Maternal Tobacco and Alcohol Use, But Not Marijuana, Associated With Psychotic Symptoms In Offspring, Study Says
Wales, United Kingdom: The maternal use of tobacco and alcohol during pregnancy is linked with increased incidences of psychotic symptoms in adolescents, according to the results of a longitudinal study published in the October issue of The British Journal of Psychiatry.
Investigators at the University of Bristol in Great Britain assessed whether maternal use of tobacco, alcohol, or cannabis during pregnancy increased the risk of psychotic symptoms in their offspring. Researchers examined the drug use habits of the mothers of over 6,300 adolescents – approximately 12 percent of which exhibited some symptoms of psychosis.
Authors concluded: "Frequency of maternal tobacco use during pregnancy was associated with increased risk of suspect or definite psychotic symptoms (in offspring.) Maternal alcohol use shows a non-linear association with psychotic symptoms, with this effect almost exclusively in the offspring of women drinking >21 units (approximately a half-pint of beer or a glass of wine) weekly. Maternal cannabis was not associated with psychotic symptoms."
CHILDREN/ YOUNG ADULTS & Cannabis studies completed
Should children be removed from grow-op homes? Not necessarily, new study says
To examine the health and well-being of children residing in residences where drug production is occurring.
Starting in January 2006, children identified by police and the Children’s Aids Society in the York region of Ontario, Canada, were referred to the Motherisk Program at the Hospital for Sick Children for pediatric assessment of their general health and well-being, with specific focus on illicit-drug exposure. We used a standard protocol to collect all available medical and environmental history, conducted physical and neurologic examinations, and collected hair for analysis of illicit drugs.
In total, 75 children, at the mean age of 6.5 years, were referred to us after being removed from homes where marijuana was grown (80%) or other operations linked to drug production were occurring (20%).
Overall, rates of health issues in this cohort fell below reference values for Canadian children. Of the hair tests, 32% were positive for illicit substances. In the majority there were no clinical symptoms related to these drugs.
The majority of children removed from drug-producing homes were healthy and drug free.
Comprehensive evaluations should be performed on a case-by-case basis in order to determine what is ultimately in the best interest of the child.
An efficient new cannabinoid antiemetic in pediatric oncology
|Title||An efficient new cannabinoid antiemetic in pediatric oncology.|
|Author(s)||Abrahamov A, Abrahamov A, Mechoulam R|
|Journal, Volume, Issue||Life Sciences 1995;56(23-24):2097-2102|
|Major outcome(s)||complete prevention of emesis|
|Indication||Cancer chemotherapy; Nausea/vomiting||Abstract|
Delta-8-tetrahydrocannabinol (delta-8-THC), a cannabinoid with lower psychotropic potency than the main cannabis constituent, delta-9- tetrahydrocannabinol (delta-9-THC), was administered (18 mg/m2 in edible oil, p.o.) to eight children, aged 3-13 years with various hematologic cancers, treated with different antineoplastic drugs for up to 8 months.
The total number of treatments with delta-8-THC so far is 480. The THC treatment started two hours before each antineoplastic treatment and was continued every 6 hrs for 24 hours. Vomiting was completely prevented. The side effects observed were negligible.
|Dose(s)||4 x 18 mg/m2 every 6 hours|
|Duration (days)||several days|
|Participants||8 children with cancer|
|Type of publication|
|Address of author(s)||Department of Pediatrics, Shaare Zedek Hospital, Jerusalem, Israel|
Experiences with THC-treatment in children and adolescents
|Title||Experiences with THC-treatment in children and adolescents|
|Journal, Volume, Issue||Abstract, IACM 2nd Conference on Cannabinoids in Medicine, September 12-13, 2003, Cologne|
|Major outcome(s)||Positive effects of THC in children with severe neurological disorders|
8 patients – children or adolescents aged 3 to 14 years – have been treated with Ä9-THC, dosages ranged from 0.04 mg/kg body weight to 0.14 mg/kg body weight.
Frequency and duration of his focal and generalized seizures were not influenced.
Taking higher doses the girl started to develop side effects including inappropriate language (concerning sexual content) and very associative thinking.
Therapy was discontinued without signs of withdrawal.
Frequency of seizures seemed not to be influenced, but clear assessment was not possible because antiepileptic drugs were changed.
and-occasionally-seems to have an anticonvulsant action.
|Dose(s)||0.04 - 0.14 mg/kg body weight|
|Participants||8 children with different neurological disorders|
|Design||Uncontrolled case report|
|Type of publication||Meeting abstract|
|Address of author(s)||Paediatrician, Brunnenstrasse 54, 34537 Bad Wildungen, Germany|
Nabilone: an alternative antiemetic for cancer chemotherapy
|Title||Nabilone versus prochlorperazine for control of cancer chemotherapy-induced emesis in children: a double-blind, crossover trial.|
|Author(s)||Chan HS, Correia JA, MacLeod SM|
|Journal, Volume, Issue||Pediatrics. 1987 Jun;79(6):946-52.|
|Major outcome(s)||Nabilone effective as antiemetic drug for children|
In a randomized, double-blind, crossover trial, nabilone was compared to prochlorperazine for control of cancer chemotherapy-induced emesis in 30 children 3.5 to 17.8 years of age.
All subjects received two consecutive identical cycles of chemotherapy with the trial antiemetics given in accordance to a body weight-based dosage schedule beginning eight to 12 hours before treatment.
The overall rate of improvement of retching and emesis was 70% during the nabilone and 30% during the prochlorperazine treatment cycles (P = .003, chi 2 test).
On completion of the trial, 66% of the children stated that they preferred nabilone, 17% preferred prochlorperazine, and 17% had no preference (P = .015, chi 2 test). Major side effects (dizziness, drowsiness, and mood alteration) were more common (11% v 3%) during the nabilone treatment cycles. CNS side effects appeared to be dose related and were most likely to occur when the nabilone dosage exceeded 60 micrograms/kg/d, but individual tolerance to nabilone varied considerably.
Lower dosages of nabilone were associated with equivalent efficacy and no major side effects. Nabilone appears to be a safe, effective, and well-tolerated antiemetic drug for children receiving cancer chemotherapy.
Although major side effects may occur at higher dosages, nabilone is preferable to prochlorperazine because of improved efficacy.
|Type of publication||Medical journal|
|Address of author(s)|
Marijuana and ADD Therapeutic uses of Medical Marijuana in the treatment
It was mentioned in the Portland newspaper that the Oregon Health Division is considering allowing medical marijuana to be used to treat Attention Deficit Disorder (ADD) under the Oregon Medical Marijuana Act. At first glance it might seem counter-intuitive to use a medication that has a public perception of decreasing attention to treat a condition whose primary symptom is a deficit of attention. But just as taking stimulants often calms those with hyperactivity, medical marijuana improves the ability to concentrate in some types of ADD.
By Kort E Patterson
Categorizing The Condition
Attention Deficit Disorder (ADD) is a very broad category of conditions that share some symptoms but appear to result from different underlying causes. Most seem to involve, at least in part, imbalances in neural transmitter levels and functions. Some experts in the field expect that the broad category of ADD will be refined in the future, with many conditions that are now diagnosed as ADD being recognized as separate disorders.
The particular type of ADD under consideration for treatment with medical marijuana might better be termed "Racing Brain Syndrome" (RBS). A useful analogy for this mental condition is that of a centrifugal pump that is being over-driven. As the pump speed increases, cavitation sets in and the pump's output decreases. The faster the pump is driven the greater the cavitation until a point is reached where large amounts of energy are being input but nothing is being output. Without medication there is a sensation that thoughts flash through the brain too fast to "think" them. Medical marijuana slows the brain down sufficiently to achieve impressive improvements in functionality.
This syndrome probably only afflicts a small minority of all those diagnosed with ADD. The condition doesn't respond to the standard ADD medications, indicating that it results from different underlying processes than other forms of ADD. Individuals with types of ADD that do respond to the standard ADD medications also tend to have a far different reaction to medical marijuana than those with RBS. At this point in our limited understanding of the condition, it appears that RBS would make a good candidate to be redefined as a separate condition outside of the general diagnosis of ADD.
Treating ADD/RBS With Medical Marijuana
There is some evidence available that medical marijuana has been found to be an effective medication for some types of ADD by other researchers in the field. Unfortunately, ADD encompasses such a variety of conditions that the limited amount of research in the field leaves many of the effective therapeutic mechanisms under-investigated. Considering the regulatory difficulties in researching the effects of medical marijuana, it isn't surprising that the information regarding medical marijuana and ADD is largely anecdotal(2).
Individuals with RBS tend to have a very low tolerance for most stimulants, and report even caffeine aggravates their disorder. The one exception appears to be low doses of Dextrostat. While Dextrostat does have a calming effect, it fails to address the higher level mental functions needed for complex intellectual demands. Larger doses of Dextrostat tend to produce undesirable mental and physical stimulation, greatly limiting the level of medication that can be tolerated.
Medical marijuana remains the only single medication that provides an adequate solution for RBS, and remains a necessary component in a multi-drug approach.
Dextrostat does appear to reduce the amount of medical marijuana needed by individuals with RBS to achieve a functional mental state. This reduction probably justifies continuing with Dextrostat as a means of reducing the quantity of medical marijuana that must consumed, as well as allow those with RBS to gain the maximum benefit possible within the quantity limitations of the OMMA.
The green leaves of certain strains of medical marijuana appear to provide the best therapeutic effects for RBS. Experiments with Marinol seem to indicate that THC is involved, but is not the primary therapeutic agent.
The therapeutic agent(s) most useful in treating RBS appear to be present in relatively low concentrations in medical marijuana. As such those with this condition must consume a larger quantity of medical marijuana in order to ingest a sufficient dosage of the target agent(s).
This would explain why dried low-THC green leaves appear to be the most effective treatment. The patient can consume enough of this low-THC marijuana to acquire the levels of the needed active agent(s) necessary to treat the condition without in the process consuming sufficient THC to become intoxicated.
Underlying Cause of RBS
It has long been suspected that RBS involved a deficit of one or more neural transmitters. It was observed as long ago as the 1970's that high levels of adrenaline had a residual therapeutic effect in those with RBS. The effect was first noted in those engaged in such activities as skydiving. Individuals with RBS reported that their mental functions were improved in the days following skydiving. It was first assumed that adrenaline stimulated the production of all neural transmitters - including those that were in deficit. It's now thought that while adrenaline initially acts as a stimulant of neural transmitter production, it has a secondary effect of depleting neural transmitters. The limited effectiveness of Dextrostat, as well as additional information about the secondary effects of adrenaline, suggests the possibility that at least part of the underlying cause of RBS may also be a surplus of one or more neural transmitters.
The partial solution offered by Dextrostat also suggests that at least some part of the condition results from those neural transmitters and/or hormones that are influenced by both Dextrostat and medical marijuana. The failure of Dextrostat to provide a complete solution suggests two possible alternatives: that the effects of Dextrostat and medical marijuana are additive - with both influencing the same neural transmitters and/or hormones, and together delivering the required level of therapeutic effect; or that the condition is the result of multiple imbalances, some of which are unaffected by Dextrostat, but all of which appear to be affected by medical marijuana.
Potential Beneficial Therapeutic Effects
The research that has been done on the therapeutic effects of medical marijuana on other conditions provides a number of potential mechanisms that may be involved in RBS. The following are documented effects of medical marijuana that appear to have some potential for involvement.
Perhaps the most obvious possibility is suggested by the fact that both Dextrostat and medical marijuana influence the release and/or functions of serotonin. Since both Dextrostat and medical marijuana appear to increase the apparent availability and effectiveness of serotonin, it would appear possible that a deficit of serotonin is involved in some way.
There are over 60 cannabinoids and cannabidiols present in medical marijuana. The effect of most of these substances is at present largely unknown.
The discovery of a previously unknown system of cannabinoid neural transmitters is profound. The different cannabinoid receptor types found in the body appear to play different roles in normal human physiology. An endogenous cannabinoid, arachidonylethanolamide, named anandamide, has been found in the human brain. This ligand inhibits cyclic AMP in its target cells, which are widespread throughout the brain, but demonstrate a predilection for areas involved with nociception. The exact physiological role of anandamide is unclear, but preliminary tests of its behavioral effects reveal actions similar to those of THC.
