Citation:

1. Tang, M., et al. (2019) Electronic-cigarette smoke induces lung adenocarcinoma and bladder urothelial hyperplasia in mice. PNAS

Source: We know vaping can cause serious lung problems. A new study says it might also cause cancer (addictionpolicy.org) December 2019

Filed under: Economic,Health,Nicotine,Social Affairs :

Medical Profession. Many professional organizations have made strong statements warning against widespread cannabis use. e.g. AMA, RACGP, AAP, ACOG, British Lung Foundation.

Common Pattern. The almost ubiquitous pattern in which medical cannabis is used today is to treat decades long cannabis addiction, with the other indications serving as mere “tickets” to engage whilst simultaneously avoiding legal censure.

Parallel Drug Approval Pathway. It is obvious that whilst all other drugs are held to a strict approvals and regulatory pathway cannabis products are held to no serious control whatsoever with the industry in an effectively unregulated exponential growth phase.

Limited Benefits. Despite the international rhetoric of many governments and the cannabis industry there is either nil or very poor evidence for the efficacy of the vast majority of cannabinoid products in the management of most indications presenting to GPs (Ref RACGP Review).

Known Harms. Alternately, there is increasing direct and indirect evidence from cellular, mechanistic, case data and epidemiological studies of “likely” harm from cannabis, both within and across generations (epigenetics). This is supported by large epidemiological studies, confirming increased cancers and neonatal congenital abnormalities in areas of increased cannabinoid use, not dissimilar from those used to identify links between tobacco or alcohol and morbidities. Numerous aging pathologies are also accelerated.

Further Harms.
1. Gateway role – Into harder drugs and criminal lifestyle is now well established by studies in numerous countries. Whilst few cannabis users progress to harder drugs, virtually all users of harder drugs have used cannabis, with much higher rates of drug and criminal progression amongst ever users of cannabis.
2. Adult Brain – Most major psychiatric syndromes have been linked with cannabis viz: sedation, amotivational state, anxiety, PTSD, serious mental disorders, depression, psychosis, bipolar disorder, schizophrenia, suicidal thoughts and completed suicides. Also linked with homicide and violence and over 70 mass shootings in USA thought to be linked with aggression (seen in both cannabis withdrawal and intoxication), impaired judgement and psychosis
3. Child Brain – ADHD-like and autism-like features; extreme aggression; impaired cortical processing; learning difficulties; smaller brain; microcephaly; anencephaly (which causes death within hours)
4. Chest disease – COPD, chronic bronchitis, emphysema, lung cysts, elevated residual volume, premalignant changes in upper and lower airways
5. Immunomodulation – Both immunosuppression and immunostimulation are described mediated via T-cells, B-cells, NK Cells, T-reg cells, antibodies and cytokines
6. Endocrinopathy – Central and peripheral hypogonadism, Prolactin elevated
7. Cardiovascular – accelerated coronary artery and atherosclerotic disease; strongly arrythmogenic (many tachyarrhythmias both atrial and ventricular)

Genetic Toxicity. These include gestationally and neonatal congenital abnormalities, cancers both childhood and adult, and the occurrence of premature age-related morbidities, and powerful direct effects on the aging process etc.

Known Mechanisms. These findings are underpinned by clear cellular mechanistic studies on how cannabinoids (both THC and CBD based) can cause the above by interfering with normal cellular and body functions creating antecedents of disease. This of course is not surprising given the increasing understanding of the role of endogenous cannabinoids in normal development, body functioning, and cellular reproduction and maintenance, chromosomes, gene maintenance and control (epigenome) and that use of large doses or prolonged exogenous cannabinoids can significantly disrupt these functions.

“Do No Harm.” Given the aforementioned, it is clear that caution needs to be applied to the medical use of cannabinoids, that although in the most positive interpretation may have a nominal impact managing morbidities, may in turn cause greater harm transgenerationally.

Multigenerational Impacts Genetic and epigenetic effects are believed to persist for at least three to four generations. Cannabinoids have been shown to be driving several childhood (and thus cross-generational) cancers including total childhood cancer. Cannabis, THC and cannabidiol have been shown to be linked with the cancers of the: breast, prostate, ovary and testis showing carcinogenesis to the reproductive organs. Also many birth defects including the absence of arms and legs and congenital brain, face, and heart defects. Also aging of the sperm and ovum themselves in rodents and humans.

Rigorous Trials – Evidence Base. It is therefore not only reasonable but essential that each cannabinoid product marketed should be assessed by the established international standards for pharmaceutical development, and to which all other pharmaceutical products, prior to being released and used in populations must conform. There is need for a robust evidence base. At present cannabis is not performing impressively in hundreds of clinical trials. In the case of cannabinoids this must include rigorous and long term tests of genetic, epigenetic and epitranscriptomic toxicity including: genotoxicity, carcinogenicity, mutagenicity, teratogenicity and gametotoxicity in both sexes.

Source: https://pubmed.ncbi.nlm.nih.gov/

Filed under: Brain and Behaviour,Cannabis/Marijuana,Health :

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.”

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.

A 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

Filed under: Cannabis/Marijuana,Drug use-various effects,Health :

The doctors told Regina Denney and her son Brian Smith Jr. what was causing his severe vomiting and abdominal pain.

Neither the teenager nor his mother believed what they said: smoking weed.

Smoking marijuana, the two knew, was recommended to cancer patients to spur the appetite. How could it lead to Brian’s condition?

As the months went by and the pounds slipped off Brian’s once healthy frame, it was clear that whatever was causing his stomach troubles had just the opposite effect.

Brian kept smoking. The symptoms continued on and off.

Last October, after another severe bout of vomiting, the teenager died. He was 17 years old.

Five months later, as Denney pored over a coroner’s report for answers, she finally accepted that marijuana played a pivotal role in her son’s death. The autopsy report, which Denney received in March, attributed her son’s death to dehydration due to cannabinoid hyperemesis syndrome.

“We had never heard about this, had never heard about marijuana causing any vomiting. He and I were like, ‘Yeah, I think it’s something else,’ ” Denney said. “Brian did not believe that was what it was because of everything we had ever been told about marijuana. … It didn’t make any sense.”

Cannabinoid hyperemesis syndrome, also known as CHS, can arise in response to long-term cannabis use. The syndrome consists of vomiting, nausea and abdominal pain, which can often be alleviated by taking hot showers.

Doctors say CHS is on the rise, but they are not certain why. Marijuana is more available than in years past, and it is more potent.

Rarely does CHS result in death.

‘Basically, they smoked weed’

Denney didn’t like the fact that her teen son started smoking at 13, but she figured the situation could be worse. Brian and she had a strong relationship, and he always had been honest with her about his use of marijuana.

For the most part, Brian was a good kid who had a tightknit group of friends who called themselves the GBS, Gimber Block Savages, after the south side street where many of them lived. Although they called themselves a gang, Denney said, they never caused any trouble.

“Basically, they smoked weed,” she said.

About two years after Brian started smoking, he began using a lot more, perhaps to help deal with depression, Denney said. He dropped out of school after ninth grade and started working full-time with an uncle who had a tree-trimming business. Brian helped clear brush.

The job provided enough money to support his marijuana habit, another reason Denney felt there was no reason for her to intervene. After all, many of Brian’s peers were using heroin or methamphetamine.

“I thought, ‘OK, if that’s all he’s doing, smoking marijuana, pick and choose your battles,’ ” she said. “If this is the worst thing he’s doing, I’m OK. He’s not in any trouble legally. He’s not playing with guns, robbing people and stealing things. He’s supporting his own habit. I thought, ‘OK, this is what it is.’ ”

Denney had no reason to be concerned about cannabinoid hyperemesis syndrome. She, like many others, had never heard of it.

‘A totally underdiagnosed entity’

A few years ago, many doctors had no idea this condition existed. First described 15 years ago, CHS symptoms follow heavy cannabis use and include intense stomach pain, bouts of vomiting and debilitating nausea.

A study published last year in the journal Basic & Clinical Pharmacology & Toxicology surveyed urban emergency room patients who smoked marijuana 20 or more days a month. Of the 155 who said yes, almost a third experienced CHS symptoms.

“A lot of papers prior to mine would say it’s very rare,” said Joseph Habboushe, one of the study’s authors and a clinical associate professor of emergency medicine at NYU Langone Health in New York City, who saw his first case five or six years ago. “Emergency room doctors on the front-line lines, we know that it’s a totally underdiagnosed entity.”

On the other side of the country, Dr. Jeff Lapoint and his colleagues saw an influx of patients with CHS symptoms about six years ago. Lapoint is the director of the division of medical toxicology at Kaiser Permanente Southern California and practices in San Diego, which he said is home to both craft beer and craft marijuana.

Many of Lapoint’s patients returned time after time when the next bout hit, seeking relief from their stomach woes.

“We would see lots of it. We would see an alarming amount of it,” Lapoint said. “People were coming in all the time, and physicians didn’t know what to do with them.”

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Lapoint said he and his colleagues have seen fewer such cases lately.

Habboushe concluded in his study that as many as 2.75 million regular cannabis users may suffer from symptoms of CHS, though many of them may be mild. Mild symptoms can serve as a warning to discontinue cannabis use to avoid more severe distress down the line, Habboushe said.

A study this year in the Journal of Forensic Science described two people in Canada who died from CHS and a third for whom the condition contributed to death.

‘It makes no sense’

Brian was Denney’s baby, her boy after two girls. From the time he was a child, he suffered from acid reflux and often took medicine to ease the symptoms.

Brian, who loved sports and the movie “Twilight,” was close to his family and called himself his mother’s “snuggle bunny.” He was beloved uncle BubBub to his toddler nephew, Zayden. He was a loyal friend, once giving up his bed so a buddy who was homeless had a place to sleep. As a teen, he split time between Denney’s home and that of his father.

In April 2018, Brian felt ill. At first everyone, including his pediatrician, thought his acid reflux was acting up. He lost 40 pounds and frequently complained of nausea that led him to avoid food.

A few days into the illness, he called his mother and told her he couldn’t stop vomiting. Denney drove to his father’s house to take him to the hospital. On the way to Franciscan St. Francis Health, Denney had to stop multiple times for Brian to vomit.

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Brian complained of tingling in his face. When they got to the hospital, half his face was numb, the muscles in his hands and legs constricted and froze, and he projectile vomited.

Denney assumed he was having a stroke.

Within a few minutes, he was hooked up to oxygen and a heart monitor. Medical staff placed IVs in each arm. Tests revealed his kidneys were failing, and many of his other lab values were abnormal. No one could tell what was behind the attack, though they knew the frequent vomiting left him dehydrated.

Another emergency room doctor poked her head in the door and asked two questions: Do you smoke marijuana often? Do you take frequent hot showers?

Yes, Brian said. Yes.

You have CHS, the doctor said.

The following day, Brian was discharged with an appointment to follow up with a gastroenterologist in July.

Although neither Denney nor Brian accepted the diagnosis completely, she urged him to consider not smoking as a process of elimination. He agreed, but he struggled with nausea and was too sick to work.

The GI doctor took a tube of blood, did no further testing and confirmed the earlier diagnosis: CHS.

Denney remained unconvinced, thinking the specialist was too quick to accept the emergency room doctor’s diagnosis without doing any confirmatory testing.

“Going to the GI doctor, I thought we’re going to finally get an answer. We’re going to finally know what we need to do to make him better,” she said. “Then when they didn’t run any other tests, it was like, ‘OK, so why are we not doing them?’ It makes no sense.”

After that visit, Brian returned to his dad – and started smoking again.

He told Denney he had symptoms the whole time he wasn’t smoking, so what was the point of quitting?

‘The dose makes the poison’

Experts aren’t 100% sure what’s behind the relatively sudden advent of this condition. They suspect that more potent cannabis may be to blame, along with several states’ decision to legalize the drug for medicinal purposes or altogether.

In the 1970s, THC concentration in most marijuana would be about 7%, Lapoint said. The mean concentration has risen to 15% to 30%, and it’s possible to make extracts with 99% THC.

“Marijuana was the joke of the toxicology world when it was 7%,” Lapoint said. “People never got sick. … But now if you make the concentration 99%, it’s just like if a 17-year-old kid goes to a frat party and has a beer. That’s a lot different than drinking shots of Everclear 151. Just like anything, the dose makes the poison.”

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The best treatment for CHS is to stop using cannabis entirely, Habboushe said.

Once a person develops the condition, he or she has probably done something permanent. Further exposure to cannabis highly increases risk of recurrence. Persuading patients to accept this can be difficult, Habboushe said.

“There’s a lot of denial,” he said. “A lot of patients are really heavy marijuana smokers, and they really don’t want to believe that it’s related to cannabis and hard for them to believe because they have been using cannabis forever.”

‘Don’t give up’

In July Brian moved back in with Denney. She knew he was not going to give up smoking, but she thought being around his nephew would encourage him to smoke less.

A few months passed. Brian did not put back the weight, but he seemed to be a bit better.

Then came Oct. 7. Brian started feeling ill again. Denney and her daughters had concert tickets, so she went to buy him Gatorade and popsicles to stem the nausea and asked his father to come and stay with him.

When they returned from the concert, he started vomiting nonstop. They rushed to the St. Francis emergency room, where doctors transferred him to Riley Hospital for Children. Once more, Brian was rehydrated.

Denney said her son cut back on smoking, but a few weeks later, he went to visit his cousins. “I know they smoked,” Denney said. “That’s just what he did.”

When she picked him up Oct. 21, he felt a little nauseated but had not been vomiting.

Three days later, Denney woke up around 5 a.m. to find her son sitting in the living room and clutching his stomach.

He told her it was his acid reflux but he was fine. Then he started vomiting again.

“He was throwing up so much,” Denney said. “I was taking the bucket in there and holding it for him because he didn’t have the energy to hold it.”

For the first time, Brian told her he was going to quit smoking.

He grabbed his lower back, saying it hurt bad.

Remembering his kidneys had suffered in his previous attacks, Denney called 911.

Before the paramedics arrived, she found her son lying on his side.

She rolled him over. He was not breathing.

Denney screamed. She started doing chest compressions. Her daughter’s boyfriend ran across the street to get their neighbor, a Navy veteran.

“I kept telling him, ‘Fight, B, fight. I need you. Don’t give up.’ I begged God to take me instead,” Denney said.

The paramedics arrived and worked on Brian for about 45 minutes to no avail. On Oct. 24, Brian died.

Because he died at home, detectives had to investigate, and the coroner prepared a report. It took five months for Denney to receive a copy. It arrived on her birthday in early March.

Soon after Brian’s death, Denney found edibles in his backpack.

She asked herself again and again what she should have done. Should she have forced him to go to rehab?

Denney devoted herself to helping raise awareness about CHS. She started a Facebook group in Brian’s name. She talks about Brian and CHS every chance she gets. She keeps Brian close to her, wherever she is.

Photos of her son hang on the walls in her bedroom. On her dresser sits a dark urn emblazoned with a gold marijuana leaf that contains Brian’s ashes. His sister chose it. She knew her brother would have liked it.

Source: Indiana boy, 17, died from smoking weed. CHS is to blame. What is CHS? (usatoday.com) September 2019

Filed under: Cannabis/Marijuana,Drug use-various effects,Health :

Colorado is on the front lines in dealing with how marijuana use affects surgery. Lessons learned on operating tables and in recovery rooms have prompted calls for more research on marijuana nationwide.

DENVER — When Colorado legalized marijuana, it became a pioneer in creating new policies to deal with the drug.

Now the state’s surgeons, nurses and anesthesiologists are becoming pioneers of a different sort in understanding what weed may do to patients who go under the knife.

Their observations and initial research show that marijuana use may affect patients’ responses to anesthesia on the operating table — and, depending on the patient’s history of using the drug, either help or hinder their symptoms afterward in the recovery room.

Colorado makes for an interesting laboratory. Since the state legalized marijuana for medicine in 2000 and allowed for its recreational sale in 2014, more Coloradans are using it — and they may also be more willing to tell their doctors about it.

Roughly 17% of Coloradans said they used marijuana in the previous 30 days in 2017, according to the National Survey on Drug Use and Health, more than double the 8% who reported doing so in 2006. By comparison, just 9% of U.S. residents said they used marijuana in 2017.

“It has been destigmatized here in Colorado,” said Dr. Andrew Monte, an associate professor of emergency medicine and medical toxicology at the University of Colorado School of Medicine and UCHealth. “We’re ahead of the game in terms of our ability to talk to patients about it. We’re also ahead of the game in identifying complications associated with use.”

One small study of Colorado patients published in May found marijuana users required more than triple the amount of one common sedation medicine, propofol, as did nonusers.

Those findings and anecdotal reports are prompting additional questions from the study’s author, Dr. Mark Twardowski, and others in the state’s medical field: If pot users indeed need more anesthesia, are there increased risks for breathing problems during minor procedures? Are there higher costs with the use of more medication, if a second or third bottle of anesthesia must be routinely opened? And what does regular cannabis use mean for recovery post-surgery?

But much is still unknown about marijuana’s impact on patients because it remains illegal on the federal level, making studies difficult to fund or undertake.

It’s even difficult to quantify how many of the estimated 800,000 to 1 million anesthesia procedures that are performed in Colorado each year involve marijuana users, according to Dr. Joy Hawkins, a professor of anesthesiology at the University of Colorado School of Medicine and president of the Colorado Society of Anesthesiologists. The Colorado Hospital Association said it doesn’t track anesthesia needs or costs specific to marijuana users.

As more states legalize cannabis to varying degrees, discussions about the drug are happening elsewhere, too. On a national level, the American Association of Nurse Anesthetists recently updated its clinical guidelines to highlight potential risks for and needs of marijuana users. American Society of Anesthesiologists spokeswoman Theresa Hill said that the use of marijuana in managing pain is a topic under discussion but that more research is needed. This year, it endorsed a federal bill calling for fewer regulatory barriers on marijuana research.

Why Should Patients Disclose Marijuana Use?

No matter where patients live, though, many nurses and doctors from around the country agree: Patients should disclose marijuana use before any surgery or procedure. Linda Stone, a certified registered nurse anesthetist in Raleigh, N.C., acknowledged that patients in states where marijuana is illegal might be more hesitant.

“We really don’t want patients to feel like there’s stigma. They really do need to divulge that information,” Stone said. “We are just trying to make sure that we provide the safest care.”

In Colorado, Hawkins said, anesthesiologists have noticed that patients who use marijuana are more tolerant of some common anesthesia drugs, such as propofol, which helps people fall asleep during general anesthesia or stay relaxed during conscious “twilight” sedation. But higher doses can increase potentially serious side effects such as low blood pressure and depressed heart function.

Limited airway flow is another issue for people who smoke marijuana. “It acts very much like cigarettes, so it makes your airway irritated,” she said.

To be sure, anesthesia must be adjusted to accommodate patients of all sorts, apart from cannabis use. Anesthesiologists are prepared to adapt and make procedures safe for all patients, Hawkins said. And in some emergency surgeries, patients might not be in a position to disclose their cannabis use ahead of time.

Even when they do, a big challenge for medical professionals is gauging the amounts of marijuana consumed, as the potency varies widely from one joint to the next or when ingested through marijuana edibles. And levels of THC, the chemical with psychoactive effects in marijuana, have been increasing in the past few decades.

“For marijuana, it’s a bit of the Wild West,” Hawkins said. “We just don’t know what’s in these products that they’re using.”

Marijuana’s Effects On Pain After Surgery

Colorado health providers are also observing how marijuana changes patients’ symptoms after they leave the operating suite — particularly relevant amid the ongoing opioid epidemic.

“We’ve been hearing reports about patients using cannabis, instead of opioids, to treat their postoperative pain,” said Dr. Mark Steven Wallace, chair of the pain medicine division in the anesthesiology department at the University of California-San Diego, in a state that also has legalized marijuana. “I have a lot of patients who say they prefer it.”

Matthew Sheahan, 25, of Denver, said he used marijuana to relieve pain after the removal of his wisdom teeth four years ago. After surgery, he smoked marijuana rather than using the ibuprofen prescribed but didn’t disclose this to his doctor because pot was illegal in Ohio, where he had the procedure. He said his doctor told him his swelling was greatly reduced. “I didn’t experience the pain that I thought I would,” Sheahan said.

In a study underway, Wallace is working with patients who’ve recently had surgery for joint replacement to see whether marijuana can be used to treat pain and reduce the need for opioids.

But this may be a Catch-22 for regular marijuana users. They reported feeling greater pain and consumed more opioids in the hospital after vehicle crash injuries compared with nonusers, according to a study published last year in the journal Patient Safety in Surgery.

“The hypothesis is that chronic marijuana users develop a tolerance to pain medications, and since they do not receive marijuana while in the hospital, they require a higher replacement dose of opioids,” said Dr. David Bar-Or, who directs trauma research at Swedish Medical Center in Englewood, Colo., and several other hospitals in Colorado, Texas, Missouri and Kansas. He is studying a synthetic form of THC called dronabinol as a potential substitute for opioids in the hospital.

Again, much more research is needed.

“We know very little about marijuana because we’ve not been allowed to study it in the way we study any other drug,” Hawkins said. “We’re all wishing we had a little more data to rely on.”

Source: If You Smoke Pot, Your Anesthesiologist Needs To Know – KFF Health News August 2019

Filed under: Cannabis/Marijuana,Health :

As states have begun to legalize marijuana, its use has been more openly discussed. While the effects of other commonly used drugs, such as alcohol, have been studied extensively, the effects of marijuana – especially on developing babies during pregnancy – have been much less studied and less widely publicized. This relative silence from the scientific community has affected the public’s opinion on the safety of marijuana: 70 percent of U.S. women think there is “slight or no risk of harm” to the baby from using marijuana during pregnancy. Expectant mothers may use marijuana rather than prescription drugs during pregnancy to relieve pain because they feel “natural” or home remedies are a safer option than prescription drugs. However, just because something is “natural” doesn’t mean it is any safer or a better alternative to well-studied prescription drugs. This seems to be the case for marijuana. Given that marijuana is the most commonly used illicit drug during pregnancy, understanding its risks and impacts on the developing fetus is important.

Three large-scale longitudinal studies tracked how maternal cannabis use affected their child’s development, and they have had surprisingly consistent results. The Ottawa Prenatal Prospective Study surveyed 700 pregnant women who used marijuana in 1978 and has followed about 200 of those children into adulthood. The U.S.-based Maternal Health Practices and Child Development Study has studied 580 children of marijuana users from pregnancy through age 14. The Generation R study is tracking almost 8,000 children in the Netherlands.

Children of marijuana users were more impulsive and hyperactive, and exhibited behavioral issues, lower IQ scores, and memory problems when compared to children of non-users. These mental health problems persisted through their teenage years, where they were significantly more likely to have attention problems and depression. Marijuana-exposed children were also almost twice as likely to display delinquent behavior, such as drug use, by the age of 14 and were more than twice as likely to regularly use marijuana and tobacco as adults. The very consistent results between mice and human studies (summarized in the infographic from The Scientist below) highlights an increasing understanding of the impacts of marijuana use on development.

It’s important to note that some behavioral outcomes may not be completely related to fetal marijuana exposure. Children of marijuana users may have grown up in a different social environment with more lax views on drugs, contributing to their increased drug use.

As marijuana continues to be legalized, we should expect to see more studies on its health effects and safety.

Source: https://sitn.hms.harvard.edu/flash/2019/marijuana-exposure-affects-developing-babies-brains/

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

ANDRI TAMBUNAN FOR THE WALL STREET JOURNAL

By Julie Wernau

Last year, members of Congress introduced a bill that would add the veterinary tranquilizer xylazine to a list of controlled substances. The drug has worsened the fentanyl crisis as it has been showing up in drug users’ fentanyl supply at an alarming pace.

What is fentanyl?

Fentanyl is a heavily regulated legal medication, prescribed largely for pain relief in cancer patients, postsurgery and for people with chronic pain who have developed tolerance for other opioids.

When prescribed by a doctor, fentanyl can be given as a shot, a patch that is placed on a person’s skin, as lozenges that are sucked like cough drops or film that sits between the cheek and gum, according to the American Society of Health-System Pharmacists Inc. It also can be sprayed in the nose or under the tongue.

The illicit form of fentanyl, a powder that is often mixed into other drugs, has overtaken the drug market in the U.S. Fentanyl is made in clandestine labs in Mexico from easily sourced chemicals.

Drug overdose deaths reached a record high in 2022, with more than 100,000 people lost to the continuing epidemic. PHOTO: ALYSSA SCHUKAR FOR THE WALL STREET JOURNAL

What is “tranq” drug xylazine?

Xylazine is a veterinary tranquilizer that has increasingly been showing up in illicit drugs, including in fentanyl. The drug, which is authorized only for animals, has been complicating overdoses and producing severe wounds for users that can lead to serious infection and amputation.

Dealers may mix xylazine into fentanyl to save money, federal law-enforcement authorities have said. The drug—known as “tranq” among some users—can be purchased at low prices from Chinese suppliers and offset some of the opioid in the mix.

Drug users often don’t know that xylazine is being mixed into their fentanyl batch and unknowingly become hooked on both substances. Drug users say xylazine can prolong a high from fentanyl but that also often means being unconscious, sometimes for hours at a time.

In February, the FDA said it would restrict imports of xylazine and more carefully scrutinize shipments of the drug into the U.S. to check that they are bound for legitimate use in animals.

The Drug Enforcement Administration said in March that about 23% of seized fentanyl powder and 7% of fentanyl pills contained xylazine last year. The Senate and House bills introduced in March would make xylazine a Schedule III drug, a category that includes ketamine. The bill would require producers and distributors to report order volumes to the DEA.

Drug test results also show xylazine is spreading throughout the U.S. About 43% of fentanyl-positive urine samples in Pennsylvania from April to July contained xylazine, according to Millennium Health, a drug-testing laboratory. The rate in North Carolina was second-highest at 40%. Rates in Ohio and Maryland were close behind.

Which drugs are typically laced with fentanyl?

Drug manufacturers mix illicit fentanyl with other materials to create a powder that can be dissolved into liquid and injected. PHOTO: MORIAH RATNER FOR THE WALL STREET JOURNAL

Fentanyl is often found mixed into heroin, cocaine and methamphetamine, according to the CDC. The drug is also made into fabricated pills that are often indiscernible from commonly prescribed medications such as Percocet (the narcotic oxycodone), Xanax (the sedative alprazolam) or even Adderall (an amphetamine).

Chinese chemical companies are making more ingredients for illegal fentanyl than ever, including N-Phenyl-4-piperidinamine, which Mexican cartels purchase to make into fentanyl.

Drug manufacturers in Mexico also mix illicit fentanyl with other materials, such as baking soda, starch and sugar, to create a powder that can be smoked or dissolved into liquid and injected, a process called “cooking,” or fabricated pills purchased on the illicit market.

Fentanyl is so powerful that in pure form the amount in roughly two sugar packets can provide a year’s supply for a user. When drug suppliers mix fentanyl into drugs or press it into illicit pills, a few grains too many can be enough to trigger a fatal overdose. It is unclear why fentanyl is showing up in such a large array of drugs. Evidence that fentanyl is showing up in more places comes from laboratory tests of drug seizures, toxicology testing and death certifications that take months to complete, according to the National Institute on Drug Abuse. Law-enforcement officials believe that in some cases, the drug is mixed in accidentally by drug manufacturers working with multiple white powders in the same lab, while at other times, drug manufacturers are experimenting in the attempt to create new psychoactive substances.

Fentanyl can be made into fabricated pills that are often indiscernible from commonly prescribed medications. PHOTO: ANDRI TAMBUNAN FOR THE WALL STREET JOURNAL

How often are illicit drugs laced with fentanyl?

Fentanyl has infiltrated virtually every channel of the illicit drug supply, according to U.S. law officials. The proportion of seized counterfeit pills in the U.S. containing a potentially lethal dose of fentanyl increased to 60% in 2022 from 10% in 2017, according to samples analyzed by the DEA.

WHAT’S NEWS

Tainted drugs are so common in cities across the country, including Columbus, Ohio, that the city offers a program for distribution of fentanyl testing strips to users so they can determine whether substances are contaminated with the drug.

In New York City, authorities have been warning of the risks of unknowingly taking fentanyl in cocaine and of its increased presence in cocaine seized by police. Of 980 cocaine deaths in 2020, 81% involved fentanyl, according to recent New York City health department data.

People who use methamphetamine are also sometimes accidentally exposed to fentanyl. But many users are intentionally using meth and opioids simultaneously or in sequence in search of balancing or offsetting effects, researchers say. The drug combination is becoming an emerging driver of U.S. overdoses.

What is fentanyl’s effect on the human body?

Fentanyl works by binding to the body’s opioid receptors—found in the areas of the brain that control pain and emotions, according to the National Institute on Drug Abuse. Some of the effects of fentanyl include euphoria, relaxation, pain relief, drowsiness and sedation, among others, according to the DEA. With repeated use, the brain adapts to the drug, making it hard to feel pleasure without it. Stopping the use of fentanyl leads to withdrawal, or “dope sickness,” which can include extreme anxiety, vomiting, muscle pain, chills, racing heartbeat and profuse sweating. Many chronic users have long since stopped feeling the euphoric effects of fentanyl and use it to avoid feeling sick.

Drug users who are accustomed to using heroin or prescription pain pills say illicit fentanyl’s effect can be more dramatic and shorter lasting than other opioids, making it more difficult to hold down a job as they seek out drugs every few hours.

Naloxone is an antidote to opioids that can reverse the effects of an overdose within two to three minutes. PHOTO: ASH PONDERS FOR THE WALL STREET JOURNAL

What are some of the signs and symptoms of someone overdosing on fentanyl?

Fentanyl slows the body down and reduces respiration but becomes deadly when it suppresses breathing to such slow shallow breaths that a person can’t sustain life and their heart stops. If someone is unconscious, awake but unable to talk, or their breathing slows sharply, that could be an early sign of an overdose. According to the New York State Department of Health, that person’s skin may soon turn bluish purple or ashen. In some cases, a person overdosing will have a faint heartbeat. An overdose can also lead to hypoxia, the decrease in oxygen to the brain, according to neuropsychopharmacologists.

Still, it can be difficult to tell if a person is just very high or experiencing an overdose, according to the National Harm Reduction Coalition. People who are high may display slurred speech or seem dazed, but still be able to respond to a loud noise or someone lightly shaking them, the group says.

How do you treat an overdose?

Naloxone is an antidote to opioids that can reverse the effects of an overdose within two to three minutes, according to the Mayo Clinic. Naloxone has virtually no effect in people who haven’t taken opioids, according to the World Health Organization.

The overdose-reversal drug binds to opioid receptors and reverses or blocks the effects of opioids. It comes in two forms: nasal sprays and injectables. Nasal sprays such as Narcan are often stocked by first responders and at healthcare facilities. Groups working with drug users typically have an injectable version of the drug on hand that can be injected into the muscle of an arm or leg to reverse an overdose. The Substance Abuse and Mental Health Services Administration recommends performing cardiopulmonary resuscitation, also known as CPR, if the person isn’t breathing on their own and said it can save a person’s life regardless of whether naloxone is present. The agency says it is important to stay with the person until medical personnel arrive, reassure them and explain what is happening, as they may reawaken agitated, confused or could overdose again if the naloxone wears off before the opioid.

Recently, the U.S. Food and Drug Administration encouraged pharmaceutical companies to apply for approval for over-the-counter versions of overdose-reversal medications such as Narcan to help address a swelling overdose crisis from bootleg versions of the powerful opioid fentanyl.

The FDA on March 29 approved Emergent BioSolutions Inc.’s Narcan brand of naloxone nasal spray for over-the-counter sale. The company said its nasal spray-version of the medication will likely become available on store shelves by late summer.

The pharmaceutical nonprofit Harm Reduction Therapeutics Inc. has already received priority review from the agency to make an inexpensive naloxone nasal spray for use without a prescription. The company said the FDA gave it a target approval date of April 28.

Supplies for drug users at an overdose prevention center in New York. PHOTO: SARAH BLESENER FOR THE WALL STREET JOURNAL

What is harm reduction?

Harm reduction is a public-health strategy aimed at reducing as much harm as possible to people while they are using drugs, rather than stopping them from taking substances altogether.

Groups that practice harm reduction for drug users teach about using clean needles to prevent infection and the spread of disease. Some groups provide fentanyl test strips so that users can test drugs for fentanyl and hand out naloxone to prevent deaths from overdose. An increasing number of groups supervise drug consumption. The Biden administration is the first to name harm reduction as a priority for drug policy.

Who is affected by overdose rates?

Disparities in access to treatment are driving up overdose rates among Black and Native American people, the CDC has said. Overdose deaths per 100,000 people increased 44% for Black people and 39% for Native Americans in 2020 from a year earlier, compared with a 22% increase among white people, according to a study in which the CDC analyzed 25 states and Washington, D.C.

Deaths from fentanyl have affected every age group, but particularly the 25-to 34-year-old and 35-to 44-year-old populations. These two groups combined made up more than half of all synthetic opioid overdose deaths in 2021, according to preliminary CDC data.

Young children have also been directly affected by fentanyl. There were 133 opioid-related deaths among children younger than 3 last year, according to federal mortality data.

Overdose rates were higher in areas with more opioid-treatment programs than average, a finding that the study’s authors said demonstrated other barriers to access for some people. Overdose rates were also higher in counties with higher income inequality, according to the study. The findings show how the escalating overdose crisis is exacting a mounting toll on minority groups that are in some cases marginalized by the healthcare system, CDC researchers said.

Some prisons and jails have programs that dispense antiaddiction medications to help put inmates who are addicted to opioids on a path to sobriety and curb overdose rates. The Biden administration has said it wants medication available for drug users in federal custody and at half of state prisons and jails by 2025.

This explanatory article may be periodically updated.

Brian Spegele, Margot Patrick, Arian Campo-Flores and Jon Kamp contributed to this article.

SOURCE: https://www.wsj.com/health/healthcare/what-is-fentanyl-drug-opioid-health-safety-explained-11658341650

Filed under: Drug use-various effects,Health,Synthetics :

As with any addiction, alcoholism is closely connected with stress. And while plenty of people first started drinking as a way to cope with stress or even just wind down after a long day, developing an alcohol use disorder can end up causing significant stresses of its own. If you’re thinking about pursuing alcohol use disorder treatment for yourself or for a loved one, it can be helpful to understand how alcohol is connected to stress.

Present Stress That Can Lead to Alcohol Use

While stresses from your past can certainly contribute to alcoholism, plenty of people also start to develop alcohol use disorder as they struggle to cope with current stress. Often, people end up turning to alcohol in order to try to manage the stresses of day-to-day life. These can include pressure at work or at school, marriage, and divorce, moving, and financial issues.

Minority stress is also an important consideration. If you’re a minority (either in terms of race/ethnicity or sexual orientation), you face unique stresses. You might stress about being passed over for a promotion at work, and you also might fear harassment or becoming the victim of a hate crime.

It’s important to note that stress alone typically does not cause a substance use disorder. However, significant stresses may place you at higher risk of developing one, and high stress levels in sobriety can also make relapse more likely. High stress is a risk factor for alcoholism, along with the following:

One or more close relatives who have an alcohol use disorder
Depression and other mental health disorders
Heavy drinking over time (which can sometimes result in alcohol-induced dementia)
Social factors (like the way alcohol is viewed or treated in your community)
A history of past traumas

Past Stress That Can Lead to Alcohol Use

Unfortunately, it isn’t just current stressful events that can predispose you to drink more. Stresses and traumas from your past can also play a role in alcoholism. Several studies point to childhood abuse and neglect as being a significant factor in the development of an alcohol use disorder. One study found that emotional abuse and neglect were most commonly seen in men and women seeking help for alcoholism. The severity of their alcoholism correlated with the severity of the abuse.

Past traumas, even if they were not experienced in childhood, may also make someone more likely to experience alcoholism. Many people with an alcohol use disorder also have PTSD. As with other mental health diagnoses, the relationship between alcoholism and PTSD becomes a vicious cycle. Alcohol use makes PTSD symptoms worse, and the PTSD symptoms make alcoholism worse.

If you have experienced trauma and are also struggling with alcohol use disorder, it’s easy to feel as though there is no hope. But at Granite Recovery Centers, we offer evidence-based therapies including trauma therapy. In therapy for trauma and PTSD, you will be able to process your trauma and develop healthier coping strategies to help you avoid self-destructive behaviors. With these therapies, you’ll be able to break the cycle of worsening symptoms and experience a greater quality of life.

How Can Alcohol Use Cause Stress?

While it might seem logical that alcohol use can cause stress, there’s also a good bit of biochemical evidence to explain, at least in part, how alcohol shapes your stress response. Even in the short term, alcohol consumption increases levels of cortisol. Cortisol is known as the stress hormone, and your body also releases it during periods of intense anxiety or fear. In the short term, a cortisol release can be helpful — it increases alertness and focus, which was helpful evolutionarily because it helped humans and animals get themselves out of dangerous situations.

However, having elevated cortisol over a long period of time can be detrimental, exhausting, and even dangerous. And in chronic heavy drinkers and those with alcohol use disorder, cortisol isn’t just elevated during intoxication — it stays elevated through withdrawal. In fact, one study even found that cortisol increased as intoxicated people started moving toward withdrawals. If you’ve ever experienced intense anxiety when withdrawing from alcohol, you’ve felt this cortisol surge firsthand.

