Preventing Marijuana Use Among Youth & Young Adults
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Smoking Cessation Treatment at Substance Abuse Rehabilitation Programs
SMOKING CEssATION TREATMENT AT SUBSTANCE ABUSE REHABILITATION PROGRAMS Malcolm S. Reid, PhD, New York University School of Medicine, Department of Psychiatry; Jeff Sel- zer, MD, North Shore Long Island Jewish Healthcare System; John Rotrosen, MD, New York University School of Medicine, Department of Psychiatry Cigarette smoking is common among persons with drug and alcohol n Nicotine is a highly use disorders, with prevalence rates of 80-90% among patients in sub- addictive substance stance use disorder treatment programs. Such concurrent smoking may that meets all of produce adverse behavioral and medical problems, and is associated the criteria for drug with greater levels of substance use disorder. dependence. CBehavioral studies indicate that the act of cigarette smoking serves as a cue for drug and alcohol craving, and the active ingredient of cigarettes, nicotine, serves as a primer for drug and alcohol abuse (Sees and Clarke, 1993; Reid et al., 1998). More critically, longitudinal studies have found tobacco use to be the number one cause of preventable death in the United States, and also the single highest contributor to mortality in patients treated for alcoholism (Hurt et al., 1996). Nicotine is a highly addictive substance that meets all of the criteria for drug dependence, and cigarette smoking is an especially effective method for the delivery of nicotine, producing peak brain levels within 15-20 seconds. This rapid drug delivery is one of a number of common properties that cigarette smok- ing shares with hazardous drug and alcohol use, such as the ability to activate the dopamine system in the reward circuitry of the brain. -
Clearing the Smoke on Cannabis: Regular Use and Cognitive Functioning
6 Clearing the Smoke on Cannabis Regular Use and Cognitive Functioning Robert Gabrys, Ph.D., Research and Policy Analyst, CCSA Amy Porath, Ph.D., Director, Research, CCSA Key Points • Regular use refers to weekly or more frequent cannabis use over a period of months to years. Regular cannabis use is associated with mild cognitive difficulties, which are typically not apparent following about one month of abstinence. Heavy (daily) and long-term cannabis use is related to more This is the first in a series of reports noticeable cognitive impairment. that reviews the effects of cannabis • Cannabis use beginning prior to the age of 16 or 17 is one of the strongest use on various aspects of human predictors of cognitive impairment. However, it is unclear which comes functioning and development. This first — whether cognitive impairment leads to early onset cannabis use or report on the effects of chronic whether beginning cannabis use early in life causes a progressive decline in cannabis use on cognitive functioning cognitive abilities. provides an update of a previous report • Regular cannabis use is associated with altered brain structure and function. with new research findings that validate Once again, it is currently unclear whether chronic cannabis exposure and extend our current understanding directly leads to brain changes or whether differences in brain structure of this issue. Other reports in this precede the onset of chronic cannabis use. series address the link between chronic • Individuals with reduced executive function and maladaptive (risky and cannabis use and mental health, the impulsive) decision making are more likely to develop problematic cannabis use and cannabis use disorder. -
Medical Cannabis Q&A
Medical Cannabis Q&A 1. What is medical cannabis? The term “medical cannabis” is used to describe products derived from the whole cannabis plant or its extracts containing a variety of active cannabinoids and terpenes, which patients take for medical reasons, after interacting with and obtaining authorization from their health care practitioner. 2. What are the main active ingredients? The chemical ingredients of cannabis are called cannabinoids. The two main therapeutic ones are: THC:CBD a. Tetrahydrocannabinol (THC) is a partial agonist of CB1 and CB2 receptors. It is psychoactive and produces the euphoric effect. Each cannabis product will contain THC and CBD, however b. Cannabidiol (CBD) has a weak affinity for CB1 and CB2 receptors and appears the THC: CBD ratio will differ to exert its activity by enhancing the positive effects of the body’s endogenous depending on the product. cannabinoids. 