Tag Archives: cannabis

Survey of Health Professionals’ Views of Cannabis Use Treatment Guidelines

Via UNSW:

Are you a health professional who counsels individuals who use cannabis?

If so, the National Cannabis and Information Centre would like to invite you to participate in an online survey to find out about your views on cannabis use treatment guidelines. The survey takes less than 30 minutes to complete and participation is confidential. You will not be asked to identify your place of employment. Participants who complete the survey will be asked to provide an email address to enter a draw to win one of ten $100 AUD via PayPal.

To complete the survey, please follow the link:

https://www.surveys.unsw.edu.au/survey/156130/586a/

Contact Dr Melissa Norberg for enquiries (m.norberg@unsw.edu.au).

This research has been approved by UNSW Human Research Ethics Advisory Panel (HREA: 2011-7-47).

Effectiveness of Sativex for cannabis withdrawal

Via the National Cannabis Prevention and Information Centre:

As reported by a number of media outlets this morning, researchers from the National Cannabis Prevention and Information Centre (NCPIC) are currently leading a study to determine whether the pharmaceutical drug Sativex can help people better manage cannabis withdrawal symptoms as a platform for ongoing abstinence.

For a copy of the official press release and further information on the trial, please go to the NCPIC website.

What is Sativex?
· SATIVEX® is a treatment for the symptomatic relief of neuropathic pain in multiple sclerosis in adults, and has been approved for use in Canada, Spain and the UK
· SATIVEX® is a buccal (mouth) spray which contains the cannabis extracts delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD)
· THC is the substance primarily responsible for the psychoactive effects of cannabis, however, the spray administers the substance at doses below the level of intoxication

Double blind, randomised, placebo controlled trial of SATIVEX® for the management of cannabis withdrawal
· The primary objective of the study is to examine the safety and efficacy of SATIVEX® in the inpatient management of cannabis withdrawal, in a double blind, randomised trial compared to placebo
· The study, funded by National Health and Medical Research Council, is currently recruiting participants over the age of 18 years, who are regular cannabis users with the desire to quit (but have tried and failed in the past), and who are willing to commit to an 8-day stay in hospital. People who are interested in taking part in the study should contact Dr David Allsop on (02) 9385 0448 during office hours, or email: cannabiswithdrawal@unsw.edu.au

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 2011

Abstract:
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

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…

Why medical marijuana could be a good thing

I saw the piece reproduced below on the ADCA Update list, and it’s quite a comprehensive look at the opportunities medical marijuana provdes and deconstructs some of the misconceptions around the use of medical cannabis in the USA. It was originally published at the excellent MAPINC:

THE CASE FOR MEDICAL MARIJUANA

In a piece published [1] here last week, Rachel Ehrenfeld reports with dismay that the National Institute on Drug Abuse is presently soliciting proposals from contractors to grow marijuana for research and other purposes. Unfortunately, Ehrenfeld’s misunderstanding of this request for proposals is so monumental that one doesn’t know whether to laugh or cry.

Ehrenfeld suggests that this is some sinister part of “ObamaCare.” “For the first time,” she writes, “the government is soliciting organizations that can grow marijuana on a ‘large scale,’ with the capability to ‘prepare marijuana cigarettes and related products … distribute marijuana, marijuana cigarettes and cannabinoids, and other related products’ not only for research, but also for ‘other government programs.'”

Ehrenfeld spends several paragraphs explaining how this is all the evil brainchild of George Soros, the pet villain of prohibitionists. After all, “Since when is the U.S. government in the business of distributing marijuana cigarettes?”

Since 1978, actually. The federal government has been distributing medical marijuana to a small group of patients for more than [2] three decades via a program known as an IND (for “investigational new drug”). This program has been covered in the media from [3] time to time, and still exists, although it was closed to new enrolment by President George H.W. Bush in 1992. It’s not exactly a state secret.

In addition, under present (thoroughly dysfunctional) rules, scientists doing clinical research on marijuana must obtain the marijuana for testing [4] from NIDA. Since the 1970s, the government has contracted with the University of Mississippi to produce marijuana for this purpose, and all expectations are that the university will get the contract again. In other words, there is nothing new here.

Having completely misconstrued NIDA’s request for proposals as something new and sinister, Ehrenfeld proceeds with a selective, wildly distorted description of research on medical marijuana, claiming, “The evidence about the harm caused by marijuana to the individual user and society is overwhelming.”

