Medicinal marijuana: Patients battle stigma and misunderstanding

 

Research recently published in Journal of Psychoactive Drugs (Routledge) examines the experiences of California residents who have been prescribed medical marijuana and the stigma they experience from public opinion. The findings indicate that the stigma of using medical marijuana may contribute to the under-treatment of those who might benefit from medical marijuana. Medical marijuana -- a controversial topic in recent years -- is now legal in 23 US states, the District of Columbia, and has been legal in the state of California since 1996. It has been noted scientifically as a viable form of treatment for medical complications like migraines, depression, chemotherapy and radiation treatment effects, chronic pain and asthma. Using interview research with 18 participants, a team of American researchers were able to better understand how patients handle this stigma and how it affects health care as well as day-to-day life. "There was obviously that kind of negative stigma of using marijuana that I'd be looked upon as kind of an addict or a drug user more than a patient," explained a participant. Almost every patient mentioned being labeled a stoner looking to take advantage of the law. Many patients felt uncomfortable discussing the matter with their primary health care providers because of embarrassment. A major norm among all of the patients is concealing their marijuana usage from family and close friends. "It's sad, it really is," said one patient. "Most people seem to be misinformed, and this includes the lawmakers. They see it as black and white. Marijuana is bad. Drugs are bad. Yet, they have no problem drinking their scotch, smoking cigars. They have no idea how incredibly beneficial cannabis can be," said a participant. "This study underscores the need for further research as well as updating the training and education of physicians and healthcare providers in order to expand the knowledge and skill base as it relates to medical marijuana treatment," wrote the researchers. "As it becomes a viable treatment option for more and more patients across the United States, studies like these will be instrumental in ensuring that medical marijuana meets its full therapeutic potential." Story Source: The above post is reprinted from materials provided by Taylor & Francis. Note: Materials may be edited for content and length. Journal Reference: Travis D. Satterlund, Juliet P. Lee, Roland S. Moore. Stigma among California’s Medical Marijuana Patients. Journal of Psychoactive Drugs, 2015; 47 (1): 10 DOI: 10.1080/02791072.2014.991858 Taylor & Francis. "Medicinal marijuana: Patients battle stigma and misunderstanding." ScienceDaily. ScienceDaily, 28 August 2015. <www.sciencedaily.com/releases/2015/08/150828113011.htm>.

Here's the real reason why marijuana is illegal in the US

 