3. Why do patients take it? Medical cannabis may be used to alleviate symptoms for a variety of conditions. It has most commonly been used in neuropathic pain and other chronic pain conditions. There is limited, but developing clinical evidence surrounding its safety and efficacy, and it does not currently have an approved Health Canada indication. 4. How do patients take it? Cannabis can be smoked, vaporized, taken orally, sublingually, topically or rectally. Different routes of administration will result in different pharmacokinetic and pharmacodynamic properties of the drug. 5. Is it possible to develop dependence on medical cannabis? Yes, abrupt discontinuation after long-term use may result in withdrawal symptoms. Additionally, chronic use may result in psychological dependence. -
Substance Abuse: the Pharmacy Educator’S Role in Prevention and Recovery
Substance Abuse: The Pharmacy Educator’s Role in Prevention and Recovery Curricular Guidelines for Pharmacy: Substance Abuse and Addictive Disease i Curricular Guidelines for Pharmacy: Substance Abuse and Addictive Disease1,2 BACKGROUND OF THE CURRICULUM DEVELOPMENT PROJECT In 1988, the AACP Special Interest Group (SIG) on Pharmacy Student and Faculty Impairment (renamed Substance Abuse Education and Assistance) undertook the development of curricular guidelines for colleges/schools of pharmacy to facilitate the growth of educational opportunities for student pharmacists. These Curricular Guidelines for Pharmacy Education: Substance Abuse and Addictive Disease were published in 1991 (AJPE. 55:311-16. Winter 1991.) One of the charges of the Special Committee on Substance Abuse and Pharmacy Education was to review and revise the 1991 curricular guidelines. Overall, the didactic and experiential components in the suggested curriculum should prepare the student pharmacist to competently problem-solve issues concerning alcohol and other drug abuse and addictive diseases affecting patients, families, colleagues, themselves, and society. The guidelines provide ten educational goals, while describing four major content areas including: psychosocial aspects of alcohol and other drug use; pharmacology and toxicology of abused substances; identification, intervention, and treatment of people with addictive diseases; and legal/ethical issues. The required curriculum suggested by these guidelines addresses the 1 These guidelines were revised by the AACP Special Committee on Substance Abuse and Pharmacy Education. Members drafting the revised guidelines were Edward M. DeSimone (Creighton University), Julie C. Kissack (Harding University), David M. Scott (North Dakota State University), and Brandon J. Patterson (University of Iowa). Other Committee members were Paul W. Jungnickel, Chair (Auburn University), Lisa A. -
Barriers and Solutions to Addressing Tobacco Dependence in Addiction Treatment Programs
Barriers and Solutions to Addressing Tobacco Dependence in Addiction Treatment Programs Douglas M. Ziedonis, M.D., M.P.H.; Joseph Guydish, Ph.D., M.P.H.; Jill Williams, M.D.; Marc Steinberg, Ph.D.; and Jonathan Foulds, Ph.D. Despite the high prevalence of tobacco use among people with substance use disorders, tobacco dependence is often overlooked in addiction treatment programs. Several studies and a meta-analytic review have concluded that patients who receive tobacco dependence treatment during addiction treatment have better overall substance abuse treatment outcomes compared with those who do not. Barriers that contribute to the lack of attention given to this important problem include staff attitudes about and use of tobacco, lack of adequate staff training to address tobacco use, unfounded fears among treatment staff and administration regarding tobacco policies, and limited tobacco dependence treatment resources. Specific clinical-, program-, and system-level changes are recommended to fully address the problem of tobacco use among alcohol and other drug abuse patients. KEY WORDS: Alcohol and tobacco; alcohol, tobacco, and other drug (ATOD) use, abuse, dependence; addiction care; tobacco dependence; smoking; secondhand smoke; nicotine; nicotine replacement; tobacco dependence screening; tobacco dependence treatment; treatment facility-based prevention; co-treatment; treatment issues; treatment barriers; treatment provider characteristics; treatment staff; staff training; AODD counselor; client counselor interaction; smoking cessation; Tobacco Dependence Program at the University of Medicine and Dentistry of New Jersey obacco dependence is one of to the other. The common genetic vul stance use was considered a potential the most common substance use nerability may be located on chromo trigger for the primary addiction. -
