DOCSLIB.ORG

The Highs and Lows of Medical Marijuana Jill Vargo Cavalet, MHS, PA-C Marijuana Use Is Prevalent Worldwide Yet Remains Controversial in Health Care

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
The Highs and Lows of Medical Marijuana Jill Vargo Cavalet, MHS, PA-C Marijuana Use Is Prevalent Worldwide Yet Remains Controversial in Health Care MEDICALMARIJUANA The Highs and Lows of Medical Marijuana Jill Vargo Cavalet, MHS, PA-C Marijuana use is prevalent worldwide yet remains controversial in health care. The general public often regards marijuana as a benign substance, but clear risks are associated with its use. Given the legalization of medical marijuana in more than 20 states, clinicians need to be aware of its negative effects—and its potential therapeutic benefits. arijuana has been used medicinally world- use. Use of marijuana for medical purposes requires wide for thousands of years.1,2 In the early a careful examination of the risks and benefits. M1990s, the discovery of cannabinoid re- ceptors in the central and peripheral nervous sys- PHARMACOKINETICS tems began to propagate interest in other potential Marijuana contains approximately 60 cannabinoids, therapeutic values of marijuana.3 Since then, mari- two of which have been specifically identified as pri- juana has been used by patients experiencing che- mary components. The first, delta-9 tetrahydrocan- motherapy-induced anorexia, nausea and vomiting, nabinol (THC), is believed to be the most psychoac- pain, and forms of spasticity. Use among patients tive.4,5 THC was identified in 1964 and is responsible with glaucoma and HIV/AIDS has also been widely for the well-documented symptoms of euphoria, reported. appetite stimulation, impaired memory and cogni- In light of this—and of increasing efforts to legal- tion, and analgesia. The THC content in marijuana ize medical marijuana use across the United States— products varies widely and has increased over time, clinicians should be cognizant of the substance’s complicating research on the long-term effects of negative effects, as well as its potential health ben- marijuana use.5,6 efits. Marijuana has significant systemic effects and The second compound, cannabidiol (CBD), is a associated risks of which patients and health care serotonin receptor agonist that lacks psychoactive providers should be aware. Questions remain re- effects. Potential benefits of CBD include antiemetic garding the safety, efficacy, and long-term impact of and anxiolytic properties, as well as anti-inflamma- tory effects. There is some evidence to suggest that CBD might also have antipsychotic properties.1,4 QUICK SUMMARY Recommendations for Marijuana Use AVAILABLE FORMULATIONS Two synthetic forms of THC have been approved Evidence for by the FDA since 1985 for medicinal use: nabilone Chemotherapy-associated nausea/vomiting (categorized as a Schedule II drug) and dronabinol Glaucoma (Schedule III). Both are cannabinoid receptor ago- Multiple sclerosis spasticity and/or pain nists approved for treating chemotherapy-induced nausea and vomiting. They are recommended for use No current evidence for after failure of standard therapies, such as 5-HT3 re- Alzheimer disease Parkinson disease ceptor antagonists, but overall interest has decreased Chron disease Rheumatoid arthritis since the advent of agents such as ondansetron.2,4 Chronic pain Seizures HIV/AIDS Tourette syndrome Jill Vargo Cavalet is a Clinical Associate Professor in the Depart- Huntington disease ment of PA Sciences at Saint Francis University in Loretto, PA, and practices clinically in inpatient psychiatry. 40 Clinician Reviews • OCTOBER 2016 clinicianreviews.com Nabiximols, an oral buccal spray, is a com- bination of THC and CBD. It was approved in Canada in 2005 for pain management in can- cer patients and for multiple sclerosis–related pain and spasticity. It is not currently available in the US.2,4 Marijuana use is currently legal in 25 states and the District of Columbia.7,8 However, state laws regarding the criteria for medical use are vague and varied. For example, not all states require that clinicians review risks and ben- efits of marijuana use with patients. Even for those that do, the lack of clinical trials on the safety and efficacy of marijuana make it dif- ficult for clinicians to properly educate them- selves and their patients.9 LIMITATIONS OF RESEARCH Credit: iStock.com/thegoodphoto Why the lack of data? In 1937, a federal tax restricted Despite these obstacles, there is some available marijuana prescription in the US, and in 1942, mari- evidence on medical use of marijuana. A review of juana was removed