Mark Leffingwell/Reuters It is hard to imagine a time when most pharmacies carried cannabis and farmers were required to grow hemp, much like they are given incentives to grow corn these days, but that is a significant part of the history of the U.S. From the 1600s to the late 1800s, hemp (a cannabis plant containing very little THC) was harvested on U.S. soil to create materials such as rope, paper, and clothing. In 1619, the Virginia Assembly decided to require farmers to grow hemp for these purposes, according to PBS. Hemp was also used as legal tender in Virginia, Pennsylvania and Maryland around that time. During the 1800s, cannabis products became a popular medicinal substance found in tinctures that were sold in many pharmacies across the nation. It became a requirement to label these over-the-counter medicines containing cannabis, including cocaine and heroin, with the Federal Food and Drugs Act of 1906, but these things were still legal. Around 1910, the Mexican Revolution was starting to boil over, and many Mexicans immigrated to the U.S. to escape the conflict. This Mexican population had its own uses for cannabis, and they referred to it as "marihuana." Not only did they use it for medicinal purposes, but they smoked it recreationally, which was a new concept for white Americans. Even the term, marihuana, was unfamiliar to them, as they called it cannabis. Southern states that were receiving the Mexican immigrants became concerned with this growing population. Newspapers ran headlines speaking of the "Mexican menace" or the "marijuana menace" and claimed Mexican men were going crazy from smoking marijuana and were killing people. El Paso, Texas became the first U.S. city to ban marijuana in 1915, and city officials started rounding up Mexicans who smoked marijuana and had them deported. "A widow and her four children have been driven insane by eating the Marihuana plant, according to doctors, who say that there is no hope of saving the children's lives and that the mother will be insane for the rest of her life," read a New York Times story from 1927. It was clear the newspapers and tabloids were building a campaign against the plant, and much of it has been said to be based on racist ideologies against Mexican immigrants. "Reefer Madness," the anti-marijuana propaganda film, came out in 1936. By 1937, 46 of the 48 states passed laws banning marijuana use. That same year, the Marijuana Tax Act was passed, which made it so it was illegal to have marijuana unless it was for specific medical or industrial reasons. That law was eventually ruled to be unconstitutional, but it would be replaced later on. Fast forward to the Boggs Act of 1952 and the Narcotics Control Act of 1956, which was when the federal government started requiring minimum prison sentences for drug crimes, such as possessing marijuana. In the 1970s, President Nixon declared his war on drugs. The Controlled Substance Act of 1970 initiated the scheduling of drugs by how dangerous they were perceived to be. Marijuana was made a schedule I drug, which meant it has no “accepted medical use and a high potential for abuse.” The U.S. Drug Enforcement Administration was created under Nixon in 1972. The way the federal government handles punishing marijuana crimes was inspired by the Rockefeller Drug Laws, created by New York Governor Nelson Rockefeller in 1973. He made it so there would be strict mandatory jail sentences for possession of drugs and led a harsh campaign against them. In the 1980s, President Ronald Reagan borrowed from these laws and created similar mandatory sentences at a federal level and started pursuing drug users more fervently. As ATTN: reported before, Reagan's escalation of the drug war led the U.S. to go from 150 people in prison per 100,000 to where it stands now, just over 700 per 100,000. The motivations were originally aimed at the Mexican population, but now people of all ethnicities have suffered from harsh drug laws. That said, minority communities are still disproportionately affected by drug laws. Marijuana may be getting closer to where it was in the 1800s, with it becoming used as medicine and grown legally, but there is still progress to be made in terms of the justice system and federal law.   NOW WATCH: This addiction specialist makes a compelling case for the legalization of marijuana source : businessinsider.com

Rising rate of marijuana exposure among children 5 years old and younger

 

Debates about legalizing marijuana have focused on crime rates, economic benefits, and health effects among adults. But a study published today from researchers at Nationwide Children's Hospital shows that the risk to young children of swallowing, breathing in or otherwise being exposed to marijuana also needs to be considered The study, published online today in Clinical Pediatrics, found that the rate of marijuana exposure among children 5 years of age and younger rose 147.5 percent from 2006 through 2013 across the United States. The rate increased almost 610 percent during the same period in states that legalized marijuana for medical use before 2000. In states that legalized marijuana from 2000 through 2013, the rate increased almost 16 percent per year after legalization, with a particular jump in the year that marijuana was legalized. Even states that had not legalized marijuana by 2013 saw a rise of 63 percent in the rate of marijuana exposures among young children from 2000 through 2013. More than 75 percent of the children who were exposed were younger than 3 years of age, and most children were exposed when they swallowed marijuana. "The high percentage of ingestions may be related to the popularity of marijuana brownies, cookies and other foods," said Henry Spiller, D.ABAT, a co-author of the study, toxicologist, and director of the Central Ohio Poison Center at Nationwide Children's. "Very young children explore their environments by putting items in their mouths, and foods such as brownies and cookies are attractive." The study findings showed that most exposures resulted in only minor clinical effects, but some children experienced coma, decreased breathing, or seizures. The main psychoactive ingredient of marijuana, THC, can be especially high in marijuana food products, and that may have contributed to some of the observed severe effects. More than 18 percent of children who were exposed were hospitalized. These hospital admissions were likely due not only to the clinical effects, but also the need to investigate the circumstances that lead to the exposure in the home. Overall, there were 1,969 young children reported to Poison Control Centers in the United States because of marijuana exposure from 2000 through 2013. While that is a relatively small number of total cases, the steep rate of increase in states that have legalized marijuana is reason for concern, said Gary Smith, MD, DrPH, senior author of the study and director of the Center for Injury Research and Policy at Nationwide Children's. "Any state considering marijuana legalization needs to include child protections in its laws from the very beginning," Dr. Smith said. "Child safety must be part of the discussion when a state is considering legalization of marijuana." Researchers recommend the same measures for commercially-available marijuana products that are now used to protect children from medicines and dangerous household chemicals, including requirements for child-resistant packaging and packaging that is not see-through. These same precautions need to be used for homemade marijuana products. If any marijuana products are in a household, they need to be kept up, away and out of sight of children, preferably in a locked cabinet. Data for this study came from the National Poison Database System, the most comprehensive and accurate database available for investigation of poisonings in the United States. The study was conducted by researchers at the Center for Injury Research and Policy and the Central Ohio Poison Center, both at Nationwide Children's.