Vol. 1, Issue 1
Methamphetamine Topical Brief Series: Vol. 1, Issue 1 What is countries involved in World War II provided amphetamine to soldiers Methamphetamine? for performance enhancement and the drug was used by “actors, artists, Methamphetamine is an addictive, athletes, politicians, and the public stimulant drug that affects the alike.”5 central nervous system. It is typically used in powder or pill form and can By the 1960s, media coverage be ingested orally, snorted, smoked, began drawing simplistic, negative or injected. Methamphetamine is connections between amphetamine known as meth, blue, ice, speed, and and crime, and government officials 1 crystal among other names. The term discussed public safety and drugs amphetamine has been used broadly as a social concern.6 Over-the- to refer to a group of chemicals that counter amphetamines were have similar, stimulating properties available until 1959,7 and by 1970 and methamphetamine is included in all amphetamines were added to 2 this group. According to the National the controlled substances list as Institute on Drug Abuse (NIDA), Schedule II drugs. Schedule II drugs “Methamphetamine differs from required a new prescription with amphetamine in that, at comparable each fill and strict documentation doses, much greater amounts of the by doctors and pharmacists.8 drug get into the brain, making it a The reduction in a legal supply 3 more potent stimulant.” of amphetamine led to increased black-market production and sale From the 1930s to the 1960s, of various types of amphetamine U.S. pharmaceutical -
Personal Use Cannabis Rules Special Adopted New Rules: N.J.A.C
NEW JERSEY CANNABIS REGULATORY COMMISSION Personal Use Cannabis Rules Special Adopted New Rules: N.J.A.C. 17:30 Adopted: August 19, 2021 by New Jersey Cannabis Regulatory Commission, Dianna Houenou, Chair. Filed: August 19, 2021 Authority: N.J.S.A. 24:6I-31 et seq. Effective Date: August 19, 2021 Expiration Date: August 19, 2022 This rule may be viewed or downloaded from the Commission’s website at nj.gov/cannabis. These rules are adopted pursuant to N.J.S.A. 24:6I-34(d)1a of the New Jersey Cannabis Regulatory, Enforcement Assistance, and Marketplace Modernization Act, N.J.S.A. 24:6I- 31 et seq., and became effective upon acceptance for filing by the Office of Administrative Law. The specially adopted new rules shall be effective for a period not to exceed one year from the date of filing of the new rules, that is, until August 19, 2022. The Commission has provided this special adoption to the Attorney General, State Treasurer, Commissioner of Health, and Commissioner of Banking and Insurance for a consultation period, after which the Commission anticipates filing a proposal to readopt these rules with amendments reflecting the results of that consultation. In accordance with N.J.S.A. 24:6I-34(d)1b the rules, as readopted, will become effective upon acceptance for filing by the Office of Administrative Law if filed on or before the expiration date of the rules published herein. The adopted amendments will be effective upon publication in the New Jersey Register. Federal Standards Analysis The Cannabis Regulatory, Enforcement Assistance, and Marketplace Modernization Act obliges the Cannabis Regulatory Commission to promulgate rules necessary or proper to enable it to carry out the Commission’s duties, functions, and powers with respect to overseeing the development, regulation, and enforcement of activities associated with the personal use of cannabis pursuant to P.L.2021, c.16. -
Drug Use and Gender