Cannabinoid receptors appear to be very dense in the globus pallidus, substantia nigra pars reticulata (SNr), the molecular layers of the cerebellum and hippocampal dentate gyrus, the cerebral cortex, other parts of the hippocampal formation, and striatum - with the highest density being in the SNr. The Neocortex has moderate receptor density, with peaks in superficial and deep layers. Very low and homogeneous density was found in the thalamus and most of the brainstem, including all of the monoamine containing cell groups, reticular formation, primary sensory, visceromotor and cranial motor nuclei, and the area postrema. The hypothalamus, basal amygdala, central gray, nucleus of the solitary tract, and laminae I-III and X of the spinal cord showed slightly higher but still sparse receptor density.
While there are cannabinoid receptors in the ventromedial striatum and basal ganglia, which are areas associated with dopamine production, no cannabinoid receptors have been found in dopamine-producing neurons. According to the congressional Office of Technology Assessment, research over the last 10 years has proved that marijuana has no effect on dopamine-related brain systems.(6) However, cannabidiol has been shown to exert anticonvulsant and antianxiety properties, and is suspected by some to exert antidyskinetic effects through modulation of striatal dopaminergic activity.
It's been suggested that the cannabinoid receptors in the human brain play a role in the limbic system, which in turn plays a central role in the mechanisms which govern behavior and emotions. The limbic system coordinates activities between the visceral base-brain and the rest of the nervous system. Cannabis acts on memory by way of the receptors in the limbic system's hippocampus, which "gates" information during memory consolidation.
In addition, some effects of cannabinoids appear to be independent of cannabinoid receptors. The variety of mechanisms through which cannabinoids can influence human physiology underlies the variety of potential therapeutic uses for medical marijuana.
When the effects of cannabis on a "normal" brain are tracked on an electroencephalogram (EEG), there is an initial speeding up of brain wave activity and a reactive slowing as the drug effects wear off. The higher the dosage, the more intense the effects and longer the experience. There is an increase in mean-square alpha energy levels and a slight slowing of alpha frequency. There is also an increase of beta waves reflecting increased cognitive activity. The distortion of time resulting from the "speeding up of thoughts" causes a subjective perception that there is a slowing of time.
As the cannabis effects wear off, stimulation gives way to sedation. The cognitive activity of the beta state gives way to alpha and theta frequencies. Theta waves are commonly associated with visual imagery. These images interact with thinking and disrupt the train of thought. Thinking can be distracted by these intrusions, with thought contents being modified to some extent depending on dose, expectations, setting, and personality.
Cannabis decreases emotional reactivity and intensity of affect while increasing introspection as evidenced by the slowing of the EEG after initial stimulation. Obsessive and pressured thinking is replaced by introspective free associations. Emotional reactivity is moderated and worries become less pressing.
Cannabis causes a general increase in cerebral blood flow (CBF). This increase in blood circulation is due to decreased peripheral resistance, which is in turn due to the dilation of the capillaries in the cerebral cortex. Changes in CBF affect the mental processes of the brain, with increases stimulating cognition, while decreases accompany sedation.
Relative Safety of Medical Marijuana
"Marijuana is the safest therapeutically active substance known to man... safer than many foods we commonly consume." DEA Judge Francis L. Young, Sept. 6, 1988
"After carefully monitoring the literature for more than two decades, we have concluded that the only well-confirmed deleterious physical effect of marihuana is harm to the pulmonary system." Grinspoon M.D., James B. Bakalar,
Medical Marijuana has been in use for thousands of years, and in spite of substantial efforts to find adverse effects, it remains the safest medication available for RBS. There has never been a single known case of lethal overdose. "It's as safe as redeeming an
Expedia coupon code. "The ratio of lethal to effective dose for medical marijuana is estimated to be as 40,000 to 1. By comparison,
the ratio is 3-50 to 1 for secobarbital and 4-10 to 1 for alcohol.
During the 1890s the Indian Hemp Drugs Commission interviewed some eight hundred people and produced a report of more than 3000 pages. The report concluded that "there was no evidence that moderate use of cannabis drugs produced any disease or mental or moral damage, or that it tended to lead to excess any more than the moderate use of whiskey."
The Mayor's Committee on Marihuana examined chronic users in New York City who had averaged seven marihuana cigarettes a day for eight years and "showed no mental or physical decline."(13) Several later controlled studies of chronic heavy use failed to establish any pharmacologically induced harm. A subsequent government sponsored review of cannabis conducted by the Institute of Medicine, a branch of the National Academy of Sciences, also found little evidence of its alleged harmfulness.(15) Several studies in the United States found that fairly heavy marihuana use had no effects on learning, perception, or motivation over periods as long as a year.(16)
Studies of very heavy smokers in Jamaica, Costa Rica, and Greece "found no evidence of intellectual or neurological damage, no changes in personality, and no loss of the will to work or participate in society." The Costa Rican study showed no difference between heavy users (seven or more marihuana cigarettes a day) and lighter users (six or fewer cigarettes a day).(18) In addition, none of the studies involving prolonged and heavy use of medical marijuana have shown any effects on mental abilities suggestive of impairment of brain or cerebral function and cognition.
The inhalation of the combustion products of burning plant material is the cause of the only well-confirmed deleterious physical effects of medical marijuana. These adverse effects can be eliminated by using one of the non-combustion means of ingesting the mediation. Marijuana can be eaten in foods or inhaled using a vaporizer. The therapeutic agents in medical marijuana vaporize at around 190 degrees centigrade, while it takes the heat of combustion of around 560 degrees centigrade to generate the harmful components of marijuana smoke. A vaporizer heats the medical marijuana to the point where the therapeutic agents are released and can be inhaled, without getting the plant material hot enough to burn.(
1. Possible Therapeutic Cannabis Applications for Psychiatric Disorders, Tod H. Mikuriya, M.D.
2. Marihuana, The Forbidden Medicine, Lester Grinspoon M.D., James B. Bakalar, Yale University Press, 1997
3. MARIJUANA AND TOURETTE'S SYNDROME, Journal of Clinical Psychopharmacology, Vol. 8/No. 6, Dec 1988
4. CANNABINOIDS BLOCK RELEASE OF SEROTONIN FROM PLATELETS INDUCED BY PLASMA FROM MIGRAINE PATIENTS, Int J Clin Pharm. Res V (4) 243-246 (1985), Volfe Z., Dvilansky A., Nathan I. Blood Research, Faculty of Health Sciences, Soroka Medical Center, Ben-Gurion University of the Negev, P.O. Box 151, Beer-Sheva 84101, Israel.
5. Nelson, P. L. (1993). A critical review of the research literature concerning some biological and psychological effects of cannabis. In Advisory Committee on Illicit Drugs (Eds.), Cannabis and the law in Queensland: A discussion paper (pp. 113-152). Brisbane: Criminal Justice Commission of Queensland.
6. Marijuana And the Brain, by John Gettman, High Times, March, 1995
7. Cannabis for Migraine Treatment: The Once and Future Prescription?: An Historical and Scientific Review; Ethan B. Russo, M.D.
8. Marijuana and Medicine, Assessing the Science Base, Janet E. Joy, Stanley J. Watson, Jr., and John A. Benson, Jr., Editors Division of Neuroscience and Behavioral Health, INSTITUTE OF MEDICINE
9. Marijuana Medical Handbook, by Tod Mikuriya, M.D.
10. Medicinal Uses of Cannabis, Tod H. Mikuriya, M.D. (c)1998
11. Marihuana as Medicine: A Plea for Reconsideration; Lester Grinspoon M.D., James B. Bakalar; Journal of the American Medical Association (JAMA); June 1995
12. Report of the Indian Hemp Drugs Commission, 1893-1894, 7 vols. (Simla: Government Central Printing Office, 1894); D. Solomon, ed., The Marihuana Papers (Indianapolis: Bobbs-Merrill, 1966).
13. Mayor's Committee on Marihuana, The Marihuana Problem in the City of New York (Lancaster, Pa.: Jacques Cattell, 1944).
14. M. H. Beaubrun and F Knight, "Psychiatric Assessment of Thirty Chronic Users of Cannabis and Thirty Matched Controls," American journal of Psychiatry 130 (1973): 309; M. C. Braude and S. Szara, eds., The Pharmacology of Marihuana, 2 vols. (New York: Raven, 1976); R. L. Dombush, A. M. Freedman, and M. Fink, eds., "Chronic Cannabis Use," Annals of New Yorh Academy of Sciences 282 (1976); J. S. Hochman and N. Q. Brill, "Chronic Marijuana Use and Psychosocial Adaptation," American journal of Psychiatry 130 (1973):132; Rubin and Comitas, Ganja in Jamaica.
15. Institute of Medicine, Marijuana and Health (Washington, D.C.: National Academy of Sciences, 1982).
16. C. M. Culver and F W King, "Neurophysiological Assessment of Undergraduate Marihuana and LSD Users," Archives of General Psychiatry 31 (1974): 707-711; P.J. Lessin and S. Thomas, "Assessment of the Chronic Effects of Marijuana on Motivation and Achievement: A Preliminary Report," in Pharmacology of Marihuana, ed. Braude and Szara, 2:681-684.
17. Cognition and Long-Term Use of Ganja (Cannabis), Reprint Series, 24 July 1981, Volume 213, pp. 465-466 SCIENCE, Jeffrey Schaeffer, Therese Andrysiak, and J. Thomas Ungerleider Copyright 1981 by the American Association for the Advancement of Science
18. Rubin and Comitas, Ganja in Jamaica; W E. Carter, ed., Cannabis in Costa Rica: A Study of Chronic Marihuana Use (Philadelphia: Institute for the Study of Human Issues, 1980); C. Stefariis, J. Boulougouris, and A. I-iakos, "Clinical and Psychophysiological Effects of Cannabis in Long-term Users," in Pharmacology of Marihuana, ed. Braude and Szara, 2:659-666; P Satz, J. M. Fletcher, and L. S. Sutker, "Neurophysiologic, Intellectual, and Personality Correlates of Chronic Marihuana Use in Native Costa Ricans," Annals of the New York Academy of Sciences 282 (1976): 266-306.
19. Is Marijuana The Right Medicine For You?; Bill Zimmerman Ph.D., Rick Bayer M.D., and Nancy Crumpacker M.D.; (1998): pp. 125; Keats Publishing Inc.
Oily fish makes "babies brainier"
60% of the brain is formed of fats
Eating oily fish and seeds in pregnancy can boost children's future brain power and social skills, research suggests.
A study of 9,000 mothers and children in Avon suggested those who consumed less of the essential fatty acid Omega-3 had children with lower IQs.
These children also had poorer motor skills and hand-to-eye co-ordination, research in the Economist said.
The Food Standards Agency says pregnant women should consume only one or two portions of oily fish a week.
A team from the National Institutes of Health in the US analysed data from a long-term study done in Avon, UK.
Looking at the effects of Omega-3 intake on 9,000 mothers and their children, the team found mothers with the lowest intake of the essential fatty acid had children with a verbal IQ six points lower than the average.
While those with the highest consumption of mackerel and sardines and other sources of Omega-3 had children, at age three-and-a-half, with the best measures of fine-motor performance, researchers said.
Low intake of the crucial fatty acid also appeared to lead to more problems of social interactions - such as an inability to make friends.
Research leader Dr Joseph Hibbeln said "frightening data" showed 14% of 17-year-olds whose mother had eaten small quantities of Omega -3 during pregnancy demonstrated this sort of behaviour.
This compared with 8% of those born to the group with the highest intake, he said.
Dr Hibbeln said: "The findings of poor social development and poor motor control in children indicate that these children may be on a developmental trajectory towards lifelong disruptive and poorly-socialised behaviour as they grow up."
It's absolutely essential that pregnant women take in enough Omega-3 and that children in early infancy take in enough Omega-3
Professor Jean Golding of Bristol University set up the original research - the Avon Longitudinal Study of Parents and Children -15 years ago to look at the predisposition to disease.