Marijuana use is associated with excessive daytime sleepiness in adolescents

A study published recently by researchers from Nationwide Children's Hospital, found 10 percent of adolescents sent to a Sleep Center for evaluation of excessive daytime sleepiness with testing results consistent with narcolepsy had urine drug screens positive for marijuana, confounding the results. "Our findings highlight and support the important step of obtaining a urine drug screen, in any patients older than 13 years of age, before accepting test findings consistent with narcolepsy, prior to physicians confirming this diagnosis," said Mark L. Splaingard, MD, director of the Sleep Disorders Center at Nationwide Children's Hospital and senior-author on the study. "Urine drug screening is also important in any population studies looking at the prevalence of narcolepsy in adolescents, especially with the recent trend in marijuana decriminalization and legalization." Typically, a diagnosis of narcolepsy is made after a clinical evaluation for excessive daytime sleepiness, followed by a standardized multiple sleep latency test (MSLT) consisting of 4-5 scheduled day time nap opportunities in which speed of sleep onset and presence of rapid eye movement sleep (REM) are both calculated. However, adult studies have shown that a variety of different medications and illicit drugs may affect MSLT results. This 10-year retrospective study of 383 children is the first to examine the prevalence of positive drug screens in pediatric patients undergoing MSLT. The study, published in Journal of Clinical Sleep Medicine, found that 43 percent of children with urine drug screens positive for marijuana actually had test results consistent with narcolepsy or abnormal REM sleep patterns. No child younger than 13 years of age had a postivie urine drug screen. The data showed that males were more likely to have a positive urine drug screen and MSLT findings consistent with narcolepsy. "We believe that many of the children who had positive urine drug testing for marijuana and testing consistent with narcolepsy had improvement of the symptom of excessive day time sleepiness after enrollment in a community drug program, because most didn't come back for repeat diagnostic studies once they were drug-free," said Dr. Splaingard, also a faculty member at The Ohio State University College of Medicine. "A key finding of this study is that marijuana use may be associated with excessive daytime sleepiness in some teenagers," said Dr. Splaingard. "A negative urine drug screen finding is an important part of the clinical evaluation before accepting a diagnosis of narcolepsy and starting treatment in a teenager." Story Source: The above story is based on materials provided by Nationwide Children's Hospital. Note: Materials may be edited for content and length. Journal Reference: Samuel Dzodzomenyo, Adrienne Stolfi, Deborah Splaingard, Elizabeth Earley, Oluwole Onadeko, Mark Splaingard. Urine Toxicology Screen in Multiple Sleep Latency Test: The Correlation of Positive Tetrahydrocannabinol, Drug Negative Patients, and Narcolepsy. Journal of Clinical Sleep Medicine, 2015; DOI: 10.5664/jcsm.4448

Marijuana users who feel low get high

 

September 15, 2014

Journal of Studies on Alcohol and Drugs

Adolescents and young adults who smoke marijuana frequently may attempt to manage negative moods by using the drug, according to a study. "One of the challenges is that people often may use marijuana to feel better but may feel worse afterward," the lead investigator says. "Marijuana use can be associated with anxiety and other negative states. People feel bad, they use, and they might momentarily feel better, but then they feel worse. They don't necessarily link feeling bad after using with the use itself, so it can become a vicious circle."

