TITLE: Alcohol, cannabis and cocaine usage in
patients with trauma injuries.
West Indian Med J 1999
Dec;48(4):200-202 (ISSN: 0043-3144)
McDonald A, Dept of Surgery, Radiology,
Anaesthesia and Intensive Care, Faculty of Medical Sciences, University of the
West Indies, Kingston, Jamaica.
Sera from 111 patients with trauma
injuries, who presented to the Accident and Emergency Unit (A&E), University
Hospital of the West Indies, during a 3-month period, were screened for blood
alcohol. Urine specimens were analysed for metabolites of cannabis and cocaine.
Sixty-two per cent (62%) of patients were positive for at least one substance
and 20% for two or more. Positivity rates were as follows: cannabis (46%),
alcohol (32%) with 71% of these having blood alcohol levels (BAC) greater than
80 mg per decilitre; cocaine (6%). Substance usage was most prevalent in the
third decade of life. The patients who yielded a positive result were
significantly younger than those who were negative. There was no significant
difference in age or substance usage between the victims of interpersonal
violence or road traffic accidents. In the group designated "other accidents",
patients were significantly older and had a lower incidence of substance usage
than the other two groups.
Cannabis was the most prevalent
substance in all groups. Fifty per cent (50%) and fifty-five per cent (55%) of
victims of road accidents and interpersonal violence,
respectively, were positive for cannabis
compared with 43% and 27% for alcohol, respectively. There was no significant
difference in Hospital Stay or Injury Severity Score between substance users and
non-users.
TITLE:
Potency trends of delta9-THC and other cannabinoids in confiscated marijuana
from 1980-1997.
El Sohly MA, National Center for The
Development of Natural Products, Research Institute of Pharmaceutical Sciences,
Departments of Pharmaceutics, University of Mississippi, University 38677, USA.
The analysis of 35,312 cannabis
preparations confiscated in the USA over a period of 18 years for
delta-9-tetrahydrocannabinol (delta9-THC) and other major cannabinoids is
reported. Samples were identified as cannabis, hashish, or hash oil. Cannabis
samples were further subdivided into marijuana (loose material, kilobricks and
buds), sinsemilla, Thai sticks and ditchweed. The data showed that more than 82%
of all confiscated samples were in the marijuana category for every year except
1980 (61%) and 1981 (75%). The potency (concentration of delta9-THC) of
marijuana samples rose from less than 1.5% in 1980 to approximately 3.3% in 1983
and 1984, then fluctuated around 3% till 1992. Since 1992, the potency of
confiscated marijuana samples has continuously risen, going from 3.1% in 1992 to
4.2% in 1997.
The average concentration of delta9-THC
in all cannabis samples showed a gradual rise from 3% in 1991 to 4.47% in 1997.
Hashish and hash oil, on the other hand, showed no specific potency trends.
Other major cannabinoids [cannabidiol (CBD), cannabinol (CBN), and
cannabichromene (CBC)] showed no significant change in their concentration over
the years.
TITLE:
Developmental associations between substance use and violence.
Dev Psychopathol 1999;11(4):785-803
(ISSN: 0954-5794)
White HR, Center of Alcohol Studies,
Rutgers University, Piscataway, NJ , USA.
This study examined the developmental
associations between substance use and violence. We examined the trends in each
behavior throughout adolescence, how the behaviors covaried over time, and the
symmetry of associations taking into account frequency and severity of each
behavior. We also examined whether changes in one behavior affected changes in
the other behavior over time. Six years of annual data were analyzed for 506
boys who were in the seventh grade at the first assessment.
Concurrent associations between
frequency of substance use and violence were relatively strong throughout
adolescence and were somewhat stronger for marijuana than alcohol, especially in
early adolescence. Type or severity of violence was not related to concurrent
alcohol or marijuana frequency, but severity of drug use was related to
concurrent violence frequency. Depending, to some degree, on the age of the
subjects, the longitudinal relationships between substance use and violence were
reciprocal during adolescence and slightly stronger for alcohol and violence
than for marijuana and violence. Further, increases in alcohol use were related
to increases in violence: however, when early alcohol use was controlled,
increases in marijuana use were not related to increases in violence. Only in
early adolescence was the longitudinal relationship between marijuana use and
later violence especially strong. The strength of the longitudinal associations
between violence and substance use did not change when common risk factors for
violence and substance use were controlled. Overall, the data lend more support
for a reciprocal than for a unidirectional association between substance use and
violence. Prevention efforts should be directed at aggressive males who are
multiple-substance users in early adolescence.
TITLE:
The onset of marijuana use from preadolescence and early adolescence to young
adulthood.
Dev Psychopathol 1999;11(4):901-914
(ISSN: 0954-5794)
Brook JS, Mount Sinai School of
Medicine, New York, NY, USA.