In fact, there is a wealth of research that documents marijuana’s medical [5] efficacy and safety, and a vast array of medical and public health organizations that have recognized marijuana’s [6] medical potential.

For the record, let’s consider a bit of what’s been said about medical marijuana by organizations that are presumably not part of the Evil Soros Conspiracy. Bear in mind that this is just a tiny sampling of the material that’s available from respected medical organizations.

. From the 124,000-member [7] American College of Physicians:

“Given marijuana’s proven efficacy at treating certain symptoms and its relatively low toxicity, reclassification [out of Schedule I of the federal Controlled Substances Act] would reduce barriers to research and increase availability of cannabinoid drugs to patients who have failed to respond to other treatments. …

“Evidence not only supports the use of medical marijuana in certain conditions but also suggests numerous indications for cannabinoids.”

. From the [8] American Nurses Association:

“There is a growing body of evidence that marijuana has a significant margin of safety when used under a practitioner’s supervision when all of the patient’s medications can be considered in the therapeutic regimen. …

“There is significant research that demonstrates a connection between therapeutic use of marijuana/cannabis and symptom relief. The American Nurses Association actively supports patients’ rights to legally and safely access marijuana/cannabis for symptom management and to promote quality of life for patients needing such an alternative to conventional therapy.”

. From the Lymphoma Foundation of America, HIV Medicine Association of the Infectious Diseases Society of America and others (in a [9] brief filed with the U.S. Supreme Court):

“For certain persons the medical use of marijuana can literally mean the difference between life and death. At a minimum, marijuana provides some seriously ill patients the gift of relative health and the ability to function as productive members of society.”

And finally, from a study of smoked marijuana as a treatment for HIV-related nerve pain, published in the February 13, 2007, issue of the journal [10] Neurology:

“The first cannabis cigarette reduced chronic pain by a median of 72% vs. 15% with placebo … No serious adverse events were reported. Conclusion: Smoked cannabis was well tolerated and effectively relieved chronic neuropathic pain from HIV-associated sensory neuropathy.”

Marijuana has been used as a medicine for some 5,000 years–maybe longer, actually, but written records only go back that far. In the world of scientific reality–not to be confused with the BizarroWorld inhabited by certain prohibition ideologues–it is both effective at treating a number of troubling symptoms and safer than the pharmaceuticals taken by millions of patients every day. Indeed, as a “recreational” substance it’s vastly safer than booze. But it’s much easier to imagine conspiracies run by billionaires with foreign-sounding names than it is to read and understand the actual research.

This article first appeared at forbes.com. Bruce Mirken, a longtime health writer, serves as director of communications for the [11] Marijuana Policy Project.

REFERENCES

1. http://drugsense.org/url/hrqFXWxS

2. http://drugsense.org/url/EmG1kbx7

3. http://drugsense.org/url/HE4Hi7XI

4. http://www.maps.org/sys/nq.pl?id=1921

5. http://www.mpp.org/assets/pdfs/library/MedConditionsHandout.pdf

6. http://www.mpp.org/library/medical-marijuana-overview.html

7. http://drugsense.org/url/RTJp0V7l

8. http://drugsense.org/url/sPuJf8tI

9. http://drugsense.org/url/bplTeMy6

10. http://www.neurology.org/cgi/content/abstract/68/7/515

11. http://www.mpp.org/

What are your thoughts? It seems a fairly straight down the line treatise to me. It’s a shame this level of defense still needs to be put up against misinformation.

Strength of cannabis – a 1970’s perspective

I came across this interesting snippet on the Update list:

“A study done by L.G.Cartwright and L.E.Mather of the Department of Pharmacy at Sydney University published in The Australian Journal of Pharmaceutical Sciences in 1972 found that in seven samples of cannabis grown in Australia THC content varied from 0.4 to 11%. The lowest concentration was found in a whole plant grown in a suburban garden in Forest Lodge, Sydney. The highest concentration was found in female flowering tops gathered wild in the Hunter Valley. Other samples contained an estimated THC content of 9.2%, 9.4%, 1.6%, 4.3% and 3%. Climate, temperature and soil were all factors cited as influencing THC content.

This study was reported in the Technical Information Bulletin No. 15, November, 1972 published by the Commonwealth Department of Health to inform the Alcohol and drug field of national and international research. It is a good source for past scientific thinking on cannabis.