from the US Pharmacopeia.2,4 the associated risks and potential uses for the sub- The Controlled Substances Act in 1970 designated stance follows. marijuana as a Schedule I drug, a categorization for drugs with high potential for abuse and no currently RISKS ASSOCIATED WITH MARIJUANA USE accepted medical use.9 Following this designation, Acute effects research on marijuana was nearly halted in the US. Most symptoms of marijuana intoxication are at- Several medical organizations have subsequently tributed to the THC component and occur due to called for reclassification to Schedule II in order to the presence of cannabinoid receptors in the central facilitate scientific research into marijuana’s medici- nervous system (see Table 1).5,10 Additional objective nal benefits and risks. signs of acute or chronic intoxication include con- Research is also limited due to the comorbid use junctival injection, tachycardia, cannabis odor, yel- of tobacco and other drugs in study subjects, the lowing of fingertips (from smoking), cough, and food variation of cannabinoid levels among products, cravings.10 and differences in the route of administration—par- A more recently identified effect of long-term ticularly smoking versus oral or buccal routes.5 Con- marijuana use is a paradoxical hyperemesis syn- ducting marijuana research in a fashion similar to drome, in which individuals experience nausea, pharmaceuticals would not only serve the medical vomiting, and abdominal pain. They obtain relief community but also the legislative faction. with hot showers or baths.6,8 Since there is a near absence of cannabinoid re- ceptors in the brain stem, marijuana does not stim- TABLE 1 ulate the autonomic nervous system. It is therefore Effects of Acute Marijuana Intoxication believed that marijuana use cannot be fatal. Cor- roborating this theory, no deaths have been reported Anxiety Increased sociability from marijuana overdose.2,11 Dizziness Laughter Dry mouth Perceptual alterations Withdrawal symptoms Euphoria Relaxation Approximately 10% of regular marijuana users be- Impaired motor function Talkativeness come physically and psychologically dependent on Increased appetite the substance. Once tolerance develops, withdrawal Sources: Hall and Degenhardt. Lancet. 20095; American symptoms occur with cessation of use (see Table 2, Psychiatric Association.10 page 42).2,5,10 Symptoms peak within the first week clinicianreviews.com OCTOBER 2016 • Clinician Reviews 41 MEDICALMARIJUANA TABLE 2 effects of long-term marijuana smoking are incon- Symptoms of Marijuana Withdrawal clusive; some studies have shown potential protec- tive effects.4-6 Other evidence suggests that the risk is Abdominal pain Diaphoresis lower in comparison to tobacco smoking.6 Anger or aggression Fever Cardiovascular. The effects of marijuana on Anorexia or weight loss Headache the cardiovascular system are not fully understood. Anxiety Insomnia Known symptoms include tachycardia, peripheral Chills Irritability vasodilation, hypotension, and syncope.4 There is Craving Restlessness some evidence that marijuana use carries an in- Depression Tremors creased risk for angina in patients with previously established heart disease.5 Patients, especially those Sources: Bostwick. Mayo Clin Proc. 20123; Hall and Degenhardt. Lancet. 20095; American Psychiatric Association.10 with known cardiovascular disease, should be edu- cated about these risks. Reproductive. There are several identified repro- following cessation and may last up to two weeks. Sleep ductive consequences of marijuana use. Research disturbances may occur for more than one month.10 has found decreased sperm count and gynecomastia Unlike with other substances of abuse, there are in men and impaired ovulation in women.4 Studies no pharmaceutical agents to treat marijuana with- on marijuana use in pregnancy consistently reveal drawal; rather, treatment is supportive. Marijuana low birth weight—this effect is, however, less than users often resume use following a period of cessa- that seen with tobacco smoking.5 Other complica- tion in order to avoid withdrawal. tions or developmental abnormalities may occur, but there is currently a lack of evidence to support Chronic effects further conclusions. Dental/oral. Smoking marijuana is associated with Neurologic. The use of marijuana results in short- an increased risk for dental caries, periodontal dis- term memory loss and other cognitive impairments. ease, and oral infections.1 Premalignant oral lesions, There is conflicting evidence as to whether long- such as leukoplakia and erythroplakia, have also term effects remain after cessation.5,6 Because acute been reported. Patient education on the risks and intoxication impairs motor skills, it is associated with need for proper oral hygiene is vital, as are regular increased rates of motor vehicle accidents.6 Driving dental examinations. while under the influence of marijuana should be Respiratory. There are several known pulmonary cautioned against. implications of smoking marijuana, and therefore, Psychiatric. Marijuana use is associated with the this route of administration is not recommended onset and exacerbation of acute psychosis. However, for medicinal use. Respiratory effects of marijuana its role
