Alcohol and marijuana use while driving--an unexpected crash risk in Pakistani commercial drivers: a cross-sectional survey.

PubMed

Mir, Mohammed Umer; Khan, Imran; Ahmed, Bilal; Abdul Razzak, Junaid

2012-02-27

A significant proportion of road traffic crashes are attributable to alcohol and marijuana use while driving globally. Sale and use of both substances is illegal in Pakistan and is not considered a threat for road traffic injuries. However literature hints that this may not be the case. We did this study to assess usage of alcohol and marijuana in Pakistani commercial drivers. A sample of 857 commercial bus and truck drivers was interviewed in October 2008 at the largest commercial vehicle station in Rawalpindi and Islamabad, Pakistan. Time location cluster sampling was used to select the subjects and a structured questionnaire was used to assess the basic demographic profile, substance abuse habits of the drivers while on the road, and reasons for usage of illicit substances while driving were recorded. Self reported information was collected after obtaining informed consent. Chi square and fisher exact tests were used to assess differences between groups and logistic regression was used to identify significant associations between driver characteristics and alcohol and marijuana use. Almost 10% of truck drivers use alcohol while driving on Pakistani roads. Marijuana use is almost 30% in some groups. Statistically different patterns of usage are seen between population subgroups based on age, ethnicity, education, and marital status. Regression analysis shows association of alcohol and marijuana use with road rage and error behaviours, and also with an increased risk of being involved in road crashes. The reported reasons for using alcohol or marijuana show a general lack of awareness of the hazardous nature of this practice among the commercial driver population. Alcohol and marijuana use is highly prevalent in Pakistani commercial drivers. The issue needs to be recognized by concerned authorities and methods such as random breath tests and sobriety check points need to be employed for proper law enforcement.

Drug Usage and Attitude Toward Drugs Among College Students

ERIC Educational Resources Information Center

Cross, Herbert J.; Keir, Richard G.

1971-01-01

Results of the data presented suggest that there is considerable experimentation among college students with illegal drugs, especially marijuana. Their attitudes toward other drugs still seems cautious. Marijuana, however, seems-to be accepted and generally positively evaluated. (Author)

Modulation of risk-taking in marijuana users by transcranial direct current stimulation (tDCS) of the dorsolateral prefrontal cortex (DLPFC).

PubMed

Boggio, Paulo S; Zaghi, Soroush; Villani, Ana Beatriz; Fecteau, Shirley; Pascual-Leone, Alvaro; Fregni, Felipe

2010-12-01

Cognitive deficits that are reported in heavy marijuana users (attention, memory, affect perception, decision-making) appear to be completely reversible after a prolonged abstinence period of about 28 days. However, it remains unclear whether the reversibility of these cognitive deficits indicates that (1) chronic marijuana use is not associated with long-lasting changes in cortical networks or (2) that such changes occur but the brain adapts to and compensates for the drug-induced changes. Therefore, we examined whether chronic marijuana smokers would demonstrate a differential pattern of response in comparison to healthy volunteers on a decision-making paradigm (Risk Task) while undergoing sham or active transcranial direct current stimulation (tDCS) of the dorsolateral prefrontal cortex (DLPFC). Twenty-five chronic marijuana users who were abstinent for at least 24h were randomly assigned to receive left anodal/right cathodal tDCS of DLPFC (n=8), right anodal/left cathodal tDCS of DLPFC (n=9), or sham stimulation (n=8); results on Risk Task during sham/active tDCS were compared to healthy volunteers from a previously published dataset. Chronic marijuana users demonstrated more conservative (i.e. less risky) decision-making during sham stimulation. While right anodal stimulation of the DLPFC enhanced conservative decision-making in healthy volunteers, both right anodal and left anodal DLPFC stimulation increased the propensity for risk-taking in marijuana users. These findings reveal alterations in the decision-making neural networks among chronic marijuana users. Finally, we also assessed the effects of tDCS on marijuana craving and observed that right anodal/left cathodal tDCS of DLPFC is significantly associated with a diminished craving for marijuana. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Adverse effects of marijuana: selected issues.

PubMed

Cohen, S

1981-01-01

I have selected two areas of concern about cannabis that have emerged because new patterns of usage are perceptible over the past few years. In the case of pulmonary pathology there is good reason to suspect that long term use can result in inflammatory or neoplastic changes, particularly when the lung has a double burden of dealing with both tobacco and cannabis smoke. With reference to chronic substantial cannabis use and its impact on brain function, the definitive studies are yet to be done. If clinical impressions are meaningful, some people, especially young people, can sustain temporary and perhaps permanent impairment of nonintoxicated mental performance.

Adult work commitment, financial stability, and social environment as related to trajectories of marijuana use beginning in adolescence.

PubMed

Brook, Judith S; Lee, Jung Yeon; Finch, Stephen J; Seltzer, Nathan; Brook, David W

2013-01-01

The objective of this study is to examine trajectories of marijuana use among African Americans and Puerto Ricans from adolescence to adulthood, with attention paid to work commitment, financial stability, drug use, and violence. Participants (N = 816) completed in-class questionnaires as students in the East Harlem area of New York City at the first wave and provided follow-up data at 4 additional points in time (mean ages = 14, 19, 24, 29, and 32 years). Among 816 participants, there were 60% females, 52% African American, and 48% Puerto Ricans. The chronic marijuana user trajectory group compared with the none or low, increasing, and/or moderate marijuana user trajectory group was associated with negative aspects of work commitment, financial stability, and the social environment. The chronic marijuana user group was similar to the increasing marijuana user group on work commitment and financial stability. These results suggest that treating marijuana use in late adolescence may reduce difficulty in the assumption of adult roles. Because chronic marijuana users experienced the most adverse effects in each of the domains, they require more intense clinical intervention than moderate marijuana users.

Marijuana and Cannabinoids in ESRD and Earlier Stages of CKD.

PubMed

Rein, Joshua L; Wyatt, Christina M

2018-02-01

Marijuana is the most commonly used recreational drug in the United States, and legal recreational and medicinal use has gained public acceptance during the last decade. Twenty-nine US states have established medical marijuana programs, 8 of which have also legalized recreational marijuana, and Canada is expected to legalize recreational marijuana in 2018. Advanced chronic kidney disease (CKD) and end-stage renal disease (ESRD) are chronic conditions with significant associated morbidity and mortality. Patients experience substantial symptom burden that is frequently undertreated due to adverse medication side effects. This article reviews the available evidence for the use of medical marijuana to manage chronic pain, nausea/vomiting, anorexia/cachexia, and pruritus, all of which are frequently reported by patients with advanced CKD or ESRD. Potential adverse health effects of medical and recreational marijuana use are also discussed. Regardless of personal, social, and political beliefs, marijuana use is becoming mainstream, and nephrologists should be aware of the potential impact on our patient population. Further research is warranted to investigate the renal endocannabinoid system, the impact of marijuana use on kidney disease outcomes, and the risks and benefits of medical marijuana use on symptoms of advanced CKD and ESRD. Copyright © 2017 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Marijuana alters the human cerebellar clock.

PubMed

O'Leary, Daniel S; Block, Robert I; Turner, Beth M; Koeppel, Julie; Magnotta, Vincent A; Ponto, Laura Boles; Watkins, G Leonard; Hichwa, Richard D; Andreasen, Nancy C

2003-06-11

The effects of marijuana on brain perfusion and internal timing were assessed using [15O] water PET in occasional and chronic users. Twelve volunteers who smoked marijuana recreationally about once weekly, and 12 volunteers who smoked daily for a number of years performed a self-paced counting task during PET imaging, before and after smoking marijuana and placebo cigarettes. Smoking marijuana increased rCBF in the ventral forebrain and cerebellar cortex in both groups, but resulted in significantly less frontal lobe activation in chronic users. Counting rate increased after smoking marijuana in both groups, as did a behavioral measure of self-paced tapping, and both increases correlated with rCBF in the cerebellum. Smoking marijuana appears to accelerate a cerebellar clock altering self-paced behaviors.

Long-term effects of marijuana use on the brain

PubMed Central

Filbey, Francesca M.; Aslan, Sina; Calhoun, Vince D.; Spence, Jeffrey S.; Damaraju, Eswar; Caprihan, Arvind; Segall, Judith

2014-01-01

Questions surrounding the effects of chronic marijuana use on brain structure continue to increase. To date, however, findings remain inconclusive. In this comprehensive study that aimed to characterize brain alterations associated with chronic marijuana use, we measured gray matter (GM) volume via structural MRI across the whole brain by using voxel-based morphology, synchrony among abnormal GM regions during resting state via functional connectivity MRI, and white matter integrity (i.e., structural connectivity) between the abnormal GM regions via diffusion tensor imaging in 48 marijuana users and 62 age- and sex-matched nonusing controls. The results showed that compared with controls, marijuana users had significantly less bilateral orbitofrontal gyri volume, higher functional connectivity in the orbitofrontal cortex (OFC) network, and higher structural connectivity in tracts that innervate the OFC (forceps minor) as measured by fractional anisotropy (FA). Increased OFC functional connectivity in marijuana users was associated with earlier age of onset. Lastly, a quadratic trend was observed suggesting that the FA of the forceps minor tract initially increased following regular marijuana use but decreased with protracted regular use. This pattern may indicate differential effects of initial and chronic marijuana use that may reflect complex neuroadaptive processes in response to marijuana use. Despite the observed age of onset effects, longitudinal studies are needed to determine causality of these effects. PMID:25385625

Perceptions of Risk as Predictors of Alcohol, Marijuana, and Cocaine Use among College Students.

ERIC Educational Resources Information Center

Gonzalez, Gerardo M.; Haney, Michael L.

1990-01-01

Examined relationship of perception of risk regarding the use of alcohol, marijuana, and cocaine to use of these substances by college students (N=242). Determined perceptions of risk significantly predicted usage patterns and attitudes toward the use of various drugs. (Author/ABL)

Divergent marijuana trajectories among men: Socioeconomic, relationship, and life satisfaction outcomes in the mid-30s

PubMed Central

White, Helene R.; Bechtold, Jordan; Loeber, Rolf; Pardini, Dustin

2016-01-01

Background Given recent changes in marijuana policy in the United States, it is important to understand the long-term effects of marijuana use on adult functioning. We examined whether men who displayed different trajectories of marijuana use from adolescence through emerging adulthood (age ~15–26) differed in terms of socioeconomic, social, and life satisfaction outcomes in their mid-30s. Methods Data came from a longitudinal sample of men who were recruited in early adolescence (N = 506) and followed into adulthood. Four trajectory groups based on patterns of marijuana use from adolescence into emerging adulthood were compared on adult outcomes (age ~36) before and after controlling for co-occurring use of other substances and several pre-existing confounding factors in early adolescence. The potential moderating effect of race was also examined. Results Although there were initially group differences across all domains, once pre-existing confounds and co-occurring other substance use were included in the model, groups only differed in terms of partner and friend marijuana use. Chronic marijuana users reported the highest proportions of both. Frequent and persistent marijuana use was associated with lower socioeconomic status (SES) for Black men only. Conclusions After statistically accounting for confounding variables, chronic marijuana users were not at a heightened risk for maladjustment in adulthood except for lower SES among Black men. Chronic users were more likely to have friends and partners who also used marijuana. Future studies should take into account pre-existing differences when examining outcomes of marijuana use. PMID:26365837

Brain glucose metabolism in chronic marijuana users at baseline and during marijuana intoxication.

PubMed

Volkow, N D; Gillespie, H; Mullani, N; Tancredi, L; Grant, C; Valentine, A; Hollister, L

1996-05-31

Despite the widespread abuse of marijuana, knowledge about its effects in the human brain is limited. Brain glucose metabolism with and without delta 9 tetrahydrocannabinol (THC) (main psychoactive component of marijuana) was evaluated in eight normal subjects and eight chronic marijuana abusers with positron emission tomography. At baseline, marijuana abusers showed lower relative cerebellar metabolism than normal subjects. THC increased relative cerebellar metabolism in all subjects, but only abusers showed increases in orbitofrontal cortex, prefrontal cortex, and basal ganglia. Cerebellar metabolism during THC intoxication was significantly correlated with the subjective sense of intoxication. The decreased cerebellar metabolism in marijuana abusers at baseline could account for the motor deficits previously reported in these subjects. The activation of orbitofrontal cortex and basal ganglia by THC in the abusers but not in the normal subjects could underlie one of the mechanisms leading to the drive and the compulsion to self-administer the drug observed in addicted individuals.

Trajectories of Marijuana Use from Adolescence to Adulthood as Predictors of Unemployment Status in the Early Forties

PubMed Central

Zhang, Chenshu; Brook, Judith S.; Leukefeld, Carl G.; Brook, David W.

2016-01-01

Objectives To study the degree to which individuals in different trajectories of marijuana use are similar or different in terms of unemployment status at mean age 43. Methods We gathered longitudinal data on a prospective cohort taken from a community sample (N = 548). Forty nine percent of the original participants were females. Over 90% of the participants were white. The participants were followed from adolescence to early midlife. The mean ages of participants at the follow-up interviews were 14.1, 16.3, 22.3, 27.0, 31.9, 36.6, and 43.0, respectively. We used the growth mixture modeling (GMM) approach to identify the trajectories of marijuana use over a 29 year period. Results Five trajectories of marijuana use were identified: chronic users/decreasers (8.3%), quitters (18.6%), increasing users (7.3%), chronic occasional users (25.6%), and nonusers/experimenters (40.2%). Compared with nonusers/experimenters, chronic users/decreasers had a significantly higher likelihood of unemployment at mean age 43 (Adjusted Odds Ratio =3.51, 95% Confidence Interval = 1.13 – 10.91), even after controlling for the covariates. Conclusions and Scientific Significance The results of the associations between the distinct trajectories of marijuana use and unemployment in early midlife indicate that it is important to develop intervention programs targeting chronic marijuana use as well as unemployment in individuals at this stage of development. Results from this study should encourage clinicians, teachers, and parents to assess and treat chronic marijuana use in adolescents. PMID:26991779

Medical marijuana use for chronic pain: risks and benefits.

PubMed

Greenwell, Garth T

2012-01-01

Questions from patients about medical marijuana use for chronic pain are becoming more common. The information in this report will help patients understand the potential risks and benefits of using this substance for painful conditions.

Chronic Offenders: A Life-Course Analysis of Marijuana Users

ERIC Educational Resources Information Center

Ragan, Daniel T.; Beaver, Kevin M.

2010-01-01

Marijuana is the most widely used illegal drug, and the use of marijuana has been linked to a wide array of maladaptive outcomes. As a result, there is great interest in identifying the factors that are associated with the use of marijuana and with desistance from marijuana. The current study employed a life-course framework to examine the factors…

Marijuana Laws: Relationships between State Policy and Drug and Alcohol Violations in On-Campus Housing

ERIC Educational Resources Information Center

Lyke, Austin

2018-01-01

This article investigates the relationship between state-level marijuana policies and drug and alcohol violations in on-campus housing. A review of trends in drug usage precedes discussion of a conceptual framework that can help explain how interactions between college and university student housing and state policy impacts student behavior.…

EEG deficits in chronic marijuana abusers during monitored abstinence: preliminary findings.

PubMed

Herning, Ronald I; Better, Warren; Tate, Kimberly; Cadet, Jean L

2003-05-01

Cognitive, cerebrovascular, and psychiatric impairments have been documented with chronic marijuana users. To better understand the nature and duration of these neurocognitive changes in marijuana abusers, we recorded the resting EEG of 29 abstinent chronic marijuana abusers and 21 control subjects. The marijuana abusers were tested twice: the first evaluation occurred within 72 hours of admission to the inpatient research unit; the second evaluation occurred after 28 to 30 days of monitored abstinence. A three-minute period of EEG was recorded during resting eyes-closed conditions from eight electrodes (F(3), C(3), P(3), O(1), F(4), C(4), P(4), and O(2)). The artifacted EEG was converted to six frequency bands (delta, theta, alpha(1), alpha(2), beta(1), and beta(2)) using a fast Fourier transform. During early abstinence, absolute power was significantly lower (p < 0.05) for the marijuana abusers than for the control subjects for the theta and alpha(1) bands. These reductions in theta and alpha(1) power persisted for 28 days of monitored abstinence. These EEG changes, together with cerebral blood flow deficits, might underlie the cognitive alterations observed in marijuana abusers. Additional research is needed to determine how long these deficits persist during abstinence and if treatment with neuroprotective agents may reverse them.

A Case Report of Cannabis Induced Hemoptysis

PubMed Central

Hashmi, Hafiz Rizwan Talib; Duncalf, Richard; Khaja, Misbahuddin

2016-01-01

Abstract As the principal route of marijuana use is by inhalation, potential harmful consequences on pulmonary structure and function can be anticipated. Here, we present a case of hemoptysis attributed to smoking cannabis in a 38-year-old man. The patient experienced an episode of hemoptysis and shortness of breath immediately after smoking marijuana. Chest radiograph and computed tomography (CT) scans of the chest showed bilateral diffuse ground-glass opacities. A fiber optic bronchoscopy confirmed bilateral diffuse bleeding from respiratory tract. Additional evaluation of hemoptysis indicated no infection or immunological responses. Urine toxicology was positive for cannabis. Chronic marijuana smoking causes visible and microscopic injury to the larger airways responsible for symptoms or chronic bronchitis. We review the beneficial and deleterious effects of marijuana and describe a case of significant hemoptysis attributed to smoking marijuana. In addition to other respiratory complications of marijuana use, physicians should educate their patients about this potentially lethal effect of marijuana smoking in the form of hemoptysis. PMID:27043693

Treatment of cannabis use among people with psychotic or depressive disorders: a systematic review.

PubMed

Baker, Amanda L; Hides, Leanne; Lubman, Dan I

2010-03-01

This article systematically reviews the evidence from randomized controlled trials (RCTs) for pharmacologic and psychological approaches to the treatment of cannabis use among individuals with psychotic or depressive disorders. A systematic literature search was conducted using the PubMed and PsychINFO databases from inception to December 2008. Individual searches in cannabis use (search terms: marijuana, cannabis, marijuana abuse, cannabis abuse, marijuana usage, cannabis usage), mental disorders (search terms: mood disorders, affective disorders, anxiety disorders, anxiety, depressive disorder, depression, psychotic disorders, psychosis, mental disorders), and pharmacotherapy (search terms: medication, drug therapy, pharmacotherapy, psychopharmacology, clinical trials, drug trial, treatment trial) were conducted and limited to humans, adolescents and adults. A search combining the individual cannabis use, mental disorder and pharmacotherapy searches produced 1,713 articles (PubMed = 1,398; PsychINFO = 315). Combining the cannabis use and mental disorder searches while limiting them to English articles and RCTs produced a total of 286 articles (PubMed = 228; PsychINFO = 58). From this literature, there were 7 RCTs conducted among mental health clients that reported cannabis use outcomes using pharmacologic or psychological interventions. While few RCTs have been conducted, there is evidence that pharmacologic and psychological interventions are effective for reducing cannabis use in the short-term among people with psychotic disorders or depression. Although it is difficult to make evidence-based treatment recommendations due to the paucity of research in this area, available studies indicate that effectively treating the mental health disorder with standard pharmacotherapy may be associated with a reduction in cannabis use and that longer or more intensive psychological interventions rather than brief interventions may be required, particularly among heavier users of cannabis and those with more chronic mental disorders. Specific recommendations regarding the type and length of specific psychological treatments cannot be made at this time, although motivational interviewing and cognitive-behavioral therapy approaches appear most promising. (c) 2010 Physicians Postgraduate Press, Inc.

Profiles of Patients Who Use Marijuana for Inflammatory Bowel Disease.

PubMed

Kerlin, Ann Marie; Long, Millie; Kappelman, Michael; Martin, Christopher; Sandler, Robert S

2018-06-01

Marijuana is legal in a number of states for indications that include inflammatory bowel diseases (IBD), and patients are interested in its potential benefits. We aimed to describe the legal use of marijuana in individuals with IBD in the USA who participate within the CCFA Partners internet-based cohort. A total of 2357 participants who lived in states where prescription or recreational marijuana was legal, were offered the opportunity to complete a survey on marijuana use and IBD symptoms including perceived benefits of therapy. Bivariate statistics and logistic regression models were used to determine factors associated with marijuana use. Surveys were completed by 1666 participants (71%) with only 214 (12.8%) indicating they had asked their medical doctor about its use and 73 actually using prescribed marijuana (4.4%). Within the respondent group (N = 1666), 234 participants lived where both medical and recreational marijuana is legal and 49 (20.9%) reported recreational marijuana use specifically for IBD. Users reported positive benefits (80.7%), but users also reported more depression, anxiety, pain interference, and lower social satisfaction than non-users. Those prescribed marijuana reported more active disease, and more use of steroids, narcotics, and zolpidem. Few IBD patients consulted their medical doctors about marijuana use or used prescription marijuana. Where recreational marijuana was available, usage rates were higher. Users reported benefits but also more IBD symptoms, depression, anxiety, and pain. Marijuana use may be higher in patients with IBD symptoms not well treated by conventional medical approaches.

Smoked marijuana as a cause of lung injury.

PubMed

Tashkin, D P

2005-06-01

In many societies, marijuana is the second most commonly smoked substance after tobacco. While delta9-tetrahydrocannabinol (THC) is unique to marijuana and nicotine to tobacco, the smoke of marijuana, like that of tobacco, consists of a toxic mixture of gases and particulates, many of which are known to be harmful to the lung. Although far fewer marijuana than tobacco cigarettes are generally smoked on a daily basis, the pulmonary consequences of marijuana smoking may be magnified by the greater deposition of smoke particulates in the lung due to the differing manner in which marijuana is smoked. Whereas THC causes modest short-term bronchodilation, regular marijuana smoking produces a number of long-term pulmonary consequences, including chronic cough and sputum, histopathologic evidence of widespread airway inflammation and injury and immunohistochemical evidence of dysregulated growth of respiratory epithelial cells, that may be precursors to lung cancer. The THC in marijuana could contribute to some of these injurious changes through its ability to augment oxidative stress, cause mitochondrial dysfunction, and inhibit apoptosis. On the other hand, physiologic, clinical or epidemiologic evidence that marijuana smoking may lead to chronic obstructive pulmonary disease or respiratory cancer is limited and inconsistent. Habitual use of marijuana is also associated with abnormalities in the structure and function of alveolar macrophages, including impairment in microbial phagocytosis and killing that is associated with defective production of immunostimulatory cytokines and nitric oxide, thereby potentially predisposing to pulmonary infection. In view of the growing interest in medicinal marijuana, further epidemiologic studies are needed to clarify the true risks of regular marijuana smoking on respiratory health.

Trajectories of marijuana use from adolescence to adulthood predicting unemployment in the mid 30s.

PubMed

Lee, Jung Yeon; Brook, Judith S; Finch, Stephen J; Brook, David W

2015-08-01

Unemployment (5.5% as of 2015) is a serious social and economic problem in our society. Since marijuana use is an important factor related to unemployment, identifying the trajectory of the use of marijuana may aid intervention programs and research on unemployment. Six hundred seventy-four participants (53% African-Americans, 47% Puerto Ricans) were surveyed (60% females) from ages 14 to 36. The first data collection was held when the participants were students attending schools in the East Harlem area of New York City. We found that the chronic marijuana use (OR = 4.07, p < .001; AOR = 2.58, p < .05) and the late marijuana quitter (OR = 2.91, p < .05) trajectory groups were associated with an increased likelihood of unemployment compared with the no marijuana use trajectory group. The results suggest that those who use marijuana chronically are at greater risk for being unemployed. Consequently, these individuals should have access to and participate in marijuana cessation treatment programs in order to reduce their risk of unemployment. Unemployment intervention programs should also consider focusing on the cessation of the use of marijuana to decrease the likelihood of later unemployment. © American Academy of Addiction Psychiatry.

Periodontal and oral manifestations of marijuana use.

PubMed

Rawal, Swati Y; Tatakis, Dimitris N; Tipton, David A

2012-01-01

Marijuana, prepared from the plant Cannabis sativa, is the most widely used illicit drug in the United States. Marijuana use has been associated with adverse psychosocial and health effects, including effects on oral tissues. Periodontal literature has limited references to the periodontal effects of cannabis use. In this report, we present two cases of marijuana-associated gingival enlargement and review the literature on oral complications of marijuana use. Two asymptomatic males, aged 23 and 42 years, presented independently for oral prophylaxis. Both had an unremarkable medical history and related a history of significant marijuana use of 2-16 years duration. Common findings following oral and periodontal examination were nicotinic stomatitis-like lesions, uvulitis and gingival enlargement. Marginal and papillary gingiva of the anterior dentition were the areas primarily affected by gingival enlargement, while some of these areas exhibited a nodular or "pebbly" appearance. Marijuana-associated gingival enlargement was diagnosed in the reported cases. A review of the literature revealed two other reports of marijuana-associated gingival enlargement, all in young adult males with chronic (2 or more years) cannabis use. These authors reported a resemblance to phenytoin-induced enlargement. Biochemical similarities between phenytoin and cannabis active compounds suggest possible common pathogenetic mechanisms. Uvulitis and nicotinic stomatitis appear to be the two most common of the several oral manifestations of marijuana use. Chronic marijuana use may result in gingival enlargement with clinical characteristics similar to phenytoin-induced enlargement.

Marijuana use trajectories during college predict health outcomes nine years post-matriculation

PubMed Central

Arria, Amelia M.; Caldeira, Kimberly M.; Bugbee, Brittany A.; Vincent, Kathryn B.; O’Grady, Kevin E.

2015-01-01

Background Several studies have linked marijuana use with a variety of health outcomes among young adults. Information about marijuana’s long-term health effects is critically needed. Methods Data are from a ten-year study of 1,253 young adults originally recruited as first-year college students and assessed annually thereafter. Six trajectories of marijuana use during college (Non-Use, Low-Stable, Early-Decline, College-Peak, Late-Increase, Chronic) were previously derived using latent variable growth mixture modeling. Nine health outcomes assessed in Year 10 (modal age 27) were regressed on a group membership variable for the six group trajectories, holding constant demographics, baseline health status, and alcohol and tobacco trajectory group membership. Results Marijuana trajectory groups differed significantly on seven of the nine outcomes (functional impairment due to injury, illness, or emotional problems; psychological distress; subjective well-being; and mental and physical health service utilization; all ps<.001), but not on general health rating or body mass index. Non-Users fared better than the Late-Increase and Chronic groups on most physical and mental health outcomes. The declining groups (Early-Decline, College-Peak) fared better than the Chronic group on mental health outcomes. The Late-Increase group fared significantly worse than the stable groups (Non-Use, Low-Stable, Chronic) on both physical and mental health outcomes. Conclusions Even occasional or time-limited marijuana use might have adverse effects on physical and mental health, perhaps enduring after several years of moderation or abstinence. Reducing marijuana use frequency might mitigate such effects. Individuals who escalate their marijuana use in their early twenties might be at especially high risk for adverse outcomes. PMID:26778758

[Pros and cons of legalizing marijuana].

PubMed

Mönckeberg B, Fernando

2014-04-01

There are already several countries that have accepted marijuana as a soft drug, separating it from more dangerous ones. Yarious therapeutic properties have even been attributed to its use. Others, however, think that its use should be prohibited due to the mental interference and behavioral changes produced either by its occasional use as well as the permanent mental damage linked to chronic marijuana use. In order to clarify this divergence of opinions, the scientific literature is reviewed. It is concluded that there is a serious risk, especially for teenagers, associated to chronic marijuana use due to the presence of more frequent psychotic and schizophrenic episodes, which can be permanent, while consumption during pregnancy results in brain damage to the fetus, similar to fetal alcohol syndrome. Scientific research also indicated that smoking marijuana produces an even more severe bronchial damage than tobacco, with risk of lung cancer. In conclusion, the notion that marijuana is a risk-free soft drug is a serious mistake, based on the available conclusive scientific research that shows the opposite.

Marijuana use patterns among patients with inflammatory bowel disease.

PubMed

Ravikoff Allegretti, Jessica; Courtwright, Andrew; Lucci, Matthew; Korzenik, Joshua R; Levine, Jonathan

2013-12-01

The prevalence and perceived effectiveness of marijuana use has not been well studied in inflammatory bowel disease (IBD) despite increasing legal permission for its use in Crohn's disease. Health care providers have little guidance about the IBD symptoms that may improve with marijuana use. The aim of this study was to assess the prevalence, sociodemographic characteristics, and perceived benefits of marijuana use among patients with IBD. Prospective cohort survey study of marijuana use patterns in patients with IBD at an academic medical center. A total of 292 patients completed the survey (response rate = 94%); 12.3% of patients were active marijuana users, 39.0% were past users, and 48.6% were never users. Among current and past users, 16.4% of patients used marijuana for disease symptoms, the majority of whom felt that marijuana was "very helpful" for relief of abdominal pain, nausea, and diarrhea. On multivariate analysis, age and chronic abdominal pain were associated with current marijuana use (odds ratio [OR], 0.93; 95% confidence interval [CI], 0.89-0.97; P < 0.001 and OR, 3.5; 95% CI, 1.24-9.82; P = 0.02). Age and chronic abdominal pain were also multivariate predictors of medicinal use of marijuana (OR, 0.93; 95% CI, 0.89-0.97; P < 0.001 and OR, 4.7; 95% CI, 1.8-12.2; P = 0.001). Half of the never users expressed an interest in using marijuana for abdominal pain, were it legally available. A significant number of patients with IBD currently use marijuana. Most patients find it very helpful for symptom control, including patients with ulcerative colitis, who are currently excluded from medical marijuana laws. Clinical trials are needed to determine marijuana's potential as an IBD therapy and to guide prescribing decisions.

Altered affective response in marijuana smokers: an FMRI study.

PubMed

Gruber, Staci A; Rogowska, Jadwiga; Yurgelun-Todd, Deborah A

2009-11-01

More than 94 million Americans have tried marijuana, and it remains the most widely used illicit drug in the nation. Investigations of the cognitive effects of marijuana report alterations in brain function during tasks requiring executive control, including inhibition and decision-making. Endogenous cannabinoids regulate a variety of emotional responses, including anxiety, mood control, and aggression; nevertheless, little is known about smokers' responses to affective stimuli. The anterior cingulate and amygdala play key roles in the inhibition of impulsive behavior and affective regulation, and studies using PET and fMRI have demonstrated changes within these regions in marijuana smokers. Given alterations in mood and perception often observed in smokers, we hypothesized altered fMRI patterns of response in 15 chronic heavy marijuana smokers relative to 15 non-marijuana smoking control subjects during the viewing of masked happy and fearful faces. Despite no between-group differences on clinical or demographic measures, smokers demonstrated a relative decrease in both anterior cingulate and amygdalar activity during masked affective stimuli compared to controls, who showed relative increases in activation within these regions during the viewing of masked faces. Findings indicate that chronic heavy marijuana smokers demonstrate altered activation of frontal and limbic systems while viewing masked faces, consistent with autoradiographic studies reporting high CB-1 receptor density in these regions. These data suggest differences in affective processing in chronic smokers, even when stimuli are presented below the level of conscious processing, and underscore the likelihood that marijuana smokers process emotional information differently from those who do not smoke, which may result in negative consequences.

CB1-Dependent Long-Term Depression in Ventral Tegmental Area GABA Neurons: A Novel Target for Marijuana

PubMed Central

Friend, Lindsey; Sandoval, Philip; Nufer, Teresa; Ostlund, Isaac

2017-01-01

The VTA is necessary for reward behavior with dopamine cells critically involved in reward signaling. Dopamine cells in turn are innervated and regulated by neighboring inhibitory GABA cells. Using whole-cell electrophysiology in juvenile-adolescent GAD67-GFP male mice, we examined excitatory plasticity in fluorescent VTA GABA cells. A novel CB1-dependent LTD was induced in GABA cells that was dependent on metabotropic glutamate receptor 5, and cannabinoid receptor 1 (CB1). LTD was absent in CB1 knock-out mice but preserved in heterozygous littermates. Bath applied Δ9-tetrahydrocannabinol depressed GABA cell activity, therefore downstream dopamine cells will be disinhibited; and thus, this could potentially result in increased reward. Chronic injections of Δ9-tetrahydrocannabinol occluded LTD compared with vehicle injections; however, a single exposure was insufficient to do so. As synaptic modifications by drugs of abuse are often tied to addiction, these data suggest a possible mechanism for the addictive effects of Δ9-tetrahydrocannabinol in juvenile-adolescents, by potentially altering reward behavioral outcomes. SIGNIFICANCE STATEMENT The present study identifies a novel form of glutamatergic synaptic plasticity in VTA GABA neurons, a currently understudied cell type that is critical for the brain's reward circuit, and how Δ9-tetrahydrocannabinol occludes this plasticity. This study specifically addresses a potential unifying mechanism whereby marijuana could exert rewarding and addictive/withdrawal effects. Marijuana use and legalization are a pressing issue for many states in the United States. Although marijuana is the most commonly abused illicit drug, the implications of legalized, widespread, or continued usage are speculative. This study in juvenile-adolescent aged mice identifies a novel form of synaptic plasticity in VTA GABA cells, and the synaptic remodeling that can occur after Δ9-tetrahydrocannabinol use. PMID:29038246

Medicinal and recreational marijuana use among HIV-infected women in the Women's Interagency HIV Study (WIHS) cohort, 1994-2010.

PubMed

Dʼsouza, Gypsyamber; Matson, Pamela A; Grady, Cynthia D; Nahvi, Shadi; Merenstein, Dan; Weber, Kathleen M; Greenblatt, Ruth; Burian, Pam; Wilson, Tracey E

2012-12-15

Despite the major benefits of effective antiretroviral therapy on HIV-related survival, there is an ongoing need to help alleviate medication side effects related to antiretroviral therapy use. Initial studies suggest that marijuana use may reduce HIV-related symptoms, but medical marijuana use among HIV-infected individuals has not been well described. The authors evaluated trends in marijuana use and reported motivations for use among 2776 HIV-infected women in the Women's Interagency HIV Study between October 1994 and March 2010. Predictors of any and daily marijuana use were explored in multivariate logistic regression models clustered by person using generalized estimating equation. In 2009, participants were asked if their marijuana use was medical, "meaning prescribed by a doctor," or recreational, or both. Over the 16 years of this study, the prevalence of current marijuana use decreased significantly from 21% to 14%. In contrast, daily marijuana use almost doubled from 3.3% to 6.1% of all women and from 18% to 51% of current marijuana users. Relaxation, appetite improvement, reduction of HIV-related symptoms, and social use were reported as common reasons for marijuana use. In 2009, most marijuana users reported either purely medicinal use (26%) or both medicinal and recreational usage (29%). Daily marijuana use was associated with higher CD4 cell count, quality of life, and older age. Demographic characteristics and risk behaviors were associated with current marijuana use overall but were not predictors of daily use. This study suggests that both recreational and medicinal marijuana use are relatively common among HIV-infected women in the United States.

Developmental Trajectories of Marijuana Use among Men: Examining Linkages with Criminal Behavior and Psychopathic Features into the Mid-30s

PubMed Central

Pardini, Dustin; Bechtold, Jordan; Loeber, Rolf; White, Helene

2015-01-01

Objectives Examine whether young men who chronically use marijuana are at risk for engaging in drug-related and non-drug-related criminal offending and exhibiting psychopathic personality features in their mid-30s. Methods Patterns of marijuana use were delineated in a sample of predominately Black and White young men from adolescence to the mid-20s using latent class growth curve analysis. Self-report and official records of criminal offending and psychopathic personality features were assessed in the mid-30s. Analyses controlled for multiple factors indicative of a preexisting antisocial lifestyle and co-occurring use of other substances and tested for moderation by race. Results Four latent marijuana trajectory groups were identified: chronic high, adolescence-limited, late increasing, and low/nonusers. Relative to low/nonusers, chronic high and late increasing marijuana users exhibited more adult psychopathic features and were more likely to engage in drug-related offending during their mid-30s. Adolescence-limited users were similar to low/nonusers in terms of psychopathic features but were more likely to be arrested for drug-related crimes. No trajectory group differences were found for violence or theft, and the group differences were not moderated by race. Conclusions Young men who engage in chronic marijuana use from adolescence into their 20s are at increased risk for exhibiting psychopathic features, dealing drugs, and enduring drug-related legal problems in their mid-30s relative to men who remain abstinent or use infrequently. PMID:26568641

Maternal Patterns of Marijuana Use and Early Sexual Behavior in Offspring of Teenage Mothers

PubMed Central

Goldschmidt, Lidush; Cornelius, Marie D.

2015-01-01

Teenage mothers use marijuana more frequently than older mothers, and marijuana use may predict HIV risk behavior in offspring. Our goals were to (1) describe trajectories of marijuana use in teenage mothers and (2) determine if these trajectories were associated with early sexual behavior in their offspring. Pregnant adolescents (12–18 years) were recruited at a prenatal clinic and interviewed during pregnancy, at delivery, and during follow-up visits when offspring were 6, 10, 14 and 16 years old. At 16 years, 332 women (71 % Black, 29 % White) and their offspring were assessed. Mothers were asked about their marijuana use at each time point. Offspring reported on their sexual behavior at age 14. Trajectory analyses using growth mixture models revealed four maternal patterns of marijuana use: no use, only at the 6 year follow-up, quit by the 16 year follow-up, and used across most of the time points. The children of chronic users were more likely to have early sex. The maternal marijuana trajectory group variable remained a statistically significant predictor in multivariate models controlling for race, gender, socioeconomic status, child pubertal timing, child externalizing behavior problems, and child marijuana use. These findings suggest that a minority of teenage mothers continue to use marijuana over time. Chronic maternal marijuana use across a decade was associated with early sex in offspring (oral or vaginal sex by age 14). Early sexual behavior places these children at significantly higher risk of teenage pregnancy and HIV risk behaviors. PMID:24942139

Factors associated with having a medical marijuana card among Veterans with recent substance use in VA outpatient treatment.

PubMed

Davis, Alan K; Bonar, Erin E; Ilgen, Mark A; Walton, Maureen A; Perron, Brian E; Chermack, Stephen T

2016-12-01

Psychiatric symptoms, somatic problems, and co-occurring substance use have been associated with medical marijuana consumption among civilian patients with substance use disorders. It is possible that these factors may impact Veterans' ability to engage in or adhere to mental health and substance use disorder treatment. Therefore, we examined whether psychiatric functioning, substance use, and somatic problems were associated with medical marijuana use among Veterans receiving substance use disorder and/or mental health treatment. Participants (n=841) completed screening measures for a randomized controlled trial and 67 (8%) reported that they had a current medical marijuana card. Most of these participants (78%) reported using marijuana to treat severe/chronic pain. Significant bivariate differences revealed that, compared to participants without a medical marijuana card, those with a card were more likely to be in a middle income bracket, unemployed, and they had a significantly higher number of recent days of marijuana use, synthetic marijuana use, and using sedatives prescribed to them. Additionally, a significantly higher proportion of participants with a medical marijuana card scored above the clinical cutoff for posttraumatic stress disorder (PTSD) symptoms, had significantly higher severity of sleep-related problems, and reported a higher level of pain. These findings highlight the co-occurrence of substance use, PTSD symptoms, sleep-related problems, and chronic pain among Veterans who use medical marijuana. Future research should investigate the inter-relationships among medical marijuana use and other clinical issues (e.g., PTSD symptoms, sleep, pain) over time, and potential implications of medical marijuana use on treatment engagement and response. Copyright © 2016 Elsevier Ltd. All rights reserved.

Marijuana and College Students: A Critical Review of the Literature

ERIC Educational Resources Information Center

Blavos, Alexis A.; Glassman, Tavis J.; Sheu, Jiunn-Jye; Thompson, Amy; DeNardo, Faith; Diehr, Aaron J.

2017-01-01

Background: Marijuana represents the most widely used illicit drug on college campuses. Repeated use can impair students' academic, emotional, and physical success and can lead to chronic diseases. Purpose: The purpose of this study was to evaluate existing literature on the associated effects of marijuana use on U.S. college students' academic…

Marijuana, the Endocannabinoid System and the Female Reproductive System.

PubMed

Brents, Lisa K

2016-06-01

Marijuana use among women is highly prevalent, but the societal conversation on marijuana rarely focuses on how marijuana affects female reproduction and endocrinology. This article reviews the current scientific literature regarding marijuana use and hypothalamic-pituitary-ovarian (HPO) axis regulation, ovarian hormone production, the menstrual cycle, and fertility. Evidence suggests that marijuana can reduce female fertility by disrupting hypothalamic release of gonadotropin releasing hormone (GnRH), leading to reduced estrogen and progesterone production and anovulatory menstrual cycles. Tolerance to these effects has been shown in rhesus monkeys, but the effects of chronic marijuana use on human female reproduction are largely unknown. Marijuana-induced analgesia, drug reinforcement properties, tolerance, and dependence are influenced by ovarian hormones, with estrogen generally increasing and progesterone decreasing sensitivity to marijuana. Carefully controlled regulation of the Endocannabinoid System (ECS) is required for successful reproduction, and the exogenous cannabinoids in marijuana may disrupt the delicate balance of the ECS in the female reproductive system.

Adolescent THC exposure does not sensitize conditioned place preferences to subthreshold d-amphetamine in male and female rats.

PubMed

Keeley, Robin J; Bye, Cameron; Trow, Jan; McDonald, Robert J

2018-01-01

The acute effects of marijuana consumption on brain physiology and behaviour are well documented, but the long-term effects of its chronic use are less well known. Chronic marijuana use during adolescence is of increased interest, given that the majority of individuals first use marijuana during this developmental stage , and  adolescent marijuana use is thought to increase the susceptibility to abusing other drugs when exposed later in life. It is possible that marijuana use during critical periods in adolescence could lead to increased sensitivity to other drugs of abuse later on. To test this, we chronically administered ∆ 9 -tetrahydrocannabinol (THC) to male and female Long-Evans (LER) and Wistar (WR) rats directly after puberty onset. Rats matured to postnatal day 90 before being exposed to a conditioned place preference task (CPP). A subthreshold dose of d-amphetamine, found not to induce place preference in drug naïve rats, was used as the unconditioned stimulus. The effect of d-amphetamine on neural activity was inferred by quantifying cfos expression in the nucleus accumbens and dorsal hippocampus following CPP training. Chronic exposure to THC post-puberty had no potentiating effect on a subthreshold dose of d-amphetamine to induce CPP. No differences in cfos expression were observed. These results show that chronic exposure to THC during puberty did not increase sensitivity to d-amphetamine in adult LER and WR rats. This supports the concept that THC may not sensitize the response to all drugs of abuse.

Pharmacologic Implications of Marijuana Use During Pregnancy.

PubMed

Fantasia, Heidi Collins

Marijuana is the most commonly used recreational drug in the United States, including among women of childbearing age and women who are pregnant. Changing legal statutes that allow for the use of medical marijuana and the decriminalization of marijuana for personal use reflect more permissive societal views on the use of this drug. Active compounds in marijuana cross the placenta rapidly and are excreted in breast milk. Results of studies of the effects of marijuana on a developing fetus and neonate are conflicting, but researchers have identified chronic marijuana exposure as a risk factor for preterm birth and small-for-gestational-age infants. This article reviews the pharmacology of marijuana and discusses implications for nurses who work with women of childbearing age. © 2017 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses.

The Challenges of Projecting the Public Health Impacts of Marijuana Legalization in Canada Comment on "Legalizing and Regulating Marijuana in Canada: Review of Potential Economic, Social, and Health Impacts".

PubMed

Lake, Stephanie; Kerr, Thomas

2016-09-10

A recent editorial in this journal provides a summary of key economic, social, and public health considerations of the forthcoming legislation to legalize, regulate, and restrict access to marijuana in Canada. As our government plans to implement an evidence-based public health framework for marijuana legalization, we reflect and expand on recent discussions of the public health implications of marijuana legalization, and offer additional points of consideration. We select two commonly cited public concerns of marijuana legalization - adolescent usage and impaired driving - and discuss how the underdeveloped and equivocal body of scientific literature surrounding these issues limits the ability to predict the effects of legalization. Finally, we discuss the potential for some potential public health benefits of marijuana legalization - specifically the potential for marijuana to be used as a substitute to opioids and other risky substance use - that have to date not received adequate attention. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Recreational marijuana use impacts white matter integrity and subcortical (but not cortical) morphometry.

PubMed

Orr, Joseph M; Paschall, Courtnie J; Banich, Marie T

2016-01-01

A recent shift in legal and social attitudes toward marijuana use has also spawned a surge of interest in understanding the effects of marijuana use on the brain. There is considerable evidence that an adolescent onset of marijuana use negatively impacts white matter coherence. On the other hand, a recent well-controlled study demonstrated no effects of marijuana use on the morphometry of subcortical or cortical structures when users and non-users were matched for alcohol use. Regardless, most studies have involved small, carefully selected samples, so the ability to generalize to larger populations is limited. In an attempt to address this issue, we examined the effects of marijuana use on white matter integrity and cortical and subcortical morphometry using data from the Human Connectome Project (HCP) consortium. The HCP data consists of ultra-high resolution neuroimaging data from a large community sample, including 466 adults reporting recreational marijuana use. Rather than just contrasting two groups of individuals who vary significantly in marijuana usage as typifies prior studies, we leveraged the large sample size provided by the HCP data to examine parametric effects of recreational marijuana use. Our results indicate that the earlier the age of onset of marijuana use, the lower was white matter coherence. Age of onset also also affected the shape of the accumbens, while the number of lifetime uses impacted the shape of the amygdala and hippocampus. Marijuana use had no effect on cortical volumes. These findings suggest subtle but significant effects of recreational marijuana use on brain structure.

Marijuana to prevent nausea and vomiting in cancer patients: a survey of clinical oncologists.

PubMed

Schwartz, R H; Voth, E A; Sheridan, M J

1997-02-01

Marijuana, if rescheduled by the Drug Enforcement Agency, would be the only Food and Drug Administration (FDA)-approved drug to be administered by smoking. American physicians need timely, factual information about probable usage patterns and potential adverse effects of medical marijuana, and a factual complete review of the literature on the subject. We mailed a survey to 1,500 American clinical oncologists. Of particular interest was whether and how often in the past 24 months these physicians recommended smoked marijuana, synthetic tetrahydrocannabinol, or 5-HT3 (serotonin) antagonists (ondansetron [Zofran], granisetron [Kytril]) for their patients. We also inquired whether and how often the oncologists would prescribe marijuana in the form of cigarettes, were it to be FDA-approved. Completed surveys were received from 1,122 (75%) of the oncologists. The percentages of oncologists who prescribed or recommended selected antiemetics more than five times between 1992 and 1994 were 98% for 5-HT, antagonists, 6% for dronabinol (Marinol), and 1% for smoked marijuana. We also found that 332 (30%) of the oncologist-respondents to this nationwide survey supported rescheduling of marijuana for medical purposes; however, two thirds (67%) of the 332 respondents who were in favor of rescheduling estimated that they would write less than one prescription per month for marijuana cigarettes. A comprehensive literature review failed to provide persuasive evidence to recommend marijuana as a needed antiemetic medicine.

Marijuana, the Endocannabinoid System and the Female Reproductive System

PubMed Central

Brents, Lisa K.

2016-01-01

Marijuana use among women is highly prevalent, but the societal conversation on marijuana rarely focuses on how marijuana affects female reproduction and endocrinology. This article reviews the current scientific literature regarding marijuana use and hypothalamic-pituitary-ovarian (HPO) axis regulation, ovarian hormone production, the menstrual cycle, and fertility. Evidence suggests that marijuana can reduce female fertility by disrupting hypothalamic release of gonadotropin releasing hormone (GnRH), leading to reduced estrogen and progesterone production and anovulatory menstrual cycles. Tolerance to these effects has been shown in rhesus monkeys, but the effects of chronic marijuana use on human female reproduction are largely unknown. Marijuana-induced analgesia, drug reinforcement properties, tolerance, and dependence are influenced by ovarian hormones, with estrogen generally increasing and progesterone decreasing sensitivity to marijuana. Carefully controlled regulation of the Endocannabinoid System (ECS) is required for successful reproduction, and the exogenous cannabinoids in marijuana may disrupt the delicate balance of the ECS in the female reproductive system. PMID:27354844

What You Need to Know about Drugs: Marijuana

MedlinePlus

... leaves, stems, seeds, and flowers of the hemp ( Cannabis sativa ) plant. It looks like green, brown, or ... Called: weed, grass, pot, chronic, joint, blunt, herb, cannabis, hashish, Mary Jane How It's Used: Marijuana is ...

Marijuana Use in the Elderly: Implications and Considerations.

PubMed

Mahvan, Tracy D; Hilaire, Michelle L; Mann, Allison; Brown, Antoinette; Linn, Becky; Gardner, Taylor; Lai, Beryen

2017-06-01

This article reviews the literature on the use of marijuana in the elderly. Pharmacists play an important role in the management of medications including drug use of potentially illegal drugs, including marijuana. The use of both recreational and medical marijuana has grown exponentially in the general population, including in older adults. As of 2017, marijuana for medical use is legal in 26 states and the District of Columbia. PubMed and Internet search using the following terms: marijuana, cannabis, delta-9-tetrhydrocannabinol (THC), cannabidiol, cannabinoid, elderly, geriatric, and pharmacology. Findings are based on data collected from older adults (65 years of age and older) through August 2016. Because of the lack of research and funding, reputable literature on the impact of marijuana on older adults is scarce. The available evidence suggests that elderly individuals should be cautious when consuming marijuana, especially those who have certain comorbid conditions. The geriatric population has a higher likelihood of having multiple comorbidities and is subject to polypharmacy. Marijuana use, medicinal or recreational, complicates the picture with additive central nervous system side effects. This article reviews the growing information on marijuana use and discusses issues to consider and cautions in usage that can apply to day-to-day clinical practice and geriatric care. The role of the pharmacist in educating patients, caregivers, and health care providers is expanding with the growing number of states that have legalized medical marijuana (26 states and the District of Columbia, as of 2017). Important education points including drug-drug interactions, drug-disease interactions, and signs and symptoms of acute overdose should be considered. With this review, pharmacists will be informed on recommendations on the use of marijuana in the older adult. Monitoring of therapy, as well as adverse effects, will be reviewed, including some legal issues and challenges.

Social Mediation of Persuasive Media in Adolescent Substance Prevention

PubMed Central

Crano, William D.; Alvaro, Eusebio M.; Tan, Cara N.; Siegel, Jason T.

2017-01-01

Social commentary about prevention messages may affect their likelihood of acceptance. To investigate this possibility, student participants (N = 663) viewed three anti-marijuana advertisements, each followed immediately by videotaped discussions involving four adults or four adolescents using either extreme or moderate language in their positive commentaries. The commentaries were expected to affect participants’ perceptions of the extent to which the ads were designed to control their behavior (perceived control), which was hypothesized to inhibit persuasion. Two indirect effects analyses were conducted. Marijuana attitudes and usage intentions were the outcome variables. Both analyses revealed statistically significant source by language interactions on participants’ perceived control (both p < .02). Further analyses revealed significant indirect effects of language extremity on attitudes and intentions through perceived control with adult, but not peer sources (both p < .05). These perceptions were associated with more negative marijuana attitudes and diminished usage intentions when adults used moderate (vs. extreme) language in their favorable ad commentaries (both p < .05). The findings may facilitate development of more effective prevention methods that emphasize the importance the role of perceived control in persuasion, and the impact of interpersonal communication variations on acceptance of media-transmitted prevention messages. PMID:28301181

Patterns of drug use from adolescence to young adulthood: I. Periods of risk for initiation, continued use, and discontinuation.

PubMed Central

Kandel, D B; Logan, J A

1984-01-01

Patterns of initiation, continued use, and decline in drug use are described on the basis of detailed drug histories in a longitudinal cohort representative of former New York State adolescents. In this cohort, the period of major risk for initiation to cigarettes, alcohol, and marijuana, is completed for the most part by age 20, and to illicit drugs other than cocaine by age 21. Those who have not experimented with any of these substances by that age are unlikely to do so thereafter. Initiation into prescribed psychoactive drugs occurs at a later age than for the licit and illicit drugs and continues through the age period covered by the survey. A potential maturational trend in marijuana use in this cohort is apparent with a decline beginning approximately at age 22.5 for most usage patterns. The periods of highest marijuana and alcohol usage decline beginning at ages 20-21 and contrast sharply with cigarettes which exhibit climbing rates of highest use through the end of the surveillance period (age 25). Overall patterns are similar for men and women, with men initiating all drugs at higher rates than women, except for prescribed psychoactives . PMID:6611092

Effects of marijuana smoking on the lung.

PubMed

Tashkin, Donald P

2013-06-01

Regular smoking of marijuana by itself causes visible and microscopic injury to the large airways that is consistently associated with an increased likelihood of symptoms of chronic bronchitis that subside after cessation of use. On the other hand, habitual use of marijuana alone does not appear to lead to significant abnormalities in lung function when assessed either cross-sectionally or longitudinally, except for possible increases in lung volumes and modest increases in airway resistance of unclear clinical significance. Therefore, no clear link to chronic obstructive pulmonary disease has been established. Although marijuana smoke contains a number of carcinogens and cocarcinogens, findings from a limited number of well-designed epidemiological studies do not suggest an increased risk for the development of either lung or upper airway cancer from light or moderate use, although evidence is mixed concerning possible carcinogenic risks of heavy, long-term use. Although regular marijuana smoking leads to bronchial epithelial ciliary loss and impairs the microbicidal function of alveolar macrophages, evidence is inconclusive regarding possible associated risks for lower respiratory tract infection. Several case reports have implicated marijuana smoking as an etiologic factor in pneumothorax/pneumomediastinum and bullous lung disease, although evidence of a possible causal link from epidemiologic studies is lacking. In summary, the accumulated weight of evidence implies far lower risks for pulmonary complications of even regular heavy use of marijuana compared with the grave pulmonary consequences of tobacco.

Endocannabinoid system: Role in depression, reward and pain control (Review).

PubMed

Huang, Wen-Juan; Chen, Wei-Wei; Zhang, Xia

2016-10-01

Depression and pain co-exist in almost 80% of patients and are associated with impaired health-related quality of life, often contributing to high mortality. However, the majority of patients who suffer from the comorbid depression and pain are not responsive to pharmacological treatments that address either pain or depression, making this comorbidity disorder a heavy burden on patients and society. In ancient times, this depression-pain comorbidity was treated using extracts of the Cannabis sativa plant, known now as marijuana and the mode of action of Δ9‑tetrahydrocannabinol, the active cannabinoid ingredient of marijuana, has only recently become known, with the identification of cannabinoid receptor type 1 (CB1) and CB2. Subsequent investigations led to the identification of endocannabinoids, anandamide and 2-arachidonoylglycerol, which exert cannabinomimetic effects through the CB1 and CB2 receptors, which are located on presynaptic membranes in the central nervous system and in peripheral tissues, respectively. These endocannabinoids are produced from membrane lipids and are lipohilic molecules that are synthesized on demand and are eliminated rapidly after their usage by hydrolyzing enzymes. Clinical studies revealed altered endocannabinoid signaling in patients with chronic pain. Considerable evidence suggested the involvement of the endocannabinoid system in eliciting potent effects on neurotransmission, neuroendocrine, and inflammatory processes, which are known to be deranged in depression and chronic pain. Several synthetic cannabinomimetic drugs are being developed to treat pain and depression. However, the precise mode of action of endocannabinoids on different targets in the body and whether their effects on pain and depression follow the same or different pathways, remains to be determined.

Recreational marijuana use and acute ischemic stroke: A population-based analysis of hospitalized patients in the United States.

PubMed

Rumalla, Kavelin; Reddy, Adithi Y; Mittal, Manoj K

2016-05-15

Recreational marijuana use is considered to have few adverse effects. However, recent evidence has suggested that it precipitates cardiovascular and cerebrovascular events. Here, we investigated the relationship between marijuana use and hospitalization for acute ischemic stroke (AIS) using data from the largest inpatient database in the United States. The Nationwide Inpatient Sample was queried from 2004 to 2011 for all patients (age 15-54) with a primary diagnosis of AIS. The incidence of AIS hospitalization in marijuana users and non-marijuana users was determined. We utilized multivariable logistic regression analyses to study the independent association between marijuana use and AIS. Overall, the incidence of AIS was significantly greater among marijuana users compared to non-users (Relative Risk [RR]: 1.13, 95% CI: 1.11-1.15, P<0.0001) and had the greatest difference in the 25-34 age group (RR: 2.26, 95% CI: 2.13-2.38, P<0.0001). Marijuana use was more prevalent among younger patients, males, African Americans, and Medicaid enrollees (P<0.0001). Marijuana users were more likely to use other illicit substances but had less overall medical comorbidity. In multivariable analysis, adjusted for potential confounders, marijuana (Odds Ratio [OR]: 1.17, 95% CI: 1.15-1.20), tobacco (OR: 1.76, 95% CI: 1.74-1.77), cocaine (OR: 1.32, 95% CI: 1.30-1.34), and amphetamine (OR: 2.21, 95% CI: 2.12-2.30) usage were found to increase the likelihood of AIS (all P<0.0001). Among younger adults, recreational marijuana use is independently associated with 17% increased likelihood of AIS hospitalization. Copyright © 2016 Elsevier B.V. All rights reserved.

CB1-Dependent Long-Term Depression in Ventral Tegmental Area GABA Neurons: A Novel Target for Marijuana.

PubMed

Friend, Lindsey; Weed, Jared; Sandoval, Philip; Nufer, Teresa; Ostlund, Isaac; Edwards, Jeffrey G

2017-11-08

The VTA is necessary for reward behavior with dopamine cells critically involved in reward signaling. Dopamine cells in turn are innervated and regulated by neighboring inhibitory GABA cells. Using whole-cell electrophysiology in juvenile-adolescent GAD67-GFP male mice, we examined excitatory plasticity in fluorescent VTA GABA cells. A novel CB1-dependent LTD was induced in GABA cells that was dependent on metabotropic glutamate receptor 5, and cannabinoid receptor 1 (CB1). LTD was absent in CB1 knock-out mice but preserved in heterozygous littermates. Bath applied Δ 9 -tetrahydrocannabinol depressed GABA cell activity, therefore downstream dopamine cells will be disinhibited; and thus, this could potentially result in increased reward. Chronic injections of Δ 9 -tetrahydrocannabinol occluded LTD compared with vehicle injections; however, a single exposure was insufficient to do so. As synaptic modifications by drugs of abuse are often tied to addiction, these data suggest a possible mechanism for the addictive effects of Δ 9 -tetrahydrocannabinol in juvenile-adolescents, by potentially altering reward behavioral outcomes. SIGNIFICANCE STATEMENT The present study identifies a novel form of glutamatergic synaptic plasticity in VTA GABA neurons, a currently understudied cell type that is critical for the brain's reward circuit, and how Δ 9 -tetrahydrocannabinol occludes this plasticity. This study specifically addresses a potential unifying mechanism whereby marijuana could exert rewarding and addictive/withdrawal effects. Marijuana use and legalization are a pressing issue for many states in the United States. Although marijuana is the most commonly abused illicit drug, the implications of legalized, widespread, or continued usage are speculative. This study in juvenile-adolescent aged mice identifies a novel form of synaptic plasticity in VTA GABA cells, and the synaptic remodeling that can occur after Δ 9 -tetrahydrocannabinol use. Copyright © 2017 the authors 0270-6474/17/3710943-12$15.00/0.

Effects of marijuana on visuospatial working memory: an fMRI study in young adults.

PubMed

Smith, Andra M; Longo, Carmelinda A; Fried, Peter A; Hogan, Matthew J; Cameron, Ian

2010-06-01

The effects of marijuana use on visuospatial working memory were investigated in 19-21-year-olds using functional magnetic resonance imaging (fMRI). Participants were members of the Ottawa Prenatal Prospective Study, a longitudinal study that collected a unique body of information on participants from infancy to young adulthood including: prenatal drug history, detailed cognitive/behavioral performance, and current and past drug usage. This information allowed for the measurement of an unprecedented number of potentially confounding drug exposure variables including: prenatal marijuana, nicotine, alcohol, and caffeine exposure and offspring alcohol, marijuana, and nicotine use. Ten marijuana users and 14 nonusing controls performed a visuospatial 2-back task while fMRI blood oxygen level-dependent response was examined. Despite similar task performance, marijuana users had significantly greater activation in the inferior and middle frontal gyri, regions of the brain normally associated with visuospatial working memory. Marijuana users also had greater activation in the right superior temporal gyrus, a region of the brain not typically associated with visuospatial working memory tasks. These results suggest that marijuana use leads to altered neural functioning during visuospatial working memory after controlling for other prenatal and current drug use. This alteration appears to be compensated for by the recruitment of blood flow in additional brain regions. It is possible that this compensation may not be sufficient in more real-life situations where this type of processing is required and thus deficits may be observed. Awareness of these neural physiological effects of marijuana in youth is critical.

The longitudinal effect of drug use on productivity status of nonmetropolitan african american young adults.

PubMed

Roldós, María Isabel

2014-01-01

The purpose of this study was to investigate the longitudinal effect of marijuana and heavy alcohol use on the productivity status of nonmetropolitan African American young adults. This analysis was based on secondary data from the Family and Community Health Study. For alcohol, the study evaluated the effects on productivity status for individuals with heavy alcohol use trajectories from adolescence into young adulthood while marijuana effects were evaluated during the period when adolescents are more likely to have initiated usage (14-16 years of age). Productivity status was measured when study participants were between 18 and 21 years, for both alcohol and marijuana. Multivariate logistic regression models were used to test the association between subjects' drug use and productivity. Bivariate analysis of the effects of marijuana use indicate that marijuana users by age 16 are 35% less likely to be productive at age 21 than those who have not initiated marijuana use (p < .005). After controlling for individual, community, and family factors, the multivariate logistic models for alcohol and marijuana use suggest that early adolescence drug use (marijuana and heavy alcohol use) do not have an impact on productivity status during early adulthood. Analyzing and understanding the different drug use trajectories in relation to a productivity outcome is important for policies and research geared to preventing drug use and in identifying its relation with micro- and macro-level labor market outcomes. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Efficacy and adverse effects of medical marijuana for chronic noncancer pain: Systematic review of randomized controlled trials.

PubMed

Deshpande, Amol; Mailis-Gagnon, Angela; Zoheiry, Nivan; Lakha, Shehnaz Fatima

2015-08-01

To determine if medical marijuana provides pain relief for patients with chronic noncancer pain (CNCP) and to determine the therapeutic dose, adverse effects, and specific indications. In April 2014, MEDLINE and EMBASE searches were conducted using the terms chronic noncancer pain, smoked marijuana or cannabinoids, placebo and pain relief, or side effects or adverse events. An article was selected for inclusion if it evaluated the effect of smoked or vaporized cannabinoids (nonsynthetic) for CNCP; it was designed as a controlled study involving a comparison group, either concurrently or historically; and it was published in English in a peer-review journal. Outcome data on pain, function, dose, and adverse effects were collected, if available. All articles that were only available in abstract form were excluded. Synthesis A total of 6 randomized controlled trials (N = 226 patients) were included in this review; 5 of them assessed the use of medical marijuana in neuropathic pain as an adjunct to other concomitant analgesics including opioids and anticonvulsants. The 5 trials were considered to be of high quality; however, all of them had challenges with masking. Data could not be pooled owing to heterogeneity in delta-9-tetrahydrocannabinol potency by dried weight, differing frequency and duration of treatment, and variability in assessing outcomes. All experimental sessions in the studies were of short duration (maximum of 5 days) and reported statistically significant pain relief with nonserious side effects. There is evidence for the use of low-dose medical marijuana in refractory neuropathic pain in conjunction with traditional analgesics. However, trials were limited by short duration, variability in dosing and strength of delta-9-tetrahydrocannabinol, and lack of functional outcomes. Although well tolerated in the short term, the long-term effects of psychoactive and neurocognitive effects of medical marijuana remain unknown. Generalizing the use of medical marijuana to all CNCP conditions does not appear to be supported by existing evidence. Clinicians should exercise caution when prescribing medical marijuana for patients, especially in those with nonneuropathic CNCP.

Efficacy and adverse effects of medical marijuana for chronic noncancer pain

PubMed Central

Deshpande, Amol; Mailis-Gagnon, Angela; Zoheiry, Nivan; Lakha, Shehnaz Fatima

2015-01-01

Abstract Objective To determine if medical marijuana provides pain relief for patients with chronic noncancer pain (CNCP) and to determine the therapeutic dose, adverse effects, and specific indications. Data sources In April 2014, MEDLINE and EMBASE searches were conducted using the terms chronic noncancer pain, smoked marijuana or cannabinoids, placebo and pain relief, or side effects or adverse events. Study selection An article was selected for inclusion if it evaluated the effect of smoked or vaporized cannabinoids (nonsynthetic) for CNCP; it was designed as a controlled study involving a comparison group, either concurrently or historically; and it was published in English in a peer-review journal. Outcome data on pain, function, dose, and adverse effects were collected, if available. All articles that were only available in abstract form were excluded. Synthesis A total of 6 randomized controlled trials (N = 226 patients) were included in this review; 5 of them assessed the use of medical marijuana in neuropathic pain as an adjunct to other concomitant analgesics including opioids and anticonvulsants. The 5 trials were considered to be of high quality; however, all of them had challenges with masking. Data could not be pooled owing to heterogeneity in delta-9-tetrahydrocannabinol potency by dried weight, differing frequency and duration of treatment, and variability in assessing outcomes. All experimental sessions in the studies were of short duration (maximum of 5 days) and reported statistically significant pain relief with nonserious side effects. Conclusion There is evidence for the use of low-dose medical marijuana in refractory neuropathic pain in conjunction with traditional analgesics. However, trials were limited by short duration, variability in dosing and strength of delta-9-tetrahydrocannabinol, and lack of functional outcomes. Although well tolerated in the short term, the long-term effects of psychoactive and neurocognitive effects of medical marijuana remain unknown. Generalizing the use of medical marijuana to all CNCP conditions does not appear to be supported by existing evidence. Clinicians should exercise caution when prescribing medical marijuana for patients, especially in those with nonneuropathic CNCP. PMID:26505059

The association between regular marijuana use and adult mental health outcomes.

PubMed

Guttmannova, Katarina; Kosterman, Rick; White, Helene R; Bailey, Jennifer A; Lee, Jungeun Olivia; Epstein, Marina; Jones, Tiffany M; Hawkins, J David

2017-10-01

The present study is a prospective examination of the relationship between regular marijuana use from adolescence through young adulthood and mental health outcomes at age 33. Data came from a gender-balanced, ethnically diverse longitudinal panel of 808 participants from Seattle, Washington. Outcomes included symptom counts for six mental health disorders. Regular marijuana use was tracked during adolescence and young adulthood. Regression analyses controlled for demographics and early environment, behaviors, and individual risk factors. Nonusers of marijuana reported fewer symptoms of alcohol use disorder, nicotine dependence, and generalized anxiety disorder than any category of marijuana users. More persistent regular marijuana use in young adulthood was positively related to more symptoms of cannabis use disorder, alcohol use disorder, and nicotine dependence at age 33. Findings highlight the importance of avoiding regular marijuana use, especially chronic use in young adulthood. Comprehensive prevention and intervention efforts focusing on marijuana and other substance use might be particularly important in the context of recent legalization of recreational marijuana use in Washington and other U.S. states. Copyright © 2017 Elsevier B.V. All rights reserved.

Effects of prenatal marijuana on response inhibition: an fMRI study of young adults.

PubMed

Smith, Andra M; Fried, Peter A; Hogan, Matthew J; Cameron, Ian

2004-01-01

The neurophysiological effects of prenatal marijuana exposure on response inhibition were assessed in 18- to 22-year-olds. Thirty-one participants from the Ottawa Prenatal Prospective Study (OPPS) performed a blocked design Go/No-Go task while neural activity was imaged with functional magnetic resonance imaging (fMRI). The OPPS is a longitudinal study that provides a unique body of information collected from each participant over 20 years, including prenatal drug history, detailed cognitive/behavioral performance from infancy to young adulthood, and current and past drug usage. The fMRI results showed that with increased prenatal marijuana exposure, there was a significant increase in neural activity in bilateral prefrontal cortex and right premotor cortex during response inhibition. There was also an attenuation of activity in left cerebellum with increased prenatal exposure to marijuana when challenging the response inhibition neural circuitry. Prenatally exposed offspring had significantly more commission errors than nonexposed participants, but all participants were able to perform the task with more than 85% accuracy. These findings were observed when controlling for present marijuana use and prenatal exposure to nicotine, alcohol and caffeine, and suggest that prenatal marijuana exposure is related to changes in neural activity during response inhibition that last into young adulthood. Copyright 2004 Elsevier Inc.

Perioperative Patient Beliefs Regarding Potential Effectiveness of Marijuana (Cannabinoids) for Treatment of Pain: A Prospective Population Survey.

PubMed

Khelemsky, Yury; Goldberg, Andrew T; Hurd, Yasmin L; Winkel, Gary; Ninh, Allen; Qian, Lucia; Oprescu, Anna; Ciccone, Jeffrey; Katz, Daniel J

Cannabinoids have an expanding presence in medicine. Perioperative patients' perceptions of the effectiveness of these compounds, and acceptance if prescribed for pain, have not been previously described. Our primary objective was to describe patients' beliefs regarding the potential effectiveness of cannabinoids for the treatment of acute and chronic pain, as well as gauge patient acceptance of these compounds if prescribed by a physician. In addition, demographic and pain history data were collected to elucidate the predictors of the aforementioned patient attitudes. Secondarily, we sought to characterize the subgroup of patients who reported marijuana use. Predictors of marijuana use, effectiveness, and adverse effects were also reported for this subgroup. An anonymous questionnaire was administered to 501 patients in the preoperative registration area at Mount Sinai Hospital, New York, New York. The questionnaire was designed to collect data on patient demographics, presence of pain, pain severity, use of pain medication, history of illicit-drug use, tobacco use, cannabis use, patient beliefs about the potential effectiveness of marijuana for acute and chronic pain and their willingness to use cannabis for pain, if prescribed by a physician. Normality of distributions for continuous variables was assessed with skewness and kurtosis measures. A logistic regression model was used to assess the demographic and medical characteristics of marijuana users compared with nonusers. The effectiveness of marijuana in dealing with pain and adverse effects associated with its use were examined using exploratory principal component analysis. More than 80% of this cohort of preoperative patients believed that marijuana could be at least somewhat effective for the treatment of pain after surgery and would be willing to use cannabinoid compounds if prescribed by their physician. Predictors of positive attitudes toward marijuana included history of marijuana use, pain history, and being a marijuana nonuser of white race. Approximately 27% of the respondents reported a history of marijuana use. Younger patients, those with higher levels of pain in the last 24 hours, and those who found standard therapies to be less effective for their pain were more likely to use marijuana. Patients generally believe that marijuana could be at least somewhat effective for the management of pain and are willing to use cannabinoid compounds for this indication, if prescribed by a physician.

Marijuana: respiratory tract effects.

PubMed

Owen, Kelly P; Sutter, Mark E; Albertson, Timothy E

2014-02-01

Marijuana is the most commonly used drug of abuse in the USA. It is commonly abused through inhalation and therefore has effects on the lung that are similar to tobacco smoke, including increased cough, sputum production, hyperinflation, and upper lobe emphysematous changes. However, at this time, it does not appear that marijuana smoke contributes to the development of chronic obstructive pulmonary disease. Marijuana can have multiple physiologic effects such as tachycardia, peripheral vasodilatation, behavioral and emotional changes, and possible prolonged cognitive impairment. The carcinogenic effects of marijuana are unclear at this time. Studies are mixed on the ability of marijuana smoke to increase the risk for head and neck squamous cell carcinoma, lung cancer, prostate cancer, and cervical cancer. Some studies show that marijuana is protective for development of malignancy. Marijuana smoke has been shown to have an inhibitory effect on the immune system. Components of cannabis are under investigation as treatment for autoimmune diseases and malignancy. As marijuana becomes legalized in many states for medical and recreational use, other forms of tetrahydrocannabinol (THC) have been developed, such as food products and beverages. As most research on marijuana at this time has been on whole marijuana smoke, rather than THC, it is difficult to determine if the currently available data is applicable to these newer products.

Cannabinoids and Symptomatic Bradycardia.

PubMed

Heckle, Mark R; Nayyar, Mannu; Sinclair, Scott E; Weber, Karl T

2018-01-01

Cannabinoids, the bioactive components of marijuana, have adverse cardiovascular consequences, including symptomatic sinus bradycardia, sinus arrest and ventricular asystole. Physicians should be aware of these deleterious consequences which can appear in otherwise healthy persons who are chronic marijuana users. Copyright © 2018 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

Marijuana use, craving, and academic motivation and performance among college students: An in-the-moment study.

PubMed

Phillips, Kristina T; Phillips, Michael M; Lalonde, Trent L; Tormohlen, Kayla N

2015-08-01

Marijuana is the most commonly used illicit substance in the U.S., with high rates among young adults in the state of Colorado. Chronic, heavy marijuana use can impact cognitive functioning, which has the potential to influence academic performance of college students. It is possible that craving for marijuana may further contribute to diminished cognitive and affective functioning, thus leading to poor outcomes for students. College student marijuana users (n=57) were recruited based on heavy use and completed ecological momentary assessment (EMA) via text-messaging. The association between marijuana use and craving in a college setting was explored, as well as how these variables might relate to academic motivation, effort and success. The participants were sent text messages for two weeks, three times per day at random times. A temporal association between craving and marijuana use was found, where momentary craving positively predicted greater marijuana use. Similarly, as craving levels increased, the number of minutes spent studying decreased at the next assessment point. A negative association between momentary craving for marijuana and academic motivation was found in the same moment. Greater academic self-efficacy positively predicted cumulative GPA, while average minutes spent smoking marijuana was negatively related. Using EMA, marijuana craving and use were significantly related. These findings provide further evidence that heavy marijuana use is negatively associated with academic outcomes. Copyright © 2015 Elsevier Ltd. All rights reserved.

Cannabinoid hyperemesis and compulsive bathing: a case series and paradoxical pathophysiological explanation.

PubMed

Patterson, Dale A; Smith, Emmaleigh; Monahan, Mark; Medvecz, Andrew; Hagerty, Beth; Krijger, Lisa; Chauhan, Aakash; Walsh, Mark

2010-01-01

Cannabinoid hyperemesis is a syndrome characterized by severe nausea and hyperemesis associated with chronic marijuana abuse and marked by compulsive bathing habits, which temporarily alleviate symptoms. We describe the syndrome in 4 adult patients for whom extensive gastrointestinal evaluations failed to identify another clear cause. Cessation of marijuana use resulted in the alleviation of their symptoms. Because recreational and medical use of marijuana is increasing in the United States, this condition should be considered in many patients who present with cyclical vomiting.

Long-term heavy marijuana users make costly decisions on a gambling task.

PubMed

Whitlow, Christopher T; Liguori, Anthony; Livengood, L Brooke; Hart, Stephanie L; Mussat-Whitlow, Becky J; Lamborn, Corey M; Laurienti, Paul J; Porrino, Linda J

2004-10-05

Chronic marijuana use has been associated with impairments of learning, memory, and executive functions. Little is known, however, about the effects of marijuana use on other cognitive domains, such as decision-making, which are thought to play an important role in addiction and drug abuse. The purpose of the present study was to determine if long-term heavy marijuana users employ different decision-making strategies than individuals with minimal marijuana exposure. Volunteers were assigned to a cannabis (n = 10) or control group (n = 10) based upon history of prior marijuana use. Demographic and neuropsychological variables were evaluated, and a decision-making task--the gambling task (GT) was administered. Although few demographic and neuropsychological differences were noted between groups, marijuana users made more decisions that led to larger immediate gains despite more costly losses than controls. These data suggest that long-term heavy marijuana users may have specific deficits in the ability to balance rewards and punishments that may contribute to continued drug-taking behavior. It is unknown, however, whether the basis for such deficits might be attributed directly to marijuana exposure or pre-existing genetic or behavioral differences.

Analysis of the medical use of marijuana and its societal implications.

PubMed

Taylor, H G

1998-01-01

To review the pharmacology, therapeutics, adverse effects, and societal implications of the medical use of marijuana. MEDLINE and manual searches of English-language marijuana literature, supplemented with interviews of scientists currently conducting cannabinoid research. Search terms included pain OR palliative care AND cannabis or ALL marijuana; cachexia OR appetite OR appetite stimulants; muscle spasticity OR spasm; immune system and cannabis; nausea and vomiting and cancer and cannabis. MEDLINE search terms: cannabis OR marijuana smoking OR marijuana abuse; all glaucoma; multiple sclerosis AND cannabis OR marijuana smoking OR marijuana abuse. Studies on pharmacology, risks, and medical potential of marijuana. Not applicable. The most prominent effects of marijuana are mediated by receptors in the brain. Acute intoxication is characterized by euphoria, loss of short-term memory, stimulation of the senses, and impaired linear thinking. Depersonalization and panic attacks are adverse effects. Increased heart rate and reddened conjunctivae are common physical effects. Chronic, high doses may cause subtle impairment of cognitive abilities that are appear to be long-term, but of unknown duration. Marijuana may be a risk factor for individuals with underlying mental illness. It causes dependence, but compared with cocaine, alcohol, heroin, and nicotine, marijuana has little addictive power and produces only mild withdrawal symptoms. Marijuana shows clinical promise for glaucoma, nausea and vomiting, analgesia, spasticity, multiple sclerosis, and AIDS wasting syndrome. As a recreational drug, marijuana poses dangers, particularly to social and emotional development during adolescence and young adulthood. As a medical drug, marijuana should be available for patients who do not adequately respond to currently available therapies.

Racial differences in the validity of self-reported drug use among men who have sex with men in Atlanta, GA.