Although it is well documented that
intrapersonal and interpersonal risk factors are related to the frequency of
marijuana use, much less is known about the initiation of marijuana use. This
paper reports on a longitudinal study of the personality, family, peer, and
ecological predictors of marijuana onset. Survival analysis was applied to a
sample of nonusers of illegal drugs, followed from age 9 years to the 20s. The
major findings indicate that (a) youngsters who are unconventional are at a
higher risk for marijuana initiation; (b) youngsters who associate with peers
who use marijuana or who smoke tobacco themselves are at increased risk for
marijuana initiation; (c) youngsters who identify with their parents are less
likely to begin marijuana use; and (d) the predictors related to marijuana onset
emerged during preadolescence, early adolescence, middle adolescence, late
adolescence, and the 20s. Results are discussed within the framework of a family
interactional perspective of development. Implications for prevention are
discussed.
TITLE:
Marijuana withdrawal among adults seeking treatment for marijuana dependence.
Budney AJ, Department of Psychiatry,
University of Vermont, S. Burlington 05403, USA. abudney
AIMS
The clinical relevance of marijuana
withdrawal has not been established. This study is the first to document the
incidence and severity of perceived marijuana withdrawal symptoms in a clinical
sample of marijuana-dependent adults.
MEASUREMENTS
Fifty-four people seeking outpatient
treatment for marijuana dependence completed a 22-item Marijuana Withdrawal
Symptom checklist based on their most recent period of marijuana abstinence.
FINDINGS
The majority (57%) indicated that they
had experienced > or = six symptoms of at least moderate severity and 47%
experienced > or = four symptoms rated as severe. Withdrawal severity was
greater in those with psychiatric symptomatology and more frequent marijuana
use.
CONCLUSIONS
This study provides further support for
a cluster of withdrawal symptoms experienced following cessation of regular
marijuana use. The affective and behavioral symptoms reported were consistent
with those observed in previous laboratory and interview studies. Since
withdrawal symptoms are frequently a target for clinical intervention with other
substances of abuse, this may also be appropriate for marijuana.
TITLE:
Cannabis abuse and serious suicide attempts.
Beautrais AL, Department of
Psychological Medicine, Christchurch School of Medicine, New Zealand. suicide
AIMS
To compare the relationship between
cannabis abuse/dependence and risk of medically serious suicide attempts in
individuals making serious suicide attempts
and randomly selected comparison
subjects.
DESIGN
Case-control comparison.
SETTING
Cases, a general hospital; controls, the
local community.
PARTICIPANTS
Cases were 302 consecutive individuals
making medically serious suicide attempts; 1028 randomly selected control
subjects. MEASUREMENTS: DSM-III-R mental disorder diagnoses; measures of
socio-demographic characteristics and childhood and family experiences.
FINDINGS
Of those making serious suicide
attempts, 16.2% met DSM-III-R criteria for cannabis abuse/dependence at the time
of the attempt, compared with 1.9% of comparison subjects (OR = 10.3; 95%CI,
5.95-17.8, p < 0.0001). Risks of serious suicide attempt were significantly
related to a series of socio-demographic and childhood characteristics, and to
mental disorders that were co-morbid with cannabis abuse/dependence. When the
association between cannabis abuse/dependence and suicide attempt risk was
controlled for socio-demographic factors, childhood factors and concurrent
psychiatric morbidity, there was a marginally significant association (OR = 2.0;
95%CI, 0.97-5.3, p < 0.06) between cannabis abuse/dependence and serious suicide
attempt risk.
CONCLUSIONS
These results suggested that much of the
association between cannabis abuse/dependence and suicide attempt risk arose
because: (a) individuals who develop cannabis abuse/dependency tend to come from
disadvantaged socio-demographic and childhood backgrounds which, independently
of cannabis abuse, are associated with higher risk of suicide attempt, or (b)
because cannabis abuse/dependence is co-morbid with other mental disorders which
are independently associated with suicidal behaviour. Nevertheless, the
possibility remains that cannabis abuse/dependence may make an independent
contribution to risk of serious suicide attempt, both directly and through the
possible effects of cannabis abuse on risk of other mental disorders.
TITLE:
Specific attentional dysfunction in adults following early start of cannabis
use.
Ehrenreich H; Rinn T; Kunert HJ; Moeller
MR; Poser W; Schilling L; Gigerenzer G; Hoehe MR, Department of Psychiatry,
Georg August University, Gottingen, Germany.
RATIONALE AND OBJECTIVE
The present study tested the hypothesis
that chronic interference by cannabis with endogenous cannabinoid systems during
peripubertal development causes specific and persistent brain alterations in
humans. As an index of cannabinoid action, visual scanning, along with other
attentional functions, was chosen. Visual scanning undergoes a major maturation
process around age 12-15 years and, in addition, the visual system is known to
react specifically and sensitively to cannabinoids.
METHOD: From 250 individuals consuming cannabis regularly, 99 healthy
pure cannabis users were selected. They were free of any other past or present
drug abuse, or history of neuropsychiatric disease. After an interview, physical
examination, analysis of routine laboratory parameters, plasma/urine analyses
for drugs, and MMPI testing, users and respective controls were subjected to a
computer-assisted attention test battery comprising visual scanning, alertness,
divided attention, flexibility, and working memory.