Drug Use and Gender Tammy L. Anderson, Ph.D. University of lllinois, Chicago, lL GENDER DIFFERENCES IN study-report a greater occurrence ofillicit substance use DRUG USE AND ABUSE among males than among females. Both surveys have consistently documented this pattern over the years. Looking at the world through a "gender lens" began According to the 1997 NHSDA survey, men reported a in most areas of social science during the second wave of higher rate of illicit substance use (any illicit drug) than the women's movement, or the late 1960s through the women, 8.5 percent to 4.5 percent, nearly double. Men 1970s. During this time feminist researchers began report higher rates of cocaine use .9 percent versus .5 questioning science's conclusions by pointing to percent. alcohol use (58 percent versus 45 percent), binge male-oriented biases in research questions, hypotheses, drinking (23 percent versus 8 percent), and heavy drinking and designs. (8.7 percent versus 2.1 percent). The same pattern was Unfortunately, the "gender lens" did not appear in observed in marijuana use (Office of Applied Studies substance use research until the early 1980s. Prior to the [OAS] tee7). 1970s, most studies of alcohol and other drug use were Johnston. O'Malley, and Bachman (1997) the conducted among males. Early studies that included at University of Michigan yearly women suffered from the "add women and stir compile data on the substance use of 8th. 10th, and 12th graders, college students, approach." Females were added to samples, but no and young adults in the MTF study. -
(A-9-THC) Content in Herbal Cannabis Over Time
32 Current Drug Abuse Reviews, 2012, 5, 32-40 Increasing Delta-9-Tetrahydrocannabinol (-9-THC) Content in Herbal Cannabis Over Time: Systematic Review and Meta-Analysis Fidelia Cascini*,1, Carola Aiello2 and GianLuca Di Tanna3 1Istituto di Medicina Legale, Università Cattolica del S. Cuore, largo F. Vito, 1 00168 Roma, Italy 2Department of Informatics and Systemics, University ‘La Sapienza’, 00185 Rome, Italy 3Department of Public Health and Infectious Diseases, University "La Sapienza", 00185, Rome, Italy Abstract: Aim: The objective of this meta-analysis is to assess the data regarding changes in herbal cannabis potency over time (from 1970 to 2009). Methods: Systematic searches of 17 electronic scientific databases identified studies on this topic, within which 21 case series studies satisfied our inclusion criteria of reporting the mean tetrahydrocannabinol (THC) value per number of samples per year. No language, publication date, publication type or status restrictions were imposed. The study selection and data extraction processes were performed independently but uniformly by two authors, included screening, determination of eligibility and inclusion of the eligible studies in the systematic review, and a meta-analysis of the results on THC content in herbal cannabis samples. We considered papers and not monographic scientific publications, rejecting all studies that were not focused on the subject of this review. Results: Meta-analysis by year was performed on 21 studies containing 75 total mean THC observations from 1979 to 2009 using the random effects model. The results revealed much variability between studies. Further, there was a significant correlation between year and mean THC in herbal cannabis. The combined data indicated the correlation between year and mean THC in herbal cannabis, revealing a temporal trend of increasing potency (5% above the mean THC value in the Poisson regression analysis). -
Endocannabinoid Stimulated Release of Nitric Oxide and Its Mitochondrial
A tica nal eu yt c ic a a m A r a c t Stefano et al., Pharm Anal Acta 2015, 6:6 h a P Pharmaceutica Analytica Acta DOI: 10.4172/2153-2435.1000378 ISSN: 2153-2435 Review Article Open Access Endocannabinoid Stimulated Release of Nitric Oxide and its Mitochondrial Influence Triggering Vascular Pathology George B Stefano*, Erin Quinn and Richard M Kream MitoGenetics LLC, 3 Bioscience Park Drive, Suite 307, Farmingdale, NY 11735, USA Abstract Endocannabinoids, and their respective receptors, are involved in a host of cellular regulatory activities. In part, some of these mediated effects occur by way of stimulating constitutive nitric oxide release. This occurs in endothelia, certain white blood cells, microglia, and in similar invertebrate tissues, demonstrating that this is a conserved chemical messenger system. This endocannabinoid chemical messenger system, coupled to constitutive