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Adolescents and young adults who smoke marijuana frequently may attempt to manage negative moods by using the drug, according to a study in September's Journal of Studies on Alcohol and Drugs.

"Young people who use marijuana frequently experience an increase in negative affect in the 24 hours leading up to a use event, which lends strong support to an affect-regulation model in this population," says the study's lead author Lydia A. Shrier, M.D., M.P.H., of the division of adolescent and young adult medicine at Boston Children's Hospital.

She notes that using marijuana as a coping technique for negative affect may make it harder for people to stop using the drug.

"One of the challenges is that people often may use marijuana to feel better but may feel worse afterward," she says. "Marijuana use can be associated with anxiety and other negative states. People feel bad, they use, and they might momentarily feel better, but then they feel worse. They don't necessarily link feeling bad after using with the use itself, so it can become a vicious circle."

For the study, Shrier and colleagues recruited 40 people, ages 15 to 24, who used marijuana at least twice a week, although their average was 9.7 times per week. They were trained to use a handheld computer that signaled them at a random time within three-hour intervals (four to six times per day) for two weeks. At each signal, participants were asked about their mood, companionship, perceived availability of marijuana, and recent marijuana use. Participants were also asked to report just before and just after any marijuana use. They completed more than 3,600 reports.

The researchers found that negative affect was significantly increased during the 24 hours before marijuana use compared with other periods. However, positive affect did not vary in the period before marijuana use compared with other times.

Also, neither the availability of marijuana nor the presence of friends modified the likelihood that chronic users would use marijuana following a period of negative affect.

The study is unique in that it collected data in real time to assess mood and marijuana use events. The study thus was able to identify mood that was occurring in the 24 hours before marijuana use and compared it with mood at other times, Shrier reports.

"There are a host of limitations with retrospective assessments, such as asking people 'the last time you used marijuana, why did you use it?'" according to Shrier. "We weren't asking people to predict anything or to recall anything -- we were just asking them to give us reports about how they were feeling right now. We were able to put under a microscope the association between those feelings and subsequent marijuana use."

Shrier says it could be beneficial for clinicians and counselors to help their patients identify patterns of negative affect and to implement alternative mood-regulation strategies to replace marijuana use.

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Story Source:

The above story is based on materials provided by Journal of Studies on Alcohol and Drugs. Note: Materials may be edited for content and length.

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Journal Reference:

1. Shrier, L. A., Ross, C. S., & Blood, E. A. Momentary positive and negative affect preceding marijuana use events in youth. Journal of Studies on Alcohol and Drugs, September 2014

Pot Isn't Harmless, Top U.S. Health Official Says

 

WEDNESDAY June 4, 2014, 2014 -- States joining the march toward marijuana legalization need to take a step back and consider the drug's adverse effects on health, the U.S. drug "czar" argues in a new paper.

Marijuana is potentially addictive, proven to contribute to fatal motor-vehicle crashes, and can disrupt the brain function and learning of young users, says Dr. Nora Volkow, director of the U.S. National Institute on Drug Abuse.

Legalizing pot will lead to the sort of nationwide health problems now attributed to alcohol and tobacco, said Volkow, lead author of a review article in the June 5 New England Journal of Medicine.

Tobacco and alcohol have a far greater impact on health in the United States than illicit drugs, as their legal status make them more widely available for use, she noted.

"By making marijuana legal, you have more widespread use and many more health implications," Volkow said. "We don't need a third legal drug. We already have enough problems with the two we have."

The pro-marijuana advocacy group NORML agrees that pot "is not a harmless substance," Deputy Director Paul Armentano said.

"But its potential risks to the individual and to society do not warrant its present schedule I illicit status under federal law, a classification that improperly argues that the plant lacks any accepted therapeutic value and that its risks equal those of heroin," Armentano said.

Volkow is making her argument as the political winds continue to shift toward pot legalization.

