Daniulaityte, Raminta; Lamy, Francois R; Barratt, Monica; Nahhas, Ramzi W; Martins, Silvia S; Boyer, Edward W; Sheth, Amit; Carlson, Robert G
The study seeks to characterize marijuana concentrate users, describe reasons and patterns of use, perceived risk, and identify predictors of daily/near daily use. An anonymous web-based survey was conducted (April-June 2016) with 673 US-based cannabis users recruited via the Bluelight.org web-forum and included questions about marijuana concentrate use, other drugs, and socio-demographics. Multivariable logistic regression analyses were conducted to identify characteristics associated with greater odds of lifetime and daily use of marijuana concentrates. About 66% of respondents reported marijuana concentrate use. The sample was 76% male, and 87% white. Marijuana concentrate use was viewed as riskier than flower cannabis. Greater odds of marijuana concentrate use was associated with living in states with "recreational" (AOR=4.91; p=0.001) or "medical, less restrictive" marijuana policies (AOR=1.87; p=0.014), being male (AOR=2.21, p=0.002), younger (AOR=0.95, pmarijuana concentrate users reported daily/near daily use. Greater odds of daily concentrate use was associated with being male (AOR=9.29, p=0.033), using concentrates for therapeutic purposes (AOR=7.61, p=0.001), using vape pens for marijuana concentrate administration (AOR=4.58, p=0.007), and lower perceived risk of marijuana concentrate use (AOR=0.92, p=0.017). Marijuana concentrate use was more common among male, younger and more experienced users, and those living in states with more liberal marijuana policies. Characteristics of daily users, in particular patterns of therapeutic use and utilization of different vaporization devices, warrant further research with community-recruited samples. Copyright © 2017 Elsevier B.V. All rights reserved.
Lankenau, Stephen E; Ataiants, Janna; Mohanty, Salini; Schrager, Sheree; Iverson, Ellen; Wong, Carolyn F
While marijuana has been legal for medical purposes in California since 1996, little is known about the health histories of young adult medical marijuana patients who are a significant proportion of medical marijuana patients. We examined whether young adult medical marijuana patients reported health conditions and motivations for use that were consistent with medical use of marijuana in California. Young adults (N = 366) aged 18 to 26 years were sampled in Los Angeles in 2014-2015 and segmented into medical marijuana 'patients' (n = 210), marijuana users with a current recommendation, and non-patient users or 'non-patients' (n = 156), marijuana users who never had a medical marijuana recommendation. Differences between patients and non-patients regarding self-reported health histories and past/current motivations for marijuana use were expressed as unadjusted risk ratios. Compared with non-patients, patients were significantly more likely to report a range of lifetime health problems, such as psychological, physical pain and gastrointestinal. In the past 90 days, patients were significantly more likely to report motivations for marijuana use than non-patients concerning sleep, anxiety, physical pain and focusing. Psychological and pain problems were the most common health conditions reported to receive a medical marijuana recommendation. Patients were significantly less likely than non-patients to report any privacy concerns about obtaining a medical marijuana recommendation. Patients were significantly more likely to report a range of health conditions and motivations associated with medical use than non-patients. A great majority of patients reported obtaining a medical marijuana recommendation for health problems in accordance with the California law. [Lankenau SE, Ataiants J,Mohanty S, Schrager S, Iverson E, Wong CF.Health conditions and motivations for marijuana use among young adultmedical marijuana patients and non-patient marijuana users. Drug
Malouff, John M; Rooke, Sally E; Copeland, Jan
Using a marijuana vaporizer may have potential harm-reduction advantages on smoking marijuana, in that the user does not inhale smoke. Little research has been published on use of vaporizers. In the first study of individuals using a vaporizer on their own initiative, 96 adults anonymously answered questions about their experiences with a vaporizer and their use of marijuana with tobacco. Users identified 4 advantages to using a vaporizer over smoking marijuana: perceived health benefits, better taste, no smoke smell, and more effect from the same amount of marijuana. Users identified 2 disadvantages: inconvenience of setup and cleaning and the time it takes to get the device operating for each use. Only 2 individuals combined tobacco in the vaporizer mix, whereas 15 combined tobacco with marijuana when they smoked marijuana. Almost all participants intended to continue using a vaporizer. Vaporizers seem to have appeal to marijuana users, who perceive them as having harm-reduction and other benefits. Vaporizers are worthy of experimental research evaluating health-related effects of using them.
Choi, Namkee G; DiNitto, Diana M; Marti, C Nathan
Compared to their non-using age peers, older marijuana users are known to have lower marijuana risk perceptions. We examined associations of older marijuana users' risk perceptions with their marijuana use patterns and substance use disorders. Data are from 2013 to 2015 National Survey of Drug Use and Health (N = 24,057 respondents aged 50+ years). Bivariate logistic regression was used to compare risk perceptions among never users, former users, and past-year users aged 50+ years. Multivariable logistic regression was used to test associations between risk perception and marijuana use status and between risk perception and marijuana use patterns. Among the total sample, former (AOR = 0.30, 95% CI = 0.27-0.32) and past-year (AOR = 0.05, 95% CI = 0.04-0.06) marijuana users had significantly lower odds of moderate/great risk perception (as opposed to no/slight risk perception) than never users. Among past-year users, odds of moderate/great risk perception were lower among those who used marijuana more frequently (AOR = 0.14, 95% CI = 0.07-0.28 for 300+ days of use compared to 1-11 days of use) and who reported any medical marijuana use (AOR = 0.27, 95% CI = 0.14-0.51). However, those who had marijuana use disorder were 3.5 times more likely to report moderate/great risk perception (AOR = 3.50, 95% CI = 1.62-7.58). Those who had a college education, had higher incomes, and resided in states with medical marijuana laws also had lower risk perceptions. Public health education on scientific evidence about marijuana's benefits and harms and age-appropriate treatment for older adults with substance use problems are needed. Research on risk perception formation using longitudinal data among older adults is also needed.
Roy-Byrne, Peter; Maynard, Charles; Bumgardner, Kristin; Krupski, Antoinette; Dunn, Chris; West, Imara I; Donovan, Dennis; Atkins, David C; Ries, Richard
Marijuana is currently approved for medical use in 23 states. Both clinicians and the lay public have questioned whether users of marijuana for medical purposes are different from users of marijuana for recreational purposes. This study examined similarities and differences in important clinical characteristics between users of medical marijuana and users of recreational marijuana. The sample consisted of 868 adult primary care patients in Washington State, who reported use of medical marijuana (n = 131), recreational marijuana (n = 525), or drugs other than marijuana (n = 212). Retention was over 87% at 3-, 6-, 9-, and 12-month assessments. The majority of medical, psychiatric, substance use, and service utilization characteristic comparisons were not significant. However, medical marijuana users had significantly more medical problems, a significantly larger proportion reported >15 days medical problems in the past month, and significantly smaller proportions reported no pain and no mobility limitations (p marijuana users also had significantly lower drug problem severity, lower alcohol problem severity, and significantly larger proportions reported using marijuana alone and concomitant opioid use only (p marijuana with at least two additional substances (48% vs. 58%, respectively, p = .05). Although our results suggest that there are few distinct differences between medical and recreational users of marijuana, the differences observed, while mostly very small in effect size (marijuana to relieve symptoms and distress associated with medical illness. © American Academy of Addiction Psychiatry.
Becker, Mary P.; Collins, Paul F.; Luciana, Monica
Background Marijuana is the most commonly used illicit substance in the United States. Use, particularly when it occurs early, has been associated with cognitive impairments in executive functioning, learning, and memory. Methods This study comprehensively measured cognitive ability as well as comorbid psychopathology and substance use history to determine the neurocognitive profile associated with young adult marijuana use. College-aged marijuana users who initiated use prior to age 17 (n=35) were compared to demographically-matched controls (n=35). Results Marijuana users were high functioning, demonstrating comparable IQs to controls and relatively better processing speed. Marijuana users demonstrated relative cognitive impairments in verbal memory, spatial working memory, spatial planning, and motivated decision-making. Comorbid use of alcohol, which was heavier in marijuana users, was unexpectedly found to be associated with better performance in some of these areas. Conclusions This study provides additional evidence of neurocognitive impairment in the context of adolescent and young adult marijuana use. Findings are discussed in relation to marijuana’s effects on intrinsic motivation and discrete aspects of cognition. PMID:24620756
Full Text Available Abstract Background The rise of authorized marijuana use in the U.S. means that many individuals are using cannabis as they concurrently engage in other forms of treatment, such as substance abuse counseling and psychotherapy. Clinical and legal decisions may be influenced by findings that suggest marijuana use during treatment serves as an obstacle to treatment success, compromises treatment integrity, or increases the prevalence or severity of relapse. In this paper, the author reviews the relationship between authorized marijuana use and substance abuse treatment utilizing data from a preliminary pilot study that, for the first time, uses a systematic methodology to collect data examining possible effects on treatment. Methods Data from the California Outcomes Measurement System (CalOMS were compared for medical (authorized marijuana users and non-marijuana users who were admitted to a public substance abuse treatment program in California. Behavioral and social treatment outcomes recorded by clinical staff at discharge and reported to the California Department of Alcohol and Drug Programs were assessed for both groups, which included a sample of 18 reported medical marijuana users. Results While the findings described here are preliminary and very limited due to the small sample size, the study demonstrates that questions about the relationship between medical marijuana use and involvement in drug treatment can be systematically evaluated. In this small sample, cannabis use did not seem to compromise substance abuse treatment amongst the medical marijuana using group, who (based on these preliminary data fared equal to or better than non-medical marijuana users in several important outcome categories (e.g., treatment completion, criminal justice involvement, medical concerns. Conclusions This exploratory study suggests that medical marijuana is consistent with participation in other forms of drug treatment and may not adversely affect
Krauss, Melissa J; Sowles, Shaina J; Sehi, Auriann; Spitznagel, Edward L; Berg, Carla J; Bierut, Laura J; Cavazos-Rehg, Patricia A
Little is known about marijuana advertising exposure among users in the U.S. We examined the prevalence of advertising exposure among young adult marijuana users through traditional and new media, and identified characteristics associated with seeking advertisements. We conducted a cross-sectional survey of 18-34 year-old past-month marijuana users in the U.S. using a pre-existing online panel (N=742). The survey queried about passively viewing and actively seeking marijuana advertisements in the past month, sources of advertisements, and marijuana use characteristics. Over half of participants were exposed to marijuana advertising in the past month (28% passively observed advertisements, 26% actively sought advertisements). Common sources for observing advertisements were digital media (i.e., social media, online, text/emails; 77%). Similarly, those actively seeking advertisements often used Internet search engines (65%) and social media (53%). Seeking advertisements was more common among those who used medically (41% medical only, 36% medical and recreational) than recreational users (18%), who used concentrates or edibles (44% and 43%) compared to those who did not (20% and 19%), and who used multiple times per day (33%) compared to those who did not (19%) (all padvertising among users is common, especially via digital media, and is associated with medical use, heavier use, and use of novel products with higher THC concentrations (i.e., concentrates) or longer intoxication duration (i.e., edibles). As the U.S. marijuana policy landscape changes, it will be important to examine potential causal associations between advertising exposure and continuation or frequency/quantity of use. Copyright © 2017 Elsevier B.V. All rights reserved.
Desai, Rupak; Patel, Upenkumar; Deshmukh, Abhishek; Sachdeva, Rajesh; Kumar, Gautam
Marijuana or Cannabis is extensively used as a recreational substance globally. Case reports have reported cardiac arrhythmias immediately following recreational marijuana use. However, the burden of arrhythmias in hospitalized marijuana users have not been evaluated through prospective or cross-sectional studies. Therefore, we planned to measure temporal trends of the frequency of arrhythmias in hospitalized marijuana users using National Inpatient Sample (NIS) database in the United States. Copyright © 2017 Elsevier B.V. All rights reserved.
Lankenau, Stephen E; Fedorova, Ekaterina V; Reed, Megan; Schrager, Sheree M; Iverson, Ellen; Wong, Carolyn F
Little is known about young adult medical marijuana patients (MMP) and their marijuana using patterns and practices, which includes frequency of use, sourcing of marijuana products, forms/modes of administration, and patterns of illicit/prescription drug misuse, compared to non-patient marijuana users (NPU). Young adults (N=366) aged 18-26 years old were sampled in Los Angeles in 2014-15 and segmented into NPU (n=156), marijuana users who never had a medical marijuana (MM) recommendation, and MMP (n=210), marijuana users with a current, verified MM recommendation. Differences regarding self-reported marijuana and other drug use during the past 90days are expressed as unadjusted risk ratios or differences in means. MMP reported significantly greater mean days of use (76.4 vs. 59.2, pmarijuana products (564.5 vs. 266.9, pmarijuana obtained from a dispensary to someone else in the past 90days. MMP were more likely to report vaporization modalities for concentrates (URR=1.5, 95% C.I.=1.2, 2.0) and for marijuana (URR=1.5, 95% C.I.=1.1, 2.1) than NPU. Though not significant, trends toward lower misuse of prescription drugs in the past 90days were observed among MMP compared to NPU. MMP reported greater access to marijuana via dispensaries, more frequent and intensive use of marijuana, and greater use of non-combustible forms of marijuana compared to NPU. MMP reported less recent misuse of prescription drugs compared to NPU. Copyright © 2016. Published by Elsevier Ireland Ltd.
Park, Ji-Yeun; Wu, Li-Tzy
Available data suggest that medical marijuana users may have more mental health problems than recreational marijuana users. There is limited information about differences in behavioral health disorders and unmet treatment needs between medical and recreational marijuana users. We compared past-year prevalence of behavioral health disorders and unmet treatment needs across three marijuana subgroups (recreational use only, medical use only, and both). Sex-stratified logistic regression was performed to determine their associations with marijuana use status. We analyzed data from adults (≥18 years) who used marijuana in the past year (N=15,440) from 2013 to 2014 National Surveys on Drug Use and Health. Among 15,440 past-year marijuana users, 90.2% used recreational marijuana only, 6.2% used medical marijuana only, and 3.6% used both. Both users had the highest prevalence of behavioral health disorders and unmet treatment needs overall, with no significant sex differences. In the sex-specific logistic regression analysis, medical only users and both users showed somewhat different patterns of associations (reference group=recreational only users). Medical only users had decreased odds of alcohol or drug use disorders, and unmet need for alcohol or drug treatment among males and females. Additionally, female medical only users had decreased odds of opioid use disorder. Both users had increased odds of major depressive episode, hallucinogen use disorder, and unmet need for mental health services among males, and cocaine use disorder among females. Different approaches tailored to individuals' sex and motives for marijuana use is needed for the prevention and treatment of behavioral health problems. Copyright © 2017 Elsevier B.V. All rights reserved.
Smith, Philip H.; Homish, Gregory G.; Leonard, Kenneth E.; Collins, R. Lorraine
Background Previous laboratory-based research suggests that withdrawal from marijuana may cause increased aggression. It is unclear whether this finding extends beyond the laboratory setting to the general population of marijuana users. The purpose of this study was to test a cross-sectional association between marijuana withdrawal symptoms and aggression among a representative sample of U.S. adult marijuana users, and to test whether this association was moderated by previous history of aggression. Methods Data were analyzed from the National Epidemiologic Survey on Alcohol and Related Conditions. Wave Two data (2004–2005) were used for all variables except for history of aggression, which was assessed during the Wave One interview (2001–2002). Two outcomes were examined: self-report general aggression and relationship aggression. Odds ratios for aggression based on withdrawal symptoms and the interaction between withdrawal symptoms and history of aggression were calculated using logistic regression, adjusting for covariates and accounting for the complex survey design. Results Among marijuana users with a history of aggression, marijuana withdrawal was associated with approximately 60% higher odds of past year relationship aggression (p aggression among those without a history of aggression, and no association with general aggression regardless of history of aggression. Conclusions The findings from this study support the notion that laboratory-based increases in aggression due to marijuana withdrawal extend to the general population of marijuana users who have a previous history of aggression. PMID:23380439
Zimmermann, Kaeli; Walz, Christina; Derckx, Raissa T; Kendrick, Keith M; Weber, Bernd; Dore, Bruce; Ochsner, Kevin N; Hurlemann, René; Becker, Benjamin
Effective regulation of negative affective states has been associated with mental health. Impaired regulation of negative affect represents a risk factor for dysfunctional coping mechanisms such as drug use and thus could contribute to the initiation and development of problematic substance use. This study investigated behavioral and neural indices of emotion regulation in regular marijuana users (n = 23) and demographically matched nonusing controls (n = 20) by means of an fMRI cognitive emotion regulation (reappraisal) paradigm. Relative to nonusing controls, marijuana users demonstrated increased neural activity in a bilateral frontal network comprising precentral, middle cingulate, and supplementary motor regions during reappraisal of negative affect (P marijuana users relative to controls. Together, the present findings could reflect an unsuccessful attempt of compensatory recruitment of additional neural resources in the context of disrupted amygdala-prefrontal interaction during volitional emotion regulation in marijuana users. As such, impaired volitional regulation of negative affect might represent a consequence of, or risk factor for, regular marijuana use. Hum Brain Mapp 38:4270-4279, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.
Cunningham, William H.; And Others
Presents a study of 547 college students which found that: 1) It is possible to distinguish between undergraduate subjects who smoke marijuana and those who do not, 2) It is possible to draw a reasonable clear picture of the marijuana users' demographic characteristics, and 3) There is a positive relationship between the use of marijuana and the…
Martins, Silvia S.; Storr, Carla L.; Alexandre, Pierre K.; Chilcoat, Howard D.
Background Perceived risk and attitudes about the consequences of drug use, perceptions of others expectations and self-efficacy influence the intent to try drugs and continue drug use once use has started. We examine associations between adolescents’ attitudes and beliefs towards ecstasy use; because most ecstasy users have a history of marijuana use, we estimate the association for three groups of adolescents: non-marijuana/ecstasy users, marijuana users (used marijuana at least once but never used ecstasy) and ecstasy users (used ecstasy at least once). Methods Data from 5,049 adolescents aged 12–18 years old who had complete weighted data information in Round 2 of the Restricted Use Files (RUF) of the National Survey of Parents and Youth (NSPY). Data were analyzed using jackknife weighted multinomial logistic regression models. Results Adolescent marijuana and ecstasy users were more likely to approve of marijuana and ecstasy use as compared to non-drug using youth. Adolescent marijuana and ecstasy users were more likely to have close friends who approved of ecstasy as compared to non-drug using youth. The magnitudes of these two associations were stronger for ecstasy use than for marijuana use in the final adjusted model. Our final adjusted model shows that approval of marijuana and ecstasy use was more strongly associated with marijuana and ecstasy use in adolescence than perceived risk in using both drugs. Conclusion Information about the risks and consequences of ecstasy use need to be presented to adolescents in order to attempt to reduce adolescents’ approval of ecstasy use as well as ecstasy experimentation. PMID:18068314
Dougherty, Donald M; Mathias, Charles W; Dawes, Michael A; Furr, R Michael; Charles, Nora E; Liguori, Anthony; Shannon, Erin E; Acheson, Ashley
Marijuana is a popular drug of abuse among adolescents, and they may be uniquely vulnerable to resulting cognitive and behavioral impairments. Previous studies have found impairments among adolescent marijuana users. However, the majority of this research has examined measures individually rather than multiple domains in a single cohesive analysis. This study used a logistic regression model that combines performance on a range of tasks to identify which measures were most altered among adolescent marijuana users. The purpose of this research was to determine unique associations between adolescent marijuana use and performances on multiple cognitive and behavioral domains (attention, memory, decision-making, and impulsivity) in 14- to 17-year-olds while simultaneously controlling for performances across the measures to determine which measures most strongly distinguish marijuana users from nonusers. Marijuana-using adolescents (n = 45) and controls (n = 48) were tested. Logistic regression analyses were conducted to test for: (1) differences between marijuana users and nonusers on each measure, (2) associations between marijuana use and each measure after controlling for the other measures, and (3) the degree to which (1) and (2) together elucidated differences among marijuana users and nonusers. Of all the cognitive and behavioral domains tested, impaired short-term recall memory and consequence sensitivity impulsivity were associated with marijuana use after controlling for performances across all measures. This study extends previous findings by identifying cognitive and behavioral impairments most strongly associated with adolescent marijuana users. These specific deficits are potential targets of intervention for this at-risk population.
Jacobus, Joanna; Squeglia, Lindsay M; Infante, M Alejandra; Castro, Norma; Brumback, Ty; Meruelo, Alejandro D; Tapert, Susan F
The effect of adolescent marijuana use on brain development remains unclear despite relaxing legal restrictions, decreased perceived harm, and increasing use rates among youth. The aim of this 3-year prospective study was to evaluate the long-term neurocognitive effects of adolescent marijuana use. Adolescent marijuana users with concomitant alcohol use (MJ + ALC, n = 49) and control teens with limited substance use histories (CON, n = 59) were given neuropsychological and substance use assessments at project baseline, when they were ages 16-19. They were then reassessed 18 and 36 months later. Changes in neuropsychological measures were evaluated with repeated measures analysis of covariance (ANCOVA), controlling for lifetime alcohol use, and examined the effects of group, time, and group by time interactions on cognitive functioning. MJ + ALC users performed significantly worse than controls, across time points, in the domains of complex attention, memory, processing speed, and visuospatial functioning (ps marijuana use onset was associated with poorer processing speed and executive functioning by the 3-year follow-up (ps ≤.02). Frequent marijuana use throughout adolescence and into young adulthood appeared linked to worsened cognitive performance. Earlier age of onset appears to be associated with poorer neurocognitive outcomes that emerge by young adulthood, providing further support for the notion that the brain may be uniquely sensitive to frequent marijuana exposure during the adolescent phase of neurodevelopment. Continued follow-up of adolescent marijuana users will determine the extent of neural recovery that may occur if use abates. (c) 2015 APA, all rights reserved).
Comello, Maria Leonora G.; Slater, Michael D.
We report on research--both quantitative and qualitative--conducted to explore perceptions of prototypes of marijuana users, as well as the extent to which self-prototype congruence predicted marijuana use intention. Results of a survey of undergraduates (N = 139) showed that prototypes of users and non-users differed in terms of key attributes,…
Wei, Binnian; Alwis, K Udeni; Li, Zheng; Wang, Lanqing; Valentin-Blasini, Liza; Sosnoff, Connie S; Xia, Yang; Conway, Kevin P; Blount, Benjamin C
Marijuana is seeing increased therapeutic use, and is the world's third most-popular recreational drug following alcohol and tobacco. This widening use poses increased exposure to potentially toxic combustion by-products from marijuana smoke and the potential for public health concerns. To compare urinary metabolites of polycyclic aromatic hydrocarbons (PAHs) and volatile organic compounds (VOCs) among self-reported recent marijuana users and nonusers, while accounting for tobacco smoke exposure. Measurements of PAH and VOC metabolites in urine samples were combined with questionnaire data collected from participants in the National Health and Nutrition Examination Surveys (NHANES) from 2005 to 2012 in order to categorize participants (≥18years) into exclusive recent marijuana users and nonusers. Adjusted geometric means (GMs) of urinary concentrations were computed for these groups using multiple regression analyses to adjust for potential confounders. Adjusted GMs of many individual monohydroxy PAHs (OH-PAHs) were significantly higher in recent marijuana users than in nonusers (pmarijuana users than in nonusers. We found elevated levels of biomarkers for potentially harmful chemicals among self-identified, recent marijuana users compared with nonusers. These findings suggest that further studies are needed to evaluate the potential health risks to humans from the exposure to these agents when smoking marijuana. Published by Elsevier Ltd.
Carla J. Berg
Full Text Available Recent changes in policy and social norms related to marijuana use have increased its use and concern about how/where marijuana should be used. We aimed to characterize rules regarding marijuana and its use in homes. We recruited 1,567 US adults aged 18–34 years through Facebook advertisements to complete an online survey assessing marijuana use, social factors, perceptions of marijuana, and rules regarding marijuana and its use in the home, targeting tobacco and marijuana users to ensure the relevance of this topic. Overall, 648 (41.6% were current marijuana users; 46.0% of participants reported that “marijuana of any type is not allowed in their home or on their property.” Of those allowing marijuana on their property, 6.4% prohibited use of marijuana in their home. Of the remainder, 29.2% prohibited smoking marijuana, and 11.0% prohibited vaping, eating, or drinking marijuana. Correlates of more restrictive rules included younger age, being female, having
Ketcherside, Ariel; Jeon-Slaughter, Haekyung; Baine, Jessica L; Filbey, Francesca M
Specific personality traits have been linked with substance use disorders (SUDs), genetic mechanisms, and brain systems. Thus, determining the specificity of personality traits to types of SUD can advance the field towards defining SUD endophenotypes as well as understanding the brain systems involved for the development of novel treatments. Disentangling these factors is particularly important in highly co morbid SUDs, such as marijuana and nicotine use, so treatment can occur effectively for both. This study evaluated personality traits that distinguish isolated and co-morbid use of marijuana and nicotine. To that end, we collected the NEO Five Factor Inventory in participants who used marijuana-only (n=59), nicotine-only (n=27), both marijuana and nicotine (n=28), and in non-using controls (n=28). We used factor analyses to identify personality profiles, which are linear combinations of the five NEO Factors. We then conducted Receiver Operating Characteristics (ROC) curve analysis to test accuracy of the personality factors in discriminating isolated and co-morbid marijuana and nicotine users from each other. ROC curve analysis distinguished the four groups based on their NEO personality patterns. Results showed that NEO Factor 2 (openness, extraversion, agreeableness) discriminated marijuana and marijuana+nicotine users from controls and nicotine-only users with high predictability. Additional ANOVA results showed that the openness dimension discriminated marijuana users from nicotine users. These findings suggest that personality dimensions distinguish marijuana users from nicotine users and should be considered in prevention strategies. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.
Auer, Reto; Vittinghoff, Eric; Yaffe, Kristine; Künzi, Arnaud; Kertesz, Stefan G; Levine, Deborah A; Albanese, Emiliano; Whitmer, Rachel A; Jacobs, David R; Sidney, Stephen; Glymour, M Maria; Pletcher, Mark J
Marijuana use is increasingly common in the United States. It is unclear whether it has long-term effects on memory and other domains of cognitive function. To study the association between cumulative lifetime exposure to marijuana use and cognitive performance in middle age. We used data from the Coronary Artery Risk Development in Young Adults (CARDIA) study, a cohort of 5115 black and white men and women aged 18 to 30 years at baseline from March 25, 1985, to June 7, 1986 (year 0), and followed up over 25 years from June 7, 1986, to August 31, 2011, to estimate cumulative years of exposure to marijuana (1 year = 365 days of marijuana use) using repeated measures and to assess associations with cognitive function at year 25. Linear regression was used to adjust for demographic factors, cardiovascular risk factors, tobacco smoking, use of alcohol and illicit drugs, physical activity, depression, and results of the mirror star tracing test (a measure of cognitive function) at year 2. Data analysis was conducted from June 7, 1986, to August 31, 2011. Three domains of cognitive function were assessed at year 25 using the Rey Auditory Verbal Learning Test (verbal memory), the Digit Symbol Substitution Test (processing speed), and the Stroop Interference Test (executive function). Among 3385 participants with cognitive function measurements at the year 25 visit, 2852 (84.3%) reported past marijuana use, but only 392 (11.6%) continued to use marijuana into middle age. Current use of marijuana was associated with worse verbal memory and processing speed; cumulative lifetime exposure was associated with worse performance in all 3 domains of cognitive function. After excluding current users and adjusting for potential confounders, cumulative lifetime exposure to marijuana remained significantly associated with worse verbal memory. For each 5 years of past exposure, verbal memory was 0.13 standardized units lower (95% CI, -0.24 to -0.02; P = .02), corresponding to a mean of
Tsai, James; Rolle, Italia V.; Singh, Tushar; Boulet, Sheree L.; McAfee, Timothy A.; Grant, Althea M.
The purpose of this study was to examine the patterns of marijuana and tobacco use and their associations with suboptimal self-rated health (SRH) among US adults who reported ?ever, even once, using marijuana or hashish.? Data came from the 2009?2012 National Health and Nutrition Examination Survey, restricting to respondents aged 20 years and older who reported using marijuana at least once in their lifetime (n?=?3,210). We assessed the age-adjusted prevalence of mutually exclusive groups of...
Whitlow, Christopher T; Liguori, Anthony; Livengood, L Brooke; Hart, Stephanie L; Mussat-Whitlow, Becky J; Lamborn, Corey M; Laurienti, Paul J; Porrino, Linda J
Chronic marijuana use has been associated with impairments of learning, memory, and executive functions. Little is known, however, about the effects of marijuana use on other cognitive domains, such as decision-making, which are thought to play an important role in addiction and drug abuse. The purpose of the present study was to determine if long-term heavy marijuana users employ different decision-making strategies than individuals with minimal marijuana exposure. Volunteers were assigned to a cannabis (n = 10) or control group (n = 10) based upon history of prior marijuana use. Demographic and neuropsychological variables were evaluated, and a decision-making task--the gambling task (GT) was administered. Although few demographic and neuropsychological differences were noted between groups, marijuana users made more decisions that led to larger immediate gains despite more costly losses than controls. These data suggest that long-term heavy marijuana users may have specific deficits in the ability to balance rewards and punishments that may contribute to continued drug-taking behavior. It is unknown, however, whether the basis for such deficits might be attributed directly to marijuana exposure or pre-existing genetic or behavioral differences.
Masters, Matthew N; Haardörfer, Regine; Windle, Michael; Berg, Carla
Limited research has examined psychosocial factors that differ among cigarette users, marijuana users, and co-users and influence their cessation efforts. We examined: 1) sociodemographic, mental health, and other substance use in relation to user category; and 2) associations among these factors in relation to recent quit attempts and readiness to quit among single product versus co-users. We used a cross-sectional design to study college students aged 18-25 from seven Georgia campuses, focusing on the 721 reporting cigarette and/or marijuana use in the past 4months (238 cigarette-only; 331 marijuana-only; 152 co-users). Multinomial logistic regression showed that correlates (p'susers were more likely to report readiness to quit and quit attempts of cigarettes versus marijuana (p'susers reported readiness to quit, 41.18% of cigarette-only and 21.75% of marijuana-only users reported recent quit attempts (p's<0.001). Binary logistic regressions indicated distinct correlates of readiness to quit and quit attempts of cigarettes and marijuana. Cessation efforts of the respective products must attend to co-use with the other product to better understand relative perceptions of importance and confidence in quitting and actual cessation efforts. Copyright © 2017 Elsevier Ltd. All rights reserved.
Cohn, Amy M; Johnson, Amanda L; Rose, Shyanika W; Rath, Jessica M; Villanti, Andrea C
As of 2015, more than half of U.S. states have legalized, medicalized, or decriminalized marijuana. This study examined the prevalence and correlates of support for marijuana legalization in a national sample of young adults and the intention to use marijuana more frequently if it were legalized. Data were from Wave 7 (weighted N = 3532) of the Truth Initiative Young Adult Cohort, a national sample of men and women aged 18-34. We assessed demographics, past 30-day substance (alcohol, tobacco, marijuana, other drug use), depression and anxiety, social smoking, marijuana harm perceptions (relative to cigarettes), and state-level marijuana policies as correlates of support for marijuana legalization and intentions to use marijuana more often if it were legalized. Multivariable models of correlates of support for legalization and intentions to use marijuana were conducted separately for the full sample and for nonmarijuana users. Weighted estimates showed that 39% of the full sample and 9% of nonmarijuana users supported marijuana legalization. Multivariable models showed that lower marijuana harm perceptions and lifetime and past 30-day tobacco use were common predictors of support for marijuana legalization and intentions to use marijuana among non-users of marijuana. Conclusions/Importance: Over a third of the sample supported marijuana legalization. Tobacco use and perceptions that marijuana is less harmful than cigarettes were robust risk correlates of support for marijuana legalization and intentions to use more frequently among nonusers. Public health campaigns should target these factors to deter marijuana-related harm in susceptible young adults.
King, Keith A.; Merianos, Ashley L.; Vidourek, Rebecca A.
Background: Because marijuana is becoming more accessible and perceived norms of use are becoming increasingly more favorable, research is needed to understand characteristics of marijuana acquisition among adolescents. Purpose: The study purpose was to examine whether sources and locations where adolescent users obtain and use marijuana differed…
In conclusion, among adult ever users of marijuana, current tobacco use is high and strongly associated with suboptimal SRH; regular marijuana smoking with or without current tobacco use is significantly associated with suboptimal SRH.
Ortiz, Ana P; González, Daisy; Ramos, Jeslie; Muñoz, Cristina; Reyes, Juan Carlos; Pérez, Cynthia M
Despite limited data, research suggests that marijuana use is associated with oral HPV infection and periodontitis, two potential oropharyngeal cancer risk factors. We assessed these associations in a Hispanic adult population in Puerto Rico. A cross-sectional study of 735 adults assessed marijuana use, determined through an audio computer-assisted self-interview, and periodontitis and self-collection of oral HPV samples following the National Health and Nutrition Examination Survey methodology. The Centers of Disease Control and Prevention/American Academy of Periodontology definition was used for periodontitis. HPV typing was performed using polymerase chain reaction with modified L1 consensus primers (MY09/MY11). 26.5% of adults reported lifetime use of marijuana, 2.7% were frequent users (lifetime use ≥ 26 times, past year use ≥ 6 times, and past 30-day use ≥2 times), 5.7% had oral HPV infection, and 20.1% had severe periodontitis. The multivariate logistic regression analysis showed that frequent marijuana users were more likely to have severe periodontitis (OR = 2.91, 95%CI = 1.06 - 7.96) than never/once lifetime users after adjusting for age, sex, healthcare coverage, smoking, binge drinking, number of oral sex partners, and oral HPV infection. However, frequent marijuana use was not associated with oral HPV infection. Marijuana use was associated with periodontitis, but not with oral HPV infection. Further evaluation of the role of marijuana use in oral HPV infection and periodontitis may inform novel preventive public health strategies, as marijuana users could be at increased risk of oral cancer. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
Keen, Larry; Turner, Arlener D.; Callender, Clive; Campbell, Alfonso
It is unknown how lifetime marijuana use affects different proinflammatory cytokines. The purpose of the current study is to explore potential differential effects of lifetime marijuana use on interleukin-1 alpha (IL-1α) and tumor necrosis factor (TNF) in a community based sample. Participants included 168 African American adults (51% female, median age= 47 years). Upon study entry, blood was drawn and the participants completed questions regarding illicit drug use history whose answers were ...
Caputi, Theodore L; Humphreys, Keith
Previous studies have found a negative population-level correlation between medical marijuana availability in US states, and trends in medical and nonmedical prescription drug use. These studies have been interpreted as evidence that use of medical marijuana reduces medical and nonmedical prescription drug use. This study evaluates whether medical marijuana use is a risk or protective factor for medical and nonmedical prescription drug use. Simulations based upon logistic regression analyses of data from the 2015 National Survey on Drug Use and Health were used to compute associations between medical marijuana use, and medical and nonmedical prescription drug use. Adjusted risk ratios (RRs) were computed with controls added for age, sex, race, health status, family income, and living in a state with legalized medical marijuana. Medical marijuana users were significantly more likely (RR 1.62, 95% confidence interval [CI] 1.50-1.74) to report medical use of 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 (RR 2.12, 95% CI 1.67-2.62), with elevated risks for pain relievers (RR 1.95, 95% CI 1.41-2.62), stimulants (RR 1.86, 95% CI 1.09-3.02), and tranquilizers (RR 2.18, 95% CI 1.45-3.16). Our findings disconfirm the hypothesis that a population-level negative correlation between medical marijuana use and prescription drug harms occurs because medical marijuana users are less likely to use prescription drugs, either medically or nonmedically. Medical marijuana users should be a target population in efforts to combat nonmedical prescription drug use.
Daniulaityte, Raminta; Zatreh, Mussa Y; Lamy, Francois R; Nahhas, Ramzi W; Martins, Silvia S; Sheth, Amit; Carlson, Robert G
The purpose of this paper is to analyze characteristics of marijuana concentrate users, describe patterns and reasons of use, and identify factors associated with daily use of concentrates among U.S.-based cannabis users recruited via a Twitter-based online survey. An anonymous Web-based survey was conducted in June 2017 with 687 U.S.-based cannabis users recruited via Twitter-based ads. The survey included questions about state of residence, socio-demographic characteristics, and cannabis use including marijuana concentrates. Multiple logistic regression analyses were conducted to identify characteristics associated with lifetime and daily use of marijuana concentrates. Almost 60% of respondents were male, 86% were white, and the mean age was 43.0 years. About 48% reported marijuana concentrate use. After adjusting for multiple testing, significant predictors of concentrate use included: living in "recreational" (AOR = 2.04; adj. p = .042) or "medical, less restrictive" (AOR = 1.74; adj. p = .030) states, being younger (AOR = 0.97, adj. p = .008), and daily herbal cannabis use (AOR = 2.57, adj. p = .008). Out of 329 marijuana concentrate users, about 13% (n = 44) reported daily/near daily use. Significant predictors of daily concentrate use included: living in recreational states (AOR = 3.59, adj. p = .020) and using concentrates for therapeutic purposes (AOR = 4.34, adj. p = .020). Living in states with more liberal marijuana policies is associated with greater likelihood of marijuana concentrate use and with more frequent use. Characteristics of daily users, in particular, patterns of therapeutic use warrant further research with community-recruited samples. Copyright © 2018 Elsevier B.V. All rights reserved.
Full Text Available The harmful effects of marijuana on health and in particular cardiovascular health are understudied. To develop such knowledge, an efficient method of developing an informative cohort of marijuana users and non-users is needed.We identified patients with a diagnosis of coronary artery disease using ICD-9 codes who were seen in the San Francisco VA in 2015. We imported these patients' medical record notes into an informatics platform that facilitated text searches. We categorized patients into those with evidence of marijuana use in the past 12 months and patients with no such evidence, using the following text strings: "marijuana", "mjx", and "cannabis". We randomly selected 51 users and 51 non-users based on this preliminary classification, and sent a recruitment letter to 97 of these patients who had contact information available. Patients were interviewed on marijuana use and domains related to cardiovascular health. Data on marijuana use collected from the medical record was compared to data collected as part of the interview.The interview completion rate was 71%. Among the 35 patients identified by text strings as having used marijuana in the previous year, 15 had used marijuana in the past 30 days (positive predictive value = 42.9%. The probability of use in the past month increased from 8.8% to 42.9% in people who have these keywords in their medical record compared to those who did not have these terms in their medical record.Methods that combine text search strategies for participant recruitment with health interviews provide an efficient approach to developing prospective cohorts that can be used to study the health effects of marijuana.
Strong, David R; Myers, Mark G; Pulvers, Kim; Noble, Madison; Brikmanis, Kristin; Doran, Neal
With an increase in marijuana use among adults in the United States (US), understanding the potential impact of marijuana use on tobacco use and associated behavioral and health consequences, including respiratory conditions, is necessary. Survey responses from Wave 1 of the nationally representative Population Assessment of Tobacco and Health (PATH) Study were used to assess tobacco use and marijuana use among non-current tobacco users (n = 17,952) and current established tobacco-users classified as: cigarette only users (n = 8689), e-cigarette only users (n = 437), cigar only (traditional, cigarillo, or filtered) users (n = 706), hookah only users (n = 461), smokeless tobacco only users (n = 971), cigarette + e-cigarette users (n = 709), and users of multiple tobacco products (n = 2314). When compared to non-current tobacco users, each tobacco user group except smokeless only users had higher odds (odds ratios ranging from 3.86-8.07) of reporting current marijuana use. Among current tobacco users, higher levels of tobacco dependence did not explain the relationship between tobacco use and marijuana use. Additionally, concurrent marijuana use was associated with lower odds of attempts to quit tobacco (OR = 0.86, 95% CI = 0.79, 0.94, p users of tobacco and marijuana. Copyright © 2018 Elsevier B.V. All rights reserved.
Roebke, Patrick V; Vadhan, Nehal P; Brooks, Daniel J; Levin, Frances R
Both individuals with marijuana use and depressive disorders exhibit verbal learning and memory decrements. This study investigated the interaction between marijuana dependence and depression on learning and memory performance. The California Verbal Learning Test-Second Edition (CVLT-II) was administered to depressed (n = 71) and non-depressed (n = 131) near-daily marijuana users. The severity of depressive symptoms was measured by the self-rated Beck Depression Inventory (BDI-II) and the clinician-rated Hamilton Depression Rating Scale (HAM-D). Multivariate analyses of covariance statistics (MANCOVA) were employed to analyze group differences in cognitive performance. Pearson's correlation coefficients were calculated to examine the relative associations between marijuana use, depression and CVLT-II performance. Findings from each group were compared to published normative data. Although both groups exhibited decreased CVLT-II performance relative to the test's normative sample (p marijuana-dependent subjects with a depressive disorder did not perform differently than marijuana-dependent subjects without a depressive disorder (p > 0.05). Further, poorer CVLT-II performance was modestly associated with increased self-reported daily amount of marijuana use (corrected p depressive symptoms (corrected p > 0.002). These findings suggest an inverse association between marijuana use and verbal learning function, but not between depression and verbal learning function in regular marijuana users.
Pedersen, Eric R; Villarosa-Hurlocker, Margo C; Prince, Mark A
Young adult veterans are at risk for problematic marijuana use and associated consequences, which is partially due to their high rates of Posttraumatic Stress Disorder (PTSD), depression, and problematic substance use. Veterans tend to endorse more severe and chronic mental health symptoms compared to their civilian counterparts and they identify marijuana use as a method to cope with their symptoms. Given the prevalence of marijuana use among veterans in the community and in clinical settings, it is important to explore the factors that may help minimize harm associated with use for those that choose to use the drug. The present study sought to examine the impact of protective behavioral strategies on the relationship between mental health symptoms and marijuana use and consequences in a sample of 180 young adult veteran marijuana users. Participants were recruited via social media advertisements and completed measures of marijuana use and consequences, protective behavioral strategies, and PTSD and depression symptoms. Findings indicated that more frequent use of protective behavioral strategies was associated with less marijuana use and consequences. Participants who screened positive for PTSD or depression reported more marijuana consequences than did those not positive on these screeners. Regression analyses revealed protective strategies moderated the relationship between PTSD and marijuana consequences such that young veterans who endorsed more PTSD symptoms and infrequent use of protective strategies reported the most marijuana consequences. No moderating effects were found for the relationship between depression and marijuana consequences. Findings have clinical implications for working with young veterans.
Desai, Rupak; Patel, Upenkumar; Sharma, Shobhit; Amin, Parth; Bhuva, Rushikkumar; Patel, Malav S; Sharma, Nitin; Shah, Manan; Patel, Smit; Savani, Sejal; Batra, Neha; Kumar, Gautam
Background Marijuana is a widely used recreational substance. Few cases have been reported of acute myocardial infarction following marijuana use. To our knowledge, this is the first ever study analyzing the lifetime odds of acute myocardial infarction (AMI) with marijuana use and the outcomes in AMI patients with versus without marijuana use. Methods We queried the 2010-2014 National Inpatient Sample (NIS) database for 11-70-year-old AMI patients. Pearson Chi-square test for categorical variables and Student T-test for continuous variables were used to compare the baseline demographic and hospital characteristics between two groups (without vs. with marijuana) of AMI patients. The univariate and multivariate analyses were used to assess and compare the clinical outcomes between two groups. We used Cochran-Armitage test to measure the trends. All statistical analyses were executed by IBM SPSS Statistics 22.0 (IBM Corp., Armonk, NY). We used weighted data to produce national estimates in our study. Results Out of 2,451,933 weighted hospitalized AMI patients, 35,771 patients with a history of marijuana and 2,416,162 patients without a history of marijuana use were identified. The AMI-marijuana group consisted more of younger, male, African American patients. The length of stay and mortality rate were lower in the AMI-marijuana group with more patients being discharged against medical advice. Multivariable analysis showed that marijuana use was a significant risk factor for AMI development when adjusted for age, sex, race (adjusted OR 1.079, 95% CI 1.065-1.093, pmarijuana group. Conclusion The lifetime AMI odds were increased in recreational marijuana users. Overall odds of mortality were not increased significantly in AMI-marijuana group. However, marijuana users showed higher trends of AMI prevalence and related mortality from 2010-2014. It is crucial to assess cardiovascular effects related to marijuana overuse and educate patients for the same.
Vidot, Denise C; Bispo, Jordan B; Hlaing, WayWay M; Prado, Guillermo; Messiah, Sarah E
The relationship between marijuana use and recreational physical activity has yet to be explored in the United States. Our aim was to examine this relationship in a population-based sample of 20-to-59-year olds (N=12,618) using 2007-2014 National Health and Nutrition Examination Surveys. Marijuana use was categorized as never (reference group), past (previously but not within the last 30-days), and current (>1day in the last 30-days) use. Current users were further categorized based on frequency of use (light, moderate, and heavy users). Physical activity was self-reported as moderate (small increase in heartrate/breathing for >10min; MPA) and vigorous (large increase in heartrate/breathing for >10min; VPA). Adjusted odds ratios (AOR) for the relationship between marijuana use and physical activity were estimated via logistic regression models. The majority of the overall sample reported either past (40.5%) or current (12.6%) marijuana use. Marijuana users had a lower prevalence of moderate physical activity than never users (current: 51.9%, past: 50.4%, never: 55.3%, p=0.001). Current (66.8%) and past (67.9%) marijuana users also had a lower prevalence of vigorous physical activity than never users (71.9%, p=0.001). Current and past users had lower odds of recreational MPA (current user AOR: 0.66, 95% CI: 0.50-0.87; past user AOR: 0.78, 95% CI: 0.62-0.98) than never users. As the frequency of marijuana use increased, time spent on MPA decreased. Results suggest that current and past marijuana users were less likely to report recreational MPA than never users. Future studies should examine the potential mechanisms and temporality of this relationship. Copyright © 2017 Elsevier B.V. All rights reserved.
Panee, Jun; Gerschenson, Mariana; Chang, Linda
Marijuana (MJ) use is associated with cognitive deficits. Both mitochondrial (mt) dysfunction and gut dysbiosis also affect cognition. We examined whether cognition is related to peripheral blood mononuclear cells' (PBMCs) mt function and fecal microbiota in chronic MJ users. Nineteen chronic MJ users and 20 non-users were evaluated using the Cognition Battery in NIH Toolbox, their mt function for ATP production, and basal and maximal respirations were measured in PBMCs using the Seahorse XFe96 Analyzer, and the abundances of Prevotella and Bacteroides (associated with plant-based and animal product-based diet, respectively) were calculated from stool microbiota analysis. Average Prevotella:Bacteroides ratio was ~13-fold higher in nonusers than users. Lifetime MJ use correlated inversely with Prevotella:Bacteroides ratio (p = 0.05), mt function (p = 0.0027-0.0057), and Flanker Inhibitory Control and Attention (p = 0.041). Prevotella abundance correlated positively, while Bacteroides abundance correlated inversely, with mt function across all participants (p = 0.0004-0.06). Prevotella abundance also correlated positively with scores of Fluid Cognition, Flanker Inhibitory Control and Attention, List Sorting, and Dimension Change Card Sort in MJ users, but not in non-users (interaction-p = 0.018-0.05). Similarly, mt function correlated positively with scores of Fluid Cognition and Flanker Inhibitory Control and Attention in MJ users, but not in non-users (interaction-p = 0.0018-0.08). These preliminary findings suggest that MJ use is associated with alterations of gut microbiota and mt function, which may further contribute to cognitive deficits. We posited that MJ-associated low vegetable/fruit intake may contribute to these changes. Future studies are needed to delineate the relationships among diet, microbiota, mt function, and cognition in MJ users.
Full Text Available Background. Adolescent marijuana use is associated with structural and functional differences in forebrain regions while performing memory and attention tasks. In the present study, we investigated neural processing in adolescent marijuana users experiencing rewards and losses. Fourteen adolescents with frequent marijuana use (>5 uses per week and 14 nonuser controls performed a computer task where they were required to guess the outcome of a simulated coin flip while undergoing magnetic resonance imaging. Results. Across all participants, “Wins” and “Losses” were associated with activations including cingulate, middle frontal, superior frontal, and inferior frontal gyri and declive activations. Relative to controls, users had greater activity in the middle and inferior frontal gyri, caudate, and claustrum during “Wins” and greater activity in the anterior and posterior cingulate, middle frontal gyrus, insula, claustrum, and declive during “Losses.” Effective connectivity analyses revealed similar overall network interactions among these regions for users and controls during both “Wins” and “Losses.” However, users and controls had significantly different causal interactions for 10 out of 28 individual paths during the “Losses” condition. Conclusions. Collectively, these results indicate adolescent marijuana users have enhanced neural responses to simulated monetary rewards and losses and relatively subtle differences in effective connectivity.
Wang, Julie B; Cataldo, Janine K
We examined effects of long-term medical marijuana legalization on cigarette co-use in a sample of adults. We conducted secondary analysis using data from the 2014 US Tobacco Attitudes and Beliefs Survey, which consisted of cigarette smokers, aged ≥ 45 years (N = 506). Participants were categorized by their state residence, where medical marijuana was (1) illegal, (2) legalized legalized ≥ 10 years. The Web-based survey assessed participants' marijuana use, beliefs and attitudes on marijuana, and nicotine dependence using Fagerstrom Tolerance for Nicotine Dependence (FTND) and Hooked on Nicotine Checklist (HONC) scores. In cigarette smokers aged ≥ 45 years, long-term legalization of medical marijuana was associated with stable positive increases in marijuana use prevalence (ever in a lifetime) (p = .005) and frequency (number of days in past 30 days) (unadjusted p = .005; adjusted p = .08). Those who reported marijuana co-use had greater FTND and HONC scores after adjusting for covariates (p = .05). These preliminary findings warrant further examination of the potential impact of long-term legalization of medical marijuana on greater cigarette and marijuana co-use in adults and higher nicotine dependence among co-users at the population level.
Schweinsburg, Alecia Denise
Marijuana is commonly used in adolescence, yet the impact on the developing brain is unclear. Working memory impairments have been observed in adult marijuana users after recent use, but may remit after a month of abstinence. The differential effects related to recent use and abstinence have not been delineated in adolescents. To address this question, three studies examined functional magnetic resonance imaging (fMRI) brain response during spatial working memory (SWM) among adolescents. Adol...
Budney, A J; Hughes, J R; Moore, B A; Novy, P L
Although withdrawal symptoms are commonly reported by persons seeking treatment for marijuana dependence, the validity and clinical significance of a marijuana withdrawal syndrome has not been established. This controlled outpatient study examined the reliability and specificity of the abstinence effects that occur when daily marijuana users abruptly stop smoking marijuana. Twelve daily marijuana smokers were assessed on 16 consecutive days during which they smoked marijuana as usual (days 1-5), abstained from smoking marijuana (days 6-8), returned to smoking marijuana (days 9-13), and again abstained from smoking marijuana (days 14-16). An overall measure of withdrawal discomfort increased significantly during the abstinence phases and returned to baseline when marijuana smoking resumed. Craving for marijuana, decreased appetite, sleep difficulty, and weight loss reliably changed across the smoking and abstinence phases. Aggression, anger, irritability, restlessness, and strange dreams increased significantly during one abstinence phase, but not the other. Collateral observers confirmed participant reports of these symptoms. This study validated several specific effects of marijuana abstinence in heavy marijuana users, and showed they were reliable and clinically significant. These withdrawal effects appear similar in type and magnitude to those observed in studies of nicotine withdrawal.
Schauer, Gillian L; King, Brian A; McAfee, Timothy A
Approximately 70% of current (past 30-day) adult marijuana users are current tobacco users, which may complicate tobacco cessation. We assessed prevalence and trends in tobacco cessation among adult ever tobacco users, by marijuana use status. Data came from the National Survey on Drug Use and Health, a cross-sectional, nationally representative, household survey of U.S. civilians. Analyses included current, former, and never marijuana users aged≥18 reporting ever tobacco use (cigarette, cigar, chew/snuff). We computed weighted estimates (2013-2014) of current tobacco use, recent tobacco cessation (quit 30days to 12months), and sustained tobacco cessation (quit>12months) and adjusted trends in tobacco use and cessation (2005-2014) by marijuana use status. We also assessed the association between marijuana and tobacco use status. In 2013-2014, among current adult marijuana users reporting ever tobacco use, 69.1% were current tobacco users (vs. 38.5% of former marijuana users, pusers, pusers, pusers, pusers, pusers, pusers who ever used tobacco had double the prevalence (vs. never-marijuana users) of current tobacco use, and significantly lower sustained abstinence. Interventions addressing tobacco cessation in the context of use of marijuana and other substances may be warranted. Copyright © 2017 Elsevier Ltd. All rights reserved.
Valerie L Forman-Hoffman
Full Text Available Marijuana initiation during adolescence, and early adolescence in particular, is associated with adverse health consequences. Our study used 2005-2014 data from the annual, cross-sectional National Survey on Drug Use and Health to study the prevalence and correlates of marijuana initiation, use, and marijuana use disorder (MUD; abuse or dependence among 12- to 14-year olds living in civilian US households (n = 84 954. Examined correlates included age, sex, race/ethnicity, poverty status, metropolitan status, year of survey, depression, tobacco use, alcohol use, and fighting at school. Sex differences in the correlates of lifetime use and past year marijuana initiation were tested via interaction. Lifetime prevalence of marijuana use was 5.5%; 3.2% reported past year initiation. About 1 in 6 (16.8% past year initiates progressed to MUD within 12 months of first use. Although men had higher prevalence of lifetime use than women, past year initiation did not differ by sex. On examining the sex*race/ethnicity interaction effects, findings determined that non-Hispanic black and Hispanic men had higher prevalence estimates of ever using marijuana and incidence of past year initiation as compared with non-Hispanic white men; these race/ethnicity differences were not found among women. Identifying correlates of initiation and progression to MUD among young adolescents is critical to improve prevention and treatment program targets.
Boggio, Paulo S; Zaghi, Soroush; Villani, Ana Beatriz; Fecteau, Shirley; Pascual-Leone, Alvaro; Fregni, Felipe
Cognitive deficits that are reported in heavy marijuana users (attention, memory, affect perception, decision-making) appear to be completely reversible after a prolonged abstinence period of about 28 days. However, it remains unclear whether the reversibility of these cognitive deficits indicates that (1) chronic marijuana use is not associated with long-lasting changes in cortical networks or (2) that such changes occur but the brain adapts to and compensates for the drug-induced changes. Therefore, we examined whether chronic marijuana smokers would demonstrate a differential pattern of response in comparison to healthy volunteers on a decision-making paradigm (Risk Task) while undergoing sham or active transcranial direct current stimulation (tDCS) of the dorsolateral prefrontal cortex (DLPFC). Twenty-five chronic marijuana users who were abstinent for at least 24h were randomly assigned to receive left anodal/right cathodal tDCS of DLPFC (n=8), right anodal/left cathodal tDCS of DLPFC (n=9), or sham stimulation (n=8); results on Risk Task during sham/active tDCS were compared to healthy volunteers from a previously published dataset. Chronic marijuana users demonstrated more conservative (i.e. less risky) decision-making during sham stimulation. While right anodal stimulation of the DLPFC enhanced conservative decision-making in healthy volunteers, both right anodal and left anodal DLPFC stimulation increased the propensity for risk-taking in marijuana users. These findings reveal alterations in the decision-making neural networks among chronic marijuana users. Finally, we also assessed the effects of tDCS on marijuana craving and observed that right anodal/left cathodal tDCS of DLPFC is significantly associated with a diminished craving for marijuana. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
Joseph M. Orr
Full Text Available A recent shift in legal and social attitudes toward marijuana use has also spawned a surge of interest in understanding the effects of marijuana use on the brain. There is considerable evidence that an adolescent onset of marijuana use negatively impacts white matter coherence. On the other hand, a recent well-controlled study demonstrated no effects of marijuana use on the morphometry of subcortical or cortical structures when users and non-users were matched for alcohol use. Regardless, most studies have involved small, carefully selected samples, so the ability to generalize to larger populations is limited. In an attempt to address this issue, we examined the effects of marijuana use on white matter integrity and cortical and subcortical morphometry using data from the Human Connectome Project (HCP consortium. The HCP data consists of ultra-high resolution neuroimaging data from a large community sample, including 466 adults reporting recreational marijuana use. Rather than just contrasting two groups of individuals who vary significantly in marijuana usage as typifies prior studies, we leveraged the large sample size provided by the HCP data to examine parametric effects of recreational marijuana use. Our results indicate that the earlier the age of onset of marijuana use, the lower was white matter coherence. Age of onset also also affected the shape of the accumbens, while the number of lifetime uses impacted the shape of the amygdala and hippocampus. Marijuana use had no effect on cortical volumes. These findings suggest subtle but significant effects of recreational marijuana use on brain structure.
Orr, Joseph M; Paschall, Courtnie J; Banich, Marie T
A recent shift in legal and social attitudes toward marijuana use has also spawned a surge of interest in understanding the effects of marijuana use on the brain. There is considerable evidence that an adolescent onset of marijuana use negatively impacts white matter coherence. On the other hand, a recent well-controlled study demonstrated no effects of marijuana use on the morphometry of subcortical or cortical structures when users and non-users were matched for alcohol use. Regardless, most studies have involved small, carefully selected samples, so the ability to generalize to larger populations is limited. In an attempt to address this issue, we examined the effects of marijuana use on white matter integrity and cortical and subcortical morphometry using data from the Human Connectome Project (HCP) consortium. The HCP data consists of ultra-high resolution neuroimaging data from a large community sample, including 466 adults reporting recreational marijuana use. Rather than just contrasting two groups of individuals who vary significantly in marijuana usage as typifies prior studies, we leveraged the large sample size provided by the HCP data to examine parametric effects of recreational marijuana use. Our results indicate that the earlier the age of onset of marijuana use, the lower was white matter coherence. Age of onset also also affected the shape of the accumbens, while the number of lifetime uses impacted the shape of the amygdala and hippocampus. Marijuana use had no effect on cortical volumes. These findings suggest subtle but significant effects of recreational marijuana use on brain structure.
Simon, William E.; And Others
The present study compares marijuana users and nonusers in terms of (a) psychological needs, (b) self-descriptions, (c) self-esteem, (d) academic achievement, (e) ordinal position of birth, and (f) attitudes toward the legalization of various items. Some significant differences were reported between groups of users. (Author/PC)
Metrik, Jane; Aston, Elizabeth R; Kahler, Christopher W; Rohsenow, Damaris J; McGeary, John E; Knopik, Valerie S
Marijuana produces acute increases in positive subjective effects and decreased reactivity to negative affective stimuli, though may also acutely induce anxiety. Implicit attentional and evaluative processes may explicate marijuana's ability to acutely increase positive and negative emotions. This within-subjects study examined whether smoked marijuana with 2.7-3.0% delta-9-tetrahydrocannabinol (THC), relative to placebo, acutely changed attentional processing of rewarding and negative affective stimuli as well as marijuana-specific stimuli. On 2 separate days, regular marijuana users (N = 89) smoked placebo or active THC cigarette and completed subjective ratings of mood, intoxication, urge to smoke marijuana, and 2 experimental tasks: pleasantness rating (response latency and perceived pleasantness of affective and marijuana-related stimuli) and emotional Stroop (attentional bias to affective stimuli). On the pleasantness rating task, active marijuana increased response latency to negatively valenced and marijuana-related (vs. neutral) visual stimuli, beyond a general slowing of response. Active marijuana also increased pleasantness ratings of marijuana images, although to a lesser extent than placebo due to reduced marijuana urge after smoking. Overall, active marijuana did not acutely change processing of positive emotional stimuli. There was no evidence of attentional bias to affective word stimuli on the emotional Stroop task with the exception of attentional bias to positive word stimuli in the subgroup of marijuana users with cannabis dependence. Marijuana may increase allocation of attentional resources toward marijuana-specific and negatively valenced visual stimuli without altering processing of positively valenced stimuli. Marijuana-specific cues may be more attractive with higher levels of marijuana craving and less wanted with low craving levels. (c) 2015 APA, all rights reserved).
Dinitto, Diana M; Choi, Namkee G
Epidemiological studies show that the number of older adults using marijuana is increasing. This study aimed to determine the correlates and patterns of marijuana use among older adults that might help health and social service providers better assist this group. Data are from the 2008 National Survey on Drug Use and Health conducted by the Substance Abuse and Mental Health Services Administration in the U.S.A. The sample consisted of 5,325 adults aged 50 years and older. Of the sample, 2.8% were past-year marijuana users. Of them, 23% had used marijuana on at least half the days of the year. Past-year users were more likely to be younger (50-64 years old), black, and not married, and they had significantly higher psychological distress scores, but they did not rate their health as poorer than others in the sample, nor did they attribute many problems, including psychological problems, as being related to their marijuana use. Nevertheless, past-year users present a high-risk profile because, in addition to frequent marijuana use, they also are more likely to smoke cigarettes, engage in binge drinking, and use other illicit drugs. Health and social service providers should be alert to the small number of routine marijuana users among the younger members of the older adult population, especially those suffering significant psychological distress, so that these individuals can be encouraged to utilize services that will help alleviate this distress and promote a healthier lifestyle and increase general well being.