nitric oxide release, also appears to exert regulatory effects on mitochondrial energy associated processes, further substantiating its primordial history. In this regard, it appears to offer some beneficial actions in the occurrence of reperfusion injury and stroke. The mechanism envisioned is one initiated via a hypoxic event, which does not restore normalcy, then progresses to a pro-inflammatory state, and the resultant chronic condition manifests itself in a specific disorder. This fits nicely into a vascular-associated origin for Alzheimer’s Disease, whereby the pro- inflammatory state encompasses vessels that have endothelial gaps, providing for a compromised blood brain barrier, beta amyloid deposition, and enhanced white blood cell trafficking. In time, due to the physical progression of the events, Alzheimer’s Disease occurs. -
Synthetic Cannabis
Global emergence of synthetic cannabinoids Source: https://www.unodc.org/LSS/SubstanceGroup/Details/ae45ce06-6d33-4f5f-916a- e873f07bde02 Source: UNODC questionnaire on NPS, 2012 Background The appearance of ‘herbal highs’ in the market is not a new phenomenon. Such products usually consisted of plant mixtures with little psychoactive effects. Since 2004, however, the composition of these herbal products seems to have substantially changed to include potent new psychoactive compounds known as synthetic cannabinoids. Research on the mechanism of cannabis activity dates back several decades when molecules with similar behaviour to Δ9-tetrahydrocannabinol (THC) were first examined. A synthetic analogue of THC , ‘HU-210’, was first synthesized in Israel in 1988[1]and is considered to have a potency of at least 100 times more than THC. Due to its similar chemical structure to THC, ‘HU-210’ is regarded as a ‘classical cannabinoid’ and has been found in synthetic cannabinoids sold in the United States and other countries. Non-classical cannabinoids include cyclohexylphenols or 3-arylcyclohexanols (‘CP’compounds). ‘CP’ compounds were developed as potential analgesics by a pharmaceutical company in the 1980s. Respondents to the UNODC questionnaire on NPS have reported the emergence of CP-47,497 and CP-47,497-C8 in numerous countries in all regions except Africa since 2009. Other structurally dissimilar varieties of synthetic cannabinoids unrelated to THC have also emerged on the market. These include aminoalkylindoles, such as naphthoylindoles (e.g. JWH-018), phenylacetylindoles (e.g. JWH-250), and benzoylindoles (e.g. AM-2233).[2] JWH-018, arguably the most widely known synthetic cannabinoid, belongs to the group of aminoalkylindoles and is considered to be three times as potent as THC. -
Understanding Synthetic Cannabis: Who Uses It, Why Do They Use It, What Are the Harms and What Are the Policy Options?
Understanding Synthetic Cannabis: Who uses it, why do they use it, what are the harms and what are the policy options? Stephen Bright 1,2, Monica Barratt 3 1. Peninsula Health 2. School of Psychology and Speech Pathology, Curtin University 3. National Drug Research Institute, Curtin University Background 2004: “Spice” (Deluca et al., 2010) Synthetic Cannabinoid Agonists ∆9-Tetrahydracannabinol (THC) JWH-018 Kronic 2011: Kronic emerged as a new drug in Australia Produced in New Zealand Who Uses Synthetic Cannabis? Survey of 316 Australian synthetic cannabis users in 2011 - 77% male (Barratt, Cakic & Lenton, 2013) - Median age of 27 - 78% were employed “Won’t somebody think - 96% had used cannabis VS about the children?” - Extensive Drug Histories (Maude Flanders, The Simpsons) Other drug use Extensive drug histories – Alcohol (98%), Cannabis (96%), Tobacco (91%), Ecstasy (64%), LSD (57%), Speed (56%), Mushrooms (41%), Cocaine (38%), Valium (35%) More common drugs used in past year – Alcohol (91%), Cannabis (84%), Tobacco (70%), Speed (26%), LSD (26%), Ecstasy (24%) Last month use only of common drugs – Alcohol (77%), Cannabis (61%), Tobacco (58%) Why do They Use It? Curiosity: to compare effects to cannabis (50%) Legal (39%) Easier to get than cannabis (23%) Recreational effects (20%) – Enjoyment, fun, relaxation, to ‘get high’ Alternative to cannabis (11%) Was offered in social situation (10%) Medicinal effects (9%) – Relief from pain, nausea, anxiety, insomnia To cease or reduce cannabis use (5%) Reasons for use - Drug testing 8% first