Because most people with an alcohol use disorder go through a near-constant cycle of intoxication and withdrawal, cortisol can remain elevated for years on end. Chronically elevated cortisol can cause a number of ill health effects:

Slow healing (of wounds, broken bones, etc.)
Acne
Thinning skin
Weight gain
Extreme fatigue
Irritability
Trouble focusing
Muscle weakness
Headaches
Elevated blood pressure

Chronically elevated cortisol may cause other health problems as well, but more research is needed to determine exactly what these effects are. Of course, the physical stresses of elevated cortisol combined with chronic heavy drinking can mean your body is put through a lot of physical stress as well as emotional stress.

You already know that plenty of people use alcohol to alleviate stress, but over time, alcohol can cause its own significant stresses. As mentioned above, the elevated cortisol you experience while intoxicated and in withdrawal can cause significant emotional distress. When your body is under stress, and elevated cortisol is effectively causing a constant stress response, it becomes significantly more difficult to handle even everyday stresses.

And in some cases (like when you are intoxicated enough to experience blackouts or respiratory suppression), being intoxicated can be a stressful experience in itself. And for many people with an alcohol use disorder, that stressful experience is something they experience on a daily or near-daily basis. Some of the physical effects of heavy drinking — including dizziness, nausea, headaches, and dehydration — can compound the emotional stress you’re already feeling.

Many people also consciously or unconsciously use alcohol to self-medicate psychiatric disorders, including depression and bipolar disorder. However, in many cases, alcohol use worsens the symptoms of mental health issues, which can cause considerably more emotional distress on a daily basis. In some cases, heavy alcohol use can even contribute to the development of new mental health diagnoses.

If you’ve been using alcohol to help manage a mental health diagnosis (or to help manage a mental health issue that has not yet been diagnosed), Granite Recovery Centers’ dual diagnosis treatment program can help you. With this approach, medical and recovery professionals work with you to find better treatments and coping mechanisms for your mental health diagnosis while also helping you manage your alcohol use disorder. In many cases, this treatment approach will greatly improve your quality of life, as you’ll be much better equipped to manage both diagnoses.

Regardless of whether you have a mental health diagnosis or not, heavy alcohol use can begin to cause stress as it starts to affect the rest of your life. For example, you may constantly worry whether someone will smell alcohol on your breath at work, or you may worry about when you can take another drink. For many people with an alcohol use disorder, it can start to feel like leading a double life, which becomes exhausting and highly stressful over time. And as a person starts to drink more, they often become more socially isolated. Feeling isolated can increase stress, and the person may then continue drinking heavily to cope with that stress.

If you struggle with an alcohol use disorder or other substance use disorder, you already know just how stressful day-to-day life can become. If you have to drink to get rid of withdrawal symptoms and can’t control your drinking once you start, it’s easy to feel trapped, which is, of course, a major stress in itself. If you feel this way, you aren’t alone — taking the first steps to get help can free you from the seemingly unending cycle of alcohol use.

How Do I Know If I’ve Developed an Alcohol Use Disorder?

If you have started using alcohol as a way to cope with stress, it can be difficult to tell whether you have developed an alcohol use disorder or if you are beginning to develop one. While you’ll need to consult a medical professional if you’re looking for a definite diagnosis, you can look for some of the common signs:

Spending a lot of time both drinking and recovering from drinking
Not being able to control how much you drink once you start
Continuing to drink even when you experience negative consequences
Giving up on hobbies or responsibilities in order to drink
Developing an alcohol tolerance
Craving alcohol or becoming preoccupied with drinking when you can’t drink
Experiencing withdrawal symptoms when you don’t drink (or drinking to ensure you avoid these symptoms)
Using alcohol when it is dangerous to do so (like when you’re driving)

Binge drinking can also be a sign of a developing alcohol use disorder. Binge drinking is defined as consuming five or more standard drinks in two hours for men and consuming four or more standard drinks in two hours for women. On its own, binge drinking doesn’t necessarily indicate an alcohol use disorder, but it could be a sign that one is starting to develop.

It’s important to keep in mind that alcohol use disorders are on a spectrum. Milder cases tend to have fewer symptoms present, while more severe cases have more. Even if you think you only have a mild case, you can still benefit tremendously from treatment. Most cases of alcohol use disorder become progressively worse over time.

How Can Treatment Help?

If you’re unfamiliar with substance use disorder treatment, you may think residential treatment’s only benefit is preventing you from accessing your substance of choice. This couldn’t be further from the truth. A good residential treatment program takes a holistic approach to help you improve your life.

In most cases (and definitely in severe cases), a stay at a residential treatment center begins with a medical detox program. In medical detox, you’ll be supervised by a doctor and likely given medication to prevent seizures and other complications of alcohol withdrawal. Withdrawing from alcohol on your own can be very dangerous, and inpatient detox can ensure that you’re safe. Granite Recovery Centers provides medical detoxification for people who do not need immediate medical intervention, are not a danger to themselves, and are capable of self-evacuation in the event of an emergency.

Once you’re in treatment, you’ll work with counselors and medical professionals to help you identify issues that make you want to drink. These professionals will help you develop healthier coping mechanisms to deal with stress so you’ll be less likely to turn to alcohol in the future. You may get to participate in cognitive behavioral therapy and dialectical behavioral therapy, as well as trauma therapy if needed.

Nutritional deficiencies developed while drinking heavily can add to stress and feeling generally unwell, so residential rehabilitation includes healthy food and ample exercise opportunities. And if you have a co-occurring mental health condition, on-site professionals will help you develop an effective treatment plan.

Ready to Take the Next Step?

Alcohol is an easy answer to stress for many people. But if you have an alcohol use disorder, chances are good that alcohol only causes more stress and worsens the stress you already have. And if the prospect of quitting by yourself seems like too much, don’t worry—the professionals working with Granite Recovery Centers will be helping you every step of the way. If you’re ready to change your life, give us a call at 855-712-7784 today!

Source: https://www.graniterecoverycenters.com/resources/the-connection-between-stress-and-alcoholism/ April 2021

Filed under: Alcohol,Brain and Behaviour,Health,Treatment and Addiction :

The title of “Cannabis in Medicine: An Evidence-Based Approach” contains an irony. In chapter after chapter in this multi-authored book written predominately by providers associated with mainstream medical facilities in Colorado, the authors point out the inadequacy of the evidence we have and the absence of the evidence we need to determine how – or even if – cannabis has medical legitimacy. The foreword’s title, “Losing Ground: The Rise of Cannabis Culture,” sets the tone. David Murray, a senior fellow at the Hudson Institute, argues convincingly that “the current experiment with cannabis, underway nationwide [is] leading us towards a future of unanticipated consequences, a future already established in the patterns of use ‘seeded’ in the population but as yet unmanifested.” In other words, the cannabis horse has not only fled the barn but has been breeding prolifically to the point that we couldn’t get rid of it and its progeny if we wanted to!

The 20 chapters following the foreword are divided into basic science (three chapters) and clinical evidence (17 chapters) sections. Over and over in the clinical evidence chapters, individual authors remind the reader of the lack of quality control in production, the dearth of strong evidence from adequately designed research trials, and the intensifying potency of cannabis with attendant dangers, particularly for youth. The organization of this section lacks consistency in that some chapters focus on specialty (e.g. pulmonary medicine), others on patient groups (e.g. the pediatric and adolescent population), others on physiological implications (e.g. clinical cardiovascular effects; neuropsychiatric effects), others on specific diseases (e.g. gastrointestinal disorders; ocular conditions), and still others on public health topics (e.g. cannabis-impaired driving). While all are relevant, a specialty or organ system focus, with a separate public health section might lend the book more coherence. It would also be worth exploring how “cannabis culture” has become in essence a parallel medical system, with many of cannabis’s most ardent proponents as dropouts from establishment medicine after its nostrums for diagnoses like chronic pain, anxiety, and depression have failed to bring them relief.

I would have liked a chapter specifically grappling with the porous boundary between federal and state jurisdictions over cannabis as medicine and marijuana as recreational substance. Lawyer David G. Evans’ admirable chapter on “The Legal Aspects of Marijuana as Medicine” moves in that direction when he writes that, “‘medical marijuana’ is not a ‘states’ rights’ issue.” To wit, for no other drug than cannabis has the federal government ceded regulatory responsibility to states that are variably (but mostly not) equipped to handle it. The truth, complex in its contradictions and inconsistencies, is that in the United States, marijuana remains a Schedule I drug without recognized medical value; the Federal Drug Administration overseeing American pharmaceuticals throws roadblocks in the way of studying it, thereby interfering with the development of a robust evidence base; the federal government has looked the other way and even colluded with the states as one after another has legalized cannabis medically, recreationally, or both; and physicians risk their federal licenses to prescribe if they do more than recommend this drug. In a nutshell, any effort to impose logic is doomed because the American scene vis-à-vis cannabis is seemingly irretrievably illogical.

The editor of this volume, Kenneth Finn, MD, a PMR and pain management specialist in Colorado Springs, Colorado, is to be commended for encouraging individual chapter authors to develop encyclopedic bibliographies. The book can thus serve as a resource for practitioners wishing to delve into a vast and growing literature that continues to offer little that is conclusive. The book can also serve as a primer on what is known about cannabis as medicine, keeping in mind a slant throughout – not necessarily unjustified, at least from an allopathic or osteopathic perspective – that cannabis is neither legitimate as medicine nor safe, even for recreational use.

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7723137/ Sept-Oct 2020

Filed under: Cannabis/Marijuana,Drug use-various effects,Health,Legal Sector,Marijuana and Medicine,Political Sector,Youth :

Limited information exists on marijuana use and male reproductive health. A recent study from Duke University evaluated differences in sperm quality resulting from tetrahydrocannabinol (THC) exposure in both rats and humans. Findings suggest that paternal marijuana use, prior to conception, may present epigenetic risks to potential offspring.

…

Public perceptions pertaining to marijuana have evolved radically over the past 2 decades. While marijuana remains criminalized at the federal level, 33 states and the District of Columbia have legalized marijuana, in some capacity, for either medical or recreational use. According to the most recent National Survey on Drug Use and Health, nearly 26 million Americans, over the age of 12, currently use marijuana. While the gender gap is narrowing, men remain significantly more likely to use marijuana than women (11.7% vs. 7.3%, respectively).

In 2017, approximately 1.9 million men, between the ages of 26 and 29, reported using marijuana in the past month. Given that the average age of first-time fathers in the U.S. is around 30, these findings suggest that a substantial number of “fathers-to-be” are using marijuana at the time of conception. Little is known, however, about the impact of paternal marijuana use on reproductive outcomes.

Epigenetics, which literally translates to “above” or “on top of” genetics, refers to the biological mechanism through which genes are activated and expressed. This process acts like a light switch, turning on or off how cells read certain heritable traits written within an individual’s unique genetic code. Sperm matures continually throughout adulthood, making it particularly vulnerable to potential epigenetic modifications, such as DNA methylation, that may result from marijuana use. This study explores differences in sperm profiles, based on cannabis exposure in both humans and rats, to better understand potential heritable effects.

Key Findings

Individuals who used marijuana can have higher and also can have significantly lower sperm concentrations, compared to those who did not, posing potential complications for fertility.
THC-exposed sperm was associated with significantly altered DNA, in both rat and human samples.

*Associations were even stronger among individuals with higher levels of THC in their urine, implying a “dose-response relationship” such that chronic marijuana users may be impacted more severely.

Authors identified three unique potential genetic pathways modified by THC exposure.

Looking to the Future

Past research suggests that offspring born to rats exposed to THC during adolescence demonstrate significant DNA alterations in their brains, display heightened drug-seeking behavior, and are at increased risk of developing opioid dependency over time, compared to controls. The present study is the first to extend this line of research to men of childbearing age, lending additional evidence for potential intergenerational, heritable consequences, resulting from paternal marijuana use. Just as other environmental triggers, such as air pollution, cigarette smoking, certain pesticides (i.e. DDT), and exposure to radiation are known to affect sperm health, THC may also increase the potential for genetic mutations.

For Clinicians

Primary care physicians and healthcare professionals, both inside and outside of substance use disorder treatment landscapes, should take time to educate patients about the impact of THC on sperm so individuals may consider potential implications for fertility and children conceived during periods of active use.

For Researchers

This article adds to a growing literature on the potential epigenetic impact of paternal marijuana use prior to conception. Findings must first be replicated in larger samples. Additionally, future longitudinal studies are necessary to explore the extent to which THC induced DNA alterations in sperm are passed down to offspring, as well as their long-term consequences.

For Policymakers

Marijuana potency continues to increase rapidly, with THC level increasing 300% over the past 20 years. Within the current political landscape and shift towards increased access to medical and recreational marijuana, policymakers should work closely with scientists to stay informed on the extent to which increased THC levels and evolving public attitudes impact men’s reproductive health.

For General Public

The full impact of passing THC-related DNA modifications onto offspring, and whether or not these changes are reversible is still unknown. Evidence of DNA alterations to existing Hippo signaling and Cancer genetic pathways may disrupt growth, enhance the potential for miscarriage, or impede healthy embryo development.

Methods

The authors employed a quantitative genome-scale approach, referred to as reduced representation bisulfite sequencing, to compare DNA methylation alterations in sperm across human and rat samples. A number of factors including, time since last ejaculation, semen volume, pH, morphology, and motility were controlled for across participants. Pyrosequencing, a DNA synthesizing method that relies on light detection, was implemented to identify genes with significant methylation differences. Data were then analyzed to uncover specific genetic pathways potentially impacted by paternal, preconception cannabis use.

Study Limitations

A relatively small sample size of human subjects, limiting the generalizability of study findings.

*24 males, age 18-40 years: (12 marijuana users & 12 non-users)

The methodological approach may fail to identify epigenetic modifications that affect multiple genes simultaneously.

Source: What you should know about Marijuana and Sperm (addictionpolicy.org) March 2019, updated October 2022

Filed under: Cannabis/Marijuana,Drug use-various effects,Drug use-various effects on foetus, babies, children and youth,Health :

Alexandria, VA) – A new study released yesterday in the Annals of Internal Medicine found that the rise in marijuana use in Colorado since the state legalized the drug has led to increased emergency room visits. The study found that 9,973 marijuana-related emergency room visits occurred from 2012-2016, more than triple the number that occurred prior to legalization. Additionally, the study found that 10.7% of visits at UCHealth were due to the ingestion of high potency marijuana edibles.

“Evidence continues to build the case that marijuana legalization results in harmful impacts on public health and safety,” said Dr. Kevin Sabet, founder of Smart Approaches to Marijuana and a former senior drug policy advisor to the Obama Administration. “Marijuana is no longer the weed of Woodstock. The industry is churning out new, highly potent candies, gummies, sodas, and ice creams as well as concentrates and vape pens that contain up to 99% THC. These kid-friendly products are regularly getting into the hands of children, whose developing brains are incredibly susceptible to permanent damage from this highly potent pot.”

The study found that 17% of emergency room visits were due to uncontrolled vomiting that was associated with the smoked form of the drug. Previous research has labeled this phenomenon as “scromiting,” or Cannabinoid Hyperemesis Syndrome. 12% of the visits were for acute psychosis and this was associated with high potency edibles. 8% of visits were associated with cardiovascular issues such as irregular heartbeat or even heart attacks after ingestion of edibles.

Another recent study found that the use of high potency edibles was directly linked with increases in severe mental illness, such as psychosis, and stated that if higher potency concentrates and edibles were removed from the market, instances of psychosis would be reduced by a third.

“Lawmakers rushing to legalize marijuana need to slow down and consider the implications it could bring upon their state,” continued Dr. Sabet. “They are certainly not receiving information such as this from the pot industry’s army of lobbyists. This is why organizations such as SAM are so important. We work tirelessly to combat the industry narrative that marijuana is harmless.

Email from SAM https://www.learnaboutsam.org March 2019

Filed under: Cannabis/Marijuana,Global Drug Legalisation Efforts,Health :

Radula complanata, a cannabinoid moss. Henri Koskinen/Shutterstock

Most of us know that the cannabis plant produces compounds that react with the human body. That’s because we have our own system that makes similar compounds, cannabinoids, that have a wide range of actions from appetite control to immune function. Cannabis contains a cannabinoid called THC that interacts with the brain, resulting in euphoria and relaxation, as well as increased hunger and anxiety. It was long thought that there was no other natural source of cannabinoids – and along with a long list of supposed medical uses the mythical power of cannabis, and the psychoactive properties of THC, has grown.

But as it turned out, another plant contains something similar: a compound that has the structural hallmarks for it to act on the brain in a similar way to THC. The discovery of this lost twin, called cis-PET (perrottetinene), or PET, was tucked away in specialist chemistry journals in papers published in 1994 and 2002, with no subsequent research confirming its biological activity. But in a new study, published in Science Advances, a group of Swiss scientists have delved into the mechanism by which PET may be acting on the brain.

The particular liverwort in question, Radula, is endemic to New Zealand and Tasmania and is used as a herbal medicine by the Maori people. Preparations using this plant are also sold as a THC-like legal high on the internet.

But while similar to THC, does PET actually produce the same effects that THC does at a cellular and molecular level? Does it mimic the physiological effects? And is it different in ways that could give it therapeutic advantage or disadvantage? Some 24 years after its first discovery, the team of chemists and biochemists behind the new study have teased some of the answers out.

Their research was no mean feat. It required a new synthesis method to produce enough PET to do meaningful experiments. Once this was achieved, the researchers looked at two mirror versions of the two compounds, cis (the version found in the liverwort) and trans (a version they artificially created in the lab). In chemistry, the cis and trans terms tell us which side of the carbon chain the functional groups are (the bit of the molecule that does the work).

The researchers wanted to find out if these two versions of PET were able to interact with the two receptors found in humans that mediate the psychoactive effects of cannaboids – CB1, the receptor that produces the “high” effect from THC, and CB2 – in the same way as THC (how strongly they bound and how much is needed to produce an effect).

The researchers found intriguing similarities between the two versions in PET and THC. For both PET and THC, the trans versions (the abundant THC version found in cannabis and the lab-synthesised version found in liverwort) bound to the CB1 receptor better than the cis versions.

THC and PET side by side. Oliver Kayser

What’s interesting about this is that while the levels of cis-PET found in the liverwort plant are too low to produce the “high” effects produced by THC (hence why smoking PET won’t produce a high), it could explain why PET might still have a medicinal effect (similar to the effect produced by lower dose THC). However, any methods to extract and concentrate the liverwort compound could lead to the same problems as THC.

But what about CB2, the other cannabinoid receptor? This receptor plays a role in immune responses. Here the Swiss scientists found that the cisversions of both THC and PET bound this receptor better than the transversions. The implications of this are yet to be explored, but it again hints at a potential medicinal benefit worth exploring further.

The authors of the study then went on to test whether the binding of the CB1 receptors in the brains of mice had the same recognisable THC effects. Usually when THC binds with this receptor it produces four key effects: reduced body temperature, muscle rigidity, reduced movement and decreased sensitivity to pain. In this behavioural test, all four effects were also achieved in the mice using cis-PET, albeit in a much bigger amount.

But there was one notable difference. Inflammation in the brain is mediated by molecules called prostaglandins that can be derived from metabolic pathways involving our own body cannabinoids or plant-derived trans-THC. In contrast, the production of these mediators was reduced by cis-PET. It remains to be seen whether this is a good thing or a bad thing.

So while the study is just a start in understanding the mechanisms and effects of PET on the brain, there’s much we still don’t know. What we do know now, however, is that the levels of PET that are found in the natural liverwort plant are too low to produce the recognised effects of THC, so smoking it is unlikely to lead to a high. But it is also interesting that this compound could well have medicinal benefits without the high – one of the key reasons that THC has previously been dismissed as a medicine. Illegal trading and cultivation has confounded much meaningful clinical research, but this is changing and this new compound will add to the treasure trove of plant-derived cannabinoids that we still have much to understand.

Source: https://theconversation.com/liverwort-could-have-medicinal-benefits-of-cannabis-thc-without-the-high Oct.24^th 2018

Filed under: Brain and Behaviour,Cannabis/Marijuana,Health,Marijuana and Medicine :

A handful of recent studies are beginning to reveal the possible health effects of e-cigarette use, and they are not all positive.
These findings and a reported uptick in teen vaping have spurred government regulators to act.
Researchers have found evidence of toxic metals like lead in e-cig vapor. Evidence also suggests that vaping may be linked to an increased risk of heart attacks.
Regulators and health experts are particularly concerned about a device called the Juul, which packs the same nicotine content per pod as a pack of cigarettes.

Smoking kills. No other habit has been so strongly tied to death.

In addition to inhaling burned tobacco and tar, smokers breathe in toxic metals like cadmium and beryllium, as well as metallic elements like nickel and chromium — all of which accumulate naturally in the leaves of the tobacco plant.

It’s no surprise, then, that much of the available evidence suggests that vaping, which involves puffing on vaporized liquid nicotine instead of inhaling burned tobacco, is at least somewhat healthier. Some limited studies have suggested that reaching for a vape pen instead of a conventional cigarette may also help people quit smoking regular cigarettes, but hard evidence of that remains elusive.

Very few studies, however, look at how vaping affects the body and brain. Even fewer specifically examine the Juul, a popular device that packs as much nicotine in each of its pods as a standard pack of cigarettes.

But a handful of studies published in the past few months have begun to illuminate some of the potential health effects tied to vaping. They are troubling.

With that in mind, the Food and Drug Administration outlined a new policy on Thursday morning designed to eventually curb the sale of e-cigs and reign in their appeal to young people.

Most recently, researchers at the Stanford University School of Medicine surveyed young people who vaped and found that those who said they used Juuls vaped more frequently than those who used other brands. The participants appeared to be insufficiently aware of how addictive the devices could be.

Most e-cigs contain toxic metals, and using them may increase the risk of a heart attack

Researchers took a look at the compounds in several popular brands of e-cigs (not the Juul) this spring and found some of the same toxic metals (such as lead) inside the device that they would normally find in conventional cigarettes. For another study published around the same time, researchers concluded that at least some of those toxins appeared to be making their way through vapers’ bodies, as evidenced by a urine analysis they ran on nearly 100 study participants.

In another study published this summer, scientists concluded that there was substantial evidence tying daily e-cig use to an increased risk of heart attack. And this week, a small study in rats suggested that vaping could have a negative effect on wound healing that’s similar to the effect of regular cigarettes.

In addition to these findings, of course, is a well-established body of evidence about the harms of nicotine. The highly addictive substance can have dramatic impacts on the developing brains of young adults.

Brain-imaging studies of adolescents who begin smoking traditional cigarettes (not e-cigs) at a young age suggest that those people have markedly reduced activity in the prefrontal cortex and perform less well on tasks related to memory and attention, compared with people who don’t smoke. Those consequences are believed to be a result of the nicotine in the cigarettes rather than other ingredients.

Nicholas Chadi, a clinical pediatrics fellow at Boston Children’s Hospital, spoke about the Juul at the American Society of Addiction Medicine’s annual conference this spring. He said these observed brain changes were also linked to increased sensitivity to other drugs as well as greater impulsivity. He described some anecdotal effects of nicotine vaping that he’d seen among teens in and around his hospital.

“After only a few months of using nicotine,” Chadi said, the teens “describe cravings, sometimes intense ones.” He continued: “Sometimes they also lose their hopes of being able to quit. And interestingly, they show less severe symptoms of withdrawal than adults, but they start to show them earlier on. After only a few hundred cigarettes — or whatever the equivalent amount of vaping pods — some start showing irritability or shakiness when they stop.”

A new survey suggests that teens who use Juul e-cigs aren’t aware of these risks

The Juul, which is made by the Silicon Valley startup Juul Labs, has captured more than 80% of the e-cig market and was recently valued at $15 billion. But the company is facing a growing backlash from the FDA and scientists who say the company intentionally marketed to teens.

On Tuesday, the company responded to some of these concerns — first by announcing that they’d be temporarily banning the sale of their flavored products at retailers and by deleting their social media accounts, which some research suggests has allured more young customers.

Yet very little research about e-cigs has homed in on the Juul specifically.

So for a study published this week, researchers from the Stanford University School of Medicine surveyed young people who vaped and asked them whether they used the Juul or another e-cigarette.

Their results can be found in a widely accessible version of the Journal of the American Medical Association called JAMA Open. Based on a sample of 445 high-school students whose average age was 19, the researchers observed that teens who used the Juul tended to say they vaped more frequently than those who used other devices. Juul users also appeared to be less aware of how addictive the devices could be compared with teens who vaped other e-cigs.

“I was surprised and concerned that so many youths were using Juul more frequently than other products,” Bonnie Halpern-Felsher, a professor of pediatrics who was a lead author of the study, said in a statement.

“We need to help them understand the risks of addiction,” she added. “This is not a combustible cigarette, but it still contains an enormous amount of nicotine — at least as much as a pack of cigarettes.”

Source: https://www.businessinsider.com/vaping-e-cigs-juul-health-effects-2018-10 October 2018

Filed under: Drug use-various effects,Health,Nicotine,Youth :

Summary

Background

Alcohol use is a leading risk factor for death and disability, but its overall association with health remains complex given the possible protective effects of moderate alcohol consumption on some conditions. With our comprehensive approach to health accounting within the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we generated improved estimates of alcohol use and alcohol-attributable deaths and disability-adjusted life-years (DALYs) for 195 locations from 1990 to 2016, for both sexes and for 5-year age groups between the ages of 15 years and 95 years and older.

Methods

Using 694 data sources of individual and population-level alcohol consumption, along with 592 prospective and retrospective studies on the risk of alcohol use, we produced estimates of the prevalence of current drinking, abstention, the distribution of alcohol consumption among current drinkers in standard drinks daily (defined as 10 g of pure ethyl alcohol), and alcohol-attributable deaths and DALYs. We made several methodological improvements compared with previous estimates: first, we adjusted alcohol sales estimates to take into account tourist and unrecorded consumption; second, we did a new meta-analysis of relative risks for 23 health outcomes associated with alcohol use; and third, we developed a new method to quantify the level of alcohol consumption that minimises the overall risk to individual health.

Findings

Globally, alcohol use was the seventh leading risk factor for both deaths and DALYs in 2016, accounting for 2·2% (95% uncertainty interval [UI] 1·5–3·0) of age-standardised female deaths and 6·8% (5·8–8·0) of age-standardised male deaths. Among the population aged 15–49 years, alcohol use was the leading risk factor globally in 2016, with 3·8% (95% UI 3·2–4·3) of female deaths and 12·2% (10·8–13·6) of male deaths attributable to alcohol use. For the population aged 15–49 years, female attributable DALYs were 2·3% (95% UI 2·0–2·6) and male attributable DALYs were 8·9% (7·8–9·9). The three leading causes of attributable deaths in this age group were tuberculosis (1·4% [95% UI 1·0–1·7] of total deaths), road injuries (1·2% [0·7–1·9]), and self-harm (1·1% [0·6–1·5]). For populations aged 50 years and older, cancers accounted for a large proportion of total alcohol-attributable deaths in 2016, constituting 27·1% (95% UI 21·2–33·3) of total alcohol-attributable female deaths and 18·9% (15·3–22·6) of male deaths. The level of alcohol consumption that minimised harm across health outcomes was zero (95% UI 0·0–0·8) standard drinks per week.

Interpretation

Alcohol use is a leading risk factor for global disease burden and causes substantial health loss. We found that the risk of all-cause mortality, and of cancers specifically, rises with increasing levels of consumption, and the level of consumption that minimises health loss is zero. These results suggest that alcohol control policies might need to be revised worldwide, refocusing on efforts to lower overall population-level consumption.

Funding

Bill & Melinda Gates Foundation.

Source: Alcohol use and burden for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016 – The Lancet August 2018

Filed under: Alcohol,Health :

This Notice of Liability Memo and attached Affidavit of Harms give formal notification to all addressees that they are morally, if not legally liable in cases of harm caused by making toxic marijuana products legally available, or knowingly withholding accurate information about the multiple risks of hemp/marijuana products to the Canadian consumer. This memo further gives notice that those elected or appointed as representatives of the people of Canada, by voting affirmatively for Bill C45, do so with the knowledge that they are breaching international treaties, conventions and law. They do so also with the knowledge that Canadian law enforcement have declared that they are not ready for implementation of marijuana legalization, and as they will not be ready to protect the lives of Canadians, there may arise grounds for a Charter of Rights challenge as all Canadian citizens are afforded a the right to security of self.

Scientific researchers and health organizations raise serious questions about the safety of ingesting even small amounts of cannabinoids. Adverse effects include risk of harm to the cardio-vascular system, respiratory tract, immune system, reproductive and endocrine systems, gastrointestinal system and the liver, hyperemesis, cognition, psychomotor performance, psychiatric effects including depression, anxiety and bipolar disorder, schizophrenia and psychosis, a-motivational syndrome, and addiction. The scientific literature also warns of teratogenicity (causing birth deformities) and epigenetic damage (affecting genetic development) and clearly establishes the need for further study. The attached affidavit cites statements made by Health Canada that are grounded in scientific evidence that documents many harms caused by smoking or ingesting marijuana.

Putting innocent citizens in “harm’s way” has been a costly bureaucratic mistake as evidenced by the 2015 Canadian $168 million payout to victims of exposure to the drug thalidomide. Health Canada approved thalidomide in 1961 to treat morning sickness in pregnant women but it caused catastrophic birth defects and death.

It would be instructive to reflect on “big tobacco” and their multi-billion-dollar liability in cases of misinformed sick and dead tobacco cigarette smokers. Litigants won lawsuits for harm done by smoking cigarettes even when it was the user’s own choice to obtain and smoke tobacco. In Minnesota during the 1930’s and up to the 1970’s tobacco cigarettes were given to generally healthy “juvenile delinquents’ incarcerated in a facility run by the state. One of the juveniles, now an adult, who received the state’s tobacco cigarettes, sued the state for addicting him. He won.

The marijuana industry, in making public, unsubstantiated claims of marijuana safety, is placing itself in the same position, in terms of liability, as the tobacco companies.
In 1954, the tobacco industry published a statement that came to be known during Minnesota’s tobacco trial as the “Frank Statement.” Tobacco companies then formed an industry group for the purposes of deceiving and confusing the public.

In the Frank Statement, tobacco industry spokesmen asserted that experiments linking smoking with lung cancer were “inconclusive,” and that there was no proof that cigarette smoking was one of the causes of lung cancer. They stated, “We believe the products we make are not injurious to health.” Judge Kenneth Fitzpatrick instructed the Minnesota jurors: “Jurors should assume in their deliberations that tobacco companies assumed a “special duty” by publishing the ad (Frank Statement), and that jurors will have to determine whether the industry fulfilled that duty.” The verdict ruled against the tobacco industry.

Effective June 19, 2009, marijuana smoke was added to the California Prop 65 list of chemicals known to cause cancer. The Carcinogen Identification Committee (CIC) of the Office of Environmental Health Hazard Assessment (OEHHA) “determined that marijuana smoke was clearly shown, through scientifically valid testing according to generally accepted principles, to cause cancer.”

Products liability and its application to marijuana businesses is a topic that was not discussed in the Senate committee hearings. Proposition 65, requires the State to publish a list of chemicals known to cause cancer, birth defects or other types of reproductive harm. Proposition 65 requires businesses to provide their customers with notice of these cancerous causing chemicals when present in consumer products and provides for both a public and private right of action.

The similarities between the tactics of “Big Tobacco” and the “Canadian Cannabis Trade Alliance Institute” and individual marijuana producers would seem to demand very close scrutiny. On May 23, a witness testified before the Canadian Senate claimed that marijuana is not carcinogenic. This evidence was not challenged.

The International Narcotics Control Board Report for 2017 reads: “Bill C-45, introduced by the Minister of Justice and Attorney General of Canada on 13 April 2017, would permit the non-medical use of cannabis. If the bill is enacted, adults aged 18 years or older will legally be allowed to possess up to 30 grams of dried cannabis or an equivalent amount in non-dried form. It will also become legal to grow a maximum of four cannabis plants, simultaneously for personal use, buy cannabis from licensed retailers, and produce edible cannabis products. The Board wishes to reiterate that article 4 (c) of the 1961 Convention restricts the use of controlled narcotic drugs to medical and scientific purposes and that legislative measures providing for non-medical use are in contravention of that Convention….

The situation pertaining to cannabis cultivation and trafficking in North America continues to be in flux owing to the widening scope of personal non-medical use schemes in force in certain constituent states of the United States. The decriminalization of cannabis has apparently led organized criminal groups to focus on manufacturing and trafficking other illegal drugs, such as heroin. This could explain why, for example, Canada saw a 32 per cent increase from 2015 to 2016 in criminal incidents involving heroin possession….The Canadian Research Initiative in Substance Misuse issued “Lower-risk cannabis use guidelines” in 2017. The document is a health education and prevention tool that acknowledges that cannabis use carries both immediate and long-term health risks.”

https://www.incb.org/documents/Publications/AnnualReports/AR2017/Annual_Report_chapters/Chapter_3_Americas_2017.pdf

Upon receipt of this Memo and Affidavit, the addressees can no longer say they are ignorant or unaware that promoting and/or distributing marijuana cigarettes for recreational purposes is an endangerment to citizens. Receipt of this Memo and Affidavit removes from the addressees any claim of ignorance as a defense in potential, future litigation.

Pamela McColl www.cleartheairnow.org

pam.mccoll@cleartheairnow.org

AFFIDAVIT May 27, 2018

I, Pamela McColl, wish to inform agencies and individuals of known and potential harm done/caused by the use of marijuana (especially marijuana cigarettes) and of the acknowledgement the risk of harm by Health Canada.

Marijuana is a complex, unstable mixture of over four hundred chemicals that, when smoked, produces over two thousand chemicals. Among those two thousand chemicals are many pollutants and cancer-causing substances. Some cannabinoids are psychoactive, all are bioactive, and all may remain in the body’s fatty tissues for long periods of times with unknown consequences. Marijuana smoke contains carcinogenic (cancer-causing) substances such as benzo(a)pyrene, benz(a)anthracene, and benzene in higher concentrations than are present in tobacco smoke. The mechanism by which benzo(a)pyrene causes cancer in smokers was demonstrated scientifically by Denissenko MF et al. Science 274:430-432, 1996.

Health Canada Consumer Information on Cannabis reads as follows: “The courts in Canada have ruled that the federal government must provide reasonable access to a legal source of marijuana for medical purposes.”

“Cannabis is not an approved therapeutic product and the provision of this information should not be interpreted as an endorsement of the use of cannabis for therapeutic purposes, or of marijuana generally, by Health Canada.”

“Serious Warnings and Precautions: Cannabis (marihuana, marijuana) contains hundreds of substances, some of which can affect the proper functioning of the brain and central nervous system.”

“The use of this product involves risks to health, some of which may not be known or fully understood. Studies supporting the safety and efficacy of cannabis for therapeutic purposes are limited and do not meet the standard required by the Food and Drug Regulations for marketed drugs in Canada.”

Health Canada – “When the product should not be used: Cannabis should not be used if you:-are under the age of 25 -are allergic to any cannabinoid or to smoke-have serious liver, kidney, heart or lung disease -have a personal or family history of serious mental disorders such as schizophrenia, psychosis, depression, or bipolar disorder-are pregnant, are planning to get pregnant, or are breast-feeding -are a man who wishes to start a family-have a history of alcohol or drug abuse or substance dependence Talk to your health care practitioner if you have any of these conditions. There may be other conditions where this product should not be used, but which are unknown due to limited scientific information.

Cannabis is not an approved therapeutic product and the provision of this information should not be interpreted as an endorsement of the use of this product, or cannabis generally, by Health Canada.”

Prepared by Health Canada Date of latest version: February 2013, accessed May 2018. https://www.canada.ca/en/health-canada/services/drugs-health-products/medical-use-marijuana/information-medical-practitioners/information-health-care-professionals-cannabis-marihuana-marijuana-cannabinoids.html

A report published by survey company RIWI Corp. (RIWI.com) can be found at: https://riwi.com/case-study/measuringcanadians-awareness-of-marijuanas-health-effects-may-2018

The report measures Canadians’ awareness of marijuana’s health effects as determined by Health Canada and published on Health Canada’s website. RIWI data indicates: 1. More than 40% of those under age 25 are unaware that marijuana impacts safe driving. Further, 21% of respondents are not aware that marijuana can negatively impact one’s ability to drive safely. Health Canada: “Using cannabis can impair your concentration, your ability to make decisions, and your reaction time and coordination. This can affect your motor skills, including your ability to drive.” 2. One in five women aged 25-34 believes marijuana is safe during pregnancy, while trying to get pregnant, or breastfeeding. • RIWI: “For women of prime childbearing age (25-34), roughly one in five believe smoking marijuana is safe during pregnancy, planning to get pregnant, and breastfeeding.” • Health Canada: “Marijuana should not be used if you are pregnant, are planning to get pregnant, or are breastfeeding. … Long-term use may negatively impact the behavioural and cognitive development of children born to mothers who used cannabis during pregnancy.” 3. One in three Canadians do not think that marijuana is addictive. • Health Canada: “Long term use may result in psychological dependence (addiction).” 4. One in three Canadians believe marijuana aids mental health. • Health Canada: “Long term use may increase the risk of triggering or aggravating psychiatric and/or mood disorders (schizophrenia, psychosis, anxiety, depression, bipolar disorder).” 5. One in two males were unaware that marijuana could harm a man’s fertility • “Marijuana should not be used if you are a man who wishes to start a family.”

ClearTheAirNow.org, a coalition of concerned Canadians commissioned the survey.

Affiant is willing to provide further sources of information about the toxicity of marijuana.