Last week, the Republican-controlled U.S. House of Representatives voted in favor of preventing the federal government from interfering with states that allow marijuana use for medical reasons. Medical marijuana is legal in nearly half the states.

"Public opinion is shifting," Rep. Dana Rohrabacher, R-Calif., said at the time.

In the new article, Volkow and colleagues said marijuana is addictive, contrary to popular opinion. Research has shown that 9 percent of people who try pot will become addicted, she said. Pot's effect is even stronger among young people, addicting 17 percent of users under 18, she said.

"This is something that a lot of people who are pro-marijuana deny. The evidence shows otherwise," Volkow said.

Marijuana also poses a public safety risk. People intoxicated by pot are 3 to 7 times more likely to cause a car crash than someone sober, Volkow said.

Most troubling is the tendency for teens and young adults to use pot and alcohol at the same time, which increases the risk of a wreck more than if they used either drug on its own, she added.

Pot also appears to affect brain development in young users. Scans have shown that teenage pot users suffer from decreased brain activity and impaired connectivity between key brain areas, Volkow said.

"During adolescence, there is a tremendous amount of neuroplasticity," she said. "Regular use of marijuana is likely to have an adverse effect on the way the human brain gets connected and organized."

This may explain why frequent use by teens is linked to lower IQ and higher odds of dropping out of school, the report noted.

Volkow said other research has shown marijuana can:

• Serve as a "gateway" drug.
• Impair school performance.
• Exacerbate mental illnesses such as schizophrenia.
• Increase the risk of health problems such as chronic bronchitis and cardiovascular disease.

Legislators considering marijuana legalization should consider these effects, as well as all the gaps in current knowledge of pot's impact on human health, Volkow said.

"What is unfortunate in my view is that the information that's being presented is not objective. It's very subjective," she said. "We all want to think there is this drug that could make us feel relaxed and good with no harmful effects. That's a lovely fairy tale we all wish were true."

However, Armentano argues that "the ongoing criminalization of marijuana is a disproportionate response to what, at worst, is a health issue, not a criminal justice issue."

The adverse health consequences associated with alcohol, tobacco, and prescription drugs are far more dangerous and costlier to society than the responsible adult use of cannabis, he said. "It's precisely because of these consequences that these products are legally regulated and their use is restricted to particular consumers and specific settings," he said.

Legalization and regulation of marijuana will "best reduce the risks associated with the plant's consumption or abuse," Armentano said.

More information

For more information on marijuana, visit the U.S. National Library of Medicine.

Research on marijuana's negative health effects summarized in report

 

June 5, 2014

NIH/National Institute on Drug Abuse

The current state of science on the adverse health effects of marijuana use links the drug to several significant adverse effects including addiction, a review reports. The review describes the science establishing that marijuana can be addictive and that this risk for addiction increases for daily or young users. It also offers insights into research on the gateway theory indicating that marijuana use, similar to nicotine and alcohol use, may be associated with an increased vulnerability to other drugs.

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The article, published today in the New England Journal of Medicine, is authored by scientists from the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health.

The review describes the science establishing that marijuana can be addictive and that this risk for addiction increases for daily or young users. It also offers insights into research on the gateway theory indicating that marijuana use, similar to nicotine and alcohol use, may be associated with an increased vulnerability to other drugs.

The authors review literature showing that marijuana impairs driving, increasing the risk of being involved in a car accident and that these risks are further enhanced when combining marijuana with alcohol. The authors also discuss the implications of rising marijuana potencies and note that, because older studies are based on the effects of marijuana containing lower THC -- the main psychoactive chemical found in marijuana -- stronger adverse health effects may occur with today's more potent marijuana.

The reviewers consider areas in which little research has been conducted. This includes possible health consequences of secondhand marijuana smoke; the long-term impact of prenatal marijuana exposure; the therapeutic potential of the individual chemicals found in the marijuana plant; and effects of marijuana legalization policies on public health.