Jennifer Tropp Sneider
Full Text Available Numerous studies have reported neurocognitive impairments associated with chronic marijuana use. Given that the hippocampus contains a high density of cannabinoid receptors, hippocampal-mediated cognitive functions, including visuospatial memory, may have increased vulnerability to chronic marijuana use. Thus, the current study examined brain activation during the performance of a virtual analogue of the classic Morris water maze task in 10 chronic marijuana (MJ users compared to 18 nonusing (NU comparison subjects. Imaging data were acquired using blood oxygen level-dependent (BOLD functional MRI at 3.0 Tesla during retrieval (hidden platform and motor control (visible platform conditions. While task performance on learning trials was similar between groups, MJ users demonstrated a deficit in memory retrieval. For BOLD fMRI data, NU subjects exhibited greater activation in the right parahippocampal gyrus and cingulate gyrus compared to the MJ group for the Retrieval-Motor Control contrast (NU > MJ. These findings suggest that hypoactivation in MJ users may be due to differences in the efficient utilization of neuronal resources during the retrieval of memory. Given the paucity of data on visuospatial memory function in MJ users, these findings may help elucidate the neurobiological effects of marijuana on brain activation during memory retrieval.
Allen, Jane A; Davis, Kevin C; Duke, Jennifer C; Nonnemaker, James M; Bradfield, Brian R; Farrelly, Matthew C
This study examines the relationships between trial of new marijuana or hashish products and unexpected highs, and use of edible products and unexpected highs. We conducted an online survey of 634 adult, past-year marijuana users in Colorado. We used logistic regression models to examine the relationship between new product trial or edible use and unexpected highs. In the first year that recreational marijuana was legal in Colorado, 71.4% of respondents tried a new marijuana or hashish product, and 53.6% used an edible product. Trial of new products was associated with greater odds of experiencing an unexpected high after controlling for age, gender, education, mental health status, current marijuana or hashish use, and mean amount of marijuana or hashish consumed in the past month (OR=2.13, pmarijuana or hashish products, or use edible marijuana or hashish products, are at greater risk for an unexpected high. It is possible that some negative outcomes associated with marijuana use and unexpected highs may be averted through a better understanding of how to use product packaging to communicate with consumers. Copyright © 2017 Elsevier B.V. All rights reserved.
Mason, W A; Hanson, Koren; Fleming, Charles B; Ringle, Jay L; Haggerty, Kevin P
In November 2012, Washington State and Colorado became the first states in the United States to legalize recreational marijuana use for adults, and Uruguay became the first country to allow the cultivation, distribution, possession, and use of marijuana. One possible consequence of these changes is increased adolescent marijuana use. Parents may mitigate this adverse consequence; however, whether parents and adolescents have accurate knowledge about the laws and are discussing marijuana use in light of the law changes is unknown. We examine perceptions, knowledge, and parent-child discussions about Washington State's recreational marijuana law in a sample of low-income families. Participants were a subset of families (n = 115) in an ongoing study that originally recruited parents and adolescents from middle schools in Tacoma, Washington. In summer 2013, when students were entering the 11(th) grade, students and their parents were asked questions about the recreational marijuana law. Participants perceived that their marijuana-related attitudes and behaviors changed little as a result of the law, and displayed uncertainty about what is legal and illegal. Most parents reported discussing the new law with their children but only occasionally, and conversations emphasized household rules, particularly among parent lifetime marijuana users compared to non-users. Conclusions/Importance: Results suggest that there should be a public health campaign focused on families that provides clear information about the recreational marijuana laws.
Krauss, Melissa J; Rajbhandari, Biva; Sowles, Shaina J; Spitznagel, Edward L; Cavazos-Rehg, Patricia
With more states legalizing marijuana use, the marijuana industry has grown, introducing a variety of marijuana products. Our study explores the use of multiple marijuana products (poly-marijuana use) and the characteristics associated with this behavior. Past-month marijuana users aged 18-34years were surveyed online via an existing online panel (n=2444). Participants answered questions about past-month use of three types of marijuana (plant-based, concentrates, edibles), marijuana use patterns, and driving after use. Latent class analysis was used to identify subgroups of marijuana users. Four classes of marijuana users were identified: Light plant users, who used only plant-based products infrequently and were unlikely to drive after use (32%); Heavy plant users, who used mainly plant-based products frequently, multiple times per day, and were likely to drive after use (37%); Plant and concentrates users, who used plant-based products heavily and concentrates at least infrequently, used multiple times per day, and were likely to drive after use (20%); Light plant and edibles users, who used both products infrequently and were unlikely to drive after use (10%). Those in legal marijuana states were more likely to belong to the poly-marijuana groups. Our findings reflect the increase in popularity of new marijuana products in legal states and suggest that heavy user groups, including concentrates users, are associated with driving after use. As various forms of marijuana use increases, monitoring and surveillance of the use of multiple types of marijuana will be important for determining potential varying impacts on physiological and social consequences. Copyright © 2017 Elsevier Ltd. All rights reserved.
Wang, Julie B; Ramo, Danielle E; Lisha, Nadra E; Cataldo, Janine K
Medical marijuana legalization is associated with a higher prevalence of marijuana use which may affect cigarette use and nicotine dependence in co-users. In the present study, we examined relationships between statewide legalization of medical marijuana and prevalence of cigarette and marijuana co-use and nicotine dependence in co-using adolescents and adults. Data were analyzed from the 2013 National Survey on Drug Use and Health. We compared cigarette and marijuana co-use in the past 30days across age categories (12-64 years) by statewide medical marijuana legalization. Logistic regression models were used to estimate the odds of having nicotine dependence among current cigarette smokers who also reported past 30-day marijuana use and "ever but not current" marijuana use (vs. "never" use) adjusting for covariates including statewide legalization of medical marijuana. Overall, 5.1% of the sample reported past 30-day cigarette and marijuana co-use and a higher proportion of co-users resided in states where medical marijuana was legal compared to illegal (5.8% vs. 4.8%; p=0.0011). Co-use was associated with greater odds of having nicotine dependence compared to cigarette-only use across age categories. Odds were highest and up to 3-times higher in adolescents aged 12-17 years (OR=3.54; 95%CI: 1.81-6.92) and adults aged 50-64 years (OR=3.08; CI: 1.45-6.55). Marijuana policy could inadvertently affect cigarette and marijuana co-use and pose challenges to tobacco cessation. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Clarke, Paige; Dodge, Tonya; Stock, Michelle L
There is little published research that tests the effect of recreational marijuana legislation on risk-related cognitions and how individuals respond immediately after legislative approval. The objective was to test whether learning about the passage of Initiative 71, a voter referendum that legalized recreational use of marijuana in the District of Columbia, would lead individuals to adopt more favorable marijuana cognitions than they had before the Initiative was passed. Undergraduate students (N = 402) completed two web-based questionnaires in 2014. The first questionnaire was completed prior to the referendum vote and the follow-up questionnaire was completed after voters approved Initiative 71. Attitudes, perceived norms, intentions, prototypes, and willingness were measured at time 1 and time 2. Study hypotheses were tested using repeated-measures analysis of covariance. Results showed that attitudes, intentions, perceived norms, and willingness to use marijuana were more favorable after Initiative 71 was passed. However, the increase in attitudes and willingness was moderated by past experience with marijuana whereby the increases were statistically significant only among those with the least experience. The increase in perceived norms was also moderated by past experience whereby increases were statistically significant among those who were moderate or heavy users. The passage of Initiative 71 had no effect on favorable prototypes. Conclusion/Importance: Legalization may have the unintended outcome of leading to more favorable intentions to use marijuana and might lead abstainers or experimental users to become more frequent users of marijuana via more positive attitudes and willingness towards marijuana use.
Callaghan, Russell C; Allebeck, Peter; Sidorchuk, Anna
Cannabis (marijuana) smoke and tobacco smoke contain many of the same potent carcinogens, but a critical-yet unresolved-medical and public-health issue is whether cannabis smoking might facilitate the development of lung cancer. The current study aimed to assess the risk of lung cancer among young marijuana users. A population-based cohort study examined men (n = 49,321) aged 18-20 years old assessed for cannabis use and other relevant variables during military conscription in Sweden in 1969-1970. Participants were tracked until 2009 for incident lung cancer outcomes in nationwide linked medical registries. Cox regression modeling assessed relationships between cannabis smoking, measured at conscription, and the hazard of subsequently receiving a lung cancer diagnosis. At the baseline conscription assessment, 10.5 % (n = 5,156) reported lifetime use of marijuana and 1.7 % (n = 831) indicated lifetime use of more than 50 times, designated as "heavy" use. Cox regression analyses (n = 44,284) found that such "heavy" cannabis smoking was significantly associated with more than a twofold risk (hazard ratio 2.12, 95 % CI 1.08-4.14) of developing lung cancer over the 40-year follow-up period, even after statistical adjustment for baseline tobacco use, alcohol use, respiratory conditions, and socioeconomic status. Our primary finding provides initial longitudinal evidence that cannabis use might elevate the risk of lung cancer. In light of the widespread use of marijuana, especially among adolescents and young adults, our study provides important data for informing the risk-benefit calculus of marijuana smoking in medical, public-health, and drug-policy settings.
Mariane Beatriz Sordi
Full Text Available Abstract: The objective of this study was to assess the oral health status of users of illicit drugs such as marijuana and cocaine/crack and compare it with individuals not using these chemical substances. Questionnaires were applied to 35 illicit drugs users to gather information on demographic status, general health, and use of drugs. Then, a clinical assessment of the oral health condition was performed to collect data on decayed, missing and filled teeth (DMFT index, salivary flow rate (SFR, and mucosal lesions. The control group was composed of 35 non-illicit drug users. In the experimental group, 91.43% were males, 80% were smokers, and 42.85% were alcoholics. Cocaine was the most common drug used (77.15%, followed by marijuana (68.6%, and crack (51.4%. The average DMFT index was 9.8 and the SFR was reduced in 60% of subjects. Mucosal alterations were detected, but no potentially malignant disorders or oral cancer were diagnosed. Compared to control group, significantly higher values for gender (40%, p = 0.0001, smoking (22.86% and heavy drinking (5.7% habits (p = 0.0001, SFR (31.4%; p = 0.0308, and oral lesions (p = 0.0488 were found for the experimental group, although significantly higher values were found in the control group for DMFT index (p = 0.0148. It can be concluded that the use of illicit drugs contributed to an increased prevalence of oral mucosa lesions. In addition, a decline on SFR and a reduced DMFT index was observed for illicit drug users.
Sordi, Mariane Beatriz; Massochin, Rachel Captzan; Camargo, Alessandra Rodrigues de; Lemos, Tadeu; Munhoz, Etiene de Andrade
The objective of this study was to assess the oral health status of users of illicit drugs such as marijuana and cocaine/crack and compare it with individuals not using these chemical substances. Questionnaires were applied to 35 illicit drugs users to gather information on demographic status, general health, and use of drugs. Then, a clinical assessment of the oral health condition was performed to collect data on decayed, missing and filled teeth (DMFT) index, salivary flow rate (SFR), and mucosal lesions. The control group was composed of 35 non-illicit drug users. In the experimental group, 91.43% were males, 80% were smokers, and 42.85% were alcoholics. Cocaine was the most common drug used (77.15%), followed by marijuana (68.6%), and crack (51.4%). The average DMFT index was 9.8 and the SFR was reduced in 60% of subjects. Mucosal alterations were detected, but no potentially malignant disorders or oral cancer were diagnosed. Compared to control group, significantly higher values for gender (40%, p = 0.0001), smoking (22.86%) and heavy drinking (5.7%) habits (p = 0.0001), SFR (31.4%; p = 0.0308), and oral lesions (p = 0.0488) were found for the experimental group, although significantly higher values were found in the control group for DMFT index (p = 0.0148). It can be concluded that the use of illicit drugs contributed to an increased prevalence of oral mucosa lesions. In addition, a decline on SFR and a reduced DMFT index was observed for illicit drug users.
Ragan, Daniel T.; Beaver, Kevin M.
Marijuana is the most widely used illegal drug, and the use of marijuana has been linked to a wide array of maladaptive outcomes. As a result, there is great interest in identifying the factors that are associated with the use of marijuana and with desistance from marijuana. The current study employed a life-course framework to examine the factors…
Bravo, Adrian J; Pearson, Matthew R; Conner, Bradley T; Parnes, Jamie E
Given the popular association between April 20 ("4/20") and marijuana, the present study examined marijuana use and consequences on 4/20 compared with other days in order to test whether 4/20 is a high-risk, event-specific marijuana use holiday among college student marijuana users. Fifty-nine college student marijuana users from three different, large U.S. universities located in Virginia, New Mexico, and Colorado completed daily brief surveys (<10 minutes) over a 12-day (April 15-April 26) period assessing prior-day marijuana use (i.e., percentage of users who consumed marijuana, number of unique marijuana use sessions, subjective high/intoxication while under the influence of marijuana, and number of grams of marijuana consumed) and marijuana-related consequences. Using oneway repeated-measures analyses of variance, we found that (a) 50% of students reported using marijuana on 4/20, which was significantly more than weekdays (28%) and weekend days (37%); (b) students reported a significantly higher number of unique marijuana use sessions on 4/20 (M = 1.47) compared with weekdays (M = 0.91); and (c) students reported a significantly higher number of grams consumed on 4/20 (M = 0.79) compared with weekdays (M = 0.35) and weekend days (M = 0.47). Our study provides preliminary support that 4/20 is a day associated with increased marijuana use but provides little evidence for an association with more problematic use.
Fairman, Brian J; Furr-Holden, C Debra; Johnson, Renee M
Recent loosening of state and federal policy restrictions on marijuana, along with changes in social norms regarding marijuana use and decreases in prevalence of other types of substance use, may lead to increases in youth initiating marijuana before other types of substances such as alcohol and tobacco. We investigated predictors and potential consequences of initiating marijuana before other drugs for youth aged 12-21-years in the USA. Nationally representative, cross-sectional survey data from the US National Survey on Drug Use and Health supplied self-reported age of first marijuana, cigarettes, alcohol, other tobacco, and other illegal drug use among 12-21-year-old samples from 2004 to 2014 (n = 275,559). We first examined the degree to which initiating marijuana use first was associated with sex, age, race/ethnicity, and survey year. Then, we examined whether using marijuana first predicted heavy marijuana use, cannabis use disorder (CUD), alcohol use disorder (AUD), nicotine dependence (ND), or lifetime use of other illegal drugs. Among all survey youth (substance users and non-users), the proportion using marijuana first increased from 4.8 to 8.8% from 2004 to 2014. Those using marijuana first (vs. alcohol or cigarettes first) were more likely to be male and older and Black, American Indian/Alaskan Native, multiracial, or Hispanic than White or Asian. Among substance users and adjusting for age of onset and the number of substances used, using marijuana first was associated higher odds of heavy current marijuana use and CUD. In recent years, youth have been increasingly likely to use marijuana as their first drug and sequence of initiation is associated with race/ethnicity, gender, and age. Using marijuana first might increase the chance of heavy use and CUD.
Ravikoff Allegretti, Jessica; Courtwright, Andrew; Lucci, Matthew; Korzenik, Joshua R; Levine, Jonathan
The prevalence and perceived effectiveness of marijuana use has not been well studied in inflammatory bowel disease (IBD) despite increasing legal permission for its use in Crohn's disease. Health care providers have little guidance about the IBD symptoms that may improve with marijuana use. The aim of this study was to assess the prevalence, sociodemographic characteristics, and perceived benefits of marijuana use among patients with IBD. Prospective cohort survey study of marijuana use patterns in patients with IBD at an academic medical center. A total of 292 patients completed the survey (response rate = 94%); 12.3% of patients were active marijuana users, 39.0% were past users, and 48.6% were never users. Among current and past users, 16.4% of patients used marijuana for disease symptoms, the majority of whom felt that marijuana was "very helpful" for relief of abdominal pain, nausea, and diarrhea. On multivariate analysis, age and chronic abdominal pain were associated with current marijuana use (odds ratio [OR], 0.93; 95% confidence interval [CI], 0.89-0.97; P marijuana (OR, 0.93; 95% CI, 0.89-0.97; P marijuana for abdominal pain, were it legally available. A significant number of patients with IBD currently use marijuana. Most patients find it very helpful for symptom control, including patients with ulcerative colitis, who are currently excluded from medical marijuana laws. Clinical trials are needed to determine marijuana's potential as an IBD therapy and to guide prescribing decisions.
Whitehurst, Lauren N; Fogler, Kethera; Hall, Kate; Hartmann, Matthew; Dyche, Jeff
Animal literature suggests a connection between marijuana use and altered circadian rhythms. However, the effect has not yet been demonstrated in humans. The present study examined the effect of chronic marijuana use on human circadian function. Participants consisted of current users who reported smoking marijuana daily for at least a year and non-marijuana user controls. Participants took a neurocognitive assessment, wore actigraphs and maintained sleep diaries for three weeks. While no significant cognitive changes were found between groups, data revealed that chronic marijuana use may act as an additional zeitgeber and lead to increased entrainment in human users.
Cermak, Timmen L
This article begins with a case vignette exemplifying the common clinical problem of heavy marijuana users. The epidemiology and basic science underlying cannabis dependence is outlined, followed by clinical strategies for basing a therapeutic alliance on known research findings and using motivational interviewing to deal with typical patterns of denial.
Cohn, Amy; Johnson, Amanda; Ehlke, Sarah; Villanti, Andrea C
Smoking marijuana in a cigar (blunt use) is gaining popularity in the U.S. Research suggests that blunt users differ from exclusive cigar or marijuana users on a variety of demographic and substance use factors. Misreporting of blunts and cigars is also common, particularly among young people, and may lead to inaccurate prevalence estimates. To determine subtype differences, this study investigated the prevalence and demographic, mental health, and substance use correlates of four mutually-exclusive groups of blunt, cigar, and marijuana past 30-day users (cigar-only, blunt-only, non-blunt marijuana, or dual cigar-blunt). Data were analyzed from the 2013 National Survey of Drug Use and Health. In weighted multinomial logistic regression models, respondents who were younger, Black, and who had used tobacco, alcohol, or other drugs in the past 30-days had the highest odds of reporting blunt-only or dual cigar-blunt use. Those reporting blunt-only and dual cigar-blunt use also endorsed a greater number of marijuana and alcohol use disorder symptoms compared to those reporting cigar-only and non-blunt marijuana use. Lower marijuana risk perceptions were associated with increased odds of marijuana use with or without blunts. Major depressive episode was uniquely associated with non-blunt marijuana use. With respect to misclassifiers, respondents who reported past 30-day blunt use but not past 30-day marijuana use were younger, Black, female, and had lower education and income. Those who report blunt-only and dual cigar-blunt use showed the most severe risk profiles. Communicating health consequences and risks of blunt use should be directed toward specific subgroups. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Finn, Kristin V.
Marijuana remains one of the most frequently used drugs among adolescents and usage has increased in recent years. In addition to general use, many high school students use marijuana during the school day. The present study focused on achievement-linked correlates of in-school marijuana use by comparing non-users, general users, and school users…
Freisthler, Bridget; Gaidus, Andrew; Tam, Christina; Ponicki, William R; Gruenewald, Paul J
A movement from medical to recreational marijuana use allows for a larger base of potential users who have easier access to marijuana, because they do not have to visit a physician before using marijuana. This study examines whether changes in the density of marijuana outlets were related to violent, property, and marijuana-specific crimes in Denver, CO during a time in which marijuana outlets began selling marijuana for recreational, and not just medical, use. We collected data on locations of crimes, marijuana outlets and covariates for 481 Census block groups over 34 months (N = 16,354 space-time units). A Bayesian Poisson space-time model assessed statistical relationships between independent measures and crime counts within "local" Census block groups. We examined spatial "lag" effects to assess whether crimes in Census block groups adjacent to locations of outlets were also affected. Independent of the effects of covariates, densities of marijuana outlets were unrelated to property and violent crimes in local areas. However, the density of marijuana outlets in spatially adjacent areas was positively related to property crime in spatially adjacent areas over time. Further, the density of marijuana outlets in local and spatially adjacent blocks groups was related to higher rates of marijuana-specific crime. This study suggests that the effects of the availability of marijuana outlets on crime do not necessarily occur within the specific areas within which these outlets are located, but may occur in adjacent areas. Thus studies assessing the effects of these outlets in local areas alone may risk underestimating their true effects.
Merianos, Ashley L; Rosen, Brittany L; Montgomery, LaTrice; Barry, Adam E; Smith, Matthew Lee
We performed a secondary analysis of Adolescent Health Risk Behavior Survey data ( N = 937), examining associations between lifetime alcohol and marijuana use with intrapersonal (i.e., risk perceptions) and interpersonal (e.g., peer approval and behavior) factors. Multinomial and binary logistic regression analyses contend students reporting lifetime alcohol use-compared to students who had never used alcohol or marijuana-perceived lower alcohol risk ( p academic performance decreased the risk of lifetime alcohol and marijuana use ( p = .043). Findings are beneficial to school nurses with students experiencing effects associated with substance use.
Kerlin, Ann Marie; Long, Millie; Kappelman, Michael; Martin, Christopher; Sandler, Robert S
Marijuana is legal in a number of states for indications that include inflammatory bowel diseases (IBD), and patients are interested in its potential benefits. We aimed to describe the legal use of marijuana in individuals with IBD in the USA who participate within the CCFA Partners internet-based cohort. A total of 2357 participants who lived in states where prescription or recreational marijuana was legal, were offered the opportunity to complete a survey on marijuana use and IBD symptoms including perceived benefits of therapy. Bivariate statistics and logistic regression models were used to determine factors associated with marijuana use. Surveys were completed by 1666 participants (71%) with only 214 (12.8%) indicating they had asked their medical doctor about its use and 73 actually using prescribed marijuana (4.4%). Within the respondent group (N = 1666), 234 participants lived where both medical and recreational marijuana is legal and 49 (20.9%) reported recreational marijuana use specifically for IBD. Users reported positive benefits (80.7%), but users also reported more depression, anxiety, pain interference, and lower social satisfaction than non-users. Those prescribed marijuana reported more active disease, and more use of steroids, narcotics, and zolpidem. Few IBD patients consulted their medical doctors about marijuana use or used prescription marijuana. Where recreational marijuana was available, usage rates were higher. Users reported benefits but also more IBD symptoms, depression, anxiety, and pain. Marijuana use may be higher in patients with IBD symptoms not well treated by conventional medical approaches.
Kashyap, Surender; Kashyap, Kartikeya
Marijuana (Cannabis sativa) has been used for recreational and medical purposes since ages. Marijuana smoking is an evil, which is on the rise with about 180.6 million active users worldwide. The recent legalization of marijuana in Uruguay has generated global interest. The purpose of this short review is to describe the various preparations, uses and adverse effects of medical marijuana. It also deals with the adverse effects of marijuana smoking when used for recreational purposes. ased on ...
Joshi, Manish; Joshi, Anita; Bartter, Thaddeus
Cannabis sativa (marijuana) is used throughout the world, and its use is increasing. In much of the world, marijuana is illicit. While inhalation of smoke generated by igniting dried components of the plant is the most common way marijuana is used, there is concern over potential adverse lung effects. The purpose of this review is to highlight recent studies that explore the impact upon the respiratory system of inhaling marijuana smoke. Smoking marijuana is associated with chronic bronchitis symptoms and large airway inflammation. Occasional use of marijuana with low cumulative use is not a risk factor for the development of chronic obstructive pulmonary disease. The heavy use of marijuana alone may lead to airflow obstruction. The immuno-histopathologic and epidemiologic evidence in marijuana users suggests biological plausibility of marijuana smoking as a risk for the development of lung cancer; at present, it has been difficult to conclusively link marijuana smoking and cancer development. There is unequivocal evidence that habitual or regular marijuana smoking is not harmless. A caution against regular heavy marijuana usage is prudent. The medicinal use of marijuana is likely not harmful to lungs in low cumulative doses, but the dose limit needs to be defined. Recreational use is not the same as medicinal use and should be discouraged.
Akano, Obinna F
There is increasing use of marijuana among young adults and more states in the United States are legalizing medical marijuana use. A number of studies have revealed both the beneficial and harmful effects of marijuana to the human system. Despite some beneficial effects, studies have shown marijuana to have a lot of deleterious effects on the visual system, which subsequently reduces the quality of eyesight. The aim of this study was to investigate if heavy marijuana smoking is associated with a poor quality of eyesight compared with light/no use of marijuana. The National Longitudinal Survey of Youths (NLSY79), a nationally representative sample of 12,686 young men and women surveyed in 1979 to 2010 was used for this study. The quality of eyesight of 1304 heavy marijuana users was compared with 1304 respondents with light or no marijuana use. The t test, multivariate and weighted logistic regression were used in the data analysis. There was no statistically significant difference in the self-reported quality of eyesight among heavy marijuana smokers compared with youths who never used marijuana or are light marijuana users. Among heavy marijuana smokers, males and high school graduates have decreased odds of reporting a poor quality of eyesight, whereas blacks have increased odds of reporting a poor quality of eyesight. The self-reported quality of eyesight among marijuana users can aid clinicians and other health practitioners facilitate the development of sex-, racial/ethnic-, and educational level-informed prevention and early intervention programs and also help characterize public opinions regarding cannabis, which are particularly relevant given the ongoing debate concerning the medicalization and legalization of cannabis in the United States.
Full Text Available Marijuana (Cannabis sativa has been used for recreational and medical purposes since ages. Marijuana smoking is an evil, which is on the rise with about 180.6 million active users worldwide. The recent legalization of marijuana in Uruguay has generated global interest. The purpose of this short review is to describe the various preparations, uses and adverse effects of medical marijuana. It also deals with the adverse effects of marijuana smoking when used for recreational purposes. ased on the current literature, medical use of marijuana is justified in certain conditions as an alternative therapy.
Weinstein, Aviv; Brickner, Orit; Lerman, Hedva; Greemland, Mazal; Bloch, Miki; Lester, Hava; Chisin, Roland; Mechoulam, Raphael; Bar-Hamburger, Rachel; Freedman, Nanette; Even-Sapir, Einat
Twelve regular users of marijuana underwent two positron emission tomography (PET) scans using [18F] Fluorodeoxyglucose (FDG), one while subject to the effects of 17 mg THC, the other without THC. In both sessions, a virtual reality maze task was performed during the FDG uptake period. When subject to the effects of 17 mg THC, regular marijuana smokers hit the walls more often on the virtual maze task than without THC. Compared to results without THC, 17 mg THC increased brain metabolism during task performance in areas that are associated with motor coordination and attention in the middle and medial frontal cortices and anterior cingulate, and reduced metabolism in areas that are related to visual integration of motion in the occipital lobes. These findings suggest that in regular marijuana users, the immediate effects of marijuana may impact on cognitive-motor skills and brain mechanisms that modulate coordinated movement and driving.
This report concerns the effects of marijuana smoking on actual driving performance. It presents the results of one pilot and three actual driving studies. The pilot study's major purpose was to establish the THC dose current marijuana users smoke to...
Hanson, Koren; Haggerty, Kevin P; Fleming, Charles B; Skinner, Martie L; Casey-Goldstein, Mary; Mason, W Alex; Thompson, Ronald W; Redmond, Cleve
As legalization of nonmedical retail marijuana increases, states are implementing public health campaigns designed to prevent increases in youth marijuana use. This study investigated which types of marijuana-related messages were rated most highly by parents and their teens and whether these preferences differed by age and marijuana use. Nine marijuana-focused messages were developed as potential radio, newspaper, or television announcements. The messages fell into four categories: information about the law, general advice/conversation starters, consequences of marijuana use/positive alternatives, and information on potential harmful effects of teen marijuana use. The messages were presented through an online survey to 282 parent (84% female) and 283 teen (54% female) participants in an ongoing study in Washington State. Both parents and youth rated messages containing information about the law higher than other types of messages. Messages about potential harms of marijuana use were rated lower than other messages by both generations. Parents who had used marijuana within the past year (n = 80) rated consequence/positive alternative messages lower than parent nonusers (n = 199). Youth marijuana users (n = 77) and nonusers (n = 202) both rated messages containing information about the law higher than other types of messages. Youth users and nonusers were less likely than parents to believe messages on the harmful effects of marijuana. The high ratings for messages based on information about the marijuana law highlight the need for informational health campaigns to be established as a first step in the marijuana legalization process.
Abstract Background The rise of authorized marijuana use in the U.S. means that many individuals are using cannabis as they concurrently engage in other forms of treatment, such as substance abuse counseling and psychotherapy. Clinical and legal decisions may be influenced by findings that suggest marijuana use during treatment serves as an obstacle to treatment success, compromises treatment integrity, or increases the prevalence or severity of relapse. In this paper, the author reviews the ...
Francesca M Filbey
Full Text Available In spite of evidence suggesting two possible mechanisms related to drug-seeking behavior, namely reward-seeking and harm avoidance, much of the addiction literature has focused largely on positive incentivization mechanisms associated with addiction. In this study, we examined the contributing neural mechanisms of avoidance of an aversive state to drug-seeking behavior during marijuana withdrawal. To that end, marijuana users were scanned while performing the monetary incentive delay task in order to assess positive and negative incentive processes. The results showed a group x incentive interaction, such that marijuana users had greater response in areas that underlie reward processes during positive incentives while controls showed greater response in the same areas, but to negative incentives. Furthermore, a negative correlation between withdrawal symptoms and response in the amygdala during negative incentives was found in the marijuana users. These findings suggest that although marijuana users have greater reward sensitivity and less harm avoidance than controls, that attenuated amygdala response, an area that underlies fear and avoidance, was present in marijuana users with greater marijuana withdrawal symptoms. This is concordant with models of drug addiction that involve multiple sources of reinforcement in substance use disorders, and suggests the importance of strategies that focus on respective mechanisms.
Mariani, John J.; Haney, Margaret; Hart, Carl L.; Vosburg, Suzanne K.; Levin, Frances R.
A post hoc analysis examined depressive symptoms in regular marijuana smokers interested in nontreatment, laboratory studies and marijuana-dependent treatment-seekers considering clinical trial participation. Among marijuana-dependent treatment-seeking patients screened for a clinical trial, the mean Beck Depression Inventory Score (BDI) was significantly higher than for marijuana-using volunteers screened for non-treatment laboratory studies. Mean self-reported baseline marijuana use was not...
Prince, Mark A; Conner, Bradley T; Pearson, Matthew R
The assessment of marijuana use quantity poses unique challenges. These challenges have limited research efforts on quantity assessments. However, quantity estimates are critical to detecting associations between marijuana use and outcomes. We examined accuracy of marijuana users' estimations of quantities of marijuana they prepared to ingest and predictors of both how much was prepared for a single dose and the degree of (in)accuracy of participants' estimates. We recruited a sample of 128 regular-to-heavy marijuana users for a field study wherein they prepared and estimated quantities of marijuana flower in a joint or a bowl as well as marijuana concentrate using a dab tool. The vast majority of participants overestimated the quantity of marijuana that they used in their preparations. We failed to find robust predictors of estimation accuracy. Self-reported quantity estimates are inaccurate, which has implications for studying the link between quantity and marijuana use outcomes. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
Full Text Available Abstract Background An important challenge in conducting social research of specific relevance to harm reduction programs is locating hidden populations of consumers of substances like cannabis who typically report few adverse or unwanted consequences of their use. Much of the deviant, pathologized perception of drug users is historically derived from, and empirically supported, by a research emphasis on gaining ready access to users in drug treatment or in prison populations with higher incidence of problems of dependence and misuse. Because they are less visible, responsible recreational users of illicit drugs have been more difficult to study. Methods This article investigates Respondent Driven Sampling (RDS as a method of recruiting experienced marijuana users representative of users in the general population. Based on sampling conducted in a multi-city study (Halifax, Montreal, Toronto, and Vancouver, and compared to samples gathered using other research methods, we assess the strengths and weaknesses of RDS recruitment as a means of gaining access to illicit substance users who experience few harmful consequences of their use. Demographic characteristics of the sample in Toronto are compared with those of users in a recent household survey and a pilot study of Toronto where the latter utilized nonrandom self-selection of respondents. Results A modified approach to RDS was necessary to attain the target sample size in all four cities (i.e., 40 'users' from each site. The final sample in Toronto was largely similar, however, to marijuana users in a random household survey that was carried out in the same city. Whereas well-educated, married, whites and females in the survey were all somewhat overrepresented, the two samples, overall, were more alike than different with respect to economic status and employment. Furthermore, comparison with a self-selected sample suggests that (even modified RDS recruitment is a cost-effective way of
Cerdá, Magdalena; Wall, Melanie; Keyes, Katherine M; Galea, Sandro; Hasin, Deborah
Marijuana is the most frequently used illicit substance in the United States. Little is known of the role that macro-level factors, including community norms and laws related to substance use, play in determining marijuana use, abuse and dependence. We tested the relationship between state-level legalization of medical marijuana and marijuana use, abuse, and dependence. We used the second wave of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a national survey of adults aged 18+ (n=34,653). Selected analyses were replicated using the National Survey on Drug Use and Health (NSDUH), a yearly survey of ∼68,000 individuals aged 12+. We measured past-year cannabis use and DSM-IV abuse/dependence. In NESARC, residents of states with medical marijuana laws had higher odds of marijuana use (OR: 1.92; 95% CI: 1.49-2.47) and marijuana abuse/dependence (OR: 1.81; 95% CI: 1.22-2.67) than residents of states without such laws. Marijuana abuse/dependence was not more prevalent among marijuana users in these states (OR: 1.03; 95% CI: 0.67-1.60), suggesting that the higher risk for marijuana abuse/dependence in these states was accounted for by higher rates of use. In NSDUH, states that legalized medical marijuana also had higher rates of marijuana use. States that legalized medical marijuana had higher rates of marijuana use. Future research needs to examine whether the association is causal, or is due to an underlying common cause, such as community norms supportive of the legalization of medical marijuana and of marijuana use. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Wu, Li-Tzy; Parrott, Andy C.; Ringwalt, Christopher L.; Yang, Chongming; Blazer, Dan G.
This study investigates the potential heterogeneity of ecstasy or MDMA (3,4-methylenedioxy-N-methylamphetamine) users. Data came from the 2001–2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Latent class analysis (LCA) and multinomial logistic regression procedures were used to identify subtypes of ecstasy users. Approximately 1.6% (n=562) of adult participants (N=43,093) reported lifetime ecstasy use. LCA identified three subtypes of ecstasy users. Class 1 exhibited pervasive use of most drug classes (ecstasy–polydrug users, 37%). Class 2 reported a high rate of use of marijuana and cocaine and a moderate use of amphetamines (ecstasy–marijuana–stimulant users, 29%). Class 3 was characterized by a high rate of use of marijuana and a low use of primarily prescription-type drugs (ecstasy– marijuana users, 34%). Subtypes were distinguished by family income, history of substance abuse treatment, and familial substance abuse. Class 1 exhibited the highest prevalence of disorders related to the use of marijuana (77%), tobacco (66%), amphetamines (36%), opioids (35%), sedatives (31%), and tranquilizers (30%). The recent resurgence in ecstasy use among adults underscores the need to monitor trends in its use. PMID:19874166
Falls, Benjamin J.; Wish, Eric D.; Garnier, Laura M.; Caldeira, Kimberly M.; O'Grady, Kevin E.; Vincent, Kathryn B.; Arria, Amelia M.
Early conduct problems have been linked to early marijuana use in adolescence. The present study examines this association in a sample of 1,076 college students that was divided into three groups: (1) early marijuana users (began marijuana use prior to age 15; N = 126), (2) late marijuana users (began marijuana use at or after age 15; N = 607),…
Johnson Joy L
Full Text Available Abstract Background There are indications that marijuana is increasingly used to alleviate symptoms and for the treatment of a variety of medical conditions both physical and psychological. The purpose of this study was to describe the health concerns and problems that prompt some adolescents to use marijuana for therapeutic reasons, and their beliefs about the risks and benefits of the therapeutic use of marijuana. Methods As part of a larger ethnographic study of 63 adolescents who were regular marijuana users, we analyzed interviews conducted with 20 youth who self-identified as using marijuana to relieve or manage health problems. Results Thematic analysis revealed that these teens differentiated themselves from recreational users and positioned their use of marijuana for relief by emphasizing their inability to find other ways to deal with their health problems, the sophisticated ways in which they titrated their intake, and the benefits that they experienced. These teens used marijuana to gain relief from difficult feelings (including depression, anxiety and stress, sleep difficulties, problems with concentration and physical pain. Most were not overly concerned about the risks associated with using marijuana, maintaining that their use of marijuana was not 'in excess' and that their use fit into the realm of 'normal.' Conclusion Marijuana is perceived by some teens to be the only available alternative for teens experiencing difficult health problems when medical treatments have failed or when they lack access to appropriate health care.
Johnson, Kirsten; Mullin, Jennifer L.; Marshall, Erin C.; Bonn-Miller, Marcel O.; Zvolensky, Michael
The current study evaluated the prediction that coping motives for marijuana use would mediate the relation between anxiety sensitivity and a marijuana dependence diagnosis after controlling for other co-occurring marijuana use motives. Participants were 136 current marijuana users (47.1% women; Mage = 21.9, SD = 7.2). Results were consistent with a mediational effect, with the relation between anxiety sensitivity and marijuana dependence being explained by the addition of coping motives into...
Richmond, Melissa K; Pampel, Fred C; Rivera, Laura S; Broderick, Kerryann B; Reimann, Brie; Fischer, Leigh
With increasing use of state legalized medical marijuana across the country, health care providers need accurate information on patterns of marijuana and other substance use for patients with access to medical marijuana. This study compared frequency and severity of marijuana use, and use of other substances, for patients with and without state legal access to medical marijuana. Data were collected from 2,030 patients who screened positive for marijuana use when seeking health care services in a large, urban safety-net medical center. Patients were screened as part of a federally funded screening, brief intervention, and referral to treatment (SBIRT) initiative. Patients were asked at screening whether they had a state-issued medical marijuana card and about risky use of tobacco, alcohol, and other illicit substances. A total of 17.4% of marijuana users had a medical marijuana card. Patients with cards had higher frequency of marijuana use and were more likely to screen at moderate than low or high risk from marijuana use. Patients with cards also had lower use of other substances than patients without cards. Findings can inform health care providers of both the specific risks of frequent, long-term use and the more limited risks of other substance use faced by legal medical marijuana users.
Schuster, Randi Melissa; Hoeppner, Susanne S; Evins, A Eden; Gilman, Jodi M
Verbal memory difficulties are the most widely reported and persistent cognitive deficit associated with early onset marijuana use. Yet, it is not known what memory stages are most impaired in those with early marijuana use. Forty-eight young adults, aged 18-25, who used marijuana at least once per week and 48 matched nonusing controls (CON) completed the California Verbal Learning Test, Second Edition (CVLT-II). Marijuana users were stratified by age of initial use: early onset users (EMJ), who started using marijuana at or before age 16 (n = 27), and late onset marijuana user group (LMJ), who started using marijuana after age 16 (n = 21). Outcome variables included trial immediate recall, total learning, clustering strategies (semantic clustering, serial clustering, ratio of semantic to serial clustering, and total number of strategies used), delayed recall, and percent retention. Learning improved with repetition, with no group effect on the learning slope. EMJ learned fewer words overall than LMJ or CON. There was no difference between LMJ and CON in total number of words learned. Reduced overall learning mediated the effect on reduced delayed recall among EMJ, but not CON or LMJ. Learning improved with greater use of semantic versus serial encoding, but this did not vary between groups. EMJ was not related to delayed recall after adjusting for encoding. Young adults reporting early onset marijuana use had learning weaknesses, which accounted for the association between early onset marijuana use and delayed recall. No amnestic effect of marijuana use was observed. (PsycINFO Database Record (c) 2016 APA, all rights reserved).
Full Text Available Studies suggest marijuana impacts gray and white matter neural tissue development, however few prospective studies have determined the relationship between cortical thickness and cannabis use spanning adolescence to young adulthood. This study aimed to understand how heavy marijuana use influences cortical thickness trajectories across adolescence. Subjects were adolescents with heavy marijuana use and concomitant alcohol use (MJ + ALC, n = 30 and controls (CON, n = 38 with limited substance use histories. Participants underwent magnetic resonance imaging and comprehensive substance use assessment at three independent time points. Repeated measures analysis of covariance was used to look at main effects of group, time, and Group × Time interactions on cortical thickness. MJ + ALC showed thicker cortical estimates across the brain (23 regions, particularly in frontal and parietal lobes (ps < .05. More cumulative marijuana use was associated with increased thickness estimates by 3-year follow-up (ps < .05. Heavy marijuana use during adolescence and into young adulthood may be associated with altered neural tissue development and interference with neuromaturation that can have neurobehavioral consequences. Continued follow-up of adolescent marijuana users will help understand ongoing neural changes that are associated with development of problematic use into adulthood, as well as potential for neural recovery with cessation of use.
Gelder, M.M.H.J. van; Reefhuis, J.; Herron, A.M.; Williams, M.L.; Roeleveld, N.
CONTEXT: Illicit drug use is associated with risky sexual behaviors in adolescents and young adults. However, few studies have examined these associations among drug users of all reproductive ages, using a control group of nonusers. METHODS: Associations between marijuana and cocaine use, and
Yang, Qinghua; Sangalang, Angeline; Rooney, Molly; Maloney, Erin; Emery, Sherry; Cappella, Joseph N
The purpose of the study is to investigate how vaping marijuana, a novel but emerging risky health behavior, is portrayed on YouTube, and how the content and features of these YouTube videos influence their popularity and retransmission. A content analysis of vaping marijuana YouTube videos published between July 2014 to June 2015 (n = 214) was conducted. Video genre, valence, promotional and warning arguments, emotional appeals, message sensation value, presence of misinformation and misleading information, and user-generated statistics, including number of views, comments, shares, likes and dislikes, were coded. The results showed that these videos were predominantly pro-marijuana-vaping, with the most frequent videos being user-sharing. The genre and message features influenced the popularity, evaluations, and retransmission of vaping marijuana YouTube videos. Theoretical and practical implications are discussed.
Franz, Christopher A; Frishman, William H
Marijuana is currently the most used illicit substance in the world. With the current trend of decriminalization and legalization of marijuana in the US, physicians in the US will encounter more patients using marijuana recreationally over a diverse range of ages and health states. Therefore, it is relevant to review marijuana's effects on human cardiovascular physiology and disease. Compared with placebo, marijuana cigarettes cause increases in heart rate, supine systolic and diastolic blood pressures, and forearm blood flow via increased sympathetic nervous system activity. These actions increase myocardial oxygen demand to a degree that they can decrease the time to exercise-induced angina in patients with a history of stable angina. In addition, marijuana has been associated with triggering myocardial infarctions (MIs) in young male patients. Smoking marijuana has been shown to increase the risk of MI onset by a factor of 4.8 for the 60 minutes after marijuana consumption, and to increase the annual risk of MI in the daily cannabis user from 1.5% to 3% per year. Human and animal models suggest that this effect may be due to coronary arterial vasospasm. However, longitudinal studies have indicated that marijuana use may not have a significant effect on long-term mortality. While further research is required to definitively determine the impact of marijuana on cardiovascular disease, it is reasonable to recommend against recreational marijuana use, especially in individuals with a history of coronary artery disorders.
National Inst. on Drug Abuse (DHHS/PHS), Rockville, MD.
Using a question and answer format, this booklet is designed to inform teens about the dangers of marijuana usage. Inset facts about marijuana and teen perspectives compliment the following topics: (1) What is marijuana? (2) How is marijuana used? (3) How long does marijuana stay in the user's body? (4) How many teens smoke marijuana? (5) Why do…
King, Keith A; Vidourek, Rebecca A; Merianos, Ashley L; Bartsch, Lauren A
Marijuana use rates remain higher among Hispanic youth compared to youth from other ethnic groups. The purpose of the study was to examine if sex, age, authoritarian parenting, perceived school experiences, lifetime depression, legal involvement, and perceived social norms of marijuana use predicted recent marijuana use and past year marijuana use among Hispanic youth. The participants of this study were a nationwide sample of Hispanic youth (n = 3,457) in the United States. A secondary data analysis of the 2012 National Survey on Drug Use and Health was performed. Unadjusted odds ratios were computed via univariate logistic regression analyses and all statistically significant variables were retained and included in the final multiple logistic regression analyses. Recent marijuana use was operationally defined as use within the past 30 days, and marijuana use in the past year was defined as use within the past year. Results indicated that 7.5% of Hispanic youth used within the past month and 14.5% of Hispanic youth used within the past year. Results revealed that significant predictors for recent use were age, authoritarian parenting, perceived school experiences, legal involvement, and perceived social norms of youth marijuana use. Predictors for past year were age, perceived school experiences, legal involvement, and perceived social norms of youth marijuana use. Findings from this study can be used to address the public health problem of marijuana use among Hispanic youth that is ultimately contributing to health disparities among this ethnic group nationwide. Recommendations for future studies are included.
Grant, Sean; Pedersen, Eric R; Neighbors, Clayton
This study involves a pilot investigation of associations between marijuana and synthetic cannabis use with PTSD symptoms among a young adult sample of U.S. veterans. In a cross-sectional survey of a community sample of 790 young adult U.S. veterans, we assessed demographics, combat severity, marijuana and synthetic cannabis use, expectancies of marijuana use, and PTSD symptoms. Overall, 61.8% and 20.4% of our sample reported lifetime and past-month marijuana use, whereas 17.0% and 3.4% reported lifetime and past-month synthetic cannabis use. Veterans screening positive for PTSD were more likely to use marijuana and synthetic cannabis in their lifetime and in the past month. Positive PTSD screens, as well as greater expectancies that marijuana leads to relaxation and tension reduction, were associated with past-month marijuana use in logistic regression analyses. Expectancies moderated the relationship between PTSD and marijuana use, such that those with positive PTSD screens reporting higher levels of relaxation and tension-reduction expectancies were most likely to report past-month marijuana use. Our findings suggest an association of PTSD symptoms with marijuana and synthetic cannabis use among young adult U.S. veterans. Future research should further investigate the link between PTSD and marijuana use, as well as the rates and consequences of synthetic cannabis use among veterans.
Larsen, Christina Viskum Lytken; Curtis, Tine; Bjerregaard, Peter
Public health research has pointed to alcohol and substance abuse as the most significant public health challenges in Greenland with the negative impact on families and communities that entail, but few studies have investigated the role of problem gambling as addictive behaviour among Inuit. The ....... The objectives of the present study were to investigate (a) the association between lifetime problem gambling and harmful alcohol use as well as frequent use of marijuana and (b) the prevalence of cross-addictive behaviour among Greenland Inuit....
Gordon, Adam J.; Conley, James W.; Gordon, Joanne M.
With the advent of legalization of marijuana for medicinal and recreational purposes, and the increase use of marijuana, healthcare providers will be increasingly confronted with marijuana users as patients in clinical environments. While there is vast literature regarding the societal and mental health harms associated with marijuana use, there is a paucity of reviews of the potential consequences of marijuana use on physical health or medical conditions. We examine the recent literature on ...
Jacobus, Joanna; Squeglia, Lindsay M; Meruelo, Alejandro D; Castro, Norma; Brumback, Ty; Giedd, Jay N; Tapert, Susan F
Studies suggest marijuana impacts gray and white matter neural tissue development, however few prospective studies have determined the relationship between cortical thickness and cannabis use spanning adolescence to young adulthood. This study aimed to understand how heavy marijuana use influences cortical thickness trajectories across adolescence. Subjects were adolescents with heavy marijuana use and concomitant alcohol use (MJ+ALC, n=30) and controls (CON, n=38) with limited substance use histories. Participants underwent magnetic resonance imaging and comprehensive substance use assessment at three independent time points. Repeated measures analysis of covariance was used to look at main effects of group, time, and Group × Time interactions on cortical thickness. MJ+ALC showed thicker cortical estimates across the brain (23 regions), particularly in frontal and parietal lobes (psadolescence and into young adulthood may be associated with altered neural tissue development and interference with neuromaturation that can have neurobehavioral consequences. Continued follow-up of adolescent marijuana users will help understand ongoing neural changes that are associated with development of problematic use into adulthood, as well as potential for neural recovery with cessation of use. Published by Elsevier Ltd.
Full Text Available CONTEXT: Hepatotoxicity is a potential complication from the usage of various illicit drugs, possibly consequent to their liver metabolism, but information on this is scarce in the medical literature. OBJECTIVE: To study the occurrence of clinical and laboratory hepatic alterations in chronic marijuana users, from the use of marijuana on its own or in association with other legal or illicit drugs. TYPE OF STUDY: transversal study SETTING: Hospital Espírita de Marília, Marília, São Paulo, Brazil PARTICIPANTS: The study was made among 123 patients interned in the Hospital Espírita de Marília from October 1996 to December 1998, divided into 3 groups: 26 (21% using only marijuana, 83 (67.5% using marijuana and crack, and 14 (11.4% consuming marijuana and alcohol. PROCEDURES AND MAIN MEASUREMENTS: Patients were examined clinically with special emphasis on types of drugs used, drug intake route, age when consumption began, length and pattern of usage, presence of tattooing, jaundice, hepatomegaly and splenomegaly. Serum determinations of total proteins, albumin, globulin, total and fractions of bilirubin, aspartate (AST and alanine (ALT aminotransferases, alkaline phosphatase (AP, gamma-glutamyltransferase and prothrombin activity were performed. RESULTS: Among users of only marijuana, hepatomegaly was observed in 57.7% and splenomegaly in 73.1%, and slightly elevated AST (42.3%, ALT (34.6% and AP (53.8%. The three groups did not differ significantly in the prevalence of hepatomegaly, splenomegaly and hepatosplenomegaly. The group using both marijuana and alcohol showed the highest prevalence of alterations and highest levels of aminotransferases. Mean AP levels were above normal in all groups. CONCLUSIONS: Chronic marijuana usage, on its own or in association with other drugs, was associated with hepatic morphologic and enzymatic alterations. This indicates that cannabinoids are possible hepatotoxic substances.
Sullivan, Ezra; Austriaco, Nicanor
Several empirical studies suggest that recreational marijuana is popularly perceived as an essentially harmless rite of passage that ends as young people settle into their careers and their adult intimate relationships. Is this perception accurate? To answer this question, we evaluate the morality of recreational marijuana use from a virtue perspective guided by the theological synthesis of St. Thomas Aquinas. Since the medical data reveals that recreational marijuana use is detrimental to the well-being of the user, we conclude that it is a vicious activity, an instance of the vice of intoxication, and as such would be morally illicit. In contrast to its medical use, the recreational use of marijuana cannot be justified for at least three reasons. First, as scientists have amply documented, it harms the organic functioning of the human body. Second, it impedes our ability to reason and in so doing does harm to us. Finally, it has lasting detrimental effects on the user and his neighbor, even when it occurs in a casual setting. Intoxication is always contrary to the integral good of the person. Thus, the use of marijuana is never warranted even for good, non-medical reasons.
Johnson, Renee M; Fairman, Brian; Gilreath, Tamika; Xuan, Ziming; Rothman, Emily F; Parnham, Taylor; Furr-Holden, C Debra M
The potential for increases in adolescent marijuana use is an important concern given recent changes in marijuana policy. The purpose of this study was to estimate trends in marijuana use from 1999 to 2013 among a national sample of US high school students. We examine changes over time by race/ethnicity and sex. Data are from the National Youth Risk Behavior Survey (YRBS), which involves biennial, school-based surveys that generate nationally representative data about 9th-12th grade students in the United States. Students self-reported sex, race/ethnicity, and marijuana use (i.e., lifetime use, past 30-day use, any use before age 13). We generated national estimates of the prevalence of marijuana use for the time period, and also tested for linear and quadratic trends (n=115,379). The prevalence of lifetime marijuana use decreased modestly from 1999 to 2009 (44% to 37%), and has increased slightly since 2009 (41%). Other marijuana use variables (e.g., past 30-day use) followed a similar pattern over time. The prevalence of past 30-day use from 1999 to 2013 for all groups and both sexes was 22.5%, and it was lowest among Asians and highest among American Indian/Alaska Natives. Although boys have historically had a higher prevalence of marijuana use, results indicate that male-female differences in marijuana use decreased over time. Despite considerable changes in state marijuana policies over the past 15 years, marijuana use among high school students has largely declined. Continued surveillance is needed to assess the impact of policy changes on adolescent marijuana use. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Vincent, Paula C; Collins, R Lorraine; Liu, Liu; Yu, Jihnhee; De Leo, Joseph A; Earleywine, Mitch
Given the growing legalization of recreational marijuana use and related increase in its prevalence in the United States, it is important to understand marijuana's appeal. We used a behavioral economic (BE) approach to examine whether the reinforcing properties of marijuana, including "demand" for marijuana, varied as a function of its perceived quality. Using an innovative, Web-based marijuana purchase task (MPT), a sample of 683 young-adult recreational marijuana users made hypothetical purchases of marijuana across three qualities (low, mid and high grade) at nine escalating prices per joint, ranging from $0/free to $20. We used nonlinear mixed effects modeling to conduct demand curve analyses, which produced separate demand indices (e.g., P max , elasticity) for each grade of marijuana. Consistent with previous research, as the price of marijuana increased, marijuana users reduced their purchasing. Demand also was sensitive to quality, with users willing to pay more for higher quality/grade marijuana. In regression analyses, demand indices accounted for significant variance in typical marijuana use. This study illustrates the value of applying BE theory to young adult marijuana use. It extends past research by examining how perceived quality affects demand for marijuana and provides support for the validity of a Web-based MPT to examine the appeal of marijuana. Our results have implications for policies to regulate marijuana use, including taxation based on the quality of different marijuana products. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Marijuana that is legally available for adults has multiple implications for adolescent substance use. One potential effect that legalization may have is an increase in adolescent use to due increased availability, greater social acceptance, and possibly lower prices. Legalization may also facilitate the introduction of new formulations of marijuana (edible, vaporized) and with potentially higher potencies. It is unknown what adolescent consumption patterns will be if marijuana is widely available and marketed in different forms, or what effects different patterns of adolescent use will have on cognition, the development of marijuana use disorders, school performance, and the development of psychotic illnesses. Also unclear is whether adolescent users will be experiencing higher levels of tetrahydrocannabinol (THC) compared with previous generations of users due to higher potencies. Although previous studies of the effects of adolescent marijuana use provide some guidance for current policy and public health recommendations, many new studies will be needed that answer questions in the context of use within a legal adult environment. Claims that marijuana has medicinal benefits create additional challenges for adolescent prevention efforts, as they contrast with messages of its harmfulness. Prevention and treatment approaches will need to address perceptions of the safety of marijuana, claims of its medicinal use, and consider family-wide effects as older siblings and parents may increasingly openly consume and advocate for marijuana use. Guidance for primary care physicians will be needed regarded screening and counseling. Widespread legalization and acceptance of marijuana implies that as law enforcement approaches for marijuana control decline, public health, medical, and scientific efforts to understand and reduce negative consequences of adolescent marijuana use need to be substantially increased to levels commensurate with those efforts for tobacco and alcohol.
Phillips, Kristina T; Lalonde, Trent L; Phillips, Michael M; Schneider, Maryia M
Marijuana is the most commonly used illicit drug among college students, with heavy use leading to negative outcomes. Use of marijuana for medical and recreational purposes in select U.S. states has been controversial, with concerns surrounding increased prevalence rates and harm. The current exploratory study aimed to assess marijuana use in college students in Colorado, demographic differences in frequency of use, and motives for using. College students (N = 300; 61% female) were recruited through introductory psychology courses and completed a series of questionnaires and a marijuana urine screen. Almost three-fourths of the sample reported lifetime use of marijuana. Sixty-five percent used marijuana within the last year and 29% tested positive on the urine screen. Hurdle Poisson regression models with a subset of participants (n = 117) showed non-Greek and freshman status were associated with increased number of days participants used marijuana in the last month. Problem marijuana use was positively associated with a range of motives-of note-motives focused on coping, boredom, alcohol, and food. Prevalence rates of marijuana use were high in this sample of college students in a state with legal recreational marijuana use. Particular students (eg, students who use marijuana to cope) may be at higher risk for problem marijuana use. Developing effective, tailored interventions for university students is warranted. (Am J Addict 2017;26:830-837). © 2017 American Academy of Addiction Psychiatry.
Melissa A. Little
Full Text Available The current article reports a large scale study of the prediction of marijuana use cessation among individuals attending alternative high schools who were regular users at baseline. Based on the Triadic Influence Theory, predictors of marijuana use cessation at one-year follow-up were organized by type of influence (e.g., interpersonal, cultural and attitudinal, and intrapersonal and level of influence (e.g., distal and ultimate. Among the 522 students who were past 30-day marijuana users at baseline, quitting was defined as having not used marijuana in the last 30 days at one-year follow-up (43% of baseline users. To account for the level of influence we employed a theory-based analytic strategy, hierarchical regression. In the final multivariate model, lower level of baseline marijuana use and less of a likelihood to endorse pro-drug-use myths remained predictors of marijuana use cessation one year later. Implications of these findings include the need to develop cessation programs that reduce psychological dependence on marijuana use, and correct cognitive misperceptions about drug use in order to help adolescents make decisions that lead to health-promoting behaviors.
Gutierrez, Kevin M; Cooper, Theodore V
Few studies have examined correlates related to the use of synthetic cannabinoids (e.g., Spice, K2) and Salvia divinorum. Two studies were conducted to investigate whether demographic, smoking-related, and substance-related variables were associated with the use of synthetic cannabinoids and Salvia. In Study 1, 185 participants (50% female; 83% Hispanic; Mage = 32 years; SD = 13.68) were recruited from a local health clinic and a university on the U.S./Mexico border for a smoking-cessation study targeting light and intermittent smokers. In Study 2, 675 participants (62.4% female; 89.1% Hispanic; Mage = 21.0, SD = 8.56) were recruited from a university on the U.S./Mexico border for an online study. In Study 1, 10% of the sample indicated they had ever used either synthetic cannabinoids or Salvia in their lifetime. Being male and dual/multiple use of tobacco products were significantly associated with having ever used synthetic cannabinoids or Salvia. In Study 2, 9%, 5%, and 3% of the sample indicated lifetime, past-year, and past 30-day use of synthetic cannabinoids, respectively. Five percent, 2%, and 1% of the sample indicated lifetime, past-year, and past 30-day use of Salvia, respectively. Logistic regression analyses revealed that past 30-day marijuana use and past 30-day ecstasy use were significantly associated with use of synthetic cannabinoids and Salvia in one's lifetime. These findings suggest that the assessment of synthetic marijuana and Salvia use is warranted in studies of other addictive behaviors, particularly among current marijuana and ecstasy users. PsycINFO Database Record (c) 2014 APA, all rights reserved.
Ste-Marie, Peter A; Shir, Yoram; Rampakakis, Emmanouil; Sampalis, John S; Karellis, Angela; Cohen, Martin; Starr, Michael; Ware, Mark A; Fitzcharles, Mary-Ann
Cannabinoids may hold potential for the management of rheumatic pain. Arthritis, often self-reported, is commonly cited as the reason for the use of medicinal herbal cannabis (marijuana). We have examined the prevalence of marijuana use among 1000 consecutive rheumatology patients with a rheumatologist-confirmed diagnosis and compared in an exploratory manner the clinical characteristics of medicinal users and nonusers. Current marijuana use, medicinal or recreational, was reported by 38 patients (3.8%; 95% CI: 2.8-5.2). Ever use of marijuana for medical purposes was reported by 4.3% (95% CI: 3.2-5.7), with 28 (2.8%; 95% CI: 1.9-4.0) reporting current medicinal use. Current medicinal users had a spectrum of rheumatic conditions, with over half diagnosed with osteoarthritis. Medicinal users were younger, more likely unemployed or disabled, and reported poorer global health. Pain report and opioid use was greater for users, but they had similar physician global assessment of disease status compared with nonusers. Medicinal users were more likely previous recreational users, with approximately 40% reporting concurrent recreational use. Therefore, less than 3% of rheumatology patients reported current use of medicinal marijuana. This low rate of use in patients with a rheumatologist-confirmed diagnosis is in stark contrast to the high rates of severe arthritis frequently reported by medicinal marijuana users, especially in Canada. Familiarity with marijuana as a recreational product may explain use for some as disease status was similar for both groups.