PubMed

White, Darcy; Rosenberg, Eli S; Cooper, Hannah L F; del Rio, Carlos; Sanchez, Travis H; Salazar, Laura F; Sullivan, Patrick S

2014-05-01

Men who have sex with men (MSM), particularly young black MSM, are disproportionately affected in the United States' HIV epidemic. Drug use may contribute to these disparities, yet previous studies have failed to provide evidence of elevated use among black MSM, relying exclusively on self-reported usage. This study uses biological assays to validate self-reports of drug use and explore the potential for misclassification to distort findings on racial patterns of use in this population. From an Atlanta-based cohort study of 454 black and 349 white MSM from 2010 to 2012, participants' self-reported drug use was compared to urine drug screening findings. The sensitivity of self-report was calculated as the proportion reporting recent usage among those who screened positive. Multivariable regression models were constructed to examine racial patterns in self-report, urine-detection, and self-report sensitivity of marijuana and cocaine usage, adjusted for socio-demographic factors. In analyses that adjusted for age, education, income, sexual orientation, and history of arrest, black MSM were less likely to report recent use of marijuana (P<0.001) and cocaine (P=0.02), but equally likely to screen positive for either drug. This discrepancy between self-reported and urine-detected drug use was explained by significantly lower sensitivity of self-report for black participants (P<0.001 for marijuana, P<0.05 for cocaine). The contribution of individual drug-related risk behaviors to the HIV disparities between black and white MSM should be revisited with methods that validate self-reports of illegal drug use. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Chronic marijuana smoke exposure in the rhesus monkey. IV: Neurochemical effects and comparison to acute and chronic exposure to delta-9-tetrahydrocannabinol (THC) in rats.

PubMed

Ali, S F; Newport, G D; Scallet, A C; Paule, M G; Bailey, J R; Slikker, W

1991-11-01

THC is the major psychoactive constituent of marijuana and is known to produce psychopharmacological effects in humans. These studies were designed to determine whether acute or chronic exposure to marijuana smoke or THC produces in vitro or in vivo neurochemical alterations in rat or monkey brain. For the in vitro study, THC was added (1-100 nM) to membranes prepared from different regions of the rat brain and muscarinic cholinergic (MCh) receptor binding was measured. For the acute in vivo study, rats were injected IP with vehicle, 1, 3, 10, or 30 mg THC/kg and sacrificed 2 h later. For the chronic study, rats were gavaged with vehicle or 10 or 20 mg THC/kg daily, 5 days/week for 90 days and sacrificed either 24 h or 2 months later. Rhesus monkeys were exposed to the smoke of a single 2.6% THC cigarette once a day, 2 or 7 days a week for 1 year. Approximately 7 months after the last exposure, animals were sacrificed by overdose with pentobarbital for neurochemical analyses. In vitro exposure to THC produced a dose-dependent inhibition of MCh receptor binding in several brain areas. This inhibition of MCh receptor binding, however, was also observed with two other nonpsychoactive derivatives of marijuana, cannabidiol and cannabinol. In the rat in vivo study, we found no significant changes in MCh or other neurotransmitter receptor binding in hippocampus, frontal cortex or caudate nucleus after acute or chronic exposure to THC. In the monkey brain, we found no alterations in the concentration of neurotransmitters in caudate nucleus, frontal cortex, hypothalamus or brain stem.(ABSTRACT TRUNCATED AT 250 WORDS)

Medical marijuana and the developing role of the pharmacist.

PubMed

Seamon, Matthew J; Fass, Jennifer A; Maniscalco-Feichtl, Maria; Abu-Shraie, Nada A

2007-05-15

The pharmacology, therapeutic uses, safety, drug-drug interactions, and drug-disease interactions of medical marijuana are reviewed, and the legal issues related to its use and the implications of medical marijuana for the pharmacist are presented. Marijuana contains more than 460 active chemicals and over 60 unique cannabinoids. The legal landscape surrounding marijuana is surprisingly complex and unsettled. In the United States, 11 states and several municipalities have legalized medical marijuana. Another state provides legislation that allows patients to claim a defense of medical necessity. Nevertheless, patients using medical marijuana may never interact with a pharmacist. Marijuana is a Schedule I controlled substance and its use is illegal under federal law. Marijuana has a number of purported therapeutic uses with a broad range of supporting evidence. There are five general indications for medical marijuana: (1) severe nausea and vomiting associated with cancer chemotherapy or other causes, (2) weight loss associated with debilitating illnesses, including HIV infection and cancer, (3) spasticity secondary to neurologic diseases, such as multiple sclerosis, (4) pain syndromes, and (5) other uses, such as for glaucoma. Marijuana is associated with adverse psychiatric, cardiovascular, respiratory, and immunologic events. Moreover, marijuana may interact with a number of prescription drugs and concomitant disease states. Several states have legalized the use of marijuana for chronic and debilitating medication conditions. Pharmacists need to understand the complex legal framework surrounding this issue so that they can protect themselves and better serve their patients.

The Relationship between Marijuana Use and Intimate Partner Violence in a Nationally Representative, Longitudinal Sample

ERIC Educational Resources Information Center

Reingle, Jennifer M.; Staras, Stephanie A. S.; Jennings, Wesley G.; Branchini, Jennifer; Maldonado-Molina, Mildred M.

2012-01-01

Intimate partner violence is a significant public health problem, as these behaviors have been associated with a number of negative health outcomes including illicit drug use, physical injury, chronic pain, sexually transmitted diseases, depression, and posttraumatic stress disorder. The current study examined the association between marijuana use…

Use of Protective Behavioral Strategies among Young Adult Veteran Marijuana Users.

PubMed

Pedersen, Eric R; Villarosa-Hurlocker, Margo C; Prince, Mark A

2018-01-01

Young adult veterans are at risk for problematic marijuana use and associated consequences, which is partially due to their high rates of Posttraumatic Stress Disorder (PTSD), depression, and problematic substance use. Veterans tend to endorse more severe and chronic mental health symptoms compared to their civilian counterparts and they identify marijuana use as a method to cope with their symptoms. Given the prevalence of marijuana use among veterans in the community and in clinical settings, it is important to explore the factors that may help minimize harm associated with use for those that choose to use the drug. The present study sought to examine the impact of protective behavioral strategies on the relationship between mental health symptoms and marijuana use and consequences in a sample of 180 young adult veteran marijuana users. Participants were recruited via social media advertisements and completed measures of marijuana use and consequences, protective behavioral strategies, and PTSD and depression symptoms. Findings indicated that more frequent use of protective behavioral strategies was associated with less marijuana use and consequences. Participants who screened positive for PTSD or depression reported more marijuana consequences than did those not positive on these screeners. Regression analyses revealed protective strategies moderated the relationship between PTSD and marijuana consequences such that young veterans who endorsed more PTSD symptoms and infrequent use of protective strategies reported the most marijuana consequences. No moderating effects were found for the relationship between depression and marijuana consequences. Findings have clinical implications for working with young veterans.

The relationship between victimization and substance use among homeless and runaway female adolescents.

PubMed

Tyler, Kimberly A; Gervais, Sarah J; Davidson, M Meghan

2013-02-01

Each year, thousands of female adolescents run away from home due to sexual abuse, yet they continue to be victims of sexual assault once on the street. To date, few studies have examined how various forms of victimization are related to different types of substance use. The purpose of this article is to investigate the relationship between street exposure, childhood abuse, and different forms of street victimization with alcohol and marijuana use among 137 homeless and runaway female adolescents. Results from path analysis revealed that child sexual abuse was positively linked to trading sex and sexual and physical victimization. In addition, those who have traded sex experienced greater physical victimization, and who have spent more time away from home, used alcohol more frequently. Moreover, trading sex and experiencing more types of sexual victimization were positively linked to more frequent marijuana usage. Age, age at first run, longest time away from home, sexual abuse, and trading sex had significant indirect effects on alcohol and/or marijuana use. Together, these factors accounted for 27% of the variance in alcohol use and 37% of the variance in marijuana use.

Health aspects of cannabis.

PubMed

Hollister, L E

1986-03-01

Marijuana seems firmly established as another social drug in Western countries, regardless of its current legal status. Patterns of use vary widely. As with other social drugs, the pattern of use is critical in determining adverse effects on health. Perhaps the major area of concern about marijuana use is among the very young. Using any drug on a regular basis that alters reality may be detrimental to the psychosocial maturation of young persons. Chronic use of marijuana may stunt the emotional growth of youngsters. Evidence for an amotivational syndrome is largely based on clinical reports; whether marijuana use is a cause or effect is uncertain. A marijuana psychosis, long rumored, has been difficult to prove. No one doubts that marijuana use may aggravate existing psychoses or other severe emotional disorders. Brain damage has not been proved. Physical dependence is rarely encountered in the usual patterns of social use, despite some degree of tolerance that may develop. The endocrine effects of the drug might be expected to delay puberty in prepubertal boys, but actual instances have been rare. As with any material that is smoked, chronic smoking of marijuana will produce bronchitis; emphysema or lung cancer have not yet been documented. Cardiovascular effects of the drug are harmful to those with preexisting heart disease; fortunately the number of users with such conditions is minimal. Fears that the drug might accumulate in the body to the point of toxicity have been groundless. The potential deleterious effects of marijuana use on driving ability seem to be self-evident; proof of such impairment has been more difficult. The drug is probably harmful when taken during pregnancy, but the risk is uncertain. One would be prudent to avoid marijuana during pregnancy, just as one would do with most other drugs not essential to life or well-being. No clinical consequences have been noted from the effects of the drug on immune response, chromosomes, or cell metabolites. Contamination of marijuana by spraying with defoliants has created the clearest danger to health; such attempts to control production should be abandoned. Therapeutic uses for marijuana, THC, or cannabinoid homologs are being actively explored. Only the synthetic homolog, nabilone, has been approved for use to control nausea and vomiting associated with cancer chemotherapy.(ABSTRACT TRUNCATED AT 400 WORDS)

Marijuana and Lung Disease.

PubMed

Tashkin, Donald P

2018-05-17

As marijuana smoking prevalence increases in the U.S. concern regarding its potential risks to lung health has also risen, given the general similarity in the smoke contents between marijuana and tobacco. Most studies have found a significant association between marijuana smoking and chronic bronchitis symptoms after adjustment for tobacco. While reports are mixed regarding associations between marijuana smoking and lung function, none has shown a relationship to decrements in forced expired volume in 1 sec (FEV1) and few have found a relationship to a decreased ratio of FEV1 to forced vital capacity (FVC), possibly related to an association between marijuana and an increased FVC. A few studies have found a modest reduction in specific airway conductance in relation to marijuana, probably reflecting endoscopic evidence of bronchial mucosal edema among habitual marijuana smokers. Diffusing capacity in marijuana smokers has been normal and two studies of thoracic high-resolution computed tomography (HRCT) have not shown any association of marijuana smoking with emphysema. Although bronchial biopsies from habitual marijuana smokers have shown precancerous histopathological changes, a large cohort study and a pooled analysis of six well-designed case-control studies have not found evidence of a link between marijuana smoking and lung cancer. The immunosuppressive effects of delta-9 tetrahydrocannabinol raise the possibility of an increased risk of pneumonia, but further studies are needed to evaluate this potential risk. Several cases series have demonstrated pneumothoraces/pneumomediastinum, as well as bullous lung disease, in marijuana smokers, but these associations require epidemiologic studies for firmer evidence of possible causality. Copyright © 2018. Published by Elsevier Inc.

Medical marijuana: medical necessity versus political agenda.

PubMed

Clark, Peter A; Capuzzi, Kevin; Fick, Cameron

2011-12-01

Marijuana is classified by the Drug Enforcement Agency (DEA) as an illegal Schedule I drug which has no accepted medical use. However, recent studies have shown that medical marijuana is effective in controlling chronic non-cancer pain, alleviating nausea and vomiting associated with chemotherapy, treating wasting syndrome associated with AIDS, and controlling muscle spasms due to multiple sclerosis. These studies state that the alleviating benefits of marijuana outweigh the negative effects of the drug, and recommend that marijuana be administered to patients who have failed to respond to other therapies. Despite supporting evidence, the DEA refuses to reclassify marijuana as a Schedule II drug, which would allow physicians to prescribe marijuana to suffering patients. The use of medical marijuana has continued to gain support among states, and is currently legal in 16 states and the District of Columbia. This is in stark contrast to the federal government's stance of zero-tolerance, which has led to a heated legal debate in the United States. After reviewing relevant scientific data and grounding the issue in ethical principles like beneficence and nonmaleficence, there is a strong argument for allowing physicians to prescribe marijuana. Patients have a right to all beneficial treatments and to deny them this right violates their basic human rights.

Medical marijuana: Medical necessity versus political agenda

PubMed Central

Clark, Peter A.; Capuzzi, Kevin; Fick, Cameron

2011-01-01

Summary Marijuana is classified by the Drug Enforcement Agency (DEA) as an illegal Schedule I drug which has no accepted medical use. However, recent studies have shown that medical marijuana is effective in controlling chronic non-cancer pain, alleviating nausea and vomiting associated with chemotherapy, treating wasting syndrome associated with AIDS, and controlling muscle spasms due to multiple sclerosis. These studies state that the alleviating benefits of marijuana outweigh the negative effects of the drug, and recommend that marijuana be administered to patients who have failed to respond to other therapies. Despite supporting evidence, the DEA refuses to reclassify marijuana as a Schedule II drug, which would allow physicians to prescribe marijuana to suffering patients. The use of medical marijuana has continued to gain support among states, and is currently legal in 16 states and the District of Columbia. This is in stark contrast to the federal government’s stance of zero-tolerance, which has led to a heated legal debate in the United States. After reviewing relevant scientific data and grounding the issue in ethical principles like beneficence and nonmaleficence, there is a strong argument for allowing physicians to prescribe marijuana. Patients have a right to all beneficial treatments and to deny them this right violates their basic human rights. PMID:22129912

Binge drinking, marijuana use, and friendships: the relationship between similar and dissimilar usage and friendship quality.

PubMed

Boman, John H; Stogner, John; Miller, Bryan Lee

2013-01-01

While it is commonly understood that the substance use of peers influences an individual's substance use, much less is understood about the interplay between substance use and friendship quality. Using a sample of 2,148 emerging adults nested within 1,074 dyadic friendships, this study separately investigates how concordance and discordance in binge drinking and marijuana use between friends is related to each friend's perceptions of friendship quality. Because "friendship quality" is a complex construct, we employ a measure containing five sub-elements--companionship, a lack of conflict, willingness to help a friend, relationship security, and closeness. Results for both binge drinking and marijuana use reveal that individuals in friendship pairs who are concordant in their substance use perceive significantly higher perceptions of friendship quality than individuals in dyads who are dissimilar in substance use. Specifically, concordant binge drinkers estimate significantly higher levels of companionship, relationship security, and willingness to help their friend than concordant non-users, discordant users, and discordant non-users. However, the highest amount of conflict in friendships is found when both friends engage in binge drinking and marijuana use. Several interpretations of these findings are discussed. Overall, concordance between friends' binge drinking and marijuana use appears to help some elements of friendship quality and harm others.

Students and Drugs at NCSU: 1977-1978 Report.

ERIC Educational Resources Information Center

Fuller, Earl H.

A survey conducted in 1977 at North Carolina State University on drugs was designed to measure usage rates for four types of drugs: marijuana, hallucinogens (such as LSD, mescaline, and psilocybin); amphetamines and barbituates; and narcotics (heroin, opium, and morphine). The questionnaire was also designed to determine student attitudes on…

Issues for Engagement: Asian Perspectives on Transnational Security Challenges

DTIC Science & Technology

2010-01-01

transshipped drugs include thailand, china, north Korea and canada for heroin; the united states and spain for ecstasy; Iran and south africa for marijuana and...shifted to synthetic drugs, and drug usage in malaysia followed suit. today, drug users in malaysia are overcrowding the prisons. Increases in the number

An Internet survey of marijuana and hot shower use in adults with cyclic vomiting syndrome (CVS).

PubMed

Venkatesan, Thangam; Sengupta, Jyotirmoy; Lodhi, Atena; Schroeder, Abigail; Adams, Kathleen; Hogan, Walter J; Wang, Yanzhi; Andrews, Christopher; Storr, Martin

2014-08-01

Cyclic vomiting syndrome (CVS) is a chronic disorder characterized by episodic nausea and vomiting. A large proportion of patients use marijuana to control their symptoms. Several case reports implicate marijuana as a cause of intractable vomiting with compulsive hot water bathing considered pathognomonic of "cannabinoid hyperemesis." We sought to examine the relationship between marijuana use and CVS. Patients >18 years of age diagnosed by a health care provider were invited to participate in an anonymous internet-based survey. A total of 514 patients participated and 437 completed questions about marijuana use. Mean age was 34 ± 12 years with patients being predominantly female (63%), Caucasian (92%) and from the USA (82%). Nineteen percent never used marijuana and 81% did. Fifty-four percent used marijuana for health issues and 43% for recreational purposes. Users stated that it improved nausea, appetite, general well-being, stress levels and vomiting. Users were more likely to be male and have an associated anxiety disorder. Sixty-seven percent of patients reported taking hot showers/baths for symptom relief, and this was associated with marijuana use. (OR 2.54, CI 1.50-4.31, P = 0.0006). Eighty-one percent of patients with CVS who completed an internet survey reported frequent use of marijuana. With marijuana use, patients noted the greatest improvement with stress levels, appetite and nausea. Marijuana users were more likely to be male and have associated anxiety. Hot showers were not pathognomonic of marijuana use though they were more likely to be associated with its use.

Therapeutic Value of Medical Marijuana in New Jersey Patients: A Community Partnership Research Endeavor.

PubMed

Crowell, Tara L

2017-01-01

The Public Health Program at Stockton University partnered with the Compassionate Care Foundation to ascertain the impact of medical marijuana on patients in New Jersey. Patients volunteered to complete a survey once a month for 8 months. The survey explored their use, form, and strain of medical marijuana and its influence on pain and 12 other physical and mental health variables. Also, an increase or decrease in other medication taken and any unexpected outcomes were recorded. From a total of 955 patients, patients responding to the surveys varied from 501 for visit 1, 290 for visit 2, to 179 for visit 3. Results provide insight into the diagnoses for which patients used medical marijuana. Results indicate increased mood, general overall condition, and energy as the highest consequences; level of pain in the middle range; and most frequent usage as 3 to 4 times a day. Repeated measures done after visit 2 showed eight statistically significant differences for patients after using medical marijuana: an increase in general quality of life, mobility, and mood, with a decrease in inflammation, intraocular pressure, spasms, seizures, and pain. Results after visit 3 indicated seven significant differences compared to visit 1: decreased seizures, intraocular pressure, spasms, nausea, and pain, along with increased energy and mobility. No differences were found by patient diagnosis or age, but sex-related differences occurred in inflammation, mood, and energy. Results support positive therapeutic benefits of medical marijuana, and despite methodological limitations, our study contributes to the growing body of literature.

Decreased dopamine brain reactivity in marijuana abusers is associated with negative emotionality and addiction severity

PubMed Central

Volkow, Nora D.; Wang, Gene-Jack; Telang, Frank; Fowler, Joanna S.; Alexoff, David; Logan, Jean; Jayne, Millard; Wong, Christopher; Tomasi, Dardo

2014-01-01

Moves to legalize marijuana highlight the urgency to investigate effects of chronic marijuana in the human brain. Here, we challenged 48 participants (24 controls and 24 marijuana abusers) with methylphenidate (MP), a drug that elevates extracellular dopamine (DA) as a surrogate for probing the reactivity of the brain to DA stimulation. We compared the subjective, cardiovascular, and brain DA responses (measured with PET and [11C]raclopride) to MP between controls and marijuana abusers. Although baseline (placebo) measures of striatal DA D2 receptor availability did not differ between groups, the marijuana abusers showed markedly blunted responses when challenged with MP. Specifically, compared with controls, marijuana abusers had significantly attenuated behavioral (“self-reports” for high, drug effects, anxiety, and restlessness), cardiovascular (pulse rate and diastolic blood pressure), and brain DA [reduced decreases in distribution volumes (DVs) of [11C]raclopride, although normal reductions in striatal nondisplaceable binding potential (BPND)] responses to MP. In ventral striatum (key brain reward region), MP-induced reductions in DVs and BPND (reflecting DA increases) were inversely correlated with scores of negative emotionality, which were significantly higher for marijuana abusers than controls. In marijuana abusers, DA responses in ventral striatum were also inversely correlated with addiction severity and craving. The attenuated responses to MP, including reduced decreases in striatal DVs, are consistent with decreased brain reactivity to the DA stimulation in marijuana abusers that might contribute to their negative emotionality (increased stress reactivity and irritability) and addictive behaviors. PMID:25024177

Legalization of Medicinal Marijuana Has Minimal Impact on Use Patterns in Patients With Inflammatory Bowel Disease.

PubMed

Merker, Ami M; Riaz, Mahrukh; Friedman, Sonia; Allegretti, Jessica R; Korzenik, Joshua

2018-05-18

Patients with inflammatory bowel disease (IBD) have reported use of marijuana to treat symptoms of the disease, yet its classification as a Schedule 1 substance by the federal government has restricted its use. In 2012, Massachusetts legalized medicinal marijuana. We aimed to assess the impact of legalization on use in IBD. Consecutive patients with IBD, cared for at a tertiary care center in Boston, were surveyed regarding use of marijuana, including its perceived benefits and attitudes. Data were then compared with results of a similar survey study conducted at our center in 2012, before marijuana's legalization. The survey was completed by 302 patients. There was a significant increase in marijuana use overall from 12.3% in 2012 to 22.8% in 2017 (P < 0.001). However, there was no significant increase in medicinal use from 2012 to 2017. On bivariate analysis, severe disease, as assessed by SIBDQ score, prior hospitalization, biologic therapy use, prior surgery, and chronic abdominal pain, was found to be more predictive of medicinal use now than in 2012. Among patients surveyed who have never used marijuana, 39.4% reported being interested in using medicinal marijuana, and 54.3% indicated that legalization did not affect their likelihood of using medicinal marijuana. In an IBD tertiary care center, we identified an overall upward trend in marijuana use but no significant change in medicinal use since its legalization in 2012. Our data suggests that the legalization of medical marijuana has resulted in an insignificant change in medicinal marijuana use in this population. 10.1093/ibd/izy141_video1izy141.video15786500236001.

Domestic Violence. Technical Assistance Packet.

ERIC Educational Resources Information Center

Join Together, Boston, MA.

Substance abuse has long been recognized as a precipitating factor in many domestic violence incidents. The main type of substance abuse is alcohol usage. Forty-six percent of the offenders reported being dependent on or abusing alcohol, while another 28% were found to be dependent on opiates, cocaine, marijuana, or inhalants. Nearly two-fifths of…

Comorbid trajectories of substance use as predictors of Antisocial Personality Disorder, Major Depressive Episode, and Generalized Anxiety Disorder.

PubMed

Brook, Judith S; Zhang, Chenshu; Rubenstone, Elizabeth; Primack, Brian A; Brook, David W

2016-11-01

To determine longitudinal associations between patterns of comorbid cigarette, alcohol, and marijuana use and Antisocial Personality Disorder (ASPD), Major Depressive Episode (MDE), and Generalized Anxiety Disorder (GAD) in adulthood. A random community-based sample [X̅ age=36.6 (SD=2.8)] from the Children and Adults in the Community Study, an on-going investigation of substance use and psychiatric disorders. Data were collected at six time waves. Conjoint trajectories of cigarette, alcohol, and marijuana use spanning adolescence to adulthood were determined; multivariable logistic regression analyses assessed associations between trajectory group membership and having ASPD, MDE, or GAD in adulthood. Five conjoint trajectory groups were obtained: HHH (chronic cigarette, alcohol, and marijuana use), DDD (delayed/late-starting cigarette, alcohol, and marijuana use), LML (low/no smoking, moderate alcohol use, occasional marijuana use), HMN (chronic smoking, moderate alcohol use, no marijuana use), and NON (occasional alcohol use only). Compared with members of the NON group, those in the HHH group had significantly greater odds for having ASPD (Adjusted Odds Ratio [AOR]=28.52, 95% Confidence Interval [CI]=9.44-86.17), MDE (AOR=2.67, 95% CI=1.14-6.26), and GAD (AOR=6.39, 95% CI=2.62-15.56). Members of the DDD, LML, and HMN groups had weaker and less consistent associations with the three psychiatric outcomes. In a large, community-based sample, long-term concurrent use of more than one substance was associated with both externalizing and internalizing psychiatric disorders in adulthood. Prevention and treatment programs might target individuals in the community and general clinical populations with comorbid substance use, even if they haven't been identified as having a substance use disorder. Copyright © 2016 Elsevier Ltd. All rights reserved.

Comorbid Trajectories of Substance Use as Predictors of Antisocial Personality Disorder, Major Depressive Episode, and Generalized Anxiety Disorder

PubMed Central

Brook, Judith S.; Zhang, Chenshu; Rubenstone, Elizabeth; Primack, Brian A.; Brook, David W.

2016-01-01

Objective To determine longitudinal associations between patterns of comorbid cigarette, alcohol, and marijuana use and Antisocial Personality Disorder (ASPD), Major Depressive Episode (MDE), and Generalized Anxiety Disorder (GAD) in adulthood. Method A random community-based sample [X̄ age=36.6 (SD=2.8)] from the Children and Adults in the Community Study, an on-going investigation of substance use and psychiatric disorders. Data were collected at six time waves. Conjoint trajectories of cigarette, alcohol, and marijuana use spanning adolescence to adulthood were determined; multivariable logistic regression analyses assessed associations between trajectory group membership and having ASPD, MDE, or GAD in adulthood. Results Five conjoint trajectory groups were obtained: HHH (chronic cigarette, alcohol, and marijuana use), DDD (delayed/late-starting cigarette, alcohol, and marijuana use), LML (low/no smoking, moderate alcohol use, occasional marijuana use), HMN (chronic smoking, moderate alcohol use, no marijuana use), and NON (occasional alcohol use only). Compared with members of the NON group, those in the HHH group had significantly greater odds for having ASPD (Adjusted Odds Ratio [AOR]=28.52, 95% Confidence Interval [CI]=9.44–86.17), MDE (AOR=2.67, 95% CI=1.14–6.26), and GAD (AOR=6.39, 95% CI=2.62–15.56). Members of the DDD, LML, and HMN groups had weaker and less consistent associations with the three psychiatric outcomes. Conclusions In a large, community-based sample, long-term concurrent use of more than one substance was associated with both externalizing and internalizing psychiatric disorders in adulthood. Prevention and treatment programs might target individuals in the community and general clinical populations with comorbid substance use, even if they haven’t been identified as having a substance use disorder. PMID:27344118

Prenatal, perinatal, and adolescent exposure to marijuana: Relationships with aggressive behavior.

PubMed

Barthelemy, Olivier J; Richardson, Mark A; Cabral, Howard J; Frank, Deborah A

This manuscript reviews research exploring the relationship between prenatal, perinatal, and adolescent exposure to marijuana and aggressive behavior, including physical aggression. Areas of inquiry include animal research, as well as human research, on prenatal exposure and on marijuana use during adolescence. Potential psychosocial and psychopharmacological mechanisms are identified, as well as relevant confounds. The prenatal marijuana exposure literature provides minimal support for a direct relationship with aggressive behavior in childhood. The adolescent use literature suggests a marginal (at best) association between acute intoxication and aggressive behavior, and an association between chronic use and aggressive behavior heavily influenced by demographic variables, rather than direct, psychopharmacological mechanisms. Cannabis withdrawal symptoms also may include aggression and anger, but there is little evidence to suggest that these effects are large or specific to withdrawal from marijuana compared to other substances. This review will offer recommendations for clinical care and public policy, as well as important questions for future research. Copyright © 2016 Elsevier Inc. All rights reserved.

Chronic Opioid Usage in Surgical Patients in a Large Academic Center

PubMed Central

Jiang, Xueying; Orton, Margaret; Feng, Rui; Hossain, Erik; Malhotra, Neil R.; Zager, Eric L.; Liu, Renyu

2017-01-01

Objective The objective of this study is to investigate the prevalence and disparity of chronic opioid usage in surgical patients and the potential risk factors associated with chronic opioid usage. Background Chronic opioid usage is common in surgical patients; however, the characteristics of opioid usage in surgical patients is unclear. In this study, we hypothesize that the prevalence of chronic opioid usage in surgical patients is high, and that significant disparities may exist among different surgical populations. Methods Data of opioid usage in outpatients among different surgical services were extracted from the electronic medical record database. Patient demographics, clinical characteristics of sex, age, race, body mass index (BMI), specialty visited, duration of opioid use, and opioid type were collected. Chronic opioid users were defined as patients who had been recorded as taking opioids for at least 90 days determined by the first and last visit dates under opioid usage during the investigation. Results There were 79,123 patients included in this study. The average prevalence is 9.2%, ranging from 4.4% to 23.8% among various specialties. The prevalence in orthopedics (23.8%), neurosurgery (18.7%), and gastrointestinal surgery (14.4%) ranked in the top three subspecialties. Major factors influencing chronic opioid use include age, Ethnicitiy, Subspecialtiy, and multiple specialty visits. Approximately 75% of chronic users took opioids that belong to the category II Drug Enforcement Administration classification. Conclusions Overall prevalence of chronic opioid usage in surgical patients is high with widespread disparity among different sex, age, ethnicity, BMI, and subspecialty groups. Information obtained from this study provides clues to reduce chronic opioid usage in surgical patients. PMID:27163960

Narrative review of the safety and efficacy of marijuana for the treatment of commonly state-approved medical and psychiatric disorders.

PubMed

Belendiuk, Katherine A; Baldini, Lisa L; Bonn-Miller, Marcel O

2015-04-21

The present investigation aimed to provide an objective narrative review of the existing literature pertaining to the benefits and harms of marijuana use for the treatment of the most common medical and psychological conditions for which it has been allowed at the state level. Common medical conditions for which marijuana is allowed (i.e., those conditions shared by at least 80 percent of medical marijuana states) were identified as: Alzheimer's disease, amyotrophic lateral sclerosis, cachexia/wasting syndrome, cancer, Crohn's disease, epilepsy and seizures, glaucoma, hepatitis C virus, human immunodeficiency virus/acquired immunodeficiency syndrome, multiple sclerosis and muscle spasticity, severe and chronic pain, and severe nausea. Post-traumatic stress disorder was also included in the review, as it is the sole psychological disorder for which medical marijuana has been allowed. Studies for this narrative review were included based on a literature search in PsycINFO, MEDLINE, and Google Scholar. Findings indicate that, for the majority of these conditions, there is insufficient evidence to support the recommendation of medical marijuana at this time. A significant amount of rigorous research is needed to definitively ascertain the potential implications of marijuana for these conditions. It is important for such work to not only examine the effects of smoked marijuana preparations, but also to compare its safety, tolerability, and efficacy in relation to existing pharmacological treatments.

The application of minority stress theory to marijuana use among sexual minority adolescents.

PubMed

Goldbach, Jeremy T; Schrager, Sheree M; Dunlap, Shannon L; Holloway, Ian W

2015-02-01

Previous research indicates that lesbian, gay, and bisexual (LGB) adolescents are at increased risk for substance use, including heightened rates of marijuana use. Minority stress theory suggests that difficult social situations create a state of chronic stress that leads to poor health outcomes for LGB adults; however, the applicability of this model has not been well explored in relation to substance use among LGB adolescents. The current study is a secondary analysis of the OutProud survey, conducted in 2000. The original study used purposive sampling to collect data from 1,911 LGB adolescents (age 12-17) across the United States, and represents the largest known study to explore experiences specific to identifying as LGB, such as homophobia and gay-related victimization. We used structural equation modeling (SEM) to explore the feasibility of applying a minority stress framework to understand marijuana use in this population. The final structural model for marijuana use in the LGB adolescent sample displayed excellent fit and modest explanatory power for marijuana use. Two of the five factors, community connectedness and internalized homophobia, were significantly (p < .05) associated with marijuana use. Findings suggest that minority stress theory may be appropriately applied to marijuana use in this population; however, better measurement of minority stress concepts for LGB adolescents is needed.

Clearing the smoke around medical marijuana.

PubMed

Ware, M A

2011-12-01

The hazy world of "medical marijuana" continues to cry out for clear data on which to base medical decision making and rational policy design. In this issue of Clinical Pharmacology & Therapeutics, Abrams and colleagues report that vaporized cannabis does not meaningfully affect opioid plasma levels and may even augment the efficacy of oxycodone and morphine in patients with chronic non-cancer pain. This Commentary considers the implications of this work for clinical practice and further research initiatives.

Cannabidiol Oil for Decreasing Addictive Use of Marijuana: A Case Report.

PubMed

Shannon, Scott; Opila-Lehman, Janet

2015-12-01

This case study illustrates the use of cannabidiol (CBD) oil to decrease the addictive use of marijuana and provide anxiolytic and sleep benefits. Addiction to marijuana is a chronic, relapsing disorder, which is becoming a prevalent condition in the United States. The most abundant compound in the marijuana, which is called tetrahydrocannabinol (THC), has been widely studied and known for its psychoactive properties. The second most abundant component-CBD-has been suggested to have the medicinal effects of decreasing anxiety, improving sleep, and other neuro-protective effects. The mechanism of action for CBD has been suggested to be antagonistic to the psychoactive properties of THC in many locations within the central nervous system. Such action raises the issue of whether it might be beneficial to use CBD in isolation to facilitate withdrawal of marijuana use. The specific use of CBD for marijuana reduction has not been widely studied. The patient was a 27-y-old male who presented with a long-standing diagnosis of bipolar disorder and a daily addiction to marijuana use. In the described intervention, the only change made to the patient's treatment was the addition of CBD oil with the dosage gradually decreasing from 24 to 18 mg. With use of the CBD oil, the patient reported being less anxious, as well as settling into a regular pattern of sleep. He also indicated that he had not used any marijuana since starting the CBD oil. With the decrease in the dosage to 18 mg, the patient was able to maintain his nonuse of marijuana.

Interactions between THC and cannabidiol in mouse models of cannabinoid activity.

PubMed

Varvel, S A; Wiley, J L; Yang, R; Bridgen, D T; Long, K; Lichtman, A H; Martin, B R

2006-06-01

Interest persists in characterizing potential interactions between Delta(9)-tetrahydocannabinol (THC) and other marijuana constituents such as cannabidiol (CBD). Such interactions may have important implications for understanding the long-term health consequences of chronic marijuana use as well as for attempts to develop therapeutic uses for THC and other CB(1) agonists. We investigated whether CBD may modulate the pharmacological effects of intravenously administered THC or inhaled marijuana smoke on hypoactivity, antinociception, catalepsy, and hypothermia, the well characterized models of cannabinoid activity. Intravenously administered CBD possessed very little activity on its own and, at a dose equal to a maximally effective dose of THC (3 mg/kg), failed to alter THC's effects on any measure. However, higher doses of CBD (ED(50)=7.4 mg/kg) dose-dependently potentiated the antinociceptive effects of a low dose of THC (0.3 mg/kg). Pretreatment with 30 mg/kg CBD, but not 3 mg/kg, significantly elevated THC blood and brain levels. No interactions between THC and CBD were observed in several variations of a marijuana smoke exposure model. Either quantities of CBD were applied directly to marijuana, CBD and THC were both applied to placebo plant material, or mice were pretreated intravenously with 30 mg/kg CBD before being exposed to marijuana smoke. As the amount of CBD found in most marijuana strains in the US is considerably less than that of THC, these results suggest that CBD concentrations relevant to what is normally found in marijuana exert very little, if any, modulatory effects on CB(1)-receptor-mediated pharmacological effects of marijuana smoke.

Effects of prenatal marijuana on visuospatial working memory: an fMRI study in young adults.

PubMed

Smith, Andra M; Fried, Peter A; Hogan, Matthew J; Cameron, Ian

2006-01-01

The long lasting neurophysiological effects of prenatal marijuana exposure on visuospatial working memory were investigated in 18-22 year olds using functional magnetic resonance imaging (fMRI). The participants are members of the Ottawa Prenatal Prospective Study (OPPS), a longitudinal study that provides a unique body of information collected from each participant over 20 years, including prenatal drug history, detailed cognitive/behavioral performance from infancy to young adulthood, and current and past drug usage. This information allowed for the control of potentially confounding drug exposure variables in the statistical analyses. Thirty-one offspring from the OPPS (16 prenatally exposed and 15 nonexposed) performed a visuospatial 2-back task while neural activity was imaged with fMRI. Cognitive performance data were also collected. No significant performance differences were observed when comparing controls versus exposed participants. Multiple regression analyses (including controls with no exposure) revealed that as the amount of prenatal marijuana exposure increased, there was significantly more neural activity in the left inferior and middle frontal gyri, left parahippocampal gyrus, left middle occipital gyrus and left cerebellum. There was also significantly less activity in right inferior and middle frontal gyri. These results suggest that prenatal marijuana exposure alters neural functioning during visuospatial working memory processing in young adulthood.

Effects of Marijuana on Ictal and Interictal EEG Activities in Idiopathic Generalized Epilepsy.

PubMed

Sivakumar, Sanjeev; Zutshi, Deepti; Seraji-Bozorgzad, Navid; Shah, Aashit K

2017-01-01

Marijuana-based treatment for refractory epilepsy shows promise in surveys, case series, and clinical trials. However, literature on their EEG effects is sparse. Our objective is to analyze the effect of marijuana on EEG in a 24-year-old patient with idiopathic generalized epilepsy treated with cannabis. We blindly reviewed 3 long-term EEGs-a 24-hour study while only on antiepileptic drugs, a 72-hour EEG with Cannabis indica smoked on days 1 and 3 in addition to antiepileptic drugs, and a 48-hour EEG with combination C indica/sativa smoked on day 1 plus antiepileptic drugs. Generalized spike-wave discharges and diffuse paroxysmal fast activity were categorized as interictal and ictal, based on duration of less than 10 seconds or greater, respectively. Data from three studies concatenated into contiguous time series, with usage of marijuana modeled as time-dependent discrete variable while interictal and ictal events constituted dependent variables. Analysis of variance as initial test for significance followed by time series analysis using Generalized Autoregressive Conditional Heteroscedasticity model was performed. Statistical significance for lower interictal events (analysis of variance P = 0.001) was seen during C indica use, but not for C indica/sativa mixture (P = 0.629) or ictal events (P = 0.087). However, time series analysis revealed a significant inverse correlation between marijuana use, with interictal (P < 0.0004) and ictal (P = 0.002) event rates. Using a novel approach to EEG data, we demonstrate a decrease in interictal and ictal electrographic events during marijuana use. Larger samples of patients and EEG, with standardized cannabinoid formulation and dosing, are needed to validate our findings.

AN ADDRESS DELIVERED BEFORE SCOPE'S CONFERENCE FOR EDUCATORS ON NARCOTICS AND SMOKING. (TITLE SUPPLIED).

ERIC Educational Resources Information Center

RICE, JULIUS T.

A SHORT HISTORY OF NARCOTICS USAGE IS PRESENTED. THE TERM DRUG DEPENDENCE IS BEING SUBSTITUTED FOR DRUG ADDICTION AND DRUG HABITUATION. THE ADVANTAGES AND DISADVANTAGES OF VARIOUS ANTIDOTES FOR OPIATES ARE DESCRIBED. THE EFFECTS OF LSD AND MARIJUANA ON PHYSICAL AND MENTAL PROCESSES ARE DESCRIBED. THE USE OF LSD FOR MEDICAL PURPOSES IS DISCUSSED.…

The MacAndrew Scale as a Measure of Substance Abuse and Delinquency among Adolescents.

ERIC Educational Resources Information Center

Rathus, Spencer A.; And Others

1980-01-01

Used regression equations to determine the predictive power of the abbreviated MacAndrew Scale of the MMPI-168 on self-reported delinquent behavior of 1,672 high school students. The abbreviated MacAndrew Scale score successfully predicted alcohol abuse but was also related to crimes against property and persons and to marijuana usage. (Author)

Social mediation of persuasive media in adolescent substance prevention.

PubMed

Crano, William D; Alvaro, Eusebio M; Tan, Cara N; Siegel, Jason T

2017-06-01

Social commentary about prevention messages may affect their likelihood of acceptance. To investigate this possibility, student participants (N = 663) viewed 3 antimarijuana advertisements, each followed immediately by videotaped discussions involving 4 adults or 4 adolescents using either extreme or moderate language in their positive commentaries. The commentaries were expected to affect participants' perceptions of the extent to which the ads were designed to control their behavior (perceived control), which was hypothesized to inhibit persuasion. Two indirect effects analyses were conducted. Marijuana attitudes and usage intentions were the outcome variables. Both analyses revealed statistically significant source by language interactions on participants' perceived control (both p < .02). Further analyses revealed significant indirect effects of language extremity on attitudes and intentions through perceived control with adult, but not peer sources (both p < .05). These perceptions were associated with more negative marijuana attitudes and diminished usage intentions when adults used moderate (vs. extreme) language in their favorable ad commentaries (both p < .05). The findings may facilitate development of more effective prevention methods that emphasize the importance of the role of perceived control in persuasion, and the impact of interpersonal communication variations on acceptance of media-transmitted prevention messages. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Therapeutic potential of monoacylglycerol lipase inhibitors.

PubMed

Mulvihill, Melinda M; Nomura, Daniel K

2013-03-19

Marijuana and aspirin have been used for millennia to treat a wide range of maladies including pain and inflammation. Both cannabinoids, like marijuana, that exert anti-inflammatory action through stimulating cannabinoid receptors, and cyclooxygenase (COX) inhibitors, like aspirin, that suppress pro-inflammatory eicosanoid production have shown beneficial outcomes in mouse models of neurodegenerative diseases and cancer. Both cannabinoids and COX inhibitors, however, have untoward effects that discourage their chronic usage, including cognitive deficits and gastrointestinal toxicity, respectively. Recent studies have uncovered that the serine hydrolase monoacylglycerol lipase (MAGL) links the endocannabinoid and eicosanoid systems together through hydrolysis of the endocannabinoid 2-arachidonoylglycerol (2-AG) to provide the major arachidonic acid (AA) precursor pools for pro-inflammatory eicosanoid synthesis in specific tissues. Studies in recent years have shown that MAGL inhibitors elicit anti-nociceptive, anxiolytic, and anti-emetic responses and attenuate precipitated withdrawal symptoms in addiction paradigms through enhancing endocannabinoid signaling. MAGL inhibitors have also been shown to exert anti-inflammatory action in the brain and protect against neurodegeneration through lowering eicosanoid production. In cancer, MAGL inhibitors have been shown to have anti-cancer properties not only through modulating the endocannabinoid-eicosanoid network, but also by controlling fatty acid release for the synthesis of protumorigenic signaling lipids. Thus, MAGL serves as a critical node in simultaneously coordinating multiple lipid signaling pathways in both physiological and disease contexts. This review will discuss the diverse (patho)physiological roles of MAGL and the therapeutic potential of MAGL inhibitors in treating a vast array of complex human diseases. Copyright © 2012 Elsevier Inc. All rights reserved.

Pediatric cannabinoid hyperemesis: two cases.

PubMed

Miller, Joseph B; Walsh, Mark; Patel, Pankaj A; Rogan, Michael; Arnold, Cliff; Maloney, Megan; Donnino, Michael

2010-12-01

Cannabinoid hyperemesis has recently been described in the literature. It is a syndrome characterized by severe nausea and hyperemesis in the setting of chronic marijuana abuse and, to date, has been described only in adults. We describe the syndrome in 2 pediatric patients, for whom extensive gastrointestinal workups failed to identify a clear cause and cessation of marijuana use resulted in the alleviation of their symptoms. As in most published adult cases, compulsive bathing was present in both of these cases.

Multiple Cerebral Infarcts in a Young Patient Associated With Marijuana Use.

PubMed

Volpon, Leila Costa; Sousa, Camila Lacerda Muniz de Melo; Moreira, Silvia Keiko Kavaguti; Teixeira, Sara Reis; Carlotti, Ana Paula de Carvalho Panzeri

: Cerebrovascular events associated with marijuana use have been reported previously. This association is plausible, but not well-established yet. A 14-year-old girl, long-term heavy cannabis user, presented with generalized tonic-clonic seizures and decreased level of consciousness a few hours after smoking cannabis. Brain magnetic resonance imaging showed multiple areas of acute, subacute and chronic ischemic lesions in the left frontal lobe, basal ganglia, and corpus callosum. History of other illicit drug use and other known causes of stroke were ruled out. Cannabis might cause stroke through direct effects on the cerebral blood circulation, orthostatic hypotension, vasculitis, vasospasm, and atrial fibrillation. Long-term daily use of marijuana in young people may cause serious damage to the cerebrovascular system.

Marijuana Use and Achievement of Abstinence from Alcohol and Other Drugs among People with Substance Dependence: A Prospective Cohort Study

PubMed Central

Mojarrad, Mohammadali; Samet, Jeffrey H; Cheng, Debbie M.; Winter, Michael R.; Saitz, Richard

2014-01-01

Background Many with alcohol and other drug dependence have concurrent marijuana use, yet it is not clear how to address it during addiction treatment. This is partially due to the lack of clarity about whether marijuana use impacts one’s ability to achieve abstinence from the target of addiction treatment. We examined the association between marijuana use and abstinence from other substances among individuals with substance dependence. Methods A secondary analysis of the Addiction Health Evaluation And Disease management study, a randomized trial testing the effectiveness of chronic disease management. Individuals met criteria for drug or alcohol dependence and reported recent drug (i.e. opioid or stimulant) or heavy alcohol use. Recruitment occurred at an inpatient detoxification unit, and all participants were referred to primary medical care. The association between marijuana use and later abstinence from drug and heavy alcohol use was assessed using longitudinal multivariable models. Results Of 563 study participants, 98% completed at least one follow-up assessment and 535 (95%) had at least one pair of consecutive assessments and were included. In adjusted analyses, marijuana use was associated with a 27% reduction in the odds of abstinence from drug and heavy alcohol use (adjusted odds ratio 0.73 [95% CI, 0.56–0.97], P=0.03). Conclusions Marijuana use among individuals with alcohol or other drug dependence is associated with a lower odds of achieving abstinence from drug and heavy alcohol use. These findings add evidence that suggests concomitant marijuana use among patients with addiction to other drugs merits attention from clinicians. PMID:24986785

The Relationship Between Marijuana Use and Intimate Partner Violence in a Nationally Representative, Longitudinal Sample

PubMed Central

Reingle, Jennifer M.; Staras, Stephanie A. S.; Jennings, Wesley G.; Branchini, Jennifer; Maldonado-Molina, Mildred M.

2013-01-01

Intimate partner violence is a significant public health problem, as these behaviors have been associated with a number of negative health outcomes including illicit drug use, physical injury, chronic pain, sexually transmitted diseases, depression, and posttraumatic stress disorder. The current study examined the association between marijuana use and intimate partner violence using a longitudinal survey of adolescents and young adults ages 15 to 26 years. Data were obtained from 9,421 adolescents in the National Longitudinal Study of Adolescent Health (Add Health) Waves 1 through 4 (1995–2008). Marijuana use was measured in the past year at each wave and participants were categorized as “users” or “nonusers.” Partner violence was constructed using six items (three pertaining to victimization and three concerning perpetration) from Wave 4 (2007–2008). Using these six items, participants were categorized as “victims only,” “perpetrators only,” or “victims and perpetrators.” Survey multinomial regression was used to examine the relationship between marijuana use and intimate partner violence. Consistent use of marijuana during adolescence was most predictive of intimate partner violence (OR = 2.08, p < .001). Consistent marijuana use (OR = 1.85, p < .05) was related to an increased risk of intimate partner violence perpetration. Adolescent marijuana use, particularly consistent use throughout adolescence, is associated with perpetration or both perpetration of and victimization by intimate partner violence in early adulthood. These findings have implications for intimate partner violence prevention efforts, as marijuana use should be considered as a target of early intimate partner violence intervention and treatment programming. PMID:22080574

Medical Marijuana: Just the Beginning of a Long, Strange Trip?

PubMed

Ciccone, Charles D

2017-02-01

Medical marijuana continues to gain acceptance and become legalized in many states. Various species of the marijuana plant have been cultivated, and this plant can contain up to 100 active compounds known as cannabinoids. Two cannabinoids seem the most clinically relevant: Δ9-tetrahydrocannabinol (THC), which tends to produce the psychotropic effects commonly associated with marijuana, and cannabidiol (CBD), which may produce therapeutic effects without appreciable psychoactive properties. Smoking marijuana, or ingesting extracts from the whole plant orally (in baked goods, teas, and so forth), introduces variable amounts of THC, CBD, and other minor cannabinoids into the systemic circulation, where they ultimately reach the central and peripheral nervous systems. Alternatively, products containing THC, CBD, or a combination of both compounds, can be ingested as oral tablets or via sprays applied to the oral mucosal membranes. These products may provide a more predictable method for delivering a known amount of specific cannabinoids into the body. Although there is still a need for randomized controlled trials, preliminary studies have suggested that medical marijuana and related cannabinoids may be beneficial in treating people with chronic pain, inflammation, spasticity, and other conditions seen commonly in physical therapist practice. Physical therapists, therefore, should be aware of the options that are available for patients considering medical marijuana and should be ready to provide information for these patients. Clinicians also should be aware that marijuana can produce untoward effects on cognition, coordination, balance, and cardiovascular and pulmonary function and should be vigilant for any problems that may arise if patients are using cannabinoids during physical rehabilitation. © 2017 American Physical Therapy Association.

Characterizing the Followers and Tweets of a Marijuana-Focused Twitter Handle

PubMed Central

Krauss, Melissa; Grucza, Richard; Bierut, Laura

2014-01-01

Background Twitter is a popular social media forum for sharing personal experiences, interests, and opinions. An improved understanding of the discourse on Twitter that encourages marijuana use can be helpful for tailoring and targeting online and offline prevention messages. Objectives The intent of the study was to assess the content of “tweets” and the demographics of followers of a popular pro-marijuana Twitter handle (@stillblazingtho). Methods We assessed the sentiment and content of tweets (sent from May 1 to December 31, 2013), as well as the demographics of consumers that follow a popular pro-marijuana Twitter handle (approximately 1,000,000 followers) using Twitter analytics from Demographics Pro. This analytics company estimates demographic characteristics based on Twitter behavior/usage, relying on multiple data signals from networks, consumption, and language and requires confidence of 95% or above to make an estimate of a single demographic characteristic. Results A total of 2590 tweets were sent from @stillblazingtho during the 8-month period and 305 (11.78%) replies to another Twitter user were excluded for qualitative analysis. Of the remaining 2285 tweets, 1875 (82.06%) were positive about marijuana, 403 (17.64%) were neutral, and 7 (0.31%) appeared negative about marijuana. Approximately 1101 (58.72%) of the positive marijuana tweets were perceived as jokes or humorous, 340 (18.13%) implied that marijuana helps you to feel good or relax, 294 (15.68%) mentioned routine, frequent, or heavy use, 193 (10.29%) mentioned blunts, marijuana edibles, or paraphernalia (eg, bongs, vaporizers), and 186 (9.92%) mentioned other risky health behaviors (eg, tobacco, alcohol, other drugs, sex). The majority (699,103/959,143; 72.89%) of @stillblazingtho followers were 19 years old or younger. Among people ages 17 to 19 years, @stillblazingtho was in the top 10% of all Twitter handles followed. More followers of @stillblazingtho in the United States were African American (323,107/759,407; 42.55%) or Hispanic (90,732/759,407; 11.95%) than the Twitter median average (African American 22.4%, inter-quartile ratio [IQR] 5.1-62.5%; Hispanic 5.4%, IQR 3.0-10.8%) and among Hispanics, @stillblazingtho was in the top 30% of all Twitter handles followed. Conclusions Young people are especially responsive to social media influences and often establish substance use patterns during this phase of development. Our findings underscore the need for surveillance efforts to monitor the pro-marijuana content reaching young people on Twitter. PMID:24974893

Characterizing the followers and tweets of a marijuana-focused Twitter handle.

PubMed

Cavazos-Rehg, Patricia; Krauss, Melissa; Grucza, Richard; Bierut, Laura

2014-06-27

Twitter is a popular social media forum for sharing personal experiences, interests, and opinions. An improved understanding of the discourse on Twitter that encourages marijuana use can be helpful for tailoring and targeting online and offline prevention messages. The intent of the study was to assess the content of "tweets" and the demographics of followers of a popular pro-marijuana Twitter handle (@stillblazingtho). We assessed the sentiment and content of tweets (sent from May 1 to December 31, 2013), as well as the demographics of consumers that follow a popular pro-marijuana Twitter handle (approximately 1,000,000 followers) using Twitter analytics from Demographics Pro. This analytics company estimates demographic characteristics based on Twitter behavior/usage, relying on multiple data signals from networks, consumption, and language and requires confidence of 95% or above to make an estimate of a single demographic characteristic. A total of 2590 tweets were sent from @stillblazingtho during the 8-month period and 305 (11.78%) replies to another Twitter user were excluded for qualitative analysis. Of the remaining 2285 tweets, 1875 (82.06%) were positive about marijuana, 403 (17.64%) were neutral, and 7 (0.31%) appeared negative about marijuana. Approximately 1101 (58.72%) of the positive marijuana tweets were perceived as jokes or humorous, 340 (18.13%) implied that marijuana helps you to feel good or relax, 294 (15.68%) mentioned routine, frequent, or heavy use, 193 (10.29%) mentioned blunts, marijuana edibles, or paraphernalia (eg, bongs, vaporizers), and 186 (9.92%) mentioned other risky health behaviors (eg, tobacco, alcohol, other drugs, sex). The majority (699,103/959,143; 72.89%) of @stillblazingtho followers were 19 years old or younger. Among people ages 17 to 19 years, @stillblazingtho was in the top 10% of all Twitter handles followed. More followers of @stillblazingtho in the United States were African American (323,107/759,407; 42.55%) or Hispanic (90,732/759,407; 11.95%) than the Twitter median average (African American 22.4%, inter-quartile ratio [IQR] 5.1-62.5%; Hispanic 5.4%, IQR 3.0-10.8%) and among Hispanics, @stillblazingtho was in the top 30% of all Twitter handles followed. Young people are especially responsive to social media influences and often establish substance use patterns during this phase of development. Our findings underscore the need for surveillance efforts to monitor the pro-marijuana content reaching young people on Twitter.

Trajectories of Marijuana Use During the Transition to Adulthood: The Big Picture Based on National Panel Data

PubMed Central

Schulenberg, John E.; Merline, Alicia C.; Johnston, Lloyd D.; O'Malley, Patrick M.; Bachman, Jerald G.; Laetz, Virginia B.

2005-01-01

The purposes of this study were to: a) identify trajectory groups of frequent marijuana use during emerging adulthood, b) distinguish among trajectory groups according to demographic and lifestyle characteristics, and c) examine how the trajectory groups relate to behavioral, attitudinal, and social-emotional correlates over time. National panel data from the Monitoring the Future study were used: 18 cohorts of high school seniors (classes of 1977-94) were followed biennially through age 24. Frequent marijuana use was defined as 3+ occasions of use in past month and/or 20 to 40+ occasions in past year. Based on four waves of complete longitudinal data (N=19,952), six frequent marijuana use trajectory groups were identified: chronic, decreased, increased, fling, rare, and abstain. Categorical analyses revealed trajectory group differences in demographic and lifestyle characteristics at senior year and age 24. The trajectory groups varied significantly in longitudinal patterns of other substance use, problem behaviors, and well-being. PMID:16534532

Infertility and Women

MedlinePlus

... alcohol, or using recreational drugs like cocaine and marijuana • certain medications like antidepressants, tranquilizers, calcium channel blockers, narcotics, and anti-cancer drugs • chronic medical conditions like kidney disease, liver disease, sickle cell ...

Medical use of cannabis products: Lessons to be learned from Israel and Canada.

PubMed

Ablin, J; Ste-Marie, P A; Schäfer, M; Häuser, W; Fitzcharles, M-A

2016-02-01

The German government intends to reduce the barriers for the medical use of cannabis products. A discussion on the indications and contraindications of the medical use of cannabis and on the changes of the regulatory framework has already begun in Germany. It is useful to draw from the experiences of other countries with a more liberal medical use of cannabis. The Israeli and Canadian experience is outlined by physicians who have been charged with expertise on the medical use of cannabis by their jurisdiction. In Israel, only the plant-based cannabinoid nabiximol (mixture of tetrahydrocannabinol/cannabidiol) can be prescribed for spasticity/chronic pain in multiple sclerosis and for cancer pain. The costs of nabiximole are reimbursed by some, but not by all health maintenance organizations. The medical use of marijuana is permitted; however, it is strictly regulated by the government. Selected companies are allowed to produce marijuana for medical use, and only certain physicians are licensed to prescribe marijuana as a therapeutic drug for specific indications such as chronic neuropathic, and cancer pain, inflammatory bowel diseases, or posttraumatic stress disorder if conventional treatments have failed. The costs of marijuana are not reimbursed by health insurance companies. In Canada, synthetic cannabinoids and the plant-based (nabiximol) are licensed for neuropathic and cancer pain, HIV-related anorexia and chemotherapy-associate nausea. The costs of these synthetic cannabinoids are covered by health insurance companies. The medical use of marijuana as a treatment option is allowed for individual patients suffering from any medical condition when authorized by a medical practitioner or nurse. Licensed producers are the only source for patients to newly access medical cannabis, although those with previous permission to grow may continue cultivation at the present time. The costs of marijuana are not reimbursed by health insurance companies. There are multiple contraindications for the medical use of cannabis products in both countries. The use of standardized, synthetic, and plant-based cannabis products should be allowed in Germany for defined medical conditions when high-level evidence of efficacy and safety exists. The costs should be reimbursed by the health insurance companies. Contraindications for the medical use of cannabis should be defined. Growing marijuana by patients for their medical use should not be allowed.

Autophagy activation by novel inducers prevents BECN2-mediated drug tolerance to cannabinoids

PubMed Central

Kuramoto, Kenta; Wang, Nan; Fan, Yuying; Zhang, Weiran; Schoenen, Frank J.; Frankowski, Kevin J.; Marugan, Juan; Zhou, Yifa; Huang, Sui; He, Congcong

2016-01-01

ABSTRACT Cannabinoids and related drugs generate profound behavioral effects (such as analgesic effects) through activating CNR1 (cannabinoid receptor 1 [brain]). However, repeated cannabinoid administration triggers lysosomal degradation of the receptor and rapid development of drug tolerance, limiting the medical use of marijuana in chronic diseases. The pathogenic mechanisms of cannabinoid tolerance are not fully understood, and little is known about its prevention. Here we show that a protein involved in macroautophagy/autophagy (a conserved lysosomal degradation pathway), BECN2 (beclin 2), mediates cannabinoid tolerance by preventing CNR1 recycling and resensitization after prolonged agonist exposure, and deletion of Becn2 rescues CNR1 activity in mouse brain and conveys resistance to analgesic tolerance to chronic cannabinoids. To target BECN2 therapeutically, we established a competitive recruitment model of BECN2 and identified novel synthetic, natural or physiological stimuli of autophagy that sequester BECN2 from its binding with GPRASP1, a receptor protein for CNR1 degradation. Co-administration of these autophagy inducers effectively restores the level and signaling of brain CNR1 and protects mice from developing tolerance to repeated cannabinoid usage. Overall, our findings demonstrate the functional link among autophagy, receptor signaling and animal behavior regulated by psychoactive drugs, and develop a new strategy to prevent tolerance and improve medical efficacy of cannabinoids by modulating the BECN2 interactome and autophagy activity. PMID:27305347

Electrophysiological evidence of early attentional bias to drug-related pictures in chronic cannabis users.

PubMed

Asmaro, Deyar; Carolan, Patrick L; Liotti, Mario

2014-01-01

Behavioral and electrophysiological correlates of attentional bias to cannabis-related cues were investigated in a marijuana dependent group and a non-user group employing a drug Stroop task in which cannabis-related, negative and neutral images were presented. Behaviorally, cannabis users were less accurate during drug-containing blocks than non-users. Electrophysiologically, in chronic marijuana-users, an early positive ERP enhancement over left frontal scalp (EAP, 200-350ms) was present in response to drug-containing blocks relative to negative blocks. This effect was absent in the non-user group. Furthermore, drug-containing blocks gave rise to enhanced voltage of a posterior P300 (300-400ms), and a posterior sustained slow wave (LPP, 400-700ms) relative to negative blocks. However, such effects were similar between cannabis users and non-users. Brain source imaging in cannabis users revealed a generator for the EAP effect to drug stimuli in left ventromedial prefrontal cortex/medial orbitofrontal cortex, a region active in fMRI studies of drug cue-reactivity and a target of the core dopaminergic mesolimbic pathway involved in the processing of substances of abuse. This study identifies the timing and brain localization of an ERP correlate of early attentional capture to drug-related pictures in chronic marijuana users. The EAP to drug cues may identify a new electrophysiological marker with clinical implications for predicting abstinence versus relapse or to evaluate treatment interventions. © 2013.

Dental treatment planning considerations for patients using cannabis: A case report.

PubMed

Grafton, Sarah Essek; Huang, Po Ning; Vieira, Alexandre R

2016-05-01

There is a deficit in clinical research on the potential risks involved in treating dental patients who use cannabis for either medicinal or recreational purposes. The aim of this case report is to illustrate the need for additional education for oral health care professionals so they can understand the wide variety of available cannabis options and their potential effects on dental treatment. A 27-year-old man sought care at the dental clinic with a nonrestorable molar requiring extraction. During the review of his medical history, the patient reported taking a "dab" of marijuana approximately 5 hours before his appointment. Because of the admission of recent illicit drug use, no treatment was rendered. The patient was offered an appointment the next day but he refused, citing bias in regard to his cannabis use. The number of Americans using marijuana is increasing rapidly. Twenty-three states and the District of Columbia have laws legalizing cannabis to some degree, and Alaska, Colorado, Oregon, and Washington have legalized marijuana for recreational use. This drastic upswing in availability and usage will require dentists to address the possible effects of cannabis on dental practices. It is imperative that dental care providers make clinical decisions based on scientific evidence regarding the pharmacologic and psychological effects of marijuana, not on the societal stigma associated with illegal drug use. Dentists should be familiar with popular delivery systems and understand the differences between various marijuana options. Clinical guidelines may need to be developed to help providers assess the patient's degree of cognitive impairment. Dentists should be able to advise patients on the potential consequences of this habit on their oral health. Copyright © 2016 American Dental Association. Published by Elsevier Inc. All rights reserved.

Information Sharing and Interoperability in Law Enforcement: An Investigation of Federal Criminal Justice Information Systems Use by State/Local Law Enforcement Organizations

DTIC Science & Technology

2003-04-09

reduction, marijuana eradication, mobile enforcement teams, and the Organized Crime Drug Enforcement Task Force. The DEA also operates eight laboratories...Owens’ Columbine Review Commission. Denver , CO: State of Colorado . Council on Foreign Relations. 2002. FBI and Law Enforcement. Washington DC...results of this research indicate high usage and perceived usefulness of the National Crime Information Center Network (NCIC Net), National Law

Therapeutic Benefit of Smoked Cannabis in Randomized Placebo-Controlled Studies.

PubMed

Bowen, Lynneice L; McRae-Clark, Aimee L

2018-01-01

The medicinal use of marijuana has been legalized in 28 states, with a wide range of specificity for approved medical conditions. Even with the emergence of non-combustion-based delivery systems, 90% of marijuana users in 2014 used smoked marijuana. This review summarizes the data available on the use of smoked marijuana for medical purposes. A literature search was performed to retrieve randomized controlled trials exploring the efficacy of smoked cannabis for treatment of a medical condition. Studies with the primary end point listed as the effect of smoked cannabis on a disease-specific characteristic were included. Open-label studies and studies using other administration methods were excluded. Seven studies met these criteria and were included in this review. Cannabis did not outperform placebo on experimentally evoked pain or the timed walk test. Clear evidence indicates that smoked cannabis reduces intraocular pressure, but the effect is too brief (less than 4 hrs) to be of therapeutic benefit for this chronic disorder. Consistent evidence also showed that smoked marijuana, even at lower concentrations of tetrahydrocannabinol, increased total daily calorie intake and number of eating occasions. Neither of the studies with quality of life as secondary outcome measures revealed statistically significantly improved outcomes with cannabis use. © 2017 Pharmacotherapy Publications, Inc.

Drug and Substance Abuse

MedlinePlus

... Some older adults also abuse illegal drugs, including marijuana, cocaine, hallucinogens, and injected narcotics. Some people misuse more than one substance. Many older adults who become addicted to drugs also have another serious medical condition, such as chronic pain or a mental ...

Attitudes Toward Medical Cannabis Legalization Among Serbian Medical Students.

PubMed

Vujcic, Isidora; Pavlovic, Aleksandar; Dubljanin, Eleonora; Maksimovic, Jadranka; Nikolic, Aleksandra; Sipetic-Grujicic, Sandra

2017-07-29

Currently, medical cannabis polices are experiencing rapid changes, and an increasing number of nations around the world legalize medical cannabis for certain groups of patients, including those in Serbia. To determine medical students' attitudes toward medical cannabis legalization and to examine the factors influencing their attitudes. Fourth-year medical students at the Faculty of Medicine, University of Belgrade, had participated in a cross-sectional study. Data were collected by an anonymous questionnaire. Overall, 63.4% students supported medical cannabis legalization, and only 20.8% supported its legalization for recreational use. Students who previously used marijuana (p <.001) and alcohol (p =.004) were significantly more in favor of medical cannabis legalization compared with students who never used them. Support for marijuana recreational use was also related to prior marijuana (p <.001) and alcohol consumption (p =.006). Only cancer (90.4%) and chronic pain (74.2%) were correctly reported approved medical indications by more than half the students. Students who supported medical cannabis legalization showed better knowledge about indications, in contrast to opponents for legalization who showed better knowledge about side effects. Beliefs that using medical cannabis is safe and has health benefits were correlated with support for legalization, and previous marijuana and alcohol use, while beliefs that medical cannabis poses health risks correlated most strongly with previous marijuana use. Conclusions/Importance: The medical students' attitudes toward medical cannabis legalization were significantly correlated with previous use of marijuana and alcohol, knowledge about medical indications and side effects, and their beliefs regarding medical cannabis health benefits and risks.

A survey of cannabis (marijuana) use and self-reported benefit in men with chronic prostatitis/chronic pelvic pain syndrome.

PubMed

Tripp, Dean A; Nickel, J Curtis; Katz, Laura; Krsmanovic, Adrijana; Ware, Mark A; Santor, Darcy

2014-11-01

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a chronic pelvic pain condition largely refractory to treatment. Cannabis (marijuana) use has been reported for a wide variety of chronic pain conditions, but no study has examined prevalence of cannabis use, symptom benefit or side effects, or frequency in CP/CPPS. Participants were recruited from an outpatient CP/CPPS urology clinic (n = 98) and online through the Prostatitis Foundation website (n = 244). Participants completed questionnaires (demographics, CP/CPPS, depression, cannabis). The clinic sample included Canadian patients and the online sample included primarily American patients. Due to differences, groups were examined separately. Almost 50% of respondents reported using cannabis (clinic n = 49; online n = 89). Of the cannabis users, 36.8% of clinic and 75% of online respondents reported that it improved their symptoms. Most of the respondents (from the clinic and online groups) reported that cannabis improved their mood, pain, muscle spasms, and sleep. However, they did not note any improvements for weakness, fatigue, numbness, ambulation, and urination. Overall, the effectiveness of cannabis for CP/CPPS was "somewhat/very effective" (57% clinic; 63% online). There were no differences between side effects or choice of consumption and most reported using cannabis rarely. These are the first estimates in men suffering from CP/CPPS and suggest that while cannabis use is prevalent, its medical use and benefit are unknown. This is an understudied area and the benefit or hazard for cannabis use awaits further study.

Working memory subsystems are impaired in chronic drug dependents.

PubMed

Soliman, Abdrabo Moghazy; Gadelrab, Hesham Fathy; Elfar, Rania Mohamed

2013-06-01

A large body of research that has investigated substance dependence and working memory (WM) resources, yet no prior study has used a comprehensive test battery to examine the impact of chronic drug dependence on WM as a multi-component system. This study examined the efficiency of several WM components in participants who were chronic drug dependents. In addition, the functioning of the four WM components was compared among dependents of various types of drugs. In total, 128 chronic drug dependents participated in this study. Their average age was 38.48 years, and they were classified into four drug-dependence groups. Chronic drug dependents were compared with a 36-participant control group that had a mean age of 37.6 years. A WM test battery that comprised eight tests and that assessed each of four WM components was administered to each participant. Compared with the control group, all four groups of drug dependents had significantly poorer test performance on all of the WM tasks. Among the four groups of drug users, the polydrug group had the poorest performance scores on each of the eight tasks, and the performance scores of the marijuana group were the least affected. Finally, the forward digit span task and the logical memory tasks were less sensitive than other tasks when differentiating between marijuana users and the normal participants. The four components of WM are impaired among chronic drug dependents. These results have implications for the development of tools, classification methods and therapeutic strategies for drug dependents.

The drug-use patterns of helping-profession students in Brisbane, Australia.

PubMed

Engs, R C

1980-10-01

A survey of 1691 first-and final-year students in the helping professions (medicine, law, nursing, pharmacy, police science, seminary, social work/ psychology, and teaching) as to their use of drugs was carried out during February to April, 1980, in Brisbane, Australia. The results indicated that about 86% drank coffee or tea, 85% drank alcohol, 85% used non-prescription analgesics, 31% used tobacco, 25% antihistamines, 9% marijuana, 9% sedatives, 6% tranquilizers, 2% hallucinogens, 2% stimulants, 1% cocaine and 1% used opiates at least once a year. Of these students, females used analgesics and antihistamines significantly more frequently than males and consumed more caffeine, tobacco and analgesics than males, while males drank significantly more alcohol than females. Final-year students used more alcohol, coffee or tea and tobacco, and used marijuana, coffee and tea and tobacco significantly more frequently than first-year students. Individuals who did not consider religion important used more alcohol and tobacco and used marijuana, tobacco and hallucinogens more frequently compared to individuals who considered religion to be important. There was also a significant difference in drug usage between the different courses of study for most of the substances, with law students using the majority of substances the most frequently and seminarians the least frequently.

Prenatal cannabis exposure - The "first hit" to the endocannabinoid system.

PubMed

Richardson, Kimberlei A; Hester, Allison K; McLemore, Gabrielle L

As more states and countries legalize medical and/or adult recreational marijuana use, the incidences of prenatal cannabis exposure (PCE) will likely increase. While young people increasingly view marijuana as innocuous, marijuana preparations have been growing in potency in recent years, potentially creating global clinical, public health, and workforce concerns. Unlike fetal alcohol spectrum disorder, there is no phenotypic syndrome associated with PCE. There is also no preponderance of evidence that PCE causes lifelong cognitive, behavioral, or functional abnormalities, and/or susceptibility to subsequent addiction. However, there is compelling circumstantial evidence, based on the principles of teratology and fetal malprogramming, suggesting that pregnant women should refrain from smoking marijuana. The usage of marijuana during pregnancy perturbs the fetal endogenous cannabinoid signaling system (ECSS), which is present and active from the early embryonic stage, modulating neurodevelopment and continuing this role into adulthood. The ECSS is present in virtually every brain structure and organ system, and there is also evidence that this system is important in the regulation of cardiovascular processes. Endocannabinoids (eCBs) undergird a broad spectrum of processes, including the early stages of fetal neurodevelopment and uterine implantation. Delta-9-tetrahydrocannabinol (THC), the psychoactive chemical in cannabis, enters maternal circulation, and readily crosses the placental membrane. THC binds to CB receptors of the fetal ECSS, altering neurodevelopment and possibly rewiring ECSS circuitry. In this review, we discuss the Double-Hit Hypothesis as it relates to PCE. We contend that PCE, similar to a neurodevelopmental teratogen, delivers the first hit to the ECSS, which is compromised in such a way that a second hit (i.e., postnatal stressors) will precipitate the emergence of a specific phenotype. In summary, we conclude that perturbations of the intrauterine milieu via the introduction of exogenous CBs alter the fetal ECSS, predisposing the offspring to abnormalities in cognition and altered emotionality. Based on recent experimental evidence that we will review here, we argue that young women who become pregnant should immediately take a "pregnant pause" from using marijuana. Copyright © 2016 Elsevier Inc. All rights reserved.

Neurocognitive Correlates of White Matter Quality in Adolescent Substance Users

ERIC Educational Resources Information Center

Bava, Sunita; Jacobus, Joanna; Mahmood, Omar; Yang, Tony T.; Tapert, Susan F.

2010-01-01

Background: Progressive myelination during adolescence implicates an increased vulnerability to neurotoxic substances and enduring neurocognitive consequences. This study examined the cognitive manifestations of altered white matter microstructure in chronic marijuana and alcohol-using (MJ + ALC) adolescents. Methods: Thirty-six MJ + ALC…

Abnormal cerebellar morphometry in abstinent adolescent marijuana users

PubMed Central

Medina, Krista Lisdahl; Nagel, Bonnie J.; Tapert, Susan F.

2010-01-01

Background Functional neuroimaging data from adults have, in general, found frontocerebellar dysfunction associated with acute and chronic marijuana (MJ) use (Loeber & Yurgelun-Todd, 1999). One structural neuroimaging study found reduced cerebellar vermis volume in young adult MJ users with a history of heavy polysubstance use (Aasly et al., 1993). The goal of this study was to characterize cerebellar volume in adolescent chronic MJ users following one month of monitored abstinence. Method Participants were MJ users (n=16) and controls (n=16) aged 16-18 years. Extensive exclusionary criteria included history of psychiatric or neurologic disorders. Drug use history, neuropsychological data, and structural brain scans were collected after 28 days of monitored abstinence. Trained research staff defined cerebellar volumes (including three cerebellar vermis lobes and both cerebellar hemispheres) on high-resolution T1-weighted magnetic resonance images. Results Adolescent MJ users demonstrated significantly larger inferior posterior (lobules VIII-X) vermis volume (p<.009) than controls, above and beyond effects of lifetime alcohol and other drug use, gender, and intracranial volume. Larger vermis volumes were associated with poorer executive functioning (p’s<.05). Conclusions Following one month of abstinence, adolescent MJ users had significantly larger posterior cerebellar vermis volumes than non-using controls. These greater volumes are suggested to be pathological based on linkage to poorer executive functioning. Longitudinal studies are needed to examine typical cerebellar development during adolescence and the influence of marijuana use. PMID:20413277

Understanding Patients' Process to Use Medical Marijuana: A Southern New Jersey Community Engagement Project.

PubMed

Crowell, Tara L

2016-09-01

Given the necessity to better understand the process patients need to go through in order to seek treatment via medical marijuana, this study investigates this process to better understand this phenomenon. Specifically, Compassion Care Foundation (CCF) and Stockton University worked together to identify a solution to this problem. Specifically, 240 new patients at CCF were asked to complete a 1-page survey regarding various aspects associated with their experience prior to their use of medicinal marijuana-diagnosis, what prompted them to seek treatment, level of satisfaction with specific stages in the process, total length of time the process took, and patient's level of pain. Results reveal numerous patient diagnoses for which medical marijuana is being prescribed; the top 4 most common are intractable skeletal spasticity, chronic and severe pain, multiple sclerosis, and inflammatory bowel disease. Next, results indicate a little over half of the patients were first prompted to seek alternative treatment from their physicians, while the remaining patients indicated that other sources such as written information along with friends, relatives, media, and the Internet persuaded them to seek treatment. These data indicate that a variety of sources play a role in prompting patients to seek alternative treatment and is a critical first step in this process. Additional results posit that once patients began the process of qualifying to receive medical marijuana as treatment, the process seemed more positive even though it takes patients on average almost 6 months to obtain their first treatment after they started the process. Finally, results indicate that patients are reporting a moderately high level of pain prior to treatment. Implication of these results highlights several important elements in the patients' initial steps toward seeking medical marijuana, along with the quality and quantity of the process patients must engage in prior to obtaining treatment. In addition, identifying patients' level of pain and better understanding the possible therapeutic value of medical marijuana are essential to patients and health practitioners.

THE SUBJECTIVE PSYCHOACTIVE EFFECTS OF ORAL DRONABINOL STUDIED IN A RANDOMIZED, CONTROLLED CROSSOVER CLINICAL TRIAL FOR PAIN

PubMed Central

Issa, Mohammed A.; Narang, Sanjeet; Jamison, Robert N.; Michna, Edward; Edwards, Robert R.; Penetar, David M.; Wasan, Ajay D.

2014-01-01

Background Many cannabinoid medications are approved in North America or in Phase III trials, such as Dronabinol, Nabilone, or Nabiximols. Little is known about their subjective psychoactive effects when used for pain management. We hypothesized that when used for pain, dronabinol has psychoactive effects in a dose response relationship, whose peak effects are comparable to smoking marijuana. Methods With IRB approval and written consent, this was a randomized controlled trial of single dose placebo, 10 or 20 mg dronabinol in 30 chronic non-cancer pain patients taking opioids and not using marijuana. Hourly, for 8 hours during 3 monitored sessions, subjects completed the Addiction Research Center Inventory (ARCI). Comparison sample was the ARCI ratings in a study population with no pain (N=20), monitored every 30 minutes after smoking a 1.99% THC (low) and a 3.51% (high strength) marijuana cigarette. Results The 10 and 20 mg dronabinol doses had significantly elevated scores on 4/5 subscales vs. placebo over time (p<.05). Average daily morphine use, total pain relief (TOTPAR), age, gender, and baseline pain level were not significant covariates. ARCI peak effects at 2 hours were similar to peak effects of smoked marijuana at 30 minutes (p=.80, 10 mg=low, 20 mg=high strength). Conclusions In pain patients, oral dronabinol has similar psychoactive effects to smoking marijuana. This risk must be considered in any decision to prescribe cannabinoid medications for pain. PMID:24281276

Marijuana use trajectories among drug-using youth presenting to an urban emergency department: Violence and social influences

PubMed Central

Walton, Maureen A.; Epstein-Ngo, Quyen; Carter, Patrick M.; Zimmerman, Marc A.; Blow, Frederic C.; Buu, Anne; Goldstick, Jason; Cunningham, Rebecca M.

2017-01-01

Aims This paper examined longitudinal marijuana use trajectories among drug-using youth presenting to the ED to inform intervention development. Methods Given interest in substance use and violence, this study oversampled those presenting with assault injuries. Assault-injured youth (ages 14-24) endorsing past 6-month drug use (n=349), and a sex and age proportionally-sampled comparison group (n=250) endorsing drug use, completed a baseline assessment and follow-ups at 6, 12, 18, and 24 months. Latent class trajectory analyses examined days of marijuana use over 2 years. Multinomial regression analyses examined baseline, 12-month and 24-month factors associated with substance use trajectory groups. Results Trajectory analyses identified 5 groups: Low (Low; 28.2%; n=169); Intermittent (INT; 16.2%; n=97); Moderate Decline (MD; 12.0%; n=72); High decline (HD, 13.2%; n=79) and Chronic (C; 30.4%; n=182). At baseline, as compared to the Low group, the other trajectory groups were more likely to be male and have greater levels of physical aggression. At 12- and 24-months, negative and positive peer influences, incarceration and community violence were additional characteristics associated with the greater marijuana use trajectories (as compared to the Low group). Conclusions Interventions for drug-using youth presenting to the urban ED should address peer influences, physical aggression and community violence exposure, given the association between these characteristics and greater marijuana use trajectories. PMID:28219802

Psychological Functioning of Women Taking Illicit Drugs during Pregnancy and the Growth and Development of Their Offspring in Early Childhood.

