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Toxicologist Peter Stout, CEO and president of the Houston Forensic Science Center, said the toxicology report showed low levels of anti-anxiety drugs and marijuana in Kelley's system.

guns, mass killings, violence

Conclusions and Relevance  This meta-analysis found a significant increase in the odds of past or current and subsequent marijuana use in adolescents and young adults who used e-cigarettes. These findings highlight the importance of addressing the rapid increases in e-cigarette use among youths as a means to help limit marijuana use in this population.

meta-analysis
powerpoint, legalization

“No amount of marijuana use during pregnancy or adolescence is safe,” said Surgeon General Jerome Adams at a press conference.

Pregnancy

Their observations and initial research show that marijuana use may affect patients’ responses to anesthesia on the operating table — and, depending on the patient’s history of using the drug, either help or hinder their symptoms afterward in the recovery room.
If pot users indeed need more anesthesia, are there increased risks for breathing problems during minor procedures? Are there higher costs with the use of more medication, if a second or third bottle of anesthesia must be routinely opened? And what does regular cannabis use mean for recovery post-surgery?

anesthesia, respiratory, Doctors

DISCUSSION AND CONCLUSIONS:
Medical and non-medical cannabis use both were both associated with increased risks of prescription opioid misuse. Medical cannabis use, however, was not associated with prescription opioid use disorder, and non-medical cannabis was. There appeared to be differential associations between cannabis use and prescription opioid use disorder by cannabis use purpose.

opioid

Conclusions: RWID and DUI are significantly associated with greater alcohol and marijuanause over time. This study highlights that teens may be at higher risk for problem substance use in the future even if they ride with someone who is impaired. Prevention and intervention efforts for adolescents need to address both driving under the influence and riding with an impaired driver to prevent downstream consequences.

drugged driving

Conclusions: Marijuana use varied in association with beliefs about its beneficial and harmful health properties. Clinical interventions that target specific marijuana-related health beliefs including unfounded claims of benefit may provide robust talking points for centering provider guidance and public health messaging.

youth, perception

FDA has determined that your “CBD Lotion,” “CBD Pain-Relief Patch,” “CBD Tincture,” and “CBD Disposable Vape Pen” products are unapproved new drugs sold in violation of sections 505(a) and 301(d) of the Federal Food, Drug, and Cosmetic Act (the FD&C Act), 21 U.S.C. 355(a) and 331(d). Furthermore, these products are misbranded drugs under section 502(f)(1) of the FD&C Act, 21 U.S.C. 352(f)(1). FDA has also determined that your “Bido CBD for Pets” products are unapproved new animal drugs that are unsafe under section 512(a) of the FD&C Act, 21 U.S.C. 360b(a), and adulterated under section 501(a)(5) of the FD&C Act, 21 U.S.C. 351(a)(5)

FDA, Curaleaf

Today, the U.S. Food and Drug Administration announced that it has issued a warning letter to Curaleaf Inc., of Wakefield, Massachusetts, for illegally selling unapproved products containing cannabidiol (CBD) online with unsubstantiated claims that the products treat cancer, Alzheimer’s disease, opioid withdrawal, pain and pet anxiety, among other conditions or diseases.

FDA, Curaleaf

Cannabis legalization has led to significant health consequences, particularly to patients in emergency departments and hospitals in Colorado. The most concerning include psychosis, suicide, and other substance abuse. Deleterious effects on the brain include decrements in complex decision-making, which may not be reversible with abstinence.

ED and urgent care (UC) visits with cannabis-associated International Classification of Diseases (ICD) codes or positive urine drug screens for teenagers and young adults have increased since legalization, and the majority require behavioral health evaluation. A subsequent retrospective review by Wang et al. from 2005–2015 identified 4202 such visits for patients 13 to <21 years old to a tertiary-care children’s hospital system. Behavioral health evaluation was obtained for 2813 (67%) and a psychiatric diagnosis was made for the majority (71%) of the visits. 

Colorado, ncbi, suicide
Texas, hemp

Cannabis is known to induce DNA damage by several mechanisms including damage to chromosomes at the time of cell division, dramatic reductions in histone formation which form the core of the nucleosomes around which DNA is twined and are crucially involved in signalling to the transcription and epigenetic machinery to regulate gene expression, alteration of DNA methylation and many other processes 2-6. And genotoxic stress of many types is known to trigger DNA checkpoints and interfere with the normal process of meiotic and mitotic cell division; and are also known to trigger ageing and cellular senescence pathways.
That it has been linked with all four areas, in the context of its many other known harms – respiratory, driving, impaired developmental trajectory, reduction in IQ, hippocampal shrinkage, brain disconnection and immunopathies - implies directly that the cannabis legalization debate itself is non-viable and profoundly and inherently misleading.

BMJ, genetics, Volkow

The AES believes that these compounds need to be under the full regulatory control of the FDA and that distribution should be limited to the well-developed legend drug process. While drug regulation is desired, in the interim, the following equally important steps should be taken to assure continuous and safe access to CBD products for patients who are currently benefiting from them.

american epiliepsy society, FDA, SAGE Journals

Cannabis effects on fetal growth (eg, low birth weight and length) may be more pronounced in women who consume marijuana frequently, especially in the first and second trimesters.4 This study highlights the importance of screening and interventions for cannabis use among all pregnant women. 
This study highlights the importance of screening and interventions for cannabis use among all pregnant women.