Load more

Recommended publications
  • Adverse Health Consequences of Cannabis Use a Survey of Scientific Studies Published up to and Including the Autumn of 2003
    The mission of the National Institute of Public Health Sweden is to promote health and to prevent illness and harm. Its mandate includes the synthesis and dissemination of research findings. This report is a survey of the harmful effects – mental as well as physical – which can arise as a consequence of cannabis use. The author, Jan Ramström, is a psychiatrist with several years’ experience of specialised drug-abuse services. A long-time Head of Clinic in the field of general psychiatry, he has been affiliated with the Swedish National Board of Health and Welfare for nine years in the capacity of Scientific Adviser on issues of psychiatry Adverse Health and substance abuse. His previous publications include other reports as well as several textbooks in the field of substance abuse, psychiatry and youth development. Consequences of The report is intended for health-care organisations, information officers such as drugs advisers and drug counsellors, and others Cannabis Use in need of knowledge-based information on the consequences of A Survey of Scientific Studies Published up to and cannabis use. including the Autumn of 2003 Jan Ramström national institute of public health – sweden National Institute of Public Health Fax +46 8 449 88 11 Rapport R 2004:46 www.fhi.se Distribution E-mail [email protected] ISSN 1651-8624 SE-120 88 Stockholm Internet www.fhi.se ISBN 91-7257-314-7 Adverse Health Consequences of Cannabis Use A Survey of Scientific Studies Published up to and including the Autumn of 2003 Jan Ramström national institute of public health – sweden www.fhi.se © national institute of public health – sweden r 2004:46 issn: 1651-8624 isbn: 91-7257-314-7 cover photo by: sjöberg, www.sjobergbild.se printing: sandvikens tryckeri, sandviken 2004 Table of Contents Foreword ____________________________________________________________ 5 Introduction __________________________________________________________ 7 Part One – General Remarks ____________________________________________ 11 1.
    [Show full text]
  • Cannabinoid Hyperemesis Syndrome: a Case Report in Mexico
    CASE REPORT Cannabinoid hyperemesis syndrome: a case report in Mexico Luis Fernando García-Frade Ruiz,1 Rodrigo Marín-Navarrete,3 Emmanuel Solís Ayala,1 Ana de la Fuente-Martín2 1 Medicina Interna, Hospital Ánge- ABSTRACT les Pedregal. 2 Escuela de Medicina, Universi- Background. The first case report on the Cannabinoid hyperemesis syndrome (CHS) was registered in 2004. dad la Salle. Years later, other research groups complemented the description of CHS, adding that it was associated with 3 Unidad de Ensayos Clínicos, Instituto Nacional de Psiquiatría such behaviors as chronic cannabis abuse, acute episodes of nausea, intractable vomiting, abdominal pain Ramón de la Fuente Muñiz. and compulsive hot baths, which ceased when cannabis use was stopped. Objective. To provide a brief re- view of CHS and report the first documented case of CHS in Mexico. Method. Through a systematic search Correspondence: Luis Fernando García-Frade Ruiz. in PUBMED from 2004 to 2016, a brief review of CHS was integrated. For the second objective, CARE clinical Medicina Interna, Hospital Ángeles case reporting guidelines were used to register and manage a patient with CHS at a high specialty general del Pedregal. hospital. Results. Until December 2016, a total of 89 cases had been reported worldwide, although none from Av. Periférico Sur 7700, Int. 681, Latin American countries. Discussion and conclusion. Despite the cases reported in the scientific literature, Col. Héroes de Padierna, Del. Magdalena Contreras, C.P. 10700 experts have yet to achieve a comprehensive consensus on CHS etiology, diagnosis and treatment. The lack Ciudad de México. of a comprehensive, standardized CHS algorithm increases the likelihood of malpractice, in addition to con- Phone: +52 (55) 2098-5988.