Pamela McColl

www.cleartheairnow.org

pam.mccoll@cleartheairnow.org

Source: From email sent to Drug Watch International May 2018

Filed under: Brain and Behaviour,Cannabis/Marijuana,Drug use-various effects,Drug use-various effects on foetus, babies, children and youth,Global Drug Legalisation Efforts,Health,Legal Sector,Marijuana and Medicine,Nicotine,Social Affairs :

Abstract

Purpose of review

Recent widespread legalization changes have promoted the availability of marijuana and its increased potency and perceived safety. The limited evidence on reproductive and perinatal outcomes from marijuana exposure is enough to warrant concern and action. The objective of this review is to provide a current and relevant summary of the recent literature surrounding this topic.

Recent findings

The available published studies on the effect of marijuana exposure on reproductive health and pregnancy outcomes are conflicting. Human studies are often observational or retrospective and confounded by self-report and polysubstance use. However, the current, limited evidence suggests that marijuana use adversely affects male and female reproductive health. Additionally, prenatal marijuana exposure has been reported to be associated with an increased risk of preterm birth and small for gestational age infants.

Summary

With the increasing prevalence of marijuana use, there is an urgent need for evidence-driven recommendations and guidelines for couples interested in conception, affected by infertility or who are expecting. At this time, no amount of marijuana use during conception or pregnancy is known to be well tolerated and the limited available evidence suggests that the safest choice is to abstain.

Source: Effects of marijuana on reproductive health: preconception a… : Current Opinion in Endocrinology, Diabetes and Obesity (lww.com) December 2021

Filed under: Cannabis/Marijuana,Drug use-various effects on foetus, babies, children and youth,Health :

Reproductive and Cancer Hazard Assessment Branch Office of Environmental Health Hazard Assessment California Environmental Protection Agency

PREFACE

The Safe Drinking Water and Toxic Enforcement Act of 1986 (Proposition 65, California Health and Safety Code 25249.5 et seq.) requires that the Governor cause to be published a list of those chemicals “known to the state” to cause cancer or reproductive toxicity. The Act specifies that “a chemical is known to the state to cause cancer or reproductive toxicity … if in the opinion of the state’s qualified experts the chemical has been clearly shown through scientifically valid testing according to generally accepted principles to cause cancer or reproductive toxicity.”

The lead agency for implementing Proposition 65 is the Office of Environmental Health Hazard Assessment (OEHHA) of the California Environmental Protection Agency. The “state’s qualified experts” regarding findings of carcinogenicity are identified as the members of the Carcinogen Identification Committee (CIC) of the OEHHA Science Advisory Board (Title 27 Cal. Code of Regs. §25301; formerly Title 22, Cal. Code of Regs. §12301). OEHHA announced the selection of marijuana smoke as a chemical for consideration for listing by the CIC in the California Regulatory Notice Register on December 12, 2007, subsequent to consultation with the Committee at their November 19, 2007 meeting.

At that meeting, the Committee advised OEHHA to prepare hazard identification materials for marijuana smoke. The December 12th notice also marked the start of a 60-day public request for information relevant to the assessment of the evidence on the carcinogenicity marijuana smoke. No information was received as a result of this request. This document was released as a draft document in March 2009 for a 60-day public comment period. No public comments were received.

The draft document provided the Committee with the available scientific evidence on the carcinogenic potential of this chemical. The current document is the final version of the document that was discussed by the Committee at their May 29, 2009 meeting. At their May 29, 2009 meeting the Committee, by a vote of five in favor and one against, found that marijuana smoke had been “clearly shown through scientifically valid testing according to generally accepted principles to cause cancer.” Accordingly, marijuana smoke was placed on the Proposition 65 list of chemicals known to the state to cause cancer.

EXECUTIVE SUMMARY

Marijuana smoke is formed when the dried flowers, leaves, stems, seeds and resins of plants in the genus Cannabis are burned. Marijuana smoke aerosol contains thousands of organic and inorganic chemicals, including psychoactive cannabinoids, which are unique to Cannabis plants. Inhaling marijuana smoke for its psychotropic properties became popular in western cultures in the 1960s, though marijuana has been used for medicinal and psychotropic purposes in other parts of the world for thousands of years. In California, use of marijuana for physician recommended purposes has been legal under state law since 1996 when Proposition 215, the Compassionate Use Act, was passed by state voters. However, the vast majority of marijuana use continues to be for recreational purposes, which remains illegal.

Marijuana smoke and tobacco smoke share many characteristics with regard to chemical composition and toxicological properties. At least 33 individual constituents present in both marijuana smoke and tobacco smoke are already listed as carcinogens under Proposition 65. In examining the potential carcinogenicity of marijuana smoke, a range of information was evaluated. Studies of cancer risk in humans and laboratory animals exposed to marijuana smoke were reviewed. Other relevant data, including studies investigating genotoxicity and effects on endocrine function, cell signalling pathways, and immune function caused by marijuana smoke, were all considered. Also of interest were the similarities in chemical composition and in toxicological properties between marijuana smoke and tobacco smoke, and the presence of numerous carcinogens in marijuana smoke. The findings of all these reviews are summarized below.

There is evidence from some epidemiological studies of people exposed to marijuana smoke suggestive of increased cancer risk from both direct and parental marijuana smoking. However, this evidence is limited by potential biases and small numbers of studies for most types of cancer. Studies reporting results for direct marijuana smoking have observed statistically significant associations with cancers of the lung, head and neck, bladder, brain, and testis. The strongest evidence of a causal association was for head and neck cancer, with two of four studies reporting statistically significant associations. The evidence was less strong but suggestive for lung cancer, with one of three studies conducted in populations that did not mix marijuana and tobacco reporting a significant association. Suggestive evidence also was seen for bladder cancer, with one of two studies reporting a significant association. For brain and testicular cancers, the single studies conducted of each of these endpoints reported significant associations.

Among the epidemiological studies that reported results for parental marijuana smoking and childhood cancer, five of six found statistically significant associations. Maternal and paternal marijuana smoking were implicated, depending on the type of cancer. Childhood cancers that have been associated with maternal marijuana smoking are acute myeloid leukaemia, neuroblastoma, and rhabdomyosarcoma. Childhood cancers that have been associated with paternal marijuana smoking are leukaemia (all types), infant leukaemia (all types), acute lymphoblastic leukaemia, acute myeloid leukaemia, and rhabdomyosarcoma. A limitation common to the epidemiologic studies was potential bias from under-reporting of marijuana smoking due to its illegality, social stigma, lack of privacy during oral interviews, and subject desire to please interviewers, and possibly different degrees of under-reporting between cancer patients and healthy controls. Another limitation of several studies was that they were conducted in geographic locations where marijuana and tobacco are commonly mixed before smoking (e.g., three of six lung cancer studies and one of two bladder cancer studies were conducted in northern Africa, and two of four oral cancer studies were conducted in England). Thus, the results of those studies may have been confounded by the effects of exposure to tobacco smoke.

In animal studies, increases in squamous cell papilloma of the skin were reported in mice exposed dermally to marijuana smoke condensate. Malignant mesenchymatous tumors were reported following six subcutaneous injections of marijuana smoke condensate to newborn rats. In a marijuana smoke inhalation study in female rats, benign tumors of the ovary (serous cytoma and follicular cysts) and benign and malignant tumors of the uterus (adenofibroma, adenosarcoma, and telengiectatic cyst and polyps) were observed. Marijuana smoke condensate also exhibited tumor promoting activity in a mouse skin tumor initiation-promotion assay.

Evidence indicating that marijuana smoke is genotoxic includes findings that marijuana smoke induces mutations in Salmonella, and several small cytogenetic studies in humans suggesting that exposure to marijuana smoke may be associated with increased mutations and chromosomal abnormalities. While the data on the genotoxicity of marijuana smoke per se are limited, many individual smoke constituents have been shown to form DNA adducts, induce gene mutations, and damage chromosomes. Evidence indicating that marijuana smoke alters endocrine function includes findings for a number of different hormonal pathways. Marijuana smoke condensate has been shown to have estrogenic effects, including findings that it can activate the estrogen receptor (ER). Marijuana smoke also has been shown to have anti-estrogenic effects, through the induction of cytochrome P450 1A1 and the resultant increase in estrogen (E2) metabolism and through the inhibition of aromatase, an enzyme that converts testosterone to E2.

Other studies indicate that marijuana smoke condensate has anti-androgenic effects, inhibiting binding of dihydrotestosterone (DHT) to the androgen receptor (AR). Studies of ∆9 -tetrahydrocannabinol (∆9 -THC) and other cannabinoids provide evidence for disruption of the hypothalamic-pituitary-gonadal axis, including evidence that ∆9 -THC inhibits the release of follicle stimulating hormone, luteinizing hormone, prolactin, growth hormone, thyroid-stimulating hormone, and corticotrophin. These alterations in endocrine function can affect the growth of hormone responsive tissues, and might increase the risk of certain cancers (e.g., testes, ovary, uterus, and breast).

Evidence suggesting that marijuana smoke alters cell signalling pathways involved in cell cycle control comes from studies of the effects of ∆9 -THC and other cannabinoids on protein kinases. Depending upon the cell type and the dose administered, ∆9 -THC and other cannabinoids may either stimulate or inhibit cell proliferation. There is evidence that marijuana smoke suppresses the innate and adaptive immune response. The bactericidal activity of rat alveolar macrophages was reduced by marijuana smoke in vivo and in vitro. Tumoricidal and bactericidal activities were reduced in alveolar macrophages from marijuana smokers, compared to non-smokers. In addition, in one study smoking marijuana was associated with a more rapid progression of human immunodeficiency virus infection to acquired immunodeficiency syndrome. ∆9 -THC and other cannabinoids present in marijuana smoke have also been shown to suppress host resistance to microbial infection, macrophage function, natural killer and T cell cytolytic activity, cytokine production by macrophages and T cells, and to decrease antigen presentation by dendritic cells. These immunosuppressive effects could lead to an increased risk of cancer by reducing immunosurveillance capacity against neoplastic cells.

Prolonged exposures to marijuana smoke in animals and humans cause proliferative and inflammatory lesions in the lung, such as cellular disorganization, squamous metaplasia, and hyperplasia of basal and goblet cells (observed in the bronchial epithelial tissues of marijuana smokers). In summary, there is some evidence from studies in humans that marijuana smoke is associated with increased cancer risk. Studies in animals also provide some evidence that marijuana smoke induces tumors, with benign and malignant tumors observed in rats exposed via inhalation, malignant tumors in rats exposed via subcutaneous injection as newborns, and benign tumors in mice exposed dermally. Studies investigating the genotoxicity, immunotoxicity, and effects on endocrine function and cell signalling pathways provide additional evidence for the carcinogenicity of marijuana smoke. Finally, the similarities in chemical composition and in toxicological activity between marijuana smoke and tobacco smoke, and the presence of numerous carcinogens in marijuana (and tobacco) smoke, provide additional evidence of carcinogenicity.

Source: Evidence on the Carcinogenicity of Marijuana Smoke August 2009

Filed under: Cannabis/Marijuana,Drug use-various effects,Health :

Damage is caused in several different ways.
BRAIN: Messages are passed from cell to cell (neurons) in the brain by chemicals called neurotransmitters which fit by shape into their own receptor sites on specific cells.
The neurotransmitter, anandamide, an endo-cannabinoid (made in body) whose job is to control by suppression the levels of other neurotransmitters is mimicked and so replaced by a cannabinoid (not made in body) in cannabis called THC (Tetrahydrocannabinol). THC is very much stronger and damps down more forcefully the release of other neurotransmitters. Consequently the total activity of the
brain decreases. Chaos ensues.

Neurotransmitters delivering messages to the hippocampus, the area for learning and memory don’t receive enough stimulation to reach it, so signals are lost for ever.
Academic performance plummets and IQs fall by about 8 points. Neurons can be lost permanently. This is brain damage. No child using cannabis even occasionally will achieve their full potential.
Because signalling is slowed down, reaction times increase. Driving becomes hazardous and fatal accidents are rising in legalised USA states. Alcohol plus cannabis in drivers is 16 times more dangerous.
Since THC is fat-soluble, it stays in cells for weeks, constantly ensuring this decrease in brain activity. In the sixties/seventies the THC content was around 1-3%, now in London only ‘skunk’ at 16-20% THC is available. Professor Sir Robin Murray has said that, ‘users will be in a state of low-grade intoxication most of the time’. The Dopamine neurotransmitter has no receptor sites for anandamide and so THC
doesn’t affect it. But the inhibitory Gaba neurotransmitter has. Gaba normally suppresses dopamine but since it is itself suppressed by THC, levels of dopamine quickly increase. Excess dopamine is found in the brains of psychotics, and even schizophrenics if they have a genetic vulnerability. Anyone taking enough THC at one sitting will suffer a psychotic episode which could become permanent. Aggression, violence, even homicides, suicides and murders have resulted from cannabis-induced psychosis. The first research paper linking THC with psychosis was published in 1845. Cannabis-induced schizophrenia costs the country around £2 billion/year. Some of these mentally ill people will spend the rest of their lives in psychiatric units.
THC also depletes the levels of the ‘happiness’ neurotransmitter Serotonin. This can cause depression which may lead to suicide. THC causes dependence. This will affect 1 in 6 using adolescents and 1 in 9 of the general population. Since THC replaces anandamide, there is no need for its production which reduces and eventually stops so the receptor sites are left empty.
Withdrawal then sets in with irritability, sleeplessness, anxiety, depression, even violence until anandamide production resumes. Rehab specialists have told us that adolescent pot addiction is the most challenging to treat.
Cannabis can also act as a gateway drug – it can ‘prime’ the brain for the use of other drugs. Professor David Fergusson (NZ) in longitudinal studies from birth found that ‘The use of cannabis in late adolescence and early adulthood emerged as the strongest risk factor for later involvement in other illicit drug use’.
THC inhibits the vomiting reflex. If a person has drunk too much alcohol, they are often sick and get rid of it. An overdose of alcohol can kill (respiratory muscles stop working) so using cannabis together with alcohol can be fatal.
The signalling of endo-cannabinoids is crucial in brain development. They guide the formation, survival, proliferation, motility and differentiation of new neurons. THC badly interferes with these essential processes. Chaos ensues among the confused brain signals and a cannabis personality develops. Users can’t think logically. They have fixed opinions and answers, can’t find words, can’t take criticism – it’s always someone else’s fault, and can’t plan their day. Families suffer from their violent mood swings – houses get trashed. Anxiety, panic and paranoia may ensue. At the same time users are lonely, miserable and feel misunderstood.

Respiratory System:
Cannabis smoke has many of the same constituents as tobacco smoke but more of its carcinogens – in cancer terms a joint equals 4/5 cigarettes. More tar is deposited in the lungs and airways. Coughing, wheezing, emphysema, bronchitis and cancers have been seen in the lungs.

Heart:
Heart rates rise and stay high for 3-4 hours after a joint. Heart attacks and strokes have been recorded. Some teenagers had strokes and died after bingeing on cannabis.

Hypothalamus:
The hypothalamus is a region of the brain known to regulate appetite. Endocannabinoids in this area send ‘I’m hungry’ messages. When you take THC, that message is boosted. This is called ‘the munchies’. Nabilone, (synthetic THC) can be used to stimulate the appetite in AIDS patients.

DNA and Reproduction:
THC affects the DNA in any new cells being made in the body. It speeds up the programmed cell death (apoptosis) of our defence white blood cells, so our immune system is diminished. There are also fewer sperm. Infertility and impotence have been reported as far back as the 1990s.
An Australian paper published in July 2016 explains this phenomenon. THC can disrupt the actual process of normal cell division mitosis and meiosis (formation of sperm and eggs). In mitosis, the chromosomes replicate and gather together at the centre of the cell. Protein strands (microtubules) are formed from the ends of the cell to pull half of the chromosomes to each end to form the 2 new cells. Unfortunately THC disrupts microtubule formation. Chromosomes can become isolated, rejoin other bits of chromosome and have other abnormalities. Some will actually be shattered into fragments (chromothripsis).
This DNA damage can also cause cancers. Oncogenes (cancer-causing genes) may be activated, and tumour suppressant genes silenced. Chromosome fragments and abnormal chromosomes are frequently seen in cancerous tissues. This would account for other cancers, leukaemia, brain, prostate, cervix, testes and bladder etc, reported in regions of the body not exposed to the smoke. Pregnant users see a 2-4
fold increase in the number of childhood cancers in their offspring. The DNA damage has also been associated with foetal abnormalities – low birth weight, pre-term birth, spontaneous miscarriage, spina bifida, anencephaly (absence of brain parts), gastroschisis (babies born with intestines outside the body) cardiac defects and shorter limbs. All these defects bear in common an arrest of cell growth and cell migration at critical development stages consistent with the inhibition of mitosis noted with cannabis.
DNA damage at meiosis results in fewer sperm as we have seen. Increased errors in meiosis have the potential for transmission to subsequent generations. The zygote (fertilised egg) death rate rises by 50% after the first division. In infants, birth weight is lower and they may be born addicted. Children may have problems with behaviour and cognitive functions as they grow. Childhood cancers are
more common. Intensive care for newborns doubles. The younger they start using cannabis, the more likely they are to remain immature, become addicted, suffer from mental illnesses or progress to other drugs. Average age of first use is 13. Regular cannabis users have worse jobs, less than average money, downward social mobility, relationship problems and antisocial behaviour.

References:
Cannabis Skunk Website www.cannabisskunksense.co.uk Cannabis: A survey of its
harmful effects by Mary Brett is available on DOWNLOADS. It is a 300+ page report
written in 2006 and kept up to date.

Chromothripsis and epigenomics complete causality criteria for cannabis- and
addiction-connected carcinogenicity, congenital toxicity and heritable genotoxicity

Book: Adverse Health Consequencies of Cannabis Use. Jan Ramstrom National Institute of Public Health Sweden www.fhi.se

Source: https://www.cannabisskunksense.co.uk/uploads/site-files/ty,Chromothripsis,CarcinogenicityandFetotoxicity,MR-FMMM.pdf March 2020

Filed under: Brain and Behaviour,Cannabis/Marijuana,Drug use-various effects,Drug use-various effects on foetus, babies, children and youth,Health :

Abstract

The aim was to examine cross-sectional association between moderate alcohol consumption and total brain volume in a cohort of participants in early middle-age, unconfounded by age-related neuronal change. 353 participants aged 39 to 45 years reported on their alcohol consumption using the AUDIT-C measure. Participants with alcohol abuse were excluded. Brain MRI was analyzed using a fully automated method. Brain volumes were adjusted by intracranial volume expressed as adjusted total brain volume (aTBV). AUDIT-C mean of 3.92 (SD 2.04) indicated moderate consumption. In a linear regression model, alcohol consumption was associated with smaller aTBV (B = – 0.258, p < .001). When sex and current smoking status were added to the model, the association remained significant. Stratified by sex, the association was seen in both males (B = – 0.258, p = 0.003) and females (B = – 0.214, p = 0.011). Adjusted for current smoking, the association remained in males (B = – 0.268, p = 0.003), but not in females. When alcohol consumption increased, total brain volume decreased by 0.2% per one AUDIT-C unit already at 39-45 years of age. Moderate alcohol use is associated with neuronal changes in both males and females suggesting health risks that should not be overlooked.

Figure 1

Association between AUDIT-C and aTBV. Association between alcohol consumption (AUDIT-C as a continuous variable) and total brain volume adjusted for intracranial volume in males and females. Points in the plot have been jittered to improve visibility of single cases.

Source: Moderate alcohol use is associated with decreased brain volume in early middle age in both sexes – PubMed (nih.gov) August 2020

Filed under: Alcohol,Brain and Behaviour,Health :

Veterans are twice as likely as non-veterans to die from accidental overdoses involving prescription opioids. In an effort to lower opioid intake, some veterans are turning to hemp products, like CBD oil, to treat chronic pain and PTSD. Now some veterans are saying they want more research and access, reports CBS News correspondent Nancy Cordes.

They are not your typical lobbyists. They’re veterans whose lives were nearly ruined — first by their injuries, and then by their meds.

“I was at a higher than likely rate of committing suicide from pain,” Navy veteran Veronica Wayne told lawmakers. She took opioids for 17 years after an airplane maintenance hatch hit her head.

“I basically became a walking zombie,” Wayne said.

She tried medical marijuana, but still felt impaired. That’s when she heard about hemp.

“It’ll still kill all the pain symptoms and give you the relief that you need, but you’re not going to feel high,” Wayne said.

Now she uses CBD oil. But, she notes, “You can’t get it from the VA. It’s not, it’s not legal.”

Like marijuana, hemp is derived from the cannabis plant. But hemp does not contain THC, the chemical that makes you high. Still both hemp and marijuana are classified as Schedule 1 controlled substances, restricting the VA and other federally funded entities from conducting research. The American Legion is leading the push to change that.

“Anything that makes a veteran feel better — especially something that’s non-toxic — is something we’re going to support,” said Louis Celli, national director of Veterans Affairs and rehabilitation at the American Legion.

Currently hemp products are marketed as unregulated supplements, which makes many doctors reluctant to recommend them.

“We’re not exactly sure how to use them, what the right dose is, how they interact,” said Wayne Jonas, the former director of the NIH office of alternative medicine.

FDA panel backs marijuana-based drug for childhood seizures

But lawmakers on both sides are pushing to change the law.

“I’m actually cautiously optimistic if we get something on the floor, that it will pass,” Rep. Earl Blumenauer, D-Ore., said.

Until then, Army reservist Dale Rider said many of his buddies are wary of the product that he said helps his back pain.

“For them, they’re all worried that because it’s so closely related to marijuana, that it could pop up on a drug test randomly,” Rider said.

The industry has a powerful ally in Senate Majority Leader Mitch McConnell, who represents Kentucky, where hemp is seen as a potential cash crop. Last month he introduced a bill in the Senate that has bipartisan support to legalize hemp as an agricultural commodity.

Veterans push lawmakers to legalize hemp products – CBS News April 2018

Filed under: Cannabis/Marijuana,Health,Marijuana and Medicine,Political Sector :

Abstract

There is a strong association between cannabis use and schizophrenia but the underlying cellular links are poorly understood. Neurons derived from human-induced pluripotent stem cells (hiPSCs) offer a platform for investigating both baseline and dynamic changes in human neural cells. Here, we exposed neurons derived from hiPSCs to Δ⁹-tetrahydrocannabinol (THC), and identified diagnosis-specific differences not detectable in vehicle-controls. RNA transcriptomic analyses revealed that THC administration, either by acute or chronic exposure, dampened the neuronal transcriptional response following potassium chloride (KCl)-induced neuronal depolarization. THC-treated neurons displayed significant synaptic, mitochondrial, and glutamate signaling alterations that may underlie their failure to activate appropriately; this blunted response resembles effects previously observed in schizophrenia hiPSC- derived neurons. Furthermore, we show a significant alteration in THC-related genes associated with autism and intellectual disability, suggesting shared molecular pathways perturbed in neuropsychiatric disorders that are exacerbated by THC.

Conflict of interest statement

The authors declare that they have no conflict of interest.

Fig. 1. THC treatment regulates genes involved in mitochondrial and glutamate pathways.

a RNA sequencing of hiPSC-derived neurons reveals 497 genes (acute) and 810 genes (chronic) are significantly changed following THC exposure, including. b genes involved in mitochondrial (e.g., COX7A2, MT-CO1, and MT-CO3) and glutamate (e.g., GRID2) pathways (Quantitative RT–PCR (qRT–PCR); Ordinary one-way ANOVA with Tukey’s multiple comparisons test: *p < 0.05. n = 5 (see qRT–PCR, Ca–Ce, Supplementary Table S1)). Ingenuity pathway analysis shows that mitochondrial oxidative phosphorylation is strongly altered after both acute c and chronic d THC exposure

Fig. 2. Postsynaptic density and ion channel genes are regulated by THC treatment.

a, b Multiple postsynaptic density and ion channel genes are significantly altered in hiPSC-derived neurons following acute or chronic THC exposure, including the postsynaptic gene HOMER1 (Quantitative RT–PCR (qRT–PCR); Ordinary one-way ANOVA with Tukey’s multiple comparisons test: *p < 0.05. n = 5 (see qRT–PCR, Ca–Ce, Supplementary Table S1)). c Network analysis combining all THC-related genes from acute and chronic THC treatment shows broad changes to fundamental cellular functions such as RNA biology, chromatin regulation and development

Fig. 3. Genes altered by THC treatment in hiPSC-derived neurons are significantly associated with autism and intellectual disability.

a Venn diagram showing the overlap between THC-related genes and autism, intellectual disability and schizophrenia. b THC-related genes are significantly related to autism and intellectual disability (p-value < 0.05)

Fig. 4. THC treatment results in neuronal hypo-excitability similar to observations using schizophrenia-associated neurons.

a Venn diagram showing impaired transcriptional response following 50 mM KCl treatment for 3 h in THC exposure hiPSC-derived neurons. b A similar decrease in significantly regulated transcripts following 50 mM KCl for 3 h is observed in schizophrenia-associated hiPSC-derived neurons. c A cohort of 5 control (C1–5) and 4 schizophrenia-associated (SZ1-4) cases were used for (d) candidate qRT–PCR analysis investigating COX7A2, GRID2 and HOMER1 following acute THC exposure. e Blunted effect of THC treatment can be seen in immediate early gene transcripts such as NR4A1 and (f) FOSB following KCl-induced activation (Quantitative RT–PCR (qRT–PCR); Ordinary one-way ANOVA with Tukey’s multiple comparisons test: *p < 0.05, **p < 0.01, ***p < 0.001, ****p < 0.0001. n = 5 controls (see qRT–PCR, Ca–Ce, Supplementary Table S1); n = 4 schizophrenia (see qRT–PCR, S1–S4, Supplementary Table S1))

Source: THC exposure of human iPSC neurons impacts genes associated with neuropsychiatric disorders – PubMed (nih.gov) April 2018

Filed under: Brain and Behaviour,Cannabis/Marijuana,Health :

Abstract

Objectives

We aimed to describe and correlate the hospital panorama of psychotic disorders (PD) with cannabis use (CU) trends in all Portuguese public hospitals.

Methods

We conducted a retrospective observational study that analysed all hospitalizations that occurred in Portuguese public hospitals from 2000 to 2015. Hospitalizations with a primary diagnosis of PD or schizophrenia were selected based on Clinical Classification Software diagnostic single-level 659. Episodes associated with CU were identified by the International Classification of Diseases Version 9, Clinical Modification code 304.3/305.2 that correspond to cannabis dependence/cannabis abuse.

Results

The number of hospitalizations with a primary diagnosis of PD and schizophrenia associated with CU rose 29.4 times during the study period, from 20 to 588 hospitalizations yearly (2000 and 2015, respectively) with a total of 3,233 hospitalizations and an average episode cost of €3,500. Male patients represented 89.8% of all episodes, and the mean/median age at discharge were 30.66/29.00 years, respectively. From all hospitalizations with a primary diagnosis of PD or schizophrenia, the ones with a secondary diagnosis of CU rose from 0.87% in 2000 to 10.60% in 2015.

Conclusions

The increase on secondary diagnosis coding and the change on cannabis patterns of consumption in Portuguese population with an increasing frequency of moderate/high dosage cannabis consumers may explain the rise on PD hospitalizations

Source: Psychotic disorders hospitalizations associated with cannabis abuse or dependence: A nationwide big data analysis. – Abstract – Europe PMC December 2019

Filed under: Brain and Behaviour,Cannabis/Marijuana,Health :

A life-threatening heart infection afflicts a growing number of people who inject opioids or meth. Costly surgery can fix it, but the addiction often goes unaddressed.

Dr. Thomas Pollard, a cardiothoracic surgeon in Knoxville, Tenn., and his team working to replace heart valves that had been damaged from endocarditis, an infection the patient developed from injecting drugs. Shawn Poynter for The New York Times

OAK RIDGE, Tenn. — Jerika Whitefield’s memories of the infection that almost killed her are muddled, except for a few. Her young children peering at her in the hospital bed. Her stepfather wrapping her limp arms around the baby. Her whispered appeal to a skeptical nurse: “Please don’t let me die. I promise, I won’t ever do it again.”

Ms. Whitefield, 28, had developed endocarditis, an infection of the heart valves caused by bacteria that entered her blood when she injected methamphetamine one morning in 2016. Doctors saved her life with open-heart surgery, but before operating, they gave her a jolting warning: If she continued shooting up and got reinfected, they would not operate again.

With meth resurgent and the opioid crisis showing no sign of abating, a growing number of people are getting endocarditis from injecting the drugs — sometimes repeatedly if they continue shooting up. Many are uninsured, and the care they need is expensive, intensive and often lasts months. All of this has doctors grappling with an ethically fraught question: Is a heart ever not worth fixing?

“We’ve literally had some continue using drugs while in the hospital,” said Dr. Thomas Pollard, a veteran cardiothoracic surgeon in Knoxville, Tenn. “That’s like trying to do a liver transplant on someone who’s drinking a fifth of vodka on the stretcher.”

The problem has consumed Dr. Pollard, a calm Texan who got his Tennessee medical license in 1996, just after the widely abused opioid painkiller OxyContin hit the market. He has seen an explosion of endocarditis cases, particularly among poor, young drug users whose hearts can usually be salvaged, but whose addiction goes unaddressed by a medical system that rarely takes responsibility for treating it.

Certain cases haunt him. A little over a year ago, he replaced a heart valve in a 25-year-old man who had injected drugs, only to see him return a few months later. Now two valves, including the new one, were badly infected, and his urine tested positive for illicit drugs. Dr. Pollard declined to operate a second time, and the patient died at a hospice.

“It was one of the hardest things I’ve ever had to do,” he said.

The Treatment Gap

As cases have multiplied around the country, doctors who used to only occasionally encounter endocarditis in patients who injected drugs are hungry for guidance. A recent study found that at two Boston hospitals, only 7 percent of endocarditis patients who were IV drug users survived for a decade without reinfection or other complications, compared with 41 percent of patients who were not IV drug users. Those hospitals are among a small but growing group trying to be more proactive.

Dr. Pollard has been lobbying hospital systems in Knoxville to provide addiction treatment for willing endocarditis patients, at least on a trial basis, after their surgery. If the hospitals offered it, he reasons, doctors would have more justification for turning away patients who refused and in the long run, hospitals would save money.

Addiction has long afflicted rural east Tennessee, where the rolling hills and mountains are woven with small towns suffering from poverty and poor health. Prescribing rates for opioids are still strikingly high, and the overdose death rate in Roane County, where Ms. Whitefield lives, is three times the national average. Jobs go unfilled here because, employers say, applicants often cannot pass a drug test.

Across Tennessee, some 163,000 poor adults remain uninsured after state lawmakers refused to expand Medicaid under the Affordable Care Act. For them, and even for many covered by Medicaid, as Ms. Whitefield is, evidence-based opioid addiction treatment remains meager. More common are cash-only clinics, or abstinence-based programs that bank on willpower instead of the addiction medications that have proved more effective.

Treatment for endocarditis usually involves up to six weeks of intravenous antibiotics, often in the hospital because doctors are wary of sending addicted patients home with IV lines for fear they would use them to inject illicit drugs. Many, like Ms. Whitefield, also need intricate surgery to repair or replace damaged heart valves. The cost can easily top $150,000, Dr. Pollard said.

Advice from specialty groups, like the American Association for Thoracic Surgery and the American College of Cardiology, about when to operate remains vague. For now, “it’s just a lot of anecdote — surgeons talking to each other, trying to determine when we should and when we shouldn’t,” said Dr. Carlo Martinez, who is one of Dr. Pollard’s partners and who operated on Ms. Whitefield at Methodist Medical Center of Oak Ridge.

Their practice, owned by Covenant Health, will almost always operate on someone with a first-time case of endocarditis from injecting drugs, Dr. Pollard said. But repeat infections, when the damage can be more extensive and harder to fix, make it a tougher call. Dr. Mark Browne, Covenant’s senior vice president and chief medical officer, said, “Each patient is evaluated individually and decisions regarding the appropriate course of care are determined by their attending physician.”

In the nearly two years since she got sick, Ms. Whitefield has felt physically diminished and been prone to illness. She also feels harshly judged by a medical system that saved her life but often treats her with suspicion and disdain.

Over the same stretch of time, Dr. Pollard has grown increasingly disillusioned with hospitals that consider addiction treatment beyond their purview, and haunted by the likelihood that many of his drug-addicted patients will die young whether they get heart surgery or not. He set up a task force in 2016 to address the problem but has faced obstacles, especially concerning cost and, he believes, a societal reluctance to spend money on people who abuse drugs.

“Everybody has sympathy for babies and children,” he said. “No one wants to help the adult drug addict because the thought is they did this to themselves.”

Dr. Pollard has been consumed by the problem of endocarditis among drug users whose addiction goes unaddressed. “We’ve literally had some continue using drugs while in the hospital,” he said. Joe Buglewicz for The New York Times

____

Ms. Whitefield, a talkative young woman with brooding eyes, goes by the nickname Shae. She started on opioid painkillers as a teenager suffering from endometriosis, a disorder of the uterine tissue, and interstitial cystitis, a painful bladder condition. She got the opioids from doctors for years, and eventually from friends.

She and her high school boyfriend, Chris Bunch, had three children by the time she was 26. She trained to become a licensed practical nurse but dropped out of the program when her oldest son, Jayden, got seriously ill as a baby. The family lives in a tiny town that Mr. Bunch, now Ms. Whitefield’s husband, described as “country, country, country.”

In 2015, after their daughter, Kyzia, was born, Ms. Whitefield sank into postpartum depression. She was obsessively worried about shielding Kyzia from sexual abuse and other traumas she had experienced as a child. She started injecting crushed opioid pills and occasionally meth, savoring the needle’s sting — she had an old habit of cutting herself to provide relief from emotional pain — at least as much as the high.

After sharing a needle with one of her brothers that day in June 2016, Ms. Whitefield started shivering and sweating. A fever soon followed, and she lay for almost a week on the couch, thinking she had a kidney infection. She was delirious by the time Jayden, then 8, woke her stepfather one morning and told him to call 911.

She arrived at Methodist Medical Center of Oak Ridge with full-blown sepsis, floating in and out of consciousness. Her organs had started to shut down.

At home, she had stared at a picture on the wall of her grandmother faintly smiling, a source of reassurance, for days. When the first nurse leaned over her in the emergency room, she thought she smelled her grandmother’s perfume.

Her stepfather, Brian Mignogna, remembers being stunned when a doctor who initially assessed her said that if it were up to him, he would not go to great lengths to save her.

“He said once someone’s been shooting up, you go through all this money and surgery and they go right back to shooting up again, so it’s not worth it,” Mr. Mignogna recalled. “I was just dumbfounded.”

Dr. Martinez was the on-call heart surgeon a few days later, though, and felt strongly about taking Ms. Whitefield’s case. Her children and stepfather had been constants at her bedside, and unlike some patients he had seen, she had readily admitted to her drug use. He believed her when she said she had not been injecting for long and wanted to stop.

“She was a young mother and her family was involved; her father was there,” he said. “To me, it seemed she had that social support that patients need once they recover from this.”

Ms. Whitefield also had health coverage through Medicaid, the government insurance program for the poor, because she has young children. It paid for her care, whereas if she were uninsured, the hospital would have had to cover the cost.

Antibiotics cleared the infection that initially led her to the hospital, but she ended up needing surgery two months later. Her mitral valve was so damaged that she had begun showing signs of heart failure. Dr. Martinez was compassionate, but he stressed that the surgery would be “a one-time deal,” Mr. Mignogna recalled.

“The way he put it was, ‘You relapse and end up with another infection, we won’t treat you again,’” Mr. Mignogna said.

Dr. Martinez repaired Ms. Whitehead’s mitral valve in a three-hour operation. It involved sawing open her breastbone, connecting her to a bypass machine to keep blood flowing through her body, and then stopping her heart and fixing the valve. He reinforced it with a small plastic ring before restarting her heart and closing her up.

She had written a note to each of her children — wise Jayden, kind Elijah, strong-willed Kyzia — in case she never woke up. Two weeks later, she was well enough to go home. She soon began seeing a counselor at a clinic unaffiliated with the hospital system and taking buprenorphine, a medication that diminishes opioid cravings and has been found to reduce the risk of relapse and fatal overdose.

Ms. Whitefield has had occasional cravings since the surgery but says she has not used drugs again, traumatized by the memory of her ordeal.

“I know next time God might not save me,” she said quietly. “They will not treat me for a second time if I have track marks or anything like that.”

As she recuperated, Ms. Whitefield started thinking about returning to school, aspiring to become a drug and alcohol counselor or real estate agent, or both.

She has also started serving as an advocate of sorts for others in her community who get endocarditis or other infections from injecting, driving them to the emergency room or sharing every detail of the protocol that saved her. She smarts at the thought of providing only “comfort care” — antibiotics but no surgery — even if a patient refuses addiction treatment.

“When do you stop wanting to save a life?” she asked. “If you have that ability, who’s to say you shouldn’t use it? I see it from their standpoint — not wanting to repeat the same game. But it’s hard, you know? This isn’t an easy disease to break away from.”

____

Dr. Pollard, a quietly driven high school valedictorian, used to have no empathy for drug-addicted patients.

“I was like everyone else: ‘They do it to themselves, they deserve what they get,’” he said. “But then when you see their children, and hear about friends my kids went to school with who have died, it’s closer to home.”

When he became president of the Knoxville Academy of Medicine in 2015, he came up with the idea of the city’s hospital systems teaming up to offer addiction treatment to endocarditis patients. He had the perfect platform to push for it, he thought.

So the following year, he set up a task force that included people from each hospital system — his own, Covenant Health; the University of Tennessee Medical Center; and Tennova Healthcare — as well as from two drug treatment centers and some community groups.