Full Text Available Substance users are more likely to have co-occurring health problems, and this pattern is intensified among those involved with the criminal justice system. Interview data for 1977 incarcerated men in 5 states from the Multi-site Family Study on Incarceration, Parenting, and Partnering that was conducted between December 2008 and August 2011 were analyzed to compare pre-incarceration substance use patterns and health outcomes between men who primarily used marijuana, primarily used alcohol, primarily used other drugs, and did not use any illicit substances during that time. Using regression modeling, we examined the influence of substance use patterns on physical and mental health. Primary marijuana users comprised the largest portion of the sample (31.5%, closely followed by nonusers (30.0%, and those who primarily used other drugs (30.0%; primary alcohol users comprised the smallest group (19.6%. The substance user groups differed significantly from the nonuser group on many aspects of physical and mental health. Findings suggest that even among justice-involved men who are not using “hard” drugs, substance use merits serious attention. Expanding the availability of substance use treatment during and after incarceration might help to promote physical and mental health during incarceration and reentry.
Hoffenberg, Edward J; McWilliams, Shannon K; Mikulich-Gilbertson, Susan K; Murphy, Brittany V; Lagueux, Megan; Robbins, Kristen; Hoffenberg, Analice S; de Zoeten, Edwin; Hopfer, Christian J
To evaluate marijuana use by adolescents and young adults with inflammatory bowel disease (IBD). This descriptive cross-sectional study of patients seen between December 2015 through June 2017 at Children's Hospital Colorado for IBD enrolled patients 13-23 years of age, independent of marijuana use status. Information obtained consisted of chart review, electronic and interview self-report, and serum cannabinoid levels. Marijuana ever-users were compared with never-users for clinical characteristics and perceptions of risk with use; users provided information on routes, patterns, motivations, and perceived benefits and problems with use. Of 99 participants, ever-use was endorsed by 32% (32 of 99) and daily or almost daily use by 9% (9 of 99). Older age was the only characteristic related to endorsing marijuana use. Twenty-nine ever-users completed all questionnaires. After adjusting for age, users were 10.7 times more likely to perceive low risk of harm with regular use (P medical reason for use was endorsed by 57% (17 of 30), most commonly for relief of physical pain (53%, 16 of 30) (2 did not complete all questionnaires). Problems from use were identified by 37% (11 of 30), most commonly craving/strong urge to use. Most common route of use was smoking (83%) followed by edibles (50%), dabbing (40%), and vaping (30%). Marijuana use by adolescents and young adults with IBD is common and perceived as beneficial. Guidelines for screening, testing, and counseling of marijuana use should be developed for patients with IBD. Copyright © 2018 Elsevier Inc. All rights reserved.
Metrik, Jane; Aston, Elizabeth R.; Kahler, Christopher W.; Rohsenow, Damaris J.; McGeary, John E.; Knopik, Valerie S.
Marijuana produces acute increases in positive subjective effects and decreased reactivity to negative affective stimuli, though may also acutely induce anxiety. Implicit attentional and evaluative processes may explicate marijuana’s ability to acutely increase positive and negative emotions. This within-subjects study examined whether smoked marijuana with 2.7–3.0 % delta-9-tetrahydrocannabinol (THC), relative to placebo, acutely changed attentional processing of rewarding and negative affective stimuli as well as marijuana-specific stimuli. On two separate days, regular marijuana users (N=89) smoked placebo or active THC cigarette and completed subjective ratings of mood, intoxication, urge to smoke marijuana, and two experimental tasks: Pleasantness Rating (response latency and perceived pleasantness of affective and marijuana-related stimuli) and Emotional Stroop (attentional bias to affective stimuli). On the Pleasantness Rating task, active marijuana increased response latency to negatively-valenced and marijuana-related (vs. neutral) visual stimuli, beyond a general slowing of response. Active marijuana also increased pleasantness ratings of marijuana images, although to a lesser extent than placebo due to reduced marijuana urge after smoking. Overall, active marijuana did not acutely change processing of positive emotional stimuli. There was no evidence of attentional bias to affective word stimuli on the Emotional Stroop task with the exception of attentional bias to positive word stimuli in the subgroup of marijuana users with cannabis dependence. Marijuana may increase allocation of attentional resources towards marijuana-specific and negatively-valenced visual stimuli without altering processing of positively-valenced stimuli. Marijuana-specific cues may be more attractive with higher levels of marijuana craving and less wanted with low craving levels. PMID:26167716
Bonn-Miller, Marcel O; Vujanovic, Anka A; Boden, Matthew Tyler; Gross, James J
In an effort to better understand factors that may explain prior findings of a positive relation between posttraumatic stress symptom severity and coping-oriented marijuana use motivation, the present study tested whether the association between posttraumatic stress symptom severity and marijuana use coping motives is mediated by difficulties in emotion regulation. Participants were 79 (39 women; M(age) = 22.29 years, SD = 6.99) community-recruited adults who reported (1) lifetime exposure to at least one posttraumatic stress disorder Criterion A traumatic event and (2) marijuana use in the past 30 days. Results indicated that difficulties in emotion regulation, as indexed by the Difficulties in Emotion Regulation Scale (Gratz & Roemer, 2004), fully mediated the association between posttraumatic stress symptom severity and marijuana use coping motives. Implications for the treatment of co-occurring posttraumatic stress and marijuana use are discussed.
Lee, Christine M; Cadigan, Jennifer M; Patrick, Megan E
Although there are serious negative harms associated with simultaneous alcohol and marijuana (SAM) use, little is known about the self-reported acute effects of SAM use and how they may be similar to or different than effects experienced when using alcohol or marijuana only. The current study examines the perceived acute effects of SAM use, compared to using alcohol or marijuana only, as well as demographic and substance use predictors of overall SAM effects. Participants were a community sample of young adults ages 18-23 participating in a longitudinal study on social role transitions and substance use during young adulthood. Young adults who reported SAM use at least once in their lifetime were selected for the present analyses (N=315; mean age=21.42; 58% female) and reported the effects they experienced from typical alcohol use, marijuana use, and SAM use. There were significant differences in the extent to which young adults perceived the effects depending on the substances used. Most effects (i.e., clumsy, confused, dizzy, difficulty concentrating) were rated strongest when engaging in SAM use, compared to typical alcohol or marijuana use alone. Feeling high and feeling marijuana effects were rated strongest when engaging in marijuana use alone compared to SAM use, but feeling drunk was greater during SAM use compared to alcohol use alone. Greater alcohol use and increased time spent high during typical SAM use were associated with greater overall SAM effects. When young adults engage in SAM use they report experiencing greater negative physiological and cognitive effects. Copyright © 2017 Elsevier B.V. All rights reserved.
Hashibe, Mia; Straif, Kurt; Tashkin, Donald P; Morgenstern, Hal; Greenland, Sander; Zhang, Zuo-Feng
Marijuana is the most commonly used illegal drug in the United States and is considered by young adults to be the illicit drug with the least risk. On the other hand, marijuana smoke contains several of the same carcinogens and co-carcinogens as the tar from tobacco, raising concerns that smoking of marijuana may be a risk factor for tobacco-related cancers. We reviewed two cohort studies and 14 case-control studies with assessment of the association of marijuana use and cancer risk. In the cohort studies, increased risks of lung or colorectal cancer due to marijuana smoking were not observed, but increased risks of prostate and cervical cancers among non-tobacco smokers, as well as adult-onset glioma among tobacco and non-tobacco smokers, were observed. The 14 case-control studies included four studies on head and neck cancers, two studies on lung cancer, two studies on non-Hodgkin's lymphoma, one study on anal cancer, one study on penile cancer, and four studies on childhood cancers with assessment of parental exposures. Zhang and colleagues reported that marijuana use may increase risk of head and neck cancers in a hospital-based case-control study in the United States, with dose-response relations for both frequency and duration of use. However, Rosenblatt and co-workers reported no association between oral cancer and marijuana use in a population-based case-control study. An eightfold increase in risk among marijuana users was observed in a lung cancer study in Tunisia. However, there was no assessment of the dose response, and marijuana may have been mixed with tobacco. Parental marijuana use during gestation was associated with increased risks of childhood leukemia, astrocytoma, and rhabdomyosarcoma, but dose-response relations were not assessed. In summary, sufficient studies are not available to adequately evaluate marijuana impact on cancer risk. Several limitations of previous studies include possible underreporting where marijuana use is illegal, small
Cavazos-Rehg, Patricia A; Krauss, Melissa J; Sowles, Shaina J; Murphy, Gabrielle M; Bierut, Laura J
Many individuals now seek out product reviews in order to make an informed decision prior to making a purchase. In this study, we investigate consumers' exposure to and content within product reviews about marijuana because of their potential to shape marijuana purchasing decisions. The terms "weed review," "marijuana review," and "cannabis review" were searched on YouTube on June 10-11, 2015; the team viewed and coded the content of 83 product review videos about marijuana. In addition, we surveyed young adult (18-34 years old) current (past month) marijuana users (n = 742) from across the USA online to assess exposure to product reviews about marijuana and associations with socio-demographic characteristics and marijuana use behaviors. In our content analysis of videos, we observed that the reviewers tended to consume marijuana during the video and often shared personal, favorable experiences towards the marijuana they ingested (e.g., became as high as possible or experienced positive effects on physical and mental health). Most videos normalized marijuana use and could be easily accessed by underage youth. About one third (34%) of the survey participants viewed/sought a product review about marijuana in the past 30 days. In a multivariable logistic regression model, living in a state where recreational use is legal or using multiple forms of marijuana was associated with increased odds of viewing/seeking marijuana reviews. Prevention messages should counter product reviews about marijuana that tend to normalize and promote marijuana use given that they are more readily viewed by individuals who are increasingly susceptible to marijuana's potential harms.
Papatheodorou, Stefania I; Buettner, Hannah; Rice, Mary B; Mittleman, Murray A
The medical and recreational use of marijuana is now legal in some parts of the United States; the health effects are unknown. We aimed to evaluate associations between recent marijuana use and exhaled nitric oxide (eNO) and pulmonary function. We performed a cross-sectional study of 10,327 US adults participating in the National Health and Nutrition Examination Survey in the years 2007 to 2012. We examined associations between marijuana use and eNO, FEV1, FVC, the FEV1/FVC ratio, and forced expiratory flow (midexpiratory phase) (FEF25%-75%) by weighted linear regression. In the study population, there were 4,797 never users, 4,084 past marijuana users, 555 participants who used marijuana 5 to 30 days before the examination, and 891 participants who used marijuana 0 to 4 days before the examination. Current marijuana use in the past 4 days was associated with 13% lower eNO (95% CI, -18% to 8%). FVC was higher in past users (75 mL; 95% CI, 38-112) and current users in the past 5 to 30 days (159 mL; 95% CI, 80-237) and in users within 0 to 4 days of the examination (204 mL; 95% CI, 139-270) compared with never users. All associations remained unchanged and statistically significant in sensitivity analyses excluding current and past tobacco users. Current marijuana use was associated with lower levels of eNO and higher FVC. The lower eNO in marijuana smokers suggests that short-term exposure to marijuana may, like tobacco, acutely affect the pulmonary vascular endothelium and impair airflow through the small airways. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.
Marijuana use in pediatric populations remains an ongoing concern, and marijuana use by adolescents had known medical, psychological, and cognitive side effects. Marijuana alters brain development and has detrimental effects on brain structure and function in ways that are incompletely understood at this point in time. Furthermore, marijuana smoke contains tar and other harmful chemicals, so marijuana cannot be recommended by physicians. At this time, no studies suggest a benefit of marijuana use by children and adolescents. In the context of limited but clear evidence showing harm or potential harm from marijuana use by adolescents, any recommendations for medical marijuana use by adolescents are based on research studies with adults and on anecdotal evidence. Criminal prosecution for marijuana possession adversely affects hundreds of thousands of youth yearly in the United States, particularly minority youth. Current evidence does not support a focus on punishment for youth who use marijuana. Rather, drug education and treatment programs should be encouraged to better help youth who are experimenting with or are dependent on marijuana. Decriminalization of recreational use of marijuana by adults has not led to an increase in youth use rates of recreational marijuana. Thus, decriminalization may be a reasonable alternative to outright criminalization, as long as it is coupled with drug education and treatment programs. The effect of outright legalization of adult recreational use of marijuana on youth use is unknown.
Como-Lesko, N; Primavera, L H; Szeszko, P R
This study investigated high school students' marijuana usage patterns in relation to their harmfulness ratings of 15 licit and illicit drugs, perceived negative consequences from using marijuana, and types of defense mechanisms employed. Subjects were classified into one of five pattern-of-use groups based on marijuana usage: principled nonusers, nonusers, light users, moderate users, and heavy users. Principled nonusers (individuals who have never used marijuana and would not do so if it was legalized) rated marijuana, hashish, cocaine, and alcohol as significantly more harmful than heavy users. A cluster analysis of the drugs' harmfulness ratings best fit a three cluster solution and were named medicinal drugs, recreational drugs, and hard drugs. In general, principled nonusers rated negative consequences from using marijuana as significantly more likely to occur than other groups. Principled nonusers and heavy users utilized reversal from the Defense Mechanism Inventory, which includes repression and denial, significantly more than nonusers, indicating some trait common to the two extreme pattern-of-use groups.
Jones, Jacob; Nicole Jones, K; Peil, Jenny
In January of 2014 the Regulate Marijuana like Alcohol Act or, Amendment 64, went into effect in Colorado. Even though it was the first state to enact recreational legalization, attitudes towards marijuana use have been changing for decades. Prompted by medical marijuana legalization, studies have found mixed results in regards to the impact that legalization has on frequency of use and abuse. With college students having the highest rates of use in the United States (U.S.), whether legal or not, it was important to explore the impact that legalization has on this population. In the current study, rates of marijuana and alcohol use in college students before and after recreational legalization were explored. Data was collected in four waves from October 2013 to March 2015, to be able to determine the trends in marijuana and alcohol use, and relationship between the substances. In addition, grade point average was measured as a possible consequence of marijuana use. We found the frequency of marijuana use in Colorado college students is much higher than the national average t(94445)=24.424, pmarijuana non-users and the once a week or more often but not daily marijuana users in grade point average, F(6, 227)=2.935, pmarijuana use in general is decreasing since the passing of Amendment 64, but not among the binge drinkers. Copyright © 2017 Elsevier Ltd. All rights reserved.
Friese, Bettina; Slater, Michael D; Annechino, Rachelle; Battle, Robynn S
Recent research indicates that marijuana-infused food product (i.e., edible) use is becoming nearly as common as smoking marijuana where medical marijuana is available. This study explores edible use among teens. We conducted four focus groups in the San Francisco Bay Area with youth, ages 15-17. The focus groups were divided by gender and whether they used marijuana. Some teens mentioned edible use at school. Youth reported that teens consume edibles, primarily to reduce the likelihood of getting caught. Edibles are also attractive to those who do not like to smoke or have concerns about smoking. Both male and female respondents suggested that females are more likely than males to prefer edibles over smoking, one reason for which may be to avoid smelling like marijuana smoke. For some young women, edibles may be a way to avoid publicly presenting themselves as marijuana users. Findings also suggest that youth have access to edibles through multiple sources. Youth reported that they can purchase edibles at school from other students who either make the edibles themselves or are reselling edibles obtained from dispensaries. Both users and non-users were aware of potentially negative consequences related to edible use. Some youth mentioned that they have heard of youth dying from edibles, and several reported being concerned about the high produced by edibles. Female non-users appeared to be more concerned than others about edibles and compared them to drinks that could be spiked with drugs. However, sentiment among some male marijuana users was that if you cannot handle edibles you should not be using them. These findings suggest that strategies to curb access to edibles and use among youth, such as restricting sales of edibles with strong youth appeal and educating youth on the risks of edibles, will need to be developed.
Mary M. Heitzeg
Full Text Available This work investigated the impact of heavy marijuana use during adolescence on emotional functioning, as well as the brain functional mediators of this effect. Participants (n = 40 were recruited from the Michigan Longitudinal Study (MLS. Data on marijuana use were collected prospectively beginning in childhood as part of the MLS. Participants were classified as heavy marijuana users (n = 20 or controls with minimal marijuana use. Two facets of emotional functioning—negative emotionality and resiliency (a self-regulatory mechanism—were assessed as part of the MLS at three time points: mean age 13.4, mean age 19.6, and mean age 23.1. Functional neuroimaging data during an emotion-arousal word task were collected at mean age 20.2. Negative emotionality decreased and resiliency increased across the three time points in controls but not heavy marijuana users. Compared with controls, heavy marijuana users had less activation to negative words in temporal, prefrontal, and occipital cortices, insula, and amygdala. Activation of dorsolateral prefrontal cortex to negative words mediated an association between marijuana group and later negative emotionality. Activation of the cuneus/lingual gyrus mediated an association between marijuana group and later resiliency. Results support growing evidence that heavy marijuana use during adolescence affects later emotional outcomes.
Choi, Namkee G; DiNitto, Diana M; Marti, C Nathan; Choi, Bryan Y
Despite growing numbers of older-adult illicit drug users, research on this topic is rare. This study examined the relationship between marijuana and/or other illicit drug use and major depressive episode (MDE) and serious suicidal thoughts among those aged 50+ years in the USA. The public use files of the 2008 to 2012 US National Survey on Drug Use and Health (NSDUH) provided data on 29,634 individuals aged 50+ years. Logistic regression analysis was used to test hypothesized associations between past-year marijuana and/or other illicit drug use and MDE and serious suicidal thoughts. Nearly 6% of the 50+ years age group reported past-year marijuana and/or other illicit drug use. Compared to non-users of any illicit drug, the odds of past-year MDE among those who used marijuana only, other illicit drugs only, and marijuana and other illicit drugs were 1.54 (95% CI = 1.17-2.03), 2.75 (95% CI = 1.75-4.33), and 2.12 (95% CI = 1.45-3.09), respectively. Those who used marijuana and other drugs also had higher odds (2.44, 95% CI = 1.58-3.77) of suicidal thoughts than non-users of any illicit drug. However, among users of any illicit drug, no difference was found among users of marijuana only, marijuana and other illicit drugs, and other illicit drugs only. Among marijuana users, marijuana use frequency was a significant correlate of suicidal thoughts only among those with MDE. Health and mental health (MH) service providers should pay close attention to the potential reciprocal effects of marijuana and other illicit drug use and MDE and suicidal thoughts among late middle-aged and older adults.
Full Text Available The impact of marijuana on nonalcoholic fatty liver disease (NAFLD is largely unknown. We studied the association between marijuana and NAFLD utilizing cross-sectional data from the National Health and Nutrition Examination Survey (NHANES from 2005-2014 and NHANES III (1988-1994.Suspected NAFLD was diagnosed if serum alanine aminotransferase (ALT was > 30 IU/L for men and > 19 IU/L for women in the absence of other liver diseases (NHANES 2005-2014. In NHANES III cohort, NAFLD was defined based on ultrasonography.Of the 14,080 (NHANES 2005-2014 and 8,286 (NHANES III participants, prevalence of suspected NAFLD and ultrasonographically-diagnosed NAFLD were inversely associated with marijuana use (p < 0.001. Compared to marijuana-naïve participants, marijuana users were less likely to have suspected NAFLD (odds ratio [OR]: 0.90, 95% confidence interval [CI]: 0.82-0.99 for past user; OR: 0.68, 95% CI: 0.58-0.80 for current user and ultrasonographically-diagnosed NAFLD (OR: 0.75, 95% CI: 0.57-0.98 for current user in the age, gender, ethnicity-adjusted model. On multivariate analysis, the ORs for suspected NAFLD comparing current light or heavy users to non-users were 0.76 (95% CI 0.58-0.98 and 0.70 (95% CI 0.56-0.89, respectively (P for trend = 0.001 with similar trends in ultrasonographically-diagnosed NAFLD (OR: 0.77, 95% CI: 0.59-1.00 for current user; OR: 0.71, 95% CI: 0.51-0.97 for current light user. In insulin resistance-adjusted model, marijuana use remained an independent predictor of lower risk of suspected NAFLD.In this nationally representative sample, active marijuana use provided a protective effect against NAFLD independent of known metabolic risk factors. The pathophysiology is unclear and warrants further investigation.
Borini, Paulo; Guimarães, Romeu Cardoso; Borini, Sabrina Bicalho
CONTEXT: Hepatotoxicity is a potential complication from the usage of various illicit drugs, possibly consequent to their liver metabolism, but information on this is scarce in the medical literature. OBJECTIVE: To study the occurrence of clinical and laboratory hepatic alterations in chronic marijuana users, from the use of marijuana on its own or in association with other legal or illicit drugs. TYPE OF STUDY: transversal study SETTING: Hospital Espírita de Marília, Marília, São Paulo, Braz...
Ketcherside, Ariel; Filbey, Francesca M
The literature widely reports that stress is associated with marijuana use, yet, to date, the path from stress to marijuana-related problems has not been tested. In this study, we evaluated whether negative affect mediates the relationship between stress and marijuana use. To that end, we tested models to determine mediators between problems with marijuana use (via Marijuana Problem Scale), stress (via Early Life Stress Questionnaire, Perceived Stress Scale), and negative affect (via Beck Depression Inventory; Beck Anxiety Inventory) in 157 current heavy marijuana users. Mediation tests and bootstrap confidence intervals were carried out via the "Mediation" package in R. Depression and anxiety scores both significantly mediated the relationship between perceived stress and problematic marijuana use. Only depression significantly mediated the relationship between early life stress and problematic marijuana use. Early life stress, perceived stress and problematic marijuana use were significant only as independent variables and dependent variables. These findings demonstrate that (1) depression mediated both early life stress and perceived stress, and problematic marijuana use, and, (2) anxiety mediated perceived stress and problematic marijuana use. This mediation analysis represents a strong first step toward understanding the relationship between these variables; however, longitudinal studies are needed to determine causality between these variables. To conclude, addressing concomitant depression and anxiety in those who report either perceived stress or early life stress is important for the prevention of cannabis use disorders. Copyright © 2015. Published by Elsevier Ltd.
Metrik, Jane; Aston, Elizabeth R.; Kahler, Christopher W.; Rohsenow, Damaris J.; McGeary, John E.; Knopik, Valerie S.; MacKillop, James
Background Incentive salience is a multidimensional construct that includes craving, drug value relative to other reinforcers, and implicit motivation such as attentional bias to drug cues. Laboratory cue reactivity (CR) paradigms have been used to evaluate marijuana incentive salience with measures of craving, but not with behavioral economic measures of marijuana demand or implicit attentional processing tasks. Methods This within-subjects study used a new CR paradigm to examine multiple dimensions of marijuana’s incentive salience and to compare CR-induced increases in craving and demand. Frequent marijuana users (N=93, 34% female) underwent exposure to neutral cues then to lit marijuana cigarettes. Craving, marijuana demand via a marijuana purchase task, and heart rate were assessed after each cue set. A modified Stroop task with cannabis and control words was completed after the marijuana cues as a measure of attentional bias. Results Relative to neutral cues, marijuana cues significantly increased subjective craving and demand indices of intensity (i.e., drug consumed at $0) and Omax (i.e., peak drug expenditure). Elasticity significantly decreased following marijuana cues, reflecting sustained purchase despite price increases. Craving was correlated with demand indices (r’s: 0.23–0.30). Marijuana users displayed significant attentional bias for cannabis-related words after marijuana cues. Cue-elicited increases in intensity were associated with greater attentional bias for marijuana words. Conclusions Greater incentive salience indexed by subjective, behavioral economic, and implicit measures was observed after marijuana versus neutral cues, supporting multidimensional assessment. The study highlights the utility of a behavioral economic approach in detecting cue-elicited changes in marijuana incentive salience. PMID:27515723
Brook, Judith S.; Lee, Jung Yeon; Finch, Stephen J.; Seltzer, Nathan; Brook, David W.
The objective is to examine trajectories of marijuana use among African Americans and Puerto Ricans from late adolescence to adulthood, with attention paid towards work commitment, financial stability, drug use and violence. (N=816.) The chronic marijuana user trajectory group compared to the none or low, increasing, and/or moderate marijuana user trajectory group was associated with negative aspects of work commitment, financial stability, and the social environment. The chronic marijuana us...
Weinstein, A; Brickner, O; Lerman, H; Greemland, M; Bloch, M; Lester, H; Chisin, R; Sarne, Y; Mechoulam, R; Bar-Hamburger, R; Freedman, N; Even-Sapir, E
Heavy use of marijuana is claimed to damage critical skills related to short-term memory, visual scanning and attention. Motor skills and driving safety may be compromised by the acute effects of marijuana. The aim of this study was to investigate the acute effects of 13 mg and 17 mg Delta 9-tetrahydrocannabinol (THC) on skills important for coordinated movement and driving and on subjective and autonomic measures in regular users of marijuana. Fourteen regular users of marijuana were enrolled. Each subject was tested on two separate days. On each test day, subjects smoked two low-nicotine cigarettes, one with and the other without THC. Seventeen mg THC was included in the cigarette on one test day and 13 mg on the other day. The sequence of cigarette types was unknown to the subject. During smoking, heart rate and blood pressure were monitored, and the subjects performed a virtual reality maze task requiring attention and motor coordination, followed by 3 other cognitive tasks (Wisconsin Card Sorting Test (WCST), a "gambling" task and estimation of time and distance from an approaching car). After smoking a cigarette with 17 mg THC, regular marijuana users hit the walls more often on the virtual maze task than after smoking cigarettes without THC; this effect was not seen in patients after they smoked cigarettes with 13 mg THC. Performance in the WCST was affected with 17 mg THC and to a lesser extent with the use of 13 mg THC. Decision making in the gambling task was affected after smoking cigarettes with 17 mg THC, but not with 13 m THC. Smoking cigarettes with 13 and 17 mg THC increased subjective ratings of pleasure and satisfaction, drug "effect" and drug "high". These findings imply that smoking of 17 mg THC results in impairment of cognitive-motor skills that could be important for coordinated movement and driving, whereas the lower dose of 13 mg THC appears to cause less impairment of such skills in regular users of marijuana.
Rumalla, Kavelin; Reddy, Adithi Y; Mittal, Manoj K
Recreational marijuana use is considered to have few adverse effects. However, recent evidence has suggested that it precipitates cardiovascular and cerebrovascular events. Here, we investigated the relationship between marijuana use and hospitalization for acute ischemic stroke (AIS) using data from the largest inpatient database in the United States. The Nationwide Inpatient Sample was queried from 2004 to 2011 for all patients (age 15-54) with a primary diagnosis of AIS. The incidence of AIS hospitalization in marijuana users and non-marijuana users was determined. We utilized multivariable logistic regression analyses to study the independent association between marijuana use and AIS. Overall, the incidence of AIS was significantly greater among marijuana users compared to non-users (Relative Risk [RR]: 1.13, 95% CI: 1.11-1.15, PMarijuana use was more prevalent among younger patients, males, African Americans, and Medicaid enrollees (PMarijuana users were more likely to use other illicit substances but had less overall medical comorbidity. In multivariable analysis, adjusted for potential confounders, marijuana (Odds Ratio [OR]: 1.17, 95% CI: 1.15-1.20), tobacco (OR: 1.76, 95% CI: 1.74-1.77), cocaine (OR: 1.32, 95% CI: 1.30-1.34), and amphetamine (OR: 2.21, 95% CI: 2.12-2.30) usage were found to increase the likelihood of AIS (all Precreational marijuana use is independently associated with 17% increased likelihood of AIS hospitalization. Copyright © 2016 Elsevier B.V. All rights reserved.
Heitzeg, Mary M; Cope, Lora M; Martz, Meghan E; Hardee, Jillian E; Zucker, Robert A
This work investigated the impact of heavy marijuana use during adolescence on emotional functioning, as well as the brain functional mediators of this effect. Participants (n=40) were recruited from the Michigan Longitudinal Study (MLS). Data on marijuana use were collected prospectively beginning in childhood as part of the MLS. Participants were classified as heavy marijuana users (n=20) or controls with minimal marijuana use. Two facets of emotional functioning-negative emotionality and resiliency (a self-regulatory mechanism)-were assessed as part of the MLS at three time points: mean age 13.4, mean age 19.6, and mean age 23.1. Functional neuroimaging data during an emotion-arousal word task were collected at mean age 20.2. Negative emotionality decreased and resiliency increased across the three time points in controls but not heavy marijuana users. Compared with controls, heavy marijuana users had less activation to negative words in temporal, prefrontal, and occipital cortices, insula, and amygdala. Activation of dorsolateral prefrontal cortex to negative words mediated an association between marijuana group and later negative emotionality. Activation of the cuneus/lingual gyrus mediated an association between marijuana group and later resiliency. Results support growing evidence that heavy marijuana use during adolescence affects later emotional outcomes. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.
Venkatesan, Thangam; Sengupta, Jyotirmoy; Lodhi, Atena; Schroeder, Abigail; Adams, Kathleen; Hogan, Walter J; Wang, Yanzhi; Andrews, Christopher; Storr, Martin
Cyclic vomiting syndrome (CVS) is a chronic disorder characterized by episodic nausea and vomiting. A large proportion of patients use marijuana to control their symptoms. Several case reports implicate marijuana as a cause of intractable vomiting with compulsive hot water bathing considered pathognomonic of "cannabinoid hyperemesis." We sought to examine the relationship between marijuana use and CVS. Patients >18 years of age diagnosed by a health care provider were invited to participate in an anonymous internet-based survey. A total of 514 patients participated and 437 completed questions about marijuana use. Mean age was 34 ± 12 years with patients being predominantly female (63%), Caucasian (92%) and from the USA (82%). Nineteen percent never used marijuana and 81% did. Fifty-four percent used marijuana for health issues and 43% for recreational purposes. Users stated that it improved nausea, appetite, general well-being, stress levels and vomiting. Users were more likely to be male and have an associated anxiety disorder. Sixty-seven percent of patients reported taking hot showers/baths for symptom relief, and this was associated with marijuana use. (OR 2.54, CI 1.50-4.31, P = 0.0006). Eighty-one percent of patients with CVS who completed an internet survey reported frequent use of marijuana. With marijuana use, patients noted the greatest improvement with stress levels, appetite and nausea. Marijuana users were more likely to be male and have associated anxiety. Hot showers were not pathognomonic of marijuana use though they were more likely to be associated with its use.
Clayton, Heather B; Lowry, Richard; Ashley, Carmen; Wolkin, Amy; Grant, Althea M
Data are limited on the behavioral risk correlates of synthetic cannabinoid use. The purpose of this study was to compare the behavioral risk correlates of synthetic cannabinoid use with those among marijuana users. Data from the 2015 Youth Risk Behavior Survey, a cross-sectional survey conducted in a nationally representative sample of students in grades 9 through 12 ( N = 15 624), were used to examine the association between self-reported type of marijuana use (ie, never use of marijuana and synthetic cannabinoids, ever use of marijuana only, and ever use of synthetic cannabinoids) and self-report of 36 risk behaviors across 4 domains: substance use, injury/violence, mental health, and sexual health. Multivariable models were used to calculate adjusted prevalence ratios. Students who ever used synthetic cannabinoids had a significantly greater likelihood of engaging in each of the behaviors in the substance use and sexual risk domains compared with students who ever used marijuana only. Students who ever used synthetic cannabinoids were more likely than students who ever used marijuana only to have used marijuana before age 13 years, to have used marijuana ≥1 times during the past 30 days, and to have used marijuana ≥20 times during the past 30 days. Several injury/violence behaviors were more prevalent among students who ever used synthetic cannabinoids compared with students who ever used marijuana only. Health professionals and school-based substance use prevention programs should include strategies focused on the prevention of both synthetic cannabinoids and marijuana. Copyright © 2017 by the American Academy of Pediatrics.
... Alcohol Club Drugs Cocaine Fentanyl Hallucinogens Inhalants Heroin Marijuana MDMA (Ecstasy/Molly) Methamphetamine Opioids Over-the-Counter Medicines Prescription Medicines Steroids (Anabolic) Synthetic Cannabinoids (K2/Spice) Synthetic Cathinones (Bath Salts) Tobacco/ ...
Wang, George Sam; Roosevelt, Genie; Heard, Kennon
An increasing number of states are decriminalizing the use of medical marijuana, and the effect on the pediatric population has not been evaluated. To compare the proportion of marijuana ingestions by young children who sought care at a children's hospital in Colorado before and after modification of drug enforcement laws in October 2009 regarding medical marijuana possession. Retrospective cohort study from January 1, 2005, through December 31, 2011. Tertiary-care children's hospital emergency department in Colorado. A total of 1378 patients younger than 12 years evaluated for unintentional ingestions: 790 patients before September 30, 2009, and 588 patients after October 1, 2009. Marijuana ingestion. Marijuana exposure visits, marijuana source, symptoms, and patient disposition. The proportion of ingestion visits in patients younger than 12 years (age range, 8 months to 12 years)that were related to marijuana exposure increased after September 30, 2009, from 0 of 790 (0%; 95% CI, 0%-0.6%) to 14 of 588 (2.4%; 95% CI, 1.4%-4.0%) (P patients had lethargy, 1 had ataxia, and 1 had respiratory insufficiency. Eight patients were admitted, 2 to the intensive care unit. Eight of the 14 cases involved medical marijuana, and 7 of these exposures were from food products. We found a new appearance of unintentional marijuana ingestions by young children after modification of drug enforcement laws for marijuana possession in Colorado. The consequences of unintentional marijuana exposure in children should be part of the ongoing debate on legalizing marijuana.
... does marijuana affect the brain? Marijuana has both short-and long-term effects on the brain. THC acts on numerous ... movement difficulty with thinking and problem-solving impaired memory ... Long-Term Effects Marijuana also affects brain development. When people ...
... and Drug Administration (FDA) has not approved the marijuana plant as a medicine. However, there have been scientific studies of cannabinoids, the chemicals in marijuana. This has led to two FDA-approved medicines. They contain THC, the active ingredient in marijuana. ...
Ridgeway, Greg; Kilmer, Beau
The average amount of marijuana in a joint is unknown, yet this figure is a critical quantity for creating credible measures of marijuana consumption. It is essential for projecting tax revenues post-legalization, estimating the size of illicit marijuana markets, and learning about how much marijuana users are consuming in order to understand health and behavioral consequences. Arrestee Drug Abuse Monitoring data collected between 2000 and 2010 contain relevant information on 10,628 marijuana transactions, joints and loose marijuana purchases, including the city in which the purchase occurred and the price paid for the marijuana. Using the Brown-Silverman drug pricing model to link marijuana price and weight, we are able to infer the distribution of grams of marijuana in a joint and provide a Bayesian posterior distribution for the mean weight of marijuana in a joint. We estimate that the mean weight of marijuana in a joint is 0.32g (95% Bayesian posterior interval: 0.30-0.35). Our estimate of the mean weight of marijuana in a joint is lower than figures commonly used to make estimates of marijuana consumption. These estimates can be incorporated into drug policy discussions to produce better understanding about illicit marijuana markets, the size of potential legalized marijuana markets, and health and behavior outcomes. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Fried, Peter; Watkinson, Barbara; James, Deborah; Gray, Robert
Assessing marijuana's impact on intelligence quotient (IQ) has been hampered by a lack of evaluation of subjects before they begin to use this substance. Using data from a group of young people whom we have been following since birth, we examined IQ scores before, during and after cessation of regular marijuana use to determine any impact of the drug on this measure of cognitive function. We determined marijuana use for seventy 17- to 20-year-olds through self-reporting and urinalysis. IQ difference scores were calculated by subtracting each person's IQ score at 9-12 years (before initiation of drug use) from his or her score at 17-20 years. We then compared the difference in IQ scores of current heavy users (at least 5 joints per week), current light users (less than 5 joints per week), former users (who had not smoked regularly for at least 3 months) and non-users (who never smoked more than once per week and no smoking in the past two weeks). Current marijuana use was significantly correlated (p marijuana use had a negative effect on global IQ score only in subjects who smoked 5 or more joints per week. A negative effect was not observed among subjects who had previously been heavy users but were no longer using the substance. We conclude that marijuana does not have a long-term negative impact on global intelligence. Whether the absence of a residual marijuana effect would also be evident in more specific cognitive domains such as memory and attention remains to be ascertained.
Anderson, D. Mark; Hansen, Benjamin; Rees, Daniel I.
While at least a dozen state legislatures in the United States have recently considered bills to allow the consumption of marijuana for medicinal purposes, the federal government is intensifying its efforts to close medical marijuana dispensaries. Federal officials contend that the legalization of medical marijuana encourages teenagers to use marijuana and have targeted dispensaries operating within 1,000 feet of schools, parks and playgrounds. Using data from the national and state Youth Ris...
Paschall, Mallie J; Grube, Joel W; Biglan, Anthony
While the legalization of marijuana for medical and recreational use has raised concerns about potential influences on marijuana use and beliefs among youth, few empirical studies have addressed this issue. We examined the association between medical marijuana patients and licensed growers per 1000 population in 32 Oregon counties from 2006 to 2015, and marijuana use among youth over the same period. We obtained data on registered medical marijuana patients and licensed growers from the Oregon Medical Marijuana Program and we obtained data on youth marijuana use, perceived parental disapproval, and demographic characteristics from the Oregon Healthy Teens Survey. Across 32 Oregon counties, the mean rate of marijuana patients per 1000 population increased from 2.9 in 2006 to 18.3 in 2015, whereas the grower rate increased from 3.8 to 11.9. Results of multi-level analyses indicated significant positive associations between rates of marijuana patients and growers per 1000 population and the prevalence of past 30-day marijuana use, controlling for youth demographic characteristics. The marijuana patient and grower rates were also inversely associated with parental disapproval of marijuana use, which decreased from 2006 to 2015 and acted as a mediator. These findings suggest that a greater number of registered marijuana patients and growers per 1000 population in Oregon counties was associated with a higher prevalence of marijuana use among youth from 2006 to 2015, and that this relationship was partially attributable to perceived norms favorable towards marijuana use.
Pacula, Rosalie Liccardo; Smart, Rosanna
State-level marijuana liberalization policies have been evolving for the past five decades, and yet the overall scientific evidence of the impact of these policies is widely believed to be inconclusive. In this review we summarize some of the key limitations of the studies evaluating the effects of decriminalization and medical marijuana laws on marijuana use, highlighting their inconsistencies in terms of the heterogeneity of policies, the timing of the evaluations, and the measures of use being considered. We suggest that the heterogeneity in the responsiveness of different populations to particular laws is important for interpreting the mixed findings from the literature, and we highlight the limitations of the existing literature in providing clear insights into the probable effects of marijuana legalization.
Full Text Available Tobacco use is responsible for most cases of chronic periodontitis in developed nations. Cigarette smoke exerts a profound effect on microbial interactions within dental plaque; promotes infection with key periodontopathogens, including Porphyromonas gingivalis; and suppresses the innate and adaptive arms of the immune response to gingival biofilms. Cannabis use is also a dose-related risk factor for plaque-induced chronic periodontitis. How cannabis exposure may predispose to this periodontal diseaseis largely unknown. Our recent data suggest that phytocannabinoids(cannabidiol [CBD]; cannabinol [CBN]; and tetrahydrocannabinol [THC] are each more toxic to oral bacteria and innate cells than is cigarette smoke. Further, while these marijuana-derived molecules appear to be potent suppressors of innate immunity, their mechanisms of action may differ from those ascribed to tobacco-mediated dampening of the inflammatory response to bacteria. These findings are discussed in the context of the etiology of chronic periodontitis and- as marijuana and tobacco are often simultaneously consumed - the need for further research on tobacco/marijuana as composite insults.
Brenton, J Nicholas; Schreiner, Teri; Karoscik, Krystle; Richter, Meg; Ferrante, Samantha; Waldman, Amy; Banwell, Brenda
Studies have shown a negative impact on cognition and brain volume in marijuana-using adult multiple sclerosis (MS) patients and healthy adolescents. Given that onset of MS during childhood and adolescence negatively impacts brain growth and the normal maturation of neuronal networks, the addition of marijuana exposure in these youth may be even more harmful. Determine attitudes toward and prevalence of recreational marijuana use in MS youth. We surveyed 52 consecutive pediatric-onset MS patients from three pediatric MS centers in the United States. Participants answered a structured questionnaire to capture attitudes toward marijuana and personal use habits, if present. Nearly half reported use of marijuana, with the majority beginning to use in mid-to-late adolescence. The most popular reasons for using marijuana were relaxation (72%), improvement of medical problems (64%), and stress reduction (52%). Over half (64%) of marijuana users perceived it to have negative effects on memory and focus. Cost and access were not barriers to use, despite all respondents being less than age 21. Youth with MS endorse recreational marijuana as safe, and many use marijuana frequently despite appreciating a negative impact on memory. More detailed understanding of the long-term impact of marijuana use in youth with MS is needed.
Berg, Carla J; Stratton, Erin; Schauer, Gillian L; Lewis, Michael; Wang, Yanwen; Windle, Michael; Kegler, Michelle
There has been an increase in non-daily smoking, alternative tobacco product and marijuana use among young adults in recent years. This study examined perceptions of health risks, addictiveness, and social acceptability of cigarettes, cigar products, smokeless tobacco, hookah, electronic cigarettes, and marijuana among young adults and correlates of such perceptions. In Spring 2013, 10,000 students at two universities in the Southeastern United States were recruited to complete an online survey (2,002 respondents), assessing personal, parental, and peer use of each product; and perceptions of health risks, addictiveness, and social acceptability of each of these products. Marijuana was the most commonly used product in the past month (19.2%), with hookah being the second most commonly used (16.4%). The least commonly used were smokeless tobacco products (2.6%) and electronic cigarettes (4.5%). There were high rates of concurrent product use, particularly among electronic cigarette users. The most positively perceived was marijuana, with hookah and electronic cigarettes being second. While tobacco use and related social factors, related positively, influenced perceptions of marijuana, marijuana use and related social factors were not associated with perceptions of any tobacco product. Conclusions/Importance: Marketing efforts to promote electronic cigarettes and hookah to be safe and socially acceptable seem to be effective, while policy changes seem to be altering perceptions of marijuana and related social norms. Research is needed to document the health risks and addictive nature of emerging tobacco products and marijuana and evaluate efforts to communicate such risks to youth.
Vin?Raviv, Neomi; Akinyemiju, Tomi; Meng, Qingrui; Sakhuja, Swati; Hayward, Reid
Abstract The purpose of this paper is to examine the relationship between marijuana use and health outcomes among hospitalized patients, including those hospitalized with a diagnosis of cancer. A total of 387,608 current marijuana users were identified based on ICD?9 codes for marijuana use among hospitalized patients in the Nationwide Inpatient Sample database between 2007 and 2011. Logistic regression analysis was performed to determine the association between marijuana use and heart failur...
Although studies have identified an increased likelihood of marijuana and tobacco co-use among African Americans as compared to other racial groups, few studies have specifically examined the prevalence and substance use characteristics of co-users among African Americans in a national survey. The current secondary analysis examined the prevalence rates and substance use characteristics (e.g., marijuana dependence) of 2024 African American past month marijuana and tobacco users and co-users participating in the 2013 National Survey on Drug Use and Health. Findings revealed that 18.5%, 53.8% and 27.7% of African Americans smoked marijuana only, tobacco only and marijuana and tobacco in the past 30days, respectively. Relative to participants who smoked marijuana only, African Americans who smoked marijuana and tobacco were more likely to be marijuana dependent in the past year and report more days of marijuana use in the past month. Further, relative to participants who smoked tobacco only, African Americans who smoked marijuana and tobacco were less likely to be dependent on nicotine, reported fewer days of cigarette use in the past month, and began smoking cigarettes, cigars and marijuana at a younger age, but were more likely to be marijuana dependent in the past year and reported more days of cigar use in the past month. Marijuana and tobacco co-use is a significant public health problem, especially among African Americans. Additional research on effective prevention and treatment interventions for African Americans who smoke marijuana and tobacco is warranted. Copyright © 2015 Elsevier Ltd. All rights reserved.
Aston, Elizabeth R; Farris, Samantha G; MacKillop, James; Metrik, Jane
Drug demand, or relative value, can be assessed via analysis of behavioral economic purchase task performance. Five demand indices are typically obtained from drug purchase tasks. The goal of this research was to determine whether metrics of marijuana reinforcement from a marijuana purchase task (MPT) exhibit a latent factor structure that efficiently characterizes marijuana demand. Participants were regular marijuana users (n = 99; 37.4% female, 71.5% marijuana use days [5 days/week], 15.2% cannabis dependent) who completed study assessments, including the MPT, during a baseline session. Principal component analysis was used to examine the latent structure underlying MPT indices. Concurrent validity was assessed via examination of relationships between latent factors and marijuana use, past quit attempts, and marijuana expectancies. A two-factor solution was confirmed as the best fitting structure, accounting for 88.5% of the overall variance. Factor 1 (65.8% variance) reflected "Persistence," indicating sensitivity to escalating marijuana price, which comprised four MPT indices (elasticity, O max , P max , and breakpoint). Factor 2 (22.7% variance) reflected "Amplitude," indicating the amount consumed at unrestricted price (intensity). Persistence factor scores were associated with fewer past marijuana quit attempts and lower expectancies of negative use outcomes. Amplitude factor scores were associated with more frequent use, dependence symptoms, craving severity, and positive marijuana outcome expectancies. Consistent with research on alcohol and cigarette purchase tasks, the MPT can be characterized with a latent two-factor structure. Thus, demand for marijuana appears to encompass distinct dimensions of price sensitivity and volumetric consumption, with differential relations to other aspects of marijuana motivation.
Cerdá, Magdalena; Wall, Melanie; Feng, Tianshu; Keyes, Katherine M; Sarvet, Aaron; Schulenberg, John; O'Malley, Patrick M; Pacula, Rosalie Liccardo; Galea, Sandro; Hasin, Deborah S
Historical shifts are occurring in marijuana policy. The effect of legalizing marijuana for recreational use on rates of adolescent marijuana use is a topic of considerable debate. To examine the association between the legalization of recreational marijuana use in Washington and Colorado in 2012 and the subsequent perceived harmfulness and use of marijuana by adolescents. We used data of 253 902 students in eighth, 10th, and 12th grades from 2010 to 2015 from Monitoring the Future, a national, annual, cross-sectional survey of students in secondary schools in the contiguous United States. Difference-in-difference estimates compared changes in perceived harmfulness of marijuana use and in past-month marijuana use in Washington and Colorado prior to recreational marijuana legalization (2010-2012) with postlegalization (2013-2015) vs the contemporaneous trends in other states that did not legalize recreational marijuana use in this period. Perceived harmfulness of marijuana use (great or moderate risk to health from smoking marijuana occasionally) and marijuana use (past 30 days). Of the 253 902 participants, 120 590 of 245 065(49.2%) were male, and the mean (SD) age was 15.6 (1.7) years. In Washington, perceived harmfulness declined 14.2% and 16.1% among eighth and 10th graders, respectively, while marijuana use increased 2.0% and 4.1% from 2010-2012 to 2013-2015. In contrast, among states that did not legalize recreational marijuana use, perceived harmfulness decreased by 4.9% and 7.2% among eighth and 10th graders, respectively, and marijuana use decreased by 1.3% and 0.9% over the same period. Difference-in-difference estimates comparing Washington vs states that did not legalize recreational drug use indicated that these differences were significant for perceived harmfulness (eighth graders: % [SD], -9.3 [3.5]; P = .01; 10th graders: % [SD], -9.0 [3.8]; P = .02) and marijuana use (eighth graders: % [SD], 5.0 [1.9]; P = .03; 10th graders
Berthiller, Julien; Lee, Yuan-Chin Amy; Boffetta, Paolo; Wei, Qingyi; Sturgis, Erich M; Greenland, Sander; Morgenstern, Hal; Zhang, Zuo-Feng; Lazarus, Philip; Muscat, Joshua; Chen, Chu; Schwartz, Stephen M; Eluf Neto, José; Wünsch Filho, Victor; Koifman, Sergio; Curado, Maria Paula; Matos, Elena; Fernandez, Leticia; Menezes, Ana; Daudt, Alexander W; Ferro, Gilles; Brennan, Paul; Hashibe, Mia
Marijuana contains carcinogens similar to tobacco smoke and has been suggested by relatively small studies to increase the risk of head and neck cancer (HNC). Because tobacco is a major risk factor for HNC, large studies with substantial numbers of never tobacco users could help to clarify whether marijuana smoking is independently associated with HNC risk. We pooled self-reported interview data on marijuana smoking and known HNC risk factors on 4,029 HNC cases and 5,015 controls from five case-control studies within the INHANCE Consortium. Subanalyses were conducted among never tobacco users (493 cases and 1,813 controls) and among individuals who did not consume alcohol or smoke tobacco (237 cases and 887 controls). The risk of HNC was not elevated by ever marijuana smoking [odds ratio (OR), 0.88; 95% confidence intervals (95% CI), 0.67-1.16], and there was no increasing risk associated with increasing frequency, duration, or cumulative consumption of marijuana smoking. An increased risk of HNC associated with marijuana use was not detected among never tobacco users (OR, 0.93; 95% CI, 0.63-1.37; three studies) nor among individuals who did not drink alcohol and smoke tobacco (OR, 1.06; 95% CI, 0.47-2.38; two studies). Our results are consistent with the notion that infrequent marijuana smoking does not confer a risk of these malignancies. Nonetheless, because the prevalence of frequent marijuana smoking was low in most of the contributing studies, we could not rule out a moderately increased risk, particularly among subgroups without exposure to tobacco and alcohol.
Ketcherside, Ariel; Baine, Jessica; Filbey, Francesca
Background Tetrahydrocannabinol (?9-THC), the primary ingredient in marijuana, exerts its effects across several neurological and biological systems that interact with the endocrine system. Thus, differential effects of ?9-THC are likely to exist based on sex and hormone levels. Methods We reviewed the existing literature to determine sex-based effects of ?9-THC on neural structure and functioning. Results The literature demonstrates differences in male and female marijuana users on brain str...
Mezquita, Laura; Ruiz-Valero, Lucía; Martínez-Gómez, Naiara; Ibáñez, Manuel I; Ortet, Generós
Marijuana motives are a proximal variable to marijuana use. This research aimed to adapt and validate the short form of the Marijuana Motives Measure (MMM; Simons, Correia, Carey, y Borsari, 1998), the MMM SF, in Spanish. The sample comprised 232 participants (mean age = 25.11 (7.58), 50.43% males) who had tried marijuana at least once in their lifetime. Item and Rasch analyses were performed to choose the final pool of 15 items. Confirmatory Factor Analysis (CFA) showed an adequate 5-factor structure (S-BX2(80) = 121.30, p = .002; NNFI = .944; CFI = .958; IFI = .959; MFI = .915; RMSEA = .047(0.029, 0.063); AIC = -38.70), and the multi-group CFA between males and females showed acceptable fit indices (S-BX2(160) = 230.01, p = .000; NNFI = .900; CFI = .924; IFI = .927; MFI = .860; RMSEA = .062(.043, .078); AIC = -89.99). The questionnaire indicated metric (S-BX2diff (15) = 13.61, p = .556)), scalar (S-BX2diff (15) = 23.15, p = .081)) and error measurement invariance (S-BX2diff (15) = 8.65, p = .895)) between gender groups. The internal consistencies and ordinal omega of the scales were between .79 and .90. In the regression analysis, enhancement, coping and low conformity motives predicted frequency and quantity of marijuana smoked. The best predictor of frequency and quantity consumed during the heaviest smoking period was enhancement, while coping and, to a lesser extent, low conformity, were the only predictors of cannabis-related problems when marijuana frequency and quantity were controlled for. The MMM SF shows adequate psychometric properties and is a suitable instrument to assess marijuana motives, especially during time-limited sessions.
Heitzeg, Mary M.; Cope, Lora M.; Martz, Meghan E.; Hardee, Jillian E.; Zucker, Robert A.
This work investigated the impact of heavy marijuana use during adolescence on emotional functioning, as well as the brain functional mediators of this effect. Participants (n = 40) were recruited from the Michigan Longitudinal Study (MLS). Data on marijuana use were collected prospectively beginning in childhood as part of the MLS. Participants were classified as heavy marijuana users (n = 20) or controls with minimal marijuana use. Two facets of emotional functioning—negative emotionality a...
Nunberg, Helen; Kilmer, Beau; Pacula, Rosalie Liccardo; Burgdorf, James
For more than a decade, medical marijuana has been at the forefront of the marijuana policy debate in the United States. Fourteen states allow physicians to recommend marijuana or provide a legal defense for patients and physicians if prosecuted in state courts; however, little is known about those individuals using marijuana for medicinal purposes and the symptoms they use it for. This study provides descriptive information from 1,655 patients seeking a physician’s recommendation for medical marijuana, the conditions for which they seek treatment, and the diagnoses made by the physicians. It conducts a systematic analysis of physician records and patient questionnaires obtained from consecutive patients being seen during a three month period at nine medical marijuana evaluation clinics belonging to a select medical group operating throughout the State of California. While this study is not representative of all medical marijuana users in California, it provides novel insights about an important population being affected by this policy. PMID:23750291
Milicic, Sandra; Leatherdale, Scott T
Use of e-cigarettes by youth is proliferating worldwide, but little is known about the behavioral profile of youth e-cigarette users and the association of e-cigarette use with other health-risky behaviors. This study examines the associations between e-cigarette use and tobacco, marijuana, and alcohol use among a large sample of Canadian youth. Using Canadian data from 39,837 grade 9 to 12 students who participated in year 3 (2014-2015) of the COMPASS study, logistic regression models were used to examine how current use of e-cigarettes were associated with tobacco, marijuana, binge drinking, and energy drinks mixed with alcohol. Pearson's chi-square tests were used to examine subgroup differences by sex. Overall, 9.75% of respondents were current e-cigarette users. Current cigarette smokers (odds ratio [OR] = 3.009), current marijuana users (OR = 5.549), and noncurrent marijuana users (OR = 3.653) were more likely to report using e-cigarettes than noncigarette smokers and nonmarijuana users. Gender differences among males and females showed higher risk of e-cigarette use among female current marijuana users (OR = 7.029) relative to males (OR = 4.931) and female current smokers (OR = 3.284) compared to males (OR = 2.862). Compared to nonbinge drinkers, weekly (OR = 3.253), monthly (OR = 3.113), and occasional (OR = 2.333) binge drinkers were more likely to use e-cigarettes. Similarly, students who consume energy drinks mixed with alcohol (OR = 1.650) were more likely to use e-cigarettes compared to students who do not consume them. We identify that youth who binge drink or use marijuana have a greater increased risk for using e-cigarettes compared to cigarette smokers. These data suggest that efforts to prevent e-cigarette use should not only be discussed in the domain of tobacco control. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Wang, George Sam; Davies, Sara Deakyne; Halmo, Laurie Seidel; Sass, Amy; Mistry, Rakesh D
Approximately 6%-8% of U.S. adolescents are daily/past-month users of marijuana. However, survey data may not reliably reflect the impact of legalization on adolescents. The objective was to evaluate the impact of marijuana legalization on adolescent emergency department and urgent cares visits to a children's hospital in Colorado, a state that has allowed both medical and recreational marijuana. Retrospective review of marijuana-related visits by International Classification of Diseases codes and urine drug screens, from 2005 through 2015, for patients ≥ 13 and marijuana-related visits were identified. Behavioral health evaluation was obtained for 2,813 (67%); a psychiatric diagnosis was made for the majority (71%) of these visits. Coingestants were common; the most common was ethanol (12%). Marijuana-related visits increased from 1.8 per 1,000 visits in 2009 to 4.9 in 2015. (p = marijuana use, our data demonstrate a significant increase in adolescent marijuana-associated emergency department and urgent cares visits in Colorado. Copyright © 2018 The Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Stewart, David G; Felleman, Benjamin I; Arger, Christopher A
This study examined whether adolescents receiving Motivational Interviewing (MI) intervention have different outcomes compared to those receiving Motivational Incentives (Motivational Interviewing combined with Contingency Management; MI+CM). A total of 136 adolescents (from a parent study of 220 adolescents) with problematic substance use were recruited from 8 high schools in Washington State, where they completed either 8-weeks of MI or MI+CM. Frequency of marijuana use was assessed at baseline, at the end-of-treatment, and at 16-week follow-up. A balanced and matched sample was created using propensity scores, then analyzed using Hierarchical Linear Modeling (HLM). Multilevel regression analyses revealed that adolescents who received MI+CM exhibited a greater reduction in use across time (pmotivation and school attendance were not found. Use of coping strategies at the end-of-treatment had a significant indirect effect on the relationship between the intervention condition and marijuana use at the end-of-treatment (F3, 121=10.20, R2=.20, p<.01). These results suggest that the inclusion of contingencies into adolescent marijuana treatment decreases the end-of-treatment frequency of marijuana use and related consequences while increasing the use of coping strategies and the pursuit of additional treatment. Copyright © 2015 Elsevier Inc. All rights reserved.
Marmor, J B
Although many clinical studies suggest the medical utility of marijuana for some conditions, the scientific evidence is weak. Many patients in California are self-medicating with marijuana, and physicians need data to assess the risks and benefits. The only reasonable solution to this problem is to encourage research on the medical effects of marijuana. The current regulatory system should be modified to remove barriers to clinical research with marijuana. The NIH panel has identified several...
Schauer, Gillian L; King, Brian A; Bunnell, Rebecca E; Promoff, Gabbi; McAfee, Timothy A
Policies legalizing marijuana for medical and recreational use have been increasing in the U.S. Considering the potential impact of these policies, important knowledge gaps exist, including information about the prevalence of various modes of marijuana use (e.g., smoked in joints, bowls, bongs; consumed in edibles or drinks) and about medical versus recreational use. Accordingly, this study assessed (1) prevalence and correlates of modes of current and ever marijuana use and (2) prevalence of medicinal and recreational marijuana use in U.S. adults. Data came from Summer Styles (n=4,269), a nationally representative consumer panel survey of adults aged ≥18 years, collected in 2014. The survey asked about past 30-day (current) and ever mode of marijuana use and current reason for use (medicinal, recreational, both). Weighted prevalence estimates were computed and correlates were assessed in 2014 using logistic regression. Overall, 7.2% of respondents reported current marijuana use; 34.5% reported ever use. Among current users, 10.5% reported medicinal-only use, 53.4% reported recreational-only use, and 36.1% reported both. Use of bowl or pipe (49.5%) and joint (49.2%) predominated among current marijuana users, with lesser use of bong, water pipe, or hookah (21.7%); blunts (20.3%); edibles/drinks (16.1%); and vaporizers (7.6%); 92.1% of the sample reported combusted-only marijuana use. Combusted modes of marijuana use are most prevalent among U.S. adults, with a majority using marijuana for recreation. In light of changing policies and patterns of use, improved marijuana surveillance is critical for public health planning. Copyright © 2016 American Journal of Preventive Medicine. All rights reserved.
Cooke, Alexis; Freisthler, Bridget; Mulholland, Elycia
As medical marijuana legislation becomes more common, concerns arise about the overconcentration of dispensaries, raising questions about the number of medicinal marijuana dispensaries (MMD) needed to serve medicinal users. This paper applies niche-marketing theory-which suggests dispensaries market to specific types of people-to examine if MMDs might be targeting recreational users. Observed differences between dispensary populations and between dispensary clients and local residents may indicate that dispensaries are drawing in patients based on factors other than medical need. Data were collected via exit surveys with patients at four dispensaries in Long Beach, CA. A total of 132 patients were surveyed regarding demographic data, purchase information, medical condition, and nearest cross street for their home address. Census tract information was collected for every dispensary. Chi-squared tests show significant associations between dispensary visited and race (χ 2 = 31.219, p market segmentation.
Aharonovich, Efrat; Brooks, Adam C; Nunes, Edward V; Hasin, Deborah S
Clinical variables that affect treatment outcome for marijuana dependent individuals are not yet well understood, including the effects of cognitive functioning. To address this, level of cognitive functioning and treatment outcome were investigated. Twenty marijuana-dependent outpatients were administered a neuropsychological battery at treatment entry. All patients received 12 weekly individual sessions of combined motivational enhancement therapy and cognitive behavioral therapy. The Wilcoxon Exact Test was used to compare cognitive functioning test scores between completers and dropouts, and the Fisher Exact Test was used to compare proportion of negative urines between those with higher and lower scores on the cognitive tests. Marijuana abstinence was unrelated to cognitive functioning. However, dropouts scored significantly lower than completers on measures of abstract reasoning and processing accuracy, providing initial evidence that cognitive functioning plays a role in treatment retention of adult marijuana dependent patients. If supported by further studies, the findings may help inform the development of interventions tailored for cognitively impaired marijuana dependent patients. PMID:18329188
Dvorak, Robert D; Raeder, Cody A; Kramer, Matthew P; Sargent, Emily; Stevenson, Brittany L; Helmy, Mai
Several large epidemiological studies have shown increasing trends on a number of indices of marijuana use among college age samples. This may be due to changing attitudes about marijuana use linked to legalization efforts. Interventions that can target problematic use on a broad scale are lacking. Recent research has shown that deviance regulation theory (DRT) can be used to design effective web-based substance use interventions. DRT relies on the interplay between perceived norms and an appropriately framed message about the given behavior. The current study examines the use of DRT to change marijuana use intentions. Participants (n = 694 college students) completed measures of marijuana use and marijuana use norms. They were then assigned to receive a positively framed message about marijuana abstainers or a negatively framed message about marijuana users. Following the manipulation, participants rated intentions to use marijuana over the next three months. Consistent with DRT, there was an interaction between message frame and marijuana use norms. The positive frame attenuated the association between marijuana use norms and use intentions. A negative frame resulted in the lowest levels of use intentions among those with low use norms. Results suggest that DRT may be used to modify use intentions in college students, a population that has shown increasing rates of use. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
Buckner, Julia D.; Schmidt, Norman B.