    [Show full text]
  • Long-Term Outcomes of Chronic, Recreational Marijuana Use
    The Corinthian Volume 20 Article 16 November 2020 Long-Term Outcomes of Chronic, Recreational Marijuana Use Celia G. Imhoff Georgia College and State University Follow this and additional works at: https://kb.gcsu.edu/thecorinthian Part of the Medicine and Health Sciences Commons, and the Psychology Commons Recommended Citation Imhoff, Celia G. (2020) "Long-Term Outcomes of Chronic, Recreational Marijuana Use," The Corinthian: Vol. 20 , Article 16. Available at: https://kb.gcsu.edu/thecorinthian/vol20/iss1/16 This Article is brought to you for free and open access by the Undergraduate Research at Knowledge Box. It has been accepted for inclusion in The Corinthian by an authorized editor of Knowledge Box. LONG-TERM OUTCOMES OF CHRONIC, RECREATIONAL MARIJUANA USE Amidst insistent, nationwide demand for the acceptance of recreational marijuana, many Americans champion the supposedly non-addictive, inconsequential, and creativity-inducing nature of this “casual” substance. However, these personal beliefs lack scientific evidence. In fact, research finds that chronic adolescent and young adult marijuana use predicts a wide range of adverse occupational, educational, social, and health outcomes. Cannabis use disorder is now recognized as a legitimate condition in the Diagnostic and Statistical Manual of Mental Disorders and cannabis dependence is gaining respect as an authentic drug disorder. Some research indicates that medical marijuana can be somewhat effective in treating assorted medical conditions such as appetite in HIV/AIDS patients, neuropathic pain, spasticity and multiple sclerosis, nausea, and seizures, and thus its value to medicine continues to evolve (Atkinson, 2016). However, many studies on medical marijuana produce mixed results, casting doubt on our understanding of marijuana's medicinal properties (Atkinson, 2016; Keehbauch, 2015).
    [Show full text]
  • GHPC Guide for the Responsible Use of Medical Marijuana
    Guide for the Responsible Use Guide for theof Responsible Medical UseMarijuana of Medical Marijuana Medical Director Dr. Suzanne Arlene Sisley, MD AZ Medical License #24426 [email protected] 480-326-60231 6/10/20 8/11/20 Self - Assessment Checklist DATE: Please indicate below your typical level of severity of the following symptoms: Symptom Severity (low to high) Comments Pain 1 2 3 4 5 Cachexia or Wasting Syndrome 1 2 3 4 5 Nausea 1 2 3 4 5 Seizures 1 2 3 4 5 Muscle Spasms 1 2 3 4 5 Agitation 1 2 3 4 5 Other 1 2 3 4 5 Notes: Copy this page to keep an on-going log of your symptoms Enigami Systems at enigamisystems.com has symptom tracking software at a nominal cost. 2 Page 2 - 8/11/20 6/11/20 MEDICATION TRACKING CALENDAR DATE: Dose Tracker Patient Name: Week Starting:________________________ Day Monday Tuesday Wednesday Thursday Friday Saturday Sunday Strain/Product Amount Method of Administration Beneficial Effects Negative Effect Bring this sheet & your symptom tracking sheets to your appointment with your recommending doctor. These will help determine the effectiveness of your medication. Copy this page to keep an on-going log of your medicine usage. 3 6/11/20 8/11/20 - Page 3 INTRODUCTION The objective of this manual is to give Patient Service Providers all the tools necessary to understand medical cannabis, be able to identify strains, and use this knowledge to better their daily health and wellness. CANNABIS OVERVIEW: Cannabis is natural herb that may now be the most studied plant ever worldwide.