At a task force meeting last August, about a year after Ms. Whitefield’s surgery, Dr. Pollard clicked through a PowerPoint presentation full of data a research nurse had compiled. From 2014 through 2016, the three hospital systems in Knoxville had provided valve surgery to 117 patients diagnosed with endocarditis from injecting drugs. Ten had received a second surgery after becoming reinfected; of those, two had received a third.

Just over half the patients were uninsured, and only 1 percent had private coverage. From the data, it was impossible to know if anyone had been reinfected but turned away by doctors. But at least 21 people — 18 percent — had died since their heart surgery, typically from sepsis or respiratory failure, which Dr. Pollard said indicated reinfection.

The group discussed Dr. Pollard’s proposal for Cornerstone of Recovery, an addiction treatment center here, to admit a handful of endocarditis patients as soon as they were cleared for discharge. Cornerstone would provide several months of inpatient treatment and up to a year’s worth of Vivitrol, a monthly $1,000 shot that blocks cravings and helps prevent relapse.

Buprenorphine, the medication Ms. Whitefield takes, is less expensive. But Cornerstone does not provide it because it is an opioid itself and “is trading one for the other,” said Webster Bailey, its executive director of marketing. Many addiction experts have called that view “grossly inaccurate.” They say it is weaker than drugs like oxycodone and heroin, activating the brain’s opioid receptors enough to ease cravings but not enough to provide a high in people who are already dependent on opioids.

Patients would sign an agreement stating that if they returned to abusing drugs after addiction treatment, they might not be considered a candidate for future heart surgery. The total cost per patient: perhaps $55,000, which Dr. Pollard hopes that government and private funding would help cover if the program expanded.

“This should be part of the treatment, just like antibiotics are,” he told the group.

A surgeon from Tennova dryly pointed out: “Not everybody in that group is going to say, ‘This is for me, I’m going to do it.’”

Still, the group decided Dr. Pollard should take the next step, pitching the pilot plan to each system’s top executives.

“We are competing systems, but this is a common enemy that unites us all,” he said afterward. “We need a united policy.”

Source: https://www.nytimes.com/2018/04/29/health/drugs-opioids-addiction-heart-endocarditis.html April 2018

Filed under: Drug use-various effects,Health,Methamphetamine/GHB/Hallucinogens/Oxycodone,Treatment and Addiction :

Smoking during pregnancy has well-documented negative effects on birth weight in infants and is linked to several childhood health problems. Now, researchers at the University at Buffalo Research Institute on Addictions have found that prenatal marijuana use also can have consequences on infants’ weight and can influence behavior problems, especially when combined with tobacco use.

“Nearly 30 percent of women who smoke cigarettes during pregnancy also report using marijuana,” says Rina Das Eiden, PhD, RIA senior research scientist. “That number is likely to increase with many states moving toward marijuana legalization, so it’s imperative we know what effects prenatal marijuana use may have on infants.”

Through a grant from the National Institute on Drug Abuse, Eiden studied nearly 250 infants and their mothers. Of these, 173 of the infants had been exposed to tobacco and/or marijuana during their mothers’ pregnancies. None were exposed to significant amounts of alcohol.

Eiden found that infants who had been exposed to both tobacco and marijuana, especially into the third trimester, were smaller in length, weight and head size, and were more likely to be born earlier, compared to babies who were not exposed to anything. They also were more likely to be smaller in length and weight compared to babies exposed only to tobacco in the third trimester. The results were stronger for boys compared to girls.

“We also found that lower birth weight and size predicted a baby’s behavior in later infancy,” Eiden says. “Babies who were smaller were reported by their mothers to be more irritable, more easily frustrated and had greater difficulty calming themselves when frustrated. Thus, there was an indirect association between co-exposure to tobacco and marijuana and infant behavior via poor growth at delivery.”

Furthermore, women who showed symptoms of anger, hostility and aggression reported more stress in pregnancy and were more likely to continue using tobacco and marijuana throughout pregnancy. Therefore, due to the co-exposure, they were more likely to give birth to infants smaller in size and who were more irritable and easily frustrated. The infants’ irritability and frustration is also linked to mothers who experienced higher levels of stress while pregnant.

“Our results suggest that interventions with women who smoke cigarettes or use marijuana while pregnant should also focus on reducing stress and helping them cope with negative emotions,” Eiden says. “This may help reduce prenatal substance exposure and subsequent behavior problems in infants.”

The study appeared in the March/April issue of Child Development and was authored by Pamela Schuetze, PhD, Department of Psychology, Buffalo State College, with co-authors Eiden; Craig R. Colder, PhD, UB Department of Psychology; Marilyn A. Huestis, PhD, Institute of Emerging Health Professions, Thomas Jefferson University, Philadelphia; and Kenneth E. Leonard, PhD, RIA director.

Source: Prenatal marijuana use can affect infant size, behavior, study finds — ScienceDaily May 2018

Filed under: Brain and Behaviour,Cannabis/Marijuana,Drug use-various effects on foetus, babies, children and youth,Health,Nicotine :

Study finds combined use of cigarettes and marijuana may increase children’s exposure to second-hand smoke

Cannabis use increased among parents who smoke cigarettes, as well as among non-smoking parents, according to a latest study from researchers at Columbia University’s Mailman School of Public Health and City University of New York. Cannabis use was nearly four times more common among cigarette smokers compared with non-smokers. Until now, little had been known about current trends in the use of cannabis among parents with children in the home, the prevalence of exposure to both tobacco and cannabis, and which populations might be at greatest risk. The findings will be published online in the June issue of Pediatrics.

“While great strides have been made to reduce children’s exposure to second-hand cigarette smoke, those efforts may be undermined by increasing use of cannabis among parents with children living at home,” said Renee Goodwin, PhD, in the Department of Epidemiology at the Mailman School of Public Health, and corresponding author.

Analyzing data from the National Survey on Drug Use and Health from 2002 to 2015, the researchers found past-month cannabis use among parents with children at home increased from 5 percent in 2002 to 7 percent in 2015, whereas cigarette smoking declined from 28 percent to 20 percent. Cannabis use increased from 11 percent in 2002 to over 17 percent in 2015 among cigarette-smoking parents and from slightly over 2 percent to 4 percent among non-cigarette-smoking parents. Cannabis use was nearly 4 times more common among cigarette smokers versus nonsmokers (17 percent vs 4 percent), as was daily cannabis use (5 percent vs 1 percent). The overall percentage of parents who used cigarettes and/or cannabis decreased from 30 percent in 2002 to 24 percent in 2015.

“While use of either cigarettes or cannabis in homes with children has declined, there was an increase in the percent of homes with both. Therefore, the increase in cannabis use may be compromising progress in curbing exposure to secondhand smoke,” noted Goodwin, who is also at the Graduate School of Public Health and Health Policy at CUNY.

Cannabis use was also more prevalent among men who also smoked compared to women (10 percent vs 6 percent) and among younger parents with children in the home (11 percent) compared with those 50 and older (4 percent). The strength of the relationship between current cannabis use and cigarette smoking was significant and similar for all income levels.

“The results of our study support the public health gains in reducing overall child secondhand tobacco smoke but raise other public health concerns about child exposure to secondhand cannabis smoke and especially high risk for combined exposures in certain subpopulations,” observed Goodwin.

Noteworthy, according to Goodwin, is that there remains a lack of information on the location of smoking, whether it occurs in the house or in the proximity of children. Unlike cigarettes, smoking cannabis outdoors and in a range of public areas is illegal in most places. Therefore, there is reason to believe that cannabis use is even more likely to occur in the home than cigarette smoking given their differences in legal status.

“Efforts to decrease secondhand smoke exposure via cigarette smoking cessation may be complicated by increases in cannabis use,” said Goodwin. “Educating parents about secondhand cannabis smoke exposure should be integrated into public health education programs on secondhand smoke exposure.”

The study was funded by the National Institutes of Health and National Institute on Drug Abuse (DA20892).

Co-authors are Melanie Wall, Deborah Hasin, and Samantha Santoscoy, Mailman School of Public Health; Keely Cheslack-Postava, Columbia University College of Physicians and Surgeons; Nina Bakoyiannis, CUNY; and Bradley Collins and Stephen Lepore, Temple University.

Source: Cannabis use up among parents with children in the home: Study finds combined use of cigarettes and marijuana may increase children’s exposure to second-hand smoke — ScienceDaily May 2018

Filed under: Cannabis/Marijuana,Drug use-various effects on foetus, babies, children and youth,Health,Nicotine :

The popularity of electronic cigarettes continues to grow worldwide, as many people view them as a safer alternative to smoking. But the long-term effects of e-cigarette usage, commonly called “vaping,” are unknown. Today, researchers report that vaping may modify the genetic material, or DNA, in the oral cells of users, which could increase their cancer risk.

The researchers will present their results today at the 256th National Meeting & Exposition of the American Chemical Society (ACS).

“E-cigarettes are a popular trend, but the long-term health effects are unknown,” says Romel Dator, Ph.D., who is presenting the work at the meeting. “We want to characterize the chemicals that vapers are exposed to, as well as any DNA damage they may cause.”

Introduced to the market in 2004, e-cigarettes are handheld electronic devices that heat a liquid, usually containing nicotine, into an aerosol that the user inhales. Different flavors of liquids are available, including many that appeal to youth, such as fruit, chocolate and candy. According to a 2016 report by the U.S. Surgeon General, 13.5 percent of middle school students, 37.7 percent of high school students and 35.8 percent of young adults (18 to 24 years of age) have used e-cigarettes, compared with 16.4 percent of older adults (25 years and up).

“It’s clear that more carcinogens arise from the combustion of tobacco in regular cigarettes than from the vapor of e-cigarettes,” says Silvia Balbo, Ph.D., the project’s lead investigator, who is at the Masonic Cancer Center at the University of Minnesota. “However, we don’t really know the impact of inhaling the combination of compounds produced by this device. Just because the threats are different doesn’t mean that e-cigarettes are completely safe.”

To characterize chemical exposures during vaping, the researchers recruited five e-cigarette users. They collected saliva samples before and after a 15-minute vaping session and analyzed the samples for chemicals that are known to damage DNA. To evaluate possible long-term effects of vaping, the team assessed DNA damage in the cells of the volunteers’ mouths. The researchers used mass-spectrometry-based methods they had developed previously for a different study in which they evaluated oral DNA damage caused by alcohol consumption.

Dator and Balbo identified three DNA-damaging compounds, formaldehyde, acrolein and methylglyoxal, whose levels increased in the saliva after vaping. Compared with people who don’t vape, four of the five e-cigarette users showed increased DNA damage related to acrolein exposure. The type of damage, called a DNA adduct, occurs when toxic chemicals, such as acrolein, react with DNA. If the cell does not repair the damage so that normal DNA replication can take place, cancer could result.

The researchers plan to follow up this preliminary study with a larger one involving more e-cigarette users and controls. They also want to see how the level of DNA adducts differs between e-cigarette users and regular cigarette smokers. “Comparing e-cigarettes and tobacco cigarettes is really like comparing apples and oranges. The exposures are completely different,” Balbo says. “We still don’t know exactly what these e-cigarette devices are doing and what kinds of effects they may have on health, but our findings suggest that a closer look is warranted.”

Source: E-cigarettes can damage DNA — ScienceDaily August 2018

Filed under: Drug use-various effects,Health,Nicotine :

Albert Stuart Reece, MBBS(Hons.), FRCS(Ed.), FRCS(Glas.), FRACGP, MD (UNSW) and Gary Kenneth Hulse, BBSc.(Hons.), MBSc., PhD.

Abstract

Background: The epidemiology of cannabinoid-related cancerogenesis has not been studied with cutting edge epidemiological techniques. Building on earlier bivariate papers in this series we aimed to conduct pathfinding studies to address this gap in two tumours of the reproductive tract, prostate and ovarian cancer.

Methods: Age-standardized cancer incidence data for 28 tumour types (including “All (non-skin) Cancer”) was sourced from Centres for Disease Control and National Cancer Institute using SEER*Stat software across US states 2001-2017. Drug exposure was sourced from the nationally representative household survey National Survey of Drug Use and Health conducted annually by the Substance Abuse and Mental Health Services Administration 2003-2017 with response rate 74.1%. Federal seizure data provided cannabinoid concentration data. US Census Bureau provided income and ethnicity data. Inverse probability weighted mixed effects, robust and panel regression together with geospatiotemporal regression analyses were conducted in R. E-Values were also calculated.

Results: 19,877 age-standardized cancer rates were returned. Based on these rates and state populations this equated to 51,623,922 cancer cases over an aggregated population 2003-2017 of 124,896,418,350. Inverse probability weighted regressions for prostate and ovarian cancers confirmed causal associations robust to adjustment. Cannabidiol alone was significantly associated with prostate cancer (β-estimate = 1.61, (95%C.I. 0.99, 2.23), P = 3.75 × 10^{– 7}). In a fully adjusted geospatiotemporal model at one spatial and two temporal years lags cannabidiol was significantly independently associated with prostate cancer (β-estimate = 2.08, (1.19, 2.98), P = 5.20 × 10^{– 6}). Cannabidiol alone was positively associated with ovarian cancer incidence in a geospatiotemporal model (β-estimate = 0.36, (0.30, 0.42), P < 2.20 × 10^{– 16}). The cigarette: THC: cannabidiol interaction was significant in a fully adjusted geospatiotemporal model at six years of temporal lag (β-estimate = 1.93, (1.07, 2.78), P = 9.96 × 10^{– 6}). Minimal modelled polynomial E-Values for prostate and ovarian cancer ranged up to 5.59 × 10⁵⁹ and 1.92 × 10¹²⁵. Geotemporospatial modelling of these tumours showed that the cannabidiol-carcinogenesis relationship was supra-linear and highly sigmoidal (P = 1.25 × 10^{– 45} and 12.82 × 10^{– 52} for linear v. polynomial models).

Conclusion: Cannabinoids including THC and cannabidiol are therefore important community carcinogens additive to the effects of tobacco and greatly exceeding those of alcohol. Reproductive tract carcinogenesis necessarily implies genotoxicity and epigenotoxicity of the germ line with transgenerational potential. Pseudoexponential and causal dose-response power functions are demonstrated.

Keywords: Cannabidiol; Cannabigerol; Cannabinoid; Cannabis; Chromosomal toxicity; Congenital anomalies; Dose-response relationship; Epigenotoxicity; Genotoxicity; Mechanisms; Multigenerational genotoxicity; Oncogenesis; Sigmoidal dose-response; Supra-linear dose response; Transgenerational teratogenicity; Δ9-tetrahydrocannabinol.

Source: Geotemporospatial and causal inferential epidemiological overview and survey of USA cannabis, cannabidiol and cannabinoid genotoxicity expressed in cancer incidence 2003-2017: part 3 – spatiotemporal, multivariable and causal inferential pathfinding and exploratory analyses of prostate and ovarian cancers – PubMed (nih.gov) March 2022

Filed under: Cannabis/Marijuana,Drug use-various effects on foetus, babies, children and youth,Health :

Albert Stuart Reece, MBBS(Hons.), FRCS(Ed.), FRCS(Glas.), FRACGP, MD (UNSW) and Gary Kenneth Hulse, BBSc.(Hons.), MBSc., PhD.

Abstract

Background: As the cannabis-cancer relationship remains an important open question epidemiological investigation is warranted to calculate key metrics including Rate Ratios (RR), Attributable Fractions in the Exposed (AFE) and Population Attributable Risks (PAR) to directly compare the implicated case burden between emerging cannabinoids and the established carcinogen tobacco.

Methods: SEER*Stat software from Centres for Disease Control was used to access age-standardized state census incidence of 28 cancer types (including “All (non-skin) Cancer”) from National Cancer Institute in US states 2001-2017. Drug exposures taken from the National Survey of Drug Use and Health 2003-2017, response rate 74.1%. Federal seizure data provided cannabinoid exposure. US Census Bureau furnished income and ethnicity. Exposure dichotomized as highest v. lowest exposure quintiles. Data processed in R.

Results: Nineteen thousand eight hundred seventy-seven age-standardized cancer rates were returned. Based on these rates and state populations this equated to 51,623,922 cancer cases over an aggregated population 2003-2017 of 124,896,418,350. Fifteen cancers displayed elevated E-Values in the highest compared to the lowest quintiles of cannabidiol exposure, namely (in order): prostate, melanoma, Kaposi sarcoma, ovarian, bladder, colorectal, stomach, Hodgkins, esophagus, Non-Hodgkins lymphoma, All cancer, brain, lung, CLL and breast. Eleven cancers were elevated in the highest THC exposure quintile: melanoma, thyroid, liver, AML, ALL, pancreas, myeloma, CML, breast, oropharynx and stomach. Twelve cancers were elevated in the highest tobacco quintile confirming extant knowledge and study methodology. For cannabidiol RR declined from 1.397 (95%C.I. 1.392, 1.402), AFE declined from 28.40% (28.14, 28.66%), PAR declined from 15.3% (15.1, 15.5%) and minimum E-Values declined from 2.13. For THC RR declined from 2.166 (95%C.I. 2.153, 2.180), AFE declined from 53.8% (53.5, 54.1%); PAR declined from 36.1% (35.9, 36.4%) and minimum E-Values declined from 3.72. For tobacco, THC and cannabidiol based on AFE this implies an excess of 93,860, 91,677 and 48,510 cases; based on PAR data imply an excess of 36,450, 55,780 and 14,819 cases.

Conclusion: Data implicate 23/28 cancers as being linked with THC or cannabidiol exposure with epidemiologically-causal relationships comparable to those for tobacco. AFE-attributable cases for cannabinoids (91,677 and 48,510) compare with PAR-attributable cases for tobacco (36,450). Cannabinoids constitute an important multivalent community carcinogen.

Keywords: Cannabidiol; Cannabigerol; Cannabinoid; Chromosomal toxicity; Congenital anomalies; Dose-response relationship; Epigenotoxicity; Genotoxicity; Mechanisms; Multigenerational genotoxicity; Oncogenesis; Sigmoidal dose-response; Supra-linear dose response; Transgenerational teratogenicity; cannabis; Δ9-tetrahydrocannabinol.

Source: Geotemporospatial and causal inferential epidemiological overview and survey of USA cannabis, cannabidiol and cannabinoid genotoxicity expressed in cancer incidence 2003-2017: part 2 – categorical bivariate analysis and attributable fractions – PubMed (nih.gov) March 2022

Filed under: Cannabis/Marijuana,Drug use-various effects,Drug use-various effects on foetus, babies, children and youth,Health :

Albert Stuart Reece, MBBS(Hons.), FRCS(Ed.), FRCS(Glas.), FRACGP, MD (UNSW) and Gary Kenneth Hulse, BBSc.(Hons.), MBSc., PhD.

Abstract

Background: The genotoxic and cancerogenic impacts of population-wide cannabinoid exposure remains an open but highly salient question. The present report examines these issues from a continuous bivariate perspective with subsequent reports continuing categorical and detailed analyses.

Methods: Age-standardized state census incidence of 28 cancer types (including “All (non-skin) Cancer”) was sourced using SEER*Stat software from Centres for Disease Control and National Cancer Institute across US states 2001-2017. It was joined with drug exposure data from the nationally representative National Survey of Drug Use and Health conducted annually by the Substance Abuse and Mental Health Services Administration 2003-2017, response rate 74.1%. Cannabinoid data was from Federal seizure data. Income and ethnicity data sourced from the US Census Bureau. Data was processed in R.

Results: Nineteen thousand eight hundred seventy-seven age-standardized cancer rates were returned. Based on these rates and state populations this equated to 51,623,922 cancer cases over an aggregated population 2003-2017 of 124,896,418,350. Regression lines were charted for cancer-substance exposures for cigarettes, alcohol use disorder (AUD), cannabis, THC, cannabidiol, cannabichromene, cannabinol and cannabigerol. In this substance series positive trends were found for 14, 9, 6, 9, 12, 6, 9 and 7 cancers; with largest minimum E-Values (mEV) of 1.76 × 10⁹, 4.67 × 10⁸, 2.74 × 10⁴, 4.72, 2.34 × 10¹⁸, 2.74 × 10¹⁷, 1.90 × 10⁷, 5.05 × 10⁹; and total sum of exponents of mEV of 34, 32, 13, 0, 103, 58, 25, 31 indicating that cannabidiol followed by cannabichromene are the most strongly implicated in environmental carcinogenesis. Breast cancer was associated with tobacco and all cannabinoids (from mEV = 3.53 × 10⁹); “All Cancer” (non-skin) linked with cannabidiol (mEV = 1.43 × 10¹¹); pediatric AML linked with cannabis (mEV = 19.61); testicular cancer linked with THC (mEV = 1.33). Cancers demonstrating elevated mEV in association with THC were: thyroid, liver, pancreas, AML, breast, oropharynx, CML, testis and kidney. Cancers demonstrating elevated mEV in relation to cannabidiol: prostate, bladder, ovary, all cancers, colorectum, Hodgkins, brain, Non-Hodgkins lymphoma, esophagus, breast and stomach.

Conclusion: Data suggest that cannabinoids including THC and cannabidiol are important community carcinogens exceeding the effects of tobacco or alcohol. Testicular, (prostatic) and ovarian tumours indicate mutagenic corruption of the germline in both sexes; pediatric tumourigenesis confirms transgenerational oncogenesis; quantitative criteria implying causality are fulfilled.

Keywords: Cannabidiol; Cannabigerol; Cannabinoid; Cannabis; Chromosomal toxicity; Congenital anomalies; Dose–response relationship; Epigenotoxicity; Genotoxicity; Mechanisms; Multigenerational genotoxicity; Oncogenesis; Sigmoidal dose–response; Supra-linear dose response; Transgenerational teratogenicity; Δ9-tetrahydrocannabinol.

Source: Geotemporospatial and causal inferential epidemiological overview and survey of USA cannabis, cannabidiol and cannabinoid genotoxicity expressed in cancer incidence 2003-2017: part 1 – continuous bivariate analysis – PubMed (nih.gov) March 2022

Filed under: Cannabis/Marijuana,Drug use-various effects,Drug use-various effects on foetus, babies, children and youth,Health :

Cannabis Use and Health 2014
Introduction

Cannabis is a group of substances from the plant cannabis sativa. Cannabis is used in three main forms: flowering heads, cannabis resin (hashish) and cannabis oil. There are more than 60 psycho-active chemicals in cannabis, including the cannabinoids:
 delta-9 tetrahydrocannabinol (THC), which is found in the resin covering the flowering tops and upper leaves of the female plant and which alters mood and produces the feeling of a ‘high’;
and
 cannabidiol, which can offset the effects of THC.

Cannabis is usually smoked, either in a hand-rolled cigarette (a ‘joint’) containing the leaf, heads or resin of the plant, or through a water-pipe (a ‘bong’) where water is used to cool the smoke before it is inhaled. In Australia, cannabis is also commonly known as gunja, yarndi, weed and dope.

Patterns of Cannabis Use in Australia and its Public Health Impacts

In 2010, cannabis was the most commonly used illicit drug in Australia. Over one third of Australians (35.4%, approximately 6.5 million) aged 14 years and over had used cannabis at least once in their lifetime, and 1.9 million of these had used cannabis recently (i.e., in the last 12
months). Recent cannabis use among those 14 years and older has increased from 9.1% in 2007 to 10.3% in 2010, though daily users decreased from 14.9% in 2007 to 13% in 2010. In 2010, approximately 247,000 Australians 14 years and over used cannabis daily. For most cannabis users, use is relatively light. Most young people have used it once or twice. However, the younger people start using cannabis, and the greater the frequency with which they use it, the greater the risk of harm.
Based on current use patterns, alcohol abuse and tobacco pose much greater harms to individual and public health in Australia than cannabis. Cannabis-related psychosis, suicide, road-traffic crashes and dependence were estimated to account for 0.2% of the total disease burden in Australia in 2003. This compares to 7.8% of the total burden attributable to tobacco use and 2.3% attributable to alcohol use. In 2004-05, the estimated social costs of cannabis use (including health, crime, road crash and labour costs) was $3.1 billion. Ninety percent of this cost was due to dependent cannabis use. In comparison, the health, crime, road-crash and labour costs of alcohol use in 2004-05 are estimated to be more than three times as much ($9.4 billion).

The Health Effects of Cannabis Use

There is a dose-response relationship between cannabis use and its effects, with stronger effects
expected from larger doses.
 Intoxicating effects occur within seconds to minutes and can last for three hours;
 Effects last longer with larger doses;
 Effects on cognitive function and coordination can last up to 24 hours;
 Short-term memory impairment may last for several weeks; and
 A single dose in a chronic user can take up to 30 days for the metabolites to be excreted.

Short-term effects of small doses
The most common short-term effects of using cannabis are:
 a feeling of euphoria or ‘high’ – with a tendency to talk and laugh more than usual;
 impaired balance, reaction time, information processing, memory retention and retrieval, and perceptual-motor coordination;
 increased heart rate;
 decreased inhibitions such as being more likely to engage in risky behaviour, e.g. unsafe
sexual practice; and
 if smoked, increased respiratory problems including asthma.

Short-term effects of large doses
The most common short-term effects of a large dose can include:
 hallucinations and changed perceptions of time, sound, colour, distance, touch and other sensations;
 panic reactions;
 vomiting;
 loss of consciousness; and
 restlessness and confusion.

The severity of these short-term effects depend on a person’s weight, tolerance to the drug, amount taken, interactions with other drugs, circumstances in which the drug is taken, and the mode of administration.

Long-term effects
The evidence associating regular cannabis use with specific long-term health conditions and adverse effects is of variable quality. Cannabis use is highly correlated with use of alcohol, tobacco and other illicit drugs, all of which have potential adverse health effects. There is sufficient evidence, however, to indicate that cannabis is a risk factor for some chronic health effects and conditions.

Regular and prolonged cannabis use may cause:
 cannabis dependence, characterised by impaired control over its use and difficulties in ceasing use; increased tolerance (meaning more of the drug is needed to produce the same effect) and possible withdrawal symptoms, including anxiety, insomnia, appetite disturbance, and
depression;
 increased risk of myocardial infarction in those who have already had a myocardial infarction;
and
 deficits in verbal learning, memory and attention (in heavy users).

While not conclusive, there is evidence that regular cannabis use can cause chronic bronchitis and impaired immunological competence of the respiratory system. Occasional cannabis use however, is not associated with adverse effects on pulmonary function. Cannabis smoke contains many carcinogens, but there is variable evidence concerning the relationship between cannabis smoking and lung cancer.

Evidence supporting an association between cannabis use and sexual and reproductive effects is weak. However, some studies show an association between cannabis use and increased risk of testicular cancer.
Daily consumption of large quantities of cannabis may lead to the neglect of other important personal and social priorities such as relationships, parenting, careers and community responsibilities.

Pregnant women
Cannabis is the most commonly used illicit drug in women of child-bearing age. Cannabis use during pregnancy has been consistently associated with lower birth-weight babies and pre-term birth, but does not appear to increase the risk of miscarriage or birth abnormalities. Some studies suggest that children exposed to cannabis in utero may have slight impairment in higher cognitive processes such as perceptual organisation and planning. There is insufficient evidence of an association between prenatal cannabis use and postnatal behaviour.

Accidental ingestion by young children
Accidental ingestion of cannabis can cause coma in young children. Cannabis ingestion can be confirmed by positive urine screening for cannabinoids. Cannabis ingestion needs to be considered in toddlers and children with impaired consciousness.

Driving under the influence of cannabis
Cannabis slows reaction time and increases the risk of having a car crash. Other risk factors are blurred vision, poor judgement and drowsiness which can persist for several hours. The effects are increased by alcohol.

Dependence and tolerance
Cannabis dependence is usually defined as impaired control over continued use and difficulty ceasing despite the harms of continued use.19 Dependence can negatively affect personal relationships, education, employment and many other aspects of a person’s life. Data from Australia and other countries indicates that demand for professional help related to cannabis is increasing. Cannabis dependence is the most frequent type of substance-dependence in Australia after alcohol and tobacco. It has been estimated that cannabis dependence will affect around one in ten cannabis users, and around half of those who use it daily. Animal and human studies demonstrate that tolerance to many of the psychological and behavioural responses to cannabis occurs with repeated exposure to the drug. The symptoms of withdrawal from cannabis appear similar to those associated with tobacco, but less severe than withdrawal from alcohol or opiates.

There is a view that the cannabis being used today has a higher THC content and potency than in the past. This may be a perception caused by changes in the mode of use (i.e. through ‘bongs’ rather than ‘joints’, and with more consumption of the heads of the cannabis plant). However, there is some independent evidence that cannabis used today can be of a higher potency. The cannabis in recent street-level seizures in Sydney and the North Coast of NSW has been shown to have a high potency, with around 15% THC, with little or no cannabidiol.

Cannabis as a Gateway Drug
The gateway hypothesis is that cannabis use may act as a causal ‘gateway’ to the use of other illicit drugs such as cocaine and heroin. It is a controversial hypothesis with proponents arguing that because the use of so-called harder drugs is almost always preceded by cannabis use, this means that cannabis use physiologically and/or psychologically causes people to progress to harder drugs. The alternative theory is known as the ‘common cause’ theory whereby a person’s use of cannabis and their later use of other illicit drugs are both seen as effects of common causes such as personal or socio-economic factors, or exposure to illicit drug distribution networks. Evidence for the gateway hypothesis is inconclusive given the difficulties in disentangling the effect of other potential influences in drug use progression. Meta-analyses suggest that the progression in use that has been observed is likely to be due partially to the influence of independent common
causes.

Cannabis and Mental Health

Cannabis and psychosis
Cannabis use is associated with poor outcomes in existing psychosis and is a risk factor for developing psychosis. For those with existing psychosis, using cannabis can trigger further episodes of psychosis, worsen delusions, mood swings, hallucinations and feelings of paranoia, as well as contributing to poor compliance with medication regimes. The research base on cannabis and psychosis has expanded in recent years with studies showing a consistent association between early-aged onset of cannabis use, regular use and a later diagnosis of schizophrenia. Meta-analyses have noted a doubling of the risk of psychotic outcomes in regular cannabis users, and earlier onset (by 2.7 years) among cannabis users who develop psychosis.
There is increasing evidence that the association between cannabis and onset of psychosis is not due to other co-occurring factors. The most plausible view is that cannabis use is a ‘contributory cause’ of psychosis in vulnerable individuals, and that it is one of a number of potential factors that can bring on psychosis (including genetic predisposition)’

Cannabis and depression
The association between cannabis use and depression is weak and insufficient to establish a causal connection. Studies that have found an association are likely to have been affected by confounding variables such as family and personality factors, other drug use and marital status.
There is currently insufficient evidence available to conclude whether cannabis use is associated with suicide. Research is made difficult by confounding factors such as the stresses of an illicit drug-dependent life and pre-existing poor mental health.

Cannabis and anxiety
There is emerging evidence associating cannabis use with anxiety disorders. However, the current level of evidence is not yet sufficient to establish a causal relationship.

Medical Uses Of Cannabis
In addition to psychoactive compounds, cannabis has constituents with other pharmacological effects, including antispastic, analgesic, anti-emetic, and anti-inflammatory actions. These constituents may have therapeutic potential.

Cannabis extracts and synthetic formulations have been licensed for medicinal use in some countries, including Canada, the USA, Great Britain and Germany, for the treatment of severe spasticity in multiple sclerosis, nausea and vomiting due to cytotoxics, and loss of appetite and cachexia associated with AIDS. The synthetic cannabis product Nabiximols (Sativex), which is delivered as a buccal spray and so avoids the harms of cannabis smoke inhalation, is effective in the management of spasticity and pain associated with multiple sclerosis. The psycho-active effects of Nabiximols can also be managed through controlling dosage.

In Australia, the synthetic cannabinoids nabilone and dronabinol are scheduled by authorities for medicinal use. Sativex is also being trialed in Australia for cancer and cannabis withdrawal. Canada has allowed the medical use of smoked cannabis if this is authorised and monitored by a doctor.
There is a growing body of evidence that certain cannabinoids are effective in the treatment of chronic pain, particularly as an alternative or adjunct to the use of opiates, when the development of opiate tolerance and withdrawal can be avoided. Controlled trials have also shown positive effects of cannabis preparations on bladder dysfunction in multiple sclerosis, tics in Tourette syndrome, and involuntary movements associated with Parkinson’s disease. Based on existing data, the adverse events associated with the short-term medicinal use of cannabis are minor.
However, the risks associated with long-term medicinal use are less well understood, particularly the risk of dependence, and any heightened risk of cardiovascular disease. Though there is a growing body of evidence regarding the therapeutic use of cannabinoids, it is still experimental.

Synthetic Cannabis
Synthetic cannabis products have been developed, usually in herbal form for smoking. These products have been marketed in Australia as ‘legal highs’ with product names such as ‘Spice’, ‘K2’, and ‘Kronic’. The psychoactive components are usually THC analogues that bind to cannabinoid receptors in the brain. These analogues are not easily detectable by routine testing, and until recently have not been captured by legislation. These synthetic cannabis products are attractive to their users because they are perceived as safe, are not easily detectable in drug tests, and until recently have not been illegal.
The synthetic cannabis products can not be considered safe given that the synthesized psychoactive substances in them have not been rigorously tested, and little is known about their long or short-term health effects, dependence potential or adverse reactions. Psychotic
symptoms have been associated with use of some synthetic cannabinoids, as well as signs of addiction and withdrawal symptoms similar to those of cannabis. Adverse outcomes have been reported from the use of Kronic in Australia.

The Control of Cannabis Use and Supply

Australian legislation
The possession, cultivation, use, and supply of cannabis is prohibited in all Australian States and Territories. In some Australian jurisdictions there are criminal penalties for the possession, cultivation and use of cannabis, and in others there are less severe civil penalties. Legislation in Australia often distinguishes between possession of small amounts of cannabis (for personal use) possession of larger amounts (trafficable quantities), and possession of even larger “commercially trafficable” quantities. The supplying of cannabis and the possession of large quantities attract criminal penalties in all Australian jurisdictions. All Australian States and Territories have diversionary schemes for minor and early cannabis offenders which require them to undertake educative and treatment programs as an alternative to receiving a criminal penalty.

Criminalisation and health
It is often thought that criminal penalties are a deterrent to cannabis use and, therefore, an effective way to prevent the health impacts and other harms associated with cannabis use. These beliefs have little foundation. A system of criminal prohibition for cannabis use applied in Australia for many years, but the incidence of cannabis use was still significant. The introduction of less serious civil penalties and diversionary alternatives to criminal sanctions did not significantly increase the rates of uptake and use among Australians.

For those who are not deterred from use by criminal penalties, criminalisation can add to the potential health and other risks to which cannabis users are exposed. These include:

 exposure of cannabis users, including teenage and occasional users, to ‘harder drugs’. Those who acquire cannabis from large scale illicit drug distribution networks will also become exposed to more harmful drugs, including the direct marketing of those drugs to them;
 exposure of cannabis users to criminal networks and activity, including exposure to the threat of violence and the risk of taking part in criminal distribution;
 the personal and health-related costs of a criminal conviction. A criminal conviction can negatively impact on a person’s employment prospects and their accommodation and travel opportunities. Limited employment and accommodation prospects can lead to poor health,
including mental health. Individuals with a criminal record are also at a disadvantage in any subsequent criminal proceedings;
 a deterrent to individuals seeking health advice, treatment and support regarding their cannabis use;
 the inability to collect high quality, reliable data regarding patterns of use and harms.

Harm reduction
A harm-reduction approach is defined as policies and initiatives that aim to reduce the adverse health, social and economic consequences of substance use to individual drug users, their families and the community. Harm reduction considers both the potential harms to individuals using substances like cannabis and the potential harms and negative impacts of the different approaches for controlling the use and supply of these substances. When harm reduction is the primary goal, the key policy focus will be on measures to reduce individuals’ harmful levels of cannabis use, or cannabis use among individuals who are most vulnerable to adverse health impacts, or cannabis use in contexts which involve serious risks to users.

Harm-reduction measures include targeted efforts to reduce the supply of cannabis and to reduce demand for it among vulnerable groups. In certain contexts, and with certain groups, measures emphasizing abstinence may also contribute, in a preventive way, to reducing harms. Policy and legislative approaches that do not effectively address cannabis-related harms or create
significant risks and adverse impacts are not consistent with harm-reduction. Prohibition of cannabis use with criminal penalties has the potential to produce harms and risks. The effectiveness of criminal prohibition of cannabis use in reducing the health-related harms
associated with cannabis use is questionable.

Treatment Options
The number of people seeking treatment for cannabis use is increasing, but most of those who experience cannabis dependence do not seek help. Many regular cannabis users do not believe they need treatment, and there is also a low awareness of the treatment options available and how to access them.
There are fewer treatment options for cannabis dependence than for alcohol or opiate dependence, and limited research on the effectiveness of different cannabis treatment options. Treatments for problematic cannabis use include psychological interventions such as cognitive
behavioural therapy and motivational enhancement, and pharmacological interventions with medications to ease the symptoms of withdrawal or block the effects of cannabis. The research on pharmacological interventions for cannabis is in its infancy, with medications still in the experimental stages of development.