This study would suggest that not all the cannabis smoked in the 1960s and early 1970s was of low THC content.”

Nothing particularly surprising there but a useful historical perspective.

Drug Free Australia launches unreferenced cannabis assault

I noticed the below information posted on the ADCA Update list. For those of you who don’t know, the ADCA update list is primarily an announcement list for ATOD professionals. Putting aside the quality of the below information aside – why would Drug Free Australia believe that providing unreferenced text to professionals would give any sense of credibility to their cause?

There ARE references cited in the text but these are obviously not viewable in the email nor could I find them on the web. Unbelievable.

The email in question:

“Marijuana Use ˆ
Some Effects
By Fred J. Payne, M.D., M.P.H.
February 2008

Part 1
Background

Marijuana, or cannabis, is a crude preparation of flowering tops, leaves, seeds, and stems of female plants of the Indian hemp Cannabis sativa; and it is usually smoked as a “recreational” drug. The intoxicating constituents of hemp are found in the resin exuded by the tops of the plants, particularly the females. Male plants produce only a small amount of resin. The resin itself, when prepared for smoking or eating, is known as “hashish.”

Various cannabis preparations are used as intoxicants throughout the world, with potency varying with the amount of resin present. The tops contain the most resin; stems, seeds, and lower leaves the least. The intoxicants in the resin are called cannabinoids, the most active of which is delta 9-tetrahydrocannabinol (THC).Although marijuana use in the United States dates back to the 19th century, its early use was confined predominantly to certain groups such as Mexican laborers, inner city Blacks, and some “Bohemian” groups.

Restricted by increasingly severe legal penalties imposed during the 1930s, its use in those relatively small groups was not a major cause for public concern. Following the widespread popularity and use of the hallucinogen LSD during the 1960s, an explosion in marijuana use took place, at first on college campuses, followed by downward spread to secondary schools and upward to portions of the middle class. Public alarm grew over the hazards to the general public posed by the rapidly growing use of marijuana and other mind-altering drugs. Marijuana, plus other drugs like heroin, had a high potential for abuse with limited or no potential for medical use, and they were designated as schedule I drugs ˆ making their use and possession illegal.

The scheduling of dangerous drugs is done by the Drug Enforcement Administration (DEA), but only after the Food and Drug Administration (FDA) decides that a new drug is a suitable medication, albeit one needing to be scheduled because of its abuse potential. The agencies work closely together, as required by law, and a routine scheduling action cannot be taken by one of the agencies without the concurrence of the other.Recent developmentsDuring the past two decades in the United States, there has been a steady increase in the number of people entering treatment for marijuana related problems.

According to one report, two-thirds of those admitted for treatment were young ˆ between the ages of 12 and 25 years (1). The majority of those admissions were from either the justice or educational systems.Marijuana use is associated with impaired educational attainment (2), reduced workplace productivity (3), and plays a major role in motor vehicle accidents (4). Marijuana is increasingly recognized as a cause, along with tobacco, of both lung cancer and emphysema (5) (6). In spite of this, an editorial in a major medical journal, the Lancet, stated as recently as 1995 that “the smoking of cannabis, even long term, is not harmful to health.”(7).In the United States, marijuana use remained stable at about 4% during the decade between 1991-1992 and 2001-2002, according to two large national surveys conducted 10 years apart (8). Marijuana use disorders among adults, however, increased significantly during that decade. The potency of THC in confiscated marijuana increased by 66% between 1992 and 2002, and this may have contributed to the problem.

The disorders included marijuana abuse, that is, use under hazardous conditions or impairment in social, occupational, or educational functioning related to use. Another marijuana use disorder is dependence, defined as increased tolerance, compulsive use, impaired control, and continued use despite physical and psychological problems caused by its use.A major focus for concern has been the extent to which marijuana use leads to the use of and dependence on “hard” drugs. There has been a longstanding debate over whether this association is due to the criminalization of marijuana use, forcing the user to seek suppliers who deal in other illicit drugs, or whether marijuana conditions the user to try other drugs.A study was reported from Australia of a volunteer sample of 311 young, adult, monozygotic and dizygotic, same sex twins discordant for early cannabis use i.e. less than 17 years (1). The outcome measures included subsequent non-medical use of prescription sedatives, hallucinogens, cocaine or other stimulants, and opioids leading to abuse or dependence on these drugs. Abuse and/or dependence on cannabis or alcohol were also outcome measures.