PubMed

Serino, Dana; Peterson, Bradley S; Rosen, Tove S

2018-04-25

Assess psychosocial history and psychological functioning in women who use drugs during pregnancy and determine how drug exposure affects child development. Pregnant marijuana (n = 38), cocaine (n = 35), methadone-maintained (n = 24), and control (n = 49) group women were enrolled and followed every 6 months through 18-24 months postnatally. There was a significantly higher incidence of mental illness in mothers in the drug groups. Prenatal stress and late-term drug severity scores were significantly higher in the cocaine and methadone mothers, who were also more likely to have abuse and incarceration histories. At 12 months, there were significantly higher rates of drug use in the marijuana group. Anxiety scores were highest in the methadone group. At 18-24 months, the methadone group reported significantly more stress, and methadone and marijuana groups had significantly higher anxiety and depression scores. At birth, methadone and marijuana neonates had significantly smaller head circumferences, with shorter lengths in the marijuana group. At one year, children in the cocaine group had significantly lower Bayley-III Cognitive and Motor scores. At 18-24 months, children in the methadone group had significantly smaller head circumferences and Cognitive scores. Children in the methadone and cocaine groups had a significantly higher incidence of atypical neurological examinations at 6-9 and 18-24 months. Methadone and cocaine group mothers presented with more severe prenatal drug use and psychosocial risk factors relative to women who used primarily marijuana. Children in the cocaine and methadone groups were neurologically atypical relative to others at study end. Mothers in the marijuana group reported chronic drug use as well as anxiety and depression in follow-up. At birth, children in the marijuana group were smaller, but this resolved with time. Similarly, children in the cocaine group had motor and cognitive delays which resolved by age two. Children in the methadone group had persistent growth and cognitive deficits. Their mothers demonstrated more anxiety, depression, and stress, the combination of which left these women and children liable to ongoing psychosocial struggle and psychological distress. Dual interventions for mother and child should be considered in attempting to optimize outcome.

Gender-Specific Relationships Between Depressive Symptoms, Marijuana Use, Parental Communication and Risky Sexual Behavior in Adolescence

PubMed Central

Schuster, Randi Melissa; Mermelstein, Robin; Wakschlag, Laurie

2012-01-01

A large body of research has identified correlates of risky sexual behavior, with depressive symptoms and marijuana use among the most consistent psychosocial predictors of sexual risk. However, substantially less research has examined the relationship between these risk variables and adolescent risky sexual behavior over time as well as the interaction of these individual-level predictors with family-level variables such as parenting factors. Additionally, most studies have been restricted to one index of risky sexual behavior, have not taken into account the complex role of gender, and have not controlled for several of the factors that independently confer risk for risky sexual behavior. Therefore, the current study investigated the association between depressive symptoms and parameters of parenting on marijuana use, number of sexual partners and condom usage measured 9 months later for both boys and girls. Participants were 9th and 10th grade adolescents (N = 1,145; 57.7 % female). We found that depressive symptoms may be a gender-specific risk factor for certain indices of risky sexual behavior. For boys only, marijuana use at Time 2 accounted for the variance in the relationship between depressive symptoms at Time 1 and number of partners at Time 2. Additionally, strictness of family rules at Time 1 was associated with the number of partners with whom girls engaged in sex at Time 2, but only among those with lower levels of depressive symptoms at Time 1. Results from the current investigation speak to the utility of examining the complex, gender-specific pathways to sexual risk in adolescents. Findings suggest that treatment of mental health and substance use problems may have important implications in rates of risky sexual behavior and, conceivably, controlling the high rates of serious individual and public health repercussions. PMID:22927009

Gender-specific relationships between depressive symptoms, marijuana use, parental communication and risky sexual behavior in adolescence.

PubMed

Schuster, Randi Melissa; Mermelstein, Robin; Wakschlag, Laurie

2013-08-01

A large body of research has identified correlates of risky sexual behavior, with depressive symptoms and marijuana use among the most consistent psychosocial predictors of sexual risk. However, substantially less research has examined the relationship between these risk variables and adolescent risky sexual behavior over time as well as the interaction of these individual-level predictors with family-level variables such as parenting factors. Additionally, most studies have been restricted to one index of risky sexual behavior, have not taken into account the complex role of gender, and have not controlled for several of the factors that independently confer risk for risky sexual behavior. Therefore, the current study investigated the association between depressive symptoms and parameters of parenting on marijuana use, number of sexual partners and condom usage measured 9 months later for both boys and girls. Participants were 9th and 10th grade adolescents (N = 1,145; 57.7% female). We found that depressive symptoms may be a gender-specific risk factor for certain indices of risky sexual behavior. For boys only, marijuana use at Time 2 accounted for the variance in the relationship between depressive symptoms at Time 1 and number of partners at Time 2. Additionally, strictness of family rules at Time 1 was associated with the number of partners with whom girls engaged in sex at Time 2, but only among those with lower levels of depressive symptoms at Time 1. Results from the current investigation speak to the utility of examining the complex, gender-specific pathways to sexual risk in adolescents. Findings suggest that treatment of mental health and substance use problems may have important implications in rates of risky sexual behavior and, conceivably, controlling the high rates of serious individual and public health repercussions.

THE USE OF FRY (EMBALMING FLUID AND PCP-LACED CIGARETTES OR MARIJUANA STICKS) AMONG CRACK COCAINE SMOKERS

PubMed Central

PETERS, RONALD J.; WILLIAMS, MARK; ROSS, MICHAEL W.; ATKINSON, JOHN; McCURDY, SHERLY A.

2010-01-01

Statistics show that the prevalence of crack cocaine use and embalming fluid and phencyclidine (PCP)-laced cigarettes or marijuana sticks, commonly referred to on the street as “fry” or “wet” is a problem; however, the relationship between these substances of abuse and concurrent polydrug use is unknown. In the present study, a cross-sectional survey was conducted among 426 African-American crack users in Houston, Texas, to investigate the difference between those who concurrently reported lifetime (defined as at least one usage of fry in life) fry use and those who stated they never used fry. The data were analyzed using chi-square and logistic regression analyses. Fry users were significantly more likely than non-users to not have a casual sex partner (92% users vs. 84% non-users, p ≤ 0.05) and were more likely to have been diagnosed with gonorrhea in the past 12 months (9% users vs. 2% non-users, p ≤ 0.05). In addition fry users had significantly higher odds of currently trading sex for drugs (OR = 2.30, p ≤ 0.05), marijuana use (OR = 12.11, p ≤ 0.05), and codeine (syrup) use (OR = 8.10, p ≤ 0.05). These findings are important in determining the “cultural novelties” relative to crack and fry use among younger African Americans. PMID:19157045

Expectancy Disconfirmation and Attitude Change.

PubMed

McPeek, Robert W; Edwards, John D

1975-08-01

An experiment was conducted testing the hypothesis that sources delivering unexpected communications (long-haired males arguing against marijuana usage and seminarians arguing in its favor) would be more persuasive than communicators of expected messages (promarijuana hippies and antimarijuana seminarians). Greater attitude change for unexpected sources was found only when the message was antimarijuana. Unexpected communicators also were rated as more sincere and honest than expected sources. Possible reasons for the failure of the expectancy effect to hold for promarijuana communications were suggested, and the results were discussed in terms of a variety of social-psychological theories.

Opposing Actions of Chronic[Deta][superscript 9] Tetrahydrocannabinol and Cannabinoid Antagonists on Hippocampal Long-Term Potentiation

ERIC Educational Resources Information Center

Hoffman, Alexander F.; Oz, Murat; Yang, Ruiqin; Lichtman, Aron H.; Lupica, Carl R.

2007-01-01

Memory deficits produced by marijuana arise partly via interaction of the psychoactive component, [Deta][superscript 9]-tetrahydrocannabinol ([Deta][superscript 9]-THC), with cannabinoid receptors in the hippocampus. Although cannabinoids acutely reduce glutamate release and block hippocampal long-term potentiation (LTP), a potential substrate for…

The effects of marijuana exposure on expiratory airflow. A study of adults who participated in the U.S. National Health and Nutrition Examination Study.

PubMed

Kempker, Jordan A; Honig, Eric G; Martin, Greg S

2015-02-01

Given the inconclusive science on the long-term effects of marijuana exposure on lung function, the increasing tetrahydrocannabinol composition of marijuana over time, and the increasing legal accessibility of the substance, continued investigation is needed. To determine the independent association between recent and chronic marijuana smoke exposure with spirometric parameters of lung function and symptoms of respiratory health in a large cohort of U.S. adults. This is a cross-sectional study of U.S. adults who participated in the National Health and Nutrition Examination Survey cycles from 2007-2008 and 2009-2010, using the data from standardized spirometry and survey questions performed during these years. In the combined 2007-2010 cohort, 59.1% replied that they had used marijuana at least once, and 12.2% had used in the past month. For each additional day of marijuana use in the prior month, there were no changes in percent predicted FEV1 (0.002 ± 0.04%; P = 0.9), but there was an associated increase in percent predicted FVC (0.13 ± 0.03%, P = 0.0001) and decrease in the FEV1/FVC ratio (-0.1 ± 0.04%; P < 0.0001). In multivariable regressions, 1-5 and 6-20 joint-years of marijuana use were not associated with an FEV1/FVC less than 70% (odds ratio [OR] = 1.1, 95% confidence interval [CI] = 0.7-1.6, P = 0.8, and OR = 1.2, 95% CI = 0.8-1.8, P = 0.4, respectively), whereas over 20 joint-years was associated with an FEV1/FVC less than 70% (OR = 2.1; 95% CI = 1.1-3.9; P = 0.02). For each additional marijuana joint-year smoked, there was no associated change in the mean percent predicted FEV1 (0.02 ± 0.02%; P = 1.00), an increase in percent predicted FVC (0.07 ± 0.02%; P = 0.004), and a decrease in FEV1/FVC (-0.03 ± 0.01%; P = 0.02). In a large cross-section of U.S. adults, cumulative lifetime marijuana use, up to 20 joint-years, is not associated with adverse changes in spirometric measures of lung health. Although greater than 20 joint-years of cumulative marijuana exposure was associated with a twofold increased odds of a FEV1/FVC less than 70%, this was the result of an increase in FVC, rather than a disproportional decrease in FEV1 as is typically associated with obstructive lung diseases.

Strain and sex differences in puberty onset and the effects of THC administration on weight gain and brain volumes.

PubMed

Keeley, R J; Trow, J; McDonald, R J

2015-10-01

The use of recreational marijuana is widespread and frequently begins and persists through adolescence. Some research has shown negative consequences of adolescent marijuana use, but this is not seen across studies, and certain factors, like genetic background and sex, may influence the results. It is critical to identify which characteristics predispose an individual to be susceptible to the negative consequences of chronic exposure to marijuana in adolescence on brain health and behavior. To this end, using males and females of two strains of rats, Long-Evans hooded (LER) and Wistar (WR) rats, we explored whether these anatomically and behaviorally dimorphic strains demonstrated differences in puberty onset and strain-specific effects of adolescent exposure to Δ9-tetrahydrocannabinol (THC), the main psychoactive component of marijuana. Daily 5 mg/kg treatment began on the day of puberty onset and continued for 14 days. Of particular interest were metrics of growth and volumetric estimates of brain areas involved in cognition that contain high densities of cannabinoid receptors, including the hippocampus and its subregions, the amygdala, and the frontal cortex. Brain volumetrics were analyzed immediately following the treatment period. LER and WR females started puberty at different ages, but no strain differences were observed in brain volumes. THC decreased weight gain throughout the treatment period for all groups. Only the hippocampus and some of its subregions were affected by THC, and increased volumes with THC administration was observed exclusively in females, regardless of strain. Long-term treatment of THC did not affect all individuals equally, and females displayed evidence of increased sensitivity to the effects of THC, and by extension, marijuana. Identifying differences in adolescent physiology of WR and LER rats could help determine the cause for strain and sex differences in brain and behavior of adults and help to refine the use of animal models in marijuana research. Copyright © 2015 IBRO. Published by Elsevier Ltd. All rights reserved.

Chronic opioid therapy risk reduction initiative: impact on urine drug testing rates and results.

PubMed

Turner, Judith A; Saunders, Kathleen; Shortreed, Susan M; Rapp, Suzanne E; Thielke, Stephen; LeResche, Linda; Riddell, Kim M; Von Korff, Michael

2014-02-01

In response to epidemic levels of prescription opioid overdose, abuse, and diversion, routine urine drug tests (UDTs) are recommended for patients receiving chronic opioid therapy (COT) for chronic pain. However, UDT ordering for COT patients is inconsistent in primary care, and little is known about how to increase UDT ordering or the impact of increased testing on rates of aberrant results. To compare rates and results of UDTs for COT patients before versus after implementation of an opioid risk reduction initiative in a large healthcare system. Pre-post observational study. Group Health patients on COT October 2008-September 2009 (N = 4,821), October 2009-September 2010 (N = 5,081), and October 2010-September 2011 (N = 5,498). Multi-faceted opioid risk reduction initiative. Annual rates of UDTs and UDT results. Half of COT patients received at least one UDT in the year after the initiative was implemented, compared to only 7 % 2 years prior. The adjusted odds of COT patients having at least one UDT in the first year of the opioid initiative were almost 16 times (adjusted OR = 15.79; 95 % CI: 13.96-17.87) those 2 years prior. The annual rate of UDT detection of marijuana and illicit drugs did not change (12.6 % after initiative implementation), and largely reflected marijuana use (detected in 11.1 % of all UDTs in the year after initiative implementation). In the year after initiative implementation, 10.7 % of UDTs were negative for opioids. The initiative appeared to dramatically increase urine drug testing of COT patients in the healthcare system without impacting rates of aberrant results. The large majority of aberrant results reflected marijuana use or absence of opioids in the urine. The utility of increased urine drug testing for COT patient safety and prevention of diversion remains uncertain.

Drug Use Patterns and Continuous Enrollment in College:Results From a Longitudinal Study

PubMed Central

Arria, Amelia M.; Garnier-Dykstra, Laura M.; Caldeira, Kimberly M.; Vincent, Kathryn B.; Winick, Emily R.; O’Grady, Kevin E.

2013-01-01

Objective: Few longitudinal studies have examined the relationship between illicit drug use and academic outcomes among college students. This study characterized drug use patterns of a cohort of young adults who were originally enrolled as first-time, first-year college students in a longitudinal study. It evaluated the association between these drug use patterns and continuous enrollment during college, holding constant demographic characteristics, high school grade point average, fraternity/sorority involvement, personality/temperament characteristics, nicotine dependence, and alcohol use disorder. Method: Participants (n = 1,133; 47% male) were purposively selected from one university and interviewed annually for 4 years, beginning with their first year of college, regardless of continued college attendance. Enrollment data were culled from administrative records. Group-based trajectory analyses characterized 4-year longitudinal drug use patterns. Two grouping variables were derived based on (a) marijuana use frequency and (b) number of illicit drugs used other than marijuana. Seventy-one percent of the sample was continuously enrolled in the home institution during the first 4 years of study. Results: Multivariable logistic regression models demonstrated that infrequent, increasing, and chronic/heavy marijuana use patterns were significantly associated with discontinuous enrollment (adjusted odds ratio = 1.66, 1.74, and 1.99, respectively), compared with minimal use, holding constant covariates. In separate models, drug use other than marijuana also was significantly associated with discontinuous enrollment. Conclusions: Marijuana use and other illicit drug use are both associated with a decreased likelihood of continuous enrollment in college, independent of several other possible risk factors. These findings highlight the need for early intervention with illicit drug users to mitigate possible negative academic consequences. PMID:23200152

Depression and anxiety among chronic pain patients receiving prescription opioids and medical marijuana.

PubMed

Feingold, Daniel; Brill, Silviu; Goor-Aryeh, Itay; Delayahu, Yael; Lev-Ran, Shaul

2017-08-15

High rates of depression and anxiety have been consistently reported among patients suffering from chronic pain. Prescription opioids are one of the most common modalities for pharmacological treatment of pain, however in recent years medical marijuana(MM) has been increasingly used for pain control in the US and in several countries worldwide. The aim of this study was to compare levels of depression and anxiety among pain patients receiving prescription opioids and MM. Participants were patients suffering from chronic pain treated with prescription opioids (OP,N=474), MM (N=329) or both (OPMM,N=77). Depression and anxiety were assessed using the depression module of the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder scale (GAD-7). Prevalence of depression among patients in the OP, MM and OPMM groups was 57.1%, 22.3% and 51.4%, respectively and rates of anxiety were 48.4%, 21.5% and 38.7%, respectively. After controlling for confounders, patients in the OP group were significantly more likely to screen positive for depression (Adjusted Odds Ratio(AOR)=6.18;95%CI=4.12-9.338) and anxiety(AOR=4.12;CI=3.84-5.71)) compared to those in the MM group. Individuals in the OPMM group were more prone for depression (AOR for depression=3.34;CI=1.52-7.34)) compared to those in the MM group. Cross-sectional study, restricting inference of causality. Levels of depression and anxiety are higher among chronic pain patients receiving prescription opioids compared to those receiving MM. Findings should be taken into consideration when deciding on the most appropriate treatment modality for chronic pain, particularly among those at risk for depression and anxiety. Copyright © 2017 Elsevier B.V. All rights reserved.

Reversible and regionally selective downregulation of brain cannabinoid CB1 receptors in chronic daily cannabis smokers.

PubMed

Hirvonen, J; Goodwin, R S; Li, C-T; Terry, G E; Zoghbi, S S; Morse, C; Pike, V W; Volkow, N D; Huestis, M A; Innis, R B

2012-06-01

Chronic cannabis (marijuana, hashish) smoking can result in dependence. Rodent studies show reversible downregulation of brain cannabinoid CB(1) (cannabinoid receptor type 1) receptors after chronic exposure to cannabis. However, whether downregulation occurs in humans who chronically smoke cannabis is unknown. Here we show, using positron emission tomography imaging, reversible and regionally selective downregulation of brain cannabinoid CB(1) receptors in human subjects who chronically smoke cannabis. Downregulation correlated with years of cannabis smoking and was selective to cortical brain regions. After ∼4 weeks of continuously monitored abstinence from cannabis on a secure research unit, CB(1) receptor density returned to normal levels. This is the first direct demonstration of cortical cannabinoid CB(1) receptor downregulation as a neuroadaptation that may promote cannabis dependence in human brain.

Does random urine drug testing reduce illicit drug use in chronic pain patients receiving opioids?

PubMed

Manchikanti, Laxmaiah; Manchukonda, Rajeev; Pampati, Vidyasagar; Damron, Kim S; Brandon, Doris E; Cash, Kim A; McManus, Carla D

2006-04-01

Prescription drug abuse and illicit drug use are common in chronic pain patients. Adherence monitoring with screening tests, and urine drug testing, periodic monitoring with prescription monitoring programs, has become a common practice in recent years. Random drug testing for appropriate use of opioids and use of illicit drugs is often used in pain management practices. Thus, it is expected that random urine drug testing will deter use of illicit drugs, and also improve compliance. To study the prevalence of illicit drug use in patients receiving opioids for chronic pain management and to compare the results of illicit drug use with the results from a previous study. A prospective, consecutive study. Interventional pain management practice setting in the United States. A total of 500 consecutive patients on opioids, considered to be receiving stable doses of opioids supplemental to their interventional techniques, were studied by random drug testing. Testing was performed by rapid drug screen. Results were considered positive if one or more of the monitored illicit drugs including cocaine, marijuana (THC), methamphetamine or amphetamines were present. Illicit drug use was evident in 80 patients, or 16%, with marijuana in 11%, cocaine in 5%, and methamphetamine and/or amphetamines in 2%. When compared with previous data, the overall illicit drug use was significantly less. Illicit drug use in elderly patients was absent. The prevalence of illicit drug abuse in patients with chronic pain receiving opioids continues to be a common occurence. This study showed significant reductions in overall illicit drug use with adherence monitoring combined with random urine drug testing.

Estrogenic effects of marijuana smoke condensate and cannabinoid compounds

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lee, Soo Yeun; Sungkyunkwan University, 300 Cheoncheon-dong, Jangan-gu, Suwon, Gyeonggi-do 440-746; Oh, Seung Min

Chronic exposure to marijuana produces adverse effects on the endocrine and reproductive systems in humans; however, the experimental evidence for this presented thus far has not been without controversy. In this study, the estrogenic effect of marijuana smoke condensate (MSC) was evaluated using in vitro bioassays, viz., the cell proliferation assay, the reporter gene assay, and the ER competitive binding assay. The results of these assays were compared with those of three major cannabinoids, i.e., THC, CBD, and CBN. The estrogenic effect of MSC was further confirmed by the immature female rat uterotrophic assay. MSC stimulated the estrogenicity related tomore » the ER-mediated pathway, while neither THC, CBD, nor CBN did. Moreover, treatment with 10 and 25 mg/kg MSC induced significant uterine response, and 10 mg/kg MSC resulted in an obvious change in the uterine epithelial cell appearance. MSC also enhanced the IGFBP-1 gene expression in a dose-dependent manner. To identify the constituents of MSC responsible for its estrogenicity, the MSC fractionated samples were examined using another cell proliferation assay, and the estrogenic active fraction was analyzed using GC-MS. In the organic acid fraction that showed the strongest estrogenic activity among the seven fractions of MSC, phenols were identified. Our results suggest that marijuana abuse is considered an endocrine-disrupting factor. Furthermore, these results suggest that the phenolic compounds contained in MSC play a role in its estrogenic effect.« less

Marijuana use/cessation expectancies and marijuana use in college students

PubMed Central

Brackenbury, Lauren M.; Ladd, Benjamin O.; Anderson, Kristen G.

2016-01-01

Background Research suggests that marijuana expectancies are associated with problematic marijuana use; however, these marijuana-related cognitions remain relatively understudied. Objective This study examined marijuana-related decision-making among college students by exploring the relationships among marijuana expectancies and marijuana use variables. Method College students (N = 357) endorsing lifetime marijuana use completed an online survey on marijuana use expectancies, marijuana cessation expectancies, marijuana use, and future marijuana use intentions. A simple regression framework was used to test the effect of each type of expectancies on marijuana outcome; a hierarchical regression framework tested the unique predictive validity when both types were entered into the same model. Results Both marijuana use expectancies and marijuana cessation expectancies independently predicted a number of marijuana use variables. Additionally, marijuana use expectancies and marijuana cessation expectancies contributed significant unique variance to the prediction of marijuana use. Conclusions It is important to consider both use expectancies and cessation expectancies, as these two domains of marijuana-related cognitions appear to act independently, rather than as opposite ends of the same construct. Longitudinal studies are needed to further examine how these factors interact to influence marijuana use and problems over time. PMID:26678375

Modulation of Human Peripheral Blood Mononuclear Cell Signaling by Medicinal Cannabinoids.

PubMed

Utomo, Wesley K; de Vries, Marjan; Braat, Henri; Bruno, Marco J; Parikh, Kaushal; Comalada, Mònica; Peppelenbosch, Maikel P; van Goor, Harry; Fuhler, Gwenny M

2017-01-01

Medical marijuana is increasingly prescribed as an analgesic for a growing number of indications, amongst which terminal cancer and multiple sclerosis. However, the mechanistic aspects and properties of cannabis remain remarkably poorly characterized. In this study we aimed to investigate the immune-cell modulatory properties of medical cannabis. Healthy volunteers were asked to ingest medical cannabis, and kinome profiling was used to generate comprehensive descriptions of the cannabis challenge on inflammatory signal transduction in the peripheral blood of these volunteers. Results were related to both short term and long term effects in patients experimentally treated with a medical marijuana preparation for suffering from abdominal pain as a result of chronic pancreatitis or other causes. The results reveal an immunosuppressive effect of cannabinoid preparations via deactivation of signaling through the pro-inflammatory p38 MAP kinase and mTOR pathways and a concomitant deactivation of the pro-mitogenic ERK pathway. However, long term cannabis exposure in two patients resulted in reversal of this effect. While these data provide a powerful mechanistic rationale for the clinical use of medical marijuana in inflammatory and oncological disease, caution may be advised with sustained use of such preparations.

Modulation of Human Peripheral Blood Mononuclear Cell Signaling by Medicinal Cannabinoids

PubMed Central

Utomo, Wesley K.; de Vries, Marjan; Braat, Henri; Bruno, Marco J.; Parikh, Kaushal; Comalada, Mònica; Peppelenbosch, Maikel P.; van Goor, Harry; Fuhler, Gwenny M.

2017-01-01

Medical marijuana is increasingly prescribed as an analgesic for a growing number of indications, amongst which terminal cancer and multiple sclerosis. However, the mechanistic aspects and properties of cannabis remain remarkably poorly characterized. In this study we aimed to investigate the immune-cell modulatory properties of medical cannabis. Healthy volunteers were asked to ingest medical cannabis, and kinome profiling was used to generate comprehensive descriptions of the cannabis challenge on inflammatory signal transduction in the peripheral blood of these volunteers. Results were related to both short term and long term effects in patients experimentally treated with a medical marijuana preparation for suffering from abdominal pain as a result of chronic pancreatitis or other causes. The results reveal an immunosuppressive effect of cannabinoid preparations via deactivation of signaling through the pro-inflammatory p38 MAP kinase and mTOR pathways and a concomitant deactivation of the pro-mitogenic ERK pathway. However, long term cannabis exposure in two patients resulted in reversal of this effect. While these data provide a powerful mechanistic rationale for the clinical use of medical marijuana in inflammatory and oncological disease, caution may be advised with sustained use of such preparations. PMID:28174520

Cannabis and Cannabinoids for Chronic Pain.

PubMed

Romero-Sandoval, E Alfonso; Kolano, Ashley L; Alvarado-Vázquez, P Abigail

2017-10-05

The purpose of this study was to provide the most up-to-date scientific evidence of the potential analgesic effects, or lack thereof, of the marijuana plant (cannabis) or cannabinoids, and of safety or tolerability of their long-term use. We found that inhaled (smoked or vaporized) cannabis is consistently effective in reducing chronic non-cancer pain. Oral cannabinoids seem to improve some aspects of chronic pain (sleep and general quality of life), or cancer chronic pain, but they do not seem effective in acute postoperative pain, abdominal chronic pain, or rheumatoid pain. The available literature shows that inhaled cannabis seems to be more tolerable and predictable than oral cannabinoids. Cannabis or cannabinoids are not universally effective for pain. Continued research on cannabis constituents and improving bioavailability for oral cannabinoids is needed. Other aspects of pain management in patients using cannabis require further open discussion: concomitant opioid use, medical vs. recreational cannabis, abuse potential, etc.

Marijuana-Related Posts on Instagram.

PubMed

Cavazos-Rehg, Patricia A; Krauss, Melissa J; Sowles, Shaina J; Bierut, Laura J

2016-08-01

Instagram is a highly visual social networking site whose audience continues to grow, especially among young adults. In the present study, we examine marijuana-related content on Instagram to better understand the varied types of marijuana-related social networking occurring on this popular social media platform. We collected 417,561 Instagram posts with marijuana-related hashtags from November 29 to December 12, 2014. We assessed content of a random sample (n = 5000) of these posts with marijuana-related hashtags. Approximately 2136 (43 %) were explicit about marijuana and further analyzed. Of the 2136 marijuana-related posts, images of marijuana were common (n = 1568). Among these 1568 marijuana images, traditional forms (i.e., buds/leaves) were the most common (63 %), followed by some novel forms of marijuana, including marijuana concentrates (20 %). Among the 568 posts that displayed marijuana being ingested, 20 % showed someone dabbing marijuana concentrates. Marijuana-related advertisements were also observed among the 2136 marijuana-related posts (9 %). Our findings signal the promotion of marijuana use in its traditional plant-based form; trendy and novel modes of marijuana ingestion were also endorsed. This content along with the explicit marketing of marijuana that we observed on Instagram have potential to influence social norms surrounding marijuana use.

Marijuana-Related Posts on Instagram

PubMed Central

Krauss, Melissa J.; Sowles, Shaina J.; Bierut, Laura J.

2016-01-01

Instagram is a highly visual social networking site whose audience continues to grow, especially among young adults. In the present study, we examine marijuana-related content on Instagram to better understand the varied types of marijuana-related social networking occurring on this popular social media platform. We collected 417,561 Instagram posts with marijuana-related hashtags from November 29 to December 12, 2014. We assessed content of a random sample (n = 5000) of these posts with marijuana-related hashtags. Approximately 2136 (43 %) were explicit about marijuana and further analyzed. Of the 2136 marijuana-related posts, images of marijuana were common (n = 1568). Among these 1568 marijuana images, traditional forms (i.e., buds/leaves) were the most common (63 %), followed by some novel forms of marijuana, including marijuana concentrates (20 %). Among the 568 posts that displayed marijuana being ingested, 20 % showed someone dabbing marijuana concentrates. Marijuana-related advertisements were also observed among the 2136 marijuana-related posts (9 %). Our findings signal the promotion of marijuana use in its traditional plant-based form; trendy and novel modes of marijuana ingestion were also endorsed. This content along with the explicit marketing of marijuana that we observed on Instagram have potential to influence social norms surrounding marijuana use. PMID:27262456

Rules regarding marijuana and its use in personal residences: findings from marijuana users and nonusers recruited through social media.

PubMed

Berg, Carla J; Buller, David B; Schauer, Gillian L; Windle, Michael; Stratton, Erin; Kegler, Michelle C

2015-01-01

Recent changes in policy and social norms related to marijuana use have increased its use and concern about how/where marijuana should be used. We aimed to characterize rules regarding marijuana and its use in homes. We recruited 1,567 US adults aged 18-34 years through Facebook advertisements to complete an online survey assessing marijuana use, social factors, perceptions of marijuana, and rules regarding marijuana and its use in the home, targeting tobacco and marijuana users to ensure the relevance of this topic. Overall, 648 (41.6%) were current marijuana users; 46.0% of participants reported that "marijuana of any type is not allowed in their home or on their property." Of those allowing marijuana on their property, 6.4% prohibited use of marijuana in their home. Of the remainder, 29.2% prohibited smoking marijuana, and 11.0% prohibited vaping, eating, or drinking marijuana. Correlates of more restrictive rules included younger age, being female, having

The Effect of Curanderismo on Chronic Non-malignant Pain: A Case Report.

PubMed

Kennedy, Laura; Gonzales, Erin; Corbin, Lisa

2016-01-01

This case study describes the effects of the use of curanderismo, an indigenous healing modality combining techniques in massage, sound, and aromatherapy, on a patient with chronic pain. Despite being a commonly used health practice in certain populations, little is reported in the medical literature about the use of curanderismo. Case report as part of a larger randomized trial of curanderismo for chronic pain. Setting was a community-based hospital affiliated primary care clinic. An adult patient with chronic, opioid dependent back pain following an injury, and subsequent spinal fusion was treated. Intervention was the patient received 33 curanderismo treatment sessions over 10 months in addition to ongoing conventional treatment at a community-based chronic pain management clinic. Main outcomes measures were self-reported assessments of pain, functional ability, mood, insomnia, and narcotic usage. Secondary outcome measure was qualitative interview. Although there was no change in quantitative self-reported pain measures, the patient reported improved function, mood, and sleep as well as decreased narcotic usage. Curanderismo, in addition to conventional pain management, improved patient reported symptoms and functional ability, led to healthy lifestyle changes, and decreased narcotic usage. Controlled studies are needed to confirm the benefit of curanderismo as safe, non-interventional, and cost-effective adjunct for chronic pain management. Copyright © 2016 Elsevier Inc. All rights reserved.

Marijuana protective behavioral strategies as a moderator of the effects of risk/protective factors on marijuana-related outcomes.

PubMed

Bravo, Adrian J; Anthenien, Amber M; Prince, Mark A; Pearson, Matthew R

2017-06-01

Given that both marijuana use and cannabis use disorder peak among college students, it is imperative to determine the factors that may reduce risk of problematic marijuana use and/or the development of cannabis use disorder. From a harm reduction perspective, the present study examined whether the use of marijuana protective behavioral strategies (PBS) buffers or amplifies the effects of several distinct risk and protective factors that have been shown to relate to marijuana-related outcomes (i.e., use frequency and consequences). Specifically, we examined marijuana-PBS use as a moderator of the effects of impulsivity-like traits, marijuana use motives, gender, and marijuana use frequency on marijuana-related outcomes in a large sample of college students (n=2093 past month marijuana users across 11 universities). In all models PBS use was robustly related with use frequency and consequences (i.e., strongly negatively associated with marijuana outcomes). Among interactions, we found: 1) unique significant interactions between specific impulsivity-like traits (i.e., premeditation, perseverance, and sensation seeking) and marijuana-PBS use in predicting marijuana consequences, 2) unique significant interactions between each marijuana use motive and marijuana-PBS use in predicting marijuana use frequency and 3) marijuana-PBS use buffered the risk associated with male gender in predicting both marijuana outcomes. Our results suggest that marijuana-PBS use can buffer risk factors and enhance protective factors among marijuana using college students. Future research is needed to understand context-specific factors and individual-level factors that may make marijuana-PBS use more effective. Copyright © 2017 Elsevier Ltd. All rights reserved.

Preliminary, open-label, pilot study of add-on oral Δ9-tetrahydrocannabinol in chronic post-traumatic stress disorder.

PubMed

Roitman, Pablo; Mechoulam, Raphael; Cooper-Kazaz, Rena; Shalev, Arieh

2014-08-01

Many patients with post-traumatic stress disorder (PTSD) achieve but partial remission with current treatments. Patients with unremitted PTSD show high rates of substance abuse. Marijuana is often used as compassion add-on therapy for treatment-resistant PTSD. This open-label study evaluates the tolerance and safety of orally absorbable Δ(9)-tetrahydrocannabinol (THC) for chronic PTSD. Ten outpatients with chronic PTSD, on stable medication, received 5 mg of Δ(9)-THC twice a day as add-on treatment. There were mild adverse effects in three patients, none of which led to treatment discontinuation. The intervention caused a statistically significant improvement in global symptom severity, sleep quality, frequency of nightmares, and PTSD hyperarousal symptoms. Orally absorbable Δ(9)-THC was safe and well tolerated by patients with chronic PTSD.

Use of strong opioids for chronic pain in osteoarthritis: an insight into the Latin American reality.

PubMed

Ruiz Iban, Miguel Angel; Benavides, Javier; Forero, Juan Pablo; Bittelman, Sacha; Martinez, Rafael; Mite, Miguel Angel; Diaz Heredia, Jorge; Ulloa, Sergio; Lizárraga Ferrand, Mauro Marcelo

2018-01-01

Osteoarthritis is the most common cause of arthritis and one of the main causes of chronic pain. Although opioids are frequently employed for chronic pain treatment, their usage for osteoarthritis pain remains controversial due to the associated adverse effects. Most guidelines reserve their use for refractory pain in patients with hip and knee osteoarthritis. The situation is even more complex in Latin America, where the prevalence of insufficient pain treatment is high because of the limited availability and use of strong opioids. Areas covered: In this article we review the epidemiology of osteoarthritis, its socioeconomic burden, its impact as a chronic pain cause and the pharmacological treatment options, giving emphasis to the role of strong opioids, their safety and efficacy, especially in Latin American countries, where restrictions regulate their usage. Expert commentary: Usage of strong opioids is safe and effective in the short-term management of osteoarthritis with moderate to severe pain, when other pharmacological treatments are inadequate and surgery is contraindicated, provided their use adheres to existing guidelines. Educational programs for patients and physicians and further research on treating chronic pain with opioids should be implemented to reduce adverse effects and improve care quality.

Elevated Norepinephrine may be a Unifying Etiological Factor in the Abuse of a Broad Range of Substances: Alcohol, Nicotine, Marijuana, Heroin, Cocaine, and Caffeine

PubMed Central

Fitzgerald, Paul J.

2013-01-01

A wide range of commonly abused drugs have effects on the noradrenergic neurotransmitter system, including alterations during acute intoxication and chronic use of these drugs. It is not established, however, that individual differences in noradrenergic signaling, which may be present prior to use of drugs, predispose certain persons to substance abuse. This paper puts forth the novel hypothesis that elevated noradrenergic signaling, which may be raised largely due to genetics but also due to environmental factors, is an etiological factor in the abuse of a wide range of substances, including alcohol, nicotine, marijuana, heroin, cocaine, and caffeine. Data are reviewed for each of these drugs comprising their interaction with norepinephrine during acute intoxication, long-term use, subsequent withdrawal, and stress-induced relapse. In general, the data suggest that these drugs acutely boost noradrenergic signaling, whereas long-term use also affects this neurotransmitter system, possibly suppressing it. During acute withdrawal after chronic drug use, noradrenergic signaling tends to be elevated, consistent with the observation that norepinephrine lowering drugs such as clonidine reduce withdrawal symptoms. Since psychological stress can promote relapse of drug seeking in susceptible individuals and stress produces elevated norepinephrine release, this suggests that these drugs may be suppressing noradrenergic signaling during chronic use or instead elevating it only in reward circuits of the brain. If elevated noradrenergic signaling is an etiological factor in the abuse of a broad range of substances, then chronic use of pharmacological agents that reduce noradrenergic signaling, such as clonidine, guanfacine, lofexidine, propranolol, or prazosin, may help prevent or treat drug abuse in general. PMID:24151426

Cannabis: A Treasure Trove or Pandora's Box?

PubMed

Solymosi, Katalin; Köfalvi, Attila

2017-01-01

Cannabis is one of the earliest cultivated plants. Cannabis of industrial utility and culinary value is generally termed as hemp. Conversely, cannabis that is bred for medical, spiritual and recreational purposes is called marijuana. The female marijuana plant produces a significant quantity of bio- and psychoactive phytocannabinoids, which regained the spotlight with the discovery of the endocannabinoid system of the animals in the early 90's. Nevertheless, marijuana is surrounded by controversies, debates and misconceptions related to its taxonomic classification, forensic identification, medical potential, legalization and its long-term health consequences. In the first part, we provide an in-depth review of the botany and taxonomy of Cannabis. We then overview the biosynthesis of phytocannabinoids within the glandular trichomes with emphasis on the role of peculiar plastids in the production of the secreted material. We also compile the analytical methods used to determine the phytocannabinoid composition of glandular trichomes. In the second part, we revisit the psychobiology and molecular medicine of marijuana. We summarize our current knowledge on the recreational use of cannabis with respect to the modes of consumption, short-term effects, chronic health consequences and cannabis use disorder. Next, we overview the molecular targets of a dozen major and minor bioactive cannabinoids in the body. This helps us introduce the endocannabinoid system in an unprecedented detail: its up-todate molecular biology, pharmacology, physiology and medical significance, and beyond. In conclusion, we offer an unbiased survey about cannabis to help better weigh its medical value versus the associated risks. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Concomitant consumption of marijuana, alcohol and tobacco in oral squamous cell carcinoma development and progression: recent advances and challenges.

PubMed

Lopes, Caio Fabio Baeta; de Angelis, Bruno Brandão; Prudente, Henrique Maciel; de Souza, Bernardo Vieira Goulart; Cardoso, Sérgio Vitorino; de Azambuja Ribeiro, Rosy Iara Maciel

2012-08-01

Oral squamous cell carcinoma (OSCC) corresponds to 95% of all malignant tumours of the mouth. The association between alcohol and tobacco is the major risk factor for this disease, increasing the chances for the development of OSCC by 35-fold. The plant, Cannabis sativa is smoked as cigarettes or blunts and is commonly used in association with tobacco and alcohol. Any type of smoking habit exposes individuals to a wide range of carcinogens or pro-carcinogens, such as polycyclic aromatic hydrocarbons, as well as some ethanol derived substances such as acetaldehyde (AA), and all are genotoxic in the same way. In addition, ethanol acts in the oral mucosa as a solvent and therefore increases the cellular membrane permeability to carcinogens. Carcinogens found in tobacco are also concentrated in marijuana, but the latter also contains high levels of cannabinoids, bioactive compounds responsible for several effects such as euphoria and analgesia. However, Δ(9)-tetrahydrocannabinol (Δ(9)-THC), the major psychotropic cannabinoid found in plants, causes a reduction of cellular metabolism and induction of apoptosis, both of which are anti-neoplastic properties. Apart from limited epidemiologic and experimental data, the effects of concomitant chronic exposure to marijuana (or Δ(9)-THC), tobacco and alcohol in OSCC development and progression is poorly known. This paper reviews the most recent findings on the effects of marijuana over cellular proliferation, as well as in the risk for OSCC, with emphasis on its interaction with tobacco and ethanol consumption. Copyright © 2012 Elsevier Ltd. All rights reserved.

Substance misuse in Aboriginal Australians.

PubMed

Gracey, M

1998-01-01

Australia's Aborigines lived in isolation from the rest of humanity as successful hunter-gatherers for tens of thousands of years. That isolation ended abruptly with British colonization in the late 18th century and was followed by a traumatic 200 years for Aborigines who are now seriously disadvantaged, socio-economically and in terms of their health standards. It has often been assumed that the Aborigines had no access to psychotropic substances before permanent European contact but several pieces of evidence dispute this view. The history of Aboriginal contact with and usage of intoxicating substances, including alcohol, is extremely complex and affected by a maze of restrictive government policies. These interact with a wide range of other Federal and State policies which have changed rapidly since the late 1960s when Aborigines were first granted the franchise; access to unrestricted drinking followed soon afterwards. Today Aborigines suffer disproportionately to other Australians from the physical and social consequences of excess alcohol consumption, tobacco usage, petrol and other solvent sniffing, usage of marijuana, amphetamines, cocaine and heroin, as well as other drugs. The Aboriginal population is dispersed in cities, towns, fringe settlements, rural and remote areas over this vast continent and there are different patterns of drug usage from place to place. This review attempts to synthesize some of this information in order to give an overview to the history, background, current status of substance misuse by Aborigines as well as some strategies being used to try to overcome this serious problem.

The efficacy of a senior outreach program in the reduction of hospital readmissions and emergency department visits among chronically ill seniors.

PubMed

Prior, Michael K; Bahret, Beverly A; Allen, Reva I; Pasupuleti, Sudershan

2012-01-01

This study reports on the effectiveness of a community-based senior outreach program in decreasing rehospitalizations and emergency department visits among chronically ill seniors. Participants had been repeatedly hospitalized with chronic illnesses and were subsequently served in an in-home program designed to address their psychosocial and medical needs. Participation in the program was found to be related to lower hospital readmission rates and emergency department usage. Clients also reported decreased financial concerns and depression and anxiety and increased social support. The study adds to the growing body of work supporting community-based programs as effective strategies for decreasing health care usage and improving quality of life for chronically ill seniors.

Marijuana's acute effects on cognitive bias for affective and marijuana cues.

PubMed

Metrik, Jane; Aston, Elizabeth R; Kahler, Christopher W; Rohsenow, Damaris J; McGeary, John E; Knopik, Valerie S

2015-10-01

Marijuana produces acute increases in positive subjective effects and decreased reactivity to negative affective stimuli, though may also acutely induce anxiety. Implicit attentional and evaluative processes may explicate marijuana's ability to acutely increase positive and negative emotions. This within-subjects study examined whether smoked marijuana with 2.7-3.0% delta-9-tetrahydrocannabinol (THC), relative to placebo, acutely changed attentional processing of rewarding and negative affective stimuli as well as marijuana-specific stimuli. On 2 separate days, regular marijuana users (N = 89) smoked placebo or active THC cigarette and completed subjective ratings of mood, intoxication, urge to smoke marijuana, and 2 experimental tasks: pleasantness rating (response latency and perceived pleasantness of affective and marijuana-related stimuli) and emotional Stroop (attentional bias to affective stimuli). On the pleasantness rating task, active marijuana increased response latency to negatively valenced and marijuana-related (vs. neutral) visual stimuli, beyond a general slowing of response. Active marijuana also increased pleasantness ratings of marijuana images, although to a lesser extent than placebo due to reduced marijuana urge after smoking. Overall, active marijuana did not acutely change processing of positive emotional stimuli. There was no evidence of attentional bias to affective word stimuli on the emotional Stroop task with the exception of attentional bias to positive word stimuli in the subgroup of marijuana users with cannabis dependence. Marijuana may increase allocation of attentional resources toward marijuana-specific and negatively valenced visual stimuli without altering processing of positively valenced stimuli. Marijuana-specific cues may be more attractive with higher levels of marijuana craving and less wanted with low craving levels. (c) 2015 APA, all rights reserved).

Support for Marijuana Legalization and Predictors of Intentions to Use Marijuana More Often in Response to Legalization Among U.S. Young Adults.

PubMed

Cohn, Amy M; Johnson, Amanda L; Rose, Shyanika W; Rath, Jessica M; Villanti, Andrea C

2017-01-28

As of 2015, more than half of U.S. states have legalized, medicalized, or decriminalized marijuana. This study examined the prevalence and correlates of support for marijuana legalization in a national sample of young adults and the intention to use marijuana more frequently if it were legalized. Data were from Wave 7 (weighted N = 3532) of the Truth Initiative Young Adult Cohort, a national sample of men and women aged 18-34. We assessed demographics, past 30-day substance (alcohol, tobacco, marijuana, other drug use), depression and anxiety, social smoking, marijuana harm perceptions (relative to cigarettes), and state-level marijuana policies as correlates of support for marijuana legalization and intentions to use marijuana more often if it were legalized. Multivariable models of correlates of support for legalization and intentions to use marijuana were conducted separately for the full sample and for nonmarijuana users. Weighted estimates showed that 39% of the full sample and 9% of nonmarijuana users supported marijuana legalization. Multivariable models showed that lower marijuana harm perceptions and lifetime and past 30-day tobacco use were common predictors of support for marijuana legalization and intentions to use marijuana among non-users of marijuana. Conclusions/Importance: Over a third of the sample supported marijuana legalization. Tobacco use and perceptions that marijuana is less harmful than cigarettes were robust risk correlates of support for marijuana legalization and intentions to use more frequently among nonusers. Public health campaigns should target these factors to deter marijuana-related harm in susceptible young adults.

Gateway to Curiosity: Medical Marijuana Ads and Intention and Use during Middle School

PubMed Central

D’Amico, Elizabeth J.; Miles, Jeremy N.V.; Tucker, Joan S.

2015-01-01

Over the past several years, medical marijuana has received increased attention in the media, and marijuana use has increased across the United States. Studies suggest that as marijuana has become more accessible and adults have become more tolerant regarding marijuana use, adolescents perceive marijuana as more beneficial and are more likely to use if they are living in an environment that is more tolerant of marijuana use. One factor that may influence adolescents’ perceptions about marijuana and marijuana use is their exposure to advertising of this product. We surveyed 6th–8th grade youth in 2010 and 2011 in 16 middle schools in southern California (n= 8214; 50% male; 52% Hispanic; mean age = 13) and assessed exposure to advertising for medical marijuana, marijuana intentions and marijuana use. Cross-lagged regressions showed a reciprocal association of advertising exposure with marijuana use and intentions during middle school. Greater initial medical marijuana advertising exposure was significantly associated with a higher probability of marijuana use and stronger intentions to use one year later, and initial marijuana use and stronger intentions to use were associated with greater medical marijuana advertising exposure one year later. Prevention programs need to better explain medical marijuana to youth, providing information on the context for proper medical use of this drug and the potential harms from use during this developmental period. Furthermore, as this is a new frontier, it is important to consider regulating medical marijuana advertisements, as is currently done for alcohol and tobacco products. PMID:26030167

Utilization of Complementary and Alternative Medicine in Multiethnic Population: The Malaysian Cohort Study.

PubMed

Abdullah, Noraidatulakma; Borhanuddin, Boekhtiar; Patah, Afzan Effiza Abdul; Abdullah, Mohd Shaharom; Dauni, Andri; Kamaruddin, Mohd Arman; Shah, Shamsul Azhar; Jamal, Rahman

2018-01-01

This study aimed to identify the factors of CAM usage for general health and to determine the factors associated with the usage of different types of CAM after the diagnosis of chronic diseases among The Malaysian Cohort participants. This was a cross-sectional study derived from The Malaysian Cohort (TMC) project, a prospective population-based cohort aged between 35 to 65 years old that recruited from April 2006 to September 2012. Association between the CAM usage and contributing factors were determined via logistic regression. The sample were mostly female (58.1%), Malays (43.1%), came from urban (71.9%), aged 44 years and below (26.8%) and had secondary education (45.9%). The prevalence of CAM usage varied across diseases; 62.8% in cancer patients, 53.3% in hypercholesterolemia, 49.4% in hypertensives and 48.6% in diabetics. General CAM usage was greater among female (OR: 1.54, 95% CI: 1.49, 1.59), Chinese (OR: 1.15, 95% CI: 1.12, 1.19), those with higher education (OR: 3.12, 95% CI: 3.00, 3.25), urban residents (OR: 1.55, 95% CI: 1.50, 1.61) and older people (OR ranging from 1.15 to 1.75) while for post-diagnosis of chronic diseases usage, the odds were higher among those with lower education and living in rural areas. Health status, educational level, age, living location and types of chronic diseases were significant factors that influence CAM usage for the intent of either health maintenance or disease treatment. Further exploration on CAM safety and benefit are crucial to minimize the adverse effect and to ensure the efficacy of CAM product.

Utilization of Complementary and Alternative Medicine in Multiethnic Population: The Malaysian Cohort Study

PubMed Central

Abdullah, Noraidatulakma; Borhanuddin, Boekhtiar; Patah, Afzan Effiza Abdul; Abdullah, Mohd Shaharom; Dauni, Andri; Kamaruddin, Mohd Arman; Shah, Shamsul Azhar

2018-01-01

Background. This study aimed to identify the factors of CAM usage for general health and to determine the factors associated with the usage of different types of CAM after the diagnosis of chronic diseases among The Malaysian Cohort participants. Methods. This was a cross-sectional study derived from The Malaysian Cohort (TMC) project, a prospective population-based cohort aged between 35 to 65 years old that recruited from April 2006 to September 2012. Association between the CAM usage and contributing factors were determined via logistic regression. Results. The sample were mostly female (58.1%), Malays (43.1%), came from urban (71.9%), aged 44 years and below (26.8%) and had secondary education (45.9%). The prevalence of CAM usage varied across diseases; 62.8% in cancer patients, 53.3% in hypercholesterolemia, 49.4% in hypertensives and 48.6% in diabetics. General CAM usage was greater among female (OR: 1.54, 95% CI: 1.49, 1.59), Chinese (OR: 1.15, 95% CI: 1.12, 1.19), those with higher education (OR: 3.12, 95% CI: 3.00, 3.25), urban residents (OR: 1.55, 95% CI: 1.50, 1.61) and older people (OR ranging from 1.15 to 1.75) while for post-diagnosis of chronic diseases usage, the odds were higher among those with lower education and living in rural areas. Conclusion. Health status, educational level, age, living location and types of chronic diseases were significant factors that influence CAM usage for the intent of either health maintenance or disease treatment. Further exploration on CAM safety and benefit are crucial to minimize the adverse effect and to ensure the efficacy of CAM product. PMID:29651870

Allowing cigarette or marijuana smoking in the home and car: prevalence and correlates in a young adult sample

PubMed Central

Padilla, Mabel; Berg, Carla J.; Schauer, Gillian L.; Lang, Delia L.; Kegler, Michelle C.

2015-01-01

Given the increased marijuana use, negative health consequences of marijuana secondhand smoke exposure (SHSe) and dearth of research regarding marijuana SHSe in personal settings, we examined the prevalence and correlates of allowing marijuana versus cigarette smoking in personal settings among 2002 online survey respondents at two southeastern US universities in 2013. Findings indicated that 14.5% allowed cigarettes in the home, 17.0% marijuana in the home, 35.9% cigarettes in cars and 27.3% marijuana in cars. Allowing cigarettes in the home was associated with younger age, racial/ethnic minority status, living off campus, personal marijuana use, parental tobacco use and positive perceptions of cigarettes (P < 0.05). Correlates of allowing marijuana in the home included older age, not having children, living off campus, positive perceptions of marijuana and personal, parental and friend marijuana use (P < 0.05). Correlates of allowing cigarettes in cars included personal cigarette and marijuana use, parental tobacco and marijuana use, more cigarette-smoking friends and positive perceptions of cigarettes (P < 0.05). Correlates of allowing marijuana in cars included being non-Hispanic black; positive perceptions of marijuana; and personal, parental and friend marijuana use (P < 0.05). Interventions must target distinct factors influencing policies regarding cigarette versus marijuana use in personal settings to address the consequences of marijuana and cigarette SHSe. PMID:25214515

Marijuana motivations across adolescence: impacts on use and consequences.

PubMed

Anderson, Kristen G; Sitney, Miranda; White, Helene R

2015-02-01

Background. Motivational models for marijuana use have focused on reasons to use marijuana, but rarely consider motives to abstain. We examined how both adolescent marijuana abstinence motives and use motives contribute to marijuana use and problems at the end of emerging adulthood. Methods. 434 community recruited youth who had not initiated marijuana use at baseline were followed from adolescence (at ages 12, 15, and 18 years) into emerging adulthood (age 25 years). Motives to abstain and to use marijuana, marijuana consumption, and marijuana-related problems were assessed across time. Results. Endorsing more motives to abstain from marijuana across adolescence predicted less marijuana use in emerging adulthood and fewer marijuana-related problems when controlling for past motives to abstain and marijuana-related behavior. Positive reinforcement use motives related to increased marijuana consumption and problems, and negative reinforcement motives predicted problems when controlling for past marijuana use motives and behaviors. Expansion motives during adolescence related to lower marijuana use in emerging adulthood. When considered together, motives to abstain buffered the effect of negative reinforcement motives on outcomes at age 25 for youth endorsing a greater number of abstinence motives. Conclusions/ Implications. Given these findings, inclusion of both motives to use and abstain is warranted within comprehensive models of marijuana use decision making and may provide important markers for prevention and intervention specialists.

Cannabis, 1977.

PubMed

1978-10-01

Recent advances in development of immunoassay methods for marijuana constituents in body fluids provide a rapid means of detection for forensic purposes and a useful research tool for accurate quantitation of dose-response relation. Therapeutic possibilities of cannabis, such as reduction in intraocular pressure and bronchodilatation, may stimulate development of synthetic cannabinoid derivatives that meet acceptable standards of safety and effiicacy for treatment of glaucoma and asthma. Cannabis use may have harmful short- and long-term impacts on health. Potentially serious short-term effects include predisposition to angina during exercise in patients with coronary artery disease. Even in healthy subjects, marijuana smoking decreases peak exercise performance, possibly because of its chronotropic effect with achievement of maximum heart rate at reduced work loads. Although no conclusive evidence exists for long-term biologic consequences of chronic cannabis use, preliminary evidence, suggesting impairment in pulmonary function and immune responses, requires further investigation with large-scale epidemiologic studies.

Marijuana

MedlinePlus

... Search Share Print Home » Drugs of Abuse » Marijuana Marijuana Email Facebook Twitter Brief Description Marijuana refers to ... drugs-abuse/marijuana. . press ctrl+c to copy Marijuana and Cannabinoids: A Neuroscience Research Summit March 22- ...

Profiles of medicinal cannabis patients attending compassion centers in rhode island.

PubMed

Zaller, Nickolas; Topletz, Ariel; Frater, Susan; Yates, Gail; Lally, Michelle

2015-01-01

Little is understood regarding medicinal marijuana dispensary users. We sought to characterize socio-demographics and reasons for medicinal marijuana use among medical cannabis dispensary patients in Rhode Island. Participants (n=200) were recruited from one of two Compassion Centers in Rhode Island and asked to participate in a short survey, which included assessment of pain interference using the Brief Pain Inventory (BPI). The majority of participants were male (73%), Caucasian (80%), college educated (68%), and had health insurance (89%). The most common reason for medicinal marijuana use was determined to be chronic pain management. Participants were more likely to have BPI pain interference scores of > 5 if they were older (OR: 1.36, 95% CI: 1.04-1.78) or reported using cannabis as a substitute for prescription medications (OR: 2.47, 95% CI: 1.23-4.95), and were less likely to have interference scores of >5 if they had higher income levels (OR: 0.53, 95% CI: 0.40-0.70) or reported having ever received treatment for an alcohol use disorder. One-fifth of participants had a history of a drug or alcohol use disorder. Most participants report that medicinal cannabis improves their pain symptomology, and are interested in alternative treatment options to opioid-based treatment regimens.

Suppression of STAT3 Signaling by Δ9-Tetrahydrocannabinol (THC) Induces Trophoblast Dysfunction.

PubMed

Chang, Xinwen; Bian, Yiding; He, Qizhi; Yao, Julei; Zhu, Jingping; Wu, Jinting; Wang, Kai; Duan, Tao

2017-01-01

Marijuana is a widely used illicit drug and its consumption during pregnancy has been associated with adverse reproductive outcomes. The purpose of this study was to determine the effects of chronic intake of Δ9-tetrahydrocannabinol (THC), the major component of marijuana, on trophoblast function, placental development, and birth outcomes. The pathological characteristics and distribution of cannabinoid receptors in placenta were observed by immunohistochemical (IHC) staining. Cell migration in response to THC was measured by transwell assays. The levels of cannabinoid receptors and Signal Transducer and Activator of Transcription 3 (STAT3) were detected by western blot. We found the placenta expressed two main cannabinoid receptors, suggesting that THC induced biological responses in placental cells. Supporting this hypothesis, we observed dramatic alterations of placental morphology in marijuana users. Using THC and inhibitors of cannabinoid receptors, we demonstrated that THC impaired trophoblast cell migration and invasion partly via cannabinoid receptors. Additionally, pregnant mice injected with THC showed adverse reproductive events including reduced number of fetuses, lower maternal and placental weights. Mechanistically, STAT3 signaling pathway was involved in the THC-induced suppression of trophoblast cell motility and pregnancy outcomes. Our study indicates that the STAT3 signaling pathway plays a critical role in THC-induced trophoblast dysfunction. © 2017 The Author(s). Published by S. Karger AG, Basel.

Neuroimaging of the Dopamine/Reward System in Adolescent Drug Use

PubMed Central

Ernst, Monique; Luciana, Monica

2015-01-01

Adolescence is characterized by heightened risk-taking, including substance misuse. These behavioral patterns are influenced by ontogenic changes in neurotransmitter systems, particularly the dopamine system, which is fundamentally involved in the neural coding of reward and motivated approach behavior. During adolescence, this system evidences a peak in activity. At the same time, the dopamine system is neuroplastically altered by substance abuse, impacting subsequent function. Here, we describe properties of the dopamine system that change with typical adolescent development and that are altered with substance abuse. Much of this work has been gleaned from animal models due to limitations in measuring dopamine in pediatric samples. Structural and functional neuroimaging techniques have been used to examine structures that are heavily DA-innervated; they measure morphological and functional changes with age and with drug exposure. Presenting marijuana abuse as an exemplar, we consider recent findings that support an adolescent peak in DA-driven reward-seeking behavior and related deviations in motivational systems that are associated with marijuana abuse/dependence. Clinicians are advised that (1) chronic adolescent marijuana use may lead to deficiencies in incentive motivation, (2) that this state is due to marijuana’s interactions with the developing DA system, and (3) that treatment strategies should be directed to remediating resultant deficiencies in goal-directed activity. PMID:26095977

Marijuana: Facts for Teens. Revised.

ERIC Educational Resources Information Center

National Inst. on Drug Abuse (DHEW/PHS), Rockville, MD.

This booklet provides teenagers with information concerning the use of marijuana. It is presented in a question/answer format. The following sixteen questions are briefly answered: What is marijuana? How is marijuana used? How long does marijuana stay in the user's body? How many teens smoke marijuana? Why do young people use marijuana? What…

The Effect of Medical Marijuana Laws on Marijuana-Related Attitude and Perception Among US Adolescents and Young Adults.

PubMed

Wen, Hefei; Hockenberry, Jason M; Druss, Benjamin G

2018-05-16

Marijuana liberalization policies are gaining momentum in the USA, coupled with limited federal interference and growing dispensary industry. This evolving regulatory landscape underscores the importance of understanding the attitudinal/perceptual pathways from marijuana policy to marijuana use behavior, especially for adolescents and young adults. Our study uses the restricted-access National Survey on Drug Use and Health (NSDUH) 2004-2012 data and a difference-in-differences design to compare the pre-policy, post-policy changes in marijuana-related attitude/perception between adolescents and young adults from ten states that implemented medical marijuana laws during the study period and those from the remaining states. We examined four attitudinal/perception pathways that may play a role in adolescent and young adult marijuana use behavior, including (1) perceived availability of marijuana, (2) perceived acceptance of marijuana use, (3) perceived wrongfulness of recreational marijuana use, and (4) perceived harmfulness of marijuana use. We found that state implementation of medical marijuana laws between 2004 and 2012 was associated with a 4.72% point increase (95% CI 0.15, 9.28) in the probability that young adults perceived no/low health risk related to marijuana use. Medical marijuana law implementation is also associated with a 0.37% point decrease (95% CI - 0.72, - 0.03) in the probability that adolescents perceived parental acceptance of marijuana use. As more states permit medical marijuana use, marijuana-related attitude/perception need to be closely monitored, especially perceived harmfulness. The physical and psychological effects of marijuana use should be carefully investigated and clearly conveyed to the public.

Use and diversion of medical marijuana among adults admitted to inpatient psychiatry.

PubMed

Nussbaum, Abraham M; Thurstone, Christian; McGarry, Laurel; Walker, Brendan; Sabel, Allison L

2015-03-01

Marijuana use is associated with anxiety, depressive, psychotic, neurocognitive, and substance use disorders. Many US states are legalizing marijuana for medical uses. To determine the prevalence of medical marijuana use and diversion among psychiatric inpatients in Colorado. Some 623 participants (54.6% male) responded to an anonymous 15-item discharge survey that assessed age, gender, marijuana use, possession of a medical marijuana card, diversion of medical marijuana, perceived substance use problems, and effects of marijuana use. Univariate statistics were used to characterize participants and their responses. Chi-square tests assessed factors associated with medical marijuana registration. Of the total number of respondents, 282 (47.6%) reported using marijuana in the last 12 months and 60 (15.1%) reported having a marijuana card. In comparison to survey respondents who denied having a medical marijuana card, those respondents with a medical marijuana card were more likely to have initiated use before the age of 25, to be male, to have used marijuana in the last 12 months, and to have used at least 20 days in the past month. 133 (24.1%) respondents reported that someone with a medical marijuana card had shared or sold medical marijuana to them; 24 (41.4%) of respondents with a medical marijuana card reported ever having shared or sold their medical marijuana. Medical marijuana use is much more prevalent among adults hospitalized with a psychiatric emergency than in the general population; diversion is common. Further studies which correlate amount, dose, duration, and strain of use with particular psychiatric disorders are needed.

Gateway to curiosity: Medical marijuana ads and intention and use during middle school.

PubMed

D'Amico, Elizabeth J; Miles, Jeremy N V; Tucker, Joan S

2015-09-01

Over the past several years, medical marijuana has received increased attention in the media, and marijuana use has increased across the United States. Studies suggest that as marijuana has become more accessible and adults have become more tolerant regarding marijuana use, adolescents perceive marijuana as more beneficial and are more likely to use if they are living in an environment that is more tolerant of marijuana use. One factor that may influence adolescents' perceptions about marijuana and marijuana use is their exposure to advertising of this product. We surveyed sixth- to eighth-grade youth in 2010 and 2011 in 16 middle schools in Southern California (n = 8,214; 50% male; 52% Hispanic; mean age = 13 years) and assessed exposure to advertising for medical marijuana, marijuana intentions, and marijuana use. Cross-lagged regressions showed a reciprocal association of advertising exposure with marijuana use and intentions during middle school. Greater initial medical marijuana advertising exposure was significantly associated with a higher probability of marijuana use and stronger intentions to use 1 year later, and initial marijuana use and stronger intentions to use were associated with greater medical marijuana advertising exposure 1 year later. Prevention programs need to better explain medical marijuana to youth, providing information on the context for proper medical use of this drug and the potential harms from use during this developmental period. Furthermore, as this is a new frontier, it is important to consider regulating medical marijuana advertisements, as is currently done for alcohol and tobacco products. (c) 2015 APA, all rights reserved).

Poor decision-making by chronic marijuana users is associated with decreased functional responsiveness to negative consequences.

PubMed

Wesley, Michael J; Hanlon, Colleen A; Porrino, Linda J

2011-01-30

Chronic marijuana users (MJ Users) perform poorly on the Iowa Gambling Task (IGT), a complex decision-making task in which monetary wins and losses guide strategy development. This functional magnetic resonance imaging (MRI) study sought to determine if the poor performance of MJ Users was related to differences in brain activity while evaluating wins and losses during the strategy development phase of the IGT. MJ Users (16) and Controls (16) performed a modified IGT in an MRI scanner. Performance was tracked and functional activity in response to early wins and losses was examined. While the MJ Users continued to perform poorly at the end of the task, there was no difference in group performance during the initial strategy development phase. During this phase, before the emergence of behavioral differences, Controls exhibited significantly greater activity in response to losses in the anterior cingulate cortex, medial frontal cortex, precuneus, superior parietal lobe, occipital lobe and cerebellum as compared to MJ Users. Furthermore, in Controls, but not MJ Users, the functional response to losses in the anterior cingulate cortex, ventral medial prefrontal cortex and rostral prefrontal cortex positively correlated with performance over time. These data suggest MJ Users are less sensitive to negative feedback during strategy development. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

[Cannabis and lung. What we know and everything we don't know yet].

PubMed

Urban, T; Hureaux, J

2017-12-01

Cannabis use increased sharply from 2010 to 2014 in France. Cannabis is often consumed with tobacco, although the use of marijuana is developing. Tobacco and cannabis smoke have many common characteristics in terms of irritants, carcinogens and carbon monoxide. They also differentiate by their dependence mechanisms, with nicotine and its receptors for tobacco and tetra-hydro-cannabinol (THC) and its specific receptors for cannabis. Chronic inhalation (700,000 daily users in France) over a long period most likely increases the relative risk of bronchial cancer. But long-term cohort studies targeting this group of strong cannabis users, especially over time, are lacking. Inhalation of cannabis smoke, despite an acute bronchodilator effect, is associated with the risk of chronic bronchitis in the case of regular use. However, the risk of developing COPD in the exclusive marijuana smoker group with no associated tobacco is not yet clear, with studies yielding discordant results. There is also a lack of long-term follow-up studies of respiratory investigations in large cannabis users. Finally, cannabis smoke contains various cannabinoids, for example cannabidiol which also have anti-inflammatory and antifibrotic properties, with the unconfirmed hypothesis that these properties can partially modulate the deleterious action of cannabis smoke. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Examination of the Divergence in Trends for Adolescent Marijuana Use and Marijuana-specific Risk Factors in Washington State

PubMed Central

Fleming, Charles B.; Guttmannova, Katarina; Cambron, Christopher; Rhew, Isaac C.; Oesterle, Sabrina

2016-01-01

Purpose As marijuana laws have become more permissive, survey data on adolescents in the United States have shown an increase in marijuana-specific risk factors, particularly in the proportion of youth who do not perceive marijuana use as harmful. Prevalence of marijuana use among youth, however, has changed little. Using representative data from Washington State, which has legalized medical and nonmedical marijuana for adults, we examined two competing hypotheses to account for this divergence in population trends. Methods Data were from 2000 – 2014 biennial Washington State surveys of 10th-grade students. First, we assessed whether associations between marijuana use and marijuana-specific risk factors have weakened over time. Second, we examined whether decreases in alcohol and cigarette use can account for the lack of expected increase in marijuana use prevalence. Results Despite stability in marijuana use prevalence, there were increases in marijuana-specific risk factors of low perceived harm, youth favorable attitudes about use, and perceived community attitudes favorable to use. Associations between marijuana use and marijuana-use predictors varied little across time; if anything, the positive association between low perceived harm and marijuana use grew stronger. Decreases in prevalence of alcohol and cigarette use largely accounted for stability in marijuana use during a period when marijuana risk factors increased. Conclusions Decreases in other types of substance use or in the underlying, common risk for substance use may have mitigated effects of increases in marijuana-specific risk factors. PMID:27318426

Adolescent Marijuana Use and Perceived Ease of Access Before and After Recreational Marijuana Implementation in Colorado.

PubMed

Harpin, Scott B; Brooks-Russell, Ashley; Ma, Ming; James, Katherine A; Levinson, Arnold H

2018-02-23

As of January 1, 2017, eight states have approved laws for recreational marijuana use. While the social impacts of these changes remain under debate, the influence on adolescent marijuana use is a key policy and health issue across the U.S. To examine changes in adolescent marijuana-use behaviors in the first year after recreational marijuana implementation in Colorado, and to analyze the effect of retail marijuana store proximity on youth use and perceptions. Secondary analysis of Healthy Kids Colorado Survey data from 40 schools surveyed before and after recreational marijuana sales were implemented (2013 student n = 12,240; 2014 student n = 11,931). Self-reported marijuana use, ease of access, and perceived harms were compared between years and by proximity of recreational marijuana stores to surveyed schools. Adolescent marijuana use behaviors, wrongness of use, and perceptions of risk of harm were unchanged from baseline to one-year follow-up. Perceived ease of access to marijuana increased (from 46% to 52%). Proximity of recreational marijuana stores was not significantly associated with perceived ease of access to marijuana. Conclusions/Importance: In the first study of adolescent marijuana use and perceptions after state retail implementation of recreational marijuana, there was little change in adolescent marijuana use but a significant change in perception of ease of access. Public health workers and policymakers should continue to monitor these changes as essential for evaluating the impact of liberalization of marijuana policies.

Allowing cigarette or marijuana smoking in the home and car: prevalence and correlates in a young adult sample.

PubMed

Padilla, Mabel; Berg, Carla J; Schauer, Gillian L; Lang, Delia L; Kegler, Michelle C

2015-02-01

Given the increased marijuana use, negative health consequences of marijuana secondhand smoke exposure (SHSe) and dearth of research regarding marijuana SHSe in personal settings, we examined the prevalence and correlates of allowing marijuana versus cigarette smoking in personal settings among 2002 online survey respondents at two southeastern US universities in 2013. Findings indicated that 14.5% allowed cigarettes in the home, 17.0% marijuana in the home, 35.9% cigarettes in cars and 27.3% marijuana in cars. Allowing cigarettes in the home was associated with younger age, racial/ethnic minority status, living off campus, personal marijuana use, parental tobacco use and positive perceptions of cigarettes (P < 0.05). Correlates of allowing marijuana in the home included older age, not having children, living off campus, positive perceptions of marijuana and personal, parental and friend marijuana use (P < 0.05). Correlates of allowing cigarettes in cars included personal cigarette and marijuana use, parental tobacco and marijuana use, more cigarette-smoking friends and positive perceptions of cigarettes (P < 0.05). Correlates of allowing marijuana in cars included being non-Hispanic black; positive perceptions of marijuana; and personal, parental and friend marijuana use (P < 0.05). Interventions must target distinct factors influencing policies regarding cigarette versus marijuana use in personal settings to address the consequences of marijuana and cigarette SHSe. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

The Effects of Perceived Quality on Behavioral Economic Demand for Marijuana: A Web-Based Experiment

PubMed Central

Vincent, Paula C.; Collins, R. Lorraine; Liu, Liu; Yu, Jihnhee; De Leo, Joseph A.; Earleywine, Mitch

2016-01-01

Background Given the growing legalization of recreational marijuana use and related increase in its prevalence in the United States, it is important to understand marijuana's appeal. We used a behavioral economic (BE) approach to examine whether the reinforcing properties of marijuana, including “demand” for marijuana, varied as a function of its perceived quality. Methods Using an innovative, Web-based marijuana purchase task (MPT), a sample of 683 young-adult recreational marijuana users made hypothetical purchases of marijuana across three qualities (low, mid and high grade) at nine escalating prices per joint, ranging from $0/free to $20. Results We used nonlinear mixed effects modeling to conduct demand curve analyses, which produced separate demand indices (e.g., Pmax, elasticity) for each grade of marijuana. Consistent with previous research, as the price of marijuana increased, marijuana users reduced their purchasing. Demand also was sensitive to quality, with users willing to pay more for higher quality/grade marijuana. In regression analyses, demand indices accounted for significant variance in typical marijuana use. Conclusions This study illustrates the value of applying BE theory to young adult marijuana use. It extends past research by examining how perceived quality affects demand for marijuana and provides support for the validity of a Web-based MPT to examine the appeal of marijuana. Our results have implications for policies to regulate marijuana use, including taxation based on the quality of different marijuana products. PMID:27951424

The effects of perceived quality on behavioral economic demand for marijuana: A web-based experiment.

PubMed

Vincent, Paula C; Collins, R Lorraine; Liu, Liu; Yu, Jihnhee; De Leo, Joseph A; Earleywine, Mitch

2017-01-01

Given the growing legalization of recreational marijuana use and related increase in its prevalence in the United States, it is important to understand marijuana's appeal. We used a behavioral economic (BE) approach to examine whether the reinforcing properties of marijuana, including "demand" for marijuana, varied as a function of its perceived quality. Using an innovative, Web-based marijuana purchase task (MPT), a sample of 683 young-adult recreational marijuana users made hypothetical purchases of marijuana across three qualities (low, mid and high grade) at nine escalating prices per joint, ranging from $0/free to $20. We used nonlinear mixed effects modeling to conduct demand curve analyses, which produced separate demand indices (e.g., P max , elasticity) for each grade of marijuana. Consistent with previous research, as the price of marijuana increased, marijuana users reduced their purchasing. Demand also was sensitive to quality, with users willing to pay more for higher quality/grade marijuana. In regression analyses, demand indices accounted for significant variance in typical marijuana use. This study illustrates the value of applying BE theory to young adult marijuana use. It extends past research by examining how perceived quality affects demand for marijuana and provides support for the validity of a Web-based MPT to examine the appeal of marijuana. Our results have implications for policies to regulate marijuana use, including taxation based on the quality of different marijuana products. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Twitter chatter about marijuana.

PubMed

Cavazos-Rehg, Patricia A; Krauss, Melissa; Fisher, Sherri L; Salyer, Patricia; Grucza, Richard A; Bierut, Laura Jean

2015-02-01

We sought to examine the sentiment and themes of marijuana-related chatter on Twitter sent by influential Twitter users and to describe the demographics of these Twitter users. We assessed the sentiment and themes of a random sample (n = 7,000) of influential marijuana-related tweets (sent from February 5, 20114, to March 5, 2014). Demographics of the users tweeting about marijuana were inferred using a social media analytics company (Demographics Pro for Twitter). Most marijuana-related tweets reflected a positive sentiment toward marijuana use, with pro-marijuana tweets outnumbering anti-marijuana tweets by a factor of greater than 15. The most common theme of pro-marijuana tweets included the Tweeter stating that he/she wants/plans to use marijuana, followed by tweeting about frequent/heavy/or regular marijuana use, and that marijuana has health benefits and/or should be legalized. Tweeters of marijuana-related content were younger and a greater proportion was African-American compared with the Twitter average. Marijuana Twitter chatter sent by influential Twitter users tends to be pro-marijuana and popular among African-Americans and youth/young adults. Marijuana-related harms may afflict some individuals; therefore, our findings should be used to inform online and offline prevention efforts that work to target individuals who are most at risk for harms associated with marijuana use. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Marijuana abstinence effects in marijuana smokers maintained in their home environment.

PubMed

Budney, A J; Hughes, J R; Moore, B A; Novy, P L

2001-10-01

Although withdrawal symptoms are commonly reported by persons seeking treatment for marijuana dependence, the validity and clinical significance of a marijuana withdrawal syndrome has not been established. This controlled outpatient study examined the reliability and specificity of the abstinence effects that occur when daily marijuana users abruptly stop smoking marijuana. Twelve daily marijuana smokers were assessed on 16 consecutive days during which they smoked marijuana as usual (days 1-5), abstained from smoking marijuana (days 6-8), returned to smoking marijuana (days 9-13), and again abstained from smoking marijuana (days 14-16). An overall measure of withdrawal discomfort increased significantly during the abstinence phases and returned to baseline when marijuana smoking resumed. Craving for marijuana, decreased appetite, sleep difficulty, and weight loss reliably changed across the smoking and abstinence phases. Aggression, anger, irritability, restlessness, and strange dreams increased significantly during one abstinence phase, but not the other. Collateral observers confirmed participant reports of these symptoms. This study validated several specific effects of marijuana abstinence in heavy marijuana users, and showed they were reliable and clinically significant. These withdrawal effects appear similar in type and magnitude to those observed in studies of nicotine withdrawal.

Marijuana Primes, Marijuana Expectancies, and Arithmetic Efficiency*

PubMed Central

Hicks, Joshua A.; Pedersen, Sarah L.; McCarthy, Denis M.; Friedman, Ronald S.

2009-01-01

Objective: Previous research has shown that primes associated with alcohol influence behavior consistent with specific alcohol expectancies. The present study examined whether exposure to marijuana-related primes and marijuana expectancies interact to produce similar effects. Specifically, the present study examined whether marijuana primes and marijuana expectancies regarding cognitive and behavioral impairment interact to influence performance on an arithmetic task. Method: Two independent samples (N = 260) of undergraduate students (both marijuana users and nonusers) first completed measures of marijuana-outcome expectancies associated with cognitive and behavioral impairment and with general negative effects (Sample 2). Later in the semester, participants were exposed to marijuana-related (or neutral) primes and then completed an arithmetic task. Results: Results from Sample 1 indicated that participants who were exposed to marijuana-themed magazine covers performed more poorly on the arithmetic task if they expected that marijuana would lead to cognitive and behavioral impairment. Results from Sample 2 indicated that, for marijuana users, cognitive and behavioral impairment expectancies, but not expectancies regarding general negative effects, similarly moderated arithmetic performance for participants exposed to marijuana-related words. Conclusions: Results support the hypothesis that the implicit activation of specific marijuana-outcome expectancies can influence cognitive processes. Implications for research on marijuana are discussed. PMID:19371490

Marijuana (Weed, Pot) Facts

MedlinePlus

... That People Abuse » Marijuana (Weed, Pot) Facts Marijuana (Weed, Pot) Facts Listen Marijuana is a green, brown, or gray mix of dried, shredded leaves and flowers from the marijuana plant. Marijuana can be rolled up and smoked ...