Cognitive behavioural therapy helps the cannabis user develop knowledge and skills to identify risk situations when using cannabis and to modify behaviour accordingly. Motivational enhancement techniques build the cannabis user’s desire to address their problematic use. These counseling interventions are increasingly available online as web-based programs, as well as face-to-face with a counselor. Online programs have the advantage of convenience and anonymity, for those who are concerned about possible stigma. Difficulties in maintaining motivation, and limitations in personalising the programs to individual needs, are drawbacks. According to current research, web-based treatment programs may not be as effective as in-person treatment. Some problematic cannabis users have particular treatment needs, including those with cannabis dependence and mental health issues. These individuals require integrated treatment and coordinated care. General practitioners can play an important role in developing a coordinated care plan to suit the needs of these patients.

The Australian Medical Association Position
The AMA acknowledges that cannabis use is harmful and can lead to adverse chronic health outcomes, including dependence, withdrawal symptoms, early onset psychosis and the exacerbation of pre-existing psychotic symptoms. While the absolute risk of these outcomes is low and those who use cannabis occasionally are unlikely to be affected, those who use cannabis frequently and for sustained periods, or who initiate cannabis use at an early age, or who are susceptible to psychosis, are most at risk.
The AMA also recognises that cannabis use has short-term effects on cognitive and perceptual functioning which can present risks to the safety of users and others. The AMA believes that cannabis use should be seen primarily as a health issue and not primarily as a matter for law enforcement. The most appropriate response to cannabis use should give priority to policies, programs and regulatory approaches that reduce the harms potentially associated with cannabis use, and particularly the health-related harms. The positions outlined below should be read in the light of this harm-reduction principle. The AMA believes the following are the important considerations and central elements in an appropriate harm-reduction response to cannabis use.

Prevention and Early Intervention
 As younger people and those who use cannabis frequently are most at risk of harm, prevention and early intervention initiatives to avoid, delay and reduce the frequency of cannabis use in these populations are essential.
 All children should have access to developmentally appropriate school-based life-skills programs to assist in preventing or reducing potential substance use problems.
 Evidence-based information on the potential risks of cannabis use and where to seek further assistance should be widely available, particularly to young people.
 Medical professionals can play an important role in the early identification of patients they believe to be at risk of adverse health outcomes from cannabis use.
 When a cannabis user comes into contact with law enforcement or justice administration agencies this should be used as an opportunity to direct them to education, counseling or treatment. This is particularly important with young and first time or early offenders.

Diagnosis and Treatment
 Medical professionals have the knowledge and opportunity to screen for and diagnose cannabis-related disorders, including dependence, withdrawal symptoms, and cannabis induced psychosis. Referral networks and linkages should be established within regions between primary care and specialist mental health and drug and alcohol services, to ensure integrated and coordinated treatment support for cannabis use problems.
 Medical professionals, particularly general practitioners, have the opportunity to counsel patients who are at risk of cannabis-related harms, and they should be supported to provide education and advice about those potential harms.
 Targeted treatment regimens should be developed and resourced for groups with particular needs, including those with dual diagnoses, multiple drug use, young teenage users and culturally appropriate services for Aboriginal peoples and Torres Strait Islanders. Of particular importance are suitable treatment services for cannabis users with mental health needs.
 Every effort should be made to address the personal and systemic barriers that cannabis users face in seeking treatment and support when they need it. These include barriers associated with perceptions of stigmatisation, users’ and professionals’ awareness of treatment options, and users’ beliefs that they do not have a health problem.
 Doctors should consider accidental cannabis ingestion in the differential diagnosis of children with impaired consciousness.
 Cannabis users should have access to the rehabilitative services and support they require to manage associated disorders and particularly the risk of relapse.

Medical Uses of Cannabis
The Australian Medical Association acknowledges that cannabis has constituents that have potential therapeutic uses.
 Appropriate clinical trials of potentially therapeutic cannabinoid formulations should be conducted to determine their safety and efficacy compared to existing medicines, and whether their long-term use for medical purposes has adverse effects.
 Therapeutic cannabinoids that are deemed safe and effective should be made available to patients for whom existing medications are not as effective.
 Smoking or ingesting a crude plant product is a risky way to deliver cannabinoids for medical purposes. Other appropriate ways of delivering cannabinoids for medical purposes should be developed.
 Any promotion of the medical use of cannabinoids will require extensive education of the public and the profession on the risks of the non-medical use of cannabis.

Law Enforcement, Cannabis Regulation and Health
 In assessing different legislative and policy approaches to the regulation of cannabis use and supply, primary consideration should be given to the impact of such approaches on the health and well-being of cannabis users.
 The AMA does not condone the trafficking or recreational use of cannabis. The AMA believes that there should be vigorous law enforcement and strong criminal penalties for the trafficking of cannabis. The personal recreational use of cannabis should also be
prohibited. However, criminal penalties for personal cannabis use can add to the potential health and other risks to which cannabis users are exposed. The AMA believes that it is consistent with a principle of harm reduction for the possession of cannabis for personal
use to attract civil penalties such as court orders requiring counselling and education (particularly for young and first time offenders), or attendance at ‘drug courts’ which divert users from the criminal justice system into treatment.
 When cannabis users come into contact with the police or courts, the opportunity should be taken to divert those users to preventive, educational and therapeutic options that they would not otherwise access.
 In allocating resources, priority should be given to policies, programs and initiatives that reduce the health-related risks of cannabis use. Law enforcement should be directed primarily at cannabis supply networks.
 The AMA believes that the availability and use of synthetic cannabis products (including herbal forms) poses significant health risks, given that the psychoactive chemical constituents of these products are unknown and unpredictable in their effect. There are
particular challenges in regulating these products, and Australian governments must make a concerted effort to develop consistent and effective legislation which captures current and emerging forms of synthetic cannabis.

Research
 Further research is needed into the relationship between cannabis use and psychosis and other mental health problems, including the identification of those at greatest risk of cannabis-induced psychosis.
 There should be continuing research to identify the risk factors that contribute to individuals developing problematic or early onset cannabis use, and the factors and interventions that can protect against these.
 Australian governments should fund research into best practice treatment methods, including suitable pharmacotherapies, for those who are cannabis-dependent or who wish to reduce or cease their use.
 There should be systematic ongoing monitoring of the different legislative and policy approaches on cannabis operating in overseas jurisdictions to assess their health and harm-related impacts. The evidence obtained should inform critical reviews of the
approaches that operate in Australia.

Source: 1 (ama.com.au) 2014

Filed under: Australia,Brain and Behaviour,Cannabis/Marijuana,Drug use-various effects,Health,Marijuana and Medicine,Prevention and Intervention,Synthetics,Treatment and Addiction :

Abstract

Background: Little is known about the relative harms of edible and inhalable cannabis products.

Objective: To describe and compare adult emergency department (ED) visits related to edible and inhaled cannabis exposure.

Design: Chart review of ED visits between 1 January 2012 and 31 December 2016.

Setting: A large urban academic hospital in Colorado.

Participants: Adults with ED visits with a cannabis-related International Classification of Diseases, Ninth or 10th Revision, Clinical Modification (ICD-9-CM or ICD-10-CM), code.

Measurements: Patient demographic characteristics, route of exposure, dose, symptoms, length of stay, disposition, discharge diagnoses, and attribution of visit to cannabis.

Results: There were 9973 visits with an ICD-9-CM or ICD-10-CM code for cannabis use. Of these, 2567 (25.7%) visits were at least partially attributable to cannabis, and 238 of those (9.3%) were related to edible cannabis. Visits attributable to inhaled cannabis were more likely to be for cannabinoid hyperemesis syndrome (18.0% vs. 8.4%), and visits attributable to edible cannabis were more likely to be due to acute psychiatric symptoms (18.0% vs. 10.9%), intoxication (48% vs. 28%), and cardiovascular symptoms (8.0% vs. 3.1%). Edible products accounted for 10.7% of cannabis-attributable visits between 2014 and 2016 but represented only 0.32% of total cannabis sales in Colorado (in kilograms of tetrahydrocannabinol) during that period.

Limitation: Retrospective study design, single academic center, self-reported exposure data, and limited availability of dose data.

Conclusion: Visits attributable to inhaled cannabis are more frequent than those attributable to edible cannabis, although the latter is associated with more acute psychiatric visits and more ED visits than expected.

Primary funding source: Colorado Department of Public Health and Environment.

Figures

Flow chart of visit selection and review.

ED = emergency department; ICD = International Classification of Diseases.

Figure 2.. Exposure to edible and inhalable cannabis products in cannabis-attributable visits at UCHED from 2012 to 2016.

Error bars indicate 95% CIs. UCHED = UCHealth University of Colorado Hospital Emergency Department.

Source: Acute Illness Associated With Cannabis Use, by Route of Exposure: An Observational Study – PubMed (nih.gov) March 2019

Filed under: Brain and Behaviour,Cannabis/Marijuana,Health :

Source: Drugwatch International 2018

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

Abstract
Background—As an increasing number of states liberalize cannabis use and develop laws and local policies, it is essential to better understand the impacts of neighborhood ecology and marijuana dispensary density on marijuana use, abuse, and dependence. We investigated associations between marijuana abuse/dependence hospitalizations and community demographic and environmental conditions from 2001–2012 in California, as well as cross-sectional associations between local and adjacent marijuana dispensary densities and marijuana hospitalizations.

Source: Drug Alcohol Depend. 2015 September 1; 154: 111–116. doi:10.1016/j.drugalcdep.

Filed under: Cannabis/Marijuana,Drug Specifics,Drug use-various effects,Health,Legal Sector,Social Affairs,USA :

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Authors:

Albert Stuart Reece, Moira Sim, Gary Kenneth Hulse

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

Researchers found smoking infrequently carries a high risk of schizophrenia
Cannabis use less than twice a week was as risky as smoking the drug daily
Comes after psychiatric admissions for cannabis use soared in Scotland

Teens who occasionally use cannabis are just as likely to develop schizophrenia as daily smokers, a study has claimed. Researchers in the Caribbean reviewed more than 590 papers looking at cannabis use in children aged 12 to 18. Smoking the drug at low frequencies came with the same six-fold increased risk of getting the mental disorder as doing it daily, results showed. Rates of schizophrenia in both groups were compared against non-smokers. Experts warned it is vital teenagers avoid using the drug while their brains are still developing. NHS figures show cannabis use in people aged 16 to 24 is rising in England and Wales, with 32.6 percent admitting having used it in 2020, compared to 30.2 per cent in 2016. It comes after data revealed psychiatric hospital admission among cannabis users soared 74 per cent since the drug was effectively decriminalised in Scotland. Scottish police changed its guidance in January 2016 so anyone found possessing cannabis could be issued with a warning rather than face prosecution. The number of prosecutions halved over the period. Last year, a record 1,263 patients in Scotland sought NHS treatment for psychiatric disorders blamed on cannabis, including schizophrenia.

The review, published in Journal of Clinical Psychology, included 591 studies from 2010 and 2020 about cannabis use in adolescents from across the globe. They classified cannabis users into two groups: low frequency users — smoking twice a week or less — and higher frequency users — who smoke daily or nearly every day. Using statistical analysis, they compared the groups’ chances of developing schizophrenia compared to teenagers who never smoked the drug. The chances of getting the mental disorder were six times higher in both groups, the researchers said. They did not specify how long it usually takes to develop the disorder after smoking. It tends to occur in men in their late teens and early 20s, and in the late 20s to early 30s in women — although it can develop at any age for either gender.

Writing in the article, the researchers said: ‘Both high- and low-frequency marijuana usage were associated with a of schizophrenia. ‘The frequency of use among high- and low-frequency users is similar in both, demonstrating statistically significant increased risk in developing schizophrenia.’

Adam Winstock, the founder of the Global Drugs Survey and honorary professor of clinical medicine at University College London, said the study showed the need for caution around cannabis use at younger ages. He told the Daily Telegraph: ‘If you want to optimise your health and wellbeing and minimise your risk of developing psychotic illnesses, don’t use drugs when you are young. ‘Grow your brain before you expand it.’

The researchers were based in the Saint James School of Medicine in Arnos Vale, St Vincent and the Grenadines. The country last month made its first ever shipment of medical cannabis to Germany, sending 110lb (49.8kg) worth of the drug. The Caribbean nation with a population of just over 110,000 people has been developing its local cannabis industry for years. In 2018, Saint Vincent created a state agency to oversee licensing and ensure its medical cannabis is available to local patients.

It comes after a host of research further bolstered the link between cannabis use and psychological disorders, including schizophrenia. One US study found that cannabis-linked psychosis admissions are 2.5 times higher in areas where the drug has been legalised.

And official NHS figures show psychiatric hospital admissions for cannabis users rocketed from 1,191 in 2015 to 2016 to 2,067 last year. Professor Jonathan Chick, of Castle Craig Hospital, a private rehabilitation centre in Peeblesshire, said lawmakers have taken their eyes ‘off the ball’ with cannabis legislation. He said the number of young people suffering psychosis and schizophrenia because of cannabis use is a ‘worry’.

NHS figures show cannabis use in people aged 16 to 24 is rising in England and Wales, with 32.6 percent admitting having used it in 2020, compared to 30.2 per cent in 2016.

Graph shows: Drug use in different ages in England and Wales over time

Despite numerous studies linking the two, scientists have yet to firm up exactly how the drug may lead to the condition. And other research has suggested the drug itself may not be enough to cause serious mental disorders.

A separate study by Harvard researchers in 2014 of cannabis users with and without a family history of schizophrenia suggested cannabis use alone does not result in the disorder. The risk of developing the disorder was higher in those with a family history, regardless of cannabis use.

Dr Lynn DeLisi, one of the authors of the paper, told the New York Times at the time: ‘My study clearly shows that cannabis does not cause schizophrenia by itself. ‘Rather, a genetic predisposition is necessary. ‘It is highly likely, based on the results of this study and others, that cannabis use during adolescence through to age 25, when the brain is maturing and at its peak of growth in a genetically vulnerable individual, can initiate the onset of schizophrenia.’

Source: https://www.dailymail.co.uk/health/article-10467473/Teenagers-smoke-cannabis-six-times-likely-develop-schizophrenia-study-claims.html February 2022

Filed under: Cannabis/Marijuana,Drug use-various effects on foetus, babies, children and youth,Health,Youth :

Case for Caution with Cannabis

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

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

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

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

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

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

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

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

Source: Email: sreece@bigpond.net.au

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

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

The use of cannabis in Colorado can be determined from the SAMHSA National Survey on Drug Use and Health. A close correlation is noted between major congenital anomaly rates and rates of cannabis use in Coloradans >12 years (R=0.8825; P=0.000029; Figure 1). Although data is not strictly comparable across U.S. registries, the Colorado registry is a passive rather than active case-finding registry and so might be expected to underestimate anomaly rates. Given the Colorado birth rate remained almost constant over the period 2000-2013, rising only 3.6%, a simple way to quantitate historical trends is to simply project forwards the historical anomaly rate and compare it to the rise in birth numbers. However rather than remaining relatively stable in line with population births, selected defects have risen several times more than the birth rate.

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

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

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

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

Source :

Albert Stuart Reece

39 Gladstone Rd.,

Highgate Hill,

Brisbane, Queensland, Australia.

Filed under: Cannabis/Marijuana,Drug Specifics,Health,Social Affairs :

As recreational marijuana dispensaries prepare to open in Massachusetts, you may be wondering whether it’s safe to indulge. Is pot good or bad for your health?

As recreational marijuana dispensaries prepare to open in Massachusetts, you may be wondering whether it’s safe to indulge. Is pot good or bad for your health?

You’ll find no shortage of anecdotes and opinions in answer to that question.

But if you want the verdict of hard science, you’re pretty much out of luck.

Although marijuana has been studied in many ways over many years, the studies vary in quality and often reach conflicting conclusions, according to experts on the issue.

Forget yesterday’s news. Get what you need today in this early-morning email.

“We’re in a situation where policy is running ahead of the science,” said Neal Shifman, chief executive of Advocates for Human Potential, a consulting group that organizes national conferences to discuss cannabis policy and science. “There’s a hunger in the marketplace for real information.”

The federal Drug Enforcement Administration classifies marijuana as among the most dangerous drugs, making it very difficult for researchers to obtain the plant for study. Nearly all the research to date involves either purified ingredients from the cannabis plant or smoked marijuana.

But marijuana has dramatically increased in potency in recent years. And today, people can rub marijuana oils on the skin, inhale highly concentrated cannabis vapors, or munch on pot-infused candies and cookies. The effects of the drug consumed in these ways have not been studied.

Amid the uncertainty, discussions tend toward pro-or-con polarization, said Dr. Kevin P. Hill, director of addiction psychiatry at Beth Israel Deaconess Medical Center.

“There are still many, many people who spend a lot of energy trying to make cannabis a simple topic — ‘the greatest medication ever’ or ‘if you use it you’re doomed,’ ” Hill said. “Neither of those is true.”

So what is true?

“If you use cannabis today, we’re pretty sure about what it can do to you,” Hill said, ticking off impairment of judgment, learning, memory, attention, and physical performance, and raising your heart rate. These reactions wear off within a day or so, he said.

But when it comes to long-term effects, the answers get murky.

A couple of years ago, the National Academies of Sciences, Engineering, and Medicine reviewed 10,000 studies of marijuana’s health effects. The result: Conclusive or substantial evidence could be found for only a handful of findings, meaning that several good studies support the finding and few refute it.

These are the beneficial effects that the National Academies concluded are supported by strong evidence:

■ Cannabis helps relieve chronic pain.

■ A cannabis ingredient (cannabidiol) taken orally reduces vomiting from chemotherapy and eases painful muscle spasms in people with multiple sclerosis.

The academies also found strong evidence that these negative effects occur more frequently among people who use marijuana:

■ the development of schizophrenia or other psychoses in adolescents;

■ an increased risk of motor vehicle crashes;

■ lower birth weight when the mother smokes during pregnancy;

■ worse respiratory symptoms and more frequent bronchitis in long-term users.

Many experts also agree that adolescents and adults younger than 25 should avoid marijuana because it can alter their developing brains.

One other effect is known for sure about marijuana, added Susan Weiss, director of the Division of Extramural Research at the National Institute on Drug Abuse: It can be addictive. About 9 percent of regular users develop cannabis use disorder; that goes up to 17 percent among people who start when they’re young.

Research limitations

Marijuana contains hundreds of chemical compounds, the most powerful of which are delta-9-tetrahydrocannabinol, or THC, and cannabidiol, or CBD.

THC produces the psychoactive effects — the marijuana high. CBD has a role in pain control and also moderates the effect of THC. But many strains of marijuana in use today have high concentrations of THC and little CBD to balance it. The long-term effects of this shift are unknown.

Last month, the Food and Drug Administration approved a purified form of CBD as a treatment for two rare forms of severe epilepsy in children, the first time it approved a marijuana ingredient as a therapeutic drug.

(Two synthetic forms of THC, dronabinol and nabilone, are approved for treating nausea and vomiting from chemotherapy.)

Because of the federal restrictions, researchers’ only legal source for study is a Mississippi farm. But the marijuana plants there are not necessarily identical to those that people get at the dispensary or on the street.

Research typically consists of comparing marijuana users with those who abstain. But the most that such studies can show is a correlation with certain outcomes, not a causal connection.

For example, some studies indicate that people who started heavy cannabis use as teens have lower educational and employment achievement and lower income than those who avoided the drug.

That doesn’t necessarily mean that marijuana directly causes those impairments, though it might have a role. The lower performance might also result from other factors in the lives of people who happen to smoke marijuana — and the marijuana smoking may even be a result of those factors rather than their cause.

The better-designed studies control for confounding factors, such as excluding people who use other drugs or have mental health issues. But even those studies still only show elevated risk — not destiny for everyone who smokes pot.

With such obstacles and ambiguities, the research yields a host of suggestive findings and unanswered questions. Among them:

Brain development

Staci Gruber, director of McLean Hospital’s Marijuana Investigations for Neuroscientific Discovery project, said her work and that of others suggests that heavy marijuana use starting before age 16 may result in difficulty with abstract reasoning, impulsivity, and problem-solving. Imaging tests show the brain structure changes, resulting in “a different pattern of cognitive performance,” she said.

But it appears these effects can be mitigated by stopping or reducing consumption, and the same effects are not seen in people who start later in life or who consume moderate amounts.

And not every pot-smoking teenager is severely damaged. “Most of these kids are doing just fine,” Gruber added.

In older patients who use marijuana for medical reasons, Gruber has observed the opposite — an improvement in cognitive functioning within three months of starting cannabis use. Perhaps people’s minds clear up when freed of pain or anxiety, or when they stop taking opioids or tranquilizers. But cannabis might also directly improve mental functioning in older people.

Pregnancy

Studies show a clear link between smoking marijuana while pregnant and lower birth weight. Otherwise, the National Academies deemed it “unclear” whether smoking marijuana affects the pregnancy or the child after birth.

But Weiss, of the National Institute on Drug Abuse, is worried about indications that children whose mothers used cannabis while pregnant have alterations in brain structure and exhibit behavioral problems as they enter school.

Mental health

Substantial evidence shows that smoking marijuana as a teen increases the risk of psychosis, particularly for those with a family history of schizophrenia or other psychotic illnesses. Otherwise, the studies are inconclusive to the point of being confusing.

People with psychotic disorders who use cannabis seem to do better on learning and memory tasks. But they also may hallucinate more.

Many people with anxiety or mood disorders use cannabis, but any relationship is murky. People may smoke marijuana to treat the symptoms of a mental disorder, or other factors may lead to both marijuana use and mental illness.

Still, some evidence suggests that regular cannabis use might increase the risk for developing an anxiety disorder, and it might also worsen the symptoms of bipolar disorder and increase thoughts of suicide.

The lungs

Regular smoking is associated with chronic cough and phlegm production. Quitting seems to resolve those problems. The National Academies couldn’t find clear evidence on its effect on other lung diseases.

But Suzaynn Schick, who studies the chemistry and toxicity of smoke at the University of California San Francisco, believes the same health effects seen with tobacco, including the hazards of secondhand smoke, will eventually come to light.

“It doesn’t matter whether you’re burning tobacco, wood, diesel, or marijuana. When you burn things, you create toxins,” she said. “Cannabis can be a medicine, but smoking it is a really stupid way to get your medicine.”

Source: https://www.bostonglobe.com/opinion/2018/07/24/the-dangers-pot July 2018

Filed under: Cannabis/Marijuana,Drug Specifics,Drug use-various effects,Health :

Abstract

Background

Epigenetic modifications of a gene have been shown to play a role in maintaining a long‐lasting change in gene expression. We hypothesize that alcohol’s modulating effect on DNA methylation on certain genes in blood is evident in binge and heavy alcohol drinkers and is associated with alcohol motivation.

Methods

Methylation‐specific polymerase chain reaction (PCR) assays were used to measure changes in gene methylation of period 2 (PER2) and proopiomelanocortin (POMC) genes in peripheral blood samples collected from non-smoking moderate, non-binging, binge, and heavy social drinkers who participated in a 3‐day behavioral alcohol motivation experiment of imagery exposure to either stress, neutral, or alcohol‐related cues, 1 per day, presented on consecutive days in counterbalanced order. Following imagery exposure on each day, subjects were exposed to discrete alcoholic beer cues followed by an alcohol taste test (ATT) to assess behavioral motivation. Quantitative real‐time PCR was used to measure gene expression of PER2 and POMC gene levels in blood samples across samples.

Results

In the sample of moderate, binge, and heavy drinkers, we found increased methylation of the PER2 and POMC DNA, reduced expression of these genes in the blood samples of the binge and heavy drinkers relative to the moderate, non-binge drinkers. Increased PER2 and POMC DNA methylation was also significantly predictive of both increased levels of subjective alcohol craving immediately following imagery (p < 0.0001), and with presentation of the alcohol (2 beers) (p < 0.0001) prior to the ATT, as well as with alcohol amount consumed during the ATT (p < 0.003).

Conclusions

These data establish significant association between binge or heavy levels of alcohol drinking and elevated levels of methylation and reduced levels of expression of POMC and PER2 genes. Furthermore, elevated methylation of POMC and PER2 genes is associated with greater subjective and behavioral motivation for alcohol.

Source: https://doi.org/10.1111/acer.13932 31^st December 2018

Filed under: Alcohol,Brain and Behaviour,Drug use-various effects,Health :

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Abstract

Cannabidiol (CBD) and cannabidivarin (CBDV) are natural cannabinoids which are consumed in increasing amounts worldwide in cannabis extracts, as they prevent epilepsy, anxiety, and seizures. It was claimed that they may be useful in cancer therapy and have anti-inflammatory properties. Adverse long-term effects of these drugs (induction of cancer and infertility) which are related to damage of the genetic material have not been investigated. Therefore, we studied their DNA-damaging properties in human-derived cell lines under conditions which reflect the exposure of consumers. Both compounds induced DNA damage in single cell gel electrophoresis (SCGE) experiments in a human liver cell line (HepG2) and in buccal-derived cells (TR146) at low levels (≥ 0.2 µM). Results of micronucleus (MN) cytome assays showed that the damage leads to formation of MNi which reflect chromosomal aberrations and leads to nuclear buds and bridges which are a consequence of gene amplifications and dicentric chromosomes. Additional experiments indicate that these effects are caused by oxidative base damage and that liver enzymes (S9) increase the genotoxic activity of both compounds. Our findings show that low concentrations of CBD and CBDV cause damage of the genetic material in human-derived cells. Furthermore, earlier studies showed that they cause chromosomal aberrations and MN in bone marrow of mice. Fixation of damage of the DNA in the form of chromosomal damage is generally considered to be essential in the multistep process of malignancy, therefore the currently available data are indicative for potential carcinogenic properties of the cannabinoids.

Source: 10.1007/s00204-018-2322-9

Filed under: Drug Specifics,Health :

Government warnings about fentanyl hitting UK streets have inadvertently sparked a demand for the deadly opioid among drug users, a community leader has told IBTimes UK.

Last month, the National Crime Agency (NCA) revealed that 60 drug deaths had been linked to fentanyl and its cousins, including the elephant tranquilizer carfentanyl, since December 2016.

This followed a warning in April from Public Health England (PHE) that the synthetic opiates, which are 50 to 10,000 times stronger than heroin, were being mixed with the street drug.

But these announcements have merely whetted the appetite of some heroin users, according to Martin McCusker, chair of the Lambeth Service User Council, a support network for drug users in south London.

“The warnings have generated a lot of interest among drug users who think ‘wow – this fentanyl stuff is sh*t cool – it must be really strong’,” he said.

McCusker said he was not surprised by the response of his peers when they learned that fentanyl, which is ravaging communities across North America, was becoming more prevalent in this country.

“We get these warnings about overdoses but that’s not what we hear,” he said, adding that a drug user’s typical thought process might be: “Wow, people are overdosing in Wandsworth. Oh right, they must have good gear in Wandsworth.”

As little as 0.002g of fentanyl and 0.00002g of carfentanyl – a few grains – can be fatal. When dealers mix this with heroin the resultant product may contain “hotspots” – unintended concentrations of the more potent substances.

People experiencing an opioid overdose effectively forget to breathe as their respiratory systems shut down.

McCusker acknowledged agencies’ predicaments when it comes to safeguarding drug users without giving harmful substances undue publicity.

But he said the government warnings, combined with media coverage about the spate of fentanyl-related deaths in the UK, had acted as “adverts” for the extra-strong painkiller, which killed the pop musician Prince.

“It’s not that people want fentanyl. It’s that people want stronger opioids and if fentanyl comes along then great,” he said. “Just today I was talking to this guy and he said ‘this dealer in [redacted] estate has got fentanyl.'”

McCusker claimed fentanyl was not being discussed among people who use heroin in the Brixton area until about six months ago, when reports of it being mixed with UK street supplies hit the mainstream press.

Recent interventions from government agencies had only heightened the buzz surrounding the drug, he added.

A spokesperson for PHE said: “The alert we put out was aimed primarily at emergency, medical and other frontline professionals. But we are aware that the decision about whether, and when, to issue an alert about a dangerous drug is a delicate balance between informing the right people to prevent overdoses and not driving demand for it.”

No UK opioid epidemic – for now

At least 60 drug-related deaths have been linked to fentanyl and its analogues in the last eight months, according to figures released by the NCA at a briefing on 31 July. That number refers to cases where the substances showed up in toxicology reports and does not mean they were the outright cause of death.

The synthetic substances, largely imported from Chinese manufacturers, were not instrumental to the recent surge in UK opiate deaths, which jumped from 1,290 in 2012 to 2,038 in 2016. That rise has been attributed to an ageing heroin-using population more prone to underlying health problems, and the increased purity of street heroin.

McCusker pointed out that it was impossible for users to know they were buying fentanyl-laced heroin “unless you’ve got an amazing drug testing kit at home”. He said that some of the excitement surrounding fentanyl was “just hype”.

NCA Deputy Director Ian Cruxton told reporters at the July briefing he was “cautiously optimistic” that the UK heroin market would not be flooded with fentanyl.

He said there had been a significant reduction in fentanyl-related deaths after major busts on mixing ‘labs’ in Leeds and Wales as well as the seizure of dark web marketplaces Alpha Bay and Hansa by law enforcement agencies.

In an April briefing paper, the NCA said: “We have not seen any evidence to date of UK heroin users demanding fentanyl-laced heroin.” McCusker’s testimony suggests the tide may have turned.

Source: https://www.ibtimes.co.uk/heroin-addicts-now-want-fentanyl-after-government-campaign-advertises-how-much-stronger-it-1634152 August 2017

Filed under: Crime/Violence/Prison,Health,Heroin/Methadone,Synthetics :

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: https://www.familyfirst.org.nz/?s=In+addition+to+smoking+a+joint+

Filed under: Drug use-various effects,Health,New Zealand :

Realizing you have a drinking problem and deciding to quit are the first two steps of recovery, and for some people, they are the hardest. So, if that’s where you are in your journey right now, know you’re not alone and that you can claim your life back from a destructive addiction.

Once you’ve decided to quit drinking, you must commit to staying sober, despite any temptations or triggers you might come across. This is much more practical when you have support from therapy, a church group, friends who don’t drink, and/or any other kind of system that motivates you and helps you to stay accountable.

It’s also essential that you add meaningful and enjoyable things to your life that don’t involve drinking, and that you move your life forward so that you can thrive. This article will provide some tips on how to get on with your life while recovering from alcohol abuse.

Get Car Insurance

One of the first things to get in order will be your car insurance (if you don’t have any), as you won’t be able to legally drive without it. If your policy lapsed due to having your license suspended, try going to your former insurance company for coverage. If they won’t work with you, you will need to look around at other companies. Sometimes, a lapse in coverage means that it’s too high a risk for standard companies to insure you. However, there are companies that specialize in insuring higher-risk drivers, though you can expect higher premiums.

Surround Yourself with Support

One of the most important aspects of staying sober is hanging around people who help you in your mission. While therapy, treatment, and church can prove invaluable, so can spending time with non-drinking friends. This is because it helps to break social connections with alcohol and normalize sobriety, and friends can keep you accountable on your journey. Plus, boredom can easily lead to relapse, and doing things with people will help prevent that from happening.

Improve Your Diet

What you eat obviously has a lot to do with your physical health, which plays a major role in your mental and emotional health. Start being conscious of your diet — maximizing fruits, vegetables, lean proteins, and healthy fats, while limiting sugar, sodium and saturated fats. You should also make mood-boosting foods like kale, eggs, spinach, nuts, and wild salmon a part of your diet. If it’s easier for you, just start by replacing one meal a day with a healthier option than you normally would consider, and build from there.

Get Fit

Physical activity is also important. Not only does regular exercise yield long-term health benefits, but it also provides short-term benefits. The endorphins released during exercise creates a sense of reward in the brain, which can instantly boost your mood, reduce stress, and make you feel productive. Also, exercise is known to reduce anxiety and depression symptoms, as well as promote better sleep.

Set New Goals

Finally, in order to move past your addiction, you have to move forward in your life. Think of where you want to be in the future, and start setting goals. This could include goals to start a new career, progress in your current career, or go back to school. It can also include goals for repairing and developing relationships, learning new activities or skills, or any other number of things. Take advantage of your commitment to change by setting and focusing on new goals.

Recovering from alcohol addiction is not easy, but the rewards far outweigh the struggle. Be sure to look into your car insurance, and start hanging around positive, non-drinking friends. Prioritize your physical health to boost your mental and emotional health, and set new goals for your future. Most importantly, have grace on yourself, and try to maintain a positive outlook throughout your journey through addiction recovery.

Source: Ryan Randolph Recovery Proud November 2019

Filed under: Health,Treatment and Addiction :

A. Benjamin Srivastava, MD

Mark S. Gold, MD

The opioid epidemic is the most important and most serious public health crisis today. The effects are reported in overdose deaths but are also starkly evident in declines in sense of well-being and general health coupled with increasing all-cause mortality, particularly among the middle-aged white population. As exceptionally well described by Rummans et al in this issue of Mayo Clinic Proceedings, the cause of the epidemic is multifactorial, including an overinterpretation of a now infamous New England Journal of Medicine letter describing addiction as a rare occurrence in hospitalized patients treated with opioids, initiatives from the Joint Commission directed toward patient satisfaction and the labeling of pain as the “5th vital sign,” the advent of extended-release oxycodone (OxyContin), an aggressive marketing campaign from Purdue Pharma L.P., and the influx of heroin and fentanyl derivatives.

To date, most initiatives directed toward fighting the opioid initiatives, and the focus of the discussion from Rummans et al, have targeted the “supply side” of the equation. These measures include restricting prescriptions, physician drug monitoring programs, and other regulatory actions. Indeed, although opioid prescriptions have decreased from peak levels, the prevalence of opioid misuse and use disorder remains extremely prevalent (nearly 5%). Further, fatal drug overdoses, to which opioids contribute to a considerable degree, continue to increase, with 63,000 in 2016 alone. Thus, although prescription supply and access are necessary and important, we need to address the problem as a whole. To this point, for example, the ease of importation and synthesis of very cheap and powerful alternatives (eg, fentanyl and heroin) and the lucrative US marketplace have contributed to the replacement pharmacy sales and diversion with widespread street-level distribution of these illicit opioids; opioid-addicted people readily switch to these illicit opioids.

A complementary and necessary approach is to target the “demand” side of opioid use, namely, implementation of preventive measures, educating physicians, requiring physician continuing education for opioid prescribing licensure, and addressing why patients use opioids in the first place. Indeed, prevention of initiation of use is the only 100% safeguard against addiction; however, millions of patients remain addicted, and they need comprehensive, rather than perfunctory, treatment. Rummans and colleagues are absolutely correct in their delineation of the unwitting consequences of a focus on pain, given that a perceived undertreatment of pain fueled the opioid epidemic in the first place. They are correct to point out how effective pain evaluation and treatment are much more than prescribing and should routinely include psychotherapy, interventional procedures, and nonopioid therapies. In addition, we have described the crossroads between pain and addiction as well as successful strategies to manage patients with both chronic pain syndromes and addiction.

Rummans and colleagues also mention much needed dissemination of medication-assisted treatment (MAT; eg, methadone and buprenorphine) and the opioid overdose medication naloxone, and we agree with both of these measures. However, in addressing the demand side of the opioid epidemic, the focus must be much more comprehensive. Viewing opioid addiction as a stand-alone disease without consideration of other substance use or comorbid psychiatric pathology provides only a limited perspective. Rather, dual disorders are the rule and not the exception, and thus addiction evaluation and treatment should also specifically focus on psychiatric symptomatology and comorbidity. Epidemiological evidence indicates that over 50% of individuals with opioid use disorder meet criteria for concurrent major depressive disorder.Recent evidence from Cicero and Ellis indicates that the majority of opioid-addicted individuals seeking treatment indicate that their reasons for use are for purposes of “self-medication” and relief of psychiatric distress. To expand on this concept, we have suggested that drugs, by targeting the nucleus accumbens, alter motivation and reinforcement circuits and change brain reward thresholds; this change results in profound dysphoria and anhedonia, which, in turn, lead to further drug use.

Obviously, then, opioid addiction treatment should focus on diagnosing and assessing psychiatric comorbidity and monitoring of affective states and other depressive symptoms. However, a bigger problem might be the pretreatment phase, considering that, as Rummans et al note, only 10% of patients with opioid use disorder receive any treatment at all. Resources have principally been devoted to mitigating the effects of acute opioid toxicity both before and during intervention in the emergency department. A principal means of medical stabilization has been overdose reversal with the μ-opioid receptor antagonist naloxone, and efforts have been largely focused on dissemination of this agent. However, while increased naloxone use among the lay public, first responders, and medical personnel has been successful in reducing deaths, recidivism is high and increased naloxone use has not affected the problem as a whole. Generally, when patients present to the emergency department, clinical experience dictates that opioid overdoses are considered accidental until proven otherwise, which, after stabilization, allows the physician to discharge the medically stable patient, the hospital to collect reimbursement, and the pharmaceutical company to raise prices (eg, naloxone prices increased by 400% from 2014 to 2016, for autoinjection formulations).

In addition to the substantial costs associated with repeated naloxone administration and emergency department visits, recidivism is inextricably linked with another problem—the reason for overdose in the first place is not addressed. As mentioned earlier in this editorial, depression prevalence is high in patients with opioid use disorders. Strikingly, using nationwide data from US poison control centers, West et al found that over 65% of opioid overdoses reported were indeed suicide attempts, and of completed overdoses, the percent of those characterized as suicides climbed to 75%. Thus, an “inconvenient truth” may be that many of these opioid overdoses presenting to emergency departments may be unrecognized suicide attempts and that many of the over 66,000 deaths may indeed be completed suicides. Thus, comprehensive evaluation and treatment become even more relevant.