Twins who used cannabis by age 17 had odds of other drug use or alcohol dependence plus drug abuse from two to five times higher than those of their discordant twin. These associations did not differ between monozygotic and dizygotic twins. The findings indicate that early use of cannabis is associated with increased risks of progression to other illicit drug use. Since the subjects were twins neither genetic nor environmental factors were likely to have produced the results. However, since marijuana use is illegal in Australia the study was unable to establish whether having to obtain the drug from dealers involved with other illegal drugs exposes the marijuana user to other illicit drugs.A similar study was conducted in the Netherlands, where out of a group of 6000 twins, 219 same sex pairs were chosen, one of whom had begun using marijuana before age 18 while the other twin had not (9). The study showed that the twin who used marijuana before the age of 18 had a significantly greater risk of using hard drugs and of drug dependence.

Since marijuana is legal and widely available in the Netherlands, the findings from both studies clearly indicate that marijuana serves as a gateway for use and abuse of other addictive drugs in adolescents whose central nervous system is still not fully developed.”

Cannabis and Lung Cancer

I noticed a posting on ADCA’s Update list yesterday that quotes an interesting study showing a correlation between cannabis use and increased risk of lung cancer. Nothing particularly surprising about that – it’ll just be interesting how the research will be used by different ideological camps to promote their cause…

“Cannabis use and risk of lung cancer: a case–control study

S. Aldington*, M. Harwood*, B. Cox#, M. Weatherall”, L. Beckert*, A. Hansell+, A. Pritchard*, G. Robinson* and R. Beasley*,1 on behalf of the Cannabis and Respiratory Disease Research Group

ABSTRACT: The aim of the present study was to determine the risk of lung cancer associated with cannabis smoking. A case–control study of lung cancer in adults <55 yrs of age was conducted in eight district health boards in New Zealand. Cases were identified from the New Zealand Cancer Registry and hospital databases. Controls were randomly selected from the electoral roll, with frequency matching to cases in 5-yr age groups and district health boards. Interviewer-administered questionnaires were used to assess possible risk factors, including cannabis use. The relative risk of lung cancer associated with cannabis smoking was estimated by logistic regression. In total, 79 cases of lung cancer and 324 controls were included in the study. The risk of lung cancer increased 8% (95% confidence interval (CI) 2–15) for each joint-yr of cannabis smoking, after adjustment for confounding variables including cigarette smoking, and 7% (95% CI 5–9) for each pack-yr of cigarette smoking, after adjustment for confounding variables including cannabis smoking. The highest tertile of cannabis use was associated with an increased risk of lung cancer (relative risk 5.7 (95% CI 1.5–21.6)), after adjustment for confounding variables including cigarette smoking. In conclusion, the results of the present study indicate that long-term cannabis use increases the risk of lung cancer in young adults. KEYWORDS: Cannabis, case–control, lung cancer, tobacco Eur Respir J 2008; 31: 280–286 DOI: 10.1183/09031936.00065707 Copyright ERS Journals Ltd 2008".

Launch of the National Cannabis Information and Helpline – 1800 30 40 50

Here’s a noteworthy addition to Australian telephonic support in ATOD:

“National Cannabis Information and Helpline – 1800 30 40 50

Do you need information on cannabis?

Do you know someone concerned about their own cannabis use, or that of a friend or family member?

Does a client need support and advice around their cannabis use?

Does someone you know want to stop using cannabis and needs help to do so?

The National Cannabis Prevention and Information Centre (NCPIC) mission is to reduce the use of cannabis in Australia by preventing uptake and providing the community with evidence-based information and interventions.

One of the most important services that NCPIC offers is the National Cannabis Information and Helpline which commences operation on Monday 14th January 2008. The Helpline will be launched formally later in the year.

The aim of the line is to provide a national free call telephone service to the general community on all issues relating to cannabis. Trained telephone counsellors can provide callers with evidence-based information on cannabis as well as targeted advice and brief intervention for cannabis users, their families and concerned others.

The call is free nationally.

For any further information, please do not hesitate to contact Paul Dillon on (02) 9385 0226.

Paul Dillon
National Communications Manager
National Cannabis Prevention and Information Centre (NCPIC)
UNSW
SYDNEY NSW 2052”