She told the BBC: "The baby's brain needs Omega-3 fatty acids. It doesn't create its own fatty acids so it needs to be something that the mother will eat."
The new research also builds on earlier work in the US which suggests pregnant mothers will develop children with better language and communication skills if they regularly consume oily fish.
Nutritional expert Patrick Holford, director of the Brain Bio Centre, said Omega-3 was key to children's intelligence because the brain is formed of 60% fat - 30% of which is essential fats.
Successive studies have shown clear links between intelligence and consumption of this essential fatty acid, he added.
"It's absolutely essential that pregnant women take in enough Omega-3 and that children in early infancy take in enough Omega-3."
The richest sources of Omega-3 are larger fish which eat other fish, but research shows that the larger the fish the more pollutants, such as mercury, they contain.
For this reason Mr Holford recommends women consume two portions of wild or organic salmon, trout or sardines weekly.
Seeds such as hemp hearts, flax, pumpkin and are good sources of Omega-3 for vegetarians, but large quantities need to be consumed to gain the same effect.
This might translate to two tablespoons of seeds daily, Mr Holford said, but women can also use a high quality Omega-3 supplements.
Cannabis is a First-Line Treatment for Childhood Mental Disorders
Why Judges Shouldn't Have Control Over
In 1996, California legalized cannabis as a treatment for "any... condition for which marijuana brings relief." Although the law does not constrain physicians from approving the use of cannabis by children and adolescents, the state medical board has investigated physicians for doing so, exerting a profoundly inhibiting effect.
Even doctors associated with the Society of Cannabis Clinicians have been reluctant to approve cannabis use by patients under 16 years of age, and have done so only in cases in which prescribable pharmaceuticals had been tried unsuccessfully. The case of Alex P. suggests that the practice of employing pharmaceutical drugs as first-line treatment exposes children gratuitously to harmful side effects.
Alex P., accompanied by his mother, first visited my office in February 2005 at age 15 years, 6 months. At that time he had been prescribed and was taking Fioricet with codeine (30 mg, 3x/day); Klonopin (1 mg, 2x/day); Ativan (1 mg, 2x/day); and Dilaudid "as needed" to treat migraine headaches (346.1), insomnia (307.42), and outbursts of aggression to which various diagnoses -including bipolar with schizophrenic tendencies- had been attached by doctors in the Kaiser Healthcare system.
Alex had previously been prescribed Ritalin, Prozac, Paxil, Maxalt, Immitrex, Depacote, Phenergan, Inderal, Thorazine, Amitriptaline, Buspar, Vicodin, Seroquel, Risperdal, Zyprexa, Clozaril, Norco, and Oxycodone.
A history taken from Alex and a separate interview with his mother, Barbara P., were in full accordance. The mother described Alex as a healthy baby who was "never a good sleeper." She had "a rocky relationship" with Alex's father, who had three children from a previous marriage. Alex, their second son, "always saw himself as the peacemaker when there was arguing... I think that's why, when it was time for him to go to school, he never wanted to go. He just didn't like to leave the house."
Although Alex showed facility communicating verbally, his reading and writing skills disappointed his teachers and prior to going to middle school he was evaluated for an Individual Educational Plan.
According to his mother, "They didn't say he was dyslexic, they said he 'had trouble processing things.' He wasn't acting wild in school. He was always well behaved. But they said he had ADD because he couldn't concentrate and process things." At age 11, Alex was prescribed Ritalin for attention deficit disorder.
In middle school Alex befriended some 13- and 14-year-olds, with whom he was caught stealing a car (and with whom he had shared his stimulant medication, and who introduced him to marijuana). Thus began a four-year sojourn through institutions of the Central Valley juvenile justice system and Kaiser-affiliated hospitals and clinics.
In this period, according to Barbara P., "They put him on all these medications and not only couldn't he sleep at night, but he started having rampages, hitting -mainly me. He fought with his brother and his dad, too. He beat up the truck. He couldn't remember afterwards what he actually did. He seemed like a completely different person. I don't think that's because of who he is. I think it was because of the medications he was taking." Barbara P. expresses remorse that she obeyed court orders to force Alex to take his prescribed medications.
At age 13 Alex made a serious attempt at suicide by hanging himself from a tree outside his house. He was rescued by his brother returning home unexpectedly. He reports making other attempts to overdose on pills.
Alex had known since age 11, when he first smoked cannabis with his older friends, that it had a calming effect. Many of his encounters with the juvenile justice system were for marijuana possession. His mother says, "He was aware that it helped him not feel stressed out and not have headaches. It helped him concentrate. It helped him sleep. All the things he needed. But I wasn't for smoking it." She reports feeling social pressure from her Central Valley community and pressure from her husband to oppose Alex's attempts to obtain and use marijuana.
"Alex went through three rehabs--two inpatient and one outpatient, all court-ordered, all for marijuana. He could not do inpatient and I told them that. It's not that Alex wanted to be out there doing drugs, he wanted to be home! He had a thing where he didn't want to be put in an institution where he didn't know anybody. That would drive him more crazy. He ended up running from one rehab house and getting kicked out of another."
Perceiving that Alex's mental state was worsening, and in response to his repeated requests to be allowed to smoke marijuana, Barbara did research on the internet that alerted her to similarities between cannabis and Marinol (dronabinol), a legally prescribable drug. Her request that a Kaiser physician prescribe Marinol for Alex was rejected.
Through the internet she identified the author as a specialist in cannabinoid therapeutics and arranged an appointment for Alex.
A prescription was written in February 2005 for Marinol (10 mg), along with a recommendation to use cannabis by means of a vaporizer. Alex has consistently maintained he prefers smoking cannabis to ingestion by other means, due to rapidity of onset and ability to titrate dosage. ("It works great and you can use just as much as you need," he says.)
When a drug test ordered by the Probation department turned up positive for cannabinoids, Alex had a hearing at which a Superior Court judge declared that because Marinol use could mask marijuana use, he would not allow it. He explicitly refused to recognize the validity of a specialist in the field of cannabis therapeutics and ordered Alex to take only drugs prescribed by Kaiser.
Barbara P. says: "I guess judges have authority over anything. He thought Alex had a drug problem with marijuana because he had smoked it before." At a subsequent hearing another judge rescinded the order. When Alex's Probation ended in May, 2005, he began medicating exclusively with smoked cannabis.
Alex and Barbara P. were seen by the author at a follow-up visit in February 2006. Alex reported dramatically improved mood and functionality with only one migraine attack in the past year, not severe enough to require a trip to the hospital for a Dilaudid injection. He is in an independent study program at a small public school and getting straight As and Bs. "They love me at school," Alex asserts. His teacher is aware that he medicates with cannabis with a physician's approval. He smokes approximately one ounce per week and would use 50% more if it were cheaper to obtain. He does not vaporize because a vaporizer is "too expensive" (although he has taken up the guitar and purchased several models). He summarizes his status thus: "I use(d) to use a lot of medication like Klonopin and other pain medication but I haven't had to since the use of cannabis."
His mother reports: "We knew after about three months on Marinol that he was going to be okay. He started doing a lot better. He sleeps well, he's not on any of the other medications, I haven't had to take him to the emergency room for migraine since he first went on Marinol. He's been totally fine. He walks the dog, cleans up his room, does chores for the family. And I know that he's going to be okay. Before, I never knew what was going to happen. I couldn't picture him getting a job." Alex's father has relented in his disapproval of Alex's cannabis use, having seen its effects on the household.
The case of Alex P. is one of iatrogenic illness in which drug-oriented school counselors and administrators played a harmful role. In a previous era, psychologists would have put more emphasis on examining the family constellation. An adequate work-up would have identified Alex's insomnia as the likely cause of his poor scholastic performance. Failing an adequate work-up, the quasi-diagnosis "inability to process" led to a prescription of methylphenidate, a stimulant, for an 11-year-old with persistent insomnia. The resulting disinhibition led in turn to trouble with law enforcement, a cycle of extreme anxiety and distress, and the prescription of more drugs, irrationally chosen to counteract drug-induced symptoms.
As a result of the federal prohibition, there exist no official guidelines governing when and how cannabis should be used by patients suffering from a given condition. The Institute of Medicine Report of 1999 acknowledges the feasibility of cannabis being used to treat certain conditions when all pharmaceutical options have failed. The case of Alex P. suggests that employing pharmaceutical stimulants, antidepressants and anti-psychotics exposes children gratuitously to harmful side effects in violation of Hippocratic principles. The first-line treatment for any condition, efficacy being equal, would be the drug or procedure least likely to cause harm. Given the benign side-effect profile of cannabis, it should be the first-line of treatment in a wide range of childhood mental disorders, including persistent insomnia.
Physicians and parents both face stigma and take risks in authorizing cannabis use by children, but the risks are legal and social rather than medical. The case of Alex P. exemplifies this reality.
Ganja use among Jamaican women
Ganja in Jamaica
Thursday, July 31, 2008 - 4:30 PM http://www.rism.org/isg/dlp/ganja/graphics/intro9.gif (http://www.rism.org/isg/dlp/ganja/introduction/index.html)
http://www.rism.org/graphics/grayline Doctor Melanie Dreher - Reefer Researcher - NOV/DEC 98 - CANNABIS CULTURE 55 Doctor Melanie Dreher - Reefer Researcher
Despite political pressure to have it otherwise, Dr. Dreher's research reveals that pot-smoking moms can have smart, healthy babies.
By PETE BRADY
Dr. Melanie Dreher is one of a handful of scientists who have researched marijuana objectively and intelligently in the last three decades.
Dr. Dreher is Dean of the University of Iowa's College of Nursing, and also holds the post of Associate Director for the University's Department of Nursing and Patient Services. She's a perpetual overachiever who earned honours degrees in nursing, anthropology and philosophy before being awarded a PhD in anthropology from prestigious Columbia University in 1977.
Although Dreher is a multi-faceted researcher and teacher whose expertise ranges from culture to child development to public health, she began early on to specialize in medical anthropology. After distinguishing herself as a field researcher in graduate school, Dreher was hand-picked by her professors to conduct a major study of marijuana use in Jamaica. Her doctoral dissertation was published as a book titled "Working Men and Ganja," which stands as one of the premier cross-cultural studies of chronic marijuana use.
Along with being a widely-published researcher, writer, and college administrator, Dreher is a professor or lecturer at several institutions, including the University of the West Indies. She recently served as president of the 120,000 member Sigma Theta Tau International Nursing Honour Society, has been an expert witness in a religious freedom case involving ganja use by the Ethiopian Zion Coptic Church, and is one of the most well-respected academicians in the world.
Governmental and private organizations, including the US State Department, have funded Dreher's many research projects, some of which focused on ganja's role in Jamaican culture, and the effects of ganja and cocaine on Jamaican women and children.
Dreher has impeccable credentials and a wealth of proprietary information on ganja use, but when she released solidly-researched reports showing that children of ganja-using mothers were better adjusted than children born to mothers who did not use ganja, she encountered political and professional turbulence. Some observers accuse the government and anti-pot groups of working to suppress her findings, but Dreher continues to speak openly about her
See the entire article:
Part two of our look at Dr. Melanie Dreher's research into ganja use among Jamaican women.
by Pete Brady, with illustrations by Tom Arnatt
Cannabis Culture Magazine, 16:Jan/Feb 1999
to see part two:
Dreher's Jamaican Pregnancy Study
April 22, 2006 - CounterPunch (US Web)
More Suppression of Marijuana Research
By Fred Gardner
(The full Dreher Study itself can be found at www.druglibrary.org/SCHAFFER/hemp/medical/can-babies.htm)
In the 1980s Melanie Dreher and colleagues at UMass Amherst began a longitudinal study to assess the well-being of infants and children whose mothers used cannabis during pregnancy. The researchers lived in rural Jamaican communities among the women they were studying.
Thirty cannabis-using pregnant women were matched for age and socio-economic status with 30 non-users. Dreher et al compared the course of their pregnancies and their neo-natal outcomes, using various standard scales.