Clearly, more thorough evaluations in emergency departments with comprehensive risk assessments are needed, especially given that these patients may be guarded about suicidal ideation in the first place. Indeed, efforts to initiate buprenorphine in the emergency department, which independently is being investigated for its therapeutic effects on suicidal ideation, have spread; however, while abstinence outcomes are favorable at 30 days, the therapeutic benefit seems to disappear at both 6 months and 1 year. This failure of opioid reversal treatment is important, especially given that at 1 year, 15% of patients rescued with naloxone had died. Additionally, lack of psychiatric services and overcrowding at many emergency departments may preclude a comprehensive evaluation; however, target screening of all high-risk patients may identify patients with even hidden suicidal ideation and allow for appropriate triage.

Most addiction treatment today is centered around time-limited settings without adequate follow-up. Although MAT is an important addition to treatment for opioid addicts, it is generally not sufficient for long-term sobriety given (1) the relatively high rates of immediate and short-term treatment discontinuation and (2) that patients rarely are using just opioids. In fact, regarding long-term outcomes, methadone may be the only MAT treatment that demonstrates superior abstinence rates, safety, opioid overdose prevention, and treatment retention. We recommend that future studies include random assignment to different treatment modalities, assessing abstinence with urine testing and other modalities, psychosocial outcomes, and overall level of functioning for 5 years.

In terms of treatment, we suggest a continuing care approach, viewing addiction as a chronic, relapsing disease, but higher quality data are needed. For example, in most states, physicians with substance use disorders who are referred for treatment indeed undergo evaluation and detoxification, but they are also monitored for 5 years with frequent drug testing, contingency management, evaluation and treatment of comorbid psychiatric issues, and mutual support groups. Outcomes are generally superior, with 5-year abstinence and return to work rates approaching 80%. Notably, most of these programs do not allow MAT, yet opioid-addicted physicians do as well in the structured, supportive, long-term care model as physicians addicted to other substances. Obviously, the threat of professional license sanctions may impel physicians to comply with treatment, but many of the aforementioned strategies including contingency management, long-term follow-up, comprehensive psychiatric evaluation, and mutual support have demonstrable evidence for addiction treatment in general.

More resources need to be devoted to addressing the opioid epidemic, particularly on the prevention and also the demand side. Access to treatment is important, but more investment is needed in improving treatment including implementing 5-year comprehensive care programs. Thus, we recommend that future studies involve random assignment to different treatment groups, focusing on urine drug test–confirmed abstinence, psychosocial outcomes, and overall functioning. Additionally, advances in neuroscience may allow for the development of novel therapeutics targeting specific neurocircuitry involved in reward and motivation (ie, moving beyond the single receptor targets). A parallel can be drawn to the AIDS epidemic, in which massive basic science investments yielded novel effective therapies, which have now become standard of care and one of the world’s great public health successes. Resources focused on these interventions and reinvigorating drug education and prevention may prove fruitful in addressing this devastating epidemic. Further, lessons from this epidemic may help us move beyond a specific “one drug, one approach” so that for future epidemics, irrespective of the drug involved, we would already have in place a generalizable framework that utilizes the full repertoire of responses and resources.

Filed under: Health,Heroin/Methadone,Prevention and Intervention,Treatment and Addiction :

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

Filed under: Cannabis/Marijuana,Health,Nicotine :

After Lynley Graham’s custody photo was posted to a police force’s Facebook page, horrified users were quick to discuss the harmful effects of hard drugs

Deep lines etched across a woman’s face and cheeks sunken to the bone – this one shocking image illustrates the effects of substance abuse.

Lynley Graham’s custody picture has been released by Humberside Police after she was jailed for 18 months for drug offences.
Graham was found in possession of class A drugs, including heroin and cocaine, and was subsequently charged with possessing a class A drug with intent to supply, Grimsby Live reports.

After the photo was posted to Humberside Police’s Facebook page on Wednesday, users were quick to discuss the 53-year-old’s weathered appearance.

Before and after pictures show a striking physical transformation.

One said: “I’m 64, I look young compared to her. Is she a lesson, perhaps, in what substance abuse can do to your skin?”

Another added: “Let’s hope some young people look at her and see what a life of drugs does apart from ruining entire families.”

Drug addiction and misuse contributed to more than 2,500 UK deaths in 2017.

Inhalants can cause damage to the kidneys, liver and bone marrow, and persistent drug consumption can result in abscesses, tooth decay – known as ‘meth mouth’ in the United States.

Other symptoms include premature ageing of the skin, often adding decades to someone’s appearance.

Rehabs.com, a US-based charity, has also published startling images of drug users to demonstrate the long-term toll narcotics have on one’s appearance.

Drugs can damage almost every system in the body; bloodshot eyes, dilated pupils, puffy faces and discoloured skin are all noticeable signs.

Some users suffer a rapid physical deterioration – with facial appearances sometimes ruined in just a matter of years.

Self-inflicted wounds, common among consumers of methamphetamine, can be caused by users picking at their skin to relieve the sensation of irritation – sometimes described as like crawling insects.

And a skeletal appearance can be the result of appetite-suppression.

Cocaine can commonly lead to chronic skin ulcers, pus-filled skin and the development of Buerger’s disease – an inflammation in small and medium-sized blood vessels.

Heroin has been known to dry the skin, leaving addicts with itchy and aged skin.

In May, Sir Angus Deaton, a world-leading economist, warned that drug abuse and alcoholism claim more lives of those in middle-age than heart disease.

‘Economic isolation’ is cited as one of the biggest contributors.

In 2017, a poll of 1,600 adults found that almost nine in ten said that seeing the physical effects of hard drugs made them less likely to take them.

The publication of such images is a common tactic among anti-addiction campaigners.

Scotland is experiencing its own drug crisis, with a 27 per cent rise in drug-related deaths, according to official statistics.

It puts Scotland’s drug mortality rate three times higher than the UK as a whole, and higher than any other country in the European Union.

The NHS offer services for drug and alcohol recovery, as do outside agencies, such as Addaction

Source: https://www.mirror.co.uk/news/uk-news/shocking-image-illustrates-how-drugs-18790997 July 2019

Filed under: Cocaine,Drug use-various effects,Health,Heroin/Methadone,Methamphetamine/GHB/Hallucinogens/Oxycodone :

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

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

What do we want?

Our demands are simple:

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

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

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

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

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

An extraordinary murder in Ireland

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Violence and legalised cannabis in Uruguay: a clarification

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

Xixi Bi Llandaff murder: Jordan Matthews jailed for life

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

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

‘Cannabis made my boy a killer’

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

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

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

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

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

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

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

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

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

Teen faces one year for vicious attack on man outside takeaway

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

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

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

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

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

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

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

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

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

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

Filed under: Cannabis/Marijuana,Drug use-various effects,Health :

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

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

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

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

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

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

‘OPPORTUNITY LOST’

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

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

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

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

SOURCE: ANNA GORMAN, KAISER HEALTH NEWS 15TH FEB2019

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

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

Filed under: Brain and Behaviour,Cannabis/Marijuana,Crime/Violence/Prison,Drug use-various effects,Global Drug Legalisation Efforts,Health,Medical Studies :

People suffering from opioid addiction in New Jersey and the U.S. have been increasingly abusing Imodium, an over-the-counter anti-diarrhea medicine, to combat their withdrawal symptoms, experts say.
While Imodium and similar medications are harmless when taken at the recommended dose, experts say the medication can stop the heart if it’s taken at an extremely high dose.
Several fatal or near-fatal overdoses have been reported in New Jersey over the past year, said Diane P. Calello, executive and medical director of New Jersey Poison Information and Education System, which recently consulted on several cases.

Imodium’s active ingredient, loperamide, is actually an opioid. The poison control center said that while its effects do not get you high like other opioids (heroin, fentanyl, oxycodone), in extremely high doses it does “stimulate the brain in the same way.”
It’s been known for some years that people sometimes use loperamide to get high. But using it to alleviate opioid withdrawal symptoms is something experts have only begun to see within the past five years, Calello said.

“It’s become clear that people are increasingly using (loperamide) to avoid withdrawal,” she said.
While only a few people have died from loperamide overdoses in New Jersey in the past three years, Calello said, it’s becoming a growing problem in the state and nation. She worries that the lack of knowledge about the dangers of the medication may contribute to more deaths. A recent study of loperamide abuse, in which Calello was involved, tied the increasing misuse of the drug to the internet and online forums filled with people casually recommending it as a cheap and readily available alternative to legitimate opioid withdrawal medications like Suboxone, which requires a prescription.
While federal regulations require other medications prone to misuse, like Sudafed, to be purchased behind the counter at pharmacies, Imodium can be bought cheaply and in unlimited amounts.
Because of that, poison control officials are seeing people taking 100 or even 400 times the recommended dose, which can cause fatal heart rhythms and death, Calello said.

“If you take Imodium for diarrhea, you’re not going to have a problem. But if you take 100 times the therapeutic dose, this is what can happen: cardiac arrest,” she said.
Withdrawing from opioids is often an agonizing process. Calello said that may drive people in pain to do desperate and unusual things to alleviate their symptoms, particularly if they don’t have a prescription for legitimate medications.

“People with opioid abuse disorder, they have a significant problem with withdrawal,” she said. “It’s one of the primary burdens of that illness. It’s exceedingly uncomfortable, an insatiable craving for the drug … body aches, flu-like symptoms, vomiting. You feel awful. You can’t function.”
Calello believes the increasing misuse of loperamide should signal that some restrictions should be put into place.
She said too many people are dying. “I think it makes sense.”

Source: https://www.nj.com/healthfit/2019/01 8th Jan.2019

Filed under: Addiction,Drug use-various effects,Health,Prescription Drugs :

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 :

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

Filed under: Cannabis/Marijuana,Drug use-various effects,Drug use-various effects on foetus, babies, children and youth,Health :

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 (1/3^rd 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

Filed under: Brain and Behaviour,Cannabis/Marijuana,Economic,Health,Social Affairs :

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

Filed under: Cannabis/Marijuana,Drug use-various effects,Health :

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

Filed under: Cannabis/Marijuana,Health,Marijuana and Medicine :

The typical overdose victim is becoming younger and more urban

EVERY 25 minutes an American baby is born addicted to opioids. The scale of both use and abuse of the drugs in the United States is hard to overstate: in 2015, the most recent year for which figures are available, an estimated 38% of adults took prescription opioids. Of those, one in eight (11.5m people in total) misused their prescription. Around 1m Americans overdosed last year, and 64,000 of them died.

The scourge of opioid abuse gained political salience last year, as voters in parts of the country with high levels of drug overdoses swung strongly towards Donald Trump. The president has taken few steps to combat the opioid crisis since taking office, but on October 26th he is expected to direct his secretary of health and human services to declare a public-health emergency. His national drug commission is due to publish a report on November 1st recommending a mix of rehabilitation, awareness-building and policing as the best response the epidemic.

Politically, it stands to reason that Mr Trump would show interest in the opioid crisis, given that press reports paint the typical abuser as an archetypal older, rural Trump voter, perhaps with a prescription to treat back pain. Yet the government runs the risk of fighting the last war in its effort to quell the epidemic, because the causes and victims of drug overdoses in America are changing fast.

The number of deaths from prescription opioids has continued to rise, from around 11,000 in 2013 to 15,000 a year now. But the rate of growth has slowed, and many forecasters predict it may be nearing its peak. By contrast, the toll from fentanyl, a synthetic opioid 50 times stronger than heroin, is soaring. After claiming just 3,000 lives in 2013, it killed 22,000 people in America last year, more than either heroin or prescription opioids. Deaths from heroin have become far more frequent as well: after being roughly a quarter as common as fatal prescription overdoses in the mid-2000s, they overtook deaths from prescription opioids in 2015.

This change in the leading causes of opioid-related deaths has been accompanied by a shift in the profile of the average victim. The highest rates of prescription-opioid abuse can be found among middle-aged rural whites, including women. By contrast, both fentanyl and heroin users tend to be much younger, more likely to live in cities, somewhat more racially diverse and overwhelmingly male (see heat map above). Reaching people at high risk of exposure to these more potent opioids cannot be done by offering services to former Rust Belt factory workers or Appalachian coal miners, but will require a different approach.

Similarly, most media attention has focused on substance abuse in states Mr Trump won, such as West Virginia, Kentucky and Ohio. But blue states like Maryland, Delaware and Massachusetts also figure among the current top ten for deaths from drug overdoses. That means Mr Trump will need to extend the government’s efforts far beyond his electoral base if he hopes to address the opioid epidemic.

Source: https://www.economist.com/graphic-detail/2017/10/26/the-shifting-toll-of-americas-drug-epidemic October 2017

Filed under: Health,Heroin/Methadone,Political Sector,Prescription Drugs :

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

Filed under: Brain and Behaviour,Cannabis/Marijuana,Health :

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

Filed under: Cannabis/Marijuana,Health,Marijuana and Medicine,Social Affairs :

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

Filed under: Cannabis/Marijuana,Drug use-various effects on foetus, babies, children and youth,Global Drug Legalisation Efforts,Health,Medicine and Marijuana :

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

Filed under: Cannabis/Marijuana,Drug use-various effects,Health,Marijuana and Medicine,Political Sector :

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 :

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

Filed under: Brain and Behaviour,Cannabis/Marijuana,Health :

Researchers at the Centre for Addiction and Mental Health (CAMH) have identified 428 distinct disease conditions that co-occur in people with Fetal Alcohol Spectrum Disorders (FASD), in the most comprehensive review of its kind.

The results were published today in The Lancet.

“We’ve systematically identified numerous disease conditions co-occurring with FASD, which underscores the fact that it isn’t safe to drink any amount or type of alcohol at any stage of pregnancy, despite the conflicting messages the public may hear,” says Dr. Lana Popova, Senior Scientist in Social and Epidemiological Research at CAMH, and lead author on the paper. “Alcohol can affect any organ or system in the developing fetus.”

FASD is a broad term describing the range of disabilities that can occur in individuals as a result of alcohol exposure before birth. The severity and symptoms vary, based on how much and when alcohol was consumed, as well as other factors in the mother’s life such as stress levels, nutrition and environmental influences. The effects are also influenced by genetic factors and the body’s ability to break down alcohol, in both the mother and fetus.

Different Canadian surveys suggest that between six and 14 per cent of women drink during pregnancy.

The 428 co-occurring conditions were identified from 127 studies included in The Lancet review. These disease conditions, coded in the International Classification of Disease (ICD-10), affected nearly every system of the body, including the central nervous system (brain), vision, hearing, cardiac, circulation, digestion, and musculoskeletal and respiratory systems, among others.

While some of these disorders are known to be caused by alcohol exposure – such as developmental and cognitive problems, and certain facial anomalies – for others, the association with FASD does not necessarily represent a cause-and-effect link.

Problems range from communications disorders to hearing loss

However, many disorders occurred more often among those with FASD than the general population. Based on 33 studies representing 1,728 individuals with Fetal Alcohol Syndrome (FAS), the most severe form of FASD, the researchers were able to conduct a series of meta-analyses to establish the frequency with which 183 disease conditions occurred.

More than 90 per cent of those with FAS had co-occurring problems with conduct. About eight in 10 had communications disorders, related to either understanding or expressing language. Seven in 10 had developmental/cognitive disorders, and more than half had problems with attention and hyperactivity.

Because most studies were from the U.S., the frequency of certain co-occurring conditions was compared with the general U.S. population. Among people with FAS, the frequency of hearing loss was estimated to be up to 129 times higher than the general U.S. population, and blindness and low vision were 31 and 71 times higher, respectively.

“Some of these other co-occurring problems may lead people to seek professional help,” says Dr. Popova. “The issue is that the underlying cause of the problem, alcohol exposure before birth, may be overlooked by the clinician and not addressed.”

The benefits of screening and diagnosis

Improving the screening and diagnosis of FASD has numerous benefits. Earlier access to programs or resources may prevent or reduce secondary outcomes that can occur among those with FASD, such as problems with relationships, schooling, employment, mental health and addictions, or with the law.

“We can prevent these issues at many stages,” says Dr. Popova. “Eliminating alcohol consumption during pregnancy or reducing it among alcohol-dependent women is extremely important. Newborns should be screened for prenatal alcohol exposure, especially among populations at high risk. And alerting clinicians to these co-occurring conditions should trigger questions about prenatal alcohol exposure.”

“It is important that the public receive a consistent and clear message – if you want to have a healthy child, stay away from alcohol when you’re planning a pregnancy and throughout your whole pregnancy,” she says.

It’s estimated that FASD costs $1.8 billion annually in Canada, due largely to productivity losses, corrections and health care costs, among others.

In addition to this review, Dr. Popova has been part of an expert group of leading FASD researchers and clinicians working with the Ontario Ministry of Children and Youth Services on its new FASD strategy. Her team is also undertaking a study to determine how common FASD is in Canada, as well as in other countries in Eastern and Central Europe and Africa.

Provided by: Centre for Addiction and Mental Health

Source: https://m.medicalxpress.com/news/2016-01-conditions-co-occur-fetal-alcohol-spectrum.html January 2016

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

Narcotics experts are warning against dangerous drugs being mis-sold as MDMA.

According to reports from the UK, this substance can lead to psychosis and some users claim it has the ability to keep them awake for up to three days. These undesired side effects are not typical of MDMA or “Molly.”

Instead, this “fake MDMA” — drug N-Ethyl-Pentylone — is made three times as strong. It was first discovered in the US in 2016, which spread to Australia in 2017 and most recently has been found at the Manchester music festival, Parklife.

This drug has been linked to mass casualties around the world. Dr. David Caldicott, an expert in emergency medicine, explained the dangers of N-Ethyl-Pentylone as follows:

“It has been clearly responsible for the deaths of people overseas, and a rather unfortunate phenomenon known as ‘mass casualty overdoses’, where 10-20 people drop simultaneously. So, it’s of great concern to the music festival environment.”

While this was discovered in the UK, it’s possible for partakers to happen upon this in North America too, so please exercise every caution if you do take the risk of doing drugs at a show or festival this summer.

Source: https://www.youredm.com/2018/06/10/mdma-lookalike-drug-makes-its-way-into-festivals/ June 2018

Filed under: Drug use-various effects,Health,Synthetics :

Anybody wondering what happens to the 8 per cent of the skunk-smoking population who develop mental illness should visit any psychiatric hospital in Britain or speak to somebody who has done so What is really needed in dealing with cannabis is a “tobacco moment”, as with cigarettes 50 years ago, when a majority of people became convinced that smoking might give them cancer and kill them. Since then the number of cigarette smokers in Britain has fallen by two-thirds.

A depressing aspect of the present debate about cannabis is that so many proponents of legalisation or decriminalisation have clearly not taken on board that the causal link between cannabis and psychosis has been scientifically proven over the past ten years, just as the connection between cancer and cigarettes was proved in the late 1940s and 1950s.

The proofs have emerged in a series of scientific studies that reach the same grim conclusion: taking cannabis significantly increases the risk of schizophrenia. One study in The Lancet Psychiatry concludes that “the risk of individuals having a psychotic disorder showed a roughly three times increase in users of skunk-like cannabis, compared with those who never used cannabis”. As 94 per cent of cannabis seized by the police today is super-strength skunk, compared to 51 per cent in 2005, almost all those who take the drug today will be vulnerable to this three-fold increase in the likelihood that they will develop psychosis.

Mental health professionals have long had no doubts about the danger. Five years ago, I asked Sir Robin Murray, professor of psychiatric research at the Institute of Psychiatry in London, about them. He said that studies showed that “if the risk of schizophrenia for the general population is about one per cent, the evidence is that, if you take ordinary cannabis, it is two per cent; if you smoke regularly you might push it up to four per cent; and if you smoke ‘skunk’ every day you push it up to eight per cent”.

Anybody wondering what happens to this 8 per cent of the skunk-smoking population should visit any mental hospital in Britain or speak to somebody who has done so. Dr Humphrey Needham-Bennett, medical director and consultant psychiatrist of Cygnet Hospital, Godden Green in Sevenoaks, explained to me that among his patients “cannabis use is so common that I assume that people use or used it. It’s quite surprising when people say ‘no, I don’t use drugs’.”

The connection between schizophrenia and cannabis was long suspected by specialists but it retained its reputation as a relatively benign drug, its image softened by the afterglow of its association with cultural and sexual liberation in the 1960s and 1970s.

This ill-deserved reputation was so widespread that even 20 years ago, the possible toxic side effects of cannabis were barely considered. Zerrin Atakan, formerly head of the National Psychosis Unit at the Maudsley Psychiatric Hospital and later a researcher at the Institute of Psychiatry,

said: “I got interested in cannabis because I was working in the 1980s in an intensive care unit where my patients would be fine after we got them well. We would give them leave and they would celebrate their new found freedom with a joint and come back psychotic a few hours later.”

She did not find it easy to pursue her professional interest in the drug. She recalls: “I was astonished to discover that cannabis, which is the most widely used illicit substance, was hardly researched in the 1990s and there was no research on how it affected the brain.” She and fellow researchers made eight different applications for research grants and had them all turned down, so they were reduced to taking the almost unheard of course of pursuing their research without the support of a grant.

Studies by Dr Atakan and other psychiatrists all showed the connection between cannabis and schizophrenia, yet this is only slowly becoming conventional wisdom. Perhaps this should not be too surprising because in 1960, long after the link between cigarettes and lung cancer had been scientifically established, only a third of US doctors were persuaded that this was the case.

A difficulty is that people are frightened of mental illness and ignorant of its causes in a way that is no longer true of physical illnesses, such as cancer or even HIV. I have always found that three quarters of those I speak to at random about mental health know nothing about psychosis and its causes, and the other quarter know all too much about it because they have a relative or friend who has been affected.

Even those who do have experience of schizophrenia do not talk about it very much because they are frightened of a loved one being stigmatised. They may also be wary of mentioning the role of cannabis because they fear that somebody they love will be dismissed as a junkie who has brought their fate upon themselves.

This fear of being stigmatised affects institutions as well as individuals. Schools and universities are often happy to have a policy about everything from sex to climate change, but steer away from informing their students about the dangers of drugs. A social scientist specialising in drugs policy explained to me that the reason for this is because “they’re frightened that, if they do, everybody will think they have a drugs problem which, of course, they all do”.

The current debate about cannabis – sparked by the confiscation of the cannabis oil needed by Billy Caldwell to treat his epilepsy and by William Hague’s call for the legalisation of the drug – is missing the main point. It is all about the merits and failings of different degrees of prohibition of cannabis when it is obvious that legal restrictions alone will not stop the 2.1 million people who take cannabis from going on doing so. But the legalisation of cannabis legitimises it and sends a message that the government views it as relatively harmless. The very fact of illegality is a powerful disincentive for many potential consumers, regardless of the chances of being punished.

The legalisation of cannabis might take its production and sale out of the hands of criminal gangs, but it would put it into the hands of commercial companies who would want to make a profit, advertise their product and increase the number of their customers. Commercialisation of cannabis has as many dangers as criminalisation.

A new legal market in cannabis might be regulated and the toxicity of super-strength skunk reduced. But the argument of those who want to legalise cannabis is that the authorities are unable to enforce regulations when the drug is illegal, so why should they be more successful in regulating it when its production and sale is no longer against the law?

The problem with these rancorous but sterile arguments for and against legalisation and decriminalisation is that they divert attention from what should and can be done: a sustained campaign to persuade people of all ages that cannabis can send them insane. To a degree people are learning this already from bitter experience. As Professor Murray told me five years ago, the average 19- to 23-year-old probably knows more about the dangers of cannabis than the average doctor “because they have a friend who has gone paranoid. People know a lot more about bad trips than they used to.”

Patrick Cockburn is the co-author of Henry’s Demons: Living With Schizophrenia, A Father and Son’s Story

Home Secretary Sajid Javid: The government will carry out a review of the scheduling of cannabis for medicinal use

Filed under: Addiction,Brain and Behaviour,Cannabis/Marijuana,Drug use-various effects,Health,Marijuana and Medicine,Psychiatric drugs :

According to a Colorado Springs Gazette editorial about legalization in Colorado there has been a doubling of drivers involved in fatal crashes testing positive for marijuana. [1]

Marijuana significantly impairs driving including time and distance estimation and reaction times and motor coordination. [2] The National Highway Traffic Safety Administration lists marijuana as the most prevalent drug in fatally injured drivers with 28 % testing positive for marijuana. [3]

It is true that the crash risk for a driver on alcohol is higher than on marijuana. But to suggest it is safe to drive after using marijuana is irresponsible. An even greater danger is the combination of alcohol and marijuana that has severe psychomotor effects that impair driving. [4]

What about our kids? Vehicle crashes are the leading cause of death among those aged 16-25. [5] Weekend nighttime driving under the influence of marijuana among young drivers has increased by 48%. [6] About 13 % of high school seniors said they drove after using marijuana while only 10 % drove after having five or more drinks.[7] Another study showed about 28,000 seniors each year admitted to being in at least one motor vehicle accident after using marijuana. [8]

The marijuana industry is backing legalization. Do we want more dangerous drivers on our roads and dead kids so the industry can make money from selling marijuana?

References regarding DUI

[1] http://gazette.com/editorial-the-sad-anniversary-of-big-commercial-pot-in-colorado/article/1614900

[2] NHTSA, Use of Controlled Substances and Highway Safety; A Report to Congress (U.S. Dept. of Transportation, Washington, D.C., 1988)

[3] http://cesar.umd.edu/cesar/cesarfax/vol19/19-49.pdf

[4] https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6448a1.htm?s_cid=mm6448a1_w

[5] Ibid.

[6] Ibid

[7] https://archives.drugabuse.gov/news-events/news-releases/drug-impaired-driving-by-youth-remains-serious-problem

[8] “Unsafe Driving by High School Seniors: National Trends from 1976 to 2001 in Tickets and Accidents After Use of Alcohol, Marijuana and Other Illegal Drugs.” Journal of Studies on Alcohol. May 2003

LEGALIZING POT WILL CAUSE MORE OPIATE USE

Legalizing marijuana will cause more marijuana use. Marijuana use is associated with an increased risk for substance use disorders. [1] The interaction between the opioid and the cannabinoid system in the human body might provide a neurobiological basis for a relationship between marijuana use and opiate abuse.[2] Marijuana use appears to increase rather than decrease the risk of developing nonmedical prescription opioid use and opioid use disorder. [3] In 2017, the National Academy of Sciences (NAS) landmark report written by top scientists concluded after a review of over 10,000 peer-reviewed academic articles, that marijuana use is connected to progression to and dependence on other drugs, including studies showing connections to heroin use. [4]

New research suggests that marijuana users may be more likely than nonusers to misuse prescription opioids and develop prescription opioid use disorder. The investigators analyzed data from more than 43,000 American adults. The respondents who reported past-year marijuana use had 2.2 times higher odds than nonusers of meeting diagnostic criteria for prescription opioid use disorder. They also had 2.6 times greater odds of initiating prescription opioid misuse. [5]

Marijuana used as a medicine is being sold as reducing the need for other medicines. However, a new study shows that medical marijuana users were significantly more likely to use prescription drugs in the past 12 months. Individuals who used medical marijuana were also significantly more likely to report nonmedical use in the past 12 months of any prescription drug with elevated risks for pain relievers, stimulants and tranquilizers. [6]

References regarding opiates

[1] JAMA Psychiatry. 2016 Apr;73(4):388-95. doi: 10.1001/jamapsychiatry.2015.3229.

Cannabis Use and Risk of Psychiatric Disorders: Prospective Evidence From a US National Longitudinal Study. Blanco C1, Hasin DS2, Wall MM2, Flórez-Salamanca L3, Hoertel N4, Wang S2, Kerridge BT2, Olfson M2. https://www.ncbi.nlm.nih.gov/pubmed/26886046

[2] Cadoni C, Pisanu A, Solinas M, Acquas E, Di Chiara G. Behavioural sensitization after repeated exposure to Delta 9-tetrahydrocannabinol and cross-sensitization with morphine. Psychopharmacology (Berl). 2001;158(3):259-266. Available from: https://www.researchgate.net/publication/11640927_Behavioral_sensitization_after_repeated_exposure_to_D9-tetrahydrocannabinol_and_cross-sensitization_with_morphine

[3] Cannabis Use and Risk of Prescription Opioid Use Disorder in the United States, Mark Olfson, M.D., M.P.H., Melanie M. Wall, Ph.D., Shang-Min Liu, M.S., Carlos Blanco, M.D., Ph.D. Published online: September 26, 2017at: https://doi.org/10.1176/appi.ajp.2017.17040413

[4] Health Effects of Cannabis and Cannabinoids: Current State of Evidence and Recommendations for Research. See: http://nationalacademies.org/hmd/~/media/Files/Report%20Files/2017/Cannabis-Health-Effects/Cannabis-chapter-highlights.pdf

[5] https://www.drugabuse.gov/news-events/news-releases/2017/09/marijuana-use-associated-increased-risk-prescription-opioid-misuse-use-disorders

[6] Journal of Addiction Medicine, http://www.newswise.com/articles/view/693004/?sc=dwtn

MARIJUANA USE BEFORE, DURING OR AFTER PREGNANCY CAN CAUSE SERIOUS MEDICAL CONDITIONS, LEARNING PROBLEMS, AND BIRTH DEFECTS

Legalizing marijuana will cause more marijuana use among women of child bearing age. Prenatal marijuana use has been linked with:

1. Developmental and neurological disorders and learning deficits in children.

3. Premature birth, miscarriage, stillbirth.

4. An increased likelihood of a person using marijuana as a young adult.

5. The American Medical Association states that marijuana use may be linked with low birth weight, premature birth, behavioral and other problems in young children.

6. Birth defects and childhood cancer.

7. Reproductive toxicity affecting spermatogenesis which is the process of the formation of male gamete including meiosis and formation of sperm cells.

Moderate concentrations of THC, the main psychoactive substance in marijuana, when ingested by mothers while pregnant or nursing, could have long-lasting effects on the child, including increasing stress responsivity and abnormal patterns of social interactions. THC consumed in breast milk could affect brain development.

References regarding pregnancy

Volkow ND, Compton WM, Wargo EM. The risks of marijuana use during pregnancy. JAMA. 2017;317(2):129-130.

https://www.drugabuse.gov/publications/research-reports/marijuana/letter-director

https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Marijuana-Use-During-Pregnancy-and-Lactation

https://womenintheworld.com/2015/11/17/ama-pushes-for-regulation-on-pot-use-during-pregnancy/?refresh

http://omr.bayer.ca/omr/online/sativex-pm-en.pdf

https://www.cdc.gov/marijuana/pdf/marijuana-pregnancy-508.pdf

Risk of Selected Birth Defects with Prenatal Illicit Drug Use, Hawaii, 1986-2002, Journal of Toxicology and Environmental Health, Part A, 70: 7-18, 2007

Maternal use of recreational drugs and neuroblastoma in offspring: a report from the Children’s Ocology Group., Cancer Causes Control, 2006 Jun:17(5):663-9, Department of Epidemiology, University of North Carolina at Chapel Hill.

DO YOU CARE?

Do you care…about our Environment? Marijuana growing creates environmental contamination. [1]

Do you care…about Pedestrian and Motor Vehicle Deaths caused by marijuana impaired drivers?

Increased marijuana impaired driving due to the increased potency of THC creates more risk.[2]

Do you care…about Freedom of Choice? Cannabis Use Disorder destroys freedom of choice. [3]

Do you care…about Violence, Domestic Abuse and Child abuse? Oftentimes marijuana is reported in incidents of violence. Continued marijuana use is associated with a 7-fold greater odds for subsequent commission of violent crimes. [4]

Do you care…about Safety in the Workplace? Numerous professions and trades require alertness that marijuana use can impair. Employers experience challenges to requirements for drug free workplaces, finding difficulty in hiring with many failing marijuana THC drug tests. [5]

Do you care…about Substance Use Disorders and the growing Addiction Epidemic? Recent data suggest that 30% of those who use marijuana may have some degree of marijuana use disorder. That sounds small? 22,000,000 US marijuana users x 30% = over 6,000,000 with a marijuana use disorder. There is a link between adolescent pot smoking and psychosis. [6]

Do you care…about Suicide Prevention? Marijuana use greatly increases risk of suicide especially among young people. [7]

Do you care…about your Pets? Vets report increases in marijuana poisoned pets since normalizing and commercializing of marijuana. [8]

Do you care…about our Students and Schools? Normalization of marijuana use brought increased use to schools. Edibles and vaping have made use harder to detect. Colorado has had an increase in high school drug violations of 71% since legalization and school suspensions for drugs increased 45%. [9]

Do you care…about Racial Inequality? Marijuana growers and sellers typically locate in poorer neighborhoods and degrade the quality of the areas. Arrests of people of color have increased since drug legalization while arrests of Caucasians have decreased. [10].

Do you care…about Our Kids and Grandkids, the Next Generations? Help protect them by advocating for their futures. [11] Please oppose increasing the use of marijuana

References

[1] https://silentpoison.com/

[2] https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6448a1.htm?s_cid=mm6448a1_w

[3] https://www.drugabuse.gov/publications/research-reports/marijuana/marijuana-addictive

[4] https://www.psychologytoday.com/blog/the-new-brain/201603/marijuana-use-increases-violent-behavior

https://www.researchgate.net/publication/297718566_Continuity_of_cannabis_use_and_violent_offending_over_the_life_course

https://www.omicsonline.org/open-access/marijuana-violence-and-law-2155-6105-S11-014.pdf https://www.healthychildren.org/English/ages-stages/teen/substance-abuse/Pages/legalizing-marijuana.aspx http://www.poppot.org/wp-content/uploads/2018/02/020518-Child-dangers-fact-sheet-FINAL_updated.pdf?x47959

[5] http://www.questdiagnostics.com/home/physicians/health-trends/drug-testing.html

[6] https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2464591

https://www.drugabuse.gov/publications/research-reports/marijuana/what-scope-marijuana-use-in-united-states https://www.drugabuse.gov/publications/drugfacts/marijuana https://www.drugabuse.gov/publications/drugfacts/marijuana

https://www.scientificamerican.com/article/link-between-adolescent-pot-smoking-and-psychosis-strengthens/

[7] https://onlinelibrary.wiley.com/doi/full/10.1002/wps.20170

http://www.thelancet.com/pdfs/journals/lanpsy/PIIS2215-0366(14)70307-4.pdf

[8] http://www.petpoisonhelpline.com/poison/marijuana/

[9] http://gazette.com/editorial-the-sad-anniversary-of-big-commercial-pot-in-colorado/article/1614900

https://youtu.be/BApEKGUpcXs Weed Documentary from a high school in Oregon

[10] https://learnaboutsam.org/comprehensive-study-finds-marijuana-legalization-drives-youth-use-crime-rates-black-market-harms-communities-color/

[11] https://www.healthychildren.org/English/ages-stages/teen/substance-abuse/Pages/legalizing-marijuana.aspx

https://learnaboutsam.org/legalization/

http://nationalacademies.org/hmd/~/media/Files/Report%20Files/2017/Cannabis-Health-Effects/Cannabis-chapter-highlights.pdf

MARIJUANA EXPOSURES AMONG CHILDREN INCREASE BY UP TO OVER 600%

The rate of marijuana exposures among children under the age of six increased by 610% in the “medical” marijuana states according to a study published in Clinical Pediatrics. The data comes from the National Poison Data System. 75% percent of the children ingested edible marijuana products such as marijuana-infused candy. Clinical effects include drowsiness or lethargy, ataxia [failure of muscle coordination], agitation or irritability, confusion and coma, respiratory depression, and single or multiple seizures.

http://journals.sagepub.com/doi/full/10.1177/0009922815589912

MORE FACTS

Today’s marijuana is very high in potency and can reach 99% THC. It is very destructive and causes addiction, mental illness, violence, crime, DUIs and many health and social problems.

https://herb.co/marijuana/news/thc-a-crystalline

FACTS FROM COLORADO

The people who are pushing marijuana legalization paint Colorado as a pot paradise. This is not true according to Peter Droege who is the Marijuana and Drug Addiction Policy Fellow for the Centennial Institute a policy think tank in Lakewood Colorado. In a April 20, 2018 opinion article he states that:

According to the 2016 National Survey on Drug Use and Health (NSDUH), Colorado is a national leader among 12-17-year-olds in (1) Last year marijuana use; (2) Last month marijuana use; and (3) The percentage of youth who tried marijuana for the first time.

A 2017 analysis by the Denver Post showed Colorado had experienced a 145% increase in the number of fatal crashes involving marijuana-impaired drivers between 2013 and 2016. While the analysis stresses that the increase cannot definitively be attributed to the legalization of marijuana, it reports that the number of marijuana-impaired drivers involved in fatal crashes has more than doubled since 2013, the year before the state legalized recreational marijuana use.

A July 20, 2016 article in Westword magazine reports that increased homelessness, drugs, and crime are causing local residents and convention visitors to shun Denver’s 16th Street Mall, once one of the most vibrant tourist destinations in the region.

A group of concerned scientists from Harvard University and other institutions wrote a letter to Governor Hickenlooper on March 10, 2017, seeking to correct the record after his Feb. 26, 2017, interview on Meet the Press in which he told Chuck Todd that Colorado had not seen a spike in youth drug use after the legalization of recreational marijuana, and that there was “anecdotal” evidence of a decline in drug dealers – claims he repeated in Rolling Stone.

In the letter, the scientists reference numerous studies, including the NSDUH survey, that report a dramatic increase in youth marijuana use, emergency room visits, mental health issues and crime tied to the legalization of marijuana in Colorado. They quote an official from the state’s attorney general’s office saying legalization “has inadvertently helped fuel the business of Mexican drug cartels … cartels are now trading drugs like heroin for marijuana, and the trade has since opened the door to drug and human trafficking.”