The impact of marijuana policies on youth: clinical, research, and legal update.

PubMed

Ammerman, Seth; Ryan, Sheryl; Adelman, William P

2015-03-01

This technical report updates the 2004 American Academy of Pediatrics technical report on the legalization of marijuana. Current epidemiology of marijuana use is presented, as are definitions and biology of marijuana compounds, side effects of marijuana use, and effects of use on adolescent brain development. Issues concerning medical marijuana specifically are also addressed. Concerning legalization of marijuana, 4 different approaches in the United States are discussed: legalization of marijuana solely for medical purposes, decriminalization of recreational use of marijuana, legalization of recreational use of marijuana, and criminal prosecution of recreational (and medical) use of marijuana. These approaches are compared, and the latest available data are presented to aid in forming public policy. The effects on youth of criminal penalties for marijuana use and possession are also addressed, as are the effects or potential effects of the other 3 policy approaches on adolescent marijuana use. Recommendations are included in the accompanying policy statement. Copyright © 2015 by the American Academy of Pediatrics.

DEA Multimedia Drug Library: Marijuana

MedlinePlus

... confidencial Press Room » Multi-Media Library » Image Gallery » Marijuana MARIJUANA To Save Images: First click on the thumbnail ... Save in directory and then click Save. Indoor Marijuana Grow Indoor Marijuana Grow Loose Marijuana Marinol 10mg ...

Medical marijuana laws in 50 states: investigating the relationship between state legalization of medical marijuana and marijuana use, abuse and dependence

PubMed Central

Cerdá, Magdalena; Wall, Melanie; Keyes, Katherine M; Galea, Sandro; Hasin, Deborah

2011-01-01

Background Marijuana is the most frequently used illicit substance in the United States. Little is known of the role that macro-level factors, including community norms and laws related to substance use, play in determining marijuana use, abuse and dependence. We tested the relationship between state-level legalization of medical marijuana and marijuana use, abuse, and dependence. Methods We used the second wave of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a national survey of adults aged 18+ (n=34,653). Selected analyses were replicated using the National Survey on Drug Use and Health (NSDUH), a yearly survey of ~68,000 individuals aged 12+. We measured past-year cannabis use and DSM-IV abuse/dependence. Results In NESARC, residents of states with medical marijuana laws had higher odds of marijuana use (OR: 1.92; 95% CI: 1.49-2.47) and marijuana abuse/dependence (OR: 1.81; 95% CI: 1.22-2.67) than residents of states without such laws. Marijuana abuse/dependence was not more prevalent among marijuana users in these states (OR: 1.03; 95% CI: 0.67-1.60), suggesting that the higher risk for marijuana abuse/dependence in these states was accounted for by higher rates of use. In NSDUH, states that legalized medical marijuana also had higher rates of marijuana use. Conclusions States that legalized medical marijuana had higher rates of marijuana use. Future research needs to examine whether the association is causal, or is due to an underlying common cause, such as community norms supportive of the legalization of medical marijuana and of marijuana use. PMID:22099393

Marijuana’s Acute Effects on Cognitive Bias for Affective and Marijuana Cues

PubMed Central

Metrik, Jane; Aston, Elizabeth R.; Kahler, Christopher W.; Rohsenow, Damaris J.; McGeary, John E.; Knopik, Valerie S.

2015-01-01

Marijuana produces acute increases in positive subjective effects and decreased reactivity to negative affective stimuli, though may also acutely induce anxiety. Implicit attentional and evaluative processes may explicate marijuana’s ability to acutely increase positive and negative emotions. This within-subjects study examined whether smoked marijuana with 2.7–3.0 % delta-9-tetrahydrocannabinol (THC), relative to placebo, acutely changed attentional processing of rewarding and negative affective stimuli as well as marijuana-specific stimuli. On two separate days, regular marijuana users (N=89) smoked placebo or active THC cigarette and completed subjective ratings of mood, intoxication, urge to smoke marijuana, and two experimental tasks: Pleasantness Rating (response latency and perceived pleasantness of affective and marijuana-related stimuli) and Emotional Stroop (attentional bias to affective stimuli). On the Pleasantness Rating task, active marijuana increased response latency to negatively-valenced and marijuana-related (vs. neutral) visual stimuli, beyond a general slowing of response. Active marijuana also increased pleasantness ratings of marijuana images, although to a lesser extent than placebo due to reduced marijuana urge after smoking. Overall, active marijuana did not acutely change processing of positive emotional stimuli. There was no evidence of attentional bias to affective word stimuli on the Emotional Stroop task with the exception of attentional bias to positive word stimuli in the subgroup of marijuana users with cannabis dependence. Marijuana may increase allocation of attentional resources towards marijuana-specific and negatively-valenced visual stimuli without altering processing of positively-valenced stimuli. Marijuana-specific cues may be more attractive with higher levels of marijuana craving and less wanted with low craving levels. PMID:26167716

Let's Be Blunt: Consumption Methods Matter Among Black Marijuana Smokers.

PubMed

Montgomery, LaTrice; Bagot, Kara

2016-05-01

Despite the high prevalence of blunt (i.e., hollowed-out cigars that are filled with marijuana) use among Black marijuana smokers, few studies have examined if and how blunt users differ from traditional joint users. The current study compared the prevalence and patterns of use for those who smoked blunts in the past month (i.e., blunt users) with those who used marijuana through other methods (i.e., other marijuana users). The sample included 935 Black past-month marijuana smokers participating in the 2013 National Survey on Drug Use and Health. Among past-month marijuana smokers, 73.2% were blunt users and 26.8% were other marijuana users. Overall, blunt users initiated marijuana use at an earlier age (15.9 vs. 17.3 years, p < .01) and reported more days of marijuana use in the past month (16 vs. 8 days, p < .01) than did other marijuana users. There were also differences by gender. Among females, blunt users reported a higher odds of past-year marijuana abuse or dependence (23.8%) than other marijuana users (11.2%) (adjusted odds ratio = 1.23, 95% CI [1.12, 3.17], p < .01). However, blunt-using males reported similar odds of past-year marijuana abuse or dependence (approximately 25%) as other marijuana-using males. These findings highlight the need for targeted interventions for blunt users as a subgroup of marijuana users, especially among Black females, who may be at increased risk for developing a marijuana use disorder as a result of blunt smoking.

Medical Marijuana Legalization and Marijuana Use Among Youth in Oregon.

PubMed

Paschall, Mallie J; Grube, Joel W; Biglan, Anthony

2017-06-01

While the legalization of marijuana for medical and recreational use has raised concerns about potential influences on marijuana use and beliefs among youth, few empirical studies have addressed this issue. We examined the association between medical marijuana patients and licensed growers per 1000 population in 32 Oregon counties from 2006 to 2015, and marijuana use among youth over the same period. We obtained data on registered medical marijuana patients and licensed growers from the Oregon Medical Marijuana Program and we obtained data on youth marijuana use, perceived parental disapproval, and demographic characteristics from the Oregon Healthy Teens Survey. Across 32 Oregon counties, the mean rate of marijuana patients per 1000 population increased from 2.9 in 2006 to 18.3 in 2015, whereas the grower rate increased from 3.8 to 11.9. Results of multi-level analyses indicated significant positive associations between rates of marijuana patients and growers per 1000 population and the prevalence of past 30-day marijuana use, controlling for youth demographic characteristics. The marijuana patient and grower rates were also inversely associated with parental disapproval of marijuana use, which decreased from 2006 to 2015 and acted as a mediator. These findings suggest that a greater number of registered marijuana patients and growers per 1000 population in Oregon counties was associated with a higher prevalence of marijuana use among youth from 2006 to 2015, and that this relationship was partially attributable to perceived norms favorable towards marijuana use.

Alcohol use potentiates marijuana problem severity in young adult women.

PubMed

Stein, Michael D; Caviness, Celeste M; Anderson, Bradley J

2014-01-01

Most young adult women who smoke marijuana also drink alcohol. Marijuana-related problems are associated with marijuana use frequency. We hypothesized that increased alcohol use frequency potentiates the association between frequency of marijuana use and marijuana-related problem severity. We recruited women aged 18 to 24 who smoked marijuana at least monthly and were not treatment seeking. Marijuana and alcohol use were measured using the timeline follow-back method. Problems associated with marijuana use were assessed using the Marijuana Problems Scale. Participants (n = 332) averaged 20.5 ± 1.8 years of age, were 66.7% non-Hispanic White, and reported using marijuana on 51.5 ± 30.6 and alcohol on 18.9 ± 16.8 of the 90 previous days. Controlling for education, ethnicity, years of marijuana use, and other drug use, frequency of marijuana use (b = .22; p < .01) and frequency of alcohol use (b = 0.13; p < .05) had significant, positive effects on marijuana problem severity. In a separate multivariate model, the linear by linear interaction of marijuana by alcohol use frequency was significant (b = 0.18; p < .01), consistent with the hypothesis. Concurrent alcohol use impacts the experience of negative consequences from marijuana use in a community sample of young women. Discussions of marijuana use in young adults should consider the possible potentiating effects of alcohol use. Copyright © 2014 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

College student marijuana involvement: Perceptions, use, and consequences across 11 college campuses.

PubMed

Pearson, Matthew R; Liese, Bruce S; Dvorak, Robert D

2017-03-01

Marijuana is currently the most commonly used illicit drug in the United States, and with the movement toward legalization of recreational marijuana, the country faces numerous issues regarding policy, prevention, and treatment of marijuana use. The present study examines the prevalence of marijuana use and consequences and compares users and non-users on a wide range of other marijuana-related constructs among college students across 11 universities. Participants included 8141 college students recruited from the psychology department participant pools of 11 universities throughout the US, including four major regions of the US (West, South, Midwest, Northeast) and states with varying policies regarding the legality of marijuana use. We observed marijuana use rates similar to representative samples of young adults and college students (i.e., 53.3% lifetime marijuana users, 26.2% past month marijuana users). About 1 in 10 past month marijuana users experienced no consequences from their use, whereas nearly 1 in 10 experienced 19 or more consequences. Lifetime marijuana users had more positive perceptions of marijuana compared to non-users on a wide-range of marijuana-related constructs. We report descriptive statistics on a wide range of marijuana-related variables. We hope that these data provide a useful baseline prior to increased legalization of recreational marijuana use. Multi-site studies like this one are needed to study the risky and protective factors for problematic marijuana use. These findings can inform interventions and public policy. Copyright © 2016 Elsevier Ltd. All rights reserved.

College Student Marijuana Involvement: Perceptions, Use, and Consequences across 11 College Campuses

PubMed Central

Pearson, Matthew R; Liese, Bruce S; Dvorak, Robert D

2016-01-01

Background Marijuana is currently the most commonly used illicit drug in the United States, and with the movement toward legalization of recreational marijuana, the country faces numerous issues regarding policy, prevention, and treatment of marijuana use. The present study examines the prevalence of marijuana use and consequences and compare users and non-users on a wide range of other marijuana-related constructs among college students across 11 universities. Method Participants included 8,141 college students recruited from the psychology department participant pools of 11 universities throughout the US, including four major regions of the US (West, South, Midwest, Northeast) and states with varying policies regarding the legality of marijuana use. Results We observed marijuana use rates similar to representative samples of young adults and college students (i.e., 53.3% lifetime marijuana users, 26.2% past month marijuana users). About 1 in 10 past month marijuana users experienced no consequences from their use, whereas nearly 1 in 10 experienced 19 or more consequences. Lifetime marijuana users had more positive perceptions of marijuana compared to non-users on a wide-range of marijuana-related constructs. Conclusions We report descriptive statistics on a wide range of marijuana-related variables. We hope that these data provide a useful baseline prior to increased legalization of recreational marijuana use. Multi-site studies like this one are needed to study the risky and protective factors for problematic marijuana use. These findings can inform interventions and public policy. PMID:27894029

Bayesian inference for the distribution of grams of marijuana in a joint.

PubMed

Ridgeway, Greg; Kilmer, Beau

2016-08-01

The average amount of marijuana in a joint is unknown, yet this figure is a critical quantity for creating credible measures of marijuana consumption. It is essential for projecting tax revenues post-legalization, estimating the size of illicit marijuana markets, and learning about how much marijuana users are consuming in order to understand health and behavioral consequences. Arrestee Drug Abuse Monitoring data collected between 2000 and 2010 contain relevant information on 10,628 marijuana transactions, joints and loose marijuana purchases, including the city in which the purchase occurred and the price paid for the marijuana. Using the Brown-Silverman drug pricing model to link marijuana price and weight, we are able to infer the distribution of grams of marijuana in a joint and provide a Bayesian posterior distribution for the mean weight of marijuana in a joint. We estimate that the mean weight of marijuana in a joint is 0.32g (95% Bayesian posterior interval: 0.30-0.35). Our estimate of the mean weight of marijuana in a joint is lower than figures commonly used to make estimates of marijuana consumption. These estimates can be incorporated into drug policy discussions to produce better understanding about illicit marijuana markets, the size of potential legalized marijuana markets, and health and behavior outcomes. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Marijuana.

PubMed

Ammerman, Seth

2014-04-01

Marijuana use in pediatric populations remains an ongoing concern, and marijuana use by adolescents had known medical, psychological, and cognitive side effects. Marijuana alters brain development and has detrimental effects on brain structure and function in ways that are incompletely understood at this point in time. Furthermore, marijuana smoke contains tar and other harmful chemicals, so marijuana cannot be recommended by physicians. At this time, no studies suggest a benefit of marijuana use by children and adolescents. In the context of limited but clear evidence showing harm or potential harm from marijuana use by adolescents, any recommendations for medical marijuana use by adolescents are based on research studies with adults and on anecdotal evidence. Criminal prosecution for marijuana possession adversely affects hundreds of thousands of youth yearly in the United States, particularly minority youth. Current evidence does not support a focus on punishment for youth who use marijuana. Rather, drug education and treatment programs should be encouraged to better help youth who are experimenting with or are dependent on marijuana. Decriminalization of recreational use of marijuana by adults has not led to an increase in youth use rates of recreational marijuana. Thus, decriminalization may be a reasonable alternative to outright criminalization, as long as it is coupled with drug education and treatment programs. The effect of outright legalization of adult recreational use of marijuana on youth use is unknown.

Medical marijuana use among adolescents in substance abuse treatment.

PubMed

Salomonsen-Sautel, Stacy; Sakai, Joseph T; Thurstone, Christian; Corley, Robin; Hopfer, Christian

2012-07-01

To assess the prevalence and frequency of medical marijuana diversion and use among adolescents in substance abuse treatment and to identify factors related to their medical marijuana use. This study calculated the prevalence and frequency of diverted medical marijuana use among adolescents (n = 164), ages 14-18 years (mean age = 16.09, SD = 1.12), in substance abuse treatment in the Denver metropolitan area. Bivariate and multivariate analyses were completed to determine factors related to adolescents' use of medical marijuana. Approximately 74% of the adolescents had used someone else's medical marijuana, and they reported using diverted medical marijuana a median of 50 times. After adjusting for gender and race/ethnicity, adolescents who used medical marijuana had an earlier age of regular marijuana use, more marijuana abuse and dependence symptoms, and more conduct disorder symptoms compared with those who did not use medical marijuana. Medical marijuana use among adolescent patients in substance abuse treatment is very common, implying substantial diversion from registered users. These results support the need for policy changes that protect against diversion of medical marijuana and reduce adolescent access to diverted medical marijuana. Future studies should examine patterns of medical marijuana diversion and use in general population adolescents. Copyright © 2012 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Health conditions and motivations for marijuana use among young adult medical marijuana patients and non-patient marijuana users.

PubMed

Lankenau, Stephen E; Ataiants, Janna; Mohanty, Salini; Schrager, Sheree; Iverson, Ellen; Wong, Carolyn F

2018-02-01

While marijuana has been legal for medical purposes in California since 1996, little is known about the health histories of young adult medical marijuana patients who are a significant proportion of medical marijuana patients. We examined whether young adult medical marijuana patients reported health conditions and motivations for use that were consistent with medical use of marijuana in California. Young adults (N = 366) aged 18 to 26 years were sampled in Los Angeles in 2014-2015 and segmented into medical marijuana 'patients' (n = 210), marijuana users with a current recommendation, and non-patient users or 'non-patients' (n = 156), marijuana users who never had a medical marijuana recommendation. Differences between patients and non-patients regarding self-reported health histories and past/current motivations for marijuana use were expressed as unadjusted risk ratios. Compared with non-patients, patients were significantly more likely to report a range of lifetime health problems, such as psychological, physical pain and gastrointestinal. In the past 90 days, patients were significantly more likely to report motivations for marijuana use than non-patients concerning sleep, anxiety, physical pain and focusing. Psychological and pain problems were the most common health conditions reported to receive a medical marijuana recommendation. Patients were significantly less likely than non-patients to report any privacy concerns about obtaining a medical marijuana recommendation. Patients were significantly more likely to report a range of health conditions and motivations associated with medical use than non-patients. A great majority of patients reported obtaining a medical marijuana recommendation for health problems in accordance with the California law. [Lankenau SE, Ataiants J,Mohanty S, Schrager S, Iverson E, Wong CF.Health conditions and motivations for marijuana use among young adultmedical marijuana patients and non-patient marijuana users. Drug Alcohol Rev 2017;00:000-000]. © 2017 Australasian Professional Society on Alcohol and other Drugs.

Use of Marijuana Edibles by Adolescents in California

PubMed Central

Friese, Bettina; Slater, Michael D.; Battle, Robynn S.

2017-01-01

We explored how adolescent marijuana edible users differ in regards to marijuana use and related beliefs from marijuana users who do not use edibles. We analyzed California Healthy Kids Survey data collected in one Northern California school district with a racially and ethnically diverse student population. Survey respondents were youth in grades 9 – 12. Overall, 33% of respondents reported having used marijuana in their lifetime, and 50% of lifetime marijuana users reported using marijuana in the past 30 days. Seventy-two percent of lifetime marijuana users and 82% of past month marijuana users reported having used edibles in their lifetime. Comparing marijuana users who have never used edibles to those users who have, we found that edible users reported using marijuana more frequently in their lifetime. Edible users were also more likely to have used marijuana in the past 30 days, more frequently in the past 30 days, more likely on school property and more frequently on school property. Edible users and non-users differed in their perceptions of risk; edible users were less likely to agree that edible use is very risky. Edible users also reported a younger age of first marijuana use and more attempts to stop using marijuana than non-edible users. Multi-level regression analyses indicate that prevalence of edible use among marijuana users was related to perceived risk of edible use. Perceived risk of edible use among marijuana users was higher among marijuana users who do not use edibles, females, and those youth who perceive school rules to be clear. The findings indicate that prevalence of edible use is high among marijuana users, especially frequent users. PMID:28470448

Exposure to and Content of Marijuana Product Reviews.

PubMed

Cavazos-Rehg, Patricia A; Krauss, Melissa J; Sowles, Shaina J; Murphy, Gabrielle M; Bierut, Laura J

2018-02-01

Many individuals now seek out product reviews in order to make an informed decision prior to making a purchase. In this study, we investigate consumers' exposure to and content within product reviews about marijuana because of their potential to shape marijuana purchasing decisions. The terms "weed review," "marijuana review," and "cannabis review" were searched on YouTube on June 10-11, 2015; the team viewed and coded the content of 83 product review videos about marijuana. In addition, we surveyed young adult (18-34 years old) current (past month) marijuana users (n = 742) from across the USA online to assess exposure to product reviews about marijuana and associations with socio-demographic characteristics and marijuana use behaviors. In our content analysis of videos, we observed that the reviewers tended to consume marijuana during the video and often shared personal, favorable experiences towards the marijuana they ingested (e.g., became as high as possible or experienced positive effects on physical and mental health). Most videos normalized marijuana use and could be easily accessed by underage youth. About one third (34%) of the survey participants viewed/sought a product review about marijuana in the past 30 days. In a multivariable logistic regression model, living in a state where recreational use is legal or using multiple forms of marijuana was associated with increased odds of viewing/seeking marijuana reviews. Prevention messages should counter product reviews about marijuana that tend to normalize and promote marijuana use given that they are more readily viewed by individuals who are increasingly susceptible to marijuana's potential harms.

The effects of internal and external control factors on college students' marijuana use and cessation of use.

PubMed

Lo, C C; Globetti, G

1995-01-01

The purpose of this study was to examine how selected internal and external control variables influence lifetime use, frequency of use, and cessation of use of marijuana. The internal control factor, comprising the variables 1) perceived risk of marijuana use and 2) attitudes toward prohibition of marijuana use, refers to a built-in personal tendency toward conventionality. The external control factor refers to social-environmental forces which discourage marijuana use. External control is indicated by factors including the number of extra-curricular activities in which an individual is involved; place of residence; the availability of marijuana; peer attitudes toward marijuana use; the number of an individual's friends who use marijuana; and the number of occasions on which an individual has observed others using marijuana. The study's results show that both internal and external control factors are significant predictors of the frequency of marijuana use. The external control factor, however, plays a more important role in explaining lifetime marijuana use and cessation of marijuana use.

Therapeutic potential of medicinal marijuana: an educational primer for health care professionals.

PubMed

Mouhamed, Yara; Vishnyakov, Andrey; Qorri, Bessi; Sambi, Manpreet; Frank, Sm Signy; Nowierski, Catherine; Lamba, Anmol; Bhatti, Umrao; Szewczuk, Myron R

2018-01-01

With the proposed Canadian July 2018 legalization of marijuana through the Cannabis Act, a thorough critical analysis of the current trials on the efficacy of medicinal marijuana (MM) as a treatment option is necessary. This review is particularly important for primary care physicians whose patients may be interested in using MM as an alternative therapy. In response to increased interest in MM, Health Canada released a document in 2013 for general practitioners (GPs) as an educational tool on the efficacy of MM in treating some chronic and acute conditions. Although additional studies have filled in some of the gaps since the release of the Health Canada document, conflicting and inconclusive results continue to pose a challenge for physicians. This review aims to supplement the Health Canada document by providing physicians with a critical yet concise update on the recent advancements made regarding the efficacy of MM as a potential therapeutic option. An update to the literature of 2013 is important given the upcoming changes in legislation on the use of marijuana. Also, we briefly highlight the current recommendations provided by Canadian medical colleges on the parameters that need to be considered prior to authorizing MM use, routes of administration as well as a general overview of the endocannabinoid system as it pertains to cannabis. Lastly, we outline the appropriate medical conditions for which the authorization of MM may present as a practical alternative option in improving patient outcomes as well as individual considerations of which GPs should be mindful. The purpose of this paper is to offer physicians an educational tool that provides a necessary, evidence-based analysis of the therapeutic potential of MM and to ensure physicians are making decisions on the therapeutic use of MM in good faith.

Therapeutic potential of medicinal marijuana: an educational primer for health care professionals

PubMed Central

Frank, SM Signy; Nowierski, Catherine; Lamba, Anmol; Bhatti, Umrao; Szewczuk, Myron R

2018-01-01

With the proposed Canadian July 2018 legalization of marijuana through the Cannabis Act, a thorough critical analysis of the current trials on the efficacy of medicinal marijuana (MM) as a treatment option is necessary. This review is particularly important for primary care physicians whose patients may be interested in using MM as an alternative therapy. In response to increased interest in MM, Health Canada released a document in 2013 for general practitioners (GPs) as an educational tool on the efficacy of MM in treating some chronic and acute conditions. Although additional studies have filled in some of the gaps since the release of the Health Canada document, conflicting and inconclusive results continue to pose a challenge for physicians. This review aims to supplement the Health Canada document by providing physicians with a critical yet concise update on the recent advancements made regarding the efficacy of MM as a potential therapeutic option. An update to the literature of 2013 is important given the upcoming changes in legislation on the use of marijuana. Also, we briefly highlight the current recommendations provided by Canadian medical colleges on the parameters that need to be considered prior to authorizing MM use, routes of administration as well as a general overview of the endocannabinoid system as it pertains to cannabis. Lastly, we outline the appropriate medical conditions for which the authorization of MM may present as a practical alternative option in improving patient outcomes as well as individual considerations of which GPs should be mindful. The purpose of this paper is to offer physicians an educational tool that provides a necessary, evidence-based analysis of the therapeutic potential of MM and to ensure physicians are making decisions on the therapeutic use of MM in good faith. PMID:29928146

Cumulative and recent psychiatric symptoms as predictors of substance use onset: does timing matter?

PubMed

Cerdá, Magdalena; Bordelois, Paula M; Keyes, Katherine M; Galea, Sandro; Koenen, Karestan C; Pardini, Dustin

2013-12-01

We examined two questions about the relationship between conduct disorder (CD), depression and anxiety symptoms and substance use onset: (i) what is the relative influence of recent and more chronic psychiatric symptoms on alcohol and marijuana use initiation and (ii) are there sensitive developmental periods when psychiatric symptoms have a stronger influence on substance use initiation? Secondary analysis of longitudinal data from the Pittsburgh Youth Study, a cohort study of boys followed annually from 7 to 19 years of age. Recruitment occurred in public schools in Pittsburgh, Pennsylvania, USA. A total of 503 boys. The primary outcomes were age of alcohol and marijuana use onset. Discrete-time hazard models were used to determine whether (i) recent (prior year); and (ii) cumulative (from age 7 until 2 years prior to substance use onset) psychiatric symptoms were associated with substance use onset. Recent anxiety symptoms [hazard ratio (HR) = 1.10, 95% confidence interval (CI) = 1.03-1.17], recent (HR = 1.59, 95% CI = 1.35-1.87), cumulative (HR = 1.45, 95% CI = 1.03-2.03) CD symptoms, and cumulative depression symptoms (HR = 1.04, 95% CI = 1.01-1.08) were associated with earlier alcohol use onset. Recent (HR = 1.39, 95% CI = 1.22-1.58) and cumulative CD symptoms (HR = 1.38, 95% CI = 1.02-1.85) were associated with marijuana use onset. Recent anxiety symptoms were only associated with alcohol use onset among black participants. Timing matters in the relationship between psychiatric symptoms and substance use onset in childhood and adolescence, and the psychiatric predictors of onset are substance-specific. There is no single sensitive developmental period for the influence of psychiatric symptoms on alcohol and marijuana use initiation. © 2013 Society for the Study of Addiction.

Associations Between Marijuana Use Trajectories and Educational and Occupational Success in Young Adulthood.

PubMed

Thompson, Kara; Leadbeater, Bonnie; Ames, Megan; Merrin, Gabriel J

2018-04-28

Adolescence and young adulthood is a critical stage when the economic foundations for life-long health are established. To date, there is little consensus as to whether marijuana use is associated with poor educational and occupational success in adulthood. We investigated associations between trajectories of marijuana use from ages 15 to 28 and multiple indicators of economic well-being in young adulthood including achievement levels (i.e., educational attainment and occupational prestige), work characteristics (i.e., full vs part-time employment, hours worked, annual income), financial strain (i.e., debt, trouble paying for necessities, delaying medical attention), and perceived workplace stress. Data were from the Victoria Healthy Youth Survey, a 10-year prospective study of a randomly recruited community sample of 662 youth (48% male; M age  = 15.5), followed biennially for six assessments. Models adjusted for baseline age, sex, SES, high school grades, heavy drinking, smoking, and internalizing and oppositional defiant disorder symptoms. Chronic users (our highest risk class) reported lower levels of educational attainment, lower occupational prestige, lower income, greater debt, and more difficulty paying for medical necessities in young adulthood compared to abstainers. Similarly, increasers also reported lower educational attainment, occupational prestige, and income. Decreasers, who had high early use but quit over time, showed resilience in economic well-being, performing similar to abstainers. Groups did not differ on employment status or perceived workplace stress. The findings indicate that early onset and persistent high or increasingly frequent use of marijuana in the transition from adolescent to young adulthood is associated with risks for achieving educational and occupational success, and subsequently health, in young adulthood.

Exposure to Advertisements and Marijuana Use Among US Adolescents.

PubMed

Dai, Hongying

2017-11-30

This study examined whether exposure to marijuana advertisements was associated with current marijuana use and frequency of use among US adolescents in grades 8, 10, and 12. Weighted estimates of exposure to marijuana advertisements and marijuana use from the 2014 and 2015 Monitoring the Future studies were investigated. Factors associated with the prevalence and frequency of marijuana use were analyzed by using logistic regression and linear regression models, respectively. Of all respondents (n = 12,988), 13.8% reported marijuana use in the past 30 days. Exposure to marijuana advertisements was prevalent among adolescents, with 52.8% reporting exposure from internet advertisements, 32.1% from television advertisements, 24.1% from magazine or newspaper advertisements, 19.7% from radio advertisements, 19.0% from advertisements on storefronts, and 16.6% from billboards. In the multivariable analysis, current use of marijuana among adolescents was associated with exposure to marijuana advertisements on storefronts (adjusted odds ratio [OR] = 1.4, P < .001), magazines or newspapers (adjusted OR = 1.6, P < .001), billboards (adjusted OR = 1.4, P = .002), internet (adjusted OR = 1.8, P < .001), television (adjusted OR = 1.4, P < .001) and radio (adjusted OR = 1.7, P < .001). Exposure to marijuana advertisements from the internet was associated with increased use of marijuana (β = 0.3, P = .04). Exposure to marijuana advertisements was associated with higher odds of current marijuana use among adolescents. Regulations that limit marijuana advertisements to adolescents and educational campaigns on harmfulness of illicit marijuana use are needed.

Exposure to Advertisements and Marijuana Use Among US Adolescents

PubMed Central

2017-01-01

Introduction This study examined whether exposure to marijuana advertisements was associated with current marijuana use and frequency of use among US adolescents in grades 8, 10, and 12. Methods Weighted estimates of exposure to marijuana advertisements and marijuana use from the 2014 and 2015 Monitoring the Future studies were investigated. Factors associated with the prevalence and frequency of marijuana use were analyzed by using logistic regression and linear regression models, respectively. Results Of all respondents (n = 12,988), 13.8% reported marijuana use in the past 30 days. Exposure to marijuana advertisements was prevalent among adolescents, with 52.8% reporting exposure from internet advertisements, 32.1% from television advertisements, 24.1% from magazine or newspaper advertisements, 19.7% from radio advertisements, 19.0% from advertisements on storefronts, and 16.6% from billboards. In the multivariable analysis, current use of marijuana among adolescents was associated with exposure to marijuana advertisements on storefronts (adjusted odds ratio [OR] = 1.4, P < .001), magazines or newspapers (adjusted OR = 1.6, P < .001), billboards (adjusted OR = 1.4, P = .002), internet (adjusted OR = 1.8, P < .001), television (adjusted OR = 1.4, P < .001) and radio (adjusted OR = 1.7, P < .001). Exposure to marijuana advertisements from the internet was associated with increased use of marijuana (β = 0.3, P = .04). Conclusion Exposure to marijuana advertisements was associated with higher odds of current marijuana use among adolescents. Regulations that limit marijuana advertisements to adolescents and educational campaigns on harmfulness of illicit marijuana use are needed. PMID:29191259

Contextual risks linking parents’ adolescent marijuana use to offspring onset

PubMed Central

Kerr, David C. R.; Tiberio, Stacey S.; Capaldi, Deborah M.

2015-01-01

Objective We studied the extent to which parent marijuana use in adolescence is associated with marijuana use onset in offspring through contextual family and peer risks. Method Fathers assessed (n = 93) since childhood, their 146 offspring (n = 83 girls), and offspring's mothers (n = 85) participated in a longitudinal study. Using discrete-time survival analysis, fathers’ (prospectively measured) and mothers’ (retrospective) adolescent marijuana use was used to predict offspring marijuana use onset through age 19 years. Parental monitoring, child exposure to marijuana use, peer deviance, peer marijuana use, and perceptions of parent disapproval of child use were measured before or concurrent with onset. Results Parents’ adolescent marijuana use was significantly associated with less monitoring, offspring alcohol use, the peer behaviors, exposure to adult marijuana use, and perceptions of less parent disapproval. Male gender and the two peer behaviors were positively associated with children's marijuana use onset, controlling for their alcohol use. Parents’ adolescent marijuana use had a significant indirect effect on child onset through children's deviant peer affiliations and a composite contextual risk score. Conclusions Parents’ histories of marijuana use may contribute indirectly to children's marijuana use onset through their influence on the social environments children encounter; specifically, those characterized by more liberal use norms, exposure to marijuana use and deviant and marijuana-using peers, and less adult supervision. Given that alcohol use onset was controlled, findings suggest that the contextual factors identified here confer unique risk for child marijuana use onset. PMID:26166667

Traversing the triangulum: the intersection of tobacco, legalised marijuana and electronic vaporisers in Denver, Colorado

PubMed Central

McDonald, Emily Anne; Popova, Lucy; Ling, Pamela M

2016-01-01

Objective To explore the intersection of tobacco, legalised marijuana and electronic vaporiser use among young adults in the ‘natural laboratory’ of Colorado, the first state with legalised retail marijuana. Methods We conducted semistructured interviews with 32 young adults (18–26 years old) in Denver, Colorado, in 2015 to understand the beliefs and practices related to the use of tobacco, marijuana and vaporisers. Results We found ambiguity about whether the phrase ‘to smoke’ refers to the use of tobacco or marijuana products. Smoking marijuana blunts (emptied cigarillo or tobacco wrap filled with marijuana) was common, but few interpreted this as tobacco use. Marijuana vaporisers were used to circumvent public consumption laws (eg, while at work or when driving). Young adults considered secondhand tobacco smoke dangerous, but perceived secondhand marijuana smoke as benign. Discussion Using tobacco products as a delivery method for marijuana (eg, blunts) might be increasing and normalising tobacco use among young adults. Surveillance should explicitly ask about use of tobacco products for marijuana. Marijuana vaporisers, often indistinguishable from nicotine vaporisers, may be used to circumvent public consumption laws; communities concerned about use of marijuana in public spaces should include vaporisers (for nicotine or marijuana) in smoke-free regulations. Tobacco, marijuana and electronic vaporisers should be studied together, rather than separately. This approach is essential in informing research and policy as more US states and countries worldwide move to legalise marijuana. PMID:27697954

Political and medical views on medical marijuana and its future.

PubMed

Rubens, Muni

2014-01-01

The policies, laws, politics, public opinions, and scientific inferences of medical marijuana are rapidly changing as the debate on medical use of marijuana has always been political, rather than scientific. Federal law has barred the use of medical marijuana though 18 state governments and Washington, DC, support the medical use of marijuana. Unfortunately, not many studies exist on medical marijuana to back these laws and policies. The judiciary, on the other hand, has elicited a diverse response to medical marijuana through its rulings over several decades. Some rulings favored the federal government's opinion, and others supported the larger public view and many state governments with legalized medical marijuana. Public opinion on legalizing medical marijuana has always favored the use of medical marijuana. The movement of scientific knowledge of medical marijuana follows an erratic, discontinuous pathway. The future place of medical marijuana in U.S. society remains unknown. The three forces-scientific knowledge, social-political acceptance, and laws-play a role in the direction that medical marijuana takes in society. Overcoming political-social forces requires a concerted effort from the scientific community and political leaders. The results of scientific research must guide the decisions for laws and medical use of marijuana. This article aims to trace the political dilemma and contradictory views shared by federal and state governments and predict the future of medical marijuana by tracing the past history of medical marijuana with its bumpy pathway in the social-political arena.

Interest in marijuana treatment programs among teenage smokers and nonsmokers.

PubMed

Sheer, Amy J; Gorelick, David A; Collins, Charles C; Schroeder, Jennifer R; Heishman, Stephen J; Leff, Michelle K; Moolchan, Eric T

2009-12-01

Little is known about adolescents' interest in marijuana treatment programs. This question was evaluated by telephone interview in a convenience sample of 575 adolescents responding to advertisements for tobacco research studies. Eighty-one percent of respondents endorsed the need for marijuana treatment programs for adolescents. These adolescents were younger and less likely to smoke tobacco, smoke marijuana, or use alcohol than those not endorsing such a need. Among the 192 marijuana smokers, the 58.8% who endorsed the need for marijuana treatment programs took their first puff of marijuana at a younger age than those who did not endorse the need. Those who were willing to participate in a marijuana treatment program were more likely African American and took their first marijuana puff at a younger age than those not interested in treatment. These findings suggest that most adolescent marijuana smokers endorse the need for and are willing to attend marijuana treatment programs.

Prevalence, correlates, and trends in tobacco use and cessation among current, former, and never adult marijuana users with a history of tobacco use, 2005-2014.

PubMed

Schauer, Gillian L; King, Brian A; McAfee, Timothy A

2017-10-01

Approximately 70% of current (past 30-day) adult marijuana users are current tobacco users, which may complicate tobacco cessation. We assessed prevalence and trends in tobacco cessation among adult ever tobacco users, by marijuana use status. Data came from the National Survey on Drug Use and Health, a cross-sectional, nationally representative, household survey of U.S. civilians. Analyses included current, former, and never marijuana users aged≥18 reporting ever tobacco use (cigarette, cigar, chew/snuff). We computed weighted estimates (2013-2014) of current tobacco use, recent tobacco cessation (quit 30days to 12months), and sustained tobacco cessation (quit>12months) and adjusted trends in tobacco use and cessation (2005-2014) by marijuana use status. We also assessed the association between marijuana and tobacco use status. In 2013-2014, among current adult marijuana users reporting ever tobacco use, 69.1% were current tobacco users (vs. 38.5% of former marijuana users, p<0.0001, and 28.2% of never marijuana users, p<0.0001); 9.1% reported recent tobacco cessation (vs. 8.4% of former marijuana users, p<0.01, and 6.3% of never marijuana users, p<0.001), and 21.8% reported sustained tobacco cessation (vs. 53.1% of former marijuana users, p<0.01, and 65.5% of never marijuana users, p<0.0001). Between 2005 and 2014, current tobacco use declined and sustained tobacco cessation increased among all marijuana use groups. Current marijuana users who ever used tobacco had double the prevalence (vs. never-marijuana users) of current tobacco use, and significantly lower sustained abstinence. Interventions addressing tobacco cessation in the context of use of marijuana and other substances may be warranted. Copyright © 2017 Elsevier Ltd. All rights reserved.

Marijuana practices and patterns of use among young adult medical marijuana patients and non-patient marijuana users.

PubMed

Lankenau, Stephen E; Fedorova, Ekaterina V; Reed, Megan; Schrager, Sheree M; Iverson, Ellen; Wong, Carolyn F

2017-01-01

Little is known about young adult medical marijuana patients (MMP) and their marijuana using patterns and practices, which includes frequency of use, sourcing of marijuana products, forms/modes of administration, and patterns of illicit/prescription drug misuse, compared to non-patient marijuana users (NPU). Young adults (N=366) aged 18-26 years old were sampled in Los Angeles in 2014-15 and segmented into NPU (n=156), marijuana users who never had a medical marijuana (MM) recommendation, and MMP (n=210), marijuana users with a current, verified MM recommendation. Differences regarding self-reported marijuana and other drug use during the past 90days are expressed as unadjusted risk ratios or differences in means. MMP reported significantly greater mean days of use (76.4 vs. 59.2, p<0.001) and mean dollars spent on marijuana products (564.5 vs. 266.9, p<0.001) than NPU. Approximately one-quarter (22.6%) of both MMP and NPU report selling marijuana obtained from a dispensary to someone else in the past 90days. MMP were more likely to report vaporization modalities for concentrates (URR=1.5, 95% C.I.=1.2, 2.0) and for marijuana (URR=1.5, 95% C.I.=1.1, 2.1) than NPU. Though not significant, trends toward lower misuse of prescription drugs in the past 90days were observed among MMP compared to NPU. MMP reported greater access to marijuana via dispensaries, more frequent and intensive use of marijuana, and greater use of non-combustible forms of marijuana compared to NPU. MMP reported less recent misuse of prescription drugs compared to NPU. Copyright © 2016. Published by Elsevier Ireland Ltd.

Predictors of Adult Marijuana Use Among Parents and Nonparents.

PubMed

Epstein, Marina; Bailey, Jennifer A; Steeger, Christine M; Hill, Karl G; Skinner, Martie L

2018-02-01

The current study examined predictors of marijuana use among adults, including subsamples of adults who are actively parenting (i.e., have regular face-to-face contact with a child) and those who have no children. Participants were a community sample of 808 adults and two subsamples drawn from the full group: 383 adults who were actively parenting and 135 who had no children. Multilevel models examined predictors of marijuana use in these three groups from ages 27 to 39. Becoming a parent was associated with a decrease in marijuana use. Regular marijuana use in young adulthood (ages 21-24), partner marijuana use, and pro-marijuana attitudes increased the likelihood of past-year marijuana use among all participants. Being a primary caregiver (among parents) was associated with less marijuana use. Overall, predictors of marijuana use were similar for all adults, regardless of parenting status. Study results suggest that the onset of parenthood alone may be insufficient to reduce adult marijuana use. Instead, preventive intervention targets may include changing adult pro-marijuana attitudes and addressing marijuana use behaviors of live-in partners. Lastly, universal approaches targeting parents and nonparents may be effective for general adult samples.

Medical marijuana

MedlinePlus

... this page: //medlineplus.gov/ency/patientinstructions/000899.htm Medical marijuana To use the sharing features on this page, ... have legalized marijuana for medical use. How Does Medical Marijuana Work? Medical marijuana may be: Smoked Vaporized Eaten ...

Cue-elicited increases in incentive salience for marijuana: Craving, demand, and attentional bias.

PubMed

Metrik, Jane; Aston, Elizabeth R; Kahler, Christopher W; Rohsenow, Damaris J; McGeary, John E; Knopik, Valerie S; MacKillop, James

2016-10-01

Incentive salience is a multidimensional construct that includes craving, drug value relative to other reinforcers, and implicit motivation such as attentional bias to drug cues. Laboratory cue reactivity (CR) paradigms have been used to evaluate marijuana incentive salience with measures of craving, but not with behavioral economic measures of marijuana demand or implicit attentional processing tasks. This within-subjects study used a new CR paradigm to examine multiple dimensions of marijuana's incentive salience and to compare CR-induced increases in craving and demand. Frequent marijuana users (N=93, 34% female) underwent exposure to neutral cues then to lit marijuana cigarettes. Craving, marijuana demand via a marijuana purchase task, and heart rate were assessed after each cue set. A modified Stroop task with cannabis and control words was completed after the marijuana cues as a measure of attentional bias. Relative to neutral cues, marijuana cues significantly increased subjective craving and demand indices of intensity (i.e., drug consumed at $0) and Omax (i.e., peak drug expenditure). Elasticity significantly decreased following marijuana cues, reflecting sustained purchase despite price increases. Craving was correlated with demand indices (r's: 0.23-0.30). Marijuana users displayed significant attentional bias for cannabis-related words after marijuana cues. Cue-elicited increases in intensity were associated with greater attentional bias for marijuana words. Greater incentive salience indexed by subjective, behavioral economic, and implicit measures was observed after marijuana versus neutral cues, supporting multidimensional assessment. The study highlights the utility of a behavioral economic approach in detecting cue-elicited changes in marijuana incentive salience. Published by Elsevier Ireland Ltd.

From Medical to Recreational Marijuana Sales: Marijuana Outlets and Crime in an Era of Changing Marijuana Legislation.

PubMed

Freisthler, Bridget; Gaidus, Andrew; Tam, Christina; Ponicki, William R; Gruenewald, Paul J

2017-06-01

A movement from medical to recreational marijuana use allows for a larger base of potential users who have easier access to marijuana, because they do not have to visit a physician before using marijuana. This study examines whether changes in the density of marijuana outlets were related to violent, property, and marijuana-specific crimes in Denver, CO during a time in which marijuana outlets began selling marijuana for recreational, and not just medical, use. We collected data on locations of crimes, marijuana outlets and covariates for 481 Census block groups over 34 months (N = 16,354 space-time units). A Bayesian Poisson space-time model assessed statistical relationships between independent measures and crime counts within "local" Census block groups. We examined spatial "lag" effects to assess whether crimes in Census block groups adjacent to locations of outlets were also affected. Independent of the effects of covariates, densities of marijuana outlets were unrelated to property and violent crimes in local areas. However, the density of marijuana outlets in spatially adjacent areas was positively related to property crime in spatially adjacent areas over time. Further, the density of marijuana outlets in local and spatially adjacent blocks groups was related to higher rates of marijuana-specific crime. This study suggests that the effects of the availability of marijuana outlets on crime do not necessarily occur within the specific areas within which these outlets are located, but may occur in adjacent areas. Thus studies assessing the effects of these outlets in local areas alone may risk underestimating their true effects.

A latent class analysis of poly-marijuana use among young adults.

PubMed

Krauss, Melissa J; Rajbhandari, Biva; Sowles, Shaina J; Spitznagel, Edward L; Cavazos-Rehg, Patricia

2017-12-01

With more states legalizing marijuana use, the marijuana industry has grown, introducing a variety of marijuana products. Our study explores the use of multiple marijuana products (poly-marijuana use) and the characteristics associated with this behavior. Past-month marijuana users aged 18-34years were surveyed online via an existing online panel (n=2444). Participants answered questions about past-month use of three types of marijuana (plant-based, concentrates, edibles), marijuana use patterns, and driving after use. Latent class analysis was used to identify subgroups of marijuana users. Four classes of marijuana users were identified: Light plant users, who used only plant-based products infrequently and were unlikely to drive after use (32%); Heavy plant users, who used mainly plant-based products frequently, multiple times per day, and were likely to drive after use (37%); Plant and concentrates users, who used plant-based products heavily and concentrates at least infrequently, used multiple times per day, and were likely to drive after use (20%); Light plant and edibles users, who used both products infrequently and were unlikely to drive after use (10%). Those in legal marijuana states were more likely to belong to the poly-marijuana groups. Our findings reflect the increase in popularity of new marijuana products in legal states and suggest that heavy user groups, including concentrates users, are associated with driving after use. As various forms of marijuana use increases, monitoring and surveillance of the use of multiple types of marijuana will be important for determining potential varying impacts on physiological and social consequences. Copyright © 2017 Elsevier Ltd. All rights reserved.

Medical marijuana policies and hospitalizations related to marijuana and opioid pain reliever.

PubMed

Shi, Yuyan

2017-04-01

Twenty-eight states in the U.S have legalized medical marijuana, yet its impacts on severe health consequences such as hospitalizations remain unknown. Meanwhile, the prevalence of opioid pain reliever (OPR) use and outcomes has increased dramatically. Recent studies suggested unintended impacts of legalizing medical marijuana on OPR, but the evidence is still limited. This study examined the associations between state medical marijuana policies and hospitalizations related to marijuana and OPR. State-level annual administrative records of hospital discharges during 1997-2014 were obtained from the State Inpatient Databases (SID). The outcome variables were rates of hospitalizations involving marijuana dependence or abuse, opioid dependence or abuse, and OPR overdose in 1000 discharges. Linear time-series regressions were used to assess the associations of implementing medical marijuana policies to hospitalizations, controlling for other marijuana- and OPR-related policies, socioeconomic factors, and state and year fixed effects. Hospitalizations related to marijuana and OPR increased sharply by 300% on average in all states. Medical marijuana legalization was associated with 23% (p=0.008) and 13% (p=0.025) reductions in hospitalizations related to opioid dependence or abuse and OPR overdose, respectively; lagged effects were observed after policy implementation. The operation of medical marijuana dispensaries had no independent impacts on OPR-related hospitalizations. Medical marijuana polices had no associations with marijuana-related hospitalizations. Medical marijuana policies were significantly associated with reduced OPR-related hospitalizations but had no associations with marijuana-related hospitalizations. Given the epidemic of problematic use of OPR, future investigation is needed to explore the causal pathways of these findings. Copyright © 2017 Elsevier B.V. All rights reserved.

Medical marijuana policies and hospitalizations related to marijuana and opioid pain reliever*

PubMed Central

Shi, Yuyan

2017-01-01

Objectives Twenty-eight states in the U.S. have legalized medical marijuana, yet its impacts on severe health consequences such as hospitalizations remain unknown. Meanwhile, the prevalence of opioid pain reliever (OPR) use and outcomes has increased dramatically. Recent studies suggested unintended impacts of legalizing medical marijuana on OPR, but the evidence is still limited. This study examined the associations between state medical marijuana policies and hospitalizations related to marijuana and OPR. Methods State-level annual administrative records of hospital discharges during 1997–2014 were obtained from the State Inpatient Databases (SID). The outcome variables were rates of hospitalizations involving marijuana dependence or abuse, opioid dependence or abuse, and OPR overdose in 1,000 discharges. Linear time-series regressions were used to assess the associations of implementing medical marijuana policies to hospitalizations, controlling for other marijuana- and OPR-related policies, socioeconomic factors, and state and year fixed effects. Results Hospitalizations related to marijuana and OPR increased sharply by 300% on average in all states. Medical marijuana legalization was associated with 23% (p=.008) and 13% (p=.025) reductions in hospitalizations related to opioid dependence or abuse and OPR overdose, respectively; lagged effects were observed after policy implementation. The operation of medical marijuana dispensaries had no independent impacts on OPR- related hospitalizations. Medical marijuana polices had no associations with marijuana-related hospitalizations. Conclusion Medical marijuana policies were significantly associated with reduced OPR-related hospitalizations but had no associations with marijuana-related hospitalizations. Given the epidemic of problematic use of OPR, future investigation is needed to explore the causal pathways of these findings. PMID:28259087

A behavioral economic approach to assessing demand for marijuana.

PubMed

Collins, R Lorraine; Vincent, Paula C; Yu, Jihnhee; Liu, Liu; Epstein, Leonard H

2014-06-01

In the United States, marijuana is the most commonly used illicit drug. Its prevalence is growing, particularly among young adults. Behavioral economic indices of the relative reinforcing efficacy (RRE) of substances have been used to examine the appeal of licit (e.g., alcohol) and illicit (e.g., heroin) drugs. The present study is the first to use an experimental, simulated purchasing task to examine the RRE of marijuana. Young-adult (M age = 21.64 years) recreational marijuana users (N = 59) completed a computerized marijuana purchasing task designed to generate demand curves and the related RRE indices (e.g., intensity of demand-purchases at lowest price; Omax-max. spent on marijuana; Pmax-price at which marijuana expenditure is max). Participants "purchased" high-grade marijuana across 16 escalating prices that ranged from $0/free to $160/joint. They also provided 2 weeks of real-time, ecological momentary assessment reports on their marijuana use. The purchasing task generated multiple RRE indices. Consistent with research on other substances, the demand for marijuana was inelastic at lower prices but became elastic at higher prices, suggesting that increases in the price of marijuana could lessen its use. In regression analyses, the intensity of demand, Omax, and Pmax, and elasticity each accounted for significant variance in real-time marijuana use. These results provide support for the validity of a simulated marijuana purchasing task to examine marijuana's reinforcing efficacy. This study highlights the value of applying a behavioral economic framework to young-adult marijuana use and has implications for prevention, treatment, and policies to regulate marijuana use. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Does Marijuana Contribute to Intimate Partner Aggression? Temporal Effects in a Community Sample of Marijuana-Using Couples.

PubMed

Testa, Maria; Derrick, Jaye L; Wang, Weijun; Leonard, Kenneth E; Kubiak, Audrey; Brown, Whitney C; Collins, R Lorraine

2018-05-01

Although patterns of marijuana use are positively associated with intimate partner aggression, there is little evidence that episodes of marijuana use contribute to the occurrence of episodes of relationship conflict and aggression. The present ecological momentary assessment study considered the temporal relationship between marijuana use episodes and the occurrence of conflict, verbal aggression, and physical aggression between intimate partners in the next 2 hours. A sample of 183 cohabiting marijuana-using couples (ages 18-30) were recruited from the community. For 30 consecutive days, each partner independently reported episodes of marijuana use and partner conflict, including verbal and physical aggression perpetration and victimization within conflicts. Temporal associations between each partner's marijuana use and subsequent conflict and aggression were examined using the Actor-Partner Interdependence Model. Analyses accounted for between-person effects of marijuana use frequency and total conflicts. We observed temporal effects of actor (but not partner) marijuana use on men's and women's reports of conflict and verbal aggression perpetration and victimization within 2 hours of use. Marijuana use episodes did not alter the likelihood of physical aggression in the next 2 hours. Partner concordance in marijuana use had no effect on verbal or physical aggression or victimization. The positive temporal effects of marijuana on conflict and verbal aggression remained significant after accounting for the effect of drinking episodes. Within generally concordant, marijuana-using young couples, marijuana use episodes contribute to the occurrence of relationship conflict and verbal aggression.

Effects of Marijuana Use on Impulsivity and Hostility in Daily Life

PubMed Central

Ansell, Emily B.; Laws, Holly B.; Roche, Michael J.; Sinha, Rajita

2015-01-01

BACKGROUND Marijuana use is increasingly prevalent among young adults. While research has found adverse effects associated with marijuana use within experimentally controlled laboratory settings, it is unclear how recreational marijuana use affects day-to-day experiences in users. The present study sought to examine the effects of marijuana use on within-person changes in impulsivity and interpersonal hostility in daily life using smartphone administered assessments. METHODS Forty-three participants with no substance dependence reported on their alcohol consumption, tobacco use, recreational marijuana use, impulsivity, and interpersonal hostility over the course of 14 days. Responses were analyzed using multilevel modeling. RESULTS Marijuana use was associated with increased impulsivity on the same day and the following day relative to days when marijuana was not used, independent of alcohol use. Marijuana was also associated with increased hostile behaviors and perceptions of hostility in others on the same day when compared to days when marijuana was not used. These effects were independent of frequency of marijuana use or alcohol use. There were no significant effects of alcohol consumption on impulsivity or interpersonal hostility. CONCLUSIONS Marijuana use is associated with changes in impulse control and hostility in daily life. This may be one route by which deleterious effects of marijuana are observed for mental health and psychosocial functioning. Given the increasing prevalence of recreational marijuana use and the potential legalization in some states, further research on the potential consequences of marijuana use in young adults’ day-to-day life is warranted. PMID:25595054

Impacts of Changing Marijuana Policies on Alcohol Use in the United States

PubMed Central

Guttmannova, Katarina; Lee, Christine M.; Kilmer, Jason R.; Fleming, Charles B.; Rhew, Isaac C.; Kosterman, Rick; Larimer, Mary E.

2015-01-01

Background Marijuana policies are rapidly evolving. In the United States, recreational use of marijuana is now legal in four states and medical marijuana is legal in 23 states. Research evaluating such policies has focused primarily on how policies affect issues of price, access to, use, and consequences of marijuana. Due to potential spillover effects, researchers also need to examine how marijuana policies may impact use and consequences of alcohol. Methods The current paper is a critical review of articles evaluating alcohol outcomes associated with marijuana decriminalization, medical marijuana legalization, and non-medical or recreational marijuana legalization. We identified articles and reports through (1) online searches of EBSCO host database including Academic search premier, Econlit, Legal collection, Medline, Psych articles, and PsycINFO, as well as PubMed and Google Scholar databases; (2) review of additional articles cited in papers identified through electronic searches; and (3) targeted searches of state and local government records regarding marijuana law implementation. We reviewed studies with respect to their data sources and sample characteristics, methodology, and the margin of alcohol and marijuana use, timing of policy change, and the aspects of laws examined. Results The extant literature provides some evidence for both substitution (i.e., more liberal marijuana policies related to less alcohol use as marijuana becomes a substitute) and complementary (i.e., more liberal marijuana policies related to increases in both marijuana and alcohol use) relationships in the context of liberalization of marijuana policies in the United States. Conclusions Impact of more liberal marijuana policies on alcohol use is complex, and likely depends on specific aspects of policy implementation, including how long the policy has been in place. Further, evaluation of marijuana policy effects on alcohol use may be sensitive to the age group studied and the margin of alcohol use examined. Design of policy evaluation research requires careful consideration of these issues. PMID:26727520

Association of State Recreational Marijuana Laws With Adolescent Marijuana Use

PubMed Central

Cerdá, Magdalena; Wall, Melanie; Feng, Tianshu; Keyes, Katherine M.; Sarvet, Aaron; Schulenberg, John; O’Malley, Patrick M.; Pacula, Rosalie Liccardo; Galea, Sandro; Hasin, Deborah S.

2017-01-01

IMPORTANCE Historical shifts are occurring in marijuana policy. The effect of legalizing marijuana for recreational use on rates of adolescent marijuana use is a topic of considerable debate. OBJECTIVE To examine the association between the legalization of recreational marijuana use in Washington and Colorado in 2012 and the subsequent perceived harmfulness and use of marijuana by adolescents. DESIGN, SETTING, AND PARTICIPANTS We used data of 253 902 students in eighth, 10th, and 12th grades from 2010 to 2015 from Monitoring the Future, a national, annual, cross-sectional survey of students in secondary schools in the contiguous United States. Difference-indifference estimates compared changes in perceived harmfulness of marijuana use and in past-month marijuana use in Washington and Colorado prior to recreational marijuana legalization (2010–2012) with post legalization (2013–2015) vs the contemporaneous trends in other states that did not legalize recreational marijuana use in this period. MAIN OUTCOMES AND MEASURES Perceived harmfulness of marijuana use (great or moderate risk to health from smoking marijuana occasionally) and marijuana use (past 30 days). RESULTS Of the 253 902 participants, 120 590 of 245 065(49.2%) were male, and the mean (SD) age was 15.6 (1.7) years. In Washington, perceived harmfulness declined 14.2%and 16.1% among eighth and 10th graders, respectively, while marijuana use increased 2.0% and 4.1% from 2010–2012 to 2013–2015. In contrast, among states that did not legalize recreational marijuana use, perceived harmfulness decreased by 4.9% and 7.2%among eighth and 10th graders, respectively, and marijuana use decreased by 1.3%and 0.9%over the same period. Difference-in-difference estimates comparing Washington vs states that did not legalize recreational drug use indicated that these differences were significant for perceived harmfulness (eighth graders:%[SD], −9.3 [3.5]; P = .01; 10th graders:%[SD], −9.0 [3.8]; P = .02) and marijuana use (eighth graders:%[SD], 5.0 [1.9]; P = .03; 10th graders:%[SD], 3.2 [1.5]; P = .007). No significant differences were found in perceived harmfulness or marijuana use among 12th graders in Washington or for any of the 3 grades in Colorado. CONCLUSIONS AND RELEVANCE Among eighth and 10th graders in Washington, perceived harmfulness of marijuana use decreased and marijuana use increased following legalization of recreational marijuana use. In contrast, Colorado did not exhibit any differential change in perceived harmfulness or past-month adolescent marijuana use following legalization. A cautious interpretation of the findings suggests investment in evidence-based adolescent substance use prevention programs in any additional states that may legalize recreational marijuana use. PMID:28027345

Association of State Recreational Marijuana Laws With Adolescent Marijuana Use.

PubMed

Cerdá, Magdalena; Wall, Melanie; Feng, Tianshu; Keyes, Katherine M; Sarvet, Aaron; Schulenberg, John; O'Malley, Patrick M; Pacula, Rosalie Liccardo; Galea, Sandro; Hasin, Deborah S

2017-02-01

Historical shifts are occurring in marijuana policy. The effect of legalizing marijuana for recreational use on rates of adolescent marijuana use is a topic of considerable debate. To examine the association between the legalization of recreational marijuana use in Washington and Colorado in 2012 and the subsequent perceived harmfulness and use of marijuana by adolescents. We used data of 253 902 students in eighth, 10th, and 12th grades from 2010 to 2015 from Monitoring the Future, a national, annual, cross-sectional survey of students in secondary schools in the contiguous United States. Difference-in-difference estimates compared changes in perceived harmfulness of marijuana use and in past-month marijuana use in Washington and Colorado prior to recreational marijuana legalization (2010-2012) with postlegalization (2013-2015) vs the contemporaneous trends in other states that did not legalize recreational marijuana use in this period. Perceived harmfulness of marijuana use (great or moderate risk to health from smoking marijuana occasionally) and marijuana use (past 30 days). Of the 253 902 participants, 120 590 of 245 065(49.2%) were male, and the mean (SD) age was 15.6 (1.7) years. In Washington, perceived harmfulness declined 14.2% and 16.1% among eighth and 10th graders, respectively, while marijuana use increased 2.0% and 4.1% from 2010-2012 to 2013-2015. In contrast, among states that did not legalize recreational marijuana use, perceived harmfulness decreased by 4.9% and 7.2% among eighth and 10th graders, respectively, and marijuana use decreased by 1.3% and 0.9% over the same period. Difference-in-difference estimates comparing Washington vs states that did not legalize recreational drug use indicated that these differences were significant for perceived harmfulness (eighth graders: % [SD], -9.3 [3.5]; P = .01; 10th graders: % [SD], -9.0 [3.8]; P = .02) and marijuana use (eighth graders: % [SD], 5.0 [1.9]; P = .03; 10th graders: % [SD], 3.2 [1.5]; P = .007). No significant differences were found in perceived harmfulness or marijuana use among 12th graders in Washington or for any of the 3 grades in Colorado. Among eighth and 10th graders in Washington, perceived harmfulness of marijuana use decreased and marijuana use increased following legalization of recreational marijuana use. In contrast, Colorado did not exhibit any differential change in perceived harmfulness or past-month adolescent marijuana use following legalization. A cautious interpretation of the findings suggests investment in evidence-based adolescent substance use prevention programs in any additional states that may legalize recreational marijuana use.

Medical marijuana for digestive disorders: high time to prescribe?

PubMed

Gerich, Mark E; Isfort, Robert W; Brimhall, Bryan; Siegel, Corey A

2015-02-01

The use of recreational and medical marijuana is increasingly accepted by the general public in the United States. Along with growing interest in marijuana use has come an understanding of marijuana's effects on normal physiology and disease, primarily through elucidation of the human endocannabinoid system. Scientific inquiry into this system has indicated potential roles for marijuana in the modulation of gastrointestinal symptoms and disease. Some patients with gastrointestinal disorders already turn to marijuana for symptomatic relief, often without a clear understanding of the risks and benefits of marijuana for their condition. Unfortunately, that lack of understanding is shared by health-care providers. Marijuana's federal legal status as a Schedule I controlled substance has limited clinical investigation of its effects. There are also potential legal ramifications for physicians who provide recommendations for marijuana for their patients. Despite these constraints, as an increasing number of patients consider marijuana as a potential therapy for their digestive disorders, health-care providers will be asked to discuss the issues surrounding medical marijuana with their patients.

Can Marijuana Make It Better? Prospective Effects of Marijuana and Temperament on Risk for Anxiety and Depression

PubMed Central

Grunberg, Victoria A.; Cordova, Kismet A.; Bidwell, L. Cinnamon; Ito, Tiffany A.

2015-01-01

Increases in marijuana use in recent years highlight the importance of understanding how marijuana affects mental health. Of particular relevance is the effect of marijuana use on anxiety and depression given that marijuana use is highest among late adolescents/early adults, the same age range in which risk for anxiety and depression is the highest. Here we examine how marijuana use moderates the effects of temperament on level of anxiety and depression in a prospective design in which baseline marijuana use and temperament predict anxiety and depression one year later. We found that harm avoidance (HA) is associated with higher anxiety and depression a year later, but only among those low in marijuana use. Those higher in marijuana use show no relation between HA and symptoms of anxiety and depression. Marijuana use also moderated the effect of novelty seeking (NS), with symptoms of anxiety and depression increasing with NS only among those with high marijuana use. NS was unrelated to symptoms of anxiety and depression among those low in marijuana use. The temperament dimension of reward dependence was unrelated to anxiety and depression symptoms. Our results suggest that marijuana use does not have an invariant relationship with anxiety and depression, and that the effects of relatively stable temperament dimensions can be moderated by other contextual factors. PMID:26415059

Marijuana Use Among 10th Grade Students - Washington, 2014.

PubMed

Shah, Anar; Stahre, Mandy

2016-12-30

Some studies have suggested that long-term, regular use of marijuana starting in adolescence might impair brain development and lower intelligence quotient (1,2). Since 2012, purchase of recreational or retail marijuana has become legal for persons aged ≥21 years in the District of Columbia, Alaska, California, Colorado, Maine, Massachusetts, Nevada, Oregon, and Washington, raising concern about increased marijuana access by youths. The law taxing and regulating recreational or retail marijuana was approved by Washington voters in 2012 and the first retail licenses were issued in July 2014; medical marijuana use has been legal since 1998. To examine the prevalence, characteristics, and behaviors of current marijuana users among 10th grade students, the Washington State Department of Health analyzed data from the state's 2014 Healthy Youth Survey (HYS) regarding current marijuana use. In 2014, 18.1% of 10th grade students (usually aged 15-16 years) reported using marijuana during the preceding 30 days; of these students, 32% reported using it on ≥10 days. Among the marijuana users, 65% reported obtaining marijuana through their peer networks, which included friends, older siblings, or at a party. Identification of comprehensive and sustainable public health interventions are needed to prevent and reduce youth marijuana use. Establishment of state and jurisdiction surveillance of youth marijuana use could be useful to anticipate and monitor the effects of legalization and track trends in use before states consider legalizing recreational or retail marijuana.

Frequency and Risk of Marijuana Use among Substance-Using Health Care Patients in Colorado with and without Access to State Legalized Medical Marijuana.

PubMed

Richmond, Melissa K; Pampel, Fred C; Rivera, Laura S; Broderick, Kerryann B; Reimann, Brie; Fischer, Leigh

2015-01-01

With increasing use of state legalized medical marijuana across the country, health care providers need accurate information on patterns of marijuana and other substance use for patients with access to medical marijuana. This study compared frequency and severity of marijuana use, and use of other substances, for patients with and without state legal access to medical marijuana. Data were collected from 2,030 patients who screened positive for marijuana use when seeking health care services in a large, urban safety-net medical center. Patients were screened as part of a federally funded screening, brief intervention, and referral to treatment (SBIRT) initiative. Patients were asked at screening whether they had a state-issued medical marijuana card and about risky use of tobacco, alcohol, and other illicit substances. A total of 17.4% of marijuana users had a medical marijuana card. Patients with cards had higher frequency of marijuana use and were more likely to screen at moderate than low or high risk from marijuana use. Patients with cards also had lower use of other substances than patients without cards. Findings can inform health care providers of both the specific risks of frequent, long-term use and the more limited risks of other substance use faced by legal medical marijuana users.

Can marijuana make it better? Prospective effects of marijuana and temperament on risk for anxiety and depression.

PubMed

Grunberg, Victoria A; Cordova, Kismet A; Bidwell, L Cinnamon; Ito, Tiffany A

2015-09-01

Increases in marijuana use in recent years highlight the importance of understanding how marijuana affects mental health. Of particular relevance is the effect of marijuana use on anxiety and depression given that marijuana use is highest among late adolescents/early adults, the same age range in which risk for anxiety and depression is the highest. Here we examine how marijuana use moderates the effects of temperament on level of anxiety and depression in a prospective design in which baseline marijuana use and temperament predict anxiety and depression 1 year later. We found that harm avoidance (HA) is associated with higher anxiety and depression a year later, but only among those low in marijuana use. Those higher in marijuana use show no relation between HA and symptoms of anxiety and depression. Marijuana use also moderated the effect of novelty seeking (NS), with symptoms of anxiety and depression increasing with NS only among those with high marijuana use. NS was unrelated to symptoms of anxiety and depression among those low in marijuana use. The temperament dimension of reward dependence was unrelated to anxiety and depression symptoms. Our results suggest that marijuana use does not have an invariant relationship with anxiety and depression, and that the effects of relatively stable temperament dimensions can be moderated by other contextual factors. (c) 2015 APA, all rights reserved).

Daily marijuana users with past alcohol problems increase alcohol consumption during marijuana abstinence.

PubMed

Peters, Erica N; Hughes, John R

2010-01-15

Drug abuse treatment programs typically recommend complete abstinence because of a fear that clients who stop use of one drug will substitute another. A within-subjects study investigated whether consumption of alcohol and other substances changes during marijuana abstinence. Twenty-eight daily marijuana users who were not trying to stop or reduce their marijuana consumption completed an 8-day baseline period in which they used marijuana and other drugs as usual, a 13-day marijuana abstinence period, and a 7-day return-to-baseline period. Participants provided self-report of substance use daily and submitted urine samples twice weekly to verify marijuana abstinence. A diagnosis of past alcohol abuse or dependence significantly moderated the alcohol increase from baseline to marijuana abstinence (p<0.01), such that individuals with this diagnosis significantly increased alcohol use (52% increase) but those without this history did not (3% increase). Increases in marijuana withdrawal discomfort scores and alcohol craving scores from baseline to marijuana abstinence significantly and positively correlated with increases in alcohol use. Increases in cigarettes, caffeine, and non-marijuana illicit drugs did not occur. This study provides empirical validation of drug substitution in a subgroup of daily marijuana users, but results need to be replicated in individuals who seek treatment for marijuana problems. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.

Does Marijuana Help Treat Glaucoma?

MedlinePlus

... Ophthalmologist Patient Stories Español Eye Health / Tips & Prevention Marijuana Sections Does Marijuana Help Treat Glaucoma? Why Eye ... Don't Recommend Marijuana for Glaucoma Infographic Does Marijuana Help Treat Glaucoma? Leer en Español: La marihuana ...

Marijuana Use and New Concerns about Medical Marijuana. E-Fact Sheet

ERIC Educational Resources Information Center

Higher Education Center for Alcohol, Drug Abuse, and Violence Prevention, 2010

2010-01-01

While alcohol remains the drug of choice among college students, marijuana ranks number two with 32 percent reporting using marijuana in 2008. That's a modest decline from 2001, when 36 percent of college students reported marijuana use. While levels of marijuana use by students are determined through a number of national and local surveys, no…

Tobacco and Marijuana Initiation Among African American and White Young Adults

PubMed Central

Kennedy, Sara M.; Patel, Roshni P.; Cheh, Paul; Hsia, Jason; Rolle, Italia V.

2016-01-01

Introduction African American youth use marijuana at similar rates and tobacco at lower rates compared with white youth; however, in adulthood, tobacco use is similar. Tobacco and marijuana use are closely associated; differing initiation patterns may contribute to observed racial differences in tobacco prevalence by age. Therefore, it is important to assess tobacco and marijuana initiation patterns by race. Methods Data were obtained from 56,555 adults aged 18–25 who completed the 2005–2012 National Survey on Drug Use and Health. The analysis was restricted to those who reported ever use of marijuana and combustible tobacco (cigarettes and/or cigars). Three mutually exclusive categories of initiation patterns were evaluated: use of marijuana before tobacco; marijuana and tobacco at the same age; and tobacco before marijuana. Multivariable regression models were used to assess changes over time and compare these outcomes by race while controlling for sociodemographics, risk perceptions, and current substance use. Results In 2005, 26.6% of African American and 14.3% of white young adults used marijuana before tobacco, compared with 41.5% of African American and 24.0% of white young adults in 2012 (P < .001). Overall, African American young adults had greater odds of using marijuana before tobacco (AOR = 1.79; 95% CI: 1.67, 1.91) compared with whites. Conclusion African American young adults were more likely than whites to use marijuana before tobacco and both groups were increasingly likely to use marijuana before tobacco over time. A greater understanding of how marijuana initiation interacts with tobacco initiation could inform more effective tobacco and marijuana use prevention efforts. Implications Among ever users of combustible tobacco and marijuana, greater proportions of African American young adults used marijuana before tobacco or at the same age than their white counterparts. Moreover, both African Americans and whites were more likely to use marijuana before tobacco in 2012 compared with 2005. Tobacco control policy may benefit from a broader understanding of the patterns of initiation to tobacco and marijuana use. Some public health interventions aimed at preventing and reducing combustible tobacco use among African American young adults may be strengthened by considering marijuana use. PMID:26391577

How does state marijuana policy affect U.S. youth? Medical marijuana laws, marijuana use and perceived harmfulness: 1991–2014

PubMed Central

Keyes, Katherine M.; Wall, Melanie; Cerdá, Magdalena; Schulenberg, John; O’Malley, Patrick M.; Galea, Sandro; Feng, Tianshu; Hasin, Deborah S.

2016-01-01

Aims To test, among US students: 1) whether perceived harmfulness of marijuana has changed over time, 2) whether perceived harmfulness of marijuana changed post-passage of state medical marijuana laws (MML) compared with pre-passage; 3) whether perceived harmfulness of marijuana mediates and/or modifies the relation between MML and marijuana use as a function of grade level. Design Cross-sectional nationally-representative surveys of U.S. students, conducted annually, 1991–2014, in the Monitoring The Future study. Setting Surveys conducted in schools in all coterminous states; 21 states passed MML between 1996–2014. Participants The sample included 1,134,734 adolescents in 8th, 10th, and 12th grades. Measures State passage of MML; perceived harmfulness of marijuana use (perceiving great or moderate risk to health from smoking marijuana occasionally versus slight or no risk); and marijuana use (prior 30 days). Data were analyzed using time-varying multi-level regression modeling. Findings Perceived harmfulness of marijuana significantly decreased since 1991 (from an estimated 84.0% in 1991 to 53.8% in 2014, p<0.01). Across time, perceived harmfulness was lower in states that passed MML (OR=0.86, 95% C.I. 0.75–0.97). In states with MML, perceived harmfulness of marijuana increased among 8th graders after MML passage (OR=1.21, 95% C.I. 1.08–1.36), while marijuana use decreased (OR=0.81, 95% C.I. 0.72–0.92). Results were null for other grades, and for all grades combined. Increases in perceived harmfulness among 8th graders after MML passage was associated with ~33% of the decrease in use. When adolescents were stratified by perceived harmfulness, use in 8th graders decreased to a greater extent among those who perceived marijuana as harmful. Conclusions While perceived harmfulness of marijuana use is decreasing nationally among adolescents, passage of medical marijuana laws is associated with increases in perceived harmfulness among young adolescents, and marijuana use decreased among those who perceive marijuana to be harmful after passage of MML. PMID:27393902

Older marijuana users' marijuana risk perceptions: associations with marijuana use patterns and marijuana and other substance use disorders.

PubMed

Choi, Namkee G; DiNitto, Diana M; Marti, C Nathan

2017-12-10

Compared to their non-using age peers, older marijuana users are known to have lower marijuana risk perceptions. We examined associations of older marijuana users' risk perceptions with their marijuana use patterns and substance use disorders. Data are from 2013 to 2015 National Survey of Drug Use and Health (N = 24,057 respondents aged 50+ years). Bivariate logistic regression was used to compare risk perceptions among never users, former users, and past-year users aged 50+ years. Multivariable logistic regression was used to test associations between risk perception and marijuana use status and between risk perception and marijuana use patterns. Among the total sample, former (AOR = 0.30, 95% CI = 0.27-0.32) and past-year (AOR = 0.05, 95% CI = 0.04-0.06) marijuana users had significantly lower odds of moderate/great risk perception (as opposed to no/slight risk perception) than never users. Among past-year users, odds of moderate/great risk perception were lower among those who used marijuana more frequently (AOR = 0.14, 95% CI = 0.07-0.28 for 300+ days of use compared to 1-11 days of use) and who reported any medical marijuana use (AOR = 0.27, 95% CI = 0.14-0.51). However, those who had marijuana use disorder were 3.5 times more likely to report moderate/great risk perception (AOR = 3.50, 95% CI = 1.62-7.58). Those who had a college education, had higher incomes, and resided in states with medical marijuana laws also had lower risk perceptions. Public health education on scientific evidence about marijuana's benefits and harms and age-appropriate treatment for older adults with substance use problems are needed. Research on risk perception formation using longitudinal data among older adults is also needed.

Parent and Grandparent Marijuana Use and Child Substance Use and Norms

PubMed Central

Bailey, Jennifer A.; Hill, Karl G.; Guttmannova, Katarina; Epstein, Marina; Abbott, Robert D.; Steeger, Christine M.; Skinner, Martie L.

2016-01-01

Purpose Using prospective longitudinal data from 3 generations, this study seeks to test whether and how parent and grandparent marijuana use (current and prior) predicts an increased likelihood of child cigarette, alcohol, and marijuana use. Methods Using multilevel modeling of prospective data spanning 3 generations (N = 306 families, children ages 6-22), this study tested associations between grandparent (G1) and parent (G2) marijuana use and child (G3) past-year cigarette, alcohol, and marijuana use. Analyses tested whether G3 substance-related norms mediated these associations. Current G1 and G2 marijuana use was examined, as was G2 high school and early adult use and G1 marijuana use when G2 parents were in early adolescence. Controls included G2 age at G3 birth, G2 education and depression, and G3 gender. Results G2 current marijuana use predicted a higher likelihood of G3 alcohol and marijuana use, but was not related to the probability of G3 cigarette use. G3's perceptions of their parents' norms and G2 current marijuana use both contributed independently to the likelihood of G3 alcohol and marijuana use when included in the same model. G3 children's own norms and their perceptions of friends' norms mediated the link between G2 current marijuana use and G3 alcohol and marijuana use. Conclusions Results are discussed in light of the growing trend toward marijuana legalization. To the extent that parent marijuana use increases under legalization, we can expect more youth to use alcohol and marijuana and to have norms that favor substance use. PMID:27265424

Associations Between Parental and Grandparental Marijuana Use and Child Substance Use Norms in a Prospective, Three-Generation Study.

PubMed

Bailey, Jennifer A; Hill, Karl G; Guttmannova, Katarina; Epstein, Marina; Abbott, Robert D; Steeger, Christine M; Skinner, Martie L

2016-09-01

Using prospective longitudinal data from three generations, this study seeks to test whether and how parent and grandparent marijuana use (current and prior) predicts an increased likelihood of child cigarette, alcohol, and marijuana use. Using multilevel modeling of prospective data spanning three generations (n = 306 families, children ages 6-22), this study tested associations between grandparent (G1) and parent (G2) marijuana use and child (G3) past-year cigarette, alcohol, and marijuana use. Analyses tested whether G3 substance-related norms mediated these associations. Current G1 and G2 marijuana use was examined, as was G2 high school and early adult use and G1 marijuana use when G2 parents were in early adolescence. Controls included G2 age at G3 birth, G2 education and depression, and G3 gender. G2 current marijuana use predicted a higher likelihood of G3 alcohol and marijuana use but was not related to the probability of G3 cigarette use. G3's perceptions of their parents' norms and G2 current marijuana use both contributed independently to the likelihood of G3 alcohol and marijuana use when included in the same model. G3 children's own norms and their perceptions of friends' norms mediated the link between G2 current marijuana use and G3 alcohol and marijuana use. Results are discussed in light of the growing trend toward marijuana legalization. To the extent that parent marijuana use increases under legalization, we can expect more youth to use alcohol and marijuana and to have norms that favor substance use. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Psychometric evaluation of the Marijuana Reduction Strategies Self-Efficacy Scale with young recreational marijuana users.