Pregnancy, Volkow, PubMed
  • Thousands of businesses, as well as local governments earning tax money off of sales, are now literally invested in that lie.
  • “The mantra about how this is a harmless, natural, and non-addictive substance—it’s now known by everybody. And it’s a lie.”
  • As for new risks: In many stores, budtenders are providing medical advice with no licensing or training whatsoever. “I’m most scared of the advice to smoke marijuana during pregnancy for cramps,” said Humphreys, arguing that sellers were providing recommendations with no scientific backing, good or bad, at all.
  • “The reckless way that we are legalizing marijuana so far is mind-boggling from a public-health perspective,” Kevin Sabet, an Obama administration official and a founder of the nonprofit Smart Approaches to Marijuana, told me. 

 

Sabet

In the four states that were among the first to legalize pot – Colorado, Nevada, Oregon and Washington – crashes were up by as much as 6% compared with neighboring states without legalized recreational weed, according to analysis of collision loss data from January 2012 through October 2017 by the Insurance Institute for Highway Safety and an October 2018 report done by the Highway Loss Data Institute.

insurance, driving

The study looked at 1991-2017 U.S. federal health data on more than 200,000 high school students. It found that the number who said they'd used pot at least once over the past month rose 10-fold -- from 0.6% in 1991 to 6.3% by 2017.

high school, Teens

An alarming finding shows that an estimated 14.8 million drivers report getting behind the wheel within one hour after using marijuana in the past 30 days. The impairing effects of marijuana are usually experienced within the first one to four hours after using the drug.1 And marijuana users who drive high are up to twice as likely to be involved in a crash.2

AAA, driving, driving drugged

In 2016 surveys, just 9% of medical schools had documented content on medical marijuana in the Association of American Medical Colleges Curriculum Inventory, and 85% of 258 surveyed residents and fellows reported having no education about medical marijuana in medical school or residency. Presented at a 2017 meeting, a single-site study of 51 resident physicians found that 76% did not know which category marijuana belonged to under the Controlled Substances Act (marijuana is currently categorized as a Schedule I drug, signifying a high potential for abuse and no accepted medical uses), and 38% believed that medical marijuana was a prescription drug approved by the US Food and Drug Administration. Other studies indicate that practicing physicians often have limited knowledge about marijuana’s health effects and want more training.”
That more than a third of the doctors surveyed in the small sample cited by Dr. Morris believed that marijuana is FDA-approved is shocking. I submitted a comment that was immediately published by JAMA. 
 

JAMA, Doctors

Then he started asking them, “do youJUUL?" and their answers changed.

 

“I wasn’t even asking the right questions, and I think a lot of clinicians still don’t ask the right questions,” Winickoff said. “Once I found out that kids were using, many of them thought that what they were using was not a big deal, that maybe they could stop any time they wanted. Some of them thought that vaping was just water vapor plus some flavor.”

Vaping, paraphernalia, high school

Alcohol is rapidly expelled from the system and is addictive only in large doses — at least to those … whose genetic make-up has been influenced by the millennia of winemaking.” Furthermore, “the effects of cannabis remain for days, and it is both more addictive and more radical, leading not just to temporary alterations of the mind but to permanent or semi-permanent transformations of personality, and in particular to a widely observed loss of moral sense.” 

It also has many physical effects, such as greater carcinogenic harm than smoking cigarettes. Unlike consuming a foodstuff in moderation, the consumption of cannabis immediately affects the functioning of the brain, an effect compounded over time, especially for adolescents. In fact, marijuana usage can permanently alter the brain, leading to a great risk of psychosis, psychological problems, and lower I.Q. scores. Further, one of the most frightening discoveries shows that consuming marijuana alters DNA, creating harmful mutations that will be passed down to children and future generations. 

alcohol

"If it's not USDA Organic certified, and it's not full panel lab tested, you have no way of knowing what you're getting," said Cranford, who's been producing CBD long before it was en vogue.

"Overseas they use hemp to do cover crops. They use it to purposely suck out the pesticides and heavy metals on soil there so they can plant food crops next," Cranford said. "These crops are being imported into the US and people are making CBD out of it. The really scary part is when you have these contaminants in your plant material, and you make this oil, you're concentrating it."

After thousands of tests, 70 percent of products were found "highly contaminated" with heavy metals like lead and arsenic, herbicides like glyphosate (the active ingredient in RoundUp) and a host of other contaminants including pesticides, BPA and toxic mold.

Virginia Commonwealth University, the Journal of the American Medical Association, and other medical journals have published studies that reflect similar outcomes to the hundreds of tests done by Ellipse Analytics, citing contamination, false labeling and false claims.

contaminated

Many producers of products containing CBD are making unfounded medical claims regarding their products’ ability to cure or alleviate many diseases and conditions.
The FDA has very strict regulations on such activity and has issued warnings to some organizations that are selling CBD products. Unfortunately, enforcement is rare. And products with very high CBD concentrations are widely available.

CBD, Doctors, Finn

Contrary to what you've been told over and over, it is not a preposterous assertion that marijuana is a gateway drug to cocaine, heroin, meth and such. Not everybody who smokes marijuana graduates to harder narcotics, true. But most of those who do go on to the harder stuff start off with weed.
Video on Snake Oil

opinion, snake oil, Neese
Florida

A Paulding County student collapsed and nearly died after taking a hit off a vape pen. The dramatic scene unfolded in front of a class when the South Paulding High School student collapsed and stopped breathing.
 