    [Show full text]
  • MARIJUANA and SUBSTANCE USE DISORDER, Part 1: a Historical Perspective and DSM-5 Overview
    MARIJUANA AND SUBSTANCE USE DISORDER, Part 1: a historical perspective and DSM-5 overview Introduction Marijuana is the most widely used illicit drug in the Western world and the third most commonly used recreational drug after alcohol and tobacco. According to the World Health Organization, it also is the illicit substance most widely cultivated, trafficked, and used. Although the long-term clinical outcome of marijuana use disorder may be less severe than other commonly used substances, it is by no means a "safe" drug. Sustained marijuana use can have negative impacts on the brain as well as the body. Studies have indicated a link between regular marijuana use and schizophrenia as well as a demonstrated relationship between marijuana use and a higher incidence of lung cancer. Although there are no pharmacological treatments available with a proven impact on marijuana use disorder, there are several types of behavior therapy that may be effective in treating this disorder. Worldwide Use Of Marijuana For a number of years, the United Nations has been compiling annual surveys of worldwide drug use, including cannabis. Reflecting the difficulties and uncertainties associated with developing estimates of the number of people who use drugs (such as the quality of the data gathered and the methodologies used to sample populations), the latest United Nations estimates are presented in ranges, reflecting the lower and upper estimates indicated through the array of surveys ce4less.com ce4less.com ce4less.com ce4less.com ce4less.com ce4less.com 1 available. In their 2012 report (covering 2010), the United Nations estimated that between 119.4 and 224.5 million people between the ages of 15 and 64 had used cannabis in the past year, representing between 2.6% and 5.0% of the world’s population.22 In 2014, approximately 22.2 million people ages 12 and up reported using marijuana during the past month.
    [Show full text]
  • Acute and Long-Term Effects of Cannabis Use: a Review
    Send Orders for Reprints to [email protected] Current Pharmaceutical Design, 2014, 20, 000-000 1 Acute and Long-Term Effects of Cannabis Use: A Review Laurent Karila1,*, Perrine Roux2, Benjamin Rolland3, Amine Benyamina4, Michel Reynaud4, Henri-Jean Aubin4 and Christophe Lançon5 1Addiction Research and Treatment Center, Paul Brousse Hospital, Paris Sud-11 University, AP-HP, INSERM-CEA U1000, Villejuif, France; 2INSERM U912 (SESSTIM), Université Aix Marseille, IRD, UMR-S912, ORS PACA, Observatoire Régional de la Santé Provence Alpes Côte d’Azur, Marseille, France; 3Department of Addiction Medicine, CHU Lille; EA1046, Univ Lille Nord de France, Lille, France; 4Addiction Research and Treatment Center, Paul Brousse Hospital, Paris Sud-11 University, AP-HP, Villejuif, France; 5Psychiatry and Addictology Department, AP-HM, Marseille, France Abstract: Cannabis remains the most commonly used and trafficked illicit drug in the world. Its use is largely concentrated among young people (15- to 34-year-olds). There is a variety of cannabis use patterns, ranging from experimental use to dependent use. Men are more likely than women to report both early initiation and frequent use of cannabis. Due to the high prevalence of cannabis use, the impact of cannabis on public health may be significant. A range of acute and chronic health problems associated with cannabis use has been identi- fied. Cannabis can frequently have negative effects in its users, which may be amplified by certain demographic and/or psychosocial factors. Acute adverse effects include hyperemesis syndrome, impaired coordination and performance, anxiety, suicidal ideations/tendencies, and psychotic symptoms. Acute cannabis consumption is also associated with an increased risk of motor vehicle crashes, especially fatal col- lisions.
    [Show full text]
  • CLINICAL PRACTICE GUIDELINES for MANAGEMENT of CANNABIS DEPENDENCE Or
    CLINICAL PRACTICE GUIDELINES FOR MANAGEMENT OF CANNABIS DEPENDENCE Or. Shiv Gautam1, Dr. I.D. Gupta2, Dr. Aftab Khan3 INTRODUCTION The cannabis plant has been used by humans in China, India and the Middle East for approximately 8,000 years for its fiber and as a medicinal agent. Cannabis was introduced to Europeans in the 9th Century via Napoleon's troops returning from Egypt and to Britain for medical use by a surgeon who has served in India. There was some recreational use in Persian bohemian demimonde in the late 19th Century. Recreational cannabis use was introduced in the United States in the 1930 from Mexico and spread via Jazz Musician to cities in the Northeastern United States. International Drug Control Treaties banned its use in United States in 1938 and in most other countries in 1961. It was used in Bohemian circles in the United States in the 1940 and 1950 before gradually disseminated to wider. US Youth Population in late 1960s and through the 1970s and 1980s. Its use was disseminated via movies, media and popular culture to many other developed countries in 1970s and 1980s. EPIDEMIOLOGY Drug abuse monitoring system (DAMS) collected data from treatment center from 23 States, 2 Union territories and Delhi (year 2002).Total sample of users is 16942. According to study the mean average age is 35.3, sample for study was equally distributed in rural (51.7%) and urban area (48.3%). For both rural and urban areas, most common substance is alcohol (43.9%), heroin (11.1 %), cannabis (11.1%), opium (8.61%), propoxyphene (2.6%) and others (18.5%).