High social anxiety is related to marijuana problems, yet the nature of this relation remains unclear. We examined relations between marijuana effect expectancies, social anxiety, and marijuana among undergraduates (N=337). Social anxiety was related positively to negative expectancies and negatively to Tension Reduction Expectancies. Among socially anxious individuals, greater belief that marijuana produces cognitive/behavioral impairment was associated with greater marijuana use rates. Nega...
Wilkinson, Samuel T; van Schalkwyk, Gerrit I; Davidson, Larry; D'Souza, Deepak C
Risk perception has been shown to be protective with regard to marijuana use. Notably, the risk perception of marijuana in individuals with substance abuse problems varies significantly from that of the general public. Understanding how risk perception is formed in substance users could explain these differences and help predict the consequences of policy changes. Using this framework, we explored risk perception and its formation in a sample of substance abusing veterans. Semi-structured interviews were conducted with veterans who were receiving treatment for substance abuse. Interviews were recorded digitally, transcribed verbatim, and analyzed using inductive thematic analysis. A prominent perspective among the 31 participants was that marijuana is significantly different from other drugs because it is safe, not addictive, not associated with physical withdrawal, and has less overt behavioral effects than other substances. Many of these participants drew upon their own innocuous experiences with the drug in developing this perspective, more so than information from any other source. A contrasting narrative emphasized marijuana's capacity to cause negative social consequences, act as a gateway to the use of other, more harmful substances, and cause paranoia or worsen psychosis. In conclusion, individual experience with marijuana featured more prominently in informing risk perception than any other source of information. Our results and previous literature suggest that the significant disconnect between the individual experiences of substance users and the current clinical and legal policy towards marijuana may weaken the legitimacy of public policy or the authority of the medical community.
Morean, Meghan E; DeMartini, Kelly S; Foster, Dawn; Patock-Peckham, Julie; Garrison, Kathleen A; Corlett, Philip R; Krystal, John H; Krishan-Sarin, Suchitra; O'Malley, Stephanie S
Substance use is partially driven by habitual processes that occur automatically in response to environmental cues and may be central to users' identities. This study was designed to validate the Self-Report Habit Index (SRHI) for assessing habitual marijuana, alcohol, cigarette, and e-cigarette use. We examined the SRHI's psychometrics in separate samples of adult marijuana (Ns = 189;170), alcohol (Ns = 100;133), cigarette (Ns = 58;371), and e-cigarette (N = 239) users. A 6-item, single-factor solution evidenced good fit across substances (CFI marijuana/alcohol/cigarettes/e-cigarettes = 0.996/0.997/0.996/0.994, RMSEA = 0.046/0.047/0.067/0.068, SRMR = 0.017/0.017/0.010/0.015) and internal consistency (α = 0.88/0.94/0.95/0.91). The SRHI was scalar invariant for sex and race. However, independent-samples t-tests indicated only that women endorsed stronger habitual e-cigarette use and that men endorsed stronger habitual marijuana use. The SRHI also was scalar invariant by product type in dual-users (cigarettes/e-cigarettes[N = 371]; alcohol/cigarettes [n = 58]), although differences in habit strength only were observed for cigarettes versus e-cigarettes, with dual-users reporting stronger habitual cigarette use. Finally, the SRHI predicted frequency of marijuana, alcohol, cigarette, and e-cigarette use (n p 2 [marijuana/alcohol/cigarettes/e-cigarettes] = 0.37/0.48/0.31/0.17) and quantity of alcohol and cigarette use (n p 2 = 0.43/0.33). The SRHI is a psychometrically sound measure of adults' habitual substance use. The SRHI detected mean differences by sex and substance type and predicted the frequency of using each substance. Future research should determine if the SRHI is appropriate for use with other substances or age groups (e.g., adolescents), how it relates to task-based, behavioral measures of habit strength, and the degree to which habit predicts the development or maintenance of addiction. Copyright © 2018
Martins, Silvia S; Mauro, Christine M; Santaella-Tenorio, Julian; Kim, June H; Cerda, Magdalena; Keyes, Katherine M; Hasin, Deborah S; Galea, Sandro; Wall, Melanie
Little is known on how perceived availability of marijuana is associated with medical marijuana laws. We examined the relationship between medical marijuana laws (MML) and the prevalence of past-month marijuana use, with perceived availability of marijuana. Data were from respondents included in the National Survey of Drug Use and Health restricted use data portal 2004-2013. Multilevel logistic regression of individual-level data was used to test differences between MML and non-MML states and changes in prevalence of past-month marijuana use and perceived availability from before to after passage of MML among adolescents, young adults and older adults controlling for demographics. Among adults 26+, past-month prevalence of marijuana use increased from 5.87% to 7.15% after MML passage (Adjusted Odds Ratio (AOR): 1.24 [1.16-1.31]), but no change in prevalence of use was found for 12-17 or 18-25 year-olds. Perceived availability of marijuana increased after MML was enacted among those 26+ but not in younger groups. Among all age groups, prevalence of marijuana use and perception of it being easily available was higher in states that would eventually pass MML by 2013 compared to those that had not. Perceived availability was significantly associated with increased risk of past-month marijuana use in all age groups. Evidence suggests perceived availability as a driver of change in use of marijuana due to MML. To date, this has only occurred in adults 26+ and different scenarios that could explain this change need to be further explored. Copyright Â© 2016 Elsevier Ireland Ltd. All rights reserved.
Twenty-eight states in the U.S have legalized medical marijuana, yet its impacts on severe health consequences such as hospitalizations remain unknown. Meanwhile, the prevalence of opioid pain reliever (OPR) use and outcomes has increased dramatically. Recent studies suggested unintended impacts of legalizing medical marijuana on OPR, but the evidence is still limited. This study examined the associations between state medical marijuana policies and hospitalizations related to marijuana and OPR. State-level annual administrative records of hospital discharges during 1997-2014 were obtained from the State Inpatient Databases (SID). The outcome variables were rates of hospitalizations involving marijuana dependence or abuse, opioid dependence or abuse, and OPR overdose in 1000 discharges. Linear time-series regressions were used to assess the associations of implementing medical marijuana policies to hospitalizations, controlling for other marijuana- and OPR-related policies, socioeconomic factors, and state and year fixed effects. Hospitalizations related to marijuana and OPR increased sharply by 300% on average in all states. Medical marijuana legalization was associated with 23% (p=0.008) and 13% (p=0.025) reductions in hospitalizations related to opioid dependence or abuse and OPR overdose, respectively; lagged effects were observed after policy implementation. The operation of medical marijuana dispensaries had no independent impacts on OPR-related hospitalizations. Medical marijuana polices had no associations with marijuana-related hospitalizations. Medical marijuana policies were significantly associated with reduced OPR-related hospitalizations but had no associations with marijuana-related hospitalizations. Given the epidemic of problematic use of OPR, future investigation is needed to explore the causal pathways of these findings. Copyright © 2017 Elsevier B.V. All rights reserved.
Objectives Twenty-eight states in the U.S. have legalized medical marijuana, yet its impacts on severe health consequences such as hospitalizations remain unknown. Meanwhile, the prevalence of opioid pain reliever (OPR) use and outcomes has increased dramatically. Recent studies suggested unintended impacts of legalizing medical marijuana on OPR, but the evidence is still limited. This study examined the associations between state medical marijuana policies and hospitalizations related to marijuana and OPR. Methods State-level annual administrative records of hospital discharges during 1997–2014 were obtained from the State Inpatient Databases (SID). The outcome variables were rates of hospitalizations involving marijuana dependence or abuse, opioid dependence or abuse, and OPR overdose in 1,000 discharges. Linear time-series regressions were used to assess the associations of implementing medical marijuana policies to hospitalizations, controlling for other marijuana- and OPR-related policies, socioeconomic factors, and state and year fixed effects. Results Hospitalizations related to marijuana and OPR increased sharply by 300% on average in all states. Medical marijuana legalization was associated with 23% (p=.008) and 13% (p=.025) reductions in hospitalizations related to opioid dependence or abuse and OPR overdose, respectively; lagged effects were observed after policy implementation. The operation of medical marijuana dispensaries had no independent impacts on OPR- related hospitalizations. Medical marijuana polices had no associations with marijuana-related hospitalizations. Conclusion Medical marijuana policies were significantly associated with reduced OPR-related hospitalizations but had no associations with marijuana-related hospitalizations. Given the epidemic of problematic use of OPR, future investigation is needed to explore the causal pathways of these findings. PMID:28259087
Marcia Fortes Wagner
marihuana presentan más perjuicios en las habilidades sociales que adolescentes no usuarios de marihuana.The present study intends to evaluate the social skills of adolescent marijuana users comparing their performance with non users. The instruments were: Inventory of Social Skills - IHS; Cognitive Screening of the WISC-III and the WAIS-III and Inventories of Anxiety and Depression of Beck. The sample consisted of 98 adolescents, 49 marijuana users and 49 non users, aged between 15 and 22. The results showed higher impairments in the group of marijuana users at the cognitive screening and in the presence of symptoms of anxiety and depression. The findings indicate significant statistical differences in the group of users, with a more impaired performance in Factor 4, Self-exposition to strangers or to new situations and Factor 5, Self-control of aggressiveness in aversive situations. The study concluded that adolescent marijuana users present more impairment in the social skills than adolescent non marijuana users.
Krauss, Melissa J.; Sowles, Shaina J.; Bierut, Laura J.
Instagram is a highly visual social networking site whose audience continues to grow, especially among young adults. In the present study, we examine marijuana-related content on Instagram to better understand the varied types of marijuana-related social networking occurring on this popular social media platform. We collected 417,561 Instagram posts with marijuana-related hashtags from November 29 to December 12, 2014. We assessed content of a random sample (n = 5000) of these posts with marijuana-related hashtags. Approximately 2136 (43 %) were explicit about marijuana and further analyzed. Of the 2136 marijuana-related posts, images of marijuana were common (n = 1568). Among these 1568 marijuana images, traditional forms (i.e., buds/leaves) were the most common (63 %), followed by some novel forms of marijuana, including marijuana concentrates (20 %). Among the 568 posts that displayed marijuana being ingested, 20 % showed someone dabbing marijuana concentrates. Marijuana-related advertisements were also observed among the 2136 marijuana-related posts (9 %). Our findings signal the promotion of marijuana use in its traditional plant-based form; trendy and novel modes of marijuana ingestion were also endorsed. This content along with the explicit marketing of marijuana that we observed on Instagram have potential to influence social norms surrounding marijuana use. PMID:27262456
Cavazos-Rehg, Patricia A; Krauss, Melissa J; Sowles, Shaina J; Bierut, Laura J
Instagram is a highly visual social networking site whose audience continues to grow, especially among young adults. In the present study, we examine marijuana-related content on Instagram to better understand the varied types of marijuana-related social networking occurring on this popular social media platform. We collected 417,561 Instagram posts with marijuana-related hashtags from November 29 to December 12, 2014. We assessed content of a random sample (n = 5000) of these posts with marijuana-related hashtags. Approximately 2136 (43 %) were explicit about marijuana and further analyzed. Of the 2136 marijuana-related posts, images of marijuana were common (n = 1568). Among these 1568 marijuana images, traditional forms (i.e., buds/leaves) were the most common (63 %), followed by some novel forms of marijuana, including marijuana concentrates (20 %). Among the 568 posts that displayed marijuana being ingested, 20 % showed someone dabbing marijuana concentrates. Marijuana-related advertisements were also observed among the 2136 marijuana-related posts (9 %). Our findings signal the promotion of marijuana use in its traditional plant-based form; trendy and novel modes of marijuana ingestion were also endorsed. This content along with the explicit marketing of marijuana that we observed on Instagram have potential to influence social norms surrounding marijuana use.
Higher Education Center for Alcohol, Drug Abuse, and Violence Prevention, 2010
While alcohol remains the drug of choice among college students, marijuana ranks number two with 32 percent reporting using marijuana in 2008. That's a modest decline from 2001, when 36 percent of college students reported marijuana use. While levels of marijuana use by students are determined through a number of national and local surveys, no…
Jacobus, Joanna; Castro, Norma; Squeglia, Lindsay M; Meloy, M J; Brumback, Ty; Huestis, Marilyn A; Tapert, Susan F
Cortical thickness abnormalities have been identified in youth using both alcohol and marijuana. However, limited studies have followed individuals pre- and post initiation of alcohol and marijuana use to help identify to what extent discrepancies in structural brain integrity are pre-existing or substance-related. Adolescents (N=69) were followed from ages 13 (pre-initiation of substance use, baseline) to ages 19 (post-initiation, follow-up). Three subgroups were identified, participants that initiated alcohol use (ALC, n=23, >20 alcohol use episodes), those that initiated both alcohol and marijuana use (ALC+MJ, n=23, >50 marijuana use episodes) and individuals that did not initiate either substance regularly by follow-up (CON, n=23, marijuana use episodes). All adolescents underwent neurocognitive testing, neuroimaging, and substance use and mental health interviews. Significant group by time interactions and main effects on cortical thickness estimates were identified for 18 cortical regions spanning the left and right hemisphere (pseffect, in cortical thickness by follow-up for individuals who have not initiated regular substance use or alcohol use only by age 19; modest between-group differences were identified at baseline in several cortical regions (ALC and CON>ALC+MJ). Minimal neurocognitive differences were observed in this sample. Findings suggest pre-existing neural differences prior to marijuana use may contribute to initiation of use and observed neural outcomes. Marijuana use may also interfere with thinning trajectories that contribute to morphological differences in young adulthood that are often observed in cross-sectional studies of heavy marijuana users. Copyright © 2016 Elsevier Inc. All rights reserved.
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Kennedy, Sara M; Patel, Roshni P; Cheh, Paul; Hsia, Jason; Rolle, Italia V
African American youth use marijuana at similar rates and tobacco at lower rates compared with white youth; however, in adulthood, tobacco use is similar. Tobacco and marijuana use are closely associated; differing initiation patterns may contribute to observed racial differences in tobacco prevalence by age. Therefore, it is important to assess tobacco and marijuana initiation patterns by race. Data were obtained from 56,555 adults aged 18-25 who completed the 2005-2012 National Survey on Drug Use and Health. The analysis was restricted to those who reported ever use of marijuana and combustible tobacco (cigarettes and/or cigars). Three mutually exclusive categories of initiation patterns were evaluated: use of marijuana before tobacco; marijuana and tobacco at the same age; and tobacco before marijuana. Multivariable regression models were used to assess changes over time and compare these outcomes by race while controlling for sociodemographics, risk perceptions, and current substance use. In 2005, 26.6% of African American and 14.3% of white young adults used marijuana before tobacco, compared with 41.5% of African American and 24.0% of white young adults in 2012 (P young adults had greater odds of using marijuana before tobacco (AOR = 1.79; 95% CI: 1.67, 1.91) compared with whites. African American young adults were more likely than whites to use marijuana before tobacco and both groups were increasingly likely to use marijuana before tobacco over time. A greater understanding of how marijuana initiation interacts with tobacco initiation could inform more effective tobacco and marijuana use prevention efforts. Among ever users of combustible tobacco and marijuana, greater proportions of African American young adults used marijuana before tobacco or at the same age than their white counterparts. Moreover, both African Americans and whites were more likely to use marijuana before tobacco in 2012 compared with 2005. Tobacco control policy may benefit from a
Merianos, Ashley L.; Rosen, Brittany L.; Montgomery, LaTrice; Barry, Adam E.; Smith, Matthew Lee
We performed a secondary analysis of Adolescent Health Risk Behavior Survey data (N=937), examining associations between lifetime alcohol and marijuana use with intrapersonal (i.e., risk perceptions) and interpersonal (e.g., peer approval and behavior) factors. Multinomial and binary logistic regression analyses contend students reporting lifetime…
Benschop, Annemieke; Liebregts, Nienke; van der Pol, Peggy; Schaap, Rick; Buisman, Renate; van Laar, Margriet; van den Brink, Wim; de Graaf, Ron; Korf, Dirk J
The Marijuana Motives Measure (MMM) has so far been examined mainly in student populations, often with relatively limited involvement in cannabis use. This study evaluated the factor structure of the MMM in a demographically mixed sample of 600 young adult (18-30 years) frequent (≥ 3 days per week) cannabis users in the Netherlands. Analysis confirmed a five-factor solution, denoting coping, enhancement, social, conformity and expansion motives. Additionally, the original MMM was extended with two items (boredom and habit), which formed a distinct, internally consistent sixth factor labelled routine motives. In a multivariable logistic regression analysis, coping and routine motives showed significant associations with 12-month DSM-IV cannabis dependence. The results suggest general reliability and validity of the MMM in a heterogeneous population of experienced cannabis users. Copyright © 2014 Elsevier Ltd. All rights reserved.
Antill, T; Jakkoju, A; Dieguez, J; Laskhmiprasad, L
Synthetic cannabinoids are designer drugs that mimic the effect of cannabis, which has become popular with young drug users. These drugs have a similar chemical structure and pharmacologic effects as marijuana, but seem to be more potent. These substances have been banned by the US Drug Enforcement Agency in 2010. Prior to 2010, these drugs were perceived as "safer" by the general population. Synthetic cannabinoids cause effects similar to marijuana making the subjects euphoric. However, they act as full, rather than partial, agonist at the receptor sites causing more severe side effects such as severe agitation, seizures, acute renal failure, and lactic acidosis.
life, physical health and mental health , large majorities of heavy users (66–90 percent) reported a negative effect.”230...9 3. Impact of Marijuana Legalization on Health and Public Safety Risk...39 2. Medical Impact ................................................................. 47 3. Health and Public Safety
With several states allowing medicinal use of marijuana and a growing number decriminalizing recreational use, many of our patients are using this herbal drug. Approximately 43% of US adults have tried marijuana, with 13% using it regularly. These users are seeking help from integrative medicine practitioners regarding safety. They are looking for advice based on research and clinical experience, not politics or philosophical bias. The major health problems caused by marijuana appear to be bronchial irritation, decreased motivation, learning difficulties, and injuries. However, less well appreciated are the toxicity problems caused by contamination with pesticides and solvent residues. We have important guidance to help prevent unnecessary toxicity in our patients who choose to use marijuana. This editorial reviews toxicity and safety. Medicinal use will be addressed in the future.
... Intoxication - marijuana (cannabis); Pot; Mary Jane; Weed; Grass; Cannabis ... drugs that have more serious side effects than marijuana. These side effects may include: Sudden high blood pressure with headache ...
Fischer, Benedikt; Kuganesan, Sharan; Room, Robin
While prohibition has been the dominant regime of cannabis control in most countries for decades, an increasing number of countries have been implementing cannabis control reforms recently, including decriminalization or even legalization frameworks. Canada has held out from this trend, although it has among the highest cannabis use rates in the world. Cannabis use is universally criminalized, and the current (conservative) federal government has vowed not to implement any softening reforms to cannabis control. As a result of several higher court decisions, the then federal government was forced to implement a 'medical marijuana access regulations' program in 2001 to allow severely ill patients therapeutic use and access to therapeutic cannabis while shielding them from prosecution. The program's regulations and approval processes were complex and subject to extensive criticism; initial uptake was low and most medical marijuana users continued their use and supply outside the program's auspices. This year, the government introduced new 'marijuana for medical purposes regulations', which allow physicians to 'authorize' medical marijuana use for virtually any health condition for which this is considered beneficial; supply is facilitated by licensed commercial producers. It is expected that some 500,000 users, and dozens of commercial producers will soon be approved under the program, arguably constituting - as with medical marijuana schemes elsewhere, e.g. in California--de facto 'legalization'. We discuss the question whether the evolving scope and realities of 'medical cannabis' provisions in Canada offer a 'sneaky side door' or a 'better third way' to cannabis control reform, and what the potential wider implications are of these developments. Copyright © 2014. Published by Elsevier B.V.
Boman, John H; Stogner, John; Miller, Bryan Lee
While it is commonly understood that the substance use of peers influences an individual's substance use, much less is understood about the interplay between substance use and friendship quality. Using a sample of 2,148 emerging adults nested within 1,074 dyadic friendships, this study separately investigates how concordance and discordance in binge drinking and marijuana use between friends is related to each friend's perceptions of friendship quality. Because "friendship quality" is a complex construct, we employ a measure containing five sub-elements--companionship, a lack of conflict, willingness to help a friend, relationship security, and closeness. Results for both binge drinking and marijuana use reveal that individuals in friendship pairs who are concordant in their substance use perceive significantly higher perceptions of friendship quality than individuals in dyads who are dissimilar in substance use. Specifically, concordant binge drinkers estimate significantly higher levels of companionship, relationship security, and willingness to help their friend than concordant non-users, discordant users, and discordant non-users. However, the highest amount of conflict in friendships is found when both friends engage in binge drinking and marijuana use. Several interpretations of these findings are discussed. Overall, concordance between friends' binge drinking and marijuana use appears to help some elements of friendship quality and harm others.
Shashwath A Meda
Full Text Available Alcohol and marijuana are the two most abused substances in US colleges. However, research on the combined influence (cross sectional or longitudinal of these substances on academic performance is currently scant.Data were derived from the longitudinal 2-year Brain and Alcohol Research in College Students (BARCS study including 1142 freshman students who completed monthly marijuana use and alcohol consumption surveys. Subjects were classified into data-driven groups based on their alcohol and marijuana consumption. A linear mixed-model (LMM was employed using this grouping factor to predict grade point average (GPA, adjusted for a variety of socio-demographic and clinical factors.Three data-driven clusters emerged: 1 No/low users of both, 2 medium-high alcohol/no-low marijuana, and 3 medium-high users of both substances. Individual cluster derivations between consecutive semesters remained stable. No significant interaction between clusters and semester (time was noted. Post-hoc analysis suggest that at the outset, compared to sober peers, students using moderate to high levels of alcohol and low marijuana demonstrate lower GPAs, but this difference becomes non-significant over time. In contrast, students consuming both substances at moderate-to-high levels score significantly lower at both the outset and across the 2-year investigation period. Our follow-up analysis also indicate that when students curtailed their substance use over time they had significantly higher academic GPA compared to those who remained stable in their substance use patterns over the two year period.Overall, our study validates and extends the current literature by providing important implications of concurrent alcohol and marijuana use on academic achievement in college.
Meda, Shashwath A; Gueorguieva, Ralitza V; Pittman, Brian; Rosen, Rivkah R; Aslanzadeh, Farah; Tennen, Howard; Leen, Samantha; Hawkins, Keith; Raskin, Sarah; Wood, Rebecca M; Austad, Carol S; Dager, Alecia; Fallahi, Carolyn; Pearlson, Godfrey D
Alcohol and marijuana are the two most abused substances in US colleges. However, research on the combined influence (cross sectional or longitudinal) of these substances on academic performance is currently scant. Data were derived from the longitudinal 2-year Brain and Alcohol Research in College Students (BARCS) study including 1142 freshman students who completed monthly marijuana use and alcohol consumption surveys. Subjects were classified into data-driven groups based on their alcohol and marijuana consumption. A linear mixed-model (LMM) was employed using this grouping factor to predict grade point average (GPA), adjusted for a variety of socio-demographic and clinical factors. Three data-driven clusters emerged: 1) No/low users of both, 2) medium-high alcohol/no-low marijuana, and 3) medium-high users of both substances. Individual cluster derivations between consecutive semesters remained stable. No significant interaction between clusters and semester (time) was noted. Post-hoc analysis suggest that at the outset, compared to sober peers, students using moderate to high levels of alcohol and low marijuana demonstrate lower GPAs, but this difference becomes non-significant over time. In contrast, students consuming both substances at moderate-to-high levels score significantly lower at both the outset and across the 2-year investigation period. Our follow-up analysis also indicate that when students curtailed their substance use over time they had significantly higher academic GPA compared to those who remained stable in their substance use patterns over the two year period. Overall, our study validates and extends the current literature by providing important implications of concurrent alcohol and marijuana use on academic achievement in college.
Subbaraman, Meenakshi Sabina; Kerr, William C
In 2012, voters in Washington state approved Initiative 502 (I-502) which legalized recreational marijuana use at the state level. This study examines the relationship between demographics, marijuana and alcohol use, and voting outcomes, as well as how these variables relate to (i) whether voters would still vote the same way (a reflection of satisfaction with the new policy) and (ii) the likelihood of using marijuana purchased from legal retail stores. The sample consists of 2,007 adult Washington state residents recruited through Random Digit Dial between January and October 2014. Bivariate tests and multivariable regressions were used for analyses. Less than five percent of those who voted for marijuana legalization would change their votes, whereas 14% of those who voted against legalization would change their votes. In multivariable models controlling for demographics, substance use, and marijuana-related opinions, those who voted for legalization had half the odds of changing their votes than those who voted against it. Among past-year non-marijuana users, almost 10% were somewhat/very likely to use marijuana if they could buy it from a legal store. Past marijuana use, the belief that adults should be allowed to grow marijuana for personal use, and the belief that marijuana is not very risky for health were all related to increased likelihood of using marijuana purchased from legal stores. Since November 2012, support for marijuana legalization in Washington state has increased; accounting for the proportion of voters who would change their votes suggests that I-502 would pass today with even more votes in favor.
Smits, J.A.J.; Bonn-Miller, M.O.; Tart, C.D.; Irons, J.G.; Zvolensky, M.J.
he present study examined the working hypothesis that moderate-intensity exercise is associated with coping-oriented marijuana use motives through its association with the fear of somatic arousal (ie, anxiety sensitivity). Using data from 146 young adult current marijuana users, we found evidence
Tashkin, Donald P
As marijuana smoking prevalence increases in the U.S. concern regarding its potential risks to lung health has also risen, given the general similarity in the smoke contents between marijuana and tobacco. Most studies have found a significant association between marijuana smoking and chronic bronchitis symptoms after adjustment for tobacco. While reports are mixed regarding associations between marijuana smoking and lung function, none has shown a relationship to decrements in forced expired volume in 1 sec (FEV1) and few have found a relationship to a decreased ratio of FEV1 to forced vital capacity (FVC), possibly related to an association between marijuana and an increased FVC. A few studies have found a modest reduction in specific airway conductance in relation to marijuana, probably reflecting endoscopic evidence of bronchial mucosal edema among habitual marijuana smokers. Diffusing capacity in marijuana smokers has been normal and two studies of thoracic high-resolution computed tomography (HRCT) have not shown any association of marijuana smoking with emphysema. Although bronchial biopsies from habitual marijuana smokers have shown precancerous histopathological changes, a large cohort study and a pooled analysis of six well-designed case-control studies have not found evidence of a link between marijuana smoking and lung cancer. The immunosuppressive effects of delta-9 tetrahydrocannabinol raise the possibility of an increased risk of pneumonia, but further studies are needed to evaluate this potential risk. Several cases series have demonstrated pneumothoraces/pneumomediastinum, as well as bullous lung disease, in marijuana smokers, but these associations require epidemiologic studies for firmer evidence of possible causality. Copyright © 2018. Published by Elsevier Inc.
Owen, Kelly P; Sutter, Mark E; Albertson, Timothy E
Marijuana is the most commonly used drug of abuse in the USA. It is commonly abused through inhalation and therefore has effects on the lung that are similar to tobacco smoke, including increased cough, sputum production, hyperinflation, and upper lobe emphysematous changes. However, at this time, it does not appear that marijuana smoke contributes to the development of chronic obstructive pulmonary disease. Marijuana can have multiple physiologic effects such as tachycardia, peripheral vasodilatation, behavioral and emotional changes, and possible prolonged cognitive impairment. The carcinogenic effects of marijuana are unclear at this time. Studies are mixed on the ability of marijuana smoke to increase the risk for head and neck squamous cell carcinoma, lung cancer, prostate cancer, and cervical cancer. Some studies show that marijuana is protective for development of malignancy. Marijuana smoke has been shown to have an inhibitory effect on the immune system. Components of cannabis are under investigation as treatment for autoimmune diseases and malignancy. As marijuana becomes legalized in many states for medical and recreational use, other forms of tetrahydrocannabinol (THC) have been developed, such as food products and beverages. As most research on marijuana at this time has been on whole marijuana smoke, rather than THC, it is difficult to determine if the currently available data is applicable to these newer products.
Buckner, Julia D; Heimberg, Richard G; Matthews, Russell A; Silgado, Jose
Individuals with elevated social anxiety appear particularly vulnerable to marijuana-related problems. In fact, individuals with social anxiety may be more likely to experience marijuana-related impairment than individuals with other types of anxiety. It is therefore important to determine whether constructs particularly relevant to socially anxious individuals play a role in the expression of marijuana-related problems in this vulnerable population. Given that both social avoidance and using marijuana to cope with negative affect broadly have been found to play a role in marijuana-related problems, the current study utilized a new measure designed to simultaneously assess social avoidance and using marijuana to cope in situations previously identified as anxiety-provoking among those with elevated social anxiety. The Marijuana Use to Cope with Social Anxiety Scale (MCSAS) assessed behaviors regarding 24 social situations: marijuana use to cope in social situations (MCSAS-Cope) and avoidance of social situations if marijuana was unavailable. In Study 1, we found preliminary support for the convergent and discriminant validity and internal consistency of the MCSAS scales. In Study 2, we examined if MCSAS scores were related to marijuana problems among those with (n = 44) and without (n = 44) clinically elevated social anxiety. Individuals with clinically meaningful social anxiety were more likely to use marijuana to cope in social situations and to avoid social situations if marijuana was unavailable. Of importance, MCSAS-Cope uniquely mediated the relationship between social anxiety group status and marijuana-related problems. Results highlight the importance of contextual factors in assessing marijuana-related behaviors among high-risk populations. PsycINFO Database Record (c) 2012 APA, all rights reserved.
Crane, Cory A; Testa, Maria; Schlauch, Robert C; Leonard, Kenneth E
Self-reported marijuana use has been associated with poor relationship functioning and decreased stability over time. The present study examined the behavioral interactions of couples with concordant and discordant patterns of marijuana use during conflict, using individual self-reports and observation by independent coders. Heavy drinking community couples (N = 149) participated in a conflict resolution paradigm. Interactions were recorded and coded by naïve coders. Approximately 30% of the sample reported past year marijuana use. Actor-Partner Interdependence Models and analysis of covariance (ANCOVA) were used to evaluate the individual and interactive effects of dyadic marijuana use on maladaptive relationship functioning. A Robust Actor × Partner Marijuana Use interaction was detected for a range of behavioral outcomes, assessed by both self-report and direct observation, including relationship satisfaction, anger experience, patterns of demand and withdrawal during conflict, constructive behaviors, and overall relationship quality. Specifically, couples in which both partners used or abstained from marijuana displayed more adaptive relationship functioning across indicators relative to couples in which only 1 partner identified as a marijuana user. This pattern was particularly strong for couples in which the female partner used marijuana and the male partner did not. Couples with discordant, rather than concordant, marijuana use displayed distinct conflict resolution behaviors that were consistent with the long-term negative relationship outcomes that have been observed in previous studies. (PsycINFO Database Record (c) 2016 APA, all rights reserved).
Yankey, Barbara A; Rothenberg, Richard; Strasser, Sheryl; Ramsey-White, Kim; Okosun, Ike S
Background Reports associate marijuana use with cardiovascular emergencies. Studies relating marijuana use to cardiovascular mortality are scarce. Recent advance towards marijuana use legalization emphasizes the importance of understanding relationships between marijuana use and cardiovascular deaths; the primary ranked mortality. Recreational marijuana is primarily smoked; we hypothesize that like cigarette smoking, marijuana use will be associated with increased cardiovascular mortalities. Design The design of this study was based on a mortality follow-up. Method We linked participants aged 20 years and above, who responded to questions on marijuana use during the 2005 US National Health and Nutrition Examination Survey to data from the 2011 public-use linked mortality file of the National Center for Health Statistics, Centers for Disease Control and Prevention. Only participants eligible for mortality follow-up were included. We conducted Cox proportional hazards regression analyses to estimate hazard ratios for hypertension, heart disease, and cerebrovascular mortality due to marijuana use. We controlled for cigarette smoking and other relevant variables. Results Of the 1213 eligible participants 72.5% were presumed to be alive. The total follow-up time was 19,569 person-years. Adjusted hazard ratios for death from hypertension among marijuana users compared to non-marijuana users was 3.42 (95% confidence interval: 1.20-9.79) and for each year of marijuana use was 1.04 (95% confidence interval: 1.00-1.07). Conclusion From our results, marijuana use may increase the risk for hypertension mortality. Increased duration of marijuana use is associated with increased risk of death from hypertension. Recreational marijuana use potentially has cardiovascular adverse effects which needs further investigation.
Harpin, Scott B; Brooks-Russell, Ashley; Ma, Ming; James, Katherine A; Levinson, Arnold H
As of January 1, 2017, eight states have approved laws for recreational marijuana use. While the social impacts of these changes remain under debate, the influence on adolescent marijuana use is a key policy and health issue across the U.S. To examine changes in adolescent marijuana-use behaviors in the first year after recreational marijuana implementation in Colorado, and to analyze the effect of retail marijuana store proximity on youth use and perceptions. Secondary analysis of Healthy Kids Colorado Survey data from 40 schools surveyed before and after recreational marijuana sales were implemented (2013 student n = 12,240; 2014 student n = 11,931). Self-reported marijuana use, ease of access, and perceived harms were compared between years and by proximity of recreational marijuana stores to surveyed schools. Adolescent marijuana use behaviors, wrongness of use, and perceptions of risk of harm were unchanged from baseline to one-year follow-up. Perceived ease of access to marijuana increased (from 46% to 52%). Proximity of recreational marijuana stores was not significantly associated with perceived ease of access to marijuana. Conclusions/Importance: In the first study of adolescent marijuana use and perceptions after state retail implementation of recreational marijuana, there was little change in adolescent marijuana use but a significant change in perception of ease of access. Public health workers and policymakers should continue to monitor these changes as essential for evaluating the impact of liberalization of marijuana policies.
Carpenter, Christopher S; Pechmann, Cornelia
We examined the relationship between exposure to the Above the Influence antidrug campaign in 210 US media markets and adolescent marijuana and alcohol use from 2006 to 2008. We analyzed monthly advertising exposure (targeted rating points) data from the Office of National Drug Control Policy and drug use data from the Monitoring the Future study. We estimated multivariate logistic regression models of marijuana use for students in grades 8, 10, and 12, with controls for individual, family, and media market characteristics and year and regional fixed effects. For eighth-grade adolescent girls, greater exposure to antidrug advertisements was associated with lower rates of past-month marijuana use (adjusted odds ratio [AOR] = 0.67; 95% confidence interval [CI] = 0.52, 0.87) and lower rates of lifetime marijuana use (AOR = 0.76; 95% CI = 0.62, 0.93), but not alcohol use (AOR = 1.00; 95% CI = 0.84, 1.19). Associations were not significant for adolescent boys or for students in grades 10 and 12. Antidrug advertising may be an effective way to dissuade eighth-grade adolescent girls from initiating marijuana use.
Phillips, Kristina T; Phillips, Michael M; Lalonde, Trent L; Tormohlen, Kayla N
Marijuana is the most commonly used illicit substance in the U.S., with high rates among young adults in the state of Colorado. Chronic, heavy marijuana use can impact cognitive functioning, which has the potential to influence academic performance of college students. It is possible that craving for marijuana may further contribute to diminished cognitive and affective functioning, thus leading to poor outcomes for students. College student marijuana users (n=57) were recruited based on heavy use and completed ecological momentary assessment (EMA) via text-messaging. The association between marijuana use and craving in a college setting was explored, as well as how these variables might relate to academic motivation, effort and success. The participants were sent text messages for two weeks, three times per day at random times. A temporal association between craving and marijuana use was found, where momentary craving positively predicted greater marijuana use. Similarly, as craving levels increased, the number of minutes spent studying decreased at the next assessment point. A negative association between momentary craving for marijuana and academic motivation was found in the same moment. Greater academic self-efficacy positively predicted cumulative GPA, while average minutes spent smoking marijuana was negatively related. Using EMA, marijuana craving and use were significantly related. These findings provide further evidence that heavy marijuana use is negatively associated with academic outcomes. Copyright © 2015 Elsevier Ltd. All rights reserved.
Ushang Desai; Paras Patel
Over the few years medical marijuana is growing in the United States. Because of the medical marijuana legislators able to legalized recreational marijuana in the two states in the US. Marijuana has several potential benefits that help in certain disease. The delivery of marijuana is also important because smoking marijuana has severe side effects. Physicians also play important role in medical marijuana, physicians also divided on the use of medical marijuana. Their attitude towards medical ...
Kevin C Davis
Full Text Available A potential unintended consequence of legalizing recreational marijuana is increased marijuana-related driving impairment. Some states where recreational marijuana is legal have begun implementing interventions to mitigate driving under the influence (DUI of marijuana, including media campaigns to increase knowledge about DUI laws. However, little is known about the associations between knowledge of DUI laws and marijuana DUI behavior. In this study, we provide new data from a survey of marijuana users in Colorado and Washington to examine associations between marijuana drugged driving and two potential behavioral precursors of marijuana DUI. We also explore other factors that may influence marijuana DUI.Data are from an online survey of marijuana users in Colorado and Washington. Respondents who reported any marijuana use in the past 30 days (n = 865 served as the analytic sample. We examined prevalence of two behavioral outcomes: (1 any driving of a motor vehicle while high in the past year and (2 driving a motor vehicle within 1 hour of using marijuana 5 or more times in the past month. Additional outcomes measuring willingness to drive while high were also assessed. Logistic regressions were used to estimate each outcome as a function of two multi-item scales measuring knowledge of the legal consequences of driving high and perceptions that driving while high is not safe. Additional covariates for potential confounders were included in each model.Prevalence of past-year driving while under the influence of marijuana was 43.6% among respondents. The prevalence of driving within 1 hour of using marijuana at least 5 times in the past month was 23.9%. Increased perception that driving high is unsafe was associated with lower odds of past-year marijuana DUI (OR = 0.31, P < 0.01 and lower past-month odds of driving 5 or more times within 1 hour of using marijuana (OR = 0.26, P < 0.01. Increased knowledge of marijuana DUI laws was also associated
Lindsay M. Squeglia
Full Text Available Characterizing the effects of alcohol and marijuana use on adolescent brain development is important for understanding potential alterations in neurodevelopment. Several cross sectional studies have identified group differences in white matter integrity after initiation of heavy alcohol and marijuana use, however none have explored white matter trajectories in adolescents pre- and post initiation of use, particularly for marijuana users. This study followed 16 adolescents with minimal alcohol and marijuana use at ages 16–18 over three years. At follow-up, teens were 19–22 years old; half of the participants initiated heavy alcohol use and half initiated heavy alcohol and marijuana use. Repeated-measures ANOVA revealed 20 clusters in association and projection fibers tracts (p < 0.01 in which a group by time interaction was found. Most consistently, white matter integrity (i.e., fractional anisotropy decreased for those who initiated both heavy alcohol and marijuana use over the follow-up interval. No effect of time or change in white matter integrity was seen for those who initiated alcohol use only in the majority of clusters. In most regions, at the baseline time point, teens who would later initiate both alcohol and marijuana use demonstrated white matter integrity greater than or equal to teens that initiated alcohol use only. Findings suggest poorer tissue integrity associated with combined initiation of heavy alcohol and marijuana use in late adolescence. While pre-existing differences may also be related to likelihood of substance use, the present data suggest an effect on tissue integrity for these teens transitioning to combined alcohol and marijuana use in later adolescence.
... C O P Y PATIENT EDUCATION | INFORMATION SERIES Smoking Marijuana and the Lungs Marijuana, also known as ... a safe way to smoke marijuana. How can smoking marijuana damage my lungs? Tobacco smoke of any ...
Juan Pablo Morales Basto
Full Text Available Marijuana is one of the most consumed psychoactive in Colombia and worldwide. It has been observed that it has effects over central nervous system; in consequence it may affect the metabolism and nutritional status of marijuana users. This article intends to evaluate if consumption of marijuana and the activation of the cannabinoid system have the capacity to activate physiological mechanisms through which the intake and the nutrient metabolism get affected. As a result, it is found that the consumption of marijuana influences increasing the orexigenic stimulus and decreasing the anorexigenic stimulus, which influence increasing the ingestion and changing the production of important enzymes in the metabolism of fat. Likewise, it affects the appearance of alterations in the nutritional status of the consumers that involve the decrease of their body max index (BMI, which contrasts with the results related to the intake, thus highlights the importance of carry out deep studies that could explain this questioning.
Easton, Caroline J; Oberleitner, Lindsay M; Scott, Melanie C; Crowley, Michael J; Babuscio, Theresa A; Carroll, Kathleen M
Few studies have addressed comorbid antisocial personality disorder (ASPD) and marijuana dependence in young adults, and results from previous studies are inconsistent. This study evaluated differences in pretreatment characteristics and treatment outcomes between marijuana-dependent young adults with and without ASPD. Data for this study were derived from a randomized trial, in which marijuana-dependent young adults (n = 136) between 18 and 25 years of age were randomized to four behavioral conditions: (1) MET/CBT with CM, (2) MET/CBT without CM, (3) DC with CM, and (4) DC without CM. Forty-four percent of the participants met DSM-IV-TR criteria for ASPD. ASPD clients had significantly more lifetime alcohol dependence disorders, marijuana use in the 28 days pretreatment, arrests, and assault and weapon charges compared to those without ASPD. ASPD clients did not differ in retention or substance use outcomes at 8 weeks posttreatment or the 6-month follow-up. In general, both groups had more attendance in the voucher condition, but there were no significant ASPD by treatment interactions. These data suggest that marijuana-dependent young adults with comorbid ASPD do not necessarily have poorer retention or substance use outcomes compared with marijuana-dependent young adults who do not have ASPD when treated in a well-defined behavioral therapy protocol. Previous research has shown increased risks for clients with comorbid ASPD and marijuana dependence; however, our findings suggest that specialized programs for clients with ASPD may not be necessary if they are provided with empirically supported, structured treatments.
... different amounts of cannabinoids. This sometimes makes the effects of medical marijuana hard to predict or control. The effects also ... wasting syndrome) Severe muscle spasms Multiple sclerosis Side Effects ... physical symptoms from using marijuana include: A fast or irregular heartbeat Dizziness Slow ...
Lobato, Mónica; Sanderman, Robbert; Pizarro, Esteban; Hagedoorn, Mariet
The purpose of the study is to examine (1) whether family and peer marijuana use are independently related to adolescent marijuana use in Chile, (2) whether family and peer marijuana use are associated with adolescent marijuana dependence in adolescents using marijuana, and (3) whether the
Thomas, Grace; Kloner, Robert A; Rezkalla, Shereif
Marijuana is the most widely used illicit drug, with approximately 200 million users worldwide. Once illegal throughout the United States, cannabis is now legal for medicinal purposes in several states and for recreational use in 3 states. The current wave of decriminalization may lead to more widespread use, and it is important that cardiologists be made aware of the potential for marijuana-associated adverse cardiovascular effects that may begin to occur in the population at a greater frequency. In this report, the investigators focus on the known cardiovascular, cerebrovascular, and peripheral effects of marijuana inhalation. Temporal associations between marijuana use and serious adverse events, including myocardial infarction, sudden cardiac death, cardiomyopathy, stroke, transient ischemic attack, and cannabis arteritis have been described. In conclusion, the potential for increased use of marijuana in the changing legal landscape suggests the need for the community to intensify research regarding the safety of marijuana use and for cardiologists to maintain an awareness of the potential for adverse effects. Copyright © 2014 Elsevier Inc. All rights reserved.
Lobato, Monica; Sanderman, Robbert; Pizarro, Esteban; Hagedoorn, Margriet
Purpose The purpose of the study is to examine (1) whether family and peer marijuana use are independently related to adolescent marijuana use in Chile, (2) whether family and peer marijuana use are associated with adolescent marijuana dependence in adolescents using marijuana, and (3) whether the
Mair, Christina; Freisthler, Bridget; Ponicki, William R.; Gaidus, Andrew
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. Methods We analyzed panel population data relating hospitalizations coded for marijuana abuse or dependence and assigned to residential ZIP codes in California from 2001 through 2012 (20,219 space-time units) to ZIP code demographic and ecological characteristics. Bayesian space-time misalignment models were used to account for spatial variations in geographic unit definitions over time, while also accounting for spatial autocorrelation using conditional autoregressive priors. We also analyzed cross-sectional associations between marijuana abuse/dependence and the density of dispensaries in local and spatially adjacent ZIP codes in 2012. Results An additional one dispensary per square mile in a ZIP code was cross-sectionally associated with a 6.8% increase in the number of marijuana hospitalizations (95% credible interval 1.033, 1.105) with a marijuana abuse/dependence code. Other local characteristics, such as the median household income and age and racial/ethnic distributions, were associated with marijuana hospitalizations in cross-sectional and panel analyses. Conclusions Prevention and intervention programs for marijuana abuse and dependence may be particularly essential in areas of concentrated disadvantage. Policy makers may want to consider regulations that limit the density of dispensaries. PMID:26154479
Zhang, Z F; Morgenstern, H; Spitz, M R; Tashkin, D P; Yu, G P; Marshall, J R; Hsu, T C; Schantz, S P
Marijuana is the most commonly used illegal drug in the United States. In some subcultures, it is widely perceived to be harmless. Although the carcinogenic properties of marijuana smoke are similar to those of tobacco, no epidemiological studies of the relationship between marijuana use and head and neck cancer have been published. The relationship between marijuana use and head and neck cancer was investigated by a case-control study of 173 previously untreated cases with pathologically confirmed diagnoses of squamous cell carcinoma of the head and neck and 176 cancer-free controls at Memorial Sloan-Kettering Cancer Center between 1992 and 1994. Epidemiological data were collected by using a structured questionnaire, which included history of tobacco smoking, alcohol use, and marijuana use. The associations between marijuana use and head and neck cancer were analyzed by Mantel-Haenszel methods and logistic regression models. Controlling for age, sex, race, education, alcohol consumption, pack-years of cigarette smoking, and passive smoking, the risk of squamous cell carcinoma of the head and neck was increased with marijuana use [odds ratio (OR) comparing ever with never users, 2.6; 95% confidence interval (CI), 1.1-6.6]. Dose-response relationships were observed for frequency of marijuana use/day (P for trend marijuana use (P for trend marijuana use were observed with cigarette smoking, mutagen sensitivity, and to a lesser extent, alcohol use. Our results suggest that marijuana use may increase the risk of head and neck cancer with a strong dose-response pattern. Our analysis indicated that marijuana use may interact with mutagen sensitivity and other risk factors to increase the risk of head and neck cancer. The results need to be interpreted with some caution in drawing causal inferences because of certain methodological limitations, especially with regard to interactions.
Hayaki, Jumi; Herman, Debra S.; Hagerty, Claire E.; de Dios, Marcel A.; Anderson, Bradley J.; Stein, Michael D.
This study tests the acquired preparedness model (APM) to explain associations among trait impulsivity, social learning principles, and marijuana use outcomes in a community sample of female marijuana users. The APM states that individuals with high-risk dispositions are more likely to acquire certain types of learning that, in turn, instigate problematic substance use behaviors. In this study, three domains of psychosocial learning were tested: positive and negative marijuana use expectancie...
Hynes, Marya; Demarco, Maria; Araneda, Juan Carlos; Cumsille, Francisco
Young adults 18 to 25 years old show the highest prevalence of marijuana use in Latin America. This study analyzes the changes in prevalence of marijuana use among university students in the Andean Community (Bolivia, Colombia, Ecuador, and Peru) from two studies carried out in 2009 and in 2012. Data were collected through representative two-stage samples of universities and students in the Andean Community. An online survey was administered using a standardized questionnaire. Prevalence was calculated for lifetime, past year, and past month. Marijuana was the most widely used illicit substance consumed among university students, in 2009 and in 2012. Past month prevalence among university students in 2009 in Colombia was 5.27%, in Peru 1.00%, in Ecuador 1.68%, and in Bolivia 0.76%. Past month prevalence in 2012 in Colombia was 7.14%, in Ecuador 3.67%, in Peru 1.62%, and in Bolivia 1.45% in 2012. Among university students in the Andean Community, past month prevalence increased among both males and females between 2009 and 2012 in most countries. Marijuana continues to be the most commonly used illicit drug in Latin American countries. Increases in prevalence among young adults could have important implications for national drug policy.
Full Text Available Young adults 18 to 25 years old show the highest prevalence of marijuana use in Latin America. This study analyzes the changes in prevalence of marijuana use among university students in the Andean Community (Bolivia, Colombia, Ecuador, and Peru from two studies carried out in 2009 and in 2012. Data were collected through representative two-stage samples of universities and students in the Andean Community. An online survey was administered using a standardized questionnaire. Prevalence was calculated for lifetime, past year, and past month. Marijuana was the most widely used illicit substance consumed among university students, in 2009 and in 2012. Past month prevalence among university students in 2009 in Colombia was 5.27%, in Peru 1.00%, in Ecuador 1.68%, and in Bolivia 0.76%. Past month prevalence in 2012 in Colombia was 7.14%, in Ecuador 3.67%, in Peru 1.62%, and in Bolivia 1.45% in 2012. Among university students in the Andean Community, past month prevalence increased among both males and females between 2009 and 2012 in most countries. Marijuana continues to be the most commonly used illicit drug in Latin American countries. Increases in prevalence among young adults could have important implications for national drug policy.
Haney, Margaret; Cooper, Ziva D; Bedi, Gillinder; Vosburg, Suzanne K; Comer, Sandra D; Foltin, Richard W
Few individuals seeking treatment for marijuana use achieve sustained abstinence. The cannabinoid receptor agonist, Δ9-tetrahydrocannabinol (THC; dronabinol), decreases marijuana withdrawal symptoms, yet does not decrease marijuana use in the laboratory or clinic. Dronabinol has poor bioavailability, which may contribute to its poor efficacy. The FDA-approved synthetic analog of THC, nabilone, has higher bioavailability and clearer dose-linearity than dronabinol. This study tested whether nab...
Freisthler, Bridget; Gruenewald, Paul J; Wolf, Jennifer Price
The current study extends previous research by examining whether and how current marijuana use and the physical availability of marijuana are related to child physical abuse, supervisory neglect, or physical neglect by parents while controlling for child, caregiver, and family characteristics in a general population survey in California. Individual level data on marijuana use and abusive and neglectful parenting were collected during a telephone survey of 3,023 respondents living in 50 mid-size cities in California. Medical marijuana dispensaries and delivery services data were obtained via six websites and official city lists. Data were analyzed using negative binomial and linear mixed effects multilevel models with individuals nested within cities. Current marijuana use was positively related to frequency of child physical abuse and negatively related to physical neglect. There was no relationship between supervisory neglect and marijuana use. Density of medical marijuana dispensaries and delivery services was positively related to frequency of physical abuse. As marijuana use becomes more prevalent, those who work with families, including child welfare workers must screen for how marijuana use may affect a parent's ability to provide for care for their children, particularly related to physical abuse. Copyright © 2015 Elsevier Ltd. All rights reserved.
Bou-Matar Ché B
Full Text Available Abstract Background Cannabis (marijuana had been used for medicinal purposes for millennia. Cannabinoid agonists are now attracting growing interest and there is also evidence that botanical cannabis is being used as self-medication for stress and anxiety as well as adjunctive therapy by the seriously ill and by patients with terminal illnesses. California became the first state to authorize medicinal use of cannabis in 1996, and it was recently estimated that between 250,000 and 350,000 Californians may now possess the physician's recommendation required to use it medically. More limited medical use has also been approved in 12 additional states and new initiatives are being considered in others. Despite that evidence of increasing public acceptance of "medical" use, a definitional problem remains and all use for any purpose is still prohibited by federal law. Results California's 1996 initiative allowed cannabis to be recommended, not only for serious illnesses, but also "for any other illness for which marijuana provides relief," thus maximally broadening the range of allowable indications. In effect, the range of conditions now being treated with federally illegal cannabis, the modes in which it is being used, and the demographics of the population using it became potentially discoverable through the required screening of applicants. This report examines the demographic profiles and other selected characteristics of 4117 California marijuana users (62% from the Greater Bay Area who applied for medical recommendations between late 2001 and mid 2007. Conclusion This study yielded a somewhat unexpected profile of a hitherto hidden population of users of America's most popular illegal drug. It also raises questions about some of the basic assumptions held by both proponents and opponents of current policy.
Lobato, Mónica; Sanderman, Robbert; Pizarro, Esteban; Hagedoorn, Mariet
Purpose The purpose of the study?is to examine (1) whether family and peer marijuana use are independently related to adolescent marijuana use in Chile, (2) whether family and peer marijuana use are associated with adolescent marijuana dependence in adolescents using marijuana, and (3) whether the adolescent?s age moderates the association between family or peer use and adolescent marijuana use and/or dependence. Method This study used data from the National Survey on Drug Use in the General ...
Holland, Cynthia L; Nkumsah, Michelle Abena; Morrison, Penelope; Tarr, Jill A; Rubio, Doris; Rodriguez, Keri L; Kraemer, Kevin L; Day, Nancy; Arnold, Robert M; Chang, Judy C
To describe obstetric provider attitudes, beliefs, approaches, concerns, and needs about addressing perinatal marijuana use with their pregnant patients. We conducted individual semi-structured interviews with obstetric providers and asked them to describe their thoughts and experiences about addressing perinatal marijuana use. Interviews were transcribed verbatim, coded and reviewed to identify themes. Fifty-one providers participated in semi-structured interviews. Providers admitted they were not familiar with identified risks of marijuana use during pregnancy, they perceived marijuana was not as dangerous as other illicit drugs, and they believed patients did not view marijuana as a drug. Most provider counseling strategies focused on marijuana's status as an illegal drug and the risk of child protective services being contacted if patients tested positive at time of delivery. When counseling about perinatal marijuana use, obstetric providers focus more on legal issues than on health risks. They describe needing more information regarding medical consequences of marijuana use during pregnancy. Provider training should include information about potential consequences of perinatal marijuana use and address ways to improve obstetric providers' counseling. Future studies should assess changes in providers' attitudes as more states consider the legalization of marijuana. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Bauer, Biljana; Kostik, Vesna; Kavrakovski, Zoran
Marijuana is very popular nowadays because of its medical use. This paper gives a short survey and review on the historical development of the ideas associated with marijuana. The aim of this paper is to look inside all faces of marijuana through history. Marijuana represents the dried top parts of female hemp plant in flower, which contains up to 6% tetrahidrocanabinol THC. Throughout human history hemp has been used for many purposes such as recreation, therapy, art, religion, medicine as a...
Osilla, Karen Chan; Pedersen, Eric R; Ewing, Brett A; Miles, Jeremy N V; Ramchand, Rajeev; D'Amico, Elizabeth J
Among high-risk youth, those who may be at increased risk for adverse alcohol and other drug (AOD) use outcomes may benefit from targeted prevention efforts; how youth acquire AOD may provide an objective means of identifying youth at elevated risk. We assessed how youth acquired alcohol and marijuana (purchasing vs. other means), demographics, AOD behaviors/consequences, and environment among adolescents referred to a diversion program called Teen Court (N = 180) at two time points (prior to the program and 180 days from baseline). Participants were predominantly White and Hispanic/Latino(a). In cross-sectional analyses among alcohol and marijuana users, purchasing marijuana was associated with more frequent marijuana use and consequences, time spent around teens who use marijuana, higher likelihood of substance use disorders, and lower resistance self-efficacy compared to non-purchasers. Teens who purchased both alcohol and marijuana experienced similar outcomes to those who purchased only marijuana, and also reported more frequent and higher quantity of drinking, greater alcohol-related consequences, time spent around teens who use other drugs, and prescription drug misuse. Longitudinally, purchasing alcohol and marijuana at baseline was associated with more frequent and higher quantity of drinking compared to non-purchasers at follow-up. Marijuana only purchasers had a greater likelihood of substance use disorders at follow-up compared to non-purchasers. In an era where drinking is commonplace and attitudes towards marijuana use are becoming more tolerant, it is essential to evaluate how accessibility to AOD and subsequent purchasing behaviors affect youth consumption and intervene accordingly to prevent future consequences.
Gonçalves, Janaina R; Nappo, Solange A
In Brazil, crack cocaine use remains a healthcare challenge due to the rapid onset of its pleasurable effects, its ability to induce craving and addiction, and the fact that it is easily accessible. Delayed action on the part of the Brazilian Government in addressing the drug problem has led users to develop their own strategies for surviving the effects of crack cocaine use, particularly the drug craving and psychosis. In this context, users have sought the benefits of combining crack cocaine with marijuana. Our aim was to identify the reasons why users combine crack cocaine with marijuana and the health implications of doing so. The present study is a qualitative study, using in-depth interviews and criteria-based sampling, following 27 crack cocaine users who combined its use with marijuana. Participants were recruited using the snowball sampling technique, and the point of theoretical saturation was used to define the sample size. Data were analyzed using the content analysis technique. The interviewees reported that the combination of crack cocaine use with marijuana provided "protection" (reduced undesirable effects, improved sleep and appetite, reduced craving for crack cocaine, and allowed the patients to recover some quality of life). Combined use of cannabis as a strategy to reduce the effects of crack exhibited several significant advantages, particularly an improved quality of life, which "protected" users from the violence typical of the crack culture. Crack use is considered a serious public health problem in Brazil, and there are few solution strategies. Within that limited context, the combination of cannabis and crack deserves more thorough clinical investigation to assess its potential use as a strategy to reduce the damage associated with crack use.
Azorlosa, J L; Greenwald, M K; Stitzer, M L
Two studies were conducted to quantify biological and behavioral effects resulting from exposure to controlled doses of marijuana smoke. In one study, puff volume (30, 60 and 90 ml) and in a second study, breathhold duration (0, 10 and 20 sec) were systematically varied while holding constant other smoking topography parameters (number of puffs = 10, interpuff interval = 60 sec and inhalation volume = 25% of vital capacity). Each study also varied levels of delta 9-tetrahydro-cannabinol marijuana cigarette content (1.75% and 3.55%). Regular marijuana users served as subjects (n = 7 in each experiment). Subjects smoked 10 puffs in each of six sessions; a seventh, nonsmoking session (all measures recorded at the same times as in active smoking sessions) served as a control. Variations in puff volume produced significant dose-related changes in postsmoking plasma delta 9-tetrahydro-cannabinol levels, carbon monoxide boost and subjective effects (e.g., "high"). In contrast, breathholding for 10 or 20 sec versus 0 sec increased plasma delta 9-tetrahydro-cannabinol levels but not CO boost or subjective effects. Task performance measures were not reliably influenced by marijuana smoke exposure within the dosing ranges examined. These findings confirm the utility of the controlled smoking technology, support the notion that cumulative puff volume systematically influences biological exposure and subjective effects, but cast doubt on the common belief that prolonged breathholding of marijuana smoke enhances classical subjective effects associated with its reinforcing value in humans.
D'Amico, Elizabeth J; Rodriguez, Anthony; Tucker, Joan S; Pedersen, Eric R; Shih, Regina A
Marijuana use during adolescence is associated with neurocognitive deficits and poorer functioning across several domains. It is likely that more states will pass both medical and recreational marijuana legalization laws in the coming elections; therefore, we must begin to look more closely at the longitudinal effects of medical marijuana (MM) advertising on marijuana use among adolescents so that we can better understand effects that this advertising may have on their subsequent marijuana use and related outcomes. We followed two cohorts of 7th and 8th graders (mean age 13) recruited from school districts in Southern California from 2010 until 2017 (mean age 19) to examine effects of MM advertising on adolescents' marijuana use, cognitions, and consequences over seven years. Latent growth models examined trajectories of self-reported exposure to medical marijuana ads in the past three months and trajectories of use, cognitions, and consequences. Higher average exposure to MM advertising was associated with higher average use, intentions to use, positive expectancies, and negative consequences. Similarly, higher rates of change in MM advertising exposure were associated with higher rates of change in use, intentions, expectancies, and consequences over seven years. Results suggest that exposure to MM advertising may not only play a significant role in shaping attitudes about marijuana, but may also contribute to increased marijuana use and related negative consequences throughout adolescence. This highlights the importance of considering regulations for marijuana advertising, similar to regulations in place for the promotion of tobacco and alcohol in the U.S. Copyright © 2018. Published by Elsevier B.V.
Soller, Brian; Lee, Juliet P.