*** This is exactly why we need to raise the age for purchasing these products to 21... give our youth a chance.

Vaping, Georgia, adolescent
resource

The study found that a number of brain disorders and behaviors predicted accelerated aging, especially schizophrenia, which showed an average of 4 years of premature aging, cannabis abuse (2.8 years of accelerated aging), bipolar disorder (1.6 years accelerated aging), ADHD (1.4 years accelerated aging) and alcohol abuse (0.6 years accelerated aging). Interestingly, the researchers did not observe accelerated aging in depression and aging, which they hypothesize may be due to different types of brain patterns for these disorders.

study, Brain, aging, science daily

Adolescent Marijuana Use increases in Florida

adolescence, Florida

In 2011, just over 5,500 reports were logged by the San Francisco Department of Public Works; in 2018, the number increased to more than 28,000.

San Francisco, california, feces

She quit marijuana completely for three months and was symptom-free. Then she tried CBD, hoping there was some form of cannabis she could enjoy. One day she took 200 milligrams of CBD in capsules. That night, she ended up in the ER.   cannabinoid hyperemesis syndrome, or CHS.

Hyperemesis Syndrome, business insider
Fried

The study authors consider high-potency cannabis to be products with more than 10 percent tetrahydrocannabinol or THC, the compound responsible for the drug's psychoactive effects. The fact that consuming high-THC cannabis products has a greater risk is concerning, Lisdahl says, because these products are more common in the market now.

Now a new study published Tuesday in the The Lancet Psychiatry shows that consuming pot on a daily basis and especially using high-potency cannabis increases the odds of having a psychotic episode later.

study, Potency, Lancet, Psychosis

In conclusion, our findings confirm previous evidence of the harmful effect on mental health of daily use of cannabis, especially of high-potency types. Importantly, they indicate for the first time how cannabis use affects the incidence of psychotic disorder. Therefore, it is of public health importance to acknowledge alongside the potential medicinal properties of some cannabis constituents the potential adverse effects that are associated with daily cannabis use, especially of high-potency varieties.

Research, study, Lancet, Potency, Psychosis, cannabis-induced psychosis

It is the latest in a long line of evidence that marijuana is not an innocent relaxation drug. “Smoking high-potency cannabis, used daily, has been linked to diagnosis of conditions like schizophrenia, paranoia and other psychosis disorders, new findings say. About 50 percent of new cases of psychosis disorders diagnosed in Amsterdam were linked to use of high-potency cannabis, according to a study published Tuesday in The Lancet.

mental health
  • cannabis is safe and helpful for PTSD are limited by either anecdotal or poor quality evidence, are offset by studies reporting opposite conclusions, and the well-demonstrated potential harms of cannabis addiction and risk for psychosis are not adequately weighed in the decision to recommend medical cannabis treatment of chronic PTSD
  • There is a consensus that multiple social harms associated with cannabis legalization are not being adequately addressed. These include concerns about youth exposure under age 25 (a time of highly active brain development) and youth-marketing of edible cannabis products (eg, gummy bears and other confections) and cannabis concentrates that are easily obtained and “vaped”; unintentional in utero exposure prior to a woman’s knowledge of pregnancy; increased rates of intentional cannabis use during pregnancy; driving impairment and the absence of appropriate technological and legal systems to detect and deter this (equivalent to the breathalyzer for alcohol impairment); and cannabis use in sensitive occupations such as public transportation, public protection, and health services. While the voting public and industry is moving cannabis expansion forward, state proceedings have not yet involved public health, neurodevelopmental experts, and experts in addiction psychiatry and medicine equally with industry and economy experts. This is anything but reassuring for all who keep in mind that the United States is by far the greatest demand population for psychoactive substances, worldwide.4
voting, Legislation

Significant effects of prenatal cannabis exposure have been found on children's sleep, cognitive functions (memory and scholastic skills), as well as on executive (frontal lobe) functions (reasoning, attention, impulsivity, and motivation), and affective (depression) and anxiety symptoms throughout the stages of development. Following the presentation of two case vignettes, we integrate the published information on outcomes of maternal use of cannabis during pregnancy on the developing fetus and the "soft" neurological deficits and neuro-behavioral disturbances manifested by them from early childhood and evolving to peaks in adolescence. Taken together, these data serve to define what we call a heretofore unspecified "fetal cannabis spectrum disorder".

Pregnancy, PubMed
  • The reality is that the medical marijuana argument is meant mostly to protect recreational users from legal problems.
  • One in every 15 alcohol drinkers  drink every day while one in every five marijuana users do so daily.
  • America is the Western country that uses the most marijuana and has the worst problem with opioids.
Berenson

Researchers say psychoactive compounds in marijuana easily cross the placenta, exposing the fetus to perhaps 10 percent of the THC — tetrahydrocannabinol — that the mother receives, and higher concentrations if the mom uses pot repeatedly.

NPR, Pregnancy
smoking, Environment

CONCLUSIONS:
Early cannabis use is associated with psychosis-related outcomes in young adults. The use of sibling pairs reduces the likelihood that unmeasured confounding explains these findings. This study provides further support for the hypothesis that early cannabis use is a risk-modifying factor for psychosis-related outcomes in young adults.