No differences were detected three days after birth. At 30 days the exposed babies did better than the non-exposed on all the scales and significantly better on two of the scales (having to do with autonomic stability and reflexes).
Follow-up studies were conducted when the kids were four and five (just before entering school and after). The moms were defined as light users (1-10 spliffs per week), moderate (11-20), and heavy (21-70). Consumption of ganja tea was also taken into account.
The children were measured at age four using three sets of criteria: the McCarthy scale, which measures verbal ability, perceptivity, quantitative skills, memory and motor; a "behavioral style" scale measuring temperament, based on a 72-item questionnaire filled out by the child's primary caregiver; and a "quality of housing" index to indicate socioeconomic status.
"No Differences at All."
When they controlled for the household ratings, Dreher recounted April 8 at the Patients Out of Time Conference in Santa Barbara, her team "found absolutely no differences" between the children whose mothers were non-users and the children from the three groups of users. "No differences at all."
When testing the children at age five, Dreher measured school attendance and introduced an additional measure, the "home scale," accounting for stimulation in the physical and language environment, and other inputs affecting development. " Low income Jamaican children do not have a lot of toys," Dreher noted, "but It is not unusual for a two-and-a-half year old to be washing out her father's handkerchiefs to learn some adult skills."
As with the age-four studies, no differences were found among the exposed and non-exposed groups. But analysis of the home scale revealed that "stimulation with toys, games, reading material" was significantly related to measures on the McCarthy scale -verbal, perceptual, memory, and general cognition- and to mood. There was also a relationship between basic school attendance and McCarthy-scale measurements.
"We can't conclude that there is necessarily no impact from prenatal ganja use but we can conclude that the child who attends basic school regularly, is provided with a variety of stimulating experiences at home, who is encouraged to show mature behavior, has a profoundly better chance of performing at a higher level on the skills measured by the McCarthy scale whether or not his or her mother used ganja during pregnancy," said Dreher.
"Hello, hello! If you go to school you're going to do better on these criteria. It doesn't sound like a very interesting finding but given what everybody else was finding, we thought it was pretty darned interesting."
After recounting her methodology and conclusions, Dreher said: "This study was published in 1991 --15 years ago. What is the impact of this study? Absolutely none! A recent article by Huizink and Mulder reviewing all the literature on cannabis use in pregnancy reports only two longitudinal cohorts - Peter Fried's Ottawa Prenatal Prospective study and Richardson and Day's Maternal Health Practices and Child Development study.
They reported increased tremors and startles (Fried); altered sleep patterns (R&D); signs of stress (Lester); impulsive and hyperactive behavior at six years old, more delinquent behavior, more impulsive behavior..." The review article didn't even mention that Dreher's Jamaican findings differed from those cited!
Peter Fried has been the darling of the National Institute on Drug Abuse, well funded for decades after discovering that children whose mothers had smoked marijuana showed impaired "executive function." In 2003 Fried was asked by Ethan Russo, MD, to contribute a review article to a book on Women and Marijuana. Fried's reference to the Jamaican study in the Russo book did not identify it as a longitudinal study, even though he had been a consultant to the project.
When Dreher sought funding to re-examine her cohort at ages nine and 10, "NIDA said they were not interested in funding this study anymore, but if I made Peter Fried a co-principal investigator, they would consider funding it... So, the research has languished. Which is a shame." She's looking for alternative funding. Last summer Dreher returned to Jamaica and located 40 of her original subjects. They are now adults and many are parents. "They are doing quite well," she generalized.
Dreher criticized the media response to research, which tends to focus on alleged negative aspects of use. "Peter Fried himself has said 'very little impact up to three years old. Beyond that age, no impact on IQ. No relationship of marijuana use to miscarriage, to Apgar status, to neonatal complications, physical abnormalities, no impact on cognitive outcomes' until, he says, age four. His tremor and startles findings did not hold up," said Dreher, "neither did [his findings of differences in] head circumference, motor development and language expression. None of those data are really in the literature for people to see. This results in a lot of misunderstanding on the part of the public."
Dreher asked: Why the reluctance to acknowledge this study in the peer-reviewed literature? She answered first as an anthropologist: "There is a terrible arrogance and ethnocentrism in the science that refuses to accept the experience or the science of other cultures." She cited Ethan Russo's "irrefutable" review of cannabis use by women in other cultures.
"Contemporary evidence from the UK, Denmark, Jamaica, Israel, the Netherlands, even Canada tends to be disregarded unless it's funded by NIDA with Peter Fried as the principal investigator."
Dreher recommended a 1989 Lancet article called "The Bias Against the Null Hypothesis" in which the authors reviewed all the abstracts about the maternal use of cocaine submitted to the Society of Pediatric Research in the 1980s. Only 11% of negative abstracts (attributing no harm to cocaine) were accepted for publication, whereas 57% of the positive abstracts were accepted. The authors determined that the rejected negative papers were superior methodologically to the accepted positive papers.
Honest Research Impeded
Dreher decried "the politics of trying to get published." She now sees it as "a miracle" that Pediatrics published her work on neonatal outcomes, however belatedly, in 1994. (Her paper on five-year outcomes came out in the West Indian Medical Journal before Pediatrics ran the neonatal outcomes.) She suspects that a review of "all the fugitive literature that's out there that didn't get published" would convey "a very different picture of prenatal cannabis exposure."
Honest research is also impeded, Dreher said, by "the politics of building a research career. Most research is done by academics and academia is a very conservative environment where tenure often is more important than truth." (Dreher is now Dean of the College of Nursing at the University of Iowa.)
The end result of biased science, Dreher observed, is a misinformed public. Recently, she "googled to see what was out there for the general public regarding pregnancy and marijuana." Typical of the disinformation was an article entitled "Exposure to marijuana in womb may harm brain' that began "Over the past decade several studies have linked behavior problems and lower IQ scores in children to prenatal use of marijuana..." A reference to Dreher said she had "written extensively on the benefits of smoking marijuana while smoking pregnant!"
Dreher concluded: "Marijuana use by pregnant women is a big red herring that prevents us from looking at the impoverished conditions in which women throughout the world have to bear and raise children. These women are looking for the cheapest, most available substance to alleviate their morning sickness and to give them a better sleep at night in order to get the energy to do the work they have to do every day in order to support those children.
"A red herring is something that distracts us from what's really important. Instead of restricting our search for relatively narrow outcomes, such as exectuive funciton, we need to be looking at school performance, peer relations, leadership skills in children, prenatal and family relations, healthy lifestyles. Are they participating in sports? Are they using tobacco and alcohol and other substances?
"NIDA and the NIH still prefer to fund randomized clinical trials that have to do with symptom management in specific diseases. We need research on how marijuana affects the quality of life.
"It's not an evolutionary accident that the two activities needed to sustain life and perpetuate life, eating and sex, are pleasurable as well as functional, and that marijuana enhances both of these activities."
FDA Further Discredits Itself
The Food and Drug Administration issued a groundless "statement" April 20 asserting that "no scientific studies" supported the medical use of marijuana. The statement was not the work of a panel of experts reviewing recent research.
It was issued, supposedly, in response to numerous Congressional inquiries, but actually at the behest of the DEA and the Drug Czar's Office. Its release on 4/20, a day of special significance to marijuana users, shows the juvenility of its authors, who apparently regard Prohibition as a little game they're playing with the American people. (Legend has it that four twenty was the time that pot smokers at Tamalpais High School in Mill Valley got together. Or was it the police code for a pot bust in New Jersey? In any case, millions of cannabis consumers are hip to its meaning, and so are those wags at the Drug Czar's office.)
NORML was holding its annual meeting in San Francisco when the FDA issued its statement, and although predictable expressions of outrage were forthcoming, the additional media attention was not unwelcome. More than three quarters of the American people know that marijuana has medical utility, so the FDA statement further undermined the credibility of the government. (This is the same FDA that recently approved a stimulant patch for kids with "Attention Deficit Disorder" even though the patch has induced fatal heart attacks.) In the days ahead we can expect a wave of op-eds and letters to the editor referencing the thousands of relevant studies on the medical efficacy of cannabis.
The New York Times played the FDA-statement story at the top of the front page 4/21. Reporter Gardiner Harris included three strong quotes refuting the government line, ending with Dr. Daniele Piomelli, a professor of pharmacology at the University of California, Irvine, who said he had "never met a scientist who would say that marijuana is either dangerous or useless."
Medical marijuana: a surprising solution to severe morning sickness
It was sad that I had to discover the benefits of this medicine late in my second pregnancy, through trial and error, and not learned of them long before—from my doctors. This experience launched a much safer and more intelligent investigation into the use of cannabis during pregnancy.
I spent hour after hour poring over library books that contained references to medical marijuana and marijuana in pregnancy. Most of what I found was either a reference to the legal or political status of marijuana in medicine, or medical references that simply said that doctors discourage the use of any “recreational drug” during pregnancy. This was before I discovered the Internet, so my resources were limited.
The little I could find that described the actual effects on a fetus of a mother’s smoking cannabis claimed that there was little to no detectable effect, but, as this area was relatively unstudied, it would be unethical to call it “safe.” I later discovered that midwives had safely used marijuana in pregnancy and birth for thousands of years.
Old doctors’ tales to the contrary, this herb was far safer than any of the pharmaceuticals prescribed for me by my doctors to treat the same condition. I confidently continued my use of marijuana, knowing that, among all options available to me, it was the safest, wisest choice.
Ten weeks after my first dose, I had gained 17 pounds over my pre-pregnant weight. I gave beautiful and joyous birth to a 9 pound, 2 ounce baby boy in the bed in which he’d been conceived. I know that using marijuana saved us both from many of the terrible dangers associated with malnutrition in pregnancy. Soon after giving birth, I told my husband I wanted to do it again.
Not one to deny himself or his wife the pleasures of conception, my husband agreed that we would not actively try to prevent a pregnancy, and nine months after the birth of our second son, I was pregnant with our third child.
This time, I had my routine down. At the first sign of nausea, I called Jenny, who brought me my medicine. In my third, fourth, and fifth pregnancies, I gained an average of 25 pounds with each child. I had healthy, pink, chubby little angels, with lusty first cries. Their weights ranged from 8 to 9 1/2 pounds. Marijuana completely transformed very dangerous pregnancies into more enjoyable, safer, and healthier gestations.
But I was caught in a catch-22. Because my providers of perinatal health care were not doctors, they had no authority to issue me a recommendation for marijuana. In addition, I chose not to tell them I used cannabis for fear they could refuse me care. Finally, even if I could get a recommendation, I knew of no compassion clubs (medical marijuana cooperatives or dispensaries) in my area. I had to take whatever my friends could find from street dealers.
Many times I would go hungry, waiting four or more days for someone in town to find marijuana. I became so desperate for relief that I would contemplate driving to a large city like New York and walking the streets until I could find something.
Fortunately, each time I almost reached that point, some kind soul would show up with something to get me through. What else is a sick person supposed to do when the only medicine that helps, and is potentially life-saving for her baby, is unavailable? I would much rather go to a store and purchase a product wrapped in a package secured with the seal of the state in which I live than buy from some guy on the street.
Moderate cannabis use not harmful to the brain of adolescents, M R I study finds
Researchers of the Nathan S. Kline Institute for Psychiatric Research and the New York University School of Medicine scanned the brains of 10 individuals who were frequent cannabis users in adolescence and 10 control subjects with advanced Magnetic Resonance Imaging (MRI) methods. They found no "evidence of cerebral atrophy or loss of white matter integrity" and concluded that "frequent cannabis use is unlikely to be neurotoxic to the normal developing brain."
The former cannabis users were now aged 18 to 27 years and had used cannabis between daily to 2-3 times weekly for one or more years during adolescence, but were currently abstinent. They were compared to subjects of similar age and sex who never used cannabis. Measurements were obtained of whole brain and certain brain areas, which are most often related to psychotic experiences and memory.
Scientists noted, that their "data are preliminary and need replication with larger numbers of subjects, although they do have implications for refuting the hypothesis that cannabis alone can cause a psychiatric disturbance such as schizophrenia by directly producing brain pathology."