    [Show full text]
  • Neuropsychological Performance in Cannabis Users and Non-Users Following Motivation Manipulation" (2010)
    University at Albany, State University of New York Scholars Archive Psychology Honors College 5-2010 Neuropsychological Performance in Cannabis Users and Non- Users Following Motivation Manipulation Michelle Stiles University at Albany, State University of New York Follow this and additional works at: https://scholarsarchive.library.albany.edu/honorscollege_psych Part of the Psychology Commons Recommended Citation Stiles, Michelle, "Neuropsychological Performance in Cannabis Users and Non-Users Following Motivation Manipulation" (2010). Psychology. 5. https://scholarsarchive.library.albany.edu/honorscollege_psych/5 This Honors Thesis is brought to you for free and open access by the Honors College at Scholars Archive. It has been accepted for inclusion in Psychology by an authorized administrator of Scholars Archive. For more information, please contact [email protected]. Neuropsychological Performance | 1 Running Head: NEUROPSYCHOLOGICAL PERFORMANCE Neuropsychological Performance in Cannabis Users and Non-Users Following Motivation Manipulation Michelle Stiles University at Albany Neuropsychological Performance | 2 ABSTRACT Background: Previous research has yielded conflicting results regarding the long term consequences of cannabis use on cognitive functioning. Although in the cannabis literature, there is a commonly held belief associated with cannabis use called, “amotivational syndrome” the authors were unable to find any studies of neuropsychological performance that attempted to manipulate motivation. Methods: Fifty-five undergraduates (34 cannabis users and 21 non-users) participated in an extensive neuropsychological battery. The experimenter read a statement at the beginning of the battery designed to induce motivation. Group differences on test performance were calculated with a one-way analysis of variance (ANOVA) for tests that did not differ in gender, and a 2 x 2 ANOVA (user by gender) for tests that did differ in gender.
    [Show full text]
  • Medical Cannabis - Review of Risks and Benefits
    MEDICAL CANNABIS - REVIEW OF RISKS AND BENEFITS INTRODUCTION Medical cannabis, or medical marijuana, refers to the use of the cannabis plant and its constituents (cannabinoids, terpenes, flavonoids) to treat disease or improve symptoms. Cannabis was used for its medicinal qualities by most of ancient civilizations, with first documented use in Ancient China dating back to 2737 BC. As a mainstay of the American Pharmacopeia, cannabis extract was used to relieve symptoms of over 100 medical conditions from 1851 until 1941. In the next 55 years, it was banned due to political reasons, against the advice of the American Medical Association. Cannabis returned to its due place of being a medicine in the United States in 1996, when the Californian law allowed the use of cannabis by patients. At present, 41 states have reenacted their medical cannabis laws, along with many other countries in the world. The first active constituents of cannabis, cannabinoids THC and CBD, were discovered in the early 1960s. Further research led to an even more important discovery of the Endocannabinoid System in the early 1990s. This system includes internally produced cannabinoids and their receptors, which are present in almost every organ and tissue of the human body. Over 22,000 studies performed to date helped to reveal numerous important physiological roles of the endocannabinoids, which control not only how the human body operates under normal conditions but also in the disease. This also helped us understand why cannabis has so many medicinal qualities. It works through interaction of the phytocannabinoids (plant cannabinoids) with our own endocannabinoid system, by acting through its receptors, by helping to restore the normal function of the cells and systems, and most importantly by helping to maintain homeostasis - the inner balance of the human body and mind.