Truth, hallucinations, cannabis-induced psychosis, Psychosis

Is the solution to the opioid epidemic as simple as the legalization of medical cannabis? Commenting on the Bachhuber et al. analysis (1), Finney et al. (4) cautioned that an ecological fallacy may be present—individuals using medical marijuana could have elevated overdose mortality rates even though there is a state-level reduction. They contended that a prospective study of individual pain patients was necessary to assess relationships between cannabis use, use of opioid medications, and other substance use (4).
 

olfson, opioid

The authors discovered several interesting things. First, all elements of both alcohol and cannabis use increase annually across the various levels of frequency of use, with the exception of daily alcohol use. Second, the effects of cannabis are considerably greater than those of alcohol. Third, there appear to be both concurrent and lagged effects of cannabis use on several cognitive domains. Thus, use of cannabis has persistent effects that are also exacerbated by continued use.

psychiatry, cognition

Two cases of sudden death are reported in patients whose self-determined seizure management primarily relied on artisanal cannabis therapies. Risks of morbidity, mortality and SUDEP in SDTC users need to be further studied. Providers should be aware of the absence of morbidity and mortality data for SDTC in patients with epilepsy may only be due to a failure of reporting.

epilepsy, science direct, Death

Experts define addiction as continued marijuana use despite negative consequences in a person's life, such as issues relating to their family, job, or relationships.
People who use marijuana regularly and then stop abruptly can experience some withdrawal symptoms.

withdrawal, addiction, medicine news today

I was surprised, to say the least. I tended to be a libertarian on drugs. Years before, I’d covered the pharmaceutical industry for The New York Times. I was aware of the claims about marijuana as medicine, and I’d watched the slow spread of legalized cannabis without much interest.
Jackie would have been within her rights to say, I know what I’m talking about, unlike you. Instead she offered something neutral like, I think that’s what the big studies say. You should read them.....

book, Berenson

Given today's concerns about maintaining a healthy body eating organic foods, low carb diets, ... reading all the labels to verify safety and good health, it is ironic the same standards are not demanded by those that consume marijuana.  Dog food is safer than marijuana!

For example, smoking pot is widely supposed to diminish the nausea associated with chemotherapy. But, the panel pointed out, “there are no good-quality randomized trials investigating this option.” We have evidence for marijuana as a treatment for pain, but “very little is known about the efficacy, dose, routes of administration, or side effects of commonly used and commercially available cannabis products in the United States.” The caveats continue. Is it good for epilepsy? “Insufficient evidence.” Tourette’s syndrome? Limited evidence. A.L.S., Huntington’s, and Parkinson’s? Insufficient evidence. Irritable-bowel syndrome? Insufficient evidence. Dementia and glaucoma? Probably not. Anxiety? Maybe. Depression? Probably not.

“dose-response relationship”... non-existent!

New Yorker

In 2017 Colorado had a record number of opioid overdose deaths from any opioid, including heroin and Colorado has had a medical marijuana program since 2001.
There are several reasons as to why any reported benefit will be outstripped by lack of benefit and increased risk of harm, and why cannabis is contributing to ongoing opioid use, and subsequently, the opioid epidemic.

  1. There is evidence in animal models showing adolescent rats exposed to THC will develop enhanced heroin self administration as adults which may be due to activation of mesolimbic transmission of dopamine by a common mu opioid receptor mechanism.,
  2. More than 90% of heroin users report a prior history of marijuana use compared to a prior history of painkiller use (47%).13
  3. Prospective twin studies demonstrated that early cannabis use was associated with an increased risk of other drug abuse. This particular study was conducted when the THC content was much lower than todays products which can reach 95% THC.
  4. Currently there is no widely available or accepted medical literature showing any benefit for pain with dispensary cannabis in common pain conditions. 

There is currently a large and growing body of evidence showing that cannabis use increases, rather than decreases non-medical prescription opioid use and opioid use disorder, based on followup of more than 33,000 people. Concurrent use of cannabis and opioids by patients with chronic pain appears to indicate a higher risk of opioid misuse. Closer monitoring for opioid-related aberrant behaviors is indicated in this group of patients and it suggests that cannabis use is a predictor of aberrant drug behaviors in patients receiving chronic opioid therapy.
There is sufficient and expanding evidence demonstrating that medical marijuana use will not curb the opioid epidemic. There is further evidence that marijuana is a companion drug rather than substitution drug and that marijuana use may be contributing to the opioid epidemic rather than improving it.

opioid, Finn, ncbi
abuse

Not good news!
Only 5 Republican Governors got passing grades from NORML and the 2nd highest grade (C) of this group was Ron DeSantis. :-( The only Republican Governor who got a higher grade (B+) was the Gov. of Vermont who signed a bill that legalized recreational pot! Most Republican governors got Ds and Fs.

norml, governor

Large-scale, longitudinal studies of humans whose mothers smoked marijuana once or more per week and experimental work on rodents exposed to cannabinoids in utero have yielded remarkably consistent intellectual and behavioral correlates of fetal exposure to this drug. Some exposed individuals exhibit deficits in memory, cognition, and measures of sociability. These aberrations appear during infancy and persist through adulthood and are tied to changes in the expression of multiple gene families, as well as more global measures of brain responsiveness and plasticity. Researchers currently consider these perturbations to be mediated by changes to the endocannabinoid system caused by the active compounds in cannabis. 