PubMed

Davis, Alan K; Osborn, Lawrence A; Rosenberg, Harold; Cross, Nicole; Lauritsen, Kirstin J; Ashrafioun, Lisham; Bradbury, Stacey; Feuille, Margaret; Lackey, Jennifer H; Hawley, Anna; Leith, Jaclyn

2014-12-01

This study evaluated the cue-reactivity and several psychometric properties of a questionnaire designed to assess marijuana users' self-efficacy to employ 21 specific cognitive-behavioral strategies to reduce their marijuana use. Using a web-based recruitment and data-collection procedure, 513 regular marijuana users completed dependent measures following marijuana-related or control cue exposure. Although exposure to marijuana-related stimuli significantly increased reported craving, mean reduction-strategy self-efficacy scores did not differ as a function of cue exposure. Reliability analyses supported retaining all 21 items as a single scale. Reduction-strategy self-efficacy was positively associated with marijuana-refusal self-efficacy and with recent past use of reduction strategies, was negatively associated with quantity and frequency of marijuana use and marijuana-related problems, and was positively but weakly associated with general self-efficacy. The most frequently reported strategies that were employed reflected restricting marijuana use to once per day, not keeping a large stash available, turning down unwanted hits, and not obtaining more marijuana right away if one's supply runs out. These findings further support the reliability and validity of the questionnaire when administered to a diverse sample of regular marijuana users. Copyright © 2014 Elsevier Ltd. All rights reserved.

Momentary positive and negative affect preceding marijuana use events in youth.

PubMed

Shrier, Lydia A; Ross, Craig S; Blood, Emily A

2014-09-01

ABSTRACT. among young people. This study examined how positive and negative affect differ before marijuana use compared with other times. Forty medical outpatients ages 15-24 years who used marijuana recreationally at least twice a week (M = 18.7 years; 58% female) reported momentary positive affect, negative affect, companionship, perceived ease of obtaining marijuana, and marijuana use several times a day for 2 weeks on a handheld computer. Mean momentary positive affect and negative affect scores in the 24 hours leading up to a marijuana use event (n = 294) were compared with affect scores in times further from subsequent use. Generalized estimating equation models considered as potential moderators perceived ease of obtaining marijuana and being with friends. Positive affect did not differ in the 24 hours before marijuana use compared with times further before use. Negative affect was significantly higher before marijuana use compared with other times. Being with friends and perceived easy marijuana availability did not moderate the associations. The association between negative affect and subsequent marijuana use was attenuated when negative affect was examined only for the moment just before use, suggesting that use may follow a period of increased negative affect. The findings support an affect regulation model for marijuana use among frequently using youth. Specifically, these youth may use marijuana to manage increased negative affect.

Cardiovascular manifestations of substance abuse: part 2: alcohol, amphetamines, heroin, cannabis, and caffeine.

PubMed

Frishman, William H; Del Vecchio, Alexander; Sanal, Shirin; Ismail, Anjum

2003-01-01

The abuse of alcohol is associated with chronic cardiomyopathy, hypertension, and arrhythmia. Abstinence or using alcohol in moderation can reverse these cardiovascular problems. Alcohol is also distinguished among the substances of abuse by having possible protective effects against coronary artery disease and stroke when used in moderate amounts. Amphetamines (eg, speed, ice, ecstasy) have many of the cardiovascular toxicities seen with cocaine, including acute and chronic cardiovascular diseases. Heroin and other opiates can cause arrhythmias and noncardiac pulmonary edema, and may reduce cardiac output. Cardiovascular problems are less common with cannabis (marijuana) than with opiates, but major cognitive disorders may be seen with its chronic use. It is still controversial whether caffeine can cause hypertension and coronary artery disease, and questions have been raised about its safety in patients with heart failure and arrhythmia.

A Behavioral Economic Approach to Assessing Demand for Marijuana

PubMed Central

Collins, R. Lorraine; Vincent, Paula C.; Yu, Jihnhee; Liu, Liu; Epstein, Leonard H.

2014-01-01

In the U.S., marijuana is the most commonly used illicit drug. Its prevalence is growing, particularly among young adults. Behavioral economic indices of the relative reinforcing efficacy (RRE) of substances have been used to examine the appeal of licit (e.g., alcohol) and illicit (e.g., heroin) drugs. The present study is the first to use an experimental, simulated purchasing task to examine the RRE of marijuana. Young-adult (M age = 21.64 years) recreational marijuana users (N = 59) completed a computerized marijuana purchasing task designed to generate demand curves and the related RRE indices (e.g., intensity of demand - purchases at lowest price; Omax - max. spent on marijuana; Pmax - price at which marijuana expenditure is max). Participants “purchased” high-grade marijuana across 16 escalating prices that ranged from $0/free to $160/joint. They also provided 2-weeks of real-time, ecological momentary assessment reports on their marijuana use. The purchasing task generated multiple RRE indices. Consistent with research on other substances, the demand for marijuana was inelastic at lower prices but became elastic at higher prices, suggesting that increases in the price of marijuana could lessen its use. In regression analyses, the intensity of demand, Omax and Pmax, and elasticity each accounted for significant variance in real-time marijuana use. These results provide support for the validity of a simulated marijuana purchasing task to examine its reinforcing efficacy. This study highlights the value of applying a behavioral economic framework to young-adult marijuana use and has implications for prevention, treatment, and policies to regulate marijuana use. PMID:24467370

Are medical marijuana users different from recreational users? The view from primary care.

PubMed

Roy-Byrne, Peter; Maynard, Charles; Bumgardner, Kristin; Krupski, Antoinette; Dunn, Chris; West, Imara I; Donovan, Dennis; Atkins, David C; Ries, Richard

2015-10-01

Marijuana is currently approved for medical use in 23 states. Both clinicians and the lay public have questioned whether users of marijuana for medical purposes are different from users of marijuana for recreational purposes. This study examined similarities and differences in important clinical characteristics between users of medical marijuana and users of recreational marijuana. The sample consisted of 868 adult primary care patients in Washington State, who reported use of medical marijuana (n = 131), recreational marijuana (n = 525), or drugs other than marijuana (n = 212). Retention was over 87% at 3-, 6-, 9-, and 12-month assessments. The majority of medical, psychiatric, substance use, and service utilization characteristic comparisons were not significant. However, medical marijuana users had significantly more medical problems, a significantly larger proportion reported >15 days medical problems in the past month, and significantly smaller proportions reported no pain and no mobility limitations (p < .001). Medical marijuana users also had significantly lower drug problem severity, lower alcohol problem severity, and significantly larger proportions reported using marijuana alone and concomitant opioid use only (p < .001). There was no significant difference between medical and recreational users in the percentage using marijuana with at least two additional substances (48% vs. 58%, respectively, p = .05). Although our results suggest that there are few distinct differences between medical and recreational users of marijuana, the differences observed, while mostly very small in effect size (<.2), are consistent with at least some medical users employing marijuana to relieve symptoms and distress associated with medical illness. © American Academy of Addiction Psychiatry.

Medical marijuana legalization and cigarette and marijuana co-use in adolescents and adults.

PubMed

Wang, Julie B; Ramo, Danielle E; Lisha, Nadra E; Cataldo, Janine K

2016-09-01

Medical marijuana legalization is associated with a higher prevalence of marijuana use which may affect cigarette use and nicotine dependence in co-users. In the present study, we examined relationships between statewide legalization of medical marijuana and prevalence of cigarette and marijuana co-use and nicotine dependence in co-using adolescents and adults. Data were analyzed from the 2013 National Survey on Drug Use and Health. We compared cigarette and marijuana co-use in the past 30days across age categories (12-64 years) by statewide medical marijuana legalization. Logistic regression models were used to estimate the odds of having nicotine dependence among current cigarette smokers who also reported past 30-day marijuana use and "ever but not current" marijuana use (vs. "never" use) adjusting for covariates including statewide legalization of medical marijuana. Overall, 5.1% of the sample reported past 30-day cigarette and marijuana co-use and a higher proportion of co-users resided in states where medical marijuana was legal compared to illegal (5.8% vs. 4.8%; p=0.0011). Co-use was associated with greater odds of having nicotine dependence compared to cigarette-only use across age categories. Odds were highest and up to 3-times higher in adolescents aged 12-17 years (OR=3.54; 95%CI: 1.81-6.92) and adults aged 50-64 years (OR=3.08; CI: 1.45-6.55). Marijuana policy could inadvertently affect cigarette and marijuana co-use and pose challenges to tobacco cessation. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Marijuana and tobacco use and co-use among African Americans: results from the 2013, National Survey on Drug Use and Health.

PubMed

Montgomery, LaTrice

2015-12-01

Although studies have identified an increased likelihood of marijuana and tobacco co-use among African Americans as compared to other racial groups, few studies have specifically examined the prevalence and substance use characteristics of co-users among African Americans in a national survey. The current secondary analysis examined the prevalence rates and substance use characteristics (e.g., marijuana dependence) of 2024 African American past month marijuana and tobacco users and co-users participating in the 2013 National Survey on Drug Use and Health. Findings revealed that 18.5%, 53.8% and 27.7% of African Americans smoked marijuana only, tobacco only and marijuana and tobacco in the past 30days, respectively. Relative to participants who smoked marijuana only, African Americans who smoked marijuana and tobacco were more likely to be marijuana dependent in the past year and report more days of marijuana use in the past month. Further, relative to participants who smoked tobacco only, African Americans who smoked marijuana and tobacco were less likely to be dependent on nicotine, reported fewer days of cigarette use in the past month, and began smoking cigarettes, cigars and marijuana at a younger age, but were more likely to be marijuana dependent in the past year and reported more days of cigar use in the past month. Marijuana and tobacco co-use is a significant public health problem, especially among African Americans. Additional research on effective prevention and treatment interventions for African Americans who smoke marijuana and tobacco is warranted. Copyright © 2015 Elsevier Ltd. All rights reserved.

Cue-Elicited Increases in Incentive Salience for Marijuana: Craving, Demand, and Attentional Bias

PubMed Central

Metrik, Jane; Aston, Elizabeth R.; Kahler, Christopher W.; Rohsenow, Damaris J.; McGeary, John E.; Knopik, Valerie S.; MacKillop, James

2016-01-01

Background Incentive salience is a multidimensional construct that includes craving, drug value relative to other reinforcers, and implicit motivation such as attentional bias to drug cues. Laboratory cue reactivity (CR) paradigms have been used to evaluate marijuana incentive salience with measures of craving, but not with behavioral economic measures of marijuana demand or implicit attentional processing tasks. Methods This within-subjects study used a new CR paradigm to examine multiple dimensions of marijuana’s incentive salience and to compare CR-induced increases in craving and demand. Frequent marijuana users (N=93, 34% female) underwent exposure to neutral cues then to lit marijuana cigarettes. Craving, marijuana demand via a marijuana purchase task, and heart rate were assessed after each cue set. A modified Stroop task with cannabis and control words was completed after the marijuana cues as a measure of attentional bias. Results Relative to neutral cues, marijuana cues significantly increased subjective craving and demand indices of intensity (i.e., drug consumed at $0) and Omax (i.e., peak drug expenditure). Elasticity significantly decreased following marijuana cues, reflecting sustained purchase despite price increases. Craving was correlated with demand indices (r’s: 0.23–0.30). Marijuana users displayed significant attentional bias for cannabis-related words after marijuana cues. Cue-elicited increases in intensity were associated with greater attentional bias for marijuana words. Conclusions Greater incentive salience indexed by subjective, behavioral economic, and implicit measures was observed after marijuana versus neutral cues, supporting multidimensional assessment. The study highlights the utility of a behavioral economic approach in detecting cue-elicited changes in marijuana incentive salience. PMID:27515723

"Anything above marijuana takes priority": Obstetric providers' attitudes and counseling strategies regarding perinatal marijuana use.

PubMed

Holland, Cynthia L; Nkumsah, Michelle Abena; Morrison, Penelope; Tarr, Jill A; Rubio, Doris; Rodriguez, Keri L; Kraemer, Kevin L; Day, Nancy; Arnold, Robert M; Chang, Judy C

2016-09-01

To describe obstetric provider attitudes, beliefs, approaches, concerns, and needs about addressing perinatal marijuana use with their pregnant patients. We conducted individual semi-structured interviews with obstetric providers and asked them to describe their thoughts and experiences about addressing perinatal marijuana use. Interviews were transcribed verbatim, coded and reviewed to identify themes. Fifty-one providers participated in semi-structured interviews. Providers admitted they were not familiar with identified risks of marijuana use during pregnancy, they perceived marijuana was not as dangerous as other illicit drugs, and they believed patients did not view marijuana as a drug. Most provider counseling strategies focused on marijuana's status as an illegal drug and the risk of child protective services being contacted if patients tested positive at time of delivery. When counseling about perinatal marijuana use, obstetric providers focus more on legal issues than on health risks. They describe needing more information regarding medical consequences of marijuana use during pregnancy. Provider training should include information about potential consequences of perinatal marijuana use and address ways to improve obstetric providers' counseling. Future studies should assess changes in providers' attitudes as more states consider the legalization of marijuana. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The Validity of Truant Youths’ Marijuana Use and Its Impact on Alcohol Use and Sexual Risk Taking

PubMed Central

Dembo, Richard; Robinson, Rhissa Briones; Barrett, Kimberly; Winters, Ken C.; Ungaro, Rocío; Karas, Lora; Belenko, Steven; Wareham, Jennifer

2013-01-01

Few studies investigating the validity of marijuana use have used samples of truant youth. In the current study, self-reports of marijuana use are compared with urine test results for marijuana to identify marijuana underreporting among adolescents participating in a longitudinal Brief Intervention for drug-involved truant youth. It was hypothesized that marijuana underreporting would be associated with alcohol underreporting and engaging in sexual risk behaviors. The results indicated marijuana underreporting was significantly associated with self-denial of alcohol use, but not associated with sexual risk behavior. Also, there was an age effect in marijuana use underreporting such that younger truant youth were more likely to underreport marijuana use, compared to older truant youth. Implications for policy and future research are discussed. PMID:26478691

Pediatric marijuana exposures in a medical marijuana state.

PubMed

Wang, George Sam; Roosevelt, Genie; Heard, Kennon

2013-07-01

An increasing number of states are decriminalizing the use of medical marijuana, and the effect on the pediatric population has not been evaluated. To compare the proportion of marijuana ingestions by young children who sought care at a children's hospital in Colorado before and after modification of drug enforcement laws in October 2009 regarding medical marijuana possession. Retrospective cohort study from January 1, 2005, through December 31, 2011. Tertiary-care children's hospital emergency department in Colorado. A total of 1378 patients younger than 12 years evaluated for unintentional ingestions: 790 patients before September 30, 2009, and 588 patients after October 1, 2009. Marijuana ingestion. Marijuana exposure visits, marijuana source, symptoms, and patient disposition. The proportion of ingestion visits in patients younger than 12 years (age range, 8 months to 12 years)that were related to marijuana exposure increased after September 30, 2009, from 0 of 790 (0%; 95% CI, 0%-0.6%) to 14 of 588 (2.4%; 95% CI, 1.4%-4.0%) (P < .001). Nine patients had lethargy, 1 had ataxia, and 1 had respiratory insufficiency. Eight patients were admitted, 2 to the intensive care unit. Eight of the 14 cases involved medical marijuana, and 7 of these exposures were from food products. We found a new appearance of unintentional marijuana ingestions by young children after modification of drug enforcement laws for marijuana possession in Colorado. The consequences of unintentional marijuana exposure in children should be part of the ongoing debate on legalizing marijuana.

Momentary Positive and Negative Affect Preceding Marijuana Use Events in Youth

PubMed Central

Shrier, Lydia A; Ross, Craig S; Blood, Emily A

2014-01-01

Objective: Desire to self-regulate affect, including to maintain or enhance positive affect and to reduce negative affect, may be a primary motivation for marijuana use among young people. This study examined how positive and negative affect differ before marijuana use compared with other times. Method: Forty medical outpatients ages 15–24 years who used marijuana recreationally at least twice a week (M = 18.7 years; 58% female) reported momentary positive affect, negative affect, companionship, perceived ease of obtaining marijuana, and marijuana use several times a day for 2 weeks on a handheld computer. Mean momentary positive affect and negative affect scores in the 24 hours leading up to a marijuana use event (n = 294) were compared with affect scores in times further from subsequent use. Generalized estimating equation models considered as potential moderators perceived ease of obtaining marijuana and being with friends. Results: Positive affect did not differ in the 24 hours before marijuana use compared with times further before use. Negative affect was significantly higher before marijuana use compared with other times. Being with friends and perceived easy marijuana availability did not moderate the associations. The association between negative affect and subsequent marijuana use was attenuated when negative affect was examined only for the moment just before use, suggesting that use may follow a period of increased negative affect. Conclusions: The findings support an affect regulation model for marijuana use among frequently using youth. Specifically, these youth may use marijuana to manage increased negative affect. PMID:25208196

Objective Testing of Marijuana-Induced Vision Changes

DTIC Science & Technology

1973-04-30

related substances smokted by Americans abroad art much higher, The ar-v effects of acute and chronic I1 IIC use on moat human functions ame not...and P.E. MERRIAM. Auditory and Visua Threshold Effects of Marihuana on Man. Percep. Motor Shi~s. 29:755-759 (1969). CRANCER, A., J.M. DILLE, J.C...invest. Opbtbal. 6:145-154 (1967). HOLLISTER, L.E. and H.K. GILLESPIE. Marihuana , Ethanol and Dextroamphetamine: Mood and Mental Function Alterations

Non-Dependent Stimulant Users of Cocaine and Prescription Amphetamines Show Verbal Learning and Memory Deficits

PubMed Central

Reske, Martina; Eidt, Carolyn A.; Delis, Dean C.; Paulus, Martin P.

2010-01-01

Background Stimulants are used increasingly to enhance social (cocaine) or cognitive performance (stimulants normally prescribed, prescription stimulants, e.g. methylphenidate, amphetamines). Chronic use, on the other hand, has been associated with significant verbal memory and learning deficits. This study sought to determine whether subtle learning and memory problems characterize individuals who exhibit occasional but not chronic use of stimulants. Methods 154 young (age 18–25) occasional, non-dependent stimulant users and 48 stimulant naïve comparison subjects performed the California Verbal Learning test (CVLT-II). Lifetime uses of stimulants and co-use of marijuana were considered in correlation and median split analyses. Results Compared to stimulant naïve subjects, occasional stimulant users showed significant performance deficits, most pronounced in the verbal recall and recognition domains. Lifetime uses of stimulants and marijuana did not affect CVLT-II performance. The type of stimulant used, however, was of major relevance: users of cocaine only were less impaired, while cumulative use of prescription stimulants was associated with impaired verbal learning and memory capacities. Conclusions These results support the hypothesis of subtle and possibly pre-existing neurocognitive deficiencies in occasional users of stimulants, which may be related to the motivation of using these drugs. More importantly, despite beneficial short-term effects, cumulative use, particularly of prescription amphetamines and methylphenidate, intensifies these deficits. PMID:20605137

Nondependent stimulant users of cocaine and prescription amphetamines show verbal learning and memory deficits.

PubMed

Reske, Martina; Eidt, Carolyn A; Delis, Dean C; Paulus, Martin P

2010-10-15

Stimulants are used increasingly to enhance social (cocaine) or cognitive performance (stimulants normally prescribed, prescription stimulants [e.g., methylphenidate, amphetamines]). Chronic use, by contrast, has been associated with significant verbal memory and learning deficits. This study sought to determine whether subtle learning and memory problems characterize individuals who exhibit occasional but not chronic use of stimulants. One hundred fifty-four young (age 18-25), occasional, nondependent stimulant users and 48 stimulant-naive comparison subjects performed the California Verbal Learning Test II. Lifetime uses of stimulants and co-use of marijuana were considered in correlation and median split analyses. Compared with stimulant-naive subjects, occasional stimulant users showed significant performance deficits, most pronounced in the verbal recall and recognition domains. Lifetime uses of stimulants and marijuana did not affect California Verbal Learning Test II performance. The type of stimulant used, however, was of major relevance: users of cocaine only were less impaired, whereas cumulative use of prescription stimulants was associated with impaired verbal learning and memory capacities. These results support the hypothesis of subtle and possibly pre-existing neurocognitive deficiencies in occasional users of stimulants, which might be related to the motivation for using these drugs. More importantly, despite beneficial short-term effects, cumulative use, particularly of prescription amphetamines and methylphenidate, intensifies these deficits. Copyright © 2010 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

SOCIAL ANXIETY DISORDER AND MARIJUANA USE PROBLEMS: THE MEDIATING ROLE OF MARIJUANA EFFECT EXPECTANCIES

PubMed Central

Buckner, Julia D.; Schmidt, Norman B.

2009-01-01

Background: Individuals with social anxiety disorder (SAD) appear particularly vulnerable to marijuana-related problems. Yet, mechanisms underlying this association are unclear. Methods: This study examined the role of marijuana effect expectancies in the relation between SAD and marijuana problems among 107 marijuana users (43.0% female), 26.2% of whom met Diagnostic and Statistical Manual for Mental Disorders—Fourth Edition criteria for SAD. Anxiety and mood disorders were determined during clinical interviews using the Anxiety Disorders Interview Schedule—IV-L (ADIS-IV). Results: Analyses (including sex, marijuana use frequency, major depressive disorder, and other anxiety disorders) suggest that SAD was the only disorder significantly associated with past 3-month marijuana problems. Compared to those without SAD, individuals with SAD were more likely to endorse the following marijuana expectancies: cognitive/behavioral impairment and global negative expectancies. Importantly, these expectancies mediated the relations between SAD status and marijuana problems. Conclusions: These data support the contention that SAD is uniquely related to marijuana problems and provide insight into mechanisms underlying this vulnerability. PMID:19373871

The Association between Early Conduct Problems and Early Marijuana Use in College Students

ERIC Educational Resources Information Center

Falls, Benjamin J.; Wish, Eric D.; Garnier, Laura M.; Caldeira, Kimberly M.; O'Grady, Kevin E.; Vincent, Kathryn B.; Arria, Amelia M.

2011-01-01

Early conduct problems have been linked to early marijuana use in adolescence. The present study examines this association in a sample of 1,076 college students that was divided into three groups: (1) early marijuana users (began marijuana use prior to age 15; N = 126), (2) late marijuana users (began marijuana use at or after age 15; N = 607),…

Dronabinol and marijuana in HIV-positive marijuana smokers. Caloric intake, mood, and sleep.

PubMed

Haney, Margaret; Gunderson, Erik W; Rabkin, Judith; Hart, Carl L; Vosburg, Suzanne K; Comer, Sandra D; Foltin, Richard W

2007-08-15

Individuals with HIV constitute the largest group using cannabinoids for medicinal reasons; yet, no studies have directly compared the tolerability and efficacy of smoked marijuana and oral dronabinol maintenance in HIV-positive marijuana smokers. This placebo-controlled within-subjects study evaluated marijuana and dronabinol across a range of behaviors: eating topography, mood, cognitive performance, physiologic measures, and sleep. HIV-positive marijuana smokers (n = 10) completed 2 16-day inpatient phases. Each dronabinol (5 and 10 mg) and marijuana (2.0% and 3.9% Delta9-tetrahydrocannabinol [THC]) dose was administered 4 times daily for 4 days, but only 1 drug was active per day, thereby maintaining double-blind dosing. Four days of placebo washout separated each active cannabinoid condition. As compared with placebo, marijuana and dronabinol dose dependently increased daily caloric intake and body weight in HIV-positive marijuana smokers. All cannabinoid conditions produced significant intoxication, except for low-dose dronabinol (5 mg); the intoxication was rated positively (eg, "good drug effect") with little evidence of discomfort and no impairment of cognitive performance. Effects of marijuana and dronabinol were comparable, except that only marijuana (3.9% THC) improved ratings of sleep. These data suggest that for HIV-positive marijuana smokers, both dronabinol (at doses 8 times current recommendations) and marijuana were well tolerated and produced substantial and comparable increases in food intake.

Marijuana use and associated motives in Colorado university students.

PubMed

Phillips, Kristina T; Lalonde, Trent L; Phillips, Michael M; Schneider, Maryia M

2017-12-01

Marijuana is the most commonly used illicit drug among college students, with heavy use leading to negative outcomes. Use of marijuana for medical and recreational purposes in select U.S. states has been controversial, with concerns surrounding increased prevalence rates and harm. The current exploratory study aimed to assess marijuana use in college students in Colorado, demographic differences in frequency of use, and motives for using. College students (N = 300; 61% female) were recruited through introductory psychology courses and completed a series of questionnaires and a marijuana urine screen. Almost three-fourths of the sample reported lifetime use of marijuana. Sixty-five percent used marijuana within the last year and 29% tested positive on the urine screen. Hurdle Poisson regression models with a subset of participants (n = 117) showed non-Greek and freshman status were associated with increased number of days participants used marijuana in the last month. Problem marijuana use was positively associated with a range of motives-of note-motives focused on coping, boredom, alcohol, and food. Prevalence rates of marijuana use were high in this sample of college students in a state with legal recreational marijuana use. Particular students (eg, students who use marijuana to cope) may be at higher risk for problem marijuana use. Developing effective, tailored interventions for university students is warranted. (Am J Addict 2017;26:830-837). © 2017 American Academy of Addiction Psychiatry.

Medical marijuana: time to contact your U.S. representative.

PubMed

James, J S

1998-04-03

Advocates for legalizing marijuana for medicinal use are encouraged to contact their U.S. representatives. The first congressional vote on medicinal use of marijuana, House Resolution 372 (the anti-medicinal-marijuana resolution), takes place on April 21. H. Res. 372 states that marijuana is a dangerous and addictive drug. Nine Democrats on the House Judiciary Committee strongly disagreed with the statement and supported State initiatives to legalize marijuana for medicinal purposes. The Marijuana Policy Project offers a script to use when contacting representatives. Contact information is provided.

Predictors of marijuana relapse in the human laboratory: robust impact of tobacco cigarette smoking status.

PubMed

Haney, Margaret; Bedi, Gillinder; Cooper, Ziva D; Glass, Andrew; Vosburg, Suzanne K; Comer, Sandra D; Foltin, Richard W

2013-02-01

Few marijuana smokers in treatment achieve sustained abstinence, yet factors contributing to high relapse rates are unknown. Study 1: data from five inpatient laboratory studies assessing marijuana intoxication, withdrawal, and relapse were combined to assess factors predicting the likelihood and severity of relapse. Daily, nontreatment-seeking marijuana smokers (n = 51; 10 ± 5 marijuana cigarettes/day) were enrolled. Study 2: to isolate the effects of cigarette smoking, marijuana intoxication, withdrawal, and relapse were assessed in daily marijuana and cigarette smokers (n = 15) under two within-subject, counter-balanced conditions: while smoking tobacco cigarettes as usual (SAU), and after at least 5 days without cigarettes (Quit). Study 1: 49% of participants relapsed the first day active marijuana became available. Tobacco cigarette smokers (75%), who were not abstaining from cigarettes, were far more likely to relapse than non-cigarette smokers (odds ratio: 19, p < .01). Individuals experiencing more positive subjective effects (i.e., feeling "high") after marijuana administration and those with more negative affect and sleep disruption during marijuana withdrawal were more likely to have severe relapse episodes (p < .05). Study 2: most participants (>87%) relapsed to marijuana whether in the SAU or Quit phase. Tobacco cigarette smoking did not significantly influence relapse, nor did it affect marijuana intoxication or most symptoms of withdrawal relative to tobacco cessation. Daily marijuana smokers who also smoke cigarettes have high rates of marijuana relapse, and cigarette smoking versus recent abstinence does not directly influence this association. These data indicate that current cigarette smoking is a clinically important marker for increased risk of marijuana relapse. Copyright © 2013 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Effect of marijuana use on cardiovascular and cerebrovascular mortality: A study using the National Health and Nutrition Examination Survey linked mortality file.

PubMed

Yankey, Barbara A; Rothenberg, Richard; Strasser, Sheryl; Ramsey-White, Kim; Okosun, Ike S

2017-11-01

Background Reports associate marijuana use with cardiovascular emergencies. Studies relating marijuana use to cardiovascular mortality are scarce. Recent advance towards marijuana use legalization emphasizes the importance of understanding relationships between marijuana use and cardiovascular deaths; the primary ranked mortality. Recreational marijuana is primarily smoked; we hypothesize that like cigarette smoking, marijuana use will be associated with increased cardiovascular mortalities. Design The design of this study was based on a mortality follow-up. Method We linked participants aged 20 years and above, who responded to questions on marijuana use during the 2005 US National Health and Nutrition Examination Survey to data from the 2011 public-use linked mortality file of the National Center for Health Statistics, Centers for Disease Control and Prevention. Only participants eligible for mortality follow-up were included. We conducted Cox proportional hazards regression analyses to estimate hazard ratios for hypertension, heart disease, and cerebrovascular mortality due to marijuana use. We controlled for cigarette smoking and other relevant variables. Results Of the 1213 eligible participants 72.5% were presumed to be alive. The total follow-up time was 19,569 person-years. Adjusted hazard ratios for death from hypertension among marijuana users compared to non-marijuana users was 3.42 (95% confidence interval: 1.20-9.79) and for each year of marijuana use was 1.04 (95% confidence interval: 1.00-1.07). Conclusion From our results, marijuana use may increase the risk for hypertension mortality. Increased duration of marijuana use is associated with increased risk of death from hypertension. Recreational marijuana use potentially has cardiovascular adverse effects which needs further investigation.

When Marijuana Is Used before Cigarettes or Alcohol: Demographic Predictors and Associations with Heavy Use, Cannabis Use Disorder, and Other Drug-related Outcomes.

PubMed

Fairman, Brian J; Furr-Holden, C Debra; Johnson, Renee M

2018-05-17

Recent loosening of state and federal policy restrictions on marijuana, along with changes in social norms regarding marijuana use and decreases in prevalence of other types of substance use, may lead to increases in youth initiating marijuana before other types of substances such as alcohol and tobacco. We investigated predictors and potential consequences of initiating marijuana before other drugs for youth aged 12-21-years in the USA. Nationally representative, cross-sectional survey data from the US National Survey on Drug Use and Health supplied self-reported age of first marijuana, cigarettes, alcohol, other tobacco, and other illegal drug use among 12-21-year-old samples from 2004 to 2014 (n = 275,559). We first examined the degree to which initiating marijuana use first was associated with sex, age, race/ethnicity, and survey year. Then, we examined whether using marijuana first predicted heavy marijuana use, cannabis use disorder (CUD), alcohol use disorder (AUD), nicotine dependence (ND), or lifetime use of other illegal drugs. Among all survey youth (substance users and non-users), the proportion using marijuana first increased from 4.8 to 8.8% from 2004 to 2014. Those using marijuana first (vs. alcohol or cigarettes first) were more likely to be male and older and Black, American Indian/Alaskan Native, multiracial, or Hispanic than White or Asian. Among substance users and adjusting for age of onset and the number of substances used, using marijuana first was associated higher odds of heavy current marijuana use and CUD. In recent years, youth have been increasingly likely to use marijuana as their first drug and sequence of initiation is associated with race/ethnicity, gender, and age. Using marijuana first might increase the chance of heavy use and CUD.

Cannabinoid hyperemesis syndrome masquerading as an eating disorder.

PubMed

Brewerton, Timothy D; Anderson, Odette

2016-08-01

The case of a 22 year old woman with cannabinoid hyperemesis syndrome (CHS) presenting as an eating disorder is described. The importance of recognizing chronic cannabis use as a cause of episodic vomiting is emphasized, given that CHS can be confused with self-induced purging and cyclic vomiting. This case was further complicated by the well-defined history of anorexia nervosa (binge-purge type), major depressive disorder, obsessive-compulsive disorder, migraine headache, and the initial denial of cannabis use. However, collateral history and a positive drug screen confirmed the diagnosis. The signs, symptoms and pathophysiological mechanisms of CHS are reviewed in light of clinical presentations that mimic eating disorder phenomenology complicated by addiction. Given the trend for increasing legalization of recreational marijuana as well as medical marijuana, CHS is an important and potentially complicating disorder that eating disorder clinicians need to be aware of. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:826-829). © 2016 Wiley Periodicals, Inc.

Stigma among California's Medical Marijuana Patients.

PubMed

Satterlund, Travis D; Lee, Juliet P; Moore, Roland S

2015-01-01

The enactment of California's Proposition 215 stipulates that patients may use marijuana for medical reasons, provided that it is recommended by a physician. Yet, medical marijuana patients risk being stigmatized for this practice. This article examines the way in which medical marijuana patients perceive and process stigma, and how it affects their interactions and experiences with others. Eighteen semi-structured interviews of medical marijuana patients were carried out using a semi-structured interview guide. Most patients circumvented their own physicians in obtaining a recommendation to use medicinal marijuana, and also used a host of strategies in order to justify their medical marijuana use to family, friends, and colleagues in order to stave off potential stigma. The stigmatization of medical marijuana thus has a profound effect on how patients seek treatment, and whether they seek medical marijuana treatment at all.

Stigma Among California's Medical Marijuana Patients

PubMed Central

Satterlund, Travis D.; Lee, Juliet P.; Moore, Roland S.

2014-01-01

The enactment of California's Proposition 215 stipulates that patients may use marijuana for medical reasons, provided that it is recommended by a physician. Yet, medical marijuana patients risk being stigmatized for this practice. This paper examines the way in which medical marijuana patients perceive and process stigma, and how it affects their interactions and experiences with others. Eighteen semi-structured interviews of medical marijuana patients were carried out using a semi-structured interview guide. Most patients circumvented their own physicians in obtaining a recommendation to use medicinal marijuana, and also used a host of strategies in order to justify their medical marijuana use to family, friends and colleagues in order to stave off potential stigma. The stigmatization of medical marijuana thus has a profound effect on how patients seek treatment, and whether they seek medical marijuana treatment at all. PMID:25715067

The relationship of college students' use of marijuana to parental attitudes and drug-taking behavior.

PubMed

Turner, C J; Willis, R J

1980-10-01

This study was part of an extensive survey of drug use patterns at a small private college in suburban New Jersey during the fall, 1975. Selected items from a questionnaire developed by the Inter-University Drug Survey Council of Metropolitan New York were cross-tabulated in order to examine the relationship between 379 college students' use of marijuana and their parents' attitudes and behavior relative to drug use. Significant results at the 0.01 level were found between (1) time of first marijuana use and parental attitudes toward alcohol and marijuana; (2) time of first marijuana use and parental use of barbiturates, marijuana, and pain-killers; (3) current frequency of marijuana use and parental attitudes toward alcohol and marijuana; and (4) current frequency of marijuana use and parental use of pain-killers.

Tobacco and Marijuana Initiation Among African American and White Young Adults.

PubMed

Kennedy, Sara M; Patel, Roshni P; Cheh, Paul; Hsia, Jason; Rolle, Italia V

2016-04-01

African American youth use marijuana at similar rates and tobacco at lower rates compared with white youth; however, in adulthood, tobacco use is similar. Tobacco and marijuana use are closely associated; differing initiation patterns may contribute to observed racial differences in tobacco prevalence by age. Therefore, it is important to assess tobacco and marijuana initiation patterns by race. Data were obtained from 56,555 adults aged 18-25 who completed the 2005-2012 National Survey on Drug Use and Health. The analysis was restricted to those who reported ever use of marijuana and combustible tobacco (cigarettes and/or cigars). Three mutually exclusive categories of initiation patterns were evaluated: use of marijuana before tobacco; marijuana and tobacco at the same age; and tobacco before marijuana. Multivariable regression models were used to assess changes over time and compare these outcomes by race while controlling for sociodemographics, risk perceptions, and current substance use. In 2005, 26.6% of African American and 14.3% of white young adults used marijuana before tobacco, compared with 41.5% of African American and 24.0% of white young adults in 2012 (P < .001). Overall, African American young adults had greater odds of using marijuana before tobacco (AOR = 1.79; 95% CI: 1.67, 1.91) compared with whites. African American young adults were more likely than whites to use marijuana before tobacco and both groups were increasingly likely to use marijuana before tobacco over time. A greater understanding of how marijuana initiation interacts with tobacco initiation could inform more effective tobacco and marijuana use prevention efforts. Among ever users of combustible tobacco and marijuana, greater proportions of African American young adults used marijuana before tobacco or at the same age than their white counterparts. Moreover, both African Americans and whites were more likely to use marijuana before tobacco in 2012 compared with 2005. Tobacco control policy may benefit from a broader understanding of the patterns of initiation to tobacco and marijuana use. Some public health interventions aimed at preventing and reducing combustible tobacco use among African American young adults may be strengthened by considering marijuana use. © The Author 2016. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Characteristics of Child Maltreatment and Adolescent Marijuana Use: A Prospective Study.

PubMed

Dubowitz, Howard; Thompson, Richard; Arria, Amelia M; English, Diana; Metzger, Richard; Kotch, Jonathan B

2016-02-01

There has been increasing acceptance of marijuana use in the United States in recent years, and rates among adolescents have risen. At the same time, marijuana use during adolescence has been linked to an array of health and social problems. Maltreated children are at risk for marijuana use, but the relationships among characteristics of maltreatment and marijuana use are unclear. In this article, we examine how the type and the extent of maltreatment are related to the level of adolescent marijuana use. Data analyses were conducted on a subsample of maltreated adolescents (n = 702) from the Longitudinal Studies of Child Abuse and Neglect project. Approximately half the sample had used marijuana, and maltreatment was associated with its use. Multivariate regression models showed that being male, extensive maltreatment, and peer marijuana use were associated with heavy use of marijuana. These findings suggest the importance of comprehensively assessing children's maltreatment experiences and their peers' drug use to help prevent or address possible marijuana use in these high-risk adolescents. © The Author(s) 2015.

Characteristics of Child Maltreatment and Adolescent Marijuana Use: A Prospective Study

PubMed Central

Dubowitz, Howard; Thompson, Richard; Arria, Amelia M.; English, Diana; Metzger, Richard; Kotch, Jonathan B.

2015-01-01

There has been increasing acceptance of marijuana use in the US in recent years, and rates among adolescents have risen. At the same time, marijuana use during adolescence has been linked to an array of health and social problems. Maltreated children are at risk for marijuana use, but the relationships among characteristics of maltreatment and marijuana use are unclear. In this paper we examine how the type and the extent of maltreatment are related to the level of adolescent marijuana use. Data analyses were conducted on a subsample of maltreated adolescents (n = 702) from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) project. Approximately half the sample had used marijuana, and maltreatment was associated with its use. Multivariate regression models showed that being male, extensive maltreatment, and peer marijuana use were associated with Heavy Use of marijuana. These findings suggest the importance of comprehensively assessing children’s maltreatment experiences and their peers’ drug use to help prevent or address possible marijuana use in these high-risk adolescents. PMID:26715532

Cigarette smoking among marijuana users in the United States.

PubMed

Richter, Kimber P; Kaur, Haroshena; Resnicow, Ken; Nazir, Niaman; Mosier, Michael C; Ahluwalia, Jasjit S

2004-06-01

The vast majority of drug users smoke cigarettes. Most use marijuana and no other illicit drug. We analyzed adult responses to the 1997 NHSDA (n = 16,661) to explore relationships between marijuana use and cigarette smoking. Multivariate analyses controlled for other illicit drug use and other potential covariates. Nearly three-quarters of current marijuana users (74%) smoked cigarettes. Compared to nonusers, the adjusted odds of being a smoker were 5.43 for current marijuana users, 3.58 for past year marijuana users, and 2.02 for former marijuana users. Odds for cigarette smoking among current poly-drug users, compared to nonusers, were 2.3 to 1. Level of cigarette smoking was directly associated with frequency of marijuana use. Nationwide, an estimated 7 million adults smoke both substances and are at increased risk for respiratory illnesses and mortality. Cigarette smoking is a major co-morbidity of marijuana use and smoking cessation should be addressed among marijuana users in addition to their other illicit drug involvement.

Quantifying cannabis: A field study of marijuana quantity estimation.

PubMed

Prince, Mark A; Conner, Bradley T; Pearson, Matthew R

2018-06-01

The assessment of marijuana use quantity poses unique challenges. These challenges have limited research efforts on quantity assessments. However, quantity estimates are critical to detecting associations between marijuana use and outcomes. We examined accuracy of marijuana users' estimations of quantities of marijuana they prepared to ingest and predictors of both how much was prepared for a single dose and the degree of (in)accuracy of participants' estimates. We recruited a sample of 128 regular-to-heavy marijuana users for a field study wherein they prepared and estimated quantities of marijuana flower in a joint or a bowl as well as marijuana concentrate using a dab tool. The vast majority of participants overestimated the quantity of marijuana that they used in their preparations. We failed to find robust predictors of estimation accuracy. Self-reported quantity estimates are inaccurate, which has implications for studying the link between quantity and marijuana use outcomes. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Marijuana intoxication

MedlinePlus

Cannabis intoxication; Intoxication - marijuana (cannabis); Pot; Mary Jane; Weed; Grass; Cannabis ... The intoxicating effects of marijuana include relaxation, ... to fast and predictable signs and symptoms. Eating marijuana ...

Does cannabis smoking predispose to lung bulla formation?

PubMed

Fiorelli, Alfonso; Accardo, Marina; Vicidomini, Giovanni; Messina, Gaetana; Laperuta, Paolo; Santini, Mario

2014-01-01

The data of a consecutive series of habitual marijuana smokers were retrospectively evaluated and compared with that of non-marijuana smokers to assess differences between the 2 groups. 13 consecutive habitual marijuana smokers were referred for treatment of spontaneous pneumothorax. The demographic, clinical, radiological, and pathological findings of these patients were reviewed and compared with 140 non-marijuana smokers treated for the same pathology at the same time. Bullae were seen in 8/13 (62%) and 110/140 (78%) of marijuana smokers and non-marijuana smokers, respectively. However, when patients less than 35-years old were considered, the incidence of bulla was higher in marijuana smokers than non-marijuana smokers (7/10 vs. 3/10, p < 0.05). The pathological findings showed a greater presence of inflammatory cells in specimens from marijuana smokers than those of non-marijuana smokers (8/11 vs. 2/42, respectively, p < 0.05). No significant differences in hospital stay and clinical outcome were registered between the 2 groups. Despite the fact that we were unable to demonstrate that marijuana had a causal role in the development of emphysema, our study showed that marijuana smokers had a higher incidence of inflammatory cells in pathological specimens, which may favor lung injury, thus predisposing to bulla formation.

Parent and Peer Pathways Linking Childhood Experiences of Abuse with Marijuana Use in Adolescence and Adulthood

PubMed Central

Russo, M. Jean; Chmelka, Mary B.; Herrenkohl, Roy C.; Herrenkohl, Todd I.

2016-01-01

Introduction The social developmental processes by which child maltreatment increases risk for marijuana use are understudied. This study examined hypothesized parent and peer pathways linking preschool abuse and sexual abuse with adolescent and adult marijuana use. Methods Analyses used data from the Lehigh Longitudinal Study. Measures included child abuse (physical abuse, emotional abuse, domestic violence, and neglect) in preschool, sexual abuse up to age 18, adolescent (average age = 18 years) parental attachment and peer marijuana approval/use, as well as adolescent and adult (average age = 36 years) marijuana use. Results Confirming elevated risk due to child maltreatment, path analysis showed that sexual abuse was positively related to adolescent marijuana use, whereas preschool abuse was positively related to adult marijuana use. In support of mediation, it was found that both forms of maltreatment were negatively related to parental attachment, which was negatively related, in turn, to having peers who use and approve of marijuana use. Peer marijuana approval/use was a strong positive predictor of adolescent marijuana use, which was a strong positive predictor, in turn, of adult marijuana use. Conclusions Results support social developmental theories that hypothesize a sequence of events leading from child maltreatment experiences to lower levels of parental attachment and, in turn, higher levels of involvement with pro-marijuana peers and, ultimately, to both adolescent and adult marijuana use. This sequence of events suggests developmentally-timed intervention activities designed to prevent maltreatment as well as the initiation and progression of marijuana use among vulnerable individuals. PMID:27889563

Marijuana use and depression among adults: Testing for causal associations.

PubMed

Harder, Valerie S; Morral, Andrew R; Arkes, Jeremy

2006-10-01

To determine whether marijuana use predicts later development of depression after accounting for differences between users and non-users of marijuana. An ongoing longitudinal survey of 12 686 men and women beginning in 1979. The National Longitudinal Survey of Youth of 1979, a nationally representative sample from the United States. A total of 8759 adults (age range 29-37 years) interviewed in 1994 had complete data on past-year marijuana use and current depression. Self-reported past-year marijuana use was tested as an independent predictor of later adult depression using the Center for Epidemiologic Studies-Depression questionnaire. Individual's propensity to use marijuana was calculated using over 50 baseline covariates. Before adjusting for group differences, the odds of current depression among past-year marijuana users is 1.4 times higher (95% CI: 1.1, 1.9) than the odds of depression among the non-using comparison group. After adjustment, the odds of current depression among past-year marijuana users is only 1.1 times higher than the comparison group (95% CI: 0.8, 1.7). Similarly, adjustment eliminates significant associations between marijuana use and depression in four additional analyses: heavy marijuana use as the risk factor, stratifying by either gender or age, and using a 4-year lag-time between marijuana use and depression. After adjusting for differences in baseline risk factors of marijuana use and depression, past-year marijuana use does not significantly predict later development of depression. These findings are discussed in terms of their relevance for understanding possible causal effects of marijuana use on depression.

Young adults report increased pleasure from smoking cigarettes when drinking alcohol but not when using marijuana.

PubMed

Gubner, Noah R; Thrul, Johannes; Kelly, Oona A; Ramo, Danielle E

2018-01-01

Among young adults, cigarette smoking is strongly associated with alcohol and marijuana use. The present study compared self-reported co-use of cigarettes and alcohol versus cigarettes and marijuana among young adults using cross-sectional survey data. Participants were young adult cigarette smokers (age 18 to 25) who also reported past month alcohol or marijuana use enrolled in a randomized trial testing a smoking cessation intervention on Facebook. Participants self-reported extent of cigarette smoking under the influence of alcohol or marijuana and differences in perceived pleasure from cigarette smoking when drinking alcohol compared to using marijuana. Among cigarette smokers who drank alcohol and used marijuana in the past month (n=200), a similar percentage of cigarettes were smoked under the influence of alcohol (42.4%±31.2%) and marijuana (43.1% ±30.0%). Among alcohol + marijuana users, perceived pleasure from smoking cigarettes was significantly greater when drinking alcohol versus when using marijuana (t (199) =7.05, p<0.001). There was, on average, an increase in perceived pleasure from smoking cigarettes when drinking alcohol, though perceived pleasure did not differ by binge drinking frequency. In contrast, there was on average no change in perceived pleasure from smoking cigarettes when using marijuana. Results from the cigarette smokers who used alcohol + marijuana were similar to cigarette smokers who only used alcohol (n=158) or only used marijuana (n=54). Findings highlight greater perceived reward from smoking cigarettes when drinking alcohol compared to when using marijuana, informing smoking cessation interventions that target users of multiple substances.

Parent and peer pathways linking childhood experiences of abuse with marijuana use in adolescence and adulthood.

PubMed

Alex Mason, W; Jean Russo, M; Chmelka, Mary B; Herrenkohl, Roy C; Herrenkohl, Todd I

2017-03-01

The social developmental processes by which child maltreatment increases risk for marijuana use are understudied. This study examined hypothesized parent and peer pathways linking preschool abuse and sexual abuse with adolescent and adult marijuana use. Analyses used data from the Lehigh Longitudinal Study. Measures included child abuse (physical abuse, emotional abuse, domestic violence, and neglect) in preschool, sexual abuse up to age 18, adolescent (average age=18years) parental attachment and peer marijuana approval/use, as well as adolescent and adult (average age=36years) marijuana use. Confirming elevated risk due to child maltreatment, path analysis showed that sexual abuse was positively related to adolescent marijuana use, whereas preschool abuse was positively related to adult marijuana use. In support of mediation, it was found that both forms of maltreatment were negatively related to parental attachment, which was negatively related, in turn, to having peers who use and approve of marijuana use. Peer marijuana approval/use was a strong positive predictor of adolescent marijuana use, which was a strong positive predictor, in turn, of adult marijuana use. Results support social developmental theories that hypothesize a sequence of events leading from child maltreatment experiences to lower levels of parental attachment and, in turn, higher levels of involvement with pro-marijuana peers and, ultimately, to both adolescent and adult marijuana use. This sequence of events suggests developmentally-timed intervention activities designed to prevent maltreatment as well as the initiation and progression of marijuana use among vulnerable individuals. Copyright © 2016 Elsevier Ltd. All rights reserved.

Correlates of Marijuana Drugged Driving and Openness to Driving While High: Evidence from Colorado and Washington.

PubMed

Davis, Kevin C; Allen, Jane; Duke, Jennifer; Nonnemaker, James; Bradfield, Brian; Farrelly, Matthew C; Shafer, Paul; Novak, Scott

2016-01-01

A potential unintended consequence of legalizing recreational marijuana is increased marijuana-related driving impairment. Some states where recreational marijuana is legal have begun implementing interventions to mitigate driving under the influence (DUI) of marijuana, including media campaigns to increase knowledge about DUI laws. However, little is known about the associations between knowledge of DUI laws and marijuana DUI behavior. In this study, we provide new data from a survey of marijuana users in Colorado and Washington to examine associations between marijuana drugged driving and two potential behavioral precursors of marijuana DUI. We also explore other factors that may influence marijuana DUI. Data are from an online survey of marijuana users in Colorado and Washington. Respondents who reported any marijuana use in the past 30 days (n = 865) served as the analytic sample. We examined prevalence of two behavioral outcomes: (1) any driving of a motor vehicle while high in the past year and (2) driving a motor vehicle within 1 hour of using marijuana 5 or more times in the past month. Additional outcomes measuring willingness to drive while high were also assessed. Logistic regressions were used to estimate each outcome as a function of two multi-item scales measuring knowledge of the legal consequences of driving high and perceptions that driving while high is not safe. Additional covariates for potential confounders were included in each model. Prevalence of past-year driving while under the influence of marijuana was 43.6% among respondents. The prevalence of driving within 1 hour of using marijuana at least 5 times in the past month was 23.9%. Increased perception that driving high is unsafe was associated with lower odds of past-year marijuana DUI (OR = 0.31, P < 0.01) and lower past-month odds of driving 5 or more times within 1 hour of using marijuana (OR = 0.26, P < 0.01). Increased knowledge of marijuana DUI laws was also associated with lower odds of each of these outcomes (OR = 0.63, P < 0.01, OR = 0.69, P = 0.02, respectively). Post-estimation Wald tests confirmed the negative associations with marijuana DUI were greater in magnitude for safety perceptions than knowledge of DUI laws. Increased perceptions that driving while high is unsafe was associated with significantly lower willingness to drive after using marijuana while increased knowledge of marijuana DUI laws was not associated with these outcomes. Despite recent interventions targeting public awareness of the legal consequences of marijuana DUI, our results suggest that knowledge of these laws is a weaker predictor of DUI behavior than perceptions that driving high is unsafe. In addition, safety perceptions predict decreased openness to driving high while knowledge of DUI laws was not associated with openness. These findings suggest that interventions for reducing the incidence of marijuana DUI are likely to be more successful by targeting safety perceptions related to marijuana DUI rather than knowledge of DUI laws. We caution that because these data are limited to an online convenience sample, results may not be generalizable beyond our sample.

Associations Between Microbiota, Mitochondrial Function, and Cognition in Chronic Marijuana Users.

PubMed

Panee, Jun; Gerschenson, Mariana; Chang, Linda

2018-03-01

Marijuana (MJ) use is associated with cognitive deficits. Both mitochondrial (mt) dysfunction and gut dysbiosis also affect cognition. We examined whether cognition is related to peripheral blood mononuclear cells' (PBMCs) mt function and fecal microbiota in chronic MJ users. Nineteen chronic MJ users and 20 non-users were evaluated using the Cognition Battery in NIH Toolbox, their mt function for ATP production, and basal and maximal respirations were measured in PBMCs using the Seahorse XFe96 Analyzer, and the abundances of Prevotella and Bacteroides (associated with plant-based and animal product-based diet, respectively) were calculated from stool microbiota analysis. Average Prevotella:Bacteroides ratio was ~13-fold higher in nonusers than users. Lifetime MJ use correlated inversely with Prevotella:Bacteroides ratio (p = 0.05), mt function (p = 0.0027-0.0057), and Flanker Inhibitory Control and Attention (p = 0.041). Prevotella abundance correlated positively, while Bacteroides abundance correlated inversely, with mt function across all participants (p = 0.0004-0.06). Prevotella abundance also correlated positively with scores of Fluid Cognition, Flanker Inhibitory Control and Attention, List Sorting, and Dimension Change Card Sort in MJ users, but not in non-users (interaction-p = 0.018-0.05). Similarly, mt function correlated positively with scores of Fluid Cognition and Flanker Inhibitory Control and Attention in MJ users, but not in non-users (interaction-p = 0.0018-0.08). These preliminary findings suggest that MJ use is associated with alterations of gut microbiota and mt function, which may further contribute to cognitive deficits. We posited that MJ-associated low vegetable/fruit intake may contribute to these changes. Future studies are needed to delineate the relationships among diet, microbiota, mt function, and cognition in MJ users.

Medical Marijuana.

PubMed

Capriotti, Teri

2016-01-01

The use of medicinal marijuana is increasing. Marijuana has been shown to have therapeutic effects in certain patients, but further research is needed regarding the safety and efficacy of marijuana as a medical treatment for various conditions. A growing body of research validates the use of marijuana for a variety of healthcare problems, but there are many issues surrounding the use of this substance. This article discusses the use of medical marijuana and provides implications for home care clinicians.

Clinical Challenges in the Growing Medical Marijuana Field.

PubMed

Barker, Jonathan

2018-03-01

Unique clinical challenges arise with the growing number of patients who possess medical marijuana cards. Medical marijuana patients with mental disorders can have worsening symptoms with marijuana use. Often there is sparse continuity of care between the patient and the medical marijuana practitioner. Lack of communication between the patient's treating practitioners and the practitioner who has authorized the medical marijuana can be problematic. This article is a discussion of the new clinical challenges practitioners are likely to encounter with the growing number of medical marijuana patients. [Full article available at http://rimed.org/rimedicaljournal-2018-03.asp].

Clinical Challenges in the Growing Medical Marijuana Field.

PubMed

Barker, Jonathan

2018-02-02

Unique clinical challenges arise with the growing number of patients who possess medical marijuana cards. Medical marijuana patients with mental disorders can have worsening symptoms with marijuana use. Often there is sparse continuity of care between the patient and the medical marijuana practitioner. Lack of communication between the patient's treating practitioners and the practitioner who has authorized the medical marijuana can be problematic. This article is a discussion of the new clinical challenges practitioners are likely to encounter with the growing number of medical marijuana patients. [Full article available at http://rimed.org/rimedicaljournal-2018-02.asp].

The effect of marijuana scenes in anti-marijuana public service announcements on adolescents' evaluation of ad effectiveness.

PubMed

Kang, Yahui; Cappella, Joseph N; Fishbein, Martin

2009-09-01

This study explored the possible negative impact of a specific ad feature-marijuana scenes-on adolescents' perceptions of ad effectiveness. A secondary data analysis was conducted on adolescents' evaluations of 60 anti-marijuana public service announcements that were a part of national and state anti-drug campaigns directed at adolescents. The major finding of the study was that marijuana scenes in anti-marijuana public service announcements negatively affected ad liking and thought valence toward the ads among adolescents who were at higher levels of risk for marijuana use. This negative impact was not reversed in the presence of strong anti-marijuana arguments. The results may be used to partially explain the lack of effectiveness of the anti-drug media campaign. It may also help researchers design more effective anti-marijuana ads by isolating adverse elements in the ads that may elicit boomerang effects in the target population.

Relations Between Anxiety Sensitivity, Distress Tolerance, and Fear Reactivity to Bodily Sensations to Coping and Conformity Marijuana Use Motives Among Young Adult Marijuana Users

PubMed Central

Zvolensky, Michael J.; Marshall, Erin C.; Johnson, Kirsten; Hogan, Julianna; Bernstein, Amit; Bonn-Miller, Marcel O.

2011-01-01

The present investigation examines anxiety sensitivity, distress tolerance, and fear reactivity to bodily sensations in relation to Coping and Conformity marijuana use motives among a sample of young adult marijuana users (n = 135; 46.7% women; Mage = 20.45, SD = 5.0). After controlling for current marijuana use frequency (past 30 days), daily cigarette smoking rate, average volume of alcohol used over the past year, negative affectivity, and other marijuana use motives, anxiety sensitivity was significantly and uniquely associated with Coping and Conformity motives for marijuana use. Distress tolerance evidenced significant and unique incremental relations to Coping motives, whereas fear reactivity to bodily sensations was unrelated to any marijuana use motive. These results provide novel information related to the role of emotional sensitivity and tolerance factors as they pertain to specific types of motives for marijuana use among young adults. PMID:19186932

Understanding Rates of Marijuana Use and Consequences Among Adolescents in a Changing Legal Landscape.

PubMed

D'Amico, Elizabeth J; Tucker, Joan S; Pedersen, Eric R; Shih, Regina A

2017-01-01

There is not one answer to address whether marijuana use has increased, decreased, or stayed the same given changes in state legalization of medical and non-medical marijuana in the USA. Evidence suggests some health benefits for medical marijuana; however, initiation of marijuana use is a risk factor for developing problem cannabis use. Though use rates have remained stable over recent years, about one in three 10th graders report marijuana use, most adolescents do not view the drug as harmful, and over 650,000 youth aged 12 to 17 struggle with cannabis use disorder. Although the health benefits of medical marijuana are becoming better understood, more research is needed. Intervention and prevention programs must better address effects of marijuana, acknowledging that while there may be some benefits medically, marijuana use can affect functioning during adolescence when the brain is still developing.

Examining the Relationship between Marijuana Use, Medical Marijuana Dispensaries, and Abusive and Neglectful Parenting

PubMed Central

Freisthler, Bridget; Gruenewald, Paul J.; Wolf, Jennifer Price

2015-01-01

The current study extends previous research by examining whether and how current marijuana use and the physical availability of marijuana are related to child physical abuse, supervisory neglect, or physical neglect by parents while controlling for child, caregiver, and family characteristics in a general population survey in California. Individual level data on marijuana use and abusive and neglectful parenting were collected during a telephone survey of 3,023 respondents living in 50 mid-size cities in California. Medical marijuana dispensaries and delivery services data were obtained via six websites and official city lists. Data were analyzed using negative binomial and linear mixed effects multilevel models with individuals nested within cities. Current marijuana use was positively related to frequency of child physical abuse and negatively related to physical neglect. There was no relationship between supervisory neglect and marijuana use. Density of medical marijuana dispensaries and delivery services was positively related to frequency of physical abuse. As marijuana use becomes more prevalent, those who work with families, including child welfare workers must screen for how marijuana use may affect a parent’s ability to provide for care for their children, particularly related to physical abuse. PMID:26198452

Being Blunt About Marijuana: Parent Communication About Marijuana with Their Emerging Adult Children

PubMed Central

Froidevaux, Nicole M.; LaBrie, Joseph W.

2016-01-01

While research suggests that parents continue to influence students’ marijuana use after matriculation to college, there is limited data examining how parents communicate about marijuana use and what impact parent marijuana communication has on college student outcomes. The aim of the current study is to investigate the types of parent marijuana messages that college students receive and the relationship between parent communication and students’ marijuana attitudes and behaviors. Students (N = 506) completed a survey assessing marijuana approval, use, negative consequences, and parent communication. A factor analysis of parent communication items yielded three factors: risk communication, permissive communication, and marijuana use communication. Risk communication was the most common form of communication. In multivariate models, risk communication was associated with increased odds of a student remaining abstinent but not with frequency of marijuana use or negative consequences. Greater permissive communication was associated with more approving student attitudes, greater odds of non-abstinence, more frequent use in the past year, and more negative consequences. These findings highlight the need to consider the different types of messages parents deliver when designing interventions aimed at engaging parents in marijuana prevention efforts. PMID:27438296

Reasons for Marijuana Use Among Young Adults and Long-Term Associations With Marijuana Use and Problems

PubMed Central

Patrick, Megan E.; Bray, Bethany C.; Berglund, Patricia A.

2016-01-01

Objective: This study examines reasons for marijuana use among young adults age 19/20 in the United States and the extent to which patterns of reasons are associated with marijuana use and problems 15 years later. Method: The national Monitoring the Future study provided data on marijuana users at age 19/20 who were also surveyed at age 35 (n = 2,288; 50% women; 83% White). Latent class analysis was used to identify distinct patterns of reasons for marijuana use, which were then used as predictors of later marijuana use and problems. Results: Five latent classes described the following patterns of reasons for marijuana use at age 19/20: Experimental, Get High + Relax, Typical, Typical + Escape, and Coping + Drug Use. Highest risk for later marijuana use and problems was found for people with Coping + Drug Use and Get High + Relax reasons in young adulthood; those with Experimental reasons were at lowest risk for later use or problems. Conclusions: Coping and getting high emerged as strong predictors of later marijuana use and problems. Results support the predictive value of self-reported reasons for using marijuana among young adults. PMID:27797689

ADHD and marijuana use expectancies in young adulthood

PubMed Central

Harty, Seth C.; Pedersen, Sarah L.; Gnagy, Elizabeth M.; Pelham, William E.; Molina, Brooke S. G.

2015-01-01

Objective This study examined mean level differences in marijuana expectancies and the differential associations between expectancies and marijuana use for individuals with and without a history of Attention-Deficit/Hyperactivity Disorder (ADHD) Background Substance use expectancies are a widely studied risk factor for alcohol and other drug use. The relations between marijuana use expectancies and self-reported marijuana use have not been examined in young adults with ADHD, a population shown to be at risk for marijuana use. Method Participants were 306 (190 ADHD and 116 nonADHD) young adults (M age = 20.06, SD = 2.03) from the Pittsburgh ADHD Longitudinal Study (PALS) who provided data about marijuana use and marijuana use expectancies. Results Individuals in the ADHD group reported lower levels of social enhancement, tension reduction, and cognitive and behavioral impairment expectancies compared to individuals in the nonADHD group. Positive and negative marijuana use expectancies were associated with marijuana use frequency in the whole sample and statistically significant ADHD group by expectancy interactions were found. Sexual enhancement expectancies were more strongly associated with marijuana use frequency among individuals with ADHD histories while cognitive behavioral impairment expectancies were more strongly associated with marijuana use frequency among individuals without ADHD. Conclusions Marijuana use expectancies may be acquired, and operate differently, for individuals with and without ADHD histories. Although future research is needed to test this speculation, these differences may be associated with ADHD-related difficulties in higher order cognitive processes that affect the encoding and utilization of expectations regarding marijuana’s effects. PMID:26548364

Patient Perceptions of the Use of Medical Marijuana in the Treatment of Pain After Musculoskeletal Trauma: A Survey of Patients at 2 Trauma Centers in Massachusetts.

PubMed

Heng, Marilyn; McTague, Michael F; Lucas, Robert C; Harris, Mitchel B; Vrahas, Mark S; Weaver, Michael J

2018-01-01

To evaluate musculoskeletal trauma patients' beliefs regarding the usefulness of marijuana as a valid medical treatment for postinjury and postoperative pain and anxiety. Prospective survey. Two academic Level 1 trauma centers. Five hundred patients in an orthopedic outpatient clinic. Survey. (1) Do patients believe that marijuana can be used as medicine? (2) Do patients believe that marijuana can help treat postinjury pain? (3) Are patients comfortable speaking with their health care providers about medical marijuana? The majority of patients felt that marijuana could be used to treat pain (78%, 390) and anxiety (62%, 309). Most patients (60%, 302) had used marijuana at least once previously, whereas only 14% reported using marijuana after their injury. Of those who used marijuana during their recovery, 90% (63/70) believed that it reduced symptoms of pain, and 81% (57/70) believed that it reduced the amount of opioid pain medication they used. The majority of patients in this study believed that medical marijuana is a valid treatment and that it does have a role in reducing postinjury and postoperative pain. Those patients who used marijuana during their recovery felt that it alleviated symptoms of pain and reduced their opioid intake. Our results help inform clinicians regarding the perceptions of patients with trauma regarding the usefulness of marijuana in treating pain and support further study into the utility of medical marijuana in this population.

Effects of Medical Marijuana on Migraine Headache Frequency in an Adult Population.

PubMed

Rhyne, Danielle N; Anderson, Sarah L; Gedde, Margaret; Borgelt, Laura M

2016-05-01

No clinical trials are currently available that demonstrate the effects of marijuana on patients with migraine headache; however, the potential effects of cannabinoids on serotonin in the central nervous system indicate that marijuana may be a therapeutic alternative. Thus, the objective of this study was to describe the effects of medical marijuana on the monthly frequency of migraine headache. Retrospective chart review. Two medical marijuana specialty clinics in Colorado. One hundred twenty-one adults with the primary diagnosis of migraine headache who were recommended migraine treatment or prophylaxis with medical marijuana by a physician, between January 2010 and September 2014, and had at least one follow-up visit. The primary outcome was number of migraine headaches per month with medical marijuana use. Secondary outcomes were the type and dose of medical marijuana used, previous and adjunctive migraine therapies, and patient-reported effects. Migraine headache frequency decreased from 10.4 to 4.6 headaches per month (p<0.0001) with the use of medical marijuana. Most patients used more than one form of marijuana and used it daily for prevention of migraine headache. Positive effects were reported in 48 patients (39.7%), with the most common effects reported being prevention of migraine headache with decreased frequency of migraine headache (24 patients [19.8%]) and aborted migraine headache (14 patients [11.6%]). Inhaled forms of marijuana were commonly used for acute migraine treatment and were reported to abort migraine headache. Negative effects were reported in 14 patients (11.6%); the most common effects were somnolence (2 patients [1.7%]) and difficulty controlling the effects of marijuana related to timing and intensity of the dose (2 patients [1.7%]), which were experienced only in patients using edible marijuana. Edible marijuana was also reported to cause more negative effects compared with other forms. The frequency of migraine headache was decreased with medical marijuana use. Prospective studies should be conducted to explore a cause-and-effect relationship and the use of different strains, formulations, and doses of marijuana to better understand the effects of medical marijuana on migraine headache treatment and prophylaxis. © 2016 Pharmacotherapy Publications, Inc.

Marijuana, alcohol, and drug impaired driving among emerging adults: Changes from high school to one-year post high school

PubMed Central

Li, Kaigang; Simons-Morton, Bruce; Gee, Benjamin; Hingson, Ralph

2016-01-01

Introduction Driving while impaired (DWI) increases the risk of a motor vehicle crash by impairing performance. Few studies have examined the prevalence and predictors of marijuana, alcohol, and drug specific DWI among emerging adults. Methods The data from wave 3 (W3, high-school seniors, 2012, N=2407) and wave 4 (W4, one year after high school, N=2178) of the NEXT Generation Health Study with a nationally-representative cohort. W4 DWI (≥1 day of past 30 days) was specified for alcohol-specific, marijuana-specific, alcohol/marijuana-combined, illicit drug-related DWI. Multinomial logistic regression models estimated the association of W4 DWI with W3 covariates (perceived peer/parent influence, drinking/binge drinking, marijuana/illicit drug use), and W4 environmental-status variables (work/school/residence) adjusting for W3 overall DWI, demographic and complex-survey variables. Results Overall DWI prevalence from W3 to W4 changed slightly (14% to 15%). W4 DWI consisted of 4.34% drinking-specific, 5.02% marijuana-specific, 2.41% drinking/marijuana-combined, and 3.37% illicit drug-related DWI. W3 DWI was significantly associated with W4 alcohol-related and alcohol/marijuana-combined DWI, but not other DWI. W3 marijuana use, binge drinking, and illicit drug use were positively associated with W4 marijuana-specific, alcohol/marijuana-combined, and illicit drug-related DWI respectively. W3 friend drunkenness and marijuana use were positively associated with W4 alcohol-specific and marijuana-related DWI respectively. W3 peer marijuana use was negatively associated with W4 alcohol-specific DWI. Conclusions Driving under the influence of alcohol, marijuana, and illicit drugs is a persistent, threatening public health concern among emerging US adults. High-school seniors’ binge drinking as well as regular alcohol drinking and marijuana/illicit drug use were independently associated with respective DWI one year after high school. Peer drunkenness and marijuana use in high school may be related to subsequent DWI of emerging adults. Practical applications The results support the use of injunctive peer norms about getting drunk and smoking marijuana in guiding the development of prevention programs to reduce youth DWI. PMID:27620930

State-Level Medical Marijuana Laws, Marijuana Use and Perceived Availability of Marijuana Among the General U.S. Population

PubMed Central

Martins, Silvia S.; Mauro, Christine M.; Santaella-Tenorio, Julian; Kim, June H.; Cerda, Magdalena; Keyes, Katherine M.; Hasin, Deborah S.; Galea, Sandro; Wall, Melanie

2016-01-01

Background Little is known on how perceived availability of marijuana is associated with medical marijuana laws. We examined the relationship between medical marijuana laws (MML) and the prevalence of past-month marijuana use, with perceived availability of marijuana. Methods Data were from respondents included in the National Survey of Drug Use and Health restricted use data portal 2004–2013. Multilevel logistic regression of individual- level data was used to test differences between MML and non-MML states and changes in prevalence of past-month marijuana use and perceived availability from before to after passage of MML among adolescents, young adults and older adults controlling for demographics. Results Among adults 26+, past-month prevalence of marijuana use increased from 5.87% to 7.15% after MML passage (Adjusted Odds Ratio (AOR): 1.24 [1.16–1.31]), but no change in prevalence of use was found for 12–17 or 18–25 year-olds. Perceived availability of marijuana increased after MML were enacted among those 26+ but not in younger groups. Among all age groups, prevalence of marijuana use and perception of it being easily available was higher in states that would eventually pass MML by 2013 compared to those that had not. Perceived availability was significantly associated with increased risk of past-month marijuana use in all age groups. Conclusion Evidence suggests perceived availability as a driver of change in use of marijuana due to MML. To date, this has only occurred in adults 26+ and different scenarios that could explain this change need to be further explored. PMID:27755989

State-level medical marijuana laws, marijuana use and perceived availability of marijuana among the general U.S. population.

PubMed

Martins, Silvia S; Mauro, Christine M; Santaella-Tenorio, Julian; Kim, June H; Cerda, Magdalena; Keyes, Katherine M; Hasin, Deborah S; Galea, Sandro; Wall, Melanie

2016-12-01

Little is known on how perceived availability of marijuana is associated with medical marijuana laws. We examined the relationship between medical marijuana laws (MML) and the prevalence of past-month marijuana use, with perceived availability of marijuana. Data were from respondents included in the National Survey of Drug Use and Health restricted use data portal 2004-2013. Multilevel logistic regression of individual-level data was used to test differences between MML and non-MML states and changes in prevalence of past-month marijuana use and perceived availability from before to after passage of MML among adolescents, young adults and older adults controlling for demographics. Among adults 26+, past-month prevalence of marijuana use increased from 5.87% to 7.15% after MML passage (Adjusted Odds Ratio (AOR): 1.24 [1.16-1.31]), but no change in prevalence of use was found for 12-17 or 18-25 year-olds. Perceived availability of marijuana increased after MML was enacted among those 26+ but not in younger groups. Among all age groups, prevalence of marijuana use and perception of it being easily available was higher in states that would eventually pass MML by 2013 compared to those that had not. Perceived availability was significantly associated with increased risk of past-month marijuana use in all age groups. Evidence suggests perceived availability as a driver of change in use of marijuana due to MML. To date, this has only occurred in adults 26+ and different scenarios that could explain this change need to be further explored. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Marijuana Use and Self-reported Quality of Eyesight.

PubMed

Akano, Obinna F

2017-05-01

There is increasing use of marijuana among young adults and more states in the United States are legalizing medical marijuana use. A number of studies have revealed both the beneficial and harmful effects of marijuana to the human system. Despite some beneficial effects, studies have shown marijuana to have a lot of deleterious effects on the visual system, which subsequently reduces the quality of eyesight. The aim of this study was to investigate if heavy marijuana smoking is associated with a poor quality of eyesight compared with light/no use of marijuana. The National Longitudinal Survey of Youths (NLSY79), a nationally representative sample of 12,686 young men and women surveyed in 1979 to 2010 was used for this study. The quality of eyesight of 1304 heavy marijuana users was compared with 1304 respondents with light or no marijuana use. The t test, multivariate and weighted logistic regression were used in the data analysis. There was no statistically significant difference in the self-reported quality of eyesight among heavy marijuana smokers compared with youths who never used marijuana or are light marijuana users. Among heavy marijuana smokers, males and high school graduates have decreased odds of reporting a poor quality of eyesight, whereas blacks have increased odds of reporting a poor quality of eyesight. The self-reported quality of eyesight among marijuana users can aid clinicians and other health practitioners facilitate the development of sex-, racial/ethnic-, and educational level-informed prevention and early intervention programs and also help characterize public opinions regarding cannabis, which are particularly relevant given the ongoing debate concerning the medicalization and legalization of cannabis in the United States.

Associations of Posttraumatic Stress Disorder Symptoms With Marijuana and Synthetic Cannabis Use Among Young Adult U.S. Veterans: A Pilot Investigation

PubMed Central

Grant, Sean; Pedersen, Eric R.; Neighbors, Clayton

2016-01-01

Objective: This study involves a pilot investigation of associations between marijuana and synthetic cannabis use with PTSD symptoms among a young adult sample of U.S. veterans. Method: In a cross-sectional survey of a community sample of 790 young adult U.S. veterans, we assessed demographics, combat severity, marijuana and synthetic cannabis use, expectancies of marijuana use, and PTSD symptoms. Results: Overall, 61.8% and 20.4% of our sample reported lifetime and past-month marijuana use, whereas 17.0% and 3.4% reported lifetime and past-month synthetic cannabis use. Veterans screening positive for PTSD were more likely to use marijuana and synthetic cannabis in their lifetime and in the past month. Positive PTSD screens, as well as greater expectancies that marijuana leads to relaxation and tension reduction, were associated with past-month marijuana use in logistic regression analyses. Expectancies moderated the relationship between PTSD and marijuana use, such that those with positive PTSD screens reporting higher levels of relaxation and tension-reduction expectancies were most likely to report past-month marijuana use. Conclusions: Our findings suggest an association of PTSD symptoms with marijuana and synthetic cannabis use among young adult U.S. veterans. Future research should further investigate the link between PTSD and marijuana use, as well as the rates and consequences of synthetic cannabis use among veterans. PMID:27172584

Mediating processes between stress and problematic marijuana use.

PubMed

Ketcherside, Ariel; Filbey, Francesca M

2015-06-01

The literature widely reports that stress is associated with marijuana use, yet, to date, the path from stress to marijuana-related problems has not been tested. In this study, we evaluated whether negative affect mediates the relationship between stress and marijuana use. To that end, we tested models to determine mediators between problems with marijuana use (via Marijuana Problem Scale), stress (via Early Life Stress Questionnaire, Perceived Stress Scale), and negative affect (via Beck Depression Inventory; Beck Anxiety Inventory) in 157 current heavy marijuana users. Mediation tests and bootstrap confidence intervals were carried out via the "Mediation" package in R. Depression and anxiety scores both significantly mediated the relationship between perceived stress and problematic marijuana use. Only depression significantly mediated the relationship between early life stress and problematic marijuana use. Early life stress, perceived stress and problematic marijuana use were significant only as independent variables and dependent variables. These findings demonstrate that (1) depression mediated both early life stress and perceived stress, and problematic marijuana use, and, (2) anxiety mediated perceived stress and problematic marijuana use. This mediation analysis represents a strong first step toward understanding the relationship between these variables; however, longitudinal studies are needed to determine causality between these variables. To conclude, addressing concomitant depression and anxiety in those who report either perceived stress or early life stress is important for the prevention of cannabis use disorders. Copyright © 2015. Published by Elsevier Ltd.

"Get drunk. Smoke weed. Have fun.": A Content Analysis of Tweets About Marijuana and Alcohol.

PubMed

Krauss, Melissa J; Grucza, Richard A; Bierut, Laura J; Cavazos-Rehg, Patricia A

2017-05-01

To explore the sentiment and themes of Twitter chatter that mentions both alcohol and marijuana. Cross-sectional analysis of tweets mentioning both alcohol and marijuana during 1 month was performed. The study setting was Twitter. Tweets sent from February 4 to March 5, 2014, were studied. A random sample (n = 5000) of tweets that mentioned alcohol and marijuana were qualitatively coded as normalizing both substances, preferring one substance over the other, or discouraging both substances. Other common themes were identified. More than half (54%) of the tweets normalized marijuana and alcohol (without preferring one substance over the other), and 24% preferred marijuana over alcohol. Only 2% expressed a preference for alcohol over marijuana, 7% discouraged the use of both substances, and the sentiment was unknown for 13% of the tweets. Common themes among tweets that normalized both substances included using the substances with friends (17%) and mentioning substance use in the context of sex or romance (14%). Common themes among tweets that preferred marijuana over alcohol were the beliefs that marijuana is safer than alcohol (46%) and preferences for effects of marijuana over alcohol (40%). Tweets normalizing polysubstance use or encouraging marijuana use over alcohol use are common. Both online and offline prevention efforts are needed to increase awareness of the risks associated with polysubstance use and marijuana use.