This article examines why Southeast Asian American adolescents and emerging adults in two urban settings prefer to use "blunts," or hollowed-out cigars filled with marijuana, over other methods of drug intake. Rationales for preferring blunts were both instrumental and social. Blunts allowed users to more easily share marijuana, the preferred drug…
Testa, Maria; Derrick, Jaye L; Wang, Weijun; Leonard, Kenneth E; Kubiak, Audrey; Brown, Whitney C; Collins, R Lorraine
Although patterns of marijuana use are positively associated with intimate partner aggression, there is little evidence that episodes of marijuana use contribute to the occurrence of episodes of relationship conflict and aggression. The present ecological momentary assessment study considered the temporal relationship between marijuana use episodes and the occurrence of conflict, verbal aggression, and physical aggression between intimate partners in the next 2 hours. A sample of 183 cohabiting marijuana-using couples (ages 18-30) were recruited from the community. For 30 consecutive days, each partner independently reported episodes of marijuana use and partner conflict, including verbal and physical aggression perpetration and victimization within conflicts. Temporal associations between each partner's marijuana use and subsequent conflict and aggression were examined using the Actor-Partner Interdependence Model. Analyses accounted for between-person effects of marijuana use frequency and total conflicts. We observed temporal effects of actor (but not partner) marijuana use on men's and women's reports of conflict and verbal aggression perpetration and victimization within 2 hours of use. Marijuana use episodes did not alter the likelihood of physical aggression in the next 2 hours. Partner concordance in marijuana use had no effect on verbal or physical aggression or victimization. The positive temporal effects of marijuana on conflict and verbal aggression remained significant after accounting for the effect of drinking episodes. Within generally concordant, marijuana-using young couples, marijuana use episodes contribute to the occurrence of relationship conflict and verbal aggression.
Grunberg, Victoria A; Cordova, Kismet A; Bidwell, L Cinnamon; Ito, Tiffany A
Increases in marijuana use in recent years highlight the importance of understanding how marijuana affects mental health. Of particular relevance is the effect of marijuana use on anxiety and depression given that marijuana use is highest among late adolescents/early adults, the same age range in which risk for anxiety and depression is the highest. Here we examine how marijuana use moderates the effects of temperament on level of anxiety and depression in a prospective design in which baseline marijuana use and temperament predict anxiety and depression 1 year later. We found that harm avoidance (HA) is associated with higher anxiety and depression a year later, but only among those low in marijuana use. Those higher in marijuana use show no relation between HA and symptoms of anxiety and depression. Marijuana use also moderated the effect of novelty seeking (NS), with symptoms of anxiety and depression increasing with NS only among those with high marijuana use. NS was unrelated to symptoms of anxiety and depression among those low in marijuana use. The temperament dimension of reward dependence was unrelated to anxiety and depression symptoms. Our results suggest that marijuana use does not have an invariant relationship with anxiety and depression, and that the effects of relatively stable temperament dimensions can be moderated by other contextual factors. (c) 2015 APA, all rights reserved).
Do It Now Foundation, Phoenix, AZ.
The document presents a collection of articles about marijuana. Article 1 reports on the results of a study by the National Academy of Sciences on the health effects of marijuana. A summary report of adverse health and behavioral consequences of cannabis (marijuana) use is provided in article 2. Article 3 presents the Surgeon General's warnings on…
... of medical care and advice from your health care provider. What is marijuana? Marijuana, also called pot, weed, or cannabis, is a drug that comes from the hemp plant. Parts of the plant are dried and smoked ...
Satterlund, Travis D; Lee, Juliet P; Moore, Roland S
The enactment of California's Proposition 215 stipulates that patients may use marijuana for medical reasons, provided that it is recommended by a physician. Yet, medical marijuana patients risk being stigmatized for this practice. This article examines the way in which medical marijuana patients perceive and process stigma, and how it affects their interactions and experiences with others. Eighteen semi-structured interviews of medical marijuana patients were carried out using a semi-structured interview guide. Most patients circumvented their own physicians in obtaining a recommendation to use medicinal marijuana, and also used a host of strategies in order to justify their medical marijuana use to family, friends, and colleagues in order to stave off potential stigma. The stigmatization of medical marijuana thus has a profound effect on how patients seek treatment, and whether they seek medical marijuana treatment at all.
Suwała, Małgorzata; Gerstenkorn, Andrzej; Szewczyk, Anna
Marijuana is the most popular illegal drug in the world. In 2010 17.6% of polish adult population (age 15-64) and 37.3% of youth (age 17-18) declared use of marijuana at least once in their lifetime. Recent years in Poland brought back public discussion regarding decriminalization and legalization of marijuana. The main goal of the study was to reveal the opinion about legalization of marijuana in Poland among students of medical and technical faculty in correlation with chosen socio-demographic factors, college major, attitude to tobacco smoking, use of drugs and religious practice. Study included 230 students (110 from Medical University of Lodz and 120 from Technical University of Lodz). Women consisted on 56.1% of surveyed and men on 43.9%. Study used audit survey as a research method. Results. 40.4% of students considered marijuana as "soft" drug and in majority (65.7%) are convinced that it is not addictive. The main part of studied group (83%) claimed that marijuana is easily accessible in Poland. The majority of the group (38.75%) was against marijuana legalization, a little bit less (35.2%) approved its legalization in Poland and 26.1% had no opinion. Type of college faculty had not been detected as a factor influencing support for legalization. Important factors influencing positive opinion on legalization was: living in the city, tobacco smoking, socializing with legalization supporters, lack of regular religious practice, drug use. CONCLUSION. Young people's diversified opinion regarding legalization of marijuana in Poland should encourage further discussion. Educational and preventive activities within different social groups are necessary to form a conscious opinion on legalization of marijuana in Poland based on the knowledge of actual scientific facts.
Roth, Cheryl K; Satran, Lori A; Smith, Shauna M
With the legalization of both medical and recreational use of marijuana in some U.S. states, nurses and other clinicians should be prepared to care for pregnant women who have used marijuana during pregnancy. This column describes the prevalence of cannabis use among women, the effect cannabis has on the body and the potential maternal, fetal and neonatal effects of marijuana use during pregnancy. © 2015 AWHONN.
Filbey, Francesca M; McQueeny, Tim; Kadamangudi, Shrinath; Bice, Collette; Ketcherside, Ariel
Combined use of marijuana (MJ) and tobacco is highly prevalent in today's population. Individual use of either substance is linked to structural brain changes and altered cognitive function, especially with consistent reports of hippocampal volume deficits and poorer memory performance. However, the combined effects of MJ and tobacco on hippocampal structure and on learning and memory processes remain unknown. In this study, we examined both the individual and combined effects of MJ and tobacco on hippocampal volumes and memory performance in four groups of adults taken from two larger studies: MJ-only users (n=36), nicotine-only (Nic-only, n=19), combined marijuana and nicotine users (MJ+Nic, n=19) and non-using healthy controls (n=16). Total bilateral hippocampal volumes and memory performance (WMS-III logical memory) were compared across groups controlling for total brain size and recent alcohol use. Results found MJ and MJ+Nic groups had smaller total hippocampal volumes compared to Nic-only and controls. No significant difference between groups was found between immediate and delayed story recall. However, the controls showed a trend for larger hippocampal volumes being associated with better memory scores, while MJ+Nic users showed a unique inversion, whereby smaller hippocampal volume was associated with better memory. Overall, results suggest abnormalities in the brain-behavior relationships underlying memory processes with combined use of marijuana and nicotine use. Further research will need to address these complex interactions between MJ and nicotine. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.
Giovenco, Daniel P; Miller Lo, Erin J; Lewis, M Jane; Delnevo, Cristine D
Cigarillo use is prevalent among young adults in the United States. Many young people use cigarillos as "blunts," a term for a cigar emptied of its tobacco and replaced with marijuana. Because cigars in the United States are not subject to the same regulations as cigarettes, they offer a diverse selection of flavors and packaging styles. It is unclear how these and other product attributes facilitate blunt use. Semi-structured telephone interviews were conducted with a sample of 40 young adult cigar or cigarillo users in the United States to assess patterns of use and perceptions about product features. Quotations from interview transcripts were coded for major themes and summarized across participants. Regardless of their preferred brand, participants felt that the brand Black & Mild is primarily smoked for the tobacco. There was a strong perception, however, that other popular cigarillo brands are almost always used to make blunts. Participants believed that cigarillo companies design their products to simplify blunt-making, with features such as perforated lines or wrappings that unroll easily. Resealable foil pouches, a popular packaging style, are often used to hold unused marijuana and mask its smell. Blunt use is pervasive among young adult cigarillo users in the United States, and certain cigar companies have developed products that facilitate blunt-making. Future surveillance measures should capture the extent to which cigarillo users are using these products as blunts. Continued surveillance of cigarillo sales and popular product attributes are needed. Cigarillo use is prevalent among young adults in the United States, many of whom are using the products as blunts. This study found that product features such as brand, flavor, packaging, and price influence the selection of cigarillos used for this purpose. There is also a strong perception among young adult cigarillo users that cigarillo companies design their products and packaging to make the blunt
Feeney, Kathleen E.; Kampman, Kyle M.
Marijuana has consistently been reported as the most commonly used illicit substance in the United States each year. Currently, the legalization of marijuana is up for debate across the nation. While marijuana use is prevalent among the adolescent population, research has shown that there can be devastating effects on health and well-being. A review of the literature shows that marijuana use can have a negative impact on physical health, psychological well-being, and multiple psychosocial out...
Fitzgerald, Kevin T; Bronstein, Alvin C; Newquist, Kristin L
The plant Cannabis sativa has been used for centuries for the effects of its psychoactive resins. The term "marijuana" typically refers to tobacco-like preparations of the leaves and flowers. The plant contains more than 400 chemicals but the cannabinoid δ-9-tetrahydrocannabinol (THC) is the major psychoactive constituent. "Hashish" is the resin extracted from the tops of flowering plants and generally has a much higher THC concentration. Marijuana is the most commonly used illicit drug in the United States. Currently, several states have passed legislation to decriminalize possession of small amounts of marijuana for both medical and personal use and several other states have similar legislation under consideration. The most common form of marijuana use in humans is inhalation of the smoke of marijuana cigarettes, followed by ingestion. In animals, although secondhand smoke inhalation is possible, the most common source of exposure is through ingestion of the owner's marijuana supply. The minimum lethal oral dose for dogs for THC is more than 3 g/kg. Although the drug has a high margin of safety, deaths have been seen after ingestion of food products containing the more concentrated medical-grade THC butter. There are two specific cannabinoid receptors in humans and dogs, CB1 (primarily in central nervous system) and CB2 (peripheral tissues). In animals, following oral ingestion, clinical effects begin within 60 minutes. All of the neuropharmacologic mechanisms by which cannabinoids produce psychoactive effects have not been identified. However, CB1 activity is believed to be responsible for the majority of cannabinoid clinical effects. Highly lipid soluble, THC is distributed in fat, liver, brain, and renal tissue. Fifteen percent of THC is excreted into the urine and the rest is eliminated in the feces through biliary excretion. Clinical signs of canine intoxication include depression, hypersalivation, mydriasis, hypermetria, vomiting, urinary incontinence
Cloutier, Renee M; Blumenthal, Heidemarie; Mischel, Emily R
Marijuana and nicotine are two of the most widely used substances among adolescents in the United States. Symptoms of social anxiety (SA) typically emerge during early adolescence, and elevated levels are associated with increased substance-related problems despite inconsistent links to frequency of use. Substance use motives, and in particular coping motives, have been found to play an important role in understanding the heightened risk for use problems among those with elevated SA. Importantly, work to date has been conducted almost exclusively with adult samples; thus the current study examined whether similar patterns would emerge among adolescents. The current project included 56 community-recruited adolescents (ages 12-17 years; 41% girls) with a positive history of lifetime marijuana and cigarette use. Consistent with the adult literature, SA was not positively associated with frequency of use across either substance. Further, SA was positively associated with conformity use motives and unrelated to social or enhancement motives for both substances. Unexpectedly, SA was unrelated to coping use motives for either marijuana or cigarettes. These preliminary data highlight the need for future research designed to forward developmentally sensitive models of substance use behaviors and etiology.
Brooks-Russell, Ashley; Levinson, Arnold; Li, Yaqiang; Roppolo, Rebecca Hebner; Bull, Sheana
Colorado is among the first states to legalize the recreational sale of marijuana and therefore among the first to develop regulations outlining the purchase, possession, consumption, and enforcement, and penalties. Colorado legislators set aside funds for a statewide informational media campaign to educate Colorado residents on legal use of marijuana. This study evaluated the effectiveness of the mass media campaign to increase awareness of the law through a prospective cohort surveyed before and 6 months after the launch of the campaign ( n = 798). A total of 28.0% reported recall of the Good to Know campaign. There was a significant positive change in accurate knowledge of marijuana laws from baseline to follow-up for each of the four primary indicators of knowledge of the marijuana laws. Among those who had inaccurate knowledge of the laws at baseline, those who reported seeing the campaign at least once or more were 2.53 (95% confidence interval = 1.29-4.95) times as likely to report accurate knowledge of the laws at follow-up compared with those who did not recall seeing the campaign, particularly among marijuana users. Those individuals who reported recall of the campaign were more likely to increase their accurate knowledge of marijuana laws.
Full Text Available I examine the transfer of the Problem Drug Use (PDU concept into Czech scientific discourse through European institutions’ projects, and view PDU’s utilization by Czech researchers in relation to marijuana decriminalization efforts.PDU is defined as intravenous and/or long-term and regular use of opiates, cocaine, or amphetamines. Out of a vast array of illicit drug use patterns, this concept isolates a relatively small population with the riskiest use patterns to become the focus of public policies. A series of European Union and Council of Europe projects in 1990’s helped bring PDU into European research mainstream. The new common standard, promoted by the European Monitoring Centre for Drugs and Drug Addiction, was utilized by Czech authors in a 2001 policy analysis entitled “Impact Analysis Project of the New Drug Legislation in the Czech Republic” (PAD. PDU played a crucial role in PAD’s drug problem modeling, focusing on a “hard core” of opiate and methamphetamine users, while diverting attention from a large group of cannabis users.By using the new European methodological standard, PAD’s authors constructed marijuana as a non-problem. This helped drug policy reformers in the Czech Government legitimize their focus on “harder” drugs, and subsequently propose more lenient sanctions for the possession and cultivation of marijuana. I argue that continued ignorance of marijuana problems might jeopardize the tolerant expert-driven drug policy in the Czech Republic. Measurement of problem cannabis use should be introduced.
Grunberg, Victoria A.; Cordova, Kismet A.; Bidwell, L. Cinnamon; Ito, Tiffany A.
Increases in marijuana use in recent years highlight the importance of understanding how marijuana affects mental health. Of particular relevance is the effect of marijuana use on anxiety and depression given that marijuana use is highest among late adolescents/early adults, the same age range in which risk for anxiety and depression is the highest. Here we examine how marijuana use moderates the effects of temperament on level of anxiety and depression in a prospective design in which baseli...
James, J S
The Cannabis Buyers' Club in San Francisco remains closed after it was raided by the office of California Attorney General Dan Lungren. Many individuals with serious illnesses such as AIDS and cancer are without safe access to medical marijuana to relieve the symptoms of their diseases. The need for access to medicinal marijuana, the return of the confiscated confidential medical records held at the buyers' club, and the passage of California Proposition 215 in the November election, which allows for the legitimate use of marijuana for medical purposes are of immediate concern. Since the raid, the Cannabis Buyers' Club has denied charges that it sold marijuana to teenagers, saying the drug was sold to a teen's mother, an undercover narcotics officer. However, the club admitted to sales to non-medical individuals who used fraudulent documents in order to obtain the drug and acknowledges the need to tighten procedures. Individuals may be able to obtain marijuana at other buyers' clubs if they have documentation of a medical need. While literature on the medical use of marijuana is lacking, the Federal government continues to block any efforts toward medical research on this issue. A list of other cannabis buyers' clubs in California is included, as well as a list of organizations working for Proposition 215.
Mithun B. Pattathan
Full Text Available Cannabis use has become one of the most commonly abused drugs in the world. It is estimated that each year 2.6 million individuals in the USA become new users and most are younger than 19 years of age. Reports describe marijuana use as high as 40–50% in male Cyclic Vomiting Syndrome patients. It is this interest in cannabis in the World, coupled with recognition of a cyclic vomiting illness associated with its chronic use that beckons a review of the most current articles, as well as a contribution from our own experiences in this area. The similarities we have demonstrated for both cannibinoid hyperemesis syndrome and cyclic vomiting make the case that cannibinoid hyperemesis syndrome is a subset of patients who have the diagnoses of cyclic vomiting syndrome and the role of marijuana should always be considered in the diagnosis of CVS, particularly in males.
Khwaja, Sara; Yacoub, Abraham; Cheema, Asima; Rihana, Nancy; Russo, Robin; Velez, Ana Paula; Nanjappa, Sowmya; Sandin, Ramon L; Bohra, Chandrashekar; Gajanan, Ganesh; Greene, John N
Worldwide, marijuana (cannabis) is a widely used drug. The incidence of marijuana smoking is increasing and is second only to tobacco as the most widely smoked substance in the general population. It is also the second most commonly used recreational drug after alcohol. Some adverse effects of marijuana smoking have been documented; however, the number of studies on the pulmonary effects of marijuana in individuals with leukemia is limited. In our case series, we report on 2 men with acute myeloid leukemia with miliary nodular lung patterns on computed tomography of the chest due to heavy marijuana use. We also report on 2 patients with acute lymphocytic leukemia who had a history of smoking marijuana and then developed lung opacities consistent with mold infection.
Full Text Available Introduction and the aim: Marijuana is the most commonly used drug in the world (excluding alcohol and tobacco. According to the literature about 16% of Poles at the age of 16 to 64 years old, at least once have used cannabis. The aim of study was to estimate the popularity of marijuana among students of Polish universities. We also asked questions about respondents’ attitude towards marijuana and opinions about its validation. Material and methods: The study was conducted in 2017 on 132 individuals – 60 men and 72 women. The results were analyzed in STATISTICA 10 at p<0.05. Results:Out of interviewees, 63.6% of them, at least once in their lives, have used marijuana. This is a percentage of up to four times greater than that one given in the literature for the general population. Even 80% of men and 50% of women have tried marijuana at least once in their lives. Students of Catholic University of Lublin reach for marijuana significantly more often than students of Medical University of Lublin. The majority of respondents (53% treats marijuana as a "soft" drug, though up 67.4% believe that it has the addictive potential. More than a half of respondents (56.8% stands for liberalization of rules relevant to marijuana in Poland. Vast majority (70% of respondents believes that marijuana is easily available in Poland. Conclusions: Marijuana is a drug popular among students. The criminalization of drug use in Poland is not effective for the prevention of its use, the majority of respondents believes that marijuana is easily available in Poland. Considering the negative health and social consequences of the current state, it is worth wondering about making changes in the education system and Polish drug law.
Cavazos-Rehg, Patricia; Krauss, Melissa; Grucza, Richard; Bierut, Laura
Twitter is a popular social media forum for sharing personal experiences, interests, and opinions. An improved understanding of the discourse on Twitter that encourages marijuana use can be helpful for tailoring and targeting online and offline prevention messages. The intent of the study was to assess the content of "tweets" and the demographics of followers of a popular pro-marijuana Twitter handle (@stillblazingtho). We assessed the sentiment and content of tweets (sent from May 1 to December 31, 2013), as well as the demographics of consumers that follow a popular pro-marijuana Twitter handle (approximately 1,000,000 followers) using Twitter analytics from Demographics Pro. This analytics company estimates demographic characteristics based on Twitter behavior/usage, relying on multiple data signals from networks, consumption, and language and requires confidence of 95% or above to make an estimate of a single demographic characteristic. A total of 2590 tweets were sent from @stillblazingtho during the 8-month period and 305 (11.78%) replies to another Twitter user were excluded for qualitative analysis. Of the remaining 2285 tweets, 1875 (82.06%) were positive about marijuana, 403 (17.64%) were neutral, and 7 (0.31%) appeared negative about marijuana. Approximately 1101 (58.72%) of the positive marijuana tweets were perceived as jokes or humorous, 340 (18.13%) implied that marijuana helps you to feel good or relax, 294 (15.68%) mentioned routine, frequent, or heavy use, 193 (10.29%) mentioned blunts, marijuana edibles, or paraphernalia (eg, bongs, vaporizers), and 186 (9.92%) mentioned other risky health behaviors (eg, tobacco, alcohol, other drugs, sex). The majority (699,103/959,143; 72.89%) of @stillblazingtho followers were 19 years old or younger. Among people ages 17 to 19 years, @stillblazingtho was in the top 10% of all Twitter handles followed. More followers of @stillblazingtho in the United States were African American (323,107/759,407; 42.55%) or
Krauss, Melissa; Grucza, Richard; Bierut, Laura
Background Twitter is a popular social media forum for sharing personal experiences, interests, and opinions. An improved understanding of the discourse on Twitter that encourages marijuana use can be helpful for tailoring and targeting online and offline prevention messages. Objectives The intent of the study was to assess the content of “tweets” and the demographics of followers of a popular pro-marijuana Twitter handle (@stillblazingtho). Methods We assessed the sentiment and content of tweets (sent from May 1 to December 31, 2013), as well as the demographics of consumers that follow a popular pro-marijuana Twitter handle (approximately 1,000,000 followers) using Twitter analytics from Demographics Pro. This analytics company estimates demographic characteristics based on Twitter behavior/usage, relying on multiple data signals from networks, consumption, and language and requires confidence of 95% or above to make an estimate of a single demographic characteristic. Results A total of 2590 tweets were sent from @stillblazingtho during the 8-month period and 305 (11.78%) replies to another Twitter user were excluded for qualitative analysis. Of the remaining 2285 tweets, 1875 (82.06%) were positive about marijuana, 403 (17.64%) were neutral, and 7 (0.31%) appeared negative about marijuana. Approximately 1101 (58.72%) of the positive marijuana tweets were perceived as jokes or humorous, 340 (18.13%) implied that marijuana helps you to feel good or relax, 294 (15.68%) mentioned routine, frequent, or heavy use, 193 (10.29%) mentioned blunts, marijuana edibles, or paraphernalia (eg, bongs, vaporizers), and 186 (9.92%) mentioned other risky health behaviors (eg, tobacco, alcohol, other drugs, sex). The majority (699,103/959,143; 72.89%) of @stillblazingtho followers were 19 years old or younger. Among people ages 17 to 19 years, @stillblazingtho was in the top 10% of all Twitter handles followed. More followers of @stillblazingtho in the United States were
Di Giovanni, Giuseppe
Marijuana has been used for centuries for medical reasons. In the early 20th century it was first linked to treatment for epilepsy. Over the last few decades researchers have been unravelling the truth behind the drug. Prof. Giuseppe Di Giovanni tells us more about using marijuana for medical research and his own research on this controversial drug.
Pacula, Rosalie Liccardo; Lundberg, Russell
Recent debates regarding liberalization of marijuana policies often rest on assumptions regarding the extent to which such policy changes would lead to a change in marijuana consumption and by whom. This paper reviews the economics literature assessing the responsiveness of consumption to changes in price and enforcement risk and explicitly considers how this responsiveness varies by different user groups. In doing so, it demonstrates how most of the research has examined responsiveness to prevalence of use, which is a composite of different user groups, rather than level of consumption among regular or heavy users, which represent the largest share of total quantities consumed. Thus, it is not possible to generate reliable estimates of the impact of liberalizing policies on either tax revenues or harms, as these outcomes are most directly influenced by the amounts consumed by regular or heavy users, not prevalence rates.
Satterlund, Travis D.; Lee, Juliet P.; Moore, Roland S.
The enactment of California's Proposition 215 stipulates that patients may use marijuana for medical reasons, provided that it is recommended by a physician. Yet, medical marijuana patients risk being stigmatized for this practice. This paper examines the way in which medical marijuana patients perceive and process stigma, and how it affects their interactions and experiences with others. Eighteen semi-structured interviews of medical marijuana patients were carried out using a semi-structure...
Fantasia, Heidi Collins
Marijuana is the most commonly used recreational drug in the United States, including among women of childbearing age and women who are pregnant. Changing legal statutes that allow for the use of medical marijuana and the decriminalization of marijuana for personal use reflect more permissive societal views on the use of this drug. Active compounds in marijuana cross the placenta rapidly and are excreted in breast milk. Results of studies of the effects of marijuana on a developing fetus and neonate are conflicting, but researchers have identified chronic marijuana exposure as a risk factor for preterm birth and small-for-gestational-age infants. This article reviews the pharmacology of marijuana and discusses implications for nurses who work with women of childbearing age. © 2017 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses.
Wu, Li-Tzy; Parrott, Andy C.; Ringwalt, Christopher L.; Patkar, Ashwin A.; Mannelli, Paolo; Blazer, Dan G.
Aim In light of the resurgence in MDMA use and its association with polysubstance use, we investigated the 12-month prevalence of substance use disorders (SUDs) among adult MDMA users to determine whether they are at risk of other drug-related problems that would call for targeted interventions. Methods Data were drawn from the 2006 National Survey on Drug Use and Health. Past-year adult drug users were grouped into three mutually exclusive categories: 1) recent MDMA users, who had used the drug within the past year; 2) former MDMA users, who had a history of using this drug but had not done so within the past year; and 3) other drug users, who had never used MDMA. Logistic regression procedures were used to estimate the association between respondents’ SUDs and MDMA use while adjusting for their socioeconomic status, mental health, age of first use, and history of polydrug use. Results Approximately 14% of adults reported drug use in the past year, and 24% of those past-year drug users reported a history of MDMA use. Recent MDMA users exhibited the highest prevalence of disorders related to alcohol (41%), marijuana (30%), cocaine (10%), pain reliever/opioid (8%), and tranquilizer (3%) use. Adjusted logistic regression analyses revealed that, relative to other drug users, those who had recently used MDMA were twice as likely to meet criteria for marijuana and pain reliever/opioid use disorders. They were also about twice as likely as former MDMA users to meet criteria for marijuana, cocaine, and tranquilizer use disorders. Conclusions Seven out of ten recent MDMA users report experiencing an SUD in the past year. Adults who have recently used MDMA should be screened for possible SUDs to ensure early detection and treatment. PMID:19361931
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Kang, Yahui; Cappella, Joseph N.; Fishbein, Martin
This study explored the possible negative impact of a specific ad feature—marijuana scenes—on adolescents’ perception of ad effectiveness. A secondary data analysis was conducted on adolescents’ evaluations of 60 anti-marijuana public service announcements (PSAs) that were a part of national and state anti-drug campaigns directed at adolescents. The major finding of the study was that marijuana scenes in anti-marijuana PSAs negatively affected ad liking and thought valence toward the ads amon...
Valerie L Forman-Hoffman; Cristie Glasheen; Kathryn R Batts
Marijuana initiation during adolescence, and early adolescence in particular, is associated with adverse health consequences. Our study used 2005?2014 data from the annual, cross-sectional National Survey on Drug Use and Health to study the prevalence and correlates of marijuana initiation, use, and marijuana use disorder (MUD; abuse or dependence) among 12- to 14-year olds living in civilian US households (n = 84 954). Examined correlates included age, sex, race/ethnicity, poverty status, me...
Rogowska-Szadkowska, Dorota; Strumiło, Julia; Chlabicz, Sławomir
In some countries of the world it is legal to use plant-based marijuana for therapeutic purposes. When we had learned that 7,000 petitioners (including doctors) signed the petition to enable access to marijuana for patients in the Czech Republic, we decided to examine the knowledge about marijuana's medical properties among Polish medical students. Anonymous questionnaire study was conducted on a group of 181 of students of the last (sixth) year of medical school. It was demonstrated that students are not provided with sufficient information about therapeutic administration of plant-based marijuana during medical studies. The majority of interviewees mentioned only one indication for medical marijuana use. All students did not interchange medical conditions for which marijuana is used in 30 USA states or Canada. Marijuana smoking for medical purposes differs from recreational smoking, and its effect does not depend on occurrence of symptoms from the central nervous system. Few studies, that were carried out along with numerous previously unreported cases of patients, demonstrated that plant-derived marijuana had therapeutic effect on many diseases where conventional medicine was of no help. All doctors, including medical students, should receive more information about the therapeutic properties of marijuana. Copyright© by the National Institute of Public Health, Prague 2018.
Kondrad, Elin; Reid, Alfred
Over the last decade, the use of medical marijuana has expanded dramatically; it is now permitted in 16 states and the District of Columbia. Our study of family physicians in Colorado is the first to gather information about physician attitudes toward this evolving practice. We distributed an anonymous web-based electronic survey to the 1727 members of the Colorado Academy of Family Physicians' listserv. Items included individual and practice characteristics as well as experience with and attitudes toward medical marijuana. Five hundred twenty family physicians responded (30% response rate). Of these, 46% did not support physicians recommending medical marijuana; only 19% thought that physicians should recommend it. A minority thought that marijuana conferred significant benefits to physical (27%) and mental (15%) health. Most agreed that marijuana poses serious mental (64%) and physical (61%) health risks. Eighty-one percent agreed that physicians should have formal training before recommending medical marijuana, and 92% agreed that continuing medical education about medical marijuana should be available to family physicians. Despite a high prevalence of use in Colorado, most family physicians are not convinced of marijuana's health benefits and believe its use carries risks. Nearly all agreed on the need for further medical education about medical marijuana.
Full Text Available Recreational substance use and misuse constitute a major public health issue. The annual rate of recreational drug overdose-related deaths is increasing exponentially, making unintentional overdose as the leading cause of injury-related deaths in the United States. Marijuana is the most widely used recreational illicit drug, with approximately 200 million users worldwide. Although it is generally regarded as having low acute toxicity, heavy marijuana usage has been associated with life-threatening consequences. Marijuana is increasingly becoming legal in the United States for both medical and recreational use. Although the most commonly seen adverse effects resulting from its consumption are typically associated with neurobehavioral and gastrointestinal symptoms, cases of severe toxicity involving the cardiovascular system have been reported. In this report, the authors describe a case of cannabis-associated ST-segment elevation myocardial infarction leading to a prolonged cardiac arrest.
Hoyt, Les Leanne
Presents an historical perspective of the public view of marijuana and examines current empirical research concerning the consequences of marijuana use on the human fetus. Included are 1979 university survey results which explore respondents' knowledge about the effects of marijuana and the relationship this has to the mass media. (Author)
Pardini, Dustin; Bechtold, Jordan; Loeber, Rolf; White, Helene
Objectives Examine whether young men who chronically use marijuana are at risk for engaging in drug-related and non-drug-related criminal offending and exhibiting psychopathic personality features in their mid-30s. Methods Patterns of marijuana use were delineated in a sample of predominately Black and White young men from adolescence to the mid-20s using latent class growth curve analysis. Self-report and official records of criminal offending and psychopathic personality features were assessed in the mid-30s. Analyses controlled for multiple factors indicative of a preexisting antisocial lifestyle and co-occurring use of other substances and tested for moderation by race. Results Four latent marijuana trajectory groups were identified: chronic high, adolescence-limited, late increasing, and low/nonusers. Relative to low/nonusers, chronic high and late increasing marijuana users exhibited more adult psychopathic features and were more likely to engage in drug-related offending during their mid-30s. Adolescence-limited users were similar to low/nonusers in terms of psychopathic features but were more likely to be arrested for drug-related crimes. No trajectory group differences were found for violence or theft, and the group differences were not moderated by race. Conclusions Young men who engage in chronic marijuana use from adolescence into their 20s are at increased risk for exhibiting psychopathic features, dealing drugs, and enduring drug-related legal problems in their mid-30s relative to men who remain abstinent or use infrequently. PMID:26568641
Mule, S.J.; Lomax, P.; Gross, S.J.
Human urine samples obtained before and after active and passive exposure to marijuana were analyzed by immune kits (Roche, Amersham, and Syva) and gas chromatography/mass spectrometry (GC/MS). Seven of eight subjects were positive for the entire five-day test period with one immune kit. The latter correlated with GC/MS in 98% of the samples. Passive inhalation experiments under conditions likely to reflect realistic exposure resulted consistently in less than 10 ng/mL of cannabinoids. The 10-100-ng/mL cannabinoid concentration range essential for detection of occasional and moderate marijuana users is thus unaffected by realistic passive inhalation
Mule, S.J.; Lomax, P.; Gross, S.J.
Human urine samples obtained before and after active and passive exposure to marijuana were analyzed by immune kits (Roche, Amersham, and Syva) and gas chromatography/mass spectrometry (GC/MS). Seven of eight subjects were positive for the entire five-day test period with one immune kit. The latter correlated with GC/MS in 98% of the samples. Passive inhalation experiments under conditions likely to reflect realistic exposure resulted consistently in less than 10 ng/mL of cannabinoids. The 10-100-ng/mL cannabinoid concentration range essential for detection of occasional and moderate marijuana users is thus unaffected by realistic passive inhalation.
Greydanus, Donald E.; Hawver, Elizabeth K.; Greydanus, Megan M.; Merrick, Joav
Marijuana (cannabis) remains a controversial drug in the twenty-first century. This paper considers current research on use of Cannabis sativa and its constituents such as the cannabinoids. Topics reviewed include prevalence of cannabis (pot) use, other drugs consumed with pot, the endocannabinoid system, use of medicinal marijuana, medical adverse effects of cannabis, and psychiatric adverse effects of cannabis use. Treatment of cannabis withdrawal and dependence is difficult and remains mai...
This study examined whether exposure to marijuana advertisements was associated with current marijuana use and frequency of use among US adolescents in grades 8, 10, and 12. Weighted estimates of exposure to marijuana advertisements and marijuana use from the 2014 and 2015 Monitoring the Future studies were investigated. Factors associated with the prevalence and frequency of marijuana use were analyzed by using logistic regression and linear regression models, respectively. Of all respondents (n = 12,988), 13.8% reported marijuana use in the past 30 days. Exposure to marijuana advertisements was prevalent among adolescents, with 52.8% reporting exposure from internet advertisements, 32.1% from television advertisements, 24.1% from magazine or newspaper advertisements, 19.7% from radio advertisements, 19.0% from advertisements on storefronts, and 16.6% from billboards. In the multivariable analysis, current use of marijuana among adolescents was associated with exposure to marijuana advertisements on storefronts (adjusted odds ratio [OR] = 1.4, P < .001), magazines or newspapers (adjusted OR = 1.6, P < .001), billboards (adjusted OR = 1.4, P = .002), internet (adjusted OR = 1.8, P < .001), television (adjusted OR = 1.4, P < .001) and radio (adjusted OR = 1.7, P < .001). Exposure to marijuana advertisements from the internet was associated with increased use of marijuana (β = 0.3, P = .04). Exposure to marijuana advertisements was associated with higher odds of current marijuana use among adolescents. Regulations that limit marijuana advertisements to adolescents and educational campaigns on harmfulness of illicit marijuana use are needed.
... Alcohol Club Drugs Cocaine Fentanyl Hallucinogens Inhalants Heroin Marijuana MDMA (Ecstasy/Molly) Methamphetamine Opioids Over-the-Counter Medicines Prescription Medicines Steroids (Anabolic) Synthetic Cannabinoids (K2/Spice) Synthetic Cathinones (Bath Salts) Tobacco/ ...
Cavazos-Rehg, Patricia A.; Krauss, Melissa J.; Sowles, Shaina J.; Bierut, Laura J.
Instagram is a highly visual social networking site whose audience continues to grow, especially among young adults. In the present study, we examine marijuana-related content on Instagram to better understand the varied types of marijuana-related social networking occurring on this popular social media platform. We collected 417,561 Instagram posts with marijuana-related hashtags from November 29 to December 12, 2014. We assessed content of a random sample (n = 5000) of these posts with mari...
Subbaraman, Meenakshi Sabina; Kerr, William C.
Background Support for the legalization of recreational marijuana continues to increase across the United States and globally. In 2016, recreational marijuana was legalized in the most populous US state of California, as well as three other states. The primary aim of this study was to examine trends in support for recreational marijuana legalization in Washington, a state which has had legal recreational marijuana for almost four years, using data collected over the four years post-legalization. A secondary aim was to examine trends in support for the cultivation of marijuana for personal use. Methods Data come from geographically representative general population samples of adult (aged 18 and over) Washington residents collected over five timepoints (every six months) between January 2014 and April 2016 (N = 4,101). Random Digit Dial was used for recruitment. Statistical analyses involved bivariate comparisons of proportions across timepoints and subgroups (defined by age, gender, and marijuana user status), and multivariable logistic regression controlling for timepoint (time) to formally test for trend while controlling for demographic and substance use covariates. All analyses adjusted for probability of selection. Results Support for legalization in Washington has significantly increased: support was 64.0% (95% CI: 61.2%–67.8%) at timepoint 1 and 77.9% (95% CI: 73.2%–81.9%) at timepoint 5. With each six months’ passing, support increased 19% on average. We found no statistically significant change in support for home-growing. Conclusions Support for marijuana legalization has continued to significantly increase in a state that has experienced the policy change for almost four years. PMID:28448904
Subbaraman, Meenakshi Sabina; Kerr, William C
Support for the legalization of recreational marijuana continues to increase across the United States and globally. In 2016, recreational marijuana was legalized in the most populous US state of California, as well as three other states. The primary aim of this study was to examine trends in support for recreational marijuana legalization in Washington, a state which has had legal recreational marijuana for almost four years, using data collected over the four years post-legalization. A secondary aim was to examine trends in support for the cultivation of marijuana for personal use. Data come from geographically representative general population samples of adult (aged 18 and over) Washington residents collected over five timepoints (every six months) between January 2014 and April 2016 (N=4101). Random Digit Dial was used for recruitment. Statistical analyses involved bivariate comparisons of proportions across timepoints and subgroups (defined by age, gender, and marijuana user status), and multivariable logistic regression controlling for timepoint (time) to formally test for trend while controlling for demographic and substance use covariates. All analyses adjusted for probability of selection. Support for legalization in Washington has significantly increased: support was 64.0% (95% CI: 61.2%-67.8%) at timepoint 1 and 77.9% (95% CI: 73.2%-81.9%) at timepoint 5. With each six months' passing, support increased 19% on average. We found no statistically significant change in support for home-growing. Support for marijuana legalization has continued to significantly increase in a state that has experienced the policy change for almost four years. Copyright © 2017. Published by Elsevier B.V.
Full Text Available Marijuana (cannabis remains a controversial drug in the 21st century. This paper considers current research on use of Cannabis sativa and its constituents such as the cannabinoids. Topics reviewed include prevalence of cannabis use, other drugs consumed with pot, the endocannabinoid system, use of medicinal marijuana, medical adverse effects of cannabis, and psychiatric adverse effects of cannabis use. Treatment of cannabis withdrawal and dependence is difficult and remains mainly based on psychological therapy; current research on pharmacologic management of problems related to cannabis consumption is also considered. The potential role of specific cannabinoids for medical benefit will be revealed as the 21st century matures. However, potential dangerous adverse effects from smoking marijuana are well known and should be clearly taught to a public often confused by a media-driven, though false message and promise of benign pot consumption.
Schuermeyer, Joseph; Salomonsen-Sautel, Stacy; Price, Rumi Kato; Balan, Sundari; Thurstone, Christian; Min, Sung-Joon; Sakai, Joseph T
In 2009, policy changes were accompanied by a rapid increase in the number of medical marijuana cardholders in Colorado. Little published epidemiological work has tracked changes in the state around this time. Using the National Survey on Drug Use and Health, we tested for temporal changes in marijuana attitudes and marijuana-use-related outcomes in Colorado (2003-11) and differences within-year between Colorado and thirty-four non-medical-marijuana states (NMMS). Using regression analyses, we further tested whether patterns seen in Colorado prior to (2006-8) and during (2009-11) marijuana commercialization differed from patterns in NMMS while controlling for demographics. Within Colorado those reporting "great-risk" to using marijuana 1-2 times/week dropped significantly in all age groups studied between 2007-8 and 2010-11 (e.g. from 45% to 31% among those 26 years and older; p=0.0006). By 2010-11 past-year marijuana abuse/dependence had become more prevalent in Colorado for 12-17 year olds (5% in Colorado, 3% in NMMS; p=0.03) and 18-25 year olds (9% vs. 5%; p=0.02). Regressions demonstrated significantly greater reductions in perceived risk (12-17 year olds, p=0.005; those 26 years and older, p=0.01), and trend for difference in changes in availability among those 26 years and older and marijuana abuse/dependence among 12-17 year olds in Colorado compared to NMMS in more recent years (2009-11 vs. 2006-8). Our results show that commercialization of marijuana in Colorado has been associated with lower risk perception. Evidence is suggestive for marijuana abuse/dependence. Analyses including subsequent years 2012+ once available, will help determine whether such changes represent momentary vs. sustained effects. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
... Mary Jane, Blunt, Joint, Trees Get the Facts… Marijuana affects your brain. THC (the active ingredient in marijuana) affects the nerve cells in the part of the brain where memories are formed. Marijuana affects your self- ...
Unique clinical challenges arise with the growing number of patients who possess medical marijuana cards. Medical marijuana patients with mental disorders can have worsening symptoms with marijuana use. Often there is sparse continuity of care between the patient and the medical marijuana practitioner. Lack of communication between the patient's treating practitioners and the practitioner who has authorized the medical marijuana can be problematic. This article is a discussion of the new clinical challenges practitioners are likely to encounter with the growing number of medical marijuana patients. [Full article available at http://rimed.org/rimedicaljournal-2018-02.asp].
Kerr, David C R; Bae, Harold; Phibbs, Sandi; Kern, Adam C
Recreational marijuana legalization (RML) went into effect in Oregon in July 2015. RML is expected to influence marijuana use by adolescents and young adults in particular, and by those with a propensity for substance use. We sought to quantify changes in rates of marijuana use among college students in Oregon from pre- to post-RML relative to college students in other states across the same time period. Repeated cross-sectional survey data from the 2012-16 administrations of the Healthy Minds Study. Seven 4-year universities in the United States. There were 10 924 undergraduate participants. One large public Oregon university participated in 2014 and 2016 (n = 588 and 1115, respectively); six universities in US states where recreational marijuana use was illegal participated both in 2016 and at least once between 2012 and 2015. Self-reported marijuana use in the past 30 days (yes/no) was regressed on time (pre/post 2015), exposure to RML (i.e. Oregon students in 2016) and covariates using mixed-effects logistic regression. Moderation of RML effects by recent heavy alcohol use was examined. Rates of marijuana use increased from pre- to post-2015 at six of the seven universities, a trend that was significant overall. Increases in rates of marijuana use were significantly greater in Oregon than in comparison institutions, but only among students reporting recent heavy alcohol use. Rates of Oregon college students' marijuana use increased (relative to that of students in other states) following recreational marijuana legislation in 2015, but only for those who reported recent heavy use of alcohol. Such alcohol misuse may be a proxy for vulnerabilities to substance use or lack of prohibitions (e.g. cultural) against it. © 2017 Society for the Study of Addiction.
Rawal, Swati Y; Tatakis, Dimitris N; Tipton, David A
Marijuana, prepared from the plant Cannabis sativa, is the most widely used illicit drug in the United States. Marijuana use has been associated with adverse psychosocial and health effects, including effects on oral tissues. Periodontal literature has limited references to the periodontal effects of cannabis use. In this report, we present two cases of marijuana-associated gingival enlargement and review the literature on oral complications of marijuana use. Two asymptomatic males, aged 23 and 42 years, presented independently for oral prophylaxis. Both had an unremarkable medical history and related a history of significant marijuana use of 2-16 years duration. Common findings following oral and periodontal examination were nicotinic stomatitis-like lesions, uvulitis and gingival enlargement. Marginal and papillary gingiva of the anterior dentition were the areas primarily affected by gingival enlargement, while some of these areas exhibited a nodular or "pebbly" appearance. Marijuana-associated gingival enlargement was diagnosed in the reported cases. A review of the literature revealed two other reports of marijuana-associated gingival enlargement, all in young adult males with chronic (2 or more years) cannabis use. These authors reported a resemblance to phenytoin-induced enlargement. Biochemical similarities between phenytoin and cannabis active compounds suggest possible common pathogenetic mechanisms. Uvulitis and nicotinic stomatitis appear to be the two most common of the several oral manifestations of marijuana use. Chronic marijuana use may result in gingival enlargement with clinical characteristics similar to phenytoin-induced enlargement.
Clark, Peter A; Capuzzi, Kevin; Fick, Cameron
Marijuana is classified by the Drug Enforcement Agency (DEA) as an illegal Schedule I drug which has no accepted medical use. However, recent studies have shown that medical marijuana is effective in controlling chronic non-cancer pain, alleviating nausea and vomiting associated with chemotherapy, treating wasting syndrome associated with AIDS, and controlling muscle spasms due to multiple sclerosis. These studies state that the alleviating benefits of marijuana outweigh the negative effects of the drug, and recommend that marijuana be administered to patients who have failed to respond to other therapies. Despite supporting evidence, the DEA refuses to reclassify marijuana as a Schedule II drug, which would allow physicians to prescribe marijuana to suffering patients. The use of medical marijuana has continued to gain support among states, and is currently legal in 16 states and the District of Columbia. This is in stark contrast to the federal government's stance of zero-tolerance, which has led to a heated legal debate in the United States. After reviewing relevant scientific data and grounding the issue in ethical principles like beneficence and nonmaleficence, there is a strong argument for allowing physicians to prescribe marijuana. Patients have a right to all beneficial treatments and to deny them this right violates their basic human rights.
Clark, Peter A.; Capuzzi, Kevin; Fick, Cameron
Summary Marijuana is classified by the Drug Enforcement Agency (DEA) as an illegal Schedule I drug which has no accepted medical use. However, recent studies have shown that medical marijuana is effective in controlling chronic non-cancer pain, alleviating nausea and vomiting associated with chemotherapy, treating wasting syndrome associated with AIDS, and controlling muscle spasms due to multiple sclerosis. These studies state that the alleviating benefits of marijuana outweigh the negative effects of the drug, and recommend that marijuana be administered to patients who have failed to respond to other therapies. Despite supporting evidence, the DEA refuses to reclassify marijuana as a Schedule II drug, which would allow physicians to prescribe marijuana to suffering patients. The use of medical marijuana has continued to gain support among states, and is currently legal in 16 states and the District of Columbia. This is in stark contrast to the federal government’s stance of zero-tolerance, which has led to a heated legal debate in the United States. After reviewing relevant scientific data and grounding the issue in ethical principles like beneficence and nonmaleficence, there is a strong argument for allowing physicians to prescribe marijuana. Patients have a right to all beneficial treatments and to deny them this right violates their basic human rights. PMID:22129912
Thompson, Christin Ann; Hay, Joel W
More research is needed on the health effects of marijuana use. Results of previous studies indicate that marijuana could alleviate certain factors of metabolic syndrome, such as obesity. Data on 6281 persons from National Health and Nutrition Examination Survey from 2005 to 2012 were used to estimate the effect of marijuana use on cardiometabolic risk factors. The reliability of ordinary least squares (OLS) regression models was tested by replacing marijuana use as the risk factor of interest with alcohol and carbohydrate consumption. Instrumental variable methods were used to account for the potential endogeneity of marijuana use. OLS models show lower fasting insulin, insulin resistance, body mass index, and waist circumference in users compared with nonusers. However, when alcohol and carbohydrate intake substitute for marijuana use in OLS models, similar metabolic benefits are estimated. The Durbin-Wu-Hausman tests provide evidence of endogeneity of marijuana use in OLS models, but instrumental variables models do not yield significant estimates for marijuana use. These findings challenge the robustness of OLS estimates of a positive relationship between marijuana use and fasting insulin, insulin resistance, body mass index, and waist circumference. Copyright © 2015 Elsevier Inc. All rights reserved.
Tradução, adaptação e validação da versão brasileira da escala Marijuana Expectancy Questionnaire Translation, adaptation, and validation of the Brazilian version of the Marijuana Expectancy Questionnaire
Rosemeri Siqueira Pedroso
Full Text Available Este estudo apresenta a tradução e a validação do Marijuana Expectancy Questionnaire (MEQ adaptação brasileira, a qual avalia as expectativas de resultados em relação ao uso de maconha, podendo ser importante no tratamento e prognóstico dos dependentes químicos dessa substância. A amostra foi de 400 sujeitos, homens (n = 217 e mulheres (n = 183, usuários de maconha (n = 147 e não-usuários (n = 253. Dentre os usuários, 90 eram dependentes de maconha. A validação semântica utilizou um Comitê de Juízes Especialistas. Na amostra brasileira, aplicaram-se os 78 itens, porém a análise estatística foi a partir da escala reduzida com 55 itens, pois as propriedades psicométricas foram similares. Obteve-se alfa = 0, 89 para as duas escalas. A validade discriminante para a escala reduzida foi, estatisticamente, significativa (p = 0,001. A estabilidade temporal foi examinada numa amostra de 123 sujeitos, com o intervalo de uma semana entre o teste e o reteste, indicando um padrão consistente de resposta ao longo do tempo (r = 0,990. O MEQ - adaptação brasileira apresentou bons resultados psicométricos, podendo avaliar as expectativas de resultados relacionadas ao uso de maconha.This study presents the translation and validation of the Marijuana Expectancy Questionnaire (MEQ - Brazilian Adaptation, which evaluates the expectancy of results in marijuana use, important for treatment and prognosis related to addiction to this substance. The sample consisted of 400 subjects, 217 males and 183 females, of whom 147 were marijuana users and 253 were non-users. In the user group, 90 subjects were marijuana-dependent. Semantic validation of the MEQ-Brazilian Adaptation was confirmed after evaluation and suggestions by an expert review panel. In the Brazilian sample, 78 items were applied; however, the decision was made for a statistical analysis using the reduced scale (55 items, with similar psychometric properties. For both scales, an
Sarvet, Aaron L; Wall, Melanie M; Keyes, Katherine M; Olfson, Mark; Cerdá, Magdalena; Hasin, Deborah S
Self-medication with drugs or alcohol is commonly reported among adults with mood or anxiety disorders, and increases the risk of developing substance use disorders. Medical marijuana laws (MML) may be associated with greater acceptance of the therapeutic value of marijuana, leading individuals to self-medicate. The study utilized data from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (2004-2005). Participants were sampled from households in the general population and included adults with a mood or anxiety disorder in the past 12 months (n = 7418), and the subset of those who used marijuana and no other drug (n = 314). Weighted logistic regression models predicted the prevalence of self-medication with drugs in U.S. states with and without MML, adjusting for individual and state-level covariates. As a negative control, analyses were repeated for self-medication with alcohol. Overall, self-medication with drugs was 3.73 percentage points higher (95% confidence interval [CI]: 0.93-6.53) among those living in MML states (p = 0.01). For the subpopulation that only used marijuana, self-medication with drugs was 21.22 percentage points higher (95% CI: 3.91-38.53) among those living in MML states (p = 0.02). In contrast, self-medication with alcohol had nearly identical prevalence in MML and non-MML states, overall and for drinkers. Among adults with mood or anxiety disorders, living in a medical marijuana law state is associated with self-medication with marijuana. While additional research is needed to determine the reasons for this association, clinical screening for self-medication with marijuana may be particularly important in states with medical marijuana laws. Copyright © 2018 Elsevier B.V. All rights reserved.
Tashkin, D P
In many societies, marijuana is the second most commonly smoked substance after tobacco. While delta9-tetrahydrocannabinol (THC) is unique to marijuana and nicotine to tobacco, the smoke of marijuana, like that of tobacco, consists of a toxic mixture of gases and particulates, many of which are known to be harmful to the lung. Although far fewer marijuana than tobacco cigarettes are generally smoked on a daily basis, the pulmonary consequences of marijuana smoking may be magnified by the greater deposition of smoke particulates in the lung due to the differing manner in which marijuana is smoked. Whereas THC causes modest short-term bronchodilation, regular marijuana smoking produces a number of long-term pulmonary consequences, including chronic cough and sputum, histopathologic evidence of widespread airway inflammation and injury and immunohistochemical evidence of dysregulated growth of respiratory epithelial cells, that may be precursors to lung cancer. The THC in marijuana could contribute to some of these injurious changes through its ability to augment oxidative stress, cause mitochondrial dysfunction, and inhibit apoptosis. On the other hand, physiologic, clinical or epidemiologic evidence that marijuana smoking may lead to chronic obstructive pulmonary disease or respiratory cancer is limited and inconsistent. Habitual use of marijuana is also associated with abnormalities in the structure and function of alveolar macrophages, including impairment in microbial phagocytosis and killing that is associated with defective production of immunostimulatory cytokines and nitric oxide, thereby potentially predisposing to pulmonary infection. In view of the growing interest in medicinal marijuana, further epidemiologic studies are needed to clarify the true risks of regular marijuana smoking on respiratory health.
Greydanus, Donald E.; Hawver, Elizabeth K.; Greydanus, Megan M.; Merrick, Joav
Marijuana (cannabis) remains a controversial drug in the twenty-first century. This paper considers current research on use of Cannabis sativa and its constituents such as the cannabinoids. Topics reviewed include prevalence of cannabis (pot) use, other drugs consumed with pot, the endocannabinoid system, use of medicinal marijuana, medical adverse effects of cannabis, and psychiatric adverse effects of cannabis use. Treatment of cannabis withdrawal and dependence is difficult and remains mainly based on psychological therapy; current research on pharmacologic management of problems related to cannabis consumption is also considered. The potential role of specific cannabinoids for medical benefit will be revealed as the twenty-first century matures. However, potential dangerous adverse effects from smoking marijuana are well known and should be clearly taught to a public that is often confused by a media-driven, though false message and promise of benign pot consumption. PMID:24350211
Albertson, Timothy E; Chenoweth, James A; Colby, Daniel K; Sutter, Mark E
The major psychoactive compounds in marijuana (cannabis) are cannabinoids, the most significant of which is delta-9-tetrahydrocannabinol. There are also two synthetic pharmaceutical cannabinoids, nabilone and dronabinol, available by prescription in the United States. The use of marijuana has increased in the United States with passage of medical marijuana laws in many states and legalization of recreational marijuana use in several states. In addition, the potency of marijuana has increased in recent years. Marijuana has been used for a variety of medical purposes, including management of nausea and vomiting, appetite and immunologic stimulation in patients with HIV infection and AIDS, glaucoma, neurologic disorders, and pain relief. Studies on the benefits of marijuana as a treatment for various conditions have been inconsistent, except for those on pain management. Marijuana has adverse effects, and has been associated with driving impairment, psychosis, dependence and withdrawal syndromes, hyperemesis, acute cardiac events, some cancers, and impaired lung function. As with studies on the benefits of marijuana, studies of adverse effects have yielded inconsistent results. Except for impaired driving and the occurrence of dependence and withdrawal syndromes, the adverse effects of marijuana use have not been fully studied. Written permission from the American Academy of Family Physicians is required for reproduction of this material in whole or in part in any form or medium.
Khelemsky, Yury; Goldberg, Andrew T; Hurd, Yasmin L; Winkel, Gary; Ninh, Allen; Qian, Lucia; Oprescu, Anna; Ciccone, Jeffrey; Katz, Daniel J
Cannabinoids have an expanding presence in medicine. Perioperative patients' perceptions of the effectiveness of these compounds, and acceptance if prescribed for pain, have not been previously described. Our primary objective was to describe patients' beliefs regarding the potential effectiveness of cannabinoids for the treatment of acute and chronic pain, as well as gauge patient acceptance of these compounds if prescribed by a physician. In addition, demographic and pain history data were collected to elucidate the predictors of the aforementioned patient attitudes. Secondarily, we sought to characterize the subgroup of patients who reported marijuana use. Predictors of marijuana use, effectiveness, and adverse effects were also reported for this subgroup. An anonymous questionnaire was administered to 501 patients in the preoperative registration area at Mount Sinai Hospital, New York, New York. The questionnaire was designed to collect data on patient demographics, presence of pain, pain severity, use of pain medication, history of illicit-drug use, tobacco use, cannabis use, patient beliefs about the potential effectiveness of marijuana for acute and chronic pain and their willingness to use cannabis for pain, if prescribed by a physician. Normality of distributions for continuous variables was assessed with skewness and kurtosis measures. A logistic regression model was used to assess the demographic and medical characteristics of marijuana users compared with nonusers. The effectiveness of marijuana in dealing with pain and adverse effects associated with its use were examined using exploratory principal component analysis. More than 80% of this cohort of preoperative patients believed that marijuana could be at least somewhat effective for the treatment of pain after surgery and would be willing to use cannabinoid compounds if prescribed by their physician. Predictors of positive attitudes toward marijuana included history of marijuana use, pain history
Elkashef, Ahmed; Vocci, Frank; Huestis, Marilyn; Haney, Margaret; Budney, Alan; Gruber, Amanda; el-Guebaly, Nady
Marijuana is the number one illicit drug of abuse worldwide and a major public health problem, especially in the younger population. The objective of this article is to update and review the state of the science and treatments available for marijuana dependence based on a pre-meeting workshop that was presented at ISAM 2006. At the workshop,…
Studies show significant negative effects of smoking marijuana on physical and mental health as well as social and occupational functioning. At the same time, there are more considerations about its ability to treat a number of diseases. This review summarizes current data in scientific literature that examines the medical effects of marijuana on human health with particular emphasis on its potential in medicine. Marijuana has a range of adverse health effects, particularly relating to young people because of higher risk for psychosis, traffic accidents, and cognitive impairment. Marijuana may be helpful in relieving symptoms of nausea and vomiting, increasing appetite and pain relief for persons with cancer, AIDS and multiple sclerosis. Smoking marijuana can impose significant public health risks. If there is a medical role for using marijuana, it lies in the application of clearly defined medical protocols and chemically defined compounds, not with using the unprocessed cannabis plant.
Dakkak, H; Brown, R; Twynstra, J; Charbonneau, K; Seabrook, J A
The prevalence of marijuana use during pregnancy ranges from 3- 30% , and most of this is for recreational purposes. Marijuana exposure during pregnancy has been linked with low birth weight babies and other adverse child health outcomes. Twitter is a popular news and social networking outlet, and is frequently used to access information about population health and behavior. The primary objective of this study was to investigate the types of messages disseminated on Twitter about marijuana use and infant and maternal health. The secondary objective was to describe the reported health outcomes associated with prenatal and postnatal marijuana use. Tweets were collected from the inception of Twitter (2006) until April 2017. If tweets included links, these links were examined to investigate the source of the message and to clarify the user's intent. In total, 550 tweets were captured, with most tweets (77.6%) having a neutral tweet tone, suggesting uncertainty about the health effects associated with pre- and post-natal marijuana exposure. The sources attached to the original tweets, however, were more likely to report on negative health outcomes. The most common health outcomes associated with prenatal marijuana exposure were: poor brain development (27.3%), inadequate development of the nervous system (23.6%), low birth weight (23.3%), poor behavioral outcomes (21.0%), and infant memory issues (19.3%). The inverse association between marijuana use and the quality and quantity of milk produced by the mother was the most commonly reported tweet for the lactation period.
Pacula, Rosalie Liccardo; Heaton, Paul
Background Marijuana potency has risen dramatically over the past two decades. In the United States, it is unclear whether state medical marijuana policies have contributed to this increase. Methods Employing a differences-in-differences model within a mediation framework, we analyzed data on n = 39,157 marijuana samples seized by law enforcement in 51 U.S. jurisdictions between 1990-2010, producing estimates of the direct and indirect effects of state medical marijuana laws on potency, as measured by Δ9-tetrahydrocannabinol content. Results We found evidence that potency increased by a half percentage point on average after legalization of medical marijuana, although this result was not significant. When we examined specific medical marijuana supply provisions, results suggest that legal allowances for retail dispensaries had the strongest influence, significantly increasing potency by about one percentage point on average. Our mediation analyses examining the mechanisms through which medical marijuana laws influence potency found no evidence of direct regulatory impact. Rather, the results suggest that the impact of these laws occurs predominantly through a compositional shift in the share of the market captured by high-potency sinsemilla. Conclusion Our findings have important implications for policymakers and those in the scientific community trying to understand the extent to which greater availability of higher potency marijuana increases the risk of negative public health outcomes, such as drugged driving and drug-induced psychoses. Future work should reconsider the impact of medical marijuana laws on health outcomes in light of dramatic and ongoing shifts in both marijuana potency and the medical marijuana policy environment. PMID:24502887
Gerich, Mark E; Isfort, Robert W; Brimhall, Bryan; Siegel, Corey A
The use of recreational and medical marijuana is increasingly accepted by the general public in the United States. Along with growing interest in marijuana use has come an understanding of marijuana's effects on normal physiology and disease, primarily through elucidation of the human endocannabinoid system. Scientific inquiry into this system has indicated potential roles for marijuana in the modulation of gastrointestinal symptoms and disease. Some patients with gastrointestinal disorders already turn to marijuana for symptomatic relief, often without a clear understanding of the risks and benefits of marijuana for their condition. Unfortunately, that lack of understanding is shared by health-care providers. Marijuana's federal legal status as a Schedule I controlled substance has limited clinical investigation of its effects. There are also potential legal ramifications for physicians who provide recommendations for marijuana for their patients. Despite these constraints, as an increasing number of patients consider marijuana as a potential therapy for their digestive disorders, health-care providers will be asked to discuss the issues surrounding medical marijuana with their patients.