Pregnancy

Whether intentional or not, mixing drugs is never safe because the effects from combining drugs may be stronger and more unpredictable than one drug alone, and even deadly.

polysubstance abuse, CCD
Berenson

The seven most frequently occurring drugs found in decedents were ethyl alcohol (5,258), benzodiazepines (5,064, including 1,889 alprazolam occurrences), cocaine (3,129), cannabinoids (2,367), fentanyl (2,088), morphine (1,992), and fentanyl analogs (1,685). Since heroin is rapidly metabolized to morphine, this may lead to a substantial over-reporting of morphine-related deaths as well as significant under-reporting of heroin-related deaths.
Cannabinoids 7 (cause of death)   2,360 (present)  2,367 (total)
 
 

fatal, Florida, Death

In summary, when approaching how to define the threshold to report a family to a child welfare system, we must first take into account our state laws. Our medical opinion, however, must be directed by many other factors, including an understanding of the circumstances and the motivation of the parent. Child welfare systems rely on medical providers to make clear statements regarding our medical opinion about whether a child has been abused or neglected. This is a powerful role. We might also use this case to advocate for a change in state laws or policies regarding the well-intentioned use of marijuana in dire circumstances such as the ones that this mother faced.

child abuse, Medical

As state lawmakers continue hashing out a marijuana legalization bill, the list of towns in New Jersey saying no to legal weed just keeps growing.
There are now nearly 40 municipalities across the state that have either banned marijuana businesses or officially voiced opposition to legal weed.

New Jersey, Ban

The advisory mentions the following risks:
1. Marijuana is addictive. Approximately one in eleven individuals who use marijuana will become addicted. The risk is greater in youth. One in six teenagers who use marijuana will become addicted, and the risk for developing a marijuana substance use disorder further increases for those who use marijuana frequently.....

TN, Public Health, Advisory
  • Marijuana is addictive. Approximately one in 11 adults who use marijuana will become addicted, and the risk of addiction is greater among youth.  
  • Marijuana now available is more potent with greater levels of tetrahydrocannabinol, or THC, the primary psychoactive substance in Cannabis than marijuana available in previous decades. The long-term health or developmental consequences of exposure to these high concentrations of marijuana are unknown.
  • Marijuana use is associated with adverse health outcomes including development of psychoses like schizophrenia and increased risk of motor vehicle crashes.....
TN, Dept. of Health

RESULTS:
In acute settings, marijuana's effects peaked at approximately 1 hour post initiation, lasting 2-4 hours. Marijuana increased cardiac workload, myocardial infarctions and strokes in young, chronic users. Cannabis caused similar pulmonary complications to those of a tobacco smoker. Marijuana caused airway obstruction and increased anesthetic dosages needed to place laryngeal airways. Use within 72 hours of general anesthesia was advised against. In vitro and in vivo studies were contradictory regarding prothrombic or antithrombotic effects.

CONCLUSIONS:
Marijuana use is problematic to surgeons, left without evidence-based approaches. In emergency settings, marijuana use may be unavoidable. However, further research would provide much needed information to guide elective procedures.

When mothers use marijuana during the first 12 years of their child's life, their cannabis-using children are more likely to start at an earlier age than children of non-using mothers, according to a new study from the Harvard T.H. Chan School of Public Health published in the American Journal of Preventive Medicine. This study is the first to establish a relationship between maternal cannabis use during a child's lifetime and earlier initiation in a nationally-representative, longitudinal cohort and examine the role of race, gender, and other social environmental factors.

Children, parents, study

“Painful cramping, vomiting occurring. It can happen every few weeks, every few months, last a few days and be incredibly uncomfortable,” said Dr. Michael Lynch of the Pittsburgh Poison Control Center at UPMC.

emergency room, Hyperemesis Syndrome, Pennsylvania

There was more alarming news. Use of illegal drugs, including cocaine, marijuana, and opioids by pregnant women increased significantly between 2015 and 2017. About 7 percent of pregnant women reported using marijuana. Three percent said they used it daily. 

McCance-Katz says marijuana use is linked to fetal growth problems, preterm births, stillbirths, hyperactivity and impaired cognition in newborns. 

Pregnancy, heroin, McCance-Katz

Marijuana concentrates such as shatter, butter or glass have THC concentrations as high as 90 percent. The same high levels are found in edible cannabis products sold in Colorado, packaged to look like popular candy bars and particularly appealing to children.
And despite the perception that marijuana is not addictive the way opiates or nicotine are, Potee said that 17 percent of those who start using it as adolescents develop addiction. For teens who use marijuana every day, the addiction rate is 30 to 50 percent.

Potee, youth, cigarettes

In conclusion, cannabis use is common in people with chronic non-cancer pain who have been prescribed opioids, and interest in medicinal use of cannabis is increasing. We found no evidence that cannabis use improved patient outcomes; those who used cannabis had greater pain and lower self-efficacy in managing pain. Furthermore, we found no evidence that cannabis use reduced pain interference or exerted an opioidsparing effect.

Lancet, study, pain

New research suggests that marijuana users may be more likely than nonusers to misuse prescription opioids and develop prescription opioid use disorder. The study was conducted by researchers at the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health, and Columbia University.

opioid

Over the past several years, FDA has issued several warning letters to firms that market unapproved new drugs that allegedly contain cannabidiol (CBD). As part of these actions, FDA has tested the chemical content of cannabinoid compounds in some of the products, and many were found to not contain the levels of CBD they claimed to contain. It is important to note that these products are not approved by FDA for the diagnosis, cure, mitigation, treatment, or prevention of any disease. Consumers should beware purchasing and using any such products.

FDA, warning

Executive Summary

RMHIDTA has published annual reports every year since 2013 tracking the impact of
legalizing recreational marijuana in Colorado. The purpose is to provide data and
information so that policy makers and citizens can make informed decisions on the
issue of marijuana legalization. This year (2018) RMHIDTA elected to provide an
update to the 2017 Volume 5 report rather than another detailed report.
 