Today’s high-potency “crack weed” is marketed to youth through vapes, candies, energy drinks, lip balms and other products easy to conceal in homes and schools. Most dispensaries in Colorado are located in low-income neighborhoods, targeting young people who do not need another obstacle in fulfilling their great potential in life. *

* https://www.usatoday.com/story/opinion/2018/04/20/colorado-governor-marijuana-hickenlooper-column/53

3731002/

MARIJUANA RELATED SUICIDES OF YOUNG PEOPLE IN COLORADO

Marijuana is the Number 1 substance now found in suicides of young people in Colorado who are 10-19 years old. Go to the below Colorado website and click on the box that lists “methods, circumstances and toxicology” and then click on the two boxes for 10-19 years olds. The marijuana data will appear.

https://cohealthviz.dphe.state.co.us/t/HSEBPublic/views/CoVDRS_12_1_17/Story1?:embed=y&:showAppBanner=false&:showShareOptions=true&:display_count=no&:showVizHome=no#4)

55% OF COLORADO MARIJUANA USERS THINK IT’S SAFE TO DRIVE WHILE HIGH

55% of marijuana users surveyed by the Colorado Department of Transportation last November said they believed it was safe to drive under the influence of marijuana. Within that group, the same percentage said they had driven high in the past 30 days, on average 12 times. A recent analysis of federal traffic fatality data by the Denver Post found that the number of Colorado drivers involved in fatal crashes who tested positive for marijuana has doubled since 2013.

CDOT survey: More than half of Colorado marijuana users think it’s safe to drive while high

TODDLERS WITH LUNG INFLAMMATION

In Colorado one in six infants and toddlers hospitalized for lung inflammation are testing positive for marijuana exposure. This has been a 100% increase since legalization (10% to 21%). Non-white kids are more likely to be exposed than white kids.

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

TEEN ER VISITS

Marijuana related emergency room visits by Colorado teens is substantially on the rise. They see more kids with psychotic symptoms and other mental health problems and chronic vomiting due to marijuana use.

https://www.reuters.com/article/us-health-marijuana-kids/marijuana-related-er-visits-by-colorado-teens-on-the-rise-idUSKBN1HO38A

LOW BIRTH WEIGHTS

The Colorado School of Public Health reports that there is a 50% increase in low birth weights among women who use marijuana during pregnancy. Low birth weight sets the stage for future

health problems including infection and time spent in neonatal intensive care.

https://www.sciencedaily.com/releases/2018/04/180423125052.htm

EMERGENCY CARE

Colorado Cannabis Legalization and Its Effect on Emergency Care

“Not surprisingly, increased marijuana use after legalization has been accompanied by an increase in the number of ED visits and hospitalizations related to acute marijuana intoxication. Retrospective data from the Colorado Hospital Association, a consortium of more than 100 hospitals in the state, has shown that the prevalence of hospitalizations for marijuana exposure in patients aged 9 years and older doubled after the legalization of medical marijuana and that ED visits nearly doubled after the legalization of recreational marijuana, although these findings may be limited because of stigma surrounding disclosure of marijuana use in the prelegalization era. However, this same trend is reflected in the number of civilian calls to the Colorado poison control center. In the years after both medical and recreational marijuana legalization, the call volume for marijuana exposure doubled compared with that during the year before legalization.

Kim HS, Monte AA. Colorado cannabis legalization and its effect on emergency care. Ann Emerg Med. 2016;68:71-75.

https://search.aol.com/aol/search?q=http%3a%2f%2fcolorado%2520cannabis%2520legalization%2520and%2520its%2520effect%2520on%2520emergency%2520care%2e&s_it=loki-dnserror

CONTAMINATION OF MARIJUANA PRODUCTS

There is contamination in marijuana products in Colorado. The Colorado Department of Public Health and Environment claims that “Cannabis is a novel industry, and currently, no recognized standard methods exist for the testing of cannabis or cannabis products.”

https://www.colorado.gov/pacific/cdphe/marijuana-sciences-reference-library

Filed under: Cannabis/Marijuana,Crime/Violence/Prison,Drug use-various effects,Drugs and Accidents,Environment,Global Drug Legalisation Efforts,Health :

The medical marijuana market is in a downward spiral as businesses, lured by big money, shift to recreational

At the height of the medical marijuana industry there were 420 dispensaries in Oregon. Now there are only eight.

In 2015, Erich Berkovitz opened his medical marijuana processing company, PharmEx, with the intention of getting sick people their medicine. His passion stemmed from his own illness. Berkovitz has Tourette syndrome, which triggers ticks in his shoulder that causes chronic pain. Cannabis takes that away.

Yet in the rapidly changing marijuana landscape, PharmEx is now one of three medical-only processors left in the entire state of Oregon.

On the retail end, it’s also grim. At the height of the medical marijuana industry in 2016, there were 420 dispensaries in Oregon available to medical cardholders. Today, only eight are left standing and only one of these medical dispensaries carries Berkovitz’s products.

Ironically, Oregon’s medical marijuana market has been on a downward spiral since the state legalized cannabis for recreational use in 2014. The option of making big money inspired many medical businesses to go recreational, dramatically shifting the focus away from patients to consumers. In 2015, the Oregon Liquor Control Commission (OLCC) took over the recreational industry. Between 2016 and 2018, nine bills were passed that expanded consumer access to marijuana while changing regulatory procedures on growing, processing and packaging.

In the shuffle, recreational marijuana turned into a million-dollar industry in Oregon, while the personalized patient-grower network of the medical program quietly dried up.

Now, sick people are suffering.

“For those patients that would need their medicine in an area that’s opted out of recreational sales, and they don’t have a grower or they’re not growing on their own, it does present a real access issue for those individuals,” said André Ourso, an administrator for the Center for Health Protection at the Oregon Health Authority. The woes of the Oregon Medical Marijuana Program (OMMP) were outlined in a recently published report by the Oregon Health Authority. The analysis found the program suffers from “insufficient and inaccurate reporting and tracking,” “inspections that did not keep pace with applications”, and “insufficient funding and staffing”.

Operating outside of Salem, Oregon, PharmEx primarily makes extracts – a solid or liquid form of concentrated cannabinoids. Through his OMMP-licensed supply chain, he gets his high dose medicine to people who suffer from cancer, Crohn’s, HIV and other autoimmune diseases. Many are end-of-life patients.

These days, most recreational dispensaries sell both consumer and medical products, which are tax-free for cardholders. The problem for Berkovitz is that he’s only medically licensed. This means recreational dispensaries can’t carry his exacts. Legally, they can

only sell products from companies with an OLCC license. Since issuing almost 1,900 licenses, the OLCC has paused on accepting new applications until further notice.

Limits on THC – a powerful active ingredient in cannabis products – are also an issue, according to Berkovitz. With the dawn of recreational dispensaries, the Oregon Health Authority began regulating THC content. A medical edible, typically in the form of a sweet treat, is now capped at 100mg THC, which Berkovitz says is not enough for a really sick person.

“If you need two 3000mg a day orally and you’re capped at a 100mg candy bar, that means you need 20 candy bars, which cost $20 a pop,” he said. “So you’re spending $400 a day to eat 20 candy bars.”

“The dispensaries never worked for high dose patients, even in the medical program,” continued Berkovitz. “What worked was people who grew their own and were able to legally process it themselves, or go to a processor who did it at a reasonable rate.”

But with increased processing and testing costs, and a decrease on the number of plants a medical grower can produce, patients are likely to seek cannabis products in a more shadowy place – the black market.

“All the people that we made these laws for – the ones who are desperately ill – are being screwed right now and are directed to the black market,” said Karla Kay, the chief of operations at PharmEx.

Kay, who also holds a medical marijuana card for her kidney disease, said some patients she knows have resorted to buying high dose medical marijuana products illegally from local farmers markets – in a state that was one of the first to legally establish a medical cannabis industry back in 1998.

Moreover, the networks between medical patients, growers and processors have diminished.

The OMMP maintains a record of processors and the few remaining dispensaries, but no published list of patients or grow sites – a privacy right protected under Oregon law, much to the chagrin of law enforcement.

According to the Oregon Health Authority’s report, just 58 of more than 20,000 medical growers were inspected last year.

In eastern Oregon’s Deschutes county, the sheriff’s office and the district attorney have repeatedly requested the location of each medical marijuana grower in their county. They’ve been consistently denied by the Oregon Health Authority.

Recently, the sheriff has gone as far as hiring a detective to focus solely on enforcing marijuana operations.

“There is an overproduction of marijuana in Oregon and the state doesn’t have adequate resources to enforce the laws when it comes to recreational marijuana, medical marijuana, as well as ensuring the growth of hemp is within the THC guidelines,” said the Deschutes sheriff, Shane Nelson. As of last February, the state database logged 1.1m pounds of cannabis flower, as reported by the Willamette Week in April. That’s three times what residents buy in a year, which means the excess is slipping out of the regulated market. To help curb the trend, senate bill 1544 was passed this year to funnel part of the state’s marijuana tax revenues into the Criminal Justice Commission and provide the funding needed to go after the black market, especially when it comes to illicit Oregon weed being smuggled to other states. The program’s priority is “placed on rural areas with lots of production and diversion, and little law enforcement”, said Rob Bovett, the legal counsel with the Association of Oregon Counties, who crafted the bill.

In a May 2018 memo on his marijuana enforcement priorities, Billy J Williams, a US attorney for the district of Oregon, noted that “since broader legalization took effect in 2015, large quantities of marijuana from Oregon have been seized in 30 states, most of which continue to prohibit marijuana.”

As of 1 July, however, all medical growers that produce plants for three or more patients – about 2,000 growers in Oregon – must track their marijuana from seed-to-sale using the OLCC’s Cannabis Tracking System.

Berkovitz, however, is looking to cut out the middle man (namely dispensaries) to keep PharmEx afloat. “The only way the patients are going to have large, high doses of medicine is if we revive the patient-grower networks. They need to communicate with each other. No one’s going to get rich, but everybody involved will get clean medicine from the people they trust at a more affordable rate.”

Source: https://www.theguardian.com/society/2018/jul/31/oregon-cannabis-medical-marijuana-problems-sick-people

Filed under: Cannabis/Marijuana,Drug use-various effects,Global Drug Legalisation Efforts,Health,Marijuana and Medicine,Medicine and Marijuana :

There are several principal pathways to inheritable genotoxicity, mutagenicity and teratogenes is induced by cannabis which are known and well established at this time including the following.
These three papers discuss different aspects of these effects.

1) Stops Brain Waves and Thinking The brain has both stimulatory and inhibitory pathways. GABA is the main brain inhibitory pathway. Brain centres talk to each other on gamma (about 40 cycles/sec) and theta frequencies (about 5 cycles/sec), where the theta waves are used as the carrier waves for the gamma wave which then interacts like harmonics in music.
The degree to which the waves are in and out of phase carries information which can be monitored externally. GABA (γ-aminobutyric acid) inhibition is key to the generation of the synchronized firing which underpins these various brain oscillations. These GABA transmissions are controlled presynaptically by type 1 cannabinoid receptors (CB1R’s) and CB1R stimulation shuts them down. This is why cannabis users forget and fall asleep.

2) Blocks GABA Pathway and Brain Formation GABA is also a key neurotransmitter in brain formation in that it guides and direct neural stem cell formation and transmission and development and growth of the cerebral cortex and other major brain areas. Gamma and theta brain waves also direct neural stem cell formation, sculpting and connectivity.

Derangements then of GABA physiology imply that the brain will not form properly. Thin frontal cortical plate measurements have been shown in humans prenatally exposed to cannabis by fMRI.
This implies that their brains can never be structurally normal which then explains the long lasting and persistent defects identified into adulthood.

3) Epigenetic Damage DNA not only carries the genetic hardware of our genetic code but it also carries the software of the code which works like traffic lights along the sequence of DNA bases to direct when to switch the genes on and off. This is known as the “epigenetic code”.

Fetal alcohol syndrome is believed to be due to damage to the software epigenetic code. The long lasting intellectual, mood regulation, attention and concentration defects which have been described after in utero cannabis exposure in the primary, middle and high schools and as college age young adults are likely due to these defects. Epigenetics “sets in stone” the errors of brain structure made in (2) above.

4) Arterial Damage. Cannabis has a well described effect to damage arteries through (CB1R’s) (American Heart Association 2007) which they carry in high concentration (Nature Reviews Cardiology 2018). In adults this causes heart attack (500% elevation in the first hour after smoking), stroke, severe cardiac arrhythmias including sudden cardiac death; but in developing babies CB1R’s acting on the developing heart tissues can lead to at least six major cardiac defects (Atrial- ventricular- and mixed atrio-ventricular and septal defects, Tetralogy of Fallot, Epstein’s deformity amongst others), whilst constriction of various babies’ arteries can lead to serious side effects such as gastroschisis (bowels hanging out) and possibly absent limbs (in at least one series).

5) Disruption of Mitotic Spindle. When cells divide the separating chromosomes actually slide along “train tracks” which are long chains made of tubulin. The tubulin chains are called “microtubules” and the whole football-shaped structure is called a “mitotic spindle”. Cannabis inhibits tubulin formation, disrupting microtubules and the mitotic spindle causing the separating chromosomes to become cut off in tiny micronuclei, where they eventually become smashed up and pulverized into “genetic junk”, which leads to foetal malformations, cancer and cell death. High rates of Down’s syndrome, chromosomal anomalies and cancers in cannabis exposed babies provide clinical evidence of this.

6) Defective Energy Generation & Downstream DNA Damage DNA is the crown jewel of the cell and its most complex molecule. Maintaining it in good repair is a very energy intensive process. Without energy DNA cannot be properly maintained. Cannabis has been known to reduce cellular energy production by the cell’s power plants, mitochondria, for many decades now. This has now been firmly linked with increased DNA damage, cancer formation and aging of the cells and indeed the whole organism. As it is known to occur in eggs and sperm, this will also damage the quality of the germ cells which go into forming the baby and lead directly to damaged babies and babies lost and wasted through spontaneous miscarriage and therapeutic termination for severe deformities.

7) Cancer induction Cannabis causes 12 cancers and has been identified as a carcinogen by the California Environmental Protection agency (2009). This makes it also a mutagen. 4 of these cancers are inheritable to children; i.e. inheritable carcinogenicity and mutagenicity. All four studies in testicular cancer are strongly positive (elevation by three fold). Carcinogen = mutagen = teratogen.

8) Colorado’s Teratology Profile. From the above described teratological profile we would expect exactly the profile of congenital defects which have been identified in Colorado (higher total defects and heart defects, and chromosomal defects) and Ottawa in Canada (long lasting and persistent brain damage seen on both functional testing and fMRI brain scans in children exposed in utero) where cannabis use has become common.

Gastroschisis was shown to be higher in all seven studies looking at this; and including in Canada, carefully controlled studies. Moreover in Australia, Canada, North Carolina, Colorado, Mexico and New Zealand, gastroschisis and sometimes other major congenital defects cluster where cannabis use is highest. Colorado 2000-2013 has experienced an extra 20,152 severely abnormal births above the rates prior to cannabis liberalization which if applied to the whole USA would equate to more than 83,000 abnormal babies live born annually (and probably about that number again therapeutically aborted); actually much more since both the number of users and concentration of cannabis have risen sharply since 2013, and cannabis has been well proven to be much more severely genotoxic at higher doses.

9) Cannabidiol is also Genotoxic and tests positive in many genotoxicity assays, just as tetrahydrocannabinol does.

10) Births defects registry data needs to be open and transparent and public. At present it is not. This looks too much like a cover up.

Source: Email from Dr Stuart Reece to Drug Watch International members May 2018

Filed under: Cannabis/Marijuana,Drug use-various effects,Drug use-various effects on foetus, babies, children and youth,Health,Medical Studies :

Eleonora Patsenker, Ph.D. and Felix Stickel, M.D., Ph.D.

Mounting evidence indicates that the endocannabinoid (EC) system (ECS) plays an important role in various liver diseases including viral hepatitis, nonalcoholic fatty liver disease (NAFLD), alcoholic liver disease, hepatic encephalopathy, and autoimmune hepatitis. The ECS also impacts on involved processes such as hepatic hemodynamics, nutrient intake and turnover, and ischemia/reperfusion (I/R) after liver transplantation. Although this involvement is undisputed, therapeutic implications regarding the ECS are just beginning to emerge; so far, no approved drug
acting specifically on the ECS is available.

Source: https://aasldpubs.onlinelibrary.wiley.com/doi/pdf/10.1002/cld.527 2016

Filed under: Cannabis/Marijuana,Health,Medicine and Marijuana :

Source:

http://www.pnas.org/content/109/40/E2657

July 2012

Filed under: Brain and Behaviour,Cannabis/Marijuana,Effects of Drugs (Papers),Health,Medical Studies :

Featuring Thomas Kosten, MD,
Professor and the Jay H. Waggoner Endowed Chair in the Menninger Department of Psychiatry and Behavioral Sciences at Baylor College of Medicine
Dr. Mark Gold and Dr. Thomas Kosten discuss anti-drug vaccines to treat substance use and addiction.

Q – Congratulations on your career to date and most recent work. Can you explain the idea behind your anti-drug vaccines? Are there any of your papers you’d suggest the reader look at?
A – Abused drugs are far too small to produce antibody responses. The vaccines work by covalently attaching the abused drug to 20 to 30 exposed amino acids on a carrier protein such as tetanus toxoid and then injecting this vaccine into humans to produce antibodies to both the tetanus toxoid and to the abused drug, because the drug now “looks like” part of this toxoid.

Q – Is the idea to block the drug’s reinforcing effects? What about overdose effects? Are each of the vaccines specific to a single drug or class of drugs?
A – Yes, the antibodies block reinforcing effects, but a slower process like overdose is still possible unless the drug is typically taken in very small quantities when abused – such drugs include PCP and fentanyl. These vaccines are highly specific to a class of drugs and have limited cross-reactivity.

Q – What happens if the drug abused is cocaine? Heroin? How would this be preferable to methadone or buprenorphine? Naltrexone?
A – For opiates, naltrexone is a better choice as a broad-spectrum blocker, but it does not effectively block the super-agonists related to fentanyl. However, these high potency agents are ideal targets for vaccine development, which is underway.

Q – How long would a single antidrug vaccine treatment last?
A – These antibodies persist at high levels for about three months and then require a booster vaccination about every three months.

Q – Are there risks that would prevent vaccination of women? Other risks? Adverse effects?
A – There are no specific risks from these tetanus toxoid based vaccines for women, since tetanus vaccine is even given to pregnant women. The antibodies cross over the placenta so that the fetus would also be protected.

Q – Are any approved for use? Why?
A – None are approved for use by the FDA because they have not met the criteria set for efficacy with either cocaine or nicotine. There have been no safety concerns, and a cocaine vaccine, particularly combined with the enhanced cholinesterase, would be the most likely to meet FDA efficacy standards relatively easily.

Q – Many experts think that the current opioid epidemic will be followed by a cocaine epidemic. What treatments exist for a cocaine-dependent patient or those presenting to an ED with a cocaine overdose? Are you developing for cocaine overdose? Cocaine addictions?
A – As suggested above, yes, we have a new and much more potent cocaine vaccine than we previously tested, but we need funds to move it forward. This vaccine combined with the Teva or other enhanced cholinesterases (Indivior also has one) would prevent overdoses.

Q – What about methamphetamine?
A – We have a methamphetamine vaccine and hope to have it in humans within a year or so, if our funding continues from NIDA.

Q – What kinds of studies are you doing right now? Planning?
A – The studies are all in animals with methamphetamine, cocaine, nicotine and fentanyl vaccines using a highly effective new adjuvant that has been used in humans at 50 times the dose needed for raising our antibody levels up to sevenfold higher than our previous cocaine vaccine.

Q – Anything else to add?
A – You covered it all, just send money. This is a difficult area for getting venture capital as well as NIDA funds to manufacture and get initial FDA approval to use these vaccines in humans.

Source: Email from Mark Gold, MD <donotreply@rivermendhealth.com> September 2017

Filed under: Health,Treatment and Addiction :

As of yesterday, it’s now legal for adults in California to purchase recreational marijuana. This is being hailed as a breakthrough against marijuana prohibition, but the masses of would-be pot smokers in California seem to carry a popular delusion that rests on the false idea that marijuana is safe to smoke in unlimited quantities because it’s “natural.”

As much as I disdain prohibition against any medicinal plant — and I’m convinced the “War on Drugs” was a miserable failure — I have news for all those who smoke pot: Smoking anything is a health risk because you’re inhaling a toxic stew of carcinogens produced in the smoke itself. Whether you’re smoking pot or tobacco, you’re still poisoning yourself with the very kind of carcinogens that promote lung cancer, heart disease, accelerated aging and cognitive decline.

Just because cannabis is now legal to smoke in California doesn’t mean it’s a wise habit to embrace. (There’s also a much better way to consume cannabis: Liquid form for oral consumption, as explained below…)

California, which increasingly seems to be operating in a delusional fairy tale bubble on every issue from immigration to transgenderism, believes the legalization of recreational marijuana is a breakthrough worth celebrating. “The dispensary staff cheered as hundreds stood in line outside the club, waiting to shop and celebrate,” reports SF Gate. “At some shops, the coming-out party was expected to feature live music, coffee and doughnuts, prizes for those first in line and speeches from supportive local politicians…”

Because, y’know, in a state that’s being overrun by illegal aliens, the junk science of “infinite genders” and university mobs of climate change cultists, what’s really needed is a whole new wave of lung cancer victims to add even more burden to the state’s health care costs. Genius! Gov. Brown should run for President or something…

Inhale some more pesticides and see how “natural” you feel

Sadly, many pro-cannabis consumers in California have convinced themselves that Big Tobacco is evil, but smoking pot is safe and natural… even “green.” Yet the cold hard truth of the matter it that marijuana in California is often produced with a toxic cocktail of pesticides, herbicides and fungicides. Yep, the very same people who buy “organic” at the grocery store are now smoking and inhaling cancer-causing weed grown with conventional pesticides. These are the same people who are concerned about 1 ppb of glyphosate in their Cheerios while simultaneously smoking 1,000 ppb of Atrazine in their weed. But science be damned, there’s a bong and a gas mask handy. Smoke up!

California pot has already been scientifically proven to be shockingly contaminated. A whopping “…93 percent of samples collected by KNBC-TV from 15 dispensaries in four Southern California counties tested positive for pesticides,” reports the UK Daily Mail, which also reports:

That may come as a surprise for consumers who tend to trust what’s on store shelves because of federal regulations by the US Agriculture Department or the US Food and Drug Administration. ‘Unfortunately, that’s not true of cannabis,’ Land said. ‘They wrongly assume it’s been tested for safety.’

I suppose all the science in the world is irrelevant when you have a mob of people who just want to get high. These are the same people who will March Against Monsanto, but they won’t even buy pesticide-free weed that they’re inhaling.

Edible cannabis products often contain toxic solvents, too

It’s not just the pesticides in weed that are a major concern: Edible pot products also frequently contain traces of toxic solvents such as hexane. Because of the shocking lack of regulation of cannabis product production in places like Colorado, many small-scale producers are using insanely dangerous solvents to extract CBD, THC and other molecules from raw cannabis plants. Those solvents include:

Hexane (a highly explosive solvent also used by the soy industry to extract soy protein)
IPA (isopropyl alcohol, which causes permanent nerve damage if you drink it)
Gasoline (also used to extract heroin in Third World countries)

Anyone who thinks consuming these solvents is somehow “healthy” may have already suffered extensive brain damage from consuming those solvents. Yet edible cannabis products are almost universally looked upon as health-enhancing products, often with no thought given whatsoever to the pesticides, solvents or other toxins they may contain. (Some shops do conduct lab testing of their products, so if you’re going to consume these products, make sure you get lab-tested cannabis products.)

In essence, the very same state where “progressives” have now come to believe there are an infinite number of genders — and that global warming causes extremely cold weather — have now embraced a delusional fairy tale about the imagined safety of consuming cannabis. All the news about the health benefits of cannabis only seems to have made the delusion worse: Some people now perceive smoking weed as a form of nutritional supplementation. They’ve even made it part of their holistic lifestyles, in a twisted kind of way.

But what California has actually unleashed with all this is a whole new wave of:

Heart disease
Lung cancer
Cognitive decline
Accelerated aging
Increased health care costs state-wide

Check with your friends in California and you’ll find that they have little to no awareness of the devastating health consequences of long-term pot smoking. It’s not going to turn you into a raging lunatic as depicted in Refer Madness, but it is going to expose your lungs, bloodstream and brain to a shockingly toxic stew of cell-damaging carcinogens. That gives pot smoke many of the same health risks as cigarette smoke.

So what’s the right answer on all this? If you want to stay healthy, stop smoking cannabis. Take it in liquid form instead.

The safer option: Liquid cannabis extracts

Liquid cannabis extracts are not only far safer to consume (because they don’t contain toxic carcinogens found in smoke); they also contain a far more diverse composition of cannabinoids.

CBD-A, for example, the carboxylic acid form of cannabidiol, is destroyed by heat. This means that when you smoke cannabis, you’re not getting any CBD-A, even if it’s naturally present in the plant. The heat of the incineration destroys it before you inhale.

The same is true with THC-A and other carboxylic acid forms of cannabinoids. In fact, cannabis extracts that are heated to destroy those components are called “decarboxylated” or just “de-carbed” for short. Lighting up a joint and burning the cannabis as you inhale actually destroys many of the more medicinal components of cannabis.

Taking cannabis extracts orally, on the other hand, gives you the full complement of all the cannabinoids, terpenes and other constituents… without the health risks associated with inhaling smoke.

The cannabis extract brand that we test and certify in our lab to meet or exceed label claims is called Native Hemp Solutions. It’s a whole-plant extract that maintains the natural cannabinoids and other constituents found in the living plant. Because it’s not an isolate, its molecules work synergistically to provide a more profound effect.

Liquid forms of cannabis are vastly superior to cannabis smoke in terms of their synergistic phytonutrients (chemical constituents). While smoking marijuana provides a more rapid assimilation of THC into your bloodstream, the oral form of cannabis extracts actually provide a vastly more diverse array of nutrients, many of which are being studied for therapeutic use.

That’s why I don’t smoke cannabis. In fact, the only cannabis I consume is high-CBD, near-zero-THC liquid forms. That’s because I don’t want to give myself lung cancer or heart disease as a side effect of consuming a cannabis product.

Smoking pot isn’t harmless: Think rationally about the way to ingest cannabis molecules

The bottom line here is that I want to encourage you to think carefully about the vectors through which you introduce cannabis molecules into your body. Smoking pot is rapid but carries long-term health risks due to carcinogenic smoke that you’re inhaling. I’m thrilled that California finally decriminalized this healing plant, but the fanfare surrounding the change in the law almost seems to be a celebration of smoking, which is a truly hazardous habit no matter what you’re smoking.

Oral forms are vastly superior in terms of ingesting the full array of nutrients, and some people on the extreme end of the spectrum actually use cannabis suppositories for a rapid effect that doesn’t involve damaging the lungs. Personally, I’m happy with taking CBD oils as a dietary supplement for the simple reason that I don’t ingest cannabis to get high; I ingest it for its health supporting effects.

Now, let us hope Jeff Sessions and the feds can finally get around to ending marijuana prohibition, too. It’s time to end the senseless war on this promising natural herb, but we must also think carefully about the ways we ingest it.

Source: https://www.naturalnews.com/2018-01-01-california-legalize-pot-smokers-cannabis-contaminated-pesticides-mold-heavy-metals.html

Filed under: Cannabis/Marijuana,Environment,Global Drug Legalisation Efforts,Health :

A warning about life-threatening bleeding linked to use of synthetic cannabinoids — commonly known as fake weed or spice — was issued by the US Centers for Disease Control and Prevention on Thursday after two deaths and dozens of patients appearing in ERs with serious unexplained bleeding.

A total of 94 people — 89 in Illinois, two in Indiana and one each in Maryland, Missouri and Wisconsin — were seen in emergency departments with heavy bleeding between March 10 and April 5, according to the CDC outbreak alert.

Both of the fatalities occurred in Illinois. Interviews with 63 of the Illinois patients revealed that all had used synthetic cannabinoids.

Synthetic cannabinoids are mind-altering chemicals that are made in a lab and sold either sprayed on shredded plant material so it can be smoked like marijuana or as liquid that can be vaporized in e-cigarettes. “Fake weed” products are marketed in shiny packages with hundreds of brand names, including Spice, K2, Joker, Black Mamba, Kush and Kronic.

At least three product samples in the latest outbreak tested positive for brodifacoum — rat poison — and further laboratory tests confirmed this exposure in at least 18 of the Illinois patients.

“A working hypothesis is the synthetic cannabinoids were contaminated with brodifacoum,” according to the CDC.

‘Huge number of toxic effects’

“This is the first time bleeding has ever been associated with synthetic cannabinioids,” said Professor Paul L. Prather of the Department of Pharmacology and Toxicology at the University of Arkansas’ College of Medicine, who was not involved in the CDC report. “It is certainly possible that the bleeding issues … might be due to products laced with the rat poison brodifacoum.”

However, he suggests that these adverse effects might be caused by an as-yet-unidentified synthetic cannabinoid chemical.

Specifically, this newest synthetic cannabinoid chemical could be derived from coumarin, a special class of chemical compounds, he believes.

A latecomer among synthetic cannabinoids, coumarin derivatives were first identified in a 2012 Journal of Medicinal Chemistry paper. This class of chemicals activates the cannabinoid receptors inthe brain while acting as anticoagulants or blood thinners. Warfarin and phenprocoumon, blood clot-preventing drugs prescribed to heart patients to protect them from getting heart attacks, are coumarin derivatives.

Although bleeding, seen for the first time in Illinois, is a “whole other can of worms,” Prather said, “there’s a huge number of toxic effects of synthetic cannabinoids.”

“They produce a lot of neurological side effects. Seizures actually bring people into emergency departments a lot of the time,” he said. Other important neurological side effects include psychosis, panic attacks, agitation, confusion and catatonia.

“Young patients will come in with acute renal or kidney failure,” he said. There are also troubling effects on the heart (chest pain and hypertension) and, recently, gastrointestinal problems and hyperemesis syndrome: an extreme amount of vomiting.

So why all the side effects?

‘Guinea pigs’

“What happens with the synthetic cannabinoid clandestine laboratories is, they’re very smart people, and they look at these papers and they go, ‘Oh, this compound has been developed, and it binds to these [cannabinoid] receptors, so if I produce this in my lab, I can probably sell this, because when people take it, it will probably produce euphoria like marijuana does,’ ” Prather explained.

Yet, he said, the compounds the clandestine scientists create — even when the formulas come from a published scientific paper — are “totally unknown chemicals.” Plus, there’s a lack of quality control.

“These drugs are made in a clandestine lab. Who knows what kind of contaminants are in this laboratory, and who knows from batch to batch how much of the chemical is actually made” — or the concentration of each chemical made, Prather added. One synthetic weed product might be four specific chemicals of a weak concentration, but the next time you buy the same product, it might be five chemicals of high concentration.

“If you’ve ever been to a drug company, they have the most rigid quality control you can imagine,” Prather said. Plus, there’s a lot of testing to ensure safety. “Believe me, in the drug industry, you kill a lot of rats and you kill a lot of mice before you get to the point of that final drug.”

Drug users are “the guinea pigs and the rats and the mice for the development of these compounds,” Prather said. “It’s really kind of crazy.”

At the National Institute on Drug Abuse, Dr. Ruben Baler, a health scientist administrator, is getting the word out about the dangers of synthetic cannabinoids by speaking at conferences, giving lectures across the nation and talking with reporters.

He believes that “the perception of harm is going up and usage is going down, at least among teenagers.”

In fact, American Association of Poison Control Centers data indicates a decreasing number of exposures to synthetic cannabinoids reported between 2011 and 2017. Poison control centers across the country received 6,968 calls about these drugs in 2011, compared with 1,952 in 2017. As of March 31, there have been 462 reports this year.

“I don’t see an explosion of use among young people,” Baler said. Mostly, those who gravitate toward synthetic cannabinoids are “marginalized people,” including the homeless and those affected by mental illness, he said. “That’s where you see the deaths so far.”

Enforcement of the law is not the role played by the National Institute on Drug Abuse; that role is played by the Drug Enforcement Administration, whose spokesman, Rusty Payne, says synthetic cannabinoids are designed for one reason only: “to get your credit card, get you high and addicted, and keep you coming back for more.”

Links to terrorism

The DEA first encountered synthetic cannabinoids about 2006, Payne said.

In 2012, the US government passed the Synthetic Drug Abuse Prevention Act, which classified a number of “designer drugs,” including synthetic cannabinoids and synthetic hallucinogens, under Schedule I of the Controlled Substances Act — meaning they have no accepted medical use and high potential for abuse.

Synthetic cannabinoids are made mainly in labs in China and mostly distributed online or at gas station convenience stores. “It used to be open shelf, but now this stuff is in the back,” Payne said.

“Ten-plus years of these problems,” he said. Despite the constantly changing chemical formulas, synthetic cannabinoids are considered illegal. Still, “that doesn’t mean it’s easy to prosecute,” he said.

“Terrorists are increasingly turning to drug trafficking to finance their operations,” Payne, said, adding that the DEA has seen “significant amount of money transfers” into the Middle East of late, including Lebanon, Jordan, Syria and areas of unrest that are “financial system black holes.” Cash from synthetic cannabinoids, in particular, is flowing to these nations.

Drug users who turn to synthetic cannabinoids are playing Russian roulette, Payne said. They are dangerous and even life-threatening, as the CDC reports. His thoughts are echoed by Baler and Prather, who added, “You hope you’re getting euphoria, but who knows what else you’re going to get?”

Source: https://edition.cnn.com/2018/04/06/health/synthetic-weed-bleeding-alert-cdc/index.html

Filed under: Cannabis/Marijuana,Health,Synthetics :

“Permission empowered models of drug policy interpretation are driving demand for drug use – NOT prohibition models. The ‘law’ is not what ruins lives, it’s those who tear down that protective fence to simply ‘get wasted’, that do that!”

“Acceptability – Accessibility – Availability, all increase consumption!” D.I
__________________________________________________________________
It is certainly no surprise that the pro-drug, cannabis promoting lobby, manifesting itself through The Greens, continue to employ tired mantras that:

deny science,
ignore best health-care practice and
propagandize harms away, with promises of tax revenues!

Here’s the first anomaly: the same lobbyists rail against alcohol harms and seek to limit the pervasive nature of this ‘legal’ drug – to the point of even stating; ‘If alcohol was bought to market for the first time today, it would be prohibited/banned!” Yet in breathtaking cognitive dissonance they want to unleash cannabis into the same promotable arena that alcohol and tobacco occupy – legal entitlement!

The second anomaly is: the tobacco fiasco – millions of dollars where spent on keeping/promoting cigarettes as not only legal and socially acceptable, but even healthy for you. Billions has been spent over the last 50 years dealing with the health outcomes of this drug – and then Billions more spent on driving this legal drug into the pariah space that is pseudo-prohibition!

Make no mistake, the cannabis industry and those promoting its regulation is just Big Tobacco all over again, but with new and greater levels of pernicious harms.

The active push to normalise and legitimise Cannabis for ‘recreational’ use has been in play since late 70’s with Richard Cowen, a former Director of NORML (National Organisation for Reform of Marijuana Laws), going on public record (speaking at 1993 conference celebrating the 50 year anniversary of the discovery of LSD) stating “The key to it [legalizing marijuana for recreational use] is to have 100’s of thousands of people using it ‘medically’ under medical supervision, the whole scam is going to be blown. Once there is medical access and we do what we continually have to do, and we will, then we will get full legalisation!”

The National Drug Strategy

The latest National Drug Strategy 2017-26, now puts Demand Reduction as the priority!
The strategy states that “Harm Minimisation includes a range of approaches to help prevent and reduce drug related problems…including a focus on abstinence-oriented strategies… [Harm minimisation] policy approach does not condone drug use.” ^{(page 6)}

^“Prevention of uptake reduces personal, family and community harms, allow better use of health and law enforcement resources, generates substantial social and economic benefits and produces a healthier workforce. Demand Reduction strategies that prevent drug use are more cost effective than treating established drug-related problems…Strategies that delay the onset of use prevent longer term harms and costs to the community.” ^{(page 8)}

We need to be reducing demand for cannabis, not increasing it through the undermining of both demand and supply reduction pillars in our National Drug Strategy!

Is the de-facto legalisation and ‘regulation’ of cannabis going to reduce demand, supply and harm, or will it promote/permit the same and to an even wider cohort?

If we have a regulated market for recreational Cannabis, will the already law-breaking and recalcitrant users suddenly line up to pay for, a now taxed product? We have seen the ‘black’ or ‘grey’ market on decriminalised prostitution continue alongside the now regulated industry for the simple reason that people do not want to pay more or be regulated as we are now seeing in the US State of Colorado!

Let us cut through the propagandised mantras about the so called ‘benign nature’ of this plant that buries evidence-based data with emotionalism and ‘big dollar’ revenue rhetoric.