Interrelationships between Marijuana Demand and Discounting of Delayed Rewards: Convergence in Behavioral Economic Methods

PubMed Central

Aston, Elizabeth R.; Metrik, Jane; Amlung, Michael; Kahler, Christopher W.; MacKillop, James

2016-01-01

Background Distinct behavioral economic domains, including high perceived drug value (demand) and delay discounting (DD), have been implicated in the initiation of drug use and the progression to dependence. However, it is unclear whether frequent marijuana users conform to a “reinforcer pathology” addiction model wherein marijuana demand and DD jointly increase risk for problematic marijuana use and cannabis dependence (CD). Methods Participants (n=88, 34% female, 14% cannabis dependent) completed a marijuana purchase task at baseline. A delay discounting task was completed following placebo marijuana cigarette (0% THC) administration during a separate experimental session. Results Marijuana demand and DD were quantified using area under the curve (AUC). In multiple regression models, demand uniquely predicted frequency of marijuana use while DD did not. In contrast, DD uniquely predicted CD symptom count while demand did not. There were no significant interactions between demand and DD in either model. Conclusions These findings suggest that frequent marijuana users exhibit key constituents of the reinforcer pathology model: high marijuana demand and steep discounting of delayed rewards. However, demand and DD appear to be independent rather than synergistic risk factors for elevated marijuana use and risk for progression to CD. Findings also provide support for using AUC as a singular marijuana demand metric, particularly when also examining other behavioral economic constructs that apply similar statistical approaches, such as DD, to support analytic methodological convergence. PMID:27810657

Marijuana Use and Cardiovascular Disease.

PubMed

Franz, Christopher A; Frishman, William H

2016-01-01

Marijuana is currently the most used illicit substance in the world. With the current trend of decriminalization and legalization of marijuana in the US, physicians in the US will encounter more patients using marijuana recreationally over a diverse range of ages and health states. Therefore, it is relevant to review marijuana's effects on human cardiovascular physiology and disease. Compared with placebo, marijuana cigarettes cause increases in heart rate, supine systolic and diastolic blood pressures, and forearm blood flow via increased sympathetic nervous system activity. These actions increase myocardial oxygen demand to a degree that they can decrease the time to exercise-induced angina in patients with a history of stable angina. In addition, marijuana has been associated with triggering myocardial infarctions (MIs) in young male patients. Smoking marijuana has been shown to increase the risk of MI onset by a factor of 4.8 for the 60 minutes after marijuana consumption, and to increase the annual risk of MI in the daily cannabis user from 1.5% to 3% per year. Human and animal models suggest that this effect may be due to coronary arterial vasospasm. However, longitudinal studies have indicated that marijuana use may not have a significant effect on long-term mortality. While further research is required to definitively determine the impact of marijuana on cardiovascular disease, it is reasonable to recommend against recreational marijuana use, especially in individuals with a history of coronary artery disorders.

Reliability and validity of young adults’ anonymous online reports of marijuana use and thoughts about use

PubMed Central

Ramo, Danielle E.; Liu, Howard; Prochaska, Judith J.

2012-01-01

With growing interest in online assessment of substance abuse behaviors, there is a need to formally evaluate the validity of the data gathered. The current investigation evaluated the reliability and validity of anonymous, online reports of young adults’ marijuana use and related cognitions. Young adults age 18 to 25 who had smoked at least one cigarette in the past 30 days were recruited over 14 months to complete an anonymous online survey. Of 3106 eligible cases, 1617 (52%) completed the entire survey. Of those, 54% (n = 884) reported past-month marijuana use (65% male, 70% Caucasian, mean age was 20.4 years [SD = 2.0]). Prevalence of marijuana use was reported reliably across three similar items, and inter-item correlations ranged from fair to excellent for measures of marijuana dependence symptoms and thoughts about marijuana use. Marijuana use frequency demonstrated good construct validity through expected correlations with marijuana use constructs, and non-significant correlations with thoughts about tobacco use. Marijuana frequency distinguished among stages of change for marijuana use and goals for use, but not among gender, ethnicity, or employment groups. Marijuana use and thoughts about use differed by stage of change in the hypothesized directions. Self-reported marijuana use and associated cognitions reported anonymously online from young adults are generally reliable and valid. Online assessments of substance use broaden the reach of addictions research. PMID:22082344

Associations of Posttraumatic Stress Disorder Symptoms With Marijuana and Synthetic Cannabis Use Among Young Adult U.S. Veterans: A Pilot Investigation.

PubMed

Grant, Sean; Pedersen, Eric R; Neighbors, Clayton

2016-05-01

This study involves a pilot investigation of associations between marijuana and synthetic cannabis use with PTSD symptoms among a young adult sample of U.S. veterans. In a cross-sectional survey of a community sample of 790 young adult U.S. veterans, we assessed demographics, combat severity, marijuana and synthetic cannabis use, expectancies of marijuana use, and PTSD symptoms. Overall, 61.8% and 20.4% of our sample reported lifetime and past-month marijuana use, whereas 17.0% and 3.4% reported lifetime and past-month synthetic cannabis use. Veterans screening positive for PTSD were more likely to use marijuana and synthetic cannabis in their lifetime and in the past month. Positive PTSD screens, as well as greater expectancies that marijuana leads to relaxation and tension reduction, were associated with past-month marijuana use in logistic regression analyses. Expectancies moderated the relationship between PTSD and marijuana use, such that those with positive PTSD screens reporting higher levels of relaxation and tension-reduction expectancies were most likely to report past-month marijuana use. Our findings suggest an association of PTSD symptoms with marijuana and synthetic cannabis use among young adult U.S. veterans. Future research should further investigate the link between PTSD and marijuana use, as well as the rates and consequences of synthetic cannabis use among veterans.

State Estimates of Adolescent Marijuana Use and Perceptions of Risk of Harm from Marijuana Use: 2013 and 2014

MedlinePlus

... aged 12 to 17 across the nation used marijuana in the past month. Adolescent marijuana use ranged from 4.98 percent in Alabama ...  adolescents nationwide perceived great risk in smoking marijuana once a month (i.e., monthly use), ranging ...

Development and evaluation of the Marijuana Reduction Strategies Self-Efficacy Scale.

PubMed

Davis, Alan K; Osborn, Lawrence A; Leith, Jaclyn; Rosenberg, Harold; Ashrafioun, Lisham; Hawley, Anna; Bannon, Erin E; Jesse, Samantha; Kraus, Shane; Kryszak, Elizabeth; Cross, Nicole; Carhart, Victoria; Baik, Kyoung-deok

2014-06-01

To evaluate several psychometric properties of a questionnaire designed to assess college students' self-efficacy to employ 21 cognitive-behavioral strategies intended to reduce the amount and/or frequency with which they consume marijuana, we recruited 273 marijuana-using students to rate their confidence that they could employ each of the strategies. Examination of frequency counts for each item, principal components analysis, internal consistency reliability, and mean interitem correlation supported retaining all 21 items in a single scale. In support of criterion validity, marijuana use-reduction self-efficacy scores were significantly positively correlated with cross-situational confidence to abstain from marijuana, and significantly negatively correlated with quantity and frequency of marijuana use and marijuana-related problems. In addition, compared with respondents whose use of marijuana either increased or remained stable, self-efficacy was significantly higher among those who had decreased their use of marijuana over the past year. This relatively short and easily administered questionnaire could be used to identify college students who have low self-efficacy to employ specific marijuana reduction strategies and as an outcome measure to evaluate educational and skill-training interventions.

Marijuana Craving During a Public Speaking Challenge: Understanding Marijuana Use Vulnerability among Women and those with Social Anxiety Disorder

PubMed Central

Silgado, José; Schmidt, Norman B.

2010-01-01

Social anxiety disorder (SAD) is associated with risk for developing marijuana dependence, yet it remains unclear whether urge to use marijuana increases in anticipation of social anxiety-provoking situation, during the situation, or afterwards (to avoid post-event processing). The present study examined the timing of marijuana craving in response to a social anxiety task among 60 (50% female; 33% with SAD) marijuana users randomly assigned to either a speech or reading task. Participants completed ratings of marijuana craving at baseline (prior to being informed of task assignment), before, during, and after task. Among women and participants with SAD, the speech task was associated with greater craving than the reading task. This effect was particularly pronounced during the social anxiety induction task. This effect was not observed for men or participants without SAD. Identification of timing of urge to use marijuana has important implications for treatment and relapse prevention of marijuana problems among women and people with SAD (a group at particular risk for marijuana-related problems). PMID:20797696

Factors associated with regular marijuana use among high school students: a long-term follow-up study.

PubMed

Griffin, Kenneth W; Botvin, Gilbert J; Scheier, Lawrence M; Nichols, Tracy R

2002-01-01

The present study investigated whether several behavioral and psychosocial factors measured during early adolescence predicted regular marijuana use 6 years later in a sample of high school students. As part of a school-based survey. 7th-grade students (N = 1,132) reported levels of alcohol, tobacco, and marijuana use, and were assessed on several domains of psychosocial functioning potentially relevant in the etiology of marijuana use. When students were followed-up in the 12th-grade, 14% smoked marijuana on a regular basis (once or more per month). Findings indicated that early cigarette smoking, alcohol use, and alcohol intoxication predicted later regular marijuana use. For boys, early marijuana use increased the odds for later regular marijuana use. Cigarette smoking by friends and siblings during early adolescence also increased the likelihood of later monthly marijuana use. The findings suggest that early prevention programs for adolescent alcohol, tobacco, and/or other drug use may have important preventive effects in terms of potentially more serious levels of marijuana involvement later in adolescence and early adulthood.

Youth marijuana use: state of the science for the practicing clinician.

PubMed

Hadland, Scott E; Harris, Sion K

2014-08-01

Despite widespread marijuana use among adolescents, accurate information on known health effects is poorly disseminated to clinicians and their patients. Amidst rapidly evolving drug policy in the United States and elsewhere, it is imperative that providers understand the short-term and long-term consequences of marijuana use. Research on regular marijuana use highlights a unique susceptibility of the developing adolescent brain to adverse neurocognitive and psychiatric outcomes. Although studies have not firmly established causality, onset of regular marijuana use in adolescence is associated with later decline in cognitive function, as well as with adult onset of psychosis and anxiety. Educational and employment outcomes may be poorer among regular marijuana-using adolescents. A number of other adverse respiratory, cardiovascular, endocrine and gastrointestinal associations with regular marijuana use have also been established. Good screening tools and promising brief intervention and behavioral treatment programs are available to clinicians, who are in a position to identify problematic marijuana use among adolescents. A common misperception among youth is that marijuana use is without harm. However, adolescent marijuana use may have measurable, durable, and potentially irreversible effects on later cognitive function and mental health.

The impact of marijuana policies on youth: clinical, research, and legal update.

PubMed

2015-03-01

This policy statement is an update of the American Academy of Pediatrics policy statement "Legalization of Marijuana: Potential Impact on Youth," published in 2004. Pediatricians have special expertise in the care of children and adolescents and may be called on to advise legislators about the potential impact of changes in the legal status of marijuana on adolescents. Parents also may look to pediatricians for advice as they consider whether to support state-level initiatives that propose to legalize the use of marijuana for medical and nonmedical purposes or to decriminalize the possession of small amounts of marijuana. This policy statement provides the position of the American Academy of Pediatrics on the issue of marijuana legalization. The accompanying technical report reviews what is currently known about the relationships of marijuana use with health and the developing brain and the legal status of marijuana and adolescents' use of marijuana to better understand how change in legal status might influence the degree of marijuana use by adolescents in the future. Copyright © 2015 by the American Academy of Pediatrics.

Anxious arousal and anhedonic depression symptoms and the frequency of current marijuana use: testing the mediating role of marijuana-use coping motives among active users.

PubMed

Johnson, Kirsten A; Bonn-Miller, Marcel O; Leyro, Teresa M; Zvolensky, Michael J

2009-07-01

The present investigation examined anxious arousal and anhedonic depression symptoms in relation to frequency of past-30-day marijuana use, as well as the role of marijuana-use coping motives in terms of mediating this relation. The present sample included current young adult marijuana users (N = 154; 48.1% female; mean [SD] age = 20.75 [5.97] years) who were recruited via study flyers and printed advertisements in local newspapers placed throughout the Burlington, VT, community. After controlling for daily cigarette smoking rate, alcohol consumption, and gender, anxious arousal symptoms, but not anhedonic depression symptoms, were significantly and uniquely associated with the frequency of marijuana use. In addition, coping motives for marijuana use mediated the relation between anxious arousal symptoms and the frequency of current marijuana use. These results provide novel information related to the explanatory role of marijuana-use coping motives in the relation between anxious arousal symptoms and the frequency of marijuana use among young adult active users. Clinical implications for the current findings are discussed.

Marijuana Use Among Patients With Glaucoma in a City With Legalized Medical Marijuana Use.

PubMed

Belyea, David A; Alhabshan, Rashed; Del Rio-Gonzalez, Ana Maria; Chadha, Nisha; Lamba, Tania; Golshani, Cyrus; Merchant, Kunal; Passi, Neena; Dan, Jacob A

2016-03-01

Previous research has shown several limitations associated with the use of marijuana as a treatment for glaucoma. However, little is known regarding patients' perceptions toward using marijuana for glaucoma and their intentions to use this therapeutic alternative. To identify factors among patients with glaucoma that could lead to intentions to use marijuana for treatment. This cross-sectional survey study of 204 patients with glaucoma or suspected to have glaucoma was conducted at an academic-based glaucoma clinic in Washington, DC, between February 1 and July 31, 2013. Patients completed a self-administered survey assessing demographics, perceived severity of glaucoma, prior knowledge about marijuana use in glaucoma, past marijuana use, perceptions toward marijuana use (legality, systemic adverse effects, safety and effectiveness, and false beliefs), satisfaction with current glaucoma management, relevance of treatment costs, and intentions to use marijuana for glaucoma. Medical records were reviewed for disease severity. Data analysis was conducted from September 1, 2013, to September 30, 2015. The main outcome was patients' intentions to use marijuana for glaucoma. Multiple linear regression analysis was conducted to identify factors associated with patients' intentions to use marijuana for glaucoma. Of the 334 patients who were invited to participate in the study, 204 (61.1%) completed the survey. About half the participants were women (104 [51.0]%), and 82 (40.2%) were white. Regression analysis of 204 respondents indicated that perceptions of legality of marijuana use (β, 0.378; 95% CI, 0.205 to 0.444; P < .001), false beliefs regarding marijuana (β, 0.323; 95% CI, 0.236 to 0.504; P < .001), satisfaction with current glaucoma care (β, -0.222; 95% CI, -0.362 to -0.128; P < .001), and relevance of marijuana and glaucoma treatment costs (β, 0.127; 95% CI, 0.008 to 0.210; P = .04) were significantly associated with intentions to use marijuana for glaucoma treatment after controlling for demographic variables, disease severity, and previous marijuana use. This study's findings suggest a need for more education on this topic for ophthalmologists to be able to protect patients with glaucoma against the increased acceptability among the public of using marijuana based on false perceptions of its therapeutic value in glaucoma therapy. Considering the strong influence of perceptions of the legality of marijuana use on intentions to use this substance as a treatment for glaucoma, patient education might be particularly relevant in states in which marijuana use for glaucoma is legal, as in the case of the current study's setting.

Substance use - marijuana

MedlinePlus

Substance abuse - marijuana; Drug abuse - marijuana; Drug use - marijuana; Cannabis; Grass; Hashish; Mary Jane; Pot; Weed ... several minutes. If you eat foods containing the drug as an ingredient, such as brownies, you may ...

The current status of medical marijuana in the United States.

PubMed

McKenna, Gerald J

2014-04-01

Medical marijuana is currently a controversial issue in medicine. There are strong pro and con opinions but relatively little scientific data on which to base medical decisions. The unfortunate scheduling of marijuana in class I has limited research and only serves to fuel the controversy. This article will review the history of laws to regulate drugs in the United States in the 20th century to provide context for the current status of medical marijuana. It will include the rationale for opposing medical marijuana laws and the problem of the Schedule I inclusion of marijuana as well as other drugs. It will examine the problems associated with smoking raw marijuana and review other routes of administration. Finally, it examines the inadvisability of medicine's promotion of smoked marijuana.

National Estimates of Marijuana Use and Related Indicators - National Survey on Drug Use and Health, United States, 2002-2014.

PubMed

Azofeifa, Alejandro; Mattson, Margaret E; Schauer, Gillian; McAfee, Tim; Grant, Althea; Lyerla, Rob

2016-09-02

In the United States, marijuana is the most commonly used illicit drug. In 2013, 7.5% (19.8 million) of the U.S. population aged ≥12 years reported using marijuana during the preceding month. Because of certain state-level policies that have legalized marijuana for medical or recreational use, population-based data on marijuana use and other related indicators are needed to help monitor behavioral health changes in the United States. 2002-2014. The National Survey on Drug Use and Health (NSDUH) is a national- and state-level survey of a representative sample of the civilian, noninstitutionalized U.S. population aged ≥12 years. NSDUH collects information about the use of illicit drugs, alcohol, and tobacco; initiation of substance use; frequency of substance use; substance dependence and abuse; perception of substance harm risk or no risk; and other related behavioral health indicators. This report describes national trends for selected marijuana use and related indicators, including prevalence of marijuana use; initiation; perception of harm risk, approval, and attitudes; perception of availability and mode of acquisition; dependence and abuse; and perception of legal penalty for marijuana possession. In 2014, a total of 2.5 million persons aged ≥12 years had used marijuana for the first time during the preceding 12 months, an average of approximately 7,000 new users each day. During 2002-2014, the prevalence of marijuana use during the past month, past year, and daily or almost daily increased among persons aged ≥18 years, but not among those aged 12-17 years. Among persons aged ≥12 years, the prevalence of perceived great risk from smoking marijuana once or twice a week and once a month decreased and the prevalence of perceived no risk increased. The prevalence of past year marijuana dependence and abuse decreased, except among persons aged ≥26 years. Among persons aged ≥12 years, the percentage reporting that marijuana was fairly easy or very easy to obtain increased. The percentage of persons aged ≥12 reporting the mode of acquisition of marijuana was buying it and growing it increased versus getting it for free and sharing it. The percentage of persons aged ≥12 years reporting that the perceived maximum legal penalty for the possession of an ounce or less of marijuana in their state is a fine and no penalty increased versus probation, community service, possible prison sentence, and mandatory prison sentence. Since 2002, marijuana use in the United States has increased among persons aged ≥18 years, but not among those aged 12-17 years. A decrease in the perception of great risk from smoking marijuana combined with increases in the perception of availability (i.e., fairly easy or very easy to obtain marijuana) and fewer punitive legal penalties (e.g., no penalty) for the possession of marijuana for personal use might play a role in increased use among adults. National- and state-level data can help federal, state, and local public health officials develop targeted prevention activities to reduce youth initiation of marijuana use, prevent marijuana dependence and abuse, and prevent adverse health effects. As state-level laws on medical and recreational marijuana use change, modifications might be needed to national- and state-level surveys and more timely and comprehensive surveillance systems might be necessary to provide these data. Marijuana use in younger age groups is a particular public health concern, and changing the perception of harm risk from smoking marijuana is needed.

Risk factors and outcomes of chronic sexual harassment during the transition to college: Examination of a two-part growth mixture model

PubMed Central

McGinley, Meredith; Wolff, Jennifer M.; Rospenda, Kathleen M.; Liu, Li; Richman, Judith A.

2016-01-01

A two-part latent growth mixture model was implemented in order to examine heterogeneity in the growth of sexual harassment (SH) victimization in college and university students, and the extent to which SH class membership explains substance use and mental health outcomes for certain groups of students. Demographic risk factors, mental health, and substance use were examined as they related to chronically experienced SH victimization. Incoming freshmen students (N = 2855; 58% female; 54% White) completed a survey at five time points. In addition to self-reporting gender, race, and sexual orientation, students completed measures of sexual harassment, anxiety, depression, binge drinking, and marijuana use. Overall, self-reported SH declined upon college entry, although levels rebounded by the third year of college. Results also supported a two-class solution (Infrequent and Chronic) for SH victimization. Being female, White, and a sexual minority were linked to being classified into the Chronic (relative to the Infrequent) SH class. In turn, Chronic SH class membership predicted greater anxiety, depression, and substance use, supporting a mediational model. PMID:27712687

Patterns of marijuana use among psychiatry patients with depression and its impact on recovery.

PubMed

Bahorik, Amber L; Leibowitz, Amy; Sterling, Stacy A; Travis, Adam; Weisner, Constance; Satre, Derek D

2017-04-15

Depression is associated with substance-related problems that worsen depression-related disability. Marijuana is frequently used by those with depression, yet whether its use contributes to significant barriers to recovery in this population has been understudied. Participants were 307 psychiatry outpatients with depression; assessed at baseline, 3-, and 6-months on symptom (PHQ-9 and GAD-7), functioning (SF-12) and past-month marijuana use for a substance use intervention trial. Longitudinal growth models examined patterns and predictors of marijuana use and its impact on symptom and functional outcomes. A considerable number of (40.7%; n=125) patients used marijuana within 30-days of baseline. Over 6-months, marijuana use decreased (B=-1.20, p<.001), but patterns varied by demographic and clinical characteristics. Depression (B=0.03, p<.001) symptoms contributed to increased marijuana use over the follow-up, and those aged 50+(B=0.44, p<.001) increased their marijuana use compared to the youngest age group. Marijuana use worsened depression (B=1.24, p<.001) and anxiety (B=0.80, p=.025) symptoms; marijuana use led to poorer mental health (B=-2.03, p=.010) functioning. Medical marijuana (26.8%; n=33) was associated with poorer physical health (B=-3.35, p=.044) functioning. Participants were psychiatry outpatients, limiting generalizability. Marijuana use is common and associated with poor recovery among psychiatry outpatients with depression. Assessing for marijuana use and considering its use in light of its impact on depression recovery may help improve outcomes. Copyright © 2017 Elsevier B.V. All rights reserved.

Perceptions of Social Norms and Exposure to Pro-Marijuana Messages Are Associated with Adolescent Marijuana Use

PubMed Central

Roditis, Maria L.; Delucchi, Kevin; Chang, Audrey; Halpern-Felsher, Bonnie

2016-01-01

Despite consistent declines in rates of cigarette use among adolescents in the last five years, rates of marijuana use have remained constant, with marijuana being the most widely used illegal drug among adolescents. More work is needed to understand how social norms, perceived risks and benefits, and social media messaging impact use of marijuana. This study compared perceptions and social norms related to marijuana, blunts and cigarettes. Additionally, we assessed how perceptions related to social norms, risks and benefits, and exposure to pro- versus anti-marijuana messaging is related to use. Participants were 786 adolescents from Southern and Northern California (36.7% male, 63.3% females; mean age = 16.1 years; SD = 1.6). Participants came from diverse ethnic backgrounds, with 207 (26.61%) White, 171 (21.98%) Asian/Pacific Islander, 232 (29.82%) Hispanic, and 168 (21.59%) other. Results indicated that marijuana and blunts were consistently perceived as more socially acceptable and less risky than cigarettes (p<0.01). Participants who reported that their friends used marijuana had a 27% greater odds of using marijuana themselves. Further, seeing messages about the good things or benefits of marijuana use was associated with a 6% greater odds of use [OR 1.06 (CI 1.00, 1.12)]. This study's findings offer a number of important public health implications, particularly as states move towards legalization of marijuana for recreational use. As this occurs, states need to take adolescents’ perceptions of risks, benefits, social norms, and peer influences into account as they implement strategies to reduce youth use of marijuana and blunts. PMID:27746339

Latent factor structure of a behavioral economic marijuana demand curve.

PubMed

Aston, Elizabeth R; Farris, Samantha G; MacKillop, James; Metrik, Jane

2017-08-01

Drug demand, or relative value, can be assessed via analysis of behavioral economic purchase task performance. Five demand indices are typically obtained from drug purchase tasks. The goal of this research was to determine whether metrics of marijuana reinforcement from a marijuana purchase task (MPT) exhibit a latent factor structure that efficiently characterizes marijuana demand. Participants were regular marijuana users (n = 99; 37.4% female, 71.5% marijuana use days [5 days/week], 15.2% cannabis dependent) who completed study assessments, including the MPT, during a baseline session. Principal component analysis was used to examine the latent structure underlying MPT indices. Concurrent validity was assessed via examination of relationships between latent factors and marijuana use, past quit attempts, and marijuana expectancies. A two-factor solution was confirmed as the best fitting structure, accounting for 88.5% of the overall variance. Factor 1 (65.8% variance) reflected "Persistence," indicating sensitivity to escalating marijuana price, which comprised four MPT indices (elasticity, O max , P max , and breakpoint). Factor 2 (22.7% variance) reflected "Amplitude," indicating the amount consumed at unrestricted price (intensity). Persistence factor scores were associated with fewer past marijuana quit attempts and lower expectancies of negative use outcomes. Amplitude factor scores were associated with more frequent use, dependence symptoms, craving severity, and positive marijuana outcome expectancies. Consistent with research on alcohol and cigarette purchase tasks, the MPT can be characterized with a latent two-factor structure. Thus, demand for marijuana appears to encompass distinct dimensions of price sensitivity and volumetric consumption, with differential relations to other aspects of marijuana motivation.

The impacts of marijuana dispensary density and neighborhood ecology on marijuana abuse and dependence

PubMed Central

Mair, Christina; Freisthler, Bridget; Ponicki, William R.; Gaidus, Andrew

2015-01-01

Background As an increasing number of states liberalize cannabis use and develop laws and local policies, it is essential to better understand the impacts of neighborhood ecology and marijuana dispensary density on marijuana use, abuse, and dependence. We investigated associations between marijuana abuse/dependence hospitalizations and community demographic and environmental conditions from 2001–2012 in California, as well as cross-sectional associations between local and adjacent marijuana dispensary densities and marijuana hospitalizations. Methods We analyzed panel population data relating hospitalizations coded for marijuana abuse or dependence and assigned to residential ZIP codes in California from 2001 through 2012 (20,219 space-time units) to ZIP code demographic and ecological characteristics. Bayesian space-time misalignment models were used to account for spatial variations in geographic unit definitions over time, while also accounting for spatial autocorrelation using conditional autoregressive priors. We also analyzed cross-sectional associations between marijuana abuse/dependence and the density of dispensaries in local and spatially adjacent ZIP codes in 2012. Results An additional one dispensary per square mile in a ZIP code was cross-sectionally associated with a 6.8% increase in the number of marijuana hospitalizations (95% credible interval 1.033, 1.105) with a marijuana abuse/dependence code. Other local characteristics, such as the median household income and age and racial/ethnic distributions, were associated with marijuana hospitalizations in cross-sectional and panel analyses. Conclusions Prevention and intervention programs for marijuana abuse and dependence may be particularly essential in areas of concentrated disadvantage. Policy makers may want to consider regulations that limit the density of dispensaries. PMID:26154479

Does social context matter? An ecological momentary assessment study of marijuana use among college students.

PubMed

Phillips, Kristina T; Phillips, Michael M; Lalonde, Trent L; Prince, Mark A

2018-08-01

Past research has shown that marijuana use occurs commonly in social situations for young adults, though few studies have examined the association between immediate social context and marijuana use patterns and associated problems. The current study examined the impact of demographics, marijuana use and problem use, alcohol use, craving, and social context on the likelihood of using marijuana with others via ecological momentary assessment (EMA). College-student marijuana users (N=56) were recruited and completed a baseline assessment and training on the two-week signal-contingent EMA protocol. Participants were sent text messages three times per day randomly for two weeks. Of the 1131 EMA instances during which participants reported using marijuana, 862 (76.22%) were labeled as being with others. Forty-five participants (80.36%) reported marijuana use with others present during at least half of the times they used marijuana. Findings from a multilevel logistic regression model showed a significant positive association between the probability of using with others and minutes spent using marijuana (b=0.047, p<0.001), social facilitation (b=0.138, p<0.001), and DSM-IV diagnosis (dependence versus no diagnosis, b=1.350, p=0.047). Cannabis dependence, more time using marijuana in the moment, and using for social facilitation purposes were positively associated with using marijuana in the context of being with others. Daily users had more variability in terms of the social context of their use. This study illustrates the complex relationship between social context and marijuana use. Copyright © 2018 Elsevier Ltd. All rights reserved.

Older marijuana users: Life stressors and perceived social support.

PubMed

Choi, Namkee G; DiNitto, Diana M; Marti, C Nathan

2016-12-01

Given increasing numbers of older-adult marijuana users, this study examined the association of marijuana use and marijuana use disorder with life stressors and perceived social support in the 50+ age group. Data came from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions (N=14,715 respondents aged 50+). Life stressors were measured with 12 items related to interpersonal, legal, and financial problems and being a crime victim. Perceived social support was measured with the 12-item Interpersonal Support Evaluation List. Using principal component analysis (PCA), we identified four components of life stressors. Linear regression analyses was used to test associations of past-year marijuana use and use disorder with PCA scores of each component and perceived social support. Of the 50+ age group, 3.89% were past-year marijuana users and 0.68% had marijuana use disorder. Marijuana users, especially those with marijuana use disorder (17.54% of past-year users), had high rates of mental and other substance use disorders. Controlling for other potential risk factors for stress, including health status and mental and other substance use disorders, marijuana use and use disorder were still significantly associated with more life stressors and lower perceived social support, possibly from low levels of social integration. A substantial proportion of older-adult marijuana users need help with mental health and substance use problems. Further examination of older marijuana users' life stressors and social support networks may aid in developing more systematic intervention strategies to address needs and reduce marijuana use. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Past 15-Year Trends in Adolescent Marijuana Use: Differences by Race/Ethnicity and Sex

PubMed Central

Johnson, Renee M.; Fairman, Brian; Gilreath, Tamika; Xuan, Ziming; Rothman, Emily F.; Parnham, Taylor; Furr-Holden, C. Debra M.

2015-01-01

Background The potential for increases in adolescent marijuana use is an important concern given recent changes in marijuana policy. The purpose of this study was to estimate trends in marijuana use from 1999-2013 among a national sample of US high school students. We examine changes over time by race/ethnicity and sex. Methods Data are from the National Youth Risk Behavior Survey (YRBS), which involves biennial, school-based surveys that generate nationally-representative data about 9th-12th grade students in the United States. Students self-reported sex, race/ethnicity, and marijuana use (i.e., lifetime use, current use, any use before age 13). We generated national estimates of the prevalence of marijuana use for the time period, and also tested for linear and quadratic trends (n=115,379). Results The prevalence of lifetime marijuana use decreased modestly from 1999 to 2009 (44% to 37%), and has increased slightly since 2009 (41%). Other marijuana use variables (e.g., past 30-day use) followed a similar pattern over time. The prevalence of past 30-day use from 1999-2013 for all groups and both sexes was 22.5%, and it was lowest among Asians and highest among American Indian/Alaska Natives. Although boys have historically had a higher prevalence of marijuana use, results indicate that male-female differences in marijuana use decreased over time. Conclusion Despite considerable changes in state marijuana policies over the past 15 years, marijuana use among high school students has largely declined. Continued surveillance is needed to assess the impact of policy changes on adolescent marijuana use. PMID:26361714

Prevalence and Perceived Financial Costs of Marijuana versus Tobacco use among Urban Low-Income Pregnant Women.

PubMed

Beatty, Jessica R; Svikis, Dace S; Ondersma, Steven J

2012-09-30

To examine the relative prevalence of marijuana and tobacco use among low-income post-partum women, using self-report, urine, and hair testing data; and to further explore perceptions of the substances among postpartum women by evaluating perceived risk and monetary cost of prenatal marijuana versus tobacco use. Data from two studies were available for a total of 100 (Study 1) and 50 (Study 2) low-income, primarily African-American post-partum women. Study 1 participants completed brief self-report measures of substance use as well as urine and hair samples; study 2 participants completed a brief opinion survey regarding the risks and monetary costs of prenatal marijuana use. In Study 1, the self-reported prevalence of any tobacco or marijuana use in the past three months was 17% and 11%, respectively. However, objectively-defined marijuana use was more prevalent than self-reported tobacco use: 14% tested positive for marijuana by urinalysis, and 28% by hair analysis. Study 2 participants were more likely to believe that there is a safe level of marijuana use during pregnancy, and nearly half believed that using marijuana during pregnancy was less expensive than smoking cigarettes. Marijuana use may be as or more prevalent than tobacco use among low-income, African-American pregnant women. These findings may in part be attributable to perceptions of roughly equivalent cost and the lack of a clear public health message regarding prenatal marijuana use, combined with growing pro-marijuana advocacy. A broader public health response to address prenatal marijuana use, along with other substances of abuse, is needed.

Marijuana policy opinions in Washington state since legalization: Would voters vote the same way?

PubMed

Subbaraman, Meenakshi Sabina; Kerr, William C

2016-12-01

In 2012, voters in Washington state approved Initiative 502 (I-502) which legalized recreational marijuana use at the state level. This study examines the relationship between demographics, marijuana and alcohol use, and voting outcomes, as well as how these variables relate to (i) whether voters would still vote the same way (a reflection of satisfaction with the new policy) and (ii) the likelihood of using marijuana purchased from legal retail stores. The sample consists of 2,007 adult Washington state residents recruited through Random Digit Dial between January and October 2014. Bivariate tests and multivariable regressions were used for analyses. Less than five percent of those who voted for marijuana legalization would change their votes, whereas 14% of those who voted against legalization would change their votes. In multivariable models controlling for demographics, substance use, and marijuana-related opinions, those who voted for legalization had half the odds of changing their votes than those who voted against it. Among past-year non-marijuana users, almost 10% were somewhat/very likely to use marijuana if they could buy it from a legal store. Past marijuana use, the belief that adults should be allowed to grow marijuana for personal use, and the belief that marijuana is not very risky for health were all related to increased likelihood of using marijuana purchased from legal stores. Since November 2012, support for marijuana legalization in Washington state has increased; accounting for the proportion of voters who would change their votes suggests that I-502 would pass today with even more votes in favor.

It’s Not Your Mother’s Marijuana: Effects on Maternal-Fetal Health and the Developing Child

PubMed Central

Warner, Tamara D.; Roussos-Ross, Dikea; Behnke, Marylou

2014-01-01

SYNOPSIS Pro-marijuana advocacy efforts exemplified by the “medical” marijuana movement, coupled with the absence of conspicuous public health messages about the potential dangers of marijuana use during pregnancy, could lead to greater use of today’s more potent marijuana, which could have significant short- and long-term consequences. This article will review the current literature regarding the effects of prenatal marijuana use on the pregnant woman and her offspring. PMID:25459779

It's not your mother's marijuana: effects on maternal-fetal health and the developing child.

PubMed

Warner, Tamara D; Roussos-Ross, Dikea; Behnke, Marylou

2014-12-01

Pro-marijuana advocacy efforts exemplified by the "medical" marijuana movement, coupled with the absence of conspicuous public health messages about the potential dangers of marijuana use during pregnancy, could lead to greater use of today's more potent marijuana, which could have significant short- and long-term consequences. This article reviews the current literature regarding the effects of prenatal marijuana use on the pregnant woman and her offspring. Copyright © 2014 Elsevier Inc. All rights reserved.

Explicit and implicit effects of anti-marijuana and anti-tobacco TV advertisements.

PubMed

Czyzewska, Maria; Ginsburg, Harvey J

2007-01-01

Effects of anti-tobacco and anti-marijuana TV advertisements on explicit (i.e., semantic differential ratings) and implicit (i.e. Implicit Association Test, IAT) attitudes toward tobacco and marijuana were compared. Two hundred twenty nine, 18- to 19-year-old U.S. college students were randomly assigned to anti-tobacco or anti-marijuana PSA viewing conditions. Participants completed a short survey on attitudes to tobacco and marijuana. Afterwards they watched 15 PSAs embedded in a 15-min science program. At the end, all participants completed IAT for marijuana, IAT for tobacco and the assessment of explicit attitudes. Results of ANCOVA revealed a significant interaction between type of TV PSAs watched and implicit attitudes, F(1,223)=7.12, p<0.01 when controlling for preexisting attitudes to both substances; the implicit attitudes were more negative toward the substance that corresponded to the content of advertisements watched (i.e., anti-tobacco or anti-marijuana). However, analogical analysis on explicit measures showed that attitudes to marijuana became less negative among students that watched anti-marijuana ads than the group with anti-tobacco ads, F(1,222)=5.79, p<0.02. The discussion focused on the practical and theoretical implications of the observed dissociation between implicit and explicit attitudes to marijuana after the exposure to anti-marijuana PSAs.

Attitudes, perceptions, and use of marijuana in youth with multiple sclerosis.

PubMed

Brenton, J Nicholas; Schreiner, Teri; Karoscik, Krystle; Richter, Meg; Ferrante, Samantha; Waldman, Amy; Banwell, Brenda

2018-02-01

Studies have shown a negative impact on cognition and brain volume in marijuana-using adult multiple sclerosis (MS) patients and healthy adolescents. Given that onset of MS during childhood and adolescence negatively impacts brain growth and the normal maturation of neuronal networks, the addition of marijuana exposure in these youth may be even more harmful. Determine attitudes toward and prevalence of recreational marijuana use in MS youth. We surveyed 52 consecutive pediatric-onset MS patients from three pediatric MS centers in the United States. Participants answered a structured questionnaire to capture attitudes toward marijuana and personal use habits, if present. Nearly half reported use of marijuana, with the majority beginning to use in mid-to-late adolescence. The most popular reasons for using marijuana were relaxation (72%), improvement of medical problems (64%), and stress reduction (52%). Over half (64%) of marijuana users perceived it to have negative effects on memory and focus. Cost and access were not barriers to use, despite all respondents being less than age 21. Youth with MS endorse recreational marijuana as safe, and many use marijuana frequently despite appreciating a negative impact on memory. More detailed understanding of the long-term impact of marijuana use in youth with MS is needed.

The Changing Drug Culture: Medical and Recreational Marijuana.

PubMed

Albertson, Timothy E; Chenoweth, James A; Colby, Daniel K; Sutter, Mark E

2016-02-01

The major psychoactive compounds in marijuana (cannabis) are cannabinoids, the most significant of which is delta-9-tetrahydrocannabinol. There are also two synthetic pharmaceutical cannabinoids, nabilone and dronabinol, available by prescription in the United States. The use of marijuana has increased in the United States with passage of medical marijuana laws in many states and legalization of recreational marijuana use in several states. In addition, the potency of marijuana has increased in recent years. Marijuana has been used for a variety of medical purposes, including management of nausea and vomiting, appetite and immunologic stimulation in patients with HIV infection and AIDS, glaucoma, neurologic disorders, and pain relief. Studies on the benefits of marijuana as a treatment for various conditions have been inconsistent, except for those on pain management. Marijuana has adverse effects, and has been associated with driving impairment, psychosis, dependence and withdrawal syndromes, hyperemesis, acute cardiac events, some cancers, and impaired lung function. As with studies on the benefits of marijuana, studies of adverse effects have yielded inconsistent results. Except for impaired driving and the occurrence of dependence and withdrawal syndromes, the adverse effects of marijuana use have not been fully studied. Written permission from the American Academy of Family Physicians is required for reproduction of this material in whole or in part in any form or medium.

Marijuana Neurobiology and Treatment

PubMed Central

Elkashef, Ahmed; Vocci, Frank; Huestis, Marilyn; Haney, Margaret; Budney, Alan; Gruber, Amanda; el-Guebaly, Nady

2008-01-01

Marijuana is the number one illicit drug of abuse worldwide and a major public health problem, especially in the younger population. The objective of this article is to update and review the state of the science and treatments available for marijuana dependence based on a pre-meeting workshop that was presented at ISAM 2006. At the workshop, several papers were presented addressing the neurobiology and pharmacology of marijuana and treatment approaches, both psychotherapy and medications, for marijuana withdrawal. Medicolegal and ethical issues concerning marijuana medical use were also discussed. Concise summaries of these presentations are incorporated in this article, which is meant to be an updated review of the state of the science. Major advances have been made in understanding the underpinning of marijuana dependence and the role of the CNS cannabinoid system, which is a major area for targeting medications to treat marijuana withdrawal and dependence, as well as other addictions. Behavioral therapies are efficacious for facilitating abstinence from marijuana. Nefazadone, Marinol, and buspirone are showing early positive signals for efficacy in ameliorating marijuana withdrawal symptoms. Effective psychotherapeutic approaches are available and promising medications studies need to be confirmed in outpatient trials. The next few years looking promising for translational research efforts to make treatment widely accessible to patients with marijuana dependence. PMID:19042204

Marijuana: Facts Parents Need To Know. Revised.

ERIC Educational Resources Information Center

National Inst. on Drug Abuse (DHEW/PHS), Rockville, MD.

This booklet is designed to educate parents about marijuana so that they can communicate with their children in a way that will prevent drug abuse. The information is presented in a question/answer format. The following 25 questions are addressed: What is marijuana? What are the current slang terms for marijuana? How is marijuana used? How many…

Sex and Grade Level Differences in Marijuana Use among Youth

ERIC Educational Resources Information Center

King, Keith A.; Vidourek, Rebecca A.; Hoffman, Ashlee R.

2012-01-01

A total of 54,361 students in seventh through twelfth grades completed a survey examining the impact of perceived harm of marijuana use, ease of access in obtaining marijuana, and perceived parent/peer disapproval of marijuana use on youth involvement in annual and recent marijuana use. Results indicated that 1 in 6 (16%) students used marijuana…

The Validity of Truant Youths' Marijuana Use and Its Impact on Alcohol Use and Sexual Risk Taking

ERIC Educational Resources Information Center

Dembo, Richard; Briones-Robinson, Rhissa; Barrett, Kimberly; Winters, Ken C.; Ungaro, Rocío; Karas, Lora; Belenko, Steven; Wareham, Jennifer

2015-01-01

Few studies investigating the validity of marijuana use have used samples of truant youths. In the current study, self-reports of marijuana use are compared with urine test results for marijuana to identify marijuana underreporting among adolescents participating in a longitudinal brief intervention for drug-involved truant youths. It was…

The Prevalence of Substance use and Associated Risk Factors Among University Students in the City of Jahrom, Southern Iran

PubMed Central

Heydari, Seyed Taghi; Izedi, Somayeh; Sarikhani, Yaser; Kalani, Navid; Akbary, Ali; Miri, Abolfazl; Mahmoodi, Mojtaba; Akbari, Maryam

2015-01-01

Background: Substance use among college students in Iran is a serious problem. Determining the pattern of substance use among University students is an important issue for implementing prevention and treatment programs. Objectives: The present survey attempts to determine the prevalence of substance usage and associated risk factors among the students of Jahrom University of Medical Sciences and Islamic Azad University of Jahrom, Jahrom, Iran. Patients and Methods: This cross-sectional study was carried out from December 2012 to February 2013 and included 1149 randomly selected students of two Jahrom universities. A standard questionnaire was used for data gathering. Data were analyzed using the SPSS version 15 for Windows. T-test and Chi-square T-test and Chi-square and Logestic regression tests were used for data analysis. Results: Tobacco (28.3%), alcohol (13.0%), and cannabis and marijuana (5.2%) were the most common substances used by the students. The prevalence of substance use among the male students was significantly higher (OR: 1.5, 95%CI: 1.42 - 2.68, P < 0.001). The risk of at least single episode of substance usage was higher among the students which were living alone (OR: 3.03, 95%CI: 1.74 - 5.28, P < 0.001) The most important motivators for beginning substance use were curiosity, in 46.4%, and seeking pleasure, in 28.8%. Conclusions: Substance usage is considered as a risk factor for students’ health among University students in Iran. Design of educational courses addressing the detrimental effects and dire consequences of substance usage could help to improve control programs. Universities could improve their drug abuse control programs by focusing on the high risk groups determined by relevant studies. PMID:26097836

The Effect of Marijuana Scenes in Anti-marijuana Public Service Announcements on Adolescents’ Evaluation of Ad Effectiveness

PubMed Central

Kang, Yahui; Cappella, Joseph N.; Fishbein, Martin

2014-01-01

This study explored the possible negative impact of a specific ad feature—marijuana scenes—on adolescents’ perception of ad effectiveness. A secondary data analysis was conducted on adolescents’ evaluations of 60 anti-marijuana public service announcements (PSAs) that were a part of national and state anti-drug campaigns directed at adolescents. The major finding of the study was that marijuana scenes in anti-marijuana PSAs negatively affected ad liking and thought valence toward the ads among adolescents who are at higher levels of risk for marijuana use. This negative impact was not reversed in the presence of strong anti-marijuana arguments. The results may be used to partially explain the lack of effectiveness of the anti-drug media campaign. It may also help us design more effective anti-marijuana PSAs by isolating adverse elements in the ads that may elicit boomerang effects in the target population. Limitations of the study and future directions were discussed. PMID:19735026

Legalizing Cannabis: A physician's primer on the pulmonary effects of marijuana.

PubMed

Lutchmansingh, Denyse; Pawar, Leena; Savici, Dana

2014-01-01

Habitual smoking of marijuana is associated with multiple respiratory symptoms such as cough, sputum production, and wheezing .These symptoms are not significantly different from those exhibited by tobacco smokers. Furthermore, endobronchial biopsies of habitual smokers of marijuana and /or tobacco have shown that both marijuana and cigarette smoking cause significant bronchial mucosal histopathology and that these effects are additive. Although marijuana smokers have minimal changes in pulmonary function studies as compared to tobacco smokers, they may develop bullous disease and spontaneous pneumothoraces. The relationship between marijuana smoking and lung cancer remains unclear due to design limitations of the studies published so far. These findings should warn individuals that marijuana smoking may result in serious short-term and long-term respiratory complications, and habitual marijuana use should be viewed with caution. The medical literature so far does not support routine evaluation by pulmonary function tests or imaging studies; until more definitive data is available, we do not recommend the regular use of these tests in the evaluation of habitual marijuana smokers.

Experiences of marijuana-vaporizer users.

PubMed

Malouff, John M; Rooke, Sally E; Copeland, Jan

2014-01-01

Using a marijuana vaporizer may have potential harm-reduction advantages on smoking marijuana, in that the user does not inhale smoke. Little research has been published on use of vaporizers. In the first study of individuals using a vaporizer on their own initiative, 96 adults anonymously answered questions about their experiences with a vaporizer and their use of marijuana with tobacco. Users identified 4 advantages to using a vaporizer over smoking marijuana: perceived health benefits, better taste, no smoke smell, and more effect from the same amount of marijuana. Users identified 2 disadvantages: inconvenience of setup and cleaning and the time it takes to get the device operating for each use. Only 2 individuals combined tobacco in the vaporizer mix, whereas 15 combined tobacco with marijuana when they smoked marijuana. Almost all participants intended to continue using a vaporizer. Vaporizers seem to have appeal to marijuana users, who perceive them as having harm-reduction and other benefits. Vaporizers are worthy of experimental research evaluating health-related effects of using them.

Committee Opinion No. 637: Marijuana Use During Pregnancy and Lactation.

PubMed

2015-07-01

Cannabis sativa (marijuana) is the illicit drug most commonly used during pregnancy. The self-reported prevalence of marijuana use during pregnancy ranges from 2% to 5% in most studies. A growing number of states are legalizing marijuana for medicinal or recreational purposes, and its use by pregnant women could increase even further as a result. Because of concerns regarding impaired neurodevelopment, as well as maternal and fetal exposure to the adverse effects of smoking, women who are pregnant or contemplating pregnancy should be encouraged to discontinue marijuana use. Obstetrician-gynecologists should be discouraged from prescribing or suggesting the use of marijuana for medicinal purposes during preconception, pregnancy, and lactation. Pregnant women or women contemplating pregnancy should be encouraged to discontinue use of marijuana for medicinal purposes in favor of an alternative therapy for which there are better pregnancy-specific safety data. There are insufficient data to evaluate the effects of marijuana use on infants during lactation and breastfeeding, and in the absence of such data, marijuana use is discouraged.

Committee Opinion No. 722: Marijuana Use During Pregnancy and Lactation.

PubMed

2017-10-01

Cannabis sativa (marijuana) is the illicit drug most commonly used during pregnancy. The self-reported prevalence of marijuana use during pregnancy ranges from 2% to 5% in most studies. A growing number of states are legalizing marijuana for medicinal or recreational purposes, and its use by pregnant women could increase even further as a result. Because of concerns regarding impaired neurodevelopment, as well as maternal and fetal exposure to the adverse effects of smoking, women who are pregnant or contemplating pregnancy should be encouraged to discontinue marijuana use. Obstetrician-gynecologists should be discouraged from prescribing or suggesting the use of marijuana for medicinal purposes during preconception, pregnancy, and lactation. Pregnant women or women contemplating pregnancy should be encouraged to discontinue use of marijuana for medicinal purposes in favor of an alternative therapy for which there are better pregnancy-specific safety data. There are insufficient data to evaluate the effects of marijuana use on infants during lactation and breastfeeding, and in the absence of such data, marijuana use is discouraged.

Committee Opinion Summary NO. 722: Marijuana Use During Pregnancy and Lactation.

PubMed

2017-10-01

Cannabis sativa (marijuana) is the illicit drug most commonly used during pregnancy. The self-reported prevalence of marijuana use during pregnancy ranges from 2% to 5% in most studies. A growing number of states are legalizing marijuana for medicinal or recreational purposes, and its use by pregnant women could increase even further as a result. Because of concerns regarding impaired neurodevelopment, as well as maternal and fetal exposure to the adverse effects of smoking, women who are pregnant or contemplating pregnancy should be encouraged to discontinue marijuana use. Obstetrician-gynecologists should be discouraged from prescribing or suggesting the use of marijuana for medicinal purposes during preconception, pregnancy, and lactation. Pregnant women or women contemplating pregnancy should be encouraged to discontinue use of marijuana for medicinal purposes in favor of an alternative therapy for which there are better pregnancy-specific safety data. There are insufficient data to evaluate the effects of marijuana use on infants during lactation and breastfeeding, and in the absence of such data, marijuana use is discouraged.

Marijuana

MedlinePlus

Marijuana is a green, brown, or gray mix of dried, crumbled parts from the marijuana plant. It can be rolled up and smoked ... in food or inhale it using a vaporizer. Marijuana can cause problems with memory, learning, and behavior. ...

Marijuana: Facts for Teens

MedlinePlus

... Publications » Marijuana: Facts for Teens » Letter to Teens Marijuana: Facts for Teens Email Facebook Twitter Letter to ... about 1 in 14 teens say they used marijuana in the past month. 1 So, if you ...

Marijuana: Facts Parents Need to Know

MedlinePlus

... Parents Need to Know » A Letter to Parents Marijuana: Facts Parents Need to Know Email Facebook Twitter ... their children to review the scientific facts about marijuana: (1) Marijuana: Facts Parents Need to Know and ( ...

Land and Law in Marijuana Country: Clean Capital, Dirty Money, and the Drug War's Rentier Nexus.

PubMed

Polson, Michael

2013-11-01

Despite its ongoing federal illegality, marijuana production has become a licit, or socially accepted, feature of northern California's real estate market. As such, marijuana is a key component of land values and the laundering of "illegal" wealth into legitimate circulation. By following land transaction practices, relations, and instruments, this article shows how formally equal property transactions become substantively unequal in light of the "il/legal" dynamics of marijuana land use. As marijuana becomes licit, prohibitionist policies have enabled the capture of ground rent by landed interests from the marijuana industry at a time when the price of marijuana is declining (in part due to its increasing licitness). The resulting "drug war rentier nexus," a state-land-finance complex, is becoming a key, if obscured, component within marijuana's contemporary political economy.

Measuring Protective Behavioral Strategies for Marijuana Use Among Young Adults.

PubMed

Pedersen, Eric R; Hummer, Justin F; Rinker, Dipali Venkataraman; Traylor, Zach K; Neighbors, Clayton

2016-05-01

Marijuana use can result in a variety of negative consequences, yet it remains popular among young adults and the general public at large. Combined with the growing empirical support for the benefits of medicinal marijuana as well as the steady increase in popular opinion regarding its legalization, it is of growing importance to identify strategies that may mitigate the harms related to marijuana use, reduce consumption levels, and limit resulting negative consequences among young adults who use marijuana. The purpose of this study was to develop and conduct initial psychometric analyses on a new scale, which we named the Protective Behavioral Strategies for Marijuana (PBSM) scale. A sample of undergraduate college students who reported past-6-month marijuana use (n = 210) responded to the initial pool of PBSM items and completed measures of marijuana use, consequences from marijuana use, alcohol use, and protective behavioral strategies for alcohol. Results from an iterative principal component analyses process yielded a single-factor structure with 39 items. The PBSM mean composite score negatively associated with marijuana use and consequences, with the strongest correlations evident for pastmonth users. The PBSM also significantly positively correlated with alcohol protective strategies. Protective behavioral strategies for marijuana appear to be a measurable construct that are related to marijuana frequency and consequences, and thus may be a useful component of intervention and prevention programs with young adults. More work testing the PBSM items with larger and more diverse samples of young adults is encouraged.

The Economic Geography of Medical Marijuana Dispensaries in California

PubMed Central

Morrison, Chris; Gruenewald, Paul J.; Freisthler, Bridget; Ponicki, William R.; Remer, Lillian G.

2014-01-01

Background The introduction of laws that permit the use of marijuana for medical purposes has led to the emergence of a medical marijuana industry in some US states. This study assessed the spatial distribution of medical marijuana dispensaries according to estimated marijuana demand, socioeconomic indicators, alcohol outlets and other socio-demographic factors. Method Telephone survey data from 5,940 residents of 39 California cities were used to estimate social and demographic correlates of marijuana demand. These individual-level estimates were then used to calculate aggregate marijuana demand (i.e. market potential) for 7,538 census block groups. Locations of actively operating marijuana dispensaries were then related to the measure of demand and the socio-demographic characteristics of census block groups using multilevel Bayesian conditional autoregressive logit models. Results Marijuana dispensaries were located in block groups with greater marijuana demand, higher rates of poverty, alcohol outlets, and in areas just outside city boundaries. For the sampled block groups, a 10% increase in demand within a block group was associated with 2.4% greater likelihood of having a dispensary, and a 10% increase in the city-wide demand was associated with a 6.7% greater likelihood of having a dispensary. Conclusion High demand for marijuana within individual block groups and within cities is related to the location of marijuana dispensaries at a block-group level. The relationship to low income, alcohol outlets and unincorporated areas indicates that dispensaries may open in areas that lack the resources to resist their establishment. PMID:24439710

Marijuana use during pregnancy: A comparison of trends and correlates among married and unmarried pregnant women.

PubMed

Oh, Sehun; Salas-Wright, Christopher P; Vaughn, Michael G; DiNitto, Diana M

2017-12-01

While recent evidence indicates increases in marijuana use among adult women in the United States (US), important questions remain with respect to marijuana use during pregnancy. This study examines trends and correlates of prenatal marijuana use and the effects of marijuana-specific risk/protective factors on marijuana use trends using a nationally representative sample. Data were derived from the National Survey on Drug Use and Health (2005-2014), a nationally representative survey that included 3640 married and 3987 unmarried pregnant women in the United States. The significance of marijuana use trends was tested using logistic regression analyses while adjusting for complex sampling design effects and controlling for sociodemographic and marijuana-specific factors. From 2005-2014, marijuana use prevalence among unmarried pregnant women increased by 85% from 5.4% to 10.0% while the prevalence among married pregnant women remained stable (mostly under 1.5%). The increasing trend among unmarried pregnant women was associated with their lower disapproval and risk perceptions of marijuana use. In addition, past-year anxiety (AOR=3.30, 95% CI=1.87-5.82) and depression (AOR=3.85, 95% CI=2.33-6.36) diagnoses were linked with marijuana use among unmarried, but not married, pregnant women. Increased attention should be paid to reducing prenatal marijuana use among unmarried women. Findings also suggest the need to attend to unmarried pregnant women's mental health problems as well as their physical health-risk behaviors. Copyright © 2017 Elsevier B.V. All rights reserved.

Impulsivity, attention, memory, and decision-making among adolescent marijuana users.

PubMed

Dougherty, Donald M; Mathias, Charles W; Dawes, Michael A; Furr, R Michael; Charles, Nora E; Liguori, Anthony; Shannon, Erin E; Acheson, Ashley

2013-03-01

Marijuana is a popular drug of abuse among adolescents, and they may be uniquely vulnerable to resulting cognitive and behavioral impairments. Previous studies have found impairments among adolescent marijuana users. However, the majority of this research has examined measures individually rather than multiple domains in a single cohesive analysis. This study used a logistic regression model that combines performance on a range of tasks to identify which measures were most altered among adolescent marijuana users. The purpose of this research was to determine unique associations between adolescent marijuana use and performances on multiple cognitive and behavioral domains (attention, memory, decision-making, and impulsivity) in 14- to 17-year-olds while simultaneously controlling for performances across the measures to determine which measures most strongly distinguish marijuana users from nonusers. Marijuana-using adolescents (n = 45) and controls (n = 48) were tested. Logistic regression analyses were conducted to test for: (1) differences between marijuana users and nonusers on each measure, (2) associations between marijuana use and each measure after controlling for the other measures, and (3) the degree to which (1) and (2) together elucidated differences among marijuana users and nonusers. Of all the cognitive and behavioral domains tested, impaired short-term recall memory and consequence sensitivity impulsivity were associated with marijuana use after controlling for performances across all measures. This study extends previous findings by identifying cognitive and behavioral impairments most strongly associated with adolescent marijuana users. These specific deficits are potential targets of intervention for this at-risk population.

Prevalence of medical marijuana use in California, 2012.

PubMed

Ryan-Ibarra, Suzanne; Induni, Marta; Ewing, Danielle

2015-03-01

The US Drug Enforcement Agency classifies marijuana as an illegal substance, yet in 22 states marijuana is legal for medicinal use. In 1996, California legalised the use of marijuana for medicinal purposes, but population-based data describing medical marijuana users in the state has not been available. Our aim was to examine the demographic differences between users and non-users of medical marijuana in California utilising population-based data. We used data from the California Behavioral Risk Factor Surveillance System 2012, an annual, random-digit-dial state-wide telephone survey that collects health data from a representative adult sample (n = 7525). Age-adjusted prevalence rates were estimated. Five percent of adults in California reported ever using medical marijuana, and most users believed that medical marijuana helped alleviate symptoms or treat a serious medical condition. Prevalence was similar when compared by gender, education and region. Prevalence of ever using medical marijuana was highest among white adults and younger adults ages 18-24 years, although use was reported by every racial/ethnic and age group examined in our study and ranged from 2% to 9%. Our study's results lend support to the idea that medical marijuana is used equally by many groups of people and is not exclusively used by any one specific group. As more states approve marijuana use for medical purposes, it is important to track medical marijuana use as a health-related behaviour and risk factor. © 2014 Australasian Professional Society on Alcohol and other Drugs.

Comparison of subjective, pharmacokinetic, and physiologic effects of marijuana smoked as joints and blunts

PubMed Central

Cooper, Ziva D.; Haney, Margaret

2009-01-01

Recent increases in marijuana smoking among the young adult population have been accompanied by the popularization of smoking marijuana as blunts instead of as joints. Blunts consist of marijuana wrapped in tobacco leaves, whereas joints consist of marijuana wrapped in cigarette paper. To date, the effects of marijuana smoked as joints and blunts have not been systematically compared. The current within-subject, randomized, double-blind, placebo-controlled study sought to directly compare the subjective, physiologic, and pharmacokinetic effects of marijuana smoked by these two methods. Marijuana blunt smokers (12 women; 12 men) were recruited and participated in a 6-session outpatient study. Participants were blindfolded and smoked three puffs from either a blunt or a joint containing marijuana with varying delta-9-tetrahydrocannabinol (THC) concentrations (0.0, 1.8, and 3.6%). Subjective, physiological (heart rate, blood pressure, carbon monoxide levels) and pharmacokinetic effects (plasma THC concentration) were monitored before and at specified time points for three hours after smoking. Joints produced greater increases in plasma THC and subjective ratings of marijuana intoxication, strength, and quality compared to blunts, and these effects were more pronounced in women compared to men. However, blunts produced equivalent increases in heart rate and higher carbon monoxide levels than joints, despite producing lower levels of plasma THC. These findings demonstrate that smoking marijuana in a tobacco leaf may increase the risks of marijuana use by enhancing carbon monoxide exposure and increasing heart rate compared to joints. PMID:19443132

Examining the relationship between the physical availability of medical marijuana and marijuana use across fifty California cities.

PubMed

Freisthler, Bridget; Gruenewald, Paul J

2014-10-01

The purpose of the current study is to assess statistical associations between individual demographic and personality characteristics, the city-level physical availability of medical marijuana (as measured through densities per roadway mile of storefront dispensaries and delivery services), and the incidence and prevalence of marijuana use. Individual level data on marijuana use were collected during a telephone survey of 8853 respondents living in 50 mid-size cities in California. Data on medical marijuana dispensaries and delivery services were obtained via six different websites and official city lists. Three outcome variables pertaining to lifetime, past year use, and frequency of past year use were analyzed using random effects logistic models (for lifetime and past year use) and random effects tobit models (for frequency of past 365-day use). The current study finds that the total physical availability of medical marijuana through dispensaries and delivery services per roadway mile at the city-level is positively related to current marijuana use and greater frequency of use, controlling for a variety of demographic and personality characteristics. As expected, current physical availability of medical marijuana was unrelated to lifetime use. Regulations on the number and densities of marijuana outlets may be a sufficient means to restrain overall levels of marijuana use within cities. However, alternative use of delivery services may also provide easy access to marijuana and mitigate these effects. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Measuring Protective Behavioral Strategies for Marijuana Use Among Young Adults

PubMed Central

Pedersen, Eric R.; Hummer, Justin F.; Rinker, Dipali Venkataraman; Traylor, Zach K.; Neighbors, Clayton

2016-01-01

Objective: Marijuana use can result in a variety of negative consequences, yet it remains popular among young adults and the general public at large. Combined with the growing empirical support for the benefits of medicinal marijuana as well as the steady increase in popular opinion regarding its legalization, it is of growing importance to identify strategies that may mitigate the harms related to marijuana use, reduce consumption levels, and limit resulting negative consequences among young adults who use marijuana. The purpose of this study was to develop and conduct initial psychometric analyses on a new scale, which we named the Protective Behavioral Strategies for Marijuana (PBSM) scale. Method: A sample of undergraduate college students who reported past-6-month marijuana use (n = 210) responded to the initial pool of PBSM items and completed measures of marijuana use, consequences from marijuana use, alcohol use, and protective behavioral strategies for alcohol. Results: Results from an iterative principal component analyses process yielded a single-factor structure with 39 items. The PBSM mean composite score negatively associated with marijuana use and consequences, with the strongest correlations evident for past-month users. The PBSM also significantly positively correlated with alcohol protective strategies. Conclusions: Protective behavioral strategies for marijuana appear to be a measurable construct that are related to marijuana frequency and consequences, and thus may be a useful component of intervention and prevention programs with young adults. More work testing the PBSM items with larger and more diverse samples of young adults is encouraged. PMID:27172576

EXAMINING THE RELATIONSHIP BETWEEN THE PHYSICAL AVAILABILITY OF MEDICAL MARIJUANA AND MARIJUANA USE ACROSS FIFTY CALIFORNIA CITIES

PubMed Central

Freisthler, Bridget; Gruenewald, Paul J.

2014-01-01

Background The purpose of the current study is to assess statistical associations between individual demographic and personality characteristics, the city-level physical availability of medical marijuana (as measured through densities per roadway mile of storefront dispensaries and delivery services), and the incidence and prevalence of marijuana use. Method Individual level data on marijuana use were collected during a telephone survey of 8,853 respondents living in 50 mid-size cities in California. Data on medical marijuana dispensaries and delivery services were obtained via six different websites and official city lists. Three outcome variables pertaining to lifetime, past year use, and frequency of past year use were analyzed using random effects logistic models (for lifetime and past year use) and random effects tobit models (for frequency of past 365-day use). Results The current study finds that the total physical availability of medical marijuana through dispensaries and delivery services per roadway mile at the city-level is positively related to current marijuana use and greater frequency of use, controlling for a variety of demographic and personality characteristics. As expected, current physical availability of medical marijuana was unrelated to lifetime use. Conclusions Regulations on the number and densities of marijuana outlets may be a sufficient means to restrain overall levels of marijuana use within cities. However, alternative use of delivery services may also provide easy access to marijuana and mitigate these effects. PMID:25156224

Exploring Marijuana Advertising on Weedmaps, a Popular Online Directory.

PubMed

Bierut, Tatiana; Krauss, Melissa J; Sowles, Shaina J; Cavazos-Rehg, Patricia A

2017-02-01

With an increase in the legalization of recreational marijuana across the USA, advertising for marijuana products is more widespread, especially on the Internet where such practices pose a regulatory challenge. In this study, we examined the content of marijuana advertising on Weedmaps, a popular website that markets marijuana retailers online. A total of 146 recreational marijuana retailers in Colorado and Washington were examined on Weedmaps. We studied the age verification practices made in retailers' own websites, the presence of health claims they made about marijuana on Weedmaps, and the characteristics of followers of Weedmaps on social media sites. Many retailers had no security measure to determine age (41 % in Colorado, 35 % in Washington). Approximately 61 % of retailers in Colorado and 44 % in Washington made health claims about the benefits of marijuana, including anxiety reduction, treatment of depression, insomnia, and pain/inflammation. Inferred demographic characteristics of followers of Weedmaps on Twitter and Instagram revealed that over 60 % were male and nearly 70 % or more were age 20-29 years old, yet some (15-18 %) were under the age of 20. Our findings indicate that marijuana retailers have a visible presence on the Internet. Potential customers might be enticed by retailers who tout health claims about marijuana use. It may also be appealing for a younger demographic to overlook age restrictions and engage with marijuana retailers via social media. As a whole, our findings can help to guide future policy making on the issue of marijuana-related advertising.

Interrelationships between marijuana demand and discounting of delayed rewards: Convergence in behavioral economic methods.

PubMed

Aston, Elizabeth R; Metrik, Jane; Amlung, Michael; Kahler, Christopher W; MacKillop, James

2016-12-01

Distinct behavioral economic domains, including high perceived drug value (demand) and delay discounting (DD), have been implicated in the initiation of drug use and the progression to dependence. However, it is unclear whether frequent marijuana users conform to a "reinforcer pathology" addiction model wherein marijuana demand and DD jointly increase risk for problematic marijuana use and cannabis dependence (CD). Participants (n=88, 34% female, 14% cannabis dependent) completed a marijuana purchase task at baseline. A delay discounting task was completed following placebo marijuana cigarette (0% THC) administration during a separate experimental session. Marijuana demand and DD were quantified using area under the curve (AUC). In multiple regression models, demand uniquely predicted frequency of marijuana use while DD did not. In contrast, DD uniquely predicted CD symptom count while demand did not. There were no significant interactions between demand and DD in either model. These findings suggest that frequent marijuana users exhibit key constituents of the reinforcer pathology model: high marijuana demand and steep discounting of delayed rewards. However, demand and DD appear to be independent rather than synergistic risk factors for elevated marijuana use and risk for progression to CD. Findings also provide support for using AUC as a singular marijuana demand metric, particularly when also examining other behavioral economic constructs that apply similar statistical approaches, such as DD, to support analytic methodological convergence. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Exploring Marijuana Advertising on Weedmaps, a Popular Online Directory

PubMed Central

Bierut, Tatiana; Krauss, Melissa J.; Sowles, Shaina J.; Cavazos-Rehg, Patricia A.

2016-01-01

With an increase in the legalization of recreational marijuana across the U.S., advertising for marijuana products is more widespread, especially on the Internet where such practices pose a regulatory challenge. In this study, we examined the content of marijuana advertising on Weedmaps, a popular website that markets marijuana retailers online. A total of 146 recreational marijuana retailers in Colorado and Washington were examined on Weedmaps. We studied the age verification practices made in retailers’ own websites, the presence of health claims they made about marijuana on Weedmaps, and the characteristics of followers of Weedmaps on social media sites. Many retailers had no security measure to determine age (41% in Colorado, 35% in Washington). Approximately 61% of retailers in Colorado and 44% in Washington made health claims about the benefits of marijuana, including anxiety reduction, treatment of depression, insomnia, and pain/inflammation. Inferred demographic characteristics of followers of Weedmaps on Twitter and Instagram revealed that over 60% were male and nearly 70% or more were age 20–29 years old, yet some (15%–18%) were under the age of 20. Our findings indicate that marijuana retailers have a visible presence on the Internet. Potential customers might be enticed by retailers who tout health claims about marijuana use. It may also be appealing for a younger demographic to overlook age restrictions and engage with marijuana retailers via social media. As a whole, our findings can help to guide future policy making on the issue of marijuana-related advertising. PMID:27534665

Medical marijuana: legal considerations.

PubMed

Schouten, J T

1999-01-01

In 1998, Washington State passed a law, Initiative 692 (I-692), that gives individuals who are charged with possession of marijuana for medical purposes a possible affirmative defense. The law lets these individuals provide a note from their doctor or a copy of their medical records stating they have a condition that may benefit from the use of marijuana. I-692 does not legalize the medical use of marijuana and does not affect Federal law, which makes obtaining, possessing, and growing marijuana illegal. The Washington law limits the amount of marijuana a patient can possess to a 60-day supply and defines the conditions for which medical marijuana may be used. These conditions include HIV, cancer, multiple sclerosis, and epilepsy.

Assessing the Relationship between Marijuana Availability and Marijuana Use: A Legal and Sociological Comparison between the United States and the Netherlands

ERIC Educational Resources Information Center

Yacoubian, George S., Jr.

2007-01-01

The United States and the Netherlands have antithetical marijuana control policies. The United States' laws criminalize the possession of even small amounts of marijuana, while the Netherlands have maintained, over the past several decades, two relatively liberal marijuana policies implemented during the 1970s and 1980s. According to the…

Medical Marijuana Legalization and Co-use in Adult Cigarette Smokers

PubMed Central

Wang, Julie B.; Cataldo, Janine K.

2016-01-01

Objectives We examined effects of long-term medical marijuana legalization on cigarette co-use in a sample of adults. Methods We conducted secondary analysis using data from the 2014 US Tobacco Attitudes and Beliefs Survey, which consisted of cigarette smokers, aged ≥ 45 years (N = 506). Participants were categorized by their state residence, where medical marijuana was (1) illegal, (2) legalized < 10 years, and (3) legalized ≥ 10 years. The Web-based survey assessed participants’ marijuana use, beliefs and attitudes on marijuana, and nicotine dependence using Fagerstrom Tolerance for Nicotine Dependence (FTND) and Hooked on Nicotine Checklist (HONC) scores. Results In cigarette smokers aged ≥ 45 years, long-term legalization of medical marijuana was associated with stable positive increases in marijuana use prevalence (ever in a lifetime) (p = .005) and frequency (number of days in past 30 days) (unadjusted p = .005; adjusted p = .08). Those who reported marijuana co-use had greater FTND and HONC scores after adjusting for covariates (p = .05). Conclusions These preliminary findings warrant further examination of the potential impact of long-term legalization of medical marijuana on greater cigarette and marijuana co-use in adults and higher nicotine dependence among co-users at the population level. PMID:26931752

Evaluating ballot initiative support for legalised marijuana: The case of Washington.

PubMed

Collingwood, Loren; O'Brien, Ben Gonzalez; Dreier, Sarah

2018-03-11

In 2012, Washington and Colorado became the first U.S. states to legalise recreational marijuana. By 2016, eight states and the District of Columbia had legalised recreational marijuana, with more expected to consider it in 2018. Despite this trend, little academic research explains what drives ballot-initiative vote choice on marijuana legalisation. This paper uses a pre-election random sample voter survey to examine the individual characteristics that correlated with Washington voters' support for legal recreational marijuana. We find that voting on marijuana ballot initiatives largely reflects public opinion about marijuana and is particularly shaped voters' political ideology, party affiliation, religious affiliation and practice, and education. Notably, we find that those reporting experiences (i.e., someone they know) with the criminal justice system are more supportive of legalisation than those who do not. We conclude that marijuana legalisation voting behavior generally aligns with public opinion on the issue. However, one key aspect of Washington's legalisation campaign-the criminal injustices of marijuana illegality-helped shape Washington state voting behavior. Further research is needed to examine if, when, and in what contexts criminal justice campaign themes are likely to strengthen or undermine future states' marijuana legalisation efforts. Copyright © 2018 Elsevier B.V. All rights reserved.

Is medical marijuana legalisation possible in Poland?

PubMed

Rogowska-Szadkowska, Dorota; Strumiło, Julia; Chlabicz, Sławomir

2018-03-01

In some countries of the world it is legal to use plant-based marijuana for therapeutic purposes. When we had learned that 7,000 petitioners (including doctors) signed the petition to enable access to marijuana for patients in the Czech Republic, we decided to examine the knowledge about marijuana's medical properties among Polish medical students. Anonymous questionnaire study was conducted on a group of 181 of students of the last (sixth) year of medical school. It was demonstrated that students are not provided with sufficient information about therapeutic administration of plant-based marijuana during medical studies. The majority of interviewees mentioned only one indication for medical marijuana use. All students did not interchange medical conditions for which marijuana is used in 30 USA states or Canada. Marijuana smoking for medical purposes differs from recreational smoking, and its effect does not depend on occurrence of symptoms from the central nervous system. Few studies, that were carried out along with numerous previously unreported cases of patients, demonstrated that plant-derived marijuana had therapeutic effect on many diseases where conventional medicine was of no help. All doctors, including medical students, should receive more information about the therapeutic properties of marijuana. Copyright© by the National Institute of Public Health, Prague 2018.

Effectiveness of a Marijuana Expectancy Manipulation: Piloting the Balanced-Placebo Design for Marijuana

PubMed Central

Metrik, Jane; Rohsenow, Damaris J.; Monti, Peter M.; McGeary, John; Cook, Travis A. R.; de Wit, Harriet; Haney, Margaret; Kahler, Christopher W.

2009-01-01

Although alcohol and nicotine administration studies have demonstrated that manipulating subjects’ expectancies regarding drug content affects drug response, research with marijuana has not adequately studied drug expectancy effects. The present pilot study was the first to evaluate the credibility and effect of expectancy manipulation on subjective measures and smoking patterns using a marijuana administration balanced-placebo design (BPD). In a 2 × 2 instructional set (told delta-9-tetrahydrocannabinol [THC] vs. told no THC) by drug (smoked marijuana with 2.8% THC vs. placebo) between-subjects design, the authors examined the effect of marijuana expectancy manipulation and the pharmacologic effect on affective and physiologic measures, cigarette ratings, and smoking behavior with 20 marijuana smokers (mean age = 20 years; 25% female). Large main effects of expectancy were found on ratings of cigarette potency, strength, taste, smell, and satisfaction, and observed smoking behavior. Pharmacologic effects were particularly evident for self-reported physical reactions to marijuana and cigarette potency and satisfaction ratings. This study demonstrated the feasibility of the BPD research with marijuana and yielded promising results for future studies examining the independent and combined effects of marijuana pharmacology and expectancies. PMID:19653787

Youth Marijuana Use: State of the Science for the Practicing Clinician

PubMed Central

Hadland, Scott E.; Harris, Sion K.

2014-01-01

Purpose of review Despite widespread marijuana use among adolescents, accurate information on known health effects is poorly disseminated to clinicians and their patients. Amidst rapidly evolving drug policy in the United States and elsewhere, it is imperative that providers understand the short- and long-term consequences of marijuana use. Recent findings Research on regular marijuana use highlights a unique susceptibility of the developing adolescent brain to adverse neurocognitive and psychiatric outcomes. Although studies have not firmly established causality, onset of regular marijuana use in adolescence is associated with later decline in cognitive function, as well as with adult onset of psychosis and anxiety. Educational and employment outcomes may be poorer among regular marijuana-using adolescents. A number of other adverse respiratory, cardiovascular, endocrine and gastrointestinal associations with regular marijuana use have also been established. Good screening tools and promising brief intervention and behavioral treatment programs are available to clinicians, who are in a position to identify problematic marijuana use among adolescents and refer for services. Summary A common misperception among youth is that marijuana use is without harm. However, adolescent marijuana use may have measurable, durable and potentially irreversible effects on later cognitive function and mental health. PMID:24914878

Medical Marijuana Legalization and Co-use in Adult Cigarette Smokers.

PubMed

Wang, Julie B; Cataldo, Janine K

2016-03-01

We examined effects of long-term medical marijuana legalization on cigarette co-use in a sample of adults. We conducted secondary analysis using data from the 2014 US Tobacco Attitudes and Beliefs Survey, which consisted of cigarette smokers, aged ≥ 45 years (N = 506). Participants were categorized by their state residence, where medical marijuana was (1) illegal, (2) legalized < 10 years, and (3) legalized ≥ 10 years. The Web-based survey assessed participants' marijuana use, beliefs and attitudes on marijuana, and nicotine dependence using Fagerstrom Tolerance for Nicotine Dependence (FTND) and Hooked on Nicotine Checklist (HONC) scores. In cigarette smokers aged ≥ 45 years, long-term legalization of medical marijuana was associated with stable positive increases in marijuana use prevalence (ever in a lifetime) (p = .005) and frequency (number of days in past 30 days) (unadjusted p = .005; adjusted p = .08). Those who reported marijuana co-use had greater FTND and HONC scores after adjusting for covariates (p = .05). These preliminary findings warrant further examination of the potential impact of long-term legalization of medical marijuana on greater cigarette and marijuana co-use in adults and higher nicotine dependence among co-users at the population level.

Colorado family physicians' attitudes toward medical marijuana.

PubMed

Kondrad, Elin; Reid, Alfred

2013-01-01

Over the last decade, the use of medical marijuana has expanded dramatically; it is now permitted in 16 states and the District of Columbia. Our study of family physicians in Colorado is the first to gather information about physician attitudes toward this evolving practice. We distributed an anonymous web-based electronic survey to the 1727 members of the Colorado Academy of Family Physicians' listserv. Items included individual and practice characteristics as well as experience with and attitudes toward medical marijuana. Five hundred twenty family physicians responded (30% response rate). Of these, 46% did not support physicians recommending medical marijuana; only 19% thought that physicians should recommend it. A minority thought that marijuana conferred significant benefits to physical (27%) and mental (15%) health. Most agreed that marijuana poses serious mental (64%) and physical (61%) health risks. Eighty-one percent agreed that physicians should have formal training before recommending medical marijuana, and 92% agreed that continuing medical education about medical marijuana should be available to family physicians. Despite a high prevalence of use in Colorado, most family physicians are not convinced of marijuana's health benefits and believe its use carries risks. Nearly all agreed on the need for further medical education about medical marijuana.

Planting the seed for marijuana use: Changes in exposure to medical marijuana advertising and subsequent adolescent marijuana use, cognitions, and consequences over seven years.