Palamar, Joseph J; Griffin-Tomas, Marybec; Kamboukos, Dimitra
Studies show that illicit cannabis (marijuana) use is related to use of other illicit drugs and that reasons for use are related to frequency of marijuana use. However, research is needed to examine whether specific reasons for marijuana use are associated with use of other illicit drugs. Data from recent marijuana-using high school seniors were examined from 12 cohorts of Monitoring the Future (Weighted n = 6481) to examine whether reasons for recent marijuana use are associated with use of eight other illicit drugs. Using "to experiment" decreased odds of reporting use of each drug and using to decrease effects of other drugs increased odds of reporting use of each drug. In multivariable models, using marijuana "to experiment" decreased the odds for reporting use of hallucinogens other than LSD and narcotics other than heroin. Using marijuana for "insight" increased the odds for use of hallucinogens other than LSD, and use due to "boredom" increased the odds for reporting use of powder cocaine and hallucinogens other than LSD. Using marijuana to increase effects of other drugs increased odds of reporting use of each of the eight drugs, and using it to decrease other drug effects increased odds of reporting use of crack, hallucinogens other than LSD, and amphetamine/stimulants. This study helped identify illicit marijuana users who are more likely to report use of other illicit drugs. Prevention efforts need to focus on students who report certain reasons for marijuana use as they may be at risk for use of other illicit drugs.
... progression of MS: Effect of oral dronabinol (a synthetic Cannabis/marijuana derivative) on progression in progressive MS: Previous ... the evidence regarding marijuana and its derivatives: Oral cannabis extract and synthetic THC (tetrahydrocannabinol — a major active component of cannabis) ...
Ketcherside, Ariel; Jeon-Slaughter, Haekyung; Baine, Jessica L.; Filbey, Francesca M
Specific personality traits have been linked with substance use disorders (SUDs), genetic mechanisms, and brain systems. Thus, determining the specificity of personality traits to types of SUD can advance the field towards defining SUD endophenotypes as well as understanding the brain systems involved for the development of novel treatments. Disentangling these factors is particularly important in highly co-morbid SUDs, such as marijuana and nicotine use, so treatment can occur effectively fo...
Goldman, Marina; Szucs-Reed, Regina P; Jagannathan, Kanchana; Ehrman, Ronald N; Wang, Ze; Li, Yin; Suh, Jesse J; Kampman, Kyle; O'Brien, Charles P; Childress, Anna Rose; Franklin, Teresa R
: Determining the brain substrates underlying the motivation to abuse addictive drugs is critical for understanding and treating addictive disorders. Laboratory neuroimaging studies have demonstrated differential activation of limbic and motivational circuitry (eg, amygdala, hippocampus, ventral striatum, insula, and orbitofrontal cortex) triggered by cocaine, heroin, nicotine, and alcohol cues. The literature on neural responses to marijuana cues is sparse. Thus, the goals of this study were to characterize the brain's response to marijuana cues, a major motivator underlying drug use and relapse, and determine whether these responses are linked to self-reported craving in a clinically relevant population of treatment-seeking marijuana-dependent subjects. : Marijuana craving was assessed in 12 marijuana-dependent subjects using the Marijuana Craving Questionnaire-Short Form. Subsequently, blood oxygen level dependent functional magnetic resonance imaging data were acquired during exposure to alternating 20-second blocks of marijuana-related versus matched nondrug visual cues. : Brain activation during marijuana cue exposure was significantly greater in the bilateral amygdala and the hippocampus. Significant positive correlations between craving scores and brain activation were found in the ventral striatum and the medial and lateral orbitofrontal cortex (P cues and craving and extends the current literature on marijuana cue reactivity. Furthermore, the correlative relationship between craving and brain activity in reward-related regions was observed in a clinically relevant sample (treatment-seeking marijuana-dependent subjects). Results are consistent with prior findings in cocaine, heroin, nicotine, and alcohol cue studies, indicating that the brain substrates of cue-triggered drug motivation are shared across abused substances.
Brents, Lisa K
Marijuana use among women is highly prevalent, but the societal conversation on marijuana rarely focuses on how marijuana affects female reproduction and endocrinology. This article reviews the current scientific literature regarding marijuana use and hypothalamic-pituitary-ovarian (HPO) axis regulation, ovarian hormone production, the menstrual cycle, and fertility. Evidence suggests that marijuana can reduce female fertility by disrupting hypothalamic release of gonadotropin releasing hormone (GnRH), leading to reduced estrogen and progesterone production and anovulatory menstrual cycles. Tolerance to these effects has been shown in rhesus monkeys, but the effects of chronic marijuana use on human female reproduction are largely unknown. Marijuana-induced analgesia, drug reinforcement properties, tolerance, and dependence are influenced by ovarian hormones, with estrogen generally increasing and progesterone decreasing sensitivity to marijuana. Carefully controlled regulation of the Endocannabinoid System (ECS) is required for successful reproduction, and the exogenous cannabinoids in marijuana may disrupt the delicate balance of the ECS in the female reproductive system.
Moeller, Karen E; Woods, Barbara
To determine pharmacy students' knowledge of and attitudes toward medical marijuana and to determine if pharmacy students need additional education on the topic. Pharmacy students were asked to complete a survey on medical marijuana that assessed their knowledge of, medical uses of, adverse effects with, and attitudes toward medical marijuana through 23 Likert-scale questions. Three hundred eleven students completed the survey. Fifty-eight percent of the students felt that medical marijuana should be legalized in all states. However, the majority of students did not feel comfortable answering consumers' questions regarding efficacy, safety, or drug interactions related to the substance. Accurate responses for diseases or conditions for permitted medical marijuana use was low, with only cancer (91%) and glaucoma (57%) identified by more than half the students. With an increasing number of states adopting medical marijuana use, pharmacy schools need to evaluate the adequacy of medical marijuana education in their curriculum.
Fligiel, S E; Beals, T F; Tashkin, D P; Paule, M G; Scallet, A C; Ali, S F; Bailey, J R; Slikker, W
As part of a large multidisciplinary study, we examined lungs from 24 periadolescent male rhesus monkeys that were sacrificed seven months after daily marijuana smoke inhalation of 12 months duration. Animals were divided into four exposure groups: A) high-dose (one marijuana cigarette 7 days/week), B) low-dose (one marijuana cigarette 2 days/week and sham smoke 5 days/week), C) placebo (one extracted marijuana cigarette 7 days/week), and D) sham (sham smoke 7 days/week). Lungs, removed intact, were formalin inflated, sectioned and examined. Several pathological alterations, including alveolitis, alveolar cell hyperplasia and granulomatous inflammation, were found with higher frequency in all cigarette-smoking groups. Other alterations, such as bronchiolitis, bronchiolar squamous metaplasia and interstitial fibrosis, were found most frequently in the marijuana-smoking groups. Alveolar cell hyperplasia with focal atypia was seen only in the marijuana-smoking animals. These changes represent mostly early alterations of small airways. Additional follow-up studies are needed to determine their long-term prognostic significance.
Wang, George Sam; Le Lait, Marie-Claire; Deakyne, Sara J; Bronstein, Alvin C; Bajaj, Lalit; Roosevelt, Genie
As of 2015, almost half of US states allow medical marijuana, and 4 states allow recreational marijuana. To our knowledge, the effect of recreational marijuana on the pediatric population has not been evaluated. To compare the incidence of pediatric marijuana exposures evaluated at a children's hospital and regional poison center (RPC) in Colorado before and after recreational marijuana legalization and to compare population rate trends of RPC cases for marijuana exposures with the rest of the United States. Retrospective cohort study of hospital admissions and RPC cases between January 1, 2009, and December 31, 2015, at Children's Hospital Colorado, Aurora, a tertiary care children's hospital. Participants included patients 0 to 9 years of age evaluated at the hospital's emergency department, urgent care centers, or inpatient unit and RPC cases from Colorado for single-substance marijuana exposures. Marijuana. Marijuana exposure visits and RPC cases, marijuana source and type, clinical effects, scenarios, disposition, and length of stay. Eighty-one patients were evaluated at the children's hospital, and Colorado's RPC received 163 marijuana exposure cases between January 1, 2009, and December 31, 2015, for children younger than 10 years of age. The median age of children's hospital visits was 2.4 years (IQR, 1.4-3.4); 25 were girls (40%) . The median age of RPC marijuana exposures was 2 years (IQR, 1.3-4.0), and 85 patients were girls (52%). The mean rate of marijuana-related visits to the children's hospital increased from 1.2 per 100 000 population 2 years prior to legalization to 2.3 per 100,000 population 2 years after legalization (P = .02). Known marijuana products involved in the exposure included 30 infused edibles (48%). Median length of stay was 11 hours (interquartile range [IQR], 6-19) and 26 hours (IQR, 19-38) for admitted patients. Annual RPC pediatric marijuana cases increased more than 5-fold from 2009 (9) to 2015 (47). Colorado had an
Seamon, Matthew J; Fass, Jennifer A; Maniscalco-Feichtl, Maria; Abu-Shraie, Nada A
The pharmacology, therapeutic uses, safety, drug-drug interactions, and drug-disease interactions of medical marijuana are reviewed, and the legal issues related to its use and the implications of medical marijuana for the pharmacist are presented. Marijuana contains more than 460 active chemicals and over 60 unique cannabinoids. The legal landscape surrounding marijuana is surprisingly complex and unsettled. In the United States, 11 states and several municipalities have legalized medical marijuana. Another state provides legislation that allows patients to claim a defense of medical necessity. Nevertheless, patients using medical marijuana may never interact with a pharmacist. Marijuana is a Schedule I controlled substance and its use is illegal under federal law. Marijuana has a number of purported therapeutic uses with a broad range of supporting evidence. There are five general indications for medical marijuana: (1) severe nausea and vomiting associated with cancer chemotherapy or other causes, (2) weight loss associated with debilitating illnesses, including HIV infection and cancer, (3) spasticity secondary to neurologic diseases, such as multiple sclerosis, (4) pain syndromes, and (5) other uses, such as for glaucoma. Marijuana is associated with adverse psychiatric, cardiovascular, respiratory, and immunologic events. Moreover, marijuana may interact with a number of prescription drugs and concomitant disease states. Several states have legalized the use of marijuana for chronic and debilitating medication conditions. Pharmacists need to understand the complex legal framework surrounding this issue so that they can protect themselves and better serve their patients.
Kerr, David C R; Tiberio, Stacey S; Capaldi, Deborah M
We studied the extent to which parent marijuana use in adolescence is associated with marijuana use onset in offspring through contextual family and peer risks. Fathers assessed (n=93) since childhood, their 146 offspring (n=83 girls), and offspring's mothers (n=85) participated in a longitudinal study. Using discrete-time survival analysis, fathers' (prospectively measured) and mothers' (retrospective) adolescent marijuana use was used to predict offspring marijuana use onset through age 19 years. Parental monitoring, child exposure to marijuana use, peer deviance, peer marijuana use, and perceptions of parent disapproval of child use were measured before or concurrent with onset. Parents' adolescent marijuana use was significantly associated with less monitoring, offspring alcohol use, the peer behaviors, exposure to adult marijuana use, and perceptions of less parent disapproval. Male gender and the two peer behaviors were positively associated with children's marijuana use onset, controlling for their alcohol use. Parents' adolescent marijuana use had a significant indirect effect on child onset through children's deviant peer affiliations and a composite contextual risk score. Parents' histories of marijuana use may contribute indirectly to children's marijuana use onset through their influence on the social environments children encounter; specifically, those characterized by more liberal use norms, exposure to marijuana use and deviant and marijuana-using peers, and less adult supervision. Given that alcohol use onset was controlled, findings suggest that the contextual factors identified here confer unique risk for child marijuana use onset. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Brents, Lisa K.
Marijuana use among women is highly prevalent, but the societal conversation on marijuana rarely focuses on how marijuana affects female reproduction and endocrinology. This article reviews the current scientific literature regarding marijuana use and hypothalamic-pituitary-ovarian (HPO) axis regulation, ovarian hormone production, the menstrual cycle, and fertility. Evidence suggests that marijuana can reduce female fertility by disrupting hypothalamic release of gonadotropin releasing hormo...
Kramer, Joan L
Answer questions and earn CME/CNE Marijuana has been used for centuries, and interest in its medicinal properties has been increasing in recent years. Investigations into these medicinal properties has led to the development of cannabinoid pharmaceuticals such as dronabinol, nabilone, and nabiximols. Dronabinol is best studied in the treatment of nausea secondary to cancer chemotherapy and anorexia associated with weight loss in patients with acquired immune deficiency syndrome, and is approved by the US Food and Drug Administration for those indications. Nabilone has been best studied for the treatment of nausea secondary to cancer chemotherapy. There are also limited studies of these drugs for other conditions. Nabiximols is only available in the United States through clinical trials, but is used in Canada and the United Kingdom for the treatment of spasticity secondary to multiple sclerosis and pain. Studies of marijuana have concentrated on nausea, appetite, and pain. This article will review the literature regarding the medical use of marijuana and these cannabinoid pharmaceuticals (with emphasis on indications relevant to oncology), as well as available information regarding adverse effects of marijuana use. © 2014 American Cancer Society.
Keyes, Katherine M.; Martins, Silvia S.; Hasin, Deborah S.
Background Ecstasy use is prevalent among young people and often co-occurs with other drug use, but little is known about the past 12-month and lifetime psychiatric comorbidity and specific additional drug abuse among young adult ecstasy users in the general population. To provide this information, we compared current ecstasy users to former users, other illicit drug users, and non-illicit drug users. Method Data were gathered in a face-to-face survey of the United States conducted in the 2001–2002 (NESARC). Participants were household and group quarters residents aged 18–29 years (n = 8666). We measured current ecstasy use defined as any use in the past year; former ecstasy use as use prior to the past year only; other lifetime drug use included any drug other than ecstasy; lifetime non-illicit drug use as no illicit drug use. Associations were determined for nine other classes of illicit drugs, eight personality disorders, and seven mood and anxiety disorders. Results Of current ecstasy users, 44% used >3 other classes of illicit drugs in the past year, compared to 1.6% of non-ecstasy drug users. Current ecstasy use was associated with current anxiety (OR = 3.7), specifically panic disorder (OR = 7.7) and specific phobia (OR = 4.1), also alcohol abuse (OR = 21.6) and dependence (OR = 4.1) and any personality disorder (OR = 5.1) compared to non-illicit drug users. Conclusions Results indicate important differences in comorbidities of current and former ecstasy users compared to other drug users and lifetime non-illicit drug users that may affect phenotype definitions and etiologic studies. Ecstasy use may represent a distinct population of drug users for which unique treatments may be necessary. PMID:18524499
Hill, Kevin P.
With 23 states and the District of Columbia having enacted medical marijuana laws as of August 2014, it is important that psychiatrists be able to address questions about medical marijuana from patients, families, and other health care professionals. The author discusses the limited medical literature on synthetic cannabinoids and medical marijuana. The synthetic cannabinoids dronabinol and nabilone are approved by the United States Food and Drug Administration for nausea and vomiting associa...
Bergeria, Cecilia L; Heil, Sarah H
Breastfeeding is associated with substantial benefits for both the child and mother. Most guidelines state that women who use illicit drugs should not breastfeed. Although this recommendation has traditionally included marijuana, this drug's changing legal status and the limited scientific research regarding marijuana's effect on breastfeeding and the nursing child may lead to varying recommendations made by lactation professionals to clients who use marijuana. Additionally, to our knowledge, there are no data estimating the prevalence of marijuana use among breastfeeding women, making it unclear how common it is. This study assessed recommendations around breastfeeding and marijuana use and estimated the prevalence of marijuana use among breastfeeding women. A convenience sample of lactation professionals who practice throughout New England and were attending the 2014 Vermont Lactation Consultant Association conference was offered the opportunity to complete a five-item survey. Of 120 conference attendees, 74 completed the survey. Forty-four percent reported their recommendations around breastfeeding and marijuana use depended on factors like the severity of maternal use. Another 41% reported recommending continued breastfeeding because the benefits outweigh the harms. The remaining 15% reported recommending that a woman should stop breastfeeding if she cannot stop using marijuana. Survey completers estimated that 15% (1,203/7,843) of their breastfeeding clients in the past year used marijuana. Lactation professionals vary widely in their recommendations to breastfeeding clients who use marijuana. The estimate of prevalence also suggests this is a relatively common issue. More research is needed to assess the generalizability of these findings.
mari- juana grown indoors , the involvement of large criminal organizations, and the patterns of domestic marijuana distribution. In response to a GAO...information is particularly important if the amount of marijuana grown indoors and the number of large-scale cultiva- tion and distribution organizations... marijuana indoors is becoming increasingly popular. A 1982 narcotics assessment by the Western States Information Network (WSIN)2 of marijuana
Mahvan, Tracy D; Hilaire, Michelle L; Mann, Allison; Brown, Antoinette; Linn, Becky; Gardner, Taylor; Lai, Beryen
This article reviews the literature on the use of marijuana in the elderly. Pharmacists play an important role in the management of medications including drug use of potentially illegal drugs, including marijuana. The use of both recreational and medical marijuana has grown exponentially in the general population, including in older adults. As of 2017, marijuana for medical use is legal in 26 states and the District of Columbia. PubMed and Internet search using the following terms: marijuana, cannabis, delta-9-tetrhydrocannabinol (THC), cannabidiol, cannabinoid, elderly, geriatric, and pharmacology. Findings are based on data collected from older adults (65 years of age and older) through August 2016. Because of the lack of research and funding, reputable literature on the impact of marijuana on older adults is scarce. The available evidence suggests that elderly individuals should be cautious when consuming marijuana, especially those who have certain comorbid conditions. The geriatric population has a higher likelihood of having multiple comorbidities and is subject to polypharmacy. Marijuana use, medicinal or recreational, complicates the picture with additive central nervous system side effects. This article reviews the growing information on marijuana use and discusses issues to consider and cautions in usage that can apply to day-to-day clinical practice and geriatric care. The role of the pharmacist in educating patients, caregivers, and health care providers is expanding with the growing number of states that have legalized medical marijuana (26 states and the District of Columbia, as of 2017). Important education points including drug-drug interactions, drug-disease interactions, and signs and symptoms of acute overdose should be considered. With this review, pharmacists will be informed on recommendations on the use of marijuana in the older adult. Monitoring of therapy, as well as adverse effects, will be reviewed, including some legal issues and
Peat, Marwick, Mitchell and Co., Columbia, MD.
This study is a comprehensive analysis of issues concerning marijuana that are of importance to state policy makers. It reviews the medical, legal, and historical dimensions of marijuana use and examines the range of policy approaches toward marijuana possession and use which state officials have considered. Attention is directed to the experience…
Introduction This study examined whether exposure to marijuana advertisements was associated with current marijuana use and frequency of use among US adolescents in grades 8, 10, and 12. Methods Weighted estimates of exposure to marijuana advertisements and marijuana use from the 2014 and 2015 Monitoring the Future studies were investigated. Factors associated with the prevalence and frequency of marijuana use were analyzed by using logistic regression and linear regression models, respective...
Ramesh, Divya; Haney, Margaret; Cooper, Ziva D.
Active marijuana produces significant subjective, psychomotor, and physiological effects relative to inactive marijuana, yet demonstrating that these effects are dose-dependent has proven difficult. This within-subject, double-blind study was designed to develop a smoking procedure to obtain a marijuana dose–response function. In four outpatient laboratory sessions, daily marijuana smokers (N = 17 males, 1 female) smoked six 5-s puffs from 3 marijuana cigarettes (2 puffs/cigarette). The numbe...
The effect of marijuana smoking on blood chemistry and serum biogenic amines concentrations in humans was investigated. Eighty Marijuana addicts and twenty non- marijuana smokers were used in the study. Blood chemistry and serum biogenic amines concentrations of the marijuana addicts and controls, were ...
Sheer, Amy J; Gorelick, David A; Collins, Charles C; Schroeder, Jennifer R; Heishman, Stephen J; Leff, Michelle K; Moolchan, Eric T
Little is known about adolescents' interest in marijuana treatment programs. This question was evaluated by telephone interview in a convenience sample of 575 adolescents responding to advertisements for tobacco research studies. Eighty-one percent of respondents endorsed the need for marijuana treatment programs for adolescents. These adolescents were younger and less likely to smoke tobacco, smoke marijuana, or use alcohol than those not endorsing such a need. Among the 192 marijuana smokers, the 58.8% who endorsed the need for marijuana treatment programs took their first puff of marijuana at a younger age than those who did not endorse the need. Those who were willing to participate in a marijuana treatment program were more likely African American and took their first marijuana puff at a younger age than those not interested in treatment. These findings suggest that most adolescent marijuana smokers endorse the need for and are willing to attend marijuana treatment programs.
Bierut, Tatiana; Krauss, Melissa J.; Sowles, Shaina J.; Cavazos-Rehg, Patricia A.
With an increase in the legalization of recreational marijuana across the U.S., advertising for marijuana products is more widespread, especially on the Internet where such practices pose a regulatory challenge. In this study, we examined the content of marijuana advertising on Weedmaps, a popular website that markets marijuana retailers online. A total of 146 recreational marijuana retailers in Colorado and Washington were examined on Weedmaps. We studied the age verification practices made ...
Murray, J B
Marijuana is complex chemically and not yet fully understood, but it is not a narcotic. Like alcohol, marijuana acts as both stimulant and depressant, but it lingers in body organs longer than alcohol. Smoking marijuana can injure mucosal tissue and may have more carcinogenic potential than tobacco. Research has indicated that marijuana intoxication definitely hinders attention, long-term memory storage, and psychomotor skills involved in driving a car or flying a plane. Expectations and past experience with marijuana have often influenced results more than pharmacological aspects have. Marijuana has triggered psychotic episodes in those more vulnerable. Psychological and some instances of physiological dependence on marijuana have been demonstrated. As a psychoactive drug, marijuana surely alters mental functioning. Although it is possible that chronic use of marijuana produces irreversible damage to mind or brain areas, this has not been determined by research.
Kelly, T H; Foltin, R W; Rose, A J; Fischman, M W; Brady, J V
The effects of marijuana smoke exposure on several measures of tobacco cigarette smoking behavior were examined. Eight healthy adult male volunteers, who smoked both tobacco and marijuana cigarettes, participated in residential studies, lasting 10 to 15 days, designed to measure the effects of marijuana smoke exposure on a range of behavioral variables. Tobacco cigarettes were available throughout the day (9:00 A.M. until midnight). Each day was divided into a private period (9:00 A.M. to 5:00 P.M.), during which subjects were socially isolated, and a social period (5:00 P.M. to midnight), during which subjects could interact. Under blind conditions, subjects smoked placebo and active marijuana cigarettes (0%, 1.3%, 2.3%, or 2.7% delta 9-tetrahydrocannabinol) four times daily (9:45 A.M., 1:30 P.M., 5:00 P.M. and 8:30 P.M.). Each subject was exposed to both placebo and one active dose over 2- to 5-consecutive-day intervals, and dose conditions (i.e., placebo or active) alternated throughout the study. Active marijuana smoking significantly decreased the number of daily tobacco smoking bouts, increased inter-bout intervals and decreased inter-puff intervals. Marijuana decreased the number of tobacco smoking bouts by delaying the initiation of tobacco cigarette smoking immediately after marijuana smoking, whereas decreases in inter-puff intervals were unrelated to the time of marijuana smoking. No consistent interactions between marijuana effects and social or private periods (i.e., time of day) were observed.
Rylander, Melanie; Valdez, Carolyn; Nussbaum, Abraham M
Suicide is among the 10 most common causes of death in the United States. Researchers have identified a number of factors associated with completed suicide, including marijuana use, and increased land elevation. Colorado is an ideal state to test the strength of these associations. The state has a completed suicide rate well above the national average and over the past 15 years has permitted first the medical and, as 2014, the recreational use of marijuana. To determine if there is a correlation between medical marijuana use, as assessed by the number of medical marijuana registrants and completed suicides per county in Colorado. The number of medical marijuana registrants was used as a proxy for marijuana use. Analysis variables included total medical marijuana registrants, medical marijuana dispensaries per county, total suicide deaths, mechanism of suicide death, gender, total suicide hospitalizations, total unemployment, and county-level information such as mean elevation and whether the county was urban or rural. Analysis was performed with mixed model Poisson regression using generalized linear modeling techniques. We found no consistent association between the number of marijuana registrants and completed suicide after controlling for multiple known risk factors for completed suicide. The legalization of medical marijuana may not have an adverse impact on suicide rates. Given the concern for the increased use of marijuana after its legalization, our negative findings provide some reassurance. However, this conclusion needs to be examined in light of the limitations of our study and may not be generalizable to those with existing severe mental illness. This finding may have significant public health implications for the presumable increase in marijuana use that may follow legalization.
Over half of the US states have adopted "medical marijuana" laws (MMLs), and 58% of Americans now favor marijuana legalization. Despite public support, federal law continues to prohibit the use and sale of marijuana due to public health concerns of increased dependence and abuse, youth access, and drugged driving. These essays contribute toward understanding the likely health consequences of marijuana liberalization using evidence from MMLs.Chapter 1 -- Growing Like Weed: Explaining Variation...
DuPont, Robert L.
Citing harmful physiological effects of marijuana, the author asserts that it is the single most serious new threat to our nation's health. He urges parents and school personnel to learn about marijuana and take a strong stand against it. (Condensed from "PTA Today," May 1981, p3-5.) (Author/SJL)
Grant, Therese M; Graham, J Christopher; Carlini, Beatriz H; Ernst, Cara C; Brown, Natalie Novick
In 2012, possession of marijuana for nonmedical use was legalized in Washington State. This study examined how legalization affected alcohol and drug use in a sample of pregnant and parenting women with substance use disorders. Study participants from nine counties in Washington State (N = 1,359) were questioned about their substance use after completing a 3-year case management intervention program. The sample was divided into two cohorts based on whether participants had completed the program before or after legalization. Most study participants reported complete abstinence from alcohol and nonprescription drugs at program exit. Among those who were still using substances, women who completed the intervention after marijuana legalization were significantly more likely to report marijuana use at program exit compared with women who completed the intervention before marijuana legalization. Across both cohorts (pre- and post-legalization), we found a positive association of exit marijuana use with alcohol, illegal methadone, other opioids, amphetamines, and cocaine use; even when we controlled for historical period, the association with some of these substances with marijuana use remained evident. Independent of marijuana use, we saw increased use during the post-legalization period of alcohol, illicit methadone, and other opioids. Marijuana use at exit from the Parent-Child Assistance Program (PCAP) increased significantly after marijuana legalization in the state. Women who were not abstinent from marijuana at program exit were likely to report use of other substances as well. Our study design demonstrates an association but does not allow us to conclude that marijuana use leads to other substance use among this sample of women with a history of polysubstance use.
Lamarine, Roland J
Marijuana has been used medically since antiquity. In recent years there has been a resurgence of interest in medical applications of various cannabis preparations. These drugs have been cited in the medical literature as potential secondary treatment agents for severe pain, muscle spasticity, anorexia, nausea, sleep disturbances, and numerous other uses. This article reviews the research literature related to medical applications of various forms of cannabis. Benefits related to medical use of cannabinoids are examined and a number of potential risks associated with cannabis use, both medical and recreational, are considered. There is a clearly identified need for further research to isolate significant benefits from the medical application of cannabinoids and to establish dosage levels, appropriate delivery mechanisms and formulations, and to determine what role, if any, cannabinoids might play in legitimate medical applications. It is also imperative to determine if reported dangers pose a significant health risks to users.
Notzon, Daniel P; Mariani, John J; Pavlicova, Martina; Glass, Andrew; Mahony, Amy L; Brooks, Daniel J; Grabowski, John; Levin, Frances R
The prevalence of ADHD is greater in substance use disorders than the general population, and ADHD and substance use disorders share neurobiological features such as dysregulation of reward circuitry. We tested the hypothesis that stimulants would decrease marijuana use in a randomized controlled trial of extended release mixed amphetamine salts (MAS-XR) for treatment of co-occurring ADHD and cocaine use disorders. Marijuana users were defined as participants reporting use in the 30 days before study initiation, collected with timeline follow-back. The original 14-week trial utilized a 3-arm randomized design, comparing placebo, MAS-XR 60 mg, and MAS-XR 80 mg. For this analysis, both MAS-XR groups were combined, leaving n = 20 in the placebo group and n = 37 in the MAS-XR group. The primary outcome was proportion of subjects reporting any marijuana use per study week. Comparisons between groups were made using a logistic mixed effects model incorporating multiple predictors and modeling time-by-treatment interactions. There were no significant baseline differences in marijuana use frequency and quantity. There was a significant decrease in the proportion of participants using marijuana over time in the MAS-XR group, but no difference in the proportion of marijuana-use days over time. Treatment of ADHD and comorbid cocaine use disorders with MAS-XR is associated with increased weekly abstinence from marijuana but not with a decrease in the proportion of marijuana using days per week. Stimulant treatment of ADHD and cocaine use disorders may diminish co-occurring cannabis use. (Am J Addict 2016;25:666-672). © 2016 American Academy of Addiction Psychiatry.
Metrik, Jane; Rohsenow, Damaris J.; Monti, Peter M.; McGeary, John; Cook, Travis A. R.; de Wit, Harriet; Haney, Margaret; Kahler, Christopher W.
Although alcohol and nicotine administration studies have demonstrated that manipulating subjects’ expectancies regarding drug content affects drug response, research with marijuana has not adequately studied drug expectancy effects. The present pilot study was the first to evaluate the credibility and effect of expectancy manipulation on subjective measures and smoking patterns using a marijuana administration balanced-placebo design (BPD). In a 2 × 2 instructional set (told delta-9-tetrahyd...
Bierut, Tatiana; Krauss, Melissa J.; Sowles, Shaina J.; Cavazos-Rehg, Patricia A.
With an increase in the legalization of recreational marijuana across the U.S., advertising for marijuana products is more widespread, especially on the Internet where such practices pose a regulatory challenge. In this study, we examined the content of marijuana advertising on Weedmaps, a popular website that markets marijuana retailers online. A total of 146 recreational marijuana retailers in Colorado and Washington were examined on Weedmaps. We studied the age verification practices made in retailers’ own websites, the presence of health claims they made about marijuana on Weedmaps, and the characteristics of followers of Weedmaps on social media sites. Many retailers had no security measure to determine age (41% in Colorado, 35% in Washington). Approximately 61% of retailers in Colorado and 44% in Washington made health claims about the benefits of marijuana, including anxiety reduction, treatment of depression, insomnia, and pain/inflammation. Inferred demographic characteristics of followers of Weedmaps on Twitter and Instagram revealed that over 60% were male and nearly 70% or more were age 20–29 years old, yet some (15%–18%) were under the age of 20. Our findings indicate that marijuana retailers have a visible presence on the Internet. Potential customers might be enticed by retailers who tout health claims about marijuana use. It may also be appealing for a younger demographic to overlook age restrictions and engage with marijuana retailers via social media. As a whole, our findings can help to guide future policy making on the issue of marijuana-related advertising. PMID:27534665
Bierut, Tatiana; Krauss, Melissa J; Sowles, Shaina J; Cavazos-Rehg, Patricia A
With an increase in the legalization of recreational marijuana across the USA, advertising for marijuana products is more widespread, especially on the Internet where such practices pose a regulatory challenge. In this study, we examined the content of marijuana advertising on Weedmaps, a popular website that markets marijuana retailers online. A total of 146 recreational marijuana retailers in Colorado and Washington were examined on Weedmaps. We studied the age verification practices made in retailers' own websites, the presence of health claims they made about marijuana on Weedmaps, and the characteristics of followers of Weedmaps on social media sites. Many retailers had no security measure to determine age (41 % in Colorado, 35 % in Washington). Approximately 61 % of retailers in Colorado and 44 % in Washington made health claims about the benefits of marijuana, including anxiety reduction, treatment of depression, insomnia, and pain/inflammation. Inferred demographic characteristics of followers of Weedmaps on Twitter and Instagram revealed that over 60 % were male and nearly 70 % or more were age 20-29 years old, yet some (15-18 %) were under the age of 20. Our findings indicate that marijuana retailers have a visible presence on the Internet. Potential customers might be enticed by retailers who tout health claims about marijuana use. It may also be appealing for a younger demographic to overlook age restrictions and engage with marijuana retailers via social media. As a whole, our findings can help to guide future policy making on the issue of marijuana-related advertising.
Anderson, D. Mark; Rees, Daniel I.
To date, 16 states have passed medical marijuana laws, yet very little is known about their effects. Using state-level data, we examine the relationship between medical marijuana laws and a variety of outcomes. Legalization of medical marijuana is associated with increased use of marijuana among adults, but not among minors. In addition, legalization is associated with a nearly 9 percent decrease in traffic fatalities, most likely to due to its impact on alcohol consumption. Our estimates pro...
Sansone, Randy A.; Sansone, Lori A.
Acute marijuana use is classically associated with snacking behavior (colloquially referred to as “the munchies”). In support of these acute appetite-enhancing effects, several authorities report that marijuana may increase body mass index in patients suffering from human immunodeficiency virus and cancer. However, for these medical conditions, while appetite may be stimulated, some studies indicate that weight gain is not always clinically meaningful. In addition, in a study of cancer patien...
Sawler, Jason; Stout, Jake M; Gardner, Kyle M; Hudson, Darryl; Vidmar, John; Butler, Laura; Page, Jonathan E; Myles, Sean
Despite its cultivation as a source of food, fibre and medicine, and its global status as the most used illicit drug, the genus Cannabis has an inconclusive taxonomic organization and evolutionary history. Drug types of Cannabis (marijuana), which contain high amounts of the psychoactive cannabinoid Δ9-tetrahydrocannabinol (THC), are used for medical purposes and as a recreational drug. Hemp types are grown for the production of seed and fibre, and contain low amounts of THC. Two species or gene pools (C. sativa and C. indica) are widely used in describing the pedigree or appearance of cultivated Cannabis plants. Using 14,031 single-nucleotide polymorphisms (SNPs) genotyped in 81 marijuana and 43 hemp samples, we show that marijuana and hemp are significantly differentiated at a genome-wide level, demonstrating that the distinction between these populations is not limited to genes underlying THC production. We find a moderate correlation between the genetic structure of marijuana strains and their reported C. sativa and C. indica ancestry and show that marijuana strain names often do not reflect a meaningful genetic identity. We also provide evidence that hemp is genetically more similar to C. indica type marijuana than to C. sativa strains.
Wilkinson, Samuel T; Yarnell, Stephanie; Radhakrishnan, Rajiv; Ball, Samuel A; D'Souza, Deepak Cyril
Marijuana is becoming legal in an increasing number of states for both medical and recreational use. Considerable controversy exists regarding the public health impact of these changes. The evidence for the legitimate medical use of marijuana or cannabinoids is limited to a few indications, notably HIV/AIDS cachexia, nausea/vomiting related to chemotherapy, neuropathic pain, and spasticity in multiple sclerosis. Although cannabinoids show therapeutic promise in other areas, robust clinical evidence is still lacking. The relationship between legalization and prevalence is still unknown. Although states where marijuana use is legal have higher rates of use than nonlegal states, these higher rates were generally found even prior to legalization. As states continue to proceed with legalization for both medical and recreational use, certain public health issues have become increasingly relevant, including the effects of acute marijuana intoxication on driving abilities, unintentional ingestion of marijuana products by children, the relationship between marijuana and opioid use, and whether there will be an increase in health problems related to marijuana use, such as dependence/addiction, psychosis, and pulmonary disorders. In light of this rapidly shifting legal landscape, more research is urgently needed to better understand the impact of legalization on public health.
Clark, Peter A.; Capuzzi, Kevin; Fick, Cameron
Summary Marijuana is classified by the Drug Enforcement Agency (DEA) as an illegal Schedule I drug which has no accepted medical use. However, recent studies have shown that medical marijuana is effective in controlling chronic non-cancer pain, alleviating nausea and vomiting associated with chemotherapy, treating wasting syndrome associated with AIDS, and controlling muscle spasms due to multiple sclerosis. These studies state that the alleviating benefits of marijuana outweigh the negative ...
Moreno, Megan A; Whitehill, Jennifer M; Quach, Vincent; Midamba, Nikita; Manskopf, Inga
OBJECTIVE The purpose of this mixed-methods study was to understand college students’ 1) views and experiences regarding marijuana, 2) voting behaviors, and 3) early perceptions of the impact of legislation. PARTICIPANTS College students from Washington and Wisconsin were interviewed between May–September 2013 METHODS Participants completed phone interviews assessing marijuana attitudes, intentions, behaviors, voting behaviors or intentions, and perceptions of the impact of legislation. RESULTS A total of 283 participants completed the interview (83.7% retention rate): 56.8% were female, 57.2% were from Wisconsin, and 74.6% were Caucasian. Almost half of Washington participants (46.3%) indicated that they voted for marijuana legalization. Participants most commonly responded that the legislation did not change their attitudes towards marijuana, though some participants discussed perceived safety of the product because legislation passed. CONCLUSIONS Findings indicate similarities in views and experiences among college students from states affected and unaffected by legalization; legalization may increase perceptions of safety. PMID:26182234
Pedersen, Eric R.; Miles, Jeremy N. V.; Osilla, Karen Chan; Ewing, Brett A.; Hunter, Sarah B.; D’Amico, Elizabeth J.
Based on expectancy theory, adolescents at risk for mental health symptoms, such as those involved in the juvenile court system, may use marijuana due to the belief that use will attenuate anxiety and depressive symptoms. In a diverse sample of youth involved in the Santa Barbara Teen Court system (N = 193), we examined the association between mental health symptoms and marijuana expectancies on marijuana use and consequences. In general, stronger positive expectancies and weaker negative exp...
Brook, Judith S.; Zhang, Chenshu; Koppel, Jonathan; Brook, David W.
We examined the longitudinal pathways from marijuana use in the familial environment (parents and siblings) and non-familial environment (peers and significant other), throughout adolescence and young adulthood, to the participants’ own marijuana use in their fourth decade of life (n = 586). Longitudinal pathways to marijuana use were assessed using structural equation modeling. Familial factors were mediated by non-familial factors; sibling marijuana use also had a direct effect on the parti...
... is also known as cannabis. Medical marijuana is cannabis used as medicine. When used as a drug, marijuana can produce ... THC). CBD and THC are taken from the cannabis plant for use in medicine. They also can be created (synthesized) in a ...
Full Text Available Despite its cultivation as a source of food, fibre and medicine, and its global status as the most used illicit drug, the genus Cannabis has an inconclusive taxonomic organization and evolutionary history. Drug types of Cannabis (marijuana, which contain high amounts of the psychoactive cannabinoid Δ9-tetrahydrocannabinol (THC, are used for medical purposes and as a recreational drug. Hemp types are grown for the production of seed and fibre, and contain low amounts of THC. Two species or gene pools (C. sativa and C. indica are widely used in describing the pedigree or appearance of cultivated Cannabis plants. Using 14,031 single-nucleotide polymorphisms (SNPs genotyped in 81 marijuana and 43 hemp samples, we show that marijuana and hemp are significantly differentiated at a genome-wide level, demonstrating that the distinction between these populations is not limited to genes underlying THC production. We find a moderate correlation between the genetic structure of marijuana strains and their reported C. sativa and C. indica ancestry and show that marijuana strain names often do not reflect a meaningful genetic identity. We also provide evidence that hemp is genetically more similar to C. indica type marijuana than to C. sativa strains.
Sawler, Jason; Stout, Jake M.; Gardner, Kyle M.; Hudson, Darryl; Vidmar, John; Butler, Laura; Page, Jonathan E.; Myles, Sean
Despite its cultivation as a source of food, fibre and medicine, and its global status as the most used illicit drug, the genus Cannabis has an inconclusive taxonomic organization and evolutionary history. Drug types of Cannabis (marijuana), which contain high amounts of the psychoactive cannabinoid Δ 9-tetrahydrocannabinol (THC), are used for medical purposes and as a recreational drug. Hemp types are grown for the production of seed and fibre, and contain low amounts of THC. Two species or gene pools (C. sativa and C. indica) are widely used in describing the pedigree or appearance of cultivated Cannabis plants. Using 14,031 single-nucleotide polymorphisms (SNPs) genotyped in 81 marijuana and 43 hemp samples, we show that marijuana and hemp are significantly differentiated at a genome-wide level, demonstrating that the distinction between these populations is not limited to genes underlying THC production. We find a moderate correlation between the genetic structure of marijuana strains and their reported C. sativa and C. indica ancestry and show that marijuana strain names often do not reflect a meaningful genetic identity. We also provide evidence that hemp is genetically more similar to C. indica type marijuana than to C. sativa strains. PMID:26308334
Ford, Benjamin M; Tai, Sherrica; Fantegrossi, William E; Prather, Paul L
In the early 2000s in Europe and shortly thereafter in the USA, it was reported that 'legal' forms of marijuana were being sold under the name K2 and/or Spice. Active ingredients in K2/Spice products were determined to be synthetic cannabinoids (SCBs), producing psychotropic actions via CB 1 cannabinoid receptors, similar to those of Δ 9 -tetrahydrocannabinol (Δ 9 -THC), the primary active constituent in marijuana. Often abused by adolescents and military personnel to elude detection in drug tests due to their lack of structural similarity to Δ 9 -THC, SCBs are falsely marketed as safe marijuana substitutes. Instead, SCBs are a highly structural diverse group of compounds, easily synthesized, which produce very dangerous adverse effects occurring by, as of yet, unknown mechanisms. Therefore, available evidence indicates that K2/Spice products are clearly not safe marijuana alternatives. Copyright © 2016 Elsevier Ltd. All rights reserved.
Nkemdirim Okere, Arinze
With the current legalization of medical marijuana and the possibility of recreational use being permitted in some states, the health care benefits associated with the use of marijuana is questionable. States that are on the path of legalizing marijuana, should recognize that as there are perceived positive benefits, there are also many evidence-based negative health consequences which may result in negative economic and societal consequences. As more data on health outcomes regarding the use of marijuana continue to emerge, policies directed toward legalizing marijuana, whether medical or recreational, should consider protecting the society from both harm and societal cost.
Wilkinson, Samuel T.; Yarnell, Stephanie; Radhakrishnan, Rajiv; Ball, Samuel A.; D'Souza, Deepak Cyril
Marijuana is becoming legal in an increasing number of states for both medical and recreational use. Considerable controversy exists regarding the public health impact of these changes. The evidence for the legitimate medical use of marijuana or cannabinoids is limited to a few indications, notably HIV/AIDS cachexia, nausea/vomiting related to chemotherapy, neuropathic pain, and spasticity in multiple sclerosis. Although cannabinoids show therapeutic promise in other areas, robust clinical evidence is still lacking. The relationship between legalization and prevalence is still unknown. Although states where marijuana use is legal have higher rates of use than nonlegal states, these higher rates were generally found even prior to legalization. As states continue to proceed with legalization for both medical and recreational use, certain public health issues have become increasingly relevant, including the effects of acute marijuana intoxication on driving abilities, unintentional ingestion of marijuana products by children, the relationship between marijuana and opioid use, and whether there will be an increase in health problems related to marijuana use, such as dependence/addiction, psychosis, and pulmonary disorders. In light of this rapidly shifting legal landscape, more research is urgently needed to better understand the impact of legalization on public health. PMID:26515984
Olukayode Abayomi; Emmanuel Babalola
Desai and Patel highlighted in a recent review that and ldquo;there are several issues related to medical marijuana, which concern public health such as its medical use, harmful effects, laws and physicians role. and rdquo; Certainly, physician's perspectives and position on the relative harm and benefits of marijuana contribute to the growing controversy over its legalization in western countries. Interestingly, the seeming resistance of physicians in western countries to marijuana prescrip...
Sullivan, Ezra; Austriaco, Nicanor
Several empirical studies suggest that recreational marijuana is popularly perceived as an essentially harmless rite of passage that ends as young people settle into their careers and their adult intimate relationships. Is this perception accurate? To answer this question, we evaluate the morality of recreational marijuana use from a virtue perspective guided by the theological synthesis of St. Thomas Aquinas. Since the medical data reveals that recreational marijuana use is detrimental to th...
Yacoubian, George S., Jr.
The United States and the Netherlands have antithetical marijuana control policies. The United States' laws criminalize the possession of even small amounts of marijuana, while the Netherlands have maintained, over the past several decades, two relatively liberal marijuana policies implemented during the 1970s and 1980s. According to the…
Hayaki, Jumi; Hagerty, Claire E.; Herman, Debra S.; de Dios, Marcel A.; Anderson, Bradley J.; Stein, Michael D.
This study examined associations between the endorsement of drug use expectancies and the frequency and severity of marijuana use in a community sample of 332 women aged 18–24 years who were not explicitly seeking treatment for their marijuana use. Participants were enrolled in a larger intervention study of motivational interviewing for various health behaviors and provided self-reports of their current and past marijuana use, marijuana abuse/dependence symptoms, and marijuana use expectanci...
Scherer, Michael; Romano, Eduardo; Voas, Robert; Taylor, Eileen
Polydrug users have been shown to be at higher risk for alcohol consumption and crash involvement. However, research has shown that polydrug groups differ in some important ways. It is currently unknown how polydrug-using groups differ in terms of crash involvement and alcohol consumption. The current study used latent class analysis to examine subgroups of polydrug users (n = 384) among a sample of drivers in Virginia Beach, Virginia (N = 10,512). A series of logistic regression analyses were conducted to determine the relationship between polydrug use categories and crash involvement and alcohol consumption. Four distinct subclasses of users were identified among polydrug-using drivers: Class 1 is the "marijuana-amphetamines class" and accounts for 21.6% of polydrug users. Class 2 is the "benzo-antidepressant class" and accounts for 39.0% of polydrug users. Class 3 is the "opioid-benzo class" and accounts for 32.7% of polydrug users. Finally, Class 4 is the "marijuana-cocaine class" and accounts for 6.7% of the study sample. Drivers in the opioid-benzo class were significantly more likely than those in any other class as well as non-drug users and single-drug users to be involved in a crash and were more likely than those in most other conditions to consume alcohol. No significant difference was found between marijuana-amphetamine users or benzo-antidepressant users and non-drug users on crash risk. Some polydrug users are indeed at greater risk for crash involvement and alcohol consumption; however, not all polydrug users are significantly worse than single-drug users and/or non-drug users, and the practice of lumping polydrug users together when predicting crash risk runs the risk of inaccurately attributing crash involvement to certain drivers.
Azofeifa, Alejandro; Mattson, Margaret E; Schauer, Gillian; McAfee, Tim; Grant, Althea; Lyerla, Rob
In the United States, marijuana is the most commonly used illicit drug. In 2013, 7.5% (19.8 million) of the U.S. population aged ≥12 years reported using marijuana during the preceding month. Because of certain state-level policies that have legalized marijuana for medical or recreational use, population-based data on marijuana use and other related indicators are needed to help monitor behavioral health changes in the United States. 2002-2014. The National Survey on Drug Use and Health (NSDUH) is a national- and state-level survey of a representative sample of the civilian, noninstitutionalized U.S. population aged ≥12 years. NSDUH collects information about the use of illicit drugs, alcohol, and tobacco; initiation of substance use; frequency of substance use; substance dependence and abuse; perception of substance harm risk or no risk; and other related behavioral health indicators. This report describes national trends for selected marijuana use and related indicators, including prevalence of marijuana use; initiation; perception of harm risk, approval, and attitudes; perception of availability and mode of acquisition; dependence and abuse; and perception of legal penalty for marijuana possession. In 2014, a total of 2.5 million persons aged ≥12 years had used marijuana for the first time during the preceding 12 months, an average of approximately 7,000 new users each day. During 2002-2014, the prevalence of marijuana use during the past month, past year, and daily or almost daily increased among persons aged ≥18 years, but not among those aged 12-17 years. Among persons aged ≥12 years, the prevalence of perceived great risk from smoking marijuana once or twice a week and once a month decreased and the prevalence of perceived no risk increased. The prevalence of past year marijuana dependence and abuse decreased, except among persons aged ≥26 years. Among persons aged ≥12 years, the percentage reporting that marijuana was fairly easy or very easy
Ammerman, Seth; Ryan, Sheryl; Adelman, William P
This technical report updates the 2004 American Academy of Pediatrics technical report on the legalization of marijuana. Current epidemiology of marijuana use is presented, as are definitions and biology of marijuana compounds, side effects of marijuana use, and effects of use on adolescent brain development. Issues concerning medical marijuana specifically are also addressed. Concerning legalization of marijuana, 4 different approaches in the United States are discussed: legalization of marijuana solely for medical purposes, decriminalization of recreational use of marijuana, legalization of recreational use of marijuana, and criminal prosecution of recreational (and medical) use of marijuana. These approaches are compared, and the latest available data are presented to aid in forming public policy. The effects on youth of criminal penalties for marijuana use and possession are also addressed, as are the effects or potential effects of the other 3 policy approaches on adolescent marijuana use. Recommendations are included in the accompanying policy statement. Copyright © 2015 by the American Academy of Pediatrics.
Taylor, H G
To review the pharmacology, therapeutics, adverse effects, and societal implications of the medical use of marijuana. MEDLINE and manual searches of English-language marijuana literature, supplemented with interviews of scientists currently conducting cannabinoid research. Search terms included pain OR palliative care AND cannabis or ALL marijuana; cachexia OR appetite OR appetite stimulants; muscle spasticity OR spasm; immune system and cannabis; nausea and vomiting and cancer and cannabis. MEDLINE search terms: cannabis OR marijuana smoking OR marijuana abuse; all glaucoma; multiple sclerosis AND cannabis OR marijuana smoking OR marijuana abuse. Studies on pharmacology, risks, and medical potential of marijuana. Not applicable. The most prominent effects of marijuana are mediated by receptors in the brain. Acute intoxication is characterized by euphoria, loss of short-term memory, stimulation of the senses, and impaired linear thinking. Depersonalization and panic attacks are adverse effects. Increased heart rate and reddened conjunctivae are common physical effects. Chronic, high doses may cause subtle impairment of cognitive abilities that are appear to be long-term, but of unknown duration. Marijuana may be a risk factor for individuals with underlying mental illness. It causes dependence, but compared with cocaine, alcohol, heroin, and nicotine, marijuana has little addictive power and produces only mild withdrawal symptoms. Marijuana shows clinical promise for glaucoma, nausea and vomiting, analgesia, spasticity, multiple sclerosis, and AIDS wasting syndrome. As a recreational drug, marijuana poses dangers, particularly to social and emotional development during adolescence and young adulthood. As a medical drug, marijuana should be available for patients who do not adequately respond to currently available therapies.
Schinke, Steven; Schwinn, Traci; Hopkins, Jessica; Gorroochurn, Prakash; Wahlstrom, Lindsey
Growing moves in the U.S. toward relaxed laws surrounding adult use of marijuana raise concerns about concurrent increases in adolescent use of marijuana. This study collected and analyzed primary data on the relationship between marijuana legalization status in U.S. states and adolescents' marijuana use. Recruited through social networking sites and youth-services community agencies, a sample of 1,310 adolescents from 48 U.S. states and the District of Columbia reported their use of marijuana. Youths' use rates were compared with the marijuana legalization status of youths' states of residence. Study findings failed to show a relationship between adolescents' use of marijuana and state laws regarding marijuana use. Relationships were found for increased marijuana use by older youths, females, and non-Hispanic youths. Youths whose parents completed 2 or more years of college were less likely to report marijuana use than those whose parents completed fewer than 2 years of college. Albeit study findings do not support predictions of growing marijuana use by adolescents in states with liberalized adult use laws, further monitoring of adolescents' use with larger and more representative samples is needed.
Pacula, Rosalie Liccardo; Powell, David; Heaton, Paul; Sevigny, Eric L.
This paper sheds light on previous inconsistencies identified in the literature regarding the relationship between medical marijuana laws (MMLs) and recreational marijuana use by closely examining the importance of policy dimensions (registration requirements, home cultivation, dispensaries) and the timing of when particular policy dimensions are enacted. Using data from our own legal analysis of state MMLs, we evaluate which features are associated with adult and youth recreational and heavy use by linking these policy variables to data from the Treatment Episodes Data System (TEDS) and the National Longitudinal Survey of Youth (NLSY97). We employ differences-in-differences techniques, controlling for state and year fixed effects, allowing us to exploit within-state policy changes. We find that while simple dichotomous indicators of MML laws are not positively associated with marijuana use or abuse, such measures hide the positive influence legal dispensaries have on adult and youth use, particularly heavy use. Sensitivity analyses that help address issues of policy endogeneity and actual implementation of dispensaries support our main conclusion that not all MML laws are the same. Dimensions of these policies, in particular legal protection of dispensaries, can lead to greater recreational marijuana use and abuse among adults and those under the legal age of 21 relative to medical marijuana laws without this supply source. PMID:25558490
Birdsall, Shauna M; Birdsall, Timothy C; Tims, Lucas A
The use of medical marijuana in cancer care presents a dilemma for both patients and physicians. The scientific evidence is evolving, yet much of the known information is still insufficient to adequately inform patients as to risks and benefits. In addition, evidence-based dosing and administration information on medical marijuana is lacking. Medical marijuana is now legal, on some level, in 24 states plus the District of Columbia, yet is not legal on the federal level. This review addresses the current state of the research, including potential indications, risks and adverse effects, preliminary data on anticancer effects, as well as legal and quality issues. A summary of the clinical trials underway on medical marijuana in the oncology setting is discussed.
Cavazos-Rehg, Patricia A; Krauss, Melissa J; Cahn, Elizabeth; Lee, Kiriam Escobar; Ferguson, Erin; Rajbhandari, Biva; Sowles, Shaina J; Floyd, Glennon M; Berg, Carla; Bierut, Laura J
Marijuana product advertising will become more common, as the use of medical and/or recreational marijuana becomes increasingly legal in the USA. In this study, we investigate the marketing tactics being used on marijuana dispensary websites in the USA that could influence substance use behaviors. One hundred dispensary websites were randomly selected from 10 states that allowed the legal use of medical or recreational marijuana and had at least 10 operational dispensaries. Three dispensaries were excluded due to non-functioning websites, leaving a sample of 97 dispensaries. Content analysis was conducted on these dispensaries' websites, with the primary areas of focus including website age verification, marijuana effects, warnings, and promotional tactics. Among the 97 dispensaries, 75% did not include age verification. Roughly 30% offered online ordering and 21% offered delivery services. Sixty-seven percent made health claims pertaining to medical conditions that could be treated by their marijuana products, with moderate or conclusive evidence to support their claims. Less than half of the dispensaries (45%) advised consumers of possible side effects, and only 18% included warnings about contraindications. Nearly half (44%) offered reduced prices or coupons, 19% offered "buy one get one free" offers, and 16% provided giveaways or free samples. Our findings indicate that marijuana dispensary websites are easily accessible to youth. In addition, only a small amount of the websites advised consumers about possible side effects or contraindications. This study suggests the need for surveillance of marijuana commercialization and online advertising especially in the context of state policy reforms.
Moon, Andrew S; Smith, Walter; Mullen, Sawyer; Ponce, Brent A; McGwin, Gerald; Shah, Ashish; Naranje, Sameer M
The association between marijuana use and surgical procedures is a matter of increasing societal relevance that has not been well studied in the literature. The primary aim of this study is to evaluate the relationship between marijuana use and in-hospital mortality, as well as to assess associated comorbidities in patients undergoing commonly billed orthopedic surgeries. The National Inpatient Sample (NIS) database from 2010 to 2014 was used to determine the odds ratios for the associations between marijuana use and in-hospital mortality, heart failure (HF), stroke, and cardiac disease (CD) in patients undergoing five common orthopedic procedures: hip (THA), knee (TKA), and shoulder arthroplasty (TSA), spinal fusion, and traumatic femur fracture fixation. Of 9,561,963 patients who underwent one of the five selected procedures in the four-year period, 26,416 (0.28%) were identified with a diagnosis of marijuana use disorder. In hip and knee arthroplasty patients, marijuana use was associated with decreased odds of mortality compared to no marijuana use (pmarijuana use (0.70%), which was associated with decreased odds of mortality (p = 0.0483), HF (p = 0.0076), and CD (p = 0.0003). For spinal fusions, marijuana use was associated with increased odds of stroke (pMarijuana use in patients undergoing shoulder arthroplasty was associated with decreased odds of mortality (pmarijuana use was associated with decreased mortality in patients undergoing THA, TKA, TSA and traumatic femur fixation, although the significance of these findings remains unclear. More research is needed to provide insight into these associations in a growing surgical population.
Bottorff, Joan L; Johnson, Joy L; Moffat, Barbara M; Mulvogue, Tamsin
Abstract Background There are indications that marijuana is increasingly used to alleviate symptoms and for the treatment of a variety of medical conditions both physical and psychological. The purpose of this study was to describe the health concerns and problems that prompt some adolescents to use marijuana for therapeutic reasons, and their beliefs about the risks and benefits of the therapeutic use of marijuana. Methods As part of a larger ethnographic study of 63 adolescents who were reg...
Shrier, Lydia A; Ross, Craig S; Blood, Emily A
ABSTRACT. among young people. This study examined how positive and negative affect differ before marijuana use compared with other times. Forty medical outpatients ages 15-24 years who used marijuana recreationally at least twice a week (M = 18.7 years; 58% female) reported momentary positive affect, negative affect, companionship, perceived ease of obtaining marijuana, and marijuana use several times a day for 2 weeks on a handheld computer. Mean momentary positive affect and negative affect scores in the 24 hours leading up to a marijuana use event (n = 294) were compared with affect scores in times further from subsequent use. Generalized estimating equation models considered as potential moderators perceived ease of obtaining marijuana and being with friends. Positive affect did not differ in the 24 hours before marijuana use compared with times further before use. Negative affect was significantly higher before marijuana use compared with other times. Being with friends and perceived easy marijuana availability did not moderate the associations. The association between negative affect and subsequent marijuana use was attenuated when negative affect was examined only for the moment just before use, suggesting that use may follow a period of increased negative affect. The findings support an affect regulation model for marijuana use among frequently using youth. Specifically, these youth may use marijuana to manage increased negative affect.
Williams, Arthur Robin; Santaella-Tenorio, Julian; Mauro, Christine M; Levin, Frances R; Martins, Silvia S
Most US states have passed medical marijuana laws (MMLs), with great variation in program regulation impacting enrollment rates. We aimed to compare changes in rates of marijuana use, heavy use and cannabis use disorder across age groups while accounting for whether states enacted medicalized (highly regulated) or non-medical mml programs. Difference-in-differences estimates with time-varying state-level MML coded by program type (medicalized versus non-medical). Multi-level linear regression models adjusted for state-level random effects and covariates as well as historical trends in use. Nation-wide cross-sectional survey data from the US National Survey of Drug Use and Health (NSDUH) restricted use data portal aggregated at the state level. Participants comprised 2004-13 NSDUH respondents (n ~ 67 500/year); age groups 12-17, 18-25 and 26+ years. States had implemented eight medicalized and 15 non-medical MML programs. Primary outcome measures included (1) active (past-month) marijuana use; (2) heavy use (> 300 days/year); and (3) cannabis use disorder diagnosis, based on DSM-IV criteria. Covariates included program type, age group and state-level characteristics throughout the study period. Adults 26+ years of age living in states with non-medical MML programs increased past-month marijuana use 1.46% (from 4.13 to 6.59%, P = 0.01), skewing towards greater heavy marijuana by 2.36% (from 14.94 to 17.30, P = 0.09) after MMLs were enacted. However, no associated increase in the prevalence of cannabis use disorder was found during the study period. Our findings do not show increases in prevalence of marijuana use among adults in states with medicalized MML programs. Additionally, there were no increases in adolescent or young adult marijuana outcomes following MML passage, irrespective of program type. Non-medical marijuana laws enacted in US states are associated with increased marijuana use, but only among adults aged 26+ years. Researchers and
Targino, Marcelo C.; Fanciullo, Gilbert J.; Martin, Douglas W.; Hartenbaum, Natalie P.; White, Jeremy M.; Franklin, Phillip
Although possession and use of marijuana is prohibited by federal law, legalization in four states (Alaska, Colorado, Oregon, and Washington) and allowance for palliation and therapy in 19 others may reposition the drug away from the fringes of society. This evolving legal environment, and growing scientific evidence of its effectiveness for select health conditions, requires assessment of the safety and appropriateness of marijuana within the American workforce. Although studies have suggested that marijuana may be used with reasonable safety in some controlled environments, there are potential consequences to its use that necessitate employer scrutiny and concern. Several drug characteristics must be considered, including Δ9-tetrahydrocannabinol (Δ9-THC, or THC) concentration, route of administration, dose and frequency, and pharmacokinetics, as well as the risks inherent to particular workplace environments. PMID:25951421
Elsheshtawy, Moustafa; Sriganesh, Priatharsini; Virparia, Vasudev; Patel, Falgun; Khanna, Ashok
Synthetic marijuana is an uptrending designer drug currently widely spread in the US. We report a case of acute deterioration of nonischemic left ventricular dysfunction after exposure to synthetic marijuana. This case illustrates the importance of history taking in cardiac patients and identifies a negative cardiovascular effect of synthetic marijuana known as K2, not yet well detected by urine toxicology screening tools.