Section I: Traffic Fatalities & Impaired Driving
x Since recreational marijuana was legalized, marijuana related traffic deaths
increased 151 percent while all Colorado traffic deaths increased 35 percent
x Since recreational marijuana was legalized, traffic deaths involving drivers who
tested positive for marijuana more than doubled from 55 in 2013 to 138 people
killed in 2017.
o This equates to one person killed every 2 1⁄2 days compared to one person
killed every 6 1⁄2 days.
x The percentage of all Colorado traffic deaths that were marijuana related
increased from 11.43 percent in 2013 to 21.3 percent in 2017.
 
Section II: Marijuana Use
x Colorado past month marijuana use shows a 45 percent increase in comparing
the three-year average prior to recreational marijuana being legalized to the three
years after legalization.
x Colorado past month marijuana use for ages 12 and older is ranked 3rd in the
nation and is 85 percent higher than the national average.
 
Section III: Public Health
x The yearly rate of emergency department visits related to marijuana increased 52
percent after the legalization of recreational marijuana. (2012 compared to 2016)
x The yearly rate of marijuana-related hospitalizations increased 148 percent after
the legalization of recreational marijuana. (2012 compared to 2016)
x Marijuana only exposures more than tripled in the five-year average (2013-2017)
since Colorado legalized recreational marijuana compared to the five-year
average (2008-2012) prior to legalization.
 
Section IV: Black Market
x RMHIDTA Colorado Task Forces (10) conducted 144 investigations of black
market marijuana in Colorado resulting in:
o 239 felony arrests
o 7.3 tons of marijuana seized
o 43,949 marijuana plants seized
o 24 different states the marijuana was destined
x The number of highway seizures of Colorado marijuana increased 39 percent
from an average of 242 seizures (2009-2012) to an average of 336 seizures (2013-
2017) during the time recreational marijuana has been legal.
x Seizures of Colorado marijuana in the U.S. mail system has increased 1,042
percent from an average of 52 parcels (2009-2012) to an average of 594 parcels
(2013-2017) during the time recreational marijuana has been legal.
 
Section V: Societal Impact
x Marijuana tax revenue represent approximately nine tenths of one percent of
Colorado’s FY 2017 budget.
x Violent crime increased 18.6 percent and property crime increased 8.3 percent in
Colorado since 2013.
x 65 percent of local jurisdictions in Colorado have banned medical and
recreational marijuana businesses.
 
Section IV: Marijuana Industry
x According to the Marijuana Policy Group, Market Size and Demand for
Marijuana in Colorado 2017 Market Update:
o “From 2014 through 2017, average annual adult use flower prices fell 62.0
percent, from $14.05 to $5.34 per gram weighted average.”
o “Adult use concentrate prices fell 47.9 percent, from $41.43 to $21.57 per
gram.”
o “The average THC content of all tested flower in 2017 was 19.6 percent
statewide compared to 17.4 percent in 2016, 16.6 percent in 2015 and 16.4
percent in 2014.”
o “The average potency of concentrated extract products increased steadily
from 56.6 percent THC content by weight in 2014 to 68.6 percent at the
end of 2017.”
 
x As of June 2017, there were 491 retail marijuana stores in the state of Colorado
compared to 392 Starbucks and 208 McDonald’s.
Colorado, Black Market, social costs, Fatalities

The importance of the published findings and the emerging research regarding the potential negative effects of marijuana on brain development are a cause for concern despite the limited research and are the basis for the following recommendations:

  1. Women who are considering becoming pregnant or who are of reproductive age need to be informed about the lack of definitive research and counseled about the current concerns regarding potential adverse effects of THC use on the woman and on fetal, infant, and child development. Marijuana can be included as part of a discussion about the use of tobacco, alcohol, and other drugs and medications during pregnancy.
  2. As part of routine anticipatory guidance and in addition to contraception counseling, it is important to advise all adolescents and young women that if they become pregnant, marijuana should not be used during pregnancy.
  3. Pregnant women who are using marijuana or other cannabinoid-containing products to treat a medical condition or to treat nausea and vomiting during pregnancy should be counseled about the lack of safety data and the possible adverse effects of THC in these products on the developing fetus and referred to their health care provider for alternative treatments that have better pregnancy-specific safety data.
  4. Women of reproductive age who are pregnant or planning to become pregnant and are identified through universal screening as using marijuana should be counseled and, as clinically indicated, receive brief intervention and be referred to treatment.
  5. Although marijuana is legal in some states, pregnant women who use marijuana can be subject to child welfare investigations if they have a positive marijuana screen result. Health care providers should emphasize that the purpose of screening is to allow treatment of the woman’s substance use, not to punish or prosecute her.
  6. Present data are insufficient to assess the effects of exposure of infants to maternal marijuana use during breastfeeding. As a result, maternal marijuana use while breastfeeding is discouraged. Because the potential risks of infant exposure to marijuana metabolites are unknown, women should be informed of the potential risk of exposure during lactation and encouraged to abstain from using any marijuana products while breastfeeding.
  7. Pregnant or breastfeeding women should be cautioned about infant exposure to smoke from marijuana in the environment, given emerging data on the effects of passive marijuana smoke.
  8. Women who have become abstinent from previous marijuana use should be encouraged to remain abstinent while pregnant and breastfeeding.
  9. Further research regarding the use of and effects of marijuana during pregnancy and breastfeeding is needed.
  10. Pediatricians are urged to work with their state and/or local health departments if legalization of marijuana is being considered or has occurred in their state to help with constructive, nonpunitive policy and education for families.
Pregnancy, Breastfeeding

