Research and Studies

1. Legalizing cannabis has been shown to increase the rates of motor vehicle accidents.
2. Cannabis use is a risk factor for mental illness.
3. Inhaled Cannabis use is a risk factor for respiratory infections.
4. Cannabis use increases the rate of vascular disease. Cannabis is the third most often identified drug of abuse
5. Cannabis use during pregnancy has been associated with increased risk of adverse birth outcomes
6. Legalization of cannabis has been shown to increase cannabis exposure in the pediatric population.
7. Heavy cannabis use is associated with diminished lifetime achievements.
Doctors must educate the public about the potential harm cannabis causes with heavy, and possibly moderate, widespread use just as they do about the dangers of tobacco use. Tobacco use has declined in the United States in large part because of the knowledge the public now holds about its adverse effects, as opposed to legislative action.

Similarly, it can be anticipated that if introduced, the indications for the  use of medical cannabinoids would expand well outside of the initial indications. Hence, the medical profession cannot justify the use of medical cannabinoids that would be associated with an iatrogenic risk of serious adverse psychological events.  The use of medical cannabinoids for any purpose, including research under closely observed conditions, is incompatible with mental health promotion.

The existence of hallucinations, delusions, and organic brain dysfunction in heavy cannabis users seems to be associated with cannabinoid levels in hair. The continuation of persistent symptoms 3 months after the discontinuation of cannabis abuse, was a remarkable finding. SCIENTIFIC SIGNIFICANCE: We provide evidence that chronic and heavy cannabis abuse results in long-lasting brain dysfunction in all users and in long-lasting schizophrenia-like psychotic symptoms in more than half of all users. These findings suggest a reevaluation of the current classification of cannabis as a "soft narcotic" which erroneously, therefore, is typically considered harmless. (Am J Addict 2017;XX:1-8).

Short-term side effects include impaired short-term memory, impaired motor function, altered judgment, and, in high doses, paranoia and psychosis. Not to mention that drivers who have recently smoked marijuana are twice as likely to get into a car accident than their sober counterparts.Approximately 9% of people who experiment with marijuana will become addicted.
If marijuana can meet all of the FDA requirements, including efficacy data, evidence of safety, and a meticulous quality control program, then the medicinal use of marijuana could be supported. Until then, we will need smoke and mirrors to make it appear that this drug not only makes people feel good, but is indeed good for you.

According to research studies, marijuana use causes aggressive behavior, causes or exacerbates psychosis and produce paranoias. These effects have been illustrated through case studies of highly publicized incidents and heightened political profiles.

Marijuana is currently a growing risk to the public in the United States. Following expanding public opinion that marijuana provides little risk to health, state and federal legislatures have begun changing laws that will significantly increase accessibility of marijuana. Greater marijuana accessibility, resulting in more use, will lead to increased health risks in all demographic categories across the country. Violence is a well-publicized, prominent risk from the more potent, current marijuana available.

Detailed Information
. Patients freely share their “medicine” with family and friends, and parents are self-diagnosing, and subsequently dosing their children with high-concentration marijuana products for conditions that may simply not exist (attention-deficit/hyperactivity disorder, anxiety, etc.); or allow their medical cards to expire and continue to grow their own.
The use of marijuana for medical conditions, including pain, needs robust studies, and subsequent products need more regulation and consistency for public consumption. Colorado is an example of the societal effect across a wide spectrum of arenas that comes with rampant cannabis use, particularly in youth use and impaired driving fatalities. The problems Colorado is seeing completely transcend “responsible use” or “marijuana as medicine.” 

CONCLUSIONS:
Medical marijuana law exposure between age 14 to 18 likely has a delayed effect on use and education that persists over time.

A common theme among every article in this issue is the overlap be- tween NMUPD, excessive drinking, and marijuana and other forms of substance use. In every investigation, nonmedical users were observed to have a history of using alcohol, marijuana, tobacco, and other psycho- active substances. Kalyanam, Katsuki, Lanckriet, and Mackey (2017)
Kalyanam, J., Katsuki, T., Lanckriet, G., & Mackey, T. K. (2017). Exploring trends of non- medical use of prescription drugs and polydrug abuse in the Twittersphere using un- supervised machine learning. Addictive Behaviors, 65, 289–295. http://dx.doi.org/10. 1016/j.addbeh.2016.08.019.

http://www.ncbi.nlm.nih.gov/pubmed/?term=marijuana

For the researchers of the study, the results present a “a major public health concern” as a number of pregnant women would report taking marijuana to alleviate morning sickness or nausea – without knowing of the adverse side-effects.

http://www.sciencedirect.com/science/article/pii/S0890623816300715#    

Highlights

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Marijuana increases the risk of spontaneous preterm birth independent of cigarette smoking status and socio-economic status.

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Women who continue to use marijuana at 20 weeks’ gestation are five times more likely to deliver preterm than those who do not.

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The rate of early SPTB is higher amongst women who continue to use marijuana at 20 weeks’ gestation.

What makes this new study more compelling than previous studies is that the researchers followed the same individuals for over 50 years from a young age to adulthood.  This is precisely what one needs to solve the chicken or egg riddle with respect to cannabis and violence:  just look and see which one happens first.
One fifth of those who were pot smokers (22%) reported violent behavior that began after beginning to use cannabis, whereas only 0.3% reported violence before using weed.  Continued use of cannabis over the life-time of the study was the strongest predictor of violent convictions, even when the other factors that contribute to violent behavior were considered in the statistical analysis.
 In conclusion, the results show that continued cannabis use is associated with a 7-fold greater odds for subsequent commission of violent crimes.  This level of risk is similar to the increased risk of lung cancer from smoking cigarettes over a similar duration (40 years).  The authors suggest that impairments in neurological circuits controlling behavior may underlie impulsive, violent behavior, as a result of cannabis altering the normal neural functioning in the ventrolateral prefrontal cortex. 