Moustafa Elsheshtawy; Priatharsini Sriganesh; Vasudev Virparia; Falgun Patel; Ashok Khanna
Synthetic marijuana is an uptrending designer drug currently widely spread in the US. We report a case of acute deterioration of nonischemic left ventricular dysfunction after exposure to synthetic marijuana. This case illustrates the importance of history taking in cardiac patients and identifies a negative cardiovascular effect of synthetic marijuana known as K2, not yet well detected by urine toxicology screening tools.
Kepple, Nancy Jo; Mulholland, Elycia; Freisthler, Bridget; Schaper, Elizabeth
Marijuana purchasing behaviors vary by the purchaser’s individual characteristics; however, little is known about patients’ purchasing behaviors when buying from medical marijuana dispensaries (MMDs). Our objective was to explore whether patient characteristics were associated with amount spent during one financial transaction at medical marijuana dispensaries. We conducted a pilot study of 4 purposively sampled MMD locations in Long Beach, California, in 2012. A total of 132 medical marijuan...
King, Keith A.; Vidourek, Rebecca A.; Hoffman, Ashlee R.
A total of 54,361 students in seventh through twelfth grades completed a survey examining the impact of perceived harm of marijuana use, ease of access in obtaining marijuana, and perceived parent/peer disapproval of marijuana use on youth involvement in annual and recent marijuana use. Results indicated that 1 in 6 (16%) students used marijuana…
Davis, Jonathan M; Mendelson, Bruce; Berkes, Jay J; Suleta, Katie; Corsi, Karen F; Booth, Robert E
The public health consequences of the legalization of marijuana, whether for medical or recreational purposes, are little understood. Despite this, numerous states are considering medical or recreational legalization. In the context of abrupt changes in marijuana policy in 2009 in Colorado, the authors sought to investigate corresponding changes in marijuana-related public health indicators. This observational, ecologic study used an interrupted time-series analysis to identify changes in public health indicators potentially related to broad policy changes that occurred in 2009. This was records-based research from the state of Colorado and Denver metropolitan area. Data were collected to examine frequency and trends of marijuana-related outcomes in hospital discharges and poison center calls between time periods before and after 2009 and adjusted for population. Analyses were conducted in 2014. Hospital discharges coded as marijuana-dependent increased 1% per month (95% CI=0.8, 1.1, pcenter calls mentioning marijuana (pcenter calls increased 0.8% per month (95% CI=0.2, 1.4, pcenter calls also increased 56% (95% CI=49%, 63%, p<0.001) in the period following the policy change. Further, there was one hospital discharge coded as dependent for every 3,159 (95% CI=2465, 3853, p<0.001) medical marijuana registrant applications. The abrupt nature of these changes suggests public health effects related to broad policy changes associated with marijuana. This report may be used to assist in policy decisions regarding the short-term public health effects of marijuana legalization. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
Guttmannova, Katarina; Lee, Christine M.; Kilmer, Jason R.; Fleming, Charles B.; Rhew, Isaac C.; Kosterman, Rick; Larimer, Mary E.
Background Marijuana policies are rapidly evolving. In the United States, recreational use of marijuana is now legal in four states and medical marijuana is legal in 23 states. Research evaluating such policies has focused primarily on how policies affect issues of price, access to, use, and consequences of marijuana. Due to potential spillover effects, researchers also need to examine how marijuana policies may impact use and consequences of alcohol. Methods The current paper is a critical review of articles evaluating alcohol outcomes associated with marijuana decriminalization, medical marijuana legalization, and non-medical or recreational marijuana legalization. We identified articles and reports through (1) online searches of EBSCO host database including Academic search premier, Econlit, Legal collection, Medline, Psych articles, and PsycINFO, as well as PubMed and Google Scholar databases; (2) review of additional articles cited in papers identified through electronic searches; and (3) targeted searches of state and local government records regarding marijuana law implementation. We reviewed studies with respect to their data sources and sample characteristics, methodology, and the margin of alcohol and marijuana use, timing of policy change, and the aspects of laws examined. Results The extant literature provides some evidence for both substitution (i.e., more liberal marijuana policies related to less alcohol use as marijuana becomes a substitute) and complementary (i.e., more liberal marijuana policies related to increases in both marijuana and alcohol use) relationships in the context of liberalization of marijuana policies in the United States. Conclusions Impact of more liberal marijuana policies on alcohol use is complex, and likely depends on specific aspects of policy implementation, including how long the policy has been in place. Further, evaluation of marijuana policy effects on alcohol use may be sensitive to the age group studied and the
Buckner, Julia D.; Ecker, Anthony H.; Welch, Katherine D.
Given that marijuana remains the most commonly used illicit substance, identification of the role of potentially malleable cognitive factors in marijuana-related behaviors remains an important goal. The Marijuana Effect Expectancies Questionnaire (MEEQ; Schafer & Brown, 1991) assesses marijuana effect expectancies that are differentially related to marijuana use and use-related problems. Evaluation of the desirability of marijuana effect expectancies may provide additional information regardi...
Full Text Available Synthetic marijuana is an uptrending designer drug currently widely spread in the US. We report a case of acute deterioration of nonischemic left ventricular dysfunction after exposure to synthetic marijuana. This case illustrates the importance of history taking in cardiac patients and identifies a negative cardiovascular effect of synthetic marijuana known as K2, not yet well detected by urine toxicology screening tools.
Dubowitz, Howard; Thompson, Richard; Arria, Amelia M; English, Diana; Metzger, Richard; Kotch, Jonathan B
There has been increasing acceptance of marijuana use in the United States in recent years, and rates among adolescents have risen. At the same time, marijuana use during adolescence has been linked to an array of health and social problems. Maltreated children are at risk for marijuana use, but the relationships among characteristics of maltreatment and marijuana use are unclear. In this article, we examine how the type and the extent of maltreatment are related to the level of adolescent marijuana use. Data analyses were conducted on a subsample of maltreated adolescents (n = 702) from the Longitudinal Studies of Child Abuse and Neglect project. Approximately half the sample had used marijuana, and maltreatment was associated with its use. Multivariate regression models showed that being male, extensive maltreatment, and peer marijuana use were associated with heavy use of marijuana. These findings suggest the importance of comprehensively assessing children's maltreatment experiences and their peers' drug use to help prevent or address possible marijuana use in these high-risk adolescents. © The Author(s) 2015.
D'Amico, Elizabeth J; Miles, Jeremy N V; Tucker, Joan S
Over the past several years, medical marijuana has received increased attention in the media, and marijuana use has increased across the United States. Studies suggest that as marijuana has become more accessible and adults have become more tolerant regarding marijuana use, adolescents perceive marijuana as more beneficial and are more likely to use if they are living in an environment that is more tolerant of marijuana use. One factor that may influence adolescents' perceptions about marijuana and marijuana use is their exposure to advertising of this product. We surveyed sixth- to eighth-grade youth in 2010 and 2011 in 16 middle schools in Southern California (n = 8,214; 50% male; 52% Hispanic; mean age = 13 years) and assessed exposure to advertising for medical marijuana, marijuana intentions, and marijuana use. Cross-lagged regressions showed a reciprocal association of advertising exposure with marijuana use and intentions during middle school. Greater initial medical marijuana advertising exposure was significantly associated with a higher probability of marijuana use and stronger intentions to use 1 year later, and initial marijuana use and stronger intentions to use were associated with greater medical marijuana advertising exposure 1 year later. Prevention programs need to better explain medical marijuana to youth, providing information on the context for proper medical use of this drug and the potential harms from use during this developmental period. Furthermore, as this is a new frontier, it is important to consider regulating medical marijuana advertisements, as is currently done for alcohol and tobacco products. (c) 2015 APA, all rights reserved).
Gunderson, Erik W; Haughey, Heather M; Ait-Daoud, Nassima; Joshi, Amruta S; Hart, Carl L
Despite growing concern about the increased rates of synthetic cannabinoid (SC) use and their effects, only limited data are available that addresses these issues. This study assessed the extent of SC product use and reported effects among a cohort of adult marijuana and tobacco users. A brief telephone interview was conducted with individuals who had given permission to be contacted for future research while screening for a cannabis/nicotine dependence medication development study (NCT01204723). Respondents (N = 42; 88% participation rate) were primarily young adults, male, racially diverse, and high school graduates. Nearly all currently smoked tobacco and cannabis, with 86% smoking cannabis on 5 or more days per week. Nearly all (91%) were familiar with SC products, half (50%) reported smoking SC products previously, and a substantial minority (24%) reported current use (i.e., past month). Despite a federal ban on 5 common SCs, which went into effect on March 1, 2011, a number of respondents reported continued SC product use. Common reasons reported for use included, but were not limited to, seeking a new "high" similar to that produced by marijuana and avoiding drug use detection via a positive urine screen. The primary side effects were trouble thinking clearly, headache, dry mouth, and anxiety. No significant differences were found between synthetic cannabinoid product users (ever or current) and nonusers by demographics or other characteristics. Among current marijuana and tobacco users, SC product consumption was common and persisted despite a federal ban. The primary reasons for the use of SC-containing products seem to be to evade drug detection and to experience a marijuana-like high.
Tashkin, Donald P
Regular smoking of marijuana by itself causes visible and microscopic injury to the large airways that is consistently associated with an increased likelihood of symptoms of chronic bronchitis that subside after cessation of use. On the other hand, habitual use of marijuana alone does not appear to lead to significant abnormalities in lung function when assessed either cross-sectionally or longitudinally, except for possible increases in lung volumes and modest increases in airway resistance of unclear clinical significance. Therefore, no clear link to chronic obstructive pulmonary disease has been established. Although marijuana smoke contains a number of carcinogens and cocarcinogens, findings from a limited number of well-designed epidemiological studies do not suggest an increased risk for the development of either lung or upper airway cancer from light or moderate use, although evidence is mixed concerning possible carcinogenic risks of heavy, long-term use. Although regular marijuana smoking leads to bronchial epithelial ciliary loss and impairs the microbicidal function of alveolar macrophages, evidence is inconclusive regarding possible associated risks for lower respiratory tract infection. Several case reports have implicated marijuana smoking as an etiologic factor in pneumothorax/pneumomediastinum and bullous lung disease, although evidence of a possible causal link from epidemiologic studies is lacking. In summary, the accumulated weight of evidence implies far lower risks for pulmonary complications of even regular heavy use of marijuana compared with the grave pulmonary consequences of tobacco.
Keller, Corey J; Chen, Evan C; Brodsky, Kimberly; Yoon, Jong H
Marijuana is one of the most widely used controlled substances in the United States. Despite extensive research on smoked marijuana, little is known regarding the potential psychotropic effects of marijuana "wax," a high-potency form of marijuana that is gaining in popularity. The authors present a case of "Mr. B," a 34-year-old veteran who presented with profound psychosis in the setting of recent initiation of heavy, daily marijuana wax use. He exhibited incoherent speech and odd behaviors and appeared to be in a dream-like state with perseverating thoughts about his combat experience. His condition persisted despite treatment with risperidone 4 mg twice a day (BID), but improved dramatically on day 8 of hospitalization with the return of baseline mental function. Following discharge, Mr. B discontinued all marijuana use and did not exhibit the return of any psychotic symptoms. This study highlights the need for future research regarding the potential medical and psychiatric effects of new, high-potency forms of marijuana. Could cannabis have a dose-dependent impact on psychosis? What other potential psychiatric effects could emerge heretofore unseen in lower potency formulations? Given the recent legalization of marijuana, these questions merit timely exploration.
Lane, Scott D.; Cherek, Don R.; Lieving, Lori M.; Tcheremissine, Oleg V.
It has long been known that acute marijuana administration impairs working memory (e.g., the discrimination of stimuli separated by a delay). The determination of which of the individual components of memory are altered by marijuana is an unresolved problem. Previous human studies did not use test protocols that allowed for the determination of…
Lauritsen, Kirstin J; Rosenberg, Harold
Although initially developed for medical purposes, synthetic cannabinoids have also been consumed for recreational purposes. To evaluate whether agreement with positive and negative outcome expectancies differed for synthetic cannabinoids versus botanical marijuana, and assess reported reasons for using synthetic cannabinoids. Using a web-based recruitment and data collection procedure, 186 adults who had used both synthetic cannabinoids and botanical marijuana and 181 adults who had used botanical marijuana but not synthetic cannabinoids, completed measures of outcome expectancies and other relevant questionnaires. A significant interaction revealed that participants who had used both synthetic cannabinoids and botanical marijuana indicated lower agreement with positive expectancies for synthetic cannabinoids, and higher agreement with positive expectancies for botanical marijuana, than did those participants who used only botanical marijuana. There was no interaction between type of drug and use history on agreement with negative expectancies, and participants agreed more strongly with negative outcome expectancies for synthetic cannabinoids than for botanical marijuana whether they had used one or both types of these drugs. The most frequently provided reasons for using synthetic cannabinoids included availability, perceived legality, cost, curiosity, and social interaction. Given growing public acceptance of recreational and medical marijuana, coupled with negative perceptions and increasing regulation of synthetic cannabinoid compounds, botanical marijuana is likely to remain more available and more popular than synthetic cannabinoids.
Terry-McElrath, Yvonne M.; McBride, Duane C.; Chriqui, Jamie F.; O'Malley, Patrick M.; VanderWaal, Curtis J.; Chaloupka, Frank J.; Johnston, Lloyd D.
This article examines relationships between local drug policy (as represented by prosecutor-reported case outcomes for first-offender juvenile marijuana possession cases) and youth self-reported marijuana use, perceived risk, and disapproval. Interviews with prosecutors and surveys of 8th-, 10th-, and 12th-grade students in the United States were…
Recent raids on buyers' clubs in San Francisco have focused attention on medicinal uses of marijuana. The Clinton administration's policy is that there is no scientific evidence that smoked marijuana is useful in treating pain and nausea in AIDS and cancer patients. However, mainstream medical literature has supported the use of cannabis in managing symptoms of diseases such as glaucoma and multiple sclerosis. Well designed, controlled studies of marijuana are needed to determine the effective medical uses of the drug and break the political stalemate on this issue.
du Plessis, Stefan S; Agarwal, Ashok; Syriac, Arun
Marijuana has the highest consumption rate among all of the illicit drugs used in the USA, and its popularity as both a recreational and medicinal drug is increasing especially among men of reproductive age. Male factor infertility is on the increase, and the exposure to the cannabinoid compounds released by marijuana could be a contributing cause. The endocannabinoid system (ECS) is deeply involved in the complex regulation of male reproduction through the endogenous release of endocannabinoids and binding to cannabinoid receptors. Disturbing the delicate balance of the ECS due to marijuana use can negatively impact reproductive potential. Various in vivo and in vitro studies have reported on the empirical role that marijuana plays in disrupting the hypothalamus-pituitary-gonadal axis, spermatogenesis, and sperm function such as motility, capacitation, and the acrosome reaction. In this review, we highlight the latest evidence regarding the effect of marijuana use on male fertility and also provide a detailed insight into the ECS and its significance in the male reproductive system.
This report was prepared in accordance with Section 4008 (Marijuana-Impaired Driving) of the Fixing Americas Surface Transportation Act (FAST Act), Pub. L. 114-94. The report summarizes what is known about marijuana use and driving. The report des...
Marijuana that is legally available for adults has multiple implications for adolescent substance use. One potential effect that legalization may have is an increase in adolescent use to due increased availability, greater social acceptance, and possibly lower prices. Legalization may also facilitate the introduction of new formulations of marijuana (edible, vaporized) and with potentially higher potencies. It is unknown what adolescent consumption patterns will be if marijuana is widely avai...
Bergeria, Cecilia L.; Heil, Sarah H.
Background: Breastfeeding is associated with substantial benefits for both the child and mother. Most guidelines state that women who use illicit drugs should not breastfeed. Although this recommendation has traditionally included marijuana, this drug's changing legal status and the limited scientific research regarding marijuana's effect on breastfeeding and the nursing child may lead to varying recommendations made by lactation professionals to clients who use marijuana. Additionally, to ou...
Salomonsen-Sautel, Stacy; Sakai, Joseph T.; Thurstone, Christian; Corley, Robin; Hopfer, Christian
Objective: To assess the prevalence and frequency of medical marijuana diversion and use among adolescents in substance abuse treatment and to identify factors related to their medical marijuana use. Method: This study calculated the prevalence and frequency of diverted medical marijuana use among adolescents (n = 164), ages 14-18 years (mean age…
Leepile A. Sehularo
Opsomming Insig in die gebruik van marijuana deur psigiatriese pasiënte is beperk, spesifiek met betrekking tot hulle redes vir voortgesette marijuana verbruik ten spyte van die negatiewe gevolge daarvan, byvoorbeeld hertoelating tot psigiatriese hospitale na marijuanageïnduseerde psigotiese episodes. Dit is dus belangrik om te verstaan waarom psigiatriese pasiënte voortgaan om marijuana te gebruik ten spyte van die negatiewe uitwerking daarvan. Hierdie navorsing was ten doel om die persepsies van psigiatriese pasiënte in verband met die gebruik van marijuana in Potchefstroom in die Noordwesprovinsie te verken en te beskryf. So kan aanbevelings gemaak word vir verpleegonderrig, verpleegnavorsing en verpleegpraktyk om meer toepaslike versorging en behandeling te verseker en uiteindelik die heropname van psigiatriese pasiënte as gevolg van marijuana-geïnduseerde psigose te verminder. ‘n Kwalitatiewe, verkennende, beskrywende en kontekstuele navorsingsontwerp is gevolg om ‘n ‘stem’ te gee aan die persepsies van psigiatriese pasiënte aangaande die gebruik van marijuana. Doelgerigte steekproefneming is gebruik om deelnemers te identifiseer wat sou voldoen aan seleksiekriteria. Die steekproefgrootte is bepaal deur dataversadiging, wat bereik is na 10 individuele onderhoude met psigiatriese pasiënte. Ongestruktureerde individuele onderhoude is gebruik om data te versamel ná geskrewe toestemming van die Etiekkomitee van die Noordwes-Universiteit (Potchefstroom Kampus, van die Noordwes Provinsiale Departement van Gesondheid, die Kliniese bestuurder van die psigiatriese hospitaal waar die data versamel is, sowel as van die psigiatriese pasiënte. Die medekodeerder en die navorser het die data onafhanklik van mekaar geanaliseer. Die bevindings van hierdie studie het die persepsies wat psigiatriese pasiënte het oor die gebruik van marijuana, die negatiewe effekte van die gebruik van marijuana, die gebruik van marijuana en psigiatriese toestande, en die
Bostwick, J Michael
For 5 millennia, Cannabis sativa has been used throughout the world medically, recreationally, and spiritually. From the mid-19th century to the 1930s, American physicians prescribed it for a plethora of indications, until the federal government started imposing restrictions on its use, culminating in 1970 with the US Congress classifying it as a Schedule I substance, illegal, and without medical value. Simultaneous with this prohibition, marijuana became the United States' most widely used illicit recreational drug, a substance generally regarded as pleasurable and relaxing without the addictive dangers of opioids or stimulants. Meanwhile, cannabis never lost its cachet in alternative medicine circles, going mainstream in 1995 when California became the first of 16 states to date to legalize its medical use, despite the federal ban. Little about cannabis is straightforward. Its main active ingredient, δ-9-tetrahydrocannabinol, was not isolated until 1964, and not until the 1990s were the far-reaching modulatory activities of the endocannabinoid system in the human body appreciated. This system's elucidation raises the possibility of many promising pharmaceutical applications, even as draconian federal restrictions that hamstring research show no signs of softening. Recreational use continues unabated, despite growing evidence of marijuana's addictive potential, particularly in the young, and its propensity for inducing and exacerbating psychotic illness in the susceptible. Public approval drives medical marijuana legalization efforts without the scientific data normally required to justify a new medication's introduction. This article explores each of these controversies, with the intent of educating physicians to decide for themselves whether marijuana is panacea, scourge, or both. PubMed searches were conducted using the following keywords: medical marijuana, medical cannabis, endocannabinoid system, CB1 receptors, CB2 receptors, THC, cannabidiol, nabilone
Bostwick, J. Michael
For 5 millennia, Cannabis sativa has been used throughout the world medically, recreationally, and spiritually. From the mid-19th century to the 1930s, American physicians prescribed it for a plethora of indications, until the federal government started imposing restrictions on its use, culminating in 1970 with the US Congress classifying it as a Schedule I substance, illegal, and without medical value. Simultaneous with this prohibition, marijuana became the United States' most widely used illicit recreational drug, a substance generally regarded as pleasurable and relaxing without the addictive dangers of opioids or stimulants. Meanwhile, cannabis never lost its cachet in alternative medicine circles, going mainstream in 1995 when California became the first of 16 states to date to legalize its medical use, despite the federal ban. Little about cannabis is straightforward. Its main active ingredient, δ-9-tetrahydrocannabinol, was not isolated until 1964, and not until the 1990s were the far-reaching modulatory activities of the endocannabinoid system in the human body appreciated. This system's elucidation raises the possibility of many promising pharmaceutical applications, even as draconian federal restrictions that hamstring research show no signs of softening. Recreational use continues unabated, despite growing evidence of marijuana's addictive potential, particularly in the young, and its propensity for inducing and exacerbating psychotic illness in the susceptible. Public approval drives medical marijuana legalization efforts without the scientific data normally required to justify a new medication's introduction. This article explores each of these controversies, with the intent of educating physicians to decide for themselves whether marijuana is panacea, scourge, or both. PubMed searches were conducted using the following keywords: medical marijuana, medical cannabis, endocannabinoid system, CB1 receptors, CB2 receptors, THC, cannabidiol, nabilone
Archer, James, Jr.; Lopata, Ann
This review examines recent research on psychological effects of marijuana. The article contains material on potency, research problems, use patterns in the United States, and expectancy, as well as a review of research on acute effects, including psychosis, toxic delirium, acute anxiety, and brain damage. (Author)
David Powell; Rosalie Liccardo Pacula; Mireille Jacobson
Many medical marijuana patients report using marijuana to alleviate chronic pain from musculoskeletal problems and other sources. If marijuana is used as a substitute for powerful and addictive pain relievers in medical marijuana states, a potential overlooked positive impact of medical marijuana laws may be a reduction in harms associated with opioid pain relievers, a far more addictive and potentially deadly substance. To assess this issue, we study the impact of medical marijuana laws on p...
Gilman, Jodi M; Kuster, John K; Lee, Sang; Lee, Myung Joo; Kim, Byoung Woo; Makris, Nikos; van der Kouwe, Andre; Blood, Anne J; Breiter, Hans C
Marijuana is the most commonly used illicit drug in the United States, but little is known about its effects on the human brain, particularly on reward/aversion regions implicated in addiction, such as the nucleus accumbens and amygdala. Animal studies show structural changes in brain regions such as the nucleus accumbens after exposure to Δ9-tetrahydrocannabinol, but less is known about cannabis use and brain morphometry in these regions in humans. We collected high-resolution MRI scans on young adult recreational marijuana users and nonusing controls and conducted three independent analyses of morphometry in these structures: (1) gray matter density using voxel-based morphometry, (2) volume (total brain and regional volumes), and (3) shape (surface morphometry). Gray matter density analyses revealed greater gray matter density in marijuana users than in control participants in the left nucleus accumbens extending to subcallosal cortex, hypothalamus, sublenticular extended amygdala, and left amygdala, even after controlling for age, sex, alcohol use, and cigarette smoking. Trend-level effects were observed for a volume increase in the left nucleus accumbens only. Significant shape differences were detected in the left nucleus accumbens and right amygdala. The left nucleus accumbens showed salient exposure-dependent alterations across all three measures and an altered multimodal relationship across measures in the marijuana group. These data suggest that marijuana exposure, even in young recreational users, is associated with exposure-dependent alterations of the neural matrix of core reward structures and is consistent with animal studies of changes in dendritic arborization.
Smith, Roberta; Hall, Katelyn E; Etkind, Paul; Van Dyke, Mike
The effects of marijuana use on workplace safety are of concern for public health and workplace safety professionals. Twenty-nine states and the District of Columbia have enacted laws legalizing marijuana at the state level for recreational and/or medical purposes. Employers and safety professionals in states where marijuana use is legal have expressed concerns about potential increases in occupational injuries, such as on-the-job motor vehicle crashes, related to employee impairment. Data published in 2017 by the Colorado Department of Public Health and Environment (CDPHE) showed that more than one in eight adult state residents aged ≥18 years currently used marijuana in 2014 (13.6%) and 2015 (13.4%) (1). To examine current marijuana use by working adults and the industries and occupations in which they are employed, CDPHE analyzed data from the state's Behavioral Risk Factor Surveillance System (BRFSS) regarding current marijuana use (at least 1 day during the preceding 30 days) among 10,169 persons who responded to the current marijuana use question. During 2014 and 2015, 14.6% of these 10,169 Colorado workers reported current marijuana use, with the highest reported prevalence among workers in the Accommodation and Food Services industry (30.1%) and Food Preparation and Serving (32.2%) occupations. Understanding the industries and occupations of adults with reported marijuana use can help direct and maximize impact of public health messaging and potential safety interventions for adults.
... Alcohol Club Drugs Cocaine Fentanyl Hallucinogens Inhalants Heroin Marijuana MDMA (Ecstasy/Molly) Methamphetamine Opioids Over-the-Counter Medicines Prescription Medicines Steroids (Anabolic) Synthetic Cannabinoids (K2/Spice) Synthetic Cathinones (Bath Salts) Tobacco/ ...
Caulkins, Jonathan P; Kilmer, Beau
In 2014 the legislature of Vermont, USA passed a law requiring the Secretary of Administration to report on the consequences of legalizing marijuana. The RAND Corporation was commissioned to write that report. This paper summarizes insights from that analysis that are germane to other jurisdictions. Translation of key findings from the RAND Corporation report to the broader policy debate. Marijuana legalization encompasses a wide range of possible regimes, distinguished along at least four dimensions: which organizations are allowed to produce and supply the drug, the regulations under which they operate, the nature of the products that can be distributed and taxes and prices. Vermont's decriminalization had already cut its costs of enforcing marijuana prohibition against adults to about $1 per resident per year. That is probably less than the cost of regulating a legal market. Revenues from taxing residents' purchases after legalization could be many times that amount, so the main fiscal cost of prohibition after decriminalization relative to outright legalization may be foregone tax revenues, not enforcement costs. Approximately 40 times as many users live within 200 miles of Vermont's borders as live within the state; drug tourism and associated tax revenues will be important considerations, as will be the response of other states. Indeed, if another state legalized with lower taxes, that could undermine the ability to collect taxes on even Vermont residents' purchases. Analysis of possible outcomes if Vermont, USA, legalized marijuana reveal that choices about how, and not just whether, to legalize a drug can have profound consequences for the effects on health and social wellbeing, and the choices of one jurisdiction can affect the options and incentives available to other jurisdictions. © 2016 Society for the Study of Addiction.
Sheer, Amy J.; Gorelick, David A.; Collins, Charles C.; Schroeder, Jennifer R.; Heishman, Stephen J.; Leff, Michelle K.; Moolchan, Eric T.
Little is known about adolescents’ interest in marijuana treatment programs. This question was evaluated by telephone interview in a convenience sample of 575 adolescents responding to advertisements for tobacco research studies. Eighty-one percent of respondents endorsed the need for marijuana treatment programs for adolescents. These adolescents were younger and less likely to smoke tobacco, smoke marijuana, or use alcohol than those not endorsing such a need. Among the 192 marijuana smoker...
Yzer, Marco C.; Cappella, Joseph N.; Fishbein, Martin; Hornik, Robert; Sayeed, Sarah; Ahern, R. Kirkland
This study uses an integrative model of behavioral prediction as an account of adolescents’ intention to use marijuana regularly. Adolescents’ risk for using marijuana regularly is examined to test the theoretical assumption that distal variables affect intention indirectly. Risk affects intention indirectly if low-risk and high-risk adolescents differ on the strength with which beliefs about marijuana are held, or if they differ on the relative importance of predictors of intention. A model ...
Lamy, Francois R; Daniulaityte, Raminta; Zatreh, Mussah; Nahhas, Ramzi W; Sheth, Amit; Martins, Silvia S; Boyer, Edward W; Carlson, Robert G
"Rosin tech" is an emerging solventless method consisting in applying moderate heat and constant pressure on marijuana flowers to prepare marijuana concentrates referred to as "rosin." This paper explores rosin concentrate-related Twitter data to describe tweet content and analyze differences in rosin-related tweeting across states with varying cannabis legal statuses. English language tweets were collected between March 15, 2015 and April 17, 2017, using Twitter API. U.S. geolocated unique (no retweets) tweets were manually coded to evaluate the content of rosin-related tweets. Adjusted proportions of Twitter users and personal communication tweets per state related to rosin concentrates were calculated. A permutation test was used to analyze differences in normalized proportions between U.S. states with different cannabis legal statuses. eDrugTrends collected 8389 tweets mentioning rosin concentrates/technique. 4164 tweets (49.6% of total sample) posted by 1264 unique users had identifiable state-level geolocation. Content analysis of 2010 non-retweeted tweets revealed a high proportion of media-related tweets (44.2%) promoting rosin as a safer and solventless production method. Tweet-volume-adjusted percentages of geolocated Twitter users and personal communication tweets about rosin were respectively up to seven and sixteen times higher between states allowing recreational use of cannabis and states where cannabis is illegal. Our results indicate that there are higher proportions of personal communication tweets and Twitter users tweeting about rosin in U.S. states where cannabis is legalized. Rosin concentrates are advertised as a safer, more natural form of concentrates, but more research on this emerging form of marijuana concentrate is needed. Copyright © 2018 Elsevier B.V. All rights reserved.
Dilley, Julia A; Hitchcock, Laura; McGroder, Nancy; Greto, Lindsey A; Richardson, Susan M
Washington State (WA) legalized a recreational marijuana market - including growing, processing and retail sales - through voter initiative 502 in November 2012. Legalized recreational marijuana retail sales began in July 2014. In response to state legalization of recreational marijuana, some cities and counties within the state have passed local ordinances that either further regulated marijuana markets, or banned them completely. The purpose of this study is to describe local-level marijuana regulations on recreational retail sales within the context of a state that had legalized a recreational marijuana market. Marijuana-related ordinances were collected from all 142 cities in the state with more than 3000 residents and from all 39 counties. Policies that were in place as of June 30, 2016 - two years after the state's recreational market opening - to regulate recreational marijuana retail sales within communities were systematically coded. A total of 125 cities and 30 counties had passed local ordinances to address recreational marijuana retail sales. Multiple communities implemented retail market bans, including some temporary bans (moratoria) while studying whether to pursue other policy options. As of June 30, 2016, 30% of the state population lived in places that had temporarily or permanently banned retail sales. Communities most frequently enacted zoning policies explicitly regulating where marijuana businesses could be established. Other policies included in ordinances placed limits on business hours and distance requirements (buffers) between marijuana businesses and youth-related land use types or other sensitive areas. State legalization does not necessarily result in uniform community environments that regulate recreational marijuana markets. Local ordinances vary among communities within Washington following statewide legalization. Further study is needed to describe how such local policies affect variation in public health and social outcomes
Lutchmansingh, Denyse; Pawar, Leena; Savici, Dana
Habitual smoking of marijuana is associated with multiple respiratory symptoms such as cough, sputum production, and wheezing .These symptoms are not significantly different from those exhibited by tobacco smokers. Furthermore, endobronchial biopsies of habitual smokers of marijuana and /or tobacco have shown that both marijuana and cigarette smoking cause significant bronchial mucosal histopathology and that these effects are additive. Although marijuana smokers have minimal changes in pulmonary function studies as compared to tobacco smokers, they may develop bullous disease and spontaneous pneumothoraces. The relationship between marijuana smoking and lung cancer remains unclear due to design limitations of the studies published so far. These findings should warn individuals that marijuana smoking may result in serious short-term and long-term respiratory complications, and habitual marijuana use should be viewed with caution. The medical literature so far does not support routine evaluation by pulmonary function tests or imaging studies; until more definitive data is available, we do not recommend the regular use of these tests in the evaluation of habitual marijuana smokers.
Voth, E A; Schwartz, R H
The use of crude marijuana for herbal medicinal applications is now being widely discussed in both the medical and lay literature. Ballot initiatives in California and Arizona have recently made crude marijuana accessible to patients under certain circumstances. As medicinal applications of pure forms of delta-9-tetrahydrocannabinol (THC) and crude marijuana are being considered, the most promising uses of any form of THC are to counteract the nausea associated with cancer chemotherapy and to stimulate appetite. We evaluated the relevant research published between 1975 and 1996 on the medical applications, physical complications, and legal precedents for the use of pure THC or crude marijuana. Our review focused on the medical use of THC derivatives for nausea associated with cancer chemotherapy, glaucoma, stimulation of appetite, and spinal cord spasticity. Despite the toxicity of THC delivered in any form, evidence supports the selective use of pure THC preparations to treat nausea associated with cancer chemotherapy and to stimulate appetite. The evidence does not support the reclassification of crude marijuana as a prescribable medicine.
Czyzewska, Maria; Ginsburg, Harvey J
Effects of anti-tobacco and anti-marijuana TV advertisements on explicit (i.e., semantic differential ratings) and implicit (i.e. Implicit Association Test, IAT) attitudes toward tobacco and marijuana were compared. Two hundred twenty nine, 18- to 19-year-old U.S. college students were randomly assigned to anti-tobacco or anti-marijuana PSA viewing conditions. Participants completed a short survey on attitudes to tobacco and marijuana. Afterwards they watched 15 PSAs embedded in a 15-min science program. At the end, all participants completed IAT for marijuana, IAT for tobacco and the assessment of explicit attitudes. Results of ANCOVA revealed a significant interaction between type of TV PSAs watched and implicit attitudes, F(1,223)=7.12, padvertisements watched (i.e., anti-tobacco or anti-marijuana). However, analogical analysis on explicit measures showed that attitudes to marijuana became less negative among students that watched anti-marijuana ads than the group with anti-tobacco ads, F(1,222)=5.79, p<0.02. The discussion focused on the practical and theoretical implications of the observed dissociation between implicit and explicit attitudes to marijuana after the exposure to anti-marijuana PSAs.
Rein, Joshua L; Wyatt, Christina M
Marijuana is the most commonly used recreational drug in the United States, and legal recreational and medicinal use has gained public acceptance during the last decade. Twenty-nine US states have established medical marijuana programs, 8 of which have also legalized recreational marijuana, and Canada is expected to legalize recreational marijuana in 2018. Advanced chronic kidney disease (CKD) and end-stage renal disease (ESRD) are chronic conditions with significant associated morbidity and mortality. Patients experience substantial symptom burden that is frequently undertreated due to adverse medication side effects. This article reviews the available evidence for the use of medical marijuana to manage chronic pain, nausea/vomiting, anorexia/cachexia, and pruritus, all of which are frequently reported by patients with advanced CKD or ESRD. Potential adverse health effects of medical and recreational marijuana use are also discussed. Regardless of personal, social, and political beliefs, marijuana use is becoming mainstream, and nephrologists should be aware of the potential impact on our patient population. Further research is warranted to investigate the renal endocannabinoid system, the impact of marijuana use on kidney disease outcomes, and the risks and benefits of medical marijuana use on symptoms of advanced CKD and ESRD. Copyright © 2017 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.
Collingwood, Loren; O'Brien, Ben Gonzalez; Dreier, Sarah
In 2012, Washington and Colorado became the first U.S. states to legalise recreational marijuana. By 2016, eight states and the District of Columbia had legalised recreational marijuana, with more expected to consider it in 2018. Despite this trend, little academic research explains what drives ballot-initiative vote choice on marijuana legalisation. This paper uses a pre-election random sample voter survey to examine the individual characteristics that correlated with Washington voters' support for legal recreational marijuana. We find that voting on marijuana ballot initiatives largely reflects public opinion about marijuana and is particularly shaped voters' political ideology, party affiliation, religious affiliation and practice, and education. Notably, we find that those reporting experiences (i.e., someone they know) with the criminal justice system are more supportive of legalisation than those who do not. We conclude that marijuana legalisation voting behavior generally aligns with public opinion on the issue. However, one key aspect of Washington's legalisation campaign-the criminal injustices of marijuana illegality-helped shape Washington state voting behavior. Further research is needed to examine if, when, and in what contexts criminal justice campaign themes are likely to strengthen or undermine future states' marijuana legalisation efforts. Copyright © 2018 Elsevier B.V. All rights reserved.
Tashkin, D P; Gliederer, F; Rose, J; Chang, P; Hui, K K; Yu, J L; Wu, T C
Previous in vitro studies suggest that, with successive puffs from a marijuana cigarette, delta-9-THC becomes concentrated in the remaining uncombusted portion of the cigarette. These observations are consistent with the common practice of smoking marijuana cigarettes to a smaller butt length than that to which tobacco cigarettes are smoked. The purpose of the present study was to compare the delivery of delta-9-THC, as well as total insoluble smoke particulates (tar) and carbon monoxide, from the distal ("first") versus the proximal ("second") halves of a standard marijuana cigarette during "natural" smoking of marijuana. On 4 separate days, ten habitual marijuana users smoked nearly all or approximately 1/2 of a standard marijuana cigarette (83 mm length; 800-900 mg; 1.24% THC), as follows: day 1, "whole" cigarette (60 mm smoked, leaving a 23-mm butt); day 2, "first" half (first 30 mm); day 3, "second" half (second 30 mm) after the "first" half was presmoked with a syringe; and day 4, "second" half after the "first" half was excised. A previously described smoking apparatus (20) was used for measurement of puff volume and inhaled tar. Puff volume and number were allowed to vary spontaneously (provided that the specified length of cigarette was consumed), while inhaled volume (1.5 liters), breathholding time (14 s) and interpuff interval (30 s) were held constant. Blood samples were withdrawn prior to smoking and serially after completion of smoking for analysis of blood carboxyhemoglobin (COHb) and serum delta-9-THC. Heart rate was measured before and 5 min after smoking. Subjects rated their level of "high" 20 min after completion of smoking.(ABSTRACT TRUNCATED AT 250 WORDS)
Maisha Kelly Freeman
Full Text Available Objectives: To provide an overview of the addiction potential; adverse effects (e.g., cardiovascular, immune dysfunction, respiratory system, mental health disorders; drug interactions; effects of accidental exposure; crime statistics; and pharmacist’s considerations for the use of inhaled medical marijuana. Methods: A PubMed search was conducted from 1966 to March 2016 to identify articles in which the safety of inhaled medical marijuana was assessed. Key MeSH search terms included medical marijuana with a subheading for adverse effect. Only articles in adult patients were considered. In addition, medical marijuana or cannabis plus one of the following search terms were searched: drug interactions, herb-drug interactions, drug-related side effects and adverse drug reactions, substance-related disorders, addiction, and abuse. A free-text search was also conducted to identify articles not included in the MeSH term search. A bibliographic search was also conducted. Articles were included if they addressed adverse effects of medical marijuana for the treatment of a condition. Meta-analyses, randomized controlled clinical trials, and case reports were included in the review if the primary focus of the article related to the adverse effect profile of inhaled medical marijuana. Medical marijuana efficacy studies were not assessed. In the absence of this information, case reports or reports of inhaled recreational marijuana use was used. Studies were excluded if published in languages other than English. In addition, studies highlighting mechanisms of action, studies of pharmacodynamics or pharmacokinetic effects were excluded, unless these effects were due to drug-drug interactions. Prescription products containing marijuana or derivatives were excluded from evaluation. An Internet search was conducted to locate the most up-to-date information on the laws concerning medical marijuana. Key findings: A PubMed search revealed 58 articles and 28 of
Wang, Xiaoyin; Derakhshandeh, Ronak; Liu, Jiangtao; Narayan, Shilpa; Nabavizadeh, Pooneh; Le, Stephenie; Danforth, Olivia M; Pinnamaneni, Kranthi; Rodriguez, Hilda J; Luu, Emmy; Sievers, Richard E; Schick, Suzaynn F; Glantz, Stanton A; Springer, Matthew L
Despite public awareness that tobacco secondhand smoke (SHS) is harmful, many people still assume that marijuana SHS is benign. Debates about whether smoke-free laws should include marijuana are becoming increasingly widespread as marijuana is legalized and the cannabis industry grows. Lack of evidence for marijuana SHS causing acute cardiovascular harm is frequently mistaken for evidence that it is harmless, despite chemical and physical similarity between marijuana and tobacco smoke. We investigated whether brief exposure to marijuana SHS causes acute vascular endothelial dysfunction. We measured endothelial function as femoral artery flow-mediated dilation (FMD) in rats before and after exposure to marijuana SHS at levels similar to real-world tobacco SHS conditions. One minute of exposure to marijuana SHS impaired FMD to a comparable extent as impairment from equal concentrations of tobacco SHS, but recovery was considerably slower for marijuana. Exposure to marijuana SHS directly caused cannabinoid-independent vasodilation that subsided within 25 minutes, whereas FMD remained impaired for at least 90 minutes. Impairment occurred even when marijuana lacked cannabinoids and rolling paper was omitted. Endothelium-independent vasodilation by nitroglycerin administration was not impaired. FMD was not impaired by exposure to chamber air. One minute of exposure to marijuana SHS substantially impairs endothelial function in rats for at least 90 minutes, considerably longer than comparable impairment by tobacco SHS. Impairment of FMD does not require cannabinoids, nicotine, or rolling paper smoke. Our findings in rats suggest that SHS can exert similar adverse cardiovascular effects regardless of whether it is from tobacco or marijuana. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.
Bates, Julie K.; Accordino, Michael P.; Hewes, Robert L.
Hierarchical regression analysis was used to test the hypothesis that specific functional factors of marijuana use would predict past 30-day marijuana use in 425 college students more precisely than demographic variables alone. This hypothesis was confirmed. Functional factors of personal/physical enhancement as well as activity enhancement were…
Rhyne, Danielle N; Anderson, Sarah L; Gedde, Margaret; Borgelt, Laura M
No clinical trials are currently available that demonstrate the effects of marijuana on patients with migraine headache; however, the potential effects of cannabinoids on serotonin in the central nervous system indicate that marijuana may be a therapeutic alternative. Thus, the objective of this study was to describe the effects of medical marijuana on the monthly frequency of migraine headache. Retrospective chart review. Two medical marijuana specialty clinics in Colorado. One hundred twenty-one adults with the primary diagnosis of migraine headache who were recommended migraine treatment or prophylaxis with medical marijuana by a physician, between January 2010 and September 2014, and had at least one follow-up visit. The primary outcome was number of migraine headaches per month with medical marijuana use. Secondary outcomes were the type and dose of medical marijuana used, previous and adjunctive migraine therapies, and patient-reported effects. Migraine headache frequency decreased from 10.4 to 4.6 headaches per month (pmedical marijuana. Most patients used more than one form of marijuana and used it daily for prevention of migraine headache. Positive effects were reported in 48 patients (39.7%), with the most common effects reported being prevention of migraine headache with decreased frequency of migraine headache (24 patients [19.8%]) and aborted migraine headache (14 patients [11.6%]). Inhaled forms of marijuana were commonly used for acute migraine treatment and were reported to abort migraine headache. Negative effects were reported in 14 patients (11.6%); the most common effects were somnolence (2 patients [1.7%]) and difficulty controlling the effects of marijuana related to timing and intensity of the dose (2 patients [1.7%]), which were experienced only in patients using edible marijuana. Edible marijuana was also reported to cause more negative effects compared with other forms. The frequency of migraine headache was decreased with medical
Wang, X; Derakhshandeh, R; Liu, J; Narayan, S; Nabavizadeh, P; Le, S; Danforth, OM; Pinnamaneni, K; Rodriguez, HJ; Luu, E; Sievers, RE; Schick, SF; Glantz, SA; Springer, ML
Background Despite public awareness that tobacco secondhand smoke (SHS) is harmful, many people still assume that marijuana SHS is benign. Debates about whether smoke?free laws should include marijuana are becoming increasingly widespread as marijuana is legalized and the cannabis industry grows. Lack of evidence for marijuana SHS causing acute cardiovascular harm is frequently mistaken for evidence that it is harmless, despite chemical and physical similarity between marijuana and tobacco sm...
Full Text Available Cristina B Bares1, Jorge Delva2, Andrew Grogan-Kaylor2, Fernando Andrade31Curtis Research and Training Center, School of Social Work, 2School of Social Work, 3School of Education, University of Michigan, Ann Arbor, MI, USAObjective: Family involvement and several characteristics of parenting have been suggested to be protective factors for adolescent substance use. Some parenting behaviors may have stronger relationships with adolescent behavior while others may have associations with undesirable behavior among youth. Although it is generally acknowledged that families play an important role in the lives of Chilean adolescents, scant research exists on how different family and parenting factors may be associated with marijuana use and related problems in this population which has one of the highest rates of drug use in Latin America.Methods: Using logistic regression and negative binomial regression, we examined whether a large number of family and parenting variables were associated with the possibility of Chilean adolescents ever using marijuana, and with marijuana-related problems. Analyses controlled for a number of demographic and peer-related variables.Results: Controlling for other parenting and family variables, adolescent reports of parental marijuana use showed a significant and positive association with adolescent marijuana use. The multivariate models also revealed that harsh parenting by fathers was the only family variable associated with the number of marijuana-related problems youth experienced. Conclusion: Of all the family and parenting variables studied, perceptions of parental use of marijuana and harsh parenting by fathers were predictors for marijuana use, and the experience of marijuana-related problems. Prevention interventions need to continue emphasizing the critical socializing role that parental behavior plays in their children's development and potential use of marijuana.Keywords: parenting, families, adolescent
Grant, Igor; Atkinson, J. Hampton; Gouaux, Ben; Wilsey, Barth
Recent advances in understanding of the mode of action of tetrahydrocannabinol and related cannabinoid in-gredients of marijuana, plus the accumulating anecdotal reports on potential medical benefits have spurred increasing re-search into possible medicinal uses of cannabis. Recent clinical trials with smoked and vaporized marijuana, as well as other botanical extracts indicate the likelihood that the cannabinoids can be useful in the management of neuropathic pain, spasticity due to multiple...
Beaudoin, Christopher E.; Hong, Traci
Objectives: To assess the influence of media use and perceived risk on marijuana use outcomes. Methods: With survey data from 750 US young adults, structural equation modeling tested how attitudes, behaviors, and behavioral intention specific to marijuana use are influenced by perceived personal and societal risk of marijuana use, media campaign…
Darley, C F; Tinklenberg, J R; Roth, W T; Vernon, S; Kopell, B S
The ability of 16 college-educated male subjects to recall from long-term memory a series of common facts was tested during intoxication with marijuana extract calibrated to 0.3 mg/kg delta-9-tetrahydrocannabinol and during placebo conditions. The subjects' ability to assess their memory capabilities was then determined by measuring how certain they were about the accuracy of their recall performance and by having them predict their performance on a subsequent recognition test involving the same recall items. Marijuana had no effect on recall or recognition performance. These results do not support the view that marijuana provides access to facts in long-term storage which are inaccessible during non-intoxication. During both marijuana and placebo conditions, subjects could accurately predict their recognition memory performance. Hence, marijuana did not alter the subjects' ability to accurately assess what information resides in long-term memory even though they did not have complete access to that information.
Office of National Drug Control Policy, Washington, DC.
This publication, part of the Office of National Drug Control Policys Asian Language Initiative, offers facts and answers about marijuana. It educates parents about what it is, its physical and physiological effects, slang terms, and how its used. It also identifies signs that indicate marijuana use, and provides tips for parents who want to…
Ehlers, Cindy L; Phillips, Evelyn; Gizer, Ian R; Gilder, David A; Wilhelmsen, Kirk C
Native Americans have some of the highest rates of marijuana and alcohol use and abuse, yet neurobiological measures associated with dependence on these substances in this population remain unknown. The present investigation evaluated the heritability of spectral characteristics of the electroencephalogram (EEG) and their correlation with marijuana and alcohol dependence in an American Indian community. Participants (n=626) were evaluated for marijuana (MJ) and alcohol (ALC) dependence, as well as other psychiatric disorders. EEGs were collected from six cortical sites and spectral power determined in five frequency bands (delta 1.0-4.0 Hz, theta 4.0-7.5 Hz, alpha 7.5-12.0 Hz, low beta 12.0-20.0 Hz and high beta/gamma 20-50 Hz). The estimated heritability (h(2)) of the EEG phenotypes was calculated using SOLAR, and ranged from 0.16 to 0.67. Stepwise linear regression was used to detect correlations between MJ and ALC dependence and the spectral characteristics of the EEG using a model that took into account: age, gender, Native American Heritage (NAH) and a lifetime diagnosis of antisocial personality and/or conduct disorder (ASPD/CD). Increases in spectral power in the delta frequency range, were significantly correlated with gender (pEEG delta and high beta/gamma activity are correlated with MJ dependence and alcohol dependence, respectively, in this community sample of Native Americans. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.
Lundahl, Leslie H; Johanson, Chris-Ellyn
Recent interest in the development of medications for treatment of cannabis-use disorders indicates the need for laboratory models to evaluate potential compounds prior to undertaking clinical trials. To investigate whether a cue-reactivity paradigm could induce marijuana craving in cannabis-dependent adults, 16 (eight female) cannabis-dependent and 16 (eight female) cannabis-naïve participants were exposed to neutral and marijuana-related cues, and subsequent changes in mood, self-reported craving, and physiologic function were assessed. Significant Group X cue interactions were found on all three VAS craving indices as well as on the Compulsivity scale of the Marijuana Craving Questionnaire-Brief Form (MCQ-BF). Cannabis-dependent individuals responded to marijuana-related cues with significantly increased reports of marijuana craving compared to neutral cue exposure, although there were no cue-induced changes in any of the physiological measures. There were no significant gender differences on any of the measures. These results indicate that marijuana craving can be induced and assessed in cannabis-dependent, healthy adults within a laboratory setting, and support the need for further research of the cue reactivity paradigm in the development of medications to treat cannabis-use disorders. (PsycINFO Database Record (c) 2011 APA, all rights reserved).
Thames, April D; Kuhn, Taylor P; Williamson, Timothy J; Jones, Jacob D; Mahmood, Zanjbeel; Hammond, Andrea
The current study examined the independent and interactive effects of HIV and marijuana (MJ) use on brain structure and cognitive function among a sample of HIV-positive (HIV+) and HIV-negative (HIV-) individuals. Participants (HIV+, n=48; HIV-, n=29) individuals underwent cognitive testing, questionnaires about substance use, and brain MRI. The HIV+ group was clinically stable based upon current plasma CD4 count, 50% had undetectable viral load (i.e.,brain structure and cognition. However, our results do not support that HIV+ MJ users are at greater risk for adverse brain or cognitive outcomes compared to HIV- MJ users. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Walker, Denise D.; Neighbors, Clayton; Rodriguez, Lindsey M.; Stephens, Robert S.; Roffman, Roger A.
Adolescence is a time in which individuals are particularly likely to engage in health-risk behaviors, with marijuana being the most prevalent illicit drug used. Perceptions of others’ use (i.e., norms) have previously been found to be related to increased marijuana use. Additionally, low refusal self-efficacy has been associated with increased marijuana consumption. This cross-sectional study examined the effects of normative perceptions and self-efficacy on negative marijuana outcomes for a...
Gruber, Staci A; Rogowska, Jadwiga; Yurgelun-Todd, Deborah A
More than 94 million Americans have tried marijuana, and it remains the most widely used illicit drug in the nation. Investigations of the cognitive effects of marijuana report alterations in brain function during tasks requiring executive control, including inhibition and decision-making. Endogenous cannabinoids regulate a variety of emotional responses, including anxiety, mood control, and aggression; nevertheless, little is known about smokers' responses to affective stimuli. The anterior cingulate and amygdala play key roles in the inhibition of impulsive behavior and affective regulation, and studies using PET and fMRI have demonstrated changes within these regions in marijuana smokers. Given alterations in mood and perception often observed in smokers, we hypothesized altered fMRI patterns of response in 15 chronic heavy marijuana smokers relative to 15 non-marijuana smoking control subjects during the viewing of masked happy and fearful faces. Despite no between-group differences on clinical or demographic measures, smokers demonstrated a relative decrease in both anterior cingulate and amygdalar activity during masked affective stimuli compared to controls, who showed relative increases in activation within these regions during the viewing of masked faces. Findings indicate that chronic heavy marijuana smokers demonstrate altered activation of frontal and limbic systems while viewing masked faces, consistent with autoradiographic studies reporting high CB-1 receptor density in these regions. These data suggest differences in affective processing in chronic smokers, even when stimuli are presented below the level of conscious processing, and underscore the likelihood that marijuana smokers process emotional information differently from those who do not smoke, which may result in negative consequences.
Mir M Ali
Full Text Available Research on adolescent substance use has consistently identified a strong relationship between adolescent behavior and the behavior of their peers. However, peer effects are difficult to estimate and causal interpretations must be undertaken with caution since individuals in most cases choose with whom to associate. In this paper we seek to empirically quantify the causal role of peer social networks in explaining marijuana usage among adolescents.Using data from a nationally representative sample of adolescents we utilize a multivariate structural model with school-level fixed effects to account for the problems of contextual effects, correlated effects and peer selections to purge the potential biases from the estimates of peer influence. Our peer group measures are drawn not only from the nomination of close friends (N = 6,377, but also from classmates (N = 19,335. Marijuana usage among the peer groups were constructed using the peers' own report of their marijuana consumption. Controlling for parent level characteristics, and other demographic parameters, we find that a 10% increase in the proportion of close friends and classmates who use marijuana increases the probability that an individual chooses to use marijuana by 5%.Our findings indicate that peer effects are important determinants of marijuana use even after controlling for potential biases We also found evidence to show that the influence of close friends and the more exogenous classmates are quite similar in magnitude under our preferred specification, supporting theory predicting the importance of peer influence. Effective policy aimed at reducing marijuana usage among adolescents would consider these significant peer effects.
Nakawaki, Brandon; Crano, William
Despite insidious effects, use of inhalant substances by adolescents remains an understudied phenomenon. This research was designed to identify patterns of past year substance use and delinquency among adolescent inhalant users. The study used a sample of adolescent inhalant users (ages ranged from 12-17 years, n = 7,476) taken from a pooled sample of the 2002 through 2012 National Survey of Drug Use and Health (NSDUH). Three-step latent class analyses were conducted with past year substance use and delinquency behaviors as class indicators. Demographic and social covariates were included in the analyses. Analyses yielded a six-class solution comprised of classes of users characterized by low substance use/low delinquency, high substance use/low delinquency, low substance use/fighting, cigarettes/alcohol/marijuana, high substance use/high delinquency, and cigarettes/alcohol/ marijuana/opioids/moderate delinquency. Findings provide insight into the taxonomy of adolescent inhalant user heterogeneity, and may inform future efforts at detection and prevention of inhalant use by suggesting warning signs of co-occurring externalizing behaviors and possible indications of underlying internalized issues.
Arria, Amelia M.; Caldeira, Kimberly M.; Bugbee, Brittany A.; Vincent, Kathryn B.; O’Grady, Kevin E.
Although several studies have shown that marijuana use can adversely affect academic achievement among adolescents, less research has focused on its impact on post-secondary educational outcomes. This study utilized data from a large longitudinal cohort study of college students to test the direct and indirect effects of marijuana use on college GPA and time to graduation, with skipping class as a mediator of these outcomes. A structural equation model was evaluated taking into account a variety of baseline risk and protective factors (i.e., demographics, college engagement, psychological functioning, alcohol and other drug use) thought to contribute to college academic outcomes. The results showed a significant path from baseline marijuana use frequency to skipping more classes at baseline to lower first-semester GPA to longer time to graduation. Baseline measures of other drug use and alcohol quantity exhibited similar indirect effects on GPA and graduation time. Over time, the rate of change in marijuana use was negatively associated with rate of change in GPA, but did not account for any additional variance in graduation time. Percentage of classes skipped was negatively associated with GPA at baseline and over time. Thus, even accounting for demographics and other factors, marijuana use adversely affected college academic outcomes, both directly and indirectly through poorer class attendance. Results extend prior research by showing that marijuana use during college can be a barrier to academic achievement. Prevention and early intervention might be important components of a comprehensive strategy for promoting post-secondary academic achievement. PMID:26237288
Estoup, Ashley C; Moise-Campbell, Claudine; Varma, Malini; Stewart, David G
Currently, only four states have legalized recreational marijuana use for adults over 21 years of age. Therefore, little is known about the influence that legalization will have on adolescent marijuana use. This study examines how marijuana legalization has impacted the frequency and consequences of adolescent use in a sample of participants in a school-based, substance use intervention. We hypothesized that adolescents enrolled in the intervention in years after marijuana legalization would present with more problematic use compared to those enrolled prior, and that changes in the perceived risk of marijuana would be a mechanism of problematic use. Participants were 262 students enrolled in a school-based substance use intervention in 2010 to 2015. The Customary Drinking and Drug Use Record, Alcohol and Drug Use Consequences Questionnaire, and a decisional balance matrix were used to assess marijuana frequency, negative consequences, and perceived risk of use. A mediation model was used to test the degree to which marijuana legalization may lead to increased frequency and consequences of use through perceived risk. Findings indicated a significantly positive correlation between marijuana-related consequences and perceived risk post legalization. Despite relatively equal use between both groups, adolescents in the legalization group experienced higher levels of perceived risk and increased negative consequences. Due to the rising legalization status of marijuana in the United States, it is imperative that psychoeducation is provided to adults and adolescents about the consequences of underage marijuana use.
Full Text Available Approximately 10% of young adults report non-medical use of stimulants (cocaine, amphetamine, methylphenidate, which puts them at risk for the development of dependence. This fMRI study investigates whether subjects at early stages of stimulant use show altered decision making processing.158 occasional stimulants users (OSU and 50 comparison subjects (CS performed a "risky gains" decision making task during which they could select safe options (cash in 20 cents or gamble them for double or nothing in two consecutive gambles (win or lose 40 or 80 cents, "risky decisions". The primary analysis focused on risky versus safe decisions. Three secondary analyses were conducted: First, a robust regression examined the effect of lifetime exposure to stimulants and marijuana; second, subgroups of OSU with >1000 (n = 42, or <50 lifetime marijuana uses (n = 32, were compared to CS with <50 lifetime uses (n = 46 to examine potential marijuana effects; third, brain activation associated with behavioral adjustment following monetary losses was probed.There were no behavioral differences between groups. OSU showed attenuated activation across risky and safe decisions in prefrontal cortex, insula, and dorsal striatum, exhibited lower anterior cingulate cortex (ACC and dorsal striatum activation for risky decisions and greater inferior frontal gyrus activation for safe decisions. Those OSU with relatively more stimulant use showed greater dorsal ACC and posterior insula attenuation. In comparison, greater lifetime marijuana use was associated with less neural differentiation between risky and safe decisions. OSU who chose more safe responses after losses exhibited similarities with CS relative to those preferring risky options.Individuals at risk for the development of stimulant use disorders presented less differentiated neural processing of risky and safe options. Specifically, OSU show attenuated brain response in regions critical for performance monitoring
Taggart, Tamara; Brown, Andre L; Kershaw, Trace
Neighborhoods are key socio-environmental contexts for marijuana use during emerging adulthood. This study examined the relationships between neighborhood context, traditional masculine norms (status, toughness, and anti-femininity), and marijuana use among 119 majority African American emerging adult men in a small urban community. Poisson regression models were used to determine the associations between neighborhood problems, social cohesion, and marijuana use. Moderator effects were examined to determine if masculinities modified these associations. Neighborhood problems and social cohesion were positively associated with marijuana use. Men who had a lower endorsement of some traditional masculine norms had greater marijuana use compared to men with a higher endorsement of these norms. These findings have implications for intervention strategies and policies.