The scientists focus on marijuana's harmful effects on teens, an age group in which the brain rapidly develops, which is one factor that could help explain increased risks from marijuana use in this population. Research suggests that marijuana impairs critical thinking and memory functions during use and that these deficits persist for days after using.

 In addition, a long-term study showed that regular marijuana use in the early teen years lowers IQ into adulthood, even if users stopped smoking marijuana as adults.

The NIDA-supported 2013 Monitoring the Future Survey says that 6.5 percent of 12th graders report daily or near-daily marijuana use, with 60 percent not perceiving that regular marijuana use can be harmful. "It is important to alert the public that using marijuana in the teen years brings health, social, and academic risk," said lead author and NIDA Director Dr. Nora D. Volkow.

 "Physicians in particular can play a role in conveying to families that early marijuana use can interfere with crucial social and developmental milestones and can impair cognitive development."

This review emphasizes that marijuana use is likely to increase as state and local policies move toward legalizing marijuana for medical or recreational purposes. As use increases, so might the number of people likely to suffer negative health consequences, the review says.

For more information on marijuana and its health consequences, go to: www.drugabuse.gov/publications/drugfacts/marijuana.

Marijuana use involved in more fatal accidents since commercialization of medical marijuana

 

 

May 15, 2014

University of Colorado Denver

The proportion of marijuana-positive drivers involved in fatal motor vehicle crashes in Colorado has increased dramatically since the commercialization of medical marijuana in the middle of 2009, according to a study. The study raises important concerns about the increase in the proportion of drivers in a fatal motor vehicle crash who were marijuana-positive since the commercialization of medical marijuana in Colorado, particularly in comparison to the 34 non-medical marijuana states.

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The proportion of marijuana-positive drivers involved in fatal motor vehicle crashes in Colorado has increased dramatically since the commercialization of medical marijuana in the middle of 2009, according to a study by University of Colorado School of Medicine researchers.

With data from the National Highway Traffic Safety Administration's Fatality Analysis Reporting System covering 1994 to 2011, the researchers analyzed fatal motor vehicle crashes in Colorado and in the 34 states that did not have medical marijuana laws, comparing changes over time in the proportion of drivers who were marijuana-positive and alcohol-impaired.

The researchers found that fatal motor vehicle crashes in Colorado involving at least one driver who tested positive for marijuana accounted for 4.5 percent in the first six months of 1994; this percentage increased to 10 percent in the last six months of 2011. They reported that Colorado underwent a significant increase in the proportion of drivers in a fatal motor vehicle crash who were marijuana-positive after the commercialization of medical marijuana in the middle of 2009. The increase in Colorado was significantly greater compared to the 34 non-medical marijuana states from mid-2009 to 2011. The researchers also reported no significant changes over time in the proportion of drivers in a fatal motor vehicle crash who were alcohol-impaired within Colorado and comparing Colorado to the 34 non-medical marijuana states.

Stacy Salomonsen-Sautel, Ph.D, who was a postdoctoral fellow in the Department of Pharmacology, is the lead author of the study, which is available online in the journal Drug and Alcohol Dependence. Christian Hopfer, MD, associate professor of psychiatry, is the senior author.

Salomonsen-Sautel said the study raises important concerns about the increase in the proportion of drivers in a fatal motor vehicle crash who were marijuana-positive since the commercialization of medical marijuana in Colorado, particularly in comparison to the 34 non-medical marijuana states. While the study does not determine cause and effect relationships, such as whether marijuana-positive drivers caused or contributed to the fatal crashes, it indicates a need for better education and prevention programs to curb impaired driving.

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Story Source:

The above story is based on materials provided by University of Colorado Denver. Note: Materials may be edited for content and length.

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Journal Reference:

1. Stacy Salomonsen-Sautel, Sung-Joon Min, Joseph T. Sakai, Christian Thurstone, Christian Hopfer. Trends in fatal motor vehicle crashes before and after marijuana commercialization in Colorado. Drug and Alcohol Dependence, 2014; DOI: 10.1016/j.drugalcdep.2014.04.008