CBD oil may potentially interact in a negative way with anti-epilepsy drugs. As of now, only in vitro (test tube) observations exist with no living organism testing proving safety. Drugs that may interact include: 

  • carbamazepine (Tegretol)
  • phenytoin (Dilantin)
  • phenobarbital (Luminal, Solfoton, Tedral)
  • primidone (anti-seizure)
hash oil, cbd oil, Pregnancy

pathway, heroin, opioid, video
DFAF, Pregnancy, Infographics

A Canadian love-fest for Florida pot companies continues to blossom with a $93 million deal that includes a Ruskin-based grower yet to begin selling marijuana products.
 
In your recent article, Canadian firm strikes a deal to enter Florida marijuana market with Ruskin grower, you have a picture of medical marijuana in a pill bottle and with a prescription pad.  MEDICAL MARIJUANA in this form IS NOT A PRESCRIPTION AND IS NOT FDA APPROVED.. NOR DO ANY MEDICAL ASSOCIATIONS SUPPORT THIS FORM OF MEDICATION.  Please show it for what it is a bag of pot with a label 'medicine'.  #FasleHope #FakeMedicine

follow the money, #FakeMedicine
opioid, Pregnancy, DFAF

First and foremost, marijuana is already associated with more abuse and dependency (now called substance abuse disorder) than all other illegal drugs combined. Roughly four out of seven problem usersof illegal drugs are using marijuana. This is a dangerous blind spot exploited by many legalization advocates (although some of them are now warning about the growing risk of heavy marijuana use under legalization)....

Bennett
SAMSHA

The preliminary figures show that 959 people died in Colorado last year from drug poisoning, a figure that includes both intentional and unintentional overdoses. In 2016, 912 people died. In 2000, for comparison, drug poisonings claimed fewer than 400 lives.

opioid
Brain, Drug Free America

We found that among young recreational cannabis users, a regular dose of cannabis had no effect on simple and learned tasks, but its use led to significant impairments on complex and novel driving-related tasks, as well as perceived driving ability and safety, for up to 5 hours after use. The present finding that the first 5 hours after cannabis use affected driving-related performance substantiates the recommendations of Canada’s Lower-Risk Cannabis Use Guidelines, which recommend waiting 6 hours after cannabis use before driving.30
 

Canada, Research, study, driving, youth
CONTENT HIGHLIGHTS
  • Medical marijuana (also called medical cannabis) is whole plant marijuana or chemicals in the plant used for medical purposes.
  • Cannabinoids are substances in medical cannabis that act on cells in the body, including the brain. The two main cannabinoids used in medicine are tetrahydrocannabinol (THC) and cannabidiol (CBD).
  • The FDA recently approved the use of Epidiolex (a plant-based formulation of CBD) to treat seizures for people 2 years of age and older with Dravet syndrome and Lennox-Gastaut syndrome (LGS).
  • Medical cannabis, CBD, and THC all have possible side effects. The most common side effects of CBD included sleepiness, diarrhea, fatigue, and decreased appetite. CBD also interacts with some other seizure medicines.
  • Careful monitoring of CBD is needed.
Charlotte's Web, Epidiolex, epilepsy

During the same time period that cigarette smoking around children came down more than 7%, marijuana smoking around children went up nearly 5%. With more and more states legalizing marijuana for recreational use, that number is likely to continue going up.
This is not good. Besides the fact that we don’t want children getting high, or exposed to the dangers of inhaled secondhand marijuana smoke, there is the additional concern about long-term effects on the brain. While research is still ongoing, there is evidence to suggest that when youth and young adults (whose brains are still developing) are exposed to marijuana, it may have permanent effects on executive function, memory, and even IQ.

second hand smoke

Click on link for updated list of drug paraphernalia

paraphernalia

When we talk about legalizing marijuana, we must acknowledge that we are talking about legalizing a mind-altering substance that affects the brain by impairing cognition, judgment, and reflexes. We need to discuss the science and data behind the consequences of marijuana consumption on our youth and their developing brains, as this is an issue that is far-too-often overlooked.

OpEd, legalization, Consequences

The treatment, which GW Pharma hopes to market under the name Epidiolex, is produced in the U.K. from a plant that has been bred to have a high cannabidiol, or CBD, content, Chief Executive Officer Justin Gover said in an interview earlier this month. The chemical is purified and made into a strawberry-flavored oral solution, he said.

gw pharm, Epidiolex, seizure, FDA

Teens have taken a technology that was supposed to help grownups stop smoking and invented a new kind of bad habit, molded in their own image.

“Juul is already a massive public-health disaster—and without dramatic action it’s going to get much, much, much worse.”

Winickoff believes that the vape industry is co-opting the national wellness trend—“when, in fact, vaping can cause something called bronchiolitis obliterans, or popcorn lung,” he said. Popcorn lung has been linked to diacetyl, an organic compound that some companies use in their e-liquid, and that has been detected as a by-product of e-cigarette vapor. But diacetyl has also been detected in cigarette smoke, at a level hundreds of times greater, and no feasible amount of smoking has been found to cause popcorn lung. (Juul does not use diacetyl in its liquid, and, in tests, the company has found no measurable amounts of diacetyl in the vapor emitted by its devices.)