“If one was to read at least three academically sourced evidence-based articles/resources on the inherent physical, psychological, environmental, genetic, social, productivity, familial & community Harms of this drug, every single day of the year for 10 years, you will still not have read half the current data on the dangers/risks of Cannabis.” D.I
^{Submission to the Canadian Senate Standing Committee on Health – for their consideration and review of Bill C.45.2017}

The following is but a snapshot of those harms:

Both cannabis intoxication and withdrawal have been linked with violence and homicide including mass shootings.
Effect on developing brains ^1-15
Effect on driving ^16-26
Effect on developmental trajectory and failure to attain normal adult goals (stable relationship, work, education) ^17,31-43
Effect on IQ and IQ regression ^13,44-48
Effect to increase numerous psychiatric and psychological disorders ^49-62
Effect on respiratory system ^63-85
Effect on reproductive system ^7,86-91
Effect in relation to immunity and immunosuppression ^92-108
Effect of now very concentrated forms of cannabis, THC and CBD which are widely available ^109,110
Outdated epidemiological studies which apply only to the era before cannabis became so potent and so concentrated ^110.
At the cellular level cannabis and cannabinoids have been linked with decreased energy production from mitochondria ^13-18,
Increased production of inflammation and reduced anti-oxidant defence ^16,18,19;
Reduced enzymes involved in DNA repair ¹⁶; and increased errors of mitosis which occur due to disruption of the tubulin “rails” of the mitotic spindle ^16,19-21 in such a way that chromosomes become left behind and eventually shatter under cellular stress ^21,22;
Cannabis also stimulates the carcinogenic oncoproteins tumour protein isoform 2 and tumour protein D54 ^23,24;
Stimulation of lipoxygenase and thromboxane synthase can lead to clotting and coagulation ^18.

Effect as a Gateway drug to other drug use including the opioid epidemic ^27-30

The Colorado Chaos!

The legalisation of Marijuana in Colorado: The Impact 2017
- Colorado Rocky Mountain High Intensity Drug Trafficking Area released its latest report 2017
- The 176-page report details the worsening impact of marijuana on Colorado, including:
- A 66% increase in marijuana-related traffic deaths
- A 12% increase in youth marijuana use in the past month
- A 71% increase in adult marijuana use in the past month
- A 72% increase in marijuana-related hospitalizations
- A 139% increase in marijuana-related exposures
- An 844% increase in parcels of marijuana seized in U.S. mail
- An 11% increase in crime state-wide
- Colorado now has more marijuana retail outlets (491) than McDonald’s (208) or Starbucks (392)
Colorado Governor: Cannabis legalisation was ‘reckless’ (Business Insider, 2014)

Crime rates have gone up, not down in Colorado – arrests of minorities in particular, are increasing.*
Black-market is flourishing – (people don’t want to pay tax under the ‘regulated’ system, so they chose the non-taxed black market product over the government endorsed product – now giving us at least two markets for supply.)*
Cartels now use shop fronts to peddle their product and their presence is growing.*
Youth use is increasing – even though poor data collection in attempting to hide such. * ^{https://youtu.be/5mFglI7KEpI}

Colorado District Attorney: ‘Marijuana is gateway drug to homicide’:

A Colorado district attorney drew attention this week after he pronounced marijuana to be a “gateway drug to homicide.” District Attorney Dan May came at a news conference Tuesday about a large black-market marijuana bust in the state. Thirteen people have been indicted

Marijuana X – The Documentary the ‘Industry’ doesn’t want you to see!
Cannabis Conundrum 100’s of articles on the inherent harms of Cannabis.

“It is estimated that there are at least 200,000 people dependent on cannabis in Australia, with one in ten people who try the drug at least once in their lifetime having problems ceasing use! (2012) ^{https://ndarc.med.unsw.edu.au/news/world-first-study-cannabis-withdrawal-management-drug}

This number has only increased, and this is all while the drug is still in its prohibition category. Permission models only increase access and use.

Call for greater accountability from proponents of Cannabis Legalisation – Time to put up or shut up!
How easy has it been in the past for legislators to present such incredibly irresponsible policy measures to unleash (via government approval) the use of Cannabis as a ‘recreational’ substance. It’s time to put your money where your mouth is.
We propose that those sponsoring/voting for such a change to our laws need to be held fiscally accountable for the costs of the harms done by their policies. As architects of a dangerous harm creating social experiment, who believe it to be in best interest of the entire community to, legalize, decriminalise, regulate or otherwise promote access/ entitlement to this drug, will then be fiscally accountable for the significant and broad ranging harms that will be incurred by our society as a result.

Any legislation passing that enables further entitlement to cannabis/marijuana should include the names and political parties who sponsor these drug use liberalisation groups. The legislation must include that all costs of harms for said legislation must pay for the negative outcomes – all health, social and welfare costs incurred. The monitoring and measuring of all aforementioned harms due to the liberalization of cannabis will be tallied and annual invoices to levied to Political Parties and individuals promoting such measures, for their remittance. If such accountabilities were in place, proponents would definitely think twice before being so outrageous in their claim.
It’s time to get serious about the drug issue as we did with the Tobacco scourge. The War on Tobacco was long, but effective. It’s time we had a serious campaign (for the first time in 30 years) on illicit drugs.

We need, as with the QUIT Tobacco Campaign, One Focus – Once Message – One Voice in every key sector in the culture; Government – Education – Media – Policing – Community!
So, who is driving drug policy now – Drug users, or law abiding, best health practice and responsible citizens?
It’s time our legislators and policy makers cared more for the clear majority of families, children and the community who do not use, or want drug use in their community. Legislators risk looking as though they have succumbed to the highly manipulative, drug-affected minority to further harm the community. These manipulators attempt to assail the law, assault families and damage public health all with the cleverly crafted, weaponised activities of the local ‘pot-head’ or desperado, currently being given too much ‘oxygen’ in the public domain.

Communications Liaison

E: admin@drugfree.org.au E: drug-advice@daca.org.au
P: 1300 975 002 M:0403 334 002
https://learnaboutsam.org/

Source: Email from The Dalgarno Institute <operations@dalgarnoinstitute.org.au>

April 2018

Filed under: Cannabis/Marijuana,Global Drug Legalisation Efforts,Health :

Sydney Parliament House, 09.07.2018

Cannabis has been greatly oversold by a left leaning press controlled by globalist and centralist forces while its real and known dangers have not been given appropriate weight in the popular press. In particular its genotoxic and teratogenic potential on an unborn generation for the next hundred years has not been aired or properly weighed in popular forums.

These weighty considerations clearly take cannabis out of the realm of personal choice or individual freedoms and place it squarely in the realm of the public good and a matter with which the whole community is rightly concerned and properly involved.

Cannabinoids are a group of 400 substances which occur only in the leaves of the Cannabis sativa plant where they are used by the plants as toxins and poisons in natural defence against other plants and against herbivores.

Major leading world experts such as Dr Nora Volkow, Director of the National Institute of Drug Abuse at NIH 1, Professor Wayne Hall, Previous Director of the Sydney Based National Drug and Alcohol Research Centre at UNSW 2, and Health Canada 3 – amongst many others – are agreed that cannabis is linked with the following impressive lists of toxicities:

1) Cannabis is addictive, particularly when used by teenagers

2) Cannabis affects brain development

3) Cannabis is a gateway to other harder drug use

4) Cannabis is linked with many mental health disorders including anxiety, depression,

psychosis, schizophrenia and bipolar disorder

5) Cannabis alters and greatly impairs the normal developmental trajectory – getting a

job, finishing a course and forming a long term stable relationship 4-11

6) Cannabis impairs driving ability 12

7) Cannabis damages the lungs

8) Cannabis is immunosuppressive

9) Cannabis is linked with heart attack, stroke and cardiovascular disease

10) Cannabis is commonly more potent in recent years, with forms up to 30% being widely available in many parts of USA, and oils up to 100% THC also widely available.

Serious questions have also been raised about its involvement in 12 different cancers, increased Emergency Room presentations and exposures of developing babies during pregnancy. It is with this latter group that the present address is mainly concerned.

Basic Physiology and Embryology Cells make energy in dedicated organelles called mitochondria. Mitochondrial energy, in the form of ATP, is known to be involved in both DNA protection and control of the immune system. This means that when the cell’s ATP is high DNA maintenance is good and the genome is intact. When cellular ATP drops DNA maintenance is impaired, DNA breaks remain unsealed, and cancers can form. Also immunity is triggered by low ATP.

As organisms age ATP falls by half each 20 years after the age of 20. Mitochondria signal and shuttle to the cell nucleus via several pathways. Not only do cells carry cannabinoid receptors on their surface, but they also exist, along with their signalling machinery, at high density on mitochondria themselves 13-19. Cannabis, and indeed all addictive drugs, are known to impair this cellular energy generation and thus promote the biochemical aging process 14-16,19,20. Most addictions are associated with increased cancers, increased infections and increased clinical signs of ageing 21-34.

The foetal heart forms very early inside the mother with a heartbeat present from day 21 of human gestation. The heart forms by complicated pathways, and arises from more than six groups of cells inside the embryo 35,36. First two arteries come together, they fold, then flex and twist to give the final shape of the adult heart. Structures in the centre of the heart mass called endocardial cushions grow out to form the heart valves between the atria and ventricles and parts of the septum which grows between the two atria and ventricles. These cardiac cushions, and their associated conoventricular ridges which grow into and divide the cardiac outflow tract into left and right halves, all carry high density cannabinoid type 1 receptors (CB1R’s) and cannabis is known to be able to interfere with their growth and development.CB1R’s appear on foetal arteries from week nine of human gestation 37.

The developing brain grows out in a complex way in the head section 35,36. Newborn brain cells are born centrally in the area adjacent to the central ventricles of the brain and then migrate along pathways into the remainder of the brain, and grow to populate the cortex, parietal lobes, olfactory lobes, limbic system, hypothalamus and hippocampus which is an important area deep in the centre of the temporal lobes where memories first form.

Developing bipolar neuroblasts migrate along pathways and then climb out along 200 million guide cells, called radial glia cells, to the cortex of the brain where they sprout dendrites and a major central axon which are then wired in to the electrical network in a “use it or lose it”, “cells that fire together wire together” manner.

The brain continues to grow and mature into the 20’s as new neurons are born and surplus dendrites are pruned by the immune system. Cannabinoids interfere with cellular migration, cellular division, the generation of newborn neurons and all the classes of glia, axonal pathfinding, dendrite sprouting, myelin formation around axons and axon tracts and the firing of both inhibitory and stimulatory synapses 14-16,19,20,38-40. Cannabinoids interfere with gene expression directly, via numerous epigenetic means, and via immune perturbation.

Cannabinoids also disrupt the mechanics of cell division by disrupting the mitotic spindle on which chromosomal separation occurs, causing severe genetic damage and frank chromosomal mis-segregation, disruption, rupture and pulverization 41-43.

Cannabis was found to be a human carcinogen by the California Environmental Protection agency in 2009 44. This makes it a likely human teratogen (deforms babies). Importantly, while discussion continues over some cancers, it bears repeating that a positive association between cannabis and testicular cancer was found in all four studies which investigated this question 45-49.

Cannabis Teratogenesis

The best animal models for human malformations are hamsters and rabbits. In rabbits cannabis exhibits a severe spectrum of foetal abnormalities when applied at high dose including shortened limbs, bowels hanging out, spina bifida and exencephaly (brain hanging out). There is also impaired foetal growth and increased foetal loss and resorption 50,51.

Many of these features have been noted in human studies 52. In 2014 Centres for Disease Control Atlanta Georgia reported increased rates of anencephaly (no brain, usually rapid death) gastroschisis (bowels hanging out), diaphragmatic hernia, and oesophageal narrowing 53,54. The American Heart Association and the American Academy of Pediatrics reported in 2007 an increased rate of ventricular septal defect and an abnormality of the tricuspid valve (Ebstein’s anomaly) 55. Strikingly, a number of studies have shown that cannabis exposure of the father is worse than that of the mother 56. In Colorado atrial septal defect is noted to have risen by over 260% from 2000-2013 (see Figure 1; note close correlation (correlation coefficient R = 0.95, P value = 0.000066) between teenage cannabis use and rising rate of major congenital anomalies in Colorado to 12.7%, or 1 in 8 live births, a rate four times higher than the USA national average !) 57.

And three longitudinal studies following children exposed to cannabis in utero have consistently noted abnormalities of brain growth with smaller brains and heads – persisting into adult life – and deficits of cortical and executive functioning persistent throughout primary, middle and high schools and into young adult life in the early 20’s 58-63. An Australian MRI neuroimaging study noted 88% disconnection of cortical wiring from the splenium to precuneus which are key integrating and computing centres in the cerebral cortex 38,39,64. Chromosomal defects were also found to be elevated in Colorado (rose 30%) 57, in Hawaii 52 in our recent analysis of cannabis use and congenital anomalies across USA, and in infants presenting from Northern New South Wales to Queensland hospitals 65. And gastroschisis shows a uniform pattern of elevation in all recent studies which have examined it (our univariate meta-analysis) 52,54,66-71.

Interestingly the gastroschisis rate doubled in North Carolina in just three years 1997-2001 72, but rose 24 times in Mexico 73 which for a long time formed a principal supply source for Southern USA 74. Within North Carolina gastroschisis and congenital heart defects closely followed cannabis distribution routes 74-76. In Canada a remarkable geographical analysis by the Canadian Government has shown repeatedly that the highest incidence of all anomalies – including chromosomal anomalies – occurs in those northern parts where most cannabis is smoked 77,78.

Congenital anomalies forms the largest cause of death of babies in the first year of life. The biggest group of them is cardiovascular defects. Since cannabis affects several major classes
of congenital defects it is obviously a major human teratogen. Its heavy epigenetic footprint,
by which it controls gene expression by controlling DNA methylation and histone modifications 79-81, imply that its effects will be felt for the next three to four generations – that is the next 100 years 82,83. Equally obviously it is presently being marketed globally as a major commodity apparently for commercial – or ideological – reasons. Since cannabis is clearly contraindicated in several groups of people including:

1) Babies

2) Children

3) Adolescents

4) Car drivers

5) Commercial Drivers – Taxis, Buses, Trains,

6) Pilots of Aeroplanes

7) Workers – Manual Tools, Construction, Concentration Jobs

8) Children

9) Adolescents

10) Males of Reproductive age

11) Females of Reproductive age

12) Pregnancy

13) Lactation

14) Workers

15) Older People – Mental Illness

16) Immunosuppressed

17) Asthmatics – 80% Population after severe chest infection

18) People with Personal History of Cancer

19) People with Family History of Cancer

20) People with Personal History of Mental Illness

21) People with Family History of Mental Illness

22) Anyone or any population concerned about ageing effects 34

… cannabis legalization is not likely to be in the best interests of public health.

Concluding Remarks

In 1854 Dr John Snow achieved lasting public health fame by taking the handle off the Broad Street pump and saving east London from its cholera epidemic, based upon the maps he drew of where the cholera cases were occurring – in the local vicinity of the Broad Street pump.

Looking across the broad spectrum of the above evidence one notices a trulyremarkable concordance of the evidence between:

1) Preclinical studies in

i) Rabbits and

ii) Hamsters

2) Cellular and biological mechanisms, particularly relating to:

i) Brain development

ii) Heart development

iii) Blood vessel development

iv) Genetic development

v) Abnormalities of chromosomal segregation

i. Downs syndrome

ii. Turners syndrome

iii. Trisomy 18

iv. Trisomy 13

vi) Cell division / mitotic poison / micronucleus formation

vii) Epigenetic change

viii) Growth inhibition

3) 84Cross-sectional Epidemiological studies, especially from:

i) Canada 77,85

ii) USA 86,87

iii) Northern New South Wales 65,88 4) Longitudinal studies from 58:

i) Ottawa 59-63

ii) Pittsburgh

iii) Netherlands

Our studies of congenital defects in USA have also shown a close concordance of congenital anomaly rates for 23 defects with the cannabis use rate indexed for the rising cannabis concentration in USA, and mostly in the three major classes of brain defects, cardiovascular defects and chromosomal defects, just as found by previous investigators in Hawaii 52.

Of no other toxin to our knowledge can it be said that it interferes with brain growth and development to the point where the brain is permanently shrunken in size or does not form at all. The demonstration by CDC twice that the incidence of anencephaly (no brain) is doubled by cannabis 53,54 implies that anencephaly is the most severe end of the neurobehavioural teratogenicity of cannabis and forms one end of a continuum with all the other impairments which are implied by the above commentary.

(Actually when blighted ova, foetal resorptions and spontaneous abortion are included in the teratological profile anencephaly is not the most severe end of the teratological spectrum – that is foetal death). It is our view that with the recent advent of high dose potent forms of cannabis reaching the foetus through both maternal and paternal lines major and clinically significant neurobehavioural teratological presentations will become commonplace, and might well become all but universal in infants experiencing significant gestational exposure.

One can only wonder if the community has been prepared for such a holocaust and tsunami amongst its children?

It is the view of myself and my collaborators that these matters are significant and salient and should be achieving greater airplay in the public discussion proceeding around the world at this time on this subject.

Whilst cannabis legalization may line the pockets of the few it will clearly not be in the public interest in any sense; and indeed the public will be picking up the bill for this unpremeditated move for generations to come. Oddly – financial gain seems to be one of the primary drivers of the present transnational push. When the above described public health message gets out amongst ambitious legal fraternities, financial gain and the threat of major medico-legal settlements for congenital defects – will quickly become be the worst reason for cannabis legalization.

Indeed it can be argued that the legalization lobby is well aware of all of the above concerns – and their controlled media pretend debate does not allow such issues to air in the public forum. The awareness of these concerns is then the likely direct reason that cannabis requires its own legislation. As noted in the patient information leaflet for the recently approved Epidiolex (cannabidiol oil for paediatric fits) the US Food and Drug Administration (FDA) is well aware of the genotoxicity of cannabinoids.

The only possible conclusion therefore is that the public is deliberately being duped. To which our only defence will be to publicize the truth.

Source: Summary of Address to Sydney Parliament House, 09.07.2018 by Professor Dr. Stuart Reece, Clinical Associate Professor, UWA Medical School. University of Western Australia

References

1 Volkow, N. D., Baler, R. D., Compton, W. M. & Weiss, S. R. B. Adverse Health Effects of Marijuana Use. New England Journal of Medicine 370, 2219-2227, doi:doi:10.1056/NEJMra1402309 (2014).

2 Hall, W. & Degenhardt, L. Adverse health effects of non-medical cannabis use. Lancet 374, 1383-1391, doi:10.1016/S0140-6736(09)61037-0 (2009).

3 Heath Canada. Health Effects of Cannabis, (2018).

4 Meier, M. H. et al. Associations Between Cannabis Use and Physical Health Problems in Early Midlife: A Longitudinal Comparison of Persistent Cannabis vs Tobacco Users. JAMA Psychiatry 73, 731-740,
doi:10.1001/jamapsychiatry.2016.0637 (2016).

5 Fergusson, D. M., Boden, J. M. & Horwood, L. J. Cannabis use and other illicit drug use: testing the cannabis gateway hypothesis. Addiction 101, 556-569, doi:ADD1322 [pii] 10.1111/j.1360-0443.2005.01322.x (2006).

6 Fergusson, D. M. & Horwood, L. J. Early onset cannabis use and psychosocial adjustment in young adults. Addiction 92, 279-296 (1997).

7 Fergusson, D. M., Horwood, L. J. & Beautrais, A. L. Cannabis and educational achievement. Addiction 98, 1681-1692, doi:573 [pii] (2003).

8 Fergusson, D. M., Horwood, L. J. & Swain-Campbell, N. Cannabis use and psychosocial adjustment in adolescence and young adulthood. Addiction 97, 1123- 1135, doi:103 [pii] (2002).

9 Fergusson, D. M., Lynskey, M. T. & Horwood, L. J. Conduct problems and attention deficit behaviour in middle childhood and cannabis use by age 15. The Australian and New Zealand journal of psychiatry 27, 673-682 (1993).

10 Lynskey, M. T., Fergusson, D. M. & Horwood, L. J. The origins of the correlations between tobacco, alcohol, and cannabis use during adolescence. Journal of child psychology and psychiatry, and allied disciplines 39, 995-1005 (1998).

11 Marie, D., Fergusson, D. M. & Boden, J. M. Links between ethnic identification, cannabis use and dependence, and life outcomes in a New Zealand birth cohort. The Australian and New Zealand journal of psychiatry 42, 780-788, doi:901464301 [pii] 10.1080/00048670802277289 (2008).

12 Fergusson, D. M., Horwood, L. J. & Boden, J. M. Is driving under the influence of cannabis becoming a greater risk to driver safety than drink driving? Findings from a longitudinal study. Accident; analysis and prevention 40, 1345-1350, doi:S0001- 4575(08)00026-2 [pii] 10.1016/j.aap.2008.02.005 (2008).

13 Bartova, A. & Birmingham, M. K. Effect of delta9-tetrahydrocannabinol on mitochondrial NADH-oxidase activity. J Biol Chem 251, 5002-5006 (1976).

14 Benard, G. et al. Mitochondrial CB(1) receptors regulate neuronal energy metabolism. Nat Neurosci 15, 558-564, doi:10.1038/nn.3053 (2012).

15 Hebert-Chatelain, E. et al. A cannabinoid link between mitochondria and memory. Nature 539, 555-559, doi:10.1038/nature20127 (2016).

16 Hebert-Chatelain, E. et al. Cannabinoid control of brain bioenergetics: Exploring the subcellular localization of the CB1 receptor. Mol Metab 3, 495-504, doi:10.1016/j.molmet.2014.03.007 (2014).

17 Koch, M. et al. Hypothalamic POMC neurons promote cannabinoid-induced feeding. Nature 519, 45-50, doi:10.1038/nature14260 (2015).

18 Mahoney, J. M. & Harris, R. A. Effect of 9 -tetrahydrocannabinol on mitochondrial precesses. Biochemical pharmacology 21, 1217-1226 (1972).

19 Wolff, V. et al. Tetrahydrocannabinol induces brain mitochondrial respiratory chain dysfunction and increases oxidative stress: a potential mechanism involved in cannabis-related stroke. Biomed Res Int 2015, 323706, doi:10.1155/2015/323706 (2015).

20 Chari-Briton, A. Proceedings: Swelling of rat liver mitochondria induced by delta1-tetrahydrocannabinol. Isr J Med Sci 11, 1189 (1975).

21 Reece, A. S. Chronic toxicology of cannabis. Clin Toxicol (Phila) 47, 517-524, doi:10.1080/15563650903074507 (2009).

22 Reece, A. S. Clinical implications of addiction related immunosuppression. J Infect 56, 437-445, doi:S0163-4453(08)00123-0 [pii] 10.1016/j.jinf.2008.03.003 (2008).

23 Reece A. S., Norman, A. & Hulse G.K. Acceleration of Cardiovascular – Biological Age by Amphetamine Exposure is a Power Function of Chronological Age. British Medical Journal Open (2017).

24 Reece A.S., Norman, A. & Hulse G.K. Cannabis Exposure as an Interactive Cardiovascular Risk Factor and Accelerant of Organismal Ageing – A Longitudinal Study. BMJ – Open 6(11) :e077891; doi:http://dx.doi.org/10.1136/bmjopen-2016- 011891 (2016).

25 Reece A.S. & G.K., H. Impact of Lifetime Opioid Exposure on Arterial Stiffness and Vascular Age: Cross-sectional and Longitudinal Studies in Men and Women. BMJ Open 4, 1-19, doi:10.1136/bmjopen-2013-004521 (2014).

26 Reece A.S. & Hulse G.K. Impact of Opioid Pharmacotherapy on Arterial stiffness and Vascular Ageing: Cross-sectional and Longitudinal Studies. Cardiovascular Toxicology 13, 254-266, doi:10.1007/s12012-013-9204-4 (2013).

27 Reece A. S. Relative and Age Dependent Stimulation of Soluble and Cellular Immunity in Opiate Dependence. Journal of Addiction Medicine 6, 10-17, doi:10.1097/ADM.0b013e31822c3bf4 (2012).

28 Reece A. S. Chronic Immune Stimulation as a Contributing Cause of Chronic Disease in Opiate Addiction Including Multi-System Ageing Medical hypotheses 75, 613-619, doi:10.1016/j.mehy.2010.07.047. Epub 2010 Aug 25. (2010).

29 Reece A.S. Improved Parameters of Metabolic Glycaemic and Immune Function and Arterial Stiffness with Naltrexone Implant Therapy. British Medical Journal, Case Reports (2008 ).

30 Reece A.S. & Hulse G. K.. Hypothalamic Pathophysiology in the Neuroimmune, Dysmetabolic and Longevity Complications of Chronic Opiate Dependency. J. Forensic Toxicology and Pharmacology 3, 3-46, doi:10.4172/2325-9841.1000126 (2014).

31 Reece, A. S. Evidence of Accelerated Ageing in Clinical Drug Addiction from Immune, Hepatic and Metabolic Biomarkers. Immun Ageing 4, 6-15, doi:10.1186/1742-4933-4-6. (2007).

32 Reece, A. S. Improved parameters of metabolic glycaemic and immune function and arterial stiffness with naltrexone implant therapy. BMJ Case Rep 2009, bcr0820080799, doi:10.1136/bcr.08.2008.0799 bcr08.2008.0799 [pii] (2009).

33 Reece, A. S. & Hulse, G. K. Elevation of the ACTH/cortisol ratio in female opioid dependent patients: A biomarker of aging and correlate of metabolic and immune activation. Neuro Endocrinol Lett 37, 325-336 (2016).

34 Reece A.S., Norman, A. & Hulse G.K. Cannabis Exposure as an Interactive Cardiovascular Risk Factor and Accelerant of Organismal Ageing – A Longitudinal Study. BMJ – Open 6, e011891-e011900, doi:http://dx.doi.org/10.1136/bmjopen- 2016-011891 (2016).

35 Sadler, T. W. Medical Embryology. 13th Edition edn, Vol. 1 1-406 (Wolters Kluwer, 2015).

36 Carlson, B. M. Human Embryology and Developmental Biology. Vol. 1 1-506 (Elsevier, 2014).

37 Pacher, P., Steffens, S., Hasko, G., Schindler, T. H. & Kunos, G. Cardiovascular effects of marijuana and synthetic cannabinoids: the good, the bad, and the ugly. Nat Rev Cardiol 15, 151-166, doi:10.1038/nrcardio.2017.130 (2018).

38 Lorenzetti, V. et al. Gross morphological brain changes with chronic, heavy cannabis use. Br J Psychiatry 206, 77-78, doi:10.1192/bjp.bp.114.151407 (2015).

39 Solowij, N. et al. Alteration to hippocampal shape in cannabis users with and without schizophrenia. Schizophrenia research 143, 179-184, doi:S0920-9964(12)00614-7 [pii] 10.1016/j.schres.2012.10.040 (2013).

40 Yates, D. Learning and memory: The cannabinoid connection. Nat Rev Neurosci 18, 4, doi:10.1038/nrn.2016.171 (2016).

41 Reece, A. S. & Hulse, G. K. Chromothripsis and epigenomics complete causality criteria for cannabis- and addiction-connected carcinogenicity, congenital toxicity and heritable genotoxicity. Mutat Res 789, 15-25, doi:10.1016/j.mrfmmm.2016.05.002 (2016).

42 Van Went, G. F. Mutagenicity testing of 3 hallucinogens: LSD, psilocybin and delta 9-THC, using the micronucleus test. Experientia 34, 324-325 (1978).

43 Zhang, C. Z. et al. Chromothripsis from DNA damage in micronuclei. Nature 522, 179-184, doi:10.1038/nature14493 (2015).

44 Tomar R.S. et al. Evidence on the Carcinogenicity of Marijuana Smoke. California Health Department 1, 1-150 (August 2009).

45 Callaghan, R. C., Allebeck, P., Akre, O., McGlynn, K. A. & Sidorchuk, A. Cannabis Use and Incidence of Testicular Cancer: A 42-Year Follow-up of Swedish Men between 1970 and 2011. Cancer Epidemiol Biomarkers Prev 26, 1644-1652,

doi:10.1158/1055-9965.EPI-17-0428 (2017).

46 Daling, J. R. et al. Association of marijuana use and the incidence of testicular germ cell tumors. Cancer 115, 1215-1223, doi:10.1002/cncr.24159 (2009).

47 Gurney, J., Shaw, C., Stanley, J., Signal, V. & Sarfati, D. Cannabis exposure and risk of testicular cancer: a systematic review and meta-analysis. BMC Cancer 15, 897, doi:10.1186/s12885-015-1905-6 (2015).

48 Lacson, J. C. et al. Population-based case-control study of recreational drug use and testis cancer risk confirms an association between marijuana use and nonseminoma risk. Cancer 118, 5374-5383, doi:10.1002/cncr.27554 (2012).

49 Trabert, B., Sigurdson, A. J., Sweeney, A. M., Strom, S. S. & McGlynn, K. A. Marijuana use and testicular germ cell tumors. Cancer 117, 848-853, doi:10.1002/cncr.25499 (2011).

50 Graham, J. D. P. in Cannabis and Health Vol. 1 (ed J.D.P. Graham) Ch. 8, 271-320 (Academic Press, 1976).

51 Geber, W. F. & Schramm, L. C. Effect of marihuana extract on fetal hamsters and rabbits. Toxicology and applied pharmacology 14, 276-282 (1969).

52 Forrester, M. B. & Merz, R. D. Risk of selected birth defects with prenatal illicit drug use, Hawaii, 1986-2002. Journal of toxicology and environmental health 70, 7-18 (2007).

53 van Gelder, M. M. et al. Maternal periconceptional illicit drug use and the risk of congenital malformations. Epidemiology 20, 60-66, doi:10.1097/EDE.0b013e31818e5930 (2009).

54 Van Gelder, M. M. H. J., Donders, A. R. T., Devine, O., Roeleveld, N. & Reefhuis, J. Using bayesian models to assess the effects of under-reporting of cannabis use on the association with birth defects, national birth defects prevention study, 1997-2005.
Paediatric and perinatal epidemiology 28, 424-433, doi:10.1111/ppe.12140 (2014).

55 Jenkins, K. J. et al. Noninherited risk factors and congenital cardiovascular defects: current knowledge: a scientific statement from the American Heart Association Council on Cardiovascular Disease in the Young: endorsed by the American Academy of Pediatrics. Circulation 115, 2995-3014,
doi:10.1161/CIRCULATIONAHA.106.183216 (2007).

56 Wilson, P. D., Loffredo, C. A., Correa-Villasenor, A. & Ferencz, C. Attributable fraction for cardiac malformations. Am J Epidemiol 148, 414-423 (1998).

57 Colorado: Department of Public Health and the Environment. Vol. 1 Birth Defect Data – Colorado Register of Congenital Surveillance Network 1 (ed Colorado: Department of Public Health and the Environment) http://www.chd.dphe.state.co.us/cohid/ (Colorado: Department of Public Health and the Environment, Denver Colorado, USA, 2018).

58 Brents L. in Handbook of Cannabis and Related Pathologies: Biology, Pharmacology, Diagnosis and Treatment Vol. 1 (ed Preedy V.R.) Ch. 17, 160-170 (Academic Press, 2017).

59 Fried, P. A. & Smith, A. M. A literature review of the consequences of prenatal marihuana exposure. An emerging theme of a deficiency in aspects of executive function. Neurotoxicol Teratol 23, 1-11 (2001).

60 Smith, A., Fried, P., Hogan, M. & Cameron, I. The effects of prenatal and current marijuana exposure on response inhibition: a functional magnetic resonance imaging study. Brain Cogn 54, 147-149 (2004).

61 Smith, A. M., Fried, P. A., Hogan, M. J. & Cameron, I. Effects of prenatal marijuana on response inhibition: an fMRI study of young adults. Neurotoxicol Teratol 26, 533-542, doi:10.1016/j.ntt.2004.04.004 (2004).

62 Smith, A. M., Longo, C. A., Fried, P. A., Hogan, M. J. & Cameron, I. Effects of marijuana on visuospatial working memory: an fMRI study in young adults. Psychopharmacology (Berl) 210, 429-438, doi:10.1007/s00213-010-1841-8 (2010).

63 Smith, A. M. et al. Prenatal marijuana exposure impacts executive functioning into young adulthood: An fMRI study. Neurotoxicol Teratol 58, 53-59, doi:10.1016/j.ntt.2016.05.010 (2016).

64 Zalesky, A. et al. Effect of long-term cannabis use on axonal fibre connectivity. Brain 135, 2245-2255, doi:aws136 [pii] 10.1093/brain/aws136 (2012).

65 Report of the Queensland Perinatal Maternal and Perinatal Quality Council & Queensland Health. Vol. 1 (ed Queensland Health) 5 (Queensland Health, Brisbane, 2018).

66 Werler, M. M., Sheehan, J. E. & Mitchell, A. A. Association of vasoconstrictive exposures with risks of gastroschisis and small intestinal atresia. Epidemiology 14, 349-354 (2003).

67 David, A. L. et al. A case-control study of maternal periconceptual and pregnancy recreational drug use and fetal malformation using hair analysis. PLoS One 9, e111038, doi:10.1371/journal.pone.0111038 (2014).

68 van Gelder, M. M. et al. Maternal periconceptional illicit drug use and the risk of congenital malformations. Epidemiology 20, 60-66, doi:10.1097/EDE.0b013e31818e5930 (2009).

69 Skarsgard, E. D. et al. Maternal risk factors for gastroschisis in Canada. Birth Defects Res A Clin Mol Teratol 103, 111-118, doi:10.1002/bdra.23349 (2015).

70 Torfs, C. P., Velie, E. M., Oechsli, F. W., Bateson, T. F. & Curry, C. J. A population-based study of gastroschisis: demographic, pregnancy, and lifestyle risk factors. Teratology 50, 44-53, doi:10.1002/tera.1420500107 (1994).

71 Draper, E. S. et al. Recreational drug use: a major risk factor for gastroschisis? Am J Epidemiol 167, 485-491, doi:10.1093/aje/kwm335 (2008).

72 Laughon, M. et al. Rising birth prevalence of gastroschisis. J Perinatol 23, 291-293, doi:10.1038/sj.jp.7210896 (2003).

73 Di Tanna, G. L., Rosano, A. & Mastroiacovo, P. Prevalence of gastroschisis at birth: retrospective study. BMJ (Clinical research ed 325, 1389-1390 (2002).

74 Centre, N. D. i. North Carolina Drug Threat Assessment, April 2003: Marijuana, (2003).

75 Nelson, J. S., Stebbins, R. C., Strassle, P. D. & Meyer, R. E. Geographic distribution of live births with tetralogy of Fallot in North Carolina 2003 to 2012. Birth Defects Res A Clin Mol Teratol 106, 881-887, doi:10.1002/bdra.23566 (2016).

76 Root, E. D., Meyer, R. E. & Emch, M. E. Evidence of localized clustering of gastroschisis births in North Carolina, 1999-2004. Social science & medicine (1982) 68, 1361-1367, doi:10.1016/j.socscimed.2009.01.034 (2009).

77 Leos-Toro C. et al. in Cannabis in Canada: Patterns and Trends, 2017 Vol. 1 (eds PROPEL, Centre for Population Health Impact, & University of Waterloo) 1-23 (University of Waterloo, Waterloo, Ontario, 2017).

78 Moore A., Roulean J. & Skarsgard E. Vol. 1 (ed Health Canada Public Health Agency of Canada) 57-63 (Health Canada, Ottawa, 2013).

79 DiNieri, J. A. et al. Maternal cannabis use alters ventral striatal dopamine D2 gene regulation in the offspring. Biol Psychiatry 70, 763-769, doi:10.1016/j.biopsych.2011.06.027 (2011).

80 Szutorisz, H. et al. Parental THC exposure leads to compulsive heroin-seeking and altered striatal synaptic plasticity in the subsequent generation. Neuropsychopharmacology 39, 1315-1323, doi:10.1038/npp.2013.352 (2014).

81 Watson, C. T. et al. Genome-Wide DNA Methylation Profiling Reveals Epigenetic Changes in the Rat Nucleus Accumbens Associated With Cross-Generational Effects of Adolescent THC Exposure. Neuropsychopharmacology, doi:10.1038/npp.2015.155 (2015).

82 Manikkam, M., Guerrero-Bosagna, C., Tracey, R., Haque, M. M. & Skinner, M. K. Transgenerational actions of environmental compounds on reproductive disease and identification of epigenetic biomarkers of ancestral exposures. PLoS One 7, e31901, doi:10.1371/journal.pone.0031901 (2012).

83 Manikkam, M., Tracey, R., Guerrero-Bosagna, C. & Skinner, M. K. Dioxin (TCDD) induces epigenetic transgenerational inheritance of adult onset disease and sperm epimutations. PLoS One 7, e46249, doi:10.1371/journal.pone.0046249 (2012).

84 Yang, X. et al. Histone modifications are associated with Delta9-tetrahydrocannabinol-mediated alterations in antigen-specific T cell responses. J Biol Chem 289, 18707-18718, doi:10.1074/jbc.M113.545210 (2014).

85 Public Health Agency of Canada. Vol. 1 (ed Health Canada Public Health Agency of Canada) 1-115 (Health Canada, Ottawa, 2013).

86 Substance Abuse and Mental Health Services Administration (SAMHSA), Department of Health and Human Services (HHS) & United States of America. National Survey on Drug Use and Health, (2018).

87 National Birth Defects Prevention Network. National Birth Defects Prevention Network, (2018).

88 Queensland Maternal and Perinatal Quality Council 2017. Vol. 1 1 (ed Queensland Health) 1-70 (Queensland Health, Brisbane, 2018).

Filed under: Australia,Brain and Behaviour,Cannabis/Marijuana,Drug use-various effects,Drug use-various effects on foetus, babies, children and youth,Effects of Drugs (Papers),Global Drug Legalisation Efforts,Health :

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

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

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

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

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

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

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

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

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

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

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

Source: Mail Online July 11th 2018

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

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