Terry Wright has put in some very hard yards and has published an extensive list of stupid / mis-informed and potentially damaging statements on substance use by a bunch of people who should know better.
Category Archives: General debate
The link between cannabis and psychosis
No real surprises in the meta-analysis described below but it certainly puts another line in the sand on the link between cannabis and mental health. The question remains on whether governments and NGOs can wait for a definitive link before making large policy changes.
Cannabis Use and Earlier Onset of Psychosis: A Systematic Meta-analysis
Matthew Large [et al.] Archives of General Psychiatry, 7th February 2011Abstract:
Context A number of studies have found that the use of cannabis and other psychoactive substances is associated with an earlier onset of psychotic illness.Objective To establish the extent to which use of cannabis, alcohol, and other psychoactive substances affects the age at onset of psychosis by meta-analysis.
Data Sources Peer-reviewed publications in English reporting age at onset of psychotic illness in substance-using and non–substance-using groups were located using searches of CINAHL, EMBASE, MEDLINE, PsycINFO, and ISI Web of Science.
Study Selection Studies in English comparing the age at onset of psychosis in cohorts of patients who use substances with age at onset of psychosis in non–substance-using patients. The searches yielded 443 articles, from which 83 studies met the inclusion criteria.
Data Extraction Information on study design, study population, and effect size were extracted independently by 2 of us.
Data Synthesis Meta-analysis found that the age at onset of psychosis for cannabis users was 2.70 years younger (standardized mean difference = –0.414) than for nonusers; for those with broadly defined substance use, the age at onset of psychosis was 2.00 years younger (standardized mean difference = –0.315) than for nonusers. Alcohol use was not associated with a significantly earlier age at onset of psychosis. Differences in the proportion of cannabis users in the substance-using group made a significant contribution to the heterogeneity in the effect sizes between studies, confirming an association between cannabis use and earlier mean age at onset of psychotic illness.
Conclusions The results of meta-analysis provide evidence for a relationship between cannabis use and earlier onset of psychotic illness, and they support the hypothesis that cannabis use plays a causal role in the development of psychosis in some patients. The results suggest the need for renewed warnings about the potentially harmful effects of cannabis.
Full text available here – http://archpsyc.ama-assn.org/cgi/content/full/archgenpsychiatry.2011.5
Injecting bath salts: fact, hysteria or both?
From the New York Times – my take is the reality is probably somewhere in the middle, as usual.
When Neil Brown got high on bath salts, he took his skinning knife and slit his face and stomach repeatedly. Brown survived, but authorities say others haven’t been so lucky after snorting, injecting or smoking powders with such innocuous-sounding names as Ivory Snow, Red Dove and Vanilla Sky.
Law enforcement agents and poison control centers say the bath salts, with their complex chemical names, are an emerging menace in several U.S. states where authorities talk of banning their sale. Some say their effects can be as powerful as those of methamphetamine.
Narconon hits the NT
The brilliant Paul Dessauer posted this fascinating piece to the ADCA update list:
The “Hubbard Detoxification Protocol” is employed by the deceptively named “Narconon”. http://en.wikipedia.org/wiki/Narconon
Narconon is a subsidiary of the Church of Scientology (CoS).
CoS also promotes this protocol for “detoxifying” toxic chemical exposure and several “treatment” centres devoted to it have attracted Government funding in the US, despite a complete absence of scientific evidence for its effectiveness, and despite serious risks of adverse effects.
L. Ron Hubbard mistakenly believed that high doses of vitamins (in particular Niacin) and prolonged high temperature saunas could rid the body of toxins (and even radioactivity). From his writings it appears that Hubbard interpreted symptoms that are consistent with Niacin poisoning as evidence of toxins being flushed from the body.
In the US there are, amongst others, centres set up to “treat” the chemical exposures of “911 Firefighters” (in NYC) and “Meth Cops” (in Utah).