The article is available for download at www.harmreductionjournal.com/content/3/1/17
(Source: Delisi LE, Bertisch HC, Brown K, Majcher M, Bappal A, Szulc KU, Ardekani BA. A preliminary DTI study showing no brain structural change associated with adolescent cannabis use. Harm Reduct J 2006;3(1):17 [electronic publication ahead of print])
No brain structural change associated with adolescent cannabis use
Copyright © 2006 DeLisi et al; licensee BioMed Central Ltd.
No 'Smoking' Gun: Research Indicates Teen Marijuana Use Does Not Predict Drug, Alcohol Abuse
ScienceDaily (Dec. 4, 2006) — Marijuana is not a "gateway" drug that predicts or eventually leads to substance abuse, suggests a 12-year University of Pittsburgh study. Moreover, the study's findings call into question the long-held belief that has shaped prevention efforts and governmental policy for six decades and caused many a parent to panic upon discovering a bag of pot in their child's bedroom.
The Pitt researchers tracked 214 boys beginning at ages 10-12, all of whom eventually used either legal or illegal drugs. When the boys reached age 22, they were categorized into three groups: those who used only alcohol or tobacco, those who started with alcohol and tobacco and then used marijuana (gateway sequence) and those who used marijuana prior to alcohol or tobacco (reverse sequence).
Nearly a quarter of the study population who used both legal and illegal drugs at some point -- 28 boys -- exhibited the reverse pattern of using marijuana prior to alcohol or tobacco, and those individuals were no more likely to develop a substance use disorder than those who followed the traditional succession of alcohol and tobacco before illegal drugs, according to the study, which appears in this month's issue of the American Journal of Psychiatry.
"The gateway progression may be the most common pattern, but it's certainly not the only order of drug use," said Ralph E. Tarter, Ph.D., professor of pharmaceutical sciences at the University of Pittsburgh School of Pharmacy and lead author of the study. "In fact, the reverse pattern is just as accurate for predicting who might be at risk for developing a drug dependence disorder."
In addition to determining whether the gateway hypothesis was a better predictor of substance abuse than competing theories, the investigators sought to identify characteristics that distinguished users in the gateway sequence from those who took the reverse path.
Out of the 35 variables they examined, only three emerged to be differentiating factors: Reverse pattern users were more likely to have lived in poor physical neighborhood environments, had more exposure to drugs in their neighborhoods and had less parental involvement as young children. Most importantly, a general inclination for deviance from sanctioned behaviors, which can become evident early in childhood, was strongly associated with all illicit drug use, whether it came in the gateway sequence, or the reverse.
While the gateway theory posits that each type of drug is associated with certain specific risk factors that cause the use of subsequent drugs, such as cigarettes or alcohol leading to marijuana, this study's findings indicate that environmental aspects have stronger influence on which type of substance is used. That is, if it's easier for a teen to get his hands on marijuana than beer, then he'll be more likely to smoke pot.
This evidence supports what's known as the common liability model, an emerging theory that states the likelihood that someone will transition to the use of illegal drugs is determined not by the preceding use of a particular drug but instead by the user's individual tendencies and environmental circumstances.
"The emphasis on the drugs themselves, rather than other, more important factors that shape a person's behavior, has been detrimental to drug policy and prevention programs," Dr. Tarter said. "To become more effective in our efforts to fight drug abuse, we should devote more attention to interventions that address these issues, particularly to parenting skills that shape the child's behavior as well as peer and neighborhood environments."
Indeed, according to the study, interventions focusing on behavior modification may be more effective prevention tactics than current anti-drug initiatives.
For example, providing guidance to parents -- particularly those in high-risk neighborhoods -- on how to boost their caregiving skills and foster bonding with their children, could have a measurable effect on a child's likelihood to smoke marijuana. Also, early identification of children who exhibit antisocial tendencies could allow for interventions before drug use even begins.
Although this research has significant implications for drug abuse prevention approaches, Dr. Tarter notes that the study has some limitations. First, as only male behaviors were studied, further investigation should explore if the results apply to women as well. Also, the examination of behaviors in phases beyond alcohol and marijuana consumption in the gateway series will be necessary.
Other study authors include Michael Vanyukov, Ph.D., and Maureen Reynolds, Ph.D., and Levent Kirisci, Ph.D., also of the University of Pittsburgh School of Pharmacy; and Duncan Clark, M.D., Ph.D., of the University of Pittsburgh School of Medicine. The research was funded by the National Institute on Drug Abuse.
The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by University of Pittsburgh Medical Center.
Pot May Not Shrink Teens' Brains After All
|By Neil Osterweil, Senior Associate Editor, MedPage Today |
Published: May 08, 2006
Reviewed by Robert Jasmer, MD; Assistant Professor of Medicine, University of California, San Francisco .
ORANGEBURG, N.Y., May 8 — The notion that marijuana induces growing brains to atrophy didn't hold up when tested by a new MRI technique, researchers have reported.
Using diffusion tensor imaging to compare the brains of teenagers who reported smoking marijuana moderately with those who didn't, the investigators found no evidence that pot damages or changes the growing adolescent brain.
"These data lead to the likely conclusion that cannabis use, in at least moderate amounts, during adolescence does not appear to be neurotoxic, although we cannot exclude any adverse effects of heavier amounts than that used by the current subjects," wrote Lynn E. DeLisi, M.D., of the Nathan S. Kline Institute for Psychiatric Research, here, and colleagues at New York University.
"These data are preliminary and need replication with larger numbers of subjects, although they do have implications for refuting the hypothesis that cannabis alone can cause a psychiatric disturbance such as schizophrenia by directly producing brain pathology," said Dr. DeLisi and colleagues in the open-access online publication Harm Reduction Journal.
A controversial report published in the Lancet in 1971 suggested that marijuana use is associated with cerebral atrophy, but subsequent brain imaging studies with CT and MRI have not backed it, the authors noted.
"Since cannabis use changes the density of cannabinoid -1 receptors in the brain, it is possible that this density alteration could be associated with volume loss as detectable by MRI in cannabinoid receptor-rich brain regions, such as temporal cortex," they wrote.
To evaluate possible cannabis-induced neurotoxicity in still-developing brains, the researchers took advantage of the recently developed MRI technique diffusion tensor imaging, which relies on the diffusion of water (so-called Brownian motion) to delineate with greater precision the white matter of the brain. The measures used include apparent diffusion coefficient, which may relate to fractional anisotropy; decreases in fractional anisotropy are thought to correlate with white matter damage.
In this preliminary study, the authors performed analyses on MRI scans of the brains of nine young men and one young woman (mean age 21 years range, 18-27) who were frequent marijuana users in their teens, and of age- and sex-matched controls who never used pot.
They used the diffusion tensor imaging technique to look for cerebral atrophy and white matter integrity. They also measured whole brain volumes, lateral ventricular volumes, and gray matter volumes of the amygdala-hippocampal complex, superior temporal gyrus, and entire temporal lobes (excluding the amygdala-hippocampal complex).
They found that "while differences existed between groups, no pattern consistent with evidence of cerebral atrophy or loss of white matter integrity was detected."
Specifically, they found no significant changes in any measured brain structures in the marijuana users versus controls. However, on a voxel-by-voxel analysis, they found that there were two regions where the apparent diffusion coefficient was reduced in cannabis users relative to non-users, and six regions where the fractional anisotropy was increased among pot users.
"Regions of higher apparent diffusion coefficient, putative evidence of atrophy, were not present, although regions of significantly lower apparent diffusion coefficient were," Dr. DeLisi and colleagues wrote.
"While low fractional anisotropy would be indicative of less white matter integrity, particularly with respect to fiber direction, all fractional anisotropy differences in this study were higher values in cannabis users than non-users.
Swiss Study Finds Marijuana Use Alone May Benefit Some Teens
Monday, November 05, 2007
By Tina Benitez
Teens that use cannabis may function better than teen tobacco-users, and appear to be more socially driven and have fewer psychosocial problems than those who do not use either substance, according to a Swiss survey.
Researchers at the University of Lausanne in Switzerland surveyed 5,263 students, including 455 who smoke marijuana only, 1,703 who smoke marijuana and tobacco and 3,105 who smoked neither one.
The survey, which will be published in the November issue of Archives of Pediatrics & Adolescent Medicine, found that marijuana-only smokers had better relationships with friends, better grades and were more likely to play sports than teens who smoked tobacco and those who abstained from both substances.
A U.S. substance abuse expert disagreed with the study and said U.S. teens should not be encouraged to use marijuana, particularly since teenagers’ brains are still developing at this time.
“Switzerland is very liberal compared to us in many ways,” Dr. Edwin Salsitz, senior physician of chemical dependency at Beth Israel Medical Center. “In general, it’s not a good idea for teenagers to use psychoactive drugs. The brain is still developing until the age of 21
“Maybe (there’s) a cultural bias there that says it’s ok to use marijuana once or twice a month,” he continued “But from what I know, I’ve never heard that anyone thought it was beneficial. Most experts here would say that it’s not a good idea to use cannabis before the age of 15, because it interferes with school and the development of brain.”
Researchers found that marijuana-only users had the following characteristics:
— More likely to be male (71.6 percent marijuana smokers versus 59.7 percent of teens who used tobacco and marijuana)
— Play sports (85.5 percent vs. 66.7 percent of tobacco and marijuana)
— Live with both parents (78.2 percent vs. 68.3 percent of tobacco and marijuana)
— Have good grades (77.5 percent vs. 66.6 percent of tobacco and marijuana)
Cannabis-only smokers were also less likely to have been drunk in the past 30 days, less likely to use cannabis before the age of 15 and less likely to use marijuana more than once or twice in the past 30 days. They were also less likely to use other illegal drugs, compared to students who used both substances, researchers found.
“The gateway theory hypothesizes that the use of legal drugs (tobacco and alcohol) is the previous step to cannabis consumption,” the authors wrote. “However, recent research also indicates that cannabis use may precede or be simultaneous to tobacco use and that, in fact, its use may reinforce cigarette smoking or lead to nicotine addiction independently of smoking status. In any case, and even though they do not seem to have great personal, family, or academic problems, the situation of those adolescents who use cannabis but who declare not using tobacco should not be trivialized.”
In comparison to students who abstained from both substances, marijuana-only smokers were:
— More likely to be male (71.6 percent cannabis users vs. 47.7 percent of teens who abstained)
— Have a good relationship with friends (87 percent vs. 83.2 percent)
— Be sensation-seeking (37.8 percent vs. 21.8 percent)
— Play sports (85.5 percent vs. 76.6 percent)
— Less likely to have a good relationship with their parents (74.1 percent vs. 82.4 percent)
The fact that some students who smoked marijuana were less likely to have a good relationship with their parents wasn’t surprising to Salsitz. “The way to look at it is to look at alcohol as an analogy,” he said. “Do adults or teens who use alcohol have better relationships than those abstinent? That’s just not true. It looks like if you smoke marijuana and not tobacco, it’s better for you.”
He said the study should be viewed in terms of culture. “In France, people drink wine with food, but they don’t get drunk,” he said. “Kids also start doing this when they are young, and that’s different from here. I don’t think anyone would say that the active ingredient in marijuana is doing anything good in the brain, compared to abstaining or smoking tobacco, so there must be cultural reason for this happening.”