RESULTS
Of the potential predictors of test
performance within the user group, including present age, age of onset of
cannabis use, degree of acute intoxication (THC+THCOH plasma levels), and
cumulative toxicity (estimated total life dose), an early age of onset turned
out to be the only predictor, predicting impaired reaction times exclusively in
visual scanning. Early-onset users (onset before age 16; n = 48) showed a
significant impairment in reaction times in this function, whereas late-onset
users (onset after age 16; n = 51) did not differ from controls (n = 49).
CONCLUSIONS
These data suggest that beginning
cannabis use during early adolescence may lead to enduring effects on specific
attentional functions in adulthood. Apparently, vulnerable periods during brain
development exist that are subject to persistent alterations by interfering
exogenous cannabinoids.
TITLE:
Abstinence symptoms following smoked marijuana in humans.
Haney M; Ward AS; Comer SD; Foltin RW;
Fischman MW, New York State Psychiatric Institute and Department of Psychiatry,
College of Physicians and Surgeons of Columbia University, NY 10032, USA.
Symptoms of withdrawal after oral
delta9-tetrahydrocannabinol (THC) administration have been reported, yet little
is known about the development of dependence on smoked marijuana in humans. In a
21-day residential study, marijuana smokers (n = 12) worked on five psychomotor
tasks during the day hours), and in the evening engaged in
recreational activities hours); subjective-effects measures were
completed 10 times/day. Food and beverages were available ad libitum from 0830
to 2330 hours. Marijuana cigarettes (0.0, 1.8, 3.1% THC) were smoked at 1000,
1400, 1800, and 2200 hours. Placebo marijuana was administered on days 1-4 . One
of the active marijuana doses was administered on days 5-8, followed by 4 days
of placebo marijuana (days 9-12). The other concentration of active marijuana
cigarettes was administered on days 13-16, followed by 4 days of placebo
marijuana (days 17-20); the order in which the high and low THC-concentration
marijuana cigarettes were administered was counter-balanced between groups. Both
active doses of marijuana increased ratings of "High," and "Good Drug Effect,"
and increased food intake, while decreasing verbal interaction compared to the
placebo baseline (days 1-4). Abstinence from active marijuana increased ratings
such as "Anxious," "Irritable," and "Stomach pain," and significantly decreased
food intake compared to baseline. This empirical demonstration of withdrawal
from smoked marijuana may suggest that daily marijuana use may be maintained, at
least in part, by the alleviation of abstinence symptoms.
TITLE:
The existence of "Nederwiet", a new fact in the history of cannabis [L'existence
du "Nederwiet", un fait nouveau dans l'histoire du cannabis.]
Ann Pharm Fr 1998;56(6):264-7 (ISSN:
0003-4509)
Paris M; Tran N, Laboratoire de
Pharmacognosie, Faculte de Pharmacie, Chatenay-Malabry.
Since the beginning of the 1990s, France
has been faced with a new problem of drug abuse. More and more people are
growing Dutch cannabis, commonly called
"nederwiet". Grown mostly indoors, its
culture requires very specific and sophisticated techniques and materials.
The Dutch have produced a cannabis with
a very high percentage of tetrahydrocannabinol. We have conducted a
morphological and chemical study of one of the known varieties of nederwiet,
"super-skunk". Using gas chromatography combined with mass spectrometry we have
identified the cannabinoid components. The question of the Dutch regulations on
drug abuse and the discussion on legalizing cannabis use in France raises many
unanswered questions of great importance.
TITLE:
Detection and identification of cannabis by DNA.
Forensic Sci Int 1998 Jan 9;91(1):71-6
(ISSN: 0379-0738)
Linacre A; Thorpe J, Department of Pure
& Applied Chemistry, University of Strathclyde, Royal College, Glasgow, UK.
cbas43
The unambiguous identification of
illicit substances, including Cannabis sativa, is a major concern of law
enforcement agencies. Current methods of cannabis
identification involve the use of
techniques such as HPLC and GC to identify cannabinoids.
A method for the identification of
cannabis using DNA-specific primers has been developed and is described here.
The nucleotide sequences between the
trnL and trnF genes in the chloroplast of Cannabis sativa have been determined
and Cannabis sativa-specific nucleotide sequences within the intergenic spacer
between the trnL 3' exon and trnF gene identified. Primers, made to these
sequences, have been tested on a range of different plant extracts but only give
a PCR product in the presence of Cannabis sativa. The successful production of a
PCR product using these primers identifies the presence of cannabis.
TITLE:
Cannabis use in a general psychiatric population.
Scott Med J 1997 Dec;42(6):171-2 (ISSN: 0036-9330)
Beesley S; Russell A, Department of
Psychological Medicine, Gartnaval Royal Hospital, Glasgow.
It is known that there is an association
between cannabis use and psychosis. Clinically we had thought that there were
increasing numbers of patients admitted to hospital who were using cannabis and
that this was affecting their illness. A study was therefore undertaken to
determine the extent of cannabis use and its relationships over a one month
period. The findings and their implications for junior doctors on-call are also
discussed.