Cofield, Stacey S; Salter, Amber; Tyry, Tuula; Crowe, Christina; Cutter, Gary R; Fox, Robert J; Marrie, Ruth Ann
Interest in and use of marijuana by persons with multiple sclerosis (MS) has increased. While potential benefits have been reported, so have concerns about potential risks. Few large studies have been conducted about the perceptions and current usage of marijuana and medical cannabinoids in persons with MS. Participants in the North American Research Committee on Multiple Sclerosis (NARCOMS) registry were surveyed in 2014 regarding legality and history of marijuana usage, both before and after diagnosis with MS. A total of 5,481 participants responded, with 78.2% female, 90% relapsing disease at onset, and a current mean age of 55.5 (10.2) years. Sixty-four percent had tried marijuana prior to their MS diagnosis, 47% have considered using for their MS, 26% have used for their MS, 20% have spoken with their physician about use, and 16% are currently using marijuana. Ninety-one percent think marijuana should be legal in some form. Men, those with higher disability, current and past nicotine smokers, and younger age were associated with a higher likelihood of current use. The majority of responders favor legalization and report high interest in the use of marijuana for treatment of MS symptoms, but may be reluctant to discuss this with health care providers. Health care providers should systematically inquire about use of marijuana.
Full Text Available Marijuana is used for psychoactive and recreational purpose. We report a case of fulminant hepatic failure following marijuana drug abuse who recovered following artificial support systems for acute liver failure. There is no published literature of management of marijuana intoxication with molecular adsorbent recirculation system (MARS. MARS is effective and safe in patients with fulminant hepatic failure following marijuana intoxication.
Kosterman, Rick; Bailey, Jennifer A; Guttmannova, Katarina; Jones, Tiffany M; Eisenberg, Nicole; Hill, Karl G; Hawkins, J David
The recent legalization of nonmedical marijuana use in several U.S. states has unknown implications for those who are actively parenting. This study examined parents' reactions to marijuana legalization and changes in attitudes and behaviors over time. Data were from a gender-balanced, ethnically diverse sample of 395 parents in Washington State who were participating in the longitudinal Seattle Social Development Project. Participants were interviewed 15 times between 1985 (age 10) and 2014 (age 39). Adult nonmedical marijuana use was legalized in Washington in 2012 and retail outlets opened in 2014. Results showed (1) one third of parents incorrectly believed the legal age of nonmedical marijuana use to be 18; (2) significant increase in approval of adult marijuana use and decrease in perceived harm of regular use; (3) wide opposition to teen use and use around one's children; and (4) substantial increases in frequency of use and marijuana use disorder among parents who used. Despite increased acceptance and frequency of adult use, parents remain widely opposed to teen use but need facts and strategies for talking with their children about marijuana. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Reinarman, Craig; Nunberg, Helen; Lanthier, Fran; Heddleston, Tom
Marijuana is a currently illegal psychoactive drug that many physicians believe has substantial therapeutic uses. The medical literature contains a growing number of studies on cannabinoids as well as case studies and anecdotal reports suggesting therapeutic potential. Fifteen states have passed medical marijuana laws, but little is known about the growing population of patients who use marijuana medicinally. This article reports on a sample of 1,746 patients from a network of nine medical marijuana evaluation clinics in California. Patients completed a standardized medical history form; evaluating physicians completed standardized evaluation forms. From this data we describe patient characteristics, self-reported presenting symptoms, physician evaluations, other treatments tried, other drug use, and medical marijuana use practices. Pain, insomnia, and anxiety were the most common conditions for which evaluating physicians recommended medical marijuana. Shifts in the medical marijuana patient population over time, the need for further research, and the issue of diversion are discussed.
Niyuhire, Floride; Varvel, Stephen A; Martin, Billy R; Lichtman, Aron H
Marijuana (Cannabis sativa) and its primary psychoactive component, delta-9-tetrahydrocannabinol (Delta(9)-THC), have long been known to disrupt cognition in humans. Although Delta(9)-THC and other cannabinoids disrupt performance in a wide range of animal models of learning and memory, few studies have investigated the effects of smoked marijuana in these paradigms. Moreover, in preclinical studies, cannabinoids are generally administered before acquisition, and because retention is generally evaluated soon afterward, it is difficult to distinguish between processes related to acquisition and retrieval. In the present study, we investigated the specific effects of marijuana smoke and injected Delta(9)-THC on acquisition versus memory retrieval in a mouse repeated acquisition Morris water-maze task. To distinguish between these processes, subjects were administered Delta(9)-THC or they were exposed to marijuana smoke either 30 min before acquisition or 30 min before the retention test. Inhalation of marijuana smoke or injected Delta(9)-THC impaired the ability of the mice to learn the location of the hidden platform and to recall the platform location once learning had already taken place. In contrast, neither drug impaired performance in a cued task in which the platform was made visible. Finally, the cannabinoid-1 (CB(1)) receptor antagonist N-(piperidin-1-yl)-5-(4-chlorophenyl)-1-(2,4-dichlorophenyl)-4-methyl-1H-pyrazole-3-carboxamide HCl (rimonabant) blocked the memory disruptive effects of both Delta(9)-THC and marijuana. These data represent the first evidence demonstrating that marijuana impairs memory retrieval through a CB(1) receptor mechanism of action and independently of its effects on sensorimotor performance, motivation, and initial acquisition.
The thesis in its theoretical parts deals with drugs in general, it describes effects of marijuana, misuse of this narcotic, system of prevention and care in Czech Republic. I paid attention mainly to questions of characteristic, origin and spread of cannabis drugs. In this thesis I wanted to point out also positive effects of marijuana for human organism, what was the history of treatment before and how is marijuana used for medical purposes today. I also researched possible risks of the usa...
Lutchmansingh, Denyse; Pawar, Leena; Savici, Dana
Habitual smoking of marijuana is associated with multiple respiratory symptoms such as cough, sputum production, and wheezing .These symptoms are not significantly different from those exhibited by tobacco smokers. Furthermore, endobronchial biopsies of habitual smokers of marijuana and /or tobacco have shown that both marijuana and cigarette smoking cause significant bronchial mucosal histopathology and that these effects are additive. Although marijuana smokers have minimal changes in pulmo...
Lamers, C. T. J.; Ramaekers, J. G.
The purpose of the present study was to assess the effects of low doses of marijuana and alcohol, and their combination, on visual search at intersections and on general driving proficiency in the City Driving Test. Sixteen recreational users of alcohol and marijuana (eight males and eight females) were treated with these substances or placebo according to a balanced, 4-way, cross-over, observer- and subject-blind design. On separate evenings, subjects received weight-calibrated doses of THC, alcohol or placebo in each of the following treatment conditions: alcohol placebo + THC placebo, alcohol + THC placebo, THC 100 &mgr;g/kg + alcohol placebo, THC 100 &mgr;g/kg + alcohol. Alcohol doses administered were sufficient for achieving a blood alcohol concentration (BAC) of about 0.05 g/dl. Initial drinking preceded smoking by one hour. The City Driving Test commenced 15 minutes after smoking and lasted 45 minutes. The test was conducted over a fixed route within the city limits of Maastricht. An eye movement recording system was mounted on each subject's head for providing relative frequency measures of appropriate visual search at intersections. General driving quality was rated by a licensed driving instructor on a shortened version of the Royal Dutch Tourist Association's Driving Proficiency Test. After placebo treatment subjects searched for traffic approaching from side streets on the right in 84% of all cases. Visual search frequency in these subjects did not change when they were treated with alcohol or marijuana alone. However, when treated with the combination of alcohol and marijuana, the frequency of visual search dropped by 3%. Performance as rated on the Driving Proficiency Scale did not differ between treatments. It was concluded that the effects of low doses of THC (100 &mgr;g/kg) and alcohol (BAC < 0.05 g/dl) on higher-level driving skills as measured in the present study are minimal. Copyright 2001 John Wiley & Sons, Ltd.
Slater, Michael D; Kelly, Kathleen J; Edwards, Ruth W; Thurman, Pamela J; Plested, Barbara A; Keefe, Thomas J; Lawrence, Frank R; Henry, Kimberly L
This study tests the impact of an in-school mediated communication campaign based on social marketing principles, in combination with a participatory, community-based media effort, on marijuana, alcohol and tobacco uptake among middle-school students. Eight media treatment and eight control communities throughout the US were randomly assigned to condition. Within both media treatment and media control communities, one school received a research-based prevention curriculum and one school did not, resulting in a crossed, split-plot design. Four waves of longitudinal data were collected over 2 years in each school and were analyzed using generalized linear mixed models to account for clustering effects. Youth in intervention communities (N = 4,216) showed fewer users at final post-test for marijuana [odds ratio (OR) = 0.50, P = 0.019], alcohol (OR = 0.40, P = 0.009) and cigarettes (OR = 0.49, P = 0.039), one-tailed. Growth trajectory results were significant for marijuana (P = 0.040), marginal for alcohol (P = 0.051) and non-significant for cigarettes (P = 0.114). Results suggest that an appropriately designed in-school and community-based media effort can reduce youth substance uptake. Effectiveness does not depend on the presence of an in-school prevention curriculum.
Benschop, A.; Liebregts, N.; van der Pol, P.; Schaap, R.; Buisman, R.; van Laar, M.; van den Brink, W.; de Graaf, R.; Korf, D.J.
The Marijuana Motives Measure (MMM) has so far been examined mainly in student populations, often with relatively limited involvement in cannabis use. This study evaluated the factor structure of the MMM in a demographically mixed sample of 600 young adult (18-30 years) frequent (≥3 days per week)
Benschop, Annemieke; Liebregts, Nienke; van der Pol, Peggy; Schaap, Rick; Buisman, Renate; van Laar, Margriet; van den Brink, Wim; de Graaf, Ron; Korf, Dirk J.
The Marijuana Motives Measure (MMM) has so far been examined mainly in student populations, often with relatively limited involvement in cannabis use. This study evaluated the factor structure of the MMM in a demographically mixed sample of 600 young adult (18-30 years) frequent (≥ 3 days per week)
In July 2014, Washington State allowed legal sales of : recreational marijuana. Working with the Washington : Traffic Safety Commission, NHTSA assisted the State in : conducting a roadside study to examine the prevalence : of marijuana use before and...
Vadhan, Nehal P.; van Gorp, Wilfred G.; Levin, Frances R.
We present the case of a young adult in treatment for marijuana dependence, with recurrent depression and a history of possible TBI, complaining of concentration, memory and initiation problems. Testing at treatment baseline revealed performance that was generally in the High Average range on measures of reaction time and attention, with a selective impairment in verbal learning (Borderline to Extremely Low range). Following 8 weeks of abstinence from marijuana, his verbal learning recovered ...
Aydelotte, Jayson D; Brown, Lawrence H; Luftman, Kevin M; Mardock, Alexandra L; Teixeira, Pedro G R; Coopwood, Ben; Brown, Carlos V R
To evaluate motor vehicle crash fatality rates in the first 2 states with recreational marijuana legalization and compare them with motor vehicle crash fatality rates in similar states without recreational marijuana legalization. We used the US Fatality Analysis Reporting System to determine the annual numbers of motor vehicle crash fatalities between 2009 and 2015 in Washington, Colorado, and 8 control states. We compared year-over-year changes in motor vehicle crash fatality rates (per billion vehicle miles traveled) before and after recreational marijuana legalization with a difference-in-differences approach that controlled for underlying time trends and state-specific population, economic, and traffic characteristics. Pre-recreational marijuana legalization annual changes in motor vehicle crash fatality rates for Washington and Colorado were similar to those for the control states. Post-recreational marijuana legalization changes in motor vehicle crash fatality rates for Washington and Colorado also did not significantly differ from those for the control states (adjusted difference-in-differences coefficient = +0.2 fatalities/billion vehicle miles traveled; 95% confidence interval = -0.4, +0.9). Three years after recreational marijuana legalization, changes in motor vehicle crash fatality rates for Washington and Colorado were not statistically different from those in similar states without recreational marijuana legalization. Future studies over a longer time remain warranted.
... called a joint) or a cigar (called a blunt). Marijuana can also be smoked in a pipe. ... Institute on Drug Abuse (NIDA) | About This Website Tools and Resources | Contact Us | Site Map | Accessibility | Privacy | ...
Against the backdrop of escalating state efforts to decriminalize marijuana, U.S. Attorneys' Offices continue to bring drug-trafficking prosecutions against defendants carrying small amounts of marijuana that are permitted under state law. Federal district courts have repeatedly barred defendants from introducing evidence that they possessed this marijuana for their own personal use. This Note argues that district courts should not exclude three increasingly common kinds of "personal use evidence" under Federal Rules of Evidence 402 and 403 when that evidence is offered to negate intent to distribute marijuana. Three types of personal use evidence are discussed in this Note: (1) a defendant's possession of a state-issued medical marijuana license, (2) evidence that a state has legalized possession of marijuana for recreational purposes, and (3) evidence that a defendant suffers from a disease that marijuana arguably treats. Part I examines each of these three categories of personal use evidence and contends that district courts are likely to confront disputes over such evidence with increasing frequency. Part II analyzes objections to the admissibility of personal use evidence on direct examination, focusing primarily on Rules 402 and 403. Part III responds to those objections and argues that the evidence is probative of intent to distribute in federal marijuana-trafficking prosecutions.
Forrester, M B; Kleinschmidt, K; Schwarz, E; Young, A
Synthetic cannabinoids have recently gained popularity as a recreational drug because they are believed to result in a marijuana-like high. This investigation compared synthetic cannabinoids and marijuana exposures reported to a large statewide poison center system. Synthetic cannabinoid and marijuana exposures reported to Texas poison centers during 2010 were identified. The distribution of exposures to the two agents with respect to various demographic and clinical factors were compared by calculating the rate ratio (RR) of the synthetic cannabinoid and marijuana percentages for each subgroup and 95% confidence interval (CI). The proportion of synthetic cannabinoid and marijuana exposures, respectively, were 87.3% and 46.5% via inhalation (RR 1.88, 95% CI 1.38-2.61), 74.9% and 65.7% in male (RR 1.14, 95% CI 0.87-1.51), 40.2% and 56.6% age ≤ 19 years (RR 0.71, 95% CI 0.52-0.98), 79.2% and 58.6% occurring at a residence (RR 1.35, 95% CI 1.02-1.82), 8.4% and 16.2% managed on-site (RR 0.52. 95% CI 0.28-1.00), and 59.3% and 41.4% with serious medical outcomes (RR 1.43, 95% CI 1.03-2.05). Compared to marijuana, synthetic cannabinoid exposures were more likely to be used through inhalation, to involve adults, to be used at a residence, and to result in serious outcomes.
Full Text Available Objective. To examine the availability of marijuana stores in Colorado and associations with neighborhood characteristics. Methods. The addresses for 650 medical and recreational marijuana stores were geocoded and linked to the characteristics of 1249 census tracts in Colorado. Accounting for spatial autocorrelations, autologistic regressions were used to quantify the associations of census tract socioeconomic characteristics with the availability of marijuana stores. Results. Regardless of store types, marijuana stores were more likely to locate in neighborhoods that had a lower proportion of young people, had a higher proportion of racial and ethnic minority population, had a lower household income, had a higher crime rate, or had a greater density of on-premise alcohol outlets. The availability of medical and recreational marijuana stores was differentially correlated with household income and racial and ethnic composition. Conclusions. Neighborhood disparities existed in the availability of marijuana stores, and associations between availability of stores and neighborhood characteristics varied by store types. This study highlighted the need for regulatory measures to prevent marijuana related outcomes in high risk neighborhoods.
Oberle, Crystal D; Garcia, Javier A
This study investigated whether use of alcohol, cigarettes, and marijuana may be predicted from preferential consumption of particular music genres. Undergraduates (257 women and 78 men) completed a questionnaire assessing these variables. Partial correlation analyses, controlling for sensation-seeking tendencies and behaviors, revealed that listening to conventional music (pop, country, and religious genres) was negatively correlated with cigarette smoking (p=.001) and marijuana use (pmusic (rap or hip-hop and soul or funk genres) was positively correlated with marijuana use (p=.004). The only significant predictor of alcohol use was country music, with which it was positively correlated (p=.04). This research suggests an especially harmful influence of energetic music on marijuana use. © The Author(s) 2015.
D'Amico, Elizabeth J; Tucker, Joan S; Pedersen, Eric R; Shih, Regina A
There is not one answer to address whether marijuana use has increased, decreased, or stayed the same given changes in state legalization of medical and non-medical marijuana in the USA. Evidence suggests some health benefits for medical marijuana; however, initiation of marijuana use is a risk factor for developing problem cannabis use. Though use rates have remained stable over recent years, about one in three 10th graders report marijuana use, most adolescents do not view the drug as harmful, and over 650,000 youth aged 12 to 17 struggle with cannabis use disorder. Although the health benefits of medical marijuana are becoming better understood, more research is needed. Intervention and prevention programs must better address effects of marijuana, acknowledging that while there may be some benefits medically, marijuana use can affect functioning during adolescence when the brain is still developing.
... so that the responsible use of marijuana by an adult will no longer be a criminal or civil offense. I've participated in long, intellectual retreats on mountaintops, suffered through multihour conference calls, participated in moot courts and legislatures, and attended dozens of conferences and symposiums all directed toward ending marijuana prohibi...
Carah, Jennifer K.; Howard, Jeanette K.; Thompson, Sally E.; Short Gianotti, Anne G.; Bauer, Scott D.; Carlson, Stephanie M.; Dralle, David N.; Gabriel, Mourad W.; Hulette, Lisa L.; Johnson, Brian J.; Knight, Curtis A.; Kupferberg, Sarah J.; Martin, Stefanie L.; Naylor, Rosamond L.; Power, Mary E.
The liberalization of marijuana policies, including the legalization of medical and recreational marijuana, is sweeping the United States and other countries. Marijuana cultivation can have significant negative collateral effects on the environment that are often unknown or overlooked. Focusing on the state of California, where by some estimates 60%–70% of the marijuana consumed in the United States is grown, we argue that (a) the environmental harm caused by marijuana cultivation merits a direct policy response, (b) current approaches to governing the environmental effects are inadequate, and (c) neglecting discussion of the environmental impacts of cultivation when shaping future marijuana use and possession policies represents a missed opportunity to reduce, regulate, and mitigate environmental harm. PMID:26955083
Miller, Austin M; Rosenman, Robert; Cowan, Benjamin W
We analyze marijuana use by college undergraduates before and after legalization of recreational marijuana. Using survey data from the National College Health Assessment, we show that students at Washington State University experienced a significant increase in marijuana use after legalization. This increase is larger than would be predicted by national trends. The change is strongest among females, Black students, and Hispanic students. The increase for underage students is as much as for legal-age students. We find no corresponding changes in the consumption of tobacco, alcohol, or other drugs.
Austin M. Miller
Full Text Available We analyze marijuana use by college undergraduates before and after legalization of recreational marijuana. Using survey data from the National College Health Assessment, we show that students at Washington State University experienced a significant increase in marijuana use after legalization. This increase is larger than would be predicted by national trends. The change is strongest among females, Black students, and Hispanic students. The increase for underage students is as much as for legal-age students. We find no corresponding changes in the consumption of tobacco, alcohol, or other drugs.
Miller, Austin M.; Rosenman, Robert; Cowan, Benjamin W.
We analyze marijuana use by college undergraduates before and after legalization of recreational marijuana. Using survey data from the National College Health Assessment, we show that students at Washington State University experienced a significant increase in marijuana use after legalization. This increase is larger than would be predicted by national trends. The change is strongest among females, Black students, and Hispanic students. The increase for underage students is as much as for le...
Shannon, Scott; Opila-Lehman, Janet
This case study illustrates the use of cannabidiol (CBD) oil to decrease the addictive use of marijuana and provide anxiolytic and sleep benefits. Addiction to marijuana is a chronic, relapsing disorder, which is becoming a prevalent condition in the United States. The most abundant compound in the marijuana, which is called tetrahydrocannabinol (THC), has been widely studied and known for its psychoactive properties. The second most abundant component-CBD-has been suggested to have the medicinal effects of decreasing anxiety, improving sleep, and other neuro-protective effects. The mechanism of action for CBD has been suggested to be antagonistic to the psychoactive properties of THC in many locations within the central nervous system. Such action raises the issue of whether it might be beneficial to use CBD in isolation to facilitate withdrawal of marijuana use. The specific use of CBD for marijuana reduction has not been widely studied. The patient was a 27-y-old male who presented with a long-standing diagnosis of bipolar disorder and a daily addiction to marijuana use. In the described intervention, the only change made to the patient's treatment was the addition of CBD oil with the dosage gradually decreasing from 24 to 18 mg. With use of the CBD oil, the patient reported being less anxious, as well as settling into a regular pattern of sleep. He also indicated that he had not used any marijuana since starting the CBD oil. With the decrease in the dosage to 18 mg, the patient was able to maintain his nonuse of marijuana.
... 32 National Defense 5 2010-07-01 2010-07-01 false Responsibilities concerning marijuana, narcotics... concerning marijuana, narcotics, and other controlled substances. (a) All personnel shall endeavor to prevent and eliminate the unauthorized use of marijuana, narcotics and other controlled substances within the...
Haney, Margaret; Bedi, Gillinder; Cooper, Ziva D; Glass, Andrew; Vosburg, Suzanne K; Comer, Sandra D; Foltin, Richard W
Few marijuana smokers in treatment achieve sustained abstinence, yet factors contributing to high relapse rates are unknown. Study 1: data from five inpatient laboratory studies assessing marijuana intoxication, withdrawal, and relapse were combined to assess factors predicting the likelihood and severity of relapse. Daily, nontreatment-seeking marijuana smokers (n = 51; 10 ± 5 marijuana cigarettes/day) were enrolled. Study 2: to isolate the effects of cigarette smoking, marijuana intoxication, withdrawal, and relapse were assessed in daily marijuana and cigarette smokers (n = 15) under two within-subject, counter-balanced conditions: while smoking tobacco cigarettes as usual (SAU), and after at least 5 days without cigarettes (Quit). Study 1: 49% of participants relapsed the first day active marijuana became available. Tobacco cigarette smokers (75%), who were not abstaining from cigarettes, were far more likely to relapse than non-cigarette smokers (odds ratio: 19, p marijuana administration and those with more negative affect and sleep disruption during marijuana withdrawal were more likely to have severe relapse episodes (p 87%) relapsed to marijuana whether in the SAU or Quit phase. Tobacco cigarette smoking did not significantly influence relapse, nor did it affect marijuana intoxication or most symptoms of withdrawal relative to tobacco cessation. Daily marijuana smokers who also smoke cigarettes have high rates of marijuana relapse, and cigarette smoking versus recent abstinence does not directly influence this association. These data indicate that current cigarette smoking is a clinically important marker for increased risk of marijuana relapse. Copyright © 2013 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
Full Text Available In three large, nationally representative surveys of U.S. 12th graders, college students, and adults ('N' = 9 million conducted 1968–2015, Americans became significantly more supportive of legal marijuana (cannabis starting in the mid-1980’s. Hierarchical models using age-period-cohort analysis on the adult (General Social Survey sample showed that the increased support for legalization is primarily a time period effect rather than generational or age effect; thus, Americans of all ages became more supportive of legal marijuana. Among 12th graders, support for marijuana legalization was closely linked to perceptions of marijuana safety.
Nussbaum, Abraham M; Boyer, Jonathan A; Kondrad, Elin C
As the use of medical marijuana expands, it is important to consider its implications for the patient-physician relationship. In Colorado, a small cohort of physicians is recommending marijuana, with 15 physicians registering 49% of all medical marijuana patients and a single physician registering 10% of all patients. Together, they have registered more than 2% of the state to use medical marijuana in the last three years. We are concerned that this dramatic expansion is occurring in a setting rife with conflicts of interest despite insufficient scientific knowledge about marijuana. This system diminishes the patient-physician relationship to the recommendation of a single substance while unburdening physicians of their usual responsibilities to the welfare of their patients.
Sun, Xiaoshen; Xu, Chaoying S; Chadha, Nisha; Chen, Allshine; Liu, Ji
Marijuana has been shown to lower intraocular pressure (IOP) but with limited duration of action and numerous adverse effects. Use of marijuana to lower IOP as a means of glaucoma treatment would require frequent use throughout the day, leading to significant adverse effects, possible progression toward Cannabis Use Disorder (CUD), and/or withdrawal symptoms. The treatment of glaucoma based on the cannabis plant or drugs based on the cannabinoid molecule should be considered carefully before being prescribed. Considerations should include the adverse physical and psychological adverse effects, including substance abuse. Currently, the deleterious effects of marijuana outweigh the benefits of its IOP-lowering capacity in most glaucoma patients. Under extremely rare circumstances, a few categories of glaucoma patients may be potential candidates for treatment with medical marijuana. Further studies on alternate routes and more focused means of cannabinoid molecule delivery to the eye for glaucoma treatment are needed.
Warner, Tamara D; Roussos-Ross, Dikea; Behnke, Marylou
Pro-marijuana advocacy efforts exemplified by the "medical" marijuana movement, coupled with the absence of conspicuous public health messages about the potential dangers of marijuana use during pregnancy, could lead to greater use of today's more potent marijuana, which could have significant short- and long-term consequences. This article reviews the current literature regarding the effects of prenatal marijuana use on the pregnant woman and her offspring. Copyright © 2014 Elsevier Inc. All rights reserved.
Wong, Kristin; Brady, Joanne E; Li, Guohua
Marijuana has become the most commonly detected non-alcohol substance among drivers in the United States and Europe. Use of marijuana has been shown to impair driving performance and increase crash risk. Due to the lack of standardization in assessing marijuana-induced impairment and limitations of zero tolerance legislation, more jurisdictions are adopting per se laws by specifying a legal limit of ?9-tetrahydrocannabinol (THC) at or above which drivers are prosecuted for driving under the i...
Ul Haq, E; Shafiq, A; Khan, A A; Awan, A A; Ezad, S; Minteer, W J; Omar, B
Marijuana is the most widely abused "recreational" substance in the United States, with highest prevalence in young adults. It is reported to cause ischemic strokes, hepatitis, anxiety, and psychosis. Although it is associated with dose dependent tachycardia and can lead to coronary vasospasm, it has not been directly related to acute myocardial infarction (AMI). Marijuana induced coronary vasospasm can result in endothelial denudation at the site of a vulnerable atherosclerotic plaque in response to hemodynamic stressors, potentially causing an AMI. Spice refers to herbal mixture with composition and effects similar to that of marijuana and therefore is referred to as "synthetic marijuana." Herein, we report 3 cases of spice induced ST-segment elevation myocardial infarction. All patients were relatively young and had few or absolutely no risk factors for cardiovascular disease. All patients underwent emergent coronary angiography, with two needing stent placement and the third requiring only aspiration thrombectomy. Our case series emphasizes the importance of suspecting and investigating synthetic marijuana use in low risk young adults presenting with AMI.
Rothman, Emily Faith; Linden, Judith A.; Baughman, Allyson L.; Kaczmarsky, Courtney; Thompson, Malindi
This exploratory study was designed to examine the beliefs of youth users of alcohol and marijuana about the connections between their substance use and dating violence perpetration. Eighteen youth (ages 14-20 years old), who were primarily of Black or Hispanic race/ethnicity, participated in in-depth interviews about times when they had…
D’Amico, Elizabeth J.; Tucker, Joan S.; Pedersen, Eric R.; Shih, Regina A.
Purpose of Review There is not one answer to address whether marijuana use has increased, decreased, or stayed the same given changes in state legalization of medical and non-medical marijuana in the USA. Recent Findings Evidence suggests some health benefits for medical marijuana; however, initiation of marijuana use is a risk factor for developing problem cannabis use. Though use rates have remained stable over recent years, about one in three 10th graders report marijuana use, most adolesc...
Malmberg, M.; Overbeek, G.J.; Vermulst, A.A.; Monshouwer, K.; Vollebergh, W.A.M.; Engels, R.C.M.E.
Background: Precursors of marijuana use in early adolescence are largely unknown because studies generally focus on marijuana use among older adolescents or adults. Methods: In this study, we examined precursors of marijuana use in a sample of 1023 Dutch early adolescents (aged 11-14 at Time 1) who
McGinty, Emma E; Niederdeppe, Jeff; Heley, Kathryn; Barry, Colleen L
In debates about recreational marijuana legalization, pro-legalization arguments highlighting economic and other potential policy benefits compete with anti-legalization arguments emphasizing public health risks. In 2016, we conducted a national survey using an online panel (N=979) designed to answer two main research questions: (1) How do Americans perceive the relative strength of competing arguments about recreational marijuana legalization? (2) How are perceptions of argument strength associated with public support for recreational marijuana legalization? We examined differences in attitudes among individuals living in states that have/have not legalized recreational marijuana and among Democrats/Independents/Republicans. Ordered logit regression assessed the relationship between perceived argument strength and public support for recreational marijuana legalization. Respondents rated pro-legalization arguments highlighting beneficial economic and criminal justice consequences as more persuasive than anti-legalization arguments emphasizing adverse public health effects. Respondents were more likely to agree with arguments highlighting legalization's potential to increase tax revenue (63.9%) and reduce prison overcrowding (62.8%) than arguments emphasizing negative consequences on motor vehicle crashes (51.8%) and youth health (49.6%). The highest rated anti-legalization arguments highlighted the conflict between state and federal marijuana laws (63.0%) and asserted that legalization will fail to eliminate the black market (57.2%). Respondents who endorsed pro-legalization economic and criminal justice arguments were more likely than other respondents to support legalization. Our findings indicate that, on both side of the recreational marijuana legalization debate, there are arguments that resonate with the American public. However, public health risk messages were viewed as less compelling than pro-legalization economic and criminal justice-oriented arguments
Schafer, John; Brown, Sandra A.
Content analyzed self-reports from 704 college students and used results to develop Marijuana Effect Expectancy Questionnaire and Cocaine Effect Expectancy Questionnaire. Identified six marijuana expectancies and five cocaine expectancies. Drug effect expectancies distinguished between patterns of nonuse and varying degrees of use of these two…
Wang, C. T.; Vizuete, W.; Wiedinmyer, C.; Ashworth, K.; Harley, P. C.; Ortega, J. V.
In 2014, Colorado became the first US state to legalize the industrial-scale cultivation of marijuana plants. There are now more than 700 marijuana cultivation facilities (MCFs) in operation in the greater Denver area. High concentrations of biogenic volatile organic compounds (VOCs), predominantly monoterpenes (C10H16) such as alpha-pinene, myrcene, and limonene have been observed in the grow rooms of MCFs, suggesting MCFs have the potential to release a significant amount of reactive VOCs into the atmosphere. Further, many MCFs are located in the urban core, where other urban emission sources are concentrated, resulting in interactions which can lead to the formation of ozone, impacting air quality. The little research done on marijuana has focused on indoor air quality and occupational exposure, or identification of the compounds associated with the characteristic smells of marijuana plants. We know of no previous studies that have identified or quantified the monoterpene emission rates from marijuana. Here, we collected air samples from leaf enclosures from different marijuana clones at different growth stages onto sorbent cartridges. These samples were analyzed using GC-MS/-FID to identify and quantify the VOCs emitted by growing marijuana plants. These results were then used to estimate basal emission rates at standard conditions (T=30 C, PPFD = 1000 umol/m2/s) using standard algorithms. We discuss the potential impact on air quality from these VOCs emitted into the atmosphere using air quality models.
Full Text Available Marijuana use initiation is associated with numerous health and behavioral consequences, particularly among young adolescents. Finding easily identifiable risk markers for marijuana initiation is an important step for targeting primary and secondary prevention efforts. This study used data from the 2010-2014 National Survey on Drug Use and Health to evaluate the association between residential mobility (no mobility, low mobility, high mobility [ie, transience], and major depressive episode(s (MDE on marijuana initiation among adolescents (12-17 and young adults (18-20. Age-stratified logistic regression models indicated that among 12- to 13-year-old adolescents, mobility in the past 5 years and past year MDE have a multiplicative effect on the odds of past year marijuana initiation. Among adolescents aged 14 to 15 years, both mobility and MDE were independently associated with marijuana initiation, but there was no interaction. Among older adolescents (aged 16-17 years, only transience (⩾3 moves in the past 5 years was associated with marijuana use initiation, and although MDE was significantly associated with marijuana initiation, there was no interaction with mobility. Among young adults, mobility was not associated with marijuana initiation. Residential mobility among young adolescents is an easily identifiable risk marker that may serve as an indicator for physical and mental health professionals, school personnel, and parents to use in targeting both depression and marijuana prevention efforts.
The medical use of marijuana has been on the forefront of public debates in many developed countries. Despite increasing evidence of marijuana's addictive propensity and its potential for causing and worsening psychotic illness in predisposed individuals, public opinion continue to fuel efforts to legalize the medical use of ...
Stella M. Resko
Full Text Available The purpose of the current study is to examine patterns in public perceptions and attitudes toward marijuana use among adolescents. Computer-assisted telephone interviewing (CATI was used to collect data from a statewide sample of adults in Michigan identified through random-digit dialing (n = 560. CATI interviews were supplemented with web- and paper-based surveys for nonrespondents. We used latent class analysis to characterize patterns in public perception, using a vignette technique that assessed (a whether adults recognize adolescent marijuana use as a problem, (b how they view the efficacy of treatment, (c how they view help-seeking with mental health professionals, and (d whether they support prevention services for adolescents. Multinomial logistic regression was used to examine the relationship between class membership and demographics, substance use, and methodological factors. Three latent classes were identified: (a a discriminating group, (b a low-concern group, and (c a high-concern group. Age and substance use were among the strongest determinants for membership in the discriminating group. Results provide insight into how the general public perceives marijuana use and marijuana-related problems among adolescents.
Crum Rosa M
Full Text Available Abstract Background Personality traits are considered risk factors for drug use, and, in turn, the psychoactive substances impact individuals' traits. Furthermore, there is increasing interest in developing treatment approaches that match an individual's personality profile. To advance our knowledge of the role of individual differences in drug use, the present study compares the personality profile of tobacco, marijuana, cocaine, and heroin users and non-users using the wide spectrum Five-Factor Model (FFM of personality in a diverse community sample. Method Participants (N = 1,102; mean age = 57 were part of the Epidemiologic Catchment Area (ECA program in Baltimore, MD, USA. The sample was drawn from a community with a wide range of socio-economic conditions. Personality traits were assessed with the Revised NEO Personality Inventory (NEO-PI-R, and psychoactive substance use was assessed with systematic interview. Results Compared to never smokers, current cigarette smokers score lower on Conscientiousness and higher on Neuroticism. Similar, but more extreme, is the profile of cocaine/heroin users, which score very high on Neuroticism, especially Vulnerability, and very low on Conscientiousness, particularly Competence, Achievement-Striving, and Deliberation. By contrast, marijuana users score high on Openness to Experience, average on Neuroticism, but low on Agreeableness and Conscientiousness. Conclusion In addition to confirming high levels of negative affect and impulsive traits, this study highlights the links between drug use and low Conscientiousness. These links provide insight into the etiology of drug use and have implications for public health interventions.
Frederick, Blaise deB; Lindsey, Kimberly P; Nickerson, Lisa D; Ryan, Elizabeth T; Lukas, Scott E
Smoking is the preferred method of administration for two of the most frequently abused drugs, marijuana and nicotine. The high temporal and spatial resolution of functional magnetic resonance imaging (fMRI) make it a natural choice for studying the neurobiological effects of smoked drugs if the challenges of smoking in a magnetic resonance (MR) scanner can be overcome. We report on a design for an MR-compatible smoking device that can be used for smoking marijuana (or tobacco) during fMRI examinations. Nine volunteers smoked marijuana cigarettes (3.51% Delta9-THC) on two occasions: with and without the device. The device allowed subjects to smoke while they lay in the scanner, while containing all smoke and odors. Plasma Delta9-THC, subjective reports of intoxication, and heart rate increases are reported, and were all similar in individuals smoking marijuana either with or without the device. The use of this device will help advance research studies on smoked drugs including marijuana, tobacco and crack cocaine.
Krauss, Melissa J; Grucza, Richard A; Bierut, Laura J; Cavazos-Rehg, Patricia A
To explore the sentiment and themes of Twitter chatter that mentions both alcohol and marijuana. Cross-sectional analysis of tweets mentioning both alcohol and marijuana during 1 month was performed. The study setting was Twitter. Tweets sent from February 4 to March 5, 2014, were studied. A random sample (n = 5000) of tweets that mentioned alcohol and marijuana were qualitatively coded as normalizing both substances, preferring one substance over the other, or discouraging both substances. Other common themes were identified. More than half (54%) of the tweets normalized marijuana and alcohol (without preferring one substance over the other), and 24% preferred marijuana over alcohol. Only 2% expressed a preference for alcohol over marijuana, 7% discouraged the use of both substances, and the sentiment was unknown for 13% of the tweets. Common themes among tweets that normalized both substances included using the substances with friends (17%) and mentioning substance use in the context of sex or romance (14%). Common themes among tweets that preferred marijuana over alcohol were the beliefs that marijuana is safer than alcohol (46%) and preferences for effects of marijuana over alcohol (40%). Tweets normalizing polysubstance use or encouraging marijuana use over alcohol use are common. Both online and offline prevention efforts are needed to increase awareness of the risks associated with polysubstance use and marijuana use.
Little, Michelle; Weaver, Scott R; King, Kevin M; Liu, Freda; Chassin, Laurie
We examined historical change in the association between adolescent deviance proneness and marijuana use using 26 years (from 1979 through 2004) of national 12th grade data from the Monitoring the Future (MTF) study. "Deviance proneness" was measured using a latent factor model of behavioral and personality characteristics that underlie both substance use and antisocial disorders. Marijuana use was measured both in terms of annual frequency of use and degree of involvement with marijuana. Separate within-gender structural equation models were used to determine whether links between deviance proneness and marijuana use were consistently significant and invariant in magnitude across 13 two-year historical cohorts. Overall results affirmed the established association between adolescent deviance proneness and both the frequency of marijuana use as well as regular use. Among male youth, the size of the association between deviance proneness and marijuana use was significantly smaller at the cohort of lowest population prevalence (1991/92) compared to cohorts marking peaks in marijuana use prevalence, thus suggesting a "softening" historical trend. By contrast, the prediction of female marijuana use from deviance proneness was not consistently related to historical shifts in population prevalence of marijuana use. Study findings point to the utility of risk-focused prevention programming that targets early precursors of both antisocial and substance use disorders.
MARIJUANA SMOKING AMONG SECONDARY SCHOOL STUDENTS IN ZARIA, NIGERIA: FACTORS RESPONSIBLE AND ... Its medico-social effects could ruin the life and future of our youths. ... A comprehensive school health education
Ostrowsky, Michael K.
Marijuana use and violent behavior are causing widespread public concern. This article reviews theory and research on the relation between marijuana use and aggressive/violent behavior. It is evident from the inconsistent findings in the literature that the exact nature of the relation remains unclear. This article identifies several possible…
Booth, A. L.; Wooller, M. J.
The spatial variation of isotope signatures in organic material is a useful forensic tool, particularly when applied to the task of tracking the production and distribution of plant-derived illicit drugs. In order to identify the likely grow-locations of drugs such as marijuana from unknown locations (i.e., confiscated during trafficking), base isotope maps are needed that include measurements of plants from known grow-locations. This task is logistically challenging in remote, large regions such as Alaska. We are therefore investigating the potential of supplementing our base (marijuana) isotope maps with data derived from other plants from known locations and with greater spatial coverage in Alaska. These currently include >150 samples of modern C3 grasses (Poaceae) as well as marijuana samples (n = 18) from known grow-locations across the state. We conducted oxygen, carbon and nitrogen stable isotope analyses of marijuana and grasses (Poaceae). Poaceae samples were obtained from the University of Alaska Fairbanks (UAF) Museum of the North herbarium collection, originally collected by field botanists from around Alaska. Results indicate that the oxygen isotopic composition of these grasses range from 10‰ to 30‰, and broadly mirror the spatial pattern of water isotopes in Alaska. Our marijuana samples were confiscated around the state of Alaska and supplied to us by the UAF Police Department. δ13C, δ15N and δ18O values exhibit geographic patterns similar to the modern grasses, but carbon and nitrogen isotopes of some marijuana plants appear to be influenced by additional factors related to indoor growing conditions (supplementary CO2 sources and the application of organic fertilizer). As well as providing a potential forensic resource, our Poaceae isotope maps could serve additional value by providing resources for studying ecosystem nutrient cycling, for tracing natural ecological processes (i.e., animal migration and food web dynamics) and providing
Kreager, Derek A; Ragan, Daniel T; Nguyen, Holly; Staff, Jeremy
Desistance scholars primarily focus on changing social roles, cognitive transformations, and shifting identities to understand the cessation of serious crime and illicit drug use in adulthood. In the current study, we move the spotlight away from adulthood and toward adolescence, the developmental stage when the prevalence of offending and substance use peak and desistance from most of these behaviors begins. Our primary hypothesis is that changes in perceived psychic rewards surrounding initial forays into marijuana use strongly predict adolescents' decisions to cease or persist that behavior. In addition, based on social learning expectations, we hypothesize that peer perceptions and behaviors provide mechanisms for perceptual change. We test these hypotheses using longitudinal data of marijuana use, perceptions, and peer networks from the PROmoting School-community-university Partnerships to Enhance Resilience (PROSPER) study. We estimate hazard models of marijuana initiation and within-person models of perceptual updating for youth from grades 6 to 12 ( n =6,154). We find that changes in marijuana's perceived psychic rewards surrounding initiation differentiated experimenters from persisters. Experimenters had significantly lower updated perceptions of marijuana as a fun behavior compared to persisters and these perceptions dropped after the initiation wave. In contrast, persisters updated their perceptions in upward directions and maintained more positive perceptions over time. Inconsistent with social learning expectations, initiators' updated perceptions of marijuana as a fun activity were not explained by peer-reported behaviors or attitudes.
The Challenges of Projecting the Public Health Impacts of Marijuana Legalization in Canada; Comment on “Legalizing and Regulating Marijuana in Canada: Review of Potential Economic, Social, and Health Impacts”
Full Text Available A recent editorial in this journal provides a summary of key economic, social, and public health considerations of the forthcoming legislation to legalize, regulate, and restrict access to marijuana in Canada. As our government plans to implement an evidence-based public health framework for marijuana legalization, we reflect and expand on recent discussions of the public health implications of marijuana legalization, and offer additional points of consideration. We select two commonly cited public concerns of marijuana legalization – adolescent usage and impaired driving – and discuss how the underdeveloped and equivocal body of scientific literature surrounding these issues limits the ability to predict the effects of legalization. Finally, we discuss the potential for some potential public health benefits of marijuana legalization – specifically the potential for marijuana to be used as a substitute to opioids and other risky substance use – that have to date not received adequate attention.
Wilson, Karen M; Torok, Michelle R; Wei, Binnian; Wang, Lanqing; Robinson, Michelle; Sosnoff, Connie S; Blount, Benjamin C
The impact of secondhand marijuana smoke exposure on children is unknown. New methods allow detection of secondhand marijuana smoke in children. We studied children ages 1 mo to 2 y hospitalized with bronchiolitis in Colorado from 2013 to 2015. Parents completed a survey, and urine samples were analyzed for cotinine using LC/MS/MS (limits of detection 0.03 ng/ml) and marijuana metabolites including COOH-THC (limits of detection 0.015 ng/ml). A total of 43 subjects had urine samples available for analysis. Most (77%) of the subjects were male, and 52% were less than 1 y of age. COOH-THC was detectable in 16% of the samples analyzed (THC+); the range in COOH-THC concentration was 0.03-1.5 ng/ml. Two subjects had levels >1 ng/ml. Exposure did not differ by gender or age. Non-white children had more exposure than white children (44 vs. 9%; P 2.0 ng/ml were THC+, compared with 7% of those with lower cotinine (P marijuana smoke can be detected in children; in this cohort, 16% were exposed. Detectable COOH-THC is more common in children with tobacco smoke exposure. More research is needed to assess the health impacts of marijuana smoke exposure on children and inform public health policy.
Shibuya, Elisa K; Souza Sarkis, Jorge E; Neto, Osvaldo Negrini; Moreira, Marcelo Z; Victoria, Reynaldo L
The stable carbon and nitrogen isotopic ratios were measured in marijuana samples (Cannabis sativa L.) seized by the law enforcement officers in the three Brazilian production sites: Pernambuco and Bahia (the country's Northeast known as Marijuana Polygon), Pará (North or Amazon region) and Mato Grosso do Sul (Midwest). These regions are regarded as different with respect to climate and water availability, factors which impact upon the isotope fractionations of these elements within plants. It was possible to differentiate samples from the dry regions (Marijuana Polygon) from those from Mato Grosso do Sul and Pará, that present heavier rainfall. The results were in agreement with the climatic conditions of the suspected regions of origin and this demonstrates that seized samples can be used to identify the isotopic signatures of marijuana from the main producing regions in Brazil.
Bot, M; Middeldorp, C M; de Geus, E J C; Lau, H M; Sinke, M; van Nieuwenhuizen, B; Smit, J H; Boomsma, D I; Penninx, B W J H
There is a paucity of valid, brief instruments for the assessment of lifetime major depressive disorder (MDD) that can be used in, for example, large-scale genomics, imaging or biomarker studies on depression. We developed the LIfetime Depression Assessment Self-report (LIDAS), which assesses lifetime MDD diagnosis according to DSM criteria, and is largely based on the widely used Composite International Diagnostic Interview (CIDI). Here, we tested the feasibility and determined the sensitivity and specificity for measuring lifetime MDD with this new questionnaire, with a regular CIDI as reference. Sensitivity and specificity analyses of the online lifetime MDD questionnaire were performed in adults with (n = 177) and without (n = 87) lifetime MDD according to regular index CIDIs, selected from the Netherlands Study of Depression and Anxiety (NESDA) and Netherlands Twin Register (NTR). Feasibility was tested in an additional non-selective, population-based sample of NTR participants (n = 245). Of the 753 invited persons, 509 (68%) completed the LIDAS, of which 419 (82%) did this online. User-friendliness of the instrument was rated high. Median completion time was 6.2 min. Sensitivity and specificity for lifetime MDD were 85% [95% confidence interval (CI) 80-91%] and 80% (95% CI 72-89%), respectively. This LIDAS instrument gave a lifetime MDD prevalence of 20.8% in the population-based sample. Measuring lifetime MDD with an online instrument was feasible. Sensitivity and specificity were adequate. The instrument gave a prevalence of lifetime MDD in line with reported population prevalences. LIDAS is a promising tool for rapid determination of lifetime MDD status in large samples, such as needed for genomics studies.
Nunberg, Helen; Kilmer, Beau; Pacula, Rosalie Liccardo; Burgdorf, James
For more than a decade, medical marijuana has been at the forefront of the marijuana policy debate in the United States. Fourteen states allow physicians to recommend marijuana or provide a legal defense for patients and physicians if prosecuted in state courts; however, little is known about those individuals using marijuana for medicinal purposes and the symptoms they use it for. This study provides descriptive information from 1,655 patients seeking a physician’s recommendation for medical...
Nussbaum, Abraham M.; Boyer, Jonathan A.; Kondrad, Elin C.
As the use of medical marijuana expands, it is important to consider its implications for the patient–physician relationship. In Colorado, a small cohort of physicians is recommending marijuana, with 15 physicians registering 49% of all medical marijuana patients and a single physician registering 10% of all patients. Together, they have registered more than 2% of the state to use medical marijuana in the last three years. We are concerned that this dramatic expansion is occurring in a settin...
Ryan, Jennie; Sharts-Hopko, Nancy
Medical marijuana is now legal in more than half of the United States but remains federally prohibited and classified as a schedule 1 drug. The chemical compounds in marijuana are known neuroprotectants; however, their clinical efficacy and safety have not been proven. Many healthcare providers remain unaware of the therapeutic potential of marijuana and its adverse effects. The conflicting laws and lack of guidance from healthcare professionals can lead to confusion and frustration for patients seeking this medication. Multiple factors contribute to the unique and varied experiences of medical marijuana patients. Because more individuals with neurological disorders seek therapeutic marijuana, it is important for healthcare professionals to understand their distinctive experiences. Qualitative research methodology is ideal to capture the thick descriptions of these experiences. This review examines the qualitative research exploring the experiences of medical marijuana patients and discusses common themes across all studies.
Covey, Dan P; Wenzel, Jennifer M; Cheer, Joseph F
Marijuana is the most popular illegal drug worldwide. Recent trends indicate that this may soon change; not due to decreased marijuana use, but to an amendment in marijuana's illegal status. The cannabinoid type 1 (CB1) receptor mediates marijuana's psychoactive and reinforcing properties. CB1 receptors are also part of the brain endocannabinoid (eCB) system and support numerous forms of learning and memory, including the conditioned reinforcing properties of cues predicting reward or punishment. This is accomplished via eCB-dependent alterations in mesolimbic dopamine function, which plays an obligatory role in reward learning and motivation. Presynaptic CB1 receptors control midbrain dopamine neuron activity and thereby shape phasic dopamine release in target regions, particularly the nucleus accumbens (NAc). By also regulating synaptic input to the NAc, CB1 receptors modulate NAc output onto downstream neurons of the basal ganglia motor circuit, and thereby support goal-directed behaviors. Abused drugs promote short- and long-term adaptations in eCB-regulation of mesolimbic dopamine function, and thereby hijack neural systems related to the pursuit of rewards to promote drug abuse. By pharmacologically targeting the CB1 receptors, marijuana has preferential access to this neuronal system and can potently alter eCB-dependent processing of reward-related stimuli. As marijuana legalization progresses, greater access to this drug should increase the utility of marijuana as a research tool to better understand the eCB system, which has the potential to advance cannabinoid-based treatments for drug addiction. Copyright © 2014 Elsevier B.V. All rights reserved.
Rubinstein, Mark L; Rait, Michelle A; Prochaska, Judith J
Marijuana and tobacco are the substances used most commonly by adolescents and co-occurring use is common. Use of one substance may potentiate the addictive properties of the other. The current study examined the severity of nicotine addiction among teen smokers as a function of co-occurring marijuana use. Participants were 165 adolescents (13-17 years old) who reported smoking at least 1 cigarette per day (CPD) in the past 30 days. General linear models examined the association of marijuana use with multiple measures of nicotine addiction including the Modified Fagerström Tolerance Questionnaire (mFTQ), Hooked on Nicotine Checklist (HONC), ICD-10, and the Nicotine Dependence Syndrome Scale (NDSS). The adolescent sample (mean age=16.1 years, SD=0.95) averaged 3.0 CPD (SD=3.0) for 1.98 years (SD=1.5). Most (79.5%) also smoked marijuana in the past 30 days. In models controlling for age, daily smoking status, and years of tobacco smoking, frequency of marijuana use accounted for 25-44% of the variance for all four measures of adolescent nicotine dependence. Marijuana use was associated with greater reported nicotine addiction among adolescent smokers. The findings suggest a role of marijuana in potentiating nicotine addiction and underscore the need for treatments that address both smoked substances. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Valencia, Celina I; Asaolu, Ibitola O; Ehiri, John E; Rosales, Cecilia
There are 43 state medical marijuana programs in the USA, yet limited evidence is available on the demographic characteristics of the patient population accessing these programs. Moreover, insights into the social and structural barriers that inform patients' success in accessing medical marijuana are limited. A current gap in the scientific literature exists regarding generalizable data on the social, cultural, and structural mechanisms that hinder access to medical marijuana among qualifying patients. The goal of this systematic review, therefore, is to identify the aforementioned mechanisms that inform disparities in access to medical marijuana in the USA. This scoping review protocol outlines the proposed study design for the systematic review and evaluation of peer-reviewed scientific literature on structural barriers to medical marijuana access. The protocol follows the guidelines set forth by the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) checklist. The overarching goal of this study is to rigorously evaluate the existing peer-reviewed data on access to medical marijuana in the USA. Income, ethnic background, stigma, and physician preferences have been posited as the primary structural barriers influencing medical marijuana patient population demographics in the USA. Identification of structural barriers to accessing medical marijuana provides a framework for future policies and programs. Evidence-based policies and programs for increasing medical marijuana access help minimize the disparity of access among qualifying patients.
Bahorik, Amber L; Leibowitz, Amy; Sterling, Stacy A; Travis, Adam; Weisner, Constance; Satre, Derek D
Depression is associated with substance-related problems that worsen depression-related disability. Marijuana is frequently used by those with depression, yet whether its use contributes to significant barriers to recovery in this population has been understudied. Participants were 307 psychiatry outpatients with depression; assessed at baseline, 3-, and 6-months on symptom (PHQ-9 and GAD-7), functioning (SF-12) and past-month marijuana use for a substance use intervention trial. Longitudinal growth models examined patterns and predictors of marijuana use and its impact on symptom and functional outcomes. A considerable number of (40.7%; n=125) patients used marijuana within 30-days of baseline. Over 6-months, marijuana use decreased (B=-1.20, pmarijuana use over the follow-up, and those aged 50+(B=0.44, pmarijuana use compared to the youngest age group. Marijuana use worsened depression (B=1.24, pmarijuana use led to poorer mental health (B=-2.03, p=.010) functioning. Medical marijuana (26.8%; n=33) was associated with poorer physical health (B=-3.35, p=.044) functioning. Participants were psychiatry outpatients, limiting generalizability. Marijuana use is common and associated with poor recovery among psychiatry outpatients with depression. Assessing for marijuana use and considering its use in light of its impact on depression recovery may help improve outcomes. Copyright © 2017 Elsevier B.V. All rights reserved.
Fiala, Steven C; Dilley, Julia A; Firth, Caislin L; Maher, Julie E
To assess exposure to marijuana advertising in Oregon after the start of retail marijuana sales in October 2015. We conducted a repeated cross-sectional online survey of 4001 Oregon adults aged 18 years and older in November 2015 and April-May 2016. We assessed subgroup differences by using the Pearson χ 2 test. More than half of adults (54.8%) statewide reported seeing marijuana advertising in the past month. These adults reported that they most frequently saw storefront (74.5%), streetside (66.5%), and billboard (55.8%) advertising. Exposure did not significantly differ by participant's age or marijuana use but was higher among those living in counties with retail sales (56.5%) than in counties without (32.5%). Most adults reported exposure to marijuana advertising following the start of retail marijuana sales in Oregon. People who do not use marijuana and those aged 18 to 24 years were as exposed to advertising as other groups. Public Health Implications. Advertising restrictions may be needed to protect youths and young adults from pro-use messages. Commercial free speech afforded by the First Amendment makes advertising restrictions challenging, but public policy experts note that restrictions aimed at protecting youths may be allowed.
Berg, Carla J.; Henriksen, Lisa; Cavazos-Rehg, Patricia; Schauer, Gillian L.; Freisthler, Bridget
As recreational marijuana expands, it is critical to develop standardized surveillance measures to study the retail environment. To this end, our research team developed and piloted a tool assessing recreational marijuana retailers in a convenience sample of 20 Denver retailers in 2016. The tool assesses: (i) compliance and security (e.g.…
Holmes, Louisa M; Popova, Lucy; Ling, Pamela M
California may vote on marijuana legalization in 2016. Young adults have the highest rates of marijuana use, but little is known about the correlates of use in this age group, including factors that may be affected by policy change. We investigated whether there are differences in marijuana use by sociodemographic characteristics, psychological distress, loneliness and social support, controlling for risk factors such as alcohol and cigarette use as well as perceived harm of marijuana. Bivariate and multivariable analysis of past 30day marijuana use using the 2014 San Francisco Bay Area Young Adult Health Survey, a probabilistic multi-mode survey of (N=1324) young adults (aged 18-26years) residing in Alameda and San Francisco Counties, stratified by race/ethnicity. 291 (27%) sample participants reported current marijuana use. Compared to non-Hispanic Whites (referent) Asian/Pacific Islander respondents were less likely to use marijuana (AOR, 0.42; 95% CI, 0.22-0.80) while multiracial participants were twice as likely (AOR, 2.27; 95% CI, 1.06-4.85). Psychological distress was not related to marijuana use, but social support (AOR, 1.42; 95% CI, 1.08-1.88) and loneliness (AOR, 1.42; 95% CI, 1.09-1.86) were. Perceived harm of marijuana was inversely related to marijuana use (AOR, 0.60; 95% CI, 0.51-0.70), while smoking cigarettes (AOR, 3.95; 95% CI, 2.28-6.84) and binge drinking (AOR, 1.13; 95% CI, 1.03-1.24) were positively related. Legalization policies should include public education campaigns addressing potential harms of marijuana use particularly targeting multiracial young adults who also engage in other risk behaviors, such as cigarette smoking and binge drinking. Copyright © 2016 Elsevier Inc. All rights reserved.
Torres, Gladys; Fiestas, Fabián
Marijuana is one of the most commonly used psychoactive substances in society, mainly among youths. Its use has been consistently associated with several health problems, many of which have in common an impairment in the cognitive processes of behavior, including the memory, attention, emotion and decision making. There is evidence suggesting that cannabinoids, marijuana's primary psychoactive substance, have a negative effect in short-term memory, working memory, and decision making. It has also been found that cannabinoids affect attention and the interaction between cognitive events and emotion. This information can be used as an argument of biological plausibility to assess clinical and epidemiological research findings that show that marijuana`s use is associated to problems such as traffic accidents, psychosis, depression and poor academic records, among others.
Shannon, Scott; Opila-Lehman, Janet
This case study illustrates the use of cannabidiol (CBD) oil to decrease the addictive use of marijuana and provide anxiolytic and sleep benefits. Addiction to marijuana is a chronic, relapsing disorder, which is becoming a prevalent condition in the United States. The most abundant compound in the marijuana, which is called tetrahydrocannabinol (THC), has been widely studied and known for its psychoactive properties. The second most abundant component—CBD—has been suggested to have the medic...
E. Ul Haq
Full Text Available Marijuana is the most widely abused “recreational” substance in the United States, with highest prevalence in young adults. It is reported to cause ischemic strokes, hepatitis, anxiety, and psychosis. Although it is associated with dose dependent tachycardia and can lead to coronary vasospasm, it has not been directly related to acute myocardial infarction (AMI. Marijuana induced coronary vasospasm can result in endothelial denudation at the site of a vulnerable atherosclerotic plaque in response to hemodynamic stressors, potentially causing an AMI. Spice refers to herbal mixture with composition and effects similar to that of marijuana and therefore is referred to as “synthetic marijuana.” Herein, we report 3 cases of spice induced ST-segment elevation myocardial infarction. All patients were relatively young and had few or absolutely no risk factors for cardiovascular disease. All patients underwent emergent coronary angiography, with two needing stent placement and the third requiring only aspiration thrombectomy. Our case series emphasizes the importance of suspecting and investigating synthetic marijuana use in low risk young adults presenting with AMI.
Tucker, Joan S; de la Haye, Kayla; Kennedy, David P; Green, Harold D; Pollard, Michael S
Although several social network studies have demonstrated peer influence effects on adolescent substance use, findings for marijuana use have been equivocal. This study examines whether structural features of friendships moderate friends' influence on adolescent marijuana use over time. Using 1-year longitudinal data from the National Longitudinal Study of Adolescent Health, this article examines whether three structural features of friendships moderate friends' influence on adolescent marijuana use: whether the friendship is reciprocated, the popularity of the nominated friend, and the popularity/status difference between the nominated friend and the adolescent. The sample consists of students in grade 10/11 at wave I, who were in grade 11/12 at wave II, from two large schools with complete grade-based friendship network data (N = 1,612). In one school, friends' influence on marijuana use was more likely to occur within mutual, reciprocated friendships compared with nonreciprocated relationships. In the other school, friends' influence was stronger when the friends were relatively popular within the school setting or much more popular than the adolescents themselves. Friends' influence on youth marijuana use may play out in different ways, depending on the school context. In one school, influence occurred predominantly within reciprocated relationships that are likely characterized by closeness and trust, whereas in the other school adopting friends' drug use behaviors appeared to be a strategy to attain social status. Further research is needed to better understand the conditions under which structural features of friendships moderate friends' influence on adolescent marijuana use. Copyright © 2014 Society for Adolescent Health and Medicine. All rights reserved.
Peters, Erica N; Rosenberry, Zachary R; Schauer, Gillian L; O'Grady, Kevin E; Johnson, Patrick S
Although marijuana and tobacco are commonly coused, the nature of their relationship has not been fully elucidated. Behavioral economics has characterized the relationship between concurrently available commodities but has not been applied to marijuana and tobacco couse. U.S. adults ≥18 years who coused marijuana and tobacco cigarettes were recruited via Mechanical Turk, a crowdsourcing service by Amazon. Participants (N = 82) completed online purchasing tasks assessing hypothetical marijuana or tobacco cigarette puff consumption across a range of per-puff prices; 2 single-commodity tasks assessed these when only 1 commodity was available, and 2 cross-commodity tasks assessed these in the presence of a concurrently available fixed-price commodity. Purchasing tasks generated measures of demand elasticity, that is, sensitivity of consumption to prices. In single-commodity tasks, consumption of tobacco cigarette puffs (elasticity of demand: α = 0.0075; 95% confidence interval [0.0066, 0.0085], R² = 0.72) and of marijuana puffs (α = .0044; 95% confidence interval [0.0038, 0.0049], R² = 0.71) declined significantly with increases in price per puff. In cross-commodity tasks when both tobacco cigarette puffs and marijuana puffs were available, demand for 1 commodity was independent of price increases in the other commodity (p