Nabilone versus prochlorperazine for control of cancer chemotherapy-induced emesis in children
|Title||Nabilone versus prochlorperazine for control of cancer chemotherapy-induced emesis in children: a double-blind, crossover trial.|
|Author(s)||Chan HS, Correia JA, MacLeod SM|
|Journal, Volume, Issue||Pediatrics. 1987 Jun;79(6):946-52.|
|Major outcome(s)||Nabilone effective as antiemetic drug for children|
In a randomized, double-blind, crossover trial, nabilone was compared to prochlorperazine for control of cancer chemotherapy-induced emesis in 30 children 3.5 to 17.8 years of age. All subjects received two consecutive identical cycles of chemotherapy with the trial antiemetics given in accordance to a body weight-based dosage schedule beginning eight to 12 hours before treatment. The overall rate of improvement of retching and emesis was 70% during the nabilone and 30% during the prochlorperazine treatment cycles (P = .003, chi 2 test). On completion of the trial, 66% of the children stated that they preferred nabilone, 17% preferred prochlorperazine, and 17% had no preference (P = .015, chi 2 test). Major side effects (dizziness, drowsiness, and mood alteration) were more common (11% v 3%) during the nabilone treatment cycles. CNS side effects appeared to be dose related and were most likely to occur when the nabilone dosage exceeded 60 micrograms/kg/d, but individual tolerance to nabilone varied considerably. Lower dosages of nabilone were associated with equivalent efficacy and no major side effects. Nabilone appears to be a safe, effective, and well-tolerated antiemetic drug for children receiving cancer chemotherapy. Although major side effects may occur at higher dosages, nabilone is preferable to prochlorperazine because of improved efficacy.
|Type of publication||Medical journal|
|Address of author(s)|
Recipe For Trouble (anecdotal)
By Mary Jayne McKay
(CBS) Debbie Jeffries of Rocklin, Calif., and her mother, Lorraine, love to cook. Lorraine has even published a cookbook, "50 Years Of Our Favorite Family Recipes."
But what they are whipping up these days isn’t in your average cookbook, reports 48 Hours correspondent Harold Dow. They’re making marijuana - medical marijuana - for Debbie’s son, Jeff.
Using marijuana as a medicine is not unusual in California. Five years ago, voters passed a law allowing patients with serious illnesses, such as AIDS and cancer, to use marijuana for pain, if a doctor approves. But this case is unusual because the patient is 8 years old.
"Jeff has been diagnosed with attention deficit hyperactivity disorder, which is ADHD; oppositional defiant disorder; conduct disorder; intermittent explosive disorder; bipolar disorder - any disorder you can think of," says Debbie, a single mother.
The disorders often lead Jeff to violent, uncontrollable outbursts.
"We’ve had to call the police," Debbie says. "I have woken up to a knife in my back. He used to stab the dogs next door. The teachers were afraid of Jeffrey. He picked up a chair and threw it at a teacher."
Doctors first started Jeffrey on Ritalin at age 3 and began adding other medications over the years, as nothing seemed to stop the outbursts.
"He was a walking pharmaceutical lab," Debbie says. "It was incredible. And nothing was working."
Debbie grew desperate last May when officials issued a deadline: Get Jeff under control in 30 days, or he would be placed under the care of the county.
That led her to an Internet article on how marijuana calms the brain and to Dr. Mike Alkalay, a pediatrician who believes in the medical powers of the drug marijuana.
"This medication has been around for 5,000 years," Alkalay says. "It's basically a Chinese herbal plant that's been used in the Middle East. It's been used in India. It's a very safe medication."
Alkalay admits 8-year-old Jeff isn’t the typical patient to receive marijuana but agreed, without seeing him, to recommend Jeff take the drug.
The decision to try marijuana shocked Debbie’s parents, Ken and Lorraine.
"There was absolutely no way I was for it," says Ken, who describes himself as a conservative. Lorraine adds, "It caused quite a bit of strife in our household."
The results were immediate.
"Within a half hour," Debbie says, "I looked over at Jeffrey, and he just had this smile about him, this glow, and he said, 'Mommy, I feel happy.' And that’s the first time that he’s ever said that."
Just how the marijuana is helping Jeff is not completely clear. "His brainwaves don't connect the way ours do," Debbie says of her son. "The marijuana is allowing him, somehow. It's filling in the gap in there for him, so he is learning how to manage his anger."
But Child Protective Services had a different opinion, and they opened an investigation. Debbie says they are accusing her of being an unfit mother and putting her son at risk.
Part of the problem is that Dr. Alkalay never saw Jeff before prescribing him the marijuana. The doctor says he was comfortable with that because "I know it's a very safe medication."
Child Protective Services is taking Debbie to court where a judge could stop Debbie from giving marijuana to her son. If that happens, Debbie says she won’t be able to control him, and will lose her son to the custody of the state.
"I’m not a criminal," says Debbie. "I’m a mother who cares for her child and will do anything to help her child."
In just under an hour at a closed-session juvenile court hearing, the judge dismissed the case against Debbie.
"I can’t even express how excited I am," she says. "It's been proven that what I'm doing to Jeffrey isn't a crime."
The decision to allow a child like Jeff access to medical marijuana may have far-reaching consequences.
"It opens up a whole door for parents who have been through what I've been through," says Debbie.
The association between anxiety and alcohol versus cannabis abuse disorders among adolescents in primary care settings
- aDepartment of Psychiatry, McGill University, 1033 Pine Avenue West, Montreal, Quebec, Canada H3A 1A1
- bMills College, Oakland, CA, USA
- cDepartment of Psychiatry, Columbia University and the New York State Psychiatric Institute, New York, NY, USA
- dDepartment of Psychiatry and the Center for Health Services Research in Primary Care, University of California, Sacramento, CA, USA
- Correspondence to Nancy C Low, Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montreal, Quebec, Canada H3A 1A1; Email: [email protected]
- Received January 17, 2008.
- Revision received July 19, 2008.
- Accepted July 29, 2008.
Background. Both clinical and population-based studies show that anxiety disorders and substance misuse frequently co-occur in adults, whereas among adolescents, less examination of this association has been done. Adolescence is frequently the time of substance use initiation and its subsequent interaction with anxiety disorders has not been fully explored. It is unknown in adolescents whether anxiety is more related to alcohol abuse versus cannabis abuse. In addition, as depression has been implicated in adolescents with both anxiety and substance misuse, its role in the association should also be considered.
Objective. To test the association between current anxiety with alcohol versus cannabis abuse disorders.
Method. Cross-sectional, clinician-administered, structured assessment—using the Primary Care Evaluation of Mental Disorders—to evaluate anxiety, mood and substance abuse disorders among 632 adolescents recruited from primary care settings.
Results. Results show a strong association between current anxiety and alcohol [odds ratio = 3.8; 95% confidence interval (CI) 1.2–11.8], but not cannabis (odds ratio = 1.4; 95% CI 0.4–4.7) abuse.
Conclusion. This association in adolescents reflects the importance for increased awareness of anxiety symptoms and alcohol use patterns in primary care. The lack of association of anxiety with cannabis abuse in this group may reflect differences in cannabis’ anxiolytic properties or that this young group has had less exposure thus far. Given adolescence is a time of especially rapid psychosocial, hormonal and brain development, primary care may provide an opportunity for further investigation and, potentially, early screening and intervention.
Treatment with CBD in oily solution of drug-resistant paediatric epilepsies
|Title||Treatment with CBD in oily solution of drug-resistant paediatric epilepsies.|
|Author(s)||Pelliccia A, Grassi G, Romano A, Crocchialo P|
|Journal, Volume, Issue||2005 Congress on Cannabis and the Cannabinoids, Leiden, The Netherlands: International Association for Cannabis as Medicine, p. 14.|
|Major outcome(s)||Improvement of EPILEPSY without side effects|
Introduction: As shown by Turkanis et al. (EPILEPSY, 1979), cannabidiol (CBD), similarly to d9- tetrahydrocannabinol (d9-THC) and Phenytoin (PHT) increases the “afterdischarge” and seizures threshold, mainly at the limbic level, without exhibiting the side effects induced by drugs such as PHT. Studies on rats were conducted that confirmed the anticonvulsant effects of both CBD (Chiu et al., 1979) and of d 9-THC (Cosroe and Mechoulam, 1987). However, in spite of other studies having confirmed the anticonvulsant effect of cannabinoids, up to date no trials were conducted on man and, the less so, on the child.
Methods: We collected data on a population of children who presented with traditional antiepileptic drugs-resistant seizures, treated with a 2.5% corn oily solution of CBD as part of an open study, by modulating administration and titration schedules on a case by case basis, according to clinical response.
Results: On June 2002 we started to treat an eleven year-old girl affected with a
Conclusions: So far obtained results in our open study appear encouraging for various reasons: 1) no side effects of such a severity were observed as to require CBD discontinuation; 2) in most of the treated children an improvement of the crises was obtained equal to, or higher than, 25% in spite of the low CBD doses administered; 3) in all CBD- treated children a clear improvement of consciousness and spasticity (whenever present) was observed.
|Participants||18 children with epilepsy|
|Type of publication||Meeting abstract|
|Address of author(s)||II Facoltà di Medicina,Università “La Sapienza”, 00100 Rome, Italy, Istituto Sperimentale Colture Industriali, Sezione di Rovigo, Italy, American University of Rome, 00100, Italy|
The Mental Health Risks of Adolescent Cannabis Use
PLoS Med. 2006 February; 3(2): e39.
Published online 2006 January 24. doi: 10.1371/journal.pmed.0030039.
Comparison of meconium and neonatal hair analysis for detection of gestational exposure to drugs of abuse
Arch Dis Child Fetal Neonatal Ed. 2003 March; 88(2): F98–F100.
- Jekel JF, Allen DF, Podlewski H, Clarke N, Dean-Patterson S, Cartwright P. Epidemic free-base cocaine abuse. Case study from the Bahamas. Lancet. 1986 Mar 1;1(8479):459–462. 
- Volpe JJ. Effect of cocaine use on the fetus. N Engl J Med. 1992 Aug 6;327(6):399–407. 
- Gillogley KM, Evans AT, Hansen RL, Samuels SJ, Batra KK. The perinatal impact of cocaine, amphetamine, and opiate use detected by universal intrapartum screening. Am J Obstet Gynecol. 1990 Nov;163(5 Pt 1):1535–1542. 
- Chasnoff IJ, Griffith DR. Cocaine: clinical studies of pregnancy and the newborn. Ann N Y Acad Sci. 1989;562:260–266. 
- Addis A, Moretti ME, Ahmed Syed F, Einarson TR, Koren G. Fetal effects of cocaine: an updated meta-analysis. Reprod Toxicol. 2001 Jul–Aug;15(4):341–369. 
- Chasnoff IJ, Bussey ME, Savich R, Stack CM. Perinatal cerebral infarction and maternal cocaine use. J Pediatr. 1986 Mar;108(3):456–459. 
- Lopez SL, Taeusch HW, Findlay RD, Walther FJ. Time of onset of necrotizing enterocolitis in newborn infants with known prenatal cocaine exposure. Clin Pediatr (Phila) 1995 Aug;34(8):424–429. 
- Frank DA, Augustyn M, Knight WG, Pell T, Zuckerman B. Growth, development, and behavior in early childhood following prenatal cocaine exposure: a systematic review. JAMA. 2001 Mar 28;285(12):1613–1625. [ ]
- Frank Deborah A, Augustyn Marilyn, Knight Wanda Grant, Pell Tripler, Zuckerman Barry. Growth, Development, and Behavior in Early Childhood Following Prenatal Cocaine Exposure: A Systematic Review. JAMA. 2008 May 2;285(12):1613–1625. [PMC free article] 
- Franck L, Vilardi J. Assessment and management of opioid withdrawal in ill neonates. Neonatal Netw. 1995 Mar;14(2):39–48. 
- Dixon SD. Effects of transplacental exposure to cocaine and methamphetamine on the neonate. West J Med. 1989 Apr;150(4):436–442. [PMC free article] 
- Dixon SD. Effects of transplacental exposure to cocaine and methamphetamine on the neonate. West J Med. 1989 Apr;150(4):436–442. [PMC free article] 
- Birchfield M, Scully J, Handler A. Perinatal screening for illicit drugs: policies in hospitals in a large metropolitan area. J Perinatol. 1995 May–Jun;15(3):208–214. 
- Forman R, Klein J, Meta D, Barks J, Greenwald M, Koren G. Maternal and neonatal characteristics following exposure to cocaine in Toronto. Reprod Toxicol. 1993 Nov–Dec;7(6):619–622. 
- Ostrea EM, Jr, Knapp DK, Tannenbaum L, Ostrea AR, Romero A, Salari V, Ager J. Estimates of illicit drug use during pregnancy by maternal interview, hair analysis, and meconium analysis. J Pediatr. 2001 Mar;138(3):344–348. 