 

Vaping, Juul, trends, paraphernalia

The Netherland’s attempt to divide markets into soft vs. hard drugs by allowing coffee shops to sell cannabis did not result in lower consumption of hard drugs. Overall it has been a social disaster.
The cannabis grown and sold today is not same drug as was available in the 1970s. The average THC has increased to more than 15%. Cannabis issue can clearly lead to addiction. The damage to the brain from chronic use is worse compared with chronic use of heroin. Among the negative effects of long-term cannabis use in adolescence include neuropsychological dysfunction, decline in IQ, short memory, among others.
Professor Madras focused on how cannabis smoking can affect the behavior and brains of children. Preclinical tests studies show that the use of cannabis before pregnancy may have adverse effects on future children.

Netherlands, madras, World Federation Against Drugs
DOH, powerpoint

This report finds that legalization in Illinois, however, would cost at least $670 million, outweighing the projected tax revenue.

Illnois

"Marijuana doctors were 2.8 times as likely as other doctors to have been disciplined by the Board of Medicine, and 2.4 times as likely to have been charged with a crime. Altogether, 108 of them were responsible for $69.4 million in malpractice judgments and settlements, some for maiming or killing patients. Some of the doctors have been fined, suspended or stripped of their licenses in other states. They’ve misdiagnosed conditions, falsified records and written prescriptions for people they never saw. They’ve been jailed for domestic violence. A few have sexually abused patients, including those as young as 14 and 16."

PotDocs, Florida, Malpractice

Note:  If you look at the blue bar you will see that opioid deaths have more than quadrupled since medical marijuana was legalized in Colorado (in 2000). And deaths rose from 377 in 2012 (year mj legalized) to 504 in 2016. No evidence that legal marijuana is helping in Colorado- if anything it could be contributing to making the opioid epidemic worse!

But the conclusion is not supported by data. This study and others that conclude marijuana helps fight the opioid crisis do not consider the many other strategies that have been implemented to fight opioid abuse, including the PDMP, treatment and Narcan. Nor is there any proof people are substituting marijuana for opioids. And this particular CO research (below) flies in the face of the actual data/ facts!

Opioid deaths in Colorado have increased based on the data from Colorado Public Health and Environment Dept.

Study's conclusion does not seem to match data.

 

 

opioid, Colorado

Researchers had two women conduct "mystery caller" phone conversations with employees at 400 dispensaries across the state, telling them that they were eight weeks pregnant and suffering from morning sickness. During the majority of those calls, the employees recommended the women use cannabis products.

Pregnancy, Colorado

Florida has lowered the original cost of the fee for doctors to be licensed to prescribe medical marijuana to $250 from $1,000 and reduced the training time to two hours from eight. It has increased the number of physicians able to recommend medical marijuana by 48 percent since the beginning of the year.
“We are looking at Florida as the biggest medical marijuana market in the United States,” he said. “As more dispensaries open and more doctors get qualified, you reach a critical mass at some point where more and more people are hearing about it and it’s easier to go to a dispensary.”

Florida, money, profit

I'm here to tell you this is not a safe drug," McCance-Katz said during a town hall event at "NatCon18," the National Council for Behavioral Health's annual conference.
"Americans have a right to know that and we should be telling them that," she continued.
And while tobacco and alcohol rates have declined among pregnant women in recent years, illicit drugs -- mainly marijuana but also opioids -- have increased from 78,000 women in 2015 to 111,000 in 2016, she said.
On the contrary, "marijuana use was associated with substantially increased risk of addiction and overdose for opioids," she said, citing research from Mark Olfson, MD, MPH, and colleagues in the American Journal of Psychiatry.
 
 

McCance-Katz, SAMSHA, opioid

They also discovered that prenatal marijuana use was associated with a 50 percent increased chance of low birth weight regardless of tobacco use during pregnancy. “Growing evidence suggests prenatal cannabis exposure has a detrimental impact on offspring brain function starting in the toddler years, specifically issues related to attention deficit disorder,” Crume said. “But much of the research on the effects of prenatal cannabis on neonatal outcomes was based on marijuana exposures in the 1980s and 1990s which may not reflect the potency of today’s cannabis or the many ways it is used.”

 

Pregnancy, study

(TIME)  April 20, also known as “420,” is a day popular with many marijuanasmokers who see it as a “national holiday” of sorts and celebrate by getting high. The term “420” originated in the 1970s with a group of California high schoolers who would regularly meet after school at 4:20 p.m. to smoke weed.
 

4/20, Fatalities, paraphernalia, getsmart

"Trust me, if the data was coming back and we saw spikes in violent crime, we saw spikes in overall crime, there would be a lot of people looking for that bottle and figuring out how we get the genie back in," he said. "It doesn't seem likely to me, but I'm not ruling it out."

Colorado, governor

Conclusions: Our findings disconfirm the hypothesis that a population-level negative correlation between medical marijuana use and prescription drug harms occurs because medical marijuana users are less likely to use prescription drugs, either medically or nonmedically. Medical marijuana users should be a target population in efforts to combat nonmedical prescription drug use.

opioid, study, Research

Many novel psychoactive substances (NPS) have entered the recreational drug scene in recent years, yet the problems they cause are similar to those found with established drugs. This article will debate the psychobiological effects of these newer and more traditional substances. It will show how they disrupt the same core psychobiological functions, so damaging well-being in similar ways.

Research, Psychoactive

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