    [Show full text]
  • Possible Amotivational Effects Following Marijuana Smoking Under Laboratory Conditions
    Experimental and Clinical Psychopharmacology Copyright 2002 by the American Psychological Association, Inc. 2002, Vol. 10, No. 1, 26–38 1064-1297/02/$5.00 DOI: 10.1037//1064-1297.10.1.26 Possible Amotivational Effects Following Marijuana Smoking Under Laboratory Conditions Don R. Cherek, Scott D. Lane, and Donald M. Dougherty University of Texas—Houston Human participants earned money by responding on a progressive-ratio (PR) schedule (initial value $50) or received money without responding on a fixed-time (FT) schedule. During the session, participants could terminate the PR schedule and initiate an FT 200-s schedule. In Experiment 1, increases in monetary value produced increased number of responses, time spent, and money earned in the PR component. In Experiment 2, marijuana smoking produced potency-related reductions in the number of responses, time spent, and money earned in the PR component, effects that can be interpreted as amotivational. Increasing the monetary value of the reinforcer diminished the acute marijuana effects on PR responding, suggesting that marijuana exerted an effect primarily on reinforcers of a smaller magnitude. The amotivational syndrome is a set of characteristics that smokers (Musty & Kaback, 1995). The authors concluded frequently have been associated with chronic marijuana use that the amotivation symptoms were primarily due to coex- (McGlothlin & West, 1968; Smith, 1968). Specific character- isting depressive symptoms. Anthropologic studies of daily, istics of the amotivational syndrome that have been noted are long-term smokers in Jamaica (Comitas, 1976) and Costa general apathy (Bindelglas, 1973; Kolansky & Moore, 1972, Rica (Carter & Doughty, 1976) did not find evidence for an 1975; Smith, 1970), loss of productivity (McGlothlin & West, amotivational syndrome.
    [Show full text]
  • Marijuana Use Affect School, Work, and Social Life? See Page 7
    How does marijuana use affect school, work, and social life? See page 7. from the director: Changes in marijuana policies across states legalizing marijuana for medical and/or recreational use suggest that marijuana is gaining greater acceptance in our society. Thus, it is particularly important for people to understand what is known about both the adverse health effects and the potential therapeutic benefits linked to marijuana. Because marijuana impairs short-term memory and judgment and distorts Marijuana perception, it can impair performance in school or at work and make it dangerous to drive an automobile. It also affects brain systems that are still maturing through young adulthood, so regular use by teens may have a negative and long-lasting effect on their cognitive development, putting them at a competitive disadvantage and possibly interfering with their well-being in other ways. Also, contrary to popular belief, marijuana can be addictive, and its use during adolescence What is may make other forms of drug abuse or addiction more likely. marijuana? Whether smoking or otherwise consuming marijuana has therapeutic arijuana — also called weed, herb, pot, grass, bud, ganja, Mary Jane, benefits that outweigh its health risks and a vast number of other slang terms — is a greenish-gray mixture is still an open question that science of the dried, shredded leaves and flowers ofCannabis sativa — the has not resolved. Although many states now permit dispensing marijuana for Mhemp plant. Some users smoke marijuana in hand-rolled cigarettes
    [Show full text]
  • Cannabis: a Danger to the Adolescent Brain – How Pediatricians Can Address Marijuana Use by Elaine Gottlieb
    Cannabis: A Danger to the Adolescent Brain – How Pediatricians Can Address Marijuana Use By Elaine Gottlieb Experimenting with sex, alcohol, and drugs is common during adolescence. Among illicit drugs, marijuana is the most commonly used. The liberalization of marijuana laws and increasing availability of medical marijuana have led to greater acceptance of the drug among adults and adolescents who view it as non-addictive and less harmful than other drugs. A recent survey of Massachusetts students showed a decline in the perceived harmfulness of marijuana and a reversal of a decade-long decrease in marijuana use. According to the CDC national Youth Risk Behavior Survey (YRBS), 43 percent of Massachusetts teens have used marijuana one or more times. “Teens think that if marijuana is used as a medicine, it must be safe,” says John Kulig, MD, MPH, Director, Adolescent Medicine, Tufts Medical Center, and Professor of Pediatrics, Public Health and Community Medicine, Tufts University School of Medicine. “Teens who say they would never smoke tobacco admit they do smoke marijuana.” This is a dangerous trend, as new advances in developmental neuroscience show that adolescent brains are differentially vulnerable to the neurotoxic effects of cannabis. As a result, an American Academy of Pediatrics AAP policy statement recommended against the legalization of marijuana because it might lead to increased use among adolescents. “The earlier an adolescent starts smoking, the earlier the potential changes to brain structure and function,” says John Knight, MD, Senior Associate in Medicine and Associate in Psychiatry, Children’s Hospital Boston and Associate Professor of Pediatrics, Harvard Medical School.
    [Show full text]