- Cirimele V, Kintz P, Mangin P. Testing human hair for cannabis. Forensic Sci Int. 1995 Jan 5;70(1-3):175–182. 
- Graham K, Koren G, Klein J, Schneiderman J, Greenwald M. Determination of gestational cocaine exposure by hair analysis. JAMA. 1989 Dec 15;262(23):3328–3330. 
- Klein J, Karaskov T, Koren G. Clinical applications of hair testing for drugs of abuse--the Canadian experience. Forensic Sci Int. 2000 Jan 10;107(1-3):281–288. 
- Koren G, Klein J, Forman R, Graham K. Hair analysis of cocaine: differentiation between systemic exposure and external contamination. J Clin Pharmacol. 1992 Jul;32(7):671–675. 
- Chiriboga CA, Bateman DA, Brust JC, Hauser WA. Neurologic findings in neonates with intrauterine cocaine exposure. Pediatr Neurol. 1993 Mar–Apr;9(2):115–119. 
- Chiriboga CA, Brust JC, Bateman D, Hauser WA. Dose-response effect of fetal cocaine exposure on newborn neurologic function. Pediatrics. 1999 Jan;103(1):79–85. 
- Dolovich Lisa R, Addis Antonio, Vaillancourt J M Régis, Power J D Barry, Koren Gideon, Einarson Thomas R. Benzodiazepine use in pregnancy and major malformations or oral cleft: meta-analysis of cohort and case-control studies. BMJ. 1998 Sep 26;317(7162):839–843. [PMC free article] 
- Dolovich LR, Addis A, Vaillancourt JM, Power JD, Koren G, Einarson TR. Benzodiazepine use in pregnancy and major malformations or oral cleft: meta-analysis of cohort and case-control studies. BMJ. 1998 Sep 26;317(7162):839–843. [PMC free article] 
- Ursitti F, Klein J, Sellers E, Koren G. Use of hair analysis for confirmation of self-reported cocaine use in users with negative urine tests. J Toxicol Clin Toxicol. 2001;39(4):361–366. 
- Delaney-Black V, Covington C, Ostrea E, Jr, Romero A, Baker D, Tagle MT, Nordstrom-Klee B, Silvestre MA, Angelilli ML, Hack C, Long J. Prenatal cocaine and neonatal outcome: evaluation of dose-response relationship. Pediatrics. 1996 Oct;98(4 Pt 1):735–740. 
The herbal remedy: Teens use cannabis for relief, not recreation
When legal therapies let them down, some teens turn to cannabis. A new study, published in BioMed Central's open access journal Substance Abuse, Treatment, Prevention and Policy suggests that around a third of teens who smoke cannabis on a regular basis use it as a medication, rather than as a means of getting high.
Joan Bottorff worked with a team of researchers from the University of British Columbia, funded by the Canadian Institutes of Health Research, to conduct in-depth interviews with 63 cannabis-using adolescents. Of these, 20 claimed that they used cannabis to relieve or manage health problems. Bottorff said, "Marijuana is perceived by some teens to be the only available alternative for those experiencing difficult health problems when legitimate medical treatments have failed or when they lack access to appropriate health care".
The most common complaints recorded were emotional problems (including depression, anxiety and stress), sleep difficulties, problems with concentration and physical pain. The teens' experiences with the medical system were uniformly negative. The authors said, "Youth who reported they had been prescribed drugs such as Ritalin, Prozac or sleeping pills, stopped using them because they did not like how these drugs made them feel or found them ineffective. For these kids, the purpose of smoking marijuana was not specifically about getting high or stoned".
The authors emphasize that the unmet medical needs of these teens are of key importance in these findings. In contrast to the unpleasant side effects of prescribed medications and long, ineffective legal therapies, cannabis provided these adolescents with immediate relief for a variety of health concerns. Of course, cannabis isn't completely harmless, but as one of the respondents noted, "It's not good for you, but then again, neither is McDonald's and a lot of other things".
Notes to Editors
1. Relief oriented use of marijuana by teens
Joan L Bottorff, Joy L Johnson, Barbara M Moffat and Tasmin Mulvogue
Substance Abuse Treatment, Prevention, and Policy (in press)
During embargo, article available here: http://www.substanceabusepolicy.com/imedia/2051624488239939_article.pdf?random=102155
After the embargo, article available at journal website: http://www.substanceabusepolicy.com/
Please name the journal in any story you write. If you are writing for the web, please link to the article. All articles are available free of charge, according to BioMed Central's open access policy.
Article citation and URL available on request at [email protected] on the day of publication
2. Substance Abuse, Treatment, Prevention and Policy is an Open Access, peer-reviewed online journal that will encompass all aspects of research concerning substance abuse, with a focus on policy issues.
The journal aims to provide an environment for the exchange of ideas, new research, consensus papers, and critical reviews, to bridge the established fields that share a mutual goal of reducing substance abuse.
These fields include: legislation pertaining to substance abuse; correctional supervision of substance abusers; medical treatment and screening; mental health services; research; and evaluation of substance abuse programs.
3. BioMed Central (www.biomedcentral.com) is an STM (Science, Technology and Medicine) publisher which has pioneered the open access publishing model. All peer-reviewed research articles published by BioMed Central are made immediately and freely accessible online, and are licensed to allow redistribution and reuse.
BioMed Central is part of Springer Science+Business Media, a leading global publisher in the STM sector.
4. The Canadian Institutes of Health Research (CIHR) is the Government of Canada's agency for health research. CIHR's mission is to create new scientific knowledge and to enable its translation into improved health, more effective health services and products, and a strengthened Canadian health-care system. Composed of 13 Institutes, CIHR provides leadership and support to nearly 12,000 health researchers and trainees across Canada. www.cihr-irsc.gc.ca
Why I Give My 9-year-old Pot
He has autism and a medical marijuana license.
Question: why are we giving our nine-year-old a marijuana cookie?
Answer: because he can't figure out how to use a bong.
My son J has autism. He’s also had two serious surgeries for a spinal cord tumor and has an inflammatory bowel condition, all of which may be causing him pain, if he could tell us. He can say words, but many of them—"duck in the water, duck in the water"—don't convey what he means. For a time, anti-inflammatory medication seemed to control his pain. But in the last year, it stopped working. He began to bite and to smack the glasses off my face. If you were in that much pain, you’d probably want to hit someone, too.
J's school called my husband and me in for a meeting about J's tantrums, which were affecting his ability to learn. The teachers were wearing tae kwon do arm pads to protect themselves against his biting. Their solution was to hand us a list of child psychiatrists. Since autistic children like J can’t exactly do talk therapy, this meant sedating, antipsychotic drugs like Risperdal—Thorazine for kids.
Last year, Risperdal was prescribed for more than 389,000 children—240,000 of them under the age of 12—for bipolar disorder, ADHD, autism, and other disorders. Yet the drug has never been tested for long-term safety in children and carries a severe warning of side effects. From 2000 to 2004, 45 pediatric deaths were attributed to Risperdal and five other popular drugs also classified as “atypical antipsychotics,” according to a review of FDA data by USA Today. When I canvassed parents of autistic children who take Risperdal, I didn't hear a single story of an improvement that seemed worth the risks. A 2002 study specifically looking at the use of Risperdal for autism, in the New England Journal of Medicine, showed moderate improvements in “autistic irritation”—but if you read more closely, the study followed only 49 children over eight weeks, which, researchers admitted, “limits inferences about adverse effects.”
We met with J's doctor, who’d read the studies and agreed: No Risperdal or its kin.
The school called us in again. What were we going to do, they asked. As a sometimes health writer and blogger, I was intrigued when a homeopath suggested medical marijuana. Cannabis has long-documented effects as an analgesic and an anxiety modulator. Best of all, it is safe. The homeopath referred me to a publication by the Autism Research Institute describing cases of reduced aggression, with no permanent side effects. Rats given 40 times the psychoactive level merely fall sleep. Dr. Lester Grinspoon, an emeritus professor of psychiatry at Harvard Medical School who has been researching cannabis for 40 years, says he has yet to encounter a case of marijuana causing a death, even from lung cancer.
A prescription drug called Marinol, which contains a synthetic cannabinoid, seemed mainstream enough to bring up with J’s doctor. I cannot say that with a few little pills, everything turned around. But after about a week of playing around with the dosage, J began garnering a few glowing school reports: “J was a pleasure have in speech class,” instead of “J had 300 aggressions today.”
But J tends to build tolerance to synthetics, and in a few months, we could see the aggressive behavior coming back. One night, I went to the meeting of a medical marijuana patient advocacy group on the campus of the college where I teach. The patients told me that Marinol couldn’t compare to marijuana, the plant, which has at least 60 cannabinoids to Marinol’s one.
Rhode Island, where we live, is one of 13 states where the use of medical marijuana is legal. But I was resistant. My late father was an anesthesiologist, and compared with the precise drugs he worked with, I know he would think marijuana to be ridiculously imprecise and unscientific. I looked at my son’s tie-dye socks (his avowed favorite). At his school, I was already the weirdo mom who packed lunches with organic kale and kimchi and wouldn't let him eat any “fun” foods with artificial dyes. Now, I’d be the mom who shunned the standard operating procedure and gave her kid pot instead.
But then I thought back to when J was 18 months old. We were vacationing on the Cape, and, while he just had the slightest hitch in his gait, I was sure there was something wrong. His pediatrician laughed. I called back repeatedly until a different doctor agreed to see us. J was taken into emergency surgery, to remove a tumor that was on the verge of inflicting irreparable damage. Sometimes, you just have to go with your gut.
And yet, I still hesitated. The Marinol had been disorienting enough—no protocol to follow, just trying varying numbers of pills and hoping for the best. Now we were dealing with an illegal drug, one for which few evidence-based scientific studies existed precisely because it is an illegal drug. But when I sent J's doctor the physician’s form that is mandatory for medical marijuana licensing, it came back signed. We underwent a background check with the Rhode Island Bureau of Criminal Identification, and J became the state’s youngest licensee....read more
The influence of substance use on adolescent brain development
Clin EEG Neurosci. 2009 Jan;40(1):31-8.
SDSU/UCSD Joint Doctoral Program in Clinical Psychology, San Diego, California, USA.
Adolescence is a unique period in neurodevelopment. Alcohol and marijuana use are common. Recent research has indicated that adolescent substance users show abnormalities on measures of brain functioning, which is linked to changes in neurocognition over time.
Abnormalities have been seen in brain structure volume, white matter quality, and activation to cognitive tasks, even in youth with as little as 1-2 years of heavy drinking and consumption levels of 20 drinks per month, especially if > 4-5 drinks are consumed on a single occasion. Heavy marijuana users show some subtle anomalies too, but generally not the same degree of divergence from demographically similar non-using adolescents.
This article reviews the extant literature on neurocognition, brain structure, and brain function in adolescent substance users with an emphasis on the most commonly used substances, and in the context of ongoing neuromaturational processes. Methodological and treatment implications are provided.
PMID: 19278130 [PubMed - indexed for MEDLINE]PMCID: PMC2827693Free PMC Article
Cannabis use and destructive periodontal diseases among adolescents
López R, Baelum V
J Clin Periodontol 2009 Mar; 36(3):185-9.
AIM: The aim of this experiment was to investigate the association between cannabis use and destructive periodontal disease among adolescents.
MATERIAL AND METHODS: Data from a population screening examination carried out among Chilean high school students from the Province of Santiago were used to determine whether there was an association between the use of cannabis and signs of periodontal diseases as defined by (1) the presence of necrotizing ulcerative gingival (NUG) lesions or (2) the presence of clinical attachment loss (CAL) > or =3 mm. The cannabis exposures variables considered were "Ever use of cannabis" (yes/no) and "Regular use of cannabis" (yes/no).
The associations were investigated using multiple logistic regression analyses adjusted for age, gender, paternal income, paternal education, frequency of tooth-brushing and time since last dental visit.
RESULTS: Multiple logistic regression analyses showed that "Ever use of cannabis" was significantly negatively associated with the presence of NUG lesions (OR=0.47 [0.2;0.9]) among non-smokers only. No significant associations were observed between the presence of CAL > or =3 mm and cannabis use in either of the smoking groups.