PubMed

D'Amico, Elizabeth J; Rodriguez, Anthony; Tucker, Joan S; Pedersen, Eric R; Shih, Regina A

2018-05-10

Marijuana use during adolescence is associated with neurocognitive deficits and poorer functioning across several domains. It is likely that more states will pass both medical and recreational marijuana legalization laws in the coming elections; therefore, we must begin to look more closely at the longitudinal effects of medical marijuana (MM) advertising on marijuana use among adolescents so that we can better understand effects that this advertising may have on their subsequent marijuana use and related outcomes. We followed two cohorts of 7th and 8th graders (mean age 13) recruited from school districts in Southern California from 2010 until 2017 (mean age 19) to examine effects of MM advertising on adolescents' marijuana use, cognitions, and consequences over seven years. Latent growth models examined trajectories of self-reported exposure to medical marijuana ads in the past three months and trajectories of use, cognitions, and consequences. Higher average exposure to MM advertising was associated with higher average use, intentions to use, positive expectancies, and negative consequences. Similarly, higher rates of change in MM advertising exposure were associated with higher rates of change in use, intentions, expectancies, and consequences over seven years. Results suggest that exposure to MM advertising may not only play a significant role in shaping attitudes about marijuana, but may also contribute to increased marijuana use and related negative consequences throughout adolescence. This highlights the importance of considering regulations for marijuana advertising, similar to regulations in place for the promotion of tobacco and alcohol in the U.S. Copyright © 2018. Published by Elsevier B.V.

Use of Marijuana and Other Substances Among Pregnant and Parenting Women With Substance Use Disorders: Changes in Washington State After Marijuana Legalization.

PubMed

Grant, Therese M; Graham, J Christopher; Carlini, Beatriz H; Ernst, Cara C; Brown, Natalie Novick

2018-01-01

In 2012, possession of marijuana for nonmedical use was legalized in Washington State. This study examined how legalization affected alcohol and drug use in a sample of pregnant and parenting women with substance use disorders. Study participants from nine counties in Washington State (N = 1,359) were questioned about their substance use after completing a 3-year case management intervention program. The sample was divided into two cohorts based on whether participants had completed the program before or after legalization. Most study participants reported complete abstinence from alcohol and nonprescription drugs at program exit. Among those who were still using substances, women who completed the intervention after marijuana legalization were significantly more likely to report marijuana use at program exit compared with women who completed the intervention before marijuana legalization. Across both cohorts (pre- and post-legalization), we found a positive association of exit marijuana use with alcohol, illegal methadone, other opioids, amphetamines, and cocaine use; even when we controlled for historical period, the association with some of these substances with marijuana use remained evident. Independent of marijuana use, we saw increased use during the post-legalization period of alcohol, illicit methadone, and other opioids. Marijuana use at exit from the Parent-Child Assistance Program (PCAP) increased significantly after marijuana legalization in the state. Women who were not abstinent from marijuana at program exit were likely to report use of other substances as well. Our study design demonstrates an association but does not allow us to conclude that marijuana use leads to other substance use among this sample of women with a history of polysubstance use.

Past 15-year trends in adolescent marijuana use: Differences by race/ethnicity and sex.

PubMed

Johnson, Renee M; Fairman, Brian; Gilreath, Tamika; Xuan, Ziming; Rothman, Emily F; Parnham, Taylor; Furr-Holden, C Debra M

2015-10-01

The potential for increases in adolescent marijuana use is an important concern given recent changes in marijuana policy. The purpose of this study was to estimate trends in marijuana use from 1999 to 2013 among a national sample of US high school students. We examine changes over time by race/ethnicity and sex. Data are from the National Youth Risk Behavior Survey (YRBS), which involves biennial, school-based surveys that generate nationally representative data about 9th-12th grade students in the United States. Students self-reported sex, race/ethnicity, and marijuana use (i.e., lifetime use, past 30-day use, any use before age 13). We generated national estimates of the prevalence of marijuana use for the time period, and also tested for linear and quadratic trends (n=115,379). The prevalence of lifetime marijuana use decreased modestly from 1999 to 2009 (44% to 37%), and has increased slightly since 2009 (41%). Other marijuana use variables (e.g., past 30-day use) followed a similar pattern over time. The prevalence of past 30-day use from 1999 to 2013 for all groups and both sexes was 22.5%, and it was lowest among Asians and highest among American Indian/Alaska Natives. Although boys have historically had a higher prevalence of marijuana use, results indicate that male-female differences in marijuana use decreased over time. Despite considerable changes in state marijuana policies over the past 15 years, marijuana use among high school students has largely declined. Continued surveillance is needed to assess the impact of policy changes on adolescent marijuana use. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Perceptions of social norms and exposure to pro-marijuana messages are associated with adolescent marijuana use.

PubMed

Roditis, Maria L; Delucchi, Kevin; Chang, Audrey; Halpern-Felsher, Bonnie

2016-12-01

Despite consistent declines in rates of cigarette use among adolescents in the last five years, rates of marijuana use have remained constant, with marijuana being the most widely used illegal drug among adolescents. More work is needed to understand how social norms, perceived risks and benefits, and social media messaging impact use of marijuana. This study compared perceptions and social norms related to marijuana, blunts and cigarettes. Additionally, we assessed how perceptions related to social norms, risks and benefits, and exposure to pro- versus anti-marijuana messaging is related to use. Participants were 786 adolescents from Southern and Northern California (36.7% male, 63.21% females; mean age=16.1years; SD=1.6). Participants came from diverse ethnic backgrounds, with 207 (26.61%) White, 171 (21.98%) Asian/Pacific Islander, 232 (29.82%) Hispanic, and 168 (21.59%) other. Results indicated that marijuana and blunts were consistently perceived as more socially acceptable and less risky than cigarettes (p<0.01). Participants who reported that their friends used marijuana had a 27% greater odds of using marijuana themselves. Further, seeing messages about the good things or benefits of marijuana use was associated with a 6% greater odds of use [OR 1.06 (CI 1.00, 1.12)]. This study's findings offer a number of important public health implications, particularly as states move towards legalization of marijuana for recreational use. As this occurs, states need to take adolescents' perceptions of risks, benefits, social norms, and peer influences into account as they implement strategies to reduce youth use of marijuana and blunts. Copyright © 2016 Elsevier Inc. All rights reserved.

The impacts of marijuana dispensary density and neighborhood ecology on marijuana abuse and dependence.

PubMed

Mair, Christina; Freisthler, Bridget; Ponicki, William R; Gaidus, Andrew

2015-09-01

As an increasing number of states liberalize cannabis use and develop laws and local policies, it is essential to better understand the impacts of neighborhood ecology and marijuana dispensary density on marijuana use, abuse, and dependence. We investigated associations between marijuana abuse/dependence hospitalizations and community demographic and environmental conditions from 2001 to 2012 in California, as well as cross-sectional associations between local and adjacent marijuana dispensary densities and marijuana hospitalizations. We analyzed panel population data relating hospitalizations coded for marijuana abuse or dependence and assigned to residential ZIP codes in California from 2001 through 2012 (20,219 space-time units) to ZIP code demographic and ecological characteristics. Bayesian space-time misalignment models were used to account for spatial variations in geographic unit definitions over time, while also accounting for spatial autocorrelation using conditional autoregressive priors. We also analyzed cross-sectional associations between marijuana abuse/dependence and the density of dispensaries in local and spatially adjacent ZIP codes in 2012. An additional one dispensary per square mile in a ZIP code was cross-sectionally associated with a 6.8% increase in the number of marijuana hospitalizations (95% credible interval 1.033, 1.105) with a marijuana abuse/dependence code. Other local characteristics, such as the median household income and age and racial/ethnic distributions, were associated with marijuana hospitalizations in cross-sectional and panel analyses. Prevention and intervention programs for marijuana abuse and dependence may be particularly essential in areas of concentrated disadvantage. Policy makers may want to consider regulations that limit the density of dispensaries. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Reward-related brain response and craving correlates of marijuana cue exposure: a preliminary study in treatment-seeking marijuana-dependent subjects.

PubMed

Goldman, Marina; Szucs-Reed, Regina P; Jagannathan, Kanchana; Ehrman, Ronald N; Wang, Ze; Li, Yin; Suh, Jesse J; Kampman, Kyle; O'Brien, Charles P; Childress, Anna Rose; Franklin, Teresa R

2013-01-01

: Determining the brain substrates underlying the motivation to abuse addictive drugs is critical for understanding and treating addictive disorders. Laboratory neuroimaging studies have demonstrated differential activation of limbic and motivational circuitry (eg, amygdala, hippocampus, ventral striatum, insula, and orbitofrontal cortex) triggered by cocaine, heroin, nicotine, and alcohol cues. The literature on neural responses to marijuana cues is sparse. Thus, the goals of this study were to characterize the brain's response to marijuana cues, a major motivator underlying drug use and relapse, and determine whether these responses are linked to self-reported craving in a clinically relevant population of treatment-seeking marijuana-dependent subjects. : Marijuana craving was assessed in 12 marijuana-dependent subjects using the Marijuana Craving Questionnaire-Short Form. Subsequently, blood oxygen level dependent functional magnetic resonance imaging data were acquired during exposure to alternating 20-second blocks of marijuana-related versus matched nondrug visual cues. : Brain activation during marijuana cue exposure was significantly greater in the bilateral amygdala and the hippocampus. Significant positive correlations between craving scores and brain activation were found in the ventral striatum and the medial and lateral orbitofrontal cortex (P < 0.0001). : This study presents direct evidence for a link between reward-relevant brain responses to marijuana cues and craving and extends the current literature on marijuana cue reactivity. Furthermore, the correlative relationship between craving and brain activity in reward-related regions was observed in a clinically relevant sample (treatment-seeking marijuana-dependent subjects). Results are consistent with prior findings in cocaine, heroin, nicotine, and alcohol cue studies, indicating that the brain substrates of cue-triggered drug motivation are shared across abused substances.

Community-level policy responses to state marijuana legalization in Washington State.

PubMed

Dilley, Julia A; Hitchcock, Laura; McGroder, Nancy; Greto, Lindsey A; Richardson, Susan M

2017-04-01

Washington State (WA) legalized a recreational marijuana market - including growing, processing and retail sales - through voter initiative 502 in November 2012. Legalized recreational marijuana retail sales began in July 2014. In response to state legalization of recreational marijuana, some cities and counties within the state have passed local ordinances that either further regulated marijuana markets, or banned them completely. The purpose of this study is to describe local-level marijuana regulations on recreational retail sales within the context of a state that had legalized a recreational marijuana market. Marijuana-related ordinances were collected from all 142 cities in the state with more than 3000 residents and from all 39 counties. Policies that were in place as of June 30, 2016 - two years after the state's recreational market opening - to regulate recreational marijuana retail sales within communities were systematically coded. A total of 125 cities and 30 counties had passed local ordinances to address recreational marijuana retail sales. Multiple communities implemented retail market bans, including some temporary bans (moratoria) while studying whether to pursue other policy options. As of June 30, 2016, 30% of the state population lived in places that had temporarily or permanently banned retail sales. Communities most frequently enacted zoning policies explicitly regulating where marijuana businesses could be established. Other policies included in ordinances placed limits on business hours and distance requirements (buffers) between marijuana businesses and youth-related land use types or other sensitive areas. State legalization does not necessarily result in uniform community environments that regulate recreational marijuana markets. Local ordinances vary among communities within Washington following statewide legalization. Further study is needed to describe how such local policies affect variation in public health and social outcomes. Copyright © 2017 Elsevier B.V. All rights reserved.

Community-level policy responses to state marijuana legalization in Washington State

PubMed Central

Dilley, Julia A.; Hitchcock, Laura; McGroder, Nancy; Greto, Lindsey A.; Richardson, Susan M.

2017-01-01

Background Washington State (WA) legalized a recreational marijuana market -- including growing, processing and retail sales -- through voter initiative 502 in November 2012. Legalized recreational marijuana retail sales began in July 2014. In response to state legalization of recreational marijuana, some cities and counties within the state have passed local ordinances that either further regulated marijuana markets, or banned them completely. The purpose of this study is to describe local-level marijuana regulations on recreational retail sales within the context of a state that had legalized a recreational marijuana market. Methods Marijuana-related ordinances were collected from all 142 cities in the state with more than 3,000 residents and from all 39 counties. Policies that were in place as of June 30, 2016 - two years after the state’s recreational market opening - to regulate recreational marijuana retail sales within communities were systematically coded. Results A total of 125 cities and 30 counties had passed local ordinances to address recreational marijuana retail sales. Multiple communities implemented retail market bans, including some temporary bans (moratoria) while studying whether to pursue other policy options. As of June 30, 2016, 30% of the state population lived in places that had temporarily or permanently banned retail sales. Communities most frequently enacted zoning policies explicitly regulating where marijuana businesses could be established. Other policies included in ordinances placed limits on business hours and distance requirements (buffers) between marijuana businesses and youth-related land use types or other sensitive areas. Conclusions State legalization does not necessarily result in uniform community environments that regulate recreational marijuana markets. Local ordinances vary among communities within Washington following statewide legalization. Further study is needed to describe how such local policies affect variation in public health and social outcomes. PMID:28365192

Mind Over Matter: The Brain's Response to Marijuana

MedlinePlus

... Brain's Response to Marijuana The Brain's Response to Marijuana Print Hi, my name is Sara Bellum. Welcome ... issue, we'll investigate the fascinating facts about marijuana. You may have heard it called pot, weed, ...

Unintentional Pediatric Exposures to Marijuana in Colorado, 2009-2015.

PubMed

Wang, George Sam; Le Lait, Marie-Claire; Deakyne, Sara J; Bronstein, Alvin C; Bajaj, Lalit; Roosevelt, Genie

2016-09-06

As of 2015, almost half of US states allow medical marijuana, and 4 states allow recreational marijuana. To our knowledge, the effect of recreational marijuana on the pediatric population has not been evaluated. To compare the incidence of pediatric marijuana exposures evaluated at a children's hospital and regional poison center (RPC) in Colorado before and after recreational marijuana legalization and to compare population rate trends of RPC cases for marijuana exposures with the rest of the United States. Retrospective cohort study of hospital admissions and RPC cases between January 1, 2009, and December 31, 2015, at Children's Hospital Colorado, Aurora, a tertiary care children's hospital. Participants included patients 0 to 9 years of age evaluated at the hospital's emergency department, urgent care centers, or inpatient unit and RPC cases from Colorado for single-substance marijuana exposures. Marijuana. Marijuana exposure visits and RPC cases, marijuana source and type, clinical effects, scenarios, disposition, and length of stay. Eighty-one patients were evaluated at the children's hospital, and Colorado's RPC received 163 marijuana exposure cases between January 1, 2009, and December 31, 2015, for children younger than 10 years of age. The median age of children's hospital visits was 2.4 years (IQR, 1.4-3.4); 25 were girls (40%) . The median age of RPC marijuana exposures was 2 years (IQR, 1.3-4.0), and 85 patients were girls (52%). The mean rate of marijuana-related visits to the children's hospital increased from 1.2 per 100 000 population 2 years prior to legalization to 2.3 per 100,000 population 2 years after legalization (P = .02). Known marijuana products involved in the exposure included 30 infused edibles (48%). Median length of stay was 11 hours (interquartile range [IQR], 6-19) and 26 hours (IQR, 19-38) for admitted patients. Annual RPC pediatric marijuana cases increased more than 5-fold from 2009 (9) to 2015 (47). Colorado had an average increase in RPC cases of 34% (P < .001) per year while the remainder of the United States had an increase of 19% (P < .001). For 10 exposure scenarios (9%), the product was not in a child-resistant container; for an additional 40 scenarios (34%), poor child supervision or product storage was reported. Edible products were responsible for 51 exposures (52%). Colorado RPC cases for pediatric marijuana increased significantly and at a higher rate than the rest of the United States. The number of children's hospital visits and RPC case rates for marijuana exposures increased between the 2 years prior to and the 2 years after legalization. Almost half of the patients seen in the children's hospital in the 2 years after legalization had exposures from recreational marijuana, suggesting that legalization did affect the incidence of exposures.

Marijuana Dependence: Not Just Smoke and Mirrors

PubMed Central

Ramesh, Divya; Schlosburg, Joel E.; Wiebelhaus, Jason M.; Lichtman, Aron H.

2012-01-01

Marijuana (Cannabis sativa) is the most commonly used illicit drug worldwide as well as in the Unites States. Prolonged use of marijuana or repeated administration of its primary psychoactive constituent, Δ9-tetrahydrocannabinol (THC), can lead to physical dependence in humans and laboratory animals. The changes that occur with repeated cannabis use include alterations in behavioral, physiological, and biochemical responses. A variety of withdrawal responses occur in cannabis-dependent individuals: anger, aggression, irritability, anxiety and nervousness, decreased appetite or weight loss, restlessness, and sleep difficulties with strange dreams. But the long half-life and other pharmacokinetic properties of THC result in delayed expression of withdrawal symptoms, and because of the lack of contiguity between drug cessation and withdrawal responses the latter are not readily recognized as a clinically relevant syndrome. Over the past 30 years, a substantial body of clinical and laboratory animal research has emerged supporting the assertion that chronic exposure to cannabinoids produces physical dependence and may contribute to drug maintenance in cannabis-dependent individuals. However, no medications are approved to treat cannabis dependence and withdrawal. In this review, we describe preclinical and clinical research that supports the existence of a cannabinoid withdrawal syndrome. In addition, we review research evaluating potential pharmacotherapies (e.g., THC, a variety of antidepressant drugs, and lithium) to reduce cannabis withdrawal responses and examine how expanded knowledge about the regulatory mechanisms in the endocannabinoid system may lead to promising new therapeutic targets. PMID:23382144

Negative urgency partially accounts for the relationship between major depressive disorder and marijuana problems.

PubMed

Gunn, Rachel L; Jackson, Kristina M; Borsari, Brian; Metrik, Jane

2018-01-01

To goal of this study was to better understand mechanisms underlying associations between Major Depressive Disorder (MDD) and marijuana use and problems. Specifically, it was hypothesized that negative urgency (NU), the tendency to act rashly while experiencing negative mood states, would uniquely (compared to other impulsivity traits: positive urgency, sensation seeking, premeditation, and perseverance) account for the relationship between MDD and marijuana use and problems. Data were collected from a sample ( N  = 357) of veterans ( M age = 33.63) recruited from a Veterans Affairs hospital who used marijuana at least once in their lifetime. Participants completed the SCID-NP to assess MDD, a marijuana problems scale, a Time-Line Follow-back to assess six-month marijuana use, and the UPPS-P Impulsive Behavior Scale for impulsivity. Path analysis was conducted using bootstrapped ( k  = 20,000) and bias-corrected 95% confidence intervals (CIs) to estimate mediation (indirect) effects, controlling for age, sex, and race. Analyses revealed a significant direct effect of MDD on NU and NU on marijuana problems. Regarding mediational analyses, there was a significant indirect effect of MDD on marijuana problems via NU. The direct effect of MDD on marijuana problems was reduced, but remained significant, suggesting partial mediation. No other impulsivity scales accounted for the relationship between MDD and marijuana problems. In predicting marijuana use, there were no significant indirect effects for any impulsivity traits, including NU, despite significant bivariate associations between use and NU and MDD. Results suggest that high levels of NU may partially explain associations between MDD and marijuana problems, but not marijuana use. No other facets of impulsivity accounted for the relationship between MDD and marijuana use or problems, underscoring the specificity of NU as a putative mechanism and the importance of assessing NU in treatment settings.

Marijuana Use Trajectories and Academic Outcomes among College Students

PubMed Central

Suerken, Cynthia K.; Reboussin, Beth A.; Egan, Kathleen L.; Sutfin, Erin L.; Wagoner, Kimberly G.; Spangler, John; Wolfson, Mark

2016-01-01

Background Marijuana is the most commonly used illicit drug by college students. Prior studies have established an association between marijuana use and poor academic performance in college, but research on the frequency of marijuana use over the entire college career is limited. The study objective was to examine the association of marijuana use trajectories on academic outcomes, including senior year enrollment, plans to graduate on time, and GPA. Methods Data were collected from a cohort of 3,146 students from 11 colleges in North Carolina and Virginia at six time points across the college career. Group-based trajectory models were used to characterize longitudinal marijuana use patterns during college. Associations between marijuana trajectory groups and academic outcomes were modeled using random-effects linear and logistic regressions. Results Five marijuana trajectory groups were identified: non-users (69.0%), infrequent users (16.6%), decreasing users (4.7%), increasing users (5.8%), and frequent users (3.9%). Decreasing users and frequent users were more likely to drop out of college and plan to delay graduation when compared to non-users. All marijuana user groups reported lower GPAs, on average, than non-users. Conclusion These results identify marijuana use patterns that put students at risk for poor academic performance in college. Students who use marijuana frequently at the beginning of the college career are especially at risk for lower academic achievement than non-users, suggesting that early intervention is critical. PMID:27020322

Using deviance regulation theory to target marijuana use intentions among college students.

PubMed

Dvorak, Robert D; Raeder, Cody A; Kramer, Matthew P; Sargent, Emily; Stevenson, Brittany L; Helmy, Mai

2018-02-01

Several large epidemiological studies have shown increasing trends on a number of indices of marijuana use among college age samples. This may be due to changing attitudes about marijuana use linked to legalization efforts. Interventions that can target problematic use on a broad scale are lacking. Recent research has shown that deviance regulation theory (DRT) can be used to design effective web-based substance use interventions. DRT relies on the interplay between perceived norms and an appropriately framed message about the given behavior. The current study examines the use of DRT to change marijuana use intentions. Participants (n = 694 college students) completed measures of marijuana use and marijuana use norms. They were then assigned to receive a positively framed message about marijuana abstainers or a negatively framed message about marijuana users. Following the manipulation, participants rated intentions to use marijuana over the next three months. Consistent with DRT, there was an interaction between message frame and marijuana use norms. The positive frame attenuated the association between marijuana use norms and use intentions. A negative frame resulted in the lowest levels of use intentions among those with low use norms. Results suggest that DRT may be used to modify use intentions in college students, a population that has shown increasing rates of use. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Which Users Should Be the Focus of Mobile Personal Health Records? Analysis of User Characteristics Influencing Usage of a Tethered Mobile Personal Health Record.

PubMed

Lee, Guna; Park, Joong Yeol; Shin, Soo-Yong; Hwang, Jong Su; Ryu, Hyeon Jeong; Lee, Jae Ho; Bates, David W

2016-05-01

This study was conducted to analyze the usage pattern of a hospital-tethered mobile personal health records (m-PHRs) application named My Chart in My Hand (MCMH) and to identify user characteristics that influence m-PHR usage. Access logs to MCMH and its menus were collected for a total of 18 months, from August 2011 to January 2013. Usage patterns between users without a patient identification number (ID) and users with a patient ID were compared. Users with a patient ID were divided into light and heavy user groups by the median number of monthly access. Multiple linear regression models were used to assess MCMH usage pattern by characteristics of MCMH user with a patient ID. The total number of MCMH logins was 105,603, and the median number of accesses was 15 times. Users (n = 7,096) mostly accessed the "My Chart" menu, but "OPD [outpatient department] Service Support" and "Health Management" menus were also frequently used. Patients with chronic diseases, experience of hospital visits including emergency room and OPD, and age group of 0-19 years were more frequently found among users with a patient ID (n = 2,186) (p < 0.001). A similar trend was found in the heavy user group (n = 1,123). Submenus of laboratory result, online appointment, and medication lists that were accessed mostly by users with a patient ID were associated with OPD visit and chronic diseases. This study showed that focuses on patients with chronic disease and more hospital visits and empowerment functions in a tethered m-PHR would be helpful to pursue the extensive use.

Who are medical marijuana patients? Population characteristics from nine California assessment clinics.

PubMed

Reinarman, Craig; Nunberg, Helen; Lanthier, Fran; Heddleston, Tom

2011-01-01

Marijuana is a currently illegal psychoactive drug that many physicians believe has substantial therapeutic uses. The medical literature contains a growing number of studies on cannabinoids as well as case studies and anecdotal reports suggesting therapeutic potential. Fifteen states have passed medical marijuana laws, but little is known about the growing population of patients who use marijuana medicinally. This article reports on a sample of 1,746 patients from a network of nine medical marijuana evaluation clinics in California. Patients completed a standardized medical history form; evaluating physicians completed standardized evaluation forms. From this data we describe patient characteristics, self-reported presenting symptoms, physician evaluations, other treatments tried, other drug use, and medical marijuana use practices. Pain, insomnia, and anxiety were the most common conditions for which evaluating physicians recommended medical marijuana. Shifts in the medical marijuana patient population over time, the need for further research, and the issue of diversion are discussed.

Pharmacy Students' Knowledge and Attitudes Regarding Medical Marijuana.

PubMed

Moeller, Karen E; Woods, Barbara

2015-08-25

To determine pharmacy students' knowledge of and attitudes toward medical marijuana and to determine if pharmacy students need additional education on the topic. Pharmacy students were asked to complete a survey on medical marijuana that assessed their knowledge of, medical uses of, adverse effects with, and attitudes toward medical marijuana through 23 Likert-scale questions. Three hundred eleven students completed the survey. Fifty-eight percent of the students felt that medical marijuana should be legalized in all states. However, the majority of students did not feel comfortable answering consumers' questions regarding efficacy, safety, or drug interactions related to the substance. Accurate responses for diseases or conditions for permitted medical marijuana use was low, with only cancer (91%) and glaucoma (57%) identified by more than half the students. With an increasing number of states adopting medical marijuana use, pharmacy schools need to evaluate the adequacy of medical marijuana education in their curriculum.

Pharmacy Students’ Knowledge and Attitudes Regarding Medical Marijuana

PubMed Central

Woods, Barbara

2015-01-01

Objective. To determine pharmacy students’ knowledge of and attitudes toward medical marijuana and to determine if pharmacy students need additional education on the topic. Methods. Pharmacy students were asked to complete a survey on medical marijuana that assessed their knowledge of, medical uses of, adverse effects with, and attitudes toward medical marijuana through 23 Likert-scale questions. Results. Three hundred eleven students completed the survey. Fifty-eight percent of the students felt that medical marijuana should be legalized in all states. However, the majority of students did not feel comfortable answering consumers’ questions regarding efficacy, safety, or drug interactions related to the substance. Accurate responses for diseases or conditions for permitted medical marijuana use was low, with only cancer (91%) and glaucoma (57%) identified by more than half the students. Conclusion. With an increasing number of states adopting medical marijuana use, pharmacy schools need to evaluate the adequacy of medical marijuana education in their curriculum. PMID:26430272

Law Enforcement Efforts to Control Domestically Grown Marijuana.

DTIC Science & Technology

1984-05-25

mari- juana grown indoors , the involvement of large criminal organizations, and the patterns of domestic marijuana distribution. In response to a GAO...information is particularly important if the amount of marijuana grown indoors and the number of large-scale cultiva- tion and distribution organizations... marijuana indoors is becoming increasingly popular. A 1982 narcotics assessment by the Western States Information Network (WSIN)2 of marijuana

Medical and recreational marijuana: commentary and review of the literature.

PubMed

Wilkinson, Samuel T

2013-01-01

Recent years have seen substantial shifts in cultural attitudes towards marijuana for medical and recreational use. Potential problems with the approval, production, dispensation, route of administration, and negative health effects of medical and recreational marijuana are reviewed. Medical marijuana should be subject to the same rigorous approval process as other medications prescribed by physicians. Legalizing recreational marijuana may have negative public health effects.

Impulsivity, Attention, Memory, and Decision-Making among Adolescent Marijuana Users

PubMed Central

Dougherty, Donald M.; Mathias, Charles W.; Dawes, Michael A.; Furr, R. Michael; Charles, Nora E.; Liguori, Anthony; Shannon, Erin E.; Acheson, Ashley

2012-01-01

Rationale Marijuana is a popular drug of abuse among adolescents, and they may be uniquely vulnerable to resulting cognitive and behavioral impairments. Previous studies have found impairments among adolescent marijuana users. However, the majority of this research has examined measures individually rather than multiple domains in a single cohesive analysis. This study used a logistic regression model that combines performance on a range of tasks to identify which measures were most altered among adolescent marijuana users. Objectives The purpose of this research was to determine unique associations between adolescent marijuana user and performances on multiple cognitive and behavioral domains (attention, memory, decision-making, and impulsivity) in 14- to 17-year-olds while simultaneously controlling for performances across the measures to determine which measures most strongly distinguish marijuana users from non-users. Methods Marijuana-using adolescents (n=45) and controls (n=48) were tested. Logistic regression analyses were conducted to test for: (a) differences between marijuana users and non-users on each measure, (b) associations between marijuana use and each measure after controlling for the other measures, and (c) the degree to which (a) and (b) together elucidated differences among marijuana users and non-users. Results Of all the cognitive and behavioral domains tested, impaired short-term recall memory and consequence sensitivity impulsivity were associated with marijuana use after controlling for performances across all measures. Conclusions This study extends previous findings by identifying cognitive and behavioral impairments most strongly associated with adolescent marijuana users. These specific deficits are potential targets of intervention for this at-risk population. PMID:23138434

Health Risk Behaviors With Synthetic Cannabinoids Versus Marijuana.

PubMed

Clayton, Heather B; Lowry, Richard; Ashley, Carmen; Wolkin, Amy; Grant, Althea M

2017-04-01

Data are limited on the behavioral risk correlates of synthetic cannabinoid use. The purpose of this study was to compare the behavioral risk correlates of synthetic cannabinoid use with those among marijuana users. Data from the 2015 Youth Risk Behavior Survey, a cross-sectional survey conducted in a nationally representative sample of students in grades 9 through 12 ( N = 15 624), were used to examine the association between self-reported type of marijuana use (ie, never use of marijuana and synthetic cannabinoids, ever use of marijuana only, and ever use of synthetic cannabinoids) and self-report of 36 risk behaviors across 4 domains: substance use, injury/violence, mental health, and sexual health. Multivariable models were used to calculate adjusted prevalence ratios. Students who ever used synthetic cannabinoids had a significantly greater likelihood of engaging in each of the behaviors in the substance use and sexual risk domains compared with students who ever used marijuana only. Students who ever used synthetic cannabinoids were more likely than students who ever used marijuana only to have used marijuana before age 13 years, to have used marijuana ≥1 times during the past 30 days, and to have used marijuana ≥20 times during the past 30 days. Several injury/violence behaviors were more prevalent among students who ever used synthetic cannabinoids compared with students who ever used marijuana only. Health professionals and school-based substance use prevention programs should include strategies focused on the prevention of both synthetic cannabinoids and marijuana. Copyright © 2017 by the American Academy of Pediatrics.

Factors associated with early marijuana initiation in a criminal justice population.

PubMed

Savage, Rebekah J; King, Vinetra L; Clark, C Brendan; Cropsey, Karen L

2017-01-01

Initiation of marijuana during adolescence is associated with negative outcomes and is more common among those with criminal justice involvement. We sought to determine demographics, psychosocial factors, mental health factors, and criminal outcomes associated with earlier age at first marijuana use in a criminal justice population. Data from structured, in-person interviews of adults in a criminal corrections program were analyzed. Participants (689 men and women ages 19 and older) were recruited for a larger smoking cessation trial (2009-2013) as a volunteer sample by flyers at a community corrections site. 516 had smoked both nicotine and marijuana and were included in the analysis. We determined associations between self-reported age at first marijuana use and sex, race, income, educational attainment, history of abuse, family problems, psychiatric problems, criminal record, and age of nicotine and alcohol initiation. Of 516 participants, 68% were men, and 64.5% were Black. No participants were of Hispanic ethnicity. Average age of marijuana initiation was 15.1years (SD 3.7years). After linear regression, earlier age at marijuana initiation was associated with male sex and more criminal offenses (person/violent and court). Race and psychiatric problems were not associated with earlier marijuana initiation. Earlier adolescent marijuana initiation is associated with more criminal offenses in a criminal justice population. Men initiate marijuana earlier than women. Adolescents at high risk of justice involvement may benefit from delayed initiation of marijuana, specifically men. Additional studies should examine prevention strategies for adolescent marijuana use that target those at highest risk. Copyright © 2016. Published by Elsevier Ltd.

What Did You Expect?: The Interaction Between Cigarette and Blunt vs. Non-Blunt Marijuana Use among African American Young Adults

PubMed Central

Ramo, Danielle

2017-01-01

Background Marijuana and tobacco co-use is highly prevalent among African American young adults. In an effort to inform prevention and treatment interventions, the current study examined the expectancies around the co-use of marijuana and cigarettes among African American young adults. Methods An anonymous online survey recruited African American adults (N = 111) age 18 to 29 who reported past-month marijuana and cigarette co-use. Participants completed the 14-item Nicotine and Marijuana Interaction Expectancy (NAMIE) Questionnaire, with three scales: (1) marijuana use increases tobacco use and urges, (2) tobacco use increases marijuana use and urges and (3) smoking to cope with marijuana urges. Participants also answered questions about marijuana and tobacco initiation and use. Analyses were conducted separately for blunt co-users (i.e., blunt and cigarette use) and non-blunt co-users (i.e., non-blunt marijuana and cigarette use). Results A majority of co-users (66%) used blunts as a form of co-use. Non-blunt co-users had higher expectancy scores on NAMIE scales 2 and 3 than blunt co-users. However, only blunt co-users showed a positive association between severity of marijuana use and NAMIE scales 2 (p <.01) and 3 (p <.01). Conclusions Findings provide further evidence for the use of the NAMIE and suggest a need to assess and address expectations regarding marijuana and tobacco co-use in prevention and treatment interventions, especially among young African American adults who co-use blunts and cigarettes. PMID:29333104

Capturing Heterogeneity in Medical Marijuana Policies: A Taxonomy of Regulatory Regimes Across the United States.

PubMed

Chapman, Susan A; Spetz, Joanne; Lin, Jessica; Chan, Krista; Schmidt, Laura A

2016-07-28

There is considerable movement in the U.S. to legalize use of cannabis for medicinal purposes. Twenty-three U.S. states and the District of Columbia have laws that decriminalize use of marijuana for medicinal purposes. Most prior studies of state medical marijuana laws and their association with overall marijuana use, adolescent use, crime rates, and alcohol traffic fatalities have used a binary coding of whether the state had a medical marijuana law or not. Mixed results from these studies raise the question of whether this method for measuring policy characteristics is adequate. Our objective was to develop a validated taxonomy of medical marijuana laws that will allow researchers to measure variation in aspects of medical marijuana statutes as well as their overall restrictiveness. We used a modified Delphi technique using detailed and validated data about each state's medical marijuana law. Three senior researchers coded elements of the state laws in initiation of use, quantity allowed, regulations around distribution, and overall restrictiveness. We used 2013 data from the U.S. National Survey on Drug Use and Health to assess validity of the taxonomy. Results indicate substantial state-level variation in medical marijuana policies. Validation analysis supported the taxonomy's validity for all four dimensions with the largest effect sizes for the quantity allowed in the state's medical marijuana policy. This analysis demonstrates the potential importance of nondichotomous measurement of medical marijuana laws in studies of their impact. These findings may also be useful to states that are considering medical marijuana laws, to understand the potential impact of characteristics of those laws.

Altered subjective reward valuation among female heavy marijuana users.

PubMed

Hefner, Kathryn R; Starr, Mark J

2017-02-01

Maladaptive decision-making is a cardinal feature of drug use, contributing to ongoing use, and reflecting alterations in how drug users assess uncertain reward value. Accumulating evidence indicates the consequences of heavy marijuana use are worse for female versus male animals and humans, but research assessing sex differences in reward-related decision-making among marijuana users remains scarce. We examined sex differences in the subjective valuation of certain and uncertain rewards among heavy marijuana users (52; 26 male and 26 female) and controls (52; 26 male and 26 female). We offered male and female heavy marijuana users and controls monetary rewards of certain and uncertain (probabilistic) values. We measured how preferences for uncertain rewards varied by the objective value of those rewards, moderators of reward uncertainty, Marijuana Group and Sex. Men were more sensitive to changes in the objective value of uncertain rewards than women. However, this effect of Sex differed by Marijuana Group. Female heavy marijuana users were more sensitive to changes in uncertain reward value, particularly when the "stakes" were high (i.e., greater difference between potential uncertain rewards), than female controls. Female heavy marijuana users' sensitivity to changes in the value of high stakes uncertain rewards was comparable to male marijuana users and controls. In contrast, male marijuana users' sensitivity to changes in the value of high stakes uncertain rewards did not differ from male controls. These results suggest sex differences in sensitivity to high risk rewards may be one pathway contributing to severer consequences of heavy marijuana use among women. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Altered subjective reward valuation among female heavy marijuana users

PubMed Central

Hefner, Kathryn R.; Starr, Mark. J.

2016-01-01

Maladaptive decision-making is a cardinal feature of drug use, contributing to ongoing use, and reflecting alterations in how drug users assess uncertain reward value. Accumulating evidence indicates the consequences of heavy marijuana use are worse for female versus male animals and humans, but research assessing sex differences in reward-related decision-making among marijuana users remains scarce. We examined sex differences in the subjective valuation of certain and uncertain rewards among heavy marijuana users (52; 26 male and 26 female) and controls (52; 26 male and 26 female). We offered male and female heavy marijuana users and controls monetary rewards of certain and uncertain (probabilistic) values. We measured how preferences for uncertain rewards varied by the objective value of those rewards, moderators of reward uncertainty, marijuana use, and sex. Men were more sensitive to changes in the objective value of uncertain rewards than women. However, this effect of sex differed by marijuana group. Female heavy marijuana users were more sensitive to changes in uncertain reward value, particularly when the ‘stakes’ were high (i.e., greater difference between potential uncertain rewards), than female controls. Female heavy marijuana users’ sensitivity to changes in the value of high stakes uncertain rewards was comparable to male marijuana users and controls. In contrast, male marijuana users’ sensitivity to changes in the value of high stakes uncertain rewards did not differ from male controls. These results suggest sex differences in sensitivity to high risk rewards may be one pathway contributing to severer consequences of heavy marijuana use among women. PMID:27936816

Demographic and socioenvironmental predictors of premorbid marijuana use among patients with first-episode psychosis.

PubMed

Pauselli, Luca; Birnbaum, Michael L; Vázquez Jaime, Beatriz Paulina; Paolini, Enrico; Kelley, Mary E; Broussard, Beth; Compton, Michael T

2018-01-31

We identified, in subjects with first-episode psychosis, demographic and socioenvironmental predictors of three variables pertaining to premorbid marijuana use: age at initiation of marijuana use, trajectories of marijuana use in the five years prior to onset of psychosis, and the cumulative "dose" of marijuana intake in that same premorbid period. We enrolled 247 first-episode psychosis patients and collected data on lifetime marijuana/alcohol/tobacco use, age at onset of psychosis, diverse socioenvironmental variables, premorbid adjustment, past traumatic experiences, perceived neighborhood-level social disorder, and cannabis use experiences. Bivariate tests were used to examine associations between the three premorbid marijuana use variables and hypothesized predictors. Regression models determined which variables remained independently significantly associated. Age at initiation of cigarette smoking was linked to earlier initiation, faster escalation, and higher cumulative dose of premorbid marijuana use. During childhood, poorer academic performance was predictive of an earlier age at initiation of marijuana use, while poorer sociability was related to more rapid escalation to daily use and a higher cumulative dose. As expected, experiencing euphoric effects was positively correlated with trajectories and cumulative dose, but having negative experiences was unrelated. Traumatic childhood/adolescent experiences were correlated with rapid escalation and amount of marijuana used, but not with age at initiation of marijuana use. These data expand the very limited literature on predictors of premorbid marijuana use in first-episode psychosis. Given its association with earlier age at onset of psychosis, and poorer outcomes among first-episode patients, prevention and treatment efforts should be further developed. Copyright © 2018 Elsevier B.V. All rights reserved.

Physicians-in-training are not prepared to prescribe medical marijuana.

PubMed

Evanoff, Anastasia B; Quan, Tiffany; Dufault, Carolyn; Awad, Michael; Bierut, Laura Jean

2017-11-01

While medical marijuana use is legal in more than half of U.S. states, evidence is limited about the preparation of physicians-in-training to prescribe medical marijuana. We asked whether current medical school and graduate medical educational training prepare physicians to prescribe medical marijuana. We conducted a national survey of U.S. medical school curriculum deans, a similar survey of residents and fellows at Washington University in St. Louis, and a query of the Association of American Medical Colleges (AAMC) Curriculum Inventory database for keywords associated with medical marijuana. Surveys were obtained from 101 curriculum deans, and 258 residents and fellows. 145 schools were included in the curriculum search. The majority of deans (66.7%) reported that their graduates were not at all prepared to prescribe medical marijuana, and 25.0% reported that their graduates were not at all prepared to answer questions about medical marijuana. The vast majority of residents and fellows (89.5%) felt not at all prepared to prescribe medical marijuana, while 35.3% felt not at all prepared to answer questions, and 84.9% reported receiving no education in medical school or residency on medical marijuana. Finally, only 9% of medical school curriculums document in the AAMC Curriculum Inventory database content on medical marijuana. Our study highlights a fundamental mismatch between the state-level legalization of medical marijuana and the lack of preparation of physicians-in-training to prescribe it. With even more states on the cusp of legalizing medical marijuana, physician training should adapt to encompass this new reality of medical practice. Copyright © 2017 Elsevier B.V. All rights reserved.

The Effects of Medical Marijuana Laws on Potency

PubMed Central

Pacula, Rosalie Liccardo; Heaton, Paul

2014-01-01

Background Marijuana potency has risen dramatically over the past two decades. In the United States, it is unclear whether state medical marijuana policies have contributed to this increase. Methods Employing a differences-in-differences model within a mediation framework, we analyzed data on n = 39,157 marijuana samples seized by law enforcement in 51 U.S. jurisdictions between 1990-2010, producing estimates of the direct and indirect effects of state medical marijuana laws on potency, as measured by Δ9-tetrahydrocannabinol content. Results We found evidence that potency increased by a half percentage point on average after legalization of medical marijuana, although this result was not significant. When we examined specific medical marijuana supply provisions, results suggest that legal allowances for retail dispensaries had the strongest influence, significantly increasing potency by about one percentage point on average. Our mediation analyses examining the mechanisms through which medical marijuana laws influence potency found no evidence of direct regulatory impact. Rather, the results suggest that the impact of these laws occurs predominantly through a compositional shift in the share of the market captured by high-potency sinsemilla. Conclusion Our findings have important implications for policymakers and those in the scientific community trying to understand the extent to which greater availability of higher potency marijuana increases the risk of negative public health outcomes, such as drugged driving and drug-induced psychoses. Future work should reconsider the impact of medical marijuana laws on health outcomes in light of dramatic and ongoing shifts in both marijuana potency and the medical marijuana policy environment. PMID:24502887

Marijuana Smoking in Patients With Leukemia.

PubMed

Khwaja, Sara; Yacoub, Abraham; Cheema, Asima; Rihana, Nancy; Russo, Robin; Velez, Ana Paula; Nanjappa, Sowmya; Sandin, Ramon L; Bohra, Chandrashekar; Gajanan, Ganesh; Greene, John N

2016-07-01

Worldwide, marijuana (cannabis) is a widely used drug. The incidence of marijuana smoking is increasing and is second only to tobacco as the most widely smoked substance in the general population. It is also the second most commonly used recreational drug after alcohol. Some adverse effects of marijuana smoking have been documented; however, the number of studies on the pulmonary effects of marijuana in individuals with leukemia is limited. In our case series, we report on 2 men with acute myeloid leukemia with miliary nodular lung patterns on computed tomography of the chest due to heavy marijuana use. We also report on 2 patients with acute lymphocytic leukemia who had a history of smoking marijuana and then developed lung opacities consistent with mold infection.

High Time for Conservation: Adding the Environment to the Debate on Marijuana Liberalization.

PubMed

Carah, Jennifer K; Howard, Jeanette K; Thompson, Sally E; Short Gianotti, Anne G; Bauer, Scott D; Carlson, Stephanie M; Dralle, David N; Gabriel, Mourad W; Hulette, Lisa L; Johnson, Brian J; Knight, Curtis A; Kupferberg, Sarah J; Martin, Stefanie L; Naylor, Rosamond L; Power, Mary E

2015-08-01

The liberalization of marijuana policies, including the legalization of medical and recreational marijuana, is sweeping the United States and other countries. Marijuana cultivation can have significant negative collateral effects on the environment that are often unknown or overlooked. Focusing on the state of California, where by some estimates 60%-70% of the marijuana consumed in the United States is grown, we argue that (a) the environmental harm caused by marijuana cultivation merits a direct policy response, (b) current approaches to governing the environmental effects are inadequate, and (c) neglecting discussion of the environmental impacts of cultivation when shaping future marijuana use and possession policies represents a missed opportunity to reduce, regulate, and mitigate environmental harm.

High Time for Conservation: Adding the Environment to the Debate on Marijuana Liberalization

PubMed Central

Carah, Jennifer K.; Howard, Jeanette K.; Thompson, Sally E.; Short Gianotti, Anne G.; Bauer, Scott D.; Carlson, Stephanie M.; Dralle, David N.; Gabriel, Mourad W.; Hulette, Lisa L.; Johnson, Brian J.; Knight, Curtis A.; Kupferberg, Sarah J.; Martin, Stefanie L.; Naylor, Rosamond L.; Power, Mary E.

2015-01-01

The liberalization of marijuana policies, including the legalization of medical and recreational marijuana, is sweeping the United States and other countries. Marijuana cultivation can have significant negative collateral effects on the environment that are often unknown or overlooked. Focusing on the state of California, where by some estimates 60%–70% of the marijuana consumed in the United States is grown, we argue that (a) the environmental harm caused by marijuana cultivation merits a direct policy response, (b) current approaches to governing the environmental effects are inadequate, and (c) neglecting discussion of the environmental impacts of cultivation when shaping future marijuana use and possession policies represents a missed opportunity to reduce, regulate, and mitigate environmental harm. PMID:26955083

Young People’s More Permissive Views About Marijuana: Local Impact of State Laws or National Trend?

PubMed Central

Jacobs, Laurie M.; Spetz, Joanne

2016-01-01

Objectives. To determine whether state medical marijuana laws “send the wrong message,” that is, have a local influence on the views of young people about the risks of using marijuana. Methods. We performed multilevel, serial, cross-sectional analyses on 10 annual waves of the US National Survey on Drug Use and Health (2004–2013) nationally and for states with marijuana laws using individual- and state-level controls. Results. Living in medical marijuana states was associated with more permissive views regarding marijuana across 5 different measures. However, these associations became non–statistically significant after we adjusted for state-level differences. By contrast, there was a consistent and significant national time trend toward more permissive attitudes, which was less pronounced among children of middle school age than it was among their older counterparts. Conclusions. Passing medical marijuana laws does not seem to directly affect the views of young people in medical marijuana states. However, there is a national trend toward young people taking more permissive views about marijuana independent of any effects within states. PMID:27196657

Longitudinal Relationships Among Perceived Injunctive and Descriptive Norms and Marijuana Use

PubMed Central

Napper, Lucy E.; Kenney, Shannon R.; Hummer, Justin F.; Fiorot, Sara; LaBrie, Joseph W.

2016-01-01

Objective: The current study uses longitudinal data to examine the relative influence of perceived descriptive and injunctive norms for proximal and distal referents on marijuana use. Method: Participants were 740 undergraduate students (67% female) who completed web-based surveys at two time points 12 months apart. Time 1 measures included reports of marijuana use, approval, perceived descriptive norms, and perceived injunctive norms for the typical student, close friends, and parents. At Time 2, students reported on their marijuana use. Results: Results of a path analysis suggest that, after we controlled for Time 1 marijuana use, greater perceived friend approval indirectly predicted Time 2 marijuana use as mediated by personal approval. Greater perceived parental approval was both indirectly and directly associated with greater marijuana use at follow-up. Perceived typical-student descriptive norms were neither directly nor indirectly related to Time 2 marijuana use. Conclusions: The findings support the role of proximal injunctive norms in predicting college student marijuana use up to 12 months later. The results indicate the potential importance of developing normative interventions that incorporate the social influences of proximal referents. PMID:27172578

Working Memory and Impulsivity Predict Marijuana-Related Problems Among Frequent Users

PubMed Central

Day, Anne M.; Metrik, Jane; Spillane, Nichea S.; Kahler, Christopher W.

2012-01-01

Background Although marijuana is the most commonly used illicit substance in the US, only a small portion of users go on to develop dependence, suggesting that there are substantial individual differences in vulnerability to marijuana-related problems among users. Deficits in working memory and high trait impulsivity are two factors that may place marijuana users at increased risk for experiencing related problems. Methods Using baseline data from an experimental study that recruited 104 frequent marijuana users (M=71.86% of prior 60 days, SD=22%), we examined the associations of working memory and trait impulsivity with marijuana-related problems. Results Lower working memory, as measured by Trail Making Test B, but not short-term memory capacity, predicted more marijuana-related problems. Higher trait impulsivity scores were independently associated with greater number of problems. Conclusions Results suggest that marijuana users with reduced executive cognitive ability are more susceptible to developing problems related to their use. Trait impulsivity and executive working memory appear to be independent risk factors for experiencing marijuana-related problems. PMID:23312340

Age of onset of marijuana use and executive function.

PubMed

Gruber, Staci A; Sagar, Kelly A; Dahlgren, Mary Kathryn; Racine, Megan; Lukas, Scott E

2012-09-01

Marijuana (MJ) remains the most widely abused illicit substance in the United States, and in recent years, a decline in perceived risk of MJ use has been accompanied by a simultaneous increase in rates of use among adolescents. In this study, the authors hypothesized that chronic MJ smokers would perform cognitive tasks, specifically those that require executive function, more poorly than control subjects and that individuals who started smoking MJ regularly prior to age 16 (early onset) would have more difficulty than those who started after age 16 (late onset). Thirty-four chronic, heavy MJ smokers separated into early and late onset groups, and 28 non-MJ smoking controls completed a battery of neurocognitive measures. As hypothesized, MJ smokers performed more poorly than controls on several measures of executive function. Age of onset analyses revealed that these between-group differences were largely attributed to the early onset group, who were also shown to smoke twice as often and nearly 3 times as much MJ per week relative to the late onset smokers. Age of onset, frequency, and magnitude of MJ use were all shown to impact cognitive performance. Findings suggest that earlier MJ onset is related to poorer cognitive function and increased frequency and magnitude of MJ use relative to later MJ onset. Exposure to MJ during a period of neurodevelopmental vulnerability, such as adolescence, may result in altered brain development and enduring neuropsychological changes. PsycINFO Database Record (c) 2012 APA, all rights reserved.

Citicoline Treatment Improves Measures of Impulsivity and Task Performance in Chronic Marijuana Smokers: A Pilot BOLD fMRI Study

PubMed Central

Gruber, Staci A.; Sagar, Kelly A.; Dahlgren, Mary Kathryn; Gonenç, Atilla; Conn, Nina A.; Winer, Jeffrey P.; Penetar, David; Lukas, Scott E.

2015-01-01

Objective Citicoline is an endogenous nucleotide that has historically been used to treat stroke, traumatic brain injury, and cognitive dysfunction. Research has also shown that citicoline treatment is associated with improved cognitive performance in substance-abusing populations. We hypothesized that marijuana (MJ) smokers who received citicoline would demonstrate improvement in cognitive performance as well as increased neural efficiency during tasks of cognitive control relative to those who received placebo. Method The current study tested this hypothesis by examining the effects of citicoline in treatment-seeking chronic MJ smokers. In an 8-week double-blind, placebo-controlled study, 19 MJ smokers were randomly assigned via a double-blind procedure to the citicoline (8 Males, 2 Females) or placebo group (9 Males, 0 Females). All participants completed fMRI scanning at baseline and after 8 weeks of treatment during two cognitive measures of inhibitory processing, the Multi Source Interference Test (MSIT) and Stroop Color Word Test, and also completed the Barratt Impulsiveness Scale (BIS-11), a self-report measure of impulsivity. Results Following the 8 week trial, MJ smokers treated with citicoline demonstrated significantly lower levels of behavioral impulsivity, improved task accuracy on both the MSIT and Stroop tasks, and exhibited significantly different patterns of brain activation relative to baseline levels and relative to those who received placebo. Conclusions Findings suggest that citicoline may facilitate the treatment of MJ use disorders by improving the cognitive skills necessary to fully engage in comprehensive treatment programs. PMID:26658924

Medical marijuana: Legal and regulatory considerations.

PubMed

Kaplan, Louise

2015-10-16

Nearly half of the United States has legalized medical marijuana. Advanced practice registered nurses (APRNs) in six states can authorize patients for medical marijuana use. Knowledge of legal and regulatory aspects of medical marijuana laws will protect an APRN's license and the public.

Shifting Drug Policy: The Politics of Marijuana in the 21st Century

DTIC Science & Technology

2014-03-01

SUBJECT TERMS Marijuana, medical marijuana, drug war, cannabis , Controlled Substances Act, international drug policy. 15. NUMBER OF PAGES 97 16...unlimited 12b. DISTRIBUTION CODE A 13. ABSTRACT (maximum 200 words) Medical and recreational marijuana legalization, and public acceptance, is in a...rapid state of change across the nation. Currently, there are 20 states along with the District of Colombia that have medical marijuana laws. Each

Marijuana in the management of amyotrophic lateral sclerosis.

PubMed

Carter, G T; Rosen, B S

2001-01-01

Marijuana has been proposed as treatment for a widening spectrum of medical conditions. Marijuana is a substance with many properties that may be applicable to the management of amyotrophic lateral sclerosis (ALS). These include analgesia, muscle relaxation, bronchodilation, saliva reduction, appetite stimulation, and sleep induction. In addition, marijuana has now been shown to have strong antioxidative and neuroprotective effects, which may prolong neuronal cell survival. In areas where it is legal to do so, marijuana should be considered in the pharmacological management of ALS. Further investigation into the usefulness of marijuana in this setting is warranted.

Policy Reform with Marijuana Use: Weighing Risks and Benefits.

PubMed

Nkemdirim Okere, Arinze

2018-03-01

With the current legalization of medical marijuana and the possibility of recreational use being permitted in some states, the health care benefits associated with the use of marijuana is questionable. States that are on the path of legalizing marijuana, should recognize that as there are perceived positive benefits, there are also many evidence-based negative health consequences which may result in negative economic and societal consequences. As more data on health outcomes regarding the use of marijuana continue to emerge, policies directed toward legalizing marijuana, whether medical or recreational, should consider protecting the society from both harm and societal cost.

Estimating the association between metabolic risk factors and marijuana use in U.S. adults using data from the continuous National Health and Nutrition Examination Survey.

PubMed

Thompson, Christin Ann; Hay, Joel W

2015-07-01

More research is needed on the health effects of marijuana use. Results of previous studies indicate that marijuana could alleviate certain factors of metabolic syndrome, such as obesity. Data on 6281 persons from National Health and Nutrition Examination Survey from 2005 to 2012 were used to estimate the effect of marijuana use on cardiometabolic risk factors. The reliability of ordinary least squares (OLS) regression models was tested by replacing marijuana use as the risk factor of interest with alcohol and carbohydrate consumption. Instrumental variable methods were used to account for the potential endogeneity of marijuana use. OLS models show lower fasting insulin, insulin resistance, body mass index, and waist circumference in users compared with nonusers. However, when alcohol and carbohydrate intake substitute for marijuana use in OLS models, similar metabolic benefits are estimated. The Durbin-Wu-Hausman tests provide evidence of endogeneity of marijuana use in OLS models, but instrumental variables models do not yield significant estimates for marijuana use. These findings challenge the robustness of OLS estimates of a positive relationship between marijuana use and fasting insulin, insulin resistance, body mass index, and waist circumference. Copyright © 2015 Elsevier Inc. All rights reserved.

Comparison of outcome expectancies for synthetic cannabinoids and botanical marijuana.

PubMed

Lauritsen, Kirstin J; Rosenberg, Harold

2016-07-01

Although initially developed for medical purposes, synthetic cannabinoids have also been consumed for recreational purposes. To evaluate whether agreement with positive and negative outcome expectancies differed for synthetic cannabinoids versus botanical marijuana, and assess reported reasons for using synthetic cannabinoids. Using a web-based recruitment and data collection procedure, 186 adults who had used both synthetic cannabinoids and botanical marijuana and 181 adults who had used botanical marijuana but not synthetic cannabinoids, completed measures of outcome expectancies and other relevant questionnaires. A significant interaction revealed that participants who had used both synthetic cannabinoids and botanical marijuana indicated lower agreement with positive expectancies for synthetic cannabinoids, and higher agreement with positive expectancies for botanical marijuana, than did those participants who used only botanical marijuana. There was no interaction between type of drug and use history on agreement with negative expectancies, and participants agreed more strongly with negative outcome expectancies for synthetic cannabinoids than for botanical marijuana whether they had used one or both types of these drugs. The most frequently provided reasons for using synthetic cannabinoids included availability, perceived legality, cost, curiosity, and social interaction. Given growing public acceptance of recreational and medical marijuana, coupled with negative perceptions and increasing regulation of synthetic cannabinoid compounds, botanical marijuana is likely to remain more available and more popular than synthetic cannabinoids.

Adverse impact of marijuana use on clinical outcomes among psychiatry patients with depression and alcohol use disorder.

PubMed

Bahorik, Amber L; Campbell, Cynthia I; Sterling, Stacy A; Leibowitz, Amy; Travis, Adam; Weisner, Constance M; Satre, Derek D

2018-01-01

This study examined whether marijuana use was associated with clinically problematic outcomes for patients with depression and alcohol use disorder (AUD). The sample consisted of 307 psychiatry outpatients with mild to severe depression and past 30-day hazardous drinking/drug use, who participated in a trial of substance use treatment. Participants were assessed for AUD based on DSM-IV criteria. Measures of marijuana use, depression symptoms, and functional status related to mental health were collected at baseline, 3, and 6 months. Differences in these outcomes were analyzed among patients with and without AUD using growth models, adjusting for treatment effects. Marijuana was examined as both an outcome (patterns of use) and a predictor (impact on depression and functioning). Forty percent used marijuana and about half the sample met AUD criteria. Fewer patients with AUD used marijuana than those without AUD at baseline. Over 6 months, the proportion of patients with AUD using marijuana increased compared to those without AUD. Patients with AUD using marijuana had greater depressive symptoms and worse functioning than those without AUD. These findings indicate that marijuana use is clinically problematic for psychiatry outpatients with depression and AUD. Addressing marijuana in the context of psychiatry treatment may help improve outcomes. Copyright © 2017 Elsevier B.V. All rights reserved.

Historical change in the link between adolescent deviance proneness and marijuana use, 1979-2004.

PubMed

Little, Michelle; Weaver, Scott R; King, Kevin M; Liu, Freda; Chassin, Laurie

2008-03-01

We examined historical change in the association between adolescent deviance proneness and marijuana use using 26 years (from 1979 through 2004) of national 12th grade data from the Monitoring the Future (MTF) study. "Deviance proneness" was measured using a latent factor model of behavioral and personality characteristics that underlie both substance use and antisocial disorders. Marijuana use was measured both in terms of annual frequency of use and degree of involvement with marijuana. Separate within-gender structural equation models were used to determine whether links between deviance proneness and marijuana use were consistently significant and invariant in magnitude across 13 two-year historical cohorts. Overall results affirmed the established association between adolescent deviance proneness and both the frequency of marijuana use as well as regular use. Among male youth, the size of the association between deviance proneness and marijuana use was significantly smaller at the cohort of lowest population prevalence (1991/92) compared to cohorts marking peaks in marijuana use prevalence, thus suggesting a "softening" historical trend. By contrast, the prediction of female marijuana use from deviance proneness was not consistently related to historical shifts in population prevalence of marijuana use. Study findings point to the utility of risk-focused prevention programming that targets early precursors of both antisocial and substance use disorders.

Epidemiologic review of marijuana use and cancer risk.

PubMed

Hashibe, Mia; Straif, Kurt; Tashkin, Donald P; Morgenstern, Hal; Greenland, Sander; Zhang, Zuo-Feng

2005-04-01

Marijuana is the most commonly used illegal drug in the United States and is considered by young adults to be the illicit drug with the least risk. On the other hand, marijuana smoke contains several of the same carcinogens and co-carcinogens as the tar from tobacco, raising concerns that smoking of marijuana may be a risk factor for tobacco-related cancers. We reviewed two cohort studies and 14 case-control studies with assessment of the association of marijuana use and cancer risk. In the cohort studies, increased risks of lung or colorectal cancer due to marijuana smoking were not observed, but increased risks of prostate and cervical cancers among non-tobacco smokers, as well as adult-onset glioma among tobacco and non-tobacco smokers, were observed. The 14 case-control studies included four studies on head and neck cancers, two studies on lung cancer, two studies on non-Hodgkin's lymphoma, one study on anal cancer, one study on penile cancer, and four studies on childhood cancers with assessment of parental exposures. Zhang and colleagues reported that marijuana use may increase risk of head and neck cancers in a hospital-based case-control study in the United States, with dose-response relations for both frequency and duration of use. However, Rosenblatt and co-workers reported no association between oral cancer and marijuana use in a population-based case-control study. An eightfold increase in risk among marijuana users was observed in a lung cancer study in Tunisia. However, there was no assessment of the dose response, and marijuana may have been mixed with tobacco. Parental marijuana use during gestation was associated with increased risks of childhood leukemia, astrocytoma, and rhabdomyosarcoma, but dose-response relations were not assessed. In summary, sufficient studies are not available to adequately evaluate marijuana impact on cancer risk. Several limitations of previous studies include possible underreporting where marijuana use is illegal, small sample sizes, and too few heavy marijuana users in the study sample. Recommendations for future studies are to (1) focus on tobacco-related cancer sites; (2) obtain detailed marijuana exposure assessment, including frequency, duration, and amount of personal use as well as mode of use (smoked in a cigarette, pipe, or bong; taken orally); (3) adjust for tobacco smoking and conduct analyses on nonusers of tobacco; and (4) conduct larger studies, meta-analyses, or pooled analyses to maximize statistical precision and investigate sources of differences in results. Despite the challenges, elucidation of the association between marijuana use and cancer risk is important in weighing the benefits and risks of medical marijuana use and to clarify the impact of marijuana use on public health.

Family and parenting characteristics associated with marijuana use by Chilean adolescents

PubMed Central

Bares, Cristina B; Delva, Jorge; Grogan-Kaylor, Andrew; Andrade, Fernando

2011-01-01

Objective Family involvement and several characteristics of parenting have been suggested to be protective factors for adolescent substance use. Some parenting behaviors may have stronger relationships with adolescent behavior while others may have associations with undesirable behavior among youth. Although it is generally acknowledged that families play an important role in the lives of Chilean adolescents, scant research exists on how different family and parenting factors may be associated with marijuana use and related problems in this population which has one of the highest rates of drug use in Latin America. Methods Using logistic regression and negative binomial regression, we examined whether a large number of family and parenting variables were associated with the possibility of Chilean adolescents ever using marijuana, and with marijuana-related problems. Analyses controlled for a number of demographic and peer-related variables. Results Controlling for other parenting and family variables, adolescent reports of parental marijuana use showed a significant and positive association with adolescent marijuana use. The multivariate models also revealed that harsh parenting by fathers was the only family variable associated with the number of marijuana-related problems youth experienced. Conclusion Of all the family and parenting variables studied, perceptions of parental use of marijuana and harsh parenting by fathers were predictors for marijuana use, and the experience of marijuana-related problems. Prevention interventions need to continue emphasizing the critical socializing role that parental behavior plays in their children’s development and potential use of marijuana. PMID:21660209

The Impact of Marijuana Legalization on Adolescent Use, Consequences, and Perceived Risk.

PubMed

Estoup, Ashley C; Moise-Campbell, Claudine; Varma, Malini; Stewart, David G

2016-12-05

Currently, only four states have legalized recreational marijuana use for adults over 21 years of age. Therefore, little is known about the influence that legalization will have on adolescent marijuana use. This study examines how marijuana legalization has impacted the frequency and consequences of adolescent use in a sample of participants in a school-based, substance use intervention. We hypothesized that adolescents enrolled in the intervention in years after marijuana legalization would present with more problematic use compared to those enrolled prior, and that changes in the perceived risk of marijuana would be a mechanism of problematic use. Participants were 262 students enrolled in a school-based substance use intervention in 2010 to 2015. The Customary Drinking and Drug Use Record, Alcohol and Drug Use Consequences Questionnaire, and a decisional balance matrix were used to assess marijuana frequency, negative consequences, and perceived risk of use. A mediation model was used to test the degree to which marijuana legalization may lead to increased frequency and consequences of use through perceived risk. Findings indicated a significantly positive correlation between marijuana-related consequences and perceived risk post legalization. Despite relatively equal use between both groups, adolescents in the legalization group experienced higher levels of perceived risk and increased negative consequences. Due to the rising legalization status of marijuana in the United States, it is imperative that psychoeducation is provided to adults and adolescents about the consequences of underage marijuana use.

Marijuana use trajectories and academic outcomes among college students.

PubMed

Suerken, Cynthia K; Reboussin, Beth A; Egan, Kathleen L; Sutfin, Erin L; Wagoner, Kimberly G; Spangler, John; Wolfson, Mark

2016-05-01

Marijuana is the most commonly used illicit drug by college students. Prior studies have established an association between marijuana use and poor academic performance in college, but research on the frequency of marijuana use over the entire college career is limited. The study objective was to examine the association of marijuana use trajectories on academic outcomes, including senior year enrollment, plans to graduate on time, and GPA. Data were collected from a cohort of 3146 students from 11 colleges in North Carolina and Virginia at six time points across the college career. Group-based trajectory models were used to characterize longitudinal marijuana use patterns during college. Associations between marijuana trajectory groups and academic outcomes were modeled using random-effects linear and logistic regressions. Five marijuana trajectory groups were identified: non-users (69.0%), infrequent users (16.6%), decreasing users (4.7%), increasing users (5.8%), and frequent users (3.9%). Decreasing users and frequent users were more likely to drop out of college and plan to delay graduation when compared to non-users. All marijuana user groups reported lower GPAs, on average, than non-users. These results identify marijuana use patterns that put students at risk for poor academic performance in college. Students who use marijuana frequently at the beginning of the college career are especially at risk for lower academic achievement than non-users, suggesting that early intervention is critical. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Availability of tobacco products associated with use of marijuana cigars (blunts).

PubMed

Lipperman-Kreda, Sharon; Lee, Juliet P; Morrison, Chris; Freisthler, Bridget

2014-01-01

This study examines factors associated with availability of tobacco products for marijuana cigars (i.e., blunts) in 50 non-contiguous mid-sized California communities. The study is based on data collected in 943 tobacco outlets. Neighborhood demographics, community adult marijuana prevalence, medical marijuana policy and access to medical marijuana dispensaries and delivery services were included. Multilevel logistic regression analyses indicated that compared with small markets, availability of tobacco products associated with use of blunts was significantly higher in convenience stores, smoke/tobacco shops and liquor stores. None of the neighborhood demographics were associated with availability of blunt wrappers and only a small percent of Whites was positively associated with availability of blunt cigars, small cigars or cigarillos at the store. Controlling for outlet type and neighborhood demographics, higher city prevalence of adult marijuana use was associated with greater availability of blunt wrappers. Also, policy that permits medical marijuana dispensaries or private cultivation was positively associated with availability of tobacco products for blunts. Density of medical marijuana dispensaries and delivery services, however, was negatively associated with greater availability of these products at tobacco outlets. Results suggest that availability of tobacco products associated with blunts is similar in neighborhoods with different socioeconomic status and racial and ethnic composition. Results also suggest the important role that community norms that support marijuana use or legalization of medical marijuana and medical marijuana policy may play in increasing availability of tobacco products associated with blunts. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Availability of Tobacco Products Associated with Use of Marijuana Cigars (Blunts)

PubMed Central

Juliet, P. Lee; Morrison, Chris; Bridget, Freisthler

2013-01-01

Objectives This study examines factors associated with availability of tobacco products for marijuana cigars (i.e., blunts) in 50 non-contiguous mid-sized California communities. Methods The study is based on data collected in 943 tobacco outlets. Neighborhood demographics, community adult marijuana prevalence, medical marijuana policy and access to medical marijuana dispensaries and delivery services were included. Results Multilevel logistic regression analyses indicated that compared with small markets, availability of tobacco products associated with use of blunts was significantly higher in convenience stores, smoke/tobacco shops and liquor stores. None of the neighborhood demographics were associated with availability of blunt wrappers and only a small percent of Whites was positively associated with availability of blunt cigars, small cigars or cigarillos at the store. Controlling for outlet type and neighborhood demographics, higher city prevalence of adult marijuana use was associated with greater availability of blunt wrappers. Also, policy that permits medical marijuana dispensaries or private cultivation was positively associated with availability of tobacco products for blunts. Density of medical marijuana dispensaries and delivery services, however, was negatively associated with greater availability of these products at tobacco outlets. Conclusions Results suggest that availability of tobacco products associated with blunts is similar in neighborhoods with different socioeconomic status and racial and ethnic composition. Results also suggest the important role that community norms that support marijuana use or legalization of medical marijuana and medical marijuana policy may play in increasing availability of tobacco products associated with blunts. PMID:24290366

Surveying Lactation Professionals Regarding Marijuana Use and Breastfeeding.

PubMed

Bergeria, Cecilia L; Heil, Sarah H

2015-09-01

Breastfeeding is associated with substantial benefits for both the child and mother. Most guidelines state that women who use illicit drugs should not breastfeed. Although this recommendation has traditionally included marijuana, this drug's changing legal status and the limited scientific research regarding marijuana's effect on breastfeeding and the nursing child may lead to varying recommendations made by lactation professionals to clients who use marijuana. Additionally, to our knowledge, there are no data estimating the prevalence of marijuana use among breastfeeding women, making it unclear how common it is. This study assessed recommendations around breastfeeding and marijuana use and estimated the prevalence of marijuana use among breastfeeding women. A convenience sample of lactation professionals who practice throughout New England and were attending the 2014 Vermont Lactation Consultant Association conference was offered the opportunity to complete a five-item survey. Of 120 conference attendees, 74 completed the survey. Forty-four percent reported their recommendations around breastfeeding and marijuana use depended on factors like the severity of maternal use. Another 41% reported recommending continued breastfeeding because the benefits outweigh the harms. The remaining 15% reported recommending that a woman should stop breastfeeding if she cannot stop using marijuana. Survey completers estimated that 15% (1,203/7,843) of their breastfeeding clients in the past year used marijuana. Lactation professionals vary widely in their recommendations to breastfeeding clients who use marijuana. The estimate of prevalence also suggests this is a relatively common issue. More research is needed to assess the generalizability of these findings.

Implications of marijuana legalization for adolescent substance use.

PubMed

Hopfer, Christian

2014-01-01

Marijuana that is legally available for adults has multiple implications for adolescent substance use. One potential effect that legalization may have is an increase in adolescent use to due increased availability, greater social acceptance, and possibly lower prices. Legalization may also facilitate the introduction of new formulations of marijuana (edible, vaporized) and with potentially higher potencies. It is unknown what adolescent consumption patterns will be if marijuana is widely available and marketed in different forms, or what effects different patterns of adolescent use will have on cognition, the development of marijuana use disorders, school performance, and the development of psychotic illnesses. Also unclear is whether adolescent users will be experiencing higher levels of tetrahydrocannabinol (THC) compared with previous generations of users due to higher potencies. Although previous studies of the effects of adolescent marijuana use provide some guidance for current policy and public health recommendations, many new studies will be needed that answer questions in the context of use within a legal adult environment. Claims that marijuana has medicinal benefits create additional challenges for adolescent prevention efforts, as they contrast with messages of its harmfulness. Prevention and treatment approaches will need to address perceptions of the safety of marijuana, claims of its medicinal use, and consider family-wide effects as older siblings and parents may increasingly openly consume and advocate for marijuana use. Guidance for primary care physicians will be needed regarded screening and counseling. Widespread legalization and acceptance of marijuana implies that as law enforcement approaches for marijuana control decline, public health, medical, and scientific efforts to understand and reduce negative consequences of adolescent marijuana use need to be substantially increased to levels commensurate with those efforts for tobacco and alcohol.

Differences in behavioral health disorders and unmet treatment needs between medical marijuana users and recreational marijuana users: Results from a national adult sample.

PubMed

Park, Ji-Yeun; Wu, Li-Tzy

2017-11-01

Available data suggest that medical marijuana users may have more mental health problems than recreational marijuana users. There is limited information about differences in behavioral health disorders and unmet treatment needs between medical and recreational marijuana users. We compared past-year prevalence of behavioral health disorders and unmet treatment needs across three marijuana subgroups (recreational use only, medical use only, and both). Sex-stratified logistic regression was performed to determine their associations with marijuana use status. We analyzed data from adults (≥18 years) who used marijuana in the past year (N=15,440) from 2013 to 2014 National Surveys on Drug Use and Health. Among 15,440 past-year marijuana users, 90.2% used recreational marijuana only, 6.2% used medical marijuana only, and 3.6% used both. Both users had the highest prevalence of behavioral health disorders and unmet treatment needs overall, with no significant sex differences. In the sex-specific logistic regression analysis, medical only users and both users showed somewhat different patterns of associations (reference group=recreational only users). Medical only users had decreased odds of alcohol or drug use disorders, and unmet need for alcohol or drug treatment among males and females. Additionally, female medical only users had decreased odds of opioid use disorder. Both users had increased odds of major depressive episode, hallucinogen use disorder, and unmet need for mental health services among males, and cocaine use disorder among females. Different approaches tailored to individuals' sex and motives for marijuana use is needed for the prevention and treatment of behavioral health problems. Copyright © 2017 Elsevier B.V. All rights reserved.

Legalization of recreational marijuana and community sales policy in Oregon: Impact on adolescent willingness and intent to use, parent use, and adolescent use.

PubMed

Rusby, Julie C; Westling, Erika; Crowley, Ryann; Light, John M

2018-02-01

Studies investigating the impact of medical marijuana legalization have found no significant changes in adolescent use. In one of the few studies focused on recreational marijuana, we investigated how recreational marijuana legalization and community sales policy influenced factors that likely impact youth use (youth willingness and intent to use, parent use) as well as youth use. Legalization of recreational marijuana in Oregon coincided with our study on adolescent substance use. Cohort 1 transitioned from 8th to 9th grade prior to legalization and Cohort 2 made this transition during legalization (N = 444; 53% female). Communities were allowed to opt out of sales. Multivariate linear regression models estimated the impact of legalization and community sales policy on changes in attitudes and parent use (2 time points 1 year apart). Zero-inflated Poisson growth curve models estimated the effects on initial levels and rate of change from 8th through 9th grade (4 time points). In communities opting out of sales, the prior-to-legalization cohort was less likely to increase their willingness and intent to use marijuana, and the legalization cohort was more likely to increase intent to use. For youth who used marijuana, legalization was associated with increased use, and those in communities opting out of sales had greater growth in marijuana use. Community policy appears to impact youth attitudes toward, and use of, marijuana. Results suggest that legalization of recreational marijuana did not increase marijuana use for youth who did not use marijuana but did increase use in youth who were already using. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Toking, Vaping, and Eating for Health or Fun: Marijuana Use Patterns in Adults, U.S., 2014.

PubMed

Schauer, Gillian L; King, Brian A; Bunnell, Rebecca E; Promoff, Gabbi; McAfee, Timothy A

2016-01-01

Policies legalizing marijuana for medical and recreational use have been increasing in the U.S. Considering the potential impact of these policies, important knowledge gaps exist, including information about the prevalence of various modes of marijuana use (e.g., smoked in joints, bowls, bongs; consumed in edibles or drinks) and about medical versus recreational use. Accordingly, this study assessed (1) prevalence and correlates of modes of current and ever marijuana use and (2) prevalence of medicinal and recreational marijuana use in U.S. adults. Data came from Summer Styles (n=4,269), a nationally representative consumer panel survey of adults aged ≥18 years, collected in 2014. The survey asked about past 30-day (current) and ever mode of marijuana use and current reason for use (medicinal, recreational, both). Weighted prevalence estimates were computed and correlates were assessed in 2014 using logistic regression. Overall, 7.2% of respondents reported current marijuana use; 34.5% reported ever use. Among current users, 10.5% reported medicinal-only use, 53.4% reported recreational-only use, and 36.1% reported both. Use of bowl or pipe (49.5%) and joint (49.2%) predominated among current marijuana users, with lesser use of bong, water pipe, or hookah (21.7%); blunts (20.3%); edibles/drinks (16.1%); and vaporizers (7.6%); 92.1% of the sample reported combusted-only marijuana use. Combusted modes of marijuana use are most prevalent among U.S. adults, with a majority using marijuana for recreation. In light of changing policies and patterns of use, improved marijuana surveillance is critical for public health planning. Copyright © 2016 American Journal of Preventive Medicine. All rights reserved.

Comparison of the Analgesic Effects of Dronabinol and Smoked Marijuana in Daily Marijuana Smokers

PubMed Central

Cooper, Ziva D; Comer, Sandra D; Haney, Margaret

2013-01-01

Recent studies have demonstrated the therapeutic potential of cannabinoids to treat pain, yet none have compared the analgesic effectiveness of smoked marijuana to orally administered Δ9-tetrahydrocannabinol (THC; dronabinol). This randomized, placebo-controlled, double-dummy, double-blind study compared the magnitude and duration of analgesic effects of smoked marijuana and dronabinol under well-controlled conditions using a validated experimental model of pain. Healthy male (N=15) and female (N=15) daily marijuana smokers participated in this outpatient study comparing the analgesic, subjective, and physiological effects of marijuana (0.00, 1.98, or 3.56% THC) to dronabinol (0, 10, or 20 mg). Pain response was assessed using the cold-pressor test (CPT): participants immersed their left hand in cold water (4 °C), and the time to report pain (pain sensitivity) and withdraw the hand from the water (pain tolerance) were recorded. Subjective pain and drug effect ratings were also measured as well as cardiovascular effects. Compared with placebo, marijuana and dronabinol decreased pain sensitivity (3.56% 20 mg), increased pain tolerance (1.98% 20 mg), and decreased subjective ratings of pain intensity (1.98, 3.56% 20 mg). The magnitude of peak change in pain sensitivity and tolerance did not differ between marijuana and dronabinol, although dronabinol produced analgesia that was of a longer duration. Marijuana (1.98, 3.56%) and dronabinol (20 mg) also increased abuse-related subjective ratings relative to placebo; these ratings were greater with marijuana. These data indicate that under controlled conditions, marijuana and dronabinol decreased pain, with dronabinol producing longer-lasting decreases in pain sensitivity and lower ratings of abuse-related subjective effects than marijuana. PMID:23609132

Retail marijuana purchases in designer and commercial markets in New York City: sales units, weights, and prices per gram.