Critics state that such centres are actually CoS recruiting centres, that the “detox” is completely ineffective, and that the protocol is widely documented to have killed participants through overdose of vitamins and/or dehydration and overheating.
This risk is greatly elevated amongst people with liver or kidney disease- such as chronic alcoholics. Now read on…
ADHD: a genetic link?
From Paul D on the ADCA update list:
This study contrasts 410 children diagnosed with ADHD against 1156 unrelated (but ethnically matched) controls, looking for large (and so easily detected) copy number variants (or CNVs). These rare chromosomal deletions and repetitions have been shown to be associated with other neurodevelopmental problems including schizophrenia and autism). Findings were replicated in 825 Icelandic patients with ADHD and 35 243 Icelandic controls.
The study detected twice as many large CNVs in the ADHD population than amongst controls. Amongst people diagnosed with ADHD, those with the most severe ADHD (IQ < 70) had six times as many CNVs. Of 15 specific CNVs, 11 were also found in the parents of ADHD sufferers, suggesting heritability. However 4 were not inheritied from parents, suggesting insult or injury in-utero may have caused these particular copy-errors. As there is some overlap with CNVs previously implicated in Schizophrenia, (chromosome 16) the emerging picture appears to be of a heritable neurodevelopmental problem that can be mediated by environmental influence. Only 16% of examined ADHD sufferers showed the “massive” CNVs that were tested for. Future research will examine smaller CNVs. If smaller CNVs are detected in similar locations in a larger percentage of ADHD sufferers, the implication would be that these polymorphisms interfere with neurogenisis or neuronal development in-utero or early infancy, increasing susceptibility to a number of psychiatric conditions. Discussion at NS; http://www.newscientist.com/article/dn19528-have-gene-findings-taken-the-stigma-from-adhd.html
California marijuana laws change again
This article in the LA Times explains it fairly well: Governor Schwarzenegger has signed into law a change that reduces marijuana possession from an offense to an infraction. As one of the world’s largest economies, California has led the way in this area and it’ll be interesting over the longer-term to see the societal changes that result.
iDoses: let the resource drain begin
After reading this story on the growth of ‘digital drugs’ in the US, the first thing that occurred to me was the time that AOD professionals are going to have to spend debunking stuff like this at the expense of real treatment and prevention work. That said, it’s also a phenomenon that needs a lot more investigation – not to determine whether it does mimic drugs (I’d nearly stake my life on the fact that it doesn’t) – but to explore its idiosyncrasies and any light it might shed on wider behaviours by young people in the digital age.
Thoughts?
Rehabilitation for prisoners
A good article in Newsweek on the issue – who would’ve thought providing rehab to those who need it would improve outcomes?
Injecting rooms improve health and rehab likelihood: study
As per ABC News, a Burnet Institute study being released next week shows improved health outcomes for those who attended one of the 76 injecting rooms surveyed worldwide. No real surprise there but it’s great to see a local, substantive study illustrating those outcomes.
Would anyone like to predict what the conservative lobby’s reaction will be to the report?
Anti-marijuana ads: impact on teens
A fascinating study published last year that I only just stumbled across thanks to Mike Ashton:
The effect of marijuana scenes in anti-marijuana public service announcements on adolescents’ evaluation of ad effectiveness is the study and it’s worth reading the whole thing.
The take home message:
The analysts concluded that their most consistent findings related to the presence of scenes showing cannabis or its use. Youngsters unlikely in any event to use the drug reacted well to anti-cannabis ads regardless, but those the ads most needed to deter – the ones most likely to use the drug – saw the ads overall as less effective, and especially those which featured the drug or its use. Neither were they swayed by what young people in general saw as stronger anti-cannabis arguments; on one important measure, they actually reacted more negatively to strong-argument ads. The lesser relevance of argument strength may have been due to the fact that in respect of cannabis deterrence, youngsters saw all the arguments as only moderately convincing. These findings caution against featuring images of cannabis or its use in anti-drug campaigns.
Are you surprised by any of that? I’m not particularly…