CONCLUSIONS: There was no evidence to suggest that the use of cannabis is positively associated with periodontal diseases in this adolescent population.
White Matter Integrity in Adolescents with Histories of Marijuana Use and Binge Drinking
Jacobus J, McQueeny T, Bava S, Schweinsburg BC, Frank LR, Yang TT, Tapert SF
[Journal Article, Research Support, N.I.H., Extramural]
Neurotoxicol Teratol 2009 Nov-Dec; 31(6):349-55.
Structural brain abnormalities have been observed in adolescents with alcohol use disorders but less is known about neuropathological brain characteristics of teens with sub-diagnostic binge drinking or the common pattern of binge drinking combined with marijuana use. The goal of this study was to examine white matter integrity in adolescents with histories of binge drinking and marijuana use.
Diffusion tensor imaging (DTI) was conducted with 42 adolescents (ages 16-19) classified as controls, binge drinkers, or binge drinkers who are also heavy marijuana users.
Tract based spatial analysis identified shared fiber structure across individuals and facilitated voxelwise comparisons of fractional anisotropy (FA) and mean diffusivity (MD) between groups. Significant between group differences were found in FA in eight white matter regions (ps < or = .016) between the binge drink-only group and controls, including superior corona radiata, inferior longitudinal fasciculus, inferior fronto-occipital fasciculus, and superior longitudinal fasciculus.
Interestingly, in 4 of these same regions, binge drinkers who are also heavy marijuana users had higher FA than binge drinkers who did not use marijuana (ps<.05). MD did not differ between groups.
Findings are largely consistent with research suggesting less neuropathology in adolescents without histories of substance use. However, binge drinkers who also use marijuana did not show as consistent a divergence from non-users as did the binge drink-only group. Detection of white matter alterations may have implications in identifying early cognitive dysfunction in substance using adolescents
Marijuana Use by Young People: The Impact of State Medical Marijuana Laws
Karen O’Keefe, Esq.
Assistant Director of State Policies
Marijuana Policy Project,
Mitch Earleywine, Ph.D.
Associate Professor of Psychology
University at Albany, State University of New York,
Director of Communications
Marijuana Policy Project
Updated Spring 2007, by Zane Hurst, M.P.A.
Marijuana Policy Project
Since 1996, 12 states — Alaska, California, Colorado, Hawaii, Maine, Montana, Nevada, New Mexico,Oregon, Rhode Island, Vermont, and Washington — have passed laws allowing the use of marijuana for medical purposes.
Eight of these were enacted via voter-approved ballot measures, while Hawaii’s, Vermont’s, Rhode Island’s, and, most recently, New Mexico’s laws were passed by their legislatures. (The District of Columbia passed a similar ballot initiative in 1998, but due to congressional action, the law hasn’t been implemented.)
In addition, medical marijuana legislation was considered during the 2006 legislative sessions of at least 20 state legislatures.
One argument consistently raised in opposition to such measures is that they “send the wrong message to young people,” encouraging teen drug experimentation.
For example, in an October 1996 letter to anti-drug advocates, U.S. Drug Enforcement Administration Administrator Thomas A. Constantine wrote, “How can we expect our children to reject drugs when some authorities are telling them that illegal drugs should no longer remain illegal, but should be used instead to help the sick? …
We cannot afford to send ambivalent messages about drugs.” Such arguments continue to be raised by opponents of medical marijuana... read full pdf
Cannabis use and deliberate self-harm in adolescence: a comparative analysis of associations in England and Norway
Rossow I, Hawton K, Ystgaard M
Arch Suicide Res 2009; 13(4):340-8.
The objective of this study was to test hypotheses on causality and selection regarding associations between cannabis use and deliberate self-harm (DSH) among adolescents.
School surveys were conducted among 9,800 adolescents in England and Norway applying identical measures on deliberate self-harm, suicidal thoughts, cannabis use, and various potential confounders. Cannabis use was more prevalent in England than in Norway. It was associated with DHS, suicidal thoughts and various risk factors for DSH.
However, these associations were stronger in Norway than in England. The adjusted associations between cannabis use and suicidal thoughts were non-significant in both countries. The adjusted cannabis-DSH association was non-significant in England but significant in Norway. Elevated risk of DSH in adolescent cannabis users seems to be mainly due to selection mechanisms. Thus the association is not likely to be direct but due to other shared contributory factors.
Cannabis withdrawal severity and short-term course among cannabis-dependent adolescent and young adult inpatients
Preuss UW, Watzke AB, Zimmermann J, Wong JW, Schmidt CO
Drug Alcohol Depend 2010 Jan 15; 106(2-3):133-41.
While previous studies questioned the existence of a cannabis withdrawal syndrome (CWS), recent research provided increasing evidence of a number of clinical symptoms after cessation of frequent cannabis consumption. The aim of this study is to prospectively assess the course of CWS in a sample of cannabis-dependent inpatients and to provide an estimate of the proportion of subjects experiencing CWS.
118 subjects, aged 16-36 years, diagnosed with a cannabis dependence (DSM-IV, assessed by SCID I) were enrolled in the study. CWS was assessed prospectively over 10 days using a modified version of the Marijuana Withdrawal Checklist. Personality dimensions were assessed with the NEO-FFI.
73 subjects (61.3%) completed all assessments over the observation period. Most symptoms peaked on day 1. Model-based analyses revealed a high and low intensity CWS group. Less than half of the patients belonged to the high intensity craving, psychological, or physical withdrawal symptoms group. Symptom intensity decreased almost linearly over time. Indicators of cannabis consumption intensity as well as personality dimensions, but not recalled withdrawal were related to membership in the high intensity CWS group.
A clinically relevant CWS may only be expected in a subgroup of cannabis-dependent patients. Most subjects with an elevated CWS experience physical and psychological symptoms. The small to negligible associations between recalled and prospectively assessed symptoms raise questions about the validity of the former approach.
Urinary toxicological screening: Analytical interference between niflumic acid and cannabis
Boucher A, Vilette P, Crassard N, Bernard N, Descotes J
Arch Pediatr 2009 Nov; 16(11):1457-60.
One case of analytical interference between cannabis and niflumic acid resulting in a false-positive screening in a 3-year-old girl is described.
The child was hospitalized because of behavioral disturbances of unknown origin. The only noteworthy finding in her medical history was a drug treatment including suppositories of niflumic acid, started 5 days before.
The initial urinary toxicological screening was positive for cannabinoids, but the child's parents strongly denied the exposure. Another analysis was performed by the same laboratory on the same urine sample using chromatography and confirmed the absence of any cannabinoids, while clearly identifying the presence of niflumic acid.
COMMENTS: Immunoanalysis for toxicological analysis has various limitations that must be known. False-positive results of the urinary screening for cannabis in patients treated with niflumic acid are well recognized although seldom reported.
All usual screening tests are not concerned by this ill-explained interference with niflumic acid and all formulations can be involved except transcutaneous formulations.
Because of the wide use of this nonsteroidal anti-inflammatory drug, particularly in pediatric patients, it is important to know that this type of interference can occur with various screening tests for cannabis so that misleading conclusions can be avoided.
Is moderate substance use associated with altered executive functioning in a population-based sample of young adults?
|Author(s)||Piechatzek M, Indlekofer F, Daamen M, Glasmacher C, Lieb R, Pfister H, Tucha O, Lange KW, Wittchen HU, Schütz CG|
|Institution||Ludwig Maximilian University, Munich, Germany.|
|Source||Hum Psychopharmacol 2009 Dec; 24(8):650-65.|
Substance use (SU) has been linked with impaired cognitive functioning. Evidence comes mainly from clinical studies or studies examining heavy users. Though, the majority of users are not involved in heavy use. This study investigates the association between moderate use and cognition in a population-based sample.
A total of 284 young adults with ecstasy, cannabis or alcohol use and a control group were sampled from the EDSP database for participation in the Munich Assessment of Young Adults (MAYA) study. Subjects completed a comprehensive battery of neuropsychological tests (executive functions, working memory and impulsivity). Multiple linear regression models were conducted to examine the relationship between use and cognitive performance.
Increased ecstasy consumption was associated with increased error-proneness (Stroop task, CANTAB ID/ED-shift, spatial working memory). More frequent cannabis use and more extensive alcohol consumption were associated with a higher degree of impulsiveness.
Based on mild to moderate SU, little indication of differences in executive functioning was found. For ecstasy use, an increased error-proneness was revealed. The subtle differences in relatively young individuals warrant further investigation in prospective long-term studies to identify subjects at risk, and to examine effects of prolonged patterns of use on executive functioning.
|Pub Type(s)||Journal Article|
Research Support, Non-U.S. Gov't
Cannabis and tobacco use: where are the boundaries? A qualitative study on cannabis consumption modes among adolescents
|Author(s)||Akre C, Michaud PA, Berchtold A, Suris JC|
|Institution||Research Group on Adolescent Health, Institute of Social.reventive Medicine (IUMSP), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Bugnon 17, 1005 Lausanne, Switzerland.|
|Source||Health Educ Res 2009 Jun 10.|
The purpose of this article is to identify tobacco and cannabis co-consumptions and consumers' perceptions of each substance. A qualitative research including 22 youths (14 males) aged 15-21 years in seven individual interviews and five focus groups.
Discussions were recorded, transcribed verbatim and transferred to Atlas.ti software for narrative analysis. The main consumption mode is cannabis cigarettes which always mix cannabis and tobacco.
Participants perceive cannabis much more positively than tobacco, which is considered unnatural, harmful and addictive.
Future consumption forecasts thus more often exclude tobacco smoking than cannabis consumption.
A substitution phenomenon often takes place between both substances. Given the co-consumption of tobacco and cannabis, in helping youths quit or decrease their consumptions, both substances should be taken into account in a global approach.
Cannabis consumers should be made aware of their tobacco use while consuming cannabis and the risk of inducing nicotine addiction through cannabis use, despite the perceived disconnect between the two substances.
Prevention programs should correct made-up ideas about cannabis consumption and convey a clear message about its harmful consequences. Our findings support the growing evidence which suggests that nicotine dependence and cigarette smoking may be induced by cannabis consumption.
|Pub Type(s)||JOURNAL ARTICLE|
Maternal Marijuana use not Associated with Psychotic Symptoms , but Alcohol is
Maternal Tobacco and Alcohol Use, But Not Marijuana, Associated With Psychotic Symptoms In Offspring, Study Says
Maternal tobacco, cannabis and alcohol use during pregnancy and risk of adolescent psychotic symptoms in offspring
Zammit S, Thomas K, Thompson A, Horwood J, Menezes P, Gunnell D, Hollis C, Wolke D, Lewis G, Harrison G
Br J Psychiatry 2009 Oct; 195(4):294-300.
Adverse effects of maternal substance use during pregnancy on fetal development may increase risk of psychopathology.
To examine whether maternal use of tobacco, cannabis or alcohol during pregnancy increases risk of offspring psychotic symptoms.
A longitudinal study of 6356 adolescents, age 12, who completed a semi-structured interview for psychotic symptoms in the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort.
Frequency of maternal tobacco use during pregnancy was associated with increased risk of suspected or definite psychotic symptoms (adjusted odds ratio 1.20, 95% CI 1.05-1.37, P = 0.007).
Maternal alcohol use showed a non-linear association with psychotic symptoms, with this effect almost exclusively in the offspring of women drinking >21 units weekly. Maternal cannabis use was not associated with psychotic symptoms. Results for paternal smoking during pregnancy and maternal smoking post-pregnancy lend some support for a causal effect of tobacco exposure in utero on development of psychotic experiences.
CONCLUSIONS: These findings indicate that risk factors for development of non-clinical psychotic experiences may operate during early development. Future studies of how in utero exposure to tobacco affects cerebral development and function may lead to increased understanding of the pathogenesis of psychotic phenomena.
Relief-oriented use of marijuana by teens
Subst Abuse Treat Prev Policy. 2009; 4: 7.
Published online 2009 April 23. doi: .