PubMed

Sifaneck, Stephen J; Ream, Geoffrey L; Johnson, Bruce D; Dunlap, Eloise

2007-09-01

This paper documents the bifurcation of the market for commercial marijuana from the market for designer marijuana in New York City. Commercial marijuana is usually grown outdoors, imported to NYC, and of average quality. By contrast, several varities of designer marijuana are usually grown indoors from specially bred strains and carefully handled for maximum quality. The mechanisms for marijuana sales include street/park sellers, delivery services, private sales, and storefronts. Retail sales units vary from 5 dollars to 50 dollars and more, but the actual weights and price per gram of retail marijuana purchases lacks scientific precision. Ethnographic staff recruited marijuana purchasers who used digital scales to weigh a purposive sample of 99 marijuana purchases. Results indicate clear differences in price per gram between the purchases of commercial (average 8.20 dollars/g) and designer (average 18.02 dollars/g) marijuana. Designer purchases are more likely to be made by whites, downtown (Lower East Side/Union Square area), via delivery services, and in units of 10 dollar bags, 50 dollar cubes, and eighth and quarter ounces. Commercial marijuana purchases are more likely to be made by blacks, uptown (Harlem), via street dealers, and in units of 5 dollar and 20 dollar bags. Imported commercial types Arizona and Chocolate were only found uptown, while designer brand names describing actual strains like Sour Diesel and White Widow were only found downtown. Findings indicate clear divisions between commercial and designer marijuana markets in New York City. The extent that these differences may be based upon different THC potencies is a matter for future research.

Temporal trends in marijuana attitudes, availability and use in Colorado compared to non-medical marijuana states: 2003-11.

PubMed

Schuermeyer, Joseph; Salomonsen-Sautel, Stacy; Price, Rumi Kato; Balan, Sundari; Thurstone, Christian; Min, Sung-Joon; Sakai, Joseph T

2014-07-01

In 2009, policy changes were accompanied by a rapid increase in the number of medical marijuana cardholders in Colorado. Little published epidemiological work has tracked changes in the state around this time. Using the National Survey on Drug Use and Health, we tested for temporal changes in marijuana attitudes and marijuana-use-related outcomes in Colorado (2003-11) and differences within-year between Colorado and thirty-four non-medical-marijuana states (NMMS). Using regression analyses, we further tested whether patterns seen in Colorado prior to (2006-8) and during (2009-11) marijuana commercialization differed from patterns in NMMS while controlling for demographics. Within Colorado those reporting "great-risk" to using marijuana 1-2 times/week dropped significantly in all age groups studied between 2007-8 and 2010-11 (e.g. from 45% to 31% among those 26 years and older; p=0.0006). By 2010-11 past-year marijuana abuse/dependence had become more prevalent in Colorado for 12-17 year olds (5% in Colorado, 3% in NMMS; p=0.03) and 18-25 year olds (9% vs. 5%; p=0.02). Regressions demonstrated significantly greater reductions in perceived risk (12-17 year olds, p=0.005; those 26 years and older, p=0.01), and trend for difference in changes in availability among those 26 years and older and marijuana abuse/dependence among 12-17 year olds in Colorado compared to NMMS in more recent years (2009-11 vs. 2006-8). Our results show that commercialization of marijuana in Colorado has been associated with lower risk perception. Evidence is suggestive for marijuana abuse/dependence. Analyses including subsequent years 2012+ once available, will help determine whether such changes represent momentary vs. sustained effects. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Relationship between marijuana and other illicit drug use and depression/suicidal thoughts among late middle-aged and older adults.

PubMed

Choi, Namkee G; DiNitto, Diana M; Marti, C Nathan; Choi, Bryan Y

2016-04-01

Despite growing numbers of older-adult illicit drug users, research on this topic is rare. This study examined the relationship between marijuana and/or other illicit drug use and major depressive episode (MDE) and serious suicidal thoughts among those aged 50+ years in the USA. The public use files of the 2008 to 2012 US National Survey on Drug Use and Health (NSDUH) provided data on 29,634 individuals aged 50+ years. Logistic regression analysis was used to test hypothesized associations between past-year marijuana and/or other illicit drug use and MDE and serious suicidal thoughts. Nearly 6% of the 50+ years age group reported past-year marijuana and/or other illicit drug use. Compared to non-users of any illicit drug, the odds of past-year MDE among those who used marijuana only, other illicit drugs only, and marijuana and other illicit drugs were 1.54 (95% CI = 1.17-2.03), 2.75 (95% CI = 1.75-4.33), and 2.12 (95% CI = 1.45-3.09), respectively. Those who used marijuana and other drugs also had higher odds (2.44, 95% CI = 1.58-3.77) of suicidal thoughts than non-users of any illicit drug. However, among users of any illicit drug, no difference was found among users of marijuana only, marijuana and other illicit drugs, and other illicit drugs only. Among marijuana users, marijuana use frequency was a significant correlate of suicidal thoughts only among those with MDE. Health and mental health (MH) service providers should pay close attention to the potential reciprocal effects of marijuana and other illicit drug use and MDE and suicidal thoughts among late middle-aged and older adults.

Comparison of the analgesic effects of dronabinol and smoked marijuana in daily marijuana smokers.

PubMed

Cooper, Ziva D; Comer, Sandra D; Haney, Margaret

2013-09-01

Recent studies have demonstrated the therapeutic potential of cannabinoids to treat pain, yet none have compared the analgesic effectiveness of smoked marijuana to orally administered Δ(9)-tetrahydrocannabinol (THC; dronabinol). This randomized, placebo-controlled, double-dummy, double-blind study compared the magnitude and duration of analgesic effects of smoked marijuana and dronabinol under well-controlled conditions using a validated experimental model of pain. Healthy male (N=15) and female (N=15) daily marijuana smokers participated in this outpatient study comparing the analgesic, subjective, and physiological effects of marijuana (0.00, 1.98, or 3.56% THC) to dronabinol (0, 10, or 20 mg). Pain response was assessed using the cold-pressor test (CPT): participants immersed their left hand in cold water (4 °C), and the time to report pain (pain sensitivity) and withdraw the hand from the water (pain tolerance) were recorded. Subjective pain and drug effect ratings were also measured as well as cardiovascular effects. Compared with placebo, marijuana and dronabinol decreased pain sensitivity (3.56%; 20 mg), increased pain tolerance (1.98%; 20 mg), and decreased subjective ratings of pain intensity (1.98, 3.56%; 20 mg). The magnitude of peak change in pain sensitivity and tolerance did not differ between marijuana and dronabinol, although dronabinol produced analgesia that was of a longer duration. Marijuana (1.98, 3.56%) and dronabinol (20 mg) also increased abuse-related subjective ratings relative to placebo; these ratings were greater with marijuana. These data indicate that under controlled conditions, marijuana and dronabinol decreased pain, with dronabinol producing longer-lasting decreases in pain sensitivity and lower ratings of abuse-related subjective effects than marijuana.

An exploratory examination of marijuana use, problem-gambling severity, and health correlates among adolescents

PubMed Central

HAMMOND, CHRISTOPHER J.; PILVER, COREY E.; RUGLE, LOREEN; STEINBERG, MARVIN A.; MAYES, LINDA C.; MALISON, ROBERT T.; KRISHNAN-SARIN, SUCHITRA; HOFF, RANI A.; POTENZA, MARC N.

2014-01-01

Background and aims: Gambling is common in adolescents and at-risk and problem/pathological gambling (ARPG) is associated with adverse measures of health and functioning in this population. Although ARPG commonly co-occurs with marijuana use, little is known how marijuana use influences the relationship between problem-gambling severity and health- and gambling-related measures. Methods: Survey data from 2,252 Connecticut high school students were analyzed using chi-square and logistic regression analyses. Results: ARPG was found more frequently in adolescents with lifetime marijuana use than in adolescents denying marijuana use. Marijuana use was associated with more severe and a higher frequency of gambling-related behaviors and different motivations for gambling. Multiple health/functioning impairments were differentially associated with problem-gambling severity amongst adolescents with and without marijuana use. Significant marijuana-use-by-problem-gambling-severity-group interactions were observed for low-average grades (OR = 0.39, 95% CI = [0.20, 0.77]), cigarette smoking (OR = 0.38, 95% CI = [0.17, 0.83]), current alcohol use (OR = 0.36, 95% CI = [0.14, 0.91]), and gambling with friends (OR = 0.47, 95% CI = [0.28, 0.77]). In all cases, weaker associations between problem-gambling severity and health/functioning correlates were observed in the marijuana-use group as compared to the marijuana-non-use group. Conclusions: Some academic, substance use, and social factors related to problem-gambling severity may be partially accounted for by a relationship with marijuana use. Identifying specific factors that underlie the relationships between specific attitudes and behaviors with gambling problems and marijuana use may help improve intervention strategies. PMID:25215219

Burden of arrhythmia in recreational marijuana users.

PubMed

Desai, Rupak; Patel, Upenkumar; Deshmukh, Abhishek; Sachdeva, Rajesh; Kumar, Gautam

2018-08-01

Marijuana or Cannabis is extensively used as a recreational substance globally. Case reports have reported cardiac arrhythmias immediately following recreational marijuana use. However, the burden of arrhythmias in hospitalized marijuana users have not been evaluated through prospective or cross-sectional studies. Therefore, we planned to measure temporal trends of the frequency of arrhythmias in hospitalized marijuana users using National Inpatient Sample (NIS) database in the United States. Copyright © 2018 Elsevier B.V. All rights reserved.

Computer mouse use predicts acute pain but not prolonged or chronic pain in the neck and shoulder.

PubMed

Andersen, J H; Harhoff, M; Grimstrup, S; Vilstrup, I; Lassen, C F; Brandt, L P A; Kryger, A I; Overgaard, E; Hansen, K D; Mikkelsen, S

2008-02-01

Computer use may have an adverse effect on musculoskeletal outcomes. This study assessed the risk of neck and shoulder pain associated with objectively recorded professional computer use. A computer programme was used to collect data on mouse and keyboard usage and weekly reports of neck and shoulder pain among 2146 technical assistants. Questionnaires were also completed at baseline and at 12 months. The three outcome measures were: (1) acute pain (measured as weekly pain); (2) prolonged pain (no or minor pain in the neck and shoulder region over four consecutive weeks followed by three consecutive weeks with a high pain score); and (3) chronic pain (reported pain or discomfort lasting more than 30 days and "quite a lot of trouble" during the past 12 months). Risk for acute neck pain and shoulder pain increased linearly by 4% and 10%, respectively, for each quartile increase in weekly mouse usage time. Mouse and keyboard usage time did not predict the onset of prolonged or chronic pain in the neck or shoulder. Women had higher risks for neck and shoulder pain. Number of keystrokes and mouse clicks, length of the average activity period, and micro-pauses did not influence reports of acute or prolonged pain. A few psychosocial factors predicted the risk of prolonged pain. Most computer workers have no or minor neck and shoulder pain, few experience prolonged pain, and even fewer, chronic neck and shoulder pain. Moreover, there seems to be no relationship between computer use and prolonged and chronic neck and shoulder pain.

Marijuana use and increased risk of squamous cell carcinoma of the head and neck.

PubMed

Zhang, Z F; Morgenstern, H; Spitz, M R; Tashkin, D P; Yu, G P; Marshall, J R; Hsu, T C; Schantz, S P

1999-12-01

Marijuana is the most commonly used illegal drug in the United States. In some subcultures, it is widely perceived to be harmless. Although the carcinogenic properties of marijuana smoke are similar to those of tobacco, no epidemiological studies of the relationship between marijuana use and head and neck cancer have been published. The relationship between marijuana use and head and neck cancer was investigated by a case-control study of 173 previously untreated cases with pathologically confirmed diagnoses of squamous cell carcinoma of the head and neck and 176 cancer-free controls at Memorial Sloan-Kettering Cancer Center between 1992 and 1994. Epidemiological data were collected by using a structured questionnaire, which included history of tobacco smoking, alcohol use, and marijuana use. The associations between marijuana use and head and neck cancer were analyzed by Mantel-Haenszel methods and logistic regression models. Controlling for age, sex, race, education, alcohol consumption, pack-years of cigarette smoking, and passive smoking, the risk of squamous cell carcinoma of the head and neck was increased with marijuana use [odds ratio (OR) comparing ever with never users, 2.6; 95% confidence interval (CI), 1.1-6.6]. Dose-response relationships were observed for frequency of marijuana use/day (P for trend <0.05) and years of marijuana use (P for trend <0.05). These associations were stronger for subjects who were 55 years of age and younger (OR, 3.1; 95% CI, 1.0-9.7). Possible interaction effects of marijuana use were observed with cigarette smoking, mutagen sensitivity, and to a lesser extent, alcohol use. Our results suggest that marijuana use may increase the risk of head and neck cancer with a strong dose-response pattern. Our analysis indicated that marijuana use may interact with mutagen sensitivity and other risk factors to increase the risk of head and neck cancer. The results need to be interpreted with some caution in drawing causal inferences because of certain methodological limitations, especially with regard to interactions.

Characterizing marijuana concentrate users: A web-based survey.

PubMed

Daniulaityte, Raminta; Lamy, Francois R; Barratt, Monica; Nahhas, Ramzi W; Martins, Silvia S; Boyer, Edward W; Sheth, Amit; Carlson, Robert G

2017-09-01

The study seeks to characterize marijuana concentrate users, describe reasons and patterns of use, perceived risk, and identify predictors of daily/near daily use. An anonymous web-based survey was conducted (April-June 2016) with 673 US-based cannabis users recruited via the Bluelight.org web-forum and included questions about marijuana concentrate use, other drugs, and socio-demographics. Multivariable logistic regression analyses were conducted to identify characteristics associated with greater odds of lifetime and daily use of marijuana concentrates. About 66% of respondents reported marijuana concentrate use. The sample was 76% male, and 87% white. Marijuana concentrate use was viewed as riskier than flower cannabis. Greater odds of marijuana concentrate use was associated with living in states with "recreational" (AOR=4.91; p=0.001) or "medical, less restrictive" marijuana policies (AOR=1.87; p=0.014), being male (AOR=2.21, p=0.002), younger (AOR=0.95, p<0.001), number of other drugs used (AOR=1.23, p<0.001), daily herbal cannabis use (AOR=4.28, p<0.001), and lower perceived risk of cannabis use (AOR=0.96, p=0.043). About 13% of marijuana concentrate users reported daily/near daily use. Greater odds of daily concentrate use was associated with being male (AOR=9.29, p=0.033), using concentrates for therapeutic purposes (AOR=7.61, p=0.001), using vape pens for marijuana concentrate administration (AOR=4.58, p=0.007), and lower perceived risk of marijuana concentrate use (AOR=0.92, p=0.017). Marijuana concentrate use was more common among male, younger and more experienced users, and those living in states with more liberal marijuana policies. Characteristics of daily users, in particular patterns of therapeutic use and utilization of different vaporization devices, warrant further research with community-recruited samples. Copyright © 2017 Elsevier B.V. All rights reserved.

Neurocognition in College-Aged Daily Marijuana Users

PubMed Central

Becker, Mary P.; Collins, Paul F.; Luciana, Monica

2014-01-01

Background Marijuana is the most commonly used illicit substance in the United States. Use, particularly when it occurs early, has been associated with cognitive impairments in executive functioning, learning, and memory. Methods This study comprehensively measured cognitive ability as well as comorbid psychopathology and substance use history to determine the neurocognitive profile associated with young adult marijuana use. College-aged marijuana users who initiated use prior to age 17 (n=35) were compared to demographically-matched controls (n=35). Results Marijuana users were high functioning, demonstrating comparable IQs to controls and relatively better processing speed. Marijuana users demonstrated relative cognitive impairments in verbal memory, spatial working memory, spatial planning, and motivated decision-making. Comorbid use of alcohol, which was heavier in marijuana users, was unexpectedly found to be associated with better performance in some of these areas. Conclusions This study provides additional evidence of neurocognitive impairment in the context of adolescent and young adult marijuana use. Findings are discussed in relation to marijuana’s effects on intrinsic motivation and discrete aspects of cognition. PMID:24620756

Attitude Ambivalence, Friend Norms, and Adolescent Drug Use

PubMed Central

Hohman, Zachary P.; Crano, William D.; Siegel, Jason T.; Alvaro, Eusebio M.

2013-01-01

This study assessed the moderating effects of attitudinal ambivalence on adolescent marijuana use in the context of the theory of planned behavior (TPB). With data from the National Survey of Parents and Youth (N=1,604), two hierarchical multiple regression models were developed to examine the association of ambivalent attitudes, intentions, and later marijuana use. The first model explored the moderating effect of ambivalence on intentions to use marijuana; the second tested the moderation of ambivalence on actual marijuana use 1 year later. Results across both analyses suggest that ambivalence moderated the association of friend norms and subsequent adolescent marijuana use: friend norms were better predictors of marijuana intentions (β=0.151, t=2.29, p=0.02) and subsequent use when adolescents were attitudinally ambivalent about marijuana use (β=0.071, t=2.76, p= 0.006). These results suggest that preventive programs that affect the certainty with which adolescents holds pro- or antimarijuana attitudes may influence the likelihood of their resistance to, initiation, or continuance of marijuana use. PMID:23404670

Medicinal and recreational marijuana: what are the risks?

PubMed

Van Gerpen, Shawn; Vik, Tamara; Soundy, Timothy J

2015-01-01

With the recent legalization of recreational marijuana in Colorado, Washington, Alaska, the District of Columbia and legislation pending for both medical and recreational marijuana in several other states, it is important for the facts regarding its potential for serious mental health consequences to be known. Little has been said about the psychiatric risks of this substance, particularly in youth. Several studies have shown increased rates of depression, anxiety and schizophrenia among those who use marijuana on a regular basis. In addition, permanent loss of IQ and structural changes in the brain have been demonstrated with habitual use. Legalization of marijuana for recreational use can influence an adolescent's perception of this substance as "safe." In states that have legalized marijuana for medical purposes, there is the very real problem of "diversion." As many as 34 percent of 12th-graders who use marijuana in states with legalized marijuana had obtained it from a person who had received it through a prescription.

An Analysis of Applicants Presenting to a Medical Marijuana Specialty Practice in California

PubMed Central

Nunberg, Helen; Kilmer, Beau; Pacula, Rosalie Liccardo; Burgdorf, James

2011-01-01

For more than a decade, medical marijuana has been at the forefront of the marijuana policy debate in the United States. Fourteen states allow physicians to recommend marijuana or provide a legal defense for patients and physicians if prosecuted in state courts; however, little is known about those individuals using marijuana for medicinal purposes and the symptoms they use it for. This study provides descriptive information from 1,655 patients seeking a physician’s recommendation for medical marijuana, the conditions for which they seek treatment, and the diagnoses made by the physicians. It conducts a systematic analysis of physician records and patient questionnaires obtained from consecutive patients being seen during a three month period at nine medical marijuana evaluation clinics belonging to a select medical group operating throughout the State of California. While this study is not representative of all medical marijuana users in California, it provides novel insights about an important population being affected by this policy. PMID:23750291

Marijuana use and serum testosterone concentrations among U.S. males.

PubMed

Thistle, J E; Graubard, B I; Braunlin, M; Vesper, H; Trabert, B; Cook, M B; McGlynn, K A

2017-07-01

Marijuana has been reported to have several effects on the male reproductive system. Marijuana has previously been linked to reduced adult testosterone, however, a study in Denmark reported increased testosterone concentrations among marijuana users. This study was performed to estimate the effect of marijuana use on testosterone in U.S. males. Data on serum testosterone, marijuana use, and covariates for 1577 men from the 2011-2012 U.S. National Health and Nutrition Examination Survey (NHANES) were analyzed. Information on marijuana use was collected by a self-administered computer-assisted questionnaire. Serum testosterone was determined using isotope dilution liquid chromatography tandem mass spectrometry. The effects of marijuana use on serum testosterone concentrations were examined by frequency, duration, and recency of use. Adjusted means and 95% confidence intervals (CI) of serum testosterone across levels of marijuana use were estimated using multiple linear regression weighted by the survey weights. The majority (66.2%) of the weighted study population reported ever using marijuana with 26.6% reporting current marijuana use. There was no difference in serum testosterone between ever users (adjusted mean = 3.69 ng/mL, 95% CI: 3.46, 3.93) and never users (adjusted mean = 3.70 ng/mL, 95% CI: 3.45, 3.98) upon multivariable analysis. However, serum testosterone was inversely associated with time since last regular use of marijuana (p-value for trend = 0.02). When restricted to men aged 18-29 years, this relationship strengthened (p-value for trend <0.01), and serum testosterone was also inversely associated with time since last use (p-value for trend <0.01), indicating that recency of use, and not duration or frequency, had the strongest relationship with testosterone levels. Serum testosterone concentrations were higher in men with more recent marijuana use. Studies are needed to determine the extent to which circulating testosterone concentrations mediate the relationship of marijuana use with male reproductive outcomes. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

Medical marijuana for HIV-associated sensory neuropathy: legal and ethical issues.

PubMed

Larriviere, Daniel G

2014-10-01

The number of states legalizing medical marijuana is increasing. Medical marijuana is possibly effective therapy for HIV-associated sensory neuropathy. Despite legalization at the state level, however, the current and contradictory federal drug enforcement policy creates the risk that physicians who recommend medical marijuana to their patients will lose their ability to prescribe medications. The federal-state tension has legal and ethical implications for neurologists who receive a request for medical marijuana from their patients since neurologists must strive to both relieve suffering and obey relevant laws. Recommendation of medical marijuana by neurologists to their patients is ethically permissible but is not ethically mandatory.

A case of butane hash oil (marijuana wax)-induced psychosis.

PubMed

Keller, Corey J; Chen, Evan C; Brodsky, Kimberly; Yoon, Jong H

2016-01-01

Marijuana is one of the most widely used controlled substances in the United States. Despite extensive research on smoked marijuana, little is known regarding the potential psychotropic effects of marijuana "wax," a high-potency form of marijuana that is gaining in popularity. The authors present a case of "Mr. B," a 34-year-old veteran who presented with profound psychosis in the setting of recent initiation of heavy, daily marijuana wax use. He exhibited incoherent speech and odd behaviors and appeared to be in a dream-like state with perseverating thoughts about his combat experience. His condition persisted despite treatment with risperidone 4 mg twice a day (BID), but improved dramatically on day 8 of hospitalization with the return of baseline mental function. Following discharge, Mr. B discontinued all marijuana use and did not exhibit the return of any psychotic symptoms. This study highlights the need for future research regarding the potential medical and psychiatric effects of new, high-potency forms of marijuana. Could cannabis have a dose-dependent impact on psychosis? What other potential psychiatric effects could emerge heretofore unseen in lower potency formulations? Given the recent legalization of marijuana, these questions merit timely exploration.

Antecedents and outcomes of marijuana use initiation during adolescence.

PubMed

Ellickson, Phyllis L; Tucker, Joan S; Klein, David J; Saner, Hilary

2004-11-01

This study identified similarities and differences in risk factors for marijuana use initiation from grades 7 to 8, grades 8 to 9, and grades 9 to 10, and examined differences between earlier initiates, later initiates, and nonusers on various problem behaviors at grade 10. Longitudinal data were used to examine predictors and outcomes associated with marijuana initiation from grade 7 (N = 1,955) to grade 10 (N = 909). Participants completed yearly surveys to assess problem behaviors, social influences, and marijuana-related attitudes and behavior. Earlier initiates were more likely than later initiates to exhibit problem-related marijuana use, hard drug use, polydrug use, poor grades, and low academic intentions at grade 10. Across ages, initiation was predicted by smoking, frequency of marijuana offers, and poor grades. Results provided some evidence for a shift from familial to peer influence on marijuana initiation with increasing age. Marijuana-related beliefs were relatively weak predictors of initiation at all ages after controlling for pro-marijuana social influences and engagement in other types of substance use and delinquent behavior. Results emphasize the importance of early intervention and identify a wide range of potentially modifiable risk factors that may be targeted.

Marijuana-using drivers, alcohol-using drivers, and their passengers: prevalence and risk factors among underage college students.

PubMed

Whitehill, Jennifer M; Rivara, Frederick P; Moreno, Megan A

2014-07-01

Driving after marijuana use increases the risk of a motor vehicle crash. Understanding this behavior among young drivers and how it may differ from alcohol-related driving behaviors could inform prevention efforts. To describe the prevalence, sex differences, and risk factors associated with underage college students' driving after using marijuana, driving after drinking alcohol, or riding with a driver using these substances. Cross-sectional telephone survey of a random sample of 315 first-year college students (aged 18-20 years) from 2 large public universities, who were participating in an ongoing longitudinal study. At recruitment, 52.8% of eligible individuals consented to participate; retention was 93.2% one year later when data for this report were collected. Self-reported past-28-day driving after marijuana use, riding with a marijuana-using driver, driving after alcohol use, and riding with an alcohol-using driver. In the prior month, 20.3% of students had used marijuana. Among marijuana-using students, 43.9% of male and 8.7% of female students drove after using marijuana (P < .001), and 51.2% of male and 34.8% of female students rode as a passenger with a marijuana-using driver (P = .21). Most students (65.1%) drank alcohol, and among this group 12.0% of male students and 2.7% of female students drove after drinking (P = .01), with 20.7% and 11.5% (P = .07), respectively, reporting riding with an alcohol-using driver. Controlling for demographics and substance use behaviors, driving after substance use was associated with at least a 2-fold increase in risk of being a passenger with another user; the reverse was also true. A 1% increase in the reported percentage of friends using marijuana was associated with a 2% increased risk of riding with a marijuana-using driver (95% CI, 1.01-1.03). Among students using any substances, past-28-day use of only marijuana was associated with a 6.24-fold increased risk of driving after substance use compared with using only alcohol (95% CI, 1.89-21.17). Driving and riding after marijuana use is common among underage, marijuana-using college students. This is concerning given recent legislation that may increase marijuana availability.

Marijuana-Using Drivers, Alcohol-Using drivers and Their Passengers: Prevalence and Risk Factors Among Underage College Students

PubMed Central

Whitehill, Jennifer M.; Rivara, Frederick P.; Moreno, Megan A.

2014-01-01

Importance Driving after marijuana use increases the risk of a motor vehicle crash. Understanding this behavior among young drivers and how it may differ from alcohol-related driving behaviors could inform prevention efforts. Objective To describe prevalence, sex differences, and risk factors associated with underage college students’ driving after using marijuana, driving after drinking alcohol, or riding with a driver using these substances. Design, Setting, Participants Cross-sectional telephone survey of a random sample of 315 first-year college students (aged 18-20 years) from 2 large public universities, who were participating in an ongoing longitudinal study. At recruitment, 52.8% of eligible individuals consented to participate; retention was 93.2% one year later when data for this report was collected. Main Outcome Measure(s) Self-reported past-28-day driving after marijuana use, riding with a marijuana-using driver, driving after alcohol use, and riding with an alcohol-using driver. Results In the prior month, 20.3% of students had used marijuana. Among marijuana-using students, 43.9% of males and 8.7% of females drove after using marijuana (p<0.001) and 51.2% of male and 34.8% of female students rode as a passenger with a marijuana-using driver (p=0.21). Most students (65.1%) drank alcohol, and among this group 12.0% of male students and 2.7% of female students drove after drinking (p=0.01), with 20.7% and 11.5% (p=0.07), respectively, reporting riding with a drinking driver. Controlling for demographics and substance use behaviors, driving after substance use was associated with at least a 2-fold increase in risk of being a passenger with another user; the reverse was also true. A 1% increase in the reported percentage of friends using marijuana was associated with a 2% increased risk of riding with a marijuana using driver (95% CI=1.01-1.03). Among students using any substances, past 28-day use of only marijuana was associated with a 6.24-fold increased risk of driving after substance use compared to using only alcohol (95% CI=1.89-21.7). Conclusions and Relevance Driving and riding after marijuana use is common among underage, marijuana-using college students. This is concerning given recent legislation that may increase marijuana availability. PMID:24820649

32 CFR 700.1138 - Responsibilities concerning marijuana, narcotics, and other controlled substances.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 5 2011-07-01 2011-07-01 false Responsibilities concerning marijuana, narcotics... concerning marijuana, narcotics, and other controlled substances. (a) All personnel shall endeavor to prevent and eliminate the unauthorized use of marijuana, narcotics and other controlled substances within the...

32 CFR 700.1138 - Responsibilities concerning marijuana, narcotics, and other controlled substances.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 5 2013-07-01 2013-07-01 false Responsibilities concerning marijuana, narcotics... concerning marijuana, narcotics, and other controlled substances. (a) All personnel shall endeavor to prevent and eliminate the unauthorized use of marijuana, narcotics and other controlled substances within the...

32 CFR 700.1138 - Responsibilities concerning marijuana, narcotics, and other controlled substances.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 5 2014-07-01 2014-07-01 false Responsibilities concerning marijuana, narcotics... concerning marijuana, narcotics, and other controlled substances. (a) All personnel shall endeavor to prevent and eliminate the unauthorized use of marijuana, narcotics and other controlled substances within the...

32 CFR 700.1138 - Responsibilities concerning marijuana, narcotics, and other controlled substances.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 5 2010-07-01 2010-07-01 false Responsibilities concerning marijuana, narcotics... concerning marijuana, narcotics, and other controlled substances. (a) All personnel shall endeavor to prevent and eliminate the unauthorized use of marijuana, narcotics and other controlled substances within the...

32 CFR 700.1138 - Responsibilities concerning marijuana, narcotics, and other controlled substances.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 5 2012-07-01 2012-07-01 false Responsibilities concerning marijuana, narcotics... concerning marijuana, narcotics, and other controlled substances. (a) All personnel shall endeavor to prevent and eliminate the unauthorized use of marijuana, narcotics and other controlled substances within the...

Brain activation to negative stimuli mediates a relationship between adolescent marijuana use and later emotional functioning.

PubMed

Heitzeg, Mary M; Cope, Lora M; Martz, Meghan E; Hardee, Jillian E; Zucker, Robert A

2015-12-01

This work investigated the impact of heavy marijuana use during adolescence on emotional functioning, as well as the brain functional mediators of this effect. Participants (n=40) were recruited from the Michigan Longitudinal Study (MLS). Data on marijuana use were collected prospectively beginning in childhood as part of the MLS. Participants were classified as heavy marijuana users (n=20) or controls with minimal marijuana use. Two facets of emotional functioning-negative emotionality and resiliency (a self-regulatory mechanism)-were assessed as part of the MLS at three time points: mean age 13.4, mean age 19.6, and mean age 23.1. Functional neuroimaging data during an emotion-arousal word task were collected at mean age 20.2. Negative emotionality decreased and resiliency increased across the three time points in controls but not heavy marijuana users. Compared with controls, heavy marijuana users had less activation to negative words in temporal, prefrontal, and occipital cortices, insula, and amygdala. Activation of dorsolateral prefrontal cortex to negative words mediated an association between marijuana group and later negative emotionality. Activation of the cuneus/lingual gyrus mediated an association between marijuana group and later resiliency. Results support growing evidence that heavy marijuana use during adolescence affects later emotional outcomes. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Marijuana Use and Maternal Experiences of Severe Nausea During Pregnancy in Hawai‘i

PubMed Central

Patrick, Walter K; Hurwitz, Eric L

2014-01-01

Recreational use of marijuana is relatively common in the United States, and medicinal use is gaining popular and legal support. Marijuana has been proposed as a potential treatment for hyperemesis gravidarum. Research into this topic is complicated by associations between marijuana use and poor birth outcomes. Cannabinoid hyperemesis syndrome, which can cause severe nausea and vomiting in marijuana users, is another complicating factor. Hawai‘i Pregnancy Risk Assessment Monitoring System data from 4,735 respondents were used to estimate prevalence of self-reported marijuana use during and in the month before pregnancy, as well as severe nausea during pregnancy. Data were weighted to be representative of all pregnancies resulting in live births in Hawai‘i between 2009 and 2011. Prevalence ratios (PR) and 95% confidence intervals (CI) were computed to estimate associations. Of recently-pregnant women in Hawai‘i, 6.0% reported using marijuana in the month before pregnancy, and 2.6% reported using marijuana during pregnancy. Approximately 21.2% reported severe nausea during pregnancy. Women who reported severe nausea during pregnancy were significantly more likely to report marijuana use during pregnancy (3.7% vs 2.3%; PR=1.63, 95% CI: 1.08–2.44). More research is needed to investigate the relationship between marijuana use and severe nausea during pregnancy, and to quantify associated risks to mother and fetus. PMID:25285255

Verbal learning in marijuana users seeking treatment: a comparison between depressed and non-depressed samples.

PubMed

Roebke, Patrick V; Vadhan, Nehal P; Brooks, Daniel J; Levin, Frances R

2014-07-01

Both individuals with marijuana use and depressive disorders exhibit verbal learning and memory decrements. This study investigated the interaction between marijuana dependence and depression on learning and memory performance. The California Verbal Learning Test-Second Edition (CVLT-II) was administered to depressed (n = 71) and non-depressed (n = 131) near-daily marijuana users. The severity of depressive symptoms was measured by the self-rated Beck Depression Inventory (BDI-II) and the clinician-rated Hamilton Depression Rating Scale (HAM-D). Multivariate analyses of covariance statistics (MANCOVA) were employed to analyze group differences in cognitive performance. Pearson's correlation coefficients were calculated to examine the relative associations between marijuana use, depression and CVLT-II performance. Findings from each group were compared to published normative data. Although both groups exhibited decreased CVLT-II performance relative to the test's normative sample (p < 0.05), marijuana-dependent subjects with a depressive disorder did not perform differently than marijuana-dependent subjects without a depressive disorder (p > 0.05). Further, poorer CVLT-II performance was modestly associated with increased self-reported daily amount of marijuana use (corrected p < 0.002), but was not significantly associated with increased scores on measures of depressive symptoms (corrected p > 0.002). These findings suggest an inverse association between marijuana use and verbal learning function, but not between depression and verbal learning function in regular marijuana users.

Washington State recreational marijuana legalization: parent and adolescent perceptions, knowledge, and discussions in a sample of low-income families.

PubMed

Mason, W A; Hanson, Koren; Fleming, Charles B; Ringle, Jay L; Haggerty, Kevin P

2015-04-01

In November 2012, Washington State and Colorado became the first states in the United States to legalize recreational marijuana use for adults, and Uruguay became the first country to allow the cultivation, distribution, possession, and use of marijuana. One possible consequence of these changes is increased adolescent marijuana use. Parents may mitigate this adverse consequence; however, whether parents and adolescents have accurate knowledge about the laws and are discussing marijuana use in light of the law changes is unknown. We examine perceptions, knowledge, and parent-child discussions about Washington State's recreational marijuana law in a sample of low-income families. Participants were a subset of families (n = 115) in an ongoing study that originally recruited parents and adolescents from middle schools in Tacoma, Washington. In summer 2013, when students were entering the 11(th) grade, students and their parents were asked questions about the recreational marijuana law. Participants perceived that their marijuana-related attitudes and behaviors changed little as a result of the law, and displayed uncertainty about what is legal and illegal. Most parents reported discussing the new law with their children but only occasionally, and conversations emphasized household rules, particularly among parent lifetime marijuana users compared to non-users. Conclusions/Importance: Results suggest that there should be a public health campaign focused on families that provides clear information about the recreational marijuana laws.

New product trial, use of edibles, and unexpected highs among marijuana and hashish users in Colorado.

PubMed

Allen, Jane A; Davis, Kevin C; Duke, Jennifer C; Nonnemaker, James M; Bradfield, Brian R; Farrelly, Matthew C

2017-07-01

This study examines the relationships between trial of new marijuana or hashish products and unexpected highs, and use of edible products and unexpected highs. We conducted an online survey of 634 adult, past-year marijuana users in Colorado. We used logistic regression models to examine the relationship between new product trial or edible use and unexpected highs. In the first year that recreational marijuana was legal in Colorado, 71.4% of respondents tried a new marijuana or hashish product, and 53.6% used an edible product. Trial of new products was associated with greater odds of experiencing an unexpected high after controlling for age, gender, education, mental health status, current marijuana or hashish use, and mean amount of marijuana or hashish consumed in the past month (OR=2.13, p<0.001). Individuals who reported having used edibles had greater odds of experiencing an unexpected high, after controlling for the same set of variables (OR=1.56, p<0.05). People who try new marijuana or hashish products, or use edible marijuana or hashish products, are at greater risk for an unexpected high. It is possible that some negative outcomes associated with marijuana use and unexpected highs may be averted through a better understanding of how to use product packaging to communicate with consumers. Copyright © 2017 Elsevier B.V. All rights reserved.

Marijuana use and maternal experiences of severe nausea during pregnancy in Hawai'i.

PubMed

Roberson, Emily K; Patrick, Walter K; Hurwitz, Eric L

2014-09-01

Recreational use of marijuana is relatively common in the United States, and medicinal use is gaining popular and legal support. Marijuana has been proposed as a potential treatment for hyperemesis gravidarum. Research into this topic is complicated by associations between marijuana use and poor birth outcomes. Cannabinoid hyperemesis syndrome, which can cause severe nausea and vomiting in marijuana users, is another complicating factor. Hawai'i Pregnancy Risk Assessment Monitoring System data from 4,735 respondents were used to estimate prevalence of self-reported marijuana use during and in the month before pregnancy, as well as severe nausea during pregnancy. Data were weighted to be representative of all pregnancies resulting in live births in Hawai'i between 2009 and 2011. Prevalence ratios (PR) and 95% confidence intervals (CI) were computed to estimate associations. Of recently-pregnant women in Hawai'i, 6.0% reported using marijuana in the month before pregnancy, and 2.6% reported using marijuana during pregnancy. Approximately 21.2% reported severe nausea during pregnancy. Women who reported severe nausea during pregnancy were significantly more likely to report marijuana use during pregnancy (3.7% vs 2.3%; PR=1.63, 95% CI: 1.08-2.44). More research is needed to investigate the relationship between marijuana use and severe nausea during pregnancy, and to quantify associated risks to mother and fetus.

Location, location, location: Assessing the spatial patterning between marijuana licenses, alcohol outlets and neighborhood characteristics within Washington state.

PubMed

Tabb, Loni Philip; Fillmore, Christina; Melly, Steven

2018-04-01

The availability of marijuana products is becoming increasingly prevalent across the United States (US), many states are allowing for the production, processing, and retailing of these products for medical and/or recreational use. The purpose of this study is to: (1) examine the spatial patterning of marijuana licenses, and (2) examine the impact of alcohol outlets in addition to other neighborhood characteristics on marijuana licenses within the state of Washington. This cross-sectional observational study examined 1458 census tracts in Washington state from 2017, using marijuana and alcohol data from the Washington State Liquor and Cannabis Board as well as neighborhood characteristics data from the American Community Survey 2011-2015 5-year estimates. We used exploratory and formal spatial regression methods, including integrated nested Laplace approximation within a Bayesian statistical framework, to address the study aims. Our results indicate there is significant spatial patterning of marijuana producers and processors across the state. We also found that all marijuana licenses are located in poorer census tracts, and marijuana retailers are co-located in census tracts with off-premises alcohol outlets. Our study provides empirical evidence of the relationship between marijuana licenses, alcohol outlets, and neighborhood characteristics, and has important implications for policymakers in other states currently considering legalizing marijuana-products for medical and/or recreational use. Copyright © 2018 Elsevier B.V. All rights reserved.

Current Marijuana Use by Industry and Occupation - Colorado, 2014-2015.

PubMed

Smith, Roberta; Hall, Katelyn E; Etkind, Paul; Van Dyke, Mike

2018-04-13

The effects of marijuana use on workplace safety are of concern for public health and workplace safety professionals. Twenty-nine states and the District of Columbia have enacted laws legalizing marijuana at the state level for recreational and/or medical purposes. Employers and safety professionals in states where marijuana use is legal have expressed concerns about potential increases in occupational injuries, such as on-the-job motor vehicle crashes, related to employee impairment. Data published in 2017 by the Colorado Department of Public Health and Environment (CDPHE) showed that more than one in eight adult state residents aged ≥18 years currently used marijuana in 2014 (13.6%) and 2015 (13.4%) (1). To examine current marijuana use by working adults and the industries and occupations in which they are employed, CDPHE analyzed data from the state's Behavioral Risk Factor Surveillance System (BRFSS) regarding current marijuana use (at least 1 day during the preceding 30 days) among 10,169 persons who responded to the current marijuana use question. During 2014 and 2015, 14.6% of these 10,169 Colorado workers reported current marijuana use, with the highest reported prevalence among workers in the Accommodation and Food Services industry (30.1%) and Food Preparation and Serving (32.2%) occupations. Understanding the industries and occupations of adults with reported marijuana use can help direct and maximize impact of public health messaging and potential safety interventions for adults.

The clinical implications of legalizing marijuana: Are physician and non-physician providers prepared?

PubMed

Brooks, Elizabeth; Gundersen, Doris C; Flynn, Erin; Brooks-Russell, Ashley; Bull, Sheana

2017-09-01

Passage of voter-driven marijuana reform laws signals a shift in public attitudes for marijuana use. For providers, legalization may necessitate practice modifications, particularly regarding patient-provider conversations about use and risk. We examined healthcare providers' knowledge of marijuana laws and health implications, professional practice behaviors, and attitudes about training. We surveyed 114 Colorado-based providers who care for children, adolescents, pregnant and breastfeeding women using a Venue-Day-Time survey methodology throughout Colorado. The survey captured providers' (e.g., physicians, nurses, medical assistants) knowledge of state marijuana laws, risk perceptions, counseling practices, and continued training needs. Providers were knowledgeable about marijuana laws, cautious supporting legalization, and perceived moderate to high risks, particularly for certain groups. About 50% of providers working with adolescents and pregnant or breastfeeding women assessed marijuana use "every" or "most" visits; 23% of those working with children reported such behavior. Conversations about specific risks varied between groups. Few providers felt completely knowledgeable about marijuana health risks and lacked confidence talking to patients about this issue. Providers frequently assess patients' marijuana use; however, they are uncomfortable and inconsistent talking to patients about specific marijuana health effects. Additional education is warranted, particularly as it relates to talking to patients about the danger of second hand smoke exposure, underage use, safe storage, and the over-consumption of edibles. Copyright © 2017 Elsevier Ltd. All rights reserved.

Reefer madness: legal & moral issues surrounding the medical prescription of marijuana.

PubMed

Barnes, R E

2000-01-01

California, Arizona, and several other states have recently legalized medical marijuana. My goal in this paper is to demonstrate that even if one grants the opponents of legalization many of their contentious assumptions, the federal government is still obligated to take several specific steps toward the legalization of medical marijuana. I defend this claim against a variety of objections, including the claims: that marijuana is unsafe, that marijuana cannot be adequately tested or produced as a drug, that the availability of synthetic THC makes marijuana superfluous, and especially that legalizing medical marijuana will increase recreational use by 'sending the wrong message.' I then go on to argue that given the intransigent position of the federal government on this issue, state governments are justified in unilaterally legalizing medical marijuana as an act of civil disobedience. A large portion of this paper consists of an extensive response to the objection that legalizing medical marijuana will 'send the wrong message'--which I take to be the primary impediment to legalization. This objection basically claims that the consequences of withholding legalization (especially preventing increased recreational use) are superior to those of legalizing medical marijuana. I argue that legalization is justified even if one were to grant both that the harms of legalization outweighed its benefits and that utilitarianism is true. This requires a subtle and somewhat extended discussion of utilitarian moral and political theory.

Structural barriers in access to medical marijuana in the USA-a systematic review protocol.

PubMed

Valencia, Celina I; Asaolu, Ibitola O; Ehiri, John E; Rosales, Cecilia

2017-08-07

There are 43 state medical marijuana programs in the USA, yet limited evidence is available on the demographic characteristics of the patient population accessing these programs. Moreover, insights into the social and structural barriers that inform patients' success in accessing medical marijuana are limited. A current gap in the scientific literature exists regarding generalizable data on the social, cultural, and structural mechanisms that hinder access to medical marijuana among qualifying patients. The goal of this systematic review, therefore, is to identify the aforementioned mechanisms that inform disparities in access to medical marijuana in the USA. This scoping review protocol outlines the proposed study design for the systematic review and evaluation of peer-reviewed scientific literature on structural barriers to medical marijuana access. The protocol follows the guidelines set forth by the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) checklist. The overarching goal of this study is to rigorously evaluate the existing peer-reviewed data on access to medical marijuana in the USA. Income, ethnic background, stigma, and physician preferences have been posited as the primary structural barriers influencing medical marijuana patient population demographics in the USA. Identification of structural barriers to accessing medical marijuana provides a framework for future policies and programs. Evidence-based policies and programs for increasing medical marijuana access help minimize the disparity of access among qualifying patients.

Historical Change in the Link between Adolescent Deviance Proneness and Marijuana Use, 1979–2004

PubMed Central

Little, Michelle; Weaver, Scott R.; King, Kevin M.; Liu, Freda; Chassin, Laurie

2009-01-01

We examined historical change in the association between adolescent deviance proneness and marijuana use using 26 years (from 1979 through 2004) of national 12th grade data from the Monitoring the Future (MTF) study. “Deviance proneness” was measured using a latent factor model of behavioral and personality characteristics that underlie both substance use and antisocial disorders. Marijuana use outcomes were measured in terms of youths’ annual frequency of use, and youths’ degree of involvement with marijuana. Separate within-gender structural equation models were used to determine whether links between deviance proneness and marijuana use were consistently significant and invariant in magnitude across 13 2-year historical cohorts. Overall results affirmed the established association between adolescent deviance proneness and both the frequency of marijuana use as well as regular use. Among male youth, the size of the association between deviance proneness and marijuana use was significantly smaller at the cohort of lowest population prevalence (1991/92) compared to cohorts marking peaks in marijuana use prevalence, thus suggesting a “softening” historical trend. By contrast, the prediction of female marijuana use from deviance proneness was not consistently related to historical shifts in population prevalence of marijuana use. Study findings point to the utility of risk-focused prevention programming that targets early precursors of both antisocial and substance use disorders. PMID:18317927

Residential Mobility, Transience, Depression, and Marijuana Use Initiation Among Adolescents and Young Adults

PubMed Central

Glasheen, Cristie; Forman-Hoffman, Valerie L; Williams, Jason

2017-01-01

Marijuana use initiation is associated with numerous health and behavioral consequences, particularly among young adolescents. Finding easily identifiable risk markers for marijuana initiation is an important step for targeting primary and secondary prevention efforts. This study used data from the 2010–2014 National Survey on Drug Use and Health to evaluate the association between residential mobility (no mobility, low mobility, high mobility [ie, transience]), and major depressive episode(s) (MDE) on marijuana initiation among adolescents (12–17) and young adults (18–20). Age-stratified logistic regression models indicated that among 12- to 13-year-old adolescents, mobility in the past 5 years and past year MDE have a multiplicative effect on the odds of past year marijuana initiation. Among adolescents aged 14 to 15 years, both mobility and MDE were independently associated with marijuana initiation, but there was no interaction. Among older adolescents (aged 16–17 years), only transience (⩾3 moves in the past 5 years) was associated with marijuana use initiation, and although MDE was significantly associated with marijuana initiation, there was no interaction with mobility. Among young adults, mobility was not associated with marijuana initiation. Residential mobility among young adolescents is an easily identifiable risk marker that may serve as an indicator for physical and mental health professionals, school personnel, and parents to use in targeting both depression and marijuana prevention efforts. PMID:28607541

State medical marijuana laws: understanding the laws and their limitations.

PubMed

Pacula, Rosalie Liccardo; Chriqui, Jamie F; Reichmann, Deborah A; Terry-McElrath, Yvonne M

2002-01-01

Significant attention has been given to the debate regarding allowances for medical marijuana use since the 1996 California and Arizona ballot initiatives. State medical marijuana allowances, however, have existed since the mid-1970s. Much of the current debate stems from confusion about the various ways states approach the issue. In this paper, we present original legal research on current state medical marijuana laws identifying four different ways states statutorily enable the medical use of marijuana. We discuss the tension these approaches have with federal law as well as their implications regarding real access for patients. In addition, we present information on how a small number of states are trying to deal with the issue of access within the context of their medical marijuana laws, and discuss the implication of various supply approaches on the enforcement of other state marijuana laws.

Effects of Marijuana Use on Brain Structure and Function: Neuroimaging Findings from a Neurodevelopmental Perspective

PubMed Central

Brumback, T.; Castro, N.; Jacobus, J.; Tapert, S.

2016-01-01

Marijuana, behind only tobacco and alcohol, is the most popular recreational drug in America with prevalence rates of use rising over the past decade. A wide range of research has highlighted neurocognitive deficits associated with marijuana use, particularly when initiated during childhood or adolescence. Neuroimaging, describing alterations to brain structure and function, has begun to provide a picture of possible mechanisms associated with the deleterious effects of marijuana use. This chapter provides a neurodevelopmental framework from which recent data on brain structural and functional abnormalities associated with marijuana use is reviewed. Based on the current data, we provide aims for future studies to more clearly delineate the effects of marijuana on the developing brain and to define underlying mechanisms of the potential long-term negative consequences of marijuana use. PMID:27503447

The effects of purchasing alcohol and marijuana among adolescents at-risk for future substance use.

PubMed

Osilla, Karen Chan; Pedersen, Eric R; Ewing, Brett A; Miles, Jeremy N V; Ramchand, Rajeev; D'Amico, Elizabeth J

2014-09-18

Among high-risk youth, those who may be at increased risk for adverse alcohol and other drug (AOD) use outcomes may benefit from targeted prevention efforts; how youth acquire AOD may provide an objective means of identifying youth at elevated risk. We assessed how youth acquired alcohol and marijuana (purchasing vs. other means), demographics, AOD behaviors/consequences, and environment among adolescents referred to a diversion program called Teen Court (N = 180) at two time points (prior to the program and 180 days from baseline). Participants were predominantly White and Hispanic/Latino(a). In cross-sectional analyses among alcohol and marijuana users, purchasing marijuana was associated with more frequent marijuana use and consequences, time spent around teens who use marijuana, higher likelihood of substance use disorders, and lower resistance self-efficacy compared to non-purchasers. Teens who purchased both alcohol and marijuana experienced similar outcomes to those who purchased only marijuana, and also reported more frequent and higher quantity of drinking, greater alcohol-related consequences, time spent around teens who use other drugs, and prescription drug misuse. Longitudinally, purchasing alcohol and marijuana at baseline was associated with more frequent and higher quantity of drinking compared to non-purchasers at follow-up. Marijuana only purchasers had a greater likelihood of substance use disorders at follow-up compared to non-purchasers. In an era where drinking is commonplace and attitudes towards marijuana use are becoming more tolerant, it is essential to evaluate how accessibility to AOD and subsequent purchasing behaviors affect youth consumption and intervene accordingly to prevent future consequences.

Reasons for recent marijuana use in relation to use of other illicit drugs among high school seniors in the United States.

PubMed

Palamar, Joseph J; Griffin-Tomas, Marybec; Kamboukos, Dimitra

2015-01-01

Studies show that illicit cannabis (marijuana) use is related to use of other illicit drugs and that reasons for use are related to frequency of marijuana use. However, research is needed to examine whether specific reasons for marijuana use are associated with use of other illicit drugs. Data from recent marijuana-using high school seniors were examined from 12 cohorts of Monitoring the Future (Weighted n = 6481) to examine whether reasons for recent marijuana use are associated with use of eight other illicit drugs. Using "to experiment" decreased odds of reporting use of each drug and using to decrease effects of other drugs increased odds of reporting use of each drug. In multivariable models, using marijuana "to experiment" decreased the odds for reporting use of hallucinogens other than LSD and narcotics other than heroin. Using marijuana for "insight" increased the odds for use of hallucinogens other than LSD, and use due to "boredom" increased the odds for reporting use of powder cocaine and hallucinogens other than LSD. Using marijuana to increase effects of other drugs increased odds of reporting use of each of the eight drugs, and using it to decrease other drug effects increased odds of reporting use of crack, hallucinogens other than LSD, and amphetamine/stimulants. This study helped identify illicit marijuana users who are more likely to report use of other illicit drugs. Prevention efforts need to focus on students who report certain reasons for marijuana use as they may be at risk for use of other illicit drugs.

Retail Marijuana Purchases in Designer and Commercial Markets in New York City: Sales Units, Weights, and Prices per Gram

PubMed Central

Sifaneck, Stephen J.; Ream, Geoffrey L.; Johnson, Bruce D.; Dunlap, Eloise

2007-01-01

This paper documents the bifurcation of the market for commercial marijuana from the market for designer marijuana in New York City. Commercial marijuana is usually grown outdoors, imported to NYC, and of average quality. By contrast, several strains of designer marijuana are usually grown indoors from specially-bred strains and carefully handled for maximum quality. The mechanisms for selling include street/park sellers, delivery services, private sales, and storefronts. Retail sales units vary from $5 to $50 and more, but the actual weights and price per gram of retail marijuana purchases lacks scientific precision. Ethnographic staff recruited marijuana purchasers who used digital scales to weigh a purposive sample of 99 marijuana purchases. Results indicate clear differences in price per gram between the purchases of commercial (avg. $8.20/gram) and designer (avg. $18.02/gram) marijuana. Designer purchases are more likely to be made by whites, downtown (Lower East Side/Union Square area), via delivery services, and in units of $10 bags, $50 cubes, and eighth and quarter ounces. Commercial marijuana purchases are more likely to be made by blacks, uptown (Harlem), via street dealers, and in units of $5 and $20 bags. Imported commercial types Arizona and Chocolate were only found uptown, while designer brand names describing actual strains like Sour Diesel and White Widow were only found downtown. Findings indicate clear divisions between commercial and designer marijuana markets in New York City. The extent that these differences may be based upon different THC potencies is a matter for future research. PMID:17055670

Trends in fatal motor vehicle crashes before and after marijuana commercialization in Colorado*

PubMed Central

Salomonsen-Sautel, Stacy; Min, Sung-Joon; Sakai, Joseph T.; Thurstone, Christian; Hopfer, Christian

2014-01-01

Background Legal medical marijuana has been commercially available on a widespread basis in Colorado since mid-2009; however, there is a dearth of information about the impact of marijuana commercialization on impaired driving. This study examined if the proportions of drivers in a fatal motor vehicle crash who were marijuana-positive and alcohol-impaired, respectively, have changed in Colorado before and after mid-2009 and then compared changes in Colorado with 34 non-medical marijuana states (NMMS). Methods Thirty-six 6-month intervals (1994–2011) from the Fatality Analysis Reporting System were used to examine temporal changes in the proportions of drivers in a fatal motor vehicle crash who were alcohol-impaired (≥ 0.08 g/dl) and marijuana-positive, respectively. The pre-commercial marijuana time period in Colorado was defined as 1994–June 2009 while July 2009–2011 represented the post-commercialization period. Results In Colorado, since mid-2009 when medical marijuana became commercially available and prevalent, the trend became positive in the proportion of drivers in a fatal motor vehicle crash who were marijuana-positive (change in trend, 2.16 (0.45), p < 0.0001); in contrast, no significant changes were seen in NMMS. For both Colorado and NMMS, no significant changes were seen in the proportion of drivers in a fatal motor vehicle crash who were alcohol-impaired. Conclusions Prevention efforts and policy changes in Colorado are needed to address this concerning trend in marijuana-positive drivers. In addition, education on the risks of marijuana-positive driving needs to be implemented. PMID:24831752

Do adolescent Ecstasy users have different attitudes towards drugs when compared to Marijuana users?

PubMed Central

Martins, Silvia S.; Storr, Carla L.; Alexandre, Pierre K.; Chilcoat, Howard D.

2008-01-01

Background Perceived risk and attitudes about the consequences of drug use, perceptions of others expectations and self-efficacy influence the intent to try drugs and continue drug use once use has started. We examine associations between adolescents’ attitudes and beliefs towards ecstasy use; because most ecstasy users have a history of marijuana use, we estimate the association for three groups of adolescents: non-marijuana/ecstasy users, marijuana users (used marijuana at least once but never used ecstasy) and ecstasy users (used ecstasy at least once). Methods Data from 5,049 adolescents aged 12–18 years old who had complete weighted data information in Round 2 of the Restricted Use Files (RUF) of the National Survey of Parents and Youth (NSPY). Data were analyzed using jackknife weighted multinomial logistic regression models. Results Adolescent marijuana and ecstasy users were more likely to approve of marijuana and ecstasy use as compared to non-drug using youth. Adolescent marijuana and ecstasy users were more likely to have close friends who approved of ecstasy as compared to non-drug using youth. The magnitudes of these two associations were stronger for ecstasy use than for marijuana use in the final adjusted model. Our final adjusted model shows that approval of marijuana and ecstasy use was more strongly associated with marijuana and ecstasy use in adolescence than perceived risk in using both drugs. Conclusion Information about the risks and consequences of ecstasy use need to be presented to adolescents in order to attempt to reduce adolescents’ approval of ecstasy use as well as ecstasy experimentation. PMID:18068314

The impact of the legalization of recreational marijuana on college students.

PubMed

Jones, Jacob; Nicole Jones, K; Peil, Jenny

2018-02-01

In January of 2014 the Regulate Marijuana like Alcohol Act or, Amendment 64, went into effect in Colorado. Even though it was the first state to enact recreational legalization, attitudes towards marijuana use have been changing for decades. Prompted by medical marijuana legalization, studies have found mixed results in regards to the impact that legalization has on frequency of use and abuse. With college students having the highest rates of use in the United States (U.S.), whether legal or not, it was important to explore the impact that legalization has on this population. In the current study, rates of marijuana and alcohol use in college students before and after recreational legalization were explored. Data was collected in four waves from October 2013 to March 2015, to be able to determine the trends in marijuana and alcohol use, and relationship between the substances. In addition, grade point average was measured as a possible consequence of marijuana use. We found the frequency of marijuana use in Colorado college students is much higher than the national average t(94445)=24.424, p<0.001, especially the percentage of daily or almost daily users, t(2191)=10.373, p<0.001. There were significant differences between the marijuana non-users and the once a week or more often but not daily marijuana users in grade point average, F(6, 227)=2.935, p<0.001. In addition, it seems that the relationship between alcohol and marijuana use in general is decreasing since the passing of Amendment 64, but not among the binge drinkers. Copyright © 2017 Elsevier Ltd. All rights reserved.

Early onset marijuana use is associated with learning inefficiencies.

PubMed

Schuster, Randi Melissa; Hoeppner, Susanne S; Evins, A Eden; Gilman, Jodi M

2016-05-01

Verbal memory difficulties are the most widely reported and persistent cognitive deficit associated with early onset marijuana use. Yet, it is not known what memory stages are most impaired in those with early marijuana use. Forty-eight young adults, aged 18-25, who used marijuana at least once per week and 48 matched nonusing controls (CON) completed the California Verbal Learning Test, Second Edition (CVLT-II). Marijuana users were stratified by age of initial use: early onset users (EMJ), who started using marijuana at or before age 16 (n = 27), and late onset marijuana user group (LMJ), who started using marijuana after age 16 (n = 21). Outcome variables included trial immediate recall, total learning, clustering strategies (semantic clustering, serial clustering, ratio of semantic to serial clustering, and total number of strategies used), delayed recall, and percent retention. Learning improved with repetition, with no group effect on the learning slope. EMJ learned fewer words overall than LMJ or CON. There was no difference between LMJ and CON in total number of words learned. Reduced overall learning mediated the effect on reduced delayed recall among EMJ, but not CON or LMJ. Learning improved with greater use of semantic versus serial encoding, but this did not vary between groups. EMJ was not related to delayed recall after adjusting for encoding. Young adults reporting early onset marijuana use had learning weaknesses, which accounted for the association between early onset marijuana use and delayed recall. No amnestic effect of marijuana use was observed. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Medicinal marijuana for epilepsy: a case series study.

PubMed

Ladino, Lady Diana; Hernández-Ronquillo, Lizbeth; Téllez-Zenteno, José Francisco

2014-11-01

To describe the social, clinical and use-patterns characteristics of medicinal marijuana use among patients with epilepsy (PWEs). Eighteen PWEs with prescriptions for medicinal marijuana from a Canadian adult-epilepsy clinic were included in this study. Eighteen patients had a prescription of medicinal marijuana from a total population of 800 PWEs in our center (2.2%). Mean age of patients was 30±7.4 (19-50) years. Twelve (67%) patients were males. Eleven (61%) patients had drug-resistant epilepsy. Eleven (61%) patients suffered a psychiatric comorbidity and reported the use of illicit substances or heavy alcohol or tobacco consumption. Only two (11%) patients were married; the rest of patients (89%) were single or divorced. The drug use pattern was similar among patients. All patients asked for marijuana permission in the epilepsy clinic. Most (83%) had a previous history of marijuana smoking, with a mean of 6.6±3 (1-15) years. The mean consumption dose was 2.05±1.8 (0.5-8) grams per day. Ten (56%) patients reported withdrawal seizure exacerbation when they stopped the marijuana. Only two patients (11%) reported side effects, and all patients found medicinal marijuana very helpful for seizure control and improvement of mood disorder. PWEs using medicinal marijuana have a common profile. They are usually young single men with drug-resistant epilepsy and psychiatric comorbidity. Most used marijuana before formal prescription and all believe the drug was effective on their seizure control. Because of the concurrent use of other antiseizure medications, it is complex to estimate the actual effect of marijuana.

Early Onset Marijuana Use Is Associated with Learning Inefficiencies

PubMed Central

Schuster, Randi Melissa; Hoeppner, Susanne S.; Evins, A. Eden; Gilman, Jodi M.

2016-01-01

Objective Verbal memory difficulties are the most widely reported and persistent cognitive deficit associated with early-onset marijuana use. Yet, it is not known what memory stages are most impaired in those with early marijuana use. Method Forty-eight young adults, aged 18–25, who used marijuana at least once per week and 48 matched non-using controls (CON) completed the California Verbal Learning Test, Second Edition (CVLT-II). Marijuana users were stratified by age of initial use: ‘early onset’ users (EMJ), who started using marijuana at or before age 16 (n = 27), and ‘late onset’ marijuana user group (LMJ), who started using marijuana after age 16 (n = 21). Outcome variables included trial immediate recall, total learning, clustering strategies (semantic clustering, serial clustering, ratio of semantic to serial clustering, and total number of strategies used), delayed recall, and percent retention. Results Learning improved with repetition, with no group effect on the learning slope. EMJ learned fewer words overall than LMJ or CON. There was no difference between LMJ and CON in total number of words learned. Reduced overall learning mediated the effect on reduced delayed recall among EMJ, but not CON or LMJ. Learning improved with greater use of semantic versus serial encoding, but this did not vary between groups. EMJ was not related to delayed recall after adjusting for encoding. Conclusions Young adults reporting early onset marijuana use had learning weaknesses, which accounted for the association between early onset marijuana use and delayed recall. No amnestic effect of marijuana use was observed. PMID:26986749

The impact of marijuana use on memory in HIV-infected patients: a comprehensive review of the HIV and marijuana literatures

PubMed Central

Skalski, Linda M.; Towe, Sheri L.; Sikkema, Kathleen J.; Meade, Christina S.

2016-01-01

Background The most robust neurocognitive effect of marijuana use is memory impairment. Memory deficits are also high among persons living with HIV/AIDS, and marijuana is the most commonly used drug in this population. Yet research examining neurocognitive outcomes resulting from co-occurring marijuana and HIV is limited. Objective The primary objectives of this comprehensive review are to: (1) examine the literature on memory functioning in HIV-infected individuals; (2) examine the literature on memory functioning in marijuana users; (3) synthesize findings and propose a theoretical framework to guide future research. Method PubMed was searched for English publications 2000–2013. Twenty-two studies met inclusion criteria in the HIV literature, and 23 studies in the marijuana literature. Results Among HIV-infected individuals, memory deficits with medium to large effect sizes were observed. Marijuana users also demonstrated memory problems, but results were less consistent due to the diversity of samples. Conclusion A compensatory hypothesis, based on the cognitive aging literature, is proposed to provide a framework to explore the interaction between marijuana and HIV. There is some evidence that individuals infected with HIV recruit additional brain regions during memory tasks to compensate for HIV-related declines in neurocognitive functioning. Marijuana use causes impairment in similar brain systems, and thus it is hypothesized that the added neural strain of marijuana can exhaust neural resources, resulting in pronounced memory impairment. It will be important to test this hypothesis empirically, and future research priorities are discussed. PMID:27138170

Predictors of Recent Marijuana Use and Past Year Marijuana Use Among a National Sample of Hispanic Youth.

PubMed

King, Keith A; Vidourek, Rebecca A; Merianos, Ashley L; Bartsch, Lauren A

2015-01-01

Marijuana use rates remain higher among Hispanic youth compared to youth from other ethnic groups. The purpose of the study was to examine if sex, age, authoritarian parenting, perceived school experiences, lifetime depression, legal involvement, and perceived social norms of marijuana use predicted recent marijuana use and past year marijuana use among Hispanic youth. The participants of this study were a nationwide sample of Hispanic youth (n = 3,457) in the United States. A secondary data analysis of the 2012 National Survey on Drug Use and Health was performed. Unadjusted odds ratios were computed via univariate logistic regression analyses and all statistically significant variables were retained and included in the final multiple logistic regression analyses. Recent marijuana use was operationally defined as use within the past 30 days, and marijuana use in the past year was defined as use within the past year. Results indicated that 7.5% of Hispanic youth used within the past month and 14.5% of Hispanic youth used within the past year. Results revealed that significant predictors for recent use were age, authoritarian parenting, perceived school experiences, legal involvement, and perceived social norms of youth marijuana use. Predictors for past year were age, perceived school experiences, legal involvement, and perceived social norms of youth marijuana use. Findings from this study can be used to address the public health problem of marijuana use among Hispanic youth that is ultimately contributing to health disparities among this ethnic group nationwide. Recommendations for future studies are included.

Long-term consequences of adolescent cannabis use: Examining intermediary processes.

PubMed

Green, Kerry M; Doherty, Elaine E; Ensminger, Margaret E

2017-09-01

In the United States, perceptions of marijuana's acceptability are at an all-time high, risk perceptions among youth are low, and rates are rising among Black youth. Thus, it is imperative to increase the understanding of long-term effects of adolescent marijuana use and ways to mitigate adverse consequences. To identify the midlife consequences of heavy adolescent marijuana use and the mechanisms driving effects among a Black, urban population. This study analyzed the propensity score-matched prospective data from the Woodlawn Study, a community cohort study of urban Black youth followed from ages 6-42. After matching the 165 adolescents who used marijuana heavily to 165 non-heavy/nonusers on background confounders to reduce selection effects (64.5% male), we tested the association of heavy marijuana use by age 16 with social, economic, and physical and psychological health outcomes in midlife and the ability of adult drug trajectories (marijuana, cocaine, and heroin use from ages 17-42) and school dropout to mediate effects. Heavy adolescent marijuana use was associated with an increased risk of being poor and of being unmarried in midlife. Marijuana use also predicted lower income and greater anxious mood in midlife. Both adult drug use trajectories and school dropout significantly mediated socioeconomic effects but not marital or anxious mood outcomes. Heavy adolescent marijuana use seems to set Black, urban youth on a long-term trajectory of disadvantage that persists into midlife. It is critical to interrupt this long-term disadvantage through the prevention of heavy adolescent marijuana use, long-term marijuana and other drug use, and school dropout.

Perceived harms and benefits of tobacco, marijuana, and electronic vaporizers among young adults in Colorado: implications for health education and research.

PubMed

Popova, Lucy; McDonald, Emily Anne; Sidhu, Sohrab; Barry, Rachel; Richers Maruyama, Tracey A; Sheon, Nicolas M; Ling, Pamela M

2017-10-01

To evaluate how young adults perceive and compare harms and benefits of marijuana and tobacco products in the context of a legal marijuana market in Colorado. Semi-structured qualitative interviews. Denver, CO, USA. Thirty-two young adults (aged 18-26 years) who used tobacco/marijuana/vaporizers. Semi-structured interviews addressed perceived harms and benefits of various tobacco and marijuana products and personal experiences with these products. Young adults evaluated harms and benefits using five dimensions: (1) combustion-smoking was considered more harmful than non-combustible products (e.g. e-cigarettes, vaporizers and edibles); (2) potency-edibles and marijuana concentrates were perceived as more harmful than smoking marijuana flower because of potential to receive too large a dose of tetrahydrocannabinol (THC); (3) chemicals-products containing chemical additives were seen as more harmful than 'pure' or 'natural' plant products; (4) addiction-participants recognized physiological addiction to nicotine, but talked primarily about psychological or life-style dependence on marijuana; and (5) source of knowledge-personal experiences, warning labels, campaigns, the media and opinions of product retailers and medical practitioners affected perceptions of harms and benefits. Among young adults in Colorado, USA, perceived harms and benefits of tobacco and marijuana include multiple dimensions. Health educational campaigns could benefit from addressing these dimensions, such as the potency of nicotine and cannabis concentrates and harmful chemicals present in the organic material of tobacco and marijuana. Descriptors such as 'natural' and 'pure' in the promotion or packaging of tobacco and marijuana products might be misleading. © 2017 Society for the Study of Addiction.

Effects of Marijuana on Fetal Development.

ERIC Educational Resources Information Center

Hoyt, Les Leanne

1981-01-01

Presents an historical perspective of the public view of marijuana and examines current empirical research concerning the consequences of marijuana use on the human fetus. Included are 1979 university survey results which explore respondents' knowledge about the effects of marijuana and the relationship this has to the mass media. (Author)

Marijuana: A Study of State Policies & Penalties.

ERIC Educational Resources Information Center

Peat, Marwick, Mitchell and Co., Columbia, MD.

This study is a comprehensive analysis of issues concerning marijuana that are of importance to state policy makers. It reviews the medical, legal, and historical dimensions of marijuana use and examines the range of policy approaches toward marijuana possession and use which state officials have considered. Attention is directed to the experience…

Drug Use and Attitudes Toward Social and Legal Aspects of Marijuana in a Large Metropolitan University

ERIC Educational Resources Information Center

Martino, Edward R.; Truss, Carroll V.

1973-01-01

Attitude toward marijuana shifted from strongly negative to strongly positive as frequency of marijuana use increased. With frequency of use controlled, attitude toward marijuana was even more favorable when other drugs had been tried, and also among students who were religiously inactive. (Author)

77 FR 28225 - Sentencing Guidelines for United States Courts

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-11

... (2d Cir. 2011). The amendment establishes a marijuana equivalency for BZP offenses in the Drug...). The marijuana equivalency established by the amendment provides that 1 gram of BZP equals 100 grams of marijuana. Prior to the amendment, the Drug Equivalency Table did not include a marijuana equivalency for...

Characteristics of Marijuana Acquisition among a National Sample of Adolescent Users

ERIC Educational Resources Information Center

King, Keith A.; Merianos, Ashley L.; Vidourek, Rebecca A.

2016-01-01

Background: Because marijuana is becoming more accessible and perceived norms of use are becoming increasingly more favorable, research is needed to understand characteristics of marijuana acquisition among adolescents. Purpose: The study purpose was to examine whether sources and locations where adolescent users obtain and use marijuana differed…

Stroke from Vasospasm due to Marijuana Use: Can Cannabis Synergistically with Other Medications Trigger Cerebral Vasospasm?

PubMed

Jamil, Marium; Zafar, Atif; Adeel Faizi, Syed; Zawar, Ifrah

2016-01-01

We present a case of imaging proven cerebral vasospasm causing ischemic stroke in a young patient chronically on buprenorphine-naloxone for heroin remission who started smoking cannabis on a daily basis. With cannabis legalization spreading across the states in the USA, it is important for physicians not only to be aware of cannabis reported association with cerebral vasospasm in some patients but also to be on the lookout for possible interacting medications that can synergistically affect cerebral vessels causing debilitating strokes.

Using Marijuana May Not Raise the Risk of Using Harder Drugs

DTIC Science & Technology

2003-02-01

Using Marijuana May Not Raise the Risk of Using Harder Drugs Marijuana is widely regarded as a "gateway" drug, that is, one whose use results in an...laws prohibiting the use or possession of marijuana . A recent analysis by RAND’s Drug Policy Research Center (DPRC) suggests that data typically used...to support a marijuana gateway effect can be explained as well by a different theory. The new research, by Andrew Morral, associate director of RAND

Civic Norms and Etiquettes Regarding Marijuana Use in Public Settings in New York City

PubMed Central

Johnson, Bruce D.; Ream, Geoffrey L.; Dunlap, Eloise; Sifaneck, Stephen J.

2008-01-01

This paper shows that active police enforcement of civic norms against marijuana smoking in public settings has influenced the locations where marijuana is smoked. It has subtly influenced the various marijuana etiquettes observed in both public and private settings. The ethnographic data reveals the importance of informal sanctions; most marijuana consumers report compliance with etiquettes mainly to avoid stigma from nonusing family, friends, and associates—they express limited concern about police and arrest. PMID:18570024

Risk factors and outcomes of chronic sexual harassment during the transition to college: Examination of a two-part growth mixture model.

PubMed

McGinley, Meredith; Wolff, Jennifer M; Rospenda, Kathleen M; Liu, Li; Richman, Judith A

2016-11-01

A two-part latent growth mixture model was implemented in order to examine heterogeneity in the growth of sexual harassment (SH) victimization in college and university students, and the extent to which SH class membership explains substance use and mental health outcomes for certain groups of students. Demographic risk factors, mental health, and substance use were examined as they related to chronically experienced SH victimization. Incoming freshmen students (N = 2855; 58% female; 54% White) completed a survey at five time points. In addition to self-reporting gender, race, and sexual orientation, students completed measures of sexual harassment, anxiety, depression, binge drinking, and marijuana use. Overall, self-reported SH declined upon college entry, although levels rebounded by the third year of college. Results also supported a two-class solution (Infrequent and Chronic) for SH victimization. Being female, White, and a sexual minority were linked to being classified into the Chronic (relative to the Infrequent) SH class. In turn, Chronic SH class membership predicted greater anxiety, depression, and substance use, supporting a mediational model. Copyright © 2016 Elsevier Inc. All rights reserved.

The Experiences of Medical Marijuana Patients: A Scoping Review of the Qualitative Literature.

PubMed

Ryan, Jennie; Sharts-Hopko, Nancy

2017-06-01

Medical marijuana is now legal in more than half of the United States but remains federally prohibited and classified as a schedule 1 drug. The chemical compounds in marijuana are known neuroprotectants; however, their clinical efficacy and safety have not been proven. Many healthcare providers remain unaware of the therapeutic potential of marijuana and its adverse effects. The conflicting laws and lack of guidance from healthcare professionals can lead to confusion and frustration for patients seeking this medication. Multiple factors contribute to the unique and varied experiences of medical marijuana patients. Because more individuals with neurological disorders seek therapeutic marijuana, it is important for healthcare professionals to understand their distinctive experiences. Qualitative research methodology is ideal to capture the thick descriptions of these experiences. This review examines the qualitative research exploring the experiences of medical marijuana patients and discusses common themes across all studies.

Land and Law in Marijuana Country: Clean Capital, Dirty Money, and the Drug War’s Rentier Nexus

PubMed Central

Polson, Michael

2015-01-01

Despite its ongoing federal illegality, marijuana production has become a licit, or socially accepted, feature of northern California’s real estate market. As such, marijuana is a key component of land values and the laundering of “illegal” wealth into legitimate circulation. By following land transaction practices, relations, and instruments, this article shows how formally equal property transactions become substantively unequal in light of the “il/legal” dynamics of marijuana land use. As marijuana becomes licit, prohibitionist policies have enabled the capture of ground rent by landed interests from the marijuana industry at a time when the price of marijuana is declining (in part due to its increasing licitness). The resulting “drug war rentier nexus,” a state–land–finance complex, is becoming a key, if obscured, component within marijuana’s contemporary political economy. PMID:26594104

[Marijuana for medical purposes--public health perspective].

PubMed

Gazdek, Davorka

2014-01-01

Studies show significant negative effects of smoking marijuana on physical and mental health as well as social and occupational functioning. At the same time, there are more considerations about its ability to treat a number of diseases. This review summarizes current data in scientific literature that examines the medical effects of marijuana on human health with particular emphasis on its potential in medicine. Marijuana has a range of adverse health effects, particularly relating to young people because of higher risk for psychosis, traffic accidents, and cognitive impairment. Marijuana may be helpful in relieving symptoms of nausea and vomiting, increasing appetite and pain relief for persons with cancer, AIDS and multiple sclerosis. Smoking marijuana can impose significant public health risks. If there is a medical role for using marijuana, it lies in the application of clearly defined medical protocols and chemically defined compounds, not with using the unprocessed cannabis plant.

The role of marijuana use etiquette in avoiding targeted police enforcement

PubMed Central

REAM, GEOFFREY L.; JOHNSON, BRUCE D.; DUNLAP, ELOISE; BENOIT, ELLEN

2012-01-01

Internationally, where marijuana is illegal, users follow etiquette rules that prevent negative consequences of use. In this study, adherence to etiquette is hypothesized to reduce likelihood of marijuana-related police stop/search and arrest. Ethnographers administered group surveys to a diverse, purposive sample of 462 marijuana-using peer groups in several areas of New York City. Findings indicated that lack of etiquette was associated with dramatically higher likelihood of police stop/search or arrest only for users who were Black, male, and/or recruited from Harlem/South Bronx. If these users followed a few identified etiquette rules, their risk of police stop/search or arrest was comparable to that of other users. Implications are that etiquette represents an intentional conscientiousness about marijuana use. Groups that are specially targeted for anti-marijuana enforcement can remediate that heightened risk by following marijuana etiquette. PMID:23155303

Marijuana. Specialized Information Service.

ERIC Educational Resources Information Center

Do It Now Foundation, Phoenix, AZ.

The document presents a collection of articles about marijuana. Article 1 reports on the results of a study by the National Academy of Sciences on the health effects of marijuana. A summary report of adverse health and behavioral consequences of cannabis (marijuana) use is provided in article 2. Article 3 presents the Surgeon General's warnings on…

Sociopsychological Characteristics of Undergraduate Marijuana Users

ERIC Educational Resources Information Center

Cunningham, William H.; And Others

1974-01-01

Presents a study of 547 college students which found that: 1) It is possible to distinguish between undergraduate subjects who smoke marijuana and those who do not, 2) It is possible to draw a reasonable clear picture of the marijuana users' demographic characteristics, and 3) There is a positive relationship between the use of marijuana and the…