A new study suggests marijuana smokers may be significantly more likely to develop an addiction to other drugs and alcohol than people who don’t use marijuana.
The study, published in JAMA Psychiatry, included almost 35,000 adults who were interviewed three years apart. At the time of the first interview, almost 1,300 used marijuana. After three years, two-thirds of people who used marijuana had some form of substance use disorder, compared with less than 20 percent of people who did not use marijuana in the previous year.

Thus, adolescent THC exposure induced behavioral abnormalities resembling positive and negative schizophrenia-related endophenotypes and a state of neuronal hyperactivity in the mesocorticolimbic dopamine (DA) pathway. Furthermore, we observed profound alterations in several prefrontal cortical molecular pathways consistent with sub-cortical DAergic dysregulation. Our findings demonstrate a profound dissociation in relative risk profiles for adolescent versus adulthood exposure to THC in terms of neuronal, behavioral, and molecular markers resembling neuropsychiatric pathology.  

These results from an uncontrolled study support the animal studies and prior reports showing that CBD may be a promising treatment for TRE and it is generally well-tolerated in doses up to 25mg/kg/day. Epidiolex is now being investigated in randomized controlled studies in DS and LGS.

The project is intended to treat 50 children from ages 2 to 16 living with epilepsy that have exhausted most of their treatment options, Carney said.
Every step of the three-year study will be meticulously tracked. Patients will check-in at regular intervals and the researchers will examine how the children are responding, Carney said.
All subjects will be clinically evaluated and seizure frequency will be recorded in a diary given to patients, according to the ClinicalTrials.gov website.
“Through this research, we want to learn about what type of children respond, if they can tolerate the medication and if there are any side effects we need to worry about,” Carney said.
The study will begin later this summer and participants are still being accepted, Carney said.The project is intended to treat 50 children from ages 2 to 16 living with epilepsy that have exhausted most of their treatment options, Carney said.
Every step of the three-year study will be meticulously tracked. Patients will check-in at regular intervals and the researchers will examine how the children are responding, Carney said.
All subjects will be clinically evaluated and seizure frequency will be recorded in a diary given to patients, according to the ClinicalTrials.gov website.
“Through this research, we want to learn about what type of children respond, if they can tolerate the medication and if there are any side effects we need to worry about,” Carney said.
The study will begin later this summer and participants are still being accepted, Carney said.

The American Medical Association (AMA) has opposed legalizing marijuana for medical use for many years due to the lack of evidence to support such action. In addition to AMA, the following medical associations also oppose legalizing marijuana or any of its components for medical use before FDA-quality evidence is available.

• Prenatal exposure to marijuana has been shown to be predictive of psychotic symptoms in young adulthood.
• Monitoring the Future survey reported a five-year decline in the perceived harm of regularly smoking marijuana, from 52.4% of high school seniors to 36.1%
• Marijuana is the most widely used illegal drug in the United States and it is estimated that it is used by 61% of all persons suffering from a substance use disorder related to drugs other than alcohol.
• The risk of developing addiction associated with cannabis use has been reported to increase to about 17% among those who start using marijuana in adolescence, and to 25-50% among those who smoke marijuana daily.
• Smoke from marijuana combustion has been shown to contain a number of carcinogens and cocarcinogens, as well as many of the toxins, irritants, and carcinogens as tobacco smoke. 
• Marijuana-infused edibles account for 45% of the legal marijuana marketplace.
• AMA Marijuana has a high potential for abuse. It has no scientifically proven, currently accepted medical use for preventing or treating any disease process in the United States.

Number Using Opioids and Marijuana on the Rise

Chart: Colorado among states with growing heroin, prescription drug abuse problem 

Consistent with the past, in 2014 still only 47 percent of operators involved in traffic deaths were tested for drug impairment.

"We found support for the synergistic effect on an individual level; people who tend to use more marijuana also tend to use more opioids," said Scott Novak, PhD, senior research scientist at RTI International, a leading research institute in Research Triangle Park, North Carolina.
What's worrisome is that the positive association between cannabis and opioid use is growing stronger. The study found that over time, people were using these drugs more often; there were more opioids days and more cannabis days.

Overall, these studies seem to indicate that cannabinoids have a significant role to play in the management of chronic pain. However, there are important issues that limit the validity of this conclusion. First and most important is how the improvement in pain was evaluated. In many of the studies, only instruments to measure the level of pain, most notably the Visual Analogue Scale, were used. This is fine when one is measuring acute pain. But when it comes to chronic pain—which is what the studies were looking at—the most important measures of the impact of any treatment are improvement in functioning and other objective measures, such as reduction in use of analgesic medications.
he review found minimal evidence that cannabinoids are beneficial for the nausea and vomiting associated with chemotherapy or for stimulation of appetite in patients with HIV/AIDS. It also found no evidence of effectiveness for the treatment of glaucoma or mental disorders; instead, it found that cannabinoids were more likely to worsen the latter. There was some evidence that cannabinoids might be beneficial for the spasticity associated with multiple sclerosis, but even here the results did not reach statistical significance. 
Current research has fallen far short of criteria required by the FDA to approve any drug, much less for conditions not considered acutely life-threatening and for which there are already many other effective and safe treatments. The variation from state to state as to which medical conditions are approved for cannabinoid use is not because lawmakers have ignored scientific evidence. Rather, it reflects the absence of such evidence and an